Friday, January 23, 2009

Cleavage Donations

Week 12: Hey everybody. How's it going? First, I wanted to let those of you who've asked how to post a comment to my blog that all you need to do is click on the title shown above the post. A comments block will open at the bottom of the window, then you're free to type away! You can always email me privately if you want to keep it personal or confidential, but otherwise posting your message will save you a step. Ask me any questions, share information, tell a joke, or share your own stories...write whatever you want. I'd love to hear from you. (And I promise I won't vote you off the island unless you're a meanie who writes bad things.) I've also had several people cheer me up by volunteering to donate their surplus "tissue" to me. I actually thought about that, except tissue from elsewhere on my own body, thanks. I think I mentioned before that the plastics doc told me that once the muscle in the abdomen is cut or lifted or otherwise compromised, she can't use it...which is what happened with my appendectomy. My back, on the other hand, is my sacred cow and messing around with it is strictly a last resort. So I asked the doc why she couldn't just use the skin from my thigh or arm as a patch over the area where the cancer is cut out. (Better yet - instead of skin from my limbs, give me a butt-lift and use the leftover skin from that! The problem with that youthful vision of mine is I wasn't blessed with any junk in the trunk. "Baby don't have 'back," so there's no underlying tissue I'd be willing to part with.) Nothing to spare from my derriere doesn't really matter though. The doc told me that taking skin alone won't work because the skin needs a blood supply. With all of my breast tissue removed, there won't be any stuffin' left to graft the skin to -- which means there won't be a source of blood supply -- and without a blood supply the skin will die. Essentially, the skin, muscle, fat and blood supply all has to come as a unit that can't be severed and then re-attached. (At least that's my interpretation of what was explained to me.) So to clear up the confusion I've probably caused now, if the tissue from my abdomen or the tissue from my back was to be used, it wouldn't be detached, moved and re-installed. It would remain attached to the veins/arteries that are feeding it (like being on a leash), then pulled through my body and brought back up to the surface to be stitched into place. Again, that's my interpretation of what was explained to me, but I could be one of those quack cancer-patients you hear about who doesn't know what she's talking about.

Wednesday, January 21, 2009

Finding Inspiration in a Song

Week 12: This week I added a link to the song "It's Not My Time." I don't recommend that you easy-listeners set the volume on your speakers too high if you plan to click on it. Don't let the soft beginning fool you. I'm keeping the song handy because I hope it will help me keep what's important in perspective. If I'm going to survive, I can't let moments of despair derail me. When I'm feeling down and out, I need that inner voice to remind me, "I'll be damned if I'm going anywhere." The song is by Three Doors Down. You might need to open another window, then click on the link and sing goes like this:
"Looking back at the beginning of this And how life was Just you and me and love and all of our friends Living life like an ocean But now the current's slowly pulling me down It's getting harder to breathe It won't be too long and I'll be going under Can you save me from this? 'Cause it's not my time, I'm not going There's a fear in me, it's not showing This could be the end of me And everything I know, Oooh, I won't go I look ahead to all the plans that we made And the dreams that we had I'm in a world that tries to take them away Oh, but I'm taking them back 'Cause all this time I've just been too blind to understand What should matter to me My friend, this life we live It's not what we have, it's what we believe And it's not my time, I'm not going There's a fear in me, it's not showing This could be the end of me And everything I know But it's not my time, I'm not going There's a will in me And now I know that This could be the end of me And everything I know, Oooh, but I won't go I won't go There might be more than you believe (There might be more than you believe) And there might be more than you can see But it's not my time, I'm not going There's a fear in me, it's not showing This could be the end of me And everything I know But it's not my time, I'm not going There's a will in me and Now it's gonna show This could be the end of me And everything I know There might be more than you believe (There might be more than you believe) And there might be more than you can see But I won't go, Oh no I won't go down Yeah"

Let's Get This Show on the Road

Week 12: I finally heard back from the scheduling office about my surgery. My cancer surgeon and my plastic surgeon only have one hospital in common, so it was more challenging than usual to schedule a time that both could be there. One to cut me open, one to sew me up. Now I wait. I have to be at Fair Oaks Hospital at 6:30am on Wednesday, January 28th. Hell, that's so early I might as well spend the night and have them roll me in when they're ready. My sleep resumes on the operating table at 8:00am. Maybe this time I'll actually pack those Heinekens that I told my sister I had for my mastectomy. That was during my post-op haze, but it goes to show you what I must have been dreaming about. If I can sip Bailey's in the line to see Santa, surely I can have a beer in the recovery room when I wake up from surgery.

The Spirit of Christmas

Weeks 10 and 11: Christmas and New Year's flew by so fast this year. We took Stephanie to see Santa for the first time. I never bothered to take her before because I was pretty certain she'd be too timid. But this time she had the support of her cousins. After her bowling party for her 7th birthday, we went up to Merrifield with my sister and my brother-in-law, who had visited the same Santa during his childhood. We were literally the last in line before they closed the door. The wait was about two hours. We sent Mike out on a beverage run. He came back with Bailey's, Jack Daniels, Coke, and a couple of Arby's sandwiches. It sure helped pass the time and made the event more memorable. Not many people I know would have enough daring. It was fun! Another highlight was when my two-year old niece told Santa she wanted a doll that poops. Santa wasn't epxecting that one! Stephanie wanted a Dallas jersey, but when Santa looked over and we shook our heads no, he told her, "I don't think so...this is Redskins territory." Whew, what a save! Quick thinking, Santa. New Year's Eve was spent over at my in-laws. Mike's aunt and uncle were in town. We had a great time. We played a very competitve, slightly drunken game of bowling on the Wii system the family got for Christmas. We hooted and hollered and shot silly string everywhere to ring in the New Year, and topped it all off with a nightcap in the hot tub/spa. Our wet hair froze, but no one seemed to mind. Thoughts of cancer, at least for a little while, receded to the background.

Love Is Where It's At

Week 10: According to Love's book, the stats for my situation are as follows: - Forty to sixty percent of local recurrences occur at the original site. (Okay, so I'm relatively "normal.") - The risk of this happening in the first place, however, is only ten percent. (Evidentally, I'm among the unlucky.) - Approximately ninety percent of these recurrences happen within the first five years. (Amazingly, mine is right on time.) - Approximately eighty to eighty-five percent of women with a local recurrence eventually develop distant metastases. (Unless I manage to get into the other fifteen to twenty percent who make it through a recurrence without metasases, I'm looking at an early death sentence.) - To top it off, I quote: "Studies, both randomized and nonrandomized, have suggested, however, that if the recurrence can be removed and radiation given, the addition of systemic therapy such as tamoxifen or chemotherapy can lead to five-year remissions of thirty-six to fifty-two percent." (Where does this leave me?) It leaves me pissed-off and heartbroken, that's where. I can have the tumor removed, but since I had radiation the first time, I can't have it again. And because my "receptors" are negative, tamoxifen won't work on me. Can I make it another five years? I'd like to think by some miracle, I'll end up in whatever bracket suggests a longer period of remission. As much as I'd like to include a corny anecdote here, I can't identify any humor in this to mask the devastation I feel, and to try to keep my spirits up. The only solace I can find lately is in thinking about my beautiful daughter and how much I love her. She will be the reason I beat this thing -- mercilessly. She is my hope for the future.

Wouldn't You Know It - I'm Special

Week 9: One of the nice things about my new plastic surgeon is that she's a woman, and she specializes in breast reconstruction, augmentation and the like. So she can empathize. The other nice thing is that she gave me a gift-package containing a bunch of information and resources about breast cancer. The packages were put together and donated by a former patient and survivor. I think that's awesome. I read numerous articles, websites and books about breast cancer the first time I was diagnosed, but a recurrence, I'm learning, is quite different. In the gift-package was a copy of "Dr Susan Love's Breast Book." I highly recommend it. Some passages are so on-the-money that they're as if I wrote them myself. It's uncanny, yet communal it would seem. I poured over the chapters in the days following my appointment. It's oddly reassuring to recognize and understand the different types of cancers, procedures, outcomes and what to expect afterwards, etc.. The terminology and imagery aren't as foreign and scary to me as they probably are for first-timers. It's comforting to know, in a morbid sort of way, that "yes, I've been there; yes, I remember that; yes, the same thing happened to me; yes, I have that...." Scarring - check Lymphedema - check Numbness - yes Pain - check Fatigue - yep Chemically induced menopause - yes Weight gain - check Hot flashes - yep Insomnia, night sweats, mood swings and fuzzy thinking - check, check, check and... check Those are just the long term effects I live with, never mind the short term side effects I previously enjoyed. The bad news about educating myself is that I know where I stand, and it's not in a great place. I read and grasped the implications of my PET and pathology reports, and my oncologist confirmed that I have Stage III invasive cancer -- the same as before. It's left over from the previous cancer, not a "new," second cancer. These aggressive, little microscopic cells have withstood each previous treatment: surgery, radiation, and chemotherapy. It gives me the creeps.

Tuesday, January 20, 2009

To Be a "B" or Not to "B"

Week 8: The following day, I met with my new plastic surgeon. She was great. We went over some options but a few of them were immediately ruled out. Because I had radiation as part of my first treatment, she said my skin won't behave the same way. It won't have as much elasticity and it won't heal as well. That removed the possibility of gradually stretching my skin with an expander followed by a permanent implant sometime down the road. That's what I did the first time. double-D's in my future. The second option was to take tissue (muscle, fat, skin, and attached blood supply) from my abdomen and relocate it up into my chest to form a new breast. Unfortunately, that approach was off the table because my abdomen has already been compromised from when I had the emergency appendectomy (not to mention a subsequent scar revision surgery - at which time I at least got the benefit of a mini tummy-tuck). Still another alternative was to take tissue from my back and relocate it to create a new breast (like the abdomen procedure, but more difficult). I decided that my back is off limits because it's the only part of my body that's still in good condition - no scars, no sagging, no wrinkles. Only two options remain. Do nothing, or go with a smaller implant that may not provide a good result because of my radiated skin. I'm going with the implant and keeping my fingers crossed.

So We Meet Again

Week 8: I went to see my cancer surgeon. She did my original mastectomy. But the last time I saw her was when I was being wheeled into emergency surgery at three in the morning five years earlier - almost to the day. She happened to be the surgeon on-call when my appendix burst about a week before I was due for my final chemo session. But that's a story for another day. This time all she did was check me and then she outlined the area of skin she intended to remove along with excising the cancer mass. It's unsettling to see the lump and feel how deep/thick it is now that my implant is deflating. In fact, it's kind of sickening to know that what could kill me is so tangible this time around.

Thursday, January 15, 2009

Hey, I Know Her!

Week 7: Much to my surprise, the interview didn't end up on the cutting room floor. A couple of days later, they ran a few of those "coming up tonight at 11" news clips and soundbites throughout the day. A family member saw one of them and called me to let me know. It wasn't much notice, but I managed to tell a few folks to tune-in even if they didn't want to see it. I had the opportunity to torture a few more people when it aired a second time the following evening. Then another family member who lives out-of-state sent me the link from the station's website. Personally, I thought I looked better on television than on-line. The hi-def wrinkles made me more recognizable than on the web video. I think I would've named the segment "Living Proof Why Women Should Do Breast Self-Exams," but I guess that's too long. The producers went with "Ann's Story." Here's the link. "Ann's Story"


Week 7: Over the weekend I noticed that my implant was leaking. Well, so much for a perfect biopsy. I called the radiologist, who told me to call my plastic surgeon. I called my plastic surgeon only to hear a recording that he was in the process of closing his practice. Leave a message and send a written request if you want your chart. Geez, what now? So I called my cancer surgeon. I knew the saline wasn't going to make me sick, and since the implant wasn't causing me any pain or discomfort. she said not to worry about it. I made an appointment to come in anyway because she had to exam me for surgery to remove the new mass. Still not using the "c" word at this point, and I don't mean "Christmas" despite the time of year. Tues Dec 8: Doreen Gentzler and crew were coming over to interview me. Minutes before they arrived - literally - the phone rang. Turns out the pathology report came back sooner than expected. "It's cancer." My heart sank. There was a knock on the door. It was Channel 4. We introduced ourselves and I told them, "your timing is perfect. I just found out I have cancer again. So your news story really did save my life." Tears welled-up and I almost lost it when I spoke those words, but I quickly regained my composure. I had to get ready for my interview...

And there it was, the silver-lining of inspiration. Had I not seen the news that night, I might've been on my way to the grave for a reason that could've been avoided.  I had a purpose now: tell women to pay attention to their bodies and monitor their health whether they think they need to or not.

Needles Don't Bother Me

Week 6: The PET scan results came back. My chest "lit up" in the same area as the mass shown on the MRI. Not good. My oncologist sent me for an ultrasound-led biopsy to get a tissue sample. Arrived for my biopsy. The radiologist was nervous. I remained calm. He was reluctant to perform the procedure because the mass was right on top of my implant with little margin for error. He was afraid he would knick it. (By the way, I adopted the term "mass" from the doctors' lingo because I think "tumor" sounds so ugly and gross.) He decided right on-the-spot to send me down the hall for a mammogram. I obliged. When the technician who performed the mammogram took a look at the first picture, a quiet "shit" slipped out from under her breath. She re-set me and took another picture. Same boob different angle. "Shit," she said again, but louder this time. While she let me loose from the machine, I asked, "what's the matter?" She said, "come here, honey," and led me over to the light box viewer-thingy that she had been looking at. "These are calcifications." She paused. "That's why I said 'shit.'" I knew what she meant. Add it up: MRI, PET scan, ultra-sound and mamogram all pointing to the same thing. "Oh," was all I could muster. Back to the examination room to wait for the news. The radiologist came back. He asked me one more time, "are you sure you want to do this or do you want to wait to have your surgeon do an excisional biopsy?" I'm pretty certain he was secretly hoping I'd take him up on the offer so he wouldn't have to do anything. Nope. I was there; might as well get it over with. "Come on, MacGyver, you can do it." The lights were dimmed, and we watched the ultra-sound screen closely as he carefully guided the needle in and vacuumed some tissue out. Nothing else happened. Success. He told me the sample would be sent to a lab and the pathology report should be back in about a week. That was the hard part. Waiting. Not knowing with 100% certainty whether or not it was malignant.

Sunday, January 11, 2009

Gee, This Seems Familiar

Week 4: This week, rather than being allowed to cancel the PET scan if the MRI results were good, I had to keep the appointment. At least my trip down the pipe wasn't nearly as uncomfortable as before. The last time I had a PET scan, it was to get the "all-clear" from any signs of cancer after my course of treatments. Back then, I couldn't comfortably stretch my arm over my head because of lingering problems from surgery. Keeping my arm raised and immobile caused my neck and shoulders to cramp to the point of excruciation. I wanted to lower it so badly, but I knew it would screw-up the scan if I did -- and then we'd have to start all over. So I laid in agony. Thank the Lord for small favors; I didn't have to suffer like that this time. And it was such a joy to be shot-up with more radioactive dye. Now that I've decided to keep a blog, I'm finding out how challenging it is to write on a regular basis. I'm worn out and we haven't even got to the good parts yet. More later...

Saturday, January 10, 2009

Is Watching TV Good for You?

Who'da thunk watching the 11 o'clock news could save my life? I guess there's something to be said for being a night owl. So let me go back to that night for a moment, and then I'll let you know what happened afterwards: Week 1: Watched the 11:00pm news on Channel 4. News anchor Doreen Gentzler featured a story about breast self-exams and a focus-group of women who failed to detect lumps in a synthetic breast. I promptly began feeling my "good" breast. To my surprise and horror, I felt what I suspected was an enlarged lymph node. It was located where the breast tissue extends into my underarm. (Yes, ladies, breast tissue reaches under your arms in addition to the top of your chest wall, so be sure to do self-exams there, too.) I obsessed with checking, and double- and triple-checking my breast all night long. I wrestled with whether it was real or just my imagination being led by the power of suggestion from the news segment. The next day, the "lump" was still there. I struggled internally with the possibility that something might be wrong, that my cancer had come back. But that's nothing new. I'm used to living with a dark cloud over my head. Every sneeze, wheeze, bruise and headache makes me wonder if I have cancer. Finally, the "I'm freaking out" voice inside my head won the argument. Thus I decided to make an appointment to see my oncologist. Week 2: My oncologist confirmed that he felt something, too. He referred me for an MRI and scheduled me for a PET scan. Better safe than sorry. I went home thinking I owed Doreen Gentzler a "thank you." If she hadn't done the segment, I wouldn't have checked myself. I sent an email to the station to let them know how important I thought the story was. A few days later, I went for an MRI. What I thought was a problem in my good breast turned out to be nothing. Instead, the MRI showed a suspicious mass on the opposite side, at the site where I had a mastectomy from my prior fight with cancer. I was already vaguely aware of said mass, but I had written it off as the valve in my implant. (I thought the implant had somehow shifted, and I was eventually going to call my plastic surgeon, but who knows when I would have actually gotten around to it.) "Okay," I reasoned, "it's just the valve they see." Deep inside, however, I wasn't convincing myself. I was nervous, but I held on to that hope anyway. At some point while this was going on, I received an email back from Channel 4 News. The producer asked me if I would meet with Doreen Gentzler for an interview. "Sure," I said. Due to conflicting schedules, we settled on meeting after the Thanksgiving holiday. Week 3: Whatever chemical they shot in me for the MRI "burned" intensely at the time, and a few days later my chest and arm started aching. The sensations were intermittent, but it hurt so much at times that I thought I was having little heart attacks. Although I didn't have a problem with it the first time I was diagnosed, I chocked it up as an after-effect of the MRI potion. Fortunately, the pain faded away a day or two later. Meanwhile, I was reminded, and disgusted, of the many, many side-effects I went through during treatment for my original cancer. Little did I know that pain in my arm was just a prelude to what's to come...

Friday, January 9, 2009

Introduction / Why We're Here

Hello, and welcome to my blog! For those of you who don't know me, my name is Ann Dollard, but most people just call me Ann (aside from other unmentionable names I'm sure I've been called at some point). In short, I'm starting this diary because I'm 44 years old and I've been diagnosed with Stage III breast cancer for the second time in five years. The situation stinks and I want the world to know it. I wasn't familiar with blogs the first time I had cancer; in fact, I'm not sure they even existed. Thus, instead of posting my thoughts, feelings, ill-famed attempts at humor, and distorted realities (accurate as they may be), I wrote a series of emails dubbed "My Cancer This Week." The emails served as updates about my journey through breast cancer. I sent them to various people I knew and didn't know whether they wanted to receive them or not. Now that I'm "on the web" (she says with pride) for all the world to see, I don't have to bother anyone anymore! You can decide to read my blog if you want to, when you want to, and if you elect not to devour my every word, that's okay. I'll get back at you somehow. I've covered a lot of ground since the news of "Ann's Story" first broke several weeks ago. Stay with me in the coming days as I post everything you need to know to get caught-up on what's happened so far. But be forewarned: I tend to wear my pink-ribbon wrapped heart on my sleeve, so it's conceivable that what I confess won't suit the fearful or easily offended reader. I smoke, swear, spit, drink and use foul language. And sometimes I tell the truth.