BRCA1 and BRCA2

Earlier I mentioned my cancer is genetic. I'm positive for BRCA1 and BRCA2 was shown to have "Uncertain Significance". As a result of my cancer being genetic, my sister was given the opportunity to be tested for BRCA1. She had the test and is also positive for the gene. Since LaDonna tested positive for the gene, she was able to do prophylactic bilateral mastectomies and reconstruction minus the chemotherapy.

In a way, cancer has been a blessing. Calling cancer a blessing is an odd way of putting it, but it was a blessing. Breast cancer has affected many lives in my family and later in my blog I'll share my family history. But back to cancer being a blessing. When you have a family history of breast cancer, there is a high probability that it may be genetic, however this is not true in all cases. When a family that is high risk, generally the one diagnosed with cancer is tested for the BRCA1 and BRCA2 gene. There are some instances when the test is given if there is no living family member that was diagnosed with breast cancer. In my instance, I was diagnosed at a fairly early stage, Stage 2A, and because I had tested positive for the gene, my sister was able to be tested and given the opportunity to be proactive in her own life.

Although my sister was never at any of my procedures, I felt that I should support her. I did not tell her that I was going to be at the hospital while she had her mastectomies, because I didn't want to make a big deal of it. On July 5, 2007 my sister was scheduled to be at Desert Samaritan Hospital at 9:00 am and the surgery was at 11:00 am. I arrived a little after 9:00 am and my sister wasn't there. For a minute I thought maybe, I was late, had the wrong date or wrong time. But I sat there waiting patiently. About 10 minutes later, LaDonna and her husband, Keith, walk in. My sister begins to cry when she sees me, and we embrace. I know this is a hard time for her and that was the reason I came. We visited for a while until the nurse came to get her. The nurse invited me to go back into Pre-Op, but I said, "They need to be alone, I'll stay here". I waited for Keith to come out so I could keep him company while my sister had her surgery.

About 45 minutes later, Keith comes out of the Pre-Op room and says to me, "LaDonna doesn't want you here!" I was dumbfounded. It was basically a slap in the face and undeserved. I said to him, "I'm staying until I know she's okay and out of surgery, then I'll leave". "I won't see her while she's in the hospital." So, I stayed until the surgery was over. When the doctor came out and reported that my sister was doing good, that's when I left. This kind of behavior proved to me that, "No good deed goes unpunished!"

I came to support LaDonna and Keith. Now keep in mind, my husband needed someone with him when I had my procedures. Robin, Sabrina, or Mary would sit with Doug while I was in the operating room, to help him, because it is scary waiting. LaDonna didn't think Doug needed anyone to be with him. As a matter of fact, we had a conversation regarding Doug needing someone with him. She made snide remarks and made belittling innuendos about him. I can still hear the tone of her voice. It was very hurtful and it confirmed to me that she really doesn't like or care for Doug. To LaDonna it's a sign of weakness or being less of a man to need someone. During our conversation she said, "Keith doesn't need anyone to be with him". This meant that Keith was more of a man because if his wife ever needed surgery, he didn't need anyone to be with him.

I believe that no one can tell someone else how to react, especially when they have a loved one that is going through a life threatening illness. It's insensitive to force your beliefs or feelings on someone else. Not everyone reacts the same. Some need the comfort of family and friends, while others chose to be alone. Both are right, no one is wrong!

Breast Reconstruction Begins

April 3, 2007 at 9:30 am I had my appointment with Dr Rhee Plastic Surgeon to begin the reconstruction process. Today he took measurements to determine what size implants that would look best on my frame. We discussed it and it was determined that I would have a C cup or about 700 cc's. At this appointment it was determined that my incision from my mastectomies were not up to my Dr Rhee's specifications. So, on April18, 2007, I had scar revision surgery at Banner Baywood. It would be several weeks before I had anymore reconstructive surgery, as my Plastic Surgeon wanted these incisions to heal completely before moving forward.

May 30, 2007, I checked into Banner Baywood Hospital at 9:00 am to have the expanders implanted. The surgery was uneventful and I have very little discomfort. I was expecting a lot of pain, but to my surprise I didn't. I had the expanders in for quite some time before the inflating process began.

June 19, 2007, Dr Rhee began the expanding process. This was my first inflation. Each breast received 200 cc's.

June 26, 2007, the second inflation. Each breast received 150 cc's.

July 3, 2007, the third inflation. Each breast received 200 cc's. After this inflation I could feel the tightness in my chest. My inflated breasts were getting harder. I never realized how hard they get. They are like those hard balls that are in the kids bouncy houses. You know what I'm talking about! Your natural breast has some "give" to it, but not these babies! Getting comfortable in bed was another issue. Again, they don't move.

July 17, 2007, my fourth inflation. The left breast received 150 cc's and the right breast received 175 cc's. Immediately after this inflation, Doug and I left for our summer vacation to Utah. I was so glad to get out of town and away from the doctors and I knew my chest needed time to adjust to this last inflation.

August 7, 2007, my last inflation. The left breast received 100 cc's and the right breast 150 cc's The final inflation. My left breast: 800 cc's My right breast: 875 cc's

Bilateral Mastectomies

March 1, 2007, 9:15 am appointment with Dr Bachrach. He's pleased that the treatment has been favorable. At this time I need blood work every three months to check my CA125, which has to do with ovarian cancer. You probably are asking yourself, "Why does she need that test when she has no ovaries?" And you know what, that's a good question, because I didn't know the reason either.

Dr Bachrach asked me, "Do you know Glida Radner?" "Yes", I said, "She died of ovarian cancer". "No, she didn't", was his reply. I was stumped as that is what the media announced when she died. Dr Bachrach proceeded to tell me that she died of paratneium (not sure if I spelled it correctly) cancer. This tissue is in the abdomen and is attached to many organs, one of which is the ovaries. So, sometimes when people are diagnosed with ovarian cancer it's actually paratneium cancer instead. The CA125 is the cancer marker for both ovarian and parathneium cancer, thus the reason I have this test every three months.

March 7,2007, today is the day I will have my bilateral mastectomies. I'm at peace with the decision. I have no worries, no concerns. I know it is the right decision and Dr Johnson has always taken the best care of me. I arrive at the hospital at 7:30 am. I check in and wait for the volunteer to call my name to take me to Pre-Op. I believe we only waited about 10 minutes when my name was called along with 2 other patients. I was weighted. They took my temperature and checked my blood sugars. The nurse had a hard time getting my IV, she tried 4 times, then another nurse tried a few more times. After that many tries I was beginning to feel funny and I told them that I was starting to feel light headed. BOOM! Down went the bed. It was that fast, I was flat. Evidently, that was a sign that I was beginning to pass out. After all those sticks trying to get the IV started they finally called another nurse to bring an ultra sound machine to find a vein. This was something totally new to me. One nurse had to locate a vein, then hold the ultra sound device on my arm while another nurse took the needle while watching the monitor to get the IV needle in. The needle was put in the oddest spot, on the backside of my forearm. But it worked! After all that drama with the IV, I decided we needed some laughter, so I asked the nurse to mark my breasts with a Smiley Face for the doctor, gotta have a sense of humor!

The surgery went well, both Doug and, my dearest friend, Robin were there with me. No other family was there to support me, kind of disappointing that I didn't even have my sister there with me. I think people do better when they have their loved ones around them, but I guess she thought differently. She even told me that she didn't understand why Doug needed someone with him while I was in surgery. She even made snide remarks, why I don't know. Maybe she just dislikes Doug so much that she cannot have any compassion for him at all. She gives me the impression that it's a sign of weakness to need support when a loved one in surgery. Where she gets that from, I have no idea.

I remember being in my room, Doug and Robin were watching a video. It was comforting to have them with me. As the evening began to set in, I felt good and decided I wanted to go home. I called the nurse and asked her to contact the doctor to make arrangements for me to go home. I surprised myself, I didn't have to stay in the hospital over night after all.

I came home with two lovely hand grenades, drains to those of you that don't know what I'm talking about, hanging from under where my breasts used to be. These appendages had to be drained and fluid measured several times throughout the day. They were kind of annoying, yet I knew they had a purpose.

I thought the hardest part would be seeing myself in the mirror for the first time with no breasts and totally flat chested. I was actually surprised at how I felt. Of course, I did look physically different, but I was at peace. I was at peace with the decision because I knew it was the right thing to do. The hardest part was that I could not take a shower while I had these drains. For 1 week I had to take bird bathes, sponge bathes to most of you. You know, you do what you have to do. That's all I could do. It was part of the process.

March 14, 2007, Time to take the drains out. Let me tell you, I was a nervous wreck when he was getting ready to remove the drains and I'll tell you why. In 1993, I had gall bladder surgery and I had a drain then too. Well, when the surgeon came in to remove the drain I started to ask him, "Please let me know when you're going to remove...", before I could finish my sentence he pulled the drain from my body. I felt like I had been punched and the wind knocked out of me. All I wanted to ask him was, "Please let me know when you're going to remove the drain, so I can take a deep breath and relax while you do it." He didn't give me the courtesy to finish speaking with him before he so rudely yanked the drain out. So, I took this moment with Dr Johnson and I explained my concerns to him. He was so understanding and removed the drains with care. What a relief to get rid of those things! The following week, March 21,2007 I saw Dr Johnson again. I had some fluid in my chest cavity that needed to be drained. He used a needle to aspirate the fluid from my chest. I was very nervous, to say the least. I don't particularly like needles and to have one going into the chest to remove fluid wasn't my idea of fun. To my amazement it didn't hurt. I had some numbness caused by the incision, which is normal, so the procedure was virtually pain free. I had two more visits to aspirate fluid and April 16, 2007 was my last visit with Dr Johnson.

A New Year ~ 2007

The past 6 months have been a roller coaster ride. Now what can I expect this year? I know there will be more surgeries and, thank heaven no more chemotherapy.

January 4, 2007, 9:30 am appointment with Dr Richmond. Due to me being positive for BRCA1 Dr Bachrach and I agree that I must have bilateral mastectomies. Doug knows it is the right decision and has come to terms with it. The doctor told me since I'm having both breasts removed that I do not need radiation therapy, however, he wants to take my case before a medical board for consensus.

January 16, 2007 I met with Dr Colleen the Gynecological Doctor. After examining me, Dr Colleen referred me to his partner Dr Rowland. Part of my treatment is to remove my ovaries. I had one salpingo oopherectomy in 1993, on the right side. This procedure is for the left. Because I'm genetically positive for BRCA1 and at high risk for Ovarian Cancer, I must have this procedure to reduce the risk. My appointment was to schedule the surgery and Dr Rowland will preforming the procedure. Later in the afternoon, I met with my Dr Rhee my Plastic Surgeon regarding breast re-construction surgery. Now that I do not have to do radiation therapy, I am a prime candidate to go through the expander process. This appointment was to discuss the process and how it works. I'll explain the process later.

January 24, 2007, I had a diagnostic mammogram in preparation for my mastectomies. This is to see that I'm clear of any abnormalities before the procedure. All is good!

February 5, 2007, I had a 9:30 am appointment with Dr Johnson to discuss my bilateral mastectomies. He explained that he would be doing a procedure that was skin sparing, so there would be enough skin tissue for the expansion process. He told me my procedure would be out-patient. "Out patient?", I said, "You have got to be kidding me?". I think he was a little surprised at my reaction, but come on you are taking off my chest and I'm going home right after the surgery. No Way! My face said it all. He could tell by my reaction that I was very uncomfortable with going home, so he told me, "We'll schedule you for a 23 hour stay." Thank heavens, what a relief that was. He said to me, "It is an emotional time isn't it?" All I could do was shake my head. He was totally understanding and knew that this moment was a lot to process.

February 15, 2007, I had outpatient surgery at Banner Baywood Medical Center. The procedure was the salpingo oopherectomy of the right side. Everything went well and no abnormalities.

February 21, 2007, I had a check x-ray needed for my upcoming surgery.

February 23, 2007, Blood draw for surgery.

February 26, 2007 I called my Dr Richmond,the Radiation Oncologist for the results of the medical board regarding me having radiation therapy. It was unanimous that I did not need radiation. I am so glad. This changes everything for me. I know now I can do reconstructive surgery. This is a good day!

All of these tests are making it more and more real. Surgery is emanate and I'm surprisingly calm. I'm ready, it's been a long time coming. I know this is the right decision for me and because of this decision my chances of being cured of breast cancer are greatly increased.