Night Before Mastectomy/Last Known Normal

Today is the last day of what has been my normal for 45 years. Tomorrow, I will be different. I’ve never had major surgery (thankfully) or a body part removed. I’ve never been truly dependent on others. I’ve never really been a patient. 

Being the triathlete nerd that I am, I fashioned this race belt into a drain holder. Instead of a race number, tomorrow it will hold plastic tubes and bulbs full of fluid that will drain from my chest for a week, give or take. I will not be able to shower or lift my arms. I will have to sleep partially upright on my back. 

I will no longer need the collection of bras I’ve amassed. I have chosen not to get reconstruction, and it has been the most eye opening and interesting part of this journey so far: the assumption that I would want fake breasts. That any woman in my situation would happily subject herself to further surgeries, foreign bodies, and additional risks just to look “normal”. Well not this woman. Let’s be real: mine aren’t that big to begin with, and even if reconstructed, I wouldn’t feel them anyway. They are much less a part of my identity than my hair - which we can discuss in a later post when/if chemo is necessary. But I do not need fake boobs to feel whole, and while I realize this is a hugely personal and individual decision, I’m at peace with my choice and my new normal.

Today I’ll say goodbye to a mostly healthy 45 year old body, to my breasts, and to my normal. Tomorrow will begin a new normal, one without bras or breasts. One without easy showers, exercise, or comfortable sleep. One in which I have to rely on others, on slowing down, on listening to my body instead of pushing through pain, one in which I am a patient. For today, I’m going to enjoy the sunshine and the normal. 

Let’s talk about partners

Given our recent binge watching of @thegreatbritishbakingshowmy incredible husband Brian baked and decorated a bye-bye boob cake to celebrate my upcoming mastectomy. It turned out beautiful, delicious, and hilarious. 

I am not on this journey alone. Beyond my family, friends, and coworkers, no one has shouldered more of this burden than @beewood17 - my rock, my partner, my love, and my very best friend. He has never wavered, in the torrential downpour of my emotions, through the doctor visits, the impending surgery, and the frightening unknowns. He has kept me laughing, exercising, eating, and functioning, when my brain wanted to spiral out of control. 

Cancer doesn’t just affect patients. I was terrified of how I would look naked in front of my husband after my mastectomy- I know now that I have nothing to be afraid of. But cancer made that conversation happen. Cancer spouses and kids need help and empathy and grace too. 

Brian, I cannot fathom being not just alone on this journey, but with anyone else by my side. You are keeping my thoughts hopeful, my spirits lifted, and my soul nurtured. I am sorry to be taking you with me on this path, but I am so thankful I don’t have to walk it alone. 

Doctor as Patient

This morning I walked out of the hospital as a doctor for the last time until May (at least). For the foreseeable future, I’m a patient. A freaking cancer patient. 

I haven’t missed a shift or called in sick for work in 14 years. The only time I took off was for maternity leave in 2011, and to work in Nepal in 2009. To walk out of there feeling completely healthy but not coming back soon is a weird sensation. 

I love my job as a physician. I feel privileged to be useful, to help people, to be intellectually stimulated every day and to walk in every night knowing every shift will be different. I am never bored. I am always needed. 

Now I have to figure out how to be a patient patient. Not easy for this doctor. 

Mastectomy Physical Therapy

 The sickly lime green walls of another medical office - this time a mastectomy physical therapist for pre-hab before my operation.

I learned I can’t prevent lymphedema (swelling on the side they remove my lymph nodes), what cording is (when your lymphatics stiffen into taught guitar strings of fibrotic tissue), and some stretches I can do to regain my range of motion. She took measurements of my arm girth so she’ll know if they swell post-op. 

Then I did my own damn workout on my bike because I already have good range of motion, exercise habits, and a stubborn AF attitude. Thankful to have found a PT that specializes in mastectomy care, and thankful to be cranking out the watts on the trainer too. Every little bit of strength now is a deposit in the bank for later. 

Genetics Testing Results

In medical school, I loved pathology. I thought the slides of different cells looked like artwork, some sort of abstract impressionism of proteins, membranes, and the cellular building blocks of life. This is a slide of what lobular breast cancer looks like. 

Some good news today: negative for BRCA1/2 and Chek2 mutations - meaning the rest of my female organs besides my left breast are not actively trying to kill me with cancer (at least not at any more than the general female population). This means I don’t have to rush out and get a hysterectomy/oopherectomy, and this means I can breathe a small sigh of relief for my daughter. 

10 day countdown to mastectomy. Still going for the double even without the mutations, because those lobular cancer cells like to show up on the other side. Pre-op for anesthesia done, Covid screening test scheduled, and puppy arrangements made. Now we wait. Waiting is intolerably hard for me. So is occupying my brain for 10 days. 

Talking to Kids About Cancer

Talking about cancer is hard. Talking about cancer to a nine year old is a special kind of hard. 

We called a family meeting with my kid, her dad, her stepdad @beewood17 and me. We asked if she knows what cancer is, and we told her about my diagnosis. More importantly, we told her our plan of action to fight it and how happy we are to have caught it early. 

We let her ask questions. She asked to see my biopsy scars, and I showed her. She asked to touch my lump, and I let her. She named my tumor “Ted” and now has a song about it. 

Kids are amazing. I find it hilarious and so sweet that she felt the need to mention my soon-to-be boob-less body in her Valentine’s Day card. I’m sorry she has to face this at the age of nine, but I’m hopeful this will be but a memory a few years from now. The meeting ended with her skipping away, saying “That was a fun family meeting!” That’s a good sign - every small win adds up to a victory. 

Let’s talk about birth control.

I went to get my IUD removed yesterday, because having an estrogen secreting foreign body inside a human body with estrogen receptor positive cancer is a dumb idea. 

It did not go well. Suffice it to say that I got shot up with toradol and Valium so I could be transferred to an ob/gyn office 25 miles away to get the damn thing out - all the while having what felt like contractions every 6-8 minutes. Finally after a local nerve block they were able to get it out with an assist from me where I launched off the guerney and my IUD went with the forceps.

It occurred to me after hours of suffering yesterday that for thirty years I have put foreign bodies in, mucked with my hormones, or put in hormone-mucking foreign bodies to control my fertility. Why aren’t there male birth control pills? Why aren’t there more options for the other 50% of humanity responsible for making babies? Why do women have to manipulate nature and our insides so disproportionately? 

I don’t have answers to this, but I do have a suggestion - for all the men out there who might read this, if you really want to do something special for your woman this Valentine’s Day and you’re done having kids, go get a vasectomy. Hell even if you do want kids - it can be reversed! No hormones or foreign bodies necessary. Call it a Valentine’s Vasectomy. 

Bone Scan Day

From a night shift in the ER to nuclear medicine for a bone scan. I was disappointed to learn the technetium does not fluoresce my pee, I will not glow in the dark, and I have no superpowers. They did give me a warm blanket and a cot to lie on for the two hours it takes to circulate into your bones. 

The scan itself is peaceful and quiet - the opposite of an MRI. Fun fact: a breast MRI is like a perverted massage table - you lie face down on a face cradle, only there are boob holes for your gals to hang through. I’ve experienced almost every type of radiology imaging that exists in the past month. Better go hydrate those kidneys! 

12 Days Post Biopsy

12 days post biopsy and cleared to swim! Haven’t been to the gym since my diagnosis. Today, I almost let my fear and sadness win, and in my head I heard the words “I can’t do this” about going to the pool. 

Then I went to the pool. Because I CAN do this. I went to that place I go to during an Ironman when my body wants to quit and my mind takes over. You CAN finish. You CAN do this. 

And so I swam - and as I’ve learned from my amazing team @biscaycoaching today was mental fortitude in the bank. Today I overcame my fear, my sadness, my anxiety, and I swam. Every small win adds up to a victory. 

Week One Update

 Week One Update

What a whirlwind. In the last 10 days I’ve had a mammogram, ultrasound, biopsy, breast MRI, and chest/abdomen/pelvis CT scan. I’ve met with the breast care center at UC Health, oncology, surgery, and genetics. 

Here’s what we know: I have invasive lobular breast cancer in my left breast. No signs of cancer in my lymph node, right breast or chest/abd/pelvis (good news). My receptors are ER/PR+, Her2 negative (also good news). 

Next steps: bone scan on Tuesday to look for spread to the bones. Waiting tissue oncotyping from the biopsy which will determine whether I need chemo or not (🤞🏻no!), and waiting on genetic testing for BRCA mutations. 

I am scheduled for a bilateral mastectomy on March 1 (or as I’m calling it “No more boobs day”) - even though there’s no cancer on the right, this type of cancer is a sneaky little bitch that likes to come back on the other side. It would also require getting shot up with gadolinium every six months for a breast MRI to look for the cancer they can’t see on mammogram-and the anxiety of that process far outweighs any attachment I have to my breast. It would feel like having a time bomb strapped to my chest. Also, symmetry. So, March 1 I say goodbye to my boobs at UC Highlands Ranch hospital. 

We’ve had a rough roller coaster of a week, but I’ve been completely overwhelmed with love and support from my family, friends, work family, Smashfest Queen teammates, and most of all my partner and my love @beewood17 who has been my rock and my strongest support this week. 
Going to try to enjoy this weekend and not think about it constantly until we have more info and updates. 

Being a Doctor Patient

Today I acted like a doctor instead of a patient. I caused myself an unimaginable amount of unnecessary stress during a stressful time, made @beewood17 cry, and sent myself into a tailspin of negative thoughts, all because I used my doctor brain on a patient problem. That’s how it normally works - except when the patient is you.

To my healthcare tribe: don’t be your own provider. Be educated, be an advocate for yourself, but let go of control and trust your healthcare team. Be a patient, period. 

DO YOUR BREAST EXAMS!

This a mammogram of my left breast - the arrows show the little clips they left in my tumor after biopsy. Here’s the kicker: this is a normal mammogram. The one I had six months ago didn’t show the tumor either. 

I found this lump myself, and it was visible on ultrasound, not mammo. 

Quote of the day from oncology: “Good on you for finding that and saving your life.” 
I saved my life, and you can too. Examine your boobs, ladies.