Decisions...

I've officially had cancer for just over two weeks. It's very, very bizarre to realize how quickly the thought of removing both my breasts, repeatedly pouring poison into my body and putting myself into menopause at 35 all seem very normal things to be deciding to do in a very short period of time.

A week ago, I was reeling at the thought of maybe having to decide to remove my healthy breast. But after meeting with several doctors and considering my alternatives, the decision now seems so very obvious to me. Which in itself is pretty odd.

My stupid cancer is aggressive and invasive. And there are three damn tumors in my tiny 34A breast. I am 35 years old with a family history of breast cancer on both sides of my family, including my grandfather. When a 35 year old shows up with breast cancer and reports a male in the family with a history as well, apparently all bets are off.

I met with an oncologist first - Dr. Robin Obenchain - and she warned me that with my age and background, the surgeon would likely recommend a mastectomy on the cancerous breast (to forever be known as the bad booby) and a prophylactic mastectomy on the other one (now a bad booby by association). And of course, being so young and having so much time ahead of me for things to go wrong again, Dr. Obenchain said that regardless of what the surgical pathology revealed after the mastectomies, she would encourage me to go through chemotherapy in an attempt to get rid of any stray, tiny, wandering, lethal cancer cell that might be lurking in my body.

A few days later, I met with Dr. Jennifer O'Neill, a breast surgeon specializing in breast cancer. She and Dr. Obenchain have worked together before and each speaks very highly of the other. Despite everyone warning me that cancer doctors tend to be distant and cold with less-than-desireable bedside manners, both of these doctors introduced themselves to Dave and me with hugs, spent hours answering questions, drawing pictures to describe how my bad boobies have turned against me, made suggestions for other doctors to join my cancer team (who the hell wants a cancer team of doctors at 35???), arranged appointments for other tests to be done, and gave more hugs on the way out. If I have to have cancer, which the universe seems to have decided I DO, I'm glad I have these two women on my side.

The meeting with Dr. O'Neill confirmed what Dr. Obenchain expected. Based on my age and family history and the fact that my multiple tumors make saving the bad booby almost impossible, Dr. O'Neill said a mastectomy is the only reliable way to get the existing cancer out of me. We talked more about risks and options for the bad booby by association and she urged me to meet with a plastic surgeon before making my decision.

After discussing it with Dave and getting over the shock of having to make this bizarre kind of decision, I realized that I am actually really comfortable with the idea of a bilateral mastectomy. I am busy - my kids are 2 and 4 years old - and I don't see myself getting any less busy in the foreseeable future. I have an increased risk of getting cancer again simply because of my age and my family history, even if I don't carry the BRCA gene (which we won't actually know until after surgery because I don't want to wait the several weeks it takes for the results to come back). I am going to have to go through the pain and stress of the mastectomy and subsequent recovery and reconstruction already, so I figured I might as well get it all done at once.

I don't want to have to go through the anxiety of searching for lumps, waiting for diagnoses, scans, tests, etc. again. And if I did get cancer on the other side in 5, 10, 20 years, I certainly wouldn't want to go through the surgery and chemo again. Besides, if I remove both sides at once, my new cancer-free boobs will be a matching pair. Bonus!

So, here I am. Two weeks out from learning I have cancer and I am quite comfortable with the idea of what lays ahead of me. (Check back on how I'm doing with the reality of it in a few weeks.) In less than a week, my body will look like SpongeBob SquarePants - flat and full of holes. (yuk, yuk, yuk... yuck.)

Once I've recovered from that a bit, we'll start putting poison in me fairly regularly - though we won't know how often or what types until after the surgery is done. But we do know I will almost surely lose my hair and go into menopause for this part. Good times.

And for the record, I am going to be one hot bald chick. My head is awesome for bald. Just check out my baby pics. I didn't grow hair until I was almost 3. :P

And while I'm pretty confident about being okay with losing my hair (though I did JUST spend a year and a half growing it out from the pixie cut I had for years... sheesh. It FINALLY looks awesome and NOT like I've got a chia head while growing out a super short cut!) I only recently realized that I will also lose my eyelashes, eyebrows, etc. That part surprised me for some reason. So I guess I'll eventually have to start wearing make-up at some point or I'll look like Powder... (if you don't know that reference, go see the movie. It's great.)

After the chemo, they will eventually finish the reconstruction. In trying to figure out what I'd like my cancer-free breasts to look like (also a very bizarre decision to make), I've taken a fairly informal poll of many friends. Almost unanimously, the men have said "Go Big!" - though not always with that much class... On the other side of the fence, most of the women say big equals stares, sweat and clothes that are hard to fit. Hmmmm....

So I met with the plastic surgeon - Dr. William Jacobsen - and he calmly assured me that I don't have to make any decisions until I'm ready to. The initial reconstruction involves leaving me with expanders that will be injected with saline over time to help stretch the muscle to accomodate the final implants. He says we will just keep making them bigger until I'm comfortable with the size myself. And all I can think of are the old David Robinson Nike pump shoes...

Finally, I've been told that I am very lucky that my cancer is estrogen and progesterone positive, which is rare in young women with cancer, but good because it leaves me with more treatment options to decrease the likilhood of future cancers. This option is hormone therapy, which will essentially maintain the menopause caused by the chemo. And which will also apparently make me moody, irritable and unpredictable for a while.

Man, am I lucky you people already love me.

So, here's where I stand at the moment: I have breast cancer at 35. I will soon be boob-free, bald and going through sudden menopause. It's going to be a crazy whirlwind, I'm sure. I won't even have eyelashes for a while. But the up side is that I will be getting big(ger) new boobs (which the plastic surgeon kept assuring me will be "absolutely beautiful"... and he also called all his patients "the ladies"), I won't have to shave my legs for months and people keep offering to come make me food and clean my house! Really now, who WOULDN'T trade places with me given these trade offs??? All this in exchange for surgery, recovery, poison, hair loss, menopause and more surgery!

But of course, I left off the most important benefits - I am going to know my grandkids in exchange for this stupid journey I'm starting, and God willing, I will never have to go through this crap again. Because this is really, really...

stupid.

<3
-B-