January 29, 2012

Excuse Yourself!?!?!?

Do people not realize that perhaps someone who has just finished their chemotherapy cycles and is trying to make a transfer back into "normal" life may be a little bit SENSITIVE!?!?!?!?!

It boggles my mind how many people come around and don't even consider this!  Okay so perhaps this is me being a little bit selfish right now, but I am sorry I feel that at times I am allowed to be a little selfish, after all if this taught me anything it was to stop letting people walk all over me because I am number one!

I am so excited to go back to work I can hardly contain those emotions!  I talk to Dave about it everyday and about all of the projects that I had on the go and accomplishments that I was working on when I left and how I cant wait to achieve those!  Anyone who has been around me in the last year knows how much I love my job and strive to succeed at it, that I have developed great relationships and pride myself in the fact that I live to work not work to live!  I wake up in the morning excited to go to work - FINALLY!

Therefore, the other day when I had a miscommunication with a friend/co-worker who told me not "stay home and not bother coming back and let the person filling in for me continue to do my job if I didn't want to do her any favors upon my return"  - Perhaps I FREAKED OUT!!!!! 

WHAT????????????????  Are you kidding me right now??????????????

For anyone not going through chemotherapy or has never gone through it, for those of you that have never fought cancer, please understand one thing - While I may seem healthy to you on the outside, I smile all the time and yes, I lost a breast and  not my sense of humor....you see me at these times and these times only, but do you see me laying in my bed crying at night or confiding in my husband all of my fears, do you see me staring in the mirror for 20 minutes every morning feeling unbeautiful because of my lack of hair and breasts and the constant redness around my eyes, do you see me sleeping for 16 hours a night because I am exhausted, do you watch me every day struggle to remember what I was just talking about in mid sentence because I suffer occasionally from chemo fog. 

You can sit there and comfort me and say "you are beautiful no matter what, don't worry about forgetting things, don't cry you should be happy because your a survivor. 

I know these things!  However, do I feel AS beautiful as I did a year ago or as I will in a year from now?  No I do not and neither would you without your hair or your breasts, it is not about the beauty within at ALL TIMES, it is about feeling like a woman!

So please - just have some compassion for the things that YOU DO NOT KNOW.  It doesn't matter how close you are to people unless you are with them 24/7 just assume there are things you do not know and emotions they are going through that you cant possibly understand.

January 27, 2012

Reconstruction

So yesterday I had my appointment with Dr. Kanashiro to discuss reconstruction.  Without a doubt I have decided to remove my right breast.  It will be called a prophylactic mastectomy (meaning preventative). 

So a little bit about my reconstruction options...

My options are

1) DIEP flap

Patients typically ask in consultation what the recovery is like following DIEP or TRAM Flap surgery. I find that patients may have some misconceptions regarding how they are going to look and feel post-operatively. Typically at one week post-operatively, most or all drains have been removed and steri-strips remain in place on the breast reconstruction or on the abdomen. Bruising and swelling often persist after the first week and being to improve over the next several months up to one year.
Autologous reconstruction such as DIEP flaps are a great alternative to implant based reconstruction if the patient has enough tissue on their abdomen to donate to one or both reconstructed breasts. In patients who have had repeated infections or capsular contracture with implants, DIEP flaps represent a great method for reconstruction.


The above photograph, the patient is status post bilateral mastectomy.


The lower abdomen and perforators (blood supply) to carry the abdominal skin and fat from the abdomen to the chest wall is marked. The preferred vessels in the chest are the internal mammary vessels when available.


In the above photograph, the patient is one week post-operatively. All drains have been removed. Steri-strips remain in place for two weeks and are then discontinuesd. Bruising and swelling improve over the next several months to one year.
2) Implants (which will require spacers to be put in to strecth my skin over a period of time before the implants can be placed)



Breast reconstruction following mastectomy can be challenging for both the patient and surgeon. Breast reconstruction can be performed immediately following mastectomy or can be performed in a delayed fashion where a patient undergoes a mastectomy in one procedure and then implant or autologous tissue reconstruction in another procedure.


I typically educate patients who undergo reconstruction with tissue expanders or implants that these procedures are frequently performed in stages. Often, the first stage of reconstruction requires the placement of a tissue expander, followed by a second procedure where implants are placed and a final symmetry procedure is performed.

I have found great utility in the use of the neo-supracapsular pocket to control and reposition the inframammary fold in breast reconstruction. I find that the surgeon can have excellent control of the fold position without any untoward puckers or dimpling. One of the goals in breast reconstruction following mastectomy, is to have the patient feel comfortable and confident in clothing and/or in a bra.


1) What is autogenous breast reconstruction?

Autogenous breast reconstruction is the use of your own body's tissue to reconstruct the breast. This includes the TRAM (transverse rectus abdominus myocutaneous flap), gluteal flap (gluteus maximus myocutaneous flap), latissimus dorsi flap, DIEP (deep inferior epigastric perforator flap), SIEA (superficial inferior epigastric artery flap) and GAP (gluteal artery perforator flap) techniques.


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2) What are the benefits of autogenous reconstruction versus implant reconstruction?

Since autogenous reconstruction uses your own body's tissue to reconstruct the breast, the tissue is there for life. You cannot reject it. It will change in volume as your normal weight fluctuations occur through life and often tends to improve in shape over time. The breast is reconstructed with fat, which is similar in density to breast tissue, thus the “feel” is similar to that of a normal breast.

Implant reconstructions tend to require multiple operations prior to achieving the final result. These could include sequential expansion of breast skin, repositioning of the implant, correction of infra-mammary fold distortion, correction of shape deformity, correction of implant extrusion, correction of implant leakage, correction of capsular contracture, removal of implant because of infection, replacement of temporary implant or expander with permanent implant. If a patient has had radiation or is planning to have radiation, implant reconstruction is discouraged because of the unacceptably high complication rate. The implants often require replacement. Implant manufacturers do not consider them “lifetime devices”. Their life expectancy is <10 years per manufacturer documentation. The occurrence of capsular contracture is often a concern with implant reconstructions. It is the result of your body's recognition of the implant as a foreign material. A capsule of scar is layed down around the prosthesis to as a barrier to contact with the body. The capsules vary in thickness and can sometimes calcify and become hard. As a result implant reconstructions tend to be more firm than a normal breast, thus feeling more artificial and remaining somewhat immobile to normal activity.

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3) Are there any benefits of implant reconstruction over autogenous?

Implant reconstructions are typically shorter operations (1-2 hours) and do not prolong hospitalization. Autogenous reconstruction, specifically perforator flap reconstruction, typically takes 4-5 hours for a single reconstruction and 5-7 hours for a bilateral breast reconstruction. The hospital stay is 3-4 days for perforator flap reconstruction and may be slightly longer with TRAM flap procedures. Implant reconstructions also do not require a donor site and recovery is therefore usually shorter.

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4) What is a DIEP flap?

DIEP stands for Deep Inferior Epigastric Perforator. This is the named vessel for which the tissue to be transferred is based. “Flap” is a plastic surgery term referring to the tissue which is to be transferred.

The deep inferior epigastric vessels arise from the external iliac vessels (the external iliac vessels become the femoral vessels in the leg). The deep inferior epigastric vessels course beneath the rectus abdominus (the major abdominal “six pack” muscle) on each side. These vessels send off branches to the muscle as well as through the muscle into the overlying fat. These perforating branches are those which are identified, preserved and transferred with the overlying tummy fat to reconstruct the breast.

Please comment your thoughts or what you would do

January 26, 2012

Moving Forward

This last bout of Chemo was the hardest without a doubt!  My hangover lasted longer and was way worse than any other and to top it off I developed a very nice chesty cough and a fever that held on for almost six days! 

Now...I am feeling better!

And with that I am ready to jump of this train of life that I seem to have been sailing by on for the last 26 years.  Lets start slow ok!

Dave leaves back to Fort Mac tomorrow and with that I am gonna give myself a couple of rules to live by.  Something to get me started back in every  day life!

1)  I am going to start setting my alarm every morning and getting back to a normal routine.  Enough sleeping until noon!

2)  I am going to start enjoying some exercises and taking the dogs out for a walk every day!  I don't know how far I will be able to go, but I can go a little farther every day in hopes of doing the Weekend to End Breast Cancer Walk soon.

3)  Mentally - I joined a support group with six women in it which my doctor referred me to, I go every Monday and my first time was last Monday, it feels good to be able to talk to other women in my situation, but still have yet to find women of my age to talk to.

Also mentally, today I met with Dr. Kanashiro (my surgeon) again for a follow up to have my other breast removed and to begin the Reconstruction phase, I will keep you up on this but at this point I have chosen to have implants. 

I have also started reading a book called picking up the pieces, which I am absolutely loving!  There are a lot of quotations in there from real life survivors and it is very inspiring, I am going to dedicate more time to this book in the next couple weeks.

I think for right now, those three goals to focus on are quite a bit and just to get back into every day life if really hard, so here's to that!

A Toast!

While I write this I proudly sip on a glass of wine! 

Here is a toast to goodbye...

Goodbye from what you might ask?

While allow me to explain the absolutely terrible things that chemo does to you!

While most people may have worse symptoms to complain about, I suffered from a five day hangover, the absolute WORST smelling farts in the world which Dave, Burgandy and myself proudly call chemo farts, and as gross as it is, I almost had to plug my nose every time I peed!

This may have been a little bit too much information, but I proudly sip on my wine while I think of the happy days ahead of me that will be free of that god awful chemo smell!!!!!!!!

CHEERS!!!!!

January 17, 2012

Graduation Day

ALL DONE!!!

The Beginning of a new Chapter or the Closing of One....either way....I am done!

On January 17th I successfully graduated from Tom Baker University!  I was accompanied to my last Chemo by my Auntie/Sister Pauline.  She called me about a week before treatment requesting to take me.  We haven't spoke in a very long time due to family drama etc (you know how it is...) but I thought this may be a nice opportunity to let the past lay in the past and that is what we did, we did not talk about our issues or problems that we had, we just simply enjoyed our time together and it was really nice for me to have family there at my last chemo session, something that I have been feeling a void in for a very long time. 

I thought there would be more to this, when I walked out of the Tom Baker there was no red carpet, trumpets playing, hands clapping, drummers marching, cheerleaders cheering....nothing.  Just me and my empty feelings of no where to go.  What do I do now?  I will not be returning here in 21 days, However I will not be returning to work either and I know I still have two weeks of feeling like shit so....what now?

I have been so positive through all of this but I must admit, it has not been easy! 

Relationships have changed, some got stronger, some are no longer there. 

I have changed.

My way of thinking is no longer the same and I think more in depth these days, I think with purpose.  I dream more these days and remember them as well, for what reason I do not know.  I must admit my relationship with God these days is stronger and we talk quite regularly.  I care about things in a different way, I want to help people that are in my situation.  I value my time more, I take time to cuddle my dogs and Dave in the mornings rather than jumping out of bed right away.  I smell my coffee and food before indulging.  While this all sounds very cliche it is very true!



BYE BYE CHAIR!!!!

January 16, 2012

The Hard Feelings I Dont Like Sharing


It is hard to explain since there are so many great people around me and having Dave attend two chemo's with me and my amazing Porshia to the other don't get me wrong I feel like the luckiest girl in the world, but there was something missing not ever having a blood relative sitting next to me and unfortunately a sadness that came with that.  Perhaps this had something to do with the fact that every time I had chemo I was under the understanding that my Mom and Dad would be by my side and while I wouldn't argue with them leaving Calgary the day before my treatments I was extremely hurt and felt a sense of unworthiness.  Always feeling like my treatments weren't important or worth sticking around for and in all honest that hurts alot.  I have never wrote about it and didn't think that I would but when all of this began my parents were my number one supporters and they planned to move in with us temporarily to make sure I would be okay and unfortunately it did not work out that way I felt like through my treatment I was constantly disappointing my Mom and I didn't know how to fix that or make it go away and it was wearing on me every day, there was nothing I could do to make this disappointment of Cancer go away.



January 10, 2012

Young Adult Cancer Canada

I am sooooo excited to have found this website community of young adults diagnosed with cancer that provides information, support, skills and opportunity.

When I was diagnosed the hardest part was trying to find sources that I could relate to, how are people my age dealing with this, were they able to have children after, how did they and are they coping....

My profile on YACC is listed here and is one of my ways of hopefully touching others my age as the people on this website were able to touch me.
http://www.youngadultcancer.ca/community/profiles_archive/beige_plotts-waldner/

I am also sooooo excited and proud to say that I have registered for the Retreat Yourself with my best friend Ashley from May 3-7th in Morley, AB where I will get to share my experience with others my age as well as hear from them and make new friends!


A few thoughts on Cancer

So today on the local news they were talking about a study to find the casue of cancer, apparently this will be the largest study they have done to date and they are looking for people between 35-50 who have never had cancer to partake in this study.  Which got me thinking about my cancer.  At 26 years old and being a triple negative we can certainly rule a few things out so I am not ER/PR or HER2 positive which leaves all medical professionals guessing why exactly I; a 26 year old healthy female have been diagnosed with Breast Cancer, lastly they will test for a genetic mutation called BRCA these results take a year to get back and should they come back I will have a high chance of developing ovarian cancer through my lifetime.

So...can I blame myself for anything? 

  • Did I develop breast cancer because of the 13 years that I smoked?  (yes I started smoking at 13). 
  • Did I develop breast cancer because I lived my whole life overweight until I was 24?
  • Did I develop breast cancer because I induldged in alchol as recent studies show is a factor in breast cancer?

If any of you out there are going through this with me, please stop asking yourself these questions!  I know it is natural to question these things and try to place blame on someone or something but you need to focus on more important questions right now.

  • What can I do to get better?
  • How can I prevent a recurrence?
  • Why did this happen to me and how can I help others in my situation?
  • What can I do in the future to make a differnce?

My answer to this is simple, it is a transition but at this time if I can help inspire others through writing I am accomplishing one of the tasks I have set out to do. 

My next steps I  at this time.

- Make appointment with my surgeon to have my second breast removed and discuss reconstruction.
- Wait three years and begin trying to have children, if we are successful - Jump with joy!
- After children if I am BRCA positive I will choose to have a hysterectomy.

I have quit smoking, I live a healthy lifestyle, I have eliminated toxic people from my life, I smile and laugh daily (which I beleive is the best medicine of all!) and I am doing all I can do medically to remain cancer free.

January 09, 2012

Never think statistics apply to you. What happens to you will happen to you 100 per cent of the time, and not even the best doctors can predict that. 

Honeymoon's a comin!

I am getting so excited to think that in a week and a half the chemo will be over and done with and I can begin thinking about other things such as reconstruction, returning to work and enjoying my muchly deserved honeymoon with my amazing husband...now on to the really important question...where the hell does a 26 year old find a mastectomy bikini????  All these mastectomy bathing suits are made for older ladies!!!!


GRRRRRR

BAD BLOGGER!

Wow!  I am going to make a commitment to update my blog more often!  I keep running into people

So much time has passed and before I knew it here I am almost done my chemo journey and have failed to blog.  I may be a senior administrator for Information Technology Management but Technology sure has taken a back burner to my life these days as with well...seems like everything!

I am currently on cycle 3 of 4 with chemotherapy and proud to post that I will be finished with chemotherapy on January 17th when I visit the Tom Baker for my last administration!

So.....where to begin....

Chemotherapy Administrations
When I was first diagnosed with Cancer at the end of September and was told that I would be receiving chemotherapy after my mastectomy Dave and I prepared for the worst!  We made arrangements for my mom and dad to move in with us for the duration of my treatment, moved our house all around so that they would be comfortable and have their own room, I sacrificed my office that I waited six years to have.  We bought a bed in breakfast tray and a high nightstand for accessibility to everything beside me assuming I would be spending a lot of time in my bed.  We stocked our pantry with lots of soup, ensure, crackers and gingerale assuming that I would not be eating very much and I amped up my diet for three weeks to gain a little weight anticipating that I would drop down in weight during chemotherapy.  BOY WERE WE WRONG.

On December 27th I received chemo administration number three of four.  My body reacts the same to chemo every time, I suffer from a five day hangover in which I am extremely hungry and eat everything in sight, day five is the worst and my body aches and then I wake up on day six perfectly fine.  About a week and a half after my chemo administration I cant sleep.  Yesterday I was awake for 47 hours straight WITH tons of energy.  On these days I try my damdest to sleep but even if I sleep for a couple hours I wake up at three or four in the morning, make myself breakfast and get a burst of energy and clean the entire house and when this spell is over I go back into the Tom Baker for happy hour and leave there with my hangover.

Chemotherapy has given me no complications since I ended up in the hospital with my fever and zero neutrophils during round one.  I have a rash that has appeared on my back and have lost my hair (which already started to grow back immediately after it fell our).

The only complication I feel that came with chemotherapy is my appearance.  I haven't been working out as much as I did prior to my cancer diagnosis and as a result my stomach has become quite "flabby".  I have gained seven pounds (during the holidays).  I am hungry constantly.  My eyes are red.  My skin is dry. My face breaks out regularly.  Oh...and I seem to be missing a boob!  :)

Most recently the biggest problem that I am facing is where to go after my treatment is all said and done.  I have been struggling ALOT with this.  I have so many questions.

- Will I be able to have children?
- How long to I wait to make sure I will be cancer free before having kids?
- Will I have a recurrence?
- Do I reconstruct before or after children?
- When will I go back to work?
- Since I had no symptoms during chemo will I suffer from post chemo symptoms?
- If I am not a chemo patient anymore who am I?

All of these questions are not answerable therefore I continue to struggle with them.  I have recently began reading a book called Picking Up the Pieces and it has made me realize that everyone who has been diagnosed with cancer has these same questions.  You are no longer able to run from Cancer once it has touched your life.  Having Cancer and having it cured it not your get out of jail free card, you are still just as much at risk to get another kind of cancer as the rest of the world is except yours will be called a recurrence.  Of course I commit myself to a healthy lifestyle of diet and excercise but this thought will not go away!


The ups and downs
When I was first diagnosed I cried and then...I picked my ass back up!  I realized quickly that that cry did not cure my cancer and other than giving me big bags under my eyes and snot running down my face it did nothing for me. 

I would like to be able to report that that was the last time that I cried but that would be a false statement.  There has been many emotions in the last three months but for the most part my spirits have remained high with a positive attitude towards a great outcome.

There was one night that Dave was late coming home from work, he wasn't answering his phone and I had supper ready, he was always home at the same time and I was getting worried.  I had gone upstairs and put on my makeup and wig and decided that tonight during dinner I was going to look beautiful for my amazing husband.  Dave however had decided to stop in quickly at a friends house and forgot his phone in the truck, before he knew it an hour had gone by and he called me to tell me he was on his way home.  When he got home I had a complete breakdown about how I made myself look pretty just to have him not appreciate me and come home late and now supper was dry because it had overcooked and on and on and on.  I lost myself...I fell on the bathroom floor and had a massive breakdown.   None of this of course had anything to do with Dave stopping to have a beer with his friend or about supper being dry and if I was crying because I made myself look good well then I need to reconsider that one because I should be making myself look and feel good EVERYDAY.  I was just simply crying...to be crying!  And again as I reintroduced myself to the baggy eyes and snot running down my face I gave myself a mental slap and sat down at the dinner table realizing that laying on the bathroom floor and falling apart had not cured my cancer and did absolutely nothing for me.

One thing that came with my cancer diagnosis was a wake up call.  A wake up call to realize that you do not need to have people in your life just simply to have them there and if people in your life make you miserable...why are they apart of it?  I can proudly say that Dave experienced this wake up call with me.  We were happily married on October 9th in a small ceremony, yes we were happy to get married and yes we thought it was a beautiful wedding but none the less there was an unfortunate circumstance to our wedding...I was having a mastectomy five days after our wedding.  We announced to all of our family and friends that while our wedding was going to be very intimate we would be having a large reception when my chemotherapy was over and done with and I was feeling better so that we could "celebrate" properly.  With this announcement came my wake up call.  It is now clear to me that when people decide to get married it doesn't matter what YOUR wishes are someone is always going to be pissed off!

While we have had amazing people come into our lives during this journey and have made many new friends and discovered just how great some of our friends are, we have also experienced the opposite of this, we have also had people that have become less active in our lives that were a big part of it before all of this.  And we are ok with that, infact, Dave and I have never been happier!  We have discovered how important and close to our family we are and have made a huge effort to be a big part of their lives as well as some very close friends that we value greatly!  Personally, I myself now have a new feeling towards relationships, it is okay to be acquaintances with people and if you have mutual friends, be civil at gatherings, however, there are many people that I feel have caused conflict in my life and I have struggled for years to resolve this conflict.  Simply put, you just aren't meant to be friends with some people and I have put so much energy and time into trying that I just cant do it anymore, my time and energy now needs to focus on myself, my family, things and people I love and living life to the fullest NOT to putting a constant effort into something that never was or that I know just will never be there!  This realization is compliments of my amazing husband that has opened my eyes to so many things since my diagnosis, the endless nights that we spend talking about what is important to us and where we want to see our lives in the future.


Where do I go from here?
On January 17th I will walk into the Tom Baker without my husband by my side as he is away at work for what will be my last chemotherapy treatment.  I have read that these are not uncommon feelings to not know where exactly you belong at this point but what I do wish is that for one day I could go through my day without the word Cancer popping into my head!