Prescriptions for Fruits & Veggies?

A yummy fruit, veg, and herb medley we made.

Images from nwedible.com.

New York City has instituted a program - a fruit and vegetable prescription program. The basic premise? "It allows doctors to 'prescribe' fresh fruit and vegetables to overweight or obese patients by giving them 'Health Bucks' that are redeemable at local farmer's markets."

One part of me thinks: great idea.

The other part says: is this what our nation's eating problems have come to?

What do you think? I'm curious to hear what you have to say.

Here is the Hungry for Change article I read about this program.

Wholesome Wave is the group that has the Fruit and Vegetable Prescription Program™ in addition to their Double Value Coupon Program and Healthy Food Commerce Investments.

-   -   -   -   - 

Since the subject of today's post is fruit and veggies, I thought this would be a great place to insert this helpful graphic on how to find a "just right" avocado. I always thought it was a guessing game based on feel and color, but this makes it simple and has helped me find perfectly ripe avocados. Yummy!

'Cause Dr. K said so!

I hold my oncologist, Dr. K, in high regard. She's wise, she's personable enough, and she doesn't mince any words in the exam room. Love that!

In my latest follow-up with her a few weeks ago, she at some point said "Start with a dog." Who cares what the context was - really, does it matter?! - I just wrote that down verbatim on my list-o-questions sheet I always bring in with me. What she said stuck in my brain all day until Joshua got home that evening. 

We've been hemming and hawing over adopting a dog for what seems like a long time - at least the better part of a year. Something finally clicked for us, because four short days later, we adopted Daisy:

Miss Daisy.

She's 100% puppy and is a delightful (mostly!) handful. Already I can't imagine our home life without her presence. And Joshua is just as smitten as I am. She's brought joy in a challenging time stemming from various upsets in the cancer world for others. 

She loves sitting in laps after she's gotten exercise.

A puppy that plays hard, sleeps hard.

Everyone's pooped after playtime. 

She's made friends with Tater...

...and took a nap in his bed.
Which looks enormous with her in it!

Lexi is getting used to Daisy in her own time.

When they're both fuzzy-headed,
interesting photo opportunities arise! 

Last week I received a call from my oncologist's office. All looks good with my tumor markers and other blood levels that she regularly checks. The news makes flying solo for the next 6 month window (not the typical 3 months) a wee bit easier.

This picture is from the evening I received my results. What great comfort to catch this moment in time with a bunch of colored pixels. I feel content.

So all this boils down to is: 

"Feeling well, got a dog, and did it 'cause the Dr. said so!"

Update and Reflections

Since the end of treatment, I've been addressing some big issues that were easier to put off during treatment; mainly: FEAR. It's a nasty four-letter word just like the others! It's got power, but you can work on diffusing that power by acknowledging it and realizing that in the now, you're okay. 

One thing that bubbles up fear [for me] are my follow-up appointments with my oncologist, Dr. K. I had one a few weeks ago. I'm feeling well and neither of us is noticing any "signs" of recurrence, which is a relief. I had five vials of blood taken last Friday and expect to get results this week. (That said, TNBC is tricky and typically doesn't show elevated CEA and CA 27.29 tumor markers like other types of breast cancer. For example, when I was diagnosed and all through treatment, my tumor marker numbers were never out of normal range. Arrgh!) As Dr. K left the exam room she said "You graduated! See you in 6 months." This means my follow-ups with Dr. K will now be at 6 month (no longer 3 month) intervals. Wahoo! The check-up leash is extended and it's nice to be at that point.

We've come a long way since my diagnosis in June 2011. Life tossed an unkind card my way, and we dealt with it in a straightforward way. I sincerely hope that sharing my emotions, losses, wins, and life events has been entertaining - if not useful - to readers. 

I'd like to keep this blog going - although I'm beginning to realize that I may not quite have the prolific amount of posting that I did during treatment. Why? 'Cause I'm LIVING - living out loud! I'm focusing my energies on helping others and nurturing myself, and it feels good. 

I still have plenty to say by way of sharing emotions associated with this journey, revisiting experiences I had during treatment that I'm still processing or mulling over, sharing positive ways we've tweaked our household post-diagnosis that everyone can do easily, posting news about breast cancer news/events/charities, and conveying what this survivor does after being spit out of the BC machine. I invite you to continue following my life journey.

Got questions? Please ask.

Medical ID/Lymphedema Alert Bracelet Update

Time for another personal BC-related update. The summer is flying by way too fast, yet I'm enjoying going and doing - something I haven't been really able to do the two summers previous. More on that later - possibly. :)

I'd like to bring attention to medical ID bracelets again.

About this time last year, I blogged about my first medical bracelet. It was a good friend - while it lasted. During my trip to Boerne, TX this year, it spontaneously flew off my wrist in several pieces (completely unprovoked, I might add!) and broke in a way that I could not repair. See what happened:

I have its bits and pieces & hope to have it repaired.
Still, a major bummer.

Luckily, I brought a second medical ID bracelet with me. It is more rugged and I purchased this one to take with me while participating in "sporty" things (hiking, biking, anything needing sunscreen application, and other dirty-making activities).

I think this bracelet has a smart design: adjustable and easy-to-use Velcro, durable materials that can stand up to a beating, waterproof, machine washable, and a handy-dandy inside pocket for customized and important medical information.

This bracelet from Amazon came with
2 foldable (and waterproof) ID cards.
It holds important customized medical information
about me in case I'm incapacitated and
need medical attention.

This lightweight, durable medical bracelet really saved me on my trip! Not having a medical alert bracelet makes me anxious - the peace of mind it gives me is powerful. And it is so important that medical personnel know to not poke me with needles nor take my blood pressure on my right arm! What a mess that could easily lead to...

While the above bracelet came to my rescue, I did prefer to have something a little less "sporty" for everyday use (something I can wear with normal clothes and when I dress up). That led me to start searching for a durable metal bracelet that could (hopefully) stand the test of time. I settled on the one shown below - and truly hope this one lasts for years and years. I chose to have it engraved with my specific medical information, too. (After all, what good does having a medical alert bracelet without information in/on it do if you aren't able to think clearly or speak to those trying to help you?!)

FYI and a tip for others:  When wearing a medical bracelet, I think it's a good choice to let that be the only bracelet on your arm. Some medical bracelets out there look like charm bracelets and hide the important "medical alert" well. To me, that seems to totally defeat the purpose of having it in the first place. While this is a lower-profile bracelet, it has the medical symbol on it + special instructions and it is the only thing I wear on my right arm (besides ye olde lovely lymphedema sleeve / glove / gauntlet when needed), so I think there's a greater possibility of someone noticing it if ever I'm in that situation.

It's also a great reminder to myself! On one of my follow-ups at the oncologist's office last year, I started hollering like a crazy cat lady when the blood pressure machine began pumping on my right arm - I had totally forgotten about my limitation. I freaked out the nurse tech (and myself), but she stopped the machine promptly and all was well.  That was when I knew I needed a visual reminder - for others as well as for myself - and it prompted me to get my first bracelet.

Think about it - it could save you and others from a lot of pain and agony.

BC Infographic

I'd like to share an informative infographic with you all. There will probably come a time another woman (or women) I know will be diagnosed, although I hope that I won't know many that do. It's a club that you don't want to be a part of, but boy is it uplifting to meet others that have "been there, done that" and "get" what this experience is all about.

Please pass on this information to anyone you know that could benefit from: knowing the facts, checking their breasts (male and female!!), or not feeling alone in their journey.

There's definitely a part of me that wants to know more about this disease. Like what specifically causes it? What are surefire ways of stopping its growth? When will there be a cure? So many questions...hopefully time and bonafide research will elicit answers.

source: http://www.onlinenursingprograms.com/code-pink/

Why Not?

Randall Munroe created the webcomic xkcd (he's also a former NASA roboticist and a is programmer). In June 2011, his fiancée was diagnosed with stage 3 breast cancer. Several relevant comics resulted - I plan to share more. For today:

My doctor visits aren't ever quite this entertaining - but I've done my best!

This would've been a GREAT approach to try...

Direct link to xkcd page with this comic.

...and if it worked, I'd have quite the stack of neck bling by now!

The Cherry on Top

A while back I declared to Joshua: "I've decided to just go ahead and order some nipples. So I'm going to do it - now." And I did.

Excited at the possibilities...

What a weird thing to tell your husband. And what a strange thing to shop for online. It's a mixed bag of emotions from my perspective: absurd, serious, and a little humorous. When the temporary tattoos from Rub-On Nipples (yeah, that's what I said) were en route to our home, I was looking forward to experimenting with them. 

While I had good intentions of applying a pair right away, it just didn't happen. Why? I think I was a bit nervous. What if my emotional self couldn't handle this experiment that stemmed from good intentions? What if I applied them lopsided and they ended up "looking" in different directions? These little pesky fears delayed me trying them...until our earthship vacation!

Boy, was I glad I finally got around to trying them!

For those women out there who have had a mastectomy and are electing to not have nipple reconstruction -OR- for those that elect to have nipple reconstruction but need to "fill the void" before that time comes, I believe these temporary tattoos offer an great alternative. Once I had mine on, it was like a puzzle piece came together - not only visually on my body, but especially in my mind. The girls really look like "girls!" There's a visual clue there that has been missing and my mind enjoys the relief of glancing at the mirror and seeing what it used to see and what the eye/brain combo is wanting to see when it looks at a chest: the "cherry on top," so to speak.

Top: colors in the "light variety" pack
Bottom: before and after

To see their color palette, size info, and dye info, click here.

I wanted to share a special offer* from Rub-On Nipples:  Save 10%!

Customer Appreciation Discount:   A 10% discount will calculate in your shopping cart with the code "March" (enter the code without quotation marks). The option to add the coupon code is on the last page of ordering, just prior to the request for credit card/PayPal information. (The price reduction does not apply to shipping and handling charges.)
Offer Expires:   March 31, 2013
To purchase:   click here.

*So you know: I am in no way affiliated with this company, nor do I receive any kind of kickback on sales made. Just want that to be clear. 

~  ~  ~  ~  ~  An Aside  ~  ~  ~  ~  ~

(source)

Joshua and I were watching a 1968 documentary recently. It reminded me a lot of the projector films we used to watch in elementary school because of the way it was filmed, narrated, and the background music. One thing the narrator said cracked me up and I had to put it on this blog somehow. Methinks this is just where it belongs:

"He doesn't need no nipple." 

--Gordon Eastman referring to 5-lb bear drinking milk from a can 

From High, Wild, and Free, a 1968 film in which Gordon Eastman takes his two sons on a journey to the wilds of British Columbia fishing, hunting, canoeing down miles of wild water, living with Indians and trapping beaver. Available on Netflix streaming. 

Young cubs can survive without their mother's nipples. I've been surviving without mine. Still, it's nice to see them again and I think I'm onto something...

Our Insurance Company DKS*

I suppose insurance companies are a necessary evil. While I am oh-so-glad to have the coverage we do, I occasionally get a little nuts-o when dealing with them. Like to the point where my head might do an Exorcist-type spin. It's not easy being your own advocate amidst an industry full of red tape. 

Anyway...

Our insurance company sent some interesting mail to me last week. It looked informative, touting a confidential health care summary and custom recommendations for "health opportunities" based on information received from my care providers and pharmacies. 

Okay, simple enough, right? 

Guess not. 

Look at this picture. See anything odd?

How about if I zoom in for you?

Seriously?!! One of my recommended opportunities is to have a mammogram this year? Hello, insurance: I'm no longer a candidate for that procedure - haven't been since October 2011. Sure seems like a techno-geek could make some check-boxes in a data entry form so that the double mastectomy subscribers don't get this in the mail. 

Granted, there's the "if this applies to you" CYA phrase in there, so I can't really go off on this, but it strikes me as puzzling. Mostly, I'm humored by this document. Still, it does have a cutting edge.

*DKS = doesn't know sh*t

11 week follow-up

Eleven weeks ago, I had my expanders taken out and my implants put in. I also opted to have my chest port taken out during the surgery. Here's what's going on now:

Yesterday's follow up went really well with my plastic surgeon.

I've healed really well! I am cleared to fly, swim (YAY!), and do pretty much anything without physical restrictions. With the exception of swinging from trees, I can pretty much do anything I'm capable of...while watching for arm/trunk swelling on my radiated (right) side.

I should check my breasts regularly for discoloration, discharge, or any redness/swelling (esp. on radiated side). Being familiar with them - by doing daily massages, stretches, and visual checks - will serve me well because I'll be able to tell if something is awry. After all, it pays to be familiar with your bits and pieces.

PSA: Ladies, have you given yourselves a breast check lately? Please do so! 

The bulk of the appointment (to my surprise) revolved around revision surgery and nipple reconstruction surgery. I'm not wanting to jump into either of those surgeries. First, I want to recover and feel great physically before signing on for more 'fun'.

In other Earth-shattering news, am finding that the more I touch all over my chest and my right underarm/torso/arm sensitive areas, the less they "zing" when touched. Pretty cool. It seemed to help me recover well last time; of course, it also might just be a time thing. But I don't think so! I just might be onto something here.   :)

How Do You Heal?

A quick update today on my physical healing. Last week's follow-up with my plastic surgeon, Dr. B, went well.

• For a little over a week before the appointment, I had a tiny area on my right (radiated) scar that looked a little bothered. It got red for a couple of days, but never got too inflamed. Turns out it was a spitting stitch. Because of all of the breast tissue being "carved out" and only a thin layer of skin remains over the implants at the scar line, this stitch wasn't wanting to be absorbed into my body. So Dr. B grabbed a couple of tools and pulled it out. Easy-peasy. There's now an indented hole where the stitch was that I'll have to put Neosporin/gauze on daily and keep an eye on. It should fill in over the next month. 
• Because of the above happening, I'm still a no-go in pools and hot tubs. Pfft!
• Got a near complete (b/c of stitch mentioned above) go-ahead to gradually begin ramping up my activity.
• Time to go bra shopping - yay! I may still be a teensy bit poofy on my right side, but that has drastically decreased over the last few weeks, so it's time to get fitted. Looking forward to not wearing the surgical bra and Warner's bras all the time. 
• Dr. B says I'm free to roam about the country, although he said I'd probably get some fluid build-up in my breast and trunk. I think I'll hold off a while longer so I'm comfortable when I do travel. I could tell when driving in the mountains at 10,000-12,000 feet that my body reacted to the altitude. Good thing I remembered to wear the lymphedema sleeve and gauntlet!

Breast Reconstruction with Implants 101

For those wondering, curious, or underinformed: here's some information about the process of breast reconstruction with implants.

My plastic surgeon used AlloDerm to help support my future breasts. The AlloDerm was placed during my first (double mastectomy) surgery and some additional AlloDerm was used during my 2nd stage reconstruction surgery. What's AlloDerm? Watch the YouTube video below to find out what it is, why it's used, and how it works:

from: http://www.youtube.com/watch?v=2KcXt3dJI_w

I'd like to call your attention to the placement of AlloDerm and also the placement of the implant - it's nestled between pectoralis muscles. Sounds nice and cozy...and it is...for the implant! Not as comfy for the muscle that's stretched OVER the implant. Those expander fillings I experienced late last year and this year were sometimes difficult to take (muscle relaxers helped on a few occasions). From time to time, I still feel twinges of pain from the muscles - especially on my right (radiated) side. The right side has a different battle because of the radiation. The daily morning massages and mashing is an effort to counteract radiation's lasting effects.

New to the mix as of last week: introducing arm stretches that work on increasing my range of motion and help loosen the pecs. They are painful to do right now and I can't stretch nearly as far as I was able to before my 2nd stage reconstruction. But I've been in a similar position before - after my 1st stage reconstruction last October - so I know it'll take time...months...to work on getting the pecs, shoulders, arms, and everything related in better shape.

If you've been reading this blog a while, you've probably noticed that I give proper credit to other sources of information, videos, and images. So I'll be upfront right now and say I honestly have no idea when I acquired these images - nor which blog they came from. I do remember finding a blog with these images and thought they accurately portrayed what reconstruction with implants (after a mastectomy) is like. They're so informative that I'm going to use them anyway, and if I ever find the originator of these illustrations, I'll give proper credit!

A great transparent view.

See all the muscle attachment in the armpit area?
That's where I really feel the tightness from lymph nodes taken, radiation,
and my pecs stretched over the implants.

A graphic illustraction if 1st, 2nd, and 3rd stage reconstruction.
Nipple tattooing is the  4th stage. 

Surgical Bras

Can your bra do this?
BEHOLD: the wonders of surgical bras...hook & eye clasps AND velcro!!

Surgical bras are many things. Several adjectives not used with this type of bra: glamorous, sexy, and dainty. They are also not fashion forward. Got the general idea? I think so.

After double mastectomy surgery
(so not filling out bra at the time).

I've had the opportunity to sport the dainty little thing (said with much sarcasm) twice now - once after my double mastectomy and again after my expander-to-implant surgery. Because of time spent in one, I thought it appropriate to dedicate a blog post on this necessary "intimate apparel" item.

In case you didn't know, one must wear this bra 'round the clock for several weeks post-surgery. All the time (shower not included, but sleeping is). :( Kinda uncomfy and weird after not wearing one so long, but do you what you gotta do to get [hopefully] well-shaped boobs.


"I'm going to learn how to unhook this bra
with just one hand!"

-Joshua, on unlatching my surgical bra
(that has 11 hook & eye clasps-->)
GOOD LUCK!

Even though the incision lines were taped up post-surgery, they still leaked a bit of stuff (looked to me like iodine or something similar - don't think it was blood, FYI). It wasn't bad the first day or two, but then started bothering me aesthetic-wise. After all, when you look good, you feel good - right? So I decided to put forth a good effort in cleaning the darned thing up.

Post-surgical grime under tape. 

"Grime - it comes with implants" 

-Joshua, 8/2012

Surgical bra before the big cleanup.

Letting the bleach pen do its thing.

Guess what? - It's nearly as good as new. Nearly all of the coloring left after a quick treatment with a bleach pen. Back into rotation the surgical bra goes.

All clean.

How are you today, ma'am?

Very well; I thank you.


Did you think that was it for this post? Not so! Here--I'll expand a little with my own little Q&A session typed out for your collective pleasure:

Q: How is your energy level?
A: At 3 weeks out from switch-out surgery, I'm feeling "well," all things considered. My energy level grows nearly each day! I have the want to get out and go, but am usually surprised at how I tire. Still, I am getting better over time and know it takes time and PATIENCE to heal. I must bend like a reed in water to go with the flow. Sharpen my mental focus and tools so when the physical challenges of rehabilitation come up, I'll be ready. Just went on my first real walk after surgery this week, too!

Q: How are you staying strong even though you're physically limited?
A: I work each day on this. There are roller coaster feelings that come along with healing. What have I chosen to do to myself? Yay, I have soft boobies! Will something not heal right? This long year+ of medical poking and prodding is over! Will I ever get a lot of my physical stamina back? ...when I realize I'm thinking like this, I BREATHE. Take a few deep, purposeful breaths, and "be."  ...  It's a purposeful pause that gets me back to the now. I don't know what will be - nobody does.

I'm also going through a bit of mental fortification for the physical conditioning that lies ahead. This I believe: I've done it before and can do it again. However, people: it's a lot of freakin' work and frustration that goes into just basic body conditioning after surgery and consecutive knock-down-get-up-agains. Grrrrr...

Q: How do your scars look?
A: They look like pursed lips! Seriously. Only not as uptight looking as the expander version. :) Kinda still a bit foldy in spots, but the scar has formed and is strong (although it won't reach its full strength until about 6 weeks post-surgery). My skin around all 3 scars (2 boobs + 1 port) is peely and itches sometimes. I'm keeping an eye out for redness or anything weird.

I put strips of Epi-Derm across my scars. It's like gooey, thick tape. It's got healing "stuff" in it. Easier to use than creams - yay!

Q: What are your melon "massages" like?
A: So yeah. The massaging...in addition to the lymphatic massages I do every morning...they're not fun right now. There's a lot of healing going on inside of my chest and squishing the implants to and fro isn't so great. Dr. B did say that, over time, they would decrease in pain. Massaging/mashing will help keep my scar capsule and space around the implants larger than the implants themselves for a softer/more natural result. It helps ward off capsular contracture, which can end up making the breasts as hard as they were with expanders.

Q: How did the first PT session go? What's your range of motion?
A: The first PT session felt GREAT and came just in time. She noticed ~2cm difference between the left and right sides of my trunk. The right side has more fluid retention than the left. Isn't that just the case...the radiated side not getting a fair shake. My left arm is way more comfortable being used and moved than my right arm. Still on Dr. orders to not lift my arms above 90 degrees, which is fine because my right arm doesn't want to go up that far - it starts pulling my pec/shoulder/armpit stuff all tight and wonky. We'll be working on this over the next few...months?

Q: Do you hurt?

A: Right now, my shoulder bones and muscles and everything is coming alive again and with a different "configuration" underneath my chest than before. I'm starting to feel a lot of tightness in my shoulder and up by my neck; also starting to "pop" more in my shoulder and right elbow - these things happened after my last surgery, too.  My right trunk area (see pic) feels bloated / fat / achy / ??? / uncomfortable at times, usually multiple times a day.

My right side seems to be the "red headed stepchild" as my friend Jo calls her radiated side. It's poofy, it's less pilable,

Q: Can you lay down flat now?
A: Although I tried laying down with just one pillow to see, it's just not comfortable at all. It's stressful feeling on my chest AND it's much harder to sit up - you USE your pec muscles and mine have been worked over and have new implants between them! Being propped up helps everything stay comfortable - except me. :)  I look forward to being able to lay straight down...and then back on my side sometime, hopefully!

Q: Where are you mentally now that your treatment and surgeries are over?
A: I am in a mentally confusing place: yay for making it through treatment well and surgeries being over! mixed with what all just happened?, what's my next step in life?, and life is on a different trajectory now! I'm excited for the possibilities that lie ahead. I want to live each day like I mean it:

Q: What do you do for stress relief?
A: A variety: send a snail mail note, look for creative project ideas/inspiration, organize, massage, acupuncture, get crafty, watch a movie/show, get together with friends, sit & think.

Q: What things do you wish you did/could do more of?
A: Hard exercise. I miss it. I wish I took more time to make projects and crafts that all live up in my head and in various digital depots. They're so much fun when I'm immersed...it's just getting started that's my challenge. Wish I could have camped a few more times this summer with Joshua - that was a lot of fun. On the good days, I wish there were more time to get to spend doing the things that excite me!

Q: Do you have "don't worry, be happy" moments?
A: Yep. And those moments are wonderful and to be treasured. Those times sneak up on me just like the opposite ones do.

Q: "Who's your daddy?" - Joshua, when asked what sort of questions he'd think people would have at this point in my survivorship.

Ha, ha, ha! Ain't life grand?  :)  <BIG SMILE>

Barium Schmarium

PET results in: all good! Normal uptake in neck, no nodes lit up, abdomen good, and bones clear. A great first scan post-chemo, mastectomy, radiation, and more chemo. ~happy dance!~
What all this nerd-speak means: no evidence of metastatic cancer.

I drank it all up in a personal
best time. Do I get a medal?

Yes, I "got" to drink the chalky Barium* drink again..."mocha" flavor this time. Not too bad for most of the 16oz...but the last 1/4C or so was more of a challenge to choke down. Ugg. Also got injected with sugar/radioactive material before the scan. After all the fluid intake, they give you ~30min to recline and let them spread all into your system. Then the scan happens. That takes 10-15min and is painless. They even put spa music on for me - not that I was fooled or anything!

My first PET scan was June 13, 2011 - before we really knew exactly what we were dealing with  cancer-wise and right before I met with Dr. K for the first time. I'll try to get images up on the blog sometime - they're fascinating to look at. You can "twirl" my body around and see various innards as different layers, you can also see 1,300+ various "slices" of my body from head to toe. Really cool. In the meantime, if you're the curious type, check out Wikipedia's article about PET (positron emission tomography) imaging. You'll see what the system looks like and an example of images made from this amazing invention.

*Barium: a mixture of barium sulfate and water, opaque to X-rays, that is swallowed to permit radiological examination of the stomach or intestines.

Doctor Downloads

Last week, I had two important appointments: a follow-up with my plastic surgeon and one with my oncologist. What follows is some of what I learned at these appointments.

Dr. K (oncologist):

• Triple negative breast cancer (TNBC) doesn't show itself well in bloodwork, unlike other types of breast cancer. Therefore, blood tests/tumor markers aren't good indicators of what's going on. FYI: my bloodwork when I was diagnosed was completely normal and gave no indication of any cancer in my body.
• Via bloodwork tests, we learned that my kidneys are functioning real well. Yay, kidneys! They're efficient, doing what they're supposed to, and bet a "better than normal" rating.
• My WBC count is within normal range. :)
• I'm back in middle school - in a way. I should "be prepared" at pretty much any time in the future to get my period. Oh, joy. The mystery, the intrigue!! <<eyeroll>>
• Dr. K pushed for getting a PET scan (now scheduled for tomorrow morning!) so we can all breathe easy at my body image not "lighting up" anymore.
• Dr. K took blood and compared that day's tumor markers with last summer's numbers. My tumor markers are down. Like I mentioned above, my tumor markers were never anything out of the ordinary, but it does feel good to know that my number now is lower than it was before.

Dr. B (plastic surgeon):

• Surgery went really well - even on the radiated side. I cannot even describe the ENORMOUS smile Dr. B had when saying this. My heart melted immediately and I was twitterpated at getting to see most of my "new" boobies. (Tape over the incisions/scars prevented me from seeing the full monty.) 
• Silicone implant sizes they put in: 700cc in the right (radiated) side and 650cc in the left. 
• Jill showed me how to massage (more like mash) my boobs to move the implants within their respective pockets. This is to be done every day multiple times for my lifetime.
  

  

  This is just the tip of the iceberg mashing-wise. Ouch.

  Massaging/mashing will help keep my scar capsule and space around the implants larger than the implants themselves for a softer/more natural result. It helps ward off capsular contracture, which can end up making the breasts as hard as they were with expanders. If that isn't enough to scare someone into doing their daily boob-mashing work, I don't know what is!
• I've still got tape over my incisions and look a bit like a craft project. 
• I will begin PT on August 17.

Things I'm doing/not doing now:

• No lifting my arms above my shoulders.
• No lifting items heavier than 10lbs.
• No airplane rides.
• No activities that make my face turn red or make me sweat for 2-4 more weeks.
• I "get" to wear a sturdy bra at 24/7 for at least 2-3 more weeks. Exceptions are when bathing (yes, I can shower!) and when boob mashing (see above).
• Just got approved to drive today; doc said to take short trips first, then build up to more as I'm/my body is comfortable doing so.

Top 10: Why 2nd Stage Reconstruction Rules

It's been a while since I've posted a Top 10 list. And 2nd stage reconstruction definitely deserves an honorable mention by way of a Top 10 list.

10. You can save some money on bras: you don't always need to wear them. (Although it's recommended to do so the majority of the time...since gravity works on these just like the real things and collagen decreases as you age.)  

Hardest part of this phase (for me):
the silicone vs saline decision.
My final decision: silicone.

9. You'll have better boobs than many of your same-aged counterparts (especially as time goes on). 

8.  It's as close to the physical puzzle pieces being put together as it's going to get. 

7. No more cold, hard nipples showing through shirts and swimsuits. 

6. You'll eventually be able to sleep on your side again. At long last! 

5. You can go to Zumba class (once completely healed) and "shake it" with the rest of 'em! 

4. They slip around in their implant pocket like 'buttah.' 

3. No more bumper cars with humans, doors, and other objects. 

2. My 2nd stage reconstruction had a bonus: my port came out, too! 

1. Bye-bye expanders - FINALLY! These sweater puppies are already more comfortable and real looking than expanders.

This is exactly what my expanders felt like to me.
(Minus the S&P holes, of course.)

O, Happy Day!

(I'll continue adding to this post as the day goes on and I'm able to via the hospital wireless.)

---9:15am---
Laura is having her rock-hard expander boobies switched out and the doctor will "slide in" some soft silicone implants during today's surgery. She is also getting her port removed from her left upper chest area as an added bonus!

We will be getting to the hospital a little before 1pm and the surgery is scheduled to begin around 2:30pm.

Thank you for keeping us in your thoughts and prayers!

---16:10---
Surgery went well and I had a brief minute to see Laura as she is coming out of her anesthesia. The nurse gave her 2mg of Dilaudid, which packs a punch based on her still mostly sleeping right now. The nurse will start bringing her to around 5:15 and we should be able to see her again at that time.

We are all very thankful that the surgery went so well and are hoping for a quiet calm recovery period in the weeks to come.


---19:45---
Laura is back home!! We weren't sure how it would go with the nausea, but thankfully Laura fell asleep on the ride home and we made it without a "spit up" incident. She is now sleeping on Adam's recliner, which he let her borrow for chemo and it is again coming in handy for this surgery. Thanks Adam we really appreciate it!

The surgeon was very happy with how the surgery went and Laura took a little peek at her new boobies in the recovery room under her new bra and said, "Wow it looks different!" You couldn't see very much, but you can tell the overfull expanders are a thing of the past and I know Laura is super stoked to experience the softer, supple texture of the silicone implants against her skin.

She is on strict orders to be like a T-Rex and not lift her arms for 6 weeks and no exertion as her post surgery cauterized arteries could rupture from elevated blood pressure. These next few weeks will be all about relaxing and taking it easy. And if that doesn't work I have been working on my knots during our camping trips and can tie her up in a double bowline!

We are absolutely relieved to be at home where it is quiet and peaceful and it warms my heart and makes me smile to see her sleeping in the place she is most comfortable. Right now she has her mouth open in typical "narcotic sleeping Laura" fashion and is hardly making a sound.

Thanks so much for the blog comments and emails. I know Laura will want to check her email and see what is going on in the world once the anesthesia wears off and she is back on this planet.

Ta-ta for now,
Joshua (& sleeping Laura)

Oh No, You Di'int!

Occasionally I hear tidbits come out of people's mouths that I'd like to verbally combat. Instead of being a word warrior to strangers, I've collected some of the particulars that have been said to me so I can process them here.

1. "If I were to have to get cancer, I'd want what you have" - Really? Do you even know what I have? Not all subtypes of cancers are created equal. And I'm not in a contest for who's got it worse--ALL cancer sucks! I'll take what's behind door #3, thank you: NO cancer.

2. "You're an inspiration" - While I'm sure this may seem true to the person saying it, hearing it makes me wince a little. I think what people mean is that they appreciate reading certain articles, hearing about actions we're taking to be informed and become more healthy, or knowing information about my particular diagnosis. I don't intend to be inspirational; I'm just going through the BC machine step-by-step in the only way I know how. My drive to blog is fueled by my own curiosity to know more about this disease, to share with family~friends~acquaintenances~strangers, to put out into the world what I would like to see, and to document this journey. What a trip to look in the rear-view mirror -- even at this point.

3. "I had a <enter relationship> that had breast cancer ... She went through <enter long detailed story> and didn't make it ... She left behind <enter children, family members>" - I want to scream: "What are you thinking?!!"  I am getting assistance on how to just plain leave conversations that begin like this. While the person may think they're trying to relate, they're really just processing what happened in their life. They aren't thinking about the effect of this news on others or anyone going through/having gone through their own journey.

4. "What are you going to do when you're done with this? / Any plans for the future?" - When AM I done with this? There's a tricky gray area that I fall into because of not having a complete response after my first 16 weeks of chemotherapy. I participated in the clinical trial (12 wks additional chemo) for several reasons - one of those is to help my chances of survival. Was I "done" at the time of my surgery? Was I "done" after the second run of chemo? How about after reconstruction is over? The list of future dates to check in with my status is far-reaching. I'll never be proclaimed "cancer free" - only possibly "no evidence of disease" if/when future tests come back in my favor.

My recurrence likelihood.

The curvy graph line above with "2 1/2" at its apex is my recurrence likelihood. Where the time and chance of recurrence axes meet is after the clinical trial ended (the recurrence timer began after my final infusion). As you can see on this graph Dr. K drew for me, the likelihood for recurrence spikes at 2.5 years and tapers off significantly at 5 years. That right, folks, I'll be having one heck of a 40th/41st birthday party. Or at least I sure hope so! No black-filled, geriatric-like celebration for me when that time rolls around. It will be such a major milestone to reach that it should be a most happy and celebratory occasion.

5. "I hope it all works out." - We do, too! This is better than "I hope you don't die"... but still leaves something to be desired.

Medical ID/Alert Bracelet

My bracelet.

I have an increased risk of lymphedema due to my double mastectomy surgery. To be more specific, it's primarily because of my right-side modified radical mastectomy: the entire breast was removed-including the tissue, areola, and nipple-as well as all lymph nodes in the armpit area.

Because of this risk, I believe it's a good idea to have a medical ID/alert bracelet on my right arm. If I am incapacitated in any way, the bracelet provides valuable information that can save me from getting "help" that could end up hurting me.

My engraved message is
"right arm: no needles - no bp"

After hemming and hawing about which bracelet to purchase (there are a TON of options out there), I decided on a stainless steel mesh bracelet...only to find out that the manufacturer had run out of right arm bracelets. Maddening! So the search began again and I found a suitable alternative (at a higher cost). There was an issue with the engraving, so I returned the original one sent to me. After all, if this bracelet is for medical personnel to read and interpret, the engraved message must be clear!

I was elated when the corrected bracelet arrived right before my first out-of-state trip. Perfect timing! I've worn it every day since receiving it and am happy with my choice. It's comfortable, doesn't pinch my skin or arm hair, and is rather low profile. Wearing this bracelet gives me a sense of security.

Some other medical alert bracelets are more fashionable, but isn't the point for medical personnel to see the alert easily? I wouldn't trust a fashionable bauble-studded bracelet to do the job...

Switch-out Surgery Explained

A little "present" I left for my plastic surgeon.

Lately I've been fielding questions like What's next? and What's this next surgery all about, anyway? Rather than press rewind and play a few more times, I thought typing and sharing on this blog might be a good way to inform everyone of what's happening at my surgery late this month.

First off, nothing is "wrong" - this is a reconstruction-related surgery. I'm under construction and this is a major step towards piecing me back together. During my double mastectomy surgery last year, expanders (which are basically like thick, ribbed plastic bags with magnetic ports in them) were inserted between my pecs and filled to 150cc. I went in for regular saline injections to fill the expanders which, in turn, stretched my breast skin. To learn more about that, read about my expansion process and filling them up. 
Now that my skin is stretched, radiation is over, the clinical trial is complete, and I am healing well from all of that...it's time for the switch-out surgery.

There are two main goals for this surgery:

1. Take expanders out; insert implants. These thick, stiff expanders have a one-way ticket outta here! Although useful and necessary for the reconstruction process, I'll be happy to not have these things in me anymore. Dr. B, my plastic surgeon, will use the same incision line left from my mastectomy surgery (in the middle of my breast) to take out expanders and insert implants. He may also remove scar tissue that's built up if he feels it's necessary.

2. Remove my port. I had the port inserted on June 17, 2011 to aid me in receiving chemotherapy treatments. While it makes me feel bionic, it kinda (still) freaks out Joshua and it's time to say goodbye to this trusty piece of technology. Thankfully, I never had a blockage or clot while the port was inside of me - I know several other women that have had issues with theirs. I've had it flushed every 4 weeks when it hasn't been in use and it's behaved nicely. I've also appreciated nobody having to fish around for a good vein in my arm. The port made things nice and simple that way!
----------

Other FAQs related to this surgery:

What's this surgery going to be like for you?
A piece of cake, 'cause I won't be an active participant. :) OK, but really...it'll be approximately 2.5 hours long. No drains and no pain med balls to tote around my waist afterwards. (Hallelujah!) I will most likely spend a night in the hospital, given my challenges in the past with coming to and getting my system up and running.

What is the recovery process going to be like?
I have heard that the recovery from this surgery is easy compared to the first one. Talk about glorious news to hear! I'll wake up with a surgical bra on. I will be able to shower 2 days after surgery. I should expect to be out of commission for about a month. Same lifting restrictions as the first surgery for 4-6 weeks. Then gradual stretching and strengthening to rehabilitate. -->I'm already finding this to be a mental hurdle to overcome. Starting "over" with the arms and rehabilitating my range of motion and muscle power again.

What cup size will you be? 
While that's getting personal, I get it and am not afraid of sharing. The short answer is: I don't exactly know.

Longer answer: Early on, I let Dr. B know that I was hoping for smaller breasts than I had naturally (like a cup size smaller). Because I needed to have radiation soon after surgery, there was a finite amount of time in which we could expand and whatever I was expanded to - that was it. (There's no further expanding post-radiation.) So...I was stretched to what I could handle within that time frame and am trusting everyone in the operating room to decide on an implant size that fits in the pockets we've created for them and "goes with" my body size/shape.

Silicone or saline?
Not sure yet.

What should I expect to see?
The outward projection should be the same for both breasts. Dr. B will do his best to get them closer together (right now they seem like they're miles apart). I may still have concave areas to the side of my breast bone. I'll have more natural looking curves (right now, I could practically sit a coffee cup on the expanders - my profile is pretty humorous). I should expect to see breasts that about the size I am now or a bit smaller; not bigger.

Are you all done after this?
For me, yes, I am choosing to be "done" after this surgery. Right now, I don't find the elective additional procedures to be necessary. For those that are scratching their heads: additional procedures can include surgery to reconstruct nipples ('cause I don't have them), and medical tattooing to color the created nipples (a.k.a. tit tats!).

When is it going to happen?
July 31. This year.