SURGERY AND MORE

We are currently headed up to San Francisco for my CT/PET scan that is taking place this afternoon. I’m looking forward to the scan being behind me and putting food in my belly. 

Surgery will take place next Tuesday at 11am at Good Samaritan Hospital in San Jose. I will arrive at the medical offices at 7am to meet with my reconstructive plastic surgeon and see the breast surgeon to have the radioactive solution injected around the tumor for sentinel node tracing during surgery. I will then head into the hospital. As mentioned, for now I am going with a single mastectomy on the right side. Once we have final pathology and a better picture, I can determine if a prophylactic mastectomy on the left is warranted during my next surgery.

I will stay overnight at the hospital and should be discharged fairly early on Wednesday. Still working through all the pre-op procedures. I will be getting a COVID test Monday, and I need to speak with the anesthesiologist and general hospital staff. Things feel like they are moving quite quickly now. All the prayers and well wishes are deeply appreciated. 

Suddenly in Overdrive

For the past few weeks trying to take some time to do our due diligence and make sure we were making the right decisions both on the procedures and doctors has been painful. It has created an immense amount of stress and coordination between four teams at three different institutions including 12 doctors with countless nurses, coordinators, schedulers, and navigators. Finally, as mentioned in my previous post, we have decided on a surgical team. Leaving the appointment at 6pm last night I knew I would not have a potential surgery time until today. I have heard from plenty of nurses and schedulers today. I scheduled a few appointments, but it felt like it was taking forever to get a response regarding the surgery date. Finally, at 4:30pm, the call came. Surgery is being scheduled. It will either be next Tuesday (yikes) or Friday. They are hoping for Friday just due to logistics and appointments that need to be taken care of prior to surgery. But if Friday can’t happen, we will proceed with Tuesday.

Before those calls, I had already scheduled a final pre-surgery consultation with the reconstructive plastic surgeon at 10am on Thursday, and thank goodness I got permission for Jeremy to attend! This alone feels like a big win for me. I am also now scheduled for a CT/PET scan up at UCSF in the city on Friday late afternoon. I am slightly concerned that appointment might have to move due to the necessary appointments needed to move forward with surgery. Like everything else, I will cross that bridge when I get there (tomorrow).

I know I mentioned it yesterday, but now I have heard back from all (but one) of the doctors and advocates in my circle helping me navigate this process and everyone believes that moving forward with a single mastectomy is the best, most conservative step. I already know I will need a minimum of three surgical procedures. I have plenty of time to decide if a prophylactic mastectomy on the left is the right choice for me. For now, let’s focus on getting the cancer out, letting my body quickly recover and moving on to the necessary therapies needed to ensure my longevity. Also, being conservative (with my body not the cancer) now will allow me more options in the future when I am better equipped to make those decisions.

Opinions matter

First, the good news - I got my genetic results back today and I am BRCA negative! That is great news for me and my sweet girls. It complicates my decisions in a good way and gives me some piece of mind that I am not passing this onto my three girls. 

Getting as many opinions as I have in a short period of time is not for the faint of heart. It is mentally and emotionally taxing, and both leaves me feeling more empowered and knowledgeable, but at times more confused and overwhelmed with details, research and statistics. And every conversation ends the same. I have to do what I believe is best for me, my body, my mental well-being and my family. Trying to weigh out and predict how I will feel in the future given the choices I make in this moment is hard. Maybe not for everyone but it is for me.

Every surgeon and a few of the oncologists and plastic surgeons have offered their personal opinion on a single versus bilateral mastectomy. No one has taken the time or had the perspective of the new surgeon I met from Stanford this evening. She is also the first doctor I met armed with my BRCA negative results. I truly loved her. She is my doctor. That is definitely a huge plus. I know my surgical team. Now, I just have to decide if a prophylactic mastectomy on the left side is the best option given everything we know about my body and cancer. For the first time, I am strongly considering just a mastectomy on the right.

I left the appointment and immediately reached out to my network to try to seek some opinions from those who have been guiding me through this process. I was interrupted by the surgeon who is supposed to operate on me this Friday calling me directly. It was almost like I was speaking to a different person. She was rude and inconsiderate. She partially tried to console me and tell me I should have the time and space to make my own decisions, but basically told me she should not be my surgeon. She even said anyone could do this and I should just use the last person I saw. The timing of her call, as I drove home from seeking another surgical opinion, as well as the lack of bedside manner and care felt like a strong sign that moving forward with the Stanford doctors is the right decision. Maybe the man upstairs knows I am in need of help and guidance, and getting that call as I merged onto a major highway is enough of a sign for me. You are not on my side. 

Upon arriving home I quickly made a few calls, texts and emails to try to touch base with those I trust and then got to sit down to a lasagne dinner that has ruined me forever. I have mentioned my local network a few times in these posts, but our small neighborhood private cabana club (swimming pool) is a huge part of our ties to this neighborhood and community. They are my home and we love the pool dearly. So many from that area of my life have stepped up in big ways to help out - taking over my volunteer responsibilities, bringing food, providing laughs and generally being supportive. The heart of that community can apparently make an incredible lasagne that I will have to now have to beg, borrow and steal for from here on out. 

So now I try to relax, wait to hear back from a few people and “sleep on it”. We will see if sleep happens, but either way I hope I can find clarity quickly.

I keep losing my sweater

I keep losing my sweater, and finding Lane either wearing it or in her room. It is oversized, sherpa-like and cozy. I don’t know if she is taking it just because it is so soft and cozy or because it is mine? She misses me and she is worried. She has such a sweet and sensitive heart. I know I expressed this in a previous post but trying to navigate the needs of three very different personalities (one being very young) has been a challenge. I am doing the best I can. I am hopeful that once we have a FINAL surgery date, even though it will no longer be “ski week”, I can carve out time with all the girls and each of them independently to have some fun, quality time together.

Now, time to tackle another day - ensure my pathology slides are en route to Stanford, my surgery is being scheduled, follow-up with genetic results I was promised “mid-week”, follow-up with first team regarding potential surgery date of 2.26 and how to navigate the conflict, clean the house, play with the kids, and hopefully start knocking a few things off my growing “to do” list of things I want adjusted and fixed around the house prior to surgery. Carpe Diem! (Yes Trey and Dad, I am talking to you.)

Falling apart and falling together

As expressed in my last few posts this has been a roller coaster. I know overall the care my body needs will be marathon, not a sprint. It will take time and there will be rough times and great times. These past 3.5 weeks have felt like a flat out sprint that I began without proper training. I believe in my soul that even though just two days ago I felt like I was watching things fall apart in mere moments, I can already see them falling back together. I trust the doctors and personal friends who have been advocating for my care. They have worked hard and gone out of their way to ensure I am afforded the correct surgical team.

Yesterday, I spent another five hours at Stanford gaining more education and with my new reconstructive plastic surgeon coming up with a plan for reconstruction that is both conservative, allowing my body to focus on getting rid of the cancer and the various therapies that will very likely be needed, while working to minimize complications and infections. The technology and innovation in both breast cancer treatment and reconstruction over the last few decades is truly amazing!

There is no reason to kid myself. I am starting a lifelong journey of ensuring the health and safety of my body from cancer and my breasts post-reconstruction. I do believe and hope that taking this approach now could possibly allow for future more innovative techniques to be utilized or even give me the opportunity to reconsider flap reconstruction if I am a better candidate in the future.

Today, I will work with the plastic surgeon’s scheduler and the breast surgeon’s (who I have yet to meet) scheduler and try to set a new tentative surgery date. On Monday afternoon, I will meet with who I hope and believe will be my 4th and final breast surgeon and finalize my plan. 

As mentioned, we have more time to plan than to execute. Please pray or send positive thoughts and vibes  that I feel confident, and trust the technique and plan this surgeon lays out on Monday. She is already intimately involved in my case. I truly believe we will have a solid plan in place once we get to meet.

The bumpy road to recovery

I did want to share the incredible experience I had yesterday at UCSF with the oncologist. The fact that I was able to obtain that appointment still feels like a miracle. I know it is because, yet again, I have someone advocating and fighting hard for me. The female oncologist I met with is brilliant. She is kind, beautiful, empathetic, extremely intelligent and thoughtful. She broke things down from an oncology perspective in a way that far trumped the prior three oncologists I have had the pleasure to meet. End of the day, she agrees surgery is first and until all of that pathology, potential lymph node involvement, and potential oncotype dx results are in, we do not have enough information to create the right plan for me. She was also frank about the number of years I might need hormone suppression. No one tries to tell me the road ahead will be easy. It will be a bumpy ride no matter the final plan. So the question becomes can I deal with the literal long and bumpy drive down 101 freeway to Mission Bay for the foreseeable future in order to obtain her care?

Opinions and the price you pay for them

And for now I’m not talking about financially. I’m talking about physically, emotionally and mentally. I’ve had so many opinions it is getting difficult to navigate the murky water. The swiftness with which my position and plan can change is astounding both me and Jeremy. I left an oncology appointment today at UCSF wanting to pump my fist in the air. Feeling like I had it figured out and I knew what to do. I sent a text of thanks to one of my healthcare advocates. Minutes later the phone rang and there I was… I was swirling again. My plan doesn’t work; the team is not correct for me. It immediately feels like a step backwards, like we are losing footing, losing time. But I know that is not the truth as my dear friend reminded me tonight - you have more time to plan than to execute. I only have one chance to get this right and choosing the correct team (surgeon and reconstructive plastic surgeon) is essential for my success. So now tomorrow I will wake up and once again start working hard advocating for myself, leaning on those I trust, trying to get more appointments with the right people. One thing has definitely become clear, I am having a bilateral mastectomy, non-nipple sparing with reconstruction that starts with expanders.

For those that are keeping track on my surgery date, it will likely change. As mentioned, I have a few more appointments that still need to be scheduled and I would not be surprised if the date of 2.26 moves back by 10-14 days. 

Yesterday had already been a long day... like a really long day. I already talked about that in my last post and was so happy to see that today was the last long day planned this week. That might not still be the case as the week progresses, and that has to be okay. I don’t think I knew what they meant when they talked about fighting cancer. You fight from day one. You fight for your doctors, you fight to keep your family safe and protected, you fight for your own well-being. And then once you have a few things figured out, I guess you start to fight the cancer.

I finally started a spreadsheet to track all the appointments I have had. There is no way to track all the calls and emails with doctors, nurses, nurse navigators, nurse coordinators, counselors and more. I think that number would spike my anxiety to new levels. What I can tell you is that in the last three weeks, I have had 21 doctors appointments or procedures. That is a lot. For some reason they have seemed to come in clusters. Maybe this is the way to prepare me for the roller coaster that will likely be chemo. Really hard days and really good days.

I am really worn out. I’m trying to stay positive and not get overwhelmed with the information and decisions but it is hard. There are so many moments I feel strong, but definitely more moments than I would like that I feel very weak and helpless. So like I said before, one foot in front of the other as I fight to make the best decisions possible.

It’s Not Always Sunny in California

I feel like I have been living in doctors’ appointments since the moment I received my diagnosis. I have always understood it is important to get more than one opinion. I understand that now more than ever. The bad news is everyone has a different opinion - some slight and some drastically different. As I mentioned in a previous post, we are still in the hunting and gathering phase to help ensure we believe we have enough information to make the best decision possible. All that being said, this process is exhausting mentally, emotionally, and physically. I literally wanted to collapse when I got home last night after being gone for 8 hours with appointments at Stanford. I was excited to finally meet a team within the Stanford Health Care organization and get what felt like a “real” second opinion. It definitely felt different. While I have loved many of the doctors I have met at PAMF, the level of care, information, research shared and discussed, and general detail about my type of cancer and particular case was amazing. I definitely left Stanford feeling very grateful for my dear friend and his connections that allowed these appointments to be expedited and take place.

There is always sunshine. I got to spend the day with one of those closest to me and one of the only friends I get to see on a regular basis. Aida and I had a delicious outdoor lunch, which is a huge treat since I can still count on one hand the number of times I have eaten out since last March. She is really good at turning lemons into lemonade, no matter the situation at hand. She had insisted on taking me up there and waiting around for me ALL DAY. I tried to make her go home a few times once I realized how late my last appointment was going to run. Naturally, she made me feel like I was doing her a favor.

I believe I mentioned this in a previous post but California has remained very much “sheltered in place” since last March. I know the situation is not the same for many friends and family in other parts of the country and world. Our family ultimately decided a small bubble was best for the social and emotional well-being of our children and selves. Are there times I have felt guilt for this decision? Sure. Are there days I am beyond grateful? Sure. Is it hard sharing this with many of my closest friends that are still listening to every local guideline? Of course. But in the end, I do not know how we would be functioning right now if this was not the path and decision we had made. Don’t get me wrong, my local friends that I am not seeing “in person” are still doing amazing, earth-moving things to help make my life work; this blog happen; personal items I know I will need in recovery are secured; the list is exhaustive. I have never felt more loved in my entire life. I know I sound like a broken record, but I am so overwhelmed and will forever be grateful. I cannot wait to figure out the ways I will “pay it forward” once I have time and strength on my side.

Another thing I want to note is my husband. Jeremy is allowed to attend very few of my appointments, the demands at his job are great right now, and he is trying to have things in place to take time off during my recovery, so please do not think - why wasn’t he with you? With him unable to attend in person, it is more effective to have him sitting comfortably at his desk attending appointments virtually where he can take notes and listen carefully than in the car waiting on me. 

Old habits die hard

So many of my friends have moved to products that are clean. That being said, old habits die hard. I still use skin and beauty products that I have used for a large portion of my lifetime.

I am currently spinning. Are the products I am using in my daily life the reason for this cancer growing in my body? I don’t know. I have had multiple doctors try to reassure me this isn’t my fault. It is still hard to think my actions might be to blame.

Sleep is obviously of the utmost importance. Unfortunately, night time is not my strong suit right now. Some nights I can’t sleep because I’m worried and scared about this process. How will it affect my family? Will I be okay? What is the answer if I’m not going to make it? I’m a positive person as I’ve said before, but night can be hard and all these thoughts creep in.

I am writing this post at 2 AM because apparently sleep is not an option tonight even with the help of medication prescribed by my doctor. And that’s okay. I never thought a blog would be important to me, but this feels therapeutic. It allows me to express and share with those that are part of my circle how I feel and what I am experiencing.

I am still struggling with deciding how I can let people help. So many have reached out to me and even more people reached out to some of my closest friends and family members asking what we want and need to make the days ahead easier. I feel like I’ve actually cried more about understanding the overwhelming amount of support coming in from people from every aspect and crevice of my life than I have about my actual diagnosis. The diagnosis and the movement forward all still feels like science. I’m collecting evidence, I have a hypothesis, and now I am just trying to reach an actionable plan that can be put in play very quickly to start the process of healing and ensuring my longevity.

We live a beautiful life in a neighborhood that we love and feel truly supported by the people around us. The outpouring of love from our local community has been overwhelming. That being said, I know there are people that are part of our life and history that want to help and keep reaching out asking what we need and what they can do. We keep saying nothing except love us, send us positive vibes, pray for us. Do whatever feels good to you to help ensure a positive outcome for both me and my family. 

We don’t live in an actual “tiny house”, but as a family of five in 1400 ft.² with everyone working from home, it does kind of feel that way at the moment. I do not have private space in my house. Once I make the bed in the morning, I leave my bedroom and that becomes my husband‘s office for the remainder of the day. My two daughters thankfully have bedrooms where they can conduct their virtual school days, and Halle and I spend our time in our living room and kitchen/ dining area that also houses my office. We are doing our best. Is this ideal? Of course not. Do I wish we had more space? Sure, naturally. Do I have any desire to move or leave my community that we have created and has allowed my family to thrive in the Bay Area? Absolutely not! So we make the best of what we’ve got. Using the word “blessed” is not something that is part of my everyday vernacular. While I am spiritual and miss the relationship I had with our church in Texas, we have not found that same home in California. Some days that is hard for me. I miss it deeply. I want it back. I wish I had the same thing here. I have tried a lot to find it locally but been unsuccessful. I also feel like right now I’m at a crossroads. I’m trying to come to terms with how I feel spiritually and how I need to foster that to give me more comfort moving forward. I believe, as always, it will all work out. Clarity will come, and what I need and what works for my family will present itself when the time is right.

The reason you always hear people say things like “fuck cancer” is becasue it comes with a lot of baggage. What did I do to deserve this tumor and diagnosis? It’s hard. There are so many unanswered questions. There are so many decisions being placed upon myself (and Jeremy). 

I truly believe we are in the hardest days. As I have said before, I am positive and deeply believe things will be okay but the road ahead will not be easy. One of the oncologists I’ve met with so far told me in no uncertain terms chemo and radiation are in my future. Had I hoped for less invasive procedures? Of course. But do I want to be conservative and allow potential for new cancers to grow in my body? Absolutely not. Aggressive and progressive treatment is my only option. It is the way I am wired. And how I will tackle this diagnosis and the cancer currently growing in my body.

People keep asking me what stage of cancer do you have? Apparently that answer is yet to be determined. When surgery is performed my lymph nodes will also be tested and we have more information about potential spread. These items will be more clear and those answers can be provided. To me, the stage doesn’t matter right now. What matters is moving forward and doing everything in my power to ensure I am afforded the long life I have planned. I love my job, I love my family, I love my friends, some of which are my family now. I love traveling and my journey is not over. So today and tomorrow and sadly for probably more days that I would like to admit - I fight for answers and I fight to ensure I am going to receive the best care.  I will make hard decisions that will ensure I create a team of doctors that I believe will do everything it takes to make sure I am a success story.

There obviously a lot of emotions wrapped into this entire process. For me, I had not actually gotten mad until yesterday. Somehow, with all the information that has been provided to me by doctor after doctor and nurses and nurse navigators, no one had mentioned the physical pathology slides are owned by a separate entity and that anyone willing to take on my case must have the option to review for themselves before proceeding. I received a phone call at 4 PM telling me I needed to decide immediately if Stanford or PAMF was going to receive my slides. I haven’t even met with the doctor at Stanford. At PAMF, I have put together a team that so far I truly love and believe in. I even have a tentative surgery date 2.26 and that is great. As I’ve said in previous posts, the one item that remains constant in every doctor that has reviewed my chart is this must come out fast. I don’t even know if 2.26 is quick enough. I am so excited and eager to meet with the team from Stanford this coming Tuesday, but I am worried if they can even move fast enough to make my surgery happen in a timely fashion. That is yet to be determined. Will I hear something new? Will I be given information that makes this decision process difficult? I don’t know. What I need to do now is create a framework so that I can quickly make that decision once these appointments have taken place. It is scary and I worry about how I will keep the emotional aspect out as I try to make what feels like the biggest decision of my life this coming week. There’s some answers that might make this easy and some that might make it hard. I’m trying to be prepared for both.

We never feel like we have enough time as we grow older. Everything moves too fast. Our children grow up too fast. Our parents get old too fast. Life flies by. This is nothing different. Everything feels like it is moving exponentially fast. Some days feel like a week. The idea that my diagnosis came less than two weeks ago is mind blowing. 

It’s kind of hysterical, it seems impossible, but yet it is the truth. It is my truth and so for now one foot in front of another. We move forward; we make decisions; we decide the next step. So for now I will attempt to sleep. Sadly that means taking another Xanax and hoping for the best.

How To Help: Meal Train

One of Jeremy’s dearest and oldest friend’s set up a Meal Train for us practically the moment we got the news. We do feel strongly that we do not want anyone to feel like they need to do anything, but people keep telling me my friends and family want to help so we are trying to come to grips with that and figure out what makes the most sense. 

I also must say, all the emails and texts, prayers, positive thoughts, gifts, food and suggestions are deeply appreciated. It is overwhelming to say the least. Also, quick note - if I do not respond to a text or email PLEASE do not take it personal. I have never felt so popular in my life. Likely, a doctor/nurse called or I got distracted by the kids, forgot what I was reading and just forgot to respond. If you do not hear back just send me another message! I have always been kind of bad about that and do not see it getting better in the immediate future. That being said, my outlook on life and those I care about has already changed and I do intent to do a better job at keeping in touch and making sure those around me feel the love I feel now.

Let’s Get Personal

If you are interested in knowing more about my “feelings”, this might be the post for you. If details and information that help create the best path forward, you might skip this one and no offense. Hey, no one will ever know you didn’t read it - haha!

I had been laying in bed for hours unable to sleep thinking about a million of my fears and the list of things that needed to get done, but just seems to keep growing. I kept writing this more personal post in my head, afraid I will forget this detail or that. Finally, at 5:30 I decided maybe a quiet house was exactly what I needed, and I should just listen to my body and get out of bed. So coffee is brewing and the house is silent.

In general I am a positive person; I truly believe the correct outlook matters. While I do not create vision boards, I store one in my mind. I know what I want for myself and my family and am always working to make those things happen. I believe in the power of prayer, positive thinking, good vibes and overall happiness. I am even fond of my new crystals from a very dear friend. We all get one shot at this. We might as well enjoy the ride. I guess I am also a fighter. I am not afraid of hard work and operate well and can stay clear headed under pressure. All of these things are helping pave the path I am about to follow.

Now for some of the harder realities as of late. Some days have been hard. A few of them are really hard. The girls have seen me and held me while I cry more than I could have ever wished. For the most part though, I spend my day being positive and advocating for myself. I just told Jeremy last night during our 10 minutes alone before bed that the last few weeks have just been so rough and exhausting. He kind of chuckled and sweetly reminded me it has been EIGHT days, not the weeks or months I am feeling. I kind of took a deep breath but more of a deep sigh and Jeremy asked, “why the sigh?” I said I was just trying to take a deep breath and re-center. He made me realize I have been sighing, kind of a feeling of negativity vs. a true deep breath that feels cleansing and centering. (I can thank my dad for those “deep sighs”. He is a professional. Maybe I will give him some breathing tips next time I see him. Not that he really needs it.) For the most part, I am strong and pretty happy during the day. I still laugh with friends and always appreciate quick wit and a good joke. I have not gotten much work done but am trying to attend meetings to see my colleagues faces. I do not {usually} feel overwhelmed by the insane amount of information coming at me constantly from doctors and nurses regarding my body, my options, and my decisions. Nights are the hardest part for me, and I think like many out there that is when all the worries in your world like to creep in and disrupt our much needed sleep. Well, that has gotten exponentially more difficult. I have tried a few sleeping aids and need to circle back with my doctor, but part of me also feels like my body and mind do need to be allowed the time and space to experience those feelings, and honestly I just don’t allow it during daylight hours for the most part.

I know it is probably a silly analogy, but I remember after having my first child I told so many of my friends, “Man, there is so much that no one tells you about the actual labor and delivery process.” I am feeling similarly with cancer. Man, there is so much no one tells you about what to expect. I told Jeremy I want us to look back but I bet I have logged more minutes on my phone in the last 8 days than last year total. It can be exhausting, but every call is important. Whether it is with part of my established care team, one of the teams I am fighting to take my case, or a dear family member or friend.  I try to call my mom whenever I get a chance, she needs it, and I do my best to support that.

First off, in all my naiveté I didn’t realize I was just going to receive a phone call with the news - “Hey, you have cancer. A doctor will contact you in the next 30 minutes.” I think I believed maybe I would either get negative biopsy results or something along the lines of “ma’am, we need to investigate further”. Maybe that is from the years working with my dad. I cannot tell you how many initial reports we have written that start out “further investigation is required”. Sometimes I guess cancer doesn’t work that way. We spent like 2.5 hours on the phone with “nurse navigators” that first day. They were already explaining radiation, chemo, hormone inhibitors, surgical options. My head was swimming. It did not feel real. I think waking up that next morning might have been one of the hardest moments for Jeremy and myself. You open your eyes and then it hits you. Shit. This is not a dream. I have cancer and A LOT of work to do.

My mother had texted me late the night of my diagnosis that our dear family friend, Phil had already contacted doctors and surgeons all over the country. I honestly didn’t know if I even believed her. It seems so surreal and I hadn’t even had a diagnosis for 12 hours. The next morning I called Phil and it was all true. He had spent the evening reaching out to some of the best places for treatment in the country and simply asked me what I wanted to do. He gave me an amazing pep talk about staying clear heading, listening to myself and my body and that these were all going to be my decisions. He said he knew being “selfish” wasn’t my strong suit but that needed to change immediately. I had to come first. Period. I didn’t even know I needed that talk, but he is amazing and helped the spinning stop and straightened the path before me. 

People have already been doing some of the most kind and heartfelt things for us. It is overwhelming. I prefer to be on the other end helping and loving those around me. The list is already so long. I am swimming, not knowing how to even show proper gratitude and worried about how I will ever have enough time to “repay” all the generosity, love and support we are receiving.

The kids are all handling it differently. My oldest Emma, 11 (but she will definitely remind you 12 in March), has been so strong and positive. I am definitely a little fearful she is just pushing the fear and questions aside but we continue to talk to her about everything. She is channeling her mind elsewhere. She decided she wants to open an online store and spent hours planning an elaborate virtual birthday party. Lane at 9 is wise beyond her years and has asked some truly deep and thoughtful questions. She is having a much harder time. She needs Jeremy and myself and our time now more than ever. She isn’t getting enough of it, but I also don’t know there is such a thing at the moment. She hugs me and cries often and has already taken one “mental health day”. But let's be honest, I think she can swing that in 4th grade. Halle, at only 4, is the wildcard. We knew when we told the kids they would all react differently. To be honest, Emma and Lane have handled this pretty closely to what I expected. Jeremy warned me that Halle would likely say some weird stuff when we told them both due to her age and understanding and because she is sort of a nutjob in all the best ways. Her first words after the girls started to react were “It is going to be really sad when Mommy dies.” Well, I can assure you we all kinda laughed but my stomach also dropped. We tried to explain things better and she settled on it being sad they had to cut off Mommy’s boobies, but did tell me she would still love me even if it looked weird. She also does not understand all the appointments. Yesterday we left the house at 6:45am and except to stop in for a bathroom break, I was not home until after lunch. Then it was straight back to emails with doctors, nurses, advocates and phone calls with the same. Finally around 2pm she told me I had been working too hard and that I needed to just do all that work later. I got the picture and she needed a nap anyhow, so I sat with her so she could fall asleep.

I mentioned in my last post that I am hopeful I will see a team of doctors at Stanford next Tuesday, and while I am awaiting the confirmation from the surgeon who has come highly recommended, I have had all my contacts assure me he plans to see me. So that is great news. Who doesn’t love a day in Palo Alto? Maybe I will get lucky and have a long enough break for an outdoor lunch in Palo Alto!

My contact at UCSF both emailed and texted with me last night, and he also said he is advocating for me and going to do his best to help secure the appointments I need.

I have so many healthcare provider apps on my phone now it is silly.

And while it has not been confirmed, I do believe I have found the right team at PAMF based on the recommendations mentioned in the last post. I also indicated in the post yesterday that the two oncologists had vastly different opinions. The first one I spoke to was via FaceTime because she is away at a medical conference and the second was in person. The first was the one that was a strong proponent for chemo first. The second said based on all the evidence and how responsive my type of cancer/tumor is to chemo, she definitely felt like surgery first (her preference within 10 days) was best. To be honest, yesterday was one of the hardest days. Having two extremely intelligent (one Harvard/Stanford, other Yale/Stanford) oncologists tell me completely opposite things was more than unsettling. Everyone tells you that they will lay out the options but YOU have to make the decision. I felt lost. How am I supposed to make this decision when these extremely capable professionals do not agree? Up until that point, everyone had said surgery first, but that oncologist came to me highly recommended and I just didn’t know how to dismiss her professional opinion. Finally, last night I received a message from the first oncologist who had spoken with the surgeon and came back and said they were in complete agreement for my case and all consider surgery first is the final answer. I literally wanted to celebrate. The weight that was removed was amazing. In that email, she told me that Dr. Runi has blocked the schedule for surgery on February 26th. All that being said, this does mean I need to make final decisions regarding my team fast.

The last appointment I had yesterday was for the pelvic ultrasound. They did find a small fibroid and cyst. The first recommendation was follow up in a few months. She said this is very normal and would explain the issues I have been having. Everything else looked great but given that the best treatment is birth control (more hormones) which is NOT AN OPTION and my current situation, we are going to do a biopsy out of an abundance of caution just to ensure there are no abnormal cells. Awaiting getting that scheduled, lucky me.

Today is a new day. I have now had a cup of coffee and it is time to figure out what I can accomplish. Currently, no doctor appointments today. Very much appreciated after the 3 appointments and 3 “procedures” yesterday. I know that could change and if it does, that is also okay! As I stated yesterday, we left the house at 6:45am for the first appointment, I was home for a bit in the afternoon but the last appointment didn’t end until close to 6pm. I have some actual work to get done, still need to talk to HR and figure out my leave, finish Halle’s preschool registration and I have a swim team meeting tonight. My friends have been great at helping me dole out some of my volunteer responsibilities, but for all of you that do a lot of volunteer work know there are many jobs and projects you cannot just walk away from. Much like we are transferring projects and knowledge at Stanford, I need to do the same with the volunteer positions. And will continue some of my real and volunteer work throughout.

Getting Started

One of Jeremy’s cousins, who has lived various places internationally due to her husband's job for the better part of the last decade, had a blog for many years. I never really yearned to have my own platform to share my story, but I can tell you one thing, I always thought if I ever did I hoped it would be as eloquent and beautiful as hers.

Starting this was hard for me. This isn’t my strong suit. I have even taken a bunch of silly photos at various appointments in case I wanted to include them in “my story”. Even though this isn’t my natural platform, so many of our loved ones are not near, and with the pandemic even many that are near are not active parts in our daily life so I decided this was a good idea. A dear friend set up a caring bridge site/blog for me quickly after my diagnosis. A perfect platform to get on and share with friends and family.

I just couldn’t do it. It felt sad. I deeply hated the ads and requests for donations all over the place, and as a graphic designer it just did not feel like me AT ALL.

I have never been very good at accepting major help - sure the carpool request or borrowing an onion is fine, but that’s about it. Well everyone has been telling me I need to get used to the help for a bit. So when one of my dear friends asked what she could do it all clicked. She is an amazingly talented designer and website wiz. We could just use my personal site that normally holds my portfolio work and make it my blog. This is all work I could do myself, however my biggest obstacle is time. We are not done fine-tuning the header and will likely make some additional tweaks, but my heartfelt thanks to her for making it happen - fast.

Doctors, doctors, and more doctors

Let me start by saying this was not intended to be my first post on this site. I kept thinking I would find the time and space to write a few chronological posts about what has happened and how I have felt since I found the tumor and received my diagnosis. Maybe I will still find time to go back, but for now I need to go forward. Fast.

To anyone reading this, writing is not my specialty. Please forgive all my grammatical errors and tense changes in advance. 

So far, I have only met with doctors at PAMF, a local branch of Sutter. To be honest, I have loved all the doctors I have met. I am feeling guilty even trying to pick the right team. I have now met with two surgeons, two oncologists, and one plastic surgeon. I am also trying hard to get appointments at both Stanford and UCSF. Unfortunately, time is not on my side. Everyone I have spoken to has given me different opinions on all but one item: I need to be in surgery or chemo in the next two weeks.

Last week, I met with a surgeon and plastic surgeon who were very compassionate and kind. After more information and conversations, I do not believe I will be using either of them. I have a very dear family friend who has been my lifeline to help make sure I am in the best hands possible. He has contacted doctors and surgeons across the country on my behalf to make sure I am given the best options. My heartfelt gratitude towards him and his family are without measure. I might share later who has helped me on my journey but I also want to respect everyone’s privacy.

He connected me with doctors at Stanford and UCSF that are advocating and referring my case out and trying to help me build teams at both locations. I have a dilemma. Everyone agrees quick aggressive treatment is needed, and I am not sure the wheels can turn fast enough for either of those locations to be a viable option. I am not giving up hope! Fingers crossed I might have appointments with a team at Stanford next Tuesday, February 16th. Hopefully, I will hear back soon regarding this possibility. I am also emailing and texting with the doctor at UCSF that is trying to get me on the books with doctors with full calendars. Appointments there are yet to be determined.

The doctor at Stanford that my friend connected me with has been amazing. He and his wife are doctors at Stanford and are not only trying their best to get their favorite surgeon (who happens to be on sabbatical) to see me next week but have also looked into every doctor at PAMF I have met with and found teams at PAMF that they know and trust.

Today started early. I met with a PAMF surgeon, Dr. Runi, at 7:30am who added me into her full schedule this week based on the referral from the Stanford doctor. Both Jeremy and I liked her very much. She specializes in breast cancer and is kind and exceedingly bright. The method and recovery she discussed was also much more comforting than what the first surgeon had outlined. Her opinion was based on my type of cancer and all other criteria points that doing a mastectomy first was the best course of action. She did indicate she wanted it scheduled very quickly as well. I will meet with a reconstructive plastic surgeon from her team next Wednesday. I am hopeful that even though I am not completely certain that she will be my surgeon or that surgery is the first step, we can get it on the calendar.

I then met with two PAMF oncologists. They were both great but had vastly different opinions. The first one is on the same team as Dr. Runi, but she was a strong proponent for chemo first. She did say my case needed to be reviewed by the “tumor board” before any final decisions were made. The second oncologist in Mountain View (my “home” location) had an opinion more in line with Dr. Runi -  mastectomy first, chemo (and radiation) after. Jeremy is more decisive than I am and he preferred the second oncologist. This relationship is long term and important, and I still feel like I am weighing the odds. I feel they have each advocated for me already in ways I appreciate.

While I was there I had a chest x-ray and EKG. This evening I go back for a pelvic ultrasound due to some significant changes in my menstrual cycle.

It is crazy how quickly things are happening. Just since I started to write this I received a call from Stanford. Fingers crossed I should see Dr. Dirbas (surgeon), an oncologist, and plastic surgeon next Tuesday.