Friday, October 3, 2008

My story - part 3 (chemo)

I started chemo on March 4th. While torn with the possibility of never being able to have children, I was anxious to begin treatment, the tumor was still growing and I had developed a rash. The nurses were unable to access my port that first day and were shocked at the size of the scar that I had from it. A week prior I had gone back to Dr. O to have the port placed. He said that it was a “simple procedure” and I remembered that it was from my mother’s experience. Not so with me, apparently I have difficult anatomy. What was supposed to be a 1-1.5 inch incision turned out to be 4 inches! He couldn’t locate whatever vein he was looking for so basically went digging around and finally had to tunnel up to my jugular. So, the nurses just inserted an IV and off we went into chemo land. My dad came with me to my first treatment and I got some pretty strange looks from the other patients when I was the one to sit down in the chair and not my dad. I was by far the youngest patient. Shortly thereafter I fired Dr. O and got another surgeon, a breast surgeon, Dr. C.

I felt ok after most of the treatments. The anti-nausea drugs were amazing, through all 6 cycles I never threw up once! The biggest hurdles were fatigue, muscle and joint pain, hot flashes from early menopause, some bathroom problems I'd rather not go into, and now nothing tasted normal. I was bound and determined to find something that tasted good, no such luck. I thought I was going to lose weight while going through chemo, sorely mistaken, I gained about 35 pounds! My hair started to fall out just before my second cycle. I knew that it would so I had got a shorter haircut the week before. It was now so bad that every time I ran my fingers through it I would have a handful of hair, not just a few strands, a handful! I decided it would be best just to shave it all off, so I called up my brother and out came the buzzers. We had a great time shaving my head. It surprised me how comfortable I was with losing my hair and hardly wore the wig I had got.

Friends came with me to the next few treatments. We joked that I was the Samantha character from “Sex and the City”, only younger and not promiscuous. The nurses got a kick out of us. I would bring my laptop, iPod, magazines, cards and whatever else we could find to make the hours pass by quickly. I was determined to lead a semi-normal life so I was driving myself to my appointments and even went to chemo alone for the last two cycles. I worked part-time for a while but eventually just ended up taking a medical leave. I was trying to get out of the house every day, but some days I never made it off the couch.

My whole medical team was amazed at how well I was coping with the entire situation but was afraid that the bottom might fall out. It’s very easy to fall into depression after receiving a cancer diagnosis, not to mention recently losing a parent on top of that! On many occasions I was given flyers for support groups and told to check out different breast cancer websites. I was stubborn though, what would I have in common with the people in the support group besides cancer? I was 31, single and had no children. Most of the other women in the group were much older, married and most had children – they couldn’t even begin to understand my situation! So, I dealt with it on my own for months. Then I found out about a conference for young women with breast cancer hosted by Dana-Farber and decided to go. I got so much great information and it turned me on to the whole support group idea, no matter how far I had to drive!

I was having an excellent response to the chemo. Every few weeks I met with Dr. K and after each cycle the tumor got smaller and smaller. I’m thinking great, no mastectomy needed! I was wrong, because of the initial size and advanced stage, mastectomy was my best option to reduce the chance of recurrence. Time to find a good plastic surgeon for reconstruction, enter Dr. B. He came very highly recommended by a friend and I immediately felt comfortable with him, he was a straight shooter. We discussed my reconstruction options and fears. My biggest fear was making the wrong decision. I knew there was cancer in one breast, but what about the other? The MRI indicated a “suspicious area” but we didn’t biopsy the area, instead an ultrasound was done and showed a cyst. Should I have both breasts removed anyway? How would I feel about wearing a prosthetic if only one was removed? What should I do?! I bought books on breast reconstruction, logged into chat rooms and read blogs – anything to find out what the “right” decision was. I was leaning towards bi-lateral but was unsure if I was being too radical. I was going out of my mind and needed help before I snapped. My salvation came while standing in the middle of the health/wellness section of Barns & Noble and making a phone call to Dr. B. I asked him what I should do, if he had a daughter my age what would he advise her to do? “Remove them both” he told me, “and that’s a personal opinion, not a medical one”. Thank you so much!! I was so relieved I almost cried. Now, what reconstruction option to go with – implants or tissue transfer – shit, yet another decision, more research!

I wasn’t too keen on the idea of having implants, especially since I would have little to no breast tissue left – the implant would be obvious. Dr. B advised me that a tissue transfer was probably the best option, it would give a more natural look. I have tattoos across my abdomen and I was concerned about them being transferred to my chest in the transfer process, I didn’t want that. He suggested doing immediate delayed reconstruction, meaning at the time of the mastectomy they would insert tissue expanders. The job of the expanders was to preserve as much of my original chest skin and would be filled with saline over time and eventually swapped out at the time of the reconstruction. I never knew how many different options for new breasts were available! I decided to go with a DIEP Flap, where they take tissue from the abdomen and move it to the chest – it’s like getting a free tummy tuck and new boobs all at once! (Some light at the end of the tunnel) I found a micro-surgeon in Boston at Brigham & Women's, Dr. C. I met with her and she agreed that DIEP was the way to go since I had to have radiation, but it would be a long recovery process. On top of that, they wouldn't start the reconstruction process until 6 months after radiation ends. Great, expanders for many months!

My last chemo was June 17th. By that time I couldn't even feel the tumor. I was amazed at how squishy my boob was, it hadn't been like that since before the reduction. Before the surgery they had another MRI done and couldn't find any suspicious areas at all. Great news! My mastectomy was scheduled for July 23rd.


Meaghan said...

Thinking of you and amazed at your wonderfully positive attitude! You GO Girl...U R a rocking cancer ass kicker :)


Michele said...

The title of your blog is hysterical. Good for you. Keep well.

Debby said...

I've just begun the second half of chemo. I pretty much breezed through the first half, but you know, the first treatment of taxol really knocked me on my butt. Good news? Although I was sicker, I seemed to get over it quicker. My next chemo is Thursday. I have 3 more treatments to go. Then I start radiation. This thing has been like a rollercoaster. I am a strong woman, but I need people. I try to be brave, but sometimes wish that I didn't have to be. We have 5 children, all grown. I want them to see me facing this as a woman of faith and courage. I'm just a flipping emotional basket case, and I can't stand me like this, wobbling between one emotion to another. How do people deal with that part of things?