Tag Archives: skin-sparing mastectomy

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Another Milestone of Thanks on 9/9/9

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“I won’t give up if you don’t give up” – Train from “Calling All Angels”

I want to give a big thank you to all friends, family and business associates who helped my family deal with my wife’s illness this past year.

Today was just another day of running around the house getting the kids out of bed, reminding them to put their clothes away, brush their teeth, comb their hair and rushing them out the door to school.  Hundreds of thousands of families repeated that same ritual this morning without batting an eye. Kids waving at me in my rear view mirror as I drove off to work just put that smile on my face that puts one in a happy place.  These small things we take for granted, but I’ve learned to cherish these moments which are the strong fibers in the fabric of our lives.

Midway through the day I was running through my emails, my Facebook updates, and my Tweets as I ate my lunch and someone wished me a “Happy 9/9/09”.  The date in slightly different formats had two meanings for me.  Exactly 10 years ago my wife went into labor with our first child.  The hospitals were then packed on 9/9/99 with tech geeks in the area wanting to have their babies on that day.  Incidentally my wife didn’t eventually give birth until 9/11 which gave my son an equally auspicious birthday. 

More recently, the date marked exactly a year since I spent one of the longest days in my life at the  hospital as my wife went through a 6 hour surgery to have her cancer removed.  As I responded to a few emails including one from the mother of my son’s classmate (her husband is dying of cancer) I could only think once again of how fortunate we are.  I can only say thank you so many times to the wonderful friends who supported us physically with meals, carpools, rehab walks, babysitting,  and even just a nice cup of coffee as well as emotionally with advice, cards, flowers, and prayers through a very tough time. All of those efforts allowed us to get back to the living our normal every day lives without hardly skipping a beat.  A big thanks also goes out to all our new friends who met as we entered into this new community in our lives who helped us better understand what we would be going through and prepared us for the months of hard work. Even more to those old friends I grew up with who gave their unconditional support even though we hadn’t seen each other in decades and barely knew my wife.

Why the video in this post?  “Calling All Angels” by Train is one of those songs that has been in my iPod for years and was listened to occasionally, but this past year it kept pushing me through some of my long night runs (over 1100 miles since the night of that surgery), inspiring me to keep going until it became a big part of my mantra run.  I felt like I was running the streets of San Francisco calling for angels to help and they did.  Incidentally, Train is coming out with a new album called “Save me San Francisco” (the band was formed here) and their hit song, Hey Soul Sister, is a catchy little tune that I think captures the energy of  the sisterhood of women suffering from breast cancer.  The fight against breast cancer is an intense one wrought with emotion.  The sisterhood is strong.  The women I met as I searched for answers showed me how a strong community atmosphere can be so supportive.  The song also captures for me my love for the woman who has been both my hope and my inspiration over the last year.

Well when I got home tonight all I could do was give my wife a big hug.  The date had hit her in the middle of the day too.  We smiled as our kids wondered why mommy and daddy were so happy that they had to give each other a big embrace in the kitchen.  We just told them we are just very very lucky people.  Only a year gone by and the ability to look back and smile and turn our heads to the future is a good thing.

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Some Mondays Don’t Go as Planned – A Loving Fight

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“It Ain’t Over til It’s Over” – Yogi Berra

Gifts from our UCSF Decision Services group
Gifts from our UCSF Decision Services group

As I start this entry we are waiting for the nurses as my wife waits on what we hope will be her final surgery, almost a year to the date of her original breast cancer surgery.

This summer has been a rough one with my father-in-law in the hospital on the opposite coast for 6 weeks fighting a staph infection that laid him up with severe back pains and a high fever which made him hallucinate.  Trying to entertain kids on their annul summer visit while juggling a couple hours in the hospital each day was not a fun chore for my wife.  On top of that her longtime neighbor and family friend died of lung cancer while we were visiting.  My wife loves going home to visit friends and family, but this time despite the pending birth of our new nephew, I think she was happy to get back home.  She hadn’t even gotten the chance to mention that she was about to undergo her 4th surgery in a year.

Four surgeries in a year is not a badge of honor and at the same time it is not even close to the amount of surgeries many people have gone through with breast cancer, but looking back on it I still wouldn’t wish it on anyone.  A total of 22 hours in surgeries so far and the 4th only expected to be 90 minutes and I can only imagine the toll all the anaesthesia takes on the brain.  Maybe its old age but I can already sense some memory issues with my wife.  She’s been through a lot and I have all the respect for her approach to this last one.

This morning our kids were cranky about having to get up early and were giving my wife a hard time.  It really didn’t make me feel good to have to pull each of them aside and remind them how lucky we are.  For two young kids who have had nothing but cancer and hospital visits all around them for the last two years, they instantly knew this was not the time to be acting up and realized how fortunate to have what they have.

(Move ahead 15 hours)

Well my wife had a bit of a temperature today and they didn’t want to operate on her for fear she might be getting sick and there could be a resulting infection.  They knew my wife and I would be disappointed when they broke the news.  We had waited 4 months for this date, but now have to wait more.  After such a hard morning  getting there it was a bit disheartening.  I could see my wife was bothered.  I was bothered too.  A little for me and a lot for her.  Tonight I just felt I had to apologize as I think she could tell I was not happy with the delay as well.  We just want to get all of this overwith.  One last surgery we hope.  Now the wait again.  A wait for another surgery date.

We can’t be angry though.  My wife and I tried to console each other and subtly reminded each other of how lucky we are to be where we are today.  It hasn’t been easy and this wasn’t going to end easy either.  We’d been patient this far and couldn’t take this personally.  It is so easy to lose your cool when you can taste that chance of moving to the next step.   What’s a few more months…heck we still have to wait a few more years to be considered cancer (and Tamoxifen) free.  The cancer clinic itself has been great.  Just a couple weeks ago during her pre-op appointment they gave her a framed article from the Wall St. Journal that she had helped with (she took photos with the physicians) as well as a huge bouquet of flowers.  They really care for her well-being and would rather err on the side of conservatism.  Getting to know people on a first name basis makes things so much easier on the patient.  I remember seeing them having to look at the charts to remember my wife’s diagnosis and name.  Unfortunately they know it real well now, but that sterile feeling of being “just another breast cancer statistic” is gone.  Being able to ask your sugreon about their kids and how they are liking their new school just helps to ease the tension.

On a side note, our son’s classmate’s father who was given only a few weeks at the beginning of the summer is still holding on.  He is weaker now, but he really wants to see his kids start the school year.  It will help them and I think he will make it to that goal.  It is really sad, but in a small way having their sons back in school with such a supporting community will make the eventual loss not as lonely.  Just last year this happened with another schoolmate when they lost their mother after her six year battle and the school rallied to make meals all year long.  I had a chance to see the father at the pool this summer and he said it had been a long year but it taught him about patience and forgiveness with his two young boys. They had lived with this cancer with their mother for 6 years and he said the highs and lows were rough.  This year was very numbing without her. Knowing that my wife was in a similar situation, he just put his hand on my back and let me know I could talk whenever I needed.

Yep.  Patience.  Practice before and after.  Take one step at a time. There is no rush when it comes to cancer because it is a long road.

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Midlife Re-birth: 8 months post-surgery

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 We don’t understand life any better at forty than at twenty, but we know it and admit it.  – Jules Renard  

This weekend marked 8 months post-surgery for my wife.  She has since had reconstruction, a follow up surgery, 6 months of shots,6 months of a test bisphosphonate, and Tamoxifen.  She has finally started to take another drug to lessen the effects of her side-effects of the drugs.  I really don’t know how she does it.  All these distractions and she continues her duties as class parent, team mom, family glue, top chef, businesswoman, and loving wife.  It’s all become par for the course.  Just yesterday she sent me a text at work to tell me that she had another follow-up procedure scheduled for the end of the summer.  It just seems like such a casual thing now for her to write me and say that she is going to have more surgery, but this is just a stage in our life, not a WAY of life.  We are going to move past this chapter.

In truth as we’ve come to realize her skin-sparing mastectomy is still a relatively new thing in the world of breast cancer surgery.  While it does save your skin and is less traumatic for the survivor than we ever imagined, there is still quite a bit different from the traditional “Hollywood boob job”.  Skin-sparing mastectomy with immediate reconstruction has become popular with patients because, compared with delayed reconstruction, it improves the cosmetic result, reduces cost and anesthetic risk, and in one sitting completes most of the surgical treatment that the patient will ever require for treatment of her breast cancer.   Provided that the breast skin is not involved with or close to the tumor, physicians prefer to perform the mastectomy with optional removal of the nipple-areolar complex (total skin sparing) and the tumor biopsy scar.  The mastectomy is otherwise the same as a standard modified radical mastectomy with removal of all breast tissue and an axillary node dissection.   The part that is difficult for most patients is that so much tissue is removed that the breast becomea basically a large water balloon that holds a big bag of silicone, saline or whatever.  Because the skin is now so much thinner, it is hard to prevent wrinkling and rippling.  With so little tissue left, the breast can look a little misshapen at times.  That said, the results do look pretty good and like life small adjust ments will be needed.  Yes, this is the procedure that you hear for celebrities like Christina Applegate. 

I know many women don’t want to talk about this too publicly.  I mean, how can you complain when you think about the alternatives?  These women are so thankful yet feel so close to what they can see is the final visual end to their suffering.  All of this though is a change.  A change from what past generations had. Not only was life extended but the quality of that life has been improved. 

It is with that frame of mind while sick the past couple of weeks it come to my mind that suddenly we were so accepting of all these new changes in our life.  We’ve reached that mid point in our life.  They talk about midlife and the word crisis is always used to describe it.  I don’t think so.  Sure we’ve come across some bumps in the road.  I told my wife that rather than a mid-life crisis, this is half-time for us.  In the world of sports, this is the time to make adjustments and a time to assess where we are, where we’ve come from and where we want to go. 

Such is mid-life for us I guess.  After taking 10 days off from running because of a nagging cold I found my rested body was now better suited to tackle my nightly runs again.  I told my wife how my body was responding and she reminded me I’m not getting any younger although I may feel young.  Either way, the rest gave me renewed energy and a new energy and perspective that allowed me to set new personal bests three days in a row.  The 10 days of mental relief reminded me of how lucky we are and how blessed our life is.  It isn’t about fate or faith, but about the sense of being.

We took our time to plan that second half, revise our targets and think about how we want to live our life.  It is not about settling.  It is about making choices and pursuing what we believe to be important to both of us.  The one thing we agreed upon is that this is a shared goal and we wouldn’t have it any other way.

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Back in a Familiar Place

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If you raise your children to feel that they can accomplish any goal or task they decide upon, you will have succeeded as a parent and you will have given your children the greatest of all blessings.”

-Brian Tracy

So here I am again waiting in the 3rd floor waiting room of the UCSF Mt. Zion cancer clinic as my wife goes into surgery for the third time in 6 months. It is a very familiar place although it has memories that I’d rather forget. Yes it is a bit easier and the procedure (that is what we call it for children so as not to alarm them) is less serious than the first two.  When my wife was first diagnosed with cancer almost 8 months ago I never imagined the path we’d take and where we are today while better than possibly imagined is not one of the many scenarios that ever ran through my head.  We’ve learned to appreciate what life has given us and to that we can’t control everything.

The venue and many of the faces are still the same here at the hospital although some things have changed or at least the first two times I was too distracted to worry about.  Over in one corner of the waiting room is a wife (I think) who is trying to hold back her tears.  She looks as if she is in her 70s or so and is elegantly dressed with a hat ( this should be definitely designated as a chapeau).  She has a lot of makeup on and you can tell she was raised in an era and with parents who told her that if she were to go out, she always needed to dress to impress.  Everyone else is sitting in here talking on cell phones and updating their loved ones, reading outdated magazines or sleeping upright waiting for their name to be called.   Of note is that Lance Armstrong and His Ride for Hope took a serious spill today as he broke his collar bone in a fall.  Also, the television overhead in the waiting room is showing photos of Liam Neeson and his two teenage sons  at the funeral of their wife and mother, actress Natasha Richardson.  The grief and sorrow are the images I had imagined for myself 6 months ago.  As I said, you just don’t know what direction life is going to point you.  You just have to take it as it comes sometimes.

As we walked into the hospital a couple hours ago I noticed we both had a bit of a smile on our faces.  We even joked a little with the admissions staff.  But what made it even more noticeable was that we ran into one of the other mom’s from our kid’s school who was just coming down from her pre-op appointment before her breast cancer surgery tomorrow.  The two mom’s hugged and I shook the husband’s hand.  Very quiet and private people (he’s a physician himself) we could see their worry and concern on their faces. We kept the conversation brief and wished each other luck as we needed to stay on time.  My wife even had a moment to discuss a play date for our two sons in the next week while she rested.  How odd is that? My wife and I got up to the room and talked about the chance meeting.  “That was us 6 months ago”.   The other couple noted that this was our third time through and mentioned how they hope this would be their only surgery.  We only hope that we showed a positive attitude and a good outlook in the face of surgery.   

That is what it is about, isn’t it?  A positive outlook?  Last night my wife even asked for a hall pass to get out and have a drink and chat with a girlfriend.  I said of course.  I mean how many other women go out and do that the night before their surgery.  The first two times my wife needed Ativan to calm her nerves and get to sleep.  This time she was ready and not worried.  I almost forgot she was having surgery when I woke up this morning.

Speaking of positive outlooks we were talking about the short term memory of our own son.  He had a bad offensive game the day before with the “hat trick” (three strikeouts) in his first little league game this season.  Although just 9 he is playing with 11 year olds twice his size and at least held his own defensively.  Other kids out there were crying when they missed a ball and we were worried that our own son was going to be deflated.  After the game I asked how he felt. “Hungry”, was his response.  And after another pause he smiled, “Don’t worry dad, I’m not going to strike out everytime.”  I laughed and he smiled back.  Here I was worried about him and he was telling me not to worry. I can’t wait til he’s 30 and able to take care of me and tell me not to worry.

Has it been 6 months?  Yep.  The timeline:

Breast Cancer Diagnosis: 7/27/08

Bilateral Skin Sparing Mastectomy: 9/9/08

Beginning of clinical Trial: 12/1/08

Exchange Surgery: 12/12/08

Revision Surgery: 3/23/09

It seems like it has been a long time but 6 months really have just vanished from our lives.  At the same time our love has grown enormously and so has the maturity of our children.  Even moreso as a couple, our respect for life and the people we meet in life’s journey has grown.  We can only hope to enrich our lives by challenging it, embracing it and finding joy whenever it is presented to us.

Thanks to modern medicine we’ll be able to continue this journey in a couple days.  I think it is amazing that within 24 hours after I get my wife home, she should be back to normal.  She’ll be stiff with limited mobility, but most importantly she’ll be here for our children, for me and for her friends.

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Listening to win – A Loving Fight

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“The ear of the leader must ring with the voices of the people.” — Woodrow Wilson

I was recently asked if some of my earlier posts could be used on the site www.Fightpink.org.  Quite frankly I was surprised as I never intended for these postings to be used elsewhere.  The intent of this blog becomes clearer every day as it is more for me than anyone else.  My memory isn’t what it used to be, but more importantly I’ve always documented my thoughts and someday I’d like my children to know why I did what I did or know what I thought about particular incidents in our lives.

Reading those old posts was haunting.  I guess I’d forgotten already how I was feeling at that time.  That is pretty funny given that many say I have a photographic memory.  I laugh at that as I pretty much find myself to be so scattered in life that I just document my life meticulously so I won’t forget.  I listen and listen hard.  I listen to learn and listen  to comfort others.  I sometimes am asked why I don’t speak up on some conversations.  I guess that I’ve always believed that sometimes silence is golden.  And sometimes silence, pictures and images speak a thousand words.

Right now it’s all about listening to my wife’s questions.  I can see and hear her concerns about her surgical scars.  She doesn’t complain but tells me about the research and conversations she is having.  The skin-sparing matectomy has several kinds of scars, but the ones my wife had (over 18 only please) can be depicted through the attached photo links:

Areolar: http://www.justbreastimplants.com/gallery/incision_areola.htm

Crease: http://www.justbreastimplants.com/gallery/incision_crease.htm

The areolar was used for the original expander, but the crease was used to help reconfigure my wife so as to allow my wife to have a bit of a reduction.  Right now the ster-strips still cover the scars.  The black and blue are gone and now the healing once again becomes both physical and emotional.  While many would think this sounds more physical, I’m listening to my wife and her voice.  She wants to look normal.  Normal for me and for her.Pictures speak a thousand words for her.  Seeing things look almost normal will have an emotional healing that things are still the same for her.  Hearing her husband honestly telling her that he thinks she looks great is one thing, but she is going to have to believe it herself.  Any married couple knows that.

Tomorrow I think I’ll talk more about my own expectations and observations for 2009.

Breast Cancer - A Loving Fight

Finding our Heart – Fighting for Life

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If you lost love, do you know where to find it? – One Republic

My wife has reached what I think is her second wind in this battle.  She has resumed her gym membership, gotten off all of her pain killers, started wearing bras again, watching old episodes of Sex and the City (the ones where Kim Cattrall has cancer and laughs about hot flashes), and strted her 3 years of hormonal therapy (Tamoxifen).  She gets her first OS shot in two days.

What else?  She has completed her shopping list for the holidays and is getting ready to send out the holiday cards.  She has an energy and zest for life I haven’t seen in a while.  She cracked me up tonight when she mentioned that when her 75 year old mother comes to visit for the holidays that she is going to drag her to the clinic to get tested for the BRACA gene.  All of this energy is so beautiful in my eyes.  I am thinking of the days when my wife wanted to just curl up and cry.  This was all a little over 3 months ago.

Now we laugh at Kim Cattrall in a bad bra and wig giving a cancer speech while suffering through hot flashes.  Obviously not funny to all but we are having to laugh at it knowing that we are just around the corner from all of that.  Somehow just commiserating has helped her find her heart.  Our heart.  We’ve lost it the past few months as we wrapped it in armor and tried to protect ourselves from the pain.  The armor seems to have been shed and we are coming out again just in time for the holidays.

I can’t take credit though for her recovery.  Its is all her.  Her fight, her energy, her love, her heart.  I’m so glad she has returned to me and our kids.  He’s been there the whole time physically, but her true being is starting to come back and the smiles in our house are returning.

Breast Cancer - A Loving Fight, Route 53 - Life is A Highway

Scarred & Healing – A Loving Fight

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Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.
 
— Oliver Sacks
Neurologist and author of The Man Who Mistook His Wife for a Hat and Musicophilia: Tales of Music and the Brain

The above quote was on my Starbucks cup of coffee this afternoon.  It seems appropriate given the feeling my wife had after the Madonna concert this past weekend.  The music inspired her to take action. 

She is getting impatient though.  Her exchange surgery has been delayed and she doesn’t seem to be getting a response.    I know she wants to get the expanders removed ASAP.  She has seen that her initial scars from the surgery have already healed. She is already started to lessen her medication and is now ready for the final removal if we can get a date for the final exchange.  Once again the waiting game is affecting us.

Her strength those is inspiring me.  I am so impressed by her ability to move forward.  Her ability to manage the kids, her job, the house, our crazy family schedule and her own illness is something I am unable to feel or understand.  All I can do is give her my undying support and make her feel loved and appreciated.  It is all I’ve got.  I wish I could do more.  Right now though I know she also wants and needs her parents and i need them to understand that they can’t wait for her to ask for them but rather for them to show their unrequested support.  It will only help in her healing process.  The scars are there, but the pain and feeling of hope will make her feel better

Breast Cancer - A Loving Fight

Back to our regularly scheduled programming? Well almost.

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“You’re not quite ready to be a full time soccer mom.”

Weekend number 3 after surgery and we started to try to get back to something normal.  Soccer season with two games across at the same time required logistical gymnastics.  Another mom drove her and our daughter to the game.  She never watches but I made her promise me that she’d stay in the car and watch the game or at least watch the whole game and not take her eye off the ball if she stood on the sideline.  I reminded her that a kid or ball running into her would not be good and that she wasn’t quite ready to be a full time soccer mom.  Of course she didn’t listen, stood on the sideline, and according to our daughter, took a ball in the hip.  Yikes!

The next day was a cousin’s wedding reception.  We have lots of older sick relatives so we hadn’t told them anything.  It was a crowded restaurant with very little wiggle room so my son and I played like offensive linemen protecting her from any blind-sided impact or overzealous hugging relatives.  Somehow we made it through the 3-hour ordeal with her being totally exhausted but happy to get out of the house.  She also had the chance to talk to a cousin and a couple of aunts who had had breast cancer.  They consoled her and reassured her that all would be well.  Their stories were all different.  My cousin had the same surgery my wife did.  One aunt had a lumpectomy and had to go back for a bilateral mastectomy.  Another had a mastectomy and reconstruction on one side.  At one point the 3 of them and my mother all took a photo together with the bride.  I alone shed a tear thinking how these 4 women all indirectly related by marriage were impacted by cancer and were sisters in a community of women who have been through a lot.  There were no shared genes.  All connected by marriage and a similar disease and very bright smiles.  I don’t think they even realized the circumstances of who was in that photo.

My wife did say that the pain was lesser and that she only seemed to be pained later in the afternoon.  She really looks great and I know part of it is her always positive style which I told her she needed to put away sometimes.  While it is good to look great so everyone can feel good for her, there might still be some tough times ahead and she might have to let everyone understand that.  We still won’t know her possible chemo plan for another week.

The week is starting off okay.  I’m still taking the kids to school and she is now picking the kids up.  I think the kids really feel better knowing mom is okay enough to pick them up and play chauffeur again.  I have to remind them to take it easy on her though.  Her mobility is good and we don’t have any visits to the PS this week so it is just a good week to get things done.  The hard part for me is to get back to work and keep my concentration.  I do worry and call just to make sure she is okay.  Letting go is going to be a hard one for me as I will not feel comfortable until she has fully regained her strength and we feel like we can truly begin the healing process.

It is hard to believe it has only been two months since her diagnosis.  It seems like forever.  And we still have a litle longer to go.

Breast Cancer - A Loving Fight

Keeping the Routine (The weekend before breast cancer surgery)

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“Keep your game face on” – today’s note to my wife

The weekend before the suregery (3 days and 2 days) before the surgery and we are trying to keep things normal. We lost our main distraction when my wife finished her massive project.  It was such a blessing to have that project to keep us focused and distracted on a big task at hand.  But now it is gone and we have only a couple of days to churn through.  A whole weekend.  So what do you do?

Day 1 of the weekend was the beginning of soccer season.  Although the kids know mommy is going to have surgery for cancer we are not telling them the exact day so that they don’t get too worried.  That said, they just know things. They can seen the tension and the irregularities in our life.  Our son played a nice game of soccer and for once his mother wasn’t chatting and saw him score.  A nice goal in which he kicked in a rebound reflection off his own shot.  He was so proud of himself and when we congratulated him later, he said, “That was a goal for you.  A goal of determination”.  Darn kids, they sure can make you cry.

As I said, the goal was to stay the course for our kids so we had a couple of boys over to help celebrate our son’s birthday and make him feel like all is okay.  They giggled their way to sleep.

Sunday was more prep and cleaning day.  The things that I don’t do most of the time and won’t have time doing: 1) Laundry, 2)Watering the garden, 3) Answering all of her well wishes emails.  I took our son to the football home opener.  The 49ers slogan today was “Get your Game Face on”.  Well we adopted it in our household.  It is how we tackled the day getting everything done.  Our family was a model of efficiency.  We planned also to have a nice birthday dinner for our son and his uncle with the immediate family.  The dinner was for them but also for my wife to get her mind off things.  A quiet dinner at home was not what we needed.  It was also a time to mentally walk through the logistics of the next two days – Who is picking up the kds?  Who is going to be there during and after the surgery?  Who is going to be with the kids when I’m at the hospital?

We’re about as prepared as we could be at this point.  99.5% prepared!  Of course my wife is pounding out emails and running around making the kid’s lunches for tomorrow as I type this out.  I think she is starting to drive me crazy with the last minute reminders.    I just looked over at her and smiled.  She got the point…Game Face…yes, put it on and keep it on.

We’ve started a nightly ritual of checking in with each other to see if we are both okay.  Still anxious?  Check.  Had a good laugh today? Check.  Had a good cry today?  Check.  Learn something new today? Check.  What a day and weekend this was.

Tomorrow- Preparation day including Pre-op Lab work, Nuclear prep, pre-op with the RN