May 8, 2010

Public Service Announcement

So far I've had two broken teeth during my chemo. It's so unusual to break off part of a tooth while eating that I started surfing the net to find out if the chemo was causing it. If you recall from a very early post of mine, I had decided to stop surfing the net for cancer information. It was just too scary and overwhelming to read about all the possible effects from chemotherapy. I decided to trust my doctors, and especially the Infusion Center nurses, to convey any and all knowledge about side effects I might experience. This turned out to be a very good idea because I wasn't being terrified all the time by internet babble about symptoms that were likely never to occur. But, I was sitting at home one day recently, eating a Snicker's ice cream bar when a piece of my back tooth broke right off. Okay, I shouldn't have been eating a Snicker's ice cream bar, but it could have just as easily happened while eating a celery stick! This incident happened about a month after a large filling popped out of a back tooth. I think I was eating a piece of candy at the time. Is a pattern emerging? No, no ,no, no I can't give up sweets! I have cancer, dammit, and I'll eat whatever I want! So, I finished the Snicker's ice cream bar. Afterwards, I sat down at the computer and, lo and behold, all kinds of dental problems can happen with chemo! Didn't know that. The enamel is weakened and plaque tends to build up a lot faster due to decreased saliva production. So that's why I can't spit out the car window while driving down York Rd anymore! Kidding! Anyhoo, lesson learned. I need to take even better care of my teeth. Maybe I'll try a fluoride rinse too, like the nurse recommended 5 months ago! They told me about mouth sores and dry mouth, which I've experienced, but not about cracking teeth. Oh, well, you can't be perfectly prepared for everything and I still stand by my decision to avoid searching the net...

Here are a couple of good sites I found for info about chemo and teeth:

www.livestrong.com/article/31610-effects-chemotherapy-teeth/       Lance Armstrong's cancer site
www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page5   from the National Cancer Institue

May 7, 2010

It happened again. This week I saw a patient for a PET/CT scan with a history of breast cancer. She told me that she had had cancer in her right breast four years ago. She had a mastectomy, chemo and radiation. Recently, they found cancer in her left breast and she was beginning the process all over again. Even before I knew I had breast cancer, I noticed that I was seeing a fair amount of women in this same situation. You know, I just don't want to go through the whole cancer treatmernt process again, although I'm sure the PET/CT scan patient didn't want to either! Having a bilateral mastectomy instead of removing just the affected breast seems more and more like the way to go for me. Some of the cancer info out there, especially the things about recurrences, can be very confusing. You really have to dig in and concentrate or the message is muddled. What I think I'm hearing and reading is that having only the affected breast removed does not increase the likelihood of a recurrence manifesting as distant metastases as opposed to opting for bilateral mastectomy. What a mouthful! See what I mean about confusing?! I interpret it as: having the bilateral mastectomy doesn't change the possibility that the cancer won't show up again outside the breast, in the liver, say, or in a bone. But, having the bilateral mastectomy removes billions and trillions of breast tissue cells, cells that have the possibility of changing into cancer again. Some of the messages might not be so straightforward but, the situation I'm seeing as a Nuclear Medicine Technologist is quite clear so I feel like I have to act on it.

May 5, 2010

My hair has been gone so completely for so long now, I hope it doesn't forget how to grow back! With everything going on, I should be more worried about other things, but vanity will always rear it's ugly head! I just have to remember what my balding friend said a few months ago, "It's a bummer that you don't have any hair now, but at least yours will grow back!". There are a few positives about having no hair. I shower in five minutes flat. When I put the car windows down on a beautiful day, no worries about messing up my hair. It's a lot cooler, having no hair, so you're going to be jealous of me in the hot, hot summer!

May 4, 2010

Here's the blog entry where I tell you what I've decided I want for my surgery on July 6. I'm going to discuss breastises in general and mine in particular as it relates to the removal of them and what I think I'll gain and lose. So, you might want to stop reading now and go back to Facebook or your email if you don't want to read the really personal stuff. It might seem odd that I will share all of this but I do it for two reasons. One- it's my blog and I get to say whatever I want with no comments (while I'm writing, anyway!) and, two - I have found it extremely helpful to talk to other women who have gone through the same thing. Not only is it helpful, but it makes me feel part of a community of sisters who share a life-altering experience. It's so nice. Some of my darling sisters have even gone so far as to show me their scars and how their chests look now, without breasts. Wow. I am grateful and humbled. So, if anyone reads my blog who is facing down the same type of breast cancer that I am - Stage III, HER2-Neu+ - I hope it helps.

I want to have a bilateral (both breasts) mastectomy and bilateral breast reconstruction.This could change after I talk again to the surgeons - plastic (for reconstruction) and general oncology (for mastectomy and lymph node removal). A few weeks ago, we were talking about a much lass drastic surgery than mastectomy. Mt oncologist felt that a 'wedge' could be taken out where the 'thing' they saw on MRI was. A primary breast tumor was not found. The surgeon is recommending a left mastectomy because we really don't know where the original tumor was. It had to be there! It was dissolved by my body but not before it sent some tumor cells out to the lymph nodes.

My reasons:
- I found out that even with only one breast removed (unilateral mastectomy), the remaining breast would  need surgery, too. Not as drastic as a mastectomy, but the remaining breast will change over time; OK, it will sag, and it will need to be surgically lifted. Also, in my case, the remaining breast will likely need to be reduced. I'm not braggin' but my breasts are not small and it would require a bigger surgery to make the reconstructed side look the same as my 'real' breast without a reduction. So, both breasts would need surgery anyway.
- To continue somewhat the above thought, I look forward to the time when I don't have big boulders on my chest. When I bike or run or even go for a fast walk, well, any kind of exercise, I have to wear a chest-crushing binder so that I won't bounce. I really don't like bouncing! It not only looks painful, it is! It's a bit lewd, too. And there's no tearing off of the t-shirt to reveal a cute little sports 'top' underneath. If I took off my tee, what you would see is a giant, medical-grade-geriatric-looking, wide strapped monster bra. Ugh! Not that I'm thinking of tearing off any tops, but I sure would like a more streamlined chest for being active.
- I think that one boob on a woman's chest becomes an oddity. I mean, what's it for? My sincere apologies to women who opted for unilateral mastectomy. I respect their decision and am not accusing them of being odd. These are simply my thought processes, right or wrong, good or ill. I met a woman who was young when she went through cancer treatment. She wanted to have another child and breastfeed so she saved the good breast. Other women want to absolutely minimize surgery. Also consider that women found in Stage 1 can have a lumpectomy only and their survival rate is still very high. But, back to my reasoning, such as it is. I believe that breasts are great and that they are great when they come in pairs. Lord knows, I have enjoyed having a very nice pair! But I just can't imagine that one real and one fake, with no nipple and a different size, would have the same impact, for me or for him. Someone reminded me that, if I kept one natural breast, I would maintain some sensation. But, could I ever get over the fact that my 'pair' is gone? It seems weird, wrong, to think of just one breast as an errogenous zone! Other body parts are a bit more critical than my breast. I would definitely save my other arm or my other eyeball. There is no practical reason to save that one breast.
- This could be the most important reason for bilateral mastectomy: I would worry about recurrence less. My oncologist told me research has shown that having the unaffected breast removed doesn't decrease the recurrence rate. I trust my oncologist and have great faith in her, but I'm not thinking about research results, I'm thinking about how I will feel. Surgery cannot remove every single breast cell. What a gruesome operation that would be! But with all the breast tissue that is removed in a mastectomy, there will be trillions and trillions less breast cells to convert to cancer cells in the future. Several breast cancer survivors said that they really didn't start worrying about recurrence until after all the treatment and the unilateral mastectomy was over. Then, anxiety kicked in. I can understand that since the treatment and surgery is overwhelming and you concentrate on the day-to-day.

Some of these reasons are justifications, I know it. Don't think for a minute that I wouldn't love to have never, ever gone through this hellish process. But, I am trying to be as positive as I can. Dwelling on the negatives is just not healthy. I will never have a normal body again. (Wow, it was hard to write that last sentence!) I can make myself totally miserable about it or I can be optimistic. I choose to find the good when I can and relish joy when I find it.