Phase II

I believe I am officially out of the eyebrow danger zone. <<applause applause>>

So the chemo phase is over. And as I wait for the side effects to dissipate (like this fresh hell- some of my fingernails are coming loose). I'm moving into Phase II of Operation: Kick Cancer Butt, which is surgery.

I've been reading up, meeting with surgeons, and getting tests done. Now, finally armed with all the facts, I've come to a hard decision which actually turned out to be quite easy to make once I had all the information.

In the beginning of May, I'll be getting a bilateral mastectomy and will immediately begin reconstruction. That means both breasts are coming off and I'm getting implants.

I say it was an easy decision because leading up the the final moment yesterday when I signed the consent forms, all signs have been pointing this way so I was able to warm up to it. I did not make it lightly. I am aware of the risks, which aside from usual surgery risks of blood loss, infection, etc, are mostly cosmetic, but I've weighed them against the opposite risks and I, along with my oncology team, have decided this is the best course to take.

The MRI shows my lymph nodes have shrunk to a normal size. That's great. It means there's a good chance that the surgeon will only have to remove 3-4 nodes. During the operation, she'll take out the one that had cancer and a few surrounding it. While I'm still under, they'll get sent to pathology to be tested. If the tests are negative, that part is done. If the tests are positive she'll continue and remove the next 10-12 lymph nodes. That would increase my chances of developing lymphedema. Then, she'll move to the second part of the surgery. The tumors are smaller but they're still there. After she's done removing all the breast tissue (kinda like a scooped out bagel), the plastic surgeon will take over and place spacers in to allow my skin to stretch for implants and he'll put in drains which will come out about a week later. I'll start radiation after the first surgery is done. I'll need a second surgery a few months later to complete the reconstruction. In between will be several visits to the plastic surgeon's office to inject air into the spacers. The good part about all this is I get to say when to stop adding air and make the switch to permanent. Double G's! No no. Kidding. I just want to look like myself again. (Also, getting rid of cancer is a good part too.) Interesting fact: During the weeks my skin is stretching, I can't go on an airplane. If I need to go somewhere, I'll have to go in and replace the air with saline so they don't react to the altitude and expand like potato chip bags. (Ow!) Why not just use saline to start with, you ask? Because the added weight could affect the healing process, put strain on the stitches, and make recuperating more painful.

Once this is done, I won't have to get mammograms every six months for the rest of my life. I won't have to have every lump, every cyst that shows up biopsied, tested for the rest of my life. My recurrence risk will drastically drop from my current rate of over 20%, which is a little high due to coming in at stage III and having the HER2/neu gene amplification and also a little high for my own personal satisfaction. The risks cannot be completely eliminated but then no woman on earth is at 0%. This is my best chance for a "cure" and my best chance at never having to go through this again. And friends, I don't ever want to do chemo again.

I'm disappointed the chemo didn't completely eradicate the tumors. When they started to shrink, I was so sure I'd be one of the 50% of women whose tumors are completely gone at the end. And when I couldn't feel them anymore and Nurse Nicole said "wow," I don't know why, but I was positive it was gone. The idea that the cancer is still in me is upsetting. That it could be fighting back and growing again right now. I guess I feel kind of naive for hoping for a miracle. David says whatever I did to remain positive throughout the process was worth it. And that maybe if I hadn't been so sure and hadn't had such a good attitude it wouldn't have responded so well. I'd like to believe that.

And it did work. The smaller the tumors are in my breast, the more likely it's gone from my lymph nodes. Now that I'm getting the bilateral mastectomy, the tumors don't really matter anymore. I'm not getting breast cancer again. What does matter is my lymph nodes because if cancer were to show up again anywhere else in my body, they'd be the likely culprit. Yes, the idea of lymphedema is scary, but the real risk here is that if the cancer spread to neighboring lymph nodes, it could have gone farther. I can't cut off my armpit. So, the fact that the tumors didn't completely shrink isn't really a "lose" situation. The fact that they responded well to the chemo is promising. That should mean that the lymph nodes responded well also. And the less my surgeon has to remove, the greater my chances are of it never coming back because it means it didn't spread. What I can't stand is that I won't know any of that until I wake up from surgery.

So that's that. I don't have a solid date yet. We need to coordinate with the plastic surgeon but it most likely will be May 1st or May 8th. My birthday is May 5th. Happy Birthday to me! That's only 2/3 sarcasm.

I thought I'd be cute and post a before and after chemo shot. The one on the right was taken 11/20/16, three days before I started. The one on the left was taken today, 4/8/17, 12 days after I finished. It's been a little over 4 months.