Friday, June 28, 2013

On The Road Again

The beautiful flowers, cards & duck I recieved.

That is an old country song that will sometimes pop into my head on my way back to work after having some time off work.  I have been on a very different road for the last month than my normal 100 mile per day commute.  I was really at peace and so thankful for the early diagnosis, but still much had to be done.  Before getting my surgery I had tests and decisions.  Dr. Sharon and Robin explained to me that as far as surgery went I had 2 choices, lumpectomy or mastectomy.  Dr. Sharon said the cancer was not close to any skin surface, so the skin sparing technic was available for me if I chose mastectomy.  Either way reconstruction was possible and covered by insurance.  Also, they expected the one small cancer to be completely removed either way.  If the lumpectomy was chosen, I would need to also have radiation.  Though that would be far easier to recover from, there were some downfalls.  For one, that the risk of cancer reoccurring would remain higher.  Also, radiation causes tissue and maybe even muscle damage which could limit the usefulness of my arm.  Lastly, it could damage the skin and interfere with future reconstruction.  That is actually what happened with my mom.  When she got cancer again, 18 years later, on the chest wall of her mastectomy side, they had to graph skin due to the damaged radiated skin.  I had an MRI to attempt to verify that there were no other spots.  It actually detected a different spot of concern also in my right breast, but it did clear the left.  I learned that dense breast tissue causes an independent increased risk of getting breast cancer in my life.  The average risk is currently 1 in 8 women.  Dense tissue also interferes with visibility and makes mamos less affective in detection.  Additionally, with my mom’s history of breast cancer twice and ovarian cancer (praise God for her early detections and survival) I had pretty much decided that a mastectomy was the wisest decision.  I also got the BRCA1 & BRAC2 genetic tests done.  I don’t know if my mom has those genes since she had not gotten that testing, but with her history it would not have been a surprise.  Those genes so drastically increase the cancer risk that I thought it likely that a double mastectomy would be wisest if they were positive.  I am so thankful those result were negative, even though my girls swore they would treat me like Angelina Jolie.  It would have been twice the pain and discomfort.  On top of that, there would have been concern for my girls and not knowing if they had the gene.  After the surgery, the final pathology showed the known DCIS (Ductal Carcinoma In Situ), a benign spot and a LCIS (Lobular Carcinoma In Situ).  The LCIS is not really a cancer, but is a pre-cancer and an additional risk factor.  So, that confirms that the mastectomy was the best option.  The re-construction process was started by placing a temporary inflatable (with saline) implant at the time of the surgery.  It was partially filled and added to the pain and discomfort.  It has been 2 weeks now and I am still dealing with some discomfort, but most of the pain is now past.  The re-construction must be done that way because the trauma to the skin and reduced blood supply makes it too difficult for it to withstand the standard implant at the same time.  I would remain with increased risks of cancer occurring in the other breast, but there are now anti-estrogen drugs that I will likely take to prevent it.  I have been resting and doing very little for these 2 weeks.  Still some of the remaining pain, the Dr. said, was probably from overdoing it.  I don’t know how, I have done so little, but it is difficult to make myself do everything left handed.  My girls have been such a blessing, waiting on me hand and foot without any complaints.  I have the greatest most loving family.  My family in the Lord and friends have also been great.  The kind thoughts, prayers, cards and flowers have given encouragement and enjoyment.  I am starting to get impatient and bored, but remain thankful and happy.  This will soon pass and could have been far worse.  God’s riches blessings to all!