Tuesday, January 15, 2013

CALL ME ID


CALL ME ID

Did I mention I am not a patient person?  And that I think delayed gratification is a crock of sh*t?  Yep, I know, you’re shocked.

According to Sigmund Freud's psychoanalytic theory of personality, personality is composed of three elements --known as the Id, the Ego and the Superego.  According to Freud, the id is the only component of personality that is present from birth. This aspect of personality is entirely unconscious and includes of the instinctive and primitive behaviors. According to Freud:

The id is the source of all psychic energy, making it the primary component of personality.  The id is driven by the pleasure principle, which strives for immediate gratification of all desires, wants, and needs. If these needs are not satisfied immediately, the result is a state anxiety or tension. For example, an increase in hunger or thirst should produce an immediate attempt to eat or drink. The id is very important early in life, because it ensures that an infant's needs are met. If the infant is hungry or uncomfortable, he or she will cry until the demands of the id are met. However, immediately satisfying these needs is not always realistic or even possible.

Yep, that’s me all right.

Started my morning off with my long-awaited consult with the plastic surgeon.  Been [im]patiently waiting for a month to meet with him to discuss what my “reconstruction options” are.  You want to know what they are?  Here’s the video Dr. Boobi-opo  had me watch:

 


 

 

So anyway, I started the morning fully prepared.  Even remembered to bring my coffee in.  Bad news is I nearly wet my pants because I had to wait so long.  Today’s goal was to not leave his office without a plan of action & a surgical date.  Sad to report that the goal was not met.

 

Here’s a quick summary of my meeting with Dr. Boobi-opo:

1) He is recommending DELayed reconstruction due to possible Radiation invasion to left breast when they zap my pit - need to wait 6 months after radiation.

2) He recommends just a unilateral mastectomy with “facelift” on other.

 

 So here I sit frustrated for so many reasons. Frustrated b/c I have already waited a month to still have no concrete plan of action, frustrated because I still have to wait, that I will have to go thru:

·         surgery = 1 month

·         chemo = 4-6 months

·         Radiation = 1 month + wait 6 months before I can get reconstruction.

My bad math says I will be without boobies for 12+ months! THAT SUCKS.  My inner 4 year old child is kicking her feet & lying on the floor wailing out of frustration.

Now logically, I get it.  I understand the doctor’s concern that even though I am only going to need radiation in my armpit, it will “spillover” to left breast & it is better to replace possible irradiated skin with fresh tummy skin (yep, this girl is gonna get a free boob job – tummy tuck out if this!) than to risk doing reconstruction first & damaging fresh new tissue with evil radiation beams.  Like I said, I get it.  However, inner child is NOT having any of it.

 

I’m also frustrated with the doctor’s implication that a bilateral mastectomy would somehow be medically unnecessary.  Does he not get that the strongest risk factor for breast cancer is age. At 40, my risk of developing breast cancer would be 1.47 % (or 1 in 68). At 70, it would be 3.82 % (or 1 in 26).  Or that only 7% of the women with breast cancer are under 50! What that means is that all the “studies” are focused on a control group that 93% of are (well) over the age of 50 – most in their 60s or 70s.  Yes, I am aware of the studies that indicate that a bilateral mastectomy may not decrease the risk of developing a contralateral breast cancer (getting cancer in the other boobie), but I have a life expectancy of another 37 years.  A 65 year old woman has a life expectancy of 20 years.  A 75 year old woman has a life expectancy of 12 years.  Translated, I have more years to live so I more years in which for cancer to reoccur.  Or how about as a younger woman, I am 9 times more likely to get cancer again if I do a lumpectomy vs. a mastectomy.  I think there was also a recent report that mammograms are not needed until age 50.  Umm, Hello? 46 here.  Cancer caught by routine annual mammogram at 46.  Cancer has already spread beyond breast into lymph nodes.  Hello? Anyone? Yeah, I’m pretty sure I would be dead by the time I reach 50 if I had waited.

There are lots of studies, but I don’t give a CRAP about studies.  This is about ME – Pam, Pamela, Daughter, PameLAMi, Doodie, Mother, Sister, niece, cousin, aunt, godmamma, friend. ME GODDAMIT!

I don’t care that my risk of developing cancer in the healthy breast may be “fairly low.”  If I get to choose between 1% and 9%, I chose the 1%.  DCIS is associated with an increased risk of invasive breast cancer.   I’m young; I have a strong family history of all kinds of cancer.  I will do everything in my power to prevent my girls from having to watch me die from this.  GODDAMMIT.

The best comment I found from someone who also faced this decision was “I decided to only dance with this devil once.”  At the end of the day, I’m just going with my gut. Cut these puppies off. 

On a more positive note, I solved my problem.  I can get Immediate Gratification.  I can make Immediate Gratification Jam.  Yep, that is its real name.  Don’t you just love Google?

Here’s the recipe–

This jam is not preserved in airtight jars with wax seals. It's completely fresh, and you only make enough to last about a week because it keeps well in the refrigerator for that long. It is delicious on toasted French bread that has been buttered as lightly or liberally as your taste and waist allow.

Ingredients -

·         Strawberries, raspberries or blueberries*

·         Approximately 1 to 2 cups sugar, depending on how much fruit you use

Directions -

1.       If the strawberries are large, cut them into four pieces; if small, cut into two pieces. The blueberries and raspberries do not need to be cut.

2.       Put the fruit in a bowl and toss with sugar until all the fruit is coated with sugar.

3.       Put the fruit in a saucepan.

4.       Add water to halfway up the fruit in the pan.

5.       Bring to a boil uncovered.

6.       Lower heat to a simmer immediately, stirring occasionally.

7.       When the fruit has turned liquid, taste and add more sugar if it's not sweet enough.

 

Once the extra sugar melts into the fruit, the jam is ready. It still looks runny but will firm up enough after it has been refrigerated.

Tuesday, January 1, 2013

Happy New Year. I have cancer. Yep that says it all. Can I just stop there? Yeah, probably not.


Happy New Year.  I have cancer.  Yep that says it all. Can I just stop there?  Yeah, probably not.

"God is our refuge and strength, an ever present help in trouble."

My TaTas.  I give full credit to Victoria’s Secret for how cute they look in this pic.

The one thing I love about Facebook it that it lets me know what my friends & family are up to in their daily lives – picked up kids, just had lobster, someone dressed the dog up in a batman costume & painted their toes. Mundane? Yes. But that is what makes me feel more connected with people I have not seen or talked to in ages because now I am part of their daily lives.

The downside about Facebook is it often results in a bunch of one-liners, so when something major happens, you always wonder - What? When? Who? Details please!!! Since there is only so much info I can put in a “status update”, my sister told me to blog it.

The short version

Annual mammogram the Monday after Thanksgiving turns into cancerous tumors found in left breast & lymph nodes in left armpit. Living life with a cup half full prognosis: Girlfriend is getting a free boob job!

Longer version -

-Monday, Nov. 28th: Had annual mammogram Monday after thanksgiving.

-Tues: Received call requesting I come back for a recheck

- Wed: Diagnostic mammogram done & ultrasound requested by radiologist & done. 2 suspicious lumps in L breast. Also possible funny business in armpit lymph glands.

- Monday, Dec. 3rd: Had needle biopsy Monday.

-Tues: Still no biopsy results, but did get OBGYN to fax me copy of Radio. report. Not good. My BIRADS score was “5”. BIRADS = Breast Imaging Reporting and Data System. This indicates the radiologist's opinion of the absence or presence of breast cancer. It sets up a classification for Level of Suspicion (LOS) - the possibility of breast cancer. "5 = Highly Suspicious of Malignancy. Lesion that has a high probability of being malignant (>= 95%); take appropriate action." Not good. :(

- Wed: Preliminary pathology report in. Yep, its cancer.

- Fri, December 7th: Met with surgeon. Diagnosis: invasive ductal carcinoma - stage 2. Preliminary course of treatment most likely- double mastectomy +chemo. Still waiting on full pathology. Need to know if my cancer is receptive to hormones &/or “supercharged.

- MRI on December 12th, genetic counselor & testing on the 13th, back to the surgeon on the 14th for further game planning, & Oncologist on the 31st.

Diagnosis:

Ø  Invasive Ductal Carcinoma: Invasive ductal carcinoma (IDC), also known as infiltrating ductal carcinoma, is cancer that began growing in the duct and has invaded the fatty tissue of the breast outside of the duct. IDC is the most common form of breast cancer, representing 80 percent of all breast cancer diagnoses.

Ø  Stage 2 (a?)

Ø  Grade 1 (5/9)

Ø  Tumors found in (think of boob as a clock dial) left breast at:

        @ 10:30  1.3cm

        @ 10:00     9 mm

        @ 12:00     6 mm

        Funky business also found @ 6. Needs further testing

Ø  Tumors found in lymph glands – level 1 & 2 nodes (15 x 6 x 11 mm)

Ø  Hormone Receptor Status: ER+ / PR+ / HER-

Now what?

The good news in all of this is I have "plain old breast cancer", which means the most researched & the best treatable. However, the median age for diagnosis for cancer of the breast is 61.  I'm 46.  That’s young in cancer world.   Because of getting cancer at a young age, & because my life expectancy is  another 40+ years, the chances of my getting cancer again in my lifetime is high.  Because of that, I am opting to have a bilateral mastectomy. Mastectomy offers 1% recurrence rate - lumpectomy offers chance of 30% recurrence. I do NOT what to go through all of this again.  Appearance is a big factor in my decision too. Take a minute and Google “breast reconstruction” & you’ll see what I mean. To do a lumpectomy with all the funky business in my breast would give me more craters than the moon. Frankly, I want my girls to match & be symmetrical. And to be really frank about it, I’ve nursed 2 babies & lost 100 lbs., so the tatas I have are not that pretty without the help of Victoria’s Secret & could use a facelift.  Also, did you know that there is a breast reconstruction technique that involves me getting a tummy tuck too?!  I am soooo there!

Now I am just waiting on others’ schedules, Oncologist wants to do radiation in armpit due to lymph node invasion + definite for chemo due to my "young" age, size of tumor found since last annual screening, and the fact that it has spread to lymph nodes.  Meeting with Plastics guy on the 15th to discuss my “reconstruction options.”  Drs then all coordinate their schedules.  No dates yet but probably end of January or beginning of February.

So how am I doing? Good. My Mom managed to raise 3 women who are amazingly strong, practical & resilient (my brother is a whole ‘nother blog article).  I’m not terrified.  I’m pissed off. The surgery doesn’t scare me.  The chemo is soo going to suck, but I am up for the fight.  The worst of all if it is the unknown -- Will this come back? When? What happens to my girls if things get really bad or go really wrong?  Those thoughts are the ones that get me.  I’m more worries about those who care about me than myself: my sister Suzanne was diagnosed & treated for cervical cancer just this past February.  She knows what I am in for because she‘s lived it; my sister Michelle has been scared witless by this – she knows what I am in for too with her medical background, & is scared at the thought that she is next (*great news just in: I’m NEGATIVE for the BRCA 1 & BRCA 2 genes! – girls in my family are not cursed!); and my Mom has now had 2 of her babies diagnosed with cancer within a year. Sucks!

In my “Living life with a cup half full” attitude, I am intrigued by the possibility of having some rockin wigs & not having to shave my legs all summer.  I am working on accepting all the love-help-support from those around me.  I plan on keeping my Starbucks card loaded. I am trying not to use my “I have cancer” card as an excuse for a shopping binge. I think that’s a good start.