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This blog column is the ninth in a alternation about my (and now, my accompanying sister’s) bactericide breast blight screening adventure that began in July 2019. The aboriginal post is about my aboriginal mammogram ever; the additional post is about my appointment at Mayo Clinic’s Breast Clinic; the third post is about my stereotactic bulk biopsy at Mayo Clinic’s Breast Clinic; the fourth post is about my analysis with “Stage 0” DCIS breast cancer; the fifth post is about my in-person DCIS analysis at Mayo Clinic, alpha thoughts on my anaplasty timeline, and advertent that my accompanying sister ability accept breast cancer, too; the sixth post is about my accompanying sister’s invasive ductal blight analytic date 2A breast blight diagnosis; the seventh column is about my breast MRI and two ultrasounds to investigate “suspicious” spots on my appropriate breast and liver; and the eighth column is about my additional DCIS analysis afterward a anniversary of MRIs, ultrasounds, and biopsies at Mayo Clinic. To accumulate tabs on new posts, assurance up for the “A Daily Miracle” email list at this link.

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My action angry upside bottomward two months ago aback two radiologists came in to allocution to me afterwards an aberrant mammogram and told me they bare to do a biopsy, finer appropriate then. I knew at that point that my life–at atomic for the accountable future–would never be the same. Already I had my DCIS diagnosis, I had a plan: Meet with a abundant doctor, agenda affairs with abundant surgeons, accomplish abiding I fabricated all of my accessories at Mayo Clinic, and I was all set. Walking through blight for myself was article I had a handle on. But then, for some reason, watching my accompanying sister go through a analysis that’s “worse” than mine was abundant harder than I’d anticipated. Knowing my blight is Date 0 while my accompanying sister’s is Date 2A causes me to feel a bit of “survivor guilt.” Yes, one of the capital reasons my accompanying sister got her blight arrested out was because I got diagnosed in the aboriginal place, but why is she the one that has to go through chemotherapy AND a above anaplasty and “all I accept to do” is a bifold mastectomy? The affliction affair has been my talking to two bodies in one anniversary who absent their sisters to breast blight this year. Not to acknowledgment how demanding it’s been watching my babyish sister’s all-overs acceleration as she realizes, at age 25, her approaching ability accessory a lot like ours and she needs to alpha breast blight screening ASAP. As my accompanying sister’s bang-up said to her about her diagnosis: “THERE IS NO JUSTICE IN THIS!!!”

I apperceive I’m alone 8 account earlier than my accompanying sister, but I was consistently the taller twin (by 3/8 of an inch), the stronger twin (I’ve advised ~10% added than her our accomplished lives and as a aftereffect accept been able to weightlift added than her on a constant base :)), and the added approachable twin. Not that actuality taller, stronger, and added outgoing means I am better served to get through chemo–I’ve heard it’s a brainy action as abundant as a concrete one–but I still feel mostly helpless. Not to acknowledgment there’s still a tiny adventitious aback they accessible me up at my bifold mastectomy that they acquisition invasive blight and I’ll charge chemotherapy too. I don’t know. But God knows!

Attending breast blight apprenticeship chic at Mayo Clinic!

I’ve tagged forth to a lot of her doctors’ visits to accomplish abiding I accept absolutely what she’s action to be action through and how I can best abutment her, and I’m action to as abounding of my babyish sister’s screening visits as I can as well. But accessory doctors’ visits doesn’t change the actuality that my accompanying sister is the one who’s action to accept to go through 6 circuit of chemotherapy afore her bifold mastectomy to be followed by some added chemo/hormone analysis afterwards the surgery. She’s acceptable action to accept to abide fatigue, exhaustion, abeyant nausea, and “chemo brain”–while I get to “skate by” on bed blow for a few weeks afterwards my bifold mastectomy.

One above thing my sister and her bedmate accept had to go through is talks about fertility. The best hasty affair we’ve abstruse on this adventure is that chemotherapy might annihilate your affairs of accepting kids naturally. That’s because the chemo ability appulse the action of the eggs in her ovaries. Also, during chemo, her doctors are action to abolish her ovarian action to achievement to assure them, but there is a adventitious she will never achieve approved ovarian action afterwards chemo is over. That adventitious is small, but she and her bedmate absitively to move advanced with egg cyberbanking “just in case.” Thankfully, she and her bedmate were able to book accessories at a abundance dispensary in the burghal two canicule afterwards her blight analysis and the dispensary rushed her case due to the actuality she’s a blight patient. They aloof completed two weeks of hormone shots to activate egg assembly to advance to an egg retrieval action that they had aftermost anniversary to benumb some eggs that will be cat-and-mouse aback chemotherapy is over and they’re accessible to alpha a family. Because she was so acknowledging to the meds / hormone shots, they were able to retrieve added than 25 eggs during the egg retrieval procedure, which is over bifold what they are commonly able to retrieve in these procedures! As a aftereffect of her aerial admiration she is additionally experiencing airtight afterwards the action and is in a fair bulk of pain. They told her up advanced she was a applicant for “Ovarian Hyperstimulation” due to the actuality she has polycystic ovarian syndrome/PCOS (like I do, too), but the retrieval action was acutely effective, so she is optimistic that in two weeks she should feel abundant bigger and she’s aloof ambidextrous with a actual balmy case of OHSS that will abate soon. Aloof in time for chemotherapy to start!

We’ve abstruse a lot in the accomplished two weeks. My apperception is accessible to explode. Amid talks with internists, oncologists, and NPs; an “Introduction to Blight Care” chic at Mayo Clinic last week; and “Educational Visits” with chemo nurses, I absitively to address all about what I’ve abstruse about chemotherapy and invasive breast blight analysis through celebratory my accompanying sister’s journey. Actuality are some above takeaways: Not all chemotherapy is created equally; chemo has scary ancillary furnishings but there are medicines like Neulasta and mechanisms like “cold caps” to potentially anticipate beard accident that happens generally in chemo; chemotherapy might booty abroad your affairs of accepting kids naturally; and you accept to accept amid chemo administering through an IV or a port. 

Meeting with oncologists, surgeons, and internists at Mayo Dispensary to bulk out my sister’s breast blight analysis plan!

Not all chemotherapy is created equal

My sister got two opinions for what chemotherapy dieting to pursue–one from an oncologist at a hospital in the city, and addition at Mayo Dispensary in Rochester. They were altered recommendations, which afraid us, because in a absolute world, every doctor’s advocacy would be the exact same. At the end of the day, my sister chose to go with the Mayo Clinic-recommended dieting because she was added adequate with the chemotherapy advocacy and the team-based access area an oncologist, radiologist, internist, surgeon, and assistant practitioner met calm to altercate her specific case and fabricated decisions calm about what they anticipation would be the best plan for her affective forward. While it would accept been aloof accomplished for her to be apparent at her bounded breast clinic/hospital, it doesn’t aching that Mayo was afresh ranked the #1 Hospital in America by U.S. News and Apple Report AND we’ve had amazing claimed adventures there.

The chemo options presented to her were acutely abundant and I’ll outline them beneath but afore I do the two above things they told her are a) My sister can absolutely plan to assignment through chemo and plan to accept some acceptable and bad days–some bodies alike “fly” through chemo with hardly any ancillary furnishings and b) It’s cool important to accumulate a account during every day of chemo administering and accretion so you apperceive absolutely what ancillary furnishings to apprehend aback in the aeon of treatments.

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Whole14 Timeline | Forever Nomday – whole30 timeline | whole30 timeline

Here are the chemo options and their ancillary effects:

MAYO CHEMO OPTION 1 (this is the one she chose):
TCHP: This dieting is six 6-hour cycles with 1 aeon occurring every 3 weeks, equalling 18 weeks total. That’s 4.5 months of TCHP, in 6-hour doses administered every 3 weeks. Actuality are the components: T = Taxotere (potentially causes a neuropathy ancillary aftereffect in the easily and anxiety that can be evaded by cutting elastogel gloves and booties during analysis to accomplish sure any assumption accident that ability action doesn’t become permanent; also, during the additional administering of “T” is where a lot of patients accept a acknowledgment during administration; you can feel warm, there ability be some redness, and a bloom action comes over you) C = Carboplatin (a platinum administered abnormally to BRCA patients–we don’t apperceive if my sister is BRCA but it doesn’t absolutely matter, this should assignment the best for her regardless) H = Herceptin (specifically for HER2 breast blight patients; can be adamantine on the affection and has a 2-3% accident of capricious cardiomyopathy. But my sister will be accepting echocardiograms, aka an ultrasound of her heart, afore she starts and every 3 months during treatment) P = Perjeta.

Side furnishings of chemo accommodate lots of things. Some of the best acute are abeyant beard loss, nausea, diarrhea, and abeyant affection failure. Fatigue builds throughout chemo treatments over time. Medications are administered about the chemo infusions that will advice with abhorrence and Imodium is recommended if diarrhea develops. 48 hours afterwards infusion are generally a “bad day.” But she will accept acceptable canicule and bad days. With claret labs throughout treatments, her doctors will accumulate an eye on her claret counts–specifically claret and white claret corpuscle counts. At Mayo Clinic, they administrate anesthetic forth with the chemotherapy to get advanced of ancillary furnishings as best they can. My sister will do echocardiograms on a approved base to accomplish abiding her affection is action as well. She will additionally be on 5 decree medications (including Benadryl and Neulasta) forth with 4 types of chemotherapy.

One catechism we had for my sister’s doctor as we listened to all of this: “This sounds absolutely intense. Is this the lightest chemo analysis accessible for her case accustomed it’s alone analytic date 2A and is not in her lymph nodes?” 

The doctor said, “Yes. Looking at your case, as your tumors are small, we are aptitude against over-treating appropriate now, but this is what we charge to do.”

The oncologist also acclaimed that there is a added acute option–his additional option, and the aboriginal advantage the burghal doctor presented to my sister–that is harder on your affection that he did not acclaim for my sister: THP AC. This was the dieting recommended at the hospital in the burghal as the “nuclear option.” The oncologist at Mayo Dispensary said it’s not a “wrong” dieting to recommend, but that he prefers to abstain this dieting because both regimens accept been accurate to be appropriately able and because ACT brings forth with it a college accident of heart abortion or alike a accident of leukemia (1 in 300-400). “I appetite to abstain this risk,” he said. 

“When should she start?” we asked.

The doctor said, “We charge to get a affection ultrasound and a anchorage installed afore the chemo starts. We could alpha as aboriginal as abutting week, but I additionally wouldn’t delay best than 6 weeks.”

The doctor encouraged her to accompany abiogenetic testing–both for BRCA and for ATM, and some added genes.

“If I were BRCA positive, would that change my analysis plan?” my sister asked.

“No,” the doctor said.

So she isn’t accomplishing abiogenetic testing appropriate at this moment, but it is article she’s considering. She additionally had an advantage to opt-in to a analytic balloon for individuals on TCHP area affection medication would be administered to 1/3 of the analysis group, but she autonomous out. It’s nice to apperceive Mayo has analytic trials available, though! Not to acknowledgment therapies developing all the time. Her oncologist said that there are several options for analysis afterwards anaplasty and he will accomplish a accommodation at that time depending on how she responds to this aboriginal annular of chemo afore surgery. For example, afterwards surgery, if there is blight larboard over, they can potentially go with a biologic alleged T-DM1, which is a “new” biologic aback mid-2010s, about 2014-2015, for analysis of HER2 breast cancer. It came from a new abstraction completed aftermost December. Tamoxifen is acceptable an advantage but he will accomplish those decisions afterwards the anaplasty is complete.

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Whole14 14: Is This Normal? (A Guide to Whole14 “Symptoms .. | whole30 timeline

She will be accepting chemo on the 10th attic of Mayo Clinic’s Gonda Building, starting in anniversary 4 afterwards our affair with the oncologist. There are alone two chairs for chemo visitors, but we can circle out and in from the cat-and-mouse room. There are 48 chemo chairs, and amid 150 and 180 bodies are alternating through accepting chemo actuality at one time. 

One catechism my sister had was if she could do chemo in the city, afterpiece to her home, alike potentially in affiliation with Mayo to analysis in on her occasionally? The acknowledgment was Yes, she could. Which was nice to know. But she chose to go to Rochester for her infusions, a accommodation we aback 150%!

My accompanying sister and her bedmate afterwards a acknowledged anchorage adjustment for her breast blight chemotherapy treatments!

IV vs. Port

Through conversations with her accompany who are assistant practitioners, my sister absitively to go with a anchorage instead of an IV, which is a tiny operation she had to do to accept it built-in beneath the bark in her chest with a tube that connects anon into her aorta to be broadcast throughout her body’s bloodstream. This way she won’t accept to be pricked with an IV in her arm every time she goes in for chemo–which would accept had to be 6 hours of intravenous distribution. We were additionally told by doctors and nurses that, typically, HER2 patients accept to accept a port. She has been abscessed for several canicule afterwards it was put in but she can consistently accept it taken out bottomward the alley if she so chooses!

Here is what a anchorage for chemo looks like!

Cold caps

Cold caps are $500, and you can buy them from a aggregation alleged Paxman. You pay incremental amounts per analysis for absolute of $2,200 out of pocket. 50% of bodies who use these during chemo lose beneath than 50% of their hair. So we are investing!

Chemotherapy can potentially annihilate your affairs of accepting kids naturally.

Chemo kills a lot of beef in your body. And potentially amercement your eggs. This ability not be a botheration for women who accept had kids already or don’t appetite them, but this agency that my 30-year-old sister and her bedmate who would actual abundant like to accept accouchement had to hop on the fast clue of ancestors planning as anon as she got her analysis and analysis plan. For them, that meant action to a abundance dispensary in the burghal and accomplishing egg banking. This agency a alternation of hormone shots to activate egg assembly over the advance of two weeks followed by a alternation of ultrasounds and ultimately an “egg retrieval” action area doctors put you beneath and go in to autumn some eggs that are stored in a freezer for an broad bulk of time. (One catechism we had about this: estrogen is generally acclimated to activate egg production. Accustomed the actuality her blight is “estrogen receptor positive,” does this mean Estrogen dispatch of egg assembly would accomplish her blight spread?) We asked her oncologist and NP this and they said it’s such a abbreviate bulk of time and baby dosage of estrogen that it should be absolutely fine. SO, when my sister is done with her blight treatments, they can retrieve her eggs and attack abundance through IVF. (Yay!) They are additionally acceptable action to abolish my sister’s ovarian action during chemotherapy. They will alpha them aback up afresh afterwards chemo is over.

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Whole14 Timeline in Pictures – Olive You Whole – whole30 timeline | whole30 timeline

What happens afterwards surgery?

40 – 50% of bodies get to anaplasty and the tumors accept gone abroad or accept diminished absolutely a bit. If tumors accept alone diminished a bit, she would still charge to do some targeted HER2 treatment. The ideal bearings is the tumors accept absolutely diminished and she can alone do a bit of hormone analysis or chemo at a low dosage afterwards the surgery. We assurance her doctors and apperceive God has a absolute plan.

So beholden for affliction bales from Phil’s Friends, a faith-based nonprofit!!

Bible, baptize bottle, blanket, and balm are alone a few of the amazing things included!

Revisiting the Five Stages of Affliction Eating Advantageous Alive Out

When I accustomed my Date 0 diagnosis, one of the nurses told me that I should apprehend to grieve my analysis emotionally as I would any added affliction I ability acquaintance in the “Five Stages of Grief:” denial, anger, bargaining, depression, and acceptance. She said I shouldn’t be afraid if I alpha arrant while watching Netflix. Or accomplishing addition accidental activity. That the tears could appear at any time. I’ve still alone cried already during this accomplished time (at the actual beginning, afore my aboriginal biopsy, aback I accomplished how annoying all of this is), so I’m anxious I’m action to access into tears at the best contrary time. For now, I consistently feel like my academician is in hyperdrive, like I’m advertising on adrenaline. That has helped me to beating out a lot of the assignment that I’m action to absence while I’m convalescent from surgery. It’s like God is giving me added activity after acute me to booty in a constant stream of Red Bull, alike admitting my doctors told me I could accumulate up my accustomed Red Bull dieting if I capital to. (Yes, I asked!) 

I’m encouraged to see that my accompanying sister’s adoration appropriate now is that her chemo afore anaplasty would be 100% able and they’d get to anaplasty and acquisition a “complete dissection response”–meaning the tumors are absolutely gone!! That is accepting if I’ve anytime apparent it 🙂 We are additionally praying she has backbone to “fly through” chemo like some of our doctors accept said happens occasionally. God is acceptable and we are beholden for auspicious words and prayers from friends–not to acknowledgment blight affliction allowance bales from places like Phil’s Friends, auspicious Bible abstraction groups, and family. Preparation has additionally included advantageous eating–Beating Blight With Nutrition is a book we’ve been account calm and arcade according to the account of acceptable foods in the book. Chicken, accomplished grains, veggies, and bake-apple are accomplished foods to eat. Sugar is bad. We’ve additionally been afterward attempt of the Whole30 / KETO diet.

When I was first diagnosed, I acquainted like I skipped over the aboriginal four stages of affliction and hopped appropriate to acceptance. But now that I’m watching both of my sisters accept to go through screening and diagnosis, I’ve accomplished a bit of what I would alarm angelic anger, which I’ve channeled into alive out as abundant as I can to get JACKED TO BEAT CANCER!!! My sister and I took a account at the gym aftermost ages to appearance how austere we are about this. Maybe Ronda Rousey or Holly Holm will appear appointment my sister during her chemo dieting for inspiration. If so or if not, my sister is starting chemo on Friday, November 8th. In the meantime, I’m affair with my surgeon on Friday, November 1st to set an official date for my surgery.

Until abutting time!

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Filed under: breast cancer, Motivation, Narrative, Truth Bomb

Tags: breast cancer, blight

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Last Updated: November 11th, 2019 by darurat
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