Once more unto the breach, dear friends...

Once more unto the breach, dear friends once more; 

Or close the wall up with our English dead!

In peace there's nothing so becomes a man

As modest stillness and humility:

But when the blast of war blows in our ears,

Then imitate the action of the tiger.
~ Shakespeare

Last Wednesday, October 15th, I met my Radiation Oncologist for the first time.  Dr. Kim is a very tall Asian man with soft, kind eyes. He spent over an hour explaining every detail of the radiation treatment that will consume my life for the next six plus weeks. 

Hopefully, Dr. Kim was unaware of the fact that I was probably still drunk for my 8:15 am appointment. I pray that he couldn't smell the alcohol leaching from my pores or the remnants of my time spent over the sink, emptying the contents of my stomach. I look back on the previous night; the night I drank the guts of two bottles of Chardonnay by myself, and ask "why did I do that?"

The answer is simple. The same reason I went and got my nails done before my radiation mapping, (more on that later), appointment on Friday the 17th, knowing full well that it would probably make me late or miss the appointment all together.

The answer: sabotage. The truth is... I am fucking exhausted. I mean, bone tired. I have hit the runner's proverbial "wall" more than once during this marathon and I've already pushed through.  I have been through hell and I'm barely clawing my way back up into a life that is almost recognizable, almost tolerable. A life that doesn't include copious amounts of drugs for everything from pain to constipation.  Managing the side effects of chemo and surgery alone could keep the pharmaceutical industry thriving!

I've had it! I'm tired, and I don't want to go through radiation. I don't have anything left in the tank. I don't have any reserves. I don't have anything left to give. I just cannot get my head around the additional exhaustion and fatigue and I can't  seem to get geared up for the inevitable burns, blisters, allergic reactions, etc. 

Don't worry, what intelligence remains will win the battle between head and emotion. I will put one foot in front of the other for as long as I must until the "active treatment" phase of this war is complete.     

Dr. Kim was kind enough to share some of my scans with us.  The following is a side-by-side view of my PET/CT scan before chemo on the left and after chemo on the right:

As you can see, the pre-chemo picture on the left has a large bright light on the left breast. That light represents an area of high metabolic activity, my large highly aggressive tumor. A few months later the scan on the right doesn't have anything lighting up. So, we know chemo works. 

The pathology studies on all eight lymph nodes, and the abundant breast tissue removed during surgery showed "no remaining carcinoma or metastasis." So, we know oncoplasty works. 

What about radiation therapy?

Well, I eventually made it to the mapping appointment. The technician had a consent to treat form all filled out and ready for me to sign. Luckily, I caught the word "tattoos" at the end of the procedure line. I asked if the tattoos were permanent and absolutely necessary. She said they were. However, after pressing her for alternatives to permanent tattoos, she finally acquiesced that it was possible to mark the skin with markers and cover the markings with stickers that would prevent the ink from rubbing off and last for approximately 2 weeks. 

Despite my obvious relief at this news, the tech continued to pressure me to get the tattoos because "it's much easier for the techs". Finally, I lost the plot and and explained to her in an elevated and clipped tone that I had enough scars and permanent reminders of this ordeal.  I told her that none of this has been easy for me, so I wasn't too concerned if her job included changing some stickers 2-3 times during my six plus weeks in radiation therapy. Thus, she saw my tiger imitation.

  

Begrudgingly, the tech placed me on a cold, hard CT table and lined me up so that green lasers traversed my chest three times. Once the doctor approved my body positioning and the positioning of the beams of green light, the tech marked my skin with bright blue ink in the places where each beam of radiation will enter and exit my body.  There are 12 markers in total, which would have meant 12 tattoos!  When I released I would have had 12 tattoos I nearly went full blown tiger on her.  Luckily for her, I am too weak and too damn tired. 

Today, I go "once more unto the breach, dear friends...".  Wish me luck and please continue to pray.  As of today at 1:15 pm, radiation beams will replace the green laser beams and attack any cancerous cells that remain,  I am scared... twice bitten by chemo and surgery, twice shy about radiation.

With Gratitude,

Tiff

October 1st

October 1st....

Yes, it's the beginning of breast cancer awareness month, so the whole world seems to be coated in Pepto Bismol pink. Puke! 

Anyone know which month is dedicated to thyroid cancer awareness, so I can look forward to the entire Today show crew being draped in Teal, Purple and Fuchsia!?! I digress...

Yes, October 1st is also one of my very favorite persons' birthday (A, you know who you are).

And, yes today marks the day that I am no longer battling breast cancer, but am now an official BREAST CANCER SURVIVOR!!!!  

For those of you who know anything about aggressive cancer, the five year clock starts ticking .... NOW!!!

At approximately 10:30 am this morning, Dr. Mel Silverstein handed me a 6 page pathology report that basically said NOTHING!!!  The eight lymph nodes and multitude of skin and tissue samples removed from my breasts during surgery all came back negative.  In other words "no carcinoma detected" and "no metastases remaining".  

Dr. Silverstein - my Surgical Oncologist, Oncoplasty pioneer, teacher, and friend. 

This is, without a doubt, the best of all possible outcomes (a sly wink to Voltaire here). 

With my husband and son at my side, I was basically handed back my life.  The chemo worked so well that the cancerous cells were ALL dead before they even cut me open.  

Seeing as how my 60+ year old doctor held me just as tight, just as long, and shed almost as many tears as myself, I knew I was an exception to the rule of aggressive tumors.

I am happy. Of course, I am happy.  I am ecstatic! But, what next!?!  Well, five more weeks of surgical recovery, followed by radiation therapy five days a week for six weeks.  

Then what!?!  Yes, the air is fresher, the sun is brighter, and my children are that much more precious.  I get it, but then what!?!

How do soldiers coming back from war do it? How do sole survivors of tragedies resulting in huge losses of life do it? How do you go on!?!  

Obviously, you go on with a great deal of respect, gratitude, love and humility.  But, how in God's name, do you begin to thank the soldiers that lost their lives before you, the doctors that spent their entire life's work to see one case like mine, or the family, friends, and acquaintances that put their own lives and families on hold to make sure me and my family were well taken care of!?!

My prayers, and the prayers of so many have been answered, now what!?!

I guess I go back to living, but the angels over my shoulders have cheeky grins on their faces, and so do I as I lay my head down to sleep.  The cheeky grin comes from knowing what would be said and done at my funeral without actually having to die. It's a warm and comforting feeling. 

I have made some terrible mistakes.  I have wronged people, I have hurt people, but if I can continue living as good a life as I have led these first 35 years, and get even close to the same outpouring of love and support for my family as I have had in the last five months, I will live this life and leave this world with my head held high and with a cheeky grin on my face.

For now, I am not going anywhere! Thank you for your help slaying the Banshee! There will be no wailing here. 

With Love,

Tiff

Almost there

Forgive the lack of sophistication in my writing this evening, but stage 3+ breast cancer really sucks! Tonight, I have no pithy one-liners or extended metaphors with which which to entertain.  All I have is a simple update.

The oncoplastic surgery went well last Thursday.  The doctors were able to remove all of the cancer-exposed tissue, reduce the size of both breasts and shape/ lift the remaining tissue into what are going to be some nice perky chi chi's. 

  

I see all three members of my medical team tomorrow. We will review the pathology reports, which will tell us once and for all whether or not the chemo completely eradicated the cancer before surgery, or whether there were some living cancer cells remaining.

Either way, I will begin radiation therapy in the middle of October.  So, we are two-thirds of the way through my treatment plan, and so far each step proves a little less physically challenging than the last, but equally as effective. 

However, the mental and emotional toll is catching up to me, my husband, and very young children.