What does normal look like?

I don’t know what normal looks like anymore. I don’t know what normal feels like anymore. I know what normal is supposed to look like and feel like, but I don’t know if I can find normal again.

A and I put some normal back in our lives this week. We both started cooking again. It may not sound like much, but we’ve lived on take out, fast food, pizza, frozen food, and leftovers sent home with us by my in-laws after a family dinner since chemo began. Yes, I know, I’m supposed to be eating healthy and all that. I know. I really do, but here’s the thing…when you work full time, when your husband works full time, when you have two kids involved in activities, when you have cancer, when you’re undergoing treatment after treatment and surgeries, something has to give. Or, it did for me. I know there are people out there who are able to do it all. I’m not them. I’m just not. Neither is A. So, what gave for us was cooking. If eating fast food and all that hinders my ability to deal with this cancer, well, I guess that’s on me. I don’t know what else to say.

As I sit here listening to conversations around me, I want to scream at the top of my lungs “I would love to have your normal!” I want to just gripe about my day because something asinine happened and not because I have a burn on my mastectomy scar that isn’t healing and keeps bleeding and I’m worried about infection. I’d like to vent about something silly like I’m hearing as I sit here outside my daughter’s dance class. And, go ahead, keep glaring at my son as he watches Super Hero Squad for the thousandth time. Say something to him. Watch how fast I’ll tell you that this is some of the most normal parts of his day because his mom is dealing with breast cancer and can’t do everything she used to do with him.

God, I crave normalcy. I crave not feeling like a failure. I crave not feeling like I’m the walking dead.

I saw a new commercial for Neulasta today and yelled at the TV screen “No one on strong chemo who needs Neulasta looks that healthy and happy!” But, maybe they are. Maybe they do look that healthy and happy. Maybe it’s just me who was unhappy and felt like death. I know there are some chemos that don’t make you look sick. I shouldn’t assume, but it’s a commercial, so I feel pretty confident in my assumption. I know it’s different in real life, and that’s something that gets me about the cancer narrative: the drugs and such directed at cancer patients show the best scenario. I’m not asking for the worst case scenario, but how about the realistic scenario? It’d be nice for something to seem realistic with cancer if it’s marketed towards cancer patients.

I’m obviously not at my best today. But, I am being honest and realistic. There are good days and bad days. I’m not having a bad day, per se. I don’t feel bad. My burns don’t hurt too badly today. I’m tired, but that’s because I woke up at 2:30 am with blood running down my tissue expander from the bleeding burn and had to deal with it. I guess my I Have no Cares to Give attitude has left the building tonight. Maybe I’ll find it again. Or maybe I’ll keep being mad.

I want to take my kids to the water park this summer. I don’t want to have surgeries this summer because I’m 38 with breast cancer. I want to go on a vacation with A where I don’t have to arrange it around infusions, tests, and surgeries because I’m 38 and have breast cancer. I just want some normal. I crave it as much as I crave chocolate, a Dr. Pepper, and seeing my children grow up.

I crave my normal life, and I don’t have it, and no matter how much A and I purposely do things we term normal, nothing will make things the way they used to be, and that’s what I want.

My life before breast cancer.

 

Little by little

My hair is slooooooowly growing back. I never lost all of it, but I lost a majority of it. After awhile, it looked so bad, I asked A to shave my head. (Pictures below are from left to right: October 2015 (after 2nd chemo), November …

Bye Eyelashes…

My bottom eyelashes jumped ship today. It’s the strangest thing to me. I kept my eyelashes all through chemo, but now that I’m nearly two months post chemo, my eyelashes fall out. Really? My top eyelashes have thinned, too.

The pictures above were taken about a month and a half apart. I am three weeks out from my last chemo in the first one. The second one was taken today. I have on mascara in the one from today, but there are no bottom lashes for me to put mascara on like in the first picture, which I took at the end of January. My top lashes are noticeably thinner as well.

I read on a message board it’s not uncommon for eyelashes and eyebrows to fall out long after the last chemo, and that for some, it takes many months for the lashes and brows to come back. Some don’t ever get their lashes and brows back like they were before chemo.

That’s disheartening.

To be honest, I’m really annoyed my eyelashes have thinned and fallen out. I liked my lashes. I liked the way they framed my eyes. I don’t want to wear false eyelashes now. I bought some months ago, prepared for my lashes to fall out during chemo.  I don’t mind wearing false eyelashes. I’ve done it before on special occasions, but I don’t want to put them on every single day. That takes a dedication to getting ready in the mornings that I don’t have. I’m all about maximizing my sleep time and minimizing my hair and makeup time. Back when I still had my hair, if it took longer than twenty minutes for me to wash, dry, and style my hair as well as get dressed and put on a full face of make up, it took too long. Now, I’m spoiled. If it takes me longer than ten or fifteen minutes to get dressed, put on my make up, and put on a wig, rest assured, it took extra time because I either fought with my eyeliner, or I changed my wig a few times.

Since I wear glasses, it’s pretty unlikely most people will even notice I don’t have bottom lashes. I know it, though.

And that annoys me.

Wait…what did you say?

I find myself asking that question a lot more often now. “What did you say?” Or “I’m sorry…could you repeat that?” Or “I missed what you said…sorry.”

It’s chemo brain. Straight up, chemo brain. At first, I scoffed at the idea of chemo brain, but after treatments five and six, I’ve noticed some struggles with things I never struggled with before. The most frustrating one is a struggle to find the right word. Sometimes, I absolutely cannot find the word I’m looking for, and it’s so frustrating! Yesterday is a great example.

My childhood BFF had a baby on Wednesday, so I went to see them yesterday. I was talking to her husband about how A can control our heating and air conditioning from his phone via an app and how he can use the Fios app to remotely record shows if he forgot to set the DVR. Here’s the thing: chemo brain struck, and I could NOT come up with ” DVR.” I could come up with cable box and DVD, but I could NOT come up with DVR for a couple of minutes. It’s frustrating. It’s embarrassing. And, it happens to me all the time lately. It’s chemo brain. (Cable box…really? Yeah, that happened.)

I’ve been warned that anesthesia may cause it’s own mental fogginess by others who’ve had similar surgeries to the one I’m facing. That sounds fun.

Cancer sucks. Chemo brain sucks. It can all #suckit. 🙂

Set in Stone

It’s happening. Surgery. It’s set and happening. February 3, 2016, I go under the knife.

I saw my breast surgeon, Dr. H, this morning, and as she said, unless something major happens with her or Dr. L, the date is set in stone. I will not see her again until the morning of surgery. I will see Dr. L for his pre-op the week of surgery.

So…what’s happening during surgery? Bilateral skin-sparing mastectomy*. Immediate DIEP* flap reconstruction*.  During the mastectomy, I will have a sentinel node biopsy* on the left side, the side confirmed to have cancer. If the sentinel node biopsy comes back clean, no further lymph nodes will be removed. If it comes back showing cancer in the nodes, I will undergo axillary lymph node removal,* which we are hoping does not happen. We are hoping Dr. O, my oncologist, is right and there has been a complete pathological response. We will not know anything about the unknown tumor in the right breast nor will we know for sure there is no cancer in the lymph nodes until the full pathology report is complete, which Dr. H told us will take about a week. Every doctor I have is confident about my response to TCHP*. I’m hoping with all my might they’re all correct.

Surgery is going to be long. Dr. H  confirmed what Dr. L told us. It will be between 6-10 hours, and she feels confident it will be on the 10 hour side because I’m having a bilateral mastectomy with immediate reconstruction, and the reconstruction I chose is the most complicated and technical. Dr. H’s part of the surgery, the skin sparing mastectomy, involves Dr. H removing all the breast tissue by separating it from the fat layer between the breast tissue and dermis. Her goal is to remove all the breast tissue, including whatever, if anything, is left of the tumor, and to leave as much as the breast skin in tact as possible. Once she removes all the tissue, she has to reach the sentinel node and examine and remove it. Then, she waits for word from pathology regarding the sentinel node. If the node is clean, her part of surgery is done. If it’s not, she continues with more lymph node removal. Her part of the surgery will take three to four hours. While she ends her part of the surgery, Dr. L begins his part. He starts with tissue harvesting. Once he harvests the tissue from my abdomen, including skin, fat layer, and blood supply, he builds the breast with the tissue he harvested. And, he has to do this for both breasts since I am having a bilateral mastectomy. It involves highly technical micro-vascular surgery. This is not a type of reconstruction offered by all plastic surgeons. It takes a highly skilled plastic surgeon. He has to carefully reconnect the blood supply. If he doesn’t, the skin and tissue die. If they die, the DIEP flap fails. They will know within 24 hours of surgery if the flap failed. If the flaps fail, I have to have more surgery and reconstruction will be delayed for upwards of six months.

I will be in the hospital for a minimum of three days. I will spend at least four weeks recovering, but Dr. H warned me recovery could take as long as eight weeks. She told me I will not be able to stand up straight for at least three weeks. I will not be able to sleep flat for weeks. I will have a minimum of four drains that could be in place for up to two weeks. I will lose my belly button (yes, they’ll replace it). She also told me to expect complications. They’re not uncommon with the surgery I chose. And, I will still need at least two more surgeries after this one. Dr. H warned me it’s likely there will be at least one unplanned surgery depending on how I respond to the initial surgery. The phrase “skin origami” was used several times by both Dr. H and Dr. L to describe part of the surgery. Talk about a phrase no one wants to hear regarding major surgery!

I’ve never been under anesthesia for longer than four hours. I can’t lie, I’m nervous about being under for so long, but I’m not nervous about the surgery anymore. Dr. H and Dr. L are very good. They’ve both done everything to put me, and A, at ease. At this point, it is what it is. I made the choice for a bilateral mastectomy. I made the choice for a DIEP flap reconstruction. I made the best choice for me based off the information I have at my disposal. I’ve talked to friends who are breast cancer survivors. I’ve done my research. I trust my medical team. I’m so grateful to my OBGYN, Dr. B, for helping me and guiding me to the medical team I have. They’re among the best in Dallas for a reason. I trust them. A trusts them. The bilateral mastectomy gives me the best chance to survive. The reconstruction gives me the best chance to feel like me again.

I don’t make decisions easily, and once I make a decision, I tend to doubt myself endlessly. I worry about my decisions endlessly. There are two decisions I haven’t doubted since August: my decision to return to the classroom and my decision to have a bilateral mastectomy.

What I am terrified of is the results of surgery. Results of a new study released recently show that women who have HER2 positive breast cancer have a much higher chance of survival if there is a pathological complete response to neoadjuvant chemo in both the breast and the lymph nodes. The chance of survival is 90% if there is no cancer found in the lymph nodes and no cancer in the breast. That’s what I’m hoping for, and I’m terrified they’re going to find cancer still hanging out. Dr. O doesn’t believe they’ll find cancer left and doesn’t believe it was ever in my lymph nodes. Dr. H did a full clinical breast exam today and said all she feels in the left breast is tough areas she thinks indicate scar tissue of a dead tumor.

I spent a lot of time after I was diagnosed asking A why this was happening to me…what did I do. I felt despair. I felt hopeless. I saw my life ending. I was angry. I was sad. The emotions come and go. I’m scared. If the cancer is still there. If the cancer is in my lymph nodes. I’m not scared of surgery. I’m scared of the results from surgery.

 

*All links to breastcancer.org and may contain images of surgery, including mastectomy and reconstruction.

Chemo 6/6: Check! Now what?

I had chemo 6/6 on Friday, January 8, 2016. As happy as I am to be done (hopefully) with the chemo portion of this program, I know I’m a long way from being done with this journey. Treatment 6/6 is the end of what I think of as Phase 1. Phase 2 is surgery and Herceptin infusions.

I have Herceptin infusions in front of me until the end of September 2016. Every three weeks. Until September 2016. It seems like forever. Granted, Herceptin infusions are not bad. The worst part is the port access. I HATE people messing with my port. I don’t like it being touched. It doesn’t hurt. It just feels strange, and I’m not okay with that. There are three nodules that sort of stick out of the port that signal to the nurses where to correctly place the giant needle for port access. I have two options when they access the port: a skin freezing spray or take a deep breath and blow it out when they stab the port. For my first two chemo treatments, I opted for the skin freezing spray, but it hurt, too. It had a burning sensation. So, with Chemo 3, I opted to just deal with the stab. It’s not fun. It hurts. I really hate people messing with my port.

So far, I’ve had no side effects from Herceptin. I’m glad for that. And, I hope keeps doing its job. Herceptin is an immune therapy designed to block HER2 receptors for HER2 positive breast cancer. As an immune therapy, it can signal the immune system to attack the cells as well. Throughout my treatment, I’ve been on two immune therapies: Herceptin and Perjeta. At this point, I’m (hopefully) done with Perjeta. Obviously, there are still some unanswered questions that can only be answered by surgery. A and I are choosing to be positive right now and believe what Dr. O told us on Friday: She cannot feel anything in the left breast. She believes there’s been a complete response, and if there is, she’s very confident in my chances for survival. We asked her to explain to us what would happen if surgery reveals the cancer spread or hasn’t completely responded, and she said she would talk to us about that if we come to it. She emphasized she expects the surgery to be successful. I really want to believe her. But, I know everything depends on surgery and the pathology report.

On the subject of surgery, I’m seeing a plastic surgeon later this week. I’m having a hard time wrapping my head around the fact that surgery is here. It’s going to be soon. It has to be. The plan we discussed earlier with Dr. H is to do a skin sparing mastectomy with immediate reconstruction. I wish I could say I understand exactly what all that means. I do, to an extent, but it’s all what I’ve research on the Internet. I know what a skin sparing mastectomy entails, if I’m a candidate. That’s something we have to discuss with Dr. H when I see her again next week. I know reconstruction will be done at the same time as the mastectomy, or at least that’s the plan. What I’m unclear on is how the process of reconstruction works. Dr. O told me they would place expanders, but I’m not sure if I’m going to do implant reconstruction or tissue reconstruction or a combination of both. The plastic surgeon I’m seeing has an online gallery of his work, and I’ve looked at what he can do. As much as I’d like to say I’ll be happy with anything, I know that’s not true. I want to come out of plastic surgery looking something like me. I don’t want to be embarrassed by what I look like afterwards. That’s a real fear of mine right now.

Another fear of mine is the side effects I might be hit with after this treatment. Over the weekend, I had a massive headache, and the headache continued through today. I went to work today because it’s really important to me to be at work as much as I can manage. I’ve only missed one day of work due to side effects. Round 3 was incredibly hard for me, and I ended up missing a day of work because I couldn’t cope with the skin side effects (very painful skin pustules), and I completely lost my voice. I’m worried about this round being difficult. Rounds 4 and 5 were fairly easy on me, and A is convinced those rounds were easier because I was off from work during each one of them. Round 4 was during Thanksgiving, and Round 5 was at the beginning of Winter Break. I had plenty of time to recuperate. I’m trying not to push myself, but my life cannot stop because I had treatment.

It’s a hard balance, and it’s one I still haven’t mastered. I’ve been through six rounds of chemo over the last eighteen weeks. Four and a half months of Taxotere, Carboplatin, Herceptin, and Perjeta. Four and a half months of side effects…of scheduling my life around treatment. It’s a balance I still haven’t learned. How do I balance my life and who I want to be as a wife, a mother, a friend, and a teacher with who I am as a breast cancer patient? I don’t know the answer to that question, and somedays, I don’t think I ever will.

Love/Hate Relationship

At the conclusion of each chemo session, I get stabbed by a lovely little device called a Neulasta On-Body Injector. It’s on my abdomen, just to the side of my belly button.

 

I wear it for 28 hours after chemo. 27 hours after chemo it begins its injection cycle slowly pushing a drug called pegfilgrastim, which is a bone marrow stimulant. In other words, it stimulates my body to make white blood cells. It keeps me from getting infections, or at least, that’s the goal.

So, for one day, I wear this little device and periodically check to make sure the green light flashes (indicating the injector is working properly and has not come disconnected). When 27 hours pass, I hear a series of beeps then a clicking sound begins, signaling the beginning of the injection cycle. Throughout the injection cycle, I watch the little screen to ensure the cycle goes well and to ensure no medication leaks. I have an emergency number to call should something go wrong. Fortunately, I haven’t had any issues with it (and here’s hoping I didn’t just jinx injection cycle six since it’s going on as I type this post).

I have a love/hate relationship with this little device. I love it because I don’t have to drive back to Baylor Dallas every Saturday for a white blood cells stimulant shot. I love it because I’ve stayed relatively healthy since I started chemo. I love it because it’s part of the medications keeping me alive. I hate it because the application hurts. I hate it because I’m a stomach sleeper and can’t sleep on my stomach while wearing it. I hate it because the day after the injection, I will feel terrible.

Granted, it’s not the only reason I’ll feel terrible. Day 2 after chemo is never fun. But, the injection can cause bone pain, which I’m on something to counteract, headaches, and joint aches. Basically, it can cause flu-like symptoms. It’s really not fun.

Days 2-7 after chemo are hard for me. If I have a skin side effect from Perjeta, it happens by Day 7. I’ve had a skin side effect from every treatment, but Round 3 was the worst. Absolutely awful.

I go back to work on Day 3 after chemo. My chemo treatments are typically on Fridays. This treatment was going to take place on Wednesday, 1/6, but a scheduling snafu came up, so it was moved to Friday, 1/8, which was when it was supposed to be anyway. So, come Monday morning, three days after treatment, I head to work bright and early at 6:15 am. I’ll wake up with a headache, and the digestive side effects from Perjeta, Taxotere, and Carboplatin will begin to kick in, and if I’m caught without my medication to lessen those side effects, it’s a potential disaster, which has happened to me once. I went to work without my refill of the medication in my medicine bag. Halfway through first period, I knew I needed the medication. I went to my medicine bag and had a moment of panic when I didn’t find the prescription. A coworker offered to cover my class so I could run home to grab the refill I’d left sitting on the counter. I was back at work within 20 minutes. It’s not an event I want to repeat, so come Monday morning, I’ll make sure every medicine I need is in my medication bag.

I have a love/hate relationship with all of this. It keeps me alive, but my quality of life for the next week, at least, will be less.

Ultimately, while I may hate all of this, it’s a small price to pay to stay alive.

 

Chemo Essentials

For every chemo treatment, I pack a bag of items I consider essential. My chemo treatment takes place over a course of 5 to 6 hours, and I can’t sleep sitting up, so I need things to do while I’m here.

1. Papers to grade: I don’t grade many, but I can generally get through two classes of work.

2. Lunch and snacks: I’m here by noon until 5:00 or 6:00. I have to have food. I bring granola bars, oatmeal, a sandwich, and some Jello or yogurt.

3. Water: I have 3 bottles of water with me at all times. On chemo days, I also have a liter of Crazy Water #3. I try to drink the entire liter of Crazy Water and at least another one of my smaller bottles.

4. My heated blanket: It is COLD in the infusion rooms, and I recieve saline throughout my entire treatment. Sometimes the saline makes me cold.

5. My purple Beats: I have an undying love of gangster rap, alternative music, pop, and country (gotta love my eclectic music collection), so the Beats allow me to listen to my music as loud as I want, and I don’t have to worry about offending the entire infusion room when Green Day drops the F bomb, when T-Pain lets loose, or Eminem comes on my playlist.

6. My laptop: I rarely use it, but I like to have it if I need to work. I had a paper due in one of my grad classes by midnight on the day of my second chemo. I used that time to work on the paper. Now that I’m finished with my master’s degree, I hardly use my laptop, but I like to keep it with me.

7. My iPad and charger: Netflix and my Kindle app for the win!

8. Fleece lined socks: I’m here for a long time and by hour 2 or 3, my shoes have to go, so comfortable, warm socks are a must.

9. A jacket: Again, it’s COLD in the infusion room. It also doubles as a pillow on the rare occasion I decide to nap.

10. My purse: I could put my wallet and keys in my chemo bag, but I prefer to have my purse. My glasses’ case, my glasses’ cloth, my wig brush, my gum, my lipgloss, and various pens, pencils, and highlighters are in it. Some of those are essential items for me.

I may not use every item at each chemo, but I keep them in my bag just in case. I’m sure it’s overkill, but with how long I have to be here, I want to make sure I’m busy and comfortable.

Ripples

My fingers have ripples on the nail bed. My oncologist told me it was possible my nails would change, and before I exiled myself from reading about my type of breast cancer on the Internet (Googling…worst idea I ever had…should’ve listened to all my doctors, family, and friends), I read it was possible my nails would fall out. Thankfully, they haven’t fallen out, but I have a ripple on the nail bed for each treatment. They resemble rings on a tree stump.

This out-of-nowhere diagnosis caused ripples, physical, mental, and emotional for me, my husband, and our families. We have a new normal. Scheduling anything revolves around my treatment schedule. There are days when I just can’t anything, so someone else has to pick up my slack. More often than not, it’s my mother and my mother in law. A, my husband, has a demanding job and commutes an hour to and from work. I know there are days when he feels beaten down by my diagnosis because he feels like he should be able to pick up all the slack, but he can’t.

Here’s somethings I’ve learned on this journey: no one should do this on their own. I know there are people who do, and I’m in awe of them. I cannot fathom enduring this without my support system. I’ve learned no one person can pick up all the slack. I hate asking for help. A hates asking for help. But, we’ve had to suck it up and ask for help. When I can’t do anything and A can’t get home for over an hour, one of us has to suck it up and text one of our parents, or another family member, or a friend. I went awhile trying my damnedest to be the “model” chemo patient who never lets it show how treatment is affecting them, but then I had my third treatment and got bitch slapped (there’s no other way to put it) by side effect after side effect along with an infection  and laryngitis to top it off. It wasn’t enough that I felt terrible, was fatigued, and had a horrible skin side effect, but one of the skin spots became infected, badly, and I couldn’t talk. That round of treatment taught me if help was available, I was an idiot if I didn’t reach out and accept it.

The day before we released for winter break, a coworker asked me how I was doing, and I broke down. It was one of those days where I felt sad and scared. My coworker let me talk, and when I finished, I apologized for becoming so upset. He said something that struck me. He told me I had no reason to apologize, and he was honored to carry some of my burden for me. He told me there were others at work who wanted to help me, to carry some of my burden, and when I was ready, I needed to reach out.

It’s so hard for me to reach out. I don’t want to be perceived as weak or needy or a burden. That’s been one of my fears since my diagnosis. I would become the burden no one wants. It’s been hard, and humbling, to show weakness.

My life has changed dramatically. I’ve changed…I don’t know if it’s a dramatic change, but I’m not the same person I was just six months ago. Every thing in my life has changed because of my diagnosis. The ripples show…physically, emotionally, and mentally. I wonder what my life is going to look like once the ripples stop (I’m not going to say if they stop…I’m choosing to be positive for right now).

Treatment 5/6 is in the books…

I had the best night of sleep last night since this crazy train started in August.

When I saw my oncologist yesterday, Dr. O, I confessed everything to her. I told her I feel fine physically except for the hot flashes, but since Tuesday, I’ve been an emotional wreck. I told her about the news story I read of the young mother who was HER2 positive and died this week. I told her how scared I am the treatment isn’t really working. I told her I haven’t slept more than four or five hours in weeks because of hot flashes and just being uncomfortable because my heel hurts (planar fasciitis from an old injury) and the toes on that same foot itch and the foot twitches at night.

I’ll give Dr. O this: tell her your struggles, and she’ll do whatever, if anything, she can to make life better.

She asked me if I was taking the prescription sleep aid Dr. H gave me. I was honest. I told her no because I’m afraid of the side effects and horror stories about it on the Internet. Dr. O laughed, told me to stay off the internet, and to take the pill. She told me she’d just come from another patient’s room who takes the same sleep aid and sleeps beautifully on it. Dr. O challenged me to try it just once this weekend when I don’t have to get up and see how it works. She told me if I had any side effects to it she would switch me to a different sleep aid because sleeping well is non negotiable. My husband, who was with me at my appointment, assured her that I would take it this weekend. And…I did. I took it last night, and it truly was the best night’s sleep I’ve had since August. My husband told me he could tell it’s the best I’ve slept in months because I didn’t toss and turn.

As for the hot flashes, I’m already on something to help treat them. Dr. O said if I’m still having them every night, the dose is not high enough and upped the dose a little bit. She also said the medicine will help with the anxiety I’m having. She assured me that the way I’m feeling right now is completely normal because chemo has messed up my ovaries, put me into menopause (or chemopause, as a friend called it), so everything is out of whack. She said the treatment, along with my fears, are causing anxiety. So, hopefully, the increased dosage stops the hot flashes and treats the anxiety.

The heel isn’t really anything she can do anything about…I just like to complain about it. Two years ago, I severely sprained my right ankle. The orthopedic I saw told me I was going to wish I’d just broken it because it would heal better and faster and because my left foot was taking so much of the pressure off my right, I would probably end up with problems with my left. She told me what every other doctor tells me. Wear supportive shoes, take ibuprofen when needed, ice it, and wrap it if the pain is really bad. The toe itching and twitching and hurting is a different matter, though. She’s concerned I may be developing a bit of neuropathy, so I’m increasing the dosage of one of my B vitamins and am supposed to report if the itching, twitching, or hurting doesn’t stop.

My fear of the treatments not working is something she did address. She did a thorough clinical breast exam, as she does at every appointment, and she told us she can no longer feel an area that feels any different than the normal breast tissue. She feels no area of density or calcification. She feels nothing. She reviewed her notes from my first visit and told us she feels nothing like what she felt then. She told us, in her medical opinion, I have responded to the treatments beautifully, and she said she believes I’ve already had a complete pathological response. She stressed that it’s impossible to know for sure right now because I haven’t had surgery, but she said all physical and clinical indications are I’ve responded. She said I have no reason to worry, but followed that by saying, she understands why I’m so worried, so we’re going to keep doing what we’re doing. I asked her about an area I can feel, so she examined it and told me it feels like normal breast tissue. She reminded me normal tissue doesn’t always feel flat. It’s bumpy and in pods. She said I’m feeling a bumpy pod. It made me laugh.

I told her how little side effects I had to treatment 4, and she was delighted and told me to do whatever I did, so hopefully this treatment goes as easily as 4.

I have some major tests and appointments coming up over the next few weeks. I have to have an echocardiogram right before New Year’s to check heart function since Herceptin can cause heart damage. I’m hoping with all my might they find my heart function to be as good as it was before I started treatment so I can stay on Herceptin, and they find no evidence of anything else.

Then, that next week, I have, what will hopefully be, my last chemo treatment. I’m having it two days early because Dr. O is scheduled to be out of the office when my treatment was originally scheduled. Since it’s my last (please) chemo, she wanted me to come in and see her, so hopefully, my counts will be good and I can have treatment.

The week after treatment, I meet the plastic surgeon for the first time. He’s come very highly recommended, is one of the top plastic surgeons in Dallas, and works closely with my breast surgeon. I have high hopes for him. I want to come out of this healthy and with breasts that don’t look totally fake…like something someone bolted onto my chest.

The week after that, I meet with my breast surgeon to schedule the bilateral mastectomy.

There’s a lot I need to do between now and then. I need to go to Nordstroms for a mastectomy bra. I need to write my lesson plans for my sub when I’m out for surgery. Those are the top of my list. I know there’s more, but those are weighing heavily on me right now.

I’m working on my positivity. Dr. O gave me a lot of hope yesterday. I just hope I’m not getting my hopes up only to be slapped down, which is my history with hope.