“chemo, pray, love”

While I was going through the process of freezing my eggs, I had to make a decision about what oncology team I was going to move forward with. This was a big decision with a lot of factors to take into account. After all, this was a team that I would be choosing to be with for many years to come, not just for my upcoming chemotherapy treatment. Whoever I selected would be monitoring my health closely for years, so it was important that I put a lot of thought into whom I wanted to establish this long-term and quite frankly “intimate” relationship with…I mean they would be feeling my boobs pretty regularly!   

In order to make my decision, I asked myself many questions. To give you an idea of what went through my head, here are a few of the things that I took into consideration…Which doctor and nurses made me feel the most comfortable and confident? Who was up on the latest breast cancer research? Did I want to go with a “team-approach” and stick with the same facility I was planning for my surgery, or did that not matter? What type of environment did I want to be surrounded by during my chemo infusions? How far was I willing to travel for appointments and infusions? How often would the oncologist see me during treatment? The list of questions goes on and on…

It certainly didn’t help that my hormones were on overload from all the fertility treatments – an emotional time was even more heightened. Making this decision felt pretty daunting, I was worried that I was going to make a “bad” call. At the end of the day, I had to remind myself that I couldn’t make a wrong decision, I would get great care wherever I went, I just needed to reflect on what was best for me. Naturally, I was also worried about hurting the feelings of those I wouldn’t be moving forward with. However, I had to be selfish and put my health and myself first, which isn’t an easy thing for me to do.

So, how did I ultimately make my decision? After a lot of thought, family discussions, appointments/visitations/tours, pro-con lists, prayers and “signs,” I realized the answer was in my “gut” all along. I think I just needed the time to logically “talk it out,” as I usually do. Once I made the decision, a heavy weight was lifted from my shoulders. I immediately felt confident that I had made the right choice for me; it was actually a rather empowering feeling. I was making headway in this journey.

Another big decision weighing on my mind was whether or not to get a port, which is a medical appliance that is surgically installed beneath the skin, typically just below the collar bone in the upper chest, but they can also be placed in the arm. They are often used for oncology and hematology patients, so that drugs can be injected and blood samples can be drawn. How does it work? Well, a catheter connects the port to a vein (generally the jugular vein, subclavian vein or superior vena cava) and the port has a silicone bubble for needle insertion (also known as the septum), wherefrom the injections are given or blood is taken. Patients that have to undergo frequent chemo treatment, are generally advised to get a port, as chemotherapy is often toxic and can damage skin and muscle tissue if administered elsewhere. The port has many advantages including easy access to a vein (less needle pricks/discomfort) and a way to deliver chemo drugs quickly/efficiently throughout the entire body. However, like anything else it also has its risks including, infection, blood clots, mechanical issues/failure, damage to the arteries, etc.

I was told I would need a port – several times. When I learned what it was, I physically got sick to my stomach. The idea of it caused a lot of anxiety for me. For most people, it probably isn’t a big deal, but to me it was terrifying. In my mind, it was a foreign object in and protruding from my body. Something attached to a major vein. It was another procedure. Another scar – two in fact, that wouldn’t easily be covered. It was another reminder of everything. I wasn’t comfortable with the idea in the least bit. All my life I had been told I had “good veins,” so I was adamant about having my veins evaluated to see if there was any way around this. Granted they had recently been through the “ringer” with all the blood work, contrast agents, etc., since my diagnosis.

When various chemo nurses at many different facilities evaluated my veins, I was highly suggested to proceed with the port. Many even mentioned that if I didn’t, I might wind up with severe damage to my arms that would require plastic surgery. Well shit, I didn’t want to have to deal with that on top of all of this. So after a lot of sleepless nights, I begrudgingly set-up my appointment to have the port placed the day before my first chemo infusion. Remember that weight that I said was lifted off my shoulders when I made the decision about my oncology team? Well, I wish that were the case with the port decision. Rather, the weight came right back and felt so much heavier. I wasn’t happy about this “port business” one bit.

As I mentioned in a previous post, I was dealing with complications from my fertility preservation right up to the day before my first scheduled chemo infusion…and my chemo schedule could not be delayed any further. It was beginning to feel a bit like I couldn’t catch a break but I knew that I had to keep strong for everything that lied ahead. Since I was having complications after the egg retrieval, I had to cancel my port placement. In my mind, it was a blessing in disguise, even though the discomfort was out of this world. I decided I was going to try to use my arms, at least for my first infusion. If there was any trouble, I knew that I would have to move forward with a port for the subsequent infusions. For the time being, my “port panic” (very appropriately termed, I might add) subsided. Thank goodness.

By the time I was discharged after my second vaginal aspiration, I had less than 15 hours to recover before chemo was to begin. Fortunately, I was feeling so much better after my procedure. A good thing because I knew I was going to need my strength. When we got home that evening, my mom started preparing all my “chemo stuff,” so that we would be ready to go bright and early the next morning. Boy, did she hook me up with everything and anything you could have needed! She had all my favorite snacks, hard candies/mints, a cozy blanket, a travel neck pillow, magazines, iPod/headphones, a cooler full of popsicles (I’ll explain later) and so much more. I’d like to add that it was all amazingly organized and well packed, but that was of no surprise to me! By the looks of all the bags, you would have thought I was moving into the place. She thought of it all, just as she always does.

The morning of Tuesday, September 18^th 2012, came sooner than I would have liked but that’s often the case, especially because I am not a “morning girl.” My original idea was that I was going to “fashionably” see my way through each of my chemo infusions. I figured since I wouldn’t be feeling well, I might as well try to look fashionable and cute. Ha, what a joke that was. When I got dressed, I said screw that idea, sweatpants it is! I did at least put make-up on, so I wouldn’t scare anyone away on my first day. My mom made me a nice breakfast that morning, saying it was important to get something in my stomach, especially before receiving treatment. She’s always looking out for everyone else and making sure they are okay. Before I left the house, I had to give myself a blood thinner injection in my stomach. This was a post-op instruction as a result of the fertility complications, to prevent developing blood clots. I was told I would have to continue these shots daily until I got my menstrual cycle.

Where I decided to have treatment is a bit of a trek. We had to allow for at least an hour and a half to get there. Of course, the weather was yucky which made the already bad traffic worse. The car ride was pretty quiet; for the most part I just tried to escape into whatever was on the radio. At one point, we were worried we wouldn’t make it on time. Fortunately, my mom, the always-calm driver, made it there right on schedule. She dropped me off at the infusion center with all the bags, so that I could register while she parked the car. Typically, before every infusion I would have blood work and meet with my oncologist and oncology nurse; however, for the first infusion I could skip these steps, since I had done all of that the week prior.

After checking in, I proceeded to the waiting area, where I was surrounded by individuals double and triple my age (and some even beyond that). Quickly, I realized I would most likely be the “baby” there. I wasn’t young enough for the pediatric unit (under 18) but I didn’t quite fit in with this crowd either. I joked that I was between “pediatrics” and “geriatrics.” I was surprisingly rather calm, as I waited to be called back. I’m not sure if I was just zoning out, still in a fog from the previous day’s anesthesia, or just at ease. Whatever it was, in hindsight, I am thankful for it.

When my name was called, I was taken back to be weighed – ugh. I don’t know anyone who likes to step on a scale! This is especially important on infusion days because your weight factors into your chemo dosage. After that, my mom and I were seated in one of the curtained off sections, similar to what you would see in an ER, except instead of a hospital bed there was a reclining chair, two visitor seats and a TV. My vitals were checked and as per usual my pulse was ridiculously high. Next the chemo nurse that was assigned to me that day, went through my “chemo orientation,” including, treatment schedule, specific drugs and their administration, side effects, etc.

Before I get into the “nitty-gritty” of my specific chemotherapy treatment, let me stop and do a very general “chemo orientation.”

What is chemotherapy? 

Also called, “chemo,” it is a type of cancer treatment that uses drugs to destroy cancer cells. It is considered a “systemic” therapy, meaning it travels throughout the body, unlike surgery or radiation, which are called “local” therapies. There are many different chemotherapy drugs, what each patient receives is based on many factors specific to their individual case.

How does chemotherapy work? 

It works by stopping or slowing the growth of cancer cells, which grow and divide quickly. However, since chemo does not know the difference between the cancerous and normal cells, it can also harm healthy cells that divide quickly, including those that line our mouth and intestines or cause our hair to grow. Unfortunately, damage to these healthy cells may cause side effects. Generally speaking, the side effects get better or even go away after treatment is over, since normal cells will grow back and be healthy.

How is chemotherapy used? 
Sometimes it is used as the only cancer treatment, however, more often than not it will be used along with other treatments including: surgery, radiation therapy, or biological therapy. Terms are given to describe when chemo is given in the sequence of treatments: 

• Adjuvant therapy: given after surgery or radiation to reduce the likelihood of the cancer returning and to destroy any cancer cells that may remain after the treatment 
• Neo-adjuvant therapy: given before surgery or radiation to shrink the tumor; potentially allowing the surgery to be more successful 
• Concurrent therapy: when 2 or more therapies are given together (i.e. chemo and radiation)  

Where do people go for chemotherapy treatment? 

It varies, depending on the patient and the drugs received. It can be received in the hospital, at home, a doctor’s office, clinic, or outpatient unit in a hospital. 

How often do people receive chemotherapy? 

Treatment schedules vary widely. How often and how long treatment is given is based on: type of cancer and how advanced it is, the goals of the treatment, the type of chemo and how one’s body reacts. Some patients receive chemo in cycles. A cycle is considered a period of chemo treatment followed by a period of rest. For example, if a patient receives 1 week of chemo, followed by 2 weeks of rest. These 3 weeks make up one cycle. The rest period gives the body a chance to build new healthy cells.

How is chemotherapy given? 

It can be given in many ways. How it is administered is based on the specific chemotherapy drug given. Examples include: Intravenous, Oral, Injection, Intraventricular/Intrathecal, Intra-arterial, Intraperitoneal, Intravesicular, Intrapleural and Topical.

How does chemotherapy make people feel? 

Chemo affects people in different ways. No one can know for certain how a patient will feel during chemo or what side effects they may have. A lot depends on how healthy the patient is before treatment, the type of cancer, how advanced the cancer is, the kind of chemo drugs given and the dose. There are a variety of side effects that one may experience but the most common is fatigue.   

This is by no means a complete overview of chemotherapy; rather it’s a “quick snapshot.” For more information, I recommend checking out the sources I’ve referenced including: Chemocare and National Cancer Institute. The important thing to realize is everyone’s cancer journey is different and treatment plans/side effects vary from person to person. Also, not everyone with cancer requires chemotherapy.

Now, going back to my specific chemotherapy treatment plan: dose-dense, neo-adjuvant therapy, given every two weeks for 8 total infusions (two parts) intravenously – which equates to four and a half months of chemotherapy. Wait, what does “dose-dense” and “neo-adjuvant” mean? Dose-dense chemotherapy is when drugs are given with less time between treatments than in standard chemo treatment plans. Neo-adjuvant chemotherapy means I was having chemo before surgery or radiation, to try to shrink the tumor, and specifically in my case, pull it away from my chest wall. “Part 1” of my chemotherapy treatment would include 4 infusions of Adriamycin and Cytoxan, while “Part 2” would include 4 infusions of Taxol. While my chemo nurse covered my entire treatment plan and all the drugs, she covered “Part 1” in the most detail, since those would be the drugs I would receive first.

Want to know how my first chemo infusion and the rest of “Part 1” went? Keep an eye out for another blog post soon! Nothing like a chemo cliffhanger, huh? 

“I’m choosing happiness over suffering, I know I am. I’m making space for the unknown future to fill up my life with yet-to-come surprises.” -- Elizabeth Gilbert; Eat, Pray, Love

Kelly

P.S. My very first freeboobin’ blog post was on September 18^th 2012, the same day as my first chemo infusion (partially a result of many steroids from the day’s treatment, ha ha). Here’s a throwback picture (age 3) of my early “blogging” days.

P.P.S. I find it very symbolic that I just watched my college quarterback win the Super Bowl. I'll take that as a sign that one hell of a fight leads to a great big win. 2013 is going to be a SUPER year. Congrats to Joe Flacco and the Ravens!

a note from mom's pink sharpie

Now that we are a good month away from the holiday season, I feel I can share how Kelly’s holiday blog post snapped me out of my bah-humbug attitude.

Several years ago, I jumped on the “holiday letter” bandwagon, by sending a one page typed letter expounding on all the wonderful things that we as a family and as individuals had accomplished that year. Shortly afterwards, I received a Christmas note from a family acquaintance who had apparently received our letter. This was from a person who had a similar family to ours: a hardworking father, a stay at home mom, three children, and a dog. The note was fairly short and to the point; but in a nutshell it asked that we not send anymore of these holiday letters about our “perfect” family. It still amazes me today how words, whether spoken or written, can have such a powerful affect. This person not only changed my outlook on “holiday letters,” but on how I expounded upon any of our accomplishments as a family, or as individuals, in the future. I became very reluctant to even talk about our family unless someone asked, and even then I seem to temper the good with some bad.

This past summer, another individual lambasted us about our “perfect” family. Kelly was diagnosed shortly afterwards. I wanted to go back and cram that word “perfect” down that individual’s throat, but then, in the months following Kelly’s diagnosis, I would begin to understand why that “holiday letter” recipient and the other individual had such attitudes about this “perfect” family. It actually didn’t have anything to do with us as a family, but rather what they were experiencing in their own lives at the time. How do I know this, because that “I don’t want to hear about their perfect life” attitude has hit me more than a few times since August. It’s hard to be happy about an engagement, a wedding, a birth, or a promotion, when you are watching some of your loved ones facing a different set of circumstances. Yet, it’s not my place to rain on someone else’s parade, but rather rejoice that we all experience “perfect” moments amidst the non-perfect ones. Our family isn’t, and never will be, “perfect;” but we do experience, accept and celebrate the good, the bad and sometimes even the ugly whether we are together or apart. 

This brings me to this past holiday season and our family Christmas card picture. After my past experience with the “holiday letter,” I was bracing myself for comments on why we were all wearing smiles as though everything was ‘perfect!’ Thus ensued my all time low during the holidays. It was easy to put on a smile for the camera and for those who might see my family, but inside I felt like the grinch had stolen my Christmas. No tree, no presents, no energy or desire to celebrate in the traditional sense. My nerves were on edge and I snapped, luckily it was only in front of my family. We decided to go to the candlelit Christmas Eve service at the church we had been married and Kelly had been baptized. In the pew in front of Kelly sat a young girl and her mom. The little girl’s hair was beautifully braided and I sat back and watched Kelly look at her while fidgeting with the scarf on her own head. I reflected on the last time we were in this church with one year old Kelly in her beautiful white dress and her full head of hair. This service, just as that one so many years ago, consisted of singing a number of hymns and I found myself belting them out through the stream of tears running down my face. After we got home, early on Christmas morning, I read Kelly’s blog and took my beautiful daughter’s advice to stop and look around. What I found was a sense of peace in that I was where I needed to be, doing what I needed to do, and feeling what I needed to feel. Was everything “perfect” in my life, no, but such is life. Do I want to send out a holiday letter or Christmas picture depicting sadness, or depicting happiness, even hopefulness? I’ll continue to choose the latter. Of course, we did receive many comments about our Christmas picture: all extremely POSITIVE.

Now here is an update to a comment I made in an earlier post:

I recently had my yearly mammogram at a different mammography center. I was expecting, as I stated before, that a doctor would come to speak with me after my scan was done. Unfortunately, I was sent on my way without any consultation. So this wasn’t any different than I had experienced at my other mammography center. However, for the first time I received the “dreaded callback.” My gynecologist called me, ironically while we were at Kelly’s chemo treatment, to tell me that I needed to go back for further testing. I wasn’t able to get an appointment until a week later. A very, very long week!  I’ll cut to the chase they did another scan and then had the doctor come to speak with me (so that’s obviously why I made the mistake of thinking the mammography center had the doctor come talk to their patients...it’s because they had also received the “dreaded callback”).

Luckily all was good with the scan, and as I approached Kelly, who was sitting anxiously in the waiting room, I motioned two thumbs up. Kelly sank into the chair with extreme relief (I do believe she was more anxious than I was). Kelly didn’t move, and I said in a fairly loud voice, “Let’s get the hell out of here. We’ve been here enough times in the last several months. I don’t want to come here for awhile!” The staff all had smiles on their faces, and dare I say, most of the people in the waiting room probably wanted to get out of there as well!

Here's to a new year!

Kimberly

“it's a wonderful life”

 

While this year certainly hasn’t unfolded the way I thought it would, I’ve learned that that’s the way life works. Sometimes, we are set on a path that we might not understand, but undoubtedly, there is a reason for it. Along the way, there will be bumps and rough patches. We may even ask ourselves – Why this route? What’s my purpose? All of which are natural thoughts and explorations. Throughout our journey, we should listen closely to life’s lessons, as they whisper quietly to us. Open yourself and let the great teachings forever change you.

Since the end of July (when I found my lump), life has taken me down a different road, one that I could have never predicted. Some may say that this is my ‘rock bottom.’ I, however, choose to look at it differently. After all, much of how you see life is all about perspective. The great thing is, you have the power to change your viewpoint. I see my cancer as a blessing. When you hear that, you might think I’m crazy. It’s a rational thought, as who would typically see cancer as a good thing, much less a blessing?

After I was diagnosed, I was forever changed…for the better. I started seeing life more clearly. All of the sudden I saw just how precious life is and how I took it for granted. I was awakened. From there, I opened myself and life’s lessons started flooding in. I’m sad that it took an illness for me to see this but I’m grateful it showed me the light. There is much that I have learned along the way, which I plan to share in posts to come. However, being that it’s Christmas, I felt it was especially important to take time to reflect on life’s blessings and give thanks.

I am extremely fortunate to be surrounded by so much love and support, especially during this time in my life. All the warm thoughts and prayers have kept me strong, hopeful and positive, as I fight my battle. The angels both in heaven and on earth continue to bless and look after me. I’ll never be able to put into words just how thankful I am but as I go forward in life, I hope to show my appreciation by giving back and enjoying every minute of what life has to offer.

This holiday season, I ask you to stop for a minute and look around. What do you see? A bird flying by? A loved one making hot chocolate? Food at your table? A roof over your head? Whatever it may be, enjoy the blessings that life has brought you and be grateful for them. Most of all be thankful for life, for it is wonderful!

Wishing all of you a very happy & healthy holiday season!

Kelly 

P.S. A tradition in my family is watching the movie, Love Actually, during the holiday season. It is not only one of my favorite movies but it is also a great reminder that “…love actually is all around.”

“eggspectations”

For a while, I would lie in bed at night wondering and worrying that my cancer was spreading by the minute. I wouldn’t sleep on my right side, not only because it was painful, but I also thought that it might make the tumor bigger. Unfortunately, this along with many other thoughts made it hard for me to fall asleep. When I finally drifted off, it was usually when most get up to start their day. I would awake not too long after that and ask myself the same question, “Do I really have cancer or was it just a bad nightmare?” Of course, the answer was always the same and every thing would repeat over again day after day… 

One morning, I woke up with a different worry. I sensed that my menstrual cycle was coming early, which meant I would soon start my egg freezing or “oocyte preservation” process. Knowing that I would need to coordinate getting my various fertility meds as soon as possible, I reached out to my fertility nurse to formulate a game plan. Fortunately, I was able to get my meds ordered and shipped overnight. Then, I scheduled my first fertility “monitoring” appointment for what I guessed would be the second day of my period. It was a good thing I listened to my senses, as it came the next day.

I don’t think I’ve ever been so excited or relieved to get my cycle. Believe it or not, I even shouted it around the house – “I got my period! I got my period!” Why all the fuss? Well, if you recall from one of my earlier posts, I would only be able to proceed with freezing my eggs if my period came on schedule, so as to not delay chemo any further. We were worried that because of all the stress the diagnosis brought with it, that either my period would be late or not come at all. It was most certainly a very big blessing when it came much earlier than it should have.

With its onset, now I was off to tackle my first “treatment battle:” fertility preservation, since chemo may compromise my fertility. What does freezing your eggs entail? Well, here is what my eggsperience was like…

When I arrived at my first morning “monitoring” appointment, I didn’t realize how crowded the fertility clinic would be. I was amazed to see so many women, some with their partners and some without, which filled the waiting room. Who knew this was such a happening place? In a way, it was comforting to know that so many women, men and couples use fertility treatments. When my name was called, I was taken back for part one of the monitoring appointments – blood work. This was primarily to evaluate my blood estrogen levels. After the blood work, I was sent back to the waiting room until they were ready to see me for part two – transvaginal ultrasound.

My name was called again and I was told to use the restroom if needed to empty my bladder. Then I was taken back to one of the many examination rooms. This time I was told to “get undressed from the waist down and wait on the examination table.” It was at least something different from what I had been hearing so often, “get undressed from the waist up….” I guess now I had to get used to this phrase and someone examining my other private area! So I did what I was told and sat bare-bottomed on the table with a disposable napkin over my lower-half, awkwardly waiting for what was next.

When the tech came in, she had me lie on the table, knees bent and feet on the stirrups…then she started the exam. A transvaginal ultrasound is used to look at a woman’s reproductive organs – uterus, ovaries and cervix. The probe sends out sound waves, which reflect off of the body’s structures and produce a picture on a monitor. For the most part the test is painless, although at times the pressure of the probe can cause some discomfort. I had my own monitor to follow along, which was not only interesting but helped to distract me.

The first thing she looked for was any cysts, fibroid tumors or growths. Luckily, she didn’t find any. Next she looked at both of my ovaries to see how they were responding under normal circumstances (without fertility meds). After the exam was over, I met with a nurse to review all the fertility meds I would be taking and how to prepare/give the various injections. I was told that later that afternoon, I would receive a call with the proper dosage instructions for my injections beginning that evening.

Even though I had a lesson from the nurse, I wanted to be certain that I prepared and gave the medicine appropriately, so, I went home and watched all the online instructional videos…multiple times. Opening the large box of fertility meds was slightly overwhelming – especially seeing the various sizes of syringes and needles. Later that evening, when it came time for my first injections, I had my dad take the lead. As a dentist, let it be known that he has the best novocaine shot technique there is, so I knew I would be in good hands! He prepared the dosage, while I held a small ice pack on my stomach just beside my belly button, to numb the area. I pinched my stomach, while he gave me the shot subcutaneously (just beneath the skin, not in the muscle). Not bad at all, though some of the meds stung a bit.

I was given various injections at the same time every morning and night for several days, though the dosage sometimes changed. For the most part, I also had “monitoring” appointments every day to evaluate my blood estrogen levels and my ovaries response to the fertility meds – checking to see how many eggs there were and how they were maturing. Normally, in a woman’s reproductive years, her body releases one egg from the ovary in the middle of each menstrual cycle. When stimulating the ovaries with fertility medications, usually multiple eggs can reach maturation during a single treatment cycle.

At one point during the process, I had to learn to prepare and give the injections myself. I’m proud to say I was able to do it! I have to admit, it was a good feeling to know I was capable of handling it myself. Another fear I was able to overcome. After a while, it even became old hat! I disposed of all the syringes and needles in what we commonly referred to as “The New Red Box” (thanks mom!) – in comparison to the movie-rental Red Box that we frequent as a family.

Photo Courtesy of Ryan Bugden

Along the way, my ovaries were responding well and quickly. It was nice to hear the doctors say that youth was on my side. After starting the meds, I did notice weight gain, abdominal discomfort, bloating and a heightened overall hormonal response. My ovaries felt like they were literally weighing me down! Around a week after starting the fertility meds, the doctor said my eggs were “ready.” This meant it was time for the “trigger shot” or as I like to call it the “ass shot.” This intramuscular shot in the butt works to trigger the developing eggs to complete maturation and eventually ovulation. It was extremely important that this drug be administered at the exact time the nurse told me, which was 12am, so we set multiple alarms to make sure we didn’t fall asleep! Again, I had my dad take the lead on this one. Nothing like having your butt hanging out for your dad. Luckily, I couldn’t feel a thing – thanks dad! So it wasn’t a pain in the ass after all! Ha-ha. I crack myself up with that one every time!

You have a “day off” of shots following the trigger – a nice little breather before the big day, the egg retrieval! With everything going on, one of the fertility nurses advised that I take something to help calm my nerves before the procedure. It happened to be the same medicine that was suggested before my MRI-Guided biopsy. After explaining that 1mg did nothing for me, she suggested I take 5mg. So, about 30 minutes prior to arriving for my appointment, I took the suggested dosage.

After signing myself in, I waited patiently with my mom by my side. Since I had my family film a lot of my injections (so I could show my future kids one day), I decided that I should film before the retrieval as well. I took the camera to film my mom and all of the sudden…I started seeing two of her. I can’t say I remember anything after that…until I woke up the next morning. So, I pretty much “blacked out” for an entire day. I think it’s safe to say 5mg works for me, however, not so sure that it was entirely the “safest” thing. I would have been fine with a much smaller dosage! While it’s probably a good thing that I was “out of it,” for the purposes of my nerves, I’m not so sure it was great that my mom pretty much had to carry me back to the pre-op room, get me undressed and into my surgical gown. Ha-ha, sorry mom! You are a saint for putting up with me!

The actual egg harvest procedure is about 30 minutes long and is performed under anesthesia in operating room conditions. While it is an outpatient procedure, it does require someone other than yourself to drive you home -- I most certainly needed this! I have to say there are some pretty entertaining pictures/video of me pre and post retrieval! There is only one thing I vaguely remember and that was the sound of the anesthesiologist’s rolling stool. Why I remember that is very odd. You would think if I remembered anything it would be them telling me how many eggs they retrieved!

When I woke up the next day, I was pleased to hear from my mom how many they got. Significantly more than they were hoping for. I was so thankful, especially because I only had one shot at this and I had high eggspectations for myself! Now, I just had to wait for a call from my fertility nurse to confirm how many of the retrieved eggs were mature. Fortunately, all were able to be frozen except for one!

The next day I felt okay, though, pretty groggy and I had some cramping/discomfort. Fast-forward to the second day after retrieval and it was a bit of a different story. At this point in time, I started noticing abdominal bloating/pain, nausea, weight gain and decreased urination. While, it was uncomfortable and I felt miserable, I didn’t think too much of it. The next day the symptoms worsened and by late evening, I couldn’t take it anymore. I knew something was wrong. I called the fertility emergency number and explained my symptoms, at which point she said I was experiencing ovarian hyperstimulation syndrome (OHSS). This is a problem that is seen in women who have taken fertility meds that stimulate egg production but only after the eggs are released from the ovary. If the ovaries are stimulated too much, they can become very swollen and fluid can leak into the belly and chest. This affects up to 1 in 10 women – of course, another rare statistic that I fell into! Though, my risk was elevated because I was under 35 and I had very high estrogen levels throughout the treatment cycle.

Since it was so late at night and the fertility clinic was closed, the nurse told me I had two options: go to the emergency room or come into the clinic first thing in the morning. I’m not a fan of the ER, so I sucked it up and opted for the latter. I was in so much discomfort, I cried myself to sleep that night. The morning couldn’t come soon enough and to be honest, I was worried it wouldn’t come at all.

I was relieved when I made it through the night. My parents took me early in the morning, so we would be there as soon as they opened. The car ride there wasn’t pleasant. The nausea was so intense it took a lot of concentration and cold air to keep me from throwing up in the bag on my lap. When we arrived, I was taken back for blood work and a transvaginal ultrasound. In addition to how I looked physically, my symptoms and exam confirmed I had OHSS and severe dehydration. On the ultrasound, they could see the fluid in my ovaries and belly.

I was then taken into pre-op for IV fluids and an emergency vaginal fluid aspiration. I was rehydrated with IV fluids for 8 hours and taken back for the procedure at the very end of the day, when the operating room was finally available. This was another relatively quick procedure under anesthesia. It was amazing to hear how much fluid they aspirated. While, I felt a bit better afterwards, the relief didn’t last for long. The next day, the symptoms were back in full force again but I tried to hold out to see if they would improve. Unfortunately, they did not and I wound up back at the fertility clinic after having just been there two days prior. I had more blood work and another transvaginal ultrasound. Again, I was taken to pre-op, for severe dehydration and a second fluid aspiration. Unfortunately, it was the same ordeal as before, I was rehydrated with IV fluids for 8 hours and aspirated after the very last appointment of the day. Would you believe that they aspirated even more fluid the second time?

The second aspiration happened to be the day before I was supposed to start chemo. For a bit there was a concern that my chemo may need to be delayed because of the OHSS. However, after checking with my oncologist, chemo couldn’t be delayed any further, so I would just have to suck it up. Luckily, the second aspiration did the trick and I felt much better. However, it had been a long couple of days and I was physically and mentally exhausted. Guess what I left the clinic with? A prescription for more injections that I needed to give myself because now they were worried about me developing blood clots. Awesome!

When I had OHSS, I’ll admit, I was thinking I wasn’t sure if it was all worth going through the process to freeze my eggs. However, I know it was just the pain speaking. I am very happy I went through with the treatment and feel very fortunate that I had the opportunity. Hopefully, my fertility will return on its own (after chemo) and this will all just be a good insurance policy! If not, at least I have piece of mind knowing that they are on ice, frozen at 27 years old, waiting for me! 

Isn’t that eggciting?
Kelly

P.S. A simple thank you to my loving parents will never be sufficient, for it is them who gave me life and have shown me endless support. Thank you for always being there and taking care of me. I truly hope that I can be half the parent and role model to my children one day, that each of you has been to me. I love you with all my heart.

“bling it on”

Pep Talk:

I wasn’t exactly doing back flips going into all these doctor’s appointments. In fact, I was getting pretty tired of them at this point. But you know what? You do what you’ve got to do and fight on!

Game 1: Kelly vs. Echocardiogram & Electrocardiogram 

When I learned I needed to visit a cardiologist, I thought to myself, what’s that all about? Yes, I have a family history of heart disease (on both sides of the family) but what does that have to do with my cancer? Come to find out that one of the first chemotherapy drugs I would have, Adriamycin, can cause a serious but uncommon side effect related to heart functionality. Specifically, the drug can cause interference with the pumping action of the heart. Actually, you can only receive a certain amount of this drug in your lifetime and it can cause heart problems years after treatment has ended. That “lifetime maximum dose” can be lowered if an individual has certain heart disease risk factors. Thus, it is important for all patients receiving this drug to have their heart function checked prior to receiving treatment as well as after.

I wasn’t too worried going into this appointment. Out of all of them, I figured this would be a walk in the park. However, as I sat in the waiting room, my family history started looming over me. I thought to myself - - Ugh! I shouldn’t have eaten all those french fries over the years. They are my vice, too good to pass up. Ugh! I wish I exercised. Why do I make so many excuses? Blah, blah, blah. Finally my name was called and I was pulled out of my self-criticizing internal battle. I was taken back to a small room and yet again told to “undress from the waist up, gown open in the front and sit on the examination table.” Is it just me or are those tables always too tall and awkward to climb up on? Then again, I’m just over 5’1”, so it’s likely just an issue for those of us on the shorter side. Not to mention that thin paper stretched over the table is just plain annoying and noisy! 

The male technician waited behind the curtain as I undressed and told me to let him know when I was ready. I couldn’t help but think of that scene from the Wizard of Oz when Dorothy visited the Wizard as he talked behind the green curtain. Once I was ready, the tech started my echocardiogram. This non-invasive test uses sound waves to produce images of your heart. It is commonly used to show how your heart is beating and pumping blood. The images from this test help cardiologists identify if there are any abnormalities in the heart muscle and valves. It was a bit awkward at first having the tech perform the test, primarily because he was a fairly young male and I was pretty much “hanging out” there as he moved the device along various areas on my chest to capture images of my heart. However, it didn’t take long to naturally ease into conversation, especially because I asked him a thousand questions. I feel like I came away from that test with enough knowledge to be the tech myself!

After my echo, it was time for my electrocardiogram, otherwise known as EKG or ECG. This test checks for problems with the electrical activity of a patient’s heart. Again, I was told, “undress from the waist up...” Seriously, if I had a dollar for every time I heard that these days! I’m not quite sure why I couldn’t just stay in my gown from the previous test…but whatever! Maybe they consider it “exercise” to have their patients get dressed and undressed? Ha-ha. Anyway, I lay still on the table while the tech placed several small metal discs (electrodes) on my arms, legs and chest. While doing so, I learned all about the steps she has to take when commuting to and from work. As I listened, my heart ached for the young girl. She continued talking for quite some time, every now and then quickly chiming in to say that the machine wasn’t registering anything and that it was likely still warming up. Meanwhile, I could feel that the electrodes were losing their grip on my skin. I didn’t want to interrupt her story but I finally spoke up and said, “I think these things are starting to fall off.” She took a look and saw that quite a few of the electrodes had indeed come off. She laughed and said, “I guess we now know why the machine wasn’t working!” After getting everything situated, the test was pretty quick.

Once my reports were produced and analyzed, the cardiologist came in for an exam. Luckily, I received a good report and was just told I needed to come back after completing chemo (but prior to surgery) to check everything out again.

Game 2: Kelly vs. Breast MRI-Guided Core Needle Biopsy & Mammogram #2

I had a pit in my stomach when I heard that I needed another biopsy. My first one wasn’t pleasant and I was still healing from it. Unfortunately, I was warned that this one would be worse, as it is a more difficult procedure. Since the doctor knew that most people often have trouble with this type of biopsy, she prescribed a medication to take beforehand. I’ve never been one that’s big on taking medicine but after the first biopsy and hearing the warnings about what was to come, I decided to take the doctor’s advice.  

I couldn’t eat or drink prior to my procedure but I was allowed to have a “sip” of water with the medication, thirty minutes beforehand. Now, keep in mind that I took 1mg…that will come into play in a future blog update (a funny story to look forward to). I kept waiting for it to kick in but nothing was happening - yikes! When I was taken back for the pre-procedural routine, I was rather quiet. I suppose it must have been obvious that I was nervous because the nurse kept assuring me that I had the very best doctor and if there were anyone I’d want to perform this particular biopsy, it would be her. The doctor even stopped by beforehand introducing herself and saying that everything would be okay.

The first part of the procedure was a standard closed breast MRI with contrast (been there, done that -- see previous blog post for description) to exactly pinpoint the location of the second mass and to verify the placement of the needle. Then, my breast was compressed between two compression plates, one of which was marked with a grid structure. The radiologist measured the position of the lesion with respect to the grid and then calculated the position and depth of the needle placement. They then injected a local anesthetic deep into my breast to numb it. Unfortunately, I felt everything and it was very uncomfortable. I was really disappointed that the medication I took earlier wasn’t helping in the least bit. A "nick" was then made in my skin at the site where the biopsy needle was inserted. I was already in pain but it was worse once they inserted the needle and advanced it to the location of the abnormality, which was pretty much at the opposite side of my breast. That was the start of the many tears to come. MRI imaging was performed to verify the needle’s position, I can’t even recall how many times I was moved in and out of the MRI unit. Tissue samples of the affected area were then removed and this was repeated several times. The sounds from the sampling instrument were loud and scary. I’ll spare you the details of that part of the process but to sum it up, it felt like an ice pick and vacuum suction were attacking me at the same time. I don’t think I’ve cried that hard in a very long time. I can’t even begin to describe the pain but one thing I do know is that the anesthetic was not working. The doctor and nurses were all very sweet, rubbing my back and comforting me along the way. Let me tell you, it’s very awkward crying face down into a face mask – not being able to move your arms to wipe or blow your nose. At many times, I felt like I was suffocating on my own tears and snot (gross, I know). Once the sampling was complete, a metallic marker was placed in the mass so the area could be easily located in the future. When the procedure was over, pressure was applied to stop the bleeding and the incision site was covered with a dressing.

I was then taken down the hall for a mammogram to confirm that the marker was in the proper position. Luckily, I knew what to expect since this was my second one. However, what I didn’t expect was that this time it would be severely uncomfortable. Compressing a breast that has just been poked and prodded during a biopsy – is not fun. I couldn’t wait to be done with all of this. After what felt like forever, I was finally able to go home. Before I left, I was given pain meds (thank goodness) and a handy little ice pack that slips easily in your bra. By the way, a regular bra isn’t exactly super comfy after all that. I recommend a sports bra.

A couple of days later, I was called with the pathology results. Luckily, it came back as a fibroadenoma, which is the most common benign tumor of the breast – especially for women under 30. This was an immediate relief.

If you recall in my very first post, I mentioned that I had a funny story about my first biopsy. I had a metallic marker placed in my original mass as well. After I was all bandaged up, the nurse said to me “You know what I like to tell women after they have a marker inserted? Now you have BLING in your boobs!” I smiled and laughed. It was nice to have some comic relief. Well, now I have double the BLING baby! Hence, the title of my post – bling it on!

Game 3: Kelly vs. Bone Scan

Similar to my earlier CT scan to see if my cancer had spread (metastasized) to any other part of my body, I also needed a bone scan to see if the cancer had spread to my bones.

Prior to my scan, I needed to have a radioactive substance injected in my arm. Before starting the injection the tech was reading over my records. He said, “I’m sorry, I think I have the wrong chart…what’s your name and birth date?” After I told him, he replied “But this says you have breast cancer, that can’t be right.” I laughed and said “Oh no, you’ve got the right girl.” He looked so sad and mumbled “But you’re only 27…I haven’t seen anyone so young with breast cancer.” I smiled and said, “I have been hearing that a lot lately.”

Since the substance takes several hours to travel through your bloodstream and into your bones, you are allowed to leave for a while and come back at the designated time they give you. Luckily, my brother, Nick, was in town visiting and kindly came with me to my appointment. Since we had time to kill and hadn’t eaten breakfast, we decided to go out for a nice meal. We happened to be in an area with a lot of restaurants within walking distance and it was a beautiful day, so we just started walking to see what we would happen upon. At one point along the way, we were prevented from crossing the street to allow a motorcade to pass – who knows, maybe it was the President? It was pretty exciting to watch…along with the cute, buff motorcycle cop stopping traffic!

Soon thereafter, we found a lovely little restaurant where we caught up over a delicious breakfast. Nick, thank you again for treating! Since we still had time left, we decided to work off our indulgence by walking down to Georgetown and hanging out on a nearby park bench. It was nice to have my brother by my side, not to mention a great distraction from everything going on. Sometimes I think we forget how relaxing and refreshing it can be to go for a walk or even just sit outside in fresh air. Something so easy can really make a big impact on so many things, including your mood, outlook, nerves, etc. We should all make a point to do it more often.

When I arrived back at the radiologist office, I was asked to empty my bladder (which is to prevent any radioactive urine from blocking the view of my pelvic bones during the scan). Then I was taken back to a room and asked to climb up on the moveable examination table and lie very still – I was getting to be a pro at this. The tech asked if I was claustrophobic and I replied, “Well, I’m not exactly fond of tight spaces but I can handle it.” He laughed and said “It’s going to be very tight in there, so to make you feel better, I’ll put this folded piece of paper (formed like a triangle) on your stomach and just know that the machine won’t go any closer than the top of the paper.” I laughed, thinking to myself, that triangle is so small it might as well not even be there – but I know he was just trying to make me feel better. Before moving me into the scanner, the tech turned on some calming jazz music.

He wasn’t kidding about the tight space, it was definitely more confined than an MRI – at one point barely grazing my nose. Closing my eyes and focusing on the music definitely helped. I was moved in and out of the scanner several times and asked to move into different positions so images could be taken of various parts of my body. The special camera used takes pictures of the radioactive substance (also called tracer) in your bones. The areas that absorb little or no tracer appear dark and are referred to as “cold spots,” which could show a lack of blood supply to the bone or certain types of cancer. Whereas areas of fast bone growth or repair absorb more of the substance and show up bright, known as “hot spots.” This may indicate problems including a fracture, infection, arthritis or a tumor.

An hour later the scan was complete. Before leaving, I thanked the tech for the music and told him it really made a difference. One lesson learned -- don’t wear a ponytail during a scan. It can be quite uncomfortable when lying flat on a hard table for an hour!

Fortunately, the results showed that my bone scan was clear. Another big sigh of relief!

Post-Game Wrap-Up:

In sports, just like in life, success has a lot to do with attitude. The right mindset and approach can make all the difference. While I’ve always believed this to be the case, I have witnessed it even more so throughout my journey thus far. A positive attitude and bright spirit can not only keep you fighting but I also truly believe it’s healing for the mind, body and soul.

For years, I kept my blue & white pom-poms in my room, to not only remind me of the “Most Spirited” award I received from cheer camp (from back in the day) but also more importantly to never give up!

So I leave you with this cheer: Be Aggressive, Be, Be, Aggressive!

Go Team – Fight On!

Kelly

P.S. My selection for “Song of the Week,” John Mayer’s “War of my Life,” has actually become more of my personal breast cancer journey song. I was playing Pandora and it came on...immediately the words spoke to me and just seemed to say everything I am feeling. Amazing how music can do that, isn’t it? The most important takeaway from his song is seen throughout this post…Fight On!