Facing fear

This has been a year for facing fears: fear of cancer, fear of the unknown, fear of needles, fear of surgery. Last weekend I faced another fear: the fear of riding a bicycle.

I have been afraid of riding wheeled vehicles longer than I can remember, starting with my Tyke Bike tricycle when I was three. When later I learned to ride a bicycle, I didn't take the training wheels off until I was twelve. TWELVE! 

I did eventually learn to ride without training wheels, and even rode it to high school for a year. But I stopped riding it once I went to college. I haven't ridden a bike since I was 19 or 20.

Until last weekend.

Earlier this year my husband and I moved to an area of town near a very nice bike path. He has a bike, and enjoys riding it on the weekends in nice weather.  I would like to find a form of exercise that my husband and I can enjoy together, and since we live so close to the bike path now, I no longer had an excuse not to learn to ride again. I had been planning to look into getting a new bike this year, but then...cancer, and the bicycle was postponed (along with so many other things).  

A few weeks ago, I told a friend of mine that I was looking for a comfort fit bike. Last week she tipped me off to a used one that showed up at a local Trek bicycle store. I went to check it out on Christmas Eve day. The used bike ended up being much too big for me, but I told the salesman what I was looking for and he sold me a new bike that actually fits me quite well. It's a Trek Verve 1, a hybrid style bike with a straight, mountain bike style handle bar.

Saturday was warm enough to take it out to try. I was terrified, but determined to learn to ride that bike! To make sure I didn't back out, I told all of my Facebook contacts, as well as several of my coworkers, I was going to learn to ride this weekend. 

I practiced on our street for a bit, until I was comfortable getting on and off the bike, steering, shifting (sort of), and stopping. I did not fall over. Whew! Next step: the bike path. Lots of other riders, walkers and runners were out also enjoying the fine warmer mid-40's weather on the bike path. I had some difficulty navigating around the other bikers and pedestrians, but I did not fall or hit anyone! Go me!

I'm really proud of myself for overcoming my fear.  I'm still a bit unsteady and unsure of myself, but I'm sure biking will get easier with a little practice, and it's great exercise. 

The knocking of my heart

“Why are you knocking at every other door? Go, knock at the door of your own heart.” — Rumi

I debated whether or not to post this entry, because it isn't directly about breast cancer. It is, however, about something that indirectly happened as a result of the radiation treatments, and so I think it deserves mention.

Remember the shortness of breath I mentioned in a previous entry? The Thursday before my last radiation treatment (which was on a Monday), the shortness of breath and heart palpitations worsened. My anxiety about what could possibly be wrong only made the symptoms worse. I thought I was having chest pains, and, afraid I might be having a heart attack, I called 911.

It's an odd thing to call 911. Three little numbers set so much in motion. An ambulance arrived in a few minutes. I was given baby aspirin and nitroglycerin as a precautionary measure, and 10 minutes later I was in a hospital.

My heart rate and blood pressure were high, my heart was beating irregularly, but a blood test quickly showed that I had not had a heart attack. I was mighty relieved by that news.

The doctors kept me overnight for observation. I underwent a number of tests that showed that my heart and lungs are fine. I do have an arrhythmia, which was showing when I was admitted, but the doctors said that it is very normal and not anything to be worried about in the absence of anything structurally wrong with my heart. That's a huge relief.

The only thing they did find was that my electrolyte levels were low, especially sodium. I generally eat a low-sodium diet and drink plenty of water. The radiation made me thirsty, so I was drinking more water than normal. I guess my body became depleted in sodium over the course of the radiation treatments until I was really out of whack. The odd thing is, I never had any of the classic symptoms of low sodium (or hyponatremia): nausea and headache. If I had, perhaps a doctor or friend might have suggested that I drink some electrolytes.

I have follow-up appointments with a cardiologist and an endocrinologist, but I kind of suspect they won't be able to tell me anything different. This may be something I simply need to be aware of and manage: make sure that I get enough sodium, especially when my body is under stress, I'm drinking more water than normal, or I feel heart palpitations. The heart palpitations and shortness of breath were scary, but I'm grateful to have gotten some good information out of it.

In other news, it has been one week since my last radiation treatment, and I'm starting to feel more normal. The fatigue last week was tough; I was possibly more tired than I was the final week of radiation. So far the past two days have been better, though. I'm hoping the trend continues.

Last Day - A Photo Essay

My course of radiation therapy is done! I had my last treatment today -- 32 treatments in all over the past six weeks. To commemorate, here is a photo essay of what the treatments have been like.

Radiation Oncology

First, I arrive at the Radiation Oncology wing of the breast center and sign in.

Waiting Room

Walk around the corner to the small waiting room. Once I change into the gown, I'll put my personal things into one of the lockers and wait to be called for treatment.

Ready For Treatment

I remove all clothing above the waist, then put on one of the provided white gowns. Since I lie on my back to get my treatments, I'm supposed to put the gown on so it is open in the back. If I'm lucky, I get one with long ties so I can wrap the ties around to the front, as in this picture. If I'm not so lucky, I have to awkwardly try and tie the gown in the back. While it was nice to lie on my back for treatments, I kind of envied women who were treated face down, and so got to wear their gowns the right way 'round, open in the front. 

Radiation Machine

This is a photo of the Radiation Machine. The big round beam emitter swivels around to the correct angle for the treatments. My treatment consisted of radiation "hits" from three different angles. I lie on the white sheet-covered bed, with my arms resting in the arm rests along side my ears. The blue thing is a specially molded bean bag sort of thing to help keep my right arm in the correct location. 

Beam Emitter

This is the beam emitter. This is what I see above me as I like on the treatment bed. The treatment lasts no more than a minute. I was usually at the breast center about 20 minutes altogether, unless it was my day to see the doctor.

Bell Ringing Ceremony

The radiation techs do a little ceremony for patients on their last day. I rang the bell three times and received a little pin in the shape of a bell. Hugs all around, and I started getting teary-eyed. 

The plaque on the bell reads:

Ring this bell

Three times well

To celebrate this day

My course is run

My work is done

And I'm on my way

Nearing the end

It is now the eve of my last week of radiation. I have had 27 treatments, with 5 to go. I haven't written in a while because, frankly, I haven't had much energy to spend on blogging. I have been very tired for weeks, and now I'm tired most of the time.

This past week I began experiencing shortness of breath during the 10 minute walk from my car to my office, and back. It was very unexpected. I had a chest x-ray and had my blood hemoglobin checked. Both were fine: my lungs are clear and I don't have anemia. The symptoms--which now occasionally also include lightheadedness and dizziness--seem to be worse when I haven't eaten. So perhaps I'm having a low-blood-sugar reaction?

I can try and eat more, especially more protein, and see if that helps. If I can't get the lightheadedness under control, I'm going to have to stop working even a limited schedule this week. I don't want to run the risk of fainting on the way to my car.

Of course, it is the last week of therapy. I gather many (perhaps most) women don't work at all during radiation. The last week is always the hardest. I had always thought I might have to take the last week off work. If that's what I need to do, so be it.

The shortness of breath has forced me to stop taking my daily half-hour walks. I kept that up through the first four weeks of radiation, but I've had to stop for the last two weeks. I also continued my yoga practice most evenings during those first 4 weeks. I can still do a  bit of yoga, but I've slowed that down, as well.

I know the fatigue is temporary; I'm told I will recover in a couple of weeks after the radiation ends. But the leaves are turning now, and I would love to be out in the woods among them, lengthening my stride and enjoying the Indian summer.

Outline of my days

I have completed 12 of 32 radiation treatments. I'm over 1/3 the way through the treatments. Here's what I can say about them:

I arrive at the Radiation Oncology wing of the breast center at 8:30. I sign in at the front desk and head to the changing room, where I undress above the waist and put on a white gown. Because I lie on my back for the treatments, the gown needs to open in the back. The first week, I picked the Small/Medium size gown, which seems appropriate to my size. But the ties of the small gowns don't wrap around to the front, and they are hard to tie in the back. So this week I started picking the Large size, which has ties that are long enough to wrap around to the front. I look like a monk wearing white.

I put my clothes and things in a locker in a small waiting area and have a seat to wait for my turn. There is usually one or two other women in the waiting area, and sometimes a volunteer who helps folks get oriented on their first day. The volunteer also keeps the waiting area stocked with water, which I appreciate. The radiation seems to make me thirstier than normal.

I usually get called for my treatment after 5 or 10 minutes, but if they are running behind it could be longer. All the technicians are very nice. I lie on my back with my arms resting in arm rests above my head. Someone places a cushion beneath my knees. I am trying to be brief tonight, so I'll leave a description of the actual treatment for a later post. Suffice it to say that it all takes only about 10 minutes.

Back in the waiting room the other ladies are surprised that I'm done so soon. I get my clothes from the locker and slip back into the changing room. Before I put on my bra, I spread some of the lotion I was given over the just-radiated breast. This is supposed to keep it soft and lessen the skin side effects. So far, I have noticed that the nipple of the irradiated breast appears darker in color than the non-treated breast. And occasionally it is itchy for a few minutes. But nothing more difficult than that.

Then I say goodbye to the other ladies and leave the breast center. If I don't have a meeting at work I need to get to, I will usually go for a walk for 15-30 minutes before heading to work. Walking helps to integrate the energy of the radiation, and since I'm starting to feel fatigue in the afternoons, it might be the only exercise I get for the day.

It doesn't take long to get to work; I'm usually there by 10am at the latest. Mornings are my highest energy time. I think I may actually be more energetic than normal after the radiation. It feels like a caffeine boost.

But then I crash a few hours later, around 1pm or so. I take a break and let myself recline on a comfy chair in a darkened conference room. Once I let myself rest I quickly become very relaxed and sleepy. After half an hour, maybe 45 minutes, I feel less deeply tired and pull myself back to work. But I don't feel refreshed. I don't feel fully awake again generally for the rest of the afternoon. I have been leaving work around 4pm most days.

Evenings are better. So far I have felt mostly awake by evening. Especially if I do a bit of yoga after I get home. I find that if I can find the energy to move at least a little, I start to feel normal pretty quickly. I do not, however, have any difficulty getting to sleep. :-)

That is the outline of my weekdays in the past week or so. I am still trying to get a handle on the best strategies for getting through the experience. It would be much easier if I weren't working. Between work and the fatigue caused by the radiation, I don't have much energy left over for fun. I have healed enough to be able to do a little yoga this week, though, and that's fun!

Mostly I keep thinking that I'm more than 1/3 done. Four more treatments and I will be half-way there. I tell myself it will be over before I know it.

Beginning in beauty

In beauty I walk.

With beauty before me, I walk.

With beauty behind me, I walk.

With beauty below me, I walk.

With beauty above me, I walk.

With beauty all around me, I walk.

It is finished in beauty,

It is finished in beauty,

It is finished in beauty,

It is finished in beauty.

'Sa'ah naaghéi, Bik'eh hózhó

—from a Navajo Ceremony

(Four Masterworks of American Indian 

Literature, ed. by John Bierhorst, 1974)

I start radiation therapy tomorrow. Of every part of my journey so far, this is the one that seems to draw the most negativity from people. I have heard that radiation will make me hot and uncomfortable, and I will want to lie for hours under a cool ceiling fan. I will get a sunburn. My skin will break down and ooze. I should take the last couple of weeks off work because I will be in so much pain. I will get very tired during the end of the treatments, a fatigue that will last for months afterward.

Yikes! That sounds horrible! At some point yesterday I realized I had been taking these experiences too much to heart. Believing that would be my experience as well, it was almost as if I was already living in this painful future.

That’s no way to be.

That New Age phrase “you create your own reality” usually makes me cringe. It seems an overly simplistic platitude. There is some truth to the concept, however. My attitude in a situation makes a huge difference in how I experience it. Just think about my experience with getting blood drawn. When I’m relaxed and calm, I have little pain or bruising. But when I’m anxious, I experience more pain and more bruising afterward. 

One way that I have found to shift my experience in this way is to practice reframing, or finding alternate ways of viewing situations. Needles become “spears of healing” instead of simply being torture devices. Or I visualize my body as made of butterflies; I simply ask the cancer butterflies to fly away. 

Since it seems that everyone’s experience with radiation therapy is slightly different, this could be a very good place to practice some reframing.

An approach has started to emerge that draws on my past experience with Native American spirituality.  Instead of a difficult, potentially painful, pain-in-the-ass thing I need to get through, why can't I instead reframe this as a sacred time of healing? Maybe a six-week-long shamanic healing ceremony? 

With my thoughts along those lines, the Navajo prayer that begins this post arose in my mind during this morning’s meditation:

With beauty before me, I walk.

With beauty behind me, I walk.

With beauty below me, I walk.

With beauty above me, I walk.

With beauty all around me, I walk.

What a lovely antidote to the unpleasant images I have been hearing about radiation! I love it!

And since taking walks in the woods was my favorite part of my healing process, and a habit I plan to continue during the course of radiation, this lovely prayer can be a way to bring that happiness with me into the treatments. 

I’ll have to ruminate on this some more. My radiation sessions are first thing in the morning before work. Maybe I will pull out my drum or rattle each morning? Make offerings of herbs? It’s been a long time since I walked the shamanic path. Perhaps it is time to bring some of that back into my life.

Struggling with change

Last week brought a lot of changes. My mother could tell you that I have always found change challenging. Apparently when I was a wee thing threw fits every time I had to change my wardrobe with the seasons.  As an adult, I have found ways to lessen the hardships of the seasonal wardrobe change (read: shopping therapy). But other changes often still throw me for a loop for a few days.

Take last week. My full time disability benefits were over; it was time to return to work. 

One week I’m taking a leisurely breakfast on the balcony followed by walking in the woods for an hour or more. The next week I’m eating a hurried breakfast, then spending the next six hours in a windowless office (I am taking advantage of my part-time disability benefits and only working an average of 6 hours a day.) 

Now, I am one of those people who is *very* sensitive to natural light. I struggle with sleepiness and sadness every autumn, until I remember to keep the desk lamp with the full spectrum light bulb burning during the work day.

So, it took me a few days (okay, a week) to get used to being inside under artificial light during the day. I eventually remembered to turn on the full spectrum light and life gradually got better.

Another big change last week came during my meeting with the radiation oncologist, on Thursday of last week. She said I was ready to start the radiation treatments in two weeks. I had known I would be starting radiation between 6 and 8 weeks after the surgery, but somehow, delusionally, I had convinced myself it was farther away. I wanted more time to adjust to working again--more of a normal life-- before my schedule was uprooted again by radiation treatments. 

Still pretty unsteady with the transition to work, the reality of this additional upcoming change shook me even more. Two weeks! I’m not ready!

Feelings of fear, anxiety, and anger surfaced over the next few days. My husband listened to them all, correctly naming them as issues related to a feeling of lack of control. Oh, yes--those feelings of lack of control that every cancer patient wrestles with. Cancer grabs you and shakes you, and reminds you that the sense of control we think we have over our lives is just an illusion. 

Finally, my husband said, “You know, I think this is just more of that anxiety you feel in the in-between times, when you are waiting for the next phase of treatment. I bet you’ll be fine once the radiation treatments start.”

He’s probably right. The treatments start in five days, so I guess we’ll see then!

For now, I have completed two full weeks of work, and I’m finally getting my “groove” back (though I am still having some trouble getting out of bed in the morning!). My energy levels are up to normal, and so is my mood (thank goodness!). I still have the hematoma in my left breast, but it is muuuch smaller than it was. The surgeon took a look at it this week, and said it would heal up just fine.  I even got my first massage since surgery!

I’m doing alright.

What got me through

It has been four weeks since my surgery. I can lift my arms over my head and do some light weight lifting. I went to a Tai Chi class today for the first time since surgery, and did pretty well. My full-time disability days are coming to a close; I go back to work on Monday.

This seems like a turning point. One chapter of the journey is over, and another is about to begin. The next step will be six weeks of radiation treatments, then after that five years of hormone therapy. I have heard from several people that the hardest part is yet to come. But to me, from my current vantage point, it feels like the most difficult hurdles are behind me. For one thing, the cancer is out of my body now, which feels huge! For another, there are far fewer needles ahead of me than behind me. I think I'll have to get blood drawn every six months, and there's always the possibility of having to go through another MRI scan or biopsy round. But neither is staring me in the face in the next few months!

I have been meaning to write about the things that have gotten me through the journey this far. Now seems like a good time.

First, the non-woo:

1. Tig Notaro. Like, big time. Tig is a stand-up comedian who performed live just days after getting a diagnosis of breast cancer. She had tumors in both breasts and has since had a double mastectomy. Her 30 minute show, called "Live" (with a short "i", as in, to stay alive), was recorded and has now been released as a CD. I bought the download for $5.

An excerpt from the show was played on a episode of This American Life. You can listen to it here.

2. My friends, students, teachers and healers. The response on my Facebook post about the diagnosis was overwhelming. I felt so much love and support, it was just amazing. I was also very lucky to have several women in my meditation and yoga classes who have experienced breast cancer first or second hand and could give me understanding and advice. I am so blessed.

3. My husband. He's been fantastic through this. He's been with me every step of the way, always telling me that everything will be fine. And only a couple of times needing to be reminded that I'm in need of more special care than usual.

4. I already listed the books I have used.


Now, the woo:  

1. Prayer and meditation. I generally begin my day with yoga, followed by a few moments of prayer or meditation. But after my diagnosis through the surgery I increased my daily contemplative time to 10 minutes or so. It really helped keep me centered when I had to go to work. Here are some of my favorite prayers.

The Serenity Prayer
Goddess grant me the serenity
To accept the things I cannot change
The courage to change the things I can
And the wisdom to know the difference.

I said this one a lot in the beginning, while I was still really grappling with the diagnosis.

The Metta Prayer
May I be safe,
May I be healthy,
May I be free from suffering,
May I live with ease.

This Buddhist prayer was my go-to meditation whenever feelings of anxiety or sadness became too much. I repeated it over and over in my mind during my lunchtime walk or on my way from my car to the office before work. It always calmed me very quickly.

Humme Hum Brahm Hum

I searched hard for a mantra to chant internally during scary medical procedures, as a way to distract me, calm my mind and relax my body. It had to be short enough to repeat on one breath, easy to remember, and pleasant to my inner ear. "Om" felt too short, and Frank Herbert's "Litany Against Fear" was too long. I finally settled on "Hummee Hum Brahm Hum" (from the Kundalini Yoga tradition). The usual Sanskrit translation is "We are we, we are God". The word Hum also relates to the heart center, and one of its meanings is the grounding of Universal Form in the body. So the mantra can be translated to mean "God is in my very being," which I love.

Hummee Hum Brahm Hum also has a lovely tune, which you can hear in this YouTube video.



2. Visualization. Two visualizations came to me during the months before the surgery.

a. One was visualizing my body turned into a flock of butterflies. Most of my body was black butterflies with blue markings. The cancer cells appeared as red and black butterflies. I picked them out of my butterfly body and asked them to fly elsewhere.

Closer to the surgery, the butterflies in the visualization all turned into bright blue butterflies with black markings (think Morpho butterflies). The red cancer butterflies were absent. I took this as a very good sign.

b. The second visualization that came to me was of a sphere, a ball I could either hold or put up around me. When faced with needles of any sort, I put my fear in the ball and bounced it away from me. Or if someone irritated or stressed me when I was at work or otherwise out and about in daily life, the sphere expanded to include all of me, as a shield against the irritation. This visualization of a sphere of power has come to me several times now; I think it will stay with me.

3. Affirmation. Each week, I took a couple of hours out of my weekend for contemplation. This is when I found the mantras and prayers I wanted to work with. I would usually do some gentle grounding yoga to get in touch with me inner strength: Warrior 1, Warrior 2, Tree Pose. Some breath work to calm me.

I also looked for the perfect affirmations for my healing. I will end with a page from my notebook of my favorite affirmations. The symbol at the bottom is the Sanskrit symbol for Hum.

Getting more active

I started taking walks in our neighborhood about 6 days after the surgery, 40+ minutes, once or twice a day. Getting some exercise did me a world of good; it was wonderful to be moving again. But I was still feeling fatigued in the late afternoon and would lie down for a few hours, maybe napping, usually just listening to a podcast.

A week after that, I remembered that there is a nice metropark just 15-20 minutes drive from where we live now. The weather was perfect: clear blue skies and unseasonably cool temperatures in the upper 60's.

It. Was. Glorious!

I chose a 2.5 mile loop trail. I encountered a number of runners, mostly women, wearing their cute running outfits. There I was, in my button-down cotton blouse from the thrift store, purchased to wear while I'm recovering and not allowed to lift my arms over my head, and my hiking shorts that are a size too big because I've lost weight since I bought them, and I didn't care! I was all, I had breast surgery two weeks ago, and here I am hiking on a real trail in the woods, motherfuckers!

By the time I finished I was grinning ear to ear.

I walked there every day last week, with the exception of one day off for recovery. I pulled out my hiking boots, and started extending the length of my walks: 3 miles,  3.5 miles. I had forgotten just how much I love hiking. I love the solitude, and the exercise. And I love the sounds: wind rustling the leaves, my boots striking the ground, water sloshing in my water bottle.

Maybe it's the exercise, or all the sun I've been getting, or maybe it's just the healing process, but I no longer find myself tired in the afternoons. I'm able to get a few things done around the house. I have shopped for a cooked my breakfasts and lunches.

I was afraid I would be bored on disability, far from it.

One day last week, I made homemade deodorant, following a recipe I found online.








The following day, I hemmed a couple of pants. Not quite as interesting as making deodorant, but useful.

Disability is starting to feel more like a vacation. I'm not ready for it to end!

Good news, plus book tips

Earlier this week, I had an appointment with my surgeon to get my pathology report. She was running over an hour late. My husband, Rob, started a new job this week, so I wasn't sure if he was going to be able to go with me. I really wanted someone there in case it was bad news. At the last minute, he was able to get leave to take a couple of hours off work. Unfortunately, because the doctor was running so late, he spent most of those hours waiting.

Finally, we got to see the nurse practitioner. She was smiling when she entered the examination room.  That's a good sign, I thought.

And it was! It was all good news! The surgeon was able to remove all the cancer.  The area of invasive cancer was 4mm, quite small. (Any tumor less than 20 mm is considered Stage 1). There was some associated non-invasive carcinoma (DCIS), which was also entirely removed. She also removed 3 sentinel lymph nodes, all of which tested negative for cancer, meaning it hasn't spread.

I am so relieved! All of this means that I won't have to have any additional surgery or chemotherapy. I made a "Score!" gesture with each new good piece of news. Yeah, totally did not play it cool, there.

The NP left after a brief visit. Rob also had to leave then and get back to work. I didn't have to wait much longer after that before the doctor appeared.

My surgeon went over the pathology results in a bit more detail, and gave me a copy to keep. She also examined my bruised left breast, which she called a hematoma.  By this point, the discoloration is concentrated around the incision, and there is a palpable goose-egg of a lump underneath. I am to treat it with warm compresses, 20-30 minutes, three times a day.

She also ripped off the steri-strips that were protecting the incisions. Ouch! I was not ready for that!

Overall, it was a lot of waiting for a short visit with the doctor and NP. They were so rushed that I wasn't able to get all my questions answered. At least I did get an answer to my major question, could I use deodorant yet? (I wasn't allowed to use any creams or deodorant after the surgery until the incisions healed up). Yes, was the answer, and thank goodness, because my B.O. was starting to get on my nerves!

I left feeling relieved, and grateful, but also like something was missing. The visit focused on the mental aspect of healing -- giving me the pathology results -- and a little on the physical. But what about the rest of me? My doctor told me my job now is to heal, but how, I wondered? I had hoped to get some exercises to do, just some simple guidance, but no such luck. I didn't even have a chance to ask for any. I left feeling cast adrift.

What I do know is that the radiation treatments will start once I'm completely healed, in about 6-8 weeks. I have an appointment to see the radiation oncologist in three weeks, and another visit with the surgeon the week after that.

Other than that, I guess I can look for guidance in the books I have picked up. Here are the ones that have been most helpful.

The Mayo Clinic Breast Cancer Book, Edited by Lynn C. Hartmann, M.D. and Charles L. Loprinzi, M.D.
Man, this book is good! It's a comprehensive guide to understanding types of breast cancer, various treatments, and decision points, like deciding whether a lumpectomy or a mastectomy is right for you. I cannot recommend this book highly enough.

Life Over Cancer by Keith Block, M.D.
I love Life Over Cancer for its clear, easy to read nutritional support for undergoing different therapies, as well as tips on nutrition to prevent cancer recurrence. LOC has more than that, but that's what I use it for. Right now I'm following the suggestions for recovering from surgery (eat plenty of protein and whole grains, in addition to lots of veggies).

Crazy Sexy Cancer Tips by Kris Carr
This book is specifically for women with cancer (not necessarily breast cancer). It's fun, and inspiring, and a little irreverent. This was a great read right after my diagnosis, as I was coming to terms with having cancer. It also gives some pretty interesting diet tips for combating cancer, which I followed after my diagnosis and before surgery (basic premise: no dairy, no sugar, lots of raw greens. Carr advocates a vegan diet, but I do eat fish because I feel healthier when I do).

And now I can add The Breast Cancer Survivor's Fitness Plan by Carolyn M. Kaelin, M.D., M.P.H.
I got this one used, online. It has a program of stretches and strengthening exercises for progressively recovering from breast cancer surgery. It contains tailored workouts based on whether you had a lumpectomy or a mastectomy, and whether you had any lymph nodes removed. This looks like the guidance I was seeking. :-)

Healing

art by Jenia Maslova, http://jeniamaslova.prosite.com/

For the most part my healing has been going really well -- better than I expected, actually. My pain level is pretty low, and gets better every day. The first couple of days were the worst, of course, but even then the pain was manageable by icing frequently during the day. I had been warned that I could have some numbness along the underside of my arm as a result of nerves being stretched or cut during the surgery. I didn't experience any numbness, but I did have a weird neuralgia along the underside of both arms down to the wrist (along the median nerve) that I would call "creepy" or "itchy".  Not painful, but unpleasant. That only lasted a couple of days, though.

I do find I tire easily, and need to rest for an hour or two in the afternoon. My energy is going toward healing.

And then there's my poor left breast.

As instructed by the home-care instructions, three days after the surgery, I -- with my husband's help -- gingerly removed the bandages covering the incisions. Everything looked fine. The incisions remained covered by steri-strips that should fall off by themselves in a week or so. I took a very awkward shower that avoided either lifting my arms over my head or letting the shower spray hit the incisions directly. Very thankful for my husband as a shower buddy!

After the shower I switched to a different bra because I didn't want to put a dirty one back on after showering. I picked a new bra that I'd bought just before the surgery but had never worn. Then I accompanied my husband grocery shopping -- I swear I didn't pick up anything, just pointed out what I wanted -- because my mind was foggy and pointing seemed easier than making a list.

The bra must not have been supportive enough, because when I took it off the side of my breast was an ugly dark purple-red. It didn't hurt internally, but it was tender to the touch, probably because it was so swollen.

I had no any signs of infection that I could tell, and I had no fever or much pain, so I wasn't too worried about it. However, I did notice during the next couple of days that the bruising seemed to get worse after I took a walk or went shopping. I decided to call the nurse practitioner just to be sure it wasn't anything to worry about. She says it is normal to have bruising at one incision site and not the others, depending on whether the cut was made near a blood vessel. So it doesn't sound like anything to be too concerned about. (Though I do wish I had been given some warning ahead of time that I might have some bruising).

Since walking made it worse, I decided it was prudent to stay off my feet for a couple of days.  The bruise definitely began fading and healing.  This photo is from three days after the bruise appeared. You can see the steri-strips over the incision site.

I am getting to know which bras* provide the best fit and support. And I found it is vitally important to wear my most cushioning, supportive shoes. The yellow is still there today, but the red has all but faded now.

*I have been instructed to wear a high-impact sports bra, with a front or back closure, for the first couple of weeks after surgery, 24/7. I bought two to wear as I recovered from the biopsies, and three more prior to surgery, in different brands and sizes (I lost weight in the months after the biopsies and the lumpectomy).

Post-surgery

I am home and recovering from surgery! I was at the hospital Thursday from 7am to about 4pm. The surgery itself lasted about 2 hours. I haven't spoken to my doctor yet, but she did find my husband in the waiting room. She told him the surgery went well. She is fairly sure she was able to remove all of the cancer, but we won't know that for sure until the pathology report comes back from the lab. My doctor also told him that the lymph nodes were okay, which is a great relief to me, because it means the cancer hasn't spread to other parts of my body. Again, we will get confirmation of that from the pathology report.

She also removed a non-cancerous lump containing "atypical cells" on my left side which will also be tested to get more information about it.

I have a follow-up appointment with my doctor scheduled for July 24th, a week and a half from now. By then, she should be able to give me the pathology lab results.

I was in the pre-op prep room for quite a while before the surgery, so I had time to ask the anesthesiologist what I was going to be given. First I would get a relaxant and an amnesiac drug via IV to put me out. Then I would get a tube down my throat for the gas. (That gave me a sore throat for about a day.)

I got a small dose in the IV before I was wheeled to the OR. I was only in the OR a for what felt like 5-10 minutes before the anesthesiologist said, "This is it." I started saying my relaxing mantra--"Humme Hum Brahm Hum"--but I didn't even make it to the last Hum!

The next thing I knew someone was waking me from a dream where I was at a party, telling a friend that I'd had "A lumpectomy, both sides." (I'm sure now that I was actually responding to a nurse's question). The nurse called my name to wake me up and asked me if I felt any pain. I was being wheeled down the hallway to the post-anesthesia care unit. I think I was out for about 5 hours.

I was pretty dizzy coming out of the anesthesia. I was given an anti-nausea drug, which kept me from throwing up, but the dizziness had to wear off on its own. I sipped water and snacked on crackers and banana until I finally began feeling myself around 6pm and ate a normal dinner. I was wide awake by 8. And 10. And 12.

To try and get sleepy, I finally took some of the Percoset I'd been given for pain, but I was afraid of taking too much and getting dizzy and nauseated again. So I took an 8th of a tablet at a time until I'd eventually taken half a tab, which finally put me out around 3am. Yay insomnia!

I took another half tab last night at 10pm. I slept all night, but woke up parched and with a crazy headache. I downed three or four glasses of water and the headache subsided. The bottle says the dose lasts about 6 hours, but honestly, it's been 20 hours since I took it, and my brain is still foggy and loopy. No one ever needs to worry about me getting hooked on opiates. I'll stick with wine, thanks.

Pre-surgery

Surgery is tomorrow morning at 9am. I'm supposed to be there at 7, which is about an hour and a half earlier than I am normally anywhere. But then, I don't have to eat, or make tea.

I'm so glad I took today off from work. It has been a difficult day. Throughout this journey, most days I have felt strong and like myself. Not today though. My emotions are all over the place....I'm practically feeling bipolar. I'm energized and disinfecting the bathroom one minute, then completely collapsed in tears the next. My eyes are red-rimmed.

This isn't how I imagined today. I imagined I would spend it strong and focused, doing meditation and prayer. A warrior goddess off to heal myself. Instead, I've been a mess.

I finally reached out to friends and posted on Facebook, asking for energy and prayers. Good move. So many of my friends have posted their support and energy. It helps so, so much. I'm still a little weepy, but feeling much less alone.

One of my friends is having a get-together at a tavern this evening, celebrating the end of her job. I think I will go join them. I won't be able to drink wine, but I'll do as much water-chugging and eating as I can! I'm not supposed to eat or drink anything after 9pm.

A busy few weeks

I have been pretty busy in these past two weeks getting ready to be out of commission post-surgery. I will be taking disability leave from work of up to four weeks. A lot of my time at work recently has been spent finishing up projects I have been working on, and delegating my workload to various coworkers to take up while I'm out. I have never taken so much time off work before. Only a week or two for vacations, never a month before. I work with great people, and I have every confidence that the work tasks will go smoothly. It does feel weird, though, to be delegating my work load for that long of a time.

In my off-work life, I found a substitute teacher for the yoga class I teach! She will only be able to teach for six weeks until she heads off to college. But the yoga students are grateful, and it will be great experience for this new graduate from yoga teacher training.

I also wrapped up the meditation class I teach. I completed the series on the Yamas - yoga ethical guidelines - that I was teaching, then taught one more class without notes, from the heart, that ended up being just a fantastic class. What a great note to end pause on. Others will teach the class while I heal from surgery.

I have also been getting my own self ready. Last weekend I bought more of the bras I'm supposed to wear post-surgery: high impact sports bras with a back closure (rather than the kind that slip on over the head). This bra construction is supposed to provide the kind of strong support I will need as I heal from the surgery.

Today is a holiday, the 4th of July. I took the 5th off as well. I'll be heading over to our old farmhouse to get more packing done, before the restrictions on lifting begin again. See, we're in the middle of a move. We have been able to move some of our things, but quite a bit still remains at the old house. Before my diagnosis, I had planned to use my vacation to finish packing and complete the move, but life had other plans. So it goes.

P.S. Surgery count-down - one week from today. Eek!

Finally....a surgery date!

Earlier this week I got a date for my surgery. June 11. Two weeks from today. Two weeks is good. Just enough time. Enough time to delegate all my work and get the house ready for my recovery period. Just enough time to get mentally and spiritually prepared.

Two weeks is not enough for me to really freak out too much, either.

Two weeks is just enough.

Pre-surgery visit

I had a visit with my surgeon's nurse practitioner today, basically a pre-surgical intake visit. I got bloodwork, an EKG, and a chest x-ray to make sure I'm in good enough health for the general anesthesia.  I also got educated about how to prepare for the surgery, what to expect the day of surgery, and aftercare.

I confirmed that I will have a lumpectomy on the right breast. I will also have a biopsy done on one of the lymph nodes of the right breast, to see whether the cancer has spread to the lymph nodes. I will also have a non-malignant (but possibly pre-cancerous) lump in the left breast removed. I will end up with three incisions: two on the right and one on the left.

What I did NOT get was the thing I was most anxious to have, the thing I've been telling everyone I would get today: a date for the surgery.

Instead, I will get a call when they have a date for me.

The waiting game is hard. As the impending surgery draws closer, my desire for a hard date grows stronger. The date is my deadline. It's my crap-I-need-to-delegate-my-workload-before-I-leave date. It's my is-the-house-ready-for-post-surgery? and am-I-mentally-prepared? deadline. I feel a great need to know this date, and how much time is left before it arrives.

"Begin to relax with, lean in to, whatever your experience may be. Drop the storyline and simply pause, look out and breathe." Pema Chodron

This is a place for good Buddhist practice. Can I sit with uncertainty? Can I, as Pema says, drop the storyline and relax into the experience? So far, the answer has been not so much, as far as the waiting game is concerned. I will have to work on that.

I am, however, doing extremely well with my needle phobia. I got two vials drawn with no pain and very little fear!  (Well, okay, I did kind of collapse into a little puddle of  relief when it was done. But I got through the actual experience just fine!).

Actually, the most difficult thing about today was discussing the disability paperwork with the nurse practitioner. I dutifully relayed the instructions I had been given by my HR person as to getting them filled out so that the State approves the leave with the least amount of hassle. The NP was incredulous about such stringent requirements and sort of argued with me a little. Finally she laughed and admitted that in the end she'll probably forget my instructions and fill them out the way she usually does. But at least I've done my due diligence!

Benign!

I finally got a call with the results of the biopsy of my left breast. It is benign! That's good news.

I was told that the results would be in 3-5 days after the biopsy, which would have been last Friday or this Tuesday. It's now Friday. I finally called yesterday morning and left a message with the secretary asking for the results. It's frustrating to have been made to wait this long. But, whatever...it's benign!

This doesn't get me out of all surgery on the left breast. As far as I know will still have a surgical biopsy done, on the area of atypical cells in the left breast that was previously biopsied with a needle. But at least I won't have to have two incisions on the left.

I also have an appointment this coming Thursday to schedule the surgery and get bloodwork (I think) and other things needed for the surgery. I have decided to go with "breast-conserving" surgery, i.e., "lumpectomy", which is apparently still an option based on the results of the MRI. Sweet!

I'm happy that things are moving forward!

Adding insult to injury

In preparation for surgery, I have been instructed to stop taking some of the supplements that I take. Some may cause extra bleeding, like Vitamin E and Omega-3 capsules. And some may interfere with the general anesthesia. One of these is St. John's Wort. St. John's Wort is a mild anti-depressant, of the SSRI type. I take it in the winter to help alleviate Seasonal Affective Disorder, aka Winter Blues.

Granted, it's nearly summer now, and I should be letting it go for the year. But REALLY???? I'm going through a major life change, here...I have CANCER, fercrissakes, and I'm supposed to give up my antidepressant?!?

*sigh*

But I'm game. And it's not going as bad as it could be. I have been stepping down gradually over the past 4 weeks. From 3 capsules to 2, then 1, then half a gelcap (open top of gelcap, sprinkle out half the powder), then a quarter gelcap. Each time I step down I have a couple of days of random weepiness and crankiness, then a couple of days of low, but gradually improving, mood. By the fifth day I am feeling back to normal. Day six is a happy day. Then it starts all over again.

I took my last quarter gelcap two days ago. That's it. No more St. John's Wort. This last time, having already gone through four cycles of sad days, and knowing there was one more coming? That took some inner fortitude. Yesterday was not great. Today I am feeling better. Knowing this will end and I will feel normal by Thursday is very good. I spent a lot of my younger years depressed, and the feelings I am having now are oh so familiar. I do not miss those days.

I have a meditation planned for this afternoon, and that will help. And I will see if I can get out for a walk in the sun in a bit. Also very therapeutic. But if you were at the party I attended last night, and I seemed down? Now you know why. Sorry about that. :-)

MRI guided biopsy

“We either make ourselves miserable, or we make ourselves strong. The amount of work is the same.” —   Carlos Castaneda

The MRI-guided biopsy went quite well, actually. The meditation and relaxation techniques I have been practicing worked well to help me get through the experience without too much stress. Not only did I cope much better with the pain of the numbing shots and IV of contrast fluid, but to my surprise, my subjective levels of pain were less! Quite a bit less, actually!

I wore my Frida Kahlo socks, for strength. 

Just as for the MRI two weeks ago, I lay on my belly with my arms over my head. The main difference was that this time the right breast was squished behind a plate to get it out of the way. The left breast, the one that was being biopsied, dropped through a hole in the bed, where it was clamped between plates like for a mammogram. The doctor worked on the breast from the side. Like in this picture, except my face was pointed down, resting on a face cradle.

(image from www.appliedradiology.com)

The MRI technicians did a series of scans, both without contrast and with, so they could hone in on the area to be sampled. This time I asked for earplugs, and the scanning process wasn't bad at all.

I was wheeled out of the machine, and the doctor started prepping me for the biopsy. All this time I had to remain completely still so as not to shift the sample site out of the "crosshairs", so to speak. (Before I was taken to the MRI room, the doctor had told me the MRI scan from two weeks ago had seen a "tiny spot" that they wanted to sample. I was all..."Tiny? Tiny is good! I like tiny!")

This was my third biopsy. The worst part for me, every time, are the numbing shots. I hate shots. This time I had my calming mantra to sing internally to myself with each breath. It worked really well. I swear the shots hurt less than they had before. I winced a couple of times, but after that it was okay.

When the core biopsy needle was inserted, I did feel a little bit of sharp pain as it came to the final position, and asked for more numbing. Before they actually started taking the samples, I was wheeled back into the MRI machine for a final scan, just to make sure they were at the right spot.

The samples were taken very quickly...it was over before I knew it. They inserted a titanium chip that will show up on a mammogram, then wheeled me back into the MRI tube for one final check that the right area had been sampled.

And that was it! The technician kept compression on the incision for 15 minutes, during which time I slowly began moving my arms, which were stiff from being held overhead for an hour or more. The last 10 minutes in the scanner things were getting pretty uncomfortable. My cheeks were sore from being pressed into the face cradle, and my shoulders were started to get pretty sore as well. I was so relieved when they finally told me I could move again!

Now another waiting game. The results should be in by early next week. Nothing to do now but wait, and recover from the biopsy.

Meeting the radiation oncologist

Thursday morning, I had a meeting with Dr. White, the radiation oncologist who will be overseeing my radiation treatments. I liked her. She was very pleasant, explained everything in good detail, and politely waited for me to ask questions. She answered all of my questions about what about what to expect from the radiation treatments.

The radiation treatments start about 6 to 8 weeks after the surgery, once my breasts have healed. I'll have 30 treatments, one per day Monday through Friday, for 6 weeks. The radiation is targeted right at the points on the breast where it is needed. The treatment itself will last about 20-30 minutes, but she said to expect to be at the breast center about 45 minutes. Once a week I will meet with her to see how things are going. That will add about 15 minutes to that visit.

I learned that everyone has some side effects from the radiation. The breast will get red and tender like a sunburn. Most women don't have any real pain, just tenderness. After about the third week you generally get progressively more tired during the day, the last week being the hardest. Dr. White suggested I work 6 hours a day during the time I'm getting radiation. Leave work at 3:30, go to the breast center for an hour, then go home and rest. I'm on board with this.

One good thing I learned is that the radiation treatments tend to change the breast tissue, making it less lumpy, dense and painful. That is great news! That means that future mammograms won't be so difficult, and I may not need so many views or follow-up ultrasound/MRIs. That's one more tic in the lumpectomy column (vs. mastectomy).

But the neatest thing I learned during my visit was learning that blood oxygen saturation can be detected using a device that slips over your finger! The device is called a pulse oximeter. It detects how saturated the arterial blood is with oxygen. Mine was 100%, meaning that all hemoglobin binding sites were filled with O2. (This is good, by the way.) It blew my mind that could be detected through the fingertip. Apparently the sensor measures absorption of different wavelengths of light to make the measurement. Totally cool!

MRI results

It took over a week to get the results of the MRI. It turns out the nurse practitioner was on vacation last week. I thought that might be the case, with the Memorial Day weekend, and all.

I finally called her on Wednesday. The MRI found a "suspicious" structure in the left breast (I don't remember the exact term, but it was pretty vague). This area is in a new location that they hadn't seen before. The doctor wants to biopsy the area to determine whether it is cancerous. I am scheduled for an MRI-guided biopsy this coming Wednesday (because clearly the pleasure of a biopsy isn't enough...this way I get to experience the joy of both biopsy and MRI!).

No, really, I'm glad it is being biopsied. Best to be sure. I only wish the MRI had been ordered earlier in the process, before I got the earlier biopsies. My breast tissue is so dense that mammograms can have difficulty seeing through it.


Now that I know what to expect from the biopsy experience, I don't think it will be as difficult for me as the previous ones were. This means another round of waiting for test results, though. The waiting is the hardest part of this. Is it cancer? If so, will it be as easy to treat as the other malignancy? Or will they say the dreaded word: "chemotherapy"?

MRIs are LOUD

Well, I made it through this MRI!

All my prep paid off. I wasn't laughing through the insertion of the IV, but I wasn't whimpering and tense, either. Also, I should remember that insertion of an IV catheter doesn't hurt as much as a shot does. I think that's because injection doesn't happen at the same time the needle is inserted. By the time I got the injection, I was safely in the MRI tube, where no one could hear me whimper.

I brought my Nook with me for some reading material in case I had to wait, but as it turned out I didn't wait in the outside waiting room at all. Instead, I waited in the MRI area, where electronic devices were prohibited. I guess the strong magnetism can wipe out the memory, which would suck.  The next time I have one of those, I should bring some actual paper reading material. As it was I had to make due with People (Ashley Judd is getting a divorce!) and Architectural Digest (pretty!).

I have had two MRIs before, one previous breast MRI and one for low back pain. Each time I was offered a choice of either music over headphones or earplugs, and I chose the earplugs both times. This time they had Pandora (as opposed to a commercial radio station), so I decided to try it.

Mistake!

I knew the machine was loud, but without the earplugs it was REALLY loud, especially in the upper registers. Klaxon is the word I would use to describe it. I got through about three of the half dozen scans they were taking before I pushed the panic button and stopped the machine so I could ask for earplugs. I was starting to fear I was going to have hearing damage (I already have some hearing loss in the upper registers. I don't need more).

It's a good thing I didn't wait any longer. When the technician pulled me out of the machine she said she had been just about to inject me with the contrast fluid. If I had stopped after she injected me, I would have had to reschedule and go through the whole scan again. I would have been royally pissed!

Life was much better once I had earplugs.  I was able to relax and meditate. I did two types of meditation. One was The Microcosmic Orbit, which is a method of concentrating on circulating energy around the body. The other was to silently repeat my calming mantra with each breath. It was really interesting that when I performed either of these meditations I was able to relax, but as soon as I stopped the concentration, I became agitated and anxious to be done. This is the power of meditation. It calms the nervous system, making difficult situations easier.

~~~~~~~~

That was Tuesday. It's Saturday now, and I haven't heard anything about the results of the MRI or gotten a call for another consultation. They didn't tell me how long it would be for the results, but I assumed I would hear something by the end of the week, at least. Monday is a holiday. If I don't get a phone call Tuesday morning I'll call after lunch and ask when I can expect the results. I still don't have a date for the surgery. I'd like to have that so I can plan when I need to take off work.

Upcoming MRI

The next step is an MRI coming up in two days, on Tuesday. My breast tissue is so dense that the doctor wants to do an MRI so that she can better see how large the area of cancer is in the right breast. The MRI should also provide more information about what's going on in the left breast, as well. The biopsy of the left breast showed atypical cells, which aren't currently cancerous. The mammogram and ultrasound showed the presence of a mass, but it really is pretty difficult to differentiate it from the surrounding tissue.

Not only does dense breast tissue make it more difficult to see cancer, but studies have shown that having extremely dense breast tissue (which I have) increases a woman's risk of getting breast cancer. Numbers I have read have indicated between 2 to 6 times the risk of breast cancer over a woman without dense breast tissue. Yikes! No wonder I have breast cancer!

I have had a breast MRI before. That time I had an IV containing a liquid that helped show contrast in the imaging. I have a fear of needles, so for the past couple of days I have been doing visualizations and practicing relaxation techniques to help me be calmer when the IV needle is inserted. I'll be armed with a breathing technique, a calming mantra to chant in my head, and a visualization of the fear floating away from me.

My favorite, though, is simply talking to the fear. I thank the fear for keeping me safe from harm (and hard drugs), that this needle is important, and safe, so I don't need to be afraid of needles right now.

I hope this all works. I'll need these relaxation techniques again for the surgery.

The MRI machine itself shouldn't be an issue. It is loud, and I'll be in a closed in space, but they will let me listen to Pandora over headphones. I'll just listen to the Yoga Radio station and meditate. Shouldn't be bad at all.

One step at a time. That's how I'm doing this.

Telling people

The hardest part so far about having breast cancer was the week between when I knew the biopsy was positive for breast cancer and the consult with my doctor, when I found out how treatable they thought it would be, and what the treatment plan is likely to be. That week of knowing but not knowing was hard. I decided not to tell people at work, which meant I had to answer everyone's questions of "How's it going?" with a generic "Fine!" My weekend plans? Probably going to be low-key.

I was also trying really hard not to worry, to think about the cancer as little as possible. Trying not to think about it seemed to take my short-term memory with it. I ended up forgetting almost everything! I would forget to bring things I needed with me to meetings. Forget to pick up the paper I had just sent to the printer.  Once I meant to go to the kitchen at work and walked into the bathroom instead. It was pretty bad.

Once I met with the doctor and nurse practitioner, and found out the basic treatment plan (surgery, radiation therapy, probably no chemo (thank gods!)) I started telling people. I posted about my diagnosis on Facebook. I got an overwhelming amount of support in the comments on that post. People told me how strong I was. They sent me energy and prayers. I felt all their love.

The most remarkable comments were from folks who I had known in high school, but hadn't spoken to in years, telling me how strong they perceive me to be. "You are a force of nature," wrote one woman. Another wrote, "I know you'll come out on top. You always do!"

These people knew me at a time in my life when I didn't feel all that strong. I certainly didn't feel like a "force of nature"! I know myself to be strong now, I've worked hard to be so. But 25 years ago was a different story. I felt lost and confused, as you do when you are 22. I had great friends, and certainly was happy much of the time, but I certainly wouldn't have described myself as always coming out on top. I wonder if they saw in me then the adult woman I would grow into? Or if what they have seen of me online over the past couple of years informs their thoughts?

I have been telling people at work that I have the most contact with, as I have the energy to. Mostly one-on-one conversations, though I did tell the workgroup I lead all at once. Everyone has been amazing with giving their support and sympathy. Also, too, I have been surprised at how many people I know have been effected by breast cancer, either they themselves are survivors, or someone they know is. I have heard the statistic that 1 in 4 or 1 in 5 women will get breast cancer. That's a lot of women!

Finding out

This blog has been languishing for months, but now I think it's time to resurrect it. I thought it was going to be a blog about my yoga practice, but now I guess it will be a blog about breast cancer. And yoga.

So yeah, I have breast cancer. It was caught on a routine mammogram on April 1st (ha!) and confirmed with a needle biopsy a week later. Five days after that, at 10:15am, I got a call at work to go over the results. Positive for cancer in the right breast. The left breast came back showing atypical cells, which could be pre-cancerous, and will require additional testing.  

For almost a week, that's all I knew. I had breast cancer, but I had no idea how bad it was or what the treatment would be. That made for a long and nerve-wracking week.

Finally, this Wednesday, I met with the surgeon for a consult. The cancer is of a very treatable sort. Chances are good the cancer is at Stage 1. This is very good news. I will most likely not have to have chemotherapy. Very very good news.

I will have surgery, probably in early June. Because I have very dense breast tissue, the doctor wants to run an MRI scan before the surgery to get a better idea of the size of the area that needs to be removed. That is planned for May 21st. The results of the MRI will guide the surgery options.

I was presented with a choice: either a lumpectomy on the right breast and radiation therapy (5 days a week for 6 weeks), or a mastectomy and no radiation. I was surprised that they appeared to give these two options equal weight. A mastectomy would remove all the lymph nodes, carrying a risk of lymphedema, which is good to avoid.  Of course, if the cancer has spread to the lymph nodes, I will have to have them removed. I will be injected with a radioactive dye before the surgery. This dye is taken up by any cancerous lymph nodes, which would be removed during the surgery.

I will also have to have surgery on the left breast to remove the atypical cells, and investigate the extent of the affected tissue. At this point what’s going on there is an unknown. This surgery could be done at the same time as the lumpectomy on the right breast, or could be scheduled for later on. 

I have good days and worse days, but overall I'm doing well. I am doing my best to breathe through this. I have decided that worrying is a waste of energy, so I'm trying to do as little of that as I can. I am strong. I am surrounded by a loving and supportive husband, and the support of many friends. I will get through this.