Thursday, May 31, 2012

A Death In the Family

Today we mourn the loss of my mom's cat, Shadrack.  While I am not particularly fond of cats because any time I'm near them I can feel my airway tightening up and I get itchy eyes, my children have grown very attached.  I went with my mom to take him to the vet because it was apparent that Shadrack was going to need to be put down.  Stupidly, we allowed my 5 year old daughter to come with us. The vet came in to examine Shadrack and immediately felt a large mass in his abdomen.  He tells us that he is pretty certain that Shadrack has cancer.  My mom starts crying and says, "Well, we know about cancer." She points at me and says, "My daughter just had her breast removed because of cancer and she's pregnant."  I immediately change the subject back to the cat and we talk about the cancer and what would happen if we didn't put him down.  At that point, I look over at my daughter who has her hands covering her face and is leaning against the exam table.  She is silently sobbing.  I took her out and sat in the car with her on my lap.  She sobbed and sobbed.  I asked her about how she felt.  She said she was so sad that Shadrack was going to die.  All I could think about was if she is relating the cats illness and death to my situation.  The word cancer and death were used together.  The death of a pet is traumatic enough.  I don't want my children to have to worry about whether or not their mom is going to die.

Lots happened last week but I've been pretty exhausted and didn't feel like updating the blog.  Last Friday I had two appointments.  One appointment was with the general surgeon and she removed my drain.  I was so happy to finally have it out but then quickly started to get nervous about what that means...the chemo can officially begin at any time now.  After that appointment I went to my OB.  She did an ultrasound and I got to see my beautiful and perfect baby.  The OB was able to tell the gender of my baby and so I asked her to write it down and seal it in an envelope so that my husband (who was up in Northern California working at the time of the appointment) could be the first to find out when he got home in the afternoon.  It's a boy!

Yesterday I had an appointment with the plastic surgeon.  I thought he was going to begin filling the expander and give me a second breast but that wasn't the case.  He did remove the stitches and set another appointment for next Thursday.  Hopefully that'll be the day he will fill my implant.  I also met with the oncologist.  Since my drain is out, chemo will most likely begin next week or the following week.

Tomorrow is my birthday.  I will be 33 years old.  My mom keeps asking me what I want for my birthday.  I can't really think of anything.  What do I need?  I have everything I need.  A husband who loves me and works hard to provide for our family, three beautiful, smart and talented children, parents who have put their comfort and peace aside to take my family into their home, sisters who are bending over backwards to do a fundraiser to cover my medical bills, friends who bless me with kind words and continuous prayers, and most of all I am blessed with a God who delights in giving me the desires of my heart.  What more could I ask for?

Thursday, May 24, 2012

Life Isn't Fair

There is so much talk about how unfair it is when people get sick or go through something hard.  I get so tired of hearing about it.  As soon as my children were old enough to start envying each other over a bigger piece of birthday cake or a cooler Christmas present I started explaining to them the reality of life. Life isn't fair.  I don't want them to grow up with a sense of self entitlement.  I don't want them to be devastated every time something bad happens because they don't think they deserve for bad things to happen to them.  When bad things happen, I want them to look at that bad situation and decide to turn it into good.  If they are too focused on pitying themselves because they are victims, life will be miserable and unfulfilling.

Through this experience I am going through, I want my kids to see me practice what I have preached.  I am not a victim of breast cancer.  I am a just a person living life.  Life is unfair.  Do I feel like it is unfair that I have breast cancer?  No.  It's just a part of life.  We go through hard things.  It is what it is.  It's not an issue of whether or not I deserve to have to go through this.  This is life and life is hard.  What I choose to do with the hard things in life is to set the best example for my children that I can. What I want my children to see is me trusting the Lord with my life.  I want them to see me praising Him for all the other blessings that have been showered upon me.  I want them to see me come out on the other end of this a different woman.  I want them to see how God can use a bad situation and turn it into good.  I want them to see me take this hard time in my life and use it as an opportunity to grow and become closer to the Lord.


Wednesday, May 23, 2012

Plans Change

This morning I had an appointment with my oncologist.  The plans have changed.  I don't like change.  I already had this all figured out.  I was going to have 18 weeks of chemo while I am pregnant.  It was totally going to work out perfectly.  Chemo would take place from June to September...awesome months to have chemo because my kids never get sick during those months and I wouldn't have to worry about my immune system being compromised as much as I would through the winter months.  After chemo was over, I would have my baby and be able to breast feed for a couple weeks until I began radiation.  During radiation I could pump and dump and then continue breast feeding again when it was all over.  I had it all figured out.  Well...so much for my plans.  Seriously!  I need to stop being disappointed when my plans don't work out.  I should know better.  

So the new plan is as follows.  Whenever I get the stupid drain out of me I will begin chemo with a drug they know is safe during pregnancy.  I will discontinue chemo 4 weeks before I deliver the baby.  I guess that's because I need to get my platelets and blood count up so I don't bleed out during delivery.  After I deliver the baby I will continue another 12 weeks of chemo on a different drug that is not yet proven safe for the baby.  After that I will have radiation and then I will be done with treatment.  I'm disappointed.  Doesn't the doctor know that I already had a great plan in place?  I guess he doesn't really care about my plan to make cancer treatment as convenient as possible.  I guess I have to be thankful for that.  He cares about getting me healthy.  He told me today that when I became his patient I became part of his family.  I totally believe him too.  I guess when you're going through cancer it makes you a part of this separate cancer culture.  

So for now I'll sit around waiting for my drain to produce less than 30 ML of fluid per day and then the chemo can begin.  I am so not looking forward to this.  

Saturday, May 19, 2012

The Discomfort of Others

I've gone out in public several times and didn't really think much about the fact that I only have one breast...at least not until I realized everyone else was paying attention.  The other day I was sitting at the kitchen counter in sweats and a cami tank top.  My drain tube and the bottle that collects all the fluid still draining from my chest (I know it's gross) are pinned to the medical bra underneath the cami and making me look as if I have a strange growth coming out of my ribs underneath my missing breast.  My dad got a phone call and informed me his long time friend was coming over to pick up a tool.  I looked down at myself and back up at my dad and then stupidly asked, "Do I need to go put on something else so he's not uncomfortable?"  The answer was obviously yes.  Duh!  But even putting on a sweatshirt didn't help the awkwardness.

I know what it's like to be around someone who is suffering from an illness or some kind of trauma.  It's awkward...especially if it's something physical...something that you have to prevent yourself from staring at.  I remember what it was like to be that person, so curious but afraid to look or to ask or to do anything that could possibly be offensive.  It's painfully uncomfortable and awkward.  Now that I find myself on the other end of this exchange...I'm feeling sorry for those who are exposed to my one breasted presence.  Not that my one breasted presence is unpleasant or anything.  I actually find myself to be quite pleasant.  My point is that I understand what it is like to be in the awkward situation other's are finding themselves in when around me....and it's only going to get worse.  Right now I only have one breast.  In a couple weeks after I've healed a little more from the surgery, the plastic surgeon will begin filling the expander implant with saline and I won't be missing a breast anymore.  That new breast will not look normal though.  It will be quite high on my chest...considerably higher than my other breast.  That'll be kinda awkward but possibly something that can be overlooked by the average person.  It's going to get really interesting when I lose my hair and begin to look obviously pregnant.  I'm trying to picture myself looking this way and I just can't envision it.  I bet people will wonder if I'm just bloated and sickly or if I'm actually a pregnant cancer patient.

The other night my husband said to me, "It's a good thing you were such a freak in high school and didn't care what anyone thought about you.  It's probably going to make it easier for you now.  You know like when old people would walk past you and look at you like you were a freak?"  I just laughed after this comment from my husband because I wasn't really a freak.  He's right about me not caring what people thought about me.  It was a good effort on his part to give me a compliment...I think.

Wednesday, May 16, 2012

Recovering

I just got a call from my health insurance company.  The representative said to me, "Congratulations!  We just received notice from your OB that you are pregnant and we would like to get you enrolled in our Healthy Pregnancy Program."  I thanked them and then declined the offer to be a member of the Healthy Pregnancy Program.  I don't need any more doctors or nurses following this pregnancy.

I've been telling myself I need to update the blog for several days but just don't have the motivation.  I am way too busy laying in bed dozing in and out of sleep or sitting on the couch and staring at the wall...Seriously.  The last week has been a blur.  I was taking pain medication every four hours as prescribed until Monday when I had my appointment with the plastic surgeon to check my incision and the drain.  He told me I should discontinue the pain medication.  And then I had an appointment with the general surgeon and she said I need the pain medication and to continue taking it.  So I decided that I would be the judge of whether or not I need it.  So I stopped taking it to determine if it is actually necessary.  It turns out that I don't need any medication to sleep at night or to function normally throughout the day.  I do need it before I go on a car ride.  I went to the store with my mom yesterday and after about two minutes in the car, I knew I'd made a poor decision to go with her.  Every turn, bump, jostle or movement of the car left me with a throbbing chest and completely drained of all energy by the time we arrived at our destination (which was only about a 7 minute car ride).  So for any car rides in my near future, I will be preparing myself with a small does of pain killers.

The pathology report came back.  There is cancer in the two of the three lymph nodes that were removed.  The oncologist says he expected for there to be microscopic amounts of cancer in the lymph nodes and it doesn't change anything.  They can't officially stage the cancer until after I've delivered the baby because it requires PET scans and all kinds of other stuff that they can't do while I'm pregnant.  He (Dr. Kass, my oncologist) is treating it as stage 2 breast cancer.  Officially it could be somewhere between stage 2 and stage 3 but he said it doesn't really change the treatment during pregnancy either way.

Cancer is stupid.  But breast cancer is something I don't really feel like I can complain about.  I have cancer.  It was in my breast.  Now my breast is gone.  My breast can be replaced.

Friday, May 11, 2012

Breast removed and still feeling blessed

Yesterday was a day full of pain and full of blessings as well.  As we were driving to the hospital at 5 am, I spent the time praying.  I prayed for my safety and safety for the baby.  I prayed for the surgeons and the nurses.  I asked God to draw the cancer back into the breast if it had spread anywhere and compact it in the center of my breast so it could be removed cleanly.  I prayed for the Anesthesiologist, that he would find the exact balance of medication to give me.  I specifically prayed that the operating room would be filled with the Lord's presence and that the procedure would go so quickly and so smoothly that there would be no denying His presence.  The procedure was supposed to take 2 1/2 hours...it was completed in under 2.  The surgeon was surprised by the size of the mass.  It was considerably smaller than they had expected.  The mass has two of the indicators that suggest it is one of the more curable types of cancer.  The amount of skin covering the mass that had to be removed was minimal and the plastic surgeon was able to do a pucker closure which will leave me with the best results when I have the reconstruction.  When they woke me up after the surgery, I immediately started talking and had great conversation and bonded with my favorite nurse ever, Rose.  The amazing part about it is that I came out of the anesthesia quickly and with minimal nausea.  The Anesthesiologist did a great job and gave me the perfect amount of medication.

I have been very apprehensive about how I was going to feel after the surgery and had to look down and see myself with only one breast.  I have to say that so far it's not as traumatizing as I thought it would be.  It's just really weird but not upsetting.  It's most likely because I know that in a couple weeks they will start filling the expander with saline and I will  begin to have the appearance of a breast again.

Today I feel pretty good for the first two hours after I take my pain medication and then I spend the next two hours waiting to take another pill.  I went for a walk this morning.  I walked from my parents house up to the corner of their street which is three houses away and then back down two houses past my parents house where we turned around.  The surgeon says walking is very important after the surgery because of the risk of blood clots and pneumonia which I am at a higher risk for both because of the pregnancy.    I felt so pathetic walking 100 yards at such a slow pace.  Everyone keeps saying they're so impressed with me.  I think I should probably stop being so hard on myself.

Today I am especially thankful for the way I have unknowingly prepared my body for this surgery. I have spent the past 11 months running and doing yoga.  I think about my friend and yoga instructor, Holly, every time I use my core muscles and every time I breathe deeply to release tension in a painful part of my body.  It hurts a lot to breathe.  Every time my lungs expand it sends horrible shooting pains through my chest.  When the pain meds start to wear off I can focus on relaxing those muscles and it helps a lot.  Today I am also thankful for pain medication.

Thursday, May 10, 2012

post op

It's 9pm and my amazing wife is alreay home and out of the hospital.

We arrived at the hospital at 6am for check in and preparation for surgery.  She went in for surgery about 7:30 and was under the knife in no time.  She was out of surgery and into her room around 11am.  The doctors advised her that if she jumped through a few hoops, she could go home the same day if she chose to.  I am proud to say that my wife did everything they asked her to do so that she could come home and sleep in her own bed. We began the check out process at around 4:30 which started with my wife walking down to the nurses station and asking to be released.  I can't really put in to words the strength my wife posesses.  I knew she was going to be awesome but you never know exactly how it will unfold.  I was amazed again by her tenacity and courage.

The next few days are going to be rough for her as she heals from the incision and procedure as a whole. I am 100% positive that she will handle the physical and emotional healing in the same manner in which she handled getting out of the hospital, head on.

Rest assured that she is getting plenty of pain medication and rest.  We will continue with pain pills most likely around the clock for at least tonight and for a couple of more days.  We go back to see the general surgeon and plastic surgeon on Monday the 14th for follow up appointments.

We are taking things one day at a time.  Today she did amazing and I am sure that she will continue to do amazing day by day.  I am uncertain as to the exact detail of how her courage and tenacity will unfold but I am sure it will be amazing every time I see it.

Pray that we will depend on The Lord day by day and minute by minute and be guided by His hand in everything we do.

Wednesday, May 9, 2012

Not sure yet if the reality of the situation has hit me..

I sat down with my kids and explained to them what was going to happen with the surgery.  I explained that I will have my breast removed but the doctors will give me a new one after a I heal. My five year old daughter's response was, "I think when they give you a new one that it's going to be black".  I guess she thinks I'm getting a transplant and she's concerned they're going to give me the wrong color breast.  My seven year old son had different concerns.  His question was, "Are they going to put a milk carton in to replace it?"  He is concerned with how the baby will get it's breast milk.  I overheard my eight year old telling my five year old, "Now Mommy is going to know what it feels like to be a man on the right side of her body." I love that my children give me plenty of reasons to laugh at the situation.

When people ask me how I'm doing, I automatically say I'm doing well or doing fine.  As soon as the words come out of my mouth I feel like I've said something wrong.  Am I just saying that I'm doing fine or am I really doing fine?  So far I have been fine.  I feel okay.  I don't question why this has happened to me.  I'm not angry.  This is just a part of life, another obstacle to overcome.  But then again, that's just how I'm feeling so far.  I haven't yet experienced the pain of surgery or the awkwardness of having only one breast.  I haven't experienced the nausea, fatigue, hair loss or anything else associated with the chemo. So for right now...I am fine.  Tomorrow might be another story.

Today I got a call from the surgeon.  She had just met with my team of doctors as well as some other colleagues and they had come across a procedure that is safe enough for the baby and can save me from losing 10 lymph nodes during the surgery tomorrow.  They injected my breast with a small amount of radiation that will travel to the main lymph node.  This will allow the surgeon to locate and remove only that lymph node.  They will biopsy that lymph node and if there isn't any cancer I am finished with surgeries until I'm ready for the reconstructive surgery.  If they find cancer in the lymph node they will have to perform another surgery to remove additional lymph nodes to get the cancer out.  My prayer for tomorrow's surgery is for there to be not a speck of cancer in the lymph node.


Monday, May 7, 2012

Surgery is scheduled

So apparently Wednesday will be my last day with two boobs... two real boobs anyhow.  The mastectomy is scheduled for this Thursday, May 10th at 7:15am.

Growing up my sister Laura called me "Becky Boobie", which at times turned into just "Boobie".  I have birthday cards addressed to me as "Boobie".  I have no idea why or where this came from but at this phase in my life, I can't help but wonder....  Why didn't she call me "Boobies"?  I guess after Wednesday the singular form of the word will finally be appropriate.

Today my dad and I were talking and he asked me if I've made peace with the fact that I'm having my breast removed.  I responded by saying, "There is no peace to be had.  I'm waging war on that boob and have no intention of mourning the loss of it's diseased tissue."  That is exactly how I feel.  I am not sad at all to be losing a boob.  I am pretty relieved that I'm not losing something that can't be replaced so easily.  In all honesty, after nursing three babies, they needed some serious work anyhow and now my health insurance will pay for it.

The only anxiety I'm really experiencing right now is out of concern for my baby.  I do not like the fact that I will be under anesthesia while pregnant... and I might as well mention the upcoming chemo my baby will have to endure.  I don't mourn the loss of my boob...but I do mourn the fact that I most likely won't be able to breast feed because of the chemo and the radiation.  I asked my sister-in-law (who had a baby last month) if she would start pumping some extra milk and freezing it for my baby.  I'm not sure if she knew I was serious.  I can't stand the thought of this baby not getting all the benefits of breast milk.  Out of all my children, this baby will need it the most after everything it's going to go through in utero.  And this is where I have to stop myself.  I tend to start worrying too far into the future.  I can't help it though...I am a Dahl...I am my father's daughter.  I analyze things and try to think of every possible outcome before it ever happens so that I can be prepared.  I should know better.  There are things that happen that just can't be anticipated....such as the situation I find myself in right now.




Saturday, May 5, 2012

Settling In

This morning in the shower, I noticed that the mass in my breast feels different...significantly different.  Today it feels like the nipple is completely surrounded by thickened cancerous tissue.  Last week it was only on the right side.  I guess it really is changing quickly and that explains how I didn't notice it sooner.  I just wish they would hurry up and cut this cancer out of me.  I want it off of my body!
It's really hard to make decisions right now.  I just can't think clearly enough to figure things out.  Right now my husband and I are trying to figure out what to do about a place for him to live for the couple days a week that he needs to be in Northern California for work.  He is blessed with a job that allows him to work from home a lot of the time but there are 2 to 3 days a week that he will need to make the 5 hour drive up there to meet with customers.  This is where the problem is.  Rent a room from someone, rent a studio, crash on a friend's couch?  None of it sounds very appealing but a decision has to be made. 

At least things are getting settled here at my parents house.  Thanks to my sisters, we finally unpacked all the boxes and clothes and got everything put away.  The kids have their room all set up and have been happy to have their cousins to play with on a daily basis. 

I have to say that so far the worst thing about this cancer business is that I feel like a huge burden on my family.  Despite the fact that I feel like a burden, I know they do not view me as a burden.  I know that everything they do for me is out of love and not out of obligation. Thank God for that.  Thank God for the loving family I am blessed to be a part of. I don't know how I would get through this without them. 

Thursday, May 3, 2012

A reason to post

I created this blog for my family quite some time ago and never had the desire to actually post anything.  I now find the name I chose back then to be very funny...chaos is the score upon which reality is written.  I had no idea what chaos really is... until now.  So here I am... ready to type away.  I can now utilize this blog to share with all my loved ones the struggles my family and I are going through and will continue to go through.  I'll give the basics of what we've been going through for the past couple of weeks.  I must say that my brain is kinda not working that great right now.  I've been pretty sleep deprived and completely overloaded with information and that is just a really bad combination.  So, here it goes...

On April 17th I found a mass in my breast.  Not just a little lump...I'm talking a huge mass taking up half of my right breast.  How did I not notice this huge mass in my breast sooner?  I have no idea.  Maybe it popped up quickly because I am pregnant.  Maybe I'm just a typical 32 year old female with no history of breast cancer anywhere in my family who doesn't do the highly recommended monthly self examination.  I'll never know and it really doesn't matter now. 

A week after finding the mass, I had a biopsy.  The results came back the following day...cancer.  I called my parents and my sisters and they suggested that I move my family from Northern California to Southern California (where my parents, three sisters, and one of my brothers live).  So that's exactly what we did.  We really had no choice.  I have three kids and need my family to take care of them while I'm going through months of treatment.

Here it is exactly one week that we've been here.  It feels more like a month.  I am very happy with the choice we made to come down to Ventura.  I am extremely pleased with my team of doctors (thanks to my amazing sister, a nurse, who made sure to find the best doctors around).  I have an oncologist and a surgeon who are going to get me well.  I have no doubt in my mind about it.  I am going to be fine and they are also going to take care of the baby growing in my womb. 

The surgeon called me today to ask if I want to have an expander put in during the mastectomy.  Sounds good to me.  So, I'll kinda have a boob...I think.  I'd google it to see exactly what the expander looks like and does but I've decided that google is my enemy.  I'll more than likely look it up and come across the nightmare story about what went wrong with one person and I'd miss the other stories about the other ten billion that have had it done and everything was fine.  My nerves can't handle any more so I'll stay away from the internet research opportunities. 

So...as of right now the plan is to meet with a plastic surgeon on Monday and then late next week or early the following week I will have the mastectomy.  Three weeks of recovery are required after the mastectomy before I can start chemo.  I will then have chemo for 18 weeks, which will need to be discontinued 4 weeks before I deliver the baby (who is due the first week of November).  If you ask me it's cutting it REALLY close.

I'm not afraid of the mastectomy at all but I am completely terrified of the chemo.  I know what the mastectomy means.  They're going to take my boob and it's going to hurt a lot.  That's just fine...pain doesn't scare me.  Chemo on the other hand...what do you expect with that?  I don't know and not knowing scares me.  Will I be able to be hold my children when they need to be comforted?  Is my compromised immune system going to prevent me from that?  I am going to have chemotherapy while I'm pregnant.  That is just plain old scary. 

Despite all the chaos, we have been so extremely blessed.  Tons of friends helped my husband pack up our entire 3,000 square foot house, have a garage sale, load the truck, clean the house and get it rented out.  All of it completed within three days.  We have also been blessed with our children enrolling in a private school which has been completely paid for by my parent's church.  We are now living with my parents.  We have taken over the upstairs of their house.  It's a huge blessing that my parents have the space for us.  There are so many more blessings to list and so many people who have revealed such genuinely kind hearts.  But for now my brain has done enough work.  I am now ready for bed.