Chemo Round 3 + A Letter to My CrossFitters from your Favorite Breast Cancer Patient

Here is a photo of the alien coming out of
my skin (aka the port).

Prelude to Round 3: Port Surgery
Each time I go in for chemotherapy, I have to get lab work done so they can review my white blood cell counts to make sure they are high enough to go for another round without added risk of infection, and look at other indicators like red blood cell counts. On round 2, we were going in for labs and instead of the usual 15-20 minutes of getting the IV and the blood draws, it took a whole hour to find a suitable vein. They claim my veins are "smart" because they know to avoid the needles, but in reality they are just a pain because it meant getting poked 3 different times in 3 different areas, leaving me bruised and battered all over my left arm.

At that time, they recommended I get a port, which is an alien-like device placed under the skin in my upper left chest area, with a direct line to my jugular vein. They can stick needles into the port and always find a good vein, and it only takes about 1 minute to get it done. The surgery was an outpatient procedure, performed by the same surgeon who did my mastectomy (a good-natured fellow, Dr. Ed Nelson) who promised he would keep his hand steady when he cut into the jugular vein. How reassuring. The port proved to be a tremendous benefit when I went in for the labs on Round 3, taking just a couple of minutes and leaving me with no additional needle pokes on my ravaged arm.

Round 3: December 17
Then on Tuesday I went in for round 3 of chemotherapy, out of a total of 8 rounds that I have scheduled. On round 5 we switch up the meds, so this was actually 75% of the way through my current chemo medications. I've come to the conclusion that I am either:

(1) Very lucky to escape most of the bad side effects, or
(3) Genetically awesome when it comes to resisting chemo side effects
(Honestly I don't care which it is, I'll take either)

Here is my best shaved-head selfie. I'm really
not that good at taking selfies.

I have had some nausea, but it's easy to control with the medication they give me, and the only other noticeable side effects have been some heartburn (also easy to control with a prescription), and some fatigue (easy to control by sleeping more and skipping work).

I did find out in this most recent lab work that I am slightly anemic, which means I have lower-than-optimal red blood cell count, and also explains why I have been so winded when I go back to workout at CrossFit (it can't be that I took 2 months off and have been eating a terrible diet around the holidays, can it? Nah, I'm sure it's the anemia).

Overall, rounds 2 and 3 have so far been very similar to round 1. I did begin losing some of my hair after round 2, and promptly shaved my head. Of course, as soon as I shaved it, the hair stopped falling out, so now I just have a shaved head of stubble. It's a little patchy, and VERY cold (I had no idea how much heat my hair was holding in), so I supplement with some awesome wigs my cousin gave me and a few hats to keep warm.

A Letter to My CrossFit People
Note: I'm writing this about CrossFit, but generally speaking, you could substitute the idea of fitness throughout, so you can read this even if you don't do CrossFit. Or you could try CrossFit because it's awesome. 

As I was sitting at the chemotherapy infusion center on Tuesday for my third round of chemotherapy (out of 8 total), I was browsing through pictures of some amazing athletes at CrossFit Timpanogos, and I was inspired to write you a little note. Some of you have seen me there recently, after I finally got clearance from the reconstructive surgeon to go back to working out and lifting weights, albeit lighter weights than before (as an added bonus, I've gotten to make some new friends when I do the Fitness WODs instead of Performance). It has been great to be back, even if I am a little out of shape.

When we talk about CrossFit, we often say that it prepares you for "the unknown and the unknowable", and as I was sitting through the chemotherapy infusion, it made me think about how completely out of the blue (the very manifestation of unknown and unknowable) this cancer diagnosis has been.

At the same time, I realized how much CrossFit has done for me to prepare me for this challenge. I can honestly say that I am a different person now than when I first walked into Cache Valley Strength & Conditioning four years ago, and CrossFit Timpanogos 3-1/2 years ago. The workouts that we do every day have not only made me physically strong (which I believe is helping me get through chemotherapy and all these surgeries a little easier), they have made me mentally tough too. The ability to power through a CrossFit WOD, your whole body screaming at you to please stop, then to find the strength to keep pushing through until you have accomplished your goal is a a tremendous benefit in this fight with cancer or any challenge in life.

Plus the people at CrossFit Timpanogos, and friends from other gyms, have provided me with much-needed emotional support through this whole ordeal, like a cheerleading squad behind me the whole time. The highlight of my days is walking into the gym to see all your smiling faces (even if those smiles do turn to agony-filled faces as the WOD progresses), to get hugs and words of encouragement, to hear how you are doing, and to hear your inspiring stories of you and your loved ones who are survivors just like me.

I have also been thinking about some of you who I haven't seen at CrossFit in a while (I won't name any names, although some of you have personally confessed to me that you've been slacking lately, so you know who you are). I can totally sympathize with you on how easy it can be to fall into a habit of not showing up at the gym, and maybe it is even for very valid reasons. But the reality is that there are so many things that you are getting when you DO show up for the workouts, whether it's achieving your goal of losing weight and getting healthier, being able to chase your kids around at the park instead of being out of breath the whole time, or even being strong enough to get through a fight with a disease like cancer or another big challenge in your life.

If you haven't been to a WOD in a while, I challenge you to join me back at the gym. Don't wait for the new year to come back (believe me, there's nothing magical about the date of January 1 that is going to change your motivation level). Come back today. Or tomorrow. Or the next day. Just come back. If it seems hard, just think about how much I want to see you there, and how much I miss you. Not just me either--I think I could speak for all the coaches and your fellow CrossFitters when I say that we all miss you.

I truly love all of you, and appreciate the support and encouragement you provide me with every day. I look forward to seeing you at the gym soon!

P.S. If you're reading this and you don't go to CrossFit, (1) what is wrong with you? It's the best workout you will ever get in your life, so you should join, and (2) feel free to join us any time at CrossFit Timpanogos in Lehi. Your first 3 classes are free!

Chemotherapy and You

When I first met with the oncologist in October, they gave me a booklet entitled "Chemotherapy and You," which included several pages explaining the most common side effects of having poisonous toxins pumped into your body over the course of several weeks and months. While it is a helpful piece of literature to anticipate some of the changes that might come, both the book and the oncologist continually emphasize that every person responds differently to chemotherapy, which means the book on "chemotherapy and me" can't really be accurately written until I am done with the treatments.

Round 1: November 19

I've never been the type of person who was nervous about new situations, but my first day of chemotherapy was definitely a mix of emotions. All the delays caused by the difficulty with getting my mastectomy incision healed meant that chemo had been put off almost a month from the original start date. It had been a while since I first met with the oncologist, and while I was not exactly excited to get this thing going, I was definitely ready to get it over with. At the same time I was very nervous about what was about to come. 

The day began simply enough with some lab work, to make sure I was in good enough condition for my first treatment (meaning my white blood cell count was high enough to withstand the onslaught of drugs coming my way without increased risk of infection). The doctor said my white blood cell count was exceptional, so we could go forward.

The next couple of hours were actually fairly relaxing--the Huntsman Cancer Center has a really nice infusion center where they have several pods that include four sections, each one complete with a recliner for the patient, another chair for a friend or family member, a couple of small desks, and even your own television with a blu-ray player. The view is also beautiful, overlooking the whole Salt Lake valley. Since my only experience with chemotherapy prior to this was basically Breaking Bad and the movie 50/50, I was expecting a small room with a few recliners placed in a semi-circle where I would have to stare awkwardly at people much older than me while we all got our bi-weekly dose of poison.

We also learned that on Tuesdays they show movies on a projector screen that covers the big windows, but apparently they only show educational stuff, so it's like the movies you had to watch in 8th grade when the teacher was out and you had a substitute. It's no Man of Steel, but I guess that has the effect of helping you sleep through your chemotherapy if you prefer.

The first four treatments will all be the same, beginning with the anti-nausea medication Dexamethasone. Once that's done dripping in, the nurse injects the Doxorubicin by hand, which comes in three small vials that have to be slowly injected over the course of 5-10 minutes (it begs the question, why can't they just get bigger vials, then only have to inject one over the course of 20-30 minutes?). Then we finish up with the Cytoxan, which takes about an hour to drip in through the IV. Overall it's about 2 to 2.5 hours, which isn't really that bad.

The Fun Part
Getting the actual chemo infusion is kind of the easy part--the really fun part is figuring out what it will do to you once you have the drugs in your system. As mentioned in my previous post, there is a laundry list of potential side effects, and in the grand scheme of things, I was actually pretty lucky. I did have a little bit of nausea that was pretty well controlled with all the anti-nausea meds they gave me, and aside from that the only major side effect was fatigue. I felt more tired and slept more than usual, but only a couple of hours more each night, which was kind of great.

I also had to go and get a shot of Neulasta at the University of Utah Daybreak Clinic the next day, and they mentioned that I might have some "bone pain" following the shot. I didn't know what that meant at the time, but on Saturday night I discovered that it feels kind of like you have bruises everywhere on your body, especially in areas where you have large bones, like your hips, shoulders, sternum, and femurs. Fortunately I took a Lortab and fell asleep on Saturday night to find that it was gone by Sunday.

I was also able to go back to work (although not all 40 hours), and even got to go back to CrossFit Timpanogos for the first time in 8 weeks. I loved it, even if I did kind of feel like I was on the verge of death after getting so out of shape in the past two months. With two weeks behind me, now it's time to find out what Round 2 would bring.

Groundhog Day

If you grew up in the early 90's like I did, you probably remember the Bill Murray movie Groundhog Day. For those of you who haven't seen it, or who don't remember back that far, it's a movie about a guy who relives the same day over and over again. Here's a little clip for your enjoyment (which you will only find amusing if you've seen the movie. If you haven't, go find it on Netflix or buy it for a few bucks at Amazon).

After the surgery on October 22, the whole mastectomy incision healing process was starting to feel like Groundhog Day, where I was just reliving the same issues over and over again. That is to say, each time the incision would look pretty good for a few days, but within about a week, fluid would begin to leak out, portions of the incision wouldn't close up, and I would wind up back at the doctor to find out what we could do. 

On November 4 when I went in to see Dr. Agarwal, the nurse told me not to eat or drink that morning because it was pretty likely that I would end up in surgery again. It was true--with the incision still struggling to heal, and not looking like it was getting any better, the doctor recommended that we go in and take out the tissue expander, a plastic, foreign object inside of me, that he thought might be making the healing process more difficult for my apparently traumatized body. This time there wasn't an option for the simple sedation method, I had to go all the way under general anesthesia again, and hope to avoid the nausea and general malaise that comes with it. It was a same-day procedure, and the result is a whole new meaning to the term "uni-boob". 

About a week later, I did have another repeat where some fluid started leaking out, but since then with some exceptional wound care (from the mini-hospital that now exists in my master bathroom), I have been able to get it closer to being completely healed. Taking the tissue expander out also means that we are going to put off the reconstruction surgery until after I am done with chemotherapy, when we will try to put the tissue expander back in, with a "Plan B" if it once again doesn't work out. I may explain Plan B in more detail later, but only if it's necessary. Suffice it to say it's not my first choice, and I am hoping my body can handle the tissue expander next time around without any major complications.

The next step, which has been postponed three weeks now due to my body's inability to heal, is to start chemotherapy. I have spent this evening reading all about the side effects, and it turns out that the next few months might suck. Or they might be mostly normal. Either way, I will probably be bald for a while, I will likely be a hypochondriac who calls the doctor on a daily basis with new symptoms, and I will definitely become a germaphobe who uses copious amounts of hand sanitizer at all times.

For anyone who has been through chemotherapy before, or anyone in the audience who is curious about my treatment, my chemotherapy regimen is eight cycles that are two weeks apart, or a "dose-dense" regimen. The oncologist said chemotherapy cycles two weeks apart instead of the traditional three weeks have been shown through research to be more effective for treating my kind of breast cancer. It includes the drugs Cyclophosphamide (brand name Cytoxan/Neosar) and Doxorubicin (brand name Adriamycin) for the first four cycles, adding Paclitaxel (brand name taxol or Onxol) for the final four cycles. One day after each chemotherapy infusion, I'll also get a shot of Pegfilgrastim (brand name Neulasta) to boost my white blood cell production.

The list of potential side effects is long, although the literature emphasizes that everyone responds to the treatments differently, so the specific side effects I will experience are still to be determined. The main ones I'll be on the lookout for include:

• Nausea
• Hair loss
• Increased risk of infection
• Rash, hives, or other allergic reaction
• Shortness of breath
• Fatigue
• Mouth, throat, and lip sores
• Loss of appetite
• Increased bleeding risk
• Muscle pain or joint pain

Other than all that, it looks like this is shaping up to be the best winter ever. On the bright side, my third surgery did postpone my chemotherapy one more week, which means that I won't have treatments the same week as Thanksgiving and Christmas. I will, however, have a treatment on my birthday. We'll see if it can compete for "worst birthday of my life", up against the year that I had my tonsils out on December 26 and woke up on New Year's Eve puking up blood and had to go back to the doctor to cauterize the wound that day. I'm hoping that 2003 birthday keeps the title.

"Uh-oh"

I have never been to medical school, but if it's not already part of the curriculum, they should have a seminar on phrases that you should never say when you see a patient. Some things that I would recommend a doctor keep out of his or her vocabulary might include:

• "Gross" 
• "Uh-oh"
• "Oops"
• "That wasn't supposed to happen"

On Tuesday we went in to meet with the reconstructive surgeon to begin the next phase to rebuild me after the mastectomy, and he peeled off the glue that was holding the incision together after surgery (it was supposed to just start flaking off as it healed, but only a small part of the glue had come off by the third week). Starting Friday night and through the weekend the area around the incision had been leaking some fluid, but I was told that as long as there were no obvious signs of infection--fever, chills, redness and warmth that spreads--then it was probably okay. They said to keep it covered and clean, and they would look at it when I came in for the appointment. 

When we got there, the doctor peeled off the remaining glue and the first thing he said was "uh-oh." Yep, definitely not what I wanted to hear him say. He proceeded to explain that after a mastectomy, there is a very thin flap of skin left, which means it may have more difficulty getting proper blood supply. It turns out that in the immediate area around my incision, the skin wasn't getting enough blood, and it died.

The biggest risk after any surgery is the risk of infection, and with dead skin in the area, the chance of infection increases. With the tissue expander in place (the thing that is used to stretch the skin and prepare for an implant later), that risk can derail the whole process. As the surgeon explained, if bacteria get into the skin around the tissue expander, they attach to the plastic and are virtually impossible to excise without taking the tissue expander out altogether. In order to prevent infection, we had to go back into surgery to remove the dead skin and re-stitch the wound with just the healthy skin. 

The appointment was at 10:30 a.m., and fortunately I had not eaten anything since the night before, so they sent me directly to the surgical area of the hospital and told me to check in. It was supposed to be a quick outpatient procedure, and I was hopeful that we would be out of there by early afternoon. What they didn't mention was that since I was scheduled at the last minute, there were no operating rooms open until 5:00 or so. That meant sitting in the waiting area playing Candy Crush (we did leave for a couple of hours to run some errands) and trying to distract myself from feeling very hungry. 

Finally around 4:00 we went back into a pre-op room and by 5:30 there was an open room available. This time around they were able to do the procedure under MAC, or monitored anesthesia care, instead of general anesthesia. Instead of going all the way under, I remained conscious (although sedated with something to help me relax) and breathing on my own, and they just numbed the immediate area. It may seem weird to be awake during surgery, but they want you to be conscious enough to tell them if you are feeling any pain--if that happens, they put you all the way under. The anesthesiologist Rachel was really great, and we actually had a nice conversation during the procedure, which lasted about 45 minutes. They said the sedation affects your memory, but I recall quite a bit of our conversation about my family, her favorite restaurants (she recommended Per Noi Trattoria in Sugarhouse), and the best Broadway shows (I highly recommended Rock of Ages). 

When it was all over, I had a newly stitched wound and no more dead skin. It did set me back a couple of days on my recovery and getting back to work, but overall it will hopefully just be a little bump in the road to full recovery.

Barbells for Boobs

If you have spent more than about 15 minutes with me, you probably already know that I love CrossFit. I won't go so far to say that I am obsessed with it, but okay, I am obsessed with it. That has pretty much been the case since I first walked into CrossFit Cache Valley in October 2009 (now Cache Valley Strength & Conditioning) at the recommendation of a couple of friends. Since that time I've averaged about 5 workouts a week, and rarely miss more than a few days at a time.

In April 2010 when we moved away from Logan, I became one of the charter members of the newly opened CrossFit Timpanogos in Lehi, where I have since become a coach and generally love everyone and everything about that place. In October 2010 we found out about a fundraiser that some CrossFitters in California started for breast cancer awareness month called Barbells for Boobs (if you would like to find out more, or donate to the cause, you can do that here). Participants donate and complete the CF benchmark workout "Grace", and the money goes to a group called Mammograms in Action that helps women and men, who would otherwise not be able to afford it, get life-saving screenings like mammograms. Supporters can also donate without doing the workout.

I can always appreciate a good cause, and when it has a catchy name like Barbells for Boobs, and involves a CrossFit workout, I'm on board. Our small gym participated in the event the first year, had a good time, and we have participated in it every year since. We're never the gym that raises the most money, but we have been able to contribute a few thousand dollars over the years.

I had been thinking about the event during the summer, wondering when I should start planning for it, when I was myself diagnosed with breast cancer. Despite the obvious challenge of not really knowing what my next few months were going to be like, I knew we had to continue with the fundraiser. In fact, I figured I could probably exploit my condition to help raise a little bit more money for the cause. I even got a chance to go on KUTV and promote it in advance, with some help from a couple of amazing athletes from CF Timpanogos.

Just 5 days after my surgery, I was able to attend and see friends and strangers come out to support the cause. This year we had over 50 donors, and about 120 people who did the workout, which was an amazing turnout. I want to send out a special thanks to everyone who participated, and those involved in putting the event together, including our sponsors that donated prizes--CrossFit Timpanogos, Progenex, Gnarly Full-on Nutrition, Texas Roadhouse in Lehi, Anytime Fitness Tanning in Saratoga Springs, SexyModest Boutique, Ute CrossFit, and RidgeCrest Herbals.

True Love

Anyone who is married knows that it requires a significant amount of sacrifice, teamwork, and a lot of love to make a marriage work. That is especially true when one of you gets sick. I remember when I first got the news that I had cancer thinking that I was so glad it was me and not Nick. While I would have preferred that neither of us would ever have to go through something like this, having the cancer myself means that I at least feel a little bit in control. If it was Nick who was going through the same thing I would feel so helpless and out of control, wanting to be able to fix it but not being able to do so. I'm sure that is how he feels too, given the circumstances.

Fortunately when I got married, I picked the absolute best, most amazing, loving, and wonderful husband that anyone could ever be lucky enough to get, and he has been right by my side through this whole thing, providing the best care while I have been laid up. I was browsing through some breast cancer forums before the surgery to try and figure out what the recovery would be like, and remember stumbling across a post from a woman who was terrified of the surgery because she was concerned her husband was going to be upset with her for not being able to take care of the kids and the house. That seemed really devastating to me--not only to have to go through the trauma of cancer and surgery, but have the added stress of an unsupportive spouse on top of that. For me it was the exact opposite.

When you get a mastectomy, they put a couple of drains into your body at the incision site to help drain excess blood and fluids and prevent swelling and infection. The little tubes dangle from your side, and must be drained a couple of times each day. In addition to being kind of gross, and supremely annoying, they make most daily activities difficult, and they are in addition to the six-inch incision across my chest that was pretty painful. So it was that for two weeks I couldn't really get dressed, shower, brush my hair, cut my food, or even open the lid to the water bottle I brought home after surgery (seriously, they tell you to stay hydrated and give you a water bottle, but you can't even get the lid off...thanks a lot, hospital).

The great news is I have a great husband, and tons of other loving and supportive friends and family. From the first day that I returned home from the hospital, I had a constant stream of visitors, plus all the help I needed from Nick. In the hospital he spent the night on a pull-out "bed" that was about a foot shorter than his body, held the bucket for me while I threw up when I got nauseated from the surgery, and didn't care that I probably looked pretty horrific after a couple of days without a shower. Since we came home he has tirelessly helped with getting me dressed, undressed, and showered, and even learned how to blow-dry my hair when I couldn't do it on my own (despite the fact that Nick had never even held a blow dryer before this whole experience). He has cooked me food, woken up in the middle of the night to fetch me some pain medication or get the water bottle I couldn't reach from bed, and gone on walks around the neighborhood so I could get out of the house for a few minutes. He texts me from work to make sure I'm doing okay when I'm home alone, and hangs out with me all day on his days off.

I have always known that I have a great husband who is a ton of fun to be around, and makes my life happy, but after these two weeks I am more convinced than ever that I hit the true love jackpot.

D-Day: September 30

As September 30 was nearing, I couldn't help but feel like it was a sort of D-day for me. Please know that comparing my breast cancer journey to the day that troops stormed the beaches at Normandy in the fight against Nazi Germany is certainly not intended to minimize or make light of what soldiers went through on that terrible day (more than 9,000 soldiers were either killed or wounded). But that operation was what General Dwight D. Eisenhower called a crusade where "we will accept nothing less than full victory." It wasn't the end of the war by any means, but it was a critical part of the battle that turned the tide in favor of the Allied forces.

The hard thing about cancer is that surgery, while a major undertaking, is really just the beginning of the battle. It's an important step down the road to recovery, but it is certainly not the end. And in my case, it was the beginning of a crusade where I will accept nothing less than full victory.

So I reported to Huntsman Cancer Hospital on September 30 to say goodbye to one of my boobs forever. It's certainly a strange feeling knowing that when you wake up part of you will be missing, but it is a necessary casualty in my own personal war.

After a quick meeting with the anesthesiologist (I had been suffering from a pretty bad cold and cough the previous week, so they sent in the anesthesiologist to make sure it would still be safe to put me under for the procedure), and some time with the plastic surgeon, I made my way to the "Nuclear Medicine" wing of the hospital. Inside a small room, there was a needle next to a container that said something to the effect of DANGER on the outside, and the surgeon explained that it was radioactive material that they were going to inject into me. So, yeah, great. They store it in a lead container and nobody wants to touch it because it's potentially dangerous, and they are about to inject it right into my body. Supposedly it's a low dose of radiation and I'm going to be fine, but once that shot is in, I'm officially nuclear.

The radioactive material is actually designed to travel to my lymph nodes, the same path that potential cancer cells might travel if they had escaped the immediate area of the tumor and decided to go somewhere else in my body. According to the surgeon, there is no specific pathway that they follow, but finding cancer cells present in the lymph nodes indicates that they may have spread elsewhere. The radioactive injection helps the surgeon find the first few lymph nodes that drain from the breast tissue, thus enabling them to do a quick biopsy of those nodes while I'm already in surgery. If they find cancer cells present, they take out the lymph nodes and can either biopsy more, or take out more in the area.

It was supposed to take 2-3 hours for this material to drain into my lymph nodes, during which time I expected to be miserably hungry and thirsty (since it was close to 11:00 by then and I hadn't eaten since midnight the previous night), but it was only about 30 minutes before the surgeon came in to go over a final few notes before the procedure, then maybe another 15 minutes or so before the anesthesiologist came in to get me and take me away. During our pre-op meeting the surgeon also took a few seconds to write "yes" on the right breast in marker, just to make sure he took out the right one, he said. I hadn't really considered the possibility of getting out of surgery to find that they had taken the wrong breast out, but that seems like it would be pretty horrific. I'm glad he gave himself this little reminder.

Once in the operating room, it only took a few minutes before they gave me the anesthesia, and the next thing I remember is waking up in the recovery room around 2:30. Apparently everything went as planned (he took out the correct breast), and after an hour or so in recovery I was taken to a hospital room for the night.

First let me say that I am very grateful for the exceptional care provided by all the nurses and aides who were at the Huntsman Cancer Hospital that night. They really were great. That said, spending the night in the hospital is miserable.

I was exhausted and in some pain, nauseated from coming out of anesthesia, and really all I wanted to do was sleep. That turned out to be impossible because of the constant activity level inside the room. I don't think we were left alone in the room for more than about 60 minutes at a time all night. Between aides coming in to take my vitals, nurses coming in to check if I needed anything, and surgeons coming in to discuss the results of the procedure, check my incision, and give me instructions for when I headed home (they do this before surgery, so they started coming in around 5:30 or 6:00 a.m., and I had several different surgeons and residents visit me because I got both the mastectomy and a tissue expander to start reconstructive surgery), I probably got a total of 3 hours of sleep that night.

There was even a time around 3:00 in the morning when one of the aides came in to tell me that she would no longer be my aide, and introduce me to the new person who would take over. Let's be honest--I'm on pain meds, delirious from lack of sleep, it's 3 a.m., and I really don't care who shows up to take my vitals. Whoever shows up, I'm going to assume they are the right person to do it, and it really doesn't require waking me up in the middle of the night just to tell me someone else is going to do it, then telling me that person will be back to wake me up again in an hour for said vitals.

Fortunately mastectomy surgery only requires a 1-2 day stay in the hospital, and the next morning they encouraged me to try and get out of bed and walk around the hospital wing at least 3-4 times that day. The first walk was just to the bathroom, and the next one was a little shaky, but by walk #4 I felt pretty good and was eager to get discharged. We found the surgeon and were able to get permission to leave and go home for a real night's sleep.

Caught Up in a Whirlwind

Probably one of the most difficult things whenever we face a big challenge or trial is the sheer volume of information and activity that happens in the wake of devastating news. I remember the week after my dad died five years ago, there was so much that had to be done, and it all had to be done quickly despite the fact that our whole family was completely overwhelmed. It would have been much easier to just lay down and cry than to spend time organizing a funeral, hosting friends and family who were coming to offer their support, and figuring out the final arrangements for his cremation.

Hearing the news about cancer sort of felt the same way. One the one hand, it would be much easier to just sit down and cry (and believe me, I did plenty of that for a couple of days), but there is so much that has to be done to figure out treatment, and it can't really wait. The next two weeks following my diagnosis were a whirlwind of appointments, consultations, and meetings with surgeons, oncologists, nurses, and other care providers.

I have never really been the type of person who actively sought medical treatment, and prior to August 2013 could probably count on two hands the number of times in my adult life that I have been to a doctor for something besides a routine physical. That all changed with my diagnosis, and from August 14 (the day of the mammogram and biopsy) to mid-September, I'm sure I had more tests, appointments, and scans than I have had pretty much ever.

The most important and pressing matter was to figure out what kind of surgery I wanted to do. Essentially, there are two options:
(1) A lumpectomy, where the surgeon removes only the tumor and some surrounding tissue, in an attempt to save as much of the breast tissue as possible.
(2) A mastectomy, where the surgeon removes all the breast tissue on one or both sides.

Given that my tumor had only shown up on one side, it wouldn't make much sense to do a bilateral mastectomy, so the choice was then down to a lumpectomy or a unilateral mastectomy on the right side. We sat through several doctor's visits learning all the options, as well as the projected outcomes and the potential for a cure. I spent way too much time on the internet researching all the pros and cons for each choice. I even found a YouTube video of a mastectomy surgery, and watched about 30 seconds of that before I had to turn it off (apparently it's good I didn't try to become a surgeon, since it made me a little queasy to watch).

During this time we also decided to go and get a second opinion at the Huntsman Cancer Institute and find out if I wanted to get treatment there instead of through IHC. While I am confident that both places could have provided good care, after meeting with Dr. Nelson (the surgical oncologist) and Dr. Agarwal (the reconstructive surgeon) at Huntsman, the choice to get treatment there was clearly the best choice for me.

After a few more tests, scans, pathology reports, and biopsies, Dr. Nelson explained that I was not a perfect candidate for either surgery choice--the perfect candidate for a lumpectomy is someone with a very small tumor and/or very large breasts, while the perfect candidate for a mastectomy is someone with a very large tumor and/or very small breasts. I had a medium-size tumor with basically average-size breasts. Armed with all this information, I decided to go ahead with a unilateral mastectomy, and the surgery date was set for September 30.

The Day That Changed Everything

We all have struggles in life, but recently when I was thinking about my own life, I realized that I have had it easy. I was born into a great family with parents who love me and believe in me, and have pretty much had what I want and need growing up. The most difficult thing I have ever had to deal with was the death of my dad after a battle with cancer, but again, having a close-knit, loving family helped to ease the pain during that very difficult time.

In light of this relatively easy life, the events of the past month have been crazy, emotional, and surreal. It started on August 12 when I had been feeling a little bit of soreness and pain in my right breast, and felt a lump. My automatic assumption, as someone with virtually no risk factors (no family history, no obesity, smoking, or drinking alcohol) was that it was nothing. Still, somehow it seemed different than the other 500 or so lumps you can usually feel in your breast tissue, so I called the doctor's office the next day and told them about it and they immediately ordered an ultrasound to check it out.

I went to American Fork Hospital on Wednesday, where the radiologist was unable to determine what the lump was after an ultrasound. He ordered a biopsy and a mammogram to check it out a little more, and a couple of hours later I left the hospital, again feeling like it was probably nothing. So it came as a pretty big shock when, the following Monday, I got a call from the doctor's office and the nurse said the "C" word--her exact words were "it is cancer."

Shock. Devastation. Tears. Fear.

I'm not really sure what I felt at that exact moment, but I was sitting in the parking lot at work, having just arrived at the office for the day, and I decided that I needed to compose myself and go into work. I was probably in shock at the time that I decided to go in to work, because I only made it about 2 hours before I had to get out of there and go home. The next few days were kind of a blur of being scared, crying, cuddling with Nick, and wondering about the future. As a 31-year-old woman who leads a relatively healthy life, this kind of news was the last thing I expected to hear.

I'm sure I spent way too much time on the internet over the next two or three days, researching, Googling, trying to find out everything I could about how someone like me ends up with this disease. While I believe the internet is a great place to find information, it's also one of the worst places to find information because you can quickly convince yourself that you are probably dying as you look at all the health websites out there (both reputable and not-so-reputable). The next step, though, was to get to the doctor and find out about what my options are.