Why August?

I made a list of reasons for and and against having the surgery in August, rather than November. Here are my pros and cons.

 Pros
1. Dan won't need to take off as much time as we'll both be on summer break and what he does take off will be teacher workdays. Not having to do sub plans make it much easier for him to take days off.
2. We won't need to worry about transitioning Carter/Sean back to daycare and then taking them out for a month or so and then re-transitioning them. They will just not go back to daycare after summer break until I go back to work post surgery. My family will be taking turns staying with us and so they'll handle the kids while I am recovering.
3. Dan coaches in the winter/spring seasons and when I go back to work after surgery I think it is wise to have him around from 4pm vs. 6pm, as I'll be exhausted from working all day. I've heard it is MONTHS and months before you feel back to your normal self. It has something to do with your muscles re-generating and the overall healing process.
4. It puts me out of work for only a few actually weeks of school and surprisingly it isn't a horrible time for me to miss as my counseling stuff like lessons and group/individual sessions don't really begin until October. A sub can easily fill in for me given what my focus is in September.
5. I'll just be returning from the beach and I can have one last boob-cation. ha ha JK on the last one

Con's
1. My mom most likely won't be able to come visit me after surgery :o( She'll be doing radiation at that time.
2. I won't be able to "hide" in winter clothes, big sweaters, etc.
3. I'll be laid up after surgery for my baby girl's first Bday :o( :o(

There isn't a magic answer or a "perfect" time to do this.  I just think my pros list for August is much bigger! Since I am months away, I hope that this will be do-able with the surgeon's schedule. First, I have to choose one!

I'll come home from our third summer vacation (with my hopefully by then rocking post birthing two children bod) and get a boob upgrade. Fabulous...right?

If only it were that simple.

My groove.

So as my best friend from college pointed out in one of her comments (Thanks Col) it appears "Stella got her groove back". I had a great run today with my favorite running buddy. It was the usual 3 mile route that we've done for years together after school. Until now, I hadn't made it the whole way without stopping (cramp, knee pain, etc.) Today, I did it! It was hot, like 85-weird I know,  and I got a cramp. I ran through it. I finished. I was proud. I was happy that I didn't stop. I think physically I am the strongest I've been in years. My weight lifting routine is great. I am moving up on the weights and I can see changes in my body. The running was my weak point and now I know that I am on the right track. I know that before my surgery that I will be at the peak of my physical condition. I will be strong, I will be a great runner again, and I will be ready.

In general this week has been much better as far as the emotions go. So yes, it seems that I got my groove back. Finally.

I stole the pic from another blogger friend.

Breast Surgeon #2

I had another good appointment with another great Dr. I liked him, but I wasn't blown away enough with him to make me choose him, necessarily. He works through VCU (GO RAMS!!) and the medical school at the hospital downtown. It is not my first choice to be a a teaching hospital nor is it my first choice to be downtown at the public hospital. It is difficult to get to, far from my house, and so I am not really going to pursue that route further. I also didn't like the "hospital" feel of the satellite office. Though it was close to my house and the nurse was super sweet it just felt weird to me, compared to the other two offices. He has several plastic surgeons he works with but since choosing him is not likely I am not going to go through another round of appointments.

The one good thing that came of it was that he said because of my previous breast reduction that (TMI ALERT) nipple sparing surgery (saving the nipple and removing all of other breast tissue) was not really a good idea because there is already a risk of the tissue dying and needing to be removed but with my history I am at increased risk.

Now, I just had another appointment on Monday and that Dr. knew about my reduction and said nipple sparing was the way to go. Hmmm....so now different Dr.'s are telling me different things. I guess that is no surprise there.

On Monday, I am on the to final Dr. which is located in the office that I'm already a patient in, due to breast feeding infections, and also the office that completed my genetic testing. The nurse practitioner
there has been super helpful to me all along this process, is very involved in the breast cancer community, and even helped me set up some of my other consults with different surgeons. I've also met with the corresponding plastic surgeon already and really had a great experience (see previous post). I called to make an appointment with the plastic surgeon that goes with surgeon #1 and it seemed she is pretty popular so I am not sure how that affects this process and my ability to get an appointment soon and have the surgery in August. We'll see. Lots to think about! I am choosing between the female Dr. located far away with the super busy plastic surgeon or the male dr. very close to my house with the plastic surgeon whom I had a good appointment with. Sounds like I am on the right track!

Breast Surgeon #1

I feel like I need a personal secretary to keep up with my scheduled appointments! At this point, I have chosen to consult with 3 of the top breast surgeon's in Richmond for my mastectomy. I also have to meet with their corresponding plastic surgeons as each one prefers to work with a different plastic surgeon. So, you can imagine how busy I am with Dr.'s appointments right now! Unfortunately, some are during the day, so yet again, I am taking more leave without pay at work. I do think finding the best surgeons for me is important so I'll put the other stuff aside and forge on. All three of the Dr.'s I've chosen to meet with were either recommended to me from friends or the genetic counselor.

The first surgeon I met with is a breast surgeon who works mostly with breast cancer patients. Her office specializes in breast issues so she obviously has a lot of experience. She seemed really nice and took a lot of time to work with me and answer my questions (I had a list of about 20!). I got a good feel about her and the office was super nice and brand new (not that I am using that as a factor). The location is not ideal as it is about 25 minutes from my house. Also the hospital she operates at is 30 minutes away, though a super nice hospital. She gave me a great plastic surgeon she works well with and so I need to now get an appointment with her. Apparently she is a busy plastic surgeon, which seems like a good thing, so I hope I can get an appointment soon. I am still months and months away from actually having the surgery so I feel I have some time to "shop around". She claimed that my comfort level with the plastic surgeon was most important as they are responsible for the cosmetics of how I will look for the rest of my life. The breast surgeon does have an important role though, they need to get as much breast tissue out as possible so I want someone with experience in that area.

Today I am off to a Dr. who works at the VCU Massey Cancer Center and I am sure he'll have a plastic surgeon that he works with. I've already met with one plastic surgeon so we mark that one off the list. I think the reason I feel so overwhelmed is because I am in the really scary part of the process....the decision making process. I am making life altering decisions. 1. to have the surgery at all 2. What doctor to use and 3. When to have the surgery. I have to say that #2 and #3 are stressful. There is never really a great time to rip apart your body and have someone piece you back together so we are just choosing the best time for our family, work, etc.

As of now, we (Dan and I) think that Mid-August after returning from our third beach trip (we are beach people!) but before Dan goes back to work would be best. Since it is so far out it seems most Dr.'s schedules are flexible and so that shouldn't be a problem. More to come after my appointment Surgeon #2.

Emotional.

I find myself being super emotional right now. Things that normally would not bother me are pushing me over the edge. I feel like on most days I could cry at any minute. I do not like this feeling but I understand why I am feeling this way. I am not worried, but more overwhelmed. I think that I need to take my own advice that I tell my students, and that the only thing that makes things easier is time. I just found out about my BRCA fate not even two months ago. I am not sure why I am expecting myself not to let it bother me. Of course it is going to bother me, it is life altering news. Like I said before, my entire life is forever changed from this day forward. I don't mean that in a bad way, but either way I am heading down a different path than I originally thought I was. I need to take a step back and stop being so hard on myself. Crying is ok and I need to stop feeling bad for letting myself get emotional (though it has shown up in some inopportune times). I just need some more time, and then it'll be easier, right?

One breath at a time. . .

If I am being honest (sorry Mom  I know it is hard for you to read) I hit rock bottom recently. I am not sure what happened but it all hit me. You could probably tell from my previous post that things were starting to take their toll on me and my ability to control my own emotions. I am not going to lie, I am frustrated. I am frustrated about a lot of things. One, I have recently gone back to work and I'd rather be at home with my two cuties, work is very stressful right now and because I leave on time everyday, I never. can. catch. up. Also, my running is almost *embarrassing*. Two years ago, I ran a 10K at an 8:55 pace. It was the peak of my running, I was on a high and I was so proud to achieve that pace as a self proclaimed "slow" runner. A year ago, I was training for a 15K when I found out I was pregnant. One 8 mile run followed by a few cramps put a stop to that and it was all downhill from there. Sure, I have a load of excuses as to why my running isn't where it should be but nonetheless it is frustrating. I am frustrated that I am missing work often to go to Dr.'s appointments because that makes it even harder to catch up, not to mention time away from work=leave with no pay. I am frustrated because my mom is going through chemo and I cannot be there to help and support her. I am frustrated because I am so distracted at work that it is affecting me and my ability to juggle my responsibilities.  I am frustrated because I know now information that drastically will change how I will my life, forever. It will never go away. I can't take it back and live in denial. Now that I know, I am charged with the commitment of doing something about it. I am frustrated mostly because I let myself get hysterical and I am not sure why.

So...I knew what I needed to do. Thanks to a friend from high school pointing it out on her blog (breathofsunshine.wordpress.com), I needed to run until I felt better and I did. I put on my running shoes, cranked up my ipod, walked to the track and in my mind I said I will run 3 miles. 2 miles has been my hurdle due to some IT band pain but I knew it was mostly mental. I needed to get past that mental barrier stopping me from improving and regaining my runners strength. I left my garmin at home and just ran. I didn't worry about pace or time or anything. I set a goal for myself (12 laps) and that is what I did. Each breath I was taking in and out was a release of some of the frustrations. I needed that me time and I know it helped. As a counselor, I obviously know the value of talking about my feelings but I also know the value of running and its affect my overall mental health. As I was running I could feel my determination to finish 3 miles growing. I felt strong, my legs felt great but I got a horrible cramp around mile 1.5. I didn't stop, I ran through the pain. A great coach once told me that I needed to learn to be comfortable with being uncomfortable. Today was my first attempt. I was uncomfortable, but I was ok. It was a great run and now I feel like I can breath again.

Whew, I a lot to take in.

I had my first ever official Dr.'s visit with a plastic surgeon. It was good and bad. The good was, that I really liked the Dr. He was very nice and took almost an hour to explain everything to me. Surprisingly, I felt super comfortable with him even during my exam. I've done enough research so that I understood what my options were before coming in to the consultation but I still appreciated the full explanation of the process.

From my understanding here is the time line I am looking at:

Surgery 1:
Complete mastectomy (removing all breast tissue but not muscle) by a breast surgeon
immediate reconstruction by the plastic surgeon using temporary expander implants

Out patient procedures: The expanders will need to be filled once a month to "expand" the skin so that there is room for the actual implants. This will take place once a month for 1-2 months.

Surgery 2: 1-2 months after my final expander fill, real implants will be put in. This is an outpatient procedure but time off of work is needed to recover. (time from original surgery 4 months)

Surgery 3: 8 weeks after (or longer if I choose) the plastic surgeon will go back and do nipple reconstruction. Again time off of work is needed. (6 months from my original surgery)

So, adding it up all was a bit overwhelming to me. I am looking at from start to finish at least 7 months of back and forth Dr.'s appointments, outpatient procedures, pain (though minimal at times) and a constant healing process for my body. It is definitely more than I realized when I initially made my decision. I know that it is the best choice for me, but that time is line is if nothing goes wrong. If I have a bump along the road, who knows how long it will be before I can look at myslef in the mirror and be "happy" about what I see.

I still believe that what I've listed is my best option for a healthy lifestyle. I'll be one of the few women in this world who don't worry every year at their mammogram that they will have breast cancer. After a surgeon performs a mastectomy, my chances of getting breast cancer (duh!) are almost zero. Those are stats that I can get behind.

I am not going to lie, I'll put it out there, I am nervous about how I'll be able to handle all of these surgeries, procedures, appointments, pain, etc. AND work a full time job AND raise two children. So many questions are coming up in my mind. For instance, though I may only need 4 weeks off of work for my major surgery how will I take the kids to their daycares if I cannot lift them out of their car seats? (I've heard 6 weeks before full functions come back, lifting, etc.). How do I pick them up and put them in the car each morning? How will I handle working a stressful, demanding job, and then coming home to take care of my two cuties? Will I be able to handle that? Will I be doing a lot a but not doing anything well? Am I expecting too much out of my body? Will I push myself too hard and cause unforseen complications? I dont' know. A lot is going through my mind right now. I am not doubting my decision to do the surgery, but I do have a lot of unknowns about how things will pan out for my family and my ability to give it my all at work and at home. I am sure this isn't the last you all will hear of these concerns. The good part is that I feel very comfortable with this Dr. and though a second opinion is probably a good idea, I am happy that I've at least started the process.