Tuesday, January 29, 2013

Recent Findings: MRI, Mammaprint, BRCA Genes, Ultrasounds

My cancer surgeon called today to let me know the results of the tests I went through in week 2 post cancer diagnosis -- last week.

BRCA1 and BRCA2 gene
For these I tested negative. The BRCA gene is the only gene, located on chromosome 16 (which, like every chromosome, is in every cell in your body) which has been found and linked to cancer. Genes are being closely studied and have come a long way thanks to advances in genetics. In the future we will see other genes 'discovered'. For now, my testing negative means that I'm not passing this particular gene onto my son (so it doesn't put him at risk for cancer caused by this gene). And for diagnostic and treatment purposes, other surgeries (eg hysterectomy) do not have to be considered at this time. The following links have useful info regarding this gene:

MRI -- Breast MRI
I have dense tissue. It's possible that the original tumor was not caught on previous mammograms. Mammograms are screens and have often missed cancer tumor. It's possible mine, Invasive Ductal Carcinoma, could have started non-invasive. It could have been growing over the past 8 years. Thankfully, there is new CA legislation that was passed last year effective 2013 (my year). This legislation is applicable to women who have dense breast tissues and it states that women must be informed by the doctor and further investigation beyond the 'screen'. This means the next level mammogram (increased magnification) and ultrasound. If these reveal suspicion then a biopsy is recommended followed then by the MRI if results turn out positive. It turns out that I fit this description in every way. And, my MRI located a second tumor the same size as the first. Both invasive. The mastectomy is my only option which I was prepared for.



Mammaprint
The mammaprint is a test surgeons can now have performed and this reveals risk level among other things. This helps them decide whether or not chemo will happen after surgery, before surgery, or neither possibly. The final decision is made in conjunction with such tests at the time of surgery. They can only truly know once they are in there. But fortunately mine came back low risk for needing pre-surgery chemo and post surgery long-term chemo. For my doctors, they will know how much (if any!) I get or if I can just do radiation and hormones instead. This made me excited about not needing chemo prior -- and it made me also upset with one of the surgeons who was adamant about doing chemo first and right away which they wanted for their study. So scary what's out there. The following is more info on the Mammaprint by its maker, Agendia:
Ultrasounds
So far, the ultrasounds measured the size of my invasive tumors at 2.3cm and 2.5 cm within a larger area of cancerous non-invasive tissue which is all along the central half of my breast. An area lit up on one lymph node and not others. This is good. It's possible it hasn't hit the lymph nodes. Like everything else, they'll know once they are in there.

So these tests are small victories but nevertheless victories which I'll take. As one friend put it, its good news within what is bad news. My next major decision is in regards reconstruction. More than I'm ready to dive into and understand at the moment but a decision I'll have to make by next week, February 4, when I meet with both cancer surgeon and reconstruction surgeon who will work in tandem together at surgery time. That's when we book that surgery date.

Thanks again for thinking of me and my family and for sending us positive thoughts, vibes and prayers.



Sunday, January 27, 2013

Cancer books for children

During my first week of this trail, my husband's cousin recommended I look into books for our son, who is 7. This might help him better understand cancer -- we can read these aloud together and talk about it. I love literature in general so I thought this was a great idea.

I ordered some books on amazon which came in yesterday. I ordered:


The last one is not cancer related, but it talks about how this village all takes care of this one child. I love this image. I want my son to know that he has a village, too. My favorite cancer books for kids so far are Butterfly Kisses and Wishes on Wings and  the Goodbye Cancer Garden.

In general all of the cancer kid books have wonderful perspectives of this disease because these are written from first hand experience. And although I loved them, I wished there was one that specifically spoke to our son. For instance, in one of the books, My Mom Has Cancer, there is a little boy who is our son's age and he talks about some changes like his mommy not being able to go to his soccer practices sometimes. I think he'll make the connection with my not being able to go to his music classes sometimes, for instance, which is exactly what this book is trying to do with these examples -- but I still wished there was a story written from his perspective. If there were, it would go something like this:

One afternoon after lunch while reading Little House in the Woods, my mom got a call from her doctor.
All of sudden she started crying really loud and I could hear the doctor talking but Mommy just kept crying over the words he said:

"I have bad news. You have an aggressive and an invasive cancer."

I didn't understand this but it made Mommy really sad. It made me scared at first but then a few moments later I rubbed her arms like she rubs mine when I'm with the doctor. I told her "Mommy, it's ok. You're going to be ok." This made Mommy cry even harder it seemed. But she pulled me in close and hugged me while she continued to cry.

The doctor kept talking. He was really nice -- nicer than some of my doctors. He told her to take her time, that crying is ok and that she needs to cry. He told her he has time and is not in a hurry. He's such a nice, nice man. When Mommy calmed down but then started to cry again, I told her to take deep breaths. This helps me when I'm at the doctor's office and they're sticking needles in me. It looks scary, but Mommy and Daddy tell me it's going to be ok, take deep breaths. They tell me this and that "We are right here with you. We are doing this together." So I told my mommy these same words. Like me at the doctor's offices, she just wanted to hold on to me.

When she finally got off the phone, she called Daddy and it seemed like this whole thing happened all over again. When Daddy answered, she could only cry really hard. Daddy said he's packing his bags. By the time Mommy said her first words to him, Daddy said he was on the freeway. Mommy cried hard as she said these words "I have cancer...it's invasive and aggressive..." I still didn't know what that all meant, but later I learned.

Mommy said some of the smallest parts of her body got bigger when they were not supposed to. They're supposed to stay in the same place, too. It's like when I fall and cut my knee. The blood is supposed to stay in the body. When it comes out like that, my body has to fight the blood from leaving so it builds up this little army of new skin to keep more from leaving. It's also not supposed to get so big and bumpy. That's inflammation. When there's inflammation things don't go where they're supposed to go and this can happen pretty fast.  So, that's when I put on ice to make my skin not get inflamed. Well, Mommy's cancer is like the blood that's escaping the skin. That's the invasive part. It's going where it's not supposed to. The aggressive part is how fast it's moving in the wrong area or direction. It's a disease -- and just like doing things like putting on a band aid from blood escaping or putting ice for the inflammation to go down, Mommy has to do some special things for her cancer.

Mommy also said cancer was like a weed in our garden. It depends on what plant it's invading, how much of that plant it's invading, and if it invaded other plants.Weeds kill good plants because they take over that plant's job. Cancers kill good body parts because they take over that body part's job. Everyone's cancer is different because it depends on where that weed is growing, how much of it is growing, and how fast it's growing. When we know this, we have decisions to make on the plan -- and this takes a lot of planning.

Mommy has to go into surgery to get the cancer out of her body. Then Mommy has to do things to make the cancer not come back. Some of these things might include treatments called chemotherapy, radiation, and hormones. All of these things will make Mommy feel tired and even sometimes feel really really bad. This will change some of our routines for a little while. She'll have to rest a lot. Mommy says the best medicine will be me curling up with her and reading a book together. But, she also said that sometimes she will just have to sleep and she'll love knowing that I'm happy and can find something to do that makes me happy -- like building Legos, or building battle scenes from Lego Ninjago (I love this Lego series). Mommy said we'll be the good guys and cancer is the villain. I like that. We're going to make sure we defeat that villain.

Up until surgery Mommy says she has to eat as healthy as possible. She says this is part of the battle. It'll help her go in strong, help the cancer not get bigger or come back, and recover. It looks like she started a farm in our fridge. It's filled with lots of green vegetables. She's juicing these many times a day. It's hard to see any foods in our fridge without any labels on it anymore. I used to be able to read all the labels on boxes and containers but now these are all fresh. She even made my yoghurt with help from a friend (I'm still getting used to this...). All of our meals are now cooked from fresh items. So, since we are all in this together we are all eating healthier without preservatives. Mommy says she wished she ate like this her whole life but she also says things always happen for a reason and sometimes we don't see that reason for a while.

Up until surgery, Mommy also says she'll try to keep my routines as best as possible. But, on some days Mommy will have to go into doctors offices and get all kinds of tests done before the surgery happens. These tests have many names, like ultrasounds, MRIs, PETSCANS, CATSCANS -- and even blood draws tests for different things. The results tell the doctors where the cancer is, how to get rid of it, and how to treat it after, too. These, too, will take so much time but the more we know, the more power we have on our journey. We are all learning so much!

Everyone thinks about cancer in a different way. Some people stay positive, some ask others to think of them, others ask for prayers, some want to learn as much as possible, some want to know other people who also have had cancer. In our family, we are doing all of these things. I'm still unsure about what cancer really is, but at night time I pray that we have courage and strength to get us through. When I go through surgeries and hospital things that are hard, I feel like Bilbo Baggins from The Hobbit who also didn't want to leave the shire and go on his journey. But even when he met dragons, other enemies, rough battles, and places that only he had to go through by himself -- he also had mentors and allies rooting for him. This gave him the courage and tools to get through. And I always learn something new to share with others who also might need to leave the shire. Mommy is like Bilbo.  She will need to be brave to get through her battles on her very long journey. We also need to be brave with her. We are all going to get through this, be on the other side of this, learn something new -- and share with others who also might need to leave the shire someday.

Mommy says everyone's battle with cancer is different. For our battle, it started with a new year and will hopefully be done by Labor Day -- just in time for third grade! I'll be 8 years old by then and it will be a victory. We'll have to create a holiday called Victory Day for the day the doctors say this cancer is defeated. Mommy says her Victory Day will be around the same time as one of her favorite races, the Race for the Cure. She says she wants to run or walk this year, wearing a pink shirt with the words 'Survivor'. That's what I am -- and that's what she WILL be.


Saturday, January 26, 2013

Posts on this blog

I'm finding that I can't access menu items on this blog from my iPhone so I'm placing here as a way to access these when I'm at appointments or markets. This is on my 'posts' page:


I'll keep post links I write here. For now, these are in chronological order from newest to oldest blog post. Below are posts as well as info found on what blogger calls 'pages' which are not date arranged.

*****************************************************************








pages:

Friday, January 25, 2013

Cancer Trail Week 2

Once I pushed through the tears and fears of week 1 -- knowing I have an invasive and aggressive cancer but not knowing if there was metastasis (cancer spread to other parts of the body) as well as the logistics that needed to happen during that time (making appointments with surgeons, oncologists, geneticists, reconstruction surgeons, and getting second opinions as recommended by family, friends, and doctors), I completed several visits to these doctors offices in order to learn about what I have and what options are available.

Week two has been all about testing: doing MRI, ultrasounds, and scheduling clearances with doctors including a cardiologist (this one is unique to me due to a hospitalization I had in 2009 after going through septic shock and having a congenital mitral valve prolapse). My MRI result of this past Thursday, January 24, showed an additional tumor caught -- fortunately within the same quadrant of my first tumor and roughly the same size of 2.5 cm within an area of 4.5 cm. The mastectomy will of course address both of these tumors.

In some ways it's been so good to be this busy because it keeps my mind off of upcoming surgery. But between balancing my high learning curve and logistics I try to keep normalcy as much as possible in the home. This means I've been homeschooling my son this week -- something we both really enjoy. I cherish these moments of sitting side by side with books, taking turns reading aloud, discussing and narrating events... this is my medicine I need daily. I've always looked forward to each of these days -- but of course now I even crave it. And Steven has been amazing. I know there's a lot on his plate and yet he's brought me to each appointment, took notes on his laptop, questioned each doctor. I also hate MRI machines. He's helped here my reading outloud (shouting -- it's loud in there) to keep my mind off of being claustrophobic. This past week in the MRI I tried making peace with the machine -- but I kept thinking "I just want to go back to the shire." "I don't want to go on this adventure, Gandalf!" I felt like Bilbo Baggins and all I wanted was to go back to the days of pre cancer but I know for some reason this road was chosen for me. I'm learning to make peace and accept it.

Week 3 will look a lot like week 2. The next serious scheduled date for me is February 4, 2013. At that point we go over all the results with both surgeon and reconstruction surgeon and schedule my February surgery.

Thank you to all my family, friends, friends of friends and friends of family who are keeping me in thoughts, positive vibes, and prayers.

Salmon

When buying salmon, the cancer recipes I have been finding advocate wild salmon vs farmed salmon. This post is just a quick recipe reminder that will be easy to find later.

The recipe I found for tonight's paleo salmon is at:

http://paleospirit.com/2012/wild-salmon-with-lemon-dill-sauce-autoimmune-paleo-recipe/

Basically set oven to 425.
In a tray put salmon.
Top with coconut oil, dill, lime or lemon juice.
Cook 15-20 min depending on thickness.

The Waiting Game: Focus on Diet, Exercise, Elimination and Rest

While I'm in the 'wait' part of my diagnosis -- waiting for appointments, info, etc, my goal is to do what I can do for now: focus on diet, exercise, rest, elimination.

DIET
In terms of 'diet' and 'elimination' part I have been on a paleo diet which means no carbs, no sugar, nothing processed, no dairy, no legumes. This ironically started January 1 -- ten days prior to having found out I had an aggressive and invasive cancer. But starting this diet -- or really, 'way of life', has given me a head start in finding the right diet solution for me in terms of fighting cancer up front and in recovery. Two main diets I've blogged previously about (in post called Starving Cancer) are the Ketogenic/Metabolic diet and Gerson Therapy.  I'm combining both under a paleo umbrella.

Ketogenic/Metabolic is basically paleo minus most fruits plus a fat/protein ration to carb from vegetables ranges from 3:1 to 5:1 per meal for a period of 14 days, repeating every 6 months. Gerson is also paleo - but specifically it limits foods to vegetarian meals along with a schedule of 13 juices per day. Their protocol is 14 days. The way I'm combining Ketogenic/Metabolic diet and Gerson Therapy is by juicing in between the meals -- then waiting 15 minutes to eat solids in order to make sure all the juiced nutrients reach the cellular level. This makes sense to me. If both Ketogenic/Metabolic diet and Gerson Therapy supplement with what the other does not have (Ketogenic/Metabolic is 3 protein to 1 green carb which also recommends supplements that are green related; Gerson which is all veggies and juicing recommends supplements that are all protein related). So I'm mixing paleo + ketogenic + Gerson. It just makes the most sense to me. It is healthy, practical, easy -- and cancer hates these good foods so my good path has to be good.


One of the Ketonic/Metabolic plans I like is called the Cantin-Ketogenic plan. I bought the  Kindle version:


In terms of Ketogenic/Metabolic Therapy, the additional step recommended is to monitor ketones in the body. The way you do this is by peeing on a strip. One important aspect of this diet is keeping ketones above negative (negative is normal) but within a certain range. Cantin Ketogenic diet prefers range of moderate to max (40 to 160). When numbers drop, she would eat coconut oil to boost these. Here's an image to help me monitor ketones:





As I mentioned, one way Cantin monitors ketones is through urinalysis strips -- which I also got through amazon. I just got my box of 100 strips in the mail today. I'm learning how to use this and I'm currently studying the role of different elements of urinalysis to help me balance the items recommended (eg ketones, ph, etc). This is one great source for more details which I found online:



I'm also hunting down any chart or else I have to make one up so that I can keep track of daily (thinking of getting a morning, afternoon, evening reading) and place in a log book.

Apparently, per the author, she saw results after day 14 of this diet. In her case as well as in others the tumors shrunk  -- or at the least after surgery, recovery was faster and prevented further cancers from developing. So she does this strict version called Cantin Ketogenic diet for 14 days every 6 months. Looks easy. It includes the monitoring of ketones (keeping in moderate to max range), l lemon per 1 cup water three times daily, hormones (eg progesteril cream) and supplements. A quote from her book "Cancer cells have trouble processing fat for energy to multiply. Healthy cells thrive on fat." The fat she is talking about is healthy fat -- eg coconut and olive oils -- and not that from processed foods filled with preservatives that make us fat. There is a difference.

Currently sticking to paleo with a mix of what might be Paleo+Gerson+Ketogenic which means eliminating red meat from paleo, reducing fruits, and increasing greens. I'm also very fortunate in that a have several friends who are registered dieticians and majored in nutrition in college. I pick their brains all the time and run my ideas by them with wonderful dialogue exchanges.


Summary:
Info on how to read urinalysis. I'm now doing this in an effort to raise ketones while also keeping all other things in check. I got this info from the Cantin Ketogenic book (the author used this diet and monitored her ketones in order to make sure she was within range. These strips also include ph which also is good to keep in check. This protocol is often used for those with other conditions.

Urinalysis for dummies (Cantin Ketogenic Diet = moderate to max (40 to 160) ketones goal via diet of 3:1 to 5:1 range of fats/proteins to low index carb like kale, broccoli, etc). If ketones low, eating coconut oil boosts numbers. Plus 1 lemon per cup three times daily for acid/alkaline balance. Hormones balanced. Supplements including B12 and those recommended by Burzinyski. Two weeks strict adherence to this diet. Stay on less version thereafter (eg paleo), repeat every 6 months.

EXERCISE
 My goal even through this stage is to exercise at least 30 minutes daily.

REST
My goal is to try to get 8 hours sleep and or lie down in the middle of the day even if for ten minutes.

ELIMINATION
My goal is to poop and peep everyday to  get rid of toxins my cancer is causing.

I think through diet, exercise, rest, elimination -- these are some things I have control over which helps me think of fighting the beast the best way possible until doctors actually have my 'treatment' options ready (eg mastectomy date, etc).

This is my day 14 of knowing I have cancer. It's still early so I'm sure things will tweak along the way.

Disclaimer:
The statements expressed on this blog, expressed by the author who is on a cancer trail, are not intended to be a substitute for professional medical advice. Readers of this blog should seek their own professional counsel for any medical condition or before starting or altering any dietary or exercise routine. 


Monday, January 21, 2013

Types of Breast Cancer

Just found this from a site my sister sent. It's very informative. My first surgeon appointment did a great job of explaining all this. Mine is an invasive ductal carcinoma.

This is a great overview in an easy to read format:

http://www.oasisofhope.com/about-breast-cancer.php

Sunday, January 20, 2013

Starving Cancer


Starving Cancer 

Ironically (or not), I had started a paleo lifestyle in eating prior to learning I had cancer (10 days prior to finding out I had cancer). Basically, paleo is  clean eating with specific guidelines to help. This includes no grains, no legumes, no dairy -- when you think about it, it's big umbrella is elimination of 'processed' -- anything with preservatives will contain something like sugar or sodium which messes up our potassium and sodium levels causing inflammation. Inflammation is the culprit. Getting rid of inflammation will get rid of quick aging and many disease. I started to think that food practices that eliminated causes of inflammation would be good because if I'm reducing inflammation then I'm allowing my body to have a natural unimpeded flow.

My particular paleo plan started as a way of jumping on the bandwagon of two of my friends who were also going paleo for the year for health reasons. Both had also seen the movies I had seen -- like Hungry for Change, Food Inc, Tapped, Supersize Me, Fat, Sick and Nearly Dead. These inspired us for change. And, because we have seen friends took on a paleo path in the previous year -- producing amazing results both medically and physically (these friends glowed and shed a couple of decades on appearance). 

All last year paleo was planted on my path after meeting friends like these who had amazing results. I also kept hearing about paleo from random people who also chose this path. I noticed cookbooks at Barnes & Noble. I saw the delicious recipes (like 'breads' not made with carbs but with coconut or almond flour with the same taste as 'bread'). The Internet is loaded with paleo recipes -- basically if you type in the word 'paleo' in front of any food in a google search, you'll get a ton of free recipes from paleo apple pie to paleo pizza and zitti.  You can eat so many of the items you normally eat -- but there are substitutions in the recipes. For instance, wherever a recipe calls for sugar then use raw honey. If something calls for wheat or white flour then instead use almond or coconut flour. If you need milk or yogurt, use coconut milk or coconut yogurt. These are some of the tricks in mind shift. More are learned along the road. It's practical, safe,  healthy, and easy once the shift happens.

When the two friends I mentioned went paleo for the start of the new year 2013, I started a blog. Immediately I knew my biggest challenges were going to be coffee and carbs. I bought  paleo cookbooks of all types to download digitally, enjoyed the swap of information with these friends, and enjoyed all creative and easy to make foods. Once the first week passed-- I didn't miss my old carbs at all. In fact, I craved the new foods that tasted real. In just one week I could really taste preserved items aversively when sampling at stores like Costco. (Coffee was a different challenge. I had a hard time with this so, based on a paleo principle of 80% paleo and 20% indulgence (anything), I allowed coffee in my diet until I learned I had cancer. Then I started eating scared and removed coffee as a 100% paleo plan (no more 20% for me).

Paleo has really helped me on so many levels. At three weeks now,  I can see the benefits of paleo: I think more clearly, I'm more calm, I crave only good foods, I lost roughly 5 pounds without trying -- I think these are the ones that are in my waist because this shrunk, my skin and hair feel better. Yesterday at my optometry appointment my eyes had improved instead of staying the same or getting worse (worse has been my trend over the past decade).

Now with this cancer battle I'm upping the ante on my paleo plan in that the focus of foods will be on choosing more of the paleo foods known to have properties to fight or heal cancer. So within paleo, I would now be eating more of the cancer fighting foods.

My overall approach in terms of being a proactive food consumer is to look at all things with eyes of 'what 'truth' or 'reliable data' can I extract from this source and what 'truth' or 'reliable data' do I know in other sources. I try my best to balance these truths against rigorous experimental data. Not easy for anyone even the experts -- but it's definitely something that's on my mind these past nights in terms of finding ways to starve this beast and ease my recovery. I don't believe in accidents -- everything happens for a reason and the fact that nutrition was my original number one modification (or paradigm shift) for the year with all the people planted on my path, then there is a call I was meant to answer at this exact moment in my life.

This "upping the ante" also means looking at other diets that are designed to fight cancer. The two I was introduced to by family and friends are Gerson Therapy and Ketogenic/Metabolic Therapy.  Both diets are two-week flush or cleansing diets which then gradually incorporate more foods. Basically Gerson Therapy is a vegetarian diet; Ketogenic/Metabolic Therapy is a meat protein diet. Gerson Therapy supplements with proteins; Ketogenic/Metabolic Therapy supplements with plant-rich supplement nutrients. In practice, Gerson Therapy incorporates 13 juices daily for the two weeks along with vegetarian cooked meals throughout the day; Ketogenic/Metabolic Therapy incorporates 3 daily meals with a protein-to-carbohydrate ratio that ranges from 2:1 to 5:1 (eg 5 proteins and 1 low glycemic value carbohydrate per each of the three meals). Water drinking in each of the plans is also key.

At this stage of my knowledge, I see similarities between both of the Ketogenic/Metabolic diets with the Paleo diet. I see all of these as Paleo with more specific guidelines. For instance, if I eat a meal that has three proteins and 1 low glycemic value carbohydrate this could well be within the guidelines of Ketogenic/Metabolic Therapy or Paleo diet. If I eat a vegetarian lunch with juice this could well be within the guidelines of Gerson Therapy or Paleo diet. The quantity is what is different. Paleo is general but Ketogenic/Metabolic offers specific quantities and Gerson Therapy does the same. So Ketogenic/Metabolic is Paleo and Gerson is Paleo -- but Ketogenic/Metabolic is not Gerson and vice-versa. In addition, Ketogenic/Metabolic offers other guidelines (various forms of Ketogenic/Metabolic exist) such as measuring 'ketones' in urine on a daily basis (more on this on another post). And, Gerson Therapy recommends daily enemas.

So for me all my paleo cookbooks are still useful. Gerson and Ketogenic/Metabolic cookbooks are also very useful. I can see studying the cross difference between Ketogenic/Metabolic and Gerson. My goal is to starve cancer from any food it likes -- fake sugar, fake sodium, preservatives, fake grains, fake meat, etc. If cancer likes pesticides, processed items in machinery laden in harmful chemicals, genetically-modified (GMO), growth hormones, then I'm not going to be these items friend to invite them into my body. If an item doesn't say organic (which means free from these harmful items I mentioned) then I eating it would be counterproductive for my mission.  If I have any control over minimizing effects or maximizing recovery then I'm prepared to do that. I know I have to go into surgery next month and I have the option of chemo prior or chemo post. I'm feeling like opting for a pre-and-post-surgery-killer-diet plan as the best choice for me -- and talking to my doctors about this!







Disclaimer:
The statements expressed on this blog, expressed by the author who is on a cancer trail, are not intended to be a substitute for professional medical advice. Readers of this blog should seek their own professional counsel for any medical condition or before starting or altering any dietary or exercise routine. 



How it started for me



On the morning of Tuesday, December 18, my friend and I went out for our regular morning run and talked about end of year doctor appointments. Some of the talk was about routine things that needed to get done, some of the talk was also about doing all the needed appointments now prior to the new year to avoid paying the deductible.

In that conversation, my friend mentioned how she hated the mammogram -- she also feared it. I told her that I can go with her and get mine done at the same time. The next thing we knew was that two days later, on December 20, we became 'mammomates' (I'm coining this term) in a nice imaging center that looked like a spa. Beautiful decor, pretty white robes, wonderful clinicians who talked to us as though we were going in for a massage.

Two days later, she got her results and these were negative. Victory! I didn't get mine -- which for my doctor's office meant good news. A call is bad news and no news is good news. But then a week later, my son needed an ultrasound of his kidneys at the same location. Routine work for us. I mentioned at this appointment that I had a mammogram done the previous week which I'm sure was ok but I didn't get my results and wanted copies for my records. So they gave me a copy. I read that had a mass on my right breast that warranted a second mammogram. This was Saturday, December 29th. I just had to wait until Monday, December 31st when the doctor's office opened so that I could schedule this. Monday came and the soonest appointment available was Wednesday, January 2 at 9am. I took this reluctantly (I really wanted something that day to get it over with -- thinking it was going to be fine -- and I wanted to avoid the deductible of the new year). In hindsight, this was a blessing. I was able to celebrate the New Year with my family in peace.

On Wednesday, January 2, I went to my repeat mammogram at 9am while my husband got ready for work at home and watched our son at the same time. The technician at the mammogram appointment was the most informative one I've ever had. She showed me areas of concern, educated me, told me she is not the one who writes the reports -- it's the radiologist who does. She told me he currently has about 200 reports to write and results take about 2-3 days -- but in my case, she wanted the radiologist to come out of his office and see this. She was so polite "With your permission, may I bring the radiologist in here to review this now. I can't promise he can do this, but I'd like to try if it's ok with you." The first thing I said was "Please do so -- if something needs attention... I have a 7 year old son..."

The radiologist came in and explained microcalcifications -- how normal these are in many women, how they may even be normal in me. These may have been on previous mammograms and mine are very difficult to decipher -- on the bad side, these could have been mistaken as normal when really something else is going on. So, he wanted me back in at 1pm for an ultrasound. At that ultrasound he said his suspicions were confirmed and the gold standard is the biopsy. A biopsy -- removal of tissue -- can be done by the surgeon with general anesthesia. Or, this can be done by the radiologist locally with ultrasound guidance of the needle. I would be awake for this  -- and since they could do this quicker than the alternative, I went with this one. The earliest appointment was for Monday, January 7, 2013 at 2pm.

On Monday, at 2pm I went in for my biopsy. In my head I was thinking long 'thin' needle as in an amniocentesis which was required for my second child since she was showing a cyst of concern. I was half right. The needle was not thin. My heart started to race. I told them as long as they keep talking to me I'll be fine. We talked Legos. I had images of my son with his Legos. We talked about Legoland and how I'd love to see the new hotel they are completing. It was good. It kept my head out of what sounded like a meat grinder/drill which extracted from several areas. Since I couldn't feel anything, I just made sure my head was filled with positive things. Being a clinician, I also pretended that my body was not my own. I was a patient without the 'I' part. After excision of tissue they inserted a titanium item called a biomarker which tells future doctors or imaging technicians the area of biopsy. In case of cancer, it can also guide the surgeon. At the end, I was told the bruising is normal, I'll be sore once medication wears off, I can exercise in about 2-3 days, and I'll hear of results in 2-3 days.

I went about my week as usual, then on Thursday at about 2pm -- while reading the final chapters of Little House in the Woods with my son, I got 'the call'.

My doctor started with "I'm afraid I don't have good news. " I started to cry.

"You have an aggressive and invasive cancer." Then I bawled, sobbed, in Spanish the best word I can think of would be llantos --  a painful cry deep within the soul of body. I can't really describe it. But this kind of crying has only happened twice in my life. The first when I got 'the call' that my dad died. The second was when I was at the hospital at time of delivery and seeing my daughter's heartbeat stop.

I kept crying while the doctor said 'It's ok to cry. You need to cry. I have time. Take your time...." and at the same time somehow my 7 year old son became an adult, rubbing my arm, saying "Mommy, it's ok. You're going to be ok. When that happens to me I take deep breaths." I started to cry even harder because I was looking at my son. I feared for my son. I started to imagine him without his mommy. I could not handle this.

Once I was able to talk, through crying I asked the doctor hysterically "Just tell me what I need to do! What do I do? Who do I call? What order do I call in...." I cried next with warrior tears. Got all the info down on paper -- shaking the whole time -- then called my husband and repeated the entire sequence from 'llantos' to details. As I was crying he packed up his things at work. I didn't need to tell him what the results were. Somehow he knew and by the time I was able to get to the talking part he was out of his office, building, streets, and well onto the freeway.

We divided the calls -- surgeon, oncologist, PETSCAN. Each call was an eternity throughout being asked many questions, being placed on hold, being transferred. Standard initial questions from everyone:

Name
Date of Birth
Insurance
Subscriber of insurance info (all my hubby info)
Address
Phone
diagnosis
referral

I was able to get a PETSCAN the next morning first thing. This was Friday, January 11, 2013. Results were to be given that day but they fell through the cracks. On the top layer of paperwork the doctors marked it as STAT -- or emergency, first thing, with priority to be read by that day. It got reported to the wrong doctor then wrongly labeled. By the time they closed it was too late to learn more. I had to wait until Monday morning. This was beyond brutal. It was the first time in this experience with cancer where I became so angry. Waiting two more days -- when I had been told it would be read that day -- was like finishing the hardest race of your life, reaching the finish line, then being told to do it one more time. I was drained. I also had a killer migraine from the radiation of the PETSCAN. Could also be a combination of going caffeine free from the day before. Regardless, for Friday and Saturday I had an intense migraine that was blinding. Sunday was my first normal full day where I just wanted to enjoy my family and do the things that make me happy -- play with my son, talk to my husband, read out loud together as a family, talk about characters in a book and dive into those stories away from reality. It was a great day.

Then on Monday, January 14, I got the call -- but this time, given the circumstance, it was a celebratory one. I don't have terminal cancer that spread to areas I feared, like the pancreas, the brain, the lungs. It's contained in my breast. It's possible lymphs nodes are affected but I won't worry about this now.  And another area highlighted on the PETSCAN -- my throat at the level of the vocal folds. Ironically, this is an area I know very well since I'm a speech language pathologist. I'm praying that the area was just lit up from intense crying from the day before the imaging. I heard this was possible, and for now, I'm hoping this is the case. That determination, or appointment to rule out my vocal folds, will have to be made with an ENT.

So all week -- from Monday, January, 14 to Friday January 18 -- we were in and out of doctors' offices (first, second and third opinion oncology surgeons, geneticist, oncologists, imaging specialists). This was my new world. My surgeons appointment, for example, was three hours long -- very thorough, informative, and I loved the surgeon I saw first this week. This is where I learned of a truer stage (my family doctor said probably stage 1-2). According to surgeons, I'm stage 2a or 2b. Lots of things go into this which warrants a different post. Lots of things also go into treatment options. In general they are saying the same thing for me with one major difference -- mastectomy plus wait and see if I need chemo, radiation, hormones OR chemo (3 months, one month off, then one month) plus mastectomy plus wait and see if I need more chemo, radiation, hormones. I'm feeling most comfortable with first option. This next week is about getting an MRI, a biopsy of lymph nodes and throat, and one last round of second opinions. Surgery needs to happen in February.

This has been my new year so far. And the only place I blog is from the doctor's offices -- it's my way of keeping my head busy, while also keeping a trail of this cancer so that I know and remember how to move forward. Despite this HUGE challenge placed in front of me, I'm feeling hopeful and grateful for all prayers and/or thoughts, positive vibes sent my way.


Note:
Regarding the PETSCAN: For this I was asked to fast in addition to eating a diet rich in protein, vegetables, fruits -- but no grains or dairy. This was interesting but a backburner thought since I had gone 'paleo' on January 1. What was described was a paleo diet and I wondered why. I later learn that grains and dairy cause inflammation and they don't want to see this on the imaging. Though I wasn't ready to learn more at this time, it was an onion layer of information that surely had some impact on future diet info.