So many emotions!

Ok, so finally surgery(s) have been scheduled!

Over dinner at our home we do "best and worst parts of your day" and all four of us share. When I shared tonight, my best and worst parts of the day were the same - getting the call from Becky (Dr. Smith's scheduler) regarding my mastectomy. I feel relieved that I finally have a date(s) and can start making plans. I feel sad, stressed, and anxious about everything that will soon be coming my way.

It took a little while this morning for it to sink in this morning, but then I had to quickly get on the phone to confirm and schedule the 2 pre-op appointments, the 2 post-op appointments, the pre-admission appointment, cancel and reschedule the 1st post-op appointment with Dr. Shah - the oncologist. It was overwhelming! I was loving my good, old-fashioned daytimer/calendar today.

After all this I had to complete the open enrollment for benefits from school (yes I waited until the last minute!) and that was depressing. I realized I may never be able to get reasonably priced life insurance again(if any at all). Not sure why that bothers me so much, but it does! I then realized how unprepared we were for all of this. Yes, we have fine - in fact I might go so far as to say good - health insurance - thank god! I can't imagine having to go through this and having to worry about that part of it! But, I have not saved up sick days, and I'm not in the sick leave bank! Big mistakes! And as far as disability insurance - we have none. Another mistake! It's funny how unimportant some things seem to be at times, and how quickly those things change!

What a perfect segue to the real stuff! Although I have been somewhat detached about losing my breasts, I was sad today at the thought that these "girls" nourished my amazing daughters. That might sound weird, but it most definitely feels sad! And despite the fact they sag far more than I would like, overall they are pretty nice breasts and have served me well. I'll miss the "girls" and I just didn't think I would!!

Then there are these incredible feelings that I have of being alone. I know, I know - I'm not alone - in so many ways I'm not alone. I have dear friends who have fought this and support me, I have dear friends who haven't but are there for me, I have dear co-workers who care about me, and I have a wonderful family who loves me - I know all that logically! I just can't help the feelings of loneliness sometimes! Then there is the infantile, but very real feeling, that I just want my mom to be here to take care of me, which leads me to thinking about how she must have felt when she was sick - and wishing I hadn't been such a pain-in-the-ass pre-teen at the time, but instead that I wish I could take care of her. Then, when I think about my mom, I think about how much I miss my dad, but I would have never wanted him to have to live through this with me. He would have been an amazing care giver, albeit a heart-broken one. Then of course, there is the fact I haven't done any back-to-school shopping or won't be able to help the girls prepare for the start of the year. For some of you, this may seem particularly silly, but I have always LOVED getting ready for school to start, then the girls came along and it magnified 20 fold! Buying treats for their teachers, making their 1st day of school dress (OK - that was years ago, but still...), helping to get them organized. I'm going to miss all that and it makes me sad - like I'm missing out on something, and like how will they do it without me? Which leads me to, oh my god, what if something happens to me????

As I'm trying to verbalize all this, through tears, to my wonderful husband, I wonder what he - in his logical brain, could be thinking. Then, as he's trying to explain to me that logically I'm not alone, the life insurance doesn't matter, etc, etc, - I realize we are in completely different planes in regards to this - but that's OK. He loves me, I love him, and we'll get through this in our own way. As for the girls, they don't see anything wrong with me, so they seem to be oblivious to the cancer. I check in with them every few days to see if they have any questions and to see how they are feeling. I'm trying to prepare them without scaring them.

As the evening has progressed, I feel better - somewhat task oriented, as the date is imminent. But all in all, I'm good, for now.

Thanks for all your love, everyone!

in peace,

monique

We have a date!

I have been scheduled for my mastectomy with Dr. Smith on Thursday Aug. 5 at 2:30 in the afternoon.

My reconstruction surgery with Dr. Lee is scheduled for Friday Aug. 13, unsure of the time yet.

Both surgeries will be at ORMC.

I'll post more later.

Final test, for now

Today I had my final test, at least for now. Dr. Shah ordered a CT of my pelvis, abdomen, and chest, again, to check if the cancer has metastasized to any of my organs, the chest wall, etc. I had to drink the barium contrast - pina colada flavored, no lie! - this morning. It was pretty gross, but having a straw to drink it helped, and honestly, it could have been so much worse. After yesterday, the anticipation for this test was causing me so much anxiety, that I got teary eyed when I got called back to the same room with the same machine! The nurses, again, were incredibly nice and even Lynda - from yesterday - came in to pat me on the back and explain to them what happened with the test yesterday. I had to have an IV again, and the material they pushed through my veins yesterday - iodine - would be the same as today, but mercifully, they only had to "push" it at a 1/4 of the speed! The heat and pee feeling were not near as intense, I had practiced my breathing all the way there, and no nausea! So I have discovered that a regular CT scan is a breeze compared to the CT/angio business!

Now, I have no surgery date yet. Yes, I am a little stressed about that, but it is what it is.

There is the obvious thought that every day the cancer stays in my body, it is continuing to spread all over my body. I think, I have not researched it but I will, this is not a rational thought. Yes, it certainly is an understandable thought, maybe not so grounded in fact. Breast cancer is urgent, but not an emergency.

There is also the thought that the sooner the surgery - this summer - the less time I will have to miss school. I don't want to miss school because #1 I love my job, #2 although I know the library will be fine without me, I still want to be the one to be there and get books in the kids' hands, #3 I don't have a ton of sick time saved up, so yes, I'm concerned about being out of work and not getting paid. Thankfully, I don't have to worry about my job in terms of not having one.

I am trying to keep focused on a few things - the doctors want me to get well, too, so they are not purposely screwing me so my cancer will spread. I have complete faith that if they were genuinely concerned about my condition getting that much worse, I would be squeezed into their schedule somewhere. It will not do any good to have some temper tantrum and scream and yell at the nurse, schedulers, doctors to hurry up and get this done. I'm guessing I'm not the only woman in Orlando who has recently been diagnosed with breast cancer. I have faith - I have to - that my doctors are looking out for my best interest. Now obviously, I am little insecure about it, hence the reiteration of all this information.

But what I would please ask of all of you is that if you are concerned about my lack of a surgery date, (or when I get one, if it's later than you think it should be) please refrain from sharing your concerns with me. I know that sounds so controlling, irrational, hostile, or just plain rude. I certainly apologize for that. So far on this journey, so many people have expressed to me that I need to take care of myself. Well, one of the ways I can take care of myself with regards to this issue is to avoid doubt about my care. Please know I will appreciate your concern and will know it is coming from a place of love, but I don't have the mental energy right now (it took me 10 minutes just to pick out paper plates in the grocery store tonight!) to reassure all of you that I am in good hands.

I have my concerns about posting this, as I don't want anyone to think it is directed at them or I don't want to hurt anyone's feelings, but I think it's important for me to be as honest as I can during this experience.

Thank you to all of you for your prayers, good wishes and hopes, and, mostly, for your love. I truly feel it all, and it really does make a difference!

much love and peace

Tests, tests, and more tests

Yesterday I had my 1st of 3 tests scheduled for this week.

*I had a bone scan that was ordered by my oncologist, Dr. Shah. This was a test to see if the cancer has metastasized to my bones - breast cancer, IF it metastasizes, will most likely spread to the bones, liver, brain, or lungs via the blood stream or the lymph system. The scan was pretty easy. First, I was given a small injection of radioactive material, told to drink lots of water for the next three hours, then my whole body was scanned by this huge machine. It was all pretty low key. I just had to lay there. But when the huge "camera" - aka vice - was lingering over my head the thought crossed my mind that it could malfunction and drop on my skull. But mostly, I just kept repeating to myself "please don't be riddled with cancer, please don't be riddled with cancer." The tech then took the films to the radiologist who asked for a couple more pictures, which got me very nervous because I was convinced he (in this case it was a male dr.) had seen something, but the tech assured me that different docs like to see different views and not to worry. Even so, I got a little teary eyed, but was trying to keep it together. All in all, it went fine and I imagine, unless there is something major, Dr. Shah will let me know the results when I see her after my surgery.

*Later in the day yesterday, I had an appt. with the social worker at the cancer center, Michelle. It was more of an introductory meeting to let me know what services they offer -

-beauty classes for how to wear scarves & wigs, how to apply your eyebrows using an eyebrow pencil (yes, my eyebrows might fall out along w/ALL my other hair), using make-up when you look like crap, etc.

-yoga & tai chi

-support groups

-individual & family counseling

I spent much of the time talking about the girls, how we told them, how we should proceed and supporting them, etc. She assured me we were doing all the right things, and as you all know, I need lots of reassurance in my parenting, so I was feeling good. She was very kind and will be very helpful.

*Today was an entirely different animal! I was scheduled for a CT/angio (computed tomography angiography) which was ordered by the reconstructive surgeon, Dr. Lee. This test will be used to determine if I have good enough blood vessels in my tummy muscle and to look at my fat tissue to be used for the reconstruction of the boobs. THE nicest nurses, esp. Linda, were there during this lovely procedure. I had to lay down on a skinny bed thingy with a huge circle (it wasn't really a body length tube) around the "bed." I was given an IV, some pictures were taken first, then (and they mentally prepared me the best they could) they had to "push" the IV very quickly with the contrast material. I felt incredibly hot - burning - from head to toe then an incredible feeling of having to pee. This all only lasted for a few minutes - although while in it it seemed as if it lasted much longer. All the while Nurse Linda was encouraging me over the speaker from the other room. When it was all done, as she was encouraging me to breathe in through my nose and out through my mouth, I was able to ask if I should be feeling sick to my stomach. She was rubbing my back and being very sweet as I threw up, mercifully she was able to get the kidney shaped bowl for me in time. I felt just terrible - I mean who likes to throw up?! Then I just started crying for one, because I felt yucky and for two, because I was sad to think that this is just the beginning of me feeling sick, wimpy, and I'm not looking forward to it. But thankfully, Nurse Linda really helped me through the whole thing, and I was grateful!

So today has not been the best day for me, emotionally. I've been a little down. And now tomorrow I have another CT scan, and this time I have to drink a bunch of yucky stuff 2 hours before, but I think tomorrow's won't be as bad as today's was. I'll let you know.

in love and peace,

No surgery date yet!

Urrgghhh!

Maybe the doctors are waiting for the rest of the scans to be completed - I have them scheduled tomorrow, Thursday, Friday.

But on a better note I was able to work a full day at school to prepare the library for me not being there at the beginning of school. A BIG THANK YOU to Chris, Charlie, Liz, Pam, Jan, Kyle, Zoe, and, of course, Edwina!! This wonderful women (and 1 young man) helped me get 4 days worth of work done in 1 day!! I feel my load has lightened! Thank you!!! You all rock!!

In peace!

The best therapy

Some of you may know this, but we currently have relatives from France staying with us until August 6th. Some of you had reservations about me/us having family I had only known via the internet and with a language barrier staying with us for a month while we're going through all of this. I even admit, I was a tad nervous...Well, it has been the best therapy for me!!

From the moment I picked up Henri, his wife Loli, and 2 of their 3 boys - Nicolas, 14, Alexis, 9, (Michael 17 stayed home in France), it has been WONDERFUL! Henri's complete, genuine, and unequivocal expression of joy at meeting and knowing us is completely endearing, and I can only hope I am showing him and his family the same joy!

Some background information: My father, Jacques, is the 1st cousin of Henri's mother, Genevive, so our grandfathers, Frederic (my Papa) and Raoul were brothers. They were born and raised in Belgium. Raoul remained there until he died, and my grandfather moved to Canada circa 1939. The two brothers remained close via letters and visits across the ocean, but once they died their children (my father and Genevive - 9 years his senior) lost touch.

Fast forward to Jan. 2009 - I received an email from Henri at work asking if I was the daughter of Jacques Mesot and granddaughter of Frederic Mesot and that's how it all started... a year and half of frequent emailing, sharing of stories, family history, memories, photos, anecdotes about our own children, and plans for meeting. He has been communicating with Jen, too, and we were all hoping for a way in which we could all be together even for a couple of days while they are in America, but with Jen having a month left until graduation with a BSN from nursing school, it is not going to be possible this trip.

Henri bears a small physical resemblance to my father and there are minuscule attributes that remind me of my father even though Henri is much younger than Daddy would be. Henri speaks English very well, although we still reach for our bi-lingual dictionaries now and again, but his wife and their boys don't speak very much English, although all three understand some and can read some. Additionally, the entire family speaks Spanish! I am now very motivated to learn another language!!

They have been so helpful - cleaning, laundry, cooking, but more importantly, their presence alone has been a remarkable distraction - really so much more - from this cancer business. We have all been learning so much about one another's countries and cultures! It's been really neat! The kids have gotten along wonderfully (having the wii as an icebreaker helped) and has prevented me from hearing "III'mmm booorrred" every other minute!! They have been doing their share of theme parks, too, and plan to go to Cape Canaveral as well as the Everglades next week. They are having a great time! They think America is amazing!

A final note, I have a a huge Victorian dollhouse that was purchased just before my mother (I think it was a dream of hers for us to have doll houses) died. My sister got a Swiss chalet, and we were going to work on them as a family. Well, 31 years later and still no work as been done on it! Henri is brilliant - I do not exaggerate - and very handy. He asked before he came if there was anything he could help with and my dollhouse came to mind. I feel like if I have a jump start (there is so much to do before I can even begin) then I'll be motivated to keep working on it!! He has been working on it every day and getting so much done! His creative mind has come up with such good ideas for fixing different parts of the house - he has even started the wiring for the electricity! It has been sooo exciting for me!

So for those of you worried or concerned, don't be!! I couldn't have asked for a more perfect summer!

Team assembled!

It's done!! All my doctors have been picked, and I love them all already! My surgeon, as I mentioned in a previous post, is Dr. Jeff Smith. My oncologist is Dr. Nikta Shah, and my plastic surgeon is Dr. Kenneth Lee. All of my doctors are at MD Anderson, so I will be having tests, appts., surgery (ies) through ORMC.

I was most definitely leaning in the direction of Florida Hospital in the beginning of this crazy process. I had both of my children at Florida Hospital, my father and my aunt were well taken care of there too, so I have always felt very comfortable there. So I began by seeing doctors who practice at F.H., and although each one was very nice, I was pushed (thank you Jennifer - I love you!!) to get second opinions at MD Anderson Cancer Center, and, in the end I chose all 3 of my doctors from there. I have included a link to the hospital's breast cancer page.

http://www.orlandohealth.com/mdanderson/CancerInformation/BreastCancer.aspx?pid=2740

My surgeon and oncologist are on the same floor and the plastic surgeon is right upstairs. They, by all accounts, work as a team, and I have already seen evidence of this when Dr. Smith told me he had already spoken to Dr. Shah about my case. Everyone, from receptionists to nurses to "schedulers" to the doctors, has been incredibly kind, compassionate and positive without showing the least bit of pity. I feel very valued, heard, and well cared for which makes me feel very confident.

Dr. Smith - He will do what is called a "skin sparring" bilateral (both) mastectomy. During surgery via microscope/various pathology methods, my lymphnodes will be evaluated for "involvement" by checking the "sentinel node." If there is cancer present, most of the other nodes will be removed during surgery. How they determine how many lymph nodes and which ones to take I have no idea, but that is a good question that I will need to ask Dr. Smith. Dr. Lee will consult with him about where and what should be cut. Dr. Shah will also be recommending that he put in a "port" at the same time. A port is used to administer chemotherapy, which I will more than likely need based on the size of my tumor. After surgery I will only stay in the hospital for 1 night (is that not unbelievable??) given there are no complications.

Dr. Lee - He will do what is called Deep Inferior Epigastric Perforator (DIEP) flap surgery 5 days later. The reason for waiting the 5 days will be to see the pathology report. The pathology will determine the treatment protocol, and therefore may impact the type of reconstruction I can have. But based on the idea I won't need radiation and that all else goes well, I will be able to have the DIEP surgery. This is reconstruction where my own tissue (aka fat from my belly) will be used to make new boobs. It will enable me to keep my abdomen muscles - a major benefit to getting out of bed in the morning! (In a TRAM flap surgery - one of the reconstruction options - the ab muscle is sacrificed and used as the blood flow source for the breast.) Blood vessels in the skin and other places will be connected microscopically to the vessels in my existing skin of the breast, which will then act as the blood source for the new boobs. My tummy will then be stitched back together pulling everything in tighter/flatter. I will be in the hospital for 5 to 7 days with recovery being 4 to 6 weeks. I am a candidate for this surgery because: a. I'm young (I confirmed this with Dr. Lee, as all my students not to mention my own children think I'm old); b. I haven't had major abdominal surgery (some how my 2 c-sections don't count!!!!); c. I don't smoke; d. I'm in good health (aside from the cancer and all); and e. I have family and friends around to take care of me while I recuperate (right??!!).

Dr. Shah - She is amazing!! Competent, professional, smart, and caring all at once! She will see me 2 weeks after surgery (I'm hoping she makes house calls but I don't think so) and by then she will have the results of the path. report and will have an idea for a treatment plan. She has already called me to tell my my basic blood work looks great except, apparently, I am iron deficient - so I started on the iron supplement she suggested (I have to take it with oj). Yes, she also suggested a stool softener - lucky me - and wouldn't you friggin' know that at the drug store, on that specific item, I didn't get the $3 off like I was supposed to, so the clerk had to get the manager to fix the dilemma!! Seriously??!!

Although doctor shopping is over, now the tests ensue! I have been scheduled for 3 different scans: a bone scan, a ct scan, and a ct angio. I'm not up to speed yet on what those are so, mercifully for you, I can't explain them. Next time...

OK - Bottom line - I have a team of AWESOME doctors, I feel good, and no surgery date yet!!

A little weepy

I got a little weepy, OK maybe more than a little, at the surgeon's office today. Don't worry nothing has changed, all is well. He even did an ultra sound of my lympnodes to see if he might be able to see any "cancerous involvement" then he would have tried to biopsy it, but good news was he was unable to see any major nodes that might have cancer cells. Now, that is NOT a guarantee that the nodes are not involved - that is something surgery will tell for sure - but at least there was nothing hugely major there!! The rest of the appt. went well, I asked a couple of questions regarding lumpectomy verses double mastectomy and the the growth rate/aggressiveness of the tumor, shared a story and all the while he was very attentive and answered my questions. I feel very safe in his hands. And Arthur seemed to like him, too, as he was able to go with me to the appt.

I think I just got overwhelmed with..., well, everything!! Thinking of all the things that I will have to do and all the things that will be done to me!! It's a lot about which to think and a lot with which to come to grips!

I have an appt. with another oncologist tomorrow ( I had one yesterday and she was very nice and informative, but I want to cover my bases) at MD Anderson. Then Thursday I'll have an appt. with another plastic surgeon, again to see and learn as much as I can. But even with those appts. the surgeon's "scheduler" should be calling in next couple of days to schedule surgery!

Thanks to you all for your loving thoughts and well wishes - I can sense and feel them all!

in peace and love

A new full time job

OK... Seriously with the dr. appointments!! This is a full time job!! Plastic surgeon Friday (about which I have already written, but must add that Kyle called the whole scene a Seinfeld episode - which is a perfect description!), oncologist today, surgeon tomorrow, another oncologist Wednesday, MRI Saturday, PET scan Monday!!! i yi yi

Plastic surgeon visit

Well, brought my posse with me (Kyle and my French cousin Loli) with me to the appt - what a trip! If you think childbirth relieves you of your modesty, try a visit to a plastic surgeon who intends on reconstructing your boobs! Hilarious, in an immature kind of way!

As it goes, his nurse came in 1st, asked a few basic questions and asked me to put on the paper towel vest open to the front. Then he comes in, asks some questions - including "what kind of bra do you where?" to which I answered "a bad one" while Kyle is chiming in with "yes, she doesn't wear the good Nordstrom's bras" to all of that his only reply was, "no, what size bra do you wear?", then pokes around my tumor. Then, because I am considering a TRAM Flap reconstruction (I'll explain in detail later if I am able to get it), I have to show him my flabby belly in all its glory!! He then takes some time to explain all the possibilities, etc. To round out this good time he has to take pictures of my breasts, front & sides plus my belly!! I ask if the photos will end up on the internet , to which we all have a good laugh!

All in all, he was a nice man, but my confidence is not there with him. Maybe it's that he didn't say what I wanted him to say, which was "it can all be done in one surgery and you'll be good to go!" And maybe I'm not being realistic, but I'll meet with another plastic surgeon through the MD Anderson group and see what he/she has to say, then I'll decide.

That's all there is to tell tonight, but I am doing fine. My spirits are up the far majority of the time - not to say if they weren't that would be bad - I'm just sharing where I am today. :)

mucho love to all!

I've made some decisions

I met with a surgeon today from Surgical Group of Orlando, affiliated with MD Anderson/ORMC. His name was Dr. Jeff Smith, and I had a very good feeling. I was greeted by a young medical student, very young. His nicely groomed beard was a needed attribute that helped him to look older than 21 or 22! He was very green, yet very kind and genuine. He was sent in to get my brief medical background and review the timeline of my diagnosis. He was trying so hard, and he was doing a great job. I was in good spirits throughout. His final question was if I was leaning toward a certain surgical choice...I shared, as with most women with this diagnosis, all I cared about was staying alive, but that my frame of reference was that my own mother had died when I was a young girl so staying alive for the next 8 years was my only priority and that I could care less about my hair, boobs, etc. As I recounted this, I shared that this was when I get really emotional, and indeed, I did begin to get teary-eyed. His own eyes got red and he turned away - although I already had a good feeling about him, this endeared me to him.

Anyway, he left and within a few minutes he was back in with the doctor. Dr. Smith also had a genuine, yet incredibly competent air about him. He was a good listener, but he only smiled at my jokes, not out right laughed (which was his only drawback). He was able to answer my questions and able to explain things in a non-condescending manner. It's difficult to put into words why I made an immediate decision, but I did - I decided to stick with him and begin making preparations for a double mastectomy.

Some of you may wonder why I chose this since my left breast appears to be fine, and the reason is very clear in my mind - I want to be able to be as worry-free as I can. I want him to get out all the cancer the 1st time, and I want to remove any chances of it creeping up in the left breast 2, 5, 10 years down the road. Now that doesn't mean I'll never have to worry about cancer again, but it does mean I won't have to worry about any lingering cancer cells, etc, in my breasts. Dr. Smith was fine with this choice.

From this point, his nurse - who I love already - was called in and I was examined. After that, I was asked to come back on Tuesday to try and have my lymph nodes ultra-sounded (don't think that's a word, but I'm using it anyway) and possibly biopsied. At that time they will have set up appointments for me with an oncologist and a plastic surgeon. (which is a huge relief because this appt. making business sucks!!) I'm getting the impression that the pre-surgery tests will be extensive, but I also gather he has a sense of urgency in wanting to get surgery done - not because of something specific he has said, it's just a feeling - which I'm in a good place to move into action. I needed these couple weeks to wrap my head around everything, but I'm ready now!

I'm looking forward to an appt. tomorrow with a plastic surgeon. I think I will get some questions answered, but additionally, my immature self is coming out, so I'm intrigued to possibly see boob choices, etc. My girlfriend, Kyle, is coming with me and I hope I don't get the giggles.

I'll keep you updated!

in peace & love

Getting it together

I've finally been able to get this ball rolling!! I was able to get into see my GP today. She was able to look at my pathology reports, mammo films, etc. I also got all the "referrals" I need for the different doctors involved in this process so far - surgeon, oncologist, plastic surgeon. She herself was diagnosed with breast cancer 2 years ago, so she also made some suggestions for docs to see. (warning - TMI coming .... she also showed me her reconstructed breast! The 1st 1 I've seen in person, and, to be honest, it wasn't as upsetting as one would think).

She also suggested I get the BRAC 1 & BRAC 2 genetic testing. This testing would tell me if I have a genetic mutation of some sort on a couple of specific genes. This may be important in deciding to have a single or double mastectomy, but more importantly, for me, it will tell me if this is something the girls may have to be concerned about as they get older (although not definitively - it all sounds complicated). I have included a reliable (albeit older, dated 2006) article about this test and different perspectives on it.

http://www.cancer.org/AboutUs/DrLensBlog/post/2006/03/21/Genetic-Tests-and-Breast-Cancer-Risk-Not-Perfect.aspx

I meant to explain the other day that I have yet to receive a "staging" of my cancer. That is something an oncologist does and will probably not do until after a surgery because 1 of the 3 parts to identifying the stage is the involvement of the lymph nodes. The other 2 parts of staging are the size of the tumor (mine is relatively big at 3cm x 3.2 cm) and whether or not the cancer has metastisized to distant sites in the body.

As for surgery, I am leaning toward having a double mastectomy using the TRAM flap procedure, if I can. I will explain more about that when the final decision is made and the surgery is scheduled.

Today I was able to schedule 2 doctor appts. for this week: I have an appt. with a surgeon at MD Anderson Cancer Center (part of ORMC hospitals) on Thursday morning, and I have an appt. with a plastic surgeon on Friday afternoon. Although I like the surgeon we met with last week, I just want to be sure about what I'm doing, get a second opinion, etc.

Thank you to all for your sweet and thoughtful sentiments! It is all appreciated.

in peace and love,

monique :)

Restless Night

OK, I think maybe the fact that I have cancer is hitting me! All my upbeatedness (is that a word?) and humor must have been keeping some the of major feelings at bay, because right now I feel completely depressed and overwhelmed that I have cancer. So, to those of you that have been impressed by my outlook so far, I may be entering a phase of unimpressive sadness, for lack of a better word at the crack of dawn. (Hopefully a short phase- although maybe that is a naive way to look at things, maybe this whole journey is just a series of emotional ups and downs and I just haven't realized it yet)

The idea that cancer is in my body, and it's not going away any time soon is crazy to me!! I mean how did this happen?? Was it something I ate? Did I not shower or wash my hands enough? Did I drink too much Coke? Or maybe it was something more spiritual like there are still lessons I need to learn about my own mother dying? Maybe I needed to parent 2 young girls while being sick? Maybe I gossip too much? Maybe I'm a rotten person? Maybe I haven't had enough "bad" things happen to me in my lifetime, yet? Whatever the case may be, I can't help but wonder WHAT THE HELL?????

I know you will be saying "No, no it's none of those things, it just happened" (but some of you may just agree about a couple of those :), like maybe the showering...). And although I will appreciate the words of encouragement and support that me getting breast cancer is not my fault, I just can't help but think...how did this happen?

1st dr. appt. & telling the girls

What a big day! And I'm feeling very optimistic and almost upbeat.

Today Arthur and I went to this 1st appointment with the surgeon who did my biopsy. He seems to be a kind man who was able to explain things in an understandable yet non-condesending manner. He went over the pathology report first - last night I was able to read up through the section on "understanding your pathology report" in my new book so I felt somewhat familiar with some of the terms and explanations.

*My tumor is in my right breast and is approximately 3cm x 3.2cm x 2.4 cm.

*Five tissue samples (from the core biopsy done on 6/21) of approximately 1.3 cm in length were examined by microscope.

*It was determined that I have Invasive Ductal Carcinoma. This means that cancer cells are present in the ducts (the tubes in which the milk travels - milk is actually produced in lobules) of my right breast and that the cancer cells have moved out of the ducts and into other breast tissue.

*Additionally, the cancer cells have been given a "grade" (Bloom-Richardson Grade: I, II, III) to tell how aggressive the cancer. The cancer cells I have received a grade of III. This was determined by how much the examined cells looked like normal breast tissue cells. The closer to normal they look the lower the grade. If the cells don't look anything like normal breast tissue cells they are given a grade of III, which is the most aggressive.

*My cancer cells have estrogen receptors and progesterone receptors. Both of those are good - but I don't understand 100% why yet.

*Finally, my cancer cells have minimal HER2 (a specific type of protein that stimulates cancer growth) which is a good thing.

OK, this may be waaaaay too much breast information for some of you, but as any good teacher knows, it helps a student (me) learn by teaching others (most of you).

So what all this means I have a pretty big cancerous tumor that needs to come out relatively soon. The dr. proceeded to explain that we needed to go about finding an oncologist. This is the dr. we would be spending lots of time with over the next God only knows how long, therefore it is important to find someone with whom we feel comfortable and confident. He gave us 3 referrals. Some of you have shared your recommendations. Please feel free to share with us if you have someone who you think is good.

Finally he explained the surgical options:

1. there is a lumpectomy - a surgeon would go in and remove the tumor plus some of the healthy tissue around the tumor (the margins). While in there, the "sentinel lymph node" would be examined to see if it has cancerous cells present. If it does, the surgeon will remove the effected lymph nodes. With this surgery, 2 incisions are made. After surgery, radiation is often needed as well as chemotherapy. Additionally, up to 25% of the cases, when the margins are examined it is determined that the surgeon must go back into because "the margins are not clean enough" meaning the breast tissue is not as clear as they would like it to be. Finally, because my lump is pretty big, I may end up with a mis-shaped boob!!

2. there is a mastectomy - a surgeon would go in and remove all of the breast tissue in the right breast. The same examination of the lymph nodes would be done and removed if necessary. Re-construction (if wanted) can be done or at least started (depending on type of re-construction) at the same time, in the same surgery, but by a plastic surgeon. There are many other details around this surgery that I will save for a later date. I don't want to tell you all the fun stuff at one time!!

He said the decision about what surgeon to pick, what type of surgery, the oncologist, etc were all up to us and that while time was a concern, it needn't be rushed. Which brings me to my plan of action. After my hair appointment tomorrow - you may wonder, like Arthur, why am I having my hair done when I may be bald soon? My thought was if it was shorter and blonder maybe no one would notice if it all falls out! :) - I will call a few doctors and try to step up a couple of appointments for the end of next week. The holiday may make it a little difficult, but I will try. I'd like to be ready to make a decision about surgery and have an oncologist by July 16th. Too hopeful?? Maybe, but at least it's a goal.

Now on to the most anticipated part of my day - telling the girls. They were at a girlfriend's house during the appt. As we picked up the girls afterward, Arthur and I were greeted with a wonderful dinner! (thank you!!) After we got home, we brought the girls up to our room, all plopping on the bed and proceeded to share the news of the cancer in mommy's breast. We told them all the facts we knew, what will probably happen to my breasts, that I maybe sick afterward if/when I have chemotherapy. We showed them the short book I got and the pamphlet we got from the doctor. We were honest and upbeat. We told them after tonight most everyone we knew would know the news. We told them they could come to us with any questions and/or anything they might hear that scares them. We ended by asking them if they wanted to see the incision from the biopsy or feel the lump which got a rousing "eeww, no!!!!" :) As you know about us, we try to be open and honest with them, so please don't hesitate or feel the need to hide information, emotions, etc from them. We will be using the word "cancer" in our house not "the c-word" in hushed tones. I will begin looking into a support group of some sort for them, so if anyone knows of one, please let me know.

As for me, I'm feeling really good tonight. I think I got more information from the appointment than I thought I would. And it was encouraging to have Arthur ask the doctor some questions and know what page I was on in my questioning. (I know he will be a support beyond words, for me, and especially for the girls. ) Another reason I feel encouraged was the how the doctor presented everything - assuring me that my treatment options were fantastic, and that, sadly, due to the proportion of women being diagnosed (1 in 8 women will be effected by breast cancer!! CRAZY, huh??) treatment has progressed amazingly.

Thank you all for taking an interest in me and my family, and for reading this breast cancer dissertation!! I will continue to update. Much love and peace to you all!

Big News

I was diagnosed with breast cancer on June 23, 2010. I felt a lump, went to my dr. (Dr. Yvonne Duffe), she ordered a diagnostic mammogram and ultrasound. She called me within hours of the completion of those and told me I needed to have a biopsy. She made sure to ask if I was OK, which I so appreciated. She then referred me to a surgeon at either Florida Hospital or ORMC (some of you may know I will not go to Health Central). I then quickly made an appt. for Monday June 21, 2010 at 9:00am thinking it would be a consultation. Arthur went with me. Dr. Posada felt the boob and suggested we he biopsy it right then. I'm a baby when it comes to needles (I guess now that will quickly change!!), it all just took a few minutes and Arthur got to be with me the whole time. He said he would rush the results, thankfully.

On June 23 I was on my way to Kentucky to pick up our precious girls from 2weeks at their grandparents' houses. Dr. Posada called me around 1:30 and told me the news - I have cancer. He didn't have much other information except that I needed to make an appointment to get this ball rolling. I feel like I knew. Maybe that is Monday morning QBing, but I just wasn't shocked. I asked him if I should turn around and come home, he said no.

I then proceeded to spend the next 5 days in a suspended reality where I embraced my girls, had fun, and let this crazy news sink in! I stayed away from the internet, tried to call as many of you as I could bear and kept having fun!

The girls and I are home now. Reality is knocking.

Tomorrow Arthur and I have our 1st of God only knows how many appointments! We meet with Dr. Posada at 3:45, and I have no idea what to expect!!?? Then, tomorrow night we will tell the girls. I am hoping to have a little more information to share with them, but who knows? The 1st book I bought was a book for kids about having a parent with cancer. For those of you that don't know my own mother died of thyroid cancer when I was 12. And the damnedest of coincidences is that she and my father told my sister and me when we were 11 and 10, just the exact ages of Skylar and Emma! I'm a little freaked about that.

I bought my 2nd book - Living Through Breast Cancer - and have started reading tonight in hopes of not seeming like a complete dumbass during our appt. tomorrow.

I started this blog to try and keep as many of you as update as I can. You all know how much I love to talk and how open I am, but I'm just not sure what to expect so I thought this would be a good way to share information. Please feel free to call or email or FB me anytime, I just can't promise I will get back to you in a timely manner. But please know I will appreciate every call, email, thought and kind wish.

As for the title of the blog, it comes from a wonderful email I got from a dear friend, who has herself fought and defeated this craziness, who wrote "Take a deep breath, hug your girls, and get ready for the fight of your life." That struck a cord with me - it inspired me and motivated me, so here I am....about to embark on the fight of my life!