(Re)Construction zone: proceed with caution

I haven't written about my most recent reconstructive surgery (which was on April 14th), largely because I'm so upset about it.  Don't get me wrong, I have one of THE most brilliant reconstructive surgeons in the area and at UCLA and he is also incredibly compassionate and caring - I'm very lucky. Dr.C has been amazing. He lays out my options, informs me of the risks and benefits of various approaches to the many steps of this process, is very talented and a great listener, and has been willing to fix things that I think many other surgeons might not bother with from what I'm hearing/seeing when comparing experiences with other breast cancer survivors.

Reconstruction has been a lengthy road for me, involving numerous surgeries. The approach I chose was bilateral mastectomy with immediate reconstruction with tissue expansion and implants.  Overall it has been a pretty straight forward process with no unexpected complications but I have had several challenges trying to achieve symmetry in shape, size and comfort because of the simple but aggravating fact that radiation changes the skin and tissue, making it less cooperative, increases lymphedema issues, etc. I handle surgeries/anesthesia really really well, thank God.

After this recent surgery, the right side finally looks wonderful - really awesome actually.  Unfortunately, in spite of our many attempts to fix it, the results for my left side (the radiated side) are not great. The appearance and feeling is actually worse than before this past surgery and that is why I haven't posted to the blog about it yet - every time I think about it I break down emotionally. Then the fact that I'm emotional about this upsets me even more because I began this journey not caring about my breasts' appearance - all I cared about was surviving this disease and being here for my family.  But I let myself be convinced by others that I would care later on and to just try to get the best results possible and I could always undo it later on if it didn't turn out well or whatever.  And then when something didn't look right I would hesitate to raise it but then would be encouraged to speak up because this is the only time it can be addressed and I have a right to get great results.   So I have endured numerous surgeries (which are just major inconveniences to my work and personal life schedule - not just for the actual day of surgery but for weeks before and afterward because I have to stop taking important supplements 3 weeks before surgery and then for 3 or more weeks afterward I'm not supposed to lift Cooper and have to avoid too much physical activity like working out till I'm cleared for those things -- so, it's a major time investment that requires garnering the help of others with Cooper since Bob is away so much). Again, I handle surgery/recovery really well thank the Lord or else I might have put a stop to this a year ago.

So why is it (left side) worse than before? Well mainly because I have lymphedema swelling that causes that side to be bigger and that's whey we've gone down implant sizes two times on that side (this last surgery included downsizing the implant) and the previous downsize was the right decision but this one not so much as the breast sits higher and remarkably smaller than the right side now.  Additionally, the lymphedema swelling combined with the toughness of the skin at the incision has made it such that the shape of the breast is yucky - the profile view reminds me of the tip of an elephant's trunk. The swelling has caused the reconstructed nipple to practically disappear into the incision because the areas above and below the incision swell and hang over the incision line where the nipple sits.

OK and that's just what's wrong with how it LOOKS. I haven't even mentioned how it FEELS - UGH. I feel like my left armpit is being held up by a meat-hook that's being tugged on and causing a pulling/twisting feeling of the breast.  Three days ago Bob pointed out to me that I had been walking around nearly 24/7 with my right hand in my left armpit and/or stroking my left side around the clock (to try to move the fluid out of the breast and down to my side).  I can only imagine how it must have looked as I walked around Trader Joe's and Whole Foods last week with my hand in my pit or on my breast without me even realizing it at the time ;/. But it just feels terrible all the time - it felt yucky or "gunky" as I often describe it before, but now it feels worse.   As of this morning it feels a little better than it has this past week but I wonder if that's because I know I'm marching into UCLA today to get some options/answers.

Frankly, I'm sick of this process. I want to be done. I want to move on with life and not be subjected to all of these surgeries and not have this daily reminder (aching, swelling, etc) that my life has been forever turned upside down by cancer. I told Dr.C during my pre-op appointment that if this one doesn't do the trick, I'll probably ask him to take the implants out and forget about having breasts.

But here I sit, sobbing like a baby knowing that if I opt for NO breasts I'll be just as sad and distraught as I am about having an ugly breast that aches 24/7.  I also know that the alternative between those two probably

I'm trying to not make any assumptions about any of this  and you can see my mind is already racing about all the things that could happen if we start over on the left side but I'm terrified that the next decision I make about this will forever change things for me/us - of course it could be for the better, but it could also mean for worse if complications arise.  I fear that I would choose to start over on the left side and have complications that would negatively impact my health because I wasn't willing to put up with an unpleasant appearance that could be hidden with layered clothing and prosthesis (which are not cheap nor comfortable).  It's just all so emotionally confusing and overwhelming so Bob is coming to this appointment today. I need him to be there and hear ALL of our options, pros/cons, risks, etc.

Please pray for guidance for this decision...that God will lead us to make the right choice and that I'll be at peace with it and able to move forward and focus on more important things.

Post-op Update - Feeling great! PTL!

Surgery went very well yesterday. The team at UCLA is always so professional and compassionate. I always manage to have a little fun with them too.  

I mentioned in a post recently that I'm working on a project called the Pink Wig Dance. We are three survivors producing a viral video of survivors and loved ones wearing pink wigs, dancing, and posting for photos that will be spliced together in a short video set to a great tune and posted to the internet to raise awareness that breast cancer affects women (and men) of all ages and walks of life. It's our way to unite and celebrate life in the process of raising awareness. We have a blog with our mission statement and instructions for how to participate: www.pinkwigdance.blogspot.com and you can email the team at pinkwigdance@gmail.com.  

Anyway, I brought a couple of pink wigs along to the hospital and explained what we are doing and managed to get my surgeon and a couple of residents to put the wig on and pose for pictures :).  Like I said, UCLA is awesome! :) I'm so grateful to them for the incredible care they have given me and for helping me through this journey by participating in other ways such as humoring me and supporting me emotionally as well as physically. I've posted the pics below :)

More about the surgery -- the anesthesiologist agreed to use my port one last time to push the first dose of medication to get me drowsy and then switch to an IV in my arm once I was asleep so I wouldn't have that icky IV placement feeling which I so hate.  I had put the numbing cream on the skin over the port when I got dressed in the morning so it was fully effective by the time they put the line in.  

With one push of a syringe, they began the process of making me sleepy - I was getting general anesthesia once sleepy since they were doing both nipple construction and port removal and incision revision.  I was awake as they wheeled me into the OR and was moved onto the operating table and then I was out like a light.  I love that. Even better is that my body handles anesthesia really really well. It works well and I handle it well. I've never become nauseated or felt sick from it any other way.  I woke up two hours later, opened my eyes and looked around as if I had woken from a nap. I could feel a little soreness on the port removal site but felt no discomfort at all on my breasts - probably because my breast skin is mostly still numb from the original bilateral mastectomy.  

Bob handed me my blackberry (he knows me well!) and then he headed down to the pharmacy to pick up my medication (antibiotics and pain medication). I read my email, responded to some work emails (I know, I'm nuts), texted some friends to let them know things went well and I'd be home soon, updated my Facebook status, etc.  I know, I know, I'm addicted haha.  When Bob returned we got my post-op instructions and a wheelchair escort who was kind enough to take me to the Simms/Mann Center for Integrative Oncology one floor down so that I could drop off a bag of standard stylish wigs donated by a wonderful and generous church member for the women in the breast cancer support group conducted there. That's the same support group I attended weekly throughout my treatment.  The facilitator was thrilled to receive the donation and promised to bring them to the group next week to offer them first dibs and any that don't get taken by the support group members will be given to Helen's Room where patients can get free donated wigs while in cancer treatment.  

Once that was done, I was wheeled down to the parking garage entrance where Bob had the car standing by and ready for me to get in and head home. We were home by 2pm. 

I've been taking it easy, taking my antibiotics as instructed, limited my activity (no lifting over 5 lbs, no reaching overhead, etc.) and have only taken two pain pills in 24 hours. I OK without it now which is great, especially since the side effects (digestive in nature) are not pleasant and I could do without THAT which I would find worse than the soreness from the surgery haha. Besides, I need to be able to drive tomorrow so no more pain pills for that fact alone.

I'm glad I took today and Monday off from work to recover so I can really rest and get some good sleep and make sure I'm not doing anything stressful.  Unfortunately, Bob has to go to work tomorrow morning so I have to be diligent and remember not to pick Cooper up which will be a challenge, especially when I need to go anywhere. So, I have a 2-step fold up stool that I'll need to have Cooper use to climb up into the car into his seat and take that along with us when we go anywhere. Tomorrow I have my friend watching Cooper when I head out for a couple hours while I get out of the house for a couple of hours so I won't have to worry about it then and she'll watch him again Sunday when I'm at church so at least it'll be a couple days before I really need to get him into the car so that's good. I know I can call several other neighbors to help though if I need help getting him lifted into the car in the event the stool option doesn't work out. I'm so blessed and grateful to have such wonderful neighbor friends.

Once I've fully healed from this step of the process, the next step will be to get the nipples tattooed. If you google nipple reconstruction you will be amazed by how natural these fake nipples turn out. I'm excited to finally look and feel "normal" again - before the end of the year, even. Yay!  Of course, those that know me well know that I would have been ok without reconstructed breasts too. I'm all about living - being alive - to me, that's all that matters and the rest is icing on the cake.

Now for the pre-op pink wig fun....

Me with Dr.Crisera

UCLA Resident physicians Mandeep Sehmbey and Victoria Vo with me

Bob Olsen - my husband :)

So there it is - I'm so blessed to have had another very successful surgery at UCLA. I can't say enough wonderful things about them. Thank you, UCLA!!!!  Praise the Lord for such a wonderful team of health care professionals, for my excellent health care coverage, and the support of family and friends. I will never take these things for granted or underestimate their immense value. xoxo

Love,

Julie

Surgery around the corner. Farewell fertility.

I'm excited and a little sad too. Excited to get this over with - the hysterectomy - and feel good knowing I'm preventing cancer of the ovaries/uterus/cervix by having said body parts removed and getting on with life. Sad that I'm saying a very final goodbye to my fertility and the possibility of ever giving Cooper a blood related sibling. Even if I wasn't having the surgery I would do everything in my power to avoid becoming pregnant again because of the fear that pregnancy hormones would ignite a deadly firestorm in my body. But it's still a really big deal to be saying goodbye to having the option of creating beautiful life. Don't get me wrong about this - I want this surgery. But one thing I've learned over the years, and especially through this cancer journey, is that a person can want and need something and still have grief about it too. Feelings must be felt and processed for healthy resolution. So, tonight, I'm looking at Cooper and experiencing a flood of emotions as I prepare to say goodbye to my reproductive organs next Tuesday. I'm so thankful to God for the timing of my pregnancy with Cooper. Had we not gotten pregnant and had Cooper when we did we would not have ever had him because of the cancer. Cooper is such an amazing and precious gift from God. I'm thankful that my body withstood the challenge that the pregnancy posed and that we were blessed with a healthy beautiful son in spite of the difficulty we had (incompetent cervix resulting from procedures years earlier to remove precancerous cells). God got us through it and gave us this amazing child. I sometimes worry that we've done Cooper a disservice by not giving him a brother or sister but I know in my heart that we're protecting him with this decision by taking steps that we believe will help keep his mom here on earth for the many important years to come. Tuesday morning I'll head down to UCLA for the surgery. I'm having a complete hysterectomy and also having one of my breast implants replaced (it's too large in light of the lymphedema swelling I have which is not likely to go away). The hysterectomy will be performed using the Davinci robot which is pretty cool since that makes it minimally invasive and greatly reduces the recovery time. In fact, the plan is for me to be back to work next month! I'll be spending the night in the hospital since it's still considered a major surgery. My mom is flying in to help out again. I am so blessed to have such an amazing mom. We can't wait for her to arrive tonight. Cooper will have so much fun with her during her visit. Thank you, mom! I love you! I appreciate your prayers and positive thoughts as we proceed with this next important step in this journey. We're praying for a successful surgery with no complications and with a quick and smooth recovery ahead. We're praying that Cooper won't struggle or be hurt when I'm unable to lift him in the couple of weeks after surgery. We're praying for clear/negative pathology results following the surgery. And we're praising God for the miracles He has performed for us already - every single day.

New surgical plan: a smaller boob and nips delayed

This afternoon I met with Dr.C (aka Dr.McHotty) to take a look at my post-radiation construction site (aka my boobs) and figure out what we are doing on May 18th, my next surgery date (besides the hysterectomy by Dr.H, of course). The original plan was that I'd be getting a couple little minor fixes to achieve better symmetry and have nipples created. My left breast has been larger than the right since the original surgery last June. This is due to natural post-surgical swelling, but also lymphedema swelling that comes and goes. Now that I'm 3+ weeks post-radiation, we see that the implant on the radiated side did well. In fact, the excess skin/tissue at the bottom pre-radiation tightened up and lifted which is great as that would have been a "fix" for the next surgery but now wouldn't be necessary. However, at the top and side of the breast I am noticeably larger than the other side and it doesn't appear to be settling down. Since lymphedema is something I'll deal with for life, this swelling will always be an issue to some extent. He gave me three options. I can only remember two of them hahaha (thank you, lingering chemo brain!). One was to accept the lack of symmetry and proceed with the original plan to just clean up and get nipples. The other was to replace the left implant with a smaller one to achieve symmetry and do the nipples a couple months later. I could hear Bob's voice in my mind asking things like "can she still get it all done in the current plan year (which ends June 30th)?" and "will the smaller implant look smaller than the other side when the swelling is calm?" and "can we still do the hysterectomy and breast surgery the same day even though we're now exposing the implant?". I forgot to ask the first question, but I can call tomorrow to find out how much time must pass between the implant swap and the nipple surgery. I didn't bother asking the second question because I feel that he wouldn't suggest it as an option for correcting symmetry issues if he thought it would just create a new case of asymmetry. The third question was my main concern as the hysterectomy is my first priority right now - I want it done before my cycle returns, and I read something in my chart last week that made this more important than everything else (more on that later). Dr.C explained that normally they won't do hysterectomy or other OB/Gyn surgery at the same time as implant surgery because the OB/Gyn surgery is generally considered "dirty" in terms of infection risk. However, since they're doing it with the DaVinci robot and that part of my surgery will be performed last, after the breast surgery is done and closed up, he is comfortable proceeding. So the new plan for May 18th is to replace the left implant and proceed with the hysterectomy. Nipples will be done after I'm healed and the port will come out when the nipples are done so that I can use it for the next Zometa treatment if I get it before the nipples are done. I'm happy with this plan even though that means I won't have the nipples as soon as I had hoped. But I know that the smaller implant will feel better and less alien and uncomfortable when I have swelling since it won't feel like it's under my chin and in my armpit and I'll be less self conscious about being lopsided (since I won't be anymore) and will not have to hide it with layers of under garments like I do now - this is a big deal as summer approaches since most of our summer involves triple digit heat around here. So that's the plan! Dear Lord, thank you for blessing me with such brilliant and compassionate physicians! Malachi 4:2 But for you who revere my name, the sun of righteousness will rise with healing in its wings. And you will go out and leap like calves released from the stall.

And next comes Zometa...

I start Zometa treatment in the morning. It's a biphosphonate drug to strengthen the bones. It's been used for people with osteoperosis and breast cancer that has spread to the bones. Neither of those uses applies to me though, thank you God! However, recent studies have shown promise for the drug to help avoid cancer spread to the bones and since I was triple negative and thus don't qualify for any of the great advances that my Estrogen+ and HER2+ sister warriors are benefitting from, my docs and I have decided we'll use whatever we can to give me any possible advantage. The side effects are considered rare and mostly minimal so we feel the benefit outweighs the possibility of the potential side effects. There is one major nasty side effect possible - it's called osteonecrosis of the jaw (basically means death of bone tissue). I am not in any of the known risk groups for this condition but that doesn't mean it can't or won't happen. I am determined for it not to happen and one way I can help prevent it is to keep my teeth and gums as healthy and infection-free as possible. I will have to avoid major dental work while on this medication and possibly for a few years afterward since the drug has a very long half life. This is an expensive medication that most insurance companies refuse to cover and mine being no exception. We were about to pay for it out of pocket at the tune of $1300 per dose with doc prescribing me to receive it every 3 months for 2 years (IV administration). However, another miracle occurred and we found out that my prescription coverage company covers it and my portion is $40 per dose! Thank you, God! So, my prayer request is for God to protect my body from rogue cancer cells that may have survived all my treatments and to protect my bones and jaw from the negative side effects of Zometa. I have a lot of plans to accomplish while I'm still here and I hope and pray that God's plan for me is to carry out those plans in my earthly form. I know that it's not up to me and only He knows his plan for me so I ask Him often to reveal it to me so that I can perform His will and give this life the most meaning possible while I'm in it. In addition to starting Zometa tomorrow I also will go to UCLA to have a follow-up meeting with the surgical oncologist that surgically removed the cancer from my breast and lymph nodes last June. I plan to have both her and my oncologist (in the AM) feel me up pretty good because I often feel little bumps in my chest below the clavicle area that freak me out. It's amazing how I used to be reluctant to disrobe at doctors' offices in years past and now I'm quickly getting topless and asking the doctors to feel around and make sure things feel normal. That's just part of the new normal I guess. *sigh* I have a friend who just had a bilateral mastectomy after a MRI revealed some lesions that they weren't able to safely biopsy the normal way. She tested positive for the BRCA gene mutation and decided that she would go ahead with the mastectomy regardless of whether it turns out to be cancerous or not. She had her surgery last week and is now anxiously awaiting the pathology results to determine if she can be considered done now or if any treatment will be necessary. I'm praying that she is done with the craziness now and I hope you'll join me in praying for her too. I also pray that her recovery is quick and free of any complications. I'm still waiting for word on my surgery date - I keep harassing the two surgeons' offices because my husband needs to bid his May schedule and we need to know when this is going to happen so he can request time off at the time of the surgery since I'll be spending the night at the hospital and my mom needs to know when to arrange to fly out to help me out the first week after surgery. I also need to figure it out so I can effectively plan my exact date for returning to work. Unfortunately I think they're ignoring the phone when my number appears haha. Don't they know who they're dealing with!? hahaha :) Wishing you blessings of good health, love, and God's favor, always. Love, Julie

Girlie parts update

As a cancer survivor, my new life centers around three things: 1) God, 2) Living life to the fullest, and 3) Making lifestyle changes and decisions that will hopefully give me the best possible chance of staying cancer-free. Now that the major treatments are done and I'm in remission, the third item on the above list involves getting into a routine of healthy habits as well as seeking out medically available and appropriate choices based on current studies and my medical history. Last week I consulted with two OB/GYN physicians to determine the appropriateness of hysterectomy surgery and what it would entail. The reasons I've been considering this surgery are as follows. In my twenties I experienced years of abnormal pap smear tests that resulted in numerous procedures to remove precancerous cells. Now that I'm a cancer survivor I do not wish to retain a cervix with a proclivity toward developing cancer. And since ovarian cancer is most often found when advanced I do not wish to allow that to happen given that triple negative breast cancer is often correlated with gene mutations relating to breast and ovarian cancer. Even though I was negative on the preliminary BRCAI/II test, I chose not to have the extended testing which could have revealed a genetic mutation (I know of at least one woman personally that was negative on the initial test but positive on the extended test). I also don't need the hormones pumping through my body. Even though I had triple negative cancer (non hormone receptive) I'm not convinced that hormones didn't play a role in the cancer I had, particularly since I was injected with hormones for 15 weeks during my pregnancy a year prior to my diagnosis. Besides, I'm not going to carry anymore babies in this body - sad but true - so I don't need my ovaries, uturus or cervix anymore. They're being evicted. When I asked the two OB/Gyn docs and also my two medical oncologists why I would/should keep the girlie parts the only answer I got was relating to putting off menopause because of the unpleasant symptoms that it brings (flashbacks, for instance). I just laughed because I've had those since July when I started chemo and I know that's temporary - should last just another year or so at most and frankly I just don't care about that because it's not as bothersome as it was in the beginning. I asked them if having the surgery puts me at greater risk for disease and when the answer was 'no' I could only respond with "let's get er done!" Both Dr.N and Dr.H (the OB/Gyn docs I consulted) liked my logic and agreed it makes sense. Now on to the timing issue. As soon as possible is my answer and here is why - first, I want/need it done before my menstrual cycle has a chance to return, and secondly, I want/need it done at a time that creates the least amount of disruption to my life and those that count on me (family, work, etc.) since it entails a couple weeks of recovery time. I also want to incur the least amount of out of pocket expenses so that means before the end of the current benefit plan year (which ends June 30) since I've already met my out of pocket maximum for the year. I have no doubt that I'll be paying out the maximum next year as well for all the follow up tests and appointments and things I'll have over the next few years but I'd rather not have to put out $2k for a single day of care if it can be avoided. I also have another breast surgery that needs to get done this spring - I need nipples! So I had a brilliant idea - let's trade in the uterus, ovaries and cervix (and probably my port-a-cath too) for a set of nipples on the same day ;). Not only would it reduce the number of times I have to go under general anaesthesia, but it would lower the costs too. Basically I'm looking to combine three surgeries into one - what insurance company wouldn't love that!? Sure, that involves coordinating a couple of surgeons but we all know I don't take 'no' for an answer. So that's the current mission. I've been on the phone back and forth between Dr.H and Dr.C's offices to help keep the ball moving to get a surgery date coordinated with them both. I don't have a set date yet but it will be in May (no later) because Dr.H (the UCLA OB/Gyn I've selected to do it) is out of town the entire month of April. I love Dr.N (the OB/Gyn that delivered Cooper) but he doesn't have privileges at UCLA so I wouldn't be able to combine surgeries if he did my hysterectomy surgery, so that's why I've chosen Dr.H. During my visit with Dr.H he did an ultrasound of my ovaries. They are "as quiet as can be" and he said there are no egg follicles whatsoever. The lining of my uterus was so thin that he said he'd be surprised if there was a trace of estrogen anywhere in my body which means my body doesn't appear to be attempting to get my cycle/fertility back and that's a good thing (for me, anyway). He said that my uterus and other girlie parts in that region are surprisingly small for someone that has had a baby and when I told him that Cooper was born at 35 weeks he was not surprised - said he couldn't have grown much beyond that in such small quarters. Dr.H also said very complimentary things about Dr.N - said he has an excellent reputation. I told him I only let doctors treat me if they have an excellent reputation. He smiled. There are several ways a hysterectomy can be performed. I'll be getting completely laparoscopic surgery with the da Vinci robot. This will make recovery much shorter and will reduce the risk of adjacent structures from being negative affected given the size of my parts. Neat stuff. So that's the latest on the girlie parts. Once I have a date set I'll update everyone that needs to know first (family and work) and then I'll update here.

The unveiling of the sisters (aka tatas)

First, let me extend my thanks again to all of you for your well wishes and prayers for a smooth and successful surgery and recovery. I KNOW your prayers go straight to God's ears and heart and I feel the shower of His blessings every single day. Every day! I'm so incredibly grateful to Him, and to you for your thoughtfulness and generosity. I have been doing GREAT! The recovery has been a breeze compared with the big surgery during the summer and what a relief that has been! I only had to take the pain medication for 3-4 days and I'm sure I didn't need them that long but I was nervous about stopping and finding myself "behind the pain" (after what happened at the hospital when one nurse delayed my meds on day 2 or 3) so I took them just in case and just took less and less each day. The only time I've felt any soreness at all is when I have broken the rules - reached for something over my head or forgot and picked Cooper up. Even when that has happened the effect has been minor and short-lived, thankfully. I have barely any swelling (a huge difference compared to last time). My only 'complaint' is the digestive trouble that comes with using pain medication - the cramping and...oh nevermind :). It's short-lived and totally bearable so I'm really not even complaining about that. Just mentioning it since it's there - but just about done with already anyway. It has been a huge help having my mom here - thank you, Mom!!! Cooper loves her so much (and so do I!) and he loves to sit at the dining room table next to her while she works on her computer. He sits and draws and plays with all her stuff - totally cute. Oh...right...the unveiling. Haha (silly chemo brain!) So, on Sunday I was allowed to take the bandages off and have a gander at the sisters, the tatas, the boobies. I was actually afraid to look because I've heard from some that it can be disappointing even when the results are good. It's hard to explain but it's sort of like when you go through anything difficult and there's one little morsel of a bonus (for lack of a better word) that you look to for fun or humor and you've talked it up and then suddenly you're faced with the reality that you may have talked it up too much and then you're suddenly disappointed not just in your own excitement about it but the actual thing itself. In the case of reconstructive surgery following breast cancer, I know from other survivors that it can go either way - it can be a moment of sheer bliss and relief or a moment of great sadness and loss. I guess how a person feels at the moment of the unveiling depends upon what their expectations were. I wasn't "attached" to my natural breasts so I didn't hesitate to instruct the surgeon to take them both from me - they failed me in life before when they were so heavy and big I could barely find attractive bras and when I had them reduced and later discovered that the surgery prevented me from breastfeeding my son and then of course when I was diagnosed with breast cancer. Me and the boobs were not my "friends" so I was totally fine letting go of them. Getting a new set of breasts that would not require wearing a bra and would be the exact size of my choosing was a nice little "bonus" to this process and although I would have been fine to not have any at all (seriously), I guess I have been psyching myself up to look at the positive side of having a set of perky fake boobs (better clothing options, perky set for life, etc.)....so I guess I was expecting bliss and that was probably a mistake. That's probably why it's taken me so long to write about it. Don't get me wrong, I'm not sad or angry about it, I'm just not as excited as I hoped I would be. Why? Well...only so much can be done in a single surgery. Not every 'issue' can be fixed and sometimes it needs to be incremental and that's the case with reconstructive surgery that involves the 'growing' and 'stretching' of skin. You see, it's not like a run of the mill boob job where you have your own original skin and nipples to tuck a squishy implant behind and voila you have perfectly symmetrical, perky and glamorous boobs. Yeah, not so much. I had ALL of my breast tissue removed in June - they had to actually cut into chest muscle and create pockets for the expanders and later implants to be set into and this causes a different look than the run of the mill boob job. I also lost a huge amount of skin from my original breasts and the expanders served to stretch/grow the remaining skin to make room for implants. Anyway, the result is that I have one side that's slightly bigger and positioned slightly differently than the other because of post-surgical settling and fluid retention (lymph drainage issue). Thankfully, these 'issues' are only noticeable when I'm nude and thankfully we're not living in a nudist colony. :)Dr.C did an excellent job but he had a lot to get done and it's hard to know how it will turn out until the swelling disappears and things settle and then he'll go back in and get more done when it's time to get some nipples (doesn't that sound so strange!? - get some nipples LOL). He warned me that there would be things that would need to be touched up along the way so I have no complaints about the way expectations were set with me - my issues are purely mine with regard the emotional buildup involved. By the way, Dr. C is such a wonderful person too - talent AND compassion is hard to come by both in a surgeon but this guy has it. I'm so glad I chose him. On the VERY plus and happy side - and this is BIG - the new implants are so much more comfortable than those expanders. So to all the ladies out there with expanders -- you will not feel icky forever. Those expanders were hard, expansive across the chest landscape, and made sleeping a challenge (for me it did). The new silicone implants I'm sporting are soft and lighter and I no longer feel like I have a chunk of steel stapled to my chest. As soon as I noticed THAT difference, I no longer cared about the temporary cosmetic issues that still linger. Another positive is that the overall shape is better and more normal looking which is a big relief because before I had to wear layers - usually a soft bra, tank top and shirt - to try to disguise the strange shape I had with the expanders. The only way I could think to describe it was that it looked/felt like I had little tree trunk stumps because of the bumpy appearance in part from the skin stretching process and results. This surgery included pulling and tucking to smooth and round out the appearance and I'm so glad about that because now I can wear a shirt without worrying about hiding my stumpy bumps. So, another milestone is behind me and that's really awesome. The next chapter, radiation treatment, begins next week. On Tuesday I go in for my radiation simulation and CT scan. The week after I begin daily radiation treatment, 5 days per week, for 7 weeks. I'm plugging along. I'm cherishing every day. I'm working on my relationship with God and with myself. I started my first ever Bible study group last night and I'm so happy to have made that important step to learning more about God's will for my life. I look forward to sharing more about that at a later time. With love and gratitude, Julie

Tissue expander - implant exchange surgery: Update

Surgery went great today. We arrived at 7:30 am at UCLA to get checked in. On our way down the hall to the surgical center we ran into Dr.C and chatted with him briefly. I asked him about his recent trip (conference at a resort I spent a couple weeks at for work a couple years ago) and he gave me the quick low-down and we had a good laugh about a warning I gave him before he went (bed bugs at the resort). Although it's not the kind of thing he nor I probably needed to cause him to think about me while he was on his trip, I was able to give him valuable advice on how not to bring those buggers home to his family and it gave us something to laugh about the last couple times I've seen him. And, I'm thinking it's always a good thing if you make your doctors smile and laugh when you see them - especially if you'll be under the knife with said doctors so I'm always looking for ways to keep him and my other doctors smiling and laughing. LOL

I got called back for surgery prep so off we went (right on schedule, too). Got into that fashionable gown, paper hat and booties, etc. Saw Dr.C again and he marked me up with that lovely purple surgical marker and I got him laughing again - so much that he had to stop marking me for a second to avoid making squiggly lines heehee. Then the anaesthesiologist arrived and I got him to use my port for the first series of iv meds which was GREAT because that meant I was asleep when they put the next iv in my arm (right arm, of course). He gave me a tube of numbing cream and some cool cream holding bandages to take home with me (bonus! esp since I've been using press n seal wrap to hold my cream in place all this time haha) since I'll have my port another year for ongoing blood draws and a iv-delivered drug I'll be getting monthly for a year (more about that later).

We reminded every team member about my left arm - NO BP, NO NEEDLES - and we put a big long piece of surgical tape on my left arm with big lettering of that message to ensure nobody tried to mess with it - mission accomplished. Just after the doc put the first series of drugs into the port iv, I closed my eyes briefly and said a simple prayer: "Dear God, I give it to you. You have my complete trust and faith. Thank you for blessing me in countless ways on this day and every day." I opened my eyes and resumed talking to Bob and quickly things started appearing fuzzy. I woke up, looked at the clock in front of me, which said 11:30am (PT) and turned to Bob and said something like "gosh, when are we getting this party started?" and he laughed and informed me it was all done. =) Sweet! No nausea from the aneasthesia - yay! (my chart showed that has never been an issue for me at any of my previous surgeries and prior to this surgery the the doc mentioned it and was impressed - I told him I'm totally an overachiever and that got him laughing haha) The surgery went well and they wrapped me up in a lovely gauze halter contraption - the same style I had after the bilateral mastectomy. I get to sport this lovely fashion statement until Sunday afternoon and that is when I'm allowed to take it off, look at my new tatas, and take a shower. As I sat there in recovery I thought about how my breast cancer sister warrior powwow (aka support group) is on Thursdays from 11-12:30 at UCLA just one floor beneath the surgical center. I was thinking I should ask them to just wheel me down there to say hello but I know that Bob would think I was cookoo so I didn't say anything. Besides, by the time they finally got us out of the surgical center it would have been too late - but I was hoping I'd run into the gals on the elevator as they wheeled me down to the parking garage. Unfortunately, I didn't see any of them.

I can ALREADY tell the difference with the pesky expanders gone. I just felt under my armpits and can't feel them (could before), and felt the top of my chest area just below where my port is and can't feel them bulging out (could before) - this is SO AWESOME! Those things (expanders) took up so much chest real estate before and were so uncomfortable, I'm so happy they're out! Woot!

I was home by 2pm PT and felt pretty good - tired and hungry, but not in any pain (due to drugs, I'm sure). I had some soup and crackers and green tea and went up to bed. Bob woke me at 4pm to give me my next pain pill and I went back to sleep and woke up around 7pm to find Bob downstairs hooking up my new wii system! Bob and mom got it for me for my birthday and it arrived today while we were at UCLA. How exciting!

I still feel good, pain meds on schedule to ensure that continues. Cooper seems to be doing OK with me not able to pick him up. I sit down and someone else picks him up and puts him in my lap (with a pillow against my chest to prevent him from pressing on or knocking my incision areas). At bed time we did that in his room on the rocking chair and then when it was time Bob picked him up and placed him in the crib and I tucked him in and he was OK with that, thankfully.

Day 2 following surgery is usually the toughest, in my experience, so tonight I'm getting all the things I'll need arranged next to my bed so I can stay in bed and rest. Hopefully it won't be too bad since they gave me a full pill bottle of pain meds. Dr.H recommended a supplement (Bromelaine) for me to start taking tomorrow to help reduce swelling so that will go down quickly and allow me to keep my radiation simulation appointment in 2 weeks.

Thank you, God, for holding me and keeping me safe and comfortable - for instilling brilliance, talent and compassion in every member of my surgical team - for blessing me with a wonderful mom and husband to help me through this here at home - for precious Cooper - and for all the many friends and family members who continue to support me through this journey. For this, and many many countless other blessings, I thank and praise Thee.

To my friends, family members, colleagues, and blog followers - thank you all for your prayers and positive thoughts. I KNOW it helped because I had an excellent surgery experience today. Thank you to the UCLA team that took such awesome care of me today, as usual. I love Dr.C and the surgical center nurses - they're truly the best in their field as far as I'm concerned and I'm so blessed to have them as my care team.

Love,

Julie

PS - Here I am, ready for surgery - no make up, no brow pencil (though they're coming back quickly haha) - I'm au naturale! :)

Prayer request: surgery tomorrow

It's hard to believe but it's already time to get these pesky tissue expanders out and exchange them for some sleek, soft silicone implants! Tomorrow morning I'll have outpatient surgery at UCLA. I'm excited because these expanders are very uncomfortable and have been bugging me since June haha. Besides getting them out and getting the implants instead, Dr.C will be "cleaning up" the area - nipping and tucking, so to speak - so that the result will be nicer to look at than what I've got now. The expansion process has been to basically stretch/grow skin and that produces funny shapes and excess skin that is just kind of icky and I'm psyched that at this time tomorrow that won't be there anymore :). I would appreciate your prayers for a successful, complication-free, surgery and recovery so that I can stay on schedule and proceed with the next important step in my treatment process - radiation - which begins next month. Thank you! Love, Julie

We're at UCLA

We are at UCLA for my big day! We're waiting for the Admissions office to open (4:30am PT).

We are praying for a successful, complication-free surgery that eliminates all the pesky uninvited cancer cells from my body. We pray for the surgical team's strength, brilliance, skills, and compassion on this critical first day of my new life as a SURVIVOR of breast cancer. We thank God for His love, and for our amazing support network that is praying for me and cheering us on. We are grateful to all of you for your love and support. You know I will be on the blackberry as soon as I can be to post updates. :)

Cancer, YOU'RE GOING DOWN, BITCH!

Love, Julie