Wednesday, October 21, 2015

Surgery day was Thursday, October 15, 2015.

When the alarm went off in the morning, it was straight into the shower for an antibacterial cleansing then off to the University of Washington Medical Center.  We checked in by 5:45am and were back in the pre operation room five minutes later.  The room was a revolving door of nurses, doctors and anesthesiologists from my surgical team introducing themselves and getting me ready for surgery.  One of the anesthesiologist placed the first of my three IVs with ease.  James and I enjoyed talking to him about Africa, a place I would someday love to visit!  He had just returned from visiting his family there.  James tried to get his mom and dad's name so we'd have a place to stay, but no such luck.  :)

Dr. Said came in with Dr. Miller and they sketched out the incision sites on each of my upper thighs.  James said it wasn't pretty.  They marked along my bikini line from the middle back of my thigh to the front of my groin, about 12 inches and then a vertical line about 6 inches long from the middle of my groin down towards my knee.  That's about what I've got for stitches right now - Yikes!

One of the nurses from the surgical team stopped in and introduced herself.  James asked her what the  doctors do for lunch and breaks...10 hours is a long time to be in surgery.  She giggled and assured him that they go in prepped with everything they need and it isn't a big deal.  As Dr. Said told us, it is just another day at the office for him, although he also said he understood that it wasn't for us.

It wasn't too much longer and the anesthesiologist asked me if I wanted some valium before heading back.  I told him no, as I was completely at peace knowing that God is at my side.  James gave me a kiss and I was on my way down many back hallways to the operating room.  When he wheeled me into the room, the surgical team was gathered around a large monitor looking at what appeared to be the CT scan of my upper legs.  They were looking at the veins and arteries.  They slid me over to the operating table and everyone from the team of 15 greeted me and shook my hand.  They strapped me to the table, put a mask over my nose and mouth telling me to breath deeply.  I was out for 10 1/2 hours.

James received updates from the head nurse every two hours.  What a long day for him.  About 6 1/2 hours into the procedure, the microsurgery portion was about complete and they were monitoring the newly transplanted tissue for blood flow while they began sewing up the donor sites.

Dr. Said came out after surgery letting James know that everything went well and then I was taken into ICU where they monitored my newly placed skin flaps every hour.  They watch the flaps very closely the first 12 hours as that is when 80% of the complications occur.

Waking up in ICU.

If you're wondering what a TUG Breast Reconstruction Surgery is, check out this site:  http://www.breastcancer.org/treatment/surgery/reconstruction/types/autologous/tug

Wednesday, October 21, 2015

In preparation for the TUG breast reconstruction, last week I had a pre-op visit with the surgeon as well as a CT scan on Tuesday.  The contrast CT scan is used by the surgical team to map my veins and arteries, planning how they'll stitch the flap together.  Absolutely amazing!

We spent Tuesday evening and Wednesday enjoying concerts.  The Wind and the Wave was a small concert at the Sunset Tractor Tavern in Ballard.  They were a fun band in a small setting.  Here's one of their songs.

Wednesday night we went to the Paramount Theater in downtown Seattle.  This theater originally opened in 1929 and seats about 2,500 people.  It is absolutely beautiful inside this venue.  We were fortunate enough to get seats up front right outside the standing room only section to see Chvrches.  They were another amazing show, and another Scottish band.  We saw the Scottish band Of Mice and Men this summer in Seattle.

Then it was home to bed and set the alarm for 4:30am so that we could be at the University of Washington Medical Center at 5:45am to check in for surgery.

Tuesday, October 20, 2015

A lot has happened in the 2 1/2 years since I last wrote this blog.  There were many times I thought about writing and wished I had kept up with it.  I finally decided that it isn't too late to jump back in and now is the perfect time.

About six months ago I began pondering breast reconstruction.  I wasn't unhappy with my body, but there were definitely times when I was disappointed I couldn't wear a certain shirt or dress.  And putting on prosthetics was certainly a reminder of Breast Cancer.  Not that it was a good or bad thing, just that it was.

During these past months, I spoke with a friend who recently underwent breast reconstruction and consulted with two surgeons about my options.  My friend was open and honest about the process.   I appreciated her willingness to share and admire her greatly for the light she sheds on cancer and all that she does to support the American Cancer Society.  Thank you, Becky!

When I consulted with the surgeon in Anchorage, she shared the process she'd recommend which was  inserting expanders and then implants.  She used words like probably, likely, might, and possibly.  Those made me a bit uncomfortable.  Going through a major surgery to possibly get an "A" cup just didn't seem like something worth the risks.

James and I celebrated our 20th Wedding Anniversary in Seattle a few weeks after the consult with the Anchorage surgeon.  I decided to seek a consultation with a doctor at the University of Washington Medical Center.  Within the week that we were traveling, I was able to get an appointment with Dr. Said.  When we met with him, he asked how I was able to get the appointment at the clinic off campus.  I just emailed, they called and voila!  I had an appointment.  It was a God thing.

While at the appointment, the plastic surgeon explained the various options and the success rate and data for each type of surgery.  He explained that trying to stretch my radiation damaged skin and insert implants was maybe a 50/50 percent chance.  He said he would not recommend that surgery for me.  He then looked at the second option which was a DIEP Breast Reconstruction where they take muscle, tissue and skin from the abdomen to build breasts.  He said that also was not a good option as I didn't have enough abdomen tissue to build two breasts.  He then talked about the latissimus dorsi flap which uses muscle and tissue from my upper back.  He didn't like this option for me either because it uses a "good" muscle.  Are there any bad muscles?

The next two options were the gluteal free flap which uses muscle and tissue from the buttocks, and the TUG or transverse upper gracillus which uses muscle and tissue from the upper thigh.  Of the two, he explained the TUG would be my best option.  Success rate for this surgery is above 95% - much better odds than the 50/50 for expanders and implants.  All of the benefits included higher success rates, using my own tissue for the entire surgery, long-term higher satisfaction among patients, and never having to mess with the site again as I would with implants.  After the consult, I immediately knew that I was going to have a TUG Breast Reconstruction with Dr. Said.  James was 100% supportive and the next part of the journey began.

A trip to Mexico after completing a year of cancer treatments.

James & Lisa

We had our picture taken here 20 years ago!

Sunday, March 17

I can't believe it has been almost one year since I first found that lump.  March 30, 2012 was the first of many doctor appointments - the one appointment which James pestered me to make for a week.  I'm glad that he did too.

Since the hysterectomy, I have recovered well.  I've been back at work full time since January 31, two weeks after surgery.  My apologies for not blogging sooner about how the surgery went, but I've been swamped with work and I am trying to keep my big rocks a priority.  The surgery went well and the doctor said that it did in fact look like my ovaries were beginning to work again, and he also commented that it was a good decision to remove my uterus as it was full of fibroids and needed to be removed.  My six week post surgery check up went well.  I haven't experienced any real hot flashes or menopausal symptoms so am very blessed in that regards.  I am officially graduated from Gynecology.

A note from the school greeting me in the entry upon my return.

I began taking the AI the day after surgery and haven't noticed any side effects.  It is a small pill I take daily in the morning for the next five years.  I'll have my next Oncology appointment on April 8.  I don't anticipate anything much at that appointment other than a check up.  From here on out I'll be monitored every 4 months with an Oncology check up.

I have noticed some real set backs with my right arm movement and armpit since I haven't been doing yoga or other exercise.  Everything is very tight, and sort of numb and sore.  I did go to yoga yesterday and will make an effort to go at least once a week.  I'll also get my butt up and moving every morning too.  I have really felt tired, sad and/or depressed lately.  I went to acupuncture on Wednesday which helped tremendously, but I still don't have the stamina I used to.

A little friend greeted me one morning when I was feeling a little blue.  Cheered me right up!

I don't plan on doing reconstruction at this point.  The process involves several surgeries to stretch the skin and place the implants.  Stretching the damaged skin is a painful process, and although the pain doesn't really scare me, I'm not thrilled about the idea of more surgery.  With implants, you also need to do follow up replacement surgeries every ten years.

I have enjoyed time off for Spring Break - it was filled with Jared, Caleb and I volunteering for Citiserve this week while James worked.  We delivered furniture for Love Inc., bagged potatoes for the Food Bank, played with kids at the Boys and Girls Club, chipped ice at the Rescue Mission and helped at Kids' Kitchen.  There are so many needs in Anchorage and it was nice to be a part of helping our community.

The best part of spring break was just being together.  We spent yesterday skiing at Alyeska; it was beautiful and fun!  We are so blessed to live in such a spectacular place and have time together as a family.

Well, tomorrow is the big day - last surgery!  I am so excited, which might seem a bit strange, but it marks the last major hurdle in this breast cancer journey.  I know I'll have follow-up care and medication to take daily, but that is all so manageable.

Since completing radiation two weeks ago, I am amazed at how quickly my skin has healed and I've recovered.  After one week, all blisters had healed up and this past week the redness has really toned down.  You can definitely still see the radiation fields and it is still a little tender - I don't want to wear a bra yet, but it is such a vast improvement over the last two weeks of radiation that I'm thrilled.  James laughed when I said I couldn't wear a bra yet - what do I need to wear one for?  For the prosthetics of course.  Although I really only wear them if the outfit requires some shape and nothing I'm wearing right now really requires that.  It has really been a blessing that I have not been working and have been able to recover completely for this surgery. 

Blood draw?

After prayer and consultation with the gynecologist, the conclusion is to remove my ovaries, uterus and cervix.  The procedure will be laproscopic surgery, three incisions in my abdomen with the organs being removed vaginally.  Any complications would result in a cut in my abdomen and organs removed through the incision.

Had some more blood taken today, and I miss the Oncology nurses!  This nurse has drawn blood twice and both times left me bruised and bloody, and I've got great veins!   I am anxious to see the result tomorrow as my last draw on December 27 had low white cell, red cell and absolute neutrophil counts.  I was surprised - my white count was at 2.2. 

I've continued with hot yoga which has helped tremendously - not only with sweating out all of the chemo drugs, but it has helped the range of motion in my right arm and shoulder.  I can feel the skin, muscles and ligaments stretching in the intense heat.  I love it!  I can't wait to get back to it after surgery.  I did get some great advice from a nurse friend of ours who said to get up and get walking right away - so that's my immediate exercise plan.

Salmon with roulade

We enjoyed a wonderful family dinner this evening - Salmon Roulade.  It is one of my favorite recipes and I want to thank our friends in North Pole who first gave us the recipe.  The boys have a hockey tournament this weekend and will take on some additional responsibilities once again.  I'm hoping to get to make their finals on Monday. 

Please keep our family in your prayers. 

Relieved!  I am so thankful to be finished with radiation.  Thursday, January 4, 2013 was my last treatment.  The daily treatments left me tired, but the last two weeks really took a beating on my skin in spite of the prescription cream, medicated bandages, supplements and other lotions.  I ended up blistered on my right side under my arm which was a most inconvenient location because my arm either rubbed the area continually or I had to hold it out like a scare crow.  I ended up holding it out scare crow style without even thinking about it.  I have a new empathy for burn patients as I found my little burns uncomfortable and painful - I can't imagine what some people must go through. 

There were three or four days during the 33 treatments when the machine was down and I had to be rescheduled later that day or evening.  I found myself hoping that the machine would stay broken so I wouldn't have to go.  The last day of treatment, the machine was down and I again found myself wishing they'd just tell me I really didn't need that last treatment.  But they squeezed me in on their second machine and I'm glad I completed the treatments.  I even received a graduation ceremony complete with music, a rose, certificate, t-shirt, water bottle and bubbles!

I've been attending hot yoga for the past month and have really enjoyed it.  I think it has helped with detoxification - the first couple of classes I had a chemically kind of stinky sweat.  Aren't you glad you weren't next to me in class?  I'm still going about five days a week up through my surgery next week - in between all of my doctor appointments. 

I met with the Oncologist and Surgeon today.  The Oncologist is pleased with how well I've done through my treatments and will start me on the AI the day after surgery.  My bone scan showed minimal loss in my spine with my hips and shoulders looking good.  I'll start a calcium supplement and he will do a bone scan every two years to monitor bone density.  My echocardiogram also looked great.  I'll get the results from the blood work next Tuesday when I meet with the Gynecologist.  When I met with the Surgeon today, she explained the process for removal of the medi-port; they simply make an incision on the previous incision, cut the two places holding the medi-port in place, pull it out along with the tubing which connects to the vein and then close everything up.   Side effects may include bruising.  She told me I couldn't keep the medi-port, but why would I?  I guess some people have wanted it for a souvenir, ornament...no thanks.

When I meet with the Gynecologist next week I'll have to have made a final decision as to whether or not I'll just have my ovaries removed, or if I'll have ovaries, uterus and cervix removed.  The Oncologist said it was a matter of preference as I don't have any genetic information showing I have a gene which predisposes me to uterine cancer.  I'm on the fence and still have a week to decide.  I've talked to people who have said I should take it all out and others who say keep what I can - each for good reasons.  I'll pray about it.

I'm still receiving acupuncture and massage weekly and will continue with those, and supplements, through the end of January.  I'm looking forward to surgery next week, as it is the last hurdle.  I plan to return to work on January 31.  In the mean time, I'm trying to recover from radiation and get healthy before surgery.  I've had a head cold for the past two weeks.  

Although I had to go to radiation every day over Christmas break, our family really had a nice time together.  The boys had a little bit of hockey; they enjoyed skating and skiing with James (I couldn't manage it with my burns); my mom came to visit; and we had several family movie nights.  We celebrated the end of radiation with a weekend of dates:  a concert, a cooking class and pizza with friends.  In spite of all of the challenges this past year, I feel blessed.  I'm so thankful that God has seen me through this experience with the help of outstanding physicians, nurses, friends and family. Thank you again for your encouragement and support - with much love, Lisa

Date night...A cooking class!

Finally!  Great weather for building a snowman.

Where to start?  I've been thinking about writing for weeks and the time just seems to get away.  I've just completed treatment 19 out of 33 - over halfway finished with radiation!  Other than fatigue and extreme redness/burn, I've been doing well.  You can now see very clearly the fields that they are radiating.  I've been keeping a variety of lotions on the area and have prevented anything too painful at this point.  My only pain this evening is a self-induced twisted ankle.  I rolled it when I missed a step this afternoon and now it is swollen and stiff.  

One of my newest observations is that my eyelashes are growing back, but now my eyebrows are falling out!  I've never been fond of the drawn-on eyebrow look and have never understood why someone would pluck all of their eyebrows just to draw them on.  I have new understanding and empathy...maybe they never had control of losing their eyebrows? 

In the past month I've had an echocardiogram, bone scan and an appointment with the Gynecologist. The Gynecologist told me I would not need a hysterectomy, however after consulting with the Oncologist he called back a few days later to say that yes I would.  I will also have my blood drawn this next week to gather baseline data prior to starting the aromatase inhibitor in January.  I'll go over all of those results with the Oncologist at the beginning of January when I'm about finished with radiation.

I started a detoxification regimen.  I was tired of feeling so crappy, and tired.   In addition to the formula that I blend up and drink each morning, I'm not eating any dairy, gluten, wheat, red meat and a few other things.  It helps that the whole family is now moving in that direction, although not necessarily by choice.  Jared's anemia and allergies to fruit led us to do some follow-up allergy testing.  He has food sensitivities to wheat, gluten, cow milk, coffee and a few other items.  I'm quickly learning a lot about cooking wheat and gluten free.  I've made a few loaves of bread that flopped and purchased a few "yucky" tasting items, but am figuring things out pretty quickly.  Today I made a delicious loaf of bread that served as our dinner - the menu called for french toast with hot cocoa.  I also made some chocolate chip cookies with sea salt that I had a hard time staying out of.  I got a thumbs up from the entire family.  Although trying to switch to gluten and wheat free cooking has been a little bit of a challenge, I think it is contributing to my feeling better.  

I tried hot yoga this week; I went to an hour class at Anchorage Yoga and really liked it.  It was another suggestion by the naturopathic doctor - a way to detox, as chemotherapy drugs will stay in fat cells as long as a year.  I'm trying my best to flush and sweat them out!

My favorite things to do while being at home - spending time with the family and cooking.  I appreciate  all of the prayers, emails, notes and phone calls.   

Cow bells, cow bells - no more cow bells!  At an Aces game.