One Year Later

One year ago today my life changed forever. On August 18, 2013 my life was (pretty much) normal. On August 19 when I got that phone call--"It is cancer," the nurse said--everything was different. I barely remember the days right after that, everything was very sad and very scary. But one year later I feel stronger and happier than ever. There have been bumps along the way, and the process isn't over yet, but the end is in sight and that is certainly worth celebrating.

The Update

I met with my reconstructive surgeon for the first time today since my tissue expander placement surgery on June 27, and was pleased that he thinks things are going well. The skin around the tissue expander is still very thin, and he said we will have to "take it slow" on the expansion, but overall it is definitely going in the right direction. We didn't set a date for my final surgery--much of that will be determined by how the expansion goes over the next few weeks--but it will likely be in October sometime.

The Changes

The past year has brought plenty of change, as I went from a healthy 31-year-old to a cancer patient, and now to a cancer survivor. I lost my hair, and now it's growing again (like a weed). It didn't even change color or grow in curly, it looks like it will be exactly the same as it was before. I gained weight and the change in hormones from the meds I'm on makes those stubborn pounds harder to lose. I have lost a good portion of my strength, and I'm a little bit nervous about going back to CrossFit, where I will likely be suffering through the WODs for a period of time while I gain that back. But overall I have also gained some perspective. I try to spend more time with the people I care about. I worry less about little things that might have otherwise bothered me before. I try to do what I can to make other people's days better, even if it's just in small ways. 

I recently had lunch with some college roommates, and one of them went through a scary pregnancy and had to undergo surgery for a potentially life-threatening condition (fortunately mom and baby are both doing well now). We discussed how the news of your own mortality is terrifying, but at the same time it really helps you to focus on what matters. I think I have always been a pretty positive, look-on-the-bright-side kind of person, but it always helps to have a reminder that life is short and every minute should be one that lifts you up, not one that you spend bringing yourself or others down. 

Another thing that has come into sharp focus is how amazing my friends and family are. I cannot tell you how many times it has brightened my day to have someone tell me they are thinking about me, praying for me, and hoping for the best. How many people have sent me messages, commented on blogs, or given me encouragement through Facebook, text, and in person. It makes a world of difference and I want to say thank you. And I would be remiss if I didn't mention Husband of the Year Nick, who has been my biggest supporter and cheerleader through the whole experience. Who never fails to make me smile, and who has always been there when I needed him most.

The Future

The best thing that has come out of the past year is my ability to look toward the future. One where I can get back to CrossFit (seriously, I'm going through withdrawals) and triathlons, where I can laugh and smile, spend time with friends and loved ones, and be thankful for every day that I get. I hope to be able to look back on this past year plus a couple of months and say "wow, what a crazy time, but I'm a better person for it."

We Begin Again...

Friday, June 27 was the date that reconstruction began again for me. If you've been following this blog since the beginning you probably already know that we tried to do "mastectomy with reconstruction" when I first had the tumor removed, meaning they placed a tissue expander at the mastectomy site right after the breast tissue was removed in the hopes of expanding the skin during chemotherapy. For a reason still unknown the incision at the mastectomy site would not heal after the surgery, and we had to remove the tissue expander so that I could move forward with chemotherapy.

Now that the chemo is all over (and I'm cancer-free), we are trying the tissue expander again. Going into this, there were essentially two options:

1. Get the tissue expander placed again, and hope that the incision heals normally. Since I'm not going through the trauma of a mastectomy or trying to fight off cancer this time around, there is hope that it will work without any other interventions.
2. The most likely culprit of the incision not healing was lack of blood flow at the incision site, so the doctor also said we could perform a "lat flap" procedure where they take a portion of my shoulder muscle and tunnel it through my body, bringing it around to the mastectomy site. It remains attached to the muscle in my back so it increases blood flow in the area. 

The second option is a much more invasive procedure, and would likely put some limitations on my range of motion and strength in the future when doing Olympic weightlifting, CrossFit, and triathlons, and for those reasons I decided that I wanted to try the first option again. There is no guarantee it will work, and if it doesn't then I go back for another surgery and we do Option 2.

So far the recovery has gone well, and it seem to be healing correctly. It's only five days after the surgery, so I'm not out of the woods yet, but I'm getting there.

As I am going through this, I also have a friend from high school who discovered that she carries the BRCA gene mutation, which puts her at a seriously high risk of developing breast cancer (I do not have the gene, which is good news for my other boob and for all the women I am related to). Many women in her family have lost their lives to the disease, and she made the courageous decision to get a preventive bilateral mastectomy. The reason I'm telling you this is that she did a TON of research into the mastectomy procedure and the reconstructive process, so I'll share links to her blog here in case you are curious about the medical side of the procedure.

Mastectomy 101 Part 1: Let's Talk About Nipples

Mastectomy 101 Part 2: Breast Reconstruction and Expansion

Mastectomy 101 Part 3: A Body That Will Never Be the Same

Mine is different from hers--I was unable to decide whether I would keep my nipples since my breast cancer tumor was very close to the nipple and it would be risky to leave the tissue (there could be residual cancer cells in the area). She is opting for a "nipple-sparing" mastectomy, while I had mine removed. I will probably eventually get a 3D tattoo that will resemble a real nipple. As she talks about in Part 3, my body will really never be the same. The best I can hope for is that both sides look pretty similar, and under my clothes people won't notice the difference.

Here's the hoping the healing process goes better this time around!

So...What's Next?

Whoa, it's been quite a while since I posted anything here. I hope you all didn't give up on the journey, it's just been a crazy couple of months trying to get back into the swing of things now that chemotherapy is over and it's back to "normal life."

While the chemotherapy is done, I'm not quite finished with everything yet, and the question that everyone has been asking is "so...what's next?" Here's the plan right now, as well as some info on the prognosis after a follow-up with the oncologist.

Step 1: Tissue Expander
You may recall from last October that I originally had a tissue expander placed when I got my mastectomy. The idea at the time was to have the tissue expander in place throughout chemotherapy, filling it every week or every other week, so that when chemo was done I would be ready or within a few weeks of being ready for my final reconstructive surgery. Unfortunately my body had different ideas, and after refusing to heal with the tissue expander (even after two more follow-up surgeries to try and clear out some of the dead skin that wasn't healing), we eventually had to take it out so I could move on with chemo.

Now that I have finished with chemotherapy, it's time to try again with the tissue expander. There are essentially two options:

1. Just try to put in the tissue expander again with no additional surgical tricks and see if my body will allow it to heal this time around. In this case the only area of my body that will be affected by the surgery is the site of the mastectomy where they will place the expander again. 
2. Put the tissue expander in and at the same time bring a portion of my lat muscle around from my back (leaving it attached to the muscle in my back), wrapping it around the area of the mastectomy in an effort to bring some additional blood flow to the area. In this case I will require some additional recovery because it will involve both the mastectomy site and my lat muscle.

When the mastectomy is performed, they remove a significant amount of tissue and leave behind only a small flap of skin. All the nerves and blood vessels are also removed at the time, which means that it can sometimes be difficult for the incision area to heal because you have very little blood flow in the area. 

We still don't know exactly why my body wouldn't heal with the tissue expander in place (although we do know that it didn't appear to be related to an infection), but the doctor's best guess is that it was because of the lack of blood flow. For that reason he was pushing me toward option #2. The down side to this option is, of course, that my range of motion and strength will be affected, which will have an impact on a lot of my hobbies, including CrossFit, triathlons (swimming), and Olympic weightlifting. For that reason, I have chosen to go ahead with option #1 and my surgery is scheduled for June 27. 

I fully understand that if things don't work out with option #1 again it will mean another surgery, and I will have to do option #2 anyway, but I really feel like I don't want to have those limitations unless it is an absolute last resort, and the only way I will know that it is a last resort is to try the other way first. In the end I will accept the limitations if required, and just work really hard to get back to where I was physically before all of this happened--heck, maybe I'll even try to get better than I was before. 

Step 2: Filling the Expander

No matter which option ends up working in the end, once the tissue expander is in place they will fill it over the course of about 8-12 weeks, stretching the skin until it is slightly larger than my other boob that was left intact. This is pretty straightforward, so not much to expound on here.

Step 3: Reconstructive Surgery, or "the boob job"

Once we get the skin stretched to a size that I like, the next step is to get the final reconstructive surgery. I will actually have an implant placed in both sides, the one at the mastectomy site will fill the whole breast and the one on the other side will just be big enough to make them even. The main reason for this is that it's difficult to get a reconstructed breast to look just like the real one, and an implant in both sides will make them look more similar. Depending on how long it takes to stretch the skin, I'm anticipating this surgery to be sometime in September/October.

Step 4: Follow-Ups

Of course, during and after all the reconstructive stuff there is the follow-up work to be done. I have already been in to the oncologist for my first follow-up appointment; he said that my blood work looked good and there was nothing abnormal about it. At that time he also prescribed Tamoxifen, an anti-estrogen drug that will help to keep my estrogen levels low for the next five years, which has been shown to help in curing breast cancer and preventing it from coming back. Since it's blocking estrogen chances are it will put me into menopause, but the oncologist thinks since I am so young I will likely come back out of menopause again after I'm done taking the pills.

I will continue to get follow-up appointments about every three months for the first year, then they will go to every six months and eventually to once a year. I'll have annual mammograms on the boob that I still have left, and we'll keep an eye on all kinds of things to make sure that I'm still healthy for many years to come.

I'll continue to keep you all updated as the surgeries progress.

Resolutions

New Year's is a time when many people decide to set resolutions, usually ones that are geared toward making yourself better in the year to come than you have been in years past. According to USA.gov, some of the most common resolutions people set include:

• Lose weight
• Quit smoking
• Get a better job
• Get a better education
• Save more money
• Eat healthier
• Get out of debt
• Spend more time with family
• Get organized
• Volunteer more
• Drink less alcohol

They all sound like great goals, and unfortunately they are also pretty vague, which is probably why only 8% of people are successful in achieving their resolutions every year, according to at study by the University of Scranton published in the Journal of Clinical Psychology. If you did make a resolution about being healthier, exercising more, etc., here is a motivational video that might help you. It was made by Rich Froning, 3-time CrossFit games champion (i.e. the "Fittest Man on Earth"). 

The most successful New Year's resolution I ever had was something like 10 or 11 years ago, when I made a resolution to floss every single day. I was successful in doing it for 21 days straight (which I hear is the threshold to make something a habit), and since that day I have rarely missed a day of flossing my teeth. My dentist is very proud. 

Before you think I am disparaging all resolutions, that is not the case. I also have set a goal with Nick to eat a healthier diet this year, and get back to CrossFit as much as I can during treatment and after this whole chemotherapy thing is all over. I believe setting goals can be a powerful motivator to keep us focused on the things we want to achieve. In that spirit, cancer and chemotherapy has also spurred a new resolution that will be ongoing every single day, every single year, from today until my time on this earth is over: live every day to the fullest, love more, hate less, and be thankful for every day that I get. 

The thing about being diagnosed with cancer is that, among other things, it makes you really think about your own mortality. I don't plan on dying from breast cancer, but when you hear that kind of diagnosis it makes you realize that any day on earth could be your last, whether you die of sickness, age, natural causes, an accident, or anything else. When I thought about that, I realized that every day is short. Every year is short. Every minute that we have to live should be a minute that we try to make ourselves, and the world around us, a better place to be. So instead of spending time thinking about how much you hate someone or something, being bitter about the past, hating your job, being mad at other people, complaining about life not being exactly the way you would like it to be, arguing and being petty, instead of that, spend more time loving, more time appreciating what you do have, more time working to make yourself the person you DO want to be, and more time letting those around you know how much you love them. I know I will. Happy New Year.

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.