So everything is about to change

It's been a VERY emotional week so far, to say the least. But good because we now have some direction. The biggest thing is that Coray & I met my Oncologist today, Dr. Heather Allen. She was great. She works for Comprehensive Cancer Centers of Nevada (www.cccnevada.com). We loved the facility. Everyone there was just so...nice. I don't have the words. What she told us, and what I've been mentally preparing myself for, is that I will definitely have to have Chemotherapy. The cancer is an aggressive one & she basically said we need to get aggressive too. It's good to have a game plan, I am better when I have goals & timeframes. The big things will be the Mastectomy & then the Chemo. I also found a Plastic Surgeon (a BYU grad too!) and met him yesterday (when I got my snow pictures!). His name is Dr. Cameron Earl. He was also great. I felt so comfortable talking to him and about the whole procedure. We ran into an issue with my current surgeon...the Plastic Surgeon she usually works with & who also works out of the same hospital as her doesn't take our insurance. So, she recommended Dr. Earl, only I need to get a new surgeon & it's at a different hospital (Summerlin), which is on the other side of the valley near Dave & Skye. Dr. Earl's office gave me the names of two surgeons that he has worked with before & recommends...both take our insurance so no issue there. I need to call them tomorrow to find out who has earliest availability & then let Dr. Earl know so they can start coordinating their schedules. This will not happen until after the holidays, so that's good. I'd like to enjoy them a bit! Anyway, the surgeon will do the Mastectomy & then Dr. Earl will begin reconstruction right away with a tissue expander. I will have to see Dr. Earl every week or two (can't remember which he said) to add fluid to the expander until my skin has grown out enough to actually have an implant put in it's place. He said that's typically a couple months. The other thing that will happen during that surgery is the surgeon will put a Port-a-cath in just under my collarbone on the right side. This will be used for my Chemo & will stay in for at least a year. It's completely internal & will go directly into my superior Vena Cava. It is the easiest way to admister Chemo & will be much better than them having to search for a vein every time. The Port is self sealing internally so they will just have to stick the IV needle through a small layer of skin to reach the access area (which is slightly smaller than a dime). Three weeks after the surgery I will begin Chemo. I will be on three drugs, only one of which I remember. It is Herceptin. I will have to have the Herceptin once a week. That is not the "killer" drug. It's the other two that are the ones that will make me lose my hair & wipe me out for a few days. BUT...the "good" thing about those two is that I only have to do them every THREE weeks. So, Herceptin every week & then the "triple cocktail" every third week. I will do that for six cycles (18 weeks roughly) and then be done with that part. I will then continue on with the Herceptin but that will drop down to every three weeks then until I have been on it for one year. Radiation is now to be determined. That would be after the Chemo & we won't know that until after the Mastectomy...I don't remember why.

Before the surgery I have several things to do, other than finding a surgeon. Friday I am having a genetic test done. This will determine if I'm positive for the Breast Cancer gene. If so then we will definitely do a double Mastectomy. If not I have some hard thinking to do. There would be no MEDICAL reason to do a double but Dr. Allen said many women (especially younger cancer patients) will do it for emotional & psychological reasons. And they will absolutely do a double for those reasons. If I'm negative for the gene I still have a 1/5 chance of developing cancer later in life. Keeping in mind that 1/8 women will be diagnosed with cancer during their lifetime. So, do we want to take that risk?? Regardless if I have a single or double BY LAW every insurance company has to cover reconstructive surgery. Meaning if I have a single then I am entitled to an implant and/or lift on the opposite side so that I end up symetrical. Coray would prefer if I just have the double & eliminate the risk. I'm just not 100% sure yet. I will wait until after the gene test & decide then. I also have to have a MUGA scan. This is basically a scan of my heart that will create a baseline for them to use during Chemo. The drugs can weaken your heart muscles and so they will do additional MUGA scans at regular intervals & make sure my heart is still strong. Then I need to have a PET scan (if my insurance company will approve it....they are quite expensive from what I'm told). It's similar to an MRI but you get injected with a radioactive material which can determine if the cancer has spread to any other areas of your body. I'm told the half life of the radioactive substance is short so I won't be left in a lead room for long...thank goodness!

So there's a LOT going on. I'm trying to explain things to the girls in age appropriate ways. Gracie won't really get much. She knows Mommy has a "boo boo" & will have more "docker poin-ments". She's going to notice changes in my physical appearance but not much else. Emma understands a little more. I think when I start the Chemo I am going to have my hair cut off. I think I'll have Emma with me so she can see that it's still me. Plus I don't think I'll break down completely with her there. She knows Mommy is going to be bald, I'm going to have lots of doctor appointments, I'm going to be sick sometimes & that I'm going to have an operation & will be in the hospital for a couple days. I've been really trying to keep it light with her, so far so good. She asked me today "Mommy, is it ok if I laugh when you cut your hair off?" I had to smile at that. Yes baby, you can laugh. I'd rather laugh than cry & I think we're going to need as much laughter as we can get during the upcoming year!