A Doctor’s Musings on His Terminal Illness

Just want to share this NYTimes article, How Long Have I Got Left?, because it is so beautifully written and insightful. My favorite quote is:

“I began to realize that coming face to face with my own mortality, in a sense, had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.”

Speaking at Survivor Luncheon

This month, I had the privilege of participating in the George Washington Breast Care Center Survivor Luncheon. It was a beautiful event celebrating the patients from the Breast Care Center – with great company, great remarks, and last, but not least, great food.  I was honored to be asked by my surgeon, Dr. Christine Teal, to sing, but I also said a few words about my experience.

Andrea Roane, anchor of a local TV news station and champion of breast cancer awareness in DC, and I.

Here are my remarks, here’s a video of me singing! Sorry for the tilted-ness and sound quality. My dad took it from his cell phone.

“Hello. I am so honored to be participating in the program today. I was diagnosed with breast cancer in March of 2011 and, though I’ve been out of treatment and surgeries for almost a year, I am still trying to find out what being a survivor means. I still feel fear and sadness on a regular basis, as I’m sure many of you can relate to, and that makes calling myself a survivor difficult.

During last year’s luncheon, they played a video profiling my story and featuring the wonderful people at the Breast Care Center. I was so grateful to be able to share my story, and I hope that people found it powerful. The video described that my cancer was genetic, from the BRCA 1 gene mutation passed down to me by my mother, who unfortunately passed away from the disease when I was just 3 years old.

For me, the most moving part of watching my video at last year’s luncheon was seeing my mother on the screen. She could have never known that her story would be broadcast to so many people she didn’t know, but people she had something in common with. And that really made me feel like the video was not just about me, but also about her. It was a way to tell a story that she never got the chance to tell.

I relate that experience to a similar experience I had in September. I was lucky enough to go on a trip with First Descents, an organization that takes brings young cancer patients and survivors on week-long adventure trips. I was rock climbing in the beautiful Colorado Rockies, and on our last night, we had a ceremony where we all floated a candle on a small pond to honor those who weren’t able to be with us. I, of course, thought about my mother, and I found myself thinking that I was on the trip both for myself and for her—because she never had the chance to be a young survivor and go rock climbing in Colorado.

I see a theme emerging in both of these examples. There are so many people who were not given the chance to survive, and that makes it so much more important that us survivors live each day like it is precious. We’re here to celebrate surviving, and I don’t think we can do that without remembering those that we’ve lost, and being grateful each day that we have the opportunity to continue experiencing all the beauty, joy, and even hardship that life brings us.

As much as I like philosophizing, I’m actually here to sing. I’ve been singing my whole life. As a child, I’m sure much to my parents’ chagrin, I belted out Disney tunes at any given opportunity. Much to my boyfriend’s chagrin, things haven’t changed much. During treatment, singing and listening to music provided a great tool for channeling my sadness and cheering me up.

I’ll be singing, “You Walk with Me,” from the musical The Full Monty. One of the characters in the show sings it at his mother’s funeral, so of course I think it is a fitting tribute to my own mother and to anyone who couldn’t be with us today, but who we still keep close to us to remind us that we have been given a gift that not everyone receives.”

Basser Research Center will focus on BRCA

This is fantastic news. Dr. Domchek was my oncologist in Philadelphia, and she is a wonderful and renowned researcher in the BRCA field. I couldn’t be happier that my hometown is getting this research center. I hope to be able to participate in whatever research they have going on in the future (as a survivor, of course – I’m kind of done with the cancer patient thing and don’t plan to do it again).

Doctor, Doctor

I’ve seen a lot of healthcare professionals recently. That included:

  • my oncologist for my regular appointment (I see her every three months, and this was the second post-chemo check up),
  • a gynecologist for a well-woman exam,
  • a nutritionist for some diet advice,
  • and a general practitioner because, well, I guess I felt it was important to have a GP.

And next month I have a dentist appointment and an appointment with Medical Faculty Associate’s Survivor Clinic.

On one hand, I tell myself I need these appointments. I need a gyno. I need a GP. I need clinical advice from a nutritionist. But on the other hand, I wonder if it’s too much and I’m doing it as a subconscious way to ensure that the healthcare world doesn’t forget about me.

“Hey, I’m still here. I had cancer; it might be gone now, but I still need attention and to be close to those who can care for me if I need care.”

It’s also a bit confusing because sometimes I’m not sure what doctor can play what role in my care. For instance, does seeing my oncologist every three months substitute for seeing a GP every year? Is seeing a gynecologic-oncologist the same as seeing a gynecologist? And can someone please be my personal assistant to keep track of all this crap?

Where is a girl to find answers?

 

The Number of…

Days since my double mastectomy: 34 (passed the month mark!)

Days since my reconstruction surgery to remove a large area of dead skin on my left breast: 10

Days since my egg retrieval: 4

Embryos my boyfriend and I now have frozen: 4

I almost never thought this day would come. Two weeks ago, on the night before my revision surgery, I could hardly breathe and hardly sleep. Everything was overwhelming me and making me anxious. First off, I was injecting a lot of hormones into my system as part of the in vitro course to prepare for my egg retrieval. On top of that, I had been so happy with my reconstruction results but it was all going to hell in a handbasket because there was a large area of dead skin on my left breast right under my nipple. The area was so large that my plastic surgeon couldn’t even say with any certainty how she would sew me back up after removing it, or that she would even be able to at all – I could have new scars, a vacuum that would require several days in the hospital, or a flap – and I had no idea what I would come out of the surgery looking like.

Well, it wasn’t that terrible. She was able to remove the skin and sew me back up using the same incision made for my mastectomy. Sure, my left breast is now flat making me lopsided and my nipple is way down at the incision line, requiring a couple more revisions to put it in the right place, but I’m banking on the fact that she’s a good surgeon and I’ll have a good final outcome no matter what.

It still really sucks that I have to deal with this complication, though. So many bloggers post pictures of their beautiful new breasts and I guess I just thought, since I’m young and resilient, things would be easy-peasy. Now that the breast cancer is gone from my body, I have my whole life to look forward to and appearances count. I don’t want to live with a deformed chest – but I’m confident that I won’t have to – even if things don’t return to normal until a year from now.

The news that I was able to bank 4 embryos was extremely exciting. Before the retrieval, I felt very disappointed that my ultrasounds only showed 7 big follicles. A young woman like me should have 20+, so what the hell was my problem? My parents said it was stress, and my doctors also pointed to the fact that BRCA1 seems to be linked to early egg depletion. Great. Not only is my biology trying to kill me with breast and ovarian cancer, it’s also trying to prevent me from having my own children.

We hoped that all the follicles would yield eggs; no such luck. Only 4 eggs were retrieved. But the next day my doctor called and gave the good news: 100% fertilization success. Overcoming great odds, all 4 of my eggs had fertilized! That’s 4 chances at a pregnancy if chemo renders me infertile, which I’m hoping it won’t in the first place. Will and I refer to our embryos as our “frids” (frozen kids), and it’s a little strange to think our possible future offspring is waiting for us in some liquid nitrogen column in West Philadelphia.

Whew. Revision surgery is out of the way. Retrieval is out of the way. Healing is going really well (now). What’s next? Moving back to DC, getting back to work, and starting chemo. I wouldn’t say I’m looking forward to any of it – lazing around with my parents, who are excellent cooks, has been great and chemo will probably suck, but it’s the next step in the process and it means things are moving along as they finally should.

And it was great to come downstairs for breakfast and see this article about the Philadelphia Susan G. Komen Race for the Cure on the front page of the Inquirer.

Surgery Update

My bilateral mastectomy was on Tuesday afternoon – but before I say anything about that, I just want to thank all of the wonderful people who reached out to me and expressed support on my blog. Though I don’t know you personally, it is amazing to know so many people care about me, understand my situation and my decisions, and are sending thoughts, prayers, and positivity my way.

And now – I am recovering from surgery. One reason I ultimately chose to have my surgery in DC with the surgeons Dr. Teal and Dr. Lenert from GWU is because they could fit me in so quickly. I was diagnosed on March 21st, and today, on April 8th, I am already three days out from surgery. Wow.

I am feeling good, too, and so so happy with my surgeons and team and all of the nurses and techs who took such wonderful care of me at the hospital. I was definitely anxious leading up to the surgery, but things were happening so fast and I decided to continue to work, so my mind was distracted. On Tuesday morning, I was definitely filled with trepidation. In the morning I had an injection of radioactive material into my right breast to locate my lymph nodes, and it hurt pretty bad. There were three very small needles that the doctor inserted under my skin around my nipple, and what stung was the actual stuff that they injected. Not pleasant, but it was pretty cool when the tech showed me the picture of how my lymph nodes lit up.

From there I was taken up to the pre-op ward, where I had to undress, answer a lot of questions, and meet with my surgeons and the anesthesiologist. The anesthesiologist asked if I wanted some “happy meds” to take my anxiety away, and boy did I! Once that started in my IV, I felt a bit lightheaded and then… blackout. I remember nothing until I woke up on my back and a guy next to me (a nurse? Surgeon? Who knows!) said, “You’re done!”

I hung out in post-op for a while with a wonderful nurse named Amelia, and my family came to visit. My brother, stepmom, dad, and boyfriend were there and it was great to be with all of them – and be on pain meds which allowed me to be happy about the whole situation.

The first thing I wanted to know out of surgery was the diagnosis on my lymph nodes. Luckily, the breast surgeon said the preliminary reports indicated they were clear of cancer. I was THRILLED to hear that, though we’re still waiting on a final pathology report. Also, I though “sentinel lymph node” meant only one, but apparently I had 8 sentinel lymph nodes and they took out all of them. Interesting.

I spent two nights in the hospital with very little sleep – a) I cannot sleep on my back and b) people are constantly coming in and out to check on me, administer antibiotics and anti-clotting medication, and give me pain meds.

And now I am in a hotel room with my parents continuing my recovery. I do feel a lot of tightness and soreness in my chest and I’m a little afraid to look at my boobs because they are so different and bruised, but other than that I feel very positive and good.

I hope that I will be able to blog throughout this situation, not just because it’s therapeutic for me, but because I want women to be able to hear what this is like.

Happy St. Biopsy Day!

I just wrote a huge post on my biopsies today and it was erased for some reason. Dammit. It was good, too! I will try and write another one because today I had both an MRI-guided core biopsy and an ultrasound-guided core biopsy, and of course I want to share the wonderful experience with you all. In the meantime, enjoy this:

Dance a jig, girlie, your biopsies are over... the rainbow!

Cool Cancer Genome project at Vanderbilt

This is a really cool website that, although it’s very new and doesn’t yet mention breast cancer, I think is worth checking out. It’s designed for clinicians to help them get a full picture of cancer genetics.

My Cancer Genome

Given the amount of doctors that don’t seem to know anything about the breast cancer genes (!), I think this is a great tool and I hope more hospitals and cancer centers start to offer it so our doctors can be better informed.

And My Boobs Emerged, Unscathed

Well I just got home from my first ever mammogram. I was pretty nervous going into it but I have to say: it was nothing.

Seriously. Here’s the blow-by-blow, for your reading pleasure: First I had to take my shirt off and put on a gown. Then I went into the room where the machine was, and the woman told me they were going to take four pictures. She arranged my breast on a platform and kind of pushed and pulled me around for a second, making sure I was in the right position. Then a plastic plate descended onto my breast, and pushed it flat. It felt a bit strange and there was some pressure, but it did not hurt. When she was satisfied, the tech moved to the computer and told me to hold my breath while she captured the image. This was probably the hardest part, but it was only a second or two until I was done. This process repeated three more times (they took 2 images of each breast) and all together I was in there about 5 minutes. Then I was done. Completely. I didn’t even have to pay a copay!

Now, as others have indicated, the hard part is waiting for the results. I might have to go in and get some more images taken, especially because I am young ang this was my first mammogram ever (they’ve got nothing to compare it to). So we’ll see what happens. I can’t say I’m too nervous – the likelihood of me having cancer at 25 is miniscule – but it’s still a possibility.

After the procedure (if you can even call it that) I went shopping. Yup, I dropped about $150 at Gap and Anthropologie. I considered it a girly reward for doing my girly duties.

Also, I wanted to share this picture. Before the mammo I had to clean the deoderant off my armpits with this aptly-named tool:

For all your memmo-wiping needs
Love whoever came up with that brilliant product name.