Sunday, November 12, 2017

Prophylactic Bilateral Mastectomy with Immediate Reconstruction


I remember telling Brandon when we were newly married not to get too attached while motioning to my chest area, in one of those kidding-not-kidding conversations. And, while we've been able to laugh that off for the past eleven years, that statement has turned to truth, and I will be having a prophylactic bilateral mastectomy on the 28th of this month. Just three weeks away. 

To be clear, I do not have breast cancer

A prophylactic bilateral (double) mastectomy is preventative surgery to remove all of the breast tissue with the ultimate goal of reducing the risk of developing breast cancer up to 97-100%. 


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B A C K S T O R Y

It was the summer of my sophomore year of college when my mom was diagnosed with breast cancer, fifteen years ago now. I was away at school in Lexington for the duration of her treatment, which included several nasty rounds of chemo, followed by weeks of radiation. She lost her hair, was sick as a dog, but fought through it like the champ she is and has been cancer-free since. Her mom, my Grammy, had breast cancer at sixty, many years before mom, along with my maternal great-grandmother and great-aunt. My mom's three sisters - my aunts - have also all had breast cancer in the past fifteen years. All currently remain in remission. 

My mom and dad with their grandchildren.
So, clearly, there is a very very very strong history of breast cancer on my mom's side.

My OBGYNs have encouraged me at my annual appointments- probably for the past five years - to do genetic counseling, and after dragging my feet, I finally met with a genetic counselor at our local hospital in April of this year. During genetic counseling, you basically meet with a nurse who has been certified to discuss your family tree along with the instances of cancer to help you determine whether or not you're a good candidate for genetic testing. 

I brought along the genetic testing results from my mom and her sister to share with the counselor and together we reviewed all of the cases of cancer, the age of diagnosis, and the outcome of each. While those tested - including my mom - do not carry BRACA1 or 2 (most well-know 'breast cancer genes' whose carriers have upwards of a 50% chance of developing cancer), one of my aunts was positive for a mutation of the NBN gene. This gene is responsible for the production of nibrin, whose job is to repair damaged DNA. In simple terms, it is a tumor suppressor.  In terms of genes associated with breast cancer, it is a newly researched one, and its carriers have an elevated risk of breast cancer compared with the normal population, though that risk level is currently unknown. 

Because my mom's testing is 15-years-old at this point, the next step was to have her re-tested to see if she, too, was positive for a mutation of the NBN gene (which wasn't a marker at the time of her testing). She was, not surprisingly, and I submitted a blood sample to a genetic testing lab shortly after finding out her results. 
Getting my mammogram in July 2017.
My results were phoned to me about two weeks later to confirm that I, too, carry the mutation of the NBN gene. By itself, it's difficult to determine just how detrimental it is to carry the NBN gene, but combined with my family history, it is concerning and I was recommended to a surgical oncologist to discuss my next steps. 

While surgery wasn't the only option I was presented, my doctor said it was a reasonable measure considering my genetic predisposition and family history, and I really went into the appointment knowing it was what I would choose. The youngest cancer case in our family was 36, and I'll be 35 next month.

Ultimately, the bottom line for me is this: Brandon, Beckham, Faith, and Benny.  


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S U R G E R Y 

I met with an absolute ass of a plastic surgeon in August, who barely looked up from his clipboard long enough to notice the tears streaming down my face.  He used fancy doctorese to describe the procedure that was ultimately going to reconstruct my breasts, and despite fully understanding what I was in for, the reality of losing a part of me was just overwhelming in that moment.  The long-term implications of the surgery are more than just the shape I'll have afterward and I felt like he neglected to acknowledge the psychological impact. While I don't doubt his medical prowess, his personal preferences as a surgeon and apathetic posture towards my personal outcomes of the procedure weren't ideal for such a life-changing surgery. 

When he finally noticed I was having a hard time keeping together, he responded with, "Obviously you weren't very prepared for this appointment," in an offhanded and extremely insensitive way. I WISH I would've been quick enough to say, "Would anything prepare you to have you balls chopped off, doctor?" #hindsight  Needless to say, he is not the plastic surgeon I chose. Bye, Felicia.

Instead, I found a female doctor whose ideals for surgery aligned with my desired outcomes.

Anyway. 

The surgery is scheduled to take approximately four hours, as I'm opting for immediate reconstruction. This means, I will not have tissue expanders put in and will, instead, have silicone gel implants inserted immediately following the mastectomy.  This will allow me to have a single surgery. Not every woman or doctor is a fan of this technique for a variety of reasons, but my build and my desire to simply replace what I already have (read: I'm not getting bigger b(o)(o)bs), made me a good candidate.  Both my surgical oncologist and plastic surgeon will be present for the surgery and are on board with what I want. I will be required to stay at the hospital for 1-2 nights post-surgery.

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R E C O V E R Y

I'm planning for the worst and hoping for the best! I cannot lift greater than ten pounds for the first six weeks after surgery, which means I cannot pick up my babies :(  Sad. No working out for six weeks, either.  I also won't be cleared to drive or cook for awhile, wash my hair, or do anything that requires moving my arms above my shoulders. Fortunately, Brandon is taking off for almost a week to take care of me and our families live close by to help out with the kiddos.  I will have 2-4 drains to help with fluid and swelling, and it sounds like I'll be sleeping upright in our recliner for a month. Apparently, I'm going to live in button-downs and mastectomy tanks.  Everyone's recovery is different, so I guess we shall see.

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T H E  N E X T  T H R E E  W E E K S

I had my physical this past week and am all cleared for surgery and will still meet with my plastic surgeon the day before the procedure. With the holidays approaching, I'm planning to get as much shopping done as I possibly can and decorate minimally so take-down isn't extensive. With our kitchen remodel in full-swing and set to finish the week before my surgery, I'll be cutting it close with getting the house presentable again and decorated (we're currently living among all the new cabinetry in our family room).  If we get a tree up,  a wreath on the front door, and stockings hung on the fireplace, we're going to call it a win.  Actually, being stuck in a recliner watching Christmas movies by the fire doesn't sound like the worst way to recover, now that I think about it ;)

To my teacher friends: I'm anticipating taking the month of December off to recover, so I will be minimally involved on Teachers Pay Teachers.  I still plan to check in with Q and As and maintain my social media pages as I can. 

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H O W  D O  I  F E E L?

I'm going to be totally honest here: I'm terrified. I've intentionally emotionally distanced myself from it for the past several months knowing how big and scary my feelings about it actually are.  But now that I'm in the final countdown, I'm so scared. Surgery and anesthesia and being under for four hours completely terrifies me. I'm so afraid I won't wake up and all I can think about is my children growing up without a mommy and Brandon losing his wife. The thought is just unbearable and I sit here crying now as I type this. 

Outside of the actual surgery, the recovery is daunting, I'm sad to lose feeling in my chest forever, I'm stressed about Brandon and the kiddos having to do life without me for a bit, and anxious about losing control over the daily goings-on while I recover (i.e. making lunches, school pick-up and drop-off, helping with homework, grocery shopping, laundry, picking up the house, etc). 

While this is obviously an elective surgery, it's also a catch-22...sit around and wait for cancer and hope that it doesn't come? Or, pray that should I get cancer that I'm a survivor like my mom? Or, praise God for the fortunate option that modern medicine has allowed me know my risk and do something about it? No good answer, but for me, this seemed like the best choice. 

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P L E A S E  P R A Y

...for a successful, uncomplicated surgery.

...wisdom, guidance, and careful hands for the doctors and nurses.

...a sense of peace for myself and our family.

...good health and strong immune systems for myself and our family.

...for Brandon, Beckham, Faith, and Benny.

...no infections and complete healing post-surgery.

...a cancer-free pathology report. (no reason to believe this would be an issue, but they do a pathology report on the tissue removed nonetheless)

T H A N K  Y O U !

Saturday, May 28, 2016

True Stories About Our Marriage

Today is our Ten Year Anniversary.

The easier post to write would be the one where I post the adoring picture of us and caption it with something along the lines of...

Happy anniversary, babe!  It's been the most amazing ten years!  Can't wait to see what the next ten years holds!  Love you BIG!

I just can't type that without feeling awkward about it.  It would portray my marriage as glossy and superficial.  And, not only is our marriage not glossy, but there is nothing superficial about marriage. Marriage is complex, refining, and beautifully brutal.  It's loving despite

There have been many times in the past ten years that I didn't think we'd make it another day.  Where loving despite seemed like a challenge we no longer wanted to endure. Because that adoring couple you see above, they only sometimes exist.  They've disagreed and said hateful things to one another in heated arguments.  They've gone to bed angry and been on the giving and receiving end of The Silent Treatment countless times (such an unfair game to play, btw). There's been shouting matches where no one wins, and there's been times where leaving seemed like a better option than staying.  

Marriage is work. Every. Single. Day.

But, it is worthy work.  I have to remind myself of that daily.  It's a sacred covenant that God intended for His good.  Marriage is an enduring, undeserving, sometime one-sided love that requires less of me and more of Him.  It's accepting that 50/50 rarely exist, and that we're given each other to offset that imbalance.  Loving despite.  

While each of these pictures shows a smiling Brandon & Abby, the back stories contradict an always-happy-always-loving couple.  

True Story: We were in Hilton Head and spent a large part of our time there arguing with one another.  I couldn't wait to come home. 

True Story: Brandon had just quit his job of seven years.  The future was uncertain.

True Story: We were headed to the fertility specialist, hoping to get pregnant. SUPER stressful.  Hormones were TERRIBLE and I was NOT a nice person during that six month stint!

True Story: We took Becks to the pumpkin patch. I took the day off of work after finding out the mother we had been matched with - and were expecting to bring her baby home to our house in a matter of weeks - had changed her mind. I was devastated and could barely function for days.  

True Story: We were at my grandpa's 80th birthday party and  it was a challenge to hold a conversation without crying about our failed adoption. Ironically, we'd leave this party to find out our daughter had been born the week prior :)

True Story: Faith had been in the hospital for a little over a month at this point and was enduring a second extremely intensive 4-hour surgery.  We were just trying to keep our heads above water at the hospital and at home.  I still don't know how we survived.

True Story: We were headed to look at Christmas lights with the kids, and almost didn't make it after getting into a ridiculous argument in the car.  

True Story: I'm about six months pregnant here and we're at Graeter's for ice cream after a session of marriage counseling.  One of the best things we've ever done for our marriage and each other. Counseling, that is.  Not Graeter's ;) 

True Story: I'm about six-weeks postpartum with Ben, and am heavier than I'd like.  But, I LOVE this picture. Even though we aren't like this ALL the time, there are plenty of times when we are.  When we look at each other as if we're the only two people in the room.  When we know that the decision we made to stand by each other forever ten years ago was the right one. 

I am a better person for being married to Brandon.  He is my best friend, my confidant and lover.  I would stand next time him today and do it all over again.  



Happy Ten Year Anniversary, B. I love you BIG. 

(PS. We are staying in downtown Cinci tonight WITHOUT kids, and will probably sleep through the night for the first time in almost three years!  Wooooo to the hooooooo!)

Wednesday, May 4, 2016

These three.

As soon as the picture above loaded into the blogger template, I couldn't help but laugh a bit.  And simultaneously blink back tears. It still startles me - in the best possible way - to see three sweet little faces staring back from the screen. 

For a long time, it seemed like I'd only be blessed to be the mama to one kiddo. Yet, here I am, happy mama to three :)

Becks is my spirited, sensitive, strong-willed,  and smart as a whip 7-year-old.  He's in a self-made band, Wikkid Vömit, takes guitar lessons once a week, plays baseball, and loves school.  He is the best big brother to the babies and still loves to be snuggled into bed a night. His two front teeth have grown in recently, a reminder of how quick this parenting thing goes. 


Faith is my fantastically adorable, ridiculously sweet, happy little joy bird. She'd spend all day outside if it were up to her, awaits the return of her Bubba from school everyday, still sneaks pacis at bedtime, and reminds us all what a blessing life is. She'll do big things someday. 

And, sweet Benny is my squishy little baby muffin.  He will be nine months in a couple of weeks.  Bathtime, graham crackers, and running the hardwood in the walker are his jam. I don't mind the 4:30am nursing sessions, knowing those precious moments are limited. He refuses to belly laugh, and instead chuckles like your old fat uncle. 

Thanking God they're mine.

Happy Wednesday :)

Monday, April 25, 2016

monday in a snap...

...a snap of this cute boy sleeping, that is.

Hope yours was happy :)

Tuesday, April 19, 2016

Turns out, I LOVE normal!


The remnants of our dinner table probably don't mean much to you, and I'm well aware that if I left those fries sitting out for the next year they probably would look exactly the same. (I know these things because our family time capsule, The Minivan, has preserved several beyond their typical shelf life in the past year or so.)  

But, I slyly snapped this picture as we were finishing up tonight because it symbolized so much more than the quick meal that it was, grabbed by B and Becks on their way home from guitar lessons tonight.  (He's started a band.  It's called Wikkid Vömit. It is awesome.)


Something about it seemed so completely normal.  

Because normal, busy families compromise their dietary values for a value meal at Mickey D's when life got too busy that day to thaw chicken or click through Pinterest for something healthy.  They sit around their dinner table with their little ones, opening cardboard clamshells and spilling fries into their compartments.  They look at the lids to fountain sodas to determine which beverage belongs to who based on which button is pushed down to indicate diet.  They peel cheap toys from plastic wrapping and serve bites of french fry to the baby.  Normal family stuff.


So many days, even weeks, have felt very, very far from normal lately.  Even a year after I wrote this post, I still don't feel the steady equilibrium that I felt before parenting a kiddo with a chronic illness. 

 In fact, the Abby that wrote posts before November 2013 isn't the same Abby that writes now.  

I have a deeper understanding and appreciation for life.  A wisdom that comes from knowing another world that is foreign to most.  A strength and endurance I can only attribute to my Heavenly father.  The wholeheartedly ability to admit that I cannot do this life on my own.  

A greater love for the average, normal day.

(Thanks for the awesome new saying, neighbor!)

Happy Tuesday :) 

Saturday, April 16, 2016

Hello. It's Me.

Well, stop the world. 


I am writing a blog post. 

Two years to the date of my last blog post, which I wrote less than a month after Faith came home from the hospital in 2014.  2014 was TWO years ago.  Oh. My. Word.  So much has changed! I use emojis and hashtags in everyday dialogue, had a baby, and drive a minivan!  #allthehearteyes


And, how pretty are things?! Things being the little facelift sweet Becca gave Babbling Abby, of course.  She's a doll and I highly recommend her.

At one point, I said I was going to close this space and print it into a book for posterity's sake, closing this chapter of my blog life.  I didn't do either.  And, I'm glad.  (Though I really would like to print and bind it all someday. Have you done that?)  I have continued to write about life and school-related fare over at The Inspired Apple, so I haven't been completely gone.  It just became a little overwhelming to maintain two blogs.  


But, here I am with good intentions to set the bar very, very low for the upkeep of online journaling.  Low expectations are everything these days.  Helps me cope with the massive amount of crumbs throughout the kitchen (but the dishes are clean!), piles of laundry (again, clean!), and normal days (turns out I love normal!).  
Here's to more random babbling!  Happy Saturday, friends!

Wednesday, April 16, 2014

Sorrynotsorry.

So, the first sentence I typed and then deleted was this:

I don't want to come across as complaining, but...

Then, I realized, complaining is exactly what I want to do.

Sorrynotsorry.

Why, as women, do we not want to complain?  Is there a biological reason we want to preface our conversations with phrases like:

I don't want to sound ungrateful, but...

I don't want to complain, but...

Don't think I'm unappreciative, but...

Seriously, this is something I do all the time.

Now, I don't mean complain in the whiney, all-the-time, annoying kind of way (friends on your FB feed are probably popping into your mind right now).  Just in the, Hey!  I lead a real life where everything is not perfect all the time! kind of way.  

So, I'm going to complain!  And, I hope you don't think I'm being ungrateful.  Because that would be the understatement of the year.  

Here goes...

I HATE IVs, TUBES, CORDS, MEDICAL EQUIPMENT, ETC.

I hate setting them up, I hate lugging them around everywhere, I hate that Faith can't lead a normal baby life because she's attached to them all the time, I hate that I feel stressed when we go into public, I hate dressing and cap changes and anything else that requires sterility, I hate the risk of infection, I hate planning life around IV windows.  

The bag I've converted into our IV tote.  Make note that they make no cute bags for the purposes of toting around IV bags and pumps.  So annoying!

I know they are life-saving and allow us to be home with our daughter instead of in the hospital.  I get that.  

But, they can GO AWAY and I will NOT miss them.

It's not a fun aspect of life right now.  

It puts regular old childhood illnesses into perspective.  Give me an ear infection ANY DAY.

All of this comes after a particularly challenging day where Faith cried the entire time I performed some necessary central line care.  Unfortunately, I have to 'reverse swaddle' her, if you will - meaning, I use a blanket to hold her arms down, tucking it underneath her back so that the weight of her body keeps her arms from flailing while I'm working on her chest.  Yeah, not fun for anyone, especially Faith.  Sometimes, this puts her to sleep.  But, not yesterday.  

Then there's the bubble flicking.  Before you run the IV you have to rid the line of any air, and this is accomplished by flicking the line.  This is never an easy process, and I'm sometimes sitting on the floor praying that gravity will allow that last bit of air to run out.  Ya know, to avoid pulmonary embolisms.  No pressure.  

Dressing changes are my least favorite thing.  Her central line site is completely exposed, running the risk of infection every time we access it.  Hate. That.  She has to be reverse swaddled, it's time consuming, and makes me have a minor panic attack until it's redressed.  

UGH.

Okay.  I'm finished.  Thanks for listening and not judging.  Little Sis is worth every single second of every single procedure we have to do every day.  But that doesn't mean it won't be a glorious day when the docs tell us it's all over.