just a little bump in the boob

I was a naturopathic physician in Arizona. I worked at an integrative cancer center, supporting patients through treatment, helping them to reduce side effects from their treatment and to reduce the risk of recurrence. On September 18, 2014, I was diagnosed with stage IIb invasive ductal carcinoma. This is not medical advice, this is my story. Click Archive to navigate from the beginning. Opinions expressed are exclusively my own.

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just a bump in the boob?

It’s been a while since I last posted. The past six years have been full of change, except on the cancer front (which is a good thing). I went through follow up exams every three months, then six, and finally, annual appointments. Mammograms, ultrasounds, and MRIs have been intermixed to evaluate my still-dense breast (I typed “s” at the end then deleted). Normal. Normal. Normal. Test after test. 

I stopped getting regular MRIs because my medical oncologist was concerned with reports that the gadolinium-based contrast potentially causes memory issues. As I was already having chemotherapy-induced and chemopause-induced cognitive dysfunction, we felt more comfortable cutting back on the MRIs. 

The last time I had an MRI, I think it was to check out something I detected related to my left implant. Everything came back normal. During my most recent follow up, I mentioned how I still feel something scraping, pulling, and sometimes “zinging” behind my left implant. Since I was only in Phoenix for a short period of time, my med onc gave me an order for an MRI, which I would get when I got back home.

I’m working back at the cancer center in Northern Indiana where I originally trained 10+ years ago. My office is literally above imaging, the MRI to be exact. I hear it beeping throughout the day and I swear the magnets in the machine mess with my computers and mouse. I scheduled the appointment, which was in the evening on September 20th. I had time to run home, take care of Chloe, record a podcast episode (oh, yeah, it’s been a while. I co-host a podcast, and yes, it’s about cancer), then drive 5 minutes to the hospital and undergo the MRI. Before I left, the tech asked where I had previously received my imaging so they had something to compare. 

It seemed to take forever for me to get my results. I’m used to the rapid results I would get when I was at the cancer center in Arizona. I sent a message through the patient portal, asking if they had received the results. I started to get nervous and scanxiety set in. 

On September 26th, I recorded a new podcast episode. Tina (my co-host) interviewed me for our breast cancer awareness month episodes. I told parts of my story and she asked some really good questions. Sometime while we were recording, I got a message from a nurse at the Arizona hospital to call her back for my MRI results. I thought that was strange, that she didn’t leave the result on my voicemail, but it’s not my voice on the message, so maybe it was for HIPAA reasons. I called back and left a message for someone to call me. I drove over to my friend, Anne’s house, to drop something off and I and mentioned how I hadn’t heard anything yet about the MRI results. I decided to call right then and, over speakerphone, got ahold of the nurse.

I don’t know exactly how she told me, but the nurse said something about wanting to get an ultrasound and biopsy of something in my right breast. My right breast. My native breast. My “normal” breast. I panicked. They’ll send an order for my imaging and biopsy to the cancer center here. I lost it. This isn’t possible. I’m on tamoxifen. I was told I didn’t need to continue it beyond five years and I chose to stay on it for a total of ten. I’m on tamoxifen. I tried to talk myself down. “At least it’s in the breast and not the bone right?” I laughed. The nurse didn’t. Anne drove me home in my car because I was not in a good state of mind.

I’ve been frantically checking my portal for a message that the order has been placed. I’ve sent a couple of messages to my Arizona team. It seems like weeks but it’s only been two days. I’ve gone through every scenario as to what this could be. When I was first in treatment, two spots were noted in my right breast and they were able to biopsy one (the other "vanished” when they attempted an MRI-guided biopsy) and it was a fibroadenoma. An actual fibroadenoma, not the adenocarcinoma that pretended to be a fibroadenoma in my left breast. That’s what they are seeing (I look up what enhances on a breast MRI, yes, could be a fibroadenoma), it’s a fibroadenoma. Or it’s cancer. Maybe it’s not hormone receptor positive like my former tumor, maybe it’s hormone receptor negative which would be why the tamoxifen didn’t affect it. Maybe it’s hormone negative and HER-2 receptor positive. I ran through all of the potential treatment options. Where would I get treatment? Do I go back to Oregon or to my team in Arizona? Or treat here in Indiana, where I have many friends but am so far from family.

(I just opened another tab to log in to my portal to check for messages. The fourth or fifth time today).

And so I wait, and try not to let my mind go to dark and scary places. But it does. And I talk my way back. It’s going to be fine. It’s going to be normal. It’s just a little bump in the boob.

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Been a while since I've posted. No news is good news, right? January 16th was the one year anniversary of completing chemo and yesterday I had a breast MRI preceding my visit Friday with the surgical oncologist. I peeked at the preliminary read on the patient portal and all looks good, will wait for my appointment to be sure. Struggling with fatigue and weight gain, two things exercise can get help with. Trying to squeeze in exercise where I can but its not easy when working all day then driving sometimes an hour to get home. Have been trying to go up to the gym in the cancer center and walk in the treadmill between patients. We pay for a gym membership, just haven't been since we first signed up. I had surgery in October and had weight and motion restrictions but was cleared for gentle exercise a while ago. Next week I meet my new med onc. I've met her at work but this will be the first time I see her as a patient. The hot flashes are still there, just milder and less frequent. Changing my diet has made a big difference. I think overall I'm tolerating the Tamoxifen. Curious to hear her thoughts on how long she recommends me taking it.

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That’s me, sitting around waiting for my annual exam, only 9 months overdue. Important to get checked out regularly now that I’m taking Tamoxifen. Chose a GYN who turned out to be such a great doctor, super easy to talk to, and her office is not too far from my house.

She caught something on my breast exam, the right, “native” one. I didn’t recall any lumps or bumps in that area, and the site of my previous biopsy was much higher up. She wrote an order for a mammo and ultrasound. I figured I’d get the imaging at work and left a message with scheduling on my drive home. Then I panicked and called my Care Managers, who encouraged me to get scheduled for tomorrow.

I freaked out on the phone and started to cry. This is why I wanted the bilateral mastectomy, so I wouldn’t have these “holy crap is this cancer again” moments. I talked myself out of it because I felt like it was too extreme. I mean, I knew the evidence and lack of survival benefit but now I regretted my decision.

I got home and figured I’d float in the pool to calm down. Scheduling called back and were working on getting my appointment tomorrow but a there was a block on appointment times. Strange, but not strange once I realized the imaging department was getting rid of the old mammo and getting a new 3D machine. If I wanted the imaging done at work I’d have to drive back to work (during rush hour) to get it done today.

My husband offered to drive me (HOV lane!) and we got to the hospital much faster than I anticipated (HOV laaaane!!). I started to tear up when I realized everyone stayed late, waiting for me to arrive. Mammo first, followed by ultrasound. Then the radiologist came in the room and reassured me it was just a cyst. A benign cyst. Huge relief!

Next week is my 3 month follow up with my medical oncology team. Hoping it’s less eventful.

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First time in pointy toe heels since neuropathy became a fact of life. My wardrobe is limited with my tamoxifen weight gain and these fancy pants need a higher heel to keep the hem from dragging. I was finding relief from the numb toes with acupuncture, but I stopped due to the stress of racing to and from appointments. I just couldn't relax. I continue to apply creams that offer temporary relief but acupuncture worked the best for me. I guess I need to put aside my issues and just schedule some more appointments.

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Power port before and after. No soaking (read: swimming) for 2 weeks. The steristrips will fall off on their own. One more step towards feeling more "normal." I'll never go back to feeling like my old self, but that's okay. This is the new me, the post-cancer me. My hair grows, my scars fade, life goes on. Looking forward to that first swim in my pool.

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What keeps you going is trying to help everyone else hold their s#!t together.

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Two months since #mastectomy: Foob, scars, vocal cord paresis. Discuss.

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#chemohair timeline. #nohairdontcare #chemostyle Almost two months since surgery, when I was bald as a baby chick. My hair is growing so fast. My brows and lashes are pretty much back to normal, except I think my lashes are actually thicker now than before treatment.

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Hard to get used to not having Tortilla around. She followed me everywhere, except the bathroom. There she would peak her head around the corner and check on me. When my husband wasn’t around, she never left my side. It used to annoy me; I called her Tortilla Underfoot, because sometimes I wouldn’t see her and tripped over her.

We called Tortilla our angel dog. She filled the hole in our hearts after losing our Aussie/lab mix. We did not plan on adopting a geriatric dog. She was sleeping soundly when we first saw her but when she woke up and met us, she immediately rolled on her back and wanted a belly rub. I started to cry and looked at J, whose eyes were also welled with tears.

We named her Tortilla. She didn’t know how to eat out of a dog bowl, so we first put her food on a plate and worked our way up to a bowl. We soaked her food in water and broth because we never saw her drink water, adding fish oil and turmeric for joint support. I introduced her to snacks of carrots, zucchini, and apples.

Her hearing never was great but seemed worsen after her teeth were cleaned and she was put on a course of antibiotics. We really didn’t need to call her because she rarely left any one of us alone. She was a sound sleeper, and until recently she woke with a start if a gentle hand was placed on her side.

She was "truck dog"; accompanying my husband on errands and on road trips between Portland and Phoenix. She was “farm dog,” following me outside to look after the chickens and basking in the yard as I gardened.

Before moving here full time with my husband, she “wintered” in Phoenix. She hated rain and getting her paws wet. She walked around puddles while Juju, my Pyrenees, veered right through them.

She had a funny habit of pooping on small shrubs. Our backyard in Phoenix has agaves and she managed to figure out how to relieve herself on the pointy leaves without stabbing herself. On walks, she boldly approached cactuses, not realizing Arizona plants aren’t dog friendly.

The song that played in the background in the lobby at the vet was "You're My Best Friend." We sat on the floor with her as she took her last breath and we cried. Tortilla is our angel dog. We miss her so.

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Two-faced #nomakeup #cancerstyle: me in 2012 and today. I’ve been browsing my old photos a lot lately, trying to remember what I look like. Funny how I used to look at myself and be so critical and now when I see those older pics, I think, wow, I was pretty. I just didn’t see it at the time. I’m not one to fish for compliments, I just think it’s sad I don’t always appreciate who I am in the moment. And I don’t think I’m alone in thinking that.

I’ve grown attached to my bald head, although it’s nice to see hair growing back. My eyelashes I missed the most, I think. Last night we went to our friends for game night and I put on eyeliner for the first time in months. So much easier to wear eyeliner with those lashes keeping the makeup on the lid, not in the eye itself! I used to be a wash and wear girl, low maintenance, off to work with a bit of coverup and powder. Since starting chemo, my morning routine changed, with more time spent on drawing eyebrows and wrapping my head in a scarf. Thank goodness for my Buffs, they make headwear that is easy to put on and take off, breathable, lightweight. Hot flash? Rip it off. Time to see a patient? Simple to put back on without a mirror.

Tomorrow I return to work. I’m scheduled to work half days, which is a huge relief because I tire so easily. I’m obsessing over my lab results: why were they so much better in the hospital than they are now, three weeks later? Is that why I’m so tired? Because my liver enzymes were elevated, I stopped using one of my allergy over-the-counter meds. No clue if that is what caused the abnormal results, but I’m so cautious of anything that will affect my liver function, now that I started tamoxifen. 

Oh yeah, I started tamoxifen. Last night I took my first dose. I couldn’t decide if I should take it during the day or at bedtime and chose bedtime because 1) for the most part, I go to bed at the same time every night, 2) I take the fewest pills/supplements at night, and 3) if I have any immediate side effects, I will sleep through at least 7 hours of them. I slept well last night. That’s a good start.

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#chemo #sideeffect Fingernails almost 2 months post chemo, the peeling started in the middle of the nails. Thumbs are the worst. I painted glitter polish on my nails during treatment and then had to remove it before surgery! I don't typically see patients during this post-surgery recovery time, so a lot of this is a mystery to me. 

Yesterday, I met with the surgical oncologist. I'm still on weight and range of motion restrictions, but otherwise, everything else looks good. I wake up with all of the energy in the world and then crash around 2 PM. My husband and mom constantly remind me to conserve my energy. 

After my appointments yesterday, we stopped at Target where I picked up new bras. The plastic surgeon told me not to wear underwires right now. Before my diagnosis, I ripped out most of the wires; I find them annoying and unnecessary for my size. I picked up some seamless, tank style bras that feel very soft. Just like during chemo, I only want to be surrounded by soft things. 

On the not-so-soft-side, at REI I bought a Foot Rubz foot massager. I thought it might help with increasing circulation in my feet. My feet always feel better after a foot rub. The neuropathy isn't that bad during the day, it's in the evening and at night when I most notice it. I take a low dose of gabapentin (more for night sweats than neuropathy, but maybe it helps) and apply Topricin to my feet. The sudden electric jolts are the most bothersome; they start in the evening after supper and continue until I fall asleep. They are a constant reminder of that awful, shearing bone pain from my last cycles of chemo. So glad that part of my treatment is behind me.

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At the hospital, I was given two Flowerpotz scarves to hold my drains. One is for the shower and it’s quite useful. I haven’t adjusted to the everyday scarf, typically clipping the drains onto my bra or wearing the terrycloth Marsupial pouch I got from Maggie, the Bald Ballerina. If you don't know Maggie, she's 23 years old, diagnosed with Stage IV breast cancer last year (with metastasis to the bones). Oh, and she is a dancer with the NYC Joffrey Concert Group and she continues to dance (not in NYC) through her treatment. Rockstar. I follow her on Facebook and saw she was giving away some of her post-surgical supplies, just for the cost of shipping. Because I still think I'm the waifish New Yorker I was 20 years ago, I jumped on the opportunity to order from her, plus made a donation to help her with medical costs. I not only got the Marsupial pouch but also a Shower Shirt and a post mastectomy compression bra. As I found out in the hospital, the bra sizing is very misleading. I wore a medium in the hospital and was switched to a large (and no, I did not go up in size with the reconstruction). So the small I got from Maggie was WAAAAAY to small, even though the measurements on the website were all me. I wore the shower shirt a couple of times but just couldn't figure out how to shower at all, with fear water would creep up the drains and I'd get an infection. But the shower shirt did offer protection from the drain site getting wet. It's pretty cool, may have to find other uses for it.

I am using the denim Flowerpotz scarf to carry around my neck my must haves, such as lip balm, nail salve, my Hope stone and various homeopathic remedies that I take (disclaimer: I don’t care if you think homeopathy is hooey. While taking it, I’m not needing to take hydrocodone for pain. If that is due to placebo effect, I’ll take it. Less constipation this way.) That said, the pain has been minimal, mostly around the surgical scar and twinges around the breast area. I find the most relief from taking the methocarbamol (muscle relaxer) as needed and it doesn't make me sleepy or loopy or constipated like the pain meds.

Hoof Alive is a product I found at the farm store we frequent. My nails are just sad since chemo: thin, splitting, peeling. I apply it to my nails when I remember, that would be several times a week.

I'm now over a week out since surgery and my drains were pulled yesterday (2 days earlier than planned!!!). I will be allowed to shower sans drains later this evening. I'm so excited and can't wait to wash off the rest of the surgical prep that has colored my skin a lovely Bain de Soleil orange.

The most annoying side effect I've experienced has been my voice, which has been hoarse since surgery. It is from being intubated, I've been told this happens to people sometimes. I am seeing our speech therapist tomorrow before I have my appointment with the surgical oncologist. If I drink too fast, I inhale fluids, which is no good. It's hard for me to not be able to speak and I'm awful at not speaking at all. When I do talk, I quickly become out of breath. This may be the one side effect that limits my ability to meet with patients, so I'm hoping, hoping, hoping, we can clear up this new little bump as soon as possible.

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My last chemo was January 16th and I am starting to feel a bit more normal. Reality hit when I scheduled my surgery. I was pretty upset, then a friend suggested I throw a going away party. Saturday we threw a Bye Bye Boobie pre-mastectomy party, with nipple cupcakes and a rather buxom cake (gluten free)!

My surgery was Monday morning; my mom and husband came with me. Sunday night I had to wipe my self down with chlorohexidine to reduce the risk of infection. I also couldn’t take my meds that help with my hot flashes and neuropathy. Quite the rough night sleep.

We arrived right before 6:30 for my radioactive tracer injection. I signed a bunch of consents and the surgeons and anesthesiologist came to see me. Then I woke up super groggy and rather nauseous. Slept most of the rest of the day and now I’m wide awake at 4:15AM! Nausea has worn off and I feel a dull ache on my left side. Looking forward to breakfast, although I have a feeling it won’t be anything too exciting, only because I don’t need to make myself ill.

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A couple of shirts friends had made for me. 2D6 cracks me up. That's the isoenzyme that metabolizes Tamoxifen, which I eventually will be taking.

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Here is a collection of what has helped me get through chemo(so far). If you have anything to add to the list, what has helped you (or a loved one) get through cancer treatment, post in the comments below!

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2014 went out with a crash. Here's to a healthy, happy and safe 2015.

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Holiday Wrap Up! Come on and celebrate and have a good time!