Monday, November 23, 2009

"Mommie's Fake Boobie IS NOT A YARMULKA!!!"

Elizabeth has some very fancy and expensive new headware. It's my fake boob insert that I use to " balance" me out. Right side is a DDD; left is now a pert C. Can we say "asymmetrical?"

Anyhoo, I left it out and she decided it made a great hat.

Sunday, November 22, 2009

Dear Goddess-Please, Please Never Let Me Go "Brain-Dead" in a Catholic Hospital

Really, this new directive from Roman Catholic Bishops crosses the line. I hope I never end up, either due to dying from breast cancer or simply an auto accident, at a Roman Catholic hospital, in a "persistative vegatative state."

"This story won’t get as much publicity as the Catholic Church’s efforts to insinuate its doctrines on abortion into the health care bill, but the bishops also declared this week that Catholic hospitals must provide the equivalents of food and water even to patients in a persistent vegetative state.

The new directive extends to patients “in chronic conditions (eg., the `persistent vegetative state’) who can reasonably be expected to live indefinitely if given such care.” In English, what this means is that if you are unlucky enough to be taken to a Catholic hospital, and you have experienced a seizure or traumatic accident that puts you in a vegetative stage from which there is no hope of recovery, the hospital will force-feed you through intravenous tubes—even if you have a living will that specifically rejects nutrition and hydration in such circumstances.

Why, you may ask, does this matter? After all, no one is forced to use a Catholic hospital. Except people are forced to do just that, in the many areas of the country where Catholic hospitals have merged with secular hospitals and have successfully demanded, as part of the price of the merger, that health care rules approved by the church be followed in the merged hospital. For more information, visit MergerWatch is a nonprofit organization that has been tracking the effects of these unions between secular and religious hospitals for more than a decade. "

This ran on The Washington Post's website today. Here's the link: On Faith.

Good to know. CJ and I have Living Wills dictating that if either of us ever end up in a "persistative vegatative state," to unplug us. If we end up in a Catholic hospital, our families or Elizabeth will have to shell out extra money to have us transferred to a non-Catholic hospital in order to be allowed to die? (And now I worry that the Church would pull some stupid crap like fighting the family in court, refusing to release/transfer the patient to another hospital because it would be "assisting murder?")

Why should my religious beliefs on being allowed to die be negated by theirs? The principle (stemming from the First Amendment) that all religions must receive equal treatment in the law is one of the US's legal achievements. One faith cannot be legally preeminent over another. Good; let's keep it that way.

Wednesday, November 18, 2009

"So....What Kind of Cancer Are You in Here For?"

CJ, my mom, and I made our second opinion pilgrimage up to Johns Hopkins today. We went to the "Incredibly Long-Named Building for a Rich Guy Who Must Have Died from Cancer and Gave Hopkins the Money for the Building," building, aka The Sidney Kimmel Comprehensive Cancer Care Center. No, really. That's the name. I hope Sidney Kimmel, whoever he was/wherever he is now, had a very good laugh making the name so incredibly long.

Once inside, sitting at Admitting, I had a good look around at the other patients there. I had the strongest impulse to poke the guy in his 20s next to me and ask in a jail cellmate-like way, "Pssst...what kind of cancer are you in here for?" Don't worry. I didn't. He was too busy talking to a patient's advocate about his upcoming surgery. And I really had to use the bathroom.

My second-opinion doctor (that is all she does-second opinions. And also works for the FDA.), Dr. Tanya Prowell  (doesn't that name just sound like it was taken from a James Bond novel?) is around my age and great. And just an FYI-her specialty is younger women with breast cancer. Oh-when you click on her bio, don't be lazy. Scroll down.

Yes, she is recommending chemo. However, she is not recommending the drug regimen that Dr. Wilkinson had recommended. (Older, harsher, more cardiotoxic drugs.)

Here are my options:

1. No chemo BUT five years of hormone therapy, i.e. Tamoxifen for the .4cm of invasive cancer that is estrogen receptor positive/ER+ and Herceptin because the cancer is also HER2 +3, which means it is way overexpressed. I cannot try to get pregnant until after that, if I go with this option.

2. This is the doctor's favorite option. Six cycles (18 weeks) of chemotherapy, using the drugs Taxotere and Carboplatin, while taking Herceptin. I would continue taking Herceptin after the chemo ended, for the rest of the year. (The 52 week year that the chemo takes place in.)

Then, after a short medically needed break (not just for me-but to be able to let the drugs leave my system before starting Tamoxifen. Otherwise, it would be hard for the doctors to differentiate any side effects/problems that are caused by the new drug.) I would take Tamoxifen for 5 years and try to get pregnant.

She is recommened CJ and I see a fertility specialist to bank some embryos before chemo, as an "insurance policy."

3. The comprimise. I do the 6 cycle chemo regimen that she suggested with the herceptin, and then take the herceptin for the rest of the year. I then do two years of Tamoxifen and then try to get pregnant.

I'm only looking at option #3 right now. Option #1, aka Dying Young and Stupid, doesn't appeal to me. Neither does Option #2's heavy fertility regimen on my badly-reacting-to-any-hormones PCOS body and the possibility of chemically frying my ovaries. Plus, the outrageous cost of fertility treatments (although CJ's current medical plan does pay for it) but also finding a specialist that can/wants to deal with my older mom age, PCOS, and the cancer cherry on top.

The PCOS problem is rearing it's ugly, acne-riddne head in all of this; my fertile time during my cycle is getting shorter. Just in the past two years. How do I know? I track it by the Fertility Awareness Method, aka FAM. I have a computer program Ovusoft that does it for me. That is how Elizabeth is here. And how I got pregnant last year. So, putting off childbearing is not OK.

Speaking of Elizabeth, I have to put her to bed. I'll write more tomorrow.

Sunday, November 15, 2009

I Hate Being Graded Without Knowing the Criterea

So, I did some research. I'm that kind of gal.

I want to know EXACTLY why I was told by the first oncologist I saw that I need chemotherapy. I didn't grow up to mearly nod my head at everything the nice doctor told me. (If I had, then I would probably be at least 300lbs., not ovulating, really bad acne, and probably a type II diabetic by now. I had to see 5 different doctors, have 3 MRIs, 1 CAT scan, and 1 really gross 24-hour urine collection to determine that I have PCOS. But I'm damn glad I did. My reason for this gladness is now "helping" brush our very disguntled cat with syrup-sticky hands.)

No, I grew up in a house where you questioned authority. (As long as it was some non-parental authority. Questioning that got you grounded/sentanced to rake leaves or steam carpets.)

Here is rubric I've been able to garner on why chemotherapy might be or might not be appropriate for me:

1. I have Stage I breast cancer, mostly DCIS, with a small invasive component. Small enough that the preliminary pathology report from my mastectomy surgery could not see it with the naked eye or under the first microscope. I'm still waiting for the final pathology results from surgery. This will include my Bloom or Nottingham score.

2. Here is what the American Cancer Society says about how oncologists evaluate your need for chemo.

Adjuvant systemic therapy: Most doctors will discuss the pros and cons of adjuvant hormone therapy (either tamoxifen or an aromatase inhibitor) with all women who have a hormone receptor–positive (estrogen or progesterone) breast cancer, no matter how small the tumor. Women with tumors larger than 0.5 cm (about 1/4 inch) across may be more likely to benefit from it.

If the tumor is smaller than 1 cm (about 1/2 inch) across, adjuvant chemotherapy is not usually offered. Some doctors may suggest it if a cancer smaller than 1 cm has any unfavorable features (such as being high-grade, estrogen receptor–negative, HER2-positive, or having a high score on one of the gene panels). Adjuvant chemotherapy is usually recommended for larger tumors.

For HER2-positive cancers larger than 1 cm across, adjuvant trastuzumab (Herceptin) is usually recommended as well.

I didn't have an invasive tumor larger than 1cm. If they can't find it yet, I'm wondering if that means it's smaller than .5 cm, too. (That's good!)

My cancer is estrogen receptor positive.(That's good!)

My cancer is also HER2-positive +3. Which means it was way overexpressed. (That's bad.)

My cancer was originally diagnosed as low to intermediate grade but the oncologist seems to think that the biospy report (which was all she had to make a diagnosis from since I saw her before I had the masectomy.) was incorrect due to some cells appearing to be more organized and thus able to replicate themselves in a more perfect fashion and quickly. (Remember high school biology? OK, now-remember mitosis? Like that. Only on speed.) This would make the invasive component high grade rather than low grade. (And, needless to say, that's bad. But we area still waiting for the final pathology results which should be in later this week.)

My cancer is not inherited. (I took the BRCA 1 and BRCA 2 genetic tests already.) Of the many things lurking in my gene pool, breast cancer isn't one of them.(That's good.)

Since I've been looking stuff up, I feel better. I hate walking into any situation blind, especially ones in which I'm supposed to have a coherent conversation about toxic chemicals that might be injected into my body...but maybe I'm just too picky.

Thursday, November 12, 2009

My Top-Five List of Who I Don't Plan on Flashing

I'm certainly not shy about showing what the new boobie looks like to anyone who asks. Except for those listed below. Not that I think, for one instant, that they want to behold it in all it's glory, but rather because it would be extremely embarassing to us both.

1. My dad. Really, when was the last time you flashed your father. I managed to make it through puberty without acknowledging any change and faked my way through pregnancy, too. Honest, Dad, Elizabeth was a "virgin birth."

2. My brother, Andy. Ick. I can't remember that last time visual nakeness occured between the two of us (I have mercifully blocked it out) but I'm sure it happened sometime between the years that I was forced to change his diapers and him peeing on me, (there's an almost 6 year age difference between us) and when my mother decided to stop being cheap and forcing us to share the same hotel room bed on our yearly Easter trips to Florida. (When I got fed up with Andy's Darth Vader-like breathing and pinched his nose shut and covered his mouth in the middle of night. He though I was trying to kill him! Ah...that crazy kid.)

3. My father-in-law. Enough said. I was embarrassed enough when I when we had to share a bathroom in their old house. I turned on the faucet every time I used the toliet. Because I'm paranoid and private like that.

4. My brother-in-law, Mike. Really, as much fun as it is to torment him with the threat of that, I think leaving his niece, alone and outside of his front door with a note pinned to her shirt saying, "Uncle Mike and Aunt Lisa, Mom and Dad said they need the weekend off. My clothes and the cat are in the bag. They said they will see you Tuesday," is a much funnier practical joke. Yes, we will be filming this for YouTube and no, we wouln't actually leave her.

5 My friend Sabina's husband, Joe. He's new to the family and we don't want to scare him too much...yet.

A word to my male friends, Bill and Dave. You've already seen the "full show" when I was nursing. Yawn. Moving on now.

Human Body Aesthetics: What is "Collateral Damage?"

I get my best blog topics in the shower. So, even though it is 1am, I hastened down to my laptop to write.

I have an appointment at Sy-Lene Lingerie in DC tomorrow morning. My mom is taking me. I need another post-surgical cami that holds surgical drains in a cute little pocket. I also look lopsided,.

I was a DDD cup on the left. (Gone now!) and am still a DD cup on the right. But lefty is now an uber perky C cup. So, I have an appointment to get fit for two new non-underwire bras plus cookies, aka "falsies", bright and early.

As I showered tonight, I noticed that the swelling in my stomach was going down. Not in the "deflated dough-like" way it did after childbirth, but segmentally.  Never have I felt more like the proverbial elementary-math pie. The left upper quadrant is smaller. (Not surprising, that is where my one remaining surgical drain is. Ohh....shocker.)

I also noticed that I haven't been this svelte in years. (Since my wedding and honeymoon.) And I, vain and selfish creature that I am, like it.

However, I've always been a strange idealist/realist mix. (Hey-you try being a Capricorn Wiccan raised by a politico and a marketing exec.) I know what should be but I also realize what works. And by "what works" I mean what skims the line of socially acceptable in fashion and style.

For me.

Screw everyone else.

But am I too hasty to appreciate the new breast? It's much perkier, much more "fashionable." If it were a simple breast reduction, I don't know many people that wouldn't think that having it reduced wasn't a good idea in terms of appearance.

But having breast cancer seems to elevate it to a weird realm of fashion holiness.  I'm "allowed" by society to fully embrace my new boob whilst mourning the old. 

It takes cancer in this society to allow us to choose what we publically like about our bodies, in the fashion-sense? The rest is just "disposable," to be cheered on when we finally "get rid" of it, either by exercise or plastic surgery? We choose healthy things in our bodies that are "collateral damage?"

Shame. I did always think it was rather funky,that unclothed, I looked like the " the "Venus of Willendorf".

Now I look like half that, half the Venus de Milo. Really, I'm not putting a link to that one-you should know it. It's on just about every Italian brochure and humorous greeting card about bodies out there.

OK  Head hurts now. Going to bed. I promise to be funnier in my next post.

Thursday, November 5, 2009

How Cancer is Giving Me a Smokin' Hot Bod

From the movie, Sixteen Candles:

Grandma: "Look, Fred; she's gotten her boobies!"

Grandpa: "I better get my magnifying glass!""

Grandma: "And they are just so perky!"

Really, the new boob is very perky. Like two sizes perkier than the original. I haven't had boobs this cute since I was 11. Then it was, quite literally, downhill from there.

My abdomen is taut. Right now, it looks like pregnant taut, but it is slowly deflating. (Or rather, draining.) The skin is stretched so tight, no lines show. (Kind of like actress Nicole Kidman's face.) Because of this, I cannot stand fully upright and tip-toe around with itty-bitty steps.

It prevents me from standing for longer than a couple of minutes. Today at Trader Joe's, I had to use the scooter cart to get around. In doing so, I incurred the wrath of the over-85 crowd ("Why do you need to use the cart?) and my three year-old. "BUT I WANT TO RIDE!!!!"

I'm feeling better. I went to Dr. Venturi, the genius plastic surgeon, for a post-op on Wednesday. He removed the drainage tube leading from my new "foob." (Faux boob) He'll take out the abdominal drains at my following post-op next Tuesday.

After this, I will most likely have "touch-up" surgeries done to:

1. install a nipple

2. smooth out any lumps or puckering on either my new breast or abdomen. I now have the world's biggest smilie face. It runs from hip to hip. The good part is that surgery removed the extra skin (my so-called "muffin top") and the skin that "Dun-lapped" over the tops of my thighs.

The bad part is that I seem to have a really, really bad allergic reaction to the surgical tape that was used for external closing. It is paper tape. And since I'm pretty sure I'm not allergic to paper, it's gotta be the glue. And it is bad. Like 3rd degree burn bad. No wonder I kept telling the hospital nurses that I was itchy after I woke up.

So, future surgery might smooth this out, too. However, I'm not terribly concerned. I've never been a bikini person (I like to really swim and dive too much) and I think the last time I bared my midriff for fashion was sometime in the mid-1990s.

And if CJ wants to spice things up, he can draw a pair of eyes and nose over the smile.

A note about Dr. Venturi. I am incredibly grateful that he was my plastic surgeon reconstruction guy. He doesn't have to offer reconstruction services (plastic surgeons can afford to be picky) and he certainly doesn't have to offer the most difficult type of reconstruction, the DIEP flap. Which, of course, being me, I chose.

According to CJ, Dr. Venturi was performing surgery on me for 9 hours. Excluding lunch and trips to the potty, that is still quite a feat. He looked beat when he came out of surgery but when ICU nurses called him at 4am the following morning because they thought my new breast was getting too low in it's temp, he came right in. And reassured them that even though everything was fine, they did the right thing.

I think he is very impressed with his work. CJ and I also think it's just killing him that I didn't want him to reduce and lift my right, healthy breast at the same time. (I'm saving it for nursing future spawn.)
Dr. Venturi remarked how unusual it is to have someone choose to not do both at the same time.
Ah, asymmetry...the bane of the artist's existence. He needn't worry. I'll be back eventually. (Thank you, Bill Clinton!!)

Right now, I'm looking a wee-bit lopsided. But that is why the Goddess created falsies.
And really feeling how heavy my breast was-it was an instant 11 lb. loss. Scary.

At least I'm getting something in trade....

Sunday, November 1, 2009

I'm Back..........

and home from the hospital. I was told I could leave at 5:15pm and was out of there by 6pm. That is the fastest discharge EVER.

Elizabeth seemed kind of nonplussed to see me; glad but I was interrupting her trick-or-treating. (Mother Nature lent me a hand there. The downpour chased my kid back inside within a half an hour.)
She's a little sad she can't fully hug me but my goodness, the drains are fascinating!! We also can't play together like we do normally. No dress-up, no chase, no soccer. Hope she enjoys endless card and board games.

CJ, Betsy, and Jo have been troopers. (All of them need sleep and alone time.) I feel bad needing more help from them.