The 5 Stages of Grief

They are as follows: 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance They say that you don't necessarily have to go through them in the order they are listed. That has been true in my case, as depression was definitely stage 1. I will never forget the despondency I felt that weekend after learning that I had cancer. It went hand in hand with being helpless. From February 12th, the day I found the lump, until March 22nd when my surgeon removed my breast, all I could do was sit there and let that cancer grow and feed off my womanly hormones. I made dietary changes to not take in substances to increase estrogen and consume foods that naturally lower estrogen, but other than that, the cancer had the control. How freaking depressing. I guess along with that came stage 3, bargaining. My prayers certainly have a bargaining aspect to them. "Please God let me live a long life, beat this and have it never come back. I promise I will help other women, share my story, try to save others from this disease." I hope He thinks it sounds like a good deal. And then came the final stage, acceptance, at a pretty early inning in this game. Never once was I in denial about what was happening to me, maybe because I knew it always would happen in some way. Creepy story...I have this fleshy mole on the side of my head that's kind of like a big skin tag. I hate it but my hair covers it. But often over the years I would think "I gotta get this removed before I have to do chemo and lose my hair." Seriously, who thinks like that?!

 Anyway, right now I'm in stage 2 in full force. I'm majorly pissed off. And it couldn't come at a better time. I'm past the 5 week period of waiting and being helpless, I'm past the lying unconscious on a table while surgeons sent from God give me the best chance of getting my life back. Now it's time where I get to join the fight. I have a say in my treatment plan and I say go hard, give me the best stuff you've got. And when the poison goes into my veins, I will enjoy it. This poison will make me ill but it will obliterate any stray cancer cells that might have made it past the breast and that one lymph node. This will all be positive. Chemo is not a dirty word. Don't be afraid of it on my behalf. I WANT IT. I WELCOME IT. And please understand that going through chemo is not what it was in the movies in the 1980's. The meds they give you are great these days and plenty of people get away with no nausea and just a bald head and extreme exhaustion. Hopefully that's me, I love naps. And please understand that by me going through chemo does not mean I'm dying of cancer. In the majority of breast cancer patients, the cancer is gone after the surgery. The chemo is the insurance policy to reduce the chance that it will come back. When breast cancer comes back, they usually mean distant recurrance, in the bones, lungs or liver. That is why it's important to hit it hard your first time facing it because the second time might not turn out so well. So right now I consider myself cancer free and everything I go through going forward is just things I'm doing to insure that I live a normal lifespan.

 But damn, I am angry, I am livid. Right at this moment, I hate you cancer. I hate that you will steal 9 months of my life to treatment that will make me feel ill. I hate that you make me question if I will live to an age where I get to meet my grand kids. I hate that you took my breasts (even though I know my next set will be bigger and better), I hate that you will take my hair even more so. And the number one thing I hate about you is how you have interfered in the grieving of my father. I hate that days go by that I don't cry over missing my dad because I'm so preoccupied with my own mortality. How dare you take away the attention that grieving him deserves in my life so that I can grieve over YOU? How dare you!? But now I get to fight. An angry Jenna mixed with intravenious poison is a potent cocktail. Cancer can have 9 months to preoccupy me, bring hardship to my life, but that's it. After that, I'm taking back what is mine. And then, after it's said and done, the hate will be gone. And cancer, I will love you. I will love you for making me realize the small stuff isn't worth sweating, I'll love you for every woman that realizes that if it can happen to me, it can happen to them, and they do a breast exam. Or they ask for a mammogram even though they're "too young for cancer." I will love you for allowing me to help another young woman diagnosed not feel so alone. I will love you for letting me be a source of hope to the newly diagnosed. Lord knows, I have had plenty of those angels in my life. So at this moment, I hate you, and I'll fight you. But then I'll slap your hand, say good game like you do to the losing team, and hopefully never see you again in a rematch.

The Healing Process

It has been almost two weeks since my surgery and I'm happy to report that while I'm in constant annoying discomfort, I am able to get around and have a semi-normal life right now. Before surgery I pictured the 4-6 weeks of healing time they estimate for this procedure to be a time of me permanently planted on the couch, knocked out by drugs all of the time. And that was definitely how I would describe the first 5 days. But on Good Friday, I was able to head to the UPC Plastic Surgery clinic and get my drains out. Good Friday, indeed! Drains typically stay in for 1-2 weeks, until the total day's output of fluid in each drain is under 30cc's. So I was happy to be on the short end of that spectrum and able to get them out in a week's time. I was very prepared for this procedure to hurt but really surprised when it didn't. What was shocking was how far up into your body the drain tubes went. The nurse told me to take a deep breath in and then exhale as she pulled them out. It didn't hurt me at all but the feeling of this thick tube making its way down from right under my clavicle and out of my side made me completely queasy. That however was not as bad as the removal of the pain ball wires that went into my chest. A pain ball is a cool little fanny pack type bag filled with a plastic circle that has what looks like a breast implant inside it. That "implant" is filled with a Novocaine type numbing agent that goes directly into my chest via little wires. The wires are wound up in a tight circle and taped to my chest so that it can't come out. I was instructed to remove this myself (!!!!) after three days when I was able to see that the ball was all out of fluid. Of course Eric removed it because I'm a wuss and he loves gross things so he removed the tape and started to pull the wires which we were told would just slip out. OMG, those suckers were in there practically up to my neck and the feeling of metal wires sliding down over my sore chest muscles 3 days after surgery had me screaming to Eric to "make it stop!!" and he's yelling "Jenna, just don't look!!" It's funny now that it's over but damn, that sucked. Oh and then there was the middle of the night vomiting two days after surgery that accompanied a low grade fever. The breast clinic and plastic surgeon's offices were called and they all agreed it sounded more like a gastrointestinal bug rather than an infection. After putting two and two together I realized that it probably wasn't the best idea to eat Outback's Ahi Tuna appetizer two days after a major surgery when you're immune resistance is down. I'm pretty sure that was my first case of food poisoning. Other than those exciting events, it's been a lot of laying on the couch, reading, eating all the delicious food brought to us by friends and neighbors, and getting yelled at by Eric for attempting to do too much. Eric, by the way, is a pretty good nurse. He was awesome at keeping me on a med schedule and always emptied my drains for me. My mom spent a lot of time here playing with Harper so Eric could take care of me and my mother-in-law also watched Harper so both Eric and I could have days of rest. And the best part of this whole surgery deal was that the dogs have taken a two week vacation to the Canine Clubhouse, Sadie's house, and the Lawson's house, so that I could rest and heal without dirty dogs jumping on me and needing to go out 50 times each day. Unfortunately, they come back today. Did you ever think I'd say such a thing? I had my first follow up appointment with the plastic surgeon yesterday and he said that things look like they are healing well. He was planning on "expanding" me yesterday but I nixed that idea quickly when I told him how much discomfort I still had from the tissue expanders. So I get to go back on 4/18 for my first tissue expander fill. They will shoot a needle into my "foob" and fill it with 50-100cc's of saline. At surgery I was filled to 150 cc's and our goal is to go to 500 cc's unless I decide I want to be a big boobie ho and fill it to 800 or something, which they said they can do as well. Go big or go home right?! The cool thing about these terrible tissue expanders is at least you can gradually see the size change until you find a size you are happy with. They like to do the implant exchange no sooner than 4 months after surgery. So if I do not need chemo, in about 4 months I will have my new reconstructed rack, if I need chemo we will wait until that's over so that I'm not subjected to a surgery while my body is weakened by chemotherapy. I have a goal to be physically whole again by Christmas time. All I want for Christmas is my new fun teets!!

 Now to the serious stuff. My follow up with the breast surgeon is next week on 4/10. That is when we will hopefully have the final pathology report and hopefully the Oncotype score which will give me an answer on if chemo will be a benefit to me for my type of cancer. I'm praying for the final pathology to not have any surprises and for a low Oncotype score so that I won't need chemo. But at the same time I want chemo. Who says that? Whatever happens, I want to do whatever I can to reduce the risk for recurrence to the lowest percentage possible. So whatever Oncotype score that is mixed with whatever treatment they recommend is what I want for myself. The only thing we know currently is that I will take Tamoxifen orally for 5 years, and if I have it my way, probably a lot longer than that. This cancer crap puts us in a situation where I will unlikely ever get to become pregnant again. There is the possibility of extracting eggs for the use in a surrogate but the steps that you have to go through to make the eggs viable involve pumping me filled with the same hormones that feed my greedy little cancer. So I'm not willing to do that. Since I will need to take Tamoxifen for 5-10 years (maybe more if evidence proves beneficial) to block my estrogen, I cannot get pregnant while on this medication. So Harper may be, like myself, an only child. This isn't what we wanted for our family but sometimes, this is the plan. She truly is everything I have ever wanted and more so my longing for another child isn't as severe as it could be. I do still get baby fever when I see newborns as we were going to start trying to have a baby pretty soon, before my cancer diagnosis happened. We never thought too much about adoption but that is an option we can look into as well. Part of me wants to kick cancer's ass and feel that my risk of it coming back is low enough so that I can confidently welcome another child into my life, knowing I'll be around to see him or her grow up. Again, thank you for your prayers, cards, and kind gestures! All the support has given me more strength than I ever knew I had. I'm amazed at what I can handle now. And to everyone who ever hears the C word in their life, it will rock your world at first. But then it will become just a part of your life and you will adapt. And there will be times when you realize you're happier than ever. After a cancer diagnosis, how is this possible? It just is. And while cancer was always my biggest fear, it happened, I'm facing it, I'm gonna beat it to a pulp, and that makes me pretty damn happier than ever.

Off With Her Boobs!!

It's about time I got to blogging about the actual main event in my battle with cancer thus far. But thanks to lots of good drugs my eyes have been drooping after looking at 3 sentences of text so writing wasn't in the cards. Reading Facebook statuses was just perfect though, hell half of them are just pictures now, shared ones that aren't even pics of my friends, the people I want to look at. Or they're political rants. Or in my case lately they're breast cancer awareness shares so I'm ratting on myself too. I didn't even plan this rant so I don't know where it's coming from. I just miss the old Facebook so everyone just for me, the sick cancer girl, take a selfie in your bathroom today and a pic of your dinner and post it up. Selfie of you eating a chocolate bunny gets extra points.

Enough of that and on to nipple injections, boob slicing, and blue pee pee! First of all, your prayers worked. I woke up cool as a cucumber and I didn't have to take any meds to get there. I laughed and joked my way to admissions and down to the basement of the hospital (our old spot Stacy Potter!!!) to nuclear med. Eric got to be in the room with me while they injected my nipple with numbing agent...no big deal. Then some other needle injected it with radioactive tracer. I wish I could be more descriptive but you're crazy if you think I watch this stuff. Then it got pretty cool. They used a machine that watched the tracer disperse through my body over the course of a half hour. On the monitor that I could see too there was a big circular glowing area and after about 10 minutes it had a little glowing ball close by. It looked like the sun and Mercury. Mercury was my Sentinel lymph node! Some high tech way to find it on my body ensued and a low tech sharpie marker made an x where they should dig in and get him out. After that, I'm on my way to the preop holding cells.

Things get fuzzy here because once you get to your preop cell they take some vitals, take some blood,  some lady came and gave a talk about signing over my tissue in the name of science and I gladly signed over my boobs, hoping they could bring joy to others. Then they gave me a 1mg Ativan, a big daddy! I've never had a 1 mg before and this was after the .5 mg I popped on the way to the hospital. (I said I woke up cool as a cuke, I didn't say I stayed that way). So bottom line, I'm feeling good. Anesthesiologist comes in, is a doll. Plastic surgeon and his team come in, is a total doll, I really like this man. Dr. Potochny, if you're in the market for new jugs. My breast surgeon doesn't come visit because she's prepping in the OR and I'd rather her be prepping, praying, meditating, whatever the hell she needs to do to make miracles happen, than come over around all these sick people and bull shit with me. Then they say that it's about time to roll out and I say wait, we need to pray. My coworker Mary is a 5 year breast cancer survivor and the holiest person I know. She prayed over me with oils and I felt so at ease. Then a nurse injected something into my vein and said "we like to call this a glass of wine" and there I was having communion right before going under the knife...perfect!

So they roll me down the hall, Eric takes a picture of me smiling like I'm going on a joyride which I don't remember. My mom apparently was crying and I said "don't worry mom, I will be fine!" Right choice of words in my inebriated state, better than the time in college where I got very drunk and sick and called her and said "I'm going to die, I drank too much, I love you, but I'm going to die." That move right there was probably why I got cancer. What an asshole!

Then I see an OR room, it's very busy. A few women with caps and green masks introduce themselves (girl power!!) and one is my surgeon. A man tells me to jump to the other table from my rolly bed and that's it. No mask, no counting down, I am out.

And a minute later I'm awake and I ask if it happened. They say yes you did good. They put me in my postop cell and I vaguely remember mom, Eric and Mary coming in. I ask about nodes. They say the sentinel was clean! I remember saying praise God over and over. Then they come right in and say its dinner time. Holy cow, is this the best day of my life or what?! I start chowing on broccoli (anti cancer diet starts now!!) and drink two ginger ales. Then I had to pee so I had to walk down the hall which sucked. Ladies, think of when you first had to get up after child birth, only there wasn't blood dripping everywhere. So after a sentinel node biopsy your pee is blue because they inject blue dye into your boob after you're under that also finds the sentinel node so they can be doubly sure they're getting the right guy. Anyway, it's cool and I have a pic of my blue pee for a nice keepsake.

From that point on its all barfing after getting morphine, watching a How It's Made marathon (hot dogs...not the ideal episode on an empty stomach), lots of meds, lots of vitals, and a swift kick out the door at 8 am! All in all, not a bad first surgery experience. I'd sign up for more elective (as in not necessary to save my life) surgeries that have less pain on the back end. What's a nose job feel like?

The Agenda for Surgery Day

730 am-arrive at admissions
745 am-nuclear medicine appointment (aka shots in my nipple)
After that-head to preop room.
11am-420pm- 4:20 haha. OR is booked.
430pm-Dr. Kass finds my mom and Eric and tells them surgery went great and turns out, I didn't have cancer after all, it was just a piece of Dove chocolate in there.

Ok, I was drifting into a fantasy for that last part.

I woke up at 5 am this morning, mind racing. I'm anticipating waking around 2 am tomorrow so I am looking forward to a Propofol induced sleep. Today I'm getting the house cleaned up, giving Harper lots of smooches, trying to figure out what I'm going to eat for my presurgery meal, and taking the dogs to stay at the Canine Clubhouse for 10 days! Since I'm heading into my first surgery tomorrow and let's face it, shit can happen, Eric is at Bed Bath & Beyond right now buying a Dyson Animal Ball vacuum cleaner for me so I can cross off that bucket list item. Nothing like a good vacuuming sesh to relieve some stress!

I would be so thankful for your prayers tomorrow! Please pray for my peace (either natural or drug induced), for my mom and Eric as they sit and wait through a long surgery, for Dr's Kass and Potochny because they are the real stars of this show, and for the best possible outcome of this surgery. God is the ultimate surgeon so I pray his hands will guide my doctors.

As many of you know, my dad passed away at Hershey Med Center after a month long illness in July of last year. It will be hard for my mom and I to be back there, a place we wanted to avoid for a long time. The memories are too fresh, of being on our knees in the chapel praying, begging; the lunches in that damn cafeteria every single day; even the frickin' Starbucks which in my opinion is usually as close to Heaven as you can get on Earth, they all make me shudder and I know my mom feels the same. I'm sure of something though. My Dad will be right beside me tomorrow in the operating room. I felt his presence when I was sitting in the dark xray room for my preop chest xray. I knew he was there and then the magnet they use as a marker on the thing you stand up against (excuse all the serious medical terminology here), flew off of the thing you stand up against!! I knew it was just a sign from him that he would be present in this place I was so afraid of.

Cancer is like Christmas!

That's a joke I make every time somebody gives me a present or I get a package in the mail. In the last month, I've made a good deal of cancer jokes. You have to. If you aren't laughing at it, you're shaking in fear because of it. Believe me, there are plenty of days where cancer has me in a headlock, I'm terrified, and it's winning. But then I make a joke about it and I've got it pinned to the mat and I'm back in control. That's a wrestling analogy inspired by all the CD wrestling superstars that live in my neighborhood :-)

Seriously though, I can't thank everyone enough who has sent a card, written an email, sent a text, made a CD, sent a care package filled with pink awesomeness, given me amazing inspirational jewelry that I wear every day with pride, my new friend who is a cancer survivor who sent me a bunch of amazing and positive books so I stop googling doom and gloom, the flower arrangements, and the restaurant gift cards to make life easier after surgery. You know who you are. Every single thing brings me to tears, but the good, happy kind because I'm so lucky to have so many angels in my life.

Ain't nobody sending cancer any presents or praying for it. Cancer doesn't have an awesome surgeon scheduled to anihilate me on Friday morning. I'm 100% ready to kick this things ass. I know surgery and recovery will be miserable. Chemo sure wont be the most fun I've ever had. But every pain or discomfort this will cause me will be one step closer to being cancer-free so bring it on!!

Thank you for your prayers!

Good News For Harper!

I just found out today that I do NOT have the breast cancer gene! So that means I wasn't genetically predisposed to this fate, I was just extremely unlucky. 0.44% remember? This is good news for Harper. While me having breast cancer at a young age makes her risk go up, at least I didn't pass a gene on to her that will basically guarantee that she will get breast or ovarian cancer. Soooo yay!!! I definitely celebrate every small victory in this battle!

On Friday I spent the afternoon at HMC doing preop appointments and testing. I met with the anesthesiologist who assured me that they can legally make me high. I signed on the dotted line right away. I'm sure he mentioned other less appealing risks and complications but all I could think of was the "happy juice". If I could get an IV started right now it would be ideal. I've never had a surgery before so my first reaction to this impending amputation was one of complete fear, even though I've never wanted anything removed from my body more. But the more I think of it, I'm really excited to be unconscious. I've wanted to be unconscious since I found out I had breast cancer so I'm looking forward to a Michael Jackson-esque nap.

I then gave a urine and blood sample. After that, I went across the hall to do a chest xray. The old lady who worked at the desk, looked at my preop paper work and whispered "I just had that done last year". So it was nice to talk to someone who just went through what I would. She said it's really not as bad as you would imagine it to be and assured me that if I choose not to have nipple reconstruction, then I can enjoy the benefits of never having to buy another bra!

Surgery is scheduled for 3/22. I'm saying my prayers every night that the cancer is just contained in the breast and that there is no cancer in the lymph nodes or anywhere else in my body. And of course I'm praying for an uncomplicated surgery that allows me to spend as little time in the hospital as possible. Smelling the purell hand sanitizer at my appointment on Friday brought me to tears. There is no doubt that smell is the strongest sense tied to memory. Because HMC's hand sanitizer smells like July to me and that's a month that I never want to relive again.

Poorly Differentiated Tumor Looking for Female Hormones for Friendship, Maybe More?

That first weekend was the worst. I couldn't sleep and when I did, I had nightmares. I had no appetite. All I did was google breast cancer statistics and survival. Except I knew nothing about my breast cancer so I didn't know what I was even looking for. Over the next few weeks, I would get more of an education in the science of breast cancer than I ever thought I'd have.

If my breast cancer had a Match.com profile, it might list some of these stats:
1) It's estimated to be about 2-2.5 cm.
2.) It is a grade 3 tumor. On a scale of 1-3, 3 is the most aggressive.Grade 1 cancer cells look closer to normal cells, grade 3 cells are what they call "poorly differentiated".
3) Grade is not to be confused with stage. Your stage of cancer is not officially known until surgery is done and they are able to see if the lymph nodes are involved, and if so, how many.
4) My tumor is 100% estrogen receptor positive. This means that out of 100 cancer cells, all of them have estrogen receptors. It is also 80% progesterone receptor positive. Hormone receptor positive tumors tend to have better prognosis, be slower growing than hormone negative tumors, and have a variety of oral hormone treatments available to stop the receptors from using estrogen as fuel. Every medical professional that sees these stats on my biopsy report has gotten really giddy. This must be a good sign.
5)My tumor is HER2 negative. HER2 is Human Epidermal Growth Factor Receptor 2. When this protein is over expressed it leads to the tumor being HER2 positive and makes it a more aggressive cancer. Lucky for people who are HER2 positive, there is a drug called Herceptin which works well on this kind of cancer. But thankfully, I don't have to worry about it because like I said, it was negative.
6) The left breast is a mess. In addition to the tumor that myself, and by now, countless others have felt, there is all kinds of other happenings going on in there, in the same area as the tumor, that were picked up on the MRI. It could be that it's more ductal carcinoma in situ, which is early stage cancer that hasn't yet become invasive. Or it's a completely different kind of cancer. Or it's a bunch of benign happenings. They won't know until they go in and do surgery.
7) At my first surgery consult, radiology looked at my MRI from Hershey and thought they saw a slightly swollen lymph node. They thought it was probably just reactionary to my breast biopsy, but decided to biopsy it to be sure. It has come back negative. This brings me hope. It's pretty close to where the tumor is and I'd like to think that if cancer hasn't gotten him, then it hasn't gotten to his buddies either. I have to be realistic though, because there are about 30-40 lymph nodes under the arm, and just because one is clean doesn't mean they all are.

I've been to Pinnacle, Hopkins, and Hershey for consults and have settled on Hershey. My breast surgeon at Hershey, Dr. Kass, is highly recommended and really impressed me at our first meeting. She thought my plan for a bilateral mastectomy was a good one. Because my lymph nodes do not show any clinical signs of having cancer in them, they will do a sentinel node biopsy where they inject a dye into my nipple (AHHHHH) and as it spreads throughout the breast, they see which lymph node it goes to first. They remove that one, test it for cancer, and if it's negative, they assume the cancer hasn't reached the others. If it's positive, they keep removing more. In the surgery, they will remove the tissue of both of my breasts, sparing the skin. They will then put tissue expanders in which they will gradually fill with saline over the course of the next few months. Once my treatment is over, I will have silicone implants put in and I can guarantee they will look better than my current situation. So there's that to be excited about.

As far as treatment, I will not know until after my surgery. If they detect positive lymph nodes I will have chemotherapy followed by hormone therapy for 5 years at least. If my lymph nodes are negative they will send away the tumor and do the Oncotype test on it. That tests 21 genes and figures out what my rate of recurrence will be. If it's on the low side, hormone therapy would be all I need and chemo wouldn't be of much benefit. But if it's intermediate to high, I will definitely go with chemo. I want to hit this with everything they got. I keep saying give me the trifecta-surgery, chemo, and radiation! I'll do it all, if it means I have a bigger chance of this being the only time breast cancer ever sets up shop in my body.

So I think you're pretty up to date by now. I'm just waiting to hear from Hershey when my surgery will be. This is the worst part, the waiting. They made sure to let me know that breast cancer is not a medical emergency as it has probably been growing in my body for 8-10 years. What's a few more weeks, right? I'm going to go throw up now.