The curve ball

Things were going along as they should.  I was getting everything in order, all my ducks in a row.  I had my last 21 days before surgery planned out nicely.  Then, I got the phone call saying they were moving my surgery up to Tuesday, July 10th.

Argh!!! I'm not ready!!! Especially on an emotional level, I am still sorting this whole thing out in my mind and trying to accept it all.  I have lots of things I need and want to do before this chapter in my life ends.  Boy do I hate Hal right now!!  I learned a long time ago that life is not fair, but that doesn't mean things like this aren't upsetting.

This really blows!!!

A little normalcy

My sister is in town for a little fun and normal life activities.  A night of Euchre, see a live comedy show, hanging out at the beach, some surfing, a softball game, hanging out with friends, and a little shopping.  Nice to have a fun weekend to take my mind off things for a little bit.

Found this guy to be my recovery buddy.  Hello R.B.

Date is Set

I got the call today with my surgery date, Tuesday, July 17th.

Reality is slowly setting in.  This is going to happen and now there is an actual date.  Don't feel so good.

Decision Time

Back at the Saul & Joyce Brandman Breast Center at Cedars-Sinai.  Today is decision day.  Again my sister is with me and I brought my journal of questions I had come up with over the weekend.


We discussed the test results from last week.  Everything seems normal, I have fibroids in my uterus (already known) and there was an enlarged lymph node behind the breast.  The doctor explained that it could be the result of the breast biopsy.  She reminded me they will be doing a lymph node biopsy during surgery.


We discussed my questions and my goal for the outcome of all this: to again be able to participate in the various activities I enjoy.


I am definitely going forward with the mastectomy, again 9cm does not leave much left of my breast.  I am choosing to do the breast implant surgery for reconstruction.  It is the least invasive to the key muscles that I use to do all my activities.


I also agreed to let the research team use Hal for future breast cancer studies.  I certainly don't want or need Hal any more and if something good can come of this down the line then so be it.


Then came the run down of all the things to prepare for surgery and recovery.  Again, lots of information good thing it's pretty much all written down for me.

So on we go.

Into the Abyss

An old family friend got it right.  I don't like options, especially options with uncertainty attached.

I'm already bummed that I have to give up the rest of my precious summer of fun activities for this disease.  Now, I have to decide how I'm going to get back to doing these activities.  Yet, I have no idea how any of these options is going to turn out.  Perhaps it's uncertainty that I don't really like.

What to do?  I can go the route of no reconstruction.  What does that mean?  Living my life with one breast.  It's very hard to imagine.  Swimming, surfing, softball, basketball, etc., all my various weekly activities with just one.  But, all my muscles will be intact and I can get back to doing the things I love.

The other route isn't very cut and dry either.  My choices are to have my muscles (abdomen or back) cut and moved to my breast area, or have my existing pectoral muscle stretched over a few weeks.  I like my muscles, I use my muscles in all my activities.  But, I'll have two breasts.

Again, there are no guarantees in life.  And not know how long any of this is gonna take is driving me crazy.  With all my sports injuries I was always given a time frame of how long it would take to heal and when I could get back on the court, on the field, in the pool, etc.  But with this, there are no time frames.  There are still so many unanswered questions, will I have to do other treatments, will I get my strength back in my arm?  It's scary to thinking about what is ahead of me.

I have a lot to ponder before my next appointment.

A day at the S. Mark Taper Imaging Center.  First up an IV hook-up and an intravenous injection of Technetium 99m Medronate (basically a shot of radioactive material) for the whole body bone scan.  While this material travels through my body I get to ingest this lovely "smoothie" (pictured) for the CT Abdomen scan.  They really should not call it a "smoothie", it tastes nothing like any smoothie I have ever had, in fact tastes like chalk.  Next, I get to sit in a waiting room, IV still in my arm, for about an hour while all these lovely chemicals travel through my body.

CT Abdomen scan is up first.  Big machine, makes lots of noise, room is cold.  Next is the CT Chest scan.  They send contrasting agents through my IV for this test.  It creates this weird internal warming sensation from my head to pelvis region.  Very strange.  Both tests take about an hour to complete.  Afterwards, I am escorted to another room with another big, noisy machine for my whole body bone scan.  This takes about 45 minutes of lying completely still while the giant machine moves over my body.

After I am finished at the Imaging Center, I walk across campus to have my first meeting with the plastic surgeon.  Once again I am being inundated with a ton of information.  He briefly explained the three options for breast reconstruction available to me:  1. Breast Implant surgery which involves stretching the pectoral muscle out by filling a balloon like pouch with saline over a few weeks time, then inserting either a silicone or saline implant.  2. TRAM Flap procedure that relocates abdomen muscle and tissue up to the breast area to form a new breast.  3.  Latissimus Dorsi Flap procedure where they cut part of the latissimus dorsi muscle in your back and move it to breast area to create a pocket for an implant.

My head was spinning after all this information was spewed at me.  My biggest concern that I expressed with the doctor was my ability to be able to do all the physical activities that I enjoy, i.e. swimming, surfing, softball and basketball.  I felt like I threw him a curve ball.  Basically his answer equates to: like life, there are no guarantees to whether or not my muscles would recover 100%.

So off I go to ponder what will be the best option for me.  I am not happy.

Plan of Action

My first appointment with the breast surgeon at the Saul & Joyce Brandman Breast Center at Cedars-Sinai.  I brought my sister along for support.  And it was a good thing, the information started flowing and my head started spinning.  My sister was able to listen and ask some questions along the way.  I was pretty useless in that department.  I'm not sure I heard half of what the doctor had to say.  A treatment plan was being formulated as we spoke.

After a quick exam, we reviewed my records and looked at the mammogram films.  She told me my cancer was at least a stage II, further testing after surgery will determine exactly what stage it really is.  She then took out a tape measure and showed me how 9cm looks, basically it's a lot when you hold it up to your breast.  My two options were either a lumpectomy or a mastectomy.  With the lumpectomy comes six weeks of radiation, mandatory.  With the mastectomy, radiation or chemotherapy would be determined after they take out the tumor and surrounding calcified tissue, plus do a sentinel lymph node biopsy.  If everything is clean, I wouldn't need either.  I will have to take tamoxifen for five years because my cancer is hormone based.  If I go with the mastectomy I can do breast reconstruction or a breast prostheses, neither of which sound appealing.

Since the size of the area that needs to come out, the first decision (albeit, a sucky one) was easy.  I will go with the mastectomy.  Having told the oncologist this, she then set up a referral for a plastic surgeon to discuss my options.  Appointments for pre-op testing were made for Monday.

And so it begins.  This is really happening.