Family and Fantastic News

I thought I would do something a little different 

and post some pictures.

Usually most of my pictures go on my private family blog,

but I am in love with the way these pictures turned out,

 so I wanted to share them.

I also wanted to share some fantastic news.

I had an MRI a few weeks ago in preparation for surgery 

and to make sure there are still no signs of cancer.

Results:

No interval change compared to 10/14/2015

 BENIGN FINDINGS: Routine follow up recommended.

AND

Last week I had a follow-up ultrasound of my thyroid.

I meet with the doctor today.

Results:

Heterogeneous left thyroid lobe nodule, unchanged. This has

been biopsied previously. No significant interval change.

I can finally breath again.

I don't think I will ever be able to put into words the worry, stress and anxiety 

I experience with every aspect of having tests done.

Waiting for the appointment day to get here;

Being in the actual room having the procedure done;

And then the waiting.

I really try not to worry but ultimately I do - a lot.

But for now everything is stable and there is no evidence of disease.

I am more thankful and grateful than I could ever express.

It's Never Ever Completely Over

I thought this was an interesting read.  

The feelings and fear are real.

by: Uzma Yunus  

“You had breast cancer... but not anymore!”

She then said to me that I should get over it!

Her eyes welled up with tears as she recounted her conversation with her mother. She has been repeatedly accused by her mom that she isn’t being positive and by “holding on” to her cancer she is not moving forward in her life.

“They just don’t understand!” she sighed.

“But you get it. It’s never over, is it?”

She looked at me straight. I replied.

“I understand. It is indeed never over.” We both smiled at each other, as we sensed the comfort of understanding the pain in a way unique to us.

My friend, also a breast cancer survivor, has been dealing with her family who expect her to “get over” her cancer. If you are a survivor and reading this, I bet you have been part of a similar conversation with a friend, a partner, a neighbor or a family member at some point in your recovery. I had been part of similar conversation, too. I had even been given signals that by continuing to blog about cancer, I was unnecessarily staying too close to cancer and that I should move on.

Those who have never had cancer think we can get “over it” by waking up one fine morning and deciding it is now over just because chemotherapy and radiations and surgeries have concluded. Let me tell you a secret: In our minds, it’s never ever completely over.

“Just because I look well and have hair doesn’t mean I am all better!” she continued. “I have gained weight, I feel tired, I feel numb. Often, getting through a day is hard. Does this sound like its over?”

I nodded as I understood exactly what she meant. I was there once, too, when I was in my post treatment phase. My cancer, however, metastasized and came back after two years. This woman is still struggling, despite being “cancer-free” per her doctor, just like I did and continue to do today.

If you have ever wondered why cancer survivors bond with each other or connect instantaneously, it is because we “get” each other. We are able to relate to each other in ways others can’t. One of the biggest emotional setbacks that breast cancer survivors deal with post treatment is the expectation from their family, friends and caregivers that survivors should “get over it” and join life in its entirety.

In fact, the survivor-ship phase, which starts after all treatments end, is actually a very daunting and nerve wrecking time. Through cancer, we get used to regular appointments and medical oversight. But then when treatments end and the oncologist looks at you and says, “You are done. Go live your life,” most survivors feel lost. After six months to a year of intense treatments, we forget what it is like to “live life.” And just like that, with a statement and a pat on the back, survivors are pushed back into the world that is no longer recognizable to them. Many have mixed feelings about the word “survivor” since they are unsure if they truly have.

“Cancer changes everything” is an understatement. Those with cancer are no longer the same people when it hit them. We took an exit off of the freeway and then got lost for a long time on unfinished roads and unfamiliar streets. It’s hard to merge back into the fast lane. It scares us to see everyone moving so fast and, sure, while we feel we are just limping along.

We are tired and exhausted from grueling treatments and their side effects linger for a while. Many of us are left with permanent scars of treatment including physical limitations, neuropathy and joint pains. Many remain on hormonal therapies or are thrown into sudden menopause. Menopause and hot flashes are just the tip of the iceberg of chaos that occurs in our bodies. Some survivors keep going through repeated surgeries for reconstruction to get their bodies somewhat similar to what they once had.

Dealing with cancer is grief and loss at multiple emotional levels. Even though, after the end of treatment, survivors are told they are cancer-free, we are anything but “free” of cancer and cancer thoughts. We are ridden with feelings of anxiety and uncertainty and stalked permanently by the fear of cancer. Many of us hardly get restful sleep at night. I remember how fractured my sleep was on Tamoxifen and how my joints hurt every single day. Women after breast cancer are on 5 or 10 years of hormonal treatment and live quietly with these side effects. They don’t say much because they feel that their life was spared so they should pretend to be happy and just suck it up.

When I was diagnosed with recurrence, there was a very strange relief from this horrible fear of recurrence. I was surprised but I do remember the feeling as if the other shoe finally dropped. For others, they are living with this dreadful anxiety of “what if it comes back” every day.

Most people look at survivors think, “They look well and are not complaining; they must have recovered.” But the truth is far from it. A survivor continues to deal with consequences of treatments and emotional aftermath of cancer for years on end. Every time there is an appointment, the whole thought process of fear and anxiety is reactivated. Going in for a test or scan or dealing with an unusual symptom always shakes up survivors and the dread of cancer being back is terrifyingly close.

Many survivors end up having clinical depression, anxiety and even post traumatic stress disorder. The battle with cancer continues for a survivor despite cancer being gone from their bodies. The fear of cancer lingers over most survivors and then about thirty percent like me have to deal with recurrence and start of the treatments all over again. For us with metastatic breast cancer, it is never over at all. Our fears just get bigger and scarier.

But all of us, no matter what stage of cancer, are scarred for life. Many times we feel like we are merely a shadow of what we once were. We try very hard to meet life halfway but then there are numerous days we fall short. And being told to “get over it” isn’t very helpful. Those are the days we need love and support. The fear sits on our chests every single day. It changes in magnitude daily but never disappears. I have yet to meet a survivor that has completely forgotten her cancer experience.

Those who are in the first five-year window after the diagnosis are especially vulnerable to complex cancer feelings and physical consequences.

So next time you are talking to a breast cancer survivor, please don’t tell them to
“get over it.” Hold back that advice. Instead, hold their hand and tell them that you know they are trying their best to recover and that you will continue to cheer them on

After the Storm

Wow - I can't believe it has been almost 2 months since my last post.
Sorry for the lack of updates.
I know some people check here to see how I am doing.
Please know that I am doing well.

Today is an anniversary date of sorts.
Two years ago today marked the end of the longest 18 weeks of my life.
Six rounds of toxic Chemotherapy - Docetaxel, Carboplatin, Trastuzumab, Pertuzumab.
As I look back, I honestly don't know how I survived it.
I remember Ryan or my mother having to get the kids ready and off to school because I was still in bed.  Soon I would finally get up, go to the restroom and get dressed. I would make my way to the living room.  By the time I would get there, the couch was as far as I could make it. I would need to sit down and rest because I was so tired, weak and in pain.
That seems a long time ago.
I am grateful that part is over.

I am grateful my side effects are settling down.
I am grateful my hair is growing back.
I am grateful my family is patient and willing to still help.

Upcoming is my annual breast MRI, this one - hopefully - is my last.
(I thought my last one was my last one but my new surgeon wants one more before the next surgery.)
I also have another Thyroid ultrasound in December to check if the nodule on my thyroid is growing and needs to be removed or if it is the same and can just be monitored.
More to come on these.

I read this article the other day and felt I totally related to it.

After the Storm 

What lingers most after breast cancer is my persistent worry.

by: Gwen Moran

"You look fantastic."

Lately, I hear this statement often from well-meaning people, usually before a heartfelt touch of my arm or a tentative hug. It puzzled me at first because I certainly don't feel like I look fantastic. I'm significantly heavier than I was two years ago and unruly shoulder-length waves have replaced my long, straight hair. Like a stranger trying to decipher a foreign tongue, I finally figured out what they mean: "I'm happy you don't look like you're dying."

That was not the case roughly two years ago, when I was wan, weak and nauseated from chemotherapy treatments for my early-stage invasive breast cancer, barely able to walk from the bone pain. Or when I was bald and shuffling slowly around the house with my arms wrapped gingerly around my T-shirt-clad breasts, trying to keep the left one, burned from radiation until it was blistered, wet and peeling, from any painful swaying.

That's what you get for trying to kill us, I wanted to tell it. Don't ever do that again.

Before April Fools' Day 2011, when I learned that my body had turned on me, I spent hours each week walking, biking, swimming and practicing yoga on the beaches of my beloved Jersey shore. Lightly tanned with visible muscle definition, I looked healthier than I had in years. A lie.

The sun's kiss is gone and so are the muscles. Steroids, chemotherapy and inactivity, not to mention countless trays of gifted lasagna, added bulk to my frame. But I'm not dying — at least, not any faster than most people.

But the façade others see is not "fantastic." Worse, it hides something dark and ugly; something few ever talk about in the tumultuous rush of stages, surgical options, hormone receptors and the alphabet soup of cancer-fighting poisons. More immediate decisions need to be made about how to best battle the disease that slowly eats people from the inside out. So, many months after chemotherapy annihilated everything in its path, followed by radiation beams that obliterated even microscopic cancer cells, I feel like parts of my brain and soul were killed, too.

Complaining feels churlish. After all, I made it through the storm and my prognosis is good. Surgery, treatments, and a year of $11,000-per-session gene-targeted therapy, administered through a needle piercing my chest every three weeks, have left me with 90 percent odds of no encore appearance in my breasts, lungs, liver or some other vital organ. This is according to some unknown statistician who calculates such things.

But even those odds, a bookmaker's dream, aren't a match for the persistent and lingering worry. Cancer is master of the sucker punch. What if it's just lurking within that 10 percent margin, waiting for the moment when I'm too weak or tired to fight again? Some days, contemplating that question fills me so completely with fear that relief comes only from deep, jagged sobs expelled from my throat.

My loved ones are quick to chirp, "You're doing fine! Remember those 90 percent chances!" I've stopped reminding them that breast cancer is funny that way. There is no disease-free "magic number" that actually does mark me cured. Each mammogram, stomachache or fever threatens to hold a devastating reprise, at least in my mind.

But now that my hair is back and the pink has returned to my cheeks, I suppose I do look fine — fantastic, even. I feel increasingly like my "old" self and there are times that I even forget about how cancer changed me. I run errands, giggle with my husband and daughter, and have thoughtful conversations with colleagues. I'm back on my bike and pedaled 10 miles the last time out. I make dates with my friends to go walking and to the gym. It feels good to move and helps push the fear away. I feel stronger, both inside and out.

Still, it's a struggle to rebuild what cancer and its treatment destroyed. While the rogue cells may be dead and gone, it's difficult to trust my body again. Accepting that this is over — "looks like it's cured to me," as my oncologist likes to say — feels like tempting fate. I'm told that, as time passes, I'll feel more at ease. For now, however, I wait for everything to feel normal again, wondering why the "after" of successful cancer treatment isn't filled entirely with unfettered joy.

Two Years

The first picture was taken when Gage was about 1 month old and about 2 weeks into my chemo treatments. My hair was falling out in clumps but I wasn't quite ready to shave my head yet so my sister just cut it off for me. As I was crying because it was so 'short' and I had always wore my hair long, I remember her saying, "In a few years you will be crying happy tears when it grows back in and is finally this 'long' again."  Thanks Steph, you were right.

The second picture was taken a few weeks ago.

Same people,

same location,

same hair style.

Different outlook on life and so grateful.

Summer is Over

Wow - it has almost been two months since the last post.
Sorry for the lack of updates.

I am about the same.
Which is good and bad.

I kinda don't know what to write about.
Still physically, mentally and emotionally feeling the same.
I guess the best word I could use right now is stuck.

School started on Thursday and while that does bring
some relief as to what to do with Abby and Kaden all day,
I am not excited about homework.
Abby had some on the first day.
Ugg, that makes me tired already.

Summer was super fun but boy did it exhaust me.
June was the month of camps.
Abby had a couple of art camps.
Kaden had nature camp.
Alyssa had dance camp, safety camp and summer school.
Throw in some park time, splash pads, swimming and movies in the park.
And dance recitals, tennis tournaments, support group meeting and doctors appointments for all of us.

Then for July.
Abby and Kaden got to go to Camp Kesem, a camp just for kids who have a parent with cancer.
They loved it!  They can't wait for next year.
Ryan broke his foot while he was motorcycle riding.
It required surgery, a plate and 5 screws.
The kids and I did a couple of trips to Salt Lake, to see more doctors and
to use our Pass of All Passes - Trafalga, Seven Peaks, Murray Park and Rocky Mountain Raceway.
Went to East Canyon where we played mini golf, basketball & shuffleboard and hiked.
And swam everyday - twice a day.
We went to the  farm. 4-wheeling, campfires, parades, taking care of animals, spring cleaning, sleeping in the new cabin, zip lining, swimming in a private swimming hole, vaccinating the cows, a huge slip and slide, going to see the BFG movie at the drive in and going to Palasides Lake. 
 We were pretty much gone most of the month of July.
(All the pictures on my other blog.)


I find that when I am doing so much,
and getting little rest,
all my side effects from chemo, radiation and surgeries act up more.
While I love going and doing all these fun activities with the kids,
I am hoping things slow down just a little so I can breathe and get caught up.

I am having a hard time finding that middle ground between going and doing and paying for it the next day.  Some things like my lymphedema can't "get better" like sore muscles. It is a life long condition.

I have been trying really hard to get caught up with my photography.
Making sure pictures are sorted, printed and put into albums.
Our annual family pictures are scrap booked and put into another album.
Journaling is caught up.
Baby books and school books are up-to-date.
For some reason I have this nagging, urgent feeling to make sure life
with my kids and husband is documented.
Is it just for fun to look back on or will be a way for the kids to remember me by?
(Sorry that was kinda dark, but sometimes that is my reality.)

Sometimes I want life to slow down so I can relax,
but on the other hand I want to go and see and do as much as I can.
I always feel like no matter what I am doing, I am missing out on something.

I guess what I mean in all this rambling is I need to find a balance.
I guess I will make that my new goal.

June 17, 2014

I have sat down several times over the past week to write a post for today.
Knowing this date was coming,
I have a lot of thoughts, feelings and mixed emotions,
but I am not really sure what I want to say.

I will always remember this date,
but it is not one I celebrate.

Today is my 2 year cancerversary.
Cancer sucks!
Plain and simple.

But..

I am so grateful that history did not repeat it self today and my thyroid biopsy came back benign.
I am so grateful I just celebrated another birthday.
I am so grateful I am a busy mom running my kids around to various summer activities.
I am so grateful I am planning a birthday party for my little guy.
I am so grateful.

No Official Call Yet...

but look what I pulled up on my health portal.

BEST WORD EVER!!!

I still haven't spoke with the doctor and most of the wording in the comments section I don't understand but right now I am only concerned with that one word.

BENIGN

Thank you everyone for your concern and support. 
I feel like I can breathe easier today.
I still don't know what the doctor will recommend next.
Leave it, watch it, or maybe remove it.
I will save that worry for another day.

Five Samples

Yesterday, I found myself as I did 2 years ago.

In a quiet, white, cold hospital room with strangers.
Friendly and nice, but strangers none the less.
I was given explanations and instructions as to what was going to happen.
What to watch for over the next few days,
and of course the estimated time frame in which I would
receive, "the call" from my doctor.

I changed into a gown - open to the front.

I layed down on a bed with the pillow under my neck,
so as to make my head tilt back.
Better access to my throat.

A tech squirted some gel on my neck,

and started moving the wand to the ultrasound machine around.
Within a few seconds, surprised, she said,
"Yep, there it is. Wow it's big.  That's good for you."

I thought in my mind how in the world could that possibly be good.

"Easier for them to get the biopsies.

Smaller ones are hard.
And since we need to get 5 samples - it is better it is large."

She wiped up the gel and said she would go get

the PA that would be doing the procedure.
The PA came in and introduced himself and a student he was training.
They asked if the student could do the biopsy.
"He has done a few of these."
Not a dozen or dozens or hundreds - a few.
Not very reassuring.

I said okay.

And just like two years ago, they draped a special cover over me

with the one hole - where they need to take the biopsy from.

The first shot is the worst one.

Pain, stabbing and burning feeling.
This is the numbing medication.

Wait a few minutes for it to start working.
I could tell the new tech was nervous.
He was making me more nervous.
He asked me probably 20 times if I was okay.
I am not sure what he wanted me to answer and I know he was trying to be polite.
I wanted to say that no I was not okay.
What would he have done if I would have said no?

Instead I just said yes as I lay there with him sticking needles into my neck.

Don't cough, or swallow or talk - or breathe for that matter.
Weird how when someone tells you not to do something, that is all you can think about.

I could feel as soon as the needle hit the nodule because

it gave some resistance and he had to push the needle harder.
That's when it hurt.
He had a hard time getting one of the samples.
He needed to get cells right from the center of the nodule.
That one hurt too.
By the time he said he was done with the third, I was about in tears.
Some because of the pain, some because of the reality of what was going on.
The new guy was probably a little slow, but I think he did a good job overall.

After the PA left the nurse asked me to say lying down.

She said she wanted to clean me up and didn't want me to freak out.
Apparently I had blood running all down my neck.
She cleaned me up, put a band aid on and told me to take it easy for a few days.
Then she handed me an ice pack, showed me to the exit and told me to have a nice day.
I wish it were that simple.

Funny how I wanted the biopsy to be over.

But now I don't.
I hate the way I feel in the waiting limbo,
like the results of this test
determine my future.

I was told 2-5 days for the call.

Most likely five.
If anything abnormal is found,
it has to be sent for further testing.
Which they do not do here, so add another day.

When I got to the car and finally looked at my neck, it surprised me.
The lovely little band aid already had blood coming out from underneath it,
so I grabbed my emergency kit. 
I put some gauze and another bigger band aid on over it. 
It was so swollen!
It looked like I had a small orange taped to my throat.
And the numbing meds were starting to wear off - and it was so sore!

It hurts to swallow, talk and chew food.

And to bend over and pick up stuff.  Pressure I guess.
Today it is doing a little bit better; at least the swelling has gone down.
I am sure tomorrow it will be even better.

 And now I wait.

Deja Vu

I feel like I am living my life
but from two years ago.
Total deja vu.

I didn't realize it when the hospital called to schedule my thyroid biopsy,
but it is on the same day, June 13th
exactly two years ago,
that I was having my breast biopsy done.

Waiting for the biopsy procedure to be done is hard.
You know something is there - growing, or festering seems a better word.
It is back!
Or is it?
Waiting for the pathology report results is even harder.

I hate sitting around.
I hate the quietness.
My mind starts to wander.
It is usually not so good thoughts.

So I turn on the radio ,
and the TV,
plus I have the kids in all kinds of activities this summer.
Just to keep busy.

Last time the thought of cancer wasn't even something I would have considered.
Now it is all I can think about.
Chances are it is nothing.
But I also know my chances of it being something - are greater.

I feel like I am trying to be two different people.
On one hand I want to be happy - but I am really scared.
I try to stay positive - but the negative thoughts are always right there.
I say everything is ok and smile - but really I just want to scream and cry.
How long can I go on like this?

First it was the headaches.
The fear of the cancer returning and spreading to my brain.
MRI - nothing was found - but I still get the headaches.
Now the fear of another cancer.
More surgery.
More toxins and chemicals.
More medication - this one would be for life.

Is this my future...
Fine for a few months,
then find something.
What is it?
Test, scans, biopsies.
Nope, all clear, you are good.
Repeat...
until it is not ok?

Not What I Was Hoping For

My thyroid ultrasound was Monday.
The "finding" was posted to my Health Portal at 5:23pm, that day.
I can't get a hold of the new doctor that ordered it.
I have left multiple messages.
Finally I called my oncologist to see if he would pull up the results and explain them to me.
It was not what I was hoping for.
I was hoping the ultrasound wouldn't find anything more than just the nodule and they would say it looks fine and to have it checked again in a year.
That is what the doctor said he hoped for too.
Instead the results say:

This thyroid nodule would meet sonographic criteria established
by the American Thyroid Association * for further evaluation by
FNA. Depending on the presence or absence of risk factors and
clinical assessment, either ultrasound follow up or more
aggressive evaluation of smaller nodules may also be
appropriate.

So now, I need a FNA - Fine-needle aspiration biopsy.

When can freak-out mode begin?

I hope this is not the beginning of how the rest of my life will be.

Just starting to find some normalcy and then get blind-sided, like before.

I understand they are just doing this to be on the cautious side.

But it is still freaking me out.

The waiting continues -

Wait for the call to make the appointment.

Wait for the day of the biopsy.

Wait for the results.

I am not sure I am prepared to handle this.

Busy Being Sick

So the last few weeks have been all sorts of busy!

A cold that lasted 2 weeks or more for each of us has finally made its way through the entire family.

Collectively we have been sick since January.

Alyssa and Gage seemed to be the only ones who didn't get anything else on the side.

I got a sinus infection that caused severe headaches.
Kaden got a double ear infection.
Abby's acid reflex got aggravated so much that her doctors ordered an
Upper GI test just to make sure nothing else was going on.
And poor Ryan is still coughing.
For the most part we are all on the mend.

Since our deductible is now met for the year, I decided to go see some specialists.

Up first was a foot doctor.

My right foot has been hurting for about a month and I kept thinking it would go away.
Feels like walking on glass.
Diagnoses - I have plantar fasciitis - or  inflammation of a thick band of tissue in the heel.
I had an ultrasound on my foot – that was kinda weird.
The doctor said the tendon should measure about a 3, mine was at an 8.5.
Extremely inflamed.
Solution - a very painful shot of steroids in my heel.
So far, aside from the pain of the shot for the first few day after, it feels tons better.

Next were a few visits to the chiropractor to see if he could help with

the mysterious and ongoing neck pain and headaches.

I am usually more in pain after I leave his office but then the next day if feels considerably better.

Then I somehow chipped a tooth - one of my back molars.
I had a temporary crown for a few weeks, and now I have my permanent porcelain one.
It has hurt to chew but slowly I am getting used to it and it is starting to feel normal.

And last was an ear, nose and throat doctor.
I am almost a year and a half out from chemo treatments, yet my nose and throat still hurt.
He gave me a prescription and some over the counter things to try. So we will see.

But...

during the examine he felt something suspicious on my thyroid.

I need to go have some blood work done and see yet another doctor who can do an ultrasound.
Possibly need to do a biopsy.
He said most of the time theses nodules are benign.
I am pretty sure I have heard that before.
Then he asked it thyroid cancer runs in my family.
Ha, nope.
But neither does breast cancer.

And so the waiting game begins again.

Wait for the doctor’s office to call to set up the appointment.
Wait for the day of the appointment.
Wait for the results.
Wait for my doctor to call me back with the results.

I hate this waiting game.

Last One

If all goes well,
I had my last mammogram today.
Like last - as in forever!
Wahoo!!!!!

I have been having a mammogram or Breast MRI's
ever six months since being diagnosed.
With the mastectomy and reconstruction I will have done soon,
I will no longer need either.
I won't miss them.

Next month I go to Salt Lake to meet and have a consultation with a plastic surgeon.
I have heard a lot of scary things about the type of reconstruction I want,
but I have also seen a lot of amazing results.
It is a very complicated surgery - micro surgery.
Surgery can last anywhere from 4 to 12 hours,
with at least 3 surgeons working simultaneously.
The hospital stay is usually 5 to 7 days, the first few being in the ICU.
Recovery is hard and long too.
Basically they want you moving,
but no cooking, cleaning, bending, lifting, stretching, climbing stairs...for months.
It can not all be done in one surgery so it is done in phases. 
Usually 3.
I hope to have all of them done in one year.
That is why I am starting in January.

The procedure is called Deep Inferior Epigastric Perforator or DIEP flap.
Simply - you are cut from hip to hip below the belly button.
They dissect the fat and skin from the muscle and relocate it to the breast.
Since fat needs a blood supply if the vessel in the chest wall are not big enough or ruined from, say radiation,
they will break a rib and tap into the blood supply there.
Then they pull, sew, stitch and glue everything back together.

Here is all the technical stuff:
A DIEP flap is a microsurgical breast reconstruction where skin, fat and the associated blood vessels that keep it alive are transplanted to the chest wall from the abdomen during the Stage 1 Procedure. No muscle or motor nerves are sacrificed in the execution of this form of breast reconstruction. Blood vessels of the flap are connected to either blood vessels in the chest wall or under the arm in the axilla using an operating room microscope. Unilateral and Bilateral DIEP flap breast reconstruction can be performed in a 4-12 hour general anesthetic in the setting of a 5-day hospital stay with a focus on flap monitoring. Blood thinners are administered to prevent deep venous thromboses or pulmonary emboli. Sensory innervation can be supplied by the incorporation of a sensory autograft. Costochondral cartilage or rib resection is uncommon unless you are a very petite woman.

Stage 2 of this reconstructive technique involves the aesthetic shaping of the breast reconstruction flap and the completion of any counterbalancing procedures of the remaining breast (breast reduction, breast lift or breast augmentation). It is typically done 3 months after Stage 1 but can occur later for patient convenience. Excess skin from the flap previously placed for perioperative monitoring will be removed. Revisions to the donor site include liposuction and scar revisions. Nipple reconstruction is completed at this stage. On occasion in the irradiated patient, nipple reconstruction is deferred to a later date allowing for the revised reconstruction to settle, therefore optimizing nipple placement. Stage 2 procedures can be completed in a 2-hour MAC anesthesia in an outpatient setting.
Areolar reconstruction will be completed as a Stage 3 procedure in 2 months in the office.

DIEP flap breast reconstruction has been associated with mild buldging of the abdominal wall but with a significantly decreased rate of abdominal wall weakness or hernia. It has not been associated with post-operative back pain. Common complications are seromas or collections of fluid under the skin that may require needle aspiration.
DIEP total flap failure can be seen in less than 1% of cases.

DIEP total flap failure is diagnosed prior to your release from the hospital. Most patients with a failed DIEP flap undergo a secondary microsurgical flap procedure during the same hospitalization or at a later date, typically at 3 months, in the form of an I-GAP flap.

DIEP partial flap loss is commonly referred to as fat necrosis. Fat necrosis can present as a firm area of the breast reconstruction flap where the blood supply was not adequate enough to keep the tissue soft and viable. It likely represents an anatomic variant of the individual (not unlike a "hole" in your Christmas tree), OR possibly the poor choice of the perforating blood vessels to support the flap reconstruction.  To avoid fat necrosis a pre-operative CT or MR angiogram is done so your procedure can be based on the most robust blood vessel of your abdominal wall.

PS In case you were wondering, I do NOT recommend googling a video of this.

PPS The mammogram came back - stable mammographic appearance.  No new concerning microcalcifications.  Benign Findings
Another Wahoo!!!

Where Is My Epiphany?

Where Is My Epiphany?
By Nancy Stordahl

Do you ever wonder what great lesson(s) you’re supposed to have learned from cancer?
I have wondered.
This is another cancer expectation that’s out there and continuously perpetuated.
We’re supposed to learn from, and therefore potentially be grateful for, the life “detour” that is cancer are we not?
We are supposed to be transformed into a new and improved version of our former selves, right?
I often read articles about cancer survivors proclaiming to be transformed, enlightened, improved upon, bettered, or whatever.
It seems many have experienced some sort of epiphany.
And I’m happy for those individuals.
 I mean that.
That is not sarcasm.
But it just hasn’t worked out that way for me.
 
Sometimes I wonder if perhaps I’m a slow learner or something.
Sometimes I wonder if someone forgot to give me my copy of the, “how to properly do and learn from cancer,” handbook.
That is sarcasm.
After five years, actually after ten years if I count my mother’s cancer experience,
I sometimes feel I should be enlightened about many things by now.
About what I have no idea.
I wish I did.
I really want to know…
  
And what is an epiphany anyway?
In this context, it’s generally defined as a revelation, a sudden manifestation, or realization about the meaning of something; an illuminating discovery.
Well, that has not happened for me.
Sure I have picked up some nuggets of wisdom during the past five years, but a lot, maybe even most of the stuff I have learned from and about cancer, is totally shitty stuff.
In fact, I was thinking about writing a blog post with that exact title – 10 Shitty Things Cancer Has Taught Me – or something like that. There are way more than ten things too.
But I probably shouldn’t publish such a post if I should end up writing it.
Maybe I shouldn’t have even published this one.
Because you know, the positivity police are always out there.
Okay, so I’m being rather sarcastic in this post and cynical and maybe even a little grumpy.
So what?
Sometimes I get weary of all the cancer expectations and cancer language nonsense out there,
much of which makes no sense to me.
And okay, sometimes I get cranky too.
And I sure would like to know…
Where is my epiphany?

I feel this way a lot.
What am I supposed to be leaning from all of this.
Is there something to learn.
Or does it all just suck and it's bad luck.
Is there a reason for all this.
Actually I think I have more questions than ever,
and a lot fewer answers.
At least I hope I have become a more understanding and sympathetic person,
not just more tired one.

A Battle NOT Lost

For the last little while I have been following the Joey+Rory story.
They are a husband and wife country singing duo.
I have never heard anything like her voice.
Calm, inspiring - just amazingly beautiful.
If you haven't heard her sing, youtube their name.
(I especially love these songs - That's Important to Me, In The Time That You Gave Me and When I'm Gone)
She has been in the news a lot since she was diagnosed with cancer. 
It spread even though she did everything the doctors told her. 
She endured the surgery, chemotherapy, and radiation.

Her husband has been writing about her journey, his feelings and their family.
(http://thislifeilive.com/)
He is an amazing writer.
I usually cry when I read his updates.
I think it is amazing to be able to convey that much love and feelings into words.
I hope to aspire to that one day.

This is an excerpt from one of his latest blog posts:
 
In the 40 short years that Joey has lived, my bride has accomplished many great things… she’s lived a very full life.  But even more than that, she has loved those around her greatly and been loved greatly in return.  I can honestly say that Joey’s isn’t just a life well-lived, it’s a life well-loved.

God only gives each of us a certain amount of time to be on this earth and every day when we wake up, we get to decide how we are going to spend those precious minutes and hours.  There are no do-overs, no second-chances, no next-time-arounds to get it right.  Joey knew this and she has made each and every day count. One of the last things Joey said before she drifted into the deep sleep she’s been in for a few days now is, “I have no regrets… I can honestly say, that I have done everything I wanted to do and lived the life I always wanted to live.”

The day she passed away I saw on the news feed that someone wrote, "She has lost her battle with cancer."

For some reason that wording bothers me.

Saying someone lost makes it sound like they didn't fight. 
She was giving all she had to be with her daughter and husband.

Saying it was a battle makes it sound like she signed up for it.
NO one would ever sign up for this kind of "battle".

I read this somewhere -

When I die don’t think you’ve lost me.
I’ll be right there with you, living on in the memories we have made.

When I die don’t say I “fought a battle.” Or “lost a battle.” Or “succumbed.”
Don’t make it sound like I didn’t try hard enough, or have the right attitude, or that I simply gave up.

When I die don’t say I “passed.”
That sounds like I walked by you in the corridor at school.

When I die tell the world what happened.
Plain and simple.
No euphemisms, no flowery language, no metaphors.

Instead, remember me and let my words live on.
Tell stories of something good I did.
Give my children a kind word. Let them know what they meant to me. That I would have stayed forever if I could.

Don’t try to comfort my children by telling them I’m an angel watching over them from heaven or that I’m in a better place:
There is no better place to me than being here with them.
They have learned about grief and they will learn more.
That is part of it all.

When I die someday just tell the truth:
I lived, I loved, I died.
The end.

I am not sure why their story has reached me so deeply.
Maybe because I just hate cancer.
Maybe because she was about my age.
Maybe because she had a young child.
Maybe because she seemed like such an amazing person full of grace, love and faith.


I hope to aspire to be like her.

In the Clear

So if you didn't see my Facebook post a while ago -
The MRI came back all clear.
Wahoo!!!!!
(The waiting just about killed me though.)

They found no visible signs of cancer.
They did see a little disk degeneration in my neck
and sinusitis (a sinus infection),
so I got another prescription to take,
but no real reason as to why I am having these constant headaches.

I see my oncologist in a month and we will talk about further options then.
I am guessing he will offer me another medication,
which I will decline.
Or maybe I will get it filled just to have on hand when they get really bad.

Other than that, life continues.

Gage is getting so big and into everything.
He acts like he doesn't hear the word "no".
Alyssa is loving school and dance.
She is starting to get a little attitude.
Kaden is the best kid.
Such a great helper.
Abby is getting very independent.
I can't wait until she can babysit!
Ryan is working hard as always.
Just finished the Parade of Homes.
Hoping to see him at our home a little more now.

Spring is almost here and I am not ready for the summer.
I actually love the winters here.
Here's to hoping for a vacation soon.

The Price of Peace of Mind

It's nothing.
It will go away.
I am fine.

Well, maybe it could be something.
What if it is?
What if it's bad...

These thoughts run through my head all the time.
If get an ache or pain or headache.

A headache that lasts for weeks.
One that will not go away.

I want to remain positive and hope that it is nothing.
But I also know the reality and statistics of my type of cancer returning.
I really don't want to be blind-sided again.

So today I went in for a MRI of my head and neck.
I really don't like MRI's.
The contrast as it is injected hurts,
the machine is beyond loud,
and laying completely still in a metal tube is claustrophobic.

Should I be worried that after I told my doctor my symptoms, he put a rush status on it? 
I needed to be seen within 2 days!
The poor techs had to give up their lunch because they were booked and
noon was the only time it could be done.

Answers will be nice.  Although I am not sure I really want to hear what they are.
The doctor should call me before close of business tomorrow.
Or I can call on Thursday.

So much for my New Year's resolution.
I was hoping to not meet our high deductible again this year.
I guess that is what peace of mind is worth.

Something For Me

Just a little present I bought for myself.

Four hand-stamped silver bracelets.
   Survivor
  ♥ Fighting For My Family♥
  ; my story isn't over yet
  ~ Don't look back, you're not going that way~

I really like looking down at them.
Simple, yet they make me smile.

Your Hair Looks Great

Guess who had a haircut!
Ok, I don't really think I can call it that, maybe a trim.
Nope, probably not that either.
My friend, who also does hair out of her home, cut a tiny bit of hair off the back.
Maybe between a 1/4 and an 1/8 an inch.
Almost not worth mentioning,
but I was excited about it.
It is starting to get a bit mullet-ish looking.
Ryan does love my afro when I wake up though.

I read this the other day and thought it felt pretty actuate, kinda long and a little harsh, but true.
I am struggling with the way my hair looks.
Even though everyone tells me it looks cute, I don't think so.
I don't really feel like me when I look in the mirror.
I miss hair clips and pony tails.
I miss my long hair.

Your Hair Looks Great
By Beth J. Caldwell
When I was a senior in college, I went home for winter break and decided I wanted to cut off my long hair.
It had been long for a few years, and I just wanted to do something different with it.
So, I went to my mom's salon and told the woman I wanted it cut short.
The conversation went something like this:

Me: I want to have it shorter.
Her: Super! You'd look great with a shoulder-length style.
Me: No, I mean short.
Her: Like a chin length bob?
Me: No, short. Like, above my ears. You know, short.
Her: Did your boyfriend just dump you?
Me: ...uh, no, I've been single for a while now.
Her: Are you flunking out of college?
Me: What?!?! No!
Her: Are you coming out or something?
Me: No, I'm straight, why do you keep asking me these questions?
Her: Because usually when people want to go from long to super short, it's because they had something bad happen or they're trying to make a big change in their lives.
Me: Wow. No, the only change I want to make is to the actual hair.
Her: Are you sure? Because, if I cut it that short, I mean, it'll take a long time to grow back out.
Me: Yeah, I'm sure. Seriously, can I just have it cut now?

Honestly, I got asked less questions by the minister when I was getting married than when I got that haircut.
People take their hair super seriously. A lot of our identity is tied up in it.
Which is why it seems to be the thing that people focus on when cancer happens.
I never really thought about it that much until my hair fell out during chemo last spring and
suddenly, my hair, or lack thereof, was a subject of conversation all the time.

I hate my hair now, because it wasn't my choice.
I didn't get asked 10,000 questions by my oncologist about whether I was sure I wanted to go bald.
Instead, he just told me the chemotherapy drugs would make it fall out.
Cancer does that to you.
A lot of the choices you used to get to make, you don't anymore.
Hair is just the most visible one of them.
I get zillions of compliments on my new 'do.
Even when people know I hate it, and even when they know I don't feel better
when they talk about my hair, they seem to be unable to stop themselves from saying how awesome my hair looks.
I get told I look great by practically everyone I know.
I have been trying to understand why people seem to have such a need to comment on my appearance.
Why do we tell the cancer patient "you look great"?
Why do we celebrate when a cancer patient doesn't look like Skellator?
I think it's this: When you have cancer, or any other life-threatening or terminal illness, people want you to be well.
They love you, and they don't want you to die.
So, they cling to every scrap of hope that you are going to beat your disease, and looking like you're not dying gives them that hope.
But the truth is, you can't tell that someone is going to be cured just by looking at them.
Lots of us folks with metastatic cancer are living with our disease for now, and we look and feel OK for now, but the truth is that we're going to die of this unless there is a miracle breakthrough in our now-shortened lifetimes.
That our hair is growing back isn't necessarily the sign of wellness people assume it is.

And for me, living with everyone else's hope is hard. I'm living with my doctor's hope that science will find a cure in time for me, when we don't seem to be putting enough resources into research. I'm living with my husband's hope that we'll die together in a nursing home in our 90s, when even the most optimistic estimates of my life span rule that out. I'm living with my former coworkers' hope that I'll get well and come back to work with them, when I am probably going to be too busy with doctor appointments the rest of my life to ever hold down a job. I'm watching everyone around me needing to hope I will be well and somehow beat this thing, but knowing I will let them down someday.

And so they say how great I look right now, and how cute my hair is, because they have hope. And inside I want to scream. I want to say, "Wake up! This is going to kill me. There is no silver lining to this. It's not cute. Every bit of this is ugly. Every bit of this is ugly." But I don't say it, and instead, I make small talk about how lucky I am to have a nicely-shaped head.
And I hope it won't be too hard for them when it turns out that looking good can't cure your cancer.

Where Am I

Out having fun.
Over the last month we have been 4-wheeling
at the sand dunes, hiking in Zions
and skiing at Brain Head.
Yep, I went skiing!
It has been 8 years and it was awesome.

Most days I feel pretty good.
Bruises are all gone.
Still a little sore.
A few side effects from the meds,
but they are manageable.

I will try to remember to update this blog once in a while,
but if you wanna know what we are up to - go to the family blog.

http://ryanloveskimrosenberg.blogspot.com

Laugh, even when you feel too sick or too worn out or tired.
Smile, even when you're trying not to cry and the tears are blurring your vision.
Sing, even when people stare at you and tell you your voice is crappy.
Trust, even when your heart begs you not to.
Twirl, even when your mind makes no sense of what you see.
Frolick, even when you are made fun of.
Kiss, even when others are watching.
Sleep, even when you're afraid of what the dreams might bring.
Run, even when it feels like you can't run any more.
And, always, remember, even when the memories pinch your heart,
the pain of all your experience is what makes you the person you are now.
And without your experience---you are an empty page, a blank notebook, a missing lyric.
What makes you brave is your willingness to live through your terrible life and
hold your head up high the next day. So don't live life in fear.
Because you are stronger now, after all the crap that has happened,
than you ever were back before it started.
― Alysha Speer