“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!

a note from mom's pink sharpie

Ever since I can remember I’ve been a “sign” person. Not the “sharp turn ahead” or “bread on isle number 3” or zodiac type signs, but the subtle hints in one’s tiny part of the universe that suggested some sort of truth, or acknowledgement, or even a course of action.

I have to admit that when I was younger I went seeking the signs rather than being more keenly aware of those coming naturally. In one’s youth, besides getting an education, establishing relationships outside of your immediate family tends to be the center of existence. Whenever I had a crush on someone, I use to say to myself, “If he looks up at me two times and smiles that means he likes me”. Of course, in second grade, the real sign would have been him pulling my hair, or teasing me incessantly. High school found me still believing in the romance novel type of sign, but in order for this to be real you have to turn and see if there are any other girls behind you, which most often is the case.

As I began to get older I didn’t seek out signs so much, but knew they were coming to me through the people I met, the experiences I had, and through my personal spiritual beliefs. Of course some were affecting my life more deeply than others, but all giving me pause to think. One of the most lighthearted and memorable signs I have with regards to Kelly actually happened before she was born. Her father and I were at a restaurant and the waitress noticed I was expecting. She asked if we knew the sex of the baby. A firm “no” being our answer she asked if she could perform the wedding ring test. My wedding ring dangled over my belly and began to move in a circle. “That means a girl”, she proclaimed. We smiled and during the rest of dinner, my husband and I talked about baby names, both girls and boys! The obvious sign was that the wedding ring was right, but the more subtle sign was that this became Kelly’s favorite restaurant and she was always made to feel extra special by the wait staff.

In the past two years, I’ve come to actually look for signs, both about the past, the present, and the future. A re-examination as to what led me to this place in life, how to deal with it as it exists, and what I need to do moving forward. Way too deep, I know, but it starts to naturally happen to most everyone as they grow older, maybe even more so if you are experiencing a difficult time. I have witnessed this in Kelly these past few months as she speaks about signs, both tangible and intangible, surrounding and, in a sense, guiding her. I hope she shares some of these in her posts, they are pretty incredible.

Diane Keaton recently stated in a magazine article, “See, this is what life is. People bring you to places you never expected you would go.” My interpretation: People often carry the “signs meant for you” through their words, action and love. Be a carrier!

Now here are a couple of interesting facts about breasts we came across: (Warning: it might seem like TMI, but good to know when talking about health.)

Nipple Hair Is Normal

Not everyone has nipple hair, but it is very common. The more hair a woman has all over her body, the more likely she is to have hairs around her nipples. These hairs are rarely cause for concern, but if you want to get rid of them, you can tweeze, laser, or trim them. However, you should “alert your physician if the amount of hair dramatically increases.” That could signal a women’s health condition or another type of medical issue that needs attention.

You Can Have More Than Two Nipples
It’s not a myth! Supernumerary nipple, also known as extra nipples, can grow on places other than your breasts and may even develop breast tissue. In fact, extra nipples are the most common congenital abnormality of the breast and can occur in both girls and boys. Some celebrities, including Lily Allen and Mark Wahlberg, are rumored to have them. Extra nipples — there can sometimes be more than one — typically develop along “milk lines,” which start in the armpit on each side of the body, run down through the nipples on the breasts, and end at the groin. However, they have also been known to occur on other areas of the body, including on a 22-year-old woman's foot, as far from the breast as it could get.

Have a Happy Thanksgiving! 
Kimberly  

“we're off to see the wizard”

I think I speak for most when I say, I don’t particularly like going to the doctor. So I knew I really had to buckle up as I began to Follow the Pink Brick Road.

Doctors, Tests and Needles…Oh My!

The First Stop: Fertility Specialist

When I met with the Breast Surgeon, I was told that because of my specific type of breast cancer, part of my treatment plan would require chemotherapy. As you can imagine, this news was extremely difficult to hear. The first question I asked was “Will I lose my hair?” Sadly, the answer was “Yes.” There would also be a long laundry list of other side effects…one of which I wasn’t expecting, the possibility of infertility.

Along with a million other things running through my mind, now I had to think about the possibility of not having children. This wasn’t an easy thing to process, especially because I’ve always wanted to be a mother. I may have not been ready for kids right now but it was something I saw as part of my future. In order to protect that part of my plan, I was willing to do whatever it takes.

The first step was meeting with a Fertility Specialist to discuss my options. Again, there I sat, my parents by my side, as I listened to every word the doctor said to the 27-year old woman sitting in front of her. Oh wait, that’s me she’s talking to! Everything still felt like an out-of-body experience and it was hard to snap out of it.

During that meeting, I learned all about the Egg Freezing process. The doctor took a very positive approach, not focusing on the possibility of my infertility but rather how fortunate I am to have this option, which has only been around the past two years. She also said that age was on my side, as my eggs could be “frozen in time” as 27-year old eggs. The doctor did say that I would need to think about what I want to do with them, should anything happen to me. I quickly responded “I’d like to donate them to my brothers.” Everyone in the room laughed and I looked perplexed as to why. My mom chuckled and said, “Kelly, that wouldn’t work. It would be like incest.” Wow, how did I not think of that?! Here I was thinking I was making a nice gesture, ha-ha! At least we all got a good laugh out of it – which we really needed.

While all the details of the process sounded a bit overwhelming, I walked away wanting to make the “investment,” even if it was just an “insurance policy.” Now, I just needed to get the “OK” to move forward with freezing my eggs (prior to chemotherapy) from the Oncologist.

The Second Stop: Blood Work

When I was younger, I dreaded having my blood drawn, getting shots and even swallowing pills. Sometimes I would even pass out! Luckily, as I’ve gotten older, I’ve been less fearful. It’s a good thing because little did I know that with this diagnosis – all of those things would become part of my “normal routine.”

To say a lot of blood was needed is an understatement. I don’t think I’ve ever had so many tubes drawn! Blood was needed for fertility testing as well as for several other tests. While drawing my blood, the Phlebotomist asked, “Are you alright?” I responded with, “Yeah, I’m fine…I just need to look away or I’ll pass out. This feels like a long time, how much more do we have?” “Oh, we’re only halfway there,” she replied. “Awesome!” I said sarcastically…and that was just the first of more “bloody” blood work to come.

The Third Stop: Breast MRI and Mammogram

Walking into the Radiologist office the morning of my appointment was like déjà vu. It brought back the nerves I had before my first ultrasound and ultrasound core needle biopsy. Now, I was anxious to see what a breast MRI and mammogram entailed. These tests were to not only get a clearer picture of the known tumor site but also to check both breasts for any other questionable areas.

The first part of the visit was the breast MRI. After changing into the standard medical gown and having blood drawn, they had me lay face down on the moveable examination table. The platform is specially designed for the procedure, which has openings to accommodate the breasts to be imaged without compression. Once I was situated on the table and given headphones to help with the loud noises, the technologist started an IV, which was for the portion of the procedure when they administered the contrast material. After about an hour of lying completely still, the imaging was finally over.

Then it was onto the mammogram. I’ll admit I had heard terrible things about them and here I was having one 13 years before we, as women, are suggested to. At first, the mammography unit looked like a scary contraption but it’s really not that bad. It’s just a few seconds of discomfort, when your breast is being compressed at the various angles. For me the most uncomfortable part was when the diseased breast was being manipulated. Luckily, I had a very friendly and funny technician who made the process feel like a piece of cake!

The results of the mammogram were very quick. After having time to look over my images, the Radiologist met with me to review everything. Fortunately, the mammogram only picked up the known tumor. The results of the breast MRI, however, would take a few days.

A message to all women: Do not put off getting a mammogram because of the scary things you may have heard, it really isn’t bad at all. You can do it!

The Fourth Stop: Genetic Counselor  

When I was tested for the BRCA1 and BRCA2 gene mutations, it was suggested that I have a consultation with a Genetic Counselor. The purpose of that meeting would be to not only review my family history but also to discuss the various genetic testing I should consider and their implications.

During that initial consult, we went over my family tree to see if there were any possible links to my cancer. Fortunately, there were not. However, since breast cancer is so rare in women my age, we also discussed additional genetic testing that I may want to consider.

While the Comprehensive BRACAnalysis is “a highly reliable and accurate test” for the sequencing of BRCA1 and BRCA2 genes, the BRACAnalysis Large Rearrangement Test (BART) was “launched to provide a way to detect additional large genomic rearrangements in both BRCA1 and BRCA2” (Source: Myriad). Thus, I was advised to be tested for a BART mutation as well.

In addition, another gene mutation that has been linked to breast cancer, among many other cancers is p53. My counselor asked me to give thought to this test as well.

After many discussions with my Genetic Counselor, doctors, insurance company, and parents, I decided it was best to “dot my i’s,” “cross my t’s” and make the investment in all of the testing, so I could have the reassurance of knowing all the facts – especially to aid with a future surgery decision.

Approximately two and a half months later, I now have all of my genetic test results. I am very pleased to report that all came back negative (no mutations)! What a big relief for both my family and me.

Even though I still keep in touch with my Genetic Counselor, I want to publicly thank her so very much for listening, her sweet nature, patience, concern, advice and loving support. You made a crazy time much more comforting – like I was talking to a big sister who was always looking out for me! Thank you for being a wonderful person that I’ll never forget.

The Fifth Stop: Oncologist   

Was I really going to meet with a doctor who deals specifically with cancer? Now I was officially the cancer patient...things were just still so surreal. When I walked into the examination room I felt fine but my pulse was skyrocketing. Even though I had my long list of organized questions, I was growing more nervous by the minute.

First, a technician came in to get my vital signs and ask if I was in any pain. Not long after that, the Physician’s Assistant came in. She asked me to recount everything that’s happened since I found the lump. I feel like I knew the story like the back of my hand at this point, since I’ve recounted it so many times. Then we discussed both my family’s medical history and mine at length. I suddenly started to get very hot and had a hard time concentrating. I was hearing what she was saying but focusing was becoming more and more difficult. I was pretty sure I was about to pass out, so I spoke up and said I didn’t feel right. Immediately, they opened the door to let in some fresh air and she ran out to get me some water and crackers. I had pretty much drenched through my clothes, so I changed into a medical gown. I guess reality was hitting me all at once.

She stepped out and gave me some time to lie down and relax. Once I was feeling better she came in to finish the appointment with a breast exam. Next the Oncologist came in smiling and asked if it would be okay to bring in some students with her. I didn’t mind at all, especially if it was to help them learn. Everyone was very nice and the doctor often placed a hand on my shoulder – talking to me in a very caring way. We went over my diagnosis and what my chemotherapy treatment plan would look like. Her recommendation was 8 infusions total, every other week, followed by a shot the day after each infusion to boost my white blood cell count. You wouldn’t believe how many questions I asked about chemotherapy and it’s side effects. While going through the details, that feeling came over me again. I had to stop the conversation as I felt as though I was going to pass out. They were very kind and all stepped out of the room to get me more water and time to regroup.

Eventually, I was “all there” and we continued the appointment. I explained that having children was important to me and asked her thoughts on freezing my eggs. The Oncologist understood, but due to the aggressiveness of my cancer she was only willing to give me permission to do one round of IVF. I couldn’t proceed if my menstrual cycle came late or not at all, as there wouldn’t be time.

Towards the end of the visit, she did a breast exam and mentioned that it was important to see if the cancer had spread. Thus, I needed both a CT and Bone Scan. Luckily, they were able to get me in for a CT Scan that day. Before wrapping up, we talked about clinical trials for a bit and she had someone meet with me to discuss them in more detail.

We met with the clinical trial contact to gather paper work and briefly discuss what the trial would entail. It was a lot of information to process at once, so I took it home to think it over. Then guess what I had to do next? More blood work! The man who drew my blood was so sweet and funny. I said “Don’t mind me, I just need to look away.” “That makes two of us,” he replied. It was nice to laugh. He then said, “Your blood is special, you must have royal blood.” Oh royal blood! Now I really liked hearing that! I’ve always liked to think there was some royal blood in me. Or maybe that’s just because I’ve always wanted to be a princess and have a weird fascination with crowns! Either way, at least now I have a stranger to help aid my theory! As he finished up, he wrapped my arm with a pink bandage to match my shirt. Now that’s what I call full service! He said I should go play a tennis match or something. Ha-ha.

It seemed like forever waiting for the CT Scan. So many steps you have to go through with insurance. Finally, it was my turn. I lied on the examination table fully clothed and they put a sheet over me and asked me to pull my pants down to my knees. I’m not going to lie; it was kind of awkward – especially coming from the guy technician who asked. Next, he hooked me up to the IV, which would administer the contrast material. I kept switching which arm to use for all these needles, as they were starting to look a bit traumatized!

The scan was fairly short; the weirdest part is when they push the contrast material through the IV. I was pretty sure I peed my pants and started to get nervous the tech would notice when he came out. So I figured I would just bring it up before it got awkward. As soon as he walked in the room, I said, “I think we have a problem.” “What’s wrong?” he asked. “I think I peed my pants…” I quietly said. “Well we can’t have you doing that, now can we! Are you sure you did?” he smiled as he replied back. “I’m pretty sure but I can’t say for certain,” I reluctantly replied. “You know peeing in your pants is only for babies and old people, right?” he laughed. “Yeah I know but I couldn’t control it!” I laughed back. “He said I’m just joking with you, that’s a very common sensation for most people when we push the contrast liquid. You didn’t pee your pants, I guarantee you,” he said. Once he left the room and allowed me to pull my pants up, I was relieved to see he was right. Thank goodness!

The next morning, I received a call from the Oncologist saying that my CT Scan was clear. So good to hear such great news! Now I just needed to get a Bone Scan scheduled.

The Sixth Stop: Breast Surgeon Follow-Up

Prior to my follow-up appointment with the Breast Surgeon, I picked up my reports and images from my mammogram and breast MRI. I also had them forwarded to surgeon, so she would have them for review prior to my visit.

The mammogram was clear, as the Radiologist mentioned, only picking up the known tumor. Unfortunately, the breast MRI picked up another questionable solid mass in another area of the diseased breast. This would require another biopsy to determine if it’s benign or cancerous. Because of its size and location, it would require a more challenging procedure than my original biopsy, called a Breast MRI-Guided Core Needle Biopsy. Ugh. Not exactly the news I wanted to hear.

The MRI also showed, as the surgeon suspected in my first visit, that there is chest wall involvement. This means that the known tumor is against the chest wall and possibly invading it. With this situation, If they were to go in for surgery, they very likely would not be able to get clear margins – which would mean that cancerous cells could be left behind in the chest wall. This news was a game changer. Even though they knew I would need chemotherapy, they now knew I would need neoadjuvant chemotherapy, or chemo prior to surgery. I was told that I needed to start chemo as soon as possible, especially if I was going to try to fit in one round of IVF beforehand.

Even though I was not looking forward to the idea of chemo and losing my hair earlier than expected, I looked at this as something that would buy me time with making my surgery decision. I also hoped that I would be able to see the tumor shrink, hopefully allowing for breast-conserving surgery.

Coming out of that visit, I had yet another set of appointments to schedule:

·      EKG and Echocardiogram (determine heart function prior to chemo)

·      Breast MRI-Guided Core Needle Biopsy

·      Mammogram #2

·      Bone Scan

 

The Next Several Stops: Additional Opinions

In order to ensure that I was making the best possible decision with my medical care, it was important to seek additional opinions. Fortunately, everyone had the same diagnosis and similar game plans. My decision would just come down to whom I felt most comfortable with.

So again, off I went to digest a wealth of information, set up more appointments, make decisions about my medical team and start to make plans for IVF.

Following The Pink Brick Road so far has brought many unexpected curves but I’ve been lucky to travel it side by side with supportive and loving family and friends. Always clicking my heels along the way, saying…

There’s no place like home!

Kelly

P.S. My brother Ryan (aka Ryden Ridge) released his latest EP today. Check it out here and in my “Song of the Week” section. Ryan, I love you and I’m so proud of you!

P.P.S. Happy Halloween! When I was younger, I was fascinated with The Wizard of Oz. Apparently, I would watch it over and over again. It’s a true classic that never gets old and thus the inspiration for today’s post theme. Here’s a picture of me in my preschool Halloween costume, dressed as Glinda the Good Witch. Thanks to my mom for the awesome creation!!