Craziness Ensues

Nothing is ever simple so I'm not sure why I even entertained the idea that was it for my blood clot. On Wednesday I had a follow up appointment with my general physician. She in turn referred me to a vascular surgeon. Thankfully I was able to get an appointment first thing Thursday morning. After reciting once again everything that happened and the time line of past testing & treatments as well as future treatments and surgery (Do you know how tired I am of telling this story??) she determines the best way to proceed is to treat the blood clot aggressively. Unfortunately not as aggressively as she would like due to my port still needing to be accessed. (She also suggested that as soon as my port was no longer needed I should have it removed being it may be the reason for the clot.) The decision was made to perform a deep vein thrombolyis first thing Friday morning followed by an over night in ICU for observation, Lucky me!! The procedure is used to dissolve the clot by inserting a catheter into the vein and clot. Then, clot-dissolving medication is delivered to the clot through the catheter. Sounds like fun...well as much as another hospital stay was not something I wanted to do it was a no brainer, I had to do it. Of course my day could not end there...

After being diagnosed with the blood clot I felt my reconstruction decision was made for me, I am going to get implants after my mastectomy. I feel the DEIP free flap was just to evasive and risky. After a conversation with my breast surgeon she confirmed what I was thinking, my surgery just became complicated. I am high risk for another blood clot as well as a hematoma. During my appointment with the vascular surgeon I needed to be on the blood thinner for 3 months before surgery. Instead of having my  mastectomy in April it is now pushed off to May 3. Ugh another month of waiting! Here's where my day got even more fun! Thursday afternoon I had an appointment with a gynecological oncologist to determine weather I could get my ovaries out in lieu of taking the tamoxifine to stop the estrogen in my body. After a consultation and exam she determined it is my best option and I could have them removed the same day as my breast surgery, Even though this decision was already made in my mind before the appointment it is still overwhelming. On May 3 I will have a mastectomy, tissue expanders put in (the first step to my reconstruction) and my ovaries out. Whew!! That is a lot to take in!

I survived the procedure and the stay in the hospital. The swelling in my arm is mostly gone and fingers crossed the clot was broken up. Today (Monday) I had a follow up with my oncologist. The antibiotic worked and the infection in my nails is gone, although they are still a mess. After lots of back and forth she is allowing me to have my last 2 chemo. In the mean time I need to be diligent on keeping my nails clean to prevent another infection or worse case sepsis. February 28th I will have my last chemo and on March 6th I will have a bone scan to see if the cancer in my hip was stopped. Then I have my follow up appointment for the results on March 10th. In the mean time she is figuring out my treatment plan moving forward, she is concerned with me going 2 full months without anything, (And now so am I!)

The last few weeks have been crazy and lots of decisions have been made. It is all overwhelming and emotionally draining. I'm trying to stay positive and take things one day at a time although it is not always easy, I have said many times over the last few weeks "I just can't do this anymore." I know no matter what I will keep fighting but at times its just a lot to handle. All the texts, messages, cards and of course the never ending encouragement from David, Jack and Ava help me get through those low points. Thank you for the love and support! Keep the prayers coming, they make all the difference!! Xo

What Now??

This past weekend was crazy! Saturday morning I woke up with a pain in my clavicle area all the way down to my port. I blew it off, I thought maybe I slept wrong. I had an early morning because Ava had a feis. After walking from the car to the venue I was also a little bit more out of breath then normal. Thankfully we were home in the early afternoon and I could spend the rest of the day resting. I was very tired which is pretty much the norm now. David and I headed up to bed a little after 11pm. As I was brushing my teeth I noticed my left hand was swelling and moving up my arm. This was not normal!! After getting someone to stay with the kids we headed to the ER. We were there for hours!! I had a CT scan and a chest x-ray. The doctor thought maybe I had a blood clot but didn't seem to confident in his diagnosis. He also wanted to do an ultrasound on my arm but unfortunately there was not a tech available until morning. I was not comfortable receiving any treatment with out knowing for sure what was wrong so we headed home at 4am. Exhausting!!

The next morning I put in a call to the surgeon who put my port in. The on call doctor agreed that I needed an ultrasound. Back to the hospital we went. The ultrasound showed a possible blood clot in my left clavicle area but they wanted to be sure. A radiologist was called in to do a venogram. He believed he saw a clot but wanted to be 100% sure of the diagnosis so he proceeded to do another CT scan. After hours of waiting I was diagnosed with left subclavian vein thrombosis aka a blood clot under my clavicle bone. They administers a shot of Heparin (anticoagulant/blood thinner) and kept over night for observation. The next morning my surgeon came back and flushed my port to make sure there was not a clot in it. I was administered another shot of Heparin and sent home with a prescription for Prodaxa (an oral blood thinner.)

I was exhausted Monday and spent much of the day napping. By Tuesday the swelling went down dramatically and off to chemo I went. In the mean time my nail situation was increasingly getting worse. A few nails are lifting and the thumb on my left had looked green under the nail and was very swollen and becoming painful. I made an appointment with my oncologist for Wednesday for her to take a look. By the time of my appointment the nail was oozing and bleeding. GROSS!! What is happening to my nails is a side effect from the chemo, she put me on an antibiotic and told me to skip chemo next week. I go back for a check up on the 20th to determine weather I will continue with chemo or not. Yesterday may have been my last. Having the blood clot also changed my treatment plan. After chemo is over I was suppose to go on Tamoxifin (estrogen modulator) for 5 years but I am not going to be able to now. I now have to consider having my ovaries removed to put me into menopause to stop producing estrogen, this lowers my risk of the cancer returning. Now that I am on a blood thinner my mastectomy maybe put off for a few weeks, I am waiting to hear back from my surgeon on this. March 6 I will go for a bone scan to check if the cancer was stopped in my hip. I am very hopeful since the tumor in my breast responded so well.

I have lots of decisions to make in the next few weeks. I'm trying to take it one day at a time but all of it is overwhelming. I'm so thankful for my family to keep me grounded. Jack and Ava have been amazing and so supportive. I know it is not easy on them and I am amazed on how strong they are. Keep the prayers coming, Amazing healing is happening! Xo

Decisions, Decisions, Decisions

The day my breast cancer was diagnosed as stage 3 (actually stage 4 because it metastasized) I knew without a doubt a double mastectomy was in my future. I feel confidant with my decision, if I opted for a single I know I would spend the rest of my life worrying that the cancer would return in the other breast. Little did I know that just deciding on the type of reconstruction would be so emotionally draining. It's a lot to wrap my head around and a big decision to be made.

On Monday I had a consultation with the plastic surgeon who will be doing my reconstructive surgery. The reconstruction will take place the same day as the mastectomy. I have two options on the type of reconstruction I can have. The first option is reconstruction with tissue expanders and breast implants. This procedure is a two stage operation, the first stage is the placement of a tissue expander implant during time of the mastectomy. The second stage is the replacement of the expander for a permanent implant several months later after radiation is complete. This option only adds 1- 1 1/2 hours to the 4-5 hour mastectomy surgery. After this procedure I would be in the hospital 2 days and drains in for up to 2 weeks. Choosing the implants would also come with some maintenance, in 10 years I would have to have the implants replaced. My second option is reconstruction with my own body's tissues. The procedure called  DIEP free flap (Deep Inferior Epigastic Perforated flap) would use the tissue from my lower abdomen with careful dissection of the blood vessels through the muscle allowing to preserve the muscle. Essentially I would get the bonus of a "tummy tuck" with my reconstruction. This surgery takes approximately 7 hours making it a total of 12 hour surgery time. I would spend 4 days in the hospital and the drains in up to 2 weeks. No further surgery would be needed but recovery will be a little rougher with healing of the abdominal surgery. I have the choice of having nipple sparing which would allow me to keep my own nipples or I could go with other options for nipples.

I received a lot of information at once. Thankfully my friend Mary was with me because half way through I was a deer in headlights. She was able to ask questions that I could not even form. For the most part I handled the information pretty well. It was all straight forward and each procedure was explained well. It wasn't until seeing before and after pictures of woman that went through these procedures that the tears came. It hit me then and there that this is life changing and I would never be the same again. I cried off and on all afternoon trying to digest it all. In the mean time due to having two c-sections I need to have a scan done on my abdominal area to make sure there is no nerve damage there, if there is the DIEP free flap will not be an option. I think this part of the journey is going to be the hardest for me. The loss of hair, crazy nails and weight gain is all temporary but reconstructive surgery is permanent.

The last couple days it has been hard to keep my emotions in check. I have 4 more chemo treatments to get through. The first week of March I will have a bone scan to see if the cancer in my hip was stopped and hopefully gone. I have the month of March to heal and regain my strength and surgery is going to be scheduled the first week of April. I need to get a radiation oncologist and after surgery and healing my radiation treatments will begin. As far as I have come I still have a long road ahead. Day by day, step by step I know I will get through this. It will be an emotional roller coaster but thankfully I have such amazing support. XO