Time heals all wounds but how much time is really needed? I was recently chatting with an old friend I have reconnected with about issues we are both struggling with in our lives. We were talking about how much of a challenge it is to stay positive when it seems like your world is crumbling around you. We both exchanged great advice but deep down we know it is easier said than done. When it isn't your problem it is easy to address, but when it is your world crumbling you can't run to the light fast enough. It is so hard to move on or to forget the problem all together. The saying "time heals all wounds" is almost a slap in the face because sometimes time isn't always on your side or time just makes you think more and more about the issue at hand. I wish I was in the movie Inception. I could go deeper into inception where I have all the time in the world to battle this cancer and when I come out of inception my cancer is gone. In inception it may have taken forever but in real life ,which is what matters most to me, it has only been minutes or days. Time is what I need in this stage of my alien disease diagnosis. It has become a lot more complex than it originally seemed to be.
As you all know my last chemo was on December 13th and on December 22nd Daniel and I jetsetted off to Kansas City. We left our two anxious but lovely dogs with a friend (bless his heart) and enjoyed a week with family and friends. It was amazing! I got to see people I haven't seen in a long time (some ten years) and it was such a wonderful feeling to know I am loved by all of them. The week was filled with happy emotions but also sad emotions. It was wonderful to see everyone but it made me miss them so much more. For example, a few of my friends are pregnant and it makes me sad I am not there to support them and cuddle their babies. It makes me sad that the thought of children has to stay far in the back of my mind till this alien disease leaves me. I also struggled during my week in Kansas City because I didn't feel like myself and I didn't feel pretty. All the confidence I have been holding on to through this whole thing seemed to crumble a little bit while being home. Not because of my friends or my family making me feel less confident (it was actually the opposite) but because I had completed chemotherapy yet everything about me still reflects my struggle through my treatments. I know my hair won't instantly grow back and my energy will slowly come back but knowing I am done with chemo and not seeing the results or feeling like myself again is really taking a toll on me. I don't feel pretty in anything I wear and I am REALLY sick of trying to match outfits with hats. Ugh...cancer problems. Hahaha! I am sure I will get over it and as I see myself return to "normal" I will calm down, otherwise, I may resort to some anxiety medicine.
As I say "normal" in the text above I chuckle because I know I will never be normal again. My normal will become a reflection of this time in my life. I will walk around with scars and various permanent side effects barring a constant reminder of the trials this year has put me through. I need to find peace in those changes and know if they do define me it will only be in positive light. As I said earlier saying this is easier than actually doing it. Time heals all wounds and only time will tell how I handle my future. The future all these crappy treatments are giving me. Thank you crappy treatments!
Now for the tough news. The week before I left for vacation I met with my breast surgeon and this week I met with my plastic surgeon and oncologist to talk about my upcoming surgery. On January 29th I will have a double mastectomy. During my surgery they will do a skin sparring surgery by taking all tissue up to my chest wall from both breasts but leaving the skin. They will also remove a sack of lymph nodes under my armpit and place expanders in both breast to stretch my skin after the surgery for reconstruction at a later date. I will have three drains in after my surgery to get excess fluid out so I will heal properly. After my drains are removed I will have to go in once a week or biweekly to get my expanders (pockets inserted under my chest muscles) filled with saline solution. They are like temporary implants to keep my skin stretched and viable for reconstruction later. I have been told by my surgeon that filling the expanders will be quicker than usual so I can continue my treatments faster. Filling quickly will cause extreme pain (so I am told) and I may not be able to work during this time because I will be on narcotics and/or muscle relaxers. This whole stage will take about 6 weeks before I can move on to the next phase. During my recovery my mom will come down and help Daniel and I with daily activities that I will not be able to perform. I can't wait t see her. I miss her already!
It doesn't stop there. Shortly after my surgery I will receive a pathology report which will tell my exactly what type of cancer I have, how much I have, whether it is invasive or slow growing or both, how much cancer they got out and what the next step will be. At first I did not think this information would be necessary for me to know. I mean, I know from my last MRI that my cancer did not respond to the chemotherapy as much as they had hoped it would. I knew going into my surgery that they would still find a lot of cancer but today my oncologist told me news that really depends on what they find on my report. When I met with my oncologist today we discussed my MRI, my current health (side effects still lingering) and my future treatments. She first asked me about my current side effects. Currently I am experiencing swelling, weight gain (up 20lbs since this summer), sensitivity from my fingernails hemorrhaging, and constant peripheral neuropathy. She told me I need to start exercising (even if just walking on a tread mill will counter the weight gain the steroids have caused), my hair will grow back within 3 months and it is unknown if the neuropathy will ever go away. Again only time will tell because time heals all wounds. Then we discussed my MRI. As I mentioned earlier my cancer did not respond as well as she had hoped it would to the chemotherapy. She believes I have two types of cancer in my breast, invasive (fast growing) and non-invasive (slow growing). The invasive cancer responds best to the chemotherapy but the non-invasive doesn't replicate as fast therefore, doesn't die as fast. So where does this put me?
When I first met with my oncologist, surgeon and radiologist they gave me a set path for my treatments. Chemotherapy (4-5 months) followed by surgery (2 months) then radiation (2-3 months) and I would be cancer free and done. Man am I naïve. I have learned through this process the word "it all depends" is a logical answer. My path to being cancer free all depends on my progress. There is NO set path to karate chopping cancer. It all depends on how I respond. With that being said today I found out from my oncologist that after my surgery I will most likely have to continue chemotherapy for at least 4-5 months. It all depends on my pathology report but she said from looking at my MRI chances are high that chemo will again be in my immediate future. This time it will be a different type of chemotherapy. It will be a three medicine regimen, one will be a pill taken weekly, and the other two will be a infusion two weeks in a row and then a week off. My oncologist said the time frame for this treatment will be at least 4-5 months but it could extend for much longer (some patients years) depending on my response to it and my blood count. I can only hope for the best and again time will tell. Surprisingly when I was delivered this news I did not cry; maybe I am still in shock, maybe I am waiting for a final word, or maybe my strength and confidence is coming back. I will let it sink in a few days and let you know which one it really is.
After my oncologist discussed this new chemotherapy treatment she told me it may postpone my radiation. She said it all depends on how my body responds on whether I can do radiation simultaneously or if I have to wait till after chemo is over. My radiation timeline affects my reconstructive surgery timeline. I cannot have reconstruction till 6 months after my skin heals from radiation. I was also told that my only option for reconstruction would be a DIEP Flap. A DIEP Flap is when they do a tummy tuck and take the fat from my stomach to make new tissue for my breast. Implants are completely out of the picture because of the placement of my radiation my skin will not be viable enough for an implant. I am unsure how I feel about this reconstruction but I have lots of time to think about it since it won't even happen until next spring at the earliest. This new treatment plan has also changed personal plans I have longed for. I have known since the beginning that once I am done with all my treatments I will have to start a drug called Tamoxifen which I will have to take for ten years. While on the drug I can not have children because it suppresses the estrogen in my body so the cells that make cancer are blocked. Well now that I have to potentially have this new chemotherapy treatment that pushes my Tamoxifen start date to a later time. I know all of these drugs are extending my life by helping me become cancer free but it is also taking time from me to do some things I want to do (i.e. have children). This is extremely upsetting but I know it will all work out. I value my life and that is what I need to focus on now otherwise nothing else could happen.
With the phrase "it all depends" lingering, my proposed timeline for finishing ALL treatments as of right now (minus the ten year Tamoxifen) is at least another year. So this whole process before I can start thinking about remission looks to be about two years, but again it all depends. This crummy job of cancer looks like it needs me to keep working a little longer. I am such a great employee it can't survive without me. Time heals all wounds. I will continue to be strong and karate chop the shit out of this alien disease during that time.
