My Journey with Breast Cancer

3 Years and Counting

2011-11-28T10:56:00.000-05:00

Lately, I have been thinking about the breast cancer again. Not sure if it is because I see a lot of women wearing Susan B. Komen t-shirts from the recent run, or just because I am hearing of more people dying of the disease.

You would think that after all this time and the level of treatment I had, and am still on, that it would not be on my mind, but you really can't stop thinking about it. Just today, I heard that someone in their mid-40s died after a lengthy battle with recurrent breast cancer. It is just unfair!

Pinktober and Mammogram

2011-10-04T10:22:00.000-04:00

It's that time of the year where we are all surrounded in pink. You just can't get away from it. So if you haven't taken the time to get your mammogram this year, think pink, and make that appointment. Early surveillance, in most case, yields a longer life!

Today was mammogram day. I dread it. It was particularly worrisome since, during the annual GYN visit, the doctor was concerned about a hardened area in my radiated breast. But...GREAT NEWS!!! All is well. There are no changes from last year, and I can wait another full year before another mammogram. Kudos to Tamoxifen and all its nasty side effects. Three years out and I'm cancer-free!

May next year bring me continued good news... Happy Pinktober everyone!

Summertime and the Living is Easy

2011-07-28T08:14:00.000-04:00

I have officially passed the half-way point for Tamoxifen treatment. While the many side effects have been annoying to the point that I cringe before taking the medicine, I still forge ahead, always keeping in mind that the alternative is far worse.

As I near the 3 year anniversary of my diagnosis, I can look back and find the good things that came out of the experience. I have learned to love myself a little more and am taking better care of myself. Pampering myself is a big change from taking care of everyone else. I am now working in a job where the atmosphere is light and fun. Where work was once the primary source of stress, it is now "fun" and I don't mind going to work every day.

My next mammogram is in October. That's always a bit scary, but I can feel assured that I continue to do all I can to keep the cancer from returning. In the meantime, I'm enjoying the summer...the flowers and the warm weather, playing with my sweet dogs, and spending time with my wonderful family and friends. It really doesn't get much better than this, living a peaceful dependable life.

2-1/2 Years Later

2011-05-04T17:08:00.003-04:00

In April, I had my 6 months check-up with the oncologist. The Tamoxifen, while creating some uncomfortable side effects, has treated my body well, and now I'm half-way over treatment. My next oncology visit is in October, right after, my next digital mammography. The bottom line: All is good!

Two Year Oncology Visit

2010-10-11T10:43:00.002-04:00

More good news. My oncology visit was short and sweet. The blood work was perfect and coupled with my good mammogram last Friday, it doesn't get better than this. I'm to continue with the Tamoxifen. Next appointment is in six months.

Stepping Out for Breast Cancer Luncheon

2010-10-11T10:34:00.002-04:00

Yesterday, I attended a beautiful luncheon sponsored by the "Stepping Out for Breast Cancer" organization. This all volunteer organization was created 13 years ago (I hope I have the right time frame) to provide services and improve the lives of women with breast cancer in Anne Arundel County, Maryland. All of their funding goes to services - most unusual in these times.

Thanks to Lynn Kay, my college roommate and very dear friend, who works selflessly for this organization and many others for inviting me to attend. The room was filled with pink - flowers, balloons, chocolate lollipops, pink cupcakes, and pink sherbert. There were wonderful vendors who graciously donated a portion of profits for the cause, but more importantly, the room was filled with women of all ages who believe in finding a cure.

Dr. Rachel Brem from George Washington University Hospital was the guest speaker and caught everyone up to date with the latest radiation technologies used to diagnose breast cancer earlier and more accurately.

A wonderful afternoon for a wonderful cause!

Race for the Cure 2010

2010-10-04T08:24:00.007-04:00

On Friday, I had my 2nd survivor year mammogram and all was good! This was the first time in years I only needed one set of films and now I don't have to go back for another year. So sweet! Prior to the exam, I made a promise to myself that if all was well, I'd participate in the Race for the Cure. Oh...way before, I had signed up and had received my dark pink t-shirt with the words Survivor on it, but could not get the nerve to go. But now I had no excuse. All was going well. I had a lot to be grateful for and it was time to show it!

My dear friend, Sharon, kept encouraging me to go with her. She had participated for the past 3 years, and found it to be an inspiring event. So at 5:45 AM yesterday, we headed off to the local Lowe's to catch a shuttle bus to the event. It was dark and cold, but so exciting! There were tents everywhere. Women dressed in pink as survivors and white as supporters.

At 6:40 AM, all the survivors walked together in between 2 pink ribbons toward a large grandstand, where we were each given a beautiful pink rose. All of us had the number of years of survival in pink ribbons on our hats, and together many of us cried as we stood together and looked out at all the people who offered their love and support to all of us who had heard the devestating diagnosis and endured the many different treatment paths. I cried for my mother and others, who was not fortunate enough to be alive now when all these wonderful diagnostic tools and treatments were available. I also cried in happiness that someone like Nancy Brinker had the motivation, knowledge, and connections to make breast cancer survival a priority and has not faltered a day in making it a reality through the Susan B. Komen foundation.

Thousands and thousands of supports and survivors ran or walked together (see picture). At the end, I was encouraged to walk on the left side of the road and instead of pink ribbons, there were rows of people slapping my hands in celebration. It was a beautiful moment and beautiful day.

Almost at the 2 Year Mark

2010-08-22T19:11:00.002-04:00

It's hard to believe it's been almost 2 years since my breast cancer diagnosis. Except for the hot flashes from the Tamoxifen and a tinier breast, I really don't think about it much.

However, in early October, I'll have my next mammogram, and I'll be praying that everything will be fine. Before that, I'll have a pelvic sonogram to make sure that the Tamoxifen isn't causing any problems with my uterus, another side effect of the drug.

I'll try not to worry before then, and just go from day to day grateful for what I have and all I have to look forward to.

Changes are Forever

2010-04-27T21:42:00.002-04:00

I'm still feeling like I'm in a good place in my life. My health has been stable for a few months. I really like my new job - the commute is much less stressful; the work is interesting; and the people are lovely.

In two months, I am looking forward to attending my oldest daughter's MBA graduation in Chicago. I'll meet up with a fellow breast cancer survivor, who happens to be the aunt of my daughter's boyfriend, and whom I've gotten to know during this past year, as I supported her through her journey with surgery, radiation and chemotherapy. We'll both hug and feel grateful we can share in a joyous family occasion together - celebrating the spirit of living with the breast cancer diagnosis behind us.

In the beginning, I thought about the cancer every hour of every day. Survivors told me it would get better. It was hard to imagine at the time. I sought the solace of support groups and read anything I could get my hands on regarding my diagnosis, treatment, physical and psychological outcomes. I was consumed, and the knowledge eased my angst.

Slowly, as the seasons changed, the focus turned toward living and not just surviving. Sure, there are days when I think of what it was like, but more days I think of what will be - the future, retirement, grandchildren...all those things I've always dreamed about.

So, if you are reading this and just starting your journey, be assured that time does bring forth joy in the morning, and that what you are going through now will hopefully be a distant memory as the months roll by. And if you find you need a little extra support, email me at joannklein@gmail.com. Pay it forward...the dividends are priceless.

Today's Oncology Visit

2010-04-12T12:19:00.003-04:00

All is well. The blood work was perfect. The only thing the oncologist mentioned was that because my December surgery for the breast duct excision showed that the tissue was atypical, usually a precursor to cancer, but not a surprise since they already found cancer in the breast, that the breast will need to be watched closely - every 6 month visits with her and yearly mammograms. She feels strongly that the Tamoxifen will prevent a further recurrence and that the five years will cover a lifetime, based on research. I'm lucky since I tolerate Tamoxifen well. So I feel quite blessed today and grateful for good medical care.

Another Checkup in the Morning

2010-04-11T19:04:00.002-04:00

It's hard to believe that it's time for another checkup with the oncologist tomorrow. Last week, I had bloodwork done, and tomorrow, everything else gets evaluated. I feel confident that all is well, but I can't help worrying that the bloodwork will show that my liver is being affected by the Tamoxifen. In addition, my skin on my radiated boob continues to either rash or itch. I'll be glad when the visit is over.

In the meantime, my new job is going well. Shorter commute and less responsibility = less stress, and that's a good thing for sure.

On to a New Job

2010-03-16T21:23:00.001-04:00

I really enjoyed the 2 weeks off between jobs. I made sure to catch up with old friends and pace myself enough to get the rest the time off was intended for. It's amazing how fast vacations are and how slow workdays are...big smile.

This week I started my new job, which is with an employer I worked for 4-1/2 years ago. The tasks are similar to my last job, just 1/10 of the responsibility. Breast cancer has a way of making you re-evaluate what is important in life, and it certainly isn't working yourself to death!

STRESS must be reduced. STRESS must be on the bottom of your list of priorities. Therefore, you have to make it happen. I'm pleased with myself and my decision. I hope I'm right.

Today is My Last Day at Work!

2010-02-26T12:03:00.002-05:00

No, it's not forever, but the breast cancer diagnosis did cause me to reflect on living the best life for the best prognosis over time. One of the items on this bucket list is to reduce all sources of stress. I loved what I did at work. I was creating something that would benefit thousands of people. It was successfully deployed, but the stress of getting there was akin to being in labor for unrelenting hours. There is no way it can't affect you over time.

Call it karma, but a similar job was offered to me with the pieces of my job I liked the most, and considerably less responsibility. I grabbed it. For now, I'll enjoy my last day at work. Then I'm taking a couple of weeks off to decompress, before I start the new position. During that time, I'll play with friends I haven't had the opportunity to see for a long time. I'll make up for some of that time lost to stress, and I'll embrace life again.

Finally Healed!

2010-02-07T10:49:00.002-05:00

I'm happy to say that the nipple wound is now healed, and hopefully this will be the end of the breast issues. It's a new year, and I'm hoping a healthier one!

On another note, we have just experienced an epic snowstorm - 23" in our backyard. Taking a look at its untouched beauty in the sunlight makes you appreciate how lucky you are to be alive!

Dogtors

2010-01-29T10:44:00.002-05:00

It's a funny thing about dogs. They sniff out healthcare problems. They are dogtors for sure. Two days ago, my dogs started sniffing my breast, trying to get under my clothes. They became agitated when they went near me, and would not leave me alone.

If you remember, I have had drainage from my left nipple almost ever since the surgery. It didn't seem to change, but my sixth sense and my dogs response to me, prompted me to call the surgeon's office. I went this morning, and she told me I had a small infection, most likely from the sutures they used. She ordered an ultrasound, which if it had shown a pocket called a seroma of fluid, she would drain it to help the healing. However, the ultrasound only showed small undrainable pockets of fluid. I am now on an antibiotic for a week, neosporin to the wound, and nursing pads to catch it all.

I go back next week for a follow-up. Until then...

Don't Count Your Chickens Before They're Hatched

2010-01-26T20:34:00.002-05:00

Unfortunately, the wound is still draining. In fact, it's hard to call a wound because you can't see it. However, there is still drainage...enough to stain my bra and get me aggravated. So I asked my brother the pathologist if he had any ideas why this is going on for seven weeks now, and he tells me that the breast is mostly fatty tissue and doesn't heal as quickly as other sites. It's not odd that it's taking so long. As long as there is no symptoms of infection, I'm good to go. Either way, if this continues another week, I'm calling back the surgeon.

Still goopy in Maryland

Bleeding Has Stopped ... Keeping Fingers Crossed

2010-01-17T17:59:00.000-05:00

It looks like the bleeding is stopping. My breast does not twinge and it's not feeling full, like it was prior to when I was seeping fluid from it. I'm keeping my fingers crossed that this is the last of it. And keeping things in perspective, one of my cancer bulletin board buddies just noted a recurrence, so I'm very very fortunate.

Sparking a Memory

2010-01-14T13:32:00.006-05:00

The bleeding from my left breast is now occuring ever 3-4 days. It has sparked a memory when at age 26, I had a biopsy on my left breast which resulted in a hematoma that was painful and had to be drained every week for 8 weeks. This is really similar to that, except there is still a small opening by my nipple and excess fluid can drain out on its own = no pain and faster healing.

Another Small Drama

2010-01-10T10:07:00.002-05:00

Good thing the surgeon told me of some possible issues that may come up once the healing process begins. Yesterday, my family and I were out to lunch (in the literal way...big smile), and I felt wet on my sweater, but wasn't quite sure what it was. When I got into the car, I quickly looked underneath, but did not see anything.

When I got home, I took off my sweater and 1/2 my turtleneck shirt was decorated with blood and the left cup of my bra was totally soaked in it. Luckily, I remembered the surgeon telling me that it could be possible that you will see a pool of blood one day without any warning. This is because the body will not allow any empty space and when tissue is removed, the body fills it with its natural fluids during the healing process. The blood burst I got was a result of the body tissue filling in and the pool of fluid being forced out of its space. All good news ultimately...but imagine if I did not have warning on this...

I'm Starting to "Look" Normal Again

2010-01-07T08:03:00.003-05:00

For a while, my breast was looking like a Picasso print. Finally, the steri-strips peeled off, the incision site along the side of my nipple and areola look normal again. I can actually look at my mini-me breast and it looks like a part of my body again.

Not sure if I've addressed this yet, but my cancer breast is now quite a bit smaller than my other breast. It really bothered me when I realized how much tissue had been removed from the cancer breast resulting in its new size, but then again, I was grateful to have a breast at all.

With a bra on, it appears normal. Couple that with my usual fashion style of twin set sweaters, the size difference can definitely be hidden; at least, from my perception.

8 Days Later - The Results

2009-12-24T09:01:00.002-05:00

All good news! There was a small papilloma, not visual on the ultrasound, that was causing the bleeding. The cells had changed, but were not malignant. That is all I wanted to hear! This is indeed a wonderful way to end 2009. So...out with 2009. Let's all ring in a happy and healthier 2010!

So Tomorrow's the Surgery

2009-12-13T19:43:00.002-05:00

I have to be at the hospital at 7:30 AM for the duct surgery. I'm unbelievably worried about the outcome, but warmed by the support of friends of co-workers. There are three of us that have desks in the same area who have had breast cancer. They have been simply wonderful as we have shared our trials and tribulations over the past year together. One of the woman gave me a guardian angel token to take with me tomorrow. It's been in my pocket for three days as a reminder that people do care, and that sometimes faith is a better protector than we give it. Pray for me tonight...please.

Pre-Operative Testing Day

2009-12-10T14:54:00.003-05:00

I was really hoping that the bleeding would go away and I could cancel everything, but I knew it just would not happen that way for me. The reality is that I'm scared I'm going to go through the cancer vortex again, and it's just one place I don't want to go!

It was quite surprising that after 30 years going to my internist, his office could not accomodate me for a pre-op physical. I'm still reeling from a little anger and surprise. Luckily, the hospital where I'm having the surgery on Monday could take care of the exam.

So...I took my letter and went to the hospital this morning. Of course, they screwed up my records. I've become accustomed to not having things turn out the way they should. Ninety minutes later, the admitting officer tells me the problem is fixed, but that was after two chats with the supervisor with my coaxing. We go downstairs for the exam, and the nurse practitioner notes that my name is still wrong with wrong info behind it. She smartly documents manually using my name and birthdate. The exam was fine, as expected.

I sure hope that things are right on Monday...

Nipple Bleeding 14 Months Later

2009-12-04T14:14:00.005-05:00

A few weeks ago, I noticed a small blood stain and thought maybe it was from our sweet bichon, Daisy, who had had surgery for torn knee ligaments. A week later, I noticed a similar stain in my bra and on my nightgown in the area of my nipple.

Noticing a dark area at the entrance of one of my nipple holes in the breast where I had been diagnosed with breast cancer last year, I expressed my nipple and out came bloody discharge. Panic was probably the first reaction. This has been a difficult health year up to now, and quite frankly, I don't have the mental energy to handle another crisis.

As soon as I could, I did contact the breast surgeon's office and was sent for an ultrasound of the breast as well as another mammogram. This was a follow-up to a very successful yearly mammogram only 2 months ago. The test results showed that nothing changed. So I am really no more knowledgeable of what is causing the problem as I was before the test.

Per the physician, it could be caused by one of 2 things: papilloma (benign wart-like growth) causing distended breast ducts that bleed or cancer. Usually the papilloma would show on the ultrasound, but it may have been so small it didn't display on my test. So the plan is to remove all the offending ducts and send them to pathology on December 14. I'm very comfortable with this decision, and will have an answer regarding the cause when I go back for my surgical follow-up.

The question then becomes how can DCIS come back so soon since it takes 15-20 years to develop? My understanding is that it may have been there all along, but not been diagnostically visible.

Finally, there are 2 ways to view...if the bleeding is caused by papilloma, the surgery will remove the cause and all will go back to the way it was. If the bleeding is caused by cancer, then I was very lucky to have symptoms to look at this further since diagnostically nothing showed on the tests.

I'll be sure to update as soon as I know more. Happy Holidays to all!

Mammograms are Saved!

2009-11-19T10:25:00.002-05:00

The federal government health czars have assured us that the surveillance of mammograms will continue as is. For once, common sense and research results prevail! Of course, this should not prevent any of us from being advocates for our own health care needs.

Please Don't Stop the Mammograms!

2009-11-18T13:51:00.002-05:00

New recommendations have been released that are recommending that regular mammograms do not commence until age 50 and then at two year intervals. Two thoughts on this one:
1. This recommendation was made by number crunchers who only look at statistics and cost, or 2. This recommendation was made while ignoring the phenomenal strides made in breast cancer awareness, prevention, and treatment.

As for me, if it were not for a yearly digital mammogram, my breast cancer would not have been "found" before it likely would become a lump, I would have found in a self-breast examination. And who knows? By then, it would likely be invasive, and I could end up dead like my mother of this beastly disease in a short period of time.

The mammogram pointed out a few years before the actual diagnosis that the area where the cancer was found was starting to change. The changes were not significant enough to biopsy but they warranted diagnostic attention. Luckily, for me, I had terrific providers who had the knowledge and expertise to find it early. At this time, my chances of survival after 5 years are close to 99%. I'll probably be more likely to die from something else than breast cancer.

My twenty-something daughters are at a bit higher risk than the general female population due to generational breast cancer and female hormone cancers. Will they be barred from having the surveillance they have been advised to start at age 30? This is totally unacceptable!

Don't let this slide by without taking a proactive stance if you truly believe this is wrong. 1 out of 12 women will have breast cancer in a lifetime. Don't we want all of them to have the opportunity to live as along as they can as healthy as they can?

Oncology Visit - One Year Later

2009-10-27T13:46:00.002-04:00

The mammogram was purposefully scheduled a few days before my oncology visit in case there was any discussion to be had over the results. Luckily, all was good. A breast check, review of my latest labs, and a discussion about general health resulted in another year's prescription for Tamoxifen and another appointment in six months. I am grateful that I am one of the lucky ones who doesn't have issues with Tamoxifen and can enjoy its benefits!

First Mammogram After Diagnosis

2009-10-27T13:38:00.002-04:00

On October 7, I had my first mammogram since my diagnosis 13 months before. Talk about nervous! I could not wait until it was over. At this point, my radiated skin issues had dissipated and I wasn't having weird pains in the affected breast anymore. I was feeling pretty optimistic.

I get to the Breast Center early hoping to get it over with asap, but one of the techs was late, and all appointments were delayed an hour. I did get a very competent tech who did not mind when I questioned everything I saw on the digital x-ray. She even showed me the x-ray of the actual tumor that was removed during the surgery last year. They use x-ray to determine if they got enough of the tumor out or have to remove more tissues.

After the first go-round, I was called back for more views of the "good" breast. I told the tech that if this was cancer, both breasts were going bye-bye. No more playing with lumpectomies. I don't think my nerves could take it.

While waiting, I went back to the waiting room, and got into a discussion with some of the lovely ladies about breast cancer and recurrence. Finally, the tech called me back and told me everything was fine! I let out a whoop and started to leave...as I was walking out the door in my x-ray gown, the ladies asked me if I wanted to get dressed before I left. It was a good giggle for everyone. Imagine being so excited you forget to put your clothes on!

The good news is that I don't have to return for another year. Things are definitely looking up!

One Year Later ... More Surprises!

2009-09-24T11:39:00.005-04:00

Hooray! I survived the first year of survivorship, the last few months being so easy, it was as if I never had any problems. My scar is almost translucent, and all the skin problems from radiation are gone. While going through it, I never thought it would end, but as always, tincture of time cures most of the little things in life.

So one year later, on the anniversary day of my diagnosis, I was in for another surprise. We had gone out to dinner to celebrate, and it was time to go to sleep when I started to get a tummy ache. It started to feel like there was a pump in my tummy being blown up. The pain went into my back and I couldn't get comfortable. This unrelenting pain went on and on, and after 2 hours, I told hubby that we needed to go to an emergency room. Of course, the first thought through my mind was that I had liver mets and my life was over...talk about making a mountain out of a molehill?

So we went to GBMC, where the cancer treatment took place, and I was triaged to wait nearly 7 hours in the waiting room and before I saw a physician. Rule 1: Never get sick on a holiday weekend...even though illness happens 24/7, hospitals still celebrate holidays with skeletal crews. During the time I wait, I finally fell asleep (probably my body's way to deal with the pain) after 4 hours of this awful discomfort. When I woke up, the pain was gone, but I felt we should still see why it happened since it was so unusual.

Turns out I had gallstones that I didn't know about, and one of them had dropped into the common bile duct that passes by the pancreas and blocked the pancreas as well as the bile duct. As a result, pancreatic enzymes used in the metabolism of foods and bile were unable to get to their destinations. This created havoc with my lab values, and I was diagnosed with acute pancreatitis.

Luckily, being a nurse has its privileges. I got absolutely fabulous care, and all the nurses were super friendly and supportive. After 5 days of rest, hydration, and a procedure to roto-rooter my bile duct and put a slit in it to prevent further stones from blocking it, I was sent home. The next step is gallbladder removal, which will happen tomorrow.

If you're reading this today, say a little prayer for me tonight. I really hope this is the end of illness for me for a LONG time.

Back to Being Me...

2009-08-05T10:06:00.004-04:00

This year has been one of tremendous personal growth. I know now what is most important. I gave up my Internet business, because I realized I was spending every waking moment working, and more so in a dark crowded environment, that was just depressing. Did some soul searching, and realized I missed some of the hobbies I used to do in the past, so I started needlepointing again with the intent of creating something for the house. Aside from the joy of creating, it is very relaxing.

Not a big fan of taking photos of myself, I recently bit the bullet and David, Rachel, and I took advantage of getting portraits taken with our dogs at the local PETCO. Our only regret was that Carol lives out of town and we could not have all of us in that picture. When we went to pickup the finished photos, I was thrilled! We were all glowing. The dogs were freshly groomed that day and looked beautiful. I ran out, bought frames, and David hung them on the wall last night, so uncharacteristic of my former self. I now want to see life and joy all around me. This morning, when I saw the pictures in our family room, I had a big smile on my face.

These times are very good times, far better in many ways, then the pre-cancer days when I did not know myself as well, and did not appreciate the goodness in my life.
I really believe that the breast cancer was G-d's way of hitting me on the head to say, "Wake up and enjoy all that is around you. You are blessed. Appreciate all that you have. Take better care of yourself. You are loved."

Just When You Think Your Head is on Straight...

2009-07-24T22:05:00.004-04:00

This week has been a rough one from an emotional point of view. I was thinking I was really settled about the breast cancer impact on my life, and then a woman my age in my community, with children who are the same age and friends of my children, dies of breast cancer. She and I were acquaintances. We would always say hello and make small talk when we bumped into each other, but her death threw me for a loop.

Combining that with other stressors, I started to sob last night...for two hours. I couldn't stop crying. Poor David did not know what to do to comfort me. My dogs climbed on my lap and licked my tears. I was inconsolable, and finally, the last drop fell, and I was totally drained, exhausted, and feeling like some of the pent-up angst that has been following me since my diagnosis last September was gone. Cathartic for sure, but also for sure to happen again.

I HATE this disease. It robs families and communities and steals your courage. It takes your free spirit away with the worry that this "beast" is lurking somewhere.

Climbing Over the Mountain

2009-07-07T11:35:00.004-04:00

Last night, I went to the Hopewell Cancer Center Support Group after a brief hiatus, and noticed how very far I have come from an emotional perspective. There really is another side to the mountain, and I am seeing the world in a much happier and positive way.

Ten months ago, my world seemed pretty bleak, particularly, since I couldn't take my thoughts away from my mother's death, and wondering if that was going to be my demise from this beastly disease. I fretted that I was never going to see my daughters married or grandchildren or live to enjoy the retirement, we have carefully saved for. The future did not look very positive at the time.

Today, while I think about the cancer, it's not an every day, every hour focus of life. It happened. It was treated. It continues to be treated with Tamoxifen. It's the best it can be. Like I said in the last blog, I'm looking at it as a message to reevaluate my life and appreciate what is most important.

I have been so lucky - terrific and loving husband, wonderful daughters, adorable dogs, great friends, and life's comforts. I am blessed.

How Did I Get Breast Cancer?

2009-06-29T08:07:00.003-04:00

I think all of us who have been diagnosed wonder what triggered it and when it started. They say that DCIS takes 5-10, 10-15 or 15-20 years to develop to the point where it can be diagnosed. That's a wide range of years and who knows which one is right, but I can pinpoint events during each of those time frames that may have created enough stress to affect my immune system enough to make it incapable of fighting the cancer cells.

Fifteen to twenty years ago, my mother had 2 strokes and died of recurrent metastatic breast cancer. She had been sick since I was 15 years old with a multitude of health issues, mostly centered around her circulatory system. My role changed from daughter to pseudo-caretaker. My mother really took her sick role seriously. She stopped working. She was afraid to do anything that may stress her. However, the stress was redirected to everyone else. My father, in turn, was not used to not having his wife do everything he wanted when we wanted it. It's like taking a stable table with four legs and moving the legs around so that it wasn't quite as stable, nor did it stand up as straight anymore. The outcome of living in that environment over a period of time resulted in an uncomfortable level of anxiety and some hypochondria based out of fear of becoming sick like my mother.

Twenty years ago, my children were also in elementary school. I was working in a job I wasn't crazy about, but it afforded me a schedule that would permit me to be home with my children whenever they were out of school.

Fifteen years ago, I found a job where I could work from home. I decided to go to graduate school full-time during that period, and while the children were a little older, my role as a mom was more important than ever. The children were the easiest part of my life at that time. The overload of school and the job caused my hair to fall out of my head in clumps, resulting in 6 months of cortisone treatments to my scalp to prevent further damage. Lessons learned: I reduced the school schedule and still graduated within the time frame I had orginally planned. I also went back to work in a structured environment where I could separate home and work responsibilities when the home job contract ended.

Ten to fifteen years ago, my daughters were getting ready for college. It was a tough financial hit, but not unexpected. It was during this time that I also experienced a bad business relationship that really stressed me out.

Five to ten years ago, I was in another job where the workload was totally overwhelming, and most of us in the department were treated badly. I was the first of 23 people who left that department over the next five years to find peaceful employment elsewhere.

Add it up, and any of these events could have thrown my body over the edge. Include a dash of family genetics, bad eating habits, and erratic exercise. Is it any wonder that I developed breast cancer? How many times do you have to get hit on the head to know that you have made bad choices?

Looking Back - 9 Months Later

2009-06-22T11:19:00.003-04:00

Most of the past nine months has been a whir of activity, primarily focusing on breast cancer - diagnosis, treatment, side effects, and survivorship. Only now am I starting to see the forest through the trees, but there are certainly many lessons I have learned along the way.

My daughter commented recently that my point of view on what is important in life has definitely changed since my diagnosis. She is pleased to see that I am focusing less on work, and more on taking care of myself. That I am focusing less on taking care of everyone else, and treating myself better in the process. These are things that I have always strived for, but could never justify in the past. Why does a cancer diagnosis finally justify it? Why did I ever have to justify focusing on myself?

Here I am, the nurse, the caregiver, the family anchor, the daughter who looks after her ailing father taking care of his bills, his medications, and listening to his daily "organ" recital, the daughter-in-law, who worries as her aging deaf 95 year old father-in-law lives day-to-day in an assisted living facility, the wife who worries that her husband's 4 hour commute each day is too stressful, making him tired and unable to do the things he used to do, the mother who worries that her daughters, now in the work force, are spending way too much working and not enough time playing. How can I blame them, they learned from the best ;->.

My daughter also commented that my life history has been filled with little "bumps" that have made me stop for moment and take notice of my choices. So that while cancer is not something I would have ever wished for, it did make me stop, take notice, and make decisions to change the course of my life in a positive way. I have learned to take the lemons and make lemonade.

Back to the Breast Surgeon

2009-06-16T15:08:00.002-04:00

After two bouts of antibiotics which helped to reduce the inflammation, heat, skin redness, and pain in the radiated breast, the symptoms are back. The radiation oncologist sent me back to the breast surgeon, whom I really trust. After careful review of the history and extensive palpation and questioning, she advised me to use "tincture of time" to let nature move forward to try to resolve the ongoing problem.

She wasn't blowing the situation off, but felt a very conservative approach is the way to go for now. Unless of course...I develop more inflammation and pain. Then, I'm to call her back.

I feel comfortable with this decision, because she took the time to review the situation, the past treatment, and synthesize it all to make a decision about the best way to move forward for the time being. Works for me!

Stay tuned...

Infection is Back Again...

2009-06-08T11:13:00.001-04:00

So...now I'm 10 days out from the finishing the 2nd antibiotic, Cipro, which I was on for 10 days and the symptoms of breast infection are back again - itching, inflammation, and swelling under my armpit. It's getting REALLY old. The Radiation Oncologist wants me to go back to the breast surgeon. He is not convinced it is all from the radiation at this point. What we do know is that it is likely an infection since it has responded to the antibiotics. Here we go again...sigh

Finally...Some Answers

2009-05-21T19:47:00.003-04:00

I'm finally turning the corner - emotionally that is. This week I have better direction on what is causing the radiation effects and an answer to the swelling in the my left neck which has gone on for two years. All are fixable...so much to be grateful for.

I've also decided to turn my focus away from the cancer and more on making my life even more meaningful than it is already.

Radiation After Effects

2009-05-07T11:16:00.003-04:00

So it's now 5 months post-radiation treatment. If you recall, when the treatment ended at the end of December 2008, I experienced a folliculitis of the treated skin area that took nearly 2 months to resolve. The dermatologist tried 3 different approaches to resolve it, including a biopsy (just showed inflammation and nothing else), and finally it went away when all three medications (topical antibiotic, steroid cream, anti-fungal cream) were applied.

Fast forward to this week... My affected breast is very warm to the touch, still pink, and painful at the boost site area as well as under my armpit where it feels swollen at times, particularly in the morning when I swear I can feel the lymph nodes. The pain is becoming more constant, particularly after the breast has been touched. So I called the breast surgeon, whose nurse referred me back to the radiation oncologist, whose office arranged for a visit that day.

The radiation oncologist advised me that it was NOT cancer, but rather a hyperreaction to the radiation treatment which occurs in 1-2% of all people who receive radiation (aren't I the lucky one?). He recommended 2 courses of treatment -heavy steroids (8 weeks) which would provide optimal results or Motrin 800 mg three times a day for 3 weeks. I made no treatment decision at the time of the visit because I think the treatment is a bit harsh to start out the gate with, and will follow up with him again in August since he says there is no harm in waiting it out a bit longer.

The day after that visit, I received a call from the radiation oncologist, who had done a bit more research, and recommended that I should try a short course of antibiotics for 10 days to make sure that the inflammation is not bacterial in nature. He ordered a broad spectrum antibiotic. If it improves the situation, I'm to see him at his office. If not, I'll give him a call to advise.

Now...with my 20/20 hindsight, maybe I shouldn't have done the radiation, but then I wouldn't have done the full battle plan and would have more about the cancer returning. Too late now to speculate about what could have been.

Psychological Support

2009-04-21T13:22:00.003-04:00

Last weekend, David and I participated in the Hopewell Cancer Center's Annual Fundraising Walk and Run. It was joyous to see my new Hopewell friends with their families and to see some of my old treatment buddies, now being active and looking healthy!

The Hopewell Center has really been a terrific place for me. It is a non-affiliated non-profit grass roots organization that provides supportive services to anyone with cancer. Services are all free of charge, and they rely entirely on donations. They recently purchased an old comfy home where their meetings take place and built a barn on the property for their spiritual classes in yoga.

Every other Monday night, they have a Breast Cancer Support Group. Last night, I went for the second time. The women change each visit, because it is a networking group, and attendance is not mandatory. It's so inspirational and freeing to talk about the cancer and learn from others' experiences, fears, etc. And it's not all cancer either...it's the fallout from the experience that is discussed as well. I highly recommend this type of activity for support.

Last Thursday, I also started weekly support group sessions at the Hopewell Center. This includes people in all stages of cancer with all types of cancer. Again, another opportunity to talk freely about cancer and never worry that someone will run away from you because you have that need. The reality is that none of us who have been through this want to burden others who have not with all the details, but sometimes there is a personal need to do just that. The weekly group is diverse, but we all connected. This will definitely be helpful for me.

If my Mom had not had breast cancer and died from it when we thought she was cured, I don't think I'd be so fixated...but it is what it is and I have to live my life with that knowledge. I feel certain that these groups will help me get over the psychological hump. How lucky I am to live in a community with so many fabulous resources!

Six Months Follow-Up

2009-04-09T17:44:00.002-04:00

Today was six month post-cancer diagnosis visit to the oncologist. Since the radiation ended, I've been having swelling in my left armpit every morning. I realized, through all my reading, that pain in the breast after radiation was really quite normal, so those pains have not scared me. The oncologist was not concerned at all. She palpated my armpit and told me that my lymph nodes were NOT enlarged, and that it is really quite common to have axilla (armpit) pain after radiation.
My blood work came back normal in all areas, and she is pleased with how I'm doing with the Tamoxifen. My breast is still a little red and a little warm from the radiation, which she says is also common, and no, it is NOT IBC. That was a relief.

My next appointment is scheduled in 6 months, one week after my next mammogram. Lots to celebrate...all is going as good as it can get!

Fast Forward...

2009-03-06T08:32:00.002-05:00

The months have flown by. Since radiation finished, I've been dealing with a residual skin problem as a result of the radiation. I was hoping it would disappear, but it has spread. The dermatologist took a biopsy last week and told me not to worry...it's not cancer, more likely something that can be easily treated. The first two medications he gave me didn't work, but last week he added a third and I'm noticing that there is less inflammation and no new spots. I'm crossing my fingers.

This past Monday night, I went to a meeting of SOS, a volunteer group of survivors, who meet with new survivors to talk about different issues such as fears, recurrence, relationships, etc. It was very uplifting, as I have been a little down in the past month from the skin issue and recurring fears. One of the messages of the meeting was to recognize that I am the top priority now and to take care of myself first before others. Of course, it's not realistic, but it's a message that I've heard a zillion times, but this time it stuck a little better. The other message I took home was to reach out for more help if you need it. It was calming to talk to others who have been through it and are surviving with the same feelings and emotions.

So...I decided to call Hopewell Cancer Center...they provide support services and have a breast cancer support group that meets twice a month. I'm looking forward to learning about their services next week. There is a sense of relief that I'm doing something to move forward. I never dreamed this would be so mentally debilitating. It doesn't make sense since the cancer is gone, but at the meeting the women said it can take a long time - 1 to 2 years until you really move forward with your life.

20 Treatments Down - 13 to Go!

2008-12-01T20:59:00.003-05:00

I didn't realize it had been so long since I blogged last. I take that as a good sign that I'm thinking less and less about the cancer and more and more about the next phase of my life. Going from "Hold" to "Active" status.

The past two weeks have been uneventful except for missing one day of therapy because the machine broke. So now my last treatment will be December 17. The doctor said my skin is in much better shape than he anticipated. I'm having some breakdown under my breast but it's very small and very manageable.

David and Rachel came up for a great idea to help it heal - a boob jack to hold it up and a small fan to provide air to it!!! We tested the theory using a toilet paper roll, but after a little while, the weight of my saggy boob crushed it, but the concept is a good one! I'll wait to see this on the market next year.

Dare I Say I'm More Back to Myself Again?

2008-11-22T13:36:00.002-05:00

These past couple of days have brought new clarity. I seem to be thinking less about the cancer and the treatment, and can focus a bit better. Not sure why unless it's that the treatment is on the way out rather than the way in, and there's hope that my life can move from "hold" status to "moving on" and getting on with life.

I cannot tell you what a great feeling it is to "feel" again. I'm happier and more content and laughing more and just feeling better about everything around me again. Sure, my breast is still pink and the treatments are a daily annoyance, but it'll be over in a few weeks and then it's just a matter of taking a pill everyday for five years. Certainly a MUCH more normal way to live.

And if God is good and my luck is positive, this will all be a major memory to look back on when I'm old and MORE gray than I am now. Happy Thanksgiving!

15 Down - 18 to Go!

2008-11-19T21:08:00.002-05:00

Things continue to move along. Last Saturday, we celebrated a beautiful event with a very special friend, her family, and community, and it was life affirming. Not only did I see people I haven't seen in years, but the sense of love and family was awesome. It was a wonderful evening!

Today was the first day of radiation where someone was there for an emergency treatment. Turned out this young woman was experiencing bone metastises from breast cancer and in severe pain. The whole thing was depressing. A group of us sitting in a room and not being able to avoid hearing her tell her companion about her experience. It shakes you to the core, but makes you feel so lucky it's not you. However, it does remind you of your mortality for sure.

8 Down - 25 to Go!

2008-11-10T20:20:00.004-05:00

Finished my 8th treatment today. The skin is looking very good, although its quite pink. The ALRA cream is keeping it from breaking down, which is very important. The big change this week is that the radiated breast has shrunk considerably. Probably something I'd notice more than a mere stranger seeing me fully dressed, but I do realize it, and it is kind of sad.

Over the weekend, I started feeling a little more tired than usual. Just not sleeping that great at night, but not being able to catch up during the day. When I left work today, after a difficult workload, to get treatment, I was just exhausted, but there were still things to do. So I'm going to make it my business to get to bed as early as I can and just relax a bit.

I can't stop focusing on the fact that I had cancer! I can't seem to get it out of my mind lately. I am really angry again. While I know all the good things about the type I had, it's just that I had it and it can always creep back. Yeah yeah...I know that I'll be vigilent and do all the things I need to in order to catch anything as early as possible, but I'm not so naive to think that I'll never be at risk again.

Ignore my blabbing...it's pity party day.

Nothing is as They Tell You

2008-11-01T18:23:00.002-04:00

I believe that nothing is really as they tell you. It's really more of an average. For example, I didn't expect SEVEN tattoos. I get into my first day of daily treatment, and it turns out the one of the main tattoos on my bad breast is 3" off. EXCUSE ME? That's not a small difference. Anyway, I now have tattoo number 8. So I told my hubby that I had a special surprise for him last night when he came home from a business trip. I gave him a pen and told him to connect the dots. Not funny...but you gotta laugh it off, right?

Going back a little, after radiation day one, I go home and notice they put some tape over two of the tattoos at the base of the bad breast. I pulled it off because after the simulator, they left on some things they told me to take off at home. Well, I got issued a new "youknowwhat" on that one. Per the rad tech, "Didn't I tell you yesterday NOT to take those off? Now we have to do it again. Hrummph."

Everything up to the radiation therapy had been going very well. But I must say, I haven't been impressed with this part. I told the tech that my skin was already pink, and she says "Impossible, no one gets pink this early." So I start justifying myself, which is ridiculous, and say "I've got extremely fair skin and always burn quickly so never say never." She then gets a bit of an attitude and I tell her, "Listen, this may be old hat for you doing this everyday, but for me this is new. I may not remember everything you tell me, and not everyone fits the mold of what you think it should be like for them." She later apologized for being a jerk (jerk=terse in her dictionary).

I hope this radiation experience gets better...cause it sure isn't what I thought it would be, and I'm normally pretty easy going and witty. I see the radiologist on Monday and he and I are going to have a little discussion about all of this.

More Genetic Tests Results

2008-10-30T09:33:00.004-04:00

Yesterday afternoon, I heard from the genetics counselor again. She advised that the final genetics tests (the $3000 test) were in and everything was negative. She was thrilled, but not as much as I was. She said that she felt strongly after seeing the results (and she gets more than a positive or negative result) that the fact that my mom and I have both had breast cancer is more coincidental than heredity. She said it could be environmental or chemical or other reasons not yet defined. She advised I continue with my follow-ups as recommended by the oncologist (duh...) and that Rachel and Carol start their vigilence at age 40. As you can imagine, Carol and Rachel were ecstatic! Too bad it takes so long to get good news.

This afternoon, I start the first radiation treatment. One of my co-workers brought me a gift today. She saw a ceramic pink ribbon today telling me that she had been thinking of me when she saw it. I was really touched, considering that before this came about, no one was talking to me at all.

Radiation Simulation - Not a Joy Ride

2008-10-28T19:46:00.003-04:00

After the happy moments last Thursday, I headed off to Radiation for the simulation. This is where they position you and draw the markings they need to properly irradiate your breast. In my case, I will have 33 treatments daily (except for Saturday and Sunday).

So they call me to the back and have me go into this dressing room that reminds me of the gym and I have to take off everything from the waist up. Then I'm guided into a waiting room of chairs lining the walls, a lonely TV hanging from a hook and set on One Life to Live, and a lot of cancer magazines. I tried to talk to this lady who walked in a little after me, but she was not very friendly so I just waited nervously and hoped someone would come get me soon.

About 15 minutes later, I was led into a room with a thin metal table with a form that looked like I would be sitting on an angle. So I hop up on this table, which barely is the width of my bodacious body and get into position. I had to put my arms in these boxes over my head and hold onto handles (kind of like a kinky movie or stretching table if you can picture that). My tush was against this hard form so I was in a sitting type position and a hard pillow was under my knees. My head was flat against the metal table and I had to maintain this position for well over an hour while they marked my chest up like a bad Picasso print with Sharpie markers. The markers, in all different colors, ended up staining my $70 bra. It was grueling to stay in that position that long, and I moved slightly after warning them. They were NOT happy. Too bad. I'm a human. Anyway, they ended this torture session with putting 7 tattoos on me for permanent marking - 2 on the good breast and 5 on the affected breast. I can't begin to imagine why any normal person would CHOOSE to have a tattoo!

Next Thursday, I start the real stuff. Oh joy oh joy!

A Lucky Lady

2008-10-23T09:21:00.003-04:00

I'm still on a high about my BRCA negative test! So lucky, particularly after reading the breast cancer bulletin boards and all the horrors that women are experiencing from their friends and families. In fact, I was telling David about all the women whose husbands left them after they had their diagnosis. He was in his closet putting away clothes and said to me, "Sorry, you're stuck with me for the long haul" and turned around and smiled. Gawd, I love that man!

All Good News Day!

2008-10-22T18:03:00.003-04:00

My genetic test for the BRCA1 and BRCA2 mutated gene came back a week early, just in time for my radiation visit today, and the good news is that I do not have that genetic problem! This is not just good news, it is wonderful!

I don't have to have the prophylactic bilateral mastectomy because my risks have dropped back to the "normal" of others with DCIS. However, the oncologist told me even if the test did come back normal, I should still have the oophorectomy to rid my body of the estrogen that feeds the type of cancer I had. The radiologist suggested I use this oncology gynecological surgeon that I've heard great things about for my oophorectomy/hysterectomy. He's in the same hospital system.

The best part of this test result is that Carol and Rachel can relax a bit. Of course, they must be aware of breast changes, but it won't haunt and scare them. That's a nice gift indeed!

The radiation visit went very well too. The radiologist was very patient in answering our many questions, as you hope they would all be, but many are not. Tomorrow I go back to the radiologist for the simulation visit at 2 PM. During that visit, the doctor positions me on the x-ray table, puts my arms in some position and then tattoos my breast where the radiation beam should go. Then it takes about a week to figure out the plan and then start the daily treatments - 28 to my entire left breast followed by five directly to the lumpectomy site. I go Monday through Friday, 1/2 hour each day, for these daily treatment. Only side effects that I might experience are fatigue and redness of the skin. Doesn't sound too bad.

Feeling Low Today

2008-10-21T14:47:00.002-04:00

I am starting to feel very sad for my family. Despite all the good news, they are very stressed and scared about me. David has been very sad and when I try to get him to talk about it, he doesn't know what to say. So I ask him if he's scared about me and he shrugs and says he guesses so. Then he starts tearing up. It breaks my heart. And Carol, who has been away at grad school during all of this, told me today she is very stressed - knowing I've been sick in addition to her boyfriend's grandpa dying in the past month, and my Aunt Sylvia, in the dying process from 10 years of Alzheimer's. Rachel seems to be doing fine. I'm grateful.

I really hate having this disease. I hate having to get treatment. I hate having to do prophylactic surgery. I fear I'll have the BRCA gene mutation. This really sucks and it won't go away, ever. Sure, I'm sure there will be a time when I don't think about cancer 20 hours a day, but it will always be there at the back of my mind. Any long-standing aches and pains will create fear of its return. It's my new pet (monkey on my back), but this one will last a lifetime and my stress will continue to feed and nurture it.

Gee, and tomorrow I can look forward to meeting with the radiologist about the next phase of treatment. Oh boy! Oh boy!

Pink Day

2008-10-20T07:58:00.003-04:00

Yesterday was the Race for the Cure, and I had the opportunity to walk with friends, but I just could not do it. Realizing that I would see other survivors there in all different phases of recovery just put the wall up for me. So while I thought I was really far along mentally, guess I am not as strong as I think I am.

Funny thing, though. In the afternoon, I went shopping and ran into a woman wearing her survivor shirt from the event. A total stranger and I started talking to her about the walk and her experience. She told me she received her diagnosis in New York and had come to Baltimore for treatment and was 1 year out from a year of intense therapy. Her joy was having her daughter come down to walk with her. I shared with her that I was a frightened of the experience, and she said she could have never done it the first year either. We parted with a hug - a stranger and myself. Yes, the sisterhood is strong.

The Genetics Counselor Visit

2008-10-14T21:12:00.007-04:00

I am so grateful that we live in a metropolitan area where so many resources related to breast cancer are available. In particular, I'm quite pleased with the services I am getting from one hospital system. It makes care easier since all the providers can communicate easily and are familiar with each other.

From past blog entries, you have learned that I have a strong family history of female-related cancers, so the surgeon and oncologist felt strongly that I could benefit from genetics counseling to determine if I had the BRCA1 or BRCA2 gene mutations that are found primarily in Jewish men and women of Ashkenazi descent. Today, I went for that visit and it was eye opening.

The genetics specialist had taken my family history and entered it into a special database to determine my personal risk, which was 19% based on my mother's history alone, compared to 10% of the Jewish women over 40 with history of breast cancer of Ashkenazi descent. She felt it would benefit me and my daughters to follow through with the testing, which is in two parts.

Some insurances won't cover it so I have to be prepared to pay toward it, but David and I discussed this was important to know so we're going for it. The first test costs $600 and it only tests for the BRCA mutations (3 types). If that test comes back negative, they do a more extensive test, which costs $3000. Hopefully, our insurance, which has paid up to now, will cover.

You may wonder what the benefits of this knowledge may be? If I am positive, then I have a 50-85% chance of getting breast cancer in my lifetime, which we know I already have. There is also increased risk in getting it in the non-affected breast in the future along with a possible 65% risk of getting ovarian cancer on top of the breast cancer. If I'm positive, I'll bow out of the radiation and go for a bilateral mastectomy and total hysterectomy, including ovaries to mitigate the risk. David and I discussed reconstruction a while ago, and we're both okay without going that route. I've been reading that should there be recurrence in the chest wall behind the reconstructed area, they have to remove it all anyway. I've enjoyed what I've had for all these years. They've effectively nursed my children, and did their duty so I can accept that they may be more a detriment than an asset.

With this knowledge, I can also guide Rachel and Carol in getting early surveillance, by being proactive. The genetics counselor advised me that new laws were passed this year preventing insurance companies AND employers from denying tests and treatment AND employment based on genetic results. The reason so many young women have recurrence is that there isn't early enough surveillance for those at risk. This way, breast MRIs are given yearly, in lieu of mammogram. MRIs help diagnose the density in younger breasts much better than mammograms so that newly developed cancers can be found before they become invasive. With positive BRCA, surveillance is recommended to start between 20 and 30 years old.

So you're probably asking what it means if the tests are all negative. The geneticist said that there could still be a family heredity, but the particular gene abnormality may not be established yet. Either way, I contribute to the pool of research knowledge that may help someone else.

Other things I learned today. I am considered at higher risk for recurrence just because I am premenopausal with breast cancer, even though I'm over 50. It is likely my mother was also premenopausal when the cancer first started, but the mammograms at that time just weren't that good at early detection, so she didn't know until she had a lump and already had node involvement. The geneticist said that other factors may have prevented my breast cancer from forming earlier. They just don't know enough yet.

So...it continues to be a journey for sure. Some days are more positive than others. Here I go again and wait for results, which I should hear in two weeks. It isn't easy.

Sunday - One Week Later

2008-10-12T12:44:00.003-04:00

Wow..I'm far behind on blogging this week. Last Monday, I went to the oncologist. She is a young fiesty spirited woman who felt strongly that I went to the very best breast surgeon around and that my chances for recurrence will be significantly reduced by going the radiation, Tamoxifen, AND...a new addition...having an oophorectomy route. This is all in light of my strong family history of female hormone-related cancers.

She said there is no need to move on the surgery immediately, but we'll talk again about it in January, after the radiation treatments are finished, to decide the next course of treatment. At first, I was really kind of taken aback. Getting your organs removed is not a "light" surgery no matter how they do it. In addition, would it be best to just have all of it removed? After all, I hear that Tamoxifen can cause weird side effects to your uterus too.

So I set out to find some answers this week, and all health personnel agreed a total hysterectomy with oophorectomy is the way to go. It can be done laparoscopy for reduced trauma. Of course, it's unknown whether insurance will pay for it, but that won't be a deciding force. Health comes first!

Speaking of doctors, I also had my post-surgery visit. Since the incision is already healed...talk about fast, I've been released, and frankly, while I really liked the surgeon, this is one person I hope NEVER to see again, at least not in medical wear.

This week I go to the genetics counselor. It should be interesting. According to the surgeon and oncologist, the geneticist has the ability to search nationwide databanks to make informed recommendations. Even if I don't test positive for a known gene defect causing breast cancer, it does not mean that there isn't a gene defect. It may not have been discovered yet. So my participation is one of the ways to help these kind of discoveries. In the meantime, the geneticist works with the oncologist to recommend the most successful treatments based on others with similar backgrounds, health problems, and treatment plans. It sounds like a win-win. For anyone reading this who wonders if the genetics counsler is covered under insurance, it is NOT. However, the fee of $150 for the counseling, possible payment of the blood work (could cost $1000), and a month wait for the results could mean the difference of a more successful outcome. At this point, my goal is to prevent recurrence as much as possible! There is never a price on personal health that is not worth investing in, at least at this point in my life.

As for the other aspects of my life, I was happy to get back to work this week. Thinking about other things besides health is not mental reprieve. Working from home was helpful, however, as I realized my stamina isn't where it was before this started, but it's darn close.

Still no bites on our house or lookers this week, but we're not giving up hope. With the state of the economy, can I blame anyone for not wanting to spend money right now? Our timing has never been quite right...we have historical experience with that..haha.

That's it for now. More after the geneticist visit. Have a great week!

Sunday - October 5

2008-10-05T18:37:00.002-04:00

Today was a really great day! Except for lifting some heavy grocery bags with my non-affected breast side leading to some twinges and some oozing from the suture site, I felt pretty good. My energy levels are back, mostly because I'm not feeling depressed.

Still nothing new on selling our house. People in this area are seriously underpricing their homes to sell them, but we're not there yet. In the mean time, we did take a trip to Odenton to see our new house and the progress to date. The builder gave us a key to the house so we could go in and look around. We're three weeks from closing in the event we have a super quick sale so most of the house was put together.

We LOVED the way it looked! The chocolate marble fireplace is just beautiful with the oak mantel. The wood stair banisters are beautiful and match the oak steps. The carpet looks beautiful too. The carpet padding, which was out of our control, isn't quite as plush as we have in our current house, but we were told that using berber limits your choices since they don't want it to show separations over time since there isn't any pile. The ceramic tile and lighting in the bathrooms are just wonderful. The kitchen and mud rooms are just perfect too! We can't wait to make the move!

Tomorrow we go to the oncologist and hope that our luck continues. More tomorrow....

Two Days After Lumpectomy

2008-10-03T13:03:00.002-04:00

Didn't sleep as well last night, more because there are issues with my work project than anything else. My breast suture line still twinges a bit and if I run up the stairs, I need to hold my breast to keep it from bobbing up and down, but that's nothing compared to what it could have been.
Today, my breast definitely looks smaller than the one of the right, not because of shape, but rather volume.

I'm still resting, just working on my computer while resting. So, off to finish a deliverable. Have a great weekend everyone!

Feeling WONDERFUL Today!

2008-10-02T11:25:00.004-04:00

The lumpectomy went extremely well. I was in and out within 2-1/2 hours from radiology to place the wire into the site through discharge. The surgery was anticipated to take an hour and it took 45 minutes. Recovery was to take 1 to 1-1/2 hours and only took 45 minutes for me to wake up and leave. The pain was not as bad as I thought, and Extra Strength Tylenol did the trick along with ice per doctor's orders and wearing my bra constantly.

I slept well last night, even on my tummy, which is my favorite position. I really felt rested this morning. Before showering, the bandage came off easily, and I could see the surgeon placed the incision totally on the side of my breast and way below my underarm. It will be totally unnoticeable even if I model in strapless gowns and bathing suits...horrors! The best part is that my breast doesn't look noticeably smaller than the other one although I can tell it is a little smaller, and my bra is not as stretched on that side. I'm sure it will be a little smaller once the surgical area heals too, but a small price to pay for my life!

I only wish it didn't take so long to get this surgery done. I feel mentally a million times better that this is out of me and I can move on to prevent its return. The pathology report will close the door on whether more surgery is needed, but I'm being optimistic that the door is closed!

I'm taking the rest of the week to do nothing but relax and sleep and heal. Monday we start again but I'm ready to continue the battle...

Thanks to all who are reading this for your prayers. So far so good.

Today I'm Scared...

2008-09-29T14:08:00.002-04:00

I think it hit me again. In two days, I'll be having the surgery and I'm really scared. Even David came over to me with a hug, crying, saying how he can't think about it or talk about it without crying. He is so frightened. While cognitively we both know that the initial pathology is very optimistic, until we get the surgical pathology back, we will still doubt, and then after that, just knowing that the "enemy" has visited and has the ability to return will always haunt us. It just sucks!

Meanwhile, our house isn't going anywhere. The new house will be ready in 3 weeks, and the market continues to suck. The money I want to put into the house will be worth nothing by the time we go to settlement the way the market is. It makes me wonder if we're getting a message from a higher authority about all of this.

On the positive side, the women who are my work project team leaders have taken all responsibility away from me this week and told me they are managing things and not to worry. I should just concentrate on me. Who can ask for anything better than that? Yet I hate so much not to maintain control of things.

Rachel will be coming in this afternoon for the holiday. I can't wait to see her. She always makes me laugh, and heavens knows, I can use it right now. She will stay until after the surgery to help us and keep David company while I'm having the procedure. I worry so much for my David. He's my life!

L'Shana Tova to my Jewish friends who are reading this. I pray we all have a happy and HEALTHY New Year!

David's Good News

2008-09-26T19:26:00.003-04:00

It's finally over. David's cardiac catherization showed no heart disease. In fact, the cardiologist offered to switch his cardiovascular system with David. David has to rest for the weekend and not drive or lift until Monday, but that's a small price to pay for the results of the test. Now it's on to further explore where it's GI or musculoskeletal, the other options causing the pain.

While we were there, I ran into one of my former managers who is now the head of the cardiac cath lab. We caught up on old times, and I remembered that she is also a breast cancer survivor - 10 years out for her. Her recommendation was to do all I can on this first shot since it's the best shot I'll get. I'm inclined to take her direction, particularly after reading about all the people that have recurrence who opted out on some of the offered treatment.

Pictures and More...

2008-09-25T07:31:00.003-04:00

Last night we celebrated David's 56th birthday. It wasn't the same without the girls, but I prepared a meal I knew he would like and topped it off with a baby birthday cake. He really liked it!

Since the breast cancer diagnosis, I had talked about taking pictures of my boob in its present state before the surgery. So last night, David took out the digital camera and we took pictures at every angle, covering up my face, just in case, g-d forbid, someone should ever find these pictures. I can ASSURE YOU that they will never be fodder for the Internet. hahaha

In turn, I took pictures of his chest since tomorrow he's having his cath and if for some reason there is more involvement than a simple stent, he'll end up with a bypass and change the look of his chest forever. We had some real giggles taking the pictures, and it was a fun way to cope with the stress!

Meanwhile, today I'm a mental wreck worrying about David's procedure tomorrow. We aren't dealing with a stomach flu, but rather, a potentially life altering problem. And David isn't one to complain easily. He'd rather keep everything to himself so I know he's feeling bad. And after all these years being together, we're so interdependent that anything that affects him, also affects me. The good and bad of long time loving relationships.

So..if you're reading this, say a few extra prayers tonight for David. Thanks.

Just When You Think It Couldn't Get Any Worse...

2008-09-24T08:42:00.003-04:00

On my way to work today, a young man slammed into the back of my car and cracked the #$% out of my right bumper. G-d, do you think you can pick on another family? We've had just about as much as we can take right now.

Mental Health Checkup

2008-09-23T12:49:00.004-04:00

Only 8 days away from the lumpectomy and 4 days until David's cardiac catheterization. Having gotten a pre-op checkup of my lungs, bloodwork, cardiac and respiratory status yesterday, I also thought this would be a good time to do a mental health checkup. For some reason, I wasn't sure I was reactnig appropriately to all the news. I really haven't cried all that much. I can stop thinking about our troubles when I'm busy, and am finding myself a lot more worried about David than myself. So...I made an appointment with my psychiatrist, whom I had visited in the past, but had not seen in the past 18 months. Today was the day!

When he asked me why I was there, I repeated everything I said above. We went into all the activities in my life within the past 18 months, including our plans to move. Fifty minutes later, I walked out with a pronouncement of excellent mental health - even more so than my last visit 18 months ago. He was pleased that David and I were reducing the commute and house maintenance stress in our lives by moving. He said my reaction to this illness was on par, basically because I really have no statement of the future until I get the results and talk to the medical oncologist. He further emphasized that he would be more upset if I were totally unwired at this point. Not that I should not be disturbed and concerned, but since I received "no sentence" at this point, why angst over the unknown? Makes sense to me.

So...I've conquered another checkpoint. Going to the dentist today for my 6 month checkup as planned. That's enough doctors until David's procedure on Friday. Then we start again. Here's hoping that Jewish New Year brings a happy and healthy one to the Klein family.

Enjoying the Weekend

2008-09-21T18:54:00.003-04:00

Since David found out he has to have a cardiac catherization next Friday, he's been as interested as I've been in keeping himself busy enough not to have too much time to think about it. So this weekend was chockful of activities.

On Friday night, we enjoyed dinner with my cousin Billy, his fiancee Randy, and his son Chad. We giggled through the entire meal as we reminsced about family history. It felt wonderful just to belly laugh.

On Saturday, we went to see the new movie, Righteous Kill, with De Niro and Pachino. We weren't disappointed. David thought maybe we should go to another movie immediately after that one, but I wanted to go home. I was mentally drained and wanted to rest a little. On the way, I thought it might be fun to go out with friends for dinner, and asked Sharon and Barry if they'd like to join us. We had such a good time munching over chinese food and talking about the usual subjects. It's wonderful to have such good friends!

Today, I went to the luncheon, saw the new house on the way home, and yes, they're really starting to put it together. The oak stairs and railing are in. The oak mantel and marble insert is in the fireplace and all the electrical outlets were covered with plates. How exciting, and I got to see all that through the windows! Now if only we can sell our house. David spent the day relaxing and then headed off to his Dad's place, finally telling him everything that was going on. As expected, he didn't say anything and life goes on.

Tomorrow is work...but we'll both be glad when Friday comes and David can finally have his procedure. Only 10 days till the lumpectomy. Time...please move fast.

Stepping Out with Breast Cancer Luncheon

2008-09-21T18:10:00.002-04:00

Today I had the privilege to attend a beautiful luncheon focused on raising funds for the breast centers at North Arundel Hospital (now called Baltimore-Washington Hospital) and Anne Arundel Hospital. A few months ago, before my own diagnosis, my college roommate Lynn, sent me an invite since this topic is near and dear to both of us (both of our moms had died from breast cancer). I had put it aside not sure what I wanted to do since it was taking place an hour away and with our house for sale, I was never sure when I would be called to action to get the house ready and the dogs out the door. Lynn reminded me about it last week and after all that has been going on, I decided it would be a good thing. Lillie Shockney, a breast cancer survivor and director of the Hopkins Avon Foundation Breast Center was going to be the speaker.

What a beautiful thing to hear that 14 women (those that belong to this group) put on such a fabulous event! There were multiple vendors, all donating a percentage of their sales to the cause and over 150 women attending the event. Every table featured pink flowers and mylar pink ribbon and celebrate the cause balloons. There were lovely "goodie bags" for every guest and the lunch was delicious.

Lillie was a dynamic speaker who made us laugh and cry with the story of her personal journey. As a fellow nurse, there was so much I could relate to. When I left today, I felt energized again to move forward toward the next steps in getting this all behind me. Many thanks to Lynn for reminding me of the event. When I wear the cap she gave me, I will always know that there is love and strength supporting me every day through this heinous process.

Finally Good News!

2008-09-19T14:06:00.003-04:00

After chasing down the breast MRI results, the news was good! There are no new places of concern. That means the lumpectomy will go as planned and we can start moving forward on getting this nasty stuff out of me!

Friendships and Family

2008-09-18T09:38:00.016-04:00

Calla Lily - Flower of Friendship. When I look back at my life, I have been very blessed to have had long lasting friendships, most stemming from my childhood. If you think about it, childhood friends accept you as are. After all, they knew you when you were most vulnerable. They knew when you had pimples before you discovered great makeup and Clearasil. They knew you when you fell on the playground, where they helped pick you up, dust off the asphalt grime, and take you to your teacher or your mom to wipe tears and get that band-aid that seemed to solve everything.

They knew you when you got your first bra, met your first boyfriend...you get the picture. There is little energy expended in being anything other than who you are. They don't care what car you drive, how big your house is, or how much money you earn. Yet, they do worry that you and your family are happy and well. These friendships are indeed precious and in our transient materialistic culture, quite rare.

I am also blessed to have met new friends along the way, too through work, play, and community activities. To all of my friends, I extend my sincere thanks and love for your telephone calls and emails. They mean more to me at this time than you'll ever know.

Love,

Jo Ann

Monday 9/8 - Visiting the Surgeon

2008-09-17T21:38:00.010-04:00

We were lucky enough to get an appointment with the surgeon one business day after the diagnosis. I cannot express enough how important this was to us. The uncertainty was making us crazy. Rather than repeat all the detail again, I'm including an email I sent to our many friends and family members:

Dear Friends and Family,

For most of you, this is an update and for some of you, this will be the first news you will hear about this. Last Friday, I was diagnosed with ductal carcinoma of the left breast (DCIS). I was lucky to get an appointment with the surgeon today and David and I spent 3 hours with her. Dr. Lauren Schnaper, at GBMC, explained very thoroughly how very lucky I am that the cancer is NOT invasive, is a VERY LOW grade and it's about the best scenario you could hope for, if you have breast cancer. I'll be having an MRI before the surgery, since Dr. Schnaper noticed an area on the mammogram that she did not like, and I'll most likely end up with another biopsy before the surgery scheduled for Wednesday, October 1. Yes, it is the second day of Rosh Hashanah, but it is the first appointment I could get since she wanted lead time for the biopsy, if it was needed.

Based on the results of the MRI, if everything is a go and the pathology doesn't change, I'll be having a lumpectomy. After that, I have an appointment with a medical oncologist. Apparently, this kind of cancer and the fact that the biopsy was reactive to estrogen and progesterone responds very well to an oral hormone therapy drug, Tamoxifen. You take it for five years, if you can put up with the side effects, and it reduces your risk of a second episode is reduced by 50% according to the latest studies.

In some cases, women with this diagnosis also have radiation, but the surgeon says it's a one shot deal and you have to weigh whether you would take that route now or save it in case the cancer did return, and you really needed it for a more invasive cancer. Because there hasn't been a lot of research years focusing on DCIS, since it has only become a diagnosis since mammograms came on the scene (approximately 1989, according to the surgeon), they don't have a lot of filtered research. Meaning, that they haven't taken the time yet to determine if women with my low stage of cancer would do just as well without hormone therapy and without radiation as someone who has a more complex grade of DCIS. Those studies are yet to come. In the meantime, you have to look at what's out there and make decisions and the surgeon says it's really tough to know how much is just enough but not too much. Considering my mother was diagnosed at 55, a little more than one year older than me and with an invasive cancer (she had node involvement), and that my maternal grandmother had uterine cancer and her sisters had female-related cancers, I've requested a genetics counselor follow-up, which I'll set up when the dust settles.

Otherwise, David and I are very encouraged that we are very very lucky and in good hands! My angel is watching over me once again! Thanks, as always, for caring and being wonderful family and friends. It makes it so much easier to have those you trust and care about to share these moments with.

Love, Jo Ann

Catching Up - September 9 - 17

2008-09-17T21:38:00.008-04:00

It's been a whirlwind week. Between trying to sell our house, keeping our house spic and span on a daily basis just in case someone wants to see the house, maintaining our busy job responsibilities, and living through this diagnosis, it's been draining.

On Monday, September 15, I had the breast MRI. At first, the tech looked at my zaftig rear and wasn't sure it would fit in the closed MRI, but I proved her wrong...with even room to spare! I can finally appreciate what back pain is after laying like a lox in a very awkward position for 35 minutes. Imagine this...you are on your belly with your breasts hanging through holes in the table. Your head is turned and smashed flat against the table with a small pillow for minimal cushioning. Your arms are straight ahead and your knees are slightly bent with legs elevated on a pillow to keep your breasts hanging as low as possible. Add the loud sounds associated with the MRI with the heat it produces along with a radioactive substance coursing through your veins, it isn't exactly like sipping Mai Tais with little umbrellas on a beautiful beach!

Yesterday, September 16, I had a meltdown while talking with Carol on the phone. No matter how old I am, there are just times when I really miss my mother and wish I were a young child again so that she can take my life over and make it all better. With all the support, there is still that missing link, and no way to bring it back. As a result, the tears just started flowing and flowing. It was the cry that I had been holding back since diagnosis day. Poor Carol bore the brunt of that one, but it was "safe" to cry with her and she understood. Afterwards, I felt much better and legitimately tired. Sleep came fast.

And so it's been 2 days since the MRI and the results are not back yet after being told they'd be ready, and I would be called. It's so maddening!

Off to bed...

2 Days after Diagnosis

2008-09-17T15:00:00.009-04:00

Most of the evening of the day of diagnosis was spent combing the Internet for treatment recommendations. The most common treatment was lumpectomy with radiation and Tamoxifen (if the tumor was estrogen receptor + or progesterone receptor +). The radiation kills rogue cells, and the Tamoxifen works to block the regeneration of new cancer cells, by blocking the ability to absorb female hormones, their "food" source. Essentially, the Tamoxifen puts you into a menopausal state, which believe it or not, at age 53, I would happily welcome! Imagine buying female products with my GRAY hair. In fact, I pretend they're for my daughters...hahah.

The best part of the day was knowing that Rachel was coming to spend the weekend with us. I knew she would keep me busy. The more I thought and the cancer, the worse I viewed my future. So on Friday night, we talked a bit about the cancer. But on Saturday, we had a day where there was not a waking minute to think about anything but having fun. We went out to breakfast, went to a morning movie, went shopping for a gift, went back to the movies again, and ended the day going to a family affair for the entire evening! It was wonderful not to dwell on the big black cloud.

On Sunday, 2 days post-diagnosis, we went to the annual bichon frise dog bash in Hayfield, Virginia. The joy of watching 200+ bichons (see the picture if you won't know what a bichon frise looks like) running off-lead in a controlled fenced portion of the park was beyond words. Our sweet dogs, Daisy and Giovanni blended right in, and it was a fun day talking about the dogs with like-minded owners, who didn't think we were nuts to be so in love with our pets. In fact, Daisy and Giovanni, as lap dogs, have been a wonderful source of comfort.

On Monday...David and I were scheduled to the see the breast surgeon...more later.

The Beginning...Last Installment

2008-09-17T14:35:00.003-04:00

I was emotionally drained after talking with my family, but knew that my father had been waiting for the results. We don't have a particularly close relationship, but since my mother died, I have taken on a lot of responsibilities in regard to his bill payment and medication management. His reaction was benign, and because he is not a nurturing person, I had no expectations that he would be particularly concerned about how I might be taking the news. Even though cognitively I knew he would react this way, it still hurt emotionally, because I simply cannot fathom how a parent would not be overtly concerned about a sick child.

My brother, the pathologist, was the next phone call. He has always been matter of fact, not particularly tactful, and always eager to show you how smart he is. With his photographic memory, I'm happy to have him on my side to interpret information. However, if I were looking to him for comforting support, I'd be in a heap of trouble. His comments to me were "You've passed the surveillance, which you knew you'd had a 30-80% risk due to Mom. So now it's time for you to lop off both your breasts and get a reconstruction. They'll tatoo nice nipples on you too." Nope, this was NOT what I wanted to hear at that moment of time, and after I advised him of the same, and stewed a bit, knowing that I should have expected that insensitive comment, I moved on to call my friends.

It was only the week before that one of the "people" in the group of friends I had hung out with over the years, had a serious health problem. One of the husbands (56 yo) had a heart attack, but after a stent and some rest, he was doing great. I was really the first one to have the big C. Being young (I still consider 53, as young, and so do the breast cancer statistics), no one wants to think we could be hit with anything of a serious nature. After all, we don't feel old. Sometimes, I act and feel like I'm a child, as my family can attest, so surely I shouldn't be experiencing anything as serious as cancer at my age!

One of the positive outcomes of this experience has been that some people I knew in my past (relationships and jobs) have stepped forward, after finding out about my diagnosis through mutual friends, and have called me and sent beautiful supportive emails, chockful of positive thoughts; each reminding me that my world is really much larger than I thought, and the power of their prayers and their kindness will go a long way in helping me beat this challenge.

My college roommate, Lynn, who lost her Mom to breast cancer, one month after my mom died of breast cancer, has been particularly active in Breast Cancer Organizations and fund-raising. She has been a rock of support as I continue to wait for results and my surgery.

Today's Lessons Learned: Love and friendship cannot be purchased with insurance, even with the best possible plan. It is something that is built and nurtured, and if this blog does nothing else, it should remind everyone reading that you should remember to keep that friendship garden nourished and growing.

The Beginning Continued

2008-09-17T07:56:00.005-04:00

The next call was to my children. I am very lucky that my daughters have also become friends as they've blossomed into adults. Carol, the oldest and now living in Chicago, has always been pragmatic, ready to tackle any challenge put in her path. Rachel, the youngest who lives an hour away, has always been the comical child. The one that couldn't sit at the dinner table without doing somersaults on her chair, hanging with her head down, just to get a rise out of us. She is also very sensitive, a little more anxious than Carol, and always seeking answers, even if they don't exist. Both girls (aren't they always going to be my little girls?) are smart and beautiful (doesn't every parent say that too?), but most of all they are caring and loving, and as a family, we have always been very close. That's why I knew these calls were going to be the worst.

I had told the girls about the need for a biopsy and the facts that 80% of the time, biopsies are negative. That didn't quell their fears. They had friends who had lost their mothers to breast cancer, had experienced my mom dying from breast cancer, and they were frightened! Carol called me early the day after the biopsy to find out if the results were back. I promised I would call as soon as I had heard. So, now I had to call her and frankly, I was scared to death. She was the easy call, because I knew she would take the information, synthesize it quickly, and ever the planner, would ask for the next steps. No doubt, she was shaken to the core. I could hear the trembling in her voice, and, as a mother, I could never stand my children to be sad. After all, aren't we only as happy as our saddest child? Here I was struggling with my emotions, as well as my family.

Carol had just moved back to Chicago a few weeks before to return to the University of Chicago for her MBA. She was so excited, and I didn't want to put a damper on this very exciting time in her life. She felt torn, and asked if she should come home. I told her she was being ridiculous, but it was a sweet gesture, and I was touched. I knew if I said yes, she would have been on the next plane.

With a promise that I would call her back later, I called Rachel. Rachel had just graduated from Cornell University with her Masters in Engineering (I'm such a proud mama), and had been working at her first "real" job for only three weeks. She had recently moved to Northern Virginia, and was having a blast with her friends, her job, her apartment and her social life. It doesn't get better than that! And here comes Mom, to put a big hole in the happy balloon. As expected, Rachel was full of questions and only wanted to hear positive information. more later....

The Beginning

2008-09-15T18:45:00.014-04:00

There is always a beginning to every story, a prequel, and multiple epilogues. This is my story, dedicated to my wonderful family, my support and anchor - my dear sweet husband and best friend of 31 years, David, and my two beautiful daughters, Rachel (24) and Carol (27).

On Friday, September 5, 2008, my world was rocked. I received the diagnosis I had been dreading ever since my own mother was diagnosed with breast cancer 25 years ago: DCIS Left Breast, .3 cm, Grade 1, micropapillary.

Should I say I was surprised? Not really. After I saw the mammogram that led to the additional mammograms, ultrasound, and stereotactic biopsy, all in the same week, I saw the "explosion of the microcalcifications". This mammogram seemed to match the mammograms with the same diagnosis on the Internet.

When the radiologist shared the news, very tactfully, and in a kind way, I was numb. My body started to shake, and the tears welled in my eyes. Luckily for me, I was in my work office, and the door was closed. I could be emotional in the privacy I so desperately needed.

My first reaction was to go online and look up everything he said on one of the great breast cancer websites I had found earlier in the week. The pathology was clearly explained (http://www.breastcancer.org/symptoms/path_report/). Then when I felt I was armed with the answers that I knew my family would seek, I called my husband.

David, as expected, was very sad. He assured me that "we" would do what needed to be done to get well again. He was definitely part of the team. For years, I had asked him what he would do if I lost a breast like my mom. And for years, he replied that nothing was more important than my health, and whatever needed to be done should and would be done. After all, as partners for 31 years, we had made a pact that we would love each other for better or for worse, in sickness and in health. He's the kind of guy that would never break a promise, nor reneg on a contract. But, in truth, we are still in love with each other, have a lot of fun together, and after all these years, still "like" each other too. He is the one constant that I know will always be my side no matter where this journey takes me.

-=-=-=-=-