One Step Closer

Three appointments in one day equals one tired lady and a three hour nap.

We arrived at the Huntsman Cancer Institute at 0800 and started the day with an ultrasound to determine if we could do the biopsy today.  The results looked clear and thus they could do the biopsy today but with another appointment at 0900, we had to wait until afterwards to allow enough time for the procedure.

At 0900 we met with Dr. Agerwal's (plastic surgeon) assistant for the first hour and another 30 minutes with Dr. Agerwal.  We discussed the process for reconstruction with mastectomy.  He was very informative and describe that the phased approach to the process in great detail.  While it varies depending upon the treatment plan we ultimately land on - we can expect that they will put the tissue expanders in behind the chest muscle at the time of the mastectomy.  This will result in a one to two day stay in the hospital.  For approximately three months, they will continue to expand and stretch the muscle wall to the appropriate size and when we are through treatment, another surgery would take place to insert the implants.  As long as it does not have any additional complications (meaning Radiation therapy), we can expect an outpatient experience.  With Radiation, it will require some muscle relocation (likely from the back) and thus another one to two day hospital stay.  The bad news, because of my breast lift, I will likely not be able to save my nipples during the process.  The good news, we can do some reconstruction (including tattooing) which will give the appearance of nipples. 

After this appointment, we were finally able to do the biopsy.  I was a little nervous about the procedure but they did a great job numbing the area and made sure I knew what was happening during each step.  I did feel some discomfort at one point but they were quick to reapply the numbing agent and things proceeded with no more pain.  It was fascinating to watch the process on the ultrasound.  They took four tissue samples and then inserted a titanium 'clip'.  This clip is to ensure we always know where the tumor was should the medications (Chemo) shrink it significantly. 

At the end of the procedure, I asked the doctor (Matthew Morgan) what his opinion was on the likelihood that this mass was cancerous based on his experience.  He stated that I should prepare myself for the likelihood that it is cancerous because it looks 'suspicious'.  I asked what made it look suspicious and he pointed out the uneven or jagged circumference of the mass.  So, we are preparing to hear that this is a cancerous mass within the next 3-4 days.  But - so much better to be prepared than surprised!!  So - I was grateful for his honesty. 

Our final appointment was with the genetic counselors.  We reviewed my family's medical history.  (Let me tell you, that was no easy feat to compile!!)  Together, we determined that a BRAC1/BRAC2 genetic test would be beneficial in helping us make the decision as to whether or not  a single or double mastectomy was the best direction to go.  It will also let me know what the risk is to my beautiful daughters, sister and mother for this same cancer and possibly ovarian/uterine cancers for all of us.  We also decided to donate additional blood samples, and tissue samples from my biopsy, for research.  Anything to help with finding the cure!!  My hope is that by doing additional genetic testing, I can offer peace of mind to my loved ones in the future or ensure they are carefully watching for these cancers. 

Tired and sore, I will confess to a three hour nap after these appointments.  It was heavenly and a bit decadent. 

We are now waiting again for the final results of the biopsy and to hear Dr. Neumayer's recommendation for treatment.  I'm ready to move from 'discovery phase' and on to the 'execution phase' of this project.  All my work friends will recognize this tendency.  :) 

We'll update again with the results and treatment plan (hopefully) in the next blog.  We are overwhelmed by the love and support from all of you.  It means so much to us.  xoxo