My Cancer Posse

"My posse's gettin' big, and my posse's gettin' bigger" ~ The New Style, Beastie Boys 

_________________________________________________________

It was three weeks from my breast cancer diagnosis to my mastectomy. It all came on so fast I didn't have the capacity to coordinate much other than who the next medical professional was I needed to meet with, and trying not to lose my mind. Today, four and a half months later, much coordination has taken place in order to care for me and my kids. I am astounded and grateful for what people have done for us.

Here is my attempt to give credit where it is due. If I have forgotten you here, I have not forgotten you in my heart. Please remember chemo medicine is eating my brain cells.

Here, is my cancer posse:

• Private nurse: Marcia
• Cleaning & laundry: Mom, Marcia, Nicole, Angie, Jeannine, Barb
• My audience when I sob so hard they can't understand what I am saying (you don't really want to be on this list!): John, Mom, Marcia
• Mental and emotional support staff: John, Mom, Marcia, Jeannine, James, Nicole, Angie, Mary, Diana, Kristen, Jen, Deb, Susan
• Chemo assistants: John, Mom, Dad, Marcia
• Hair and makeup: Jeannine and Angie 
• Babysitters: Mom, Marcia, Nicole, Monica, Jeff & Annie, John & Jennifer, Angie & Tim 
• Personal chefs: Tori, Janet, Kim & Kevin, Karen, April, Bruce & Michelle, Michele, Crystal, Austin, Lisa, Ron & Lori, Diana, Jerome & Jamie, Deb, Marge, Kathy, Doug & Tammy, John & Jennifer, Mark & Christi, and many more to come

I used to think helping people was hard, or took too much of my time that I needed for myself. I have learned through everyone that has helped us that folding a basket of laundry and putting it away can make someone feel taken care of. I now know that giving someone a gift card to a simple restaurant can make them feel like it is Christmas. I know that dropping off a hot meal for someone who is exhausted and wouldn't cook healthy for themselves can bring great relief.

My LAST chemotherapy treatment is 3.5 weeks away. Soon after that, I will begin to feel like myself again. I cannot wait until I am better so that I can help others in the same way we have been helped. 

Quotes for today:

"Say yes when nobody asked." ~ Lao proverb

Some people are afraid to ask for help. I used to be. I have learned I need it. I am not Superwoman. I always thought I was. Now I know I am only strong because of all of you who are around me. ~ Gwen


Romans 15:1-2
We who are strong ought to bear with the failings of the weak and not please ourselves.
Each of us should please his neighbor for his good, to build him up.

The goal of a Christian is to reflect the life of Jesus in how we live our lives. I have some serious work to do. But so many of you have taught me how to get closer to that goal through your works in my life. For that, I am grateful. ~ Gwen

Breast Cancer Top 10

The top ten best things about being diagnosed with breast cancer:

10.  You are told NOT to lose weight. 
9.  You get prescription medications, with little or no question, that make you feel good.  
8.  You never have to worry about messing up your hair.   
7.  You get a brazilian wax - without the wax and without the pain.
6.  You may have chemo-induced menopause = no visits from "Aunt Mable".
5.  Everyone tells you "you look great!" ALL of the time.
4.  You get a pair of homemade earrings, a ring of hope, or a homemade bookmark at each doctor's visit from Gems of Hope
3.  People make you food and offer to take your kids.
2.  You get a free personal trainer through the Mercy Thrive Cancer Wellness & Fitness Center.
1.  Walking among ~17,000 people, 500 being Survivors, who are supporting a Race for a Cure in the Especially for You walk/run in Cedar Rapids, IA this past Oct. 2 (check out the last picture of Survivors). 

Quotes for today:
"Go ahead - use the cancer card: Your membership begins the day you are diagnosed. Use it, don't abuse it. Some phrases for use:

• I need to rest. I have cancer.
• Don't dump your garbage on me. I have cancer.
• No you can't have that parking spot, I have cancer. Back off!

From the book Crazy, Sexy Cancer Tips by Kris Carr.

I have used my cancer card, but only to be humorous (I think). If you can't laugh when life seems like absolute crap, then I can't hang wid dat. ~ Gwen



Psalm 116:1-2
I love the Lord,
for he heard my voice;
he heard my cry for mercy.
Because he turned his ear to me,
I will call on him as long as I live.
  
Some people have to reach a point of despair, or rock bottom, before they reach out to God. This is what it took for me to reach out to people - the people in my every day life. I don't like to show weakness. And I seldom ask for help. My life has been harder - but in a different way - and I didn't accept help, let alone reach out for it. Now, I find myself welcoming it - sometimes begging for it (right, Mom?!). I have often been overwhelmed to happy tears by the good and graciousness people have shown me. What this has taught me is that life can be hard. But when my life is back to simple, I can now see how EASY it is to reach out to people who need it. And I can now see how easy it is to give them help whether they ask for it or not. I am so thankful for this life lesson. It is one of the many I am sure to learn through this process of breast cancer. ~ Gwen

Chemotherapy Schemotherapy

I have seen this tagline on several things - "Cancer sucks". Disagree. Chemo sucks.

"Everyone is telling me I NEED to have chemotherapy. But NO ONE is telling me WHY, " I said to my oncologist, Dr. Deb Wilbur. "It isn't in my lymph nodes and we got the tumor out."

However, what I learned is that studies have shown breast cancer cells to spread through blood stream and grow in other parts of your body - brain, bone (2 Bs), liver, or lungs (2 Ls). Dr. Wilber showed me a database that  I think is called the Finprog Study, but I am not sure. The database gives a percentage of breast cancer recurrence over the next ten years, based on the following factors of my cancer diagnosis:

• Lymph node status - negative
• Age - 39
• Tumor size - 3.3 cm
• Histological grade - 3
• ER - positive (even tho it was only 1% positive)

With this diagnosis, based on national studies and statistics, if I don't do chemotherapy there is a 34% chance this cancer will reoccur in the next 10 years. If I do chemotherapy, there is a 17% chance this cancer will reoccur in the next 10 years. The average person has a 8-10% chance of getting breast cancer. Easy peasy. Gimme my chemo cocktails.

I had my first chemotherapy treatment 3.5 weeks after my surgery, on September 26. I am scheduled to have six treatments, three weeks apart:

• Monday, September 26 (COMPLETE)
• Monday, October 17 (COMPLETE)
• Monday, November 7 (COMPLETE)
• Monday, November 28 (COMPLETE)
• Monday, December 19 (COMPLETE)
• Monday, January 9 10 (COMPLETE)

My chemo cocktail, or regimen, consists of:

1. Dexomethasone  - steroid that treats the side effects of potential nausea, taken orally for 3 days, starting one day prior to chemo
2. Emend - steroid that treats the side effects of potential nausea that may occur 24 hours after chemotherapy, given IV thru my port, takes ~20 minutes to administer 
3. Aloxi - anti-nausea medication that treats the side effects of potential nausea that may occur up to 5 days after treatment, takes 5 minutes to administer. 
4. Dexamethasone- steroid that treats the side effects of potential nausea that may occur 2-7 days after chemotherapy, given IV thru my port, takes ~30 minutes to administer 
5. Adriamycin - called the "red devil", weakens or destroys breast cancer cells, given by push IV thru my port, takes ~15 to administer, can cause mouth sores, so I suck on ice or popsicles during this infusion to constrict the blood vessels in my mouth, with the hope it will prevent mouth sores.
6. Cytoxan - reduces risk of cancer recurrence, given by IV drip thru my port, takes ~1 hour to administer. 
7. Wait one hour between infusions.
8. Taxotere - interferes with cancer cells dividing (growing), given by IV drip thru my port, takes ~1 hour to administer
9. Neulasta - stimulates white blood cell growth, injection in my upper arm, given 24 hours after chemotherapy is done

When I arrive for treatment, they do labs to check my white blood cell counts, platelets, etc. Then I meet with the Nurse Practitioner, every other time with the oncologist, to review any issues with the last treatment, discuss any questions, and have a check-up. Then I start chemo. During chemo, they have an on site massage therapist. I schedule my time with her during the one hour wait period mentioned above.

There are so many more details I could include here, but this is the jist of my treatment.

As far as side effects, so far...

• I lose my taste buds the morning after, lasts 4-6 days; new after the third treatment, lasts 2-3 weeks
• Starting same day, I either have diarrhea or constipation (lovely!), lasts 5-7 days; new after the third treatment, we figured out if I start taking stool softeners three days prior to treatment, for one week, this side effect goes away
• By the day after, I crave certain foods, have indigestion, and eat constantly, lasts 4-6 days - for those of you who have been pregnant, it is very much like that
• Two days after I have extreme flu-like symptoms, headache, all over body ache, chills, lasts one day
• Follow that day with same flu-like symptoms, but not as bad, lasts one day
• New after the third treatment was nausea that doesn't go away
• New after the fourth treatment was extreme discomfort and inability to focus, feels as if my brain is not firing signals correctly to my body and it is very hard to move, lasts 4-5 days 
• My finger and toe nails get very soft and buttery, after about two days, lasts 10-12 days
• Major bone areas ache due to Neulasta shot 2-3 days after the injection (#9 above), because the white blood cells grow in your bone marrow, lasts 2-3 days
• General fatigue, lasts 2 weeks; new after the fourth treatment, fatigue doesn't go away 

All in all, this is not bad. It's not a party, but it is something I can manage. If all goes as scheduled, I will have my last chemotherapy treatment on January 9, and be cleared for surgery after February 8. At that time, I will schedule my secondary breast reconstruction surgery to remove the expanders and place the implants. I will also schedule my hysterectomy (oh yeah, remember that?!), and possibly, my foot surgery. Lordy.

Quote for today:
"Instead of looking at it like chemotherapy with a little bit of life, try to think of it as LIFE, with a little bit of chemotherapy." ~ Dale March, co-worker, mentor

I try. I really do. But it is very difficult sometimes for me. Because no matter what I do... no matter how much progress I make at work... no matter how much fun I have with my friends... no matter how much quality time I get with my family and John... no matter how hard or long I cuddle with the kids... when it is time for chemotherapy, I HAVE to go there. ~ Gwen

Philippians 4:13
I can do all this through Him who gives me strength.

Strong Enough, by Matthew West

Thinking about the words that Matthew West chose for this song, I know I am not at rock bottom. But I know I am weak right now. I am not giving up, and I know I don't have to be strong enough. I just need my God to be strong enough... for both of us... right now. ~ Gwen

My Tent

"I see, I hear, I smell, I speak."
Almost two months ago at my grandfather's funeral, the pastor addressed the children at the gravesite about how our bodies are the "tents" that God gives us. It was a wonderful message, explaining our belief that our souls go to heaven upon death. And that while we are living, God gives us a heart so that we can love, arms so that we can hug, legs so that we can walk, eyes so that we can see, lips so we can talk, etc.

I laughed to myself, because when my children, nieces and nephews were toddlers, my Mom would always take their hands and point to their eyes, ears, nose and mouth while saying, "I see, I hear, I smell, I speak." After the funeral, I told her this, and she said, "See, I knew what I was talking about!" Hilarious.

So here's my tent, that God gave me...

Mother Nature
I was born with one kidney and partial reproductive organs. Twelve years ago I chose to undergo fertility treatments, which resulted in the loss of two babies, many weeks of bedrest, and an amazing, healthy daughter. Several more fertility attempts two years later led to mourning the loss of never bearing another child, and to being matched through adoption with an incredible, resilient son.

Ironic that now I am faced with pre-cancer in my reproductive organs. The hysterectomy that I was scheduled to have five weeks ago - then my breast cancer was discovered - is now postponed to next Spring. So the way I look at it is - I was given these organs to have my daughter, and I was given the test of fertility to lead to adoption (a whole other story there on all the "signs" that our son was MEANT for us!). Now, I don't need any of that jazz. Take it.

My Hair
I have struggled with trichotillomania for 20 years. I was at my worst a year prior to my divorce, when I had a 3 x 4 inch patch missing on the top of my head. No one knew, of course, except those whom I shared this with. I was to the point of not being able to hide it. The only way to give my hair a chance to grow back was to wear a hair replacement system that was created to match my hair and was sewn into my existing hair to hold it in place. I called them extensions. I wore that for 1.5 years to regrow my hair because I couldn't get to it to pull it. I have NOT worn the replacement for 1.5 years, and nine months ago was the first time in seven years that I could style my hair without having to worry about covering up a bald spot. My hair is now the same length as my replacement - all on my own! 

Again, ironic that now that I am healing from this, I face chemotherapy-induced hair loss in the next two weeks. I went through a ton of shame and humility in destructing my own self. Healing through that and regrowing my hair has helped me to increase my self esteem. I see this experience as preparing me to be bald, not of my own accord, and having it be an extremely public thing.

My Breasts
And then there's my breasts. I have always joked - put a tit on a butt cheek and see if guys get as excited. It's fat, people. Lumps of fat with nipples. The immediate reconstructive surgery has saved my emotions. I am 39 and single, so this was a MAJOR concern of mine. So the ONLY thing that has saved me is that I know, and I can see, something is coming that is much greater than those hefty "DDDs" I was toting around. My breasts are gone. Nothing more to say here.

My Tent
My tent. That is all it is. A shell. What really counts, and what I believe the pastor was trying to tell the kids, is this:

We have our body for the time that we need it. After that, our soul - our mind, our visual and audible memories, our emotions, and the love in our hearts - is what goes on... forever... and ever. Amen.


Quote for today:
"You may be banged up and feeling like fifty cents rather than a million bucks, but remember, this body of yours is only a temporary house built to protect the righteous Aphrodite within. Worship her." ~ Kris Carr, author of Crazy, Sexy Cancer Tips, from Chapter Seven, Bald is Beautiful 

Courtesy of the American Cancer Society and those who donate to it, I have some gorgeous wigs, great scarves, and adorable hats. I'm feeling okay about it, but yet a bit squeamish. Please help me by giving me hints on what to do with fashion, how to wear these things, and most of all - compliment me (even if you don't mean it!). Crying while I write this, John just put his arms around me and said "The most important and ONLY thing you need to wear is your smile". Everyone supporting me have given me SO many reasons to smile. I plan to do just that. ~ Gwen


Genesis 1:27
So God created man
in his own image,
in the image of God
he created him;
male and female
he created them.

Beautiful, by Mercy Me 

I love God's imprint of myself. He gave me, and omitted from me, what he did for a reason. The value of my own worth is not for me to figure out. It is my responsibility to use the gifts He has given me to live in His world. I only hope I use those gifts to the fullest of His intent. As the song linked above says, I have the heart to fight this fight. It's the biggest part of my tent so far. ~ Gwen

The Fembot Report

I don't really know how to put any fancy dressing on a pathology report, so I will just explain. Because of the size of the tumor, that it is invasive, and there is no lymph node involvement, the cancer is Stage 2A.

Refer to this post for further definitions and links: http://myfembot-gwen.blogspot.com/2011/08/and-then-there-was-cancer.html

LYMPH NODES:
Sentinal node biopsy - No tumor identified
Gwen's commentary - Yippee ki-yay! Doctor said he is 95% certain this means NO cancer in my lymph nodes. 

DIAGNOSIS:
Right breast - Invasive ductal carcinoma (IDC), grade III, size 3.3 cm tumor in central outer breast, second microscopic (0.28 cm) tumor, necrosis identified, rare focus of lymph-vascular invasion, all other quadrants clear.
Left breast - clear.
Gwen's commentary - based on clinical diagnosis, we knew: IDC, grade III,  size of 2.5 cm. Anatomical diagnosis confirmed the type of cancer is IDC, is larger than we thought, and grade of tumor is III. It also found that the tumor has a Nottingham score of 8 (3+3+2), which is comprised of three characteristics not mentioned anywhere I am looking, which leads to the grade III. A new, additional microscopic tumor had started in the same quadrant and necrosis was evident, which suggests aggressiveness. The cancer was just starting to invade the lymph channels. We got this out JUST IN TIME! 

Quote for today:
"There is absolutely no way that a person who has not had cancer can fully understand the feeling of absolute vulnerability and terrorizing fear that occurs when you hear the diagnosis." ~ J.M., prostrate cancer survivor, from the book Help Me Live

It is exceptionally difficult for me to describe how I feel and to explain how I am acting. In some respects, I feel as if I am going through the motions because people I trust are managing my care. I do not feel _I_ am managing my care. There are questions that John asks that make me think, "Why didn't I think of that?!". I act calm. I feel calm. I am centered. I don't have a a choice. I don't feel like I have the emotional capacity to do much more than be the patient and let whoever needs to take a whack at me. ~ Gwen

Proverbs 3:5-6 
Trust in the Lord with all your heart
and lean not on your own understanding;
in all your ways acknowledge him, 
and he will make your paths straight.

Love the Lord, Lincoln Brewster

I don't care why. I don't need to understand. None of that matters because I TRUST in the Lord with ALL my heart. I do not know what I am supposed to do with _this_. I do know I have two darling children who need to see how to live... how to survive... how to cope. ~ Gwen 

The Surgeon, the Pathologist, and the Ta Ta Maker

Ladies and gentleman, I have no breasts. And I have no tumor. Here is how it all went down... 

Thursday, September 1, 2011
5:30 a.m. - My alarm goes off. I hit snooze three times. 

7:10 a.m. - Depart my townhouse for St. Luke's Hospital, Dad gets a little ticked that I am paying attention to my phone and miss telling him to jump three lanes to turn left immediately after exiting the interstate. Ruh row! It's alright - we still found it!

7:23 a.m. - Arrive at St. Luke's Hospital Surgicare (outpatient center) with my father, bonus mother, and boyfriend. Yes, folks, a double mastectomy and immediate reconstruction surgery is done as an outpatient procedure, with a 23 hr. maximum observation period. Seriously.

7:40 a.m. - We are escorted to my pre-surgery prep room by a gal who asks me basic questions, while I am hoping she is not my "person" for the morning, as she doesn't really have me feeling groovy.

8:00 ish a.m. - Semi-cool nurse arrives and starts filtering through tons of paperwork, starts my IV, etc.

8:35 a.m. - Transporter arrives to wheel me to the Women's Breast and Bone Health Center for the radioactive tracer injection that is needed for the sentinel lymph node biopsy. This substance follows the same flow in my breast the cancer would into the sentinel (first) node and into the lymph node system. It takes about an hour for the dye to flow from the center of the breast to the sentinel node. 

8:45 a.m. - Arrive at Women's Breast and Bone Health Center for 9:00 a.m. scheduled injection. Wait. Wait. Wait. After 30 minutes of unbelievably annoying conversation with this nurse who behaves as if she is just riding to retirement, I ask her to go fetch the doctor. Now, most of you know how I am. I promise you this is the ONLY moment thus far that I have been a biotch about anything. My surgery is supposed to begin at 9:30 and I haven't even talked to the surgeon yet. The doctor for the injection stumbles in and apologizes for being late. He tells me the shot will hurt less than the IV insertion. Whatever. No offense, but I wanted to tell him to take an injection into something similar to a full breast on his body, then we'll have a conversation. Grrr.

9:35 a.m. - Arrive back to the pre-surgery room. Things started to move VERY quickly from here on. The general surgeon, the very hot Dr. Renz, stops in to spend about 10 minutes discussing the surgery. I cannot even say enough to tell you what a gem this man is. Another nurse, Becky, arrives and tells me she will be my nurse in the OR and through the recovery room stage. She was rock solid awesome! Another lady walks in and sits down next to my bed and starts talking to me very casually about what will happen in the OR. I look at her and say, "Who are you, and what is it that you do?" Hello, anesthesiologist, Dr. Dykstra! She's my bestie for the next six hours of my life!

She talks about how Dr. Renz is more quiet than usual today. I advise her it is because I am losing my breasts and that makes him very sad. She looks at me as if I am crazy. See, she just doesn't know me that well yet. Dr. Dykstra asked if I wanted something to help me keep calm. I made it that far with minimal anxiety and I really want to be aware of everything, so I declined. I take one last look down at my breasts, and Becky asks if that is indeed what I am doing. I offer John one last opportunity at a "motor boat", his face turns red. Becky wheels me away. As we are racing down the hall, I say to her "Can you believe this is actually happening?!"

9:55 a.m. - Arrive outside operating room. It is JUST like on Grey's Anatomy! LOL!! Becky puts on my bonnet, ties her mask, and in we go! There are women in scrubs bustling all over the place. Eighties music is playing, they are all arranging trays and movable LCD panels extended from the ceiling. There is a light right above me that is as big as a circle I can make with my arms. A nurse asks me to scoot on over to the operating table, while telling me she is the one who is in charge of this whole business today. I shout "Woo hoo, let's get this show on the road!", while I hear Dr. Dykstra above my head saying she hasn't given me any drugs yet and I am this fun! I tell Dr. Dykstra to keep me alive while two other nurses are extending and positioning my arms out into these large silicon pads. We all banter back a forth for a bit, and the head nurse puts a mask to my face, I tell her 'Not yet, I'm not ready." She says, "This is just oxygen, not gas", and I... am out...

The surgery schedule:
9:30 a.m     Place Port-a-Cath for chemotherapy
10:00 a.m.  Sentinel node biopsy
10:30 a.m.  Double mastectomy
12:30 a.m.  Double reconstruction
3:00 p.m.    Recovery
4:00 p.m.    To hospital room

12:20 ish p.m. - Dr. Renz comes to the waiting room to tell John, John Weger, Mom, and Dad that surgery went well, that there is NO CANCER IN THE LYMPH NODES (note that he did not give any qualifications to that statement), and that Dr. Emery has begun the reconstruction. Full pathology report is expected by September 8th. I cannot wait to see how much those suckers weighed. The word from both Mom and John is that there was not a dry eye in the waiting room. Well, at least for those four.

2:20 ish p.m. - Dr. Emery comes to waiting room to tell everyone that the surgery went well and that I will be in recovery for about 30-45 minutes.

I have no clue what time p.m. - I wake up in recovery, out of a bad dream, crying uncontrollably. Becky is asking me how my pain is and I try to get out while almost hyperventilating that I am upset from a dream and cannot feel any pain. She gets me calmed down, I am loosy goosey and really have no clue what is going on. Heading to my room, I see John, Mom, and Dad down the hall. I keep my eyes closed to keep from getting motion sickness. They put a patch behind my ear before surgery to help with this also, because I got so sick from this when I had my daughter.

4:15 p.m. - I arrive at my hospital room - corner room, two windows - yeah-yuh! Becky asked everyone to wait outside while they transfer me into the bed. Everyone comes in and John kisses me and tells me there is no cancer in the lymph nodes. I am still so out of it, this has little significance to me at the time. 

Quotes for today:
"Prayer doesn't change things; it changes people, and they change things". ~ Anonymous, included in the book Help Me Live: Twenty Things People With Cancer Want You To Know 

I sincerely thank everyone who prayed for me, added me to the prayer chain at their house of worship, and/or thought of me just once this past week. I, myself, pray for ME daily. I start by thanking the Lord for the blessings of this day, thanking Him for bringing John into my life, ask Him to continue to protect our little lambs (the children), ask Him to continue to provide me the strength, courage, and peace that has been bestowed upon me, and thank Him for loving me. ~ Gwen 


Known in my tradition as 'The Benediction':
Numbers 6:24-26
The Lord bless you
and keep you;
the Lord make his face shine upon you
and be gracious to you;
the Lord turn his face toward you
and give you peace. 

This is my absolute favorite passage and the point in a religious service I look most forward to. Much like being on a swing, it is impossible for me not to smile when I hear these words. The tumor is out of my body. Thank you, Lord for shining over me. ~ Gwen

Martin Luther's Daily Prayer

I cut this out of our church newsletter a long time ago, and found it in my nightstand last night. See, I told you the Holy Spirit is active in my life...

"We give thanks to you, heavenly Father, through Jesus Christ your dear Son, that you have protected us through the night from all danger and harm. We ask you to preserve and keep us this day also, from all sin and evil, that in all our thoughts, words, and deeds we may serve and please you. Into your hands we commend our bodies and souls and all that is ours. Let your holy angels have charge of us, that the wicked one have no power over us. Amen." - LBW 1978

Surgery is Tomorrow

My double mastectomy with immediate reconstructive surgery is tomorrow. I will post as soon as I can to let you know how it all goes!

Quotes for today:
"To suffering there is a limit; to fearing, none." ~ Francis Bacon

Ok, I lied. I am afraid. Sometimes. I feel as if I am almost to the peak of a hill on a roller coaster, and I really, really, really want off, but the only option (jumping) is NOT an option for this woman.  ~Gwen

Romans 8:18
I consider that our present sufferings are not worth comparing with the glory that will be revealed in us.

This piece of my life's puzzle will be useful. For what, and when, who knows. Who cares. I know that God's promise to me will make it all fit together into a more beautiful view than what I can see today. ~ Gwen

The "Hot" Pink Ribbon Society

Yesterday my girlfriend, Kim, invited many co-workers/friends to meet outside my office area and don hot pink ribbons. As a group, they showed up at my desk and gave me an awesome card that Michelle had routed around.

The plan is to wear the ribbons at work until the day of my surgery. What an awesome show of kindness and support! It means a lot to me that people took the time to show their support and are willing to wear this ribbon in honor of me! Go Team Fembots!!

This is a fabulous idea for people to re-use!

Decision Point C (cup)

Where I work, we refer to times during the blah blah of blah as decision points, using letters from the alphabet (was I evasive enough?).

Given all of the information I have in front of me and opinions of three doctors - all from a "get rid of this tumor!" perspective, one from a woman's "how am I going to look and feel?" perspective - I have decided my course of treatment.

Next Thursday, September 1, I will have a bilateral mastectomy with immediate reconstructive surgery. During that surgery, they will also "install" a port to administer chemotherapy medication for 5 months following surgery. They will also test the sentinal lymph node for cancer. If it is determined there is cancer there, that is something I will address after surgery. I'm just trying to get to the next step, and not finding it very easy.  

Yes, I am at peace with all of this. However, I am still extremely freaked out.

Ok, for the boys in the room, this may be too much information (TMI). And for those boys I work with, don't be looking at me funny in the hall. The plastic surgeon is going to do reconstructive surgery using expanders, then replacing them with implants once my skin is stretched to the desired size - C cup. Thus, decision point C. I have been wanting/needing/hoping for a reduction for years. I joked that I would save the expense and wait to get it done through cancer. Not so funny, ha, ha now. All negatives aside, I am looking forward to having my fembots back to the size they originally came in.

I'm not going to go into why I made this decision, or my thoughts on all of the options. Just know I fully trust I am making the best decision for myself as a cancer patient first, and as a woman second.    

Bon voyage "ta tas"! You will definitely be missed. XOXO

P.S. - For those of you wondering, NO, I have not "lost it" yet. But I feel it coming.

Quote for today:
"Tip No. 37: Play Gloria Gaynor's "I Will Survive" so loud that the neighbors call the cops." ~ from the book Crazy Sexy Cancer Tips (gift from John)


This is a passage that I found shortly after I felt some sort of healing after "the great divide". Whenever I am feeling weak, I sort of turn it into a mantra...

Psalm 30: 1-2, 5-7,10-12 (or something of the sort)
I will exalt you, O Lord,
for you lifted me out of the depths
and did not let my enemies gloat over me.

O Lord my God, I called to you for help
and you healed me.

...weeping may remain for a night,
but rejoicing comes in the morning.

When I felt secure, I said,
"I will never be shaken."
O Lord, when you favored me,
you made my mountain stand firm.

... O Lord, be my help.

You turned my wailing into dancing;
you removed my sackcloth and clothed me with joy,
that my heart may sing to you and not be silent.
O Lord my God, I will give you thanks forever.

How You Can Help

"I will clean your toilet," said one of the engineers I work with. "Even if you just need someone to clean the cat's litter box, let me know," said a friend from high school. Wowza!

I am flabbergasted at the number of people who have reached out to offer help. I will need it. My family will need it. And I am completely okay with being selfish and taking it. I just don't know all that I need at this moment.

Just this weekend alone I am realizing how much the kids require. In the back of my mind as we are doing things around the house, I am thinking to myself - how am I going to do this or that? With help, of course. I intend to create a list of people who have offered help, how they can help, and their numbers. I will also make a list of things we need help with.

For now, this is how you can help:

Join the Especially for You Race Against Breast Cancer, downtown Cedar Rapids, IA, Sunday October 2, 8:00 a.m. 
It is a race for breast cancer awareness and funding for those who cannot afford mammograms. Jaime Whitehead, a co-worker, has started a team in my name (Gwen Lange Manning), along with my personal theme for this whole disaster of Team Fembot. Registrations are due by Aug. 28. If you check the box for the $1 t-shirt logo, a Team Fembot logo will be printed on the back of your shirt. Monetary donations are awesome whether or not you can participate in the actual walk/run. 

John and Lea are going to be forming a racing team for BikeStock, Cedar Rapids, IA, Hawkeye Downs, Saturday, October 8, 10:00 a.m.
You can join, donate, or come for the day and participate in any of the family activities they will have. I will send a notice when the team is up and running.

Quote for today:
"I needed to hear my friends say. 'I'm bringing over dinner,' without asking me if I wanted them to make dinner or what I wanted to eat. Hell, I didn't know what I wanted to eat. I had bigger problems than food!" ~ S.N., lung cancer survivor

"My friend said, 'If you need anything - someone to clean toilets or punch around to blow off stress - I'm available from 9 to 9:15 this Tuesday.' It made me feel like laughing, because it was an offer, but I didn't have to make a real commitment. ~ S.M., uterine cancer survivor

both from the book Help Me Live: 20 Things People With Cancer Wants You To Know 

Medical Team, What Say You?

After a week of medical appointments, I am pleased to introduce my medical team and share what we have learned about Gwen, patient #123 (they told me I have a number assigned, I want to know what it is to see if it contains any of my lucky numbers):

1. Genetic counselor, Julie, to receive results from the blood test submitted last week to determine if I am a carrier of the BRCA1 and BRCA2 mutations (pronounced brack-a), which are human genes known to be linked to hereditary breast and ovarian cancer. I tested negative for these two genes. What Julie shared was that any family has a 10% chance of having this gene. If it is in the family, children have a 50% of getting the gene passed to them from either parent. If passed, that person has an 85% chance of getting breast cancer, and anywhere from 25-40% chance of getting ovarian cancer because of this gene. The average person has an 8-10% chance of getting cancer. There was a ton more information Julie shared, but in the interest of keeping 1.5 hours of conversation to a shorter story, I'll leave it to you to search the web.
2. Navigator Nurse, Mona, at St. Luke's, who gave me a great educational book on breast cancer and how to deal with every aspect of my life that it will affect, with areas specifically highlighted for my case. Oncology Associates has a Navigator Nurse also, so I will see what she has to offer at my next visit there.
3. Nutrionist, I don't remember her name, provided by the Cook Cancer Wellness Program, who will help me with suggestions and plans for meals and food that will help me while I am going through treatment and after. I will begin meeting with her next week. Oncology Associates also offers this service.
4. Personal trainer, Matt, also provided by the Cook Cancer Wellness Program. Rumor has it everybody adores him. I'll get to be like a Kardashian! Matt will work with me at whatever level I can manage before, during, and after treatment. I need this accountability to make sure I get healthier and stay that way. They also offer weekly workouts such as Zumba and Pilates. What is great about this program is I will be in it with other people who are in different stages of their cancer treatment. If Gwennie gets hots during a workout, I can throw off my wiggers and no one will think anything of it! Yay, me!! 
5. Social worker, Nancy, who will help get me and the kids set up with counselors who specialize in individual, child, and family counseling for people/families with cancer.
6. General surgeon, Dr. Renz, and nurse Brenda, who are leading the surgical efforts in my treatment to remove the tumor. The three options I have are lumpectomy with radiation, mastectomy, or bilateral (double) mastectomy, one being prophylactic. It sounds like radiation is a standard follow up to a lumpectomy. Did I  mention Dr. Renz is hot, hot, hot?! I want him to play 'Take Me Away' from The Ugly Truth while he is removing my breastuses.  Love, love the Kathryn Heigl girly dance.
7. Plastic surgeon, Dr. Emery, and nurse Bethany who advised me of the procedures and process for the reconstruction options I have. John and Mom said it was interesting to watch Dr. Emery and me interact, as we fed off of each other in conversation and changed topics about every two sentences! I was extremely impressed with the work he has done and so I am able to put that fear to rest.
8. Oncologist, Dr. Wilbur, and nurse Paula, who pretty much told me how it is - lol! She is my age and we bantered back and forth very well. She is the one to determine if my hormone receptors are going to be called triple negative or not (see blog that talks about this more). She is calling this triple negative, but will treat the 1% positive estrogen because, um, I can't remember why. I am sure John does. She calls my clinical diagnosis - Stage 2, ER weakly negative, PR negative, HER-2neu negative, grade III, invasive ductal carcinoma. The treatment she recommends is 1) local - surgery, with 2) system-wide - chemotherapy. Why chemotherapy? That is what I asked, over, and over, and over again. She explained by putting a number of my stats into a database, including my (young) age, and it showed that if I do not have chemotherapy, I have a 45% chance of this cancer reocurring somewhere else. This typically occurs by some cancer cell(s) getting into the bloodstream. Even though the genetic test result was negative, she is still concerned with the prominence breast cancer has in my family, and admits that we (science) only know about these two mutations now. There may be more. I will meet with her again for chemotherapy "training". As of right now, she is suggesting eight weeks of one chemo cocktail with a shot of another cocktail after each treatment. Then 12 weeks of another chemo cocktail, and followed up with five years of Tamoxifen, which she is recommending because of my 1% positive ER result.

Whew!

Quote for Today:
"Okay, so the shit hit the fan. Take a deep breath, get grounded, and center yourself. Like Alice in Cancerland, you're falling down a dark and creepy rabbit hole. Doctors are spewing lots of information, most of which probably goes in one ear and out the other. Why? Because when you are newly diagnosed with cancer, this is what you hear: "Blah, blah, CANCER, blah blah, ... CANCER, blah blah blah." ~ Kris Carr, Crazy Sexy Cancer Tips 

I am overwhelmed with information right now. While I have lots of things ahead, I find I am only able to focus on the next step in front of me. ~ Gwen

This is a song that has helped me through the last three years of my life, when I was hoping I could save my marriage, when I was starting my life over at age 37, and now when I am facing a monster I have no control over:
While I'm Waiting ~ John Waller

I have no idea where this journey of cancer will take me. But... I am strong, I am faithful, and I am at peace. Because of this, albeit emotionally exhausted, I am able to make it through every day. ~ Gwen

And Then There Was Cancer

The radiologist said, "It looks like you have a little bit of cancer." Really? Just a little bit?!

Beside manner, beware. Not so fond of this gal.

I was set to have a hysterectomy tomorrow (sidenote - I think it is extremely hilarious that I got my period today!). When I went in for my pre-op physical, I also had my annual mammogram. When my gynecologist (Dr. Rozeboom) came into the exam room, he quickly talked about the hysterectomy surgery, and then said he wanted to talk about the lump he saw on the films. We talked briefly about the lump, said that regardless of what it is, he would want it out. He scheduled an appointment with my surgeon (Dr. Renz - hot, hot, hot!) a few days later, saying it would be helpful if we could group the two surgeries together. He suggested the surgeon may want to do a biopsy. The next day, the radiologist (at RCI) called to schedule an appointment for a more specific mammogram and an ultrasound. At that appointment the next day we talked about my upcoming appointment with the surgeon, and how he may want to do a biopsy. The radiologist called the surgeon and they agreed doing the biopsy sooner would be best. A few minutes later, they had a time slot open that afternoon, so I came back and hour later for an ultrasound biopsy.

It just plain sucked. I went straight to Dairy Queen after and got a Peanut Butter Bash. If you've never had one, STOP reading this blog NOW and go get one!

The day I met with the surgeon and was expecting the biopsy results, I woke up with a bad feeling in my gut. Early in the morning, the radiologist called and asked me to make an appointment to discuss my biopsy results. Yeah, the two other times I have had a breast biopsy, they have told me 'benign' over the phone. I told her I was going to come to her office right then. This is when she told me I have cancer. The tumor is clinically diagnosed as Stage II cancer, 2.5 cm in size, and grade 3 in appearance. I say clinical because until I have surgery and they can test the slices of the tumor, we won't know the true pathology of this thing. My receptor test results were: 

• Estrogen Receptor (ER): Positive (+) 1%, Allred score: 2
• Progesteron Receptor (PR): Negative (-), Allred score: 0
• HER-2-, score 1+
• Ki-67 Proliferation Index: High 60%

In lay terms, the best I understand this clinical diagnosis is:

• Stage 2 (on a scale of 4) because of the size of the tumor (20 x 19 x 26 cm)
• Grade 3 (on a scale of 1-3) because it is most abnormal in appearance and considered to be aggressive
• These three results help the oncologist determine the best treatment for me:
• ER+ (1%), Allred score of 2 (on a scale of 1-8)
• PR-, Allred score of 0 (on a scale of 1-8)
• Both indicate the tumor is most likely not stimulated by estrogen or progesterone, and may mean that it will not respond well to hormone therapy 
• HER-2 negative, score 1+ (on a scale of 0-3+), which indicates this is a mildly agressive, fast growing cancer
• Ki-67, high at 60% indicates that my cells are dividing rapidly, another aggressive cancer indication; lower than 10% is a preferred result

All of these statistics define my personal cancer, which therefore helps the doctors determine the best course of treatment. There are so many factors involved that make up my particular case that differentiates it from other's. This is why there is no set treatment for cancer in general, but so many treatment options depending on a specific diagnosis.


Quote for today:
"We learned more about cancer in two hours than I learned about anything in four years of college." ~ Sheryl Crow, from the Foreword of Crazy Sexy Cancer Tips (a gift from John)

One of my most favorite songs, based on Psalm 119:105, Thy Word, by Amy Grant:
Thy Word is a lamp unto my feet
And a light unto my path.
When I feel afraid
And think I lost my way,
Still, you're there right beside me.
Nothing will I fear
As long as you are near;
Please be near me to the end.
Thy Word is a lamp unto my feet
And a light unto my path.

Fear Not

The other night when I was tucking my daughter in, she asked, "Mommy, are you scared because you have cancer?". I said, "No, honey. You know why? Because I know God has my back". She smiled the sweetest smile.

Quote for today:
"I think what I most didn't want to hear was other peoples' fears. I wasn't prisoner of my own fears, and I didn't want to have to take on anyone else's." ~ W.T., lung cancer survivor, from Help Me Live: 20 Things People With Cancer Want You To Know 

I am not scared of this cancer. I am enough. ~ Gwen

Isaiah 41:13
For I am the Lord your God
who takes hold of your right hand
and says to you, Do not fear;
I will help you.

It is eerily evident that the Holy Spirit is active in life. This is what allows me to completely trust that who is holding my hand is bigger than all of us. ~Gwen 

Day I

Hi, my name is Gwen. I am 39 years old, and I have breast cancer.

I just found out that I have breast cancer. Specifically, invasive ductal carcinoma. When the doctor was explaining the options, including his explanation of reconstructive surgery, what immediately came to mind was Austin Power's Fembots.

Thus the name for my blog. I anticipate having my own version of these Fembot cannons through this.

I have a strong history of breast cancer in my family, so I always suspected I could get breast cancer someday. I am not surprised. I wonder if I am still kind of numb. It hit me today that maybe I feel the way I do is because I am sort of thinking...  _I_ don't have cancer, my breast does.

I have three reason for creating this blog: 

1. I need this release.
2. It is a place I can share with everyone.
3. Someone may learn something which helps them or someone they care about. 

Quotes for today:
"I loved it when friends resisted the urge to say something 'wise' to fill the silence. Sometimes the wisest words are those that remain unspoken." ~ L.C., lung cancer survivor, from Help Me Live: 20 Things People With Cancer Want You To Know 

You don't have to say anything; just being here is enough. ~ Gwen 


Isaiah 53: 7
He was oppressed and afflicted,
   yet he did not open his mouth;
he was led like a lamb to the slaughter,
   and as a sheep before its shearers is silent,
   so he did not open his mouth.

I have a huge trust in God to care for me. I am okay. I will be okay. ~ Gwen