Follow-up with My Surgeon

On Wednesday, I went to see my surgeon to go over the results of my mammogram and to have him take a look at my breast implants and surgery site from my surgery that was just about four months ago. When he came into the exam room, he said that yes, I have some small cysts in my right breast, but that he is 0% concerned about them. I asked him if the cysts could turn into cancer, and he said no, they wouldn’t as they are benign. I asked him if anything needs to be done about the cysts, and he said that we do not need to do anything concerning them; they will most likely go away with time. He said that he is very pleased with the images from my mammogram and ultrasound and that everything is clear and looks great! {He explained to me when he ordered the mammogram that we had to wait for at least six months after finishing my radiation treatments to do it, or the images would be cloudy, so that is why I had to wait so long.}

Next, he took a look at how I have healed from my last surgery and how my breast implants are settling in. Everything is looking good so far, but my chest has not finished settling into place, meaning that the area under my left breast, in particular, has not dropped down and rounded out, it is still somewhat flat. It takes time for the internal part of the chest to heal and for the implant to get into place, so there is nothing to be alarmed about; my body just needs more time.

We do have to watch for a complication from my breast implants. It is called Capsular Contracture, and it is a breast augmentation complication that develops when internal scar tissue forms a tight or constricting capsule around a breast implant, contracting it until it becomes misshapen and hard. When my surgeon put my breast implants in, he added donor tissue to help prevent this complication from happening, but that doesn’t mean that it won’t happen anyway. He said that if it does happen, I will need to gauge my level of pain, watch for distortion, let him know that I have a problem, and that I am in pain that I can’t bear. He explained that some patients would have a severe case of Capsular Contracture and have very little pain, while others would have a milder case and have horrible pain. He said that if the pain is too much for me, I need to tell him to fix it, meaning I will need to go into surgery and have my implants removed. Whether or not I would need to have a new set of implants put in or have them left out is hard to say; it just depends on the circumstances. Being the excellent surgeon that he is, he told me that this could happen when we were discussing the option of breast implants. I told him that it was worth the risk to me as I was feeling very out of proportion after my first reconstruction surgery. I wanted to feel like me again and not the stranger staring back at me in the mirror.

The reason why we were even discussing this horrible complication on Wednesday was that he pointed out that the implant in my left breast is much firmer than the implant in my right breast during my exam. The firmness is caused by the 25 radiation treatments that were part of the breast cancer treatment performed on my left breast. So, it is already firm, and I need to watch it and check to make sure that I don’t have any harder areas that could indicate a problem is developing.

Unless I notice anything in the meantime, I will not go back to follow-up with him until six months from now. I have fewer appointments with my oncologist and surgeon these days, a real sign that I am healing and adjusting to life after breast cancer. 💕

My First Mammogram in 18 Months

On Monday, I had my first mammogram in 18 months. Once my temperature was checked, I signed the necessary paperwork, and then I went over to the registration area. I noticed while going through the process of registering that the paperwork from my surgeon ordering my mammogram, said to do an ultrasound “if medically necessary.” I prayed that I would not need an ultrasound because I knew that meant that they saw something during the mammogram and would need to take a closer look.

The breast center that I go to, which is in the same building as my surgeon and oncologist, takes terrific care of me. I barely waited for 5 minutes before the nurse came to get me to take me to the back so I could change into a gown. I love the gowns there, they are pre-heated, and so are the blankets! It’s the little things I guess, anything to feel more comfortable when you are waiting to go in to have your breasts smashed in a machine. I was incredibly nervous because I couldn’t help but think about the last time I had a mammogram; when the results said that I had a mass that was “highly suspicious of malignancy.”

When I went back for the mammogram, the first task we needed to take care of was to go over everything I had been through concerning my breast cancer and treatment. It was hard to recount everything from the number of treatments to how many surgeries I have had, what type of surgery it was, and when everything occurred. It was hard to go through the details, not because I couldn’t remember them but because I could, and it was just so much to go through in a short period of time. Even now, when I start thinking about everything that has happened, I get depressed, and sometimes I am brought to tears. I am lucky to be here, and I know that, but that fact doesn’t take away the memories and pain of every blood draw, surgery, and treatment that I have endured.

I didn’t realize how different the process of a mammogram would be with breast implants, so it was a shock to go through what seemed like twice as much imaging. First, I had a regular mammogram, and the standard trays were used with the usual amount of images being taken. But since I have breast implants, I had to have extra imaging done with my implants being pushed up and out of the way. I won’t lie, it was painful to have the edge of the metal platform jam into the scars under my breasts, but it was necessary to be in that position to move my implants out of the way. Once we had finished the mammogram, the tech had me go back to the waiting room while the doctor looked over the images. I waited for a few minutes, and when I saw the tech come back, I was hoping that it was time to leave, but no, the doctor asked for a few more images. So we went back to the mammogram room, and she took two more images, and then sent me back to the waiting room.

I waited for a few more minutes, and then a different and very pregnant tech came to get me. I noticed right away that she was taking me into the ultrasound room, and I immediately got upset. She told me not to worry and that this was normal, but I knew better. She only imaged my right breast, the side where I did not have breast cancer. Once she was finished getting more images, she took me back to the waiting room while the doctor took a look at the ultrasound images. After a few minutes, the mammogram tech came to take me back to the mammogram room for one last mammogram image of my right breast. Now my anxiety is starting to kick into high gear! “What did they find? Do I have cancer in my right breast now? I can’t go through everything again!” My mind was racing, and I wasn’t going to calm down until I knew what was going on. Still, at the same time, I truly appreciated that they were taking their time to make sure that they were able to see and identify what was showing up in the images and give my surgeon and me accurate information.

This time instead of taking me back to the waiting room, the tech had me wait in the mammogram room while the doctor took a look at the last image. She said that I might have to go back to the ultrasound room with the doctor so she could pinpoint the area that was causing concern. Sure enough, I went back into the ultrasound room, and the tech did some measuring and marked an area with a pen for the doctor. The doctor came in and took a few extra images, looked at everything carefully, and then told me that I have some tiny cysts in my right breast, but they are benign, there is no sign of cancer! 😊

How Do You Tell People That You Have Cancer?

Telling people that are close to me that I was diagnosed with breast cancer was a very personal and difficult decision. I am sure you are thinking that I am crazy for saying that and I would have agreed with you when I was first diagnosed, but I don’t agree now. Why wouldn’t a patient want to tell their family and friends? Or, what would make a cancer patient regret telling them? It will probably surprise you to know that I have spoken with some cancer patients that didn’t tell anyone, or that after the fact, they had wished that they hadn’t.

Family members, friends, and co-workers are never comfortable hearing that someone they know and care about has received a breast cancer diagnosis. It is a hard subject to discuss and every cancer patient knows that to some degree once they start telling people that they have cancer, the flood gates open with questions and in some cases blame. It is sad but true that sometimes out of fear, people are ignorant enough to ask a cancer patient what they “did or didn’t do to get cancer”. I can tell you that I was blaming myself early on. I was sure that it was my fault, that I had done something wrong and that is why I ended up with breast cancer. I know now that it was ignorant of me to blame myself. I didn’t do anything to cause my cancer, cancer chose me.

Sometimes people stay away because it is easy for them to assume that since someone they know was terribly sick during chemo, that you will be too; or someone they know did not survive breast cancer, so you won’t either. Understandably, they are afraid to be close to you because they think that you will die and it will hurt more if they step into the reality of your cancer so if they don’t talk to you, it isn’t real. I have found myself reminding people that I am still me, that every breast cancer patient’s experiences and outcomes are different, even if they have the exact same diagnosis. So many factors go into how a patient will respond to chemo and radiation treatments as well as undergoing multiple surgeries like most of us do, so it is impossible to predict what will happen. I am happy to say that I am doing well now that I am well over a year out from my diagnosis…I am a survivor!

I didn’t tell anyone right away because my husband and I were in shock and we needed to process what was going on. I also had my first biopsy to go through and I wanted to have the specifics of my breast cancer before sharing the information with anyone. Just a few weeks later once all of the test results were back, I told my family and close friends first through phone calls and private messages. As the news spread of my diagnosis, some people reached out to me immediately and others often times the people I wanted to talk to the most, stayed away from me, not knowing what to say. I can’t blame people for distancing themselves because I understand how hard it is to hear about the pain, endless doctors’ appointments, and everything else that I had to endure both physically and mentally for months on end. I also understand that people think that they would be bothering me or burdening me if they wanted to talk about things that they are going through, but if that is what they are thinking, they couldn’t be more mistaken. Right now, especially while I am laid off from work, I need my friends and family, I need to connect with people.

Being diagnosed with breast cancer has taught me that we never know what tomorrow will bring. Putting off spending time with the people that we care about and love should not be left until tomorrow, or next week or when we think we will have time because time is not on our side. {Yes, I know that the virus we are all dealing with is not helping bring us together, face to face, but there are other ways to communicate.} Sometimes the choices we make will only bring us to feelings of regret in the future, and sometimes it is too late to go back to the cherished moments we should have had with those that we love and value.

6 Tips to Support a Loved One After Breast Cancer Recovery

Very helpful information…Once a cancer patient is in recovery most people think that the worst is over, and it is as far as treatments and surgeries are concerned. But recovery involves not only dealing with and healing from the physical effects, but the mental effects as well. As the first sentence of this article states, “Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.”  Breast cancer and what a patient has to endure to survive it, is indeed a trauma, so it is very important that their support system is there for them more than ever when moving into the recovery phase.

Recovery from cancer is not easy, it takes time to navigate through all of the experiences and emotions that come up during what seems like endless chemotherapy and radiation treatments, blood draws, scans and surgeries. Coming to terms with the damage that everything I have been through has done to my body and mind is overwhelming at times. Every time I look in the mirror it is impossible to ignore my slowly growing hair, the scars on my breasts and the discolored skin under my left arm, from radiation treatments. I know that as time passes my hair will grow back and the scars and discoloration will fade, and maybe as I see those changes then I will feel like I am moving through my recovery instead of feeling like I do now, impatient and stuck.

I have to say that with Covid-19 limiting socialization and disrupting life as we know it, there is a stress that normally wouldn’t be an issue. I would be working on getting back to a normal life, life before breast cancer, and I am, but I am also dealing with the isolation and depression that the virus has brought to most of us at one time or another in the last few months. Normally, I would still be working at my job, and not laid off, which really helps keep me focused in all aspects of my life. I would also be making plans to spend much needed time with friends and family as I miss them terribly and being around them would help my recovery in so many ways. So in the meantime as I wait to find out when I will be going back to work and we finally get to a time when it is safe to get together again with those that we love; I am doing what I can each day to get through these uncertain times as best as I can.

Medically reviewed by Krystal Cascetta, MD — Written by Theodora Blanchfield on July 6, 2020

Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.

If you’ve ever lost a loved one, you may remember what it felt like immediately after your loss: friends checking in on you, bringing you food, and generally showing up for you. But as weeks fade into months and months into years, those check ins drop off — or disappear altogether.

This feeling is all too familiar to some breast cancer survivors who may suddenly feel alone as they struggle to adjust to their new normal.

Do you want to be there for your friend but have no idea where to start? We talked to mental health experts who work with cancer survivors to get the scoop on how you can continue to show up.

1. Respect their trauma and grief

“Loved ones should understand that a great deal of loss has occurred for the survivor,” says Renee Exelbert, PhD, CFT, a psycho-oncologist and breast cancer survivor.

This includes loss of safety in their body, loss of safety in the world, and sometimes, the loss of physical body parts, or the loss of prior functioning, she explains.

With that loss comes relearning how to relate in the world.

Even if your person appears strong on the outside, “understand that their mind and body are still recovering from a trauma,” says Gabriela Gutierrez, LMFT, clinical oncology therapist at Loma Linda University Cancer Center.

The physical loss associated with breast cancer can lead to a kind of identity rebuilding, she says.

“Women are learning how to still see themselves as women even after their breasts have been altered or removed all together,” Gutierrez says.

2. Understand fear of recurrence

You may be wondering why your friend isn’t being more celebratory. After all, they just got a clean bill of health and survived cancer.

Unfortunately, it’s not that simple.

According to the Cleveland Clinic, up to 50 percent of breast cancer survivors worry their cancer will come back.

“This fear of recurrence is a very common phenomenon that patients face as their bodies learn how to adjust back into the ‘normal world’ and as their bodies process the physical and emotional trauma they just endured.”

3. Ask what their needs are

It may be tempting to want to jump in and try to “fix” things or to try to take the burden off of them, but now is the time for your loved one to tell you what they need.

Because their process was so emotionally grueling, there are all kinds of things that may be innocuous to you but a trigger to them, such as a food they couldn’t eat while they were sick.

“Careful listening will demonstrate the desire to help the survivor feel connected to and understood,” says Exelbert. “Knowing that someone wants to help you is extremely meaningful.”

“But if they’re feeling stuck knowing what they need, you might want to offer to help them get back on track with exercise or other forms of self-care,” she says.

4. Continue showing up

More than anything, your person just needs to know that you’ll continue to be there for them.

“Remind them to be patient with themselves, and to have compassion for themselves,” says Gutierrez. “Remind them it is OK to bring up hard conversations with you, so long as you feel like you are a safe person to do so with.”

They may be afraid to bring up these heavy emotions with you, and they need to know they’re not a burden to you.

5. Understand their priorities may have shifted

You’ve been running with your friend for 10 years, and now that she’s healthy again you’re wondering why she’s not interested in running.

When someone has gone through a traumatic experience like an illness, perspectives and priorities will shift. Understand that it’s not personal.

“Loved ones need to be aware that the survivor may not place the same value or importance on previously shared values, relationships, or stressors,” says Exelbert. “What was at one time significant to the survivor, may no longer carry relevance at all.”

6. Take care of yourself

How can you take care of someone else if you’re not taking care of yourself?

“Many caregivers feel they do not deserve a voice as they were not the patient, but cancer is a relational illness, and your experience matters as well,” says Gutierrez.

You were also part of the emotional cancer journey, and your feelings are valid, too.

If processing your own grief and trauma around the experience is too much for you, consider finding a therapist to help you work through it.

Anastrozole Check-up with My Oncologists PA

Today I had a check-up with the PA at my oncologists office to see how I am doing on Anastrozole. I have been taking it for about 5 1/2 months and I have been doing well. I was having problems with dizziness in the beginning so I changed the time of day that I take it from right before bedtime to when I wake up in the morning. I haven’t had a dizzy spell in a few weeks so it seems that my body has adjusted well.

First we went over my labs from the blood that they drew today. My white blood cell count is finally in the normal range, on the low end, but that was good to see as it means that my immune system is getting back to normal. My red blood cell count is still out of range, just a little low, so that goes along with me still fighting fatigue. I had one other value that was high but she said that it indicates that I have allergies to which I said “I don’t have allergies.” She laughed and said that as far as I know I don’t have allergies but I could be developing them….I hope not.

For the first time ever, she actually mentioned my weight but in a good way. She was happy to see that I have lost weight since the end of chemo, which was at the beginning of October last year, 27 lbs lost in total so far. She said that she knew it upset me to gain so much weight during chemo but she said that while going through chemo it is good to gain some weight because my body needed me to eat well. We agreed that my gaining weight helped me get through chemo as well as I did. She was also happy that I have been losing weight while taking Anastrozole because most women complain that they gain weight while  on it, which for me will be 10 years, so I will keep doing what I have been doing to get to my goal weight.

She also asked me how everything went with the second part of my reconstruction surgery that I had 11 weeks ago today. She was happy that my surgeon was able to get me on his schedule so quickly before my medical insurance ran out due to being laid off. She reminded me that it has only been 11 weeks since that surgery and since I have had so much surgery in the last year, it will still take some time for my body to recover from all of the trauma I have been through.

I asked her when the 5 year count starts as it is the main focus now that I am done with my treatments and surgeries. She said that in their office they start the count from when I completed all of my treatments, both chemotherapy and radiation, which was this year at the end of January. I then asked what the next steps are in their care for me as a cancer patient. I will continue to have check-ups every 3 months for the first 2 years after completing treatments, then every 6 months until I get to 5 years after treatments and after 5 years she said that most patients go back to seeing their regular doctor once a year. My chances of recurrence are at their highest until I get to 2 years, then it will drop a bit until I get to 5 years and then it will drop substantially after 5 years without recurrence.

We also talked about my next mammogram which is coming up in August. I am nervous about it and she assured me that especially with this being the first imaging done in over a year, it is completely normal for me to be worrying and nervous. I told her that am paranoid about the cancer coming back so I am checking my breasts often for anything that feels abnormal. But, I also told her that I am well aware that I have been through the maximum treatments for my type of cancer, having had both chemotherapy and radiation, plus having an excellent surgeon who removed all of the cancer; so keep reminding myself that there should not be anything visible in my mammogram.

So all in all I am doing well and getting healthier and stronger as I get further away from having ended chemotherapy, radiation and 4 surgeries. Here’s to another 3 months of continuing to improve! 🙂

Final Follow-up with My Surgeon

Mood: Accomplished 😊

I had my final follow-up appointment with my surgeon earlier this week. Both sides of my chest look good. During my surgery he stitched up my breasts from underneath a little bit so the implants would drop and settle without making my entire chest drop too much. During the first reconstruction surgery I had a breast lift so it was important that during the second reconstruction surgery, when he inserted my implants, that all the work he had done with my lift would not be ruined.

It has been 9 weeks since my surgery and my breasts are almost completely done dropping into a natural position. I am completely healed from surgery and cleared, no restrictions! It was important for me to get to the place where I am cleared with no restrictions because I have been having issues with a bulge on the side of my left breast, the side where the cancer was, that has been causing me some pain and discomfort since my first surgery over a year ago. The pain isn’t constant, but it is enough to bother me. I am feeling pain and pressure both when my arm is resting against the side of my breast and if I wear a bra for more than a few hours. With most of my clothes I don’t have to wear a bra anymore thanks to my reconstruction surgeries, but now I feel like I don’t have an option concerning wearing a bra or not due to the pain and discomfort.

During my last follow-up appointment with him we discussed this problem and it seemed like it might go away with time. He also stressed that it is difficult to operate due to pain, as he would be blind going in, not being able to actually see what is causing the problem. But since that appointment the pain and discomfort has only gotten worse so I mentioned it to him again this week during my appointment and we talked about it in more detail.

I asked him if he thought that the bulge was fat or tissue and he said that fat is tissue. So I asked if getting back to working out and maybe even lifting weights, now that I am cleared, would help give me some relief or even possibly get rid of the problem altogether. He said that it possibly could help and it was worth a try before falling back on having  another surgery that could fix the problem or not, no guarantees. So, we agreed to wait and see what happens once I am working out again and instead of making an appointment for three months out, the normal amount of time, we will see how I am doing in 7 weeks when I go back to see him after my mammogram in mid-August for my results.

In other news….here is a picture of what my hair looks like now! After 8 months of growth, I am a blonde again! 😁 I couldn’t deal with the dark/gray hair anymore…it was seriously depressing me!