Rocky helping me work from home a couple of weeks ago.

I was just getting out of the shower when my phone alerted me that there was a new test result in my MyChart app. I quickly got dressed…well as quickly as you can with tubes coming out of your side. It was the test result I’d been waiting for. My surgical pathology report. As you’d imagine I have a bit of PTSD when it comes to reading the results of my tests online.

Path reports are hard to interpret unless you come from the certain genre of medicine that the pathology pertains to. I used to read pathology reports for cystectomies, prostatectomies and nephrectomies (Oh my!) and pick out the important details for the doctors for patients’ post-op appointments. I’m grateful for that experience as pathology reports are similar in some regards.

My eyes skimmed the report. “1. LEFT AXILLARY SENTINEL LYMPH NODE, EXCISION: – METASTATIC CARCINOMA IN ONE OF FOUR LYMPH NODES (1/4).” As my doctor expected…although the cancer had shrunk, it was still in my lymph node – the one that was big enough that it could be see bulging slightly in my armpit if I looked in the mirror. “2. LEFT AXILLARY CONTENTS REMAINING LEVEL 1 AND 2, EXCISION: – METASTATIC CARCINOMA IN 2 OF 8 LYMPH NODES (2/8).” I’d be happy that cancer was only in 3 of 12 lymph nodes if the cancer hadn’t already spread to my bone. But I guess 3 of 12 is better than 12 of 12. “3. LEFT BREAST, INFERIOR LATERAL QUADRANT, QUADRANTECTOMY: – INVASIVE DUCTAL CARCINOMA WITH MUCINOUS FEATURES AND CHANGES ATTRIBUTED TO PRIOR THERAPY…DUCTAL CARCINOMA IN SITU (DCIS), INTERMEDIATE GRADE. – EXTENSIVE LYMPHOVASCULAR INVASION IS PRESENT. – IN SITU AND INVASIVE CARCINOMA ARE MORE THAN 0.2 CM AWAY TO ALL MARGINS – SEE SEPARATE RESULTS FOR EXTENDED MARGINS BELOW.” The quadrantectomy means that the area the doctor took was the entire lower and outer quadrant of my breast. I knew my cancer was Invasive Ductal Carcinoma from my initial biopsy. Ductal Carcinoma In Situ means pre-cancer was found. I guess that wasn’t a total surprise. Lymphovascular invasion, yep, that’s how it spread to my bone. Then to the good stuff. The fact that the cancer and the pre-cancer were more than 0.2 cm away from all the margins meant that my margins were clear! Yay! But wait. See separate results for extended margins. Ok. “4. LEFT BREAST EXTENDED SUPERIOR MARGIN, EXCISION: – INVASIVE DUCTAL CARCINOMA, MULTIPLE FOCI (0.3 CM, 0.3 CM AND 0.15 CM). – INVASIVE CARCINOMA PRESENT AT THE BLUE INKED MARGIN (0.15 CM IN EXTENT). – FOCAL LYMPHOVASCULAR INVASION PRESENT.” I felt my face get hot and my feet go cold. My margins weren’t clear. Well the main part of the tissue taken was clear, but the extra tissue the surgeon took just to be safe was not. That’s when I went out to my car to cry. Because that’s what I do so I don’t put too much on my kids. I called Jeff and told him the bad news.

Jeff was driving through Arizona as he reassured me that this was just another step in the journey. He told me that he was here for me, well not here here, but here for me in terms of emotional support. I started getting angry as we talked. “She said it was a 1 – 3% chance I’d have to come back for a second surgery. Of freaking course I’m in the 1 – 3%” Then the anger shifted and fueled a resolve. “I have cancer, but cancer can’t have me! I’m going to die an old woman. I’m tough as nails and I’m going to beat this!” Then Jeff yelled back, “What are you going to do?!” Admittedly I was confused. Why was he yelling? Did he not hear me? Oh wait. I know! I exclaimed back to him, “I’m going to beat this!” and we repeated the exchange back and forth until I was yelling and shaking. It was my first impromptu locker room pep talk I guess you could say, only I was sitting in an SUV and my coach was thousands of miles away and the opponent is a sneaky gene mutation. After I dried my eyes and finished talking to Jeff I went back inside the house and allowed myself to wallow a bit. Ice cream was had. I sat on the couch and zoned out watching Frasier re-runs.

This was 2 weeks ago. I’m nearly a month out from surgery now. I’ve talked with my surgeons. I met with a radiation oncologist who encouraged me to have the mastectomy. She explained that it used to be thought that radiation can clear up whatever cancer might be left in the breast when margins aren’t clear, but recent studies have suggested a higher recurrence rate when only radiation was used after a lumpectomy. So that’s what I’m going to do. As my oncologist put it, “We’re going for broke here. We want you to be around for a long time so let’s go back to the operating room.” I really love that woman.

I was offered surgical dates either a week before Christmas or the week after. I chose the week after. I know where I’ll be ringing in the new year and it will be at the Huntsman. December 31st is the day.

Just as I was getting used to my one smaller breast, I’ll be going flat on both sides with tissue expanders that they will slowly fill to stretch my skin in preparation for breast reconstruction down the road. My surgeon likes to remind me that reconstruction is not a breast. It’s reconstructed mounds that will be numb for the rest of my life. Almond Joy’s got nuts! Mounds don’t! Sorry. Couldn’t help myself. In the breast cancer support groups we call them Foobs, for fake boobs. And that’s what I’ll have. But I’m tough as nails so bring it on.

What’s the good news you might ask? The good news is that God was looking out for me once again. If my surgeon had taken even a fraction less tissue the pathologist would have declared my margins clear. We wouldn’t have found the tiny spots in my breast that weren’t detectable by imaging. Maybe it wouldn’t have mattered, but maybe it would have. Ultimately, I’m grateful.

Jeff took this picture and sent it to me with the title “Monkeying around”. Payton is obsessed with finding ingrown stubble or small zits on my head. If you look closely you can see my youngest just hanging out while Payton sits on her. It’s a pretty good life. I love these girls.

Lately I take selfies when I actually put on makeup and a wig. It’s felt pretty daunting this last month to do something so simple. This wig is named Rachel. She’s a 90’s girly.

Monday was my first day back at work. I named this wig Ginger, although my friend Melissa thinks it should be named Shelby because it looks like a good old Southern girl. Returning to work has lifted my spirits. It helps with the feeling of returning to normality. The doctors and nurses and MAs at the clinic are so wonderful to me. When I get too hot and take my wig off I get complimented on my bald head. One nurse practitioner stops by my desk and tells me dad jokes every day. I receive hugs from my MA friends often and am asked how I’m doing. I’m happy to feel so supported and cared for at work.

In other news Brielle and her dad flew to France this week to help Ava celebrate her 19th birthday this Saturday. I can’t even believe that sentence is real. 19? How did that happen?

I cried on the way home from work yesterday because a country song reminded me that children grow up. I cherish all the moments I’ve had raising my beautiful Ava Katie. She’s always been my child that is most like me in temperament and personality. In the middle school years that made us butt heads, but now we are two peas in a pod and I’m so lucky to call her my daughter.