PET Scan (November)

NEGATIVE! I think that speaks for itself!

The rest of chemo...and my last chemo with a twist! (August,September, October)

This part of my journey was tough. So as I went though week after week of chemo, I had to take more breaks from chemo than I could have even imagined. How long can we possible drag this out, well don't ask that question. My blood counts kept dropping and it took 2 weeks for them to recover each time. When it came down to the decision of if we should continue with both chemo agents or give one up so I could actually finish this mess, I decided to keep going full steam ahead with both chemo agents. Now was not the time to be lazy, this was it, the last lap of the race. I didn't want to regret not getting all the chemo I could. So we kept chugging... In the meantime, I had become a member of a new group, South Sound Women in Medicine (SSWIM) and had decided to volunteer to be a part of any breast cancer events they had going on. Well that turned into me and my oncologist becoming the breast cancer committee and organizing the upcoming breast cancer walks. Well once October hit, Breast Cancer Awareness was everywhere. Where did all this "pink" come from? Is it because I didn't have breast cancer previously so I didn't notice and now that I have breast cancer, it catches my attention? Or is breast cancer the sexy disease for people to care about. I mean there are a ton of diseases out there to support, breast cancer is a good one, affects so many men and women in this country and abroad, but I do feel that it is a super popular disease. Anyway, I went all out with my pink tutu my friend made me and everything and I walked a 5k 3 weekends in a row! These walks kept me busy and kept my mind off off of the long chemo journey that seemed like it would never end. My last chemotherapy was finally on October 13th (originally slated for the end of August)! I was waiting for this day all year, and I was excited, yet anxious. Happy yet depressed. It was weird. Everyone asked me if I was really excited but it was definitely bitter-sweet because chemo gave me a sense of security. I felt like I was safe while I was on the chemo and that I wouldn't be safe once it ended. It's the "what now" phenomenon and I have heard of many other cancer survivors who feel this way. It seems weird but its a common feeling. So I basically was in a bad mood that day, asking my oncologist to up the antidepressant because I was already feeling depressed. Then I went into chemo, just like any other time, except laced with vegan cupcakes with pink ribbons on them! My parents were there with my husband. As I was coming out of the bathroom, one of my friends and colleague came in and said "Yay its your last chemo"...and I replied with "Why are my eyes so itchy"...and before I knew it, I had 3 chemo nurses on top of me carrying me to the chemo chair and getting the IV Benadryl. I was having an allergic reaction to the carboplatin chemo drug. How you ask? Well even though I had it 10 times before that day, it apparently can cause an allergic reaction once a certain amount accumulates in your body. And I had not just any kind of allergic reaction, I had an anaphylactic one and had to go to the ER to be monitored after I was given a lot of steroids and Benadryl. I threw up my celebratory cupcake, my whole body was itching, I had a tingling tongue and my heart rate was super high. It was very scary, probably one of the more scarier things that had happened to me in this entire process. So what did I learn from this experience...not to complain! And not to worry with fear and be depressed waiting for a recurrence. I have to be thankful to be cancer free in this moment. No more need for antidepressants, I felt that this was God's way of saying, "Get over yourself and enjoy your life", and so I will.

It's my birthday month! (July)

Now if you know me, you know that I walk around the entire month of July informing the world that it is my birthday month! I haven't done that this year, I'm not too excited about my birthday this year for obvious reasons. I am waiting for all this treatment to be over to truly celebrate! My mom calls it my new birthdate...and in a way she is right, it is my new birthdate! When will that be, who knows! I have 8 more treatments left, that means 8 more weeks, as long as I have no more delays. I have planned a surprise trip for Matt for my birthday weekend, I know that sounds weird but he deserves a vacation almost more than I do! He has been super dad, super doctor, super husband and there is nothing more left, we need a reboot! I am surprising him with a seaplane ride to Orcas Island and we are staying at the Rosario Resort and Spa. Of course I am bummed that I can't have any spa services because of the chemo, can't get into the pool, can't get into a hot-tub...but it will still be great to spend so much time with my hubby all alone! And it was!

Another bump in the road...and some fun! (June)

So I started Carbo with taxol, my new chemo regimen, and I felt more nauseated than I did with to so-called bad chemo, lost a few pounds because nothing tasted good and so on. Then I just received taxol the following week, I never got neutropenic (low white blood cells), but I did get anemic and thrombocytopenic (my platelets were super low). So then I couldn't receive my chemo the last 2 weeks of June, so I skipped 2 cycles and of course I have to make it up so this takes me out into september which is a total and complete bummer. Not to mention that its not good to skip chemo, so this is another bump in the road, and I am assured there will be more bumps to come. I guess this is par for the course. Along the same theme of "bumps in the road", I had to have my port replaced this month because the tip was in my tricuspid valve (this is not good!). So another procedure and more radiation with risk of infection and not healing because of the chemo, but it all turned out ok...thank goodness! In the meantime, I have made a friend in chemo, I call her my chemo buddy, Maggie. She is awesome because she has an optimism that I am totally jealous of, but its contagious! I think knowing her has made me more optimistic! I did relay for life in gig harbor, I literally found out about it that day, signed up, paid to meet my fundraiser goal (I really wanted a t-shirt) and went to do the survivor lap but everyone was still parking their cars and we were late so I walked by myself. There were a few ladies that befriended me immediately during our lap so I walked with them. It's amazing how close you can get to someone in such a short period of time when you have cancer in common. Now if I were to do it right, I would have had a team and we would have relay walked around the track all day and night and camped out...next time! Then Maggie invited me to her relay for life in Puyallup and she did it right, she had a great team, an awesome tent, did the camping out and her family even had t-shirts made that said "I'm in 4 Maggie", of course Seahawks fans! So I did the survivor lap with Maggie and her family and that was fun. At this point I have lost all my eyelashes and my eyebrows are almost gone, so makeup has become my best friend. Oh how I miss those days where I could just walk out the door without any makeup, but for that you need eyelashes and eyebrows, you don't realize how important they are to your face until you lose them! I also had the most amazing friend, although I have a great deal of amazing friends (you are all amazing and you know who you are), bring me thai food from Seattle, of course he didn't stop there, he brought groceries and a variety of drinks and dessert from my favorite bakery, he had to have made 10 stops and drove it all down to me in gig harbor. So sweet, I can't believe there are people like him out there, but I'm not surprised, he is an awesome person.

The Last of the Red Sunshine (5/28/2014)

So today is the last of the so call Red Devil (adriamycin), I call it the Red Sunshine because that is how it is referred to in a book I read called "the Red Sunshine" written by a physician who battled stage 3 breast cancer who lives in Seattle. So I prefer to call it the red sunshine. Anyway, its over, and that was suppose to be the worst of the chemo regimen. This last treatment was a week delayed because of the infection, but that is a small bump in the road.

I now will start 12 weeks of carboplatin and taxol. Apparently the worst that can happen with this is peripheral neuropathy (numbness and tingling in the hands and feet) which we hope is temporary but can be permanent. I'm not scared, let's do it!

And I was hospitalized...(5/18/2014)

So today is the day I posted my blog on Facebook, what I had thus far. Ironically enough I ended up in the hospital the same day, so all the messages from people supporting me could not have come at a better time. So the entire weekend I felt hot, then cold and so so tired. I was taking 3 hour naps and still felt so tired. Well everyone knows that doctors are the worst patients, this is for several reason, but generally we are super bad and doctoring ourselves. It should have occurred to me that I was sick and having chills, but it didn't until I started to tell Matt my symptoms out loud on a sunday evening while he was putting our baby to bed and then it dawned on me...duh! So I took my temperature and sure enough I had a temp of 100.9. Off to the hospital we had to go, but we had to find someone to watch baby Finn, I wasn't going to take a 4 month old to the ER with me when it was his bedtime. So we made what felt like a thousand calls. No one was home, or they were unavailable. Luckily we have one family member in Gig Harbor and they were available, thank goodness!

I ended up having cellulitis of my left breast, so if you are counting, this is the second time my left boob has tried to kill me. I met sepsis criteria so of course I was admitted and had to stay in the hospital for 2 days...torture! I felt like they were trying to kill me, on purpose! I exaggerate but it was not the best experience. Now I am on IV antibiotics for the time being and will likely be on antibiotics for quite a while because underneath my left boob skin infection is a foreign body, the tissue expander! There were talks about having to take it out if the infection didn't get better with antibiotics, but hopefully that doesn't have to happen. I already had to postpone chemo for one week, if I have to have surgery, then we would have to postpone it further and that is not good. I want to get these chemo cycles over with! To be continued I guess...

Oh the neutropenia! (4/17/2014)

Well not only did I start chemo in April, but that same week I went back to work after 4 months! I think I had the most tumultuous maternity leave ever! I couldn't stand being home any longer. Now of course I am setting myself up for sounding like the worst mom ever, but I was ready to go back to work. I just don't have it in me to be a stay at home mom, what's the point of becoming a doctor if you are going to be a stay at home mom after just a few years, mommy has loans to pay off! Ironically enough, I would probably make more money if I stayed home on disability, but I really wanted to get back to my patients and having a reason to get dressed and go out of the house everyday.

So I went back to work and started chemo the same week. On the day of chemo, I had a little sore throat and we convinced ourselves that  it was allergies cause I felt fine. Well...we were wrong, dead wrong. I had the worst cold I have had in years, and of course I became horrifically neutropenic (low white blood cell counts) which meant I had no immune system to fight anything. So my oncologist sent me home from work...I had barely started!

Needless to say, it took forever to get over this cold and I coughed for over a month later. It is difficult to tell what symptoms I had from the chemo because I was so sick with a cold, but the nausea was minimal and I didn't throw up so I considered that a success. The side effect that is probably the most bothersome for me is the fatigue and the neutropenia (because I am on house arrest for 3 days while my blood counts are low).

Oh yeah, I also started losing my hair about 2 weeks after my first chemo. First, I tried a short faux hawk hairstyle, but it was coming out fast and furious so Matt shaved my head. Lucky for me, Natalie Portman from V for Vendetta is my husband's celebrity crush, so he likes bald chicks! Of course, I had my wigs ready to go and they are fabulous! I forgot to mention that I took a one day hiatus with Matt to Los Angeles to buy wigs during this journey, where else do you get the best wigs than in hollywood! Losing my hair has not been the worst part of chemo so far, it really hasn't bothered me as much as I thought it would, maybe its because my wigs look better than my real hair did!

Starting Chemotherapy, The Red Sunshine (4/10/2014)

Three days after I froze my eggs and 6 days after I had my port placed, I was in getting my first chemo infusion. I was super nervous, once you start it you can't go back! Crazy thoughts: What if they were wrong again and I really didn't need chemo? What if I was allergic? What if I get really sick? I was scared to say the least. Matt was with me during my chemo and that was super comforting. Of course I was the youngest person there, although there were a group of younger women and you could tell they were the breast cancer group. Usually I'm pretty friendly and love to talk to people, but that day I didn't want anyone to know me, recognize me or talk to me about my cancer, I don't think I was ready yet. My oncologist and oncology PA/friend came to visit me and that made me feel super comforted.

The Red Sunshine refers to the medication adriamycin. It's red, it makes you pee red and its the most toxic of all the chemotherapy agents that I will be taking. I have 4 cycles of adriamycin with cytoxan and then I have 12 weeks of taxol after that. This is a pretty standard regimen. At first they were telling me I only had to have 2 of the 3 chemos, then they thought to be safe I should do all 3, and then they called be back and said that there was a new study (from Dec 2013) that showed that a 4th chemo agent called carboplatin (not new, but not usually used in breast cancer) used in patients with triple negative breast cancer (like me) had a much greater percentage of complete pathologic response. That means that peoples tumors disappeared! Now we won't know what it will do for my tumor because my tumor is out, but this is all for the just in case it spread microscopically to another place in my body so we can kill it so it doesn't come back.

This is always in my thoughts, the fear of recurrence. Everyone tells me I need to think positively, but it's hard to do that when you know what this demon cancer is capable of. I have the most aggressive type that has a 30% recurrence rate without chemo and with chemo it only brings that down to 20%. That is a huge percentage. And if it does come back it will be stage 4. So this fear does consume me very often throughout the day, but every night before I go to bed, I tell myself its not coming back and I will beat it, I hope the cancer believes me and doesn't smell my fear!

Freezing my eggs! (4/7/2014)

So, according to my oncologist, I had just enough time to freeze my eggs if I wanted to, I basically had a little less than 3 weeks to do it, so where was the time to decide if I even wanted to? By the way, just so your know, when you freeze your eggs or do in vitro fertilization, its generally an out of pocket expense and its EXPENSIVE! So when you are freezing your eggs because you are going to have chemo, the insurance companies for sure don't cover it. Anyway, I made the fastest appointment I could with the fertility specialist and when in to discuss my options. Before we left that appointment, we had already started the process, so there was no time to think about it, there was only time to just do it and think later! Oh and the fertility specialist gave me the caveat that we might do all this and it might not work at all if my body is too stressed. Well let's see, I just had a baby, was just diagnosed with breast cancer and had just had surgery, yes I think my body was under a little stress! Oh and if it doesn't work, you are just out of luck, you don't get your money back!

I then started the tedious process of giving myself 3 shots a day for about 2 weeks, going in to check how big my eggs/follicles were getting, and they were huge! And at the end of this minor torture, a procedure where they harvest your eggs. Well I was super proud of myself (as if I had any control) but they harvested 23 eggs and 15 were viable to be frozen...that's a lot! My reproductive system seemed to be working just fine, minor victories!

After all of this, my fertility specialist decided to keep me on lupron to put me into menopause with the hope that if my ovaries are quiet during the chemotherapy, maybe the chemo won't affect them as much, so now I am only on one shot a day during my 5 months of chemo.

And that my friends is how you freeze your eggs! Now do Matt and I even know if we want more kids, nope not sure yet, but its always better to be safe then sorry!

Surprise!! (3/14/2014)

So it took 2 weeks for me to finally come to terms with the fact that I wouldn't need chemotherapy and that would be ok, better than ok. I was finally starting to understand how lucky I was that I wouldn't need chemotherapy, but strangely felt like I wasn't a breast cancer survivor because I didn't have to suffer as much as others I knew who were in the same position. None of the side effects of chemotherapy, and they are really bad ones! And I wasn't going to have to lose my hair! I know that sounds stupid but it was a big fear, even though I was going to do whatever it took.

Well as I was moving on with my life, I had completely forgotten about that second opinion from UW because it had been almost 3 weeks. I figured no news was good news, I mean how different could a pathology report be with the same specimen?!! And then I got a call from my oncologist, usually he tells me things over the phone, but he wanted me to come in and see him that afternoon. I knew that it was going to be bad news, I know how this works! I went alone and that was probably a mistake, but I knew what was coming so I thought I was prepared.

And of course the pathology report from UW came back positive for invasive breast cancer, exactly what they always thought. But how could they have missed that! Not only was it invasive, the pathologist had 5 other pathologists verify her findings because it was such a complex tumor. Trust me when I tell you that you don't want to be interesting to doctors, you want to be run of the mill! So I have triple negative, aggressive, highly replicating invasive breast cancer. I wasn't mad as much as I was sad,  because this means that I have to have chemotherapy (after I had talked myself into how great it was that I didn't need it). This changes everything, including my prognosis, now instead about a 5% change of recurrence with metastatic disease, I had a 30% chance! Not to mention the fact that if they had known this to begin with, then I would have had chemo a lot earlier, ideally before surgery. I felt that every step of the way, they had tried to not see what was truly there all along, not anyone's fault per se but definitely not lucky. But then if my oncologist hadn't sent it for second opinion, I could have had metastatic disease in a few years, so he did save my life and for that I was definitely lucky and grateful! And more good news was that my nodes were still negative based on the second opinion as well so I was stage 1.

Recovering from Surgery

Easier said than done! I have had some friends that have gone through this same surgery tell me how difficult it was to recover, but I still thought how hard could it be? It was hard! I had just had a c-section so I figured it couldn't be too much more difficult than that, but I was very wrong. The worst part of my recovery was having drains in both sides of me for over 2 weeks, it was gross and painful. I was very proud though that I weaned myself off of the pain medication within one week. I needed help doing everything...showering, dressing, driving! I could barely hold my own plate of food! I had a lifting restriction of 10 pounds for 6 weeks so the very worst part of the entire recovery process was that I couldn't carry my baby! So far I feel like I have missed my little baby grow up so much because I have had so many doctors appointments, procedures and restrictions after surgery...it was depressing!

A week after surgery we got the pathology report back. Remember that my doctors were very sure this will likely come back invasive but the pathology report showed DCIS (non-invasive) with microinvasion. Well what did that mean? I hated that this was the gray zone, I either wanted it to be one or the other not a little of both. This meant that there were a few very small areas less than 1 mm in size that had broken out of the duct and therefore had the potential to get into my blood stream or lymph system, but apparently the chances are very small and therefore I would not need chemotherapy according to my doctors. Of course I have two oncologists so I always had a second opinion and I couldn't imagine it any other way because my case has been so confusing thus far.

Now you would think that I would be thrilled that I didn't need chemotherapy, but I was not! I was told this was invasive, I had prepared myself for chemo and the worst case scenario and now they were changing their minds! A part of me didn't trust it and another part of me wanted chemotherapy because I wanted that reassurance. I wanted a guarantee but of all people I should known there was no guarantee in life but especially in medicine.

My oncologist sent the pathology specimen for second opinion to the University of Washington just in case. I guess I was suppose to move on now, how do I do that? This was all so anticlimactic!! Now what?

Surgery Day! (2/21/2014)

Surgery day came quickly. Of course I had a cold right before I had to go into surgery but didn't dare tell my doctor for fear of having the surgery postponed. 

Going into the surgery, I was told that this tumor will very likely be invasive, even though all the multiple biopsies showed DCIS (non-invasive disease). So I was hoping for the best but expecting the worst. I felt like I had a very realistic outlook. I was just hoping and praying for my lymph nodes to be negative because my prognosis would be so much better that way. 

On the day of surgery I was nervous but excited to get the tumor out of me, I was sad about losing my boobs for a split second, but I got over that quickly. My first stop was to radiology to get my left breast injected with dye so they know which lymph node to take out first which follows the flow of the lymphatic system. Then off to the OR, where they did a great job of making me feel comfortable. I thought that was funny because I knew as soon as they put me to sleep, they were gonna manhandle me and do what they had to do, but that extra time to get me a warm blanket, let me pick the music, and make me feel comfortable before they put me to sleep meant a great deal. It was also funny because the anesthesiologist asked me where I wanted to go on vacation and I answered as if it wasn't a rhetorical question and I started to answer " we are hoping to go to Hawaii"...then quickly realized he meant where did I want to go to lala land as I felt the medicine go into my IV and I was out! 

I was in for about 6 hours and had 2 surgeons working on me at the same time, a breast surgeon that does the mastectomies and the plastic surgeon that does the reconstruction. My husband waited for me the entire time, my mom home with the baby, and it occurred to me that there would be no one waiting with my husband. This is the part that I found the most amazing...I actually had my friends and co-workers that didn't even know Matt with their own kids volunteer to keep him company and they did! I also called one of his own co-workers and asked her to see if any of them would be available to visit, expecting only 1 person to be able to make it and there were a stream of visitors that came. It might be funny that this is what I worried about going into surgery, but it was. I knew he was going to be there for me when I woke up, but who was going to be there for him! He has been so strong, I think we forget how much he was going through. A new baby, a post-partum wife with the baby blues, then breast cancer! He is and has been beyond amazing and I am the luckiest lady in the world!

Happy Valentines Day/Happy Boob Job Day! (2/14/2014)

So if you are gonna have something awful happen to you, you might as well get barbie boobs out of the deal! So I should say that I am not a person that would have ever gotten a boob job on my own, I hate going to the doctor, never wanted surgery for anything and barely take medications, but all of this was out of my control and I got over all of these phobias quickly because I had to.

I had no idea there was so much decision making when it came to boob jobs, saline vs silicone, round vs this new natural shaped breasts, nipples vs. no nipples...too much. To a certain extent, some of these choices were made for me, I could have a skin sparing mastectomy, but they couldn't spare my nipple or areola on the left because it was too close to the tumor, so again for symmetry purposes I took the nipple and areola from the other side and decided on nipple tattoos. There is something else I never thought I would get in my lifetime... a tattoo! But they looked surprising natural in the pictures. Now you can decide to have a nipple reconstruction where they pucker your skin to try to make a nipple, but I didn't feel that I needed that. There are also nipple prosthesis, which was funny because my plastic surgeon said I can use those for the times in my life I want my nipples to stick out. Now if you are a girl, you know that there is usually no occasion that you want your nipples to stick out, that was such a guy thing to say but it made me chuckle!

So because we didn't know what kind of tumor I truly had, we had to keep all our options open, so I would have a skin sparing bilateral mastectomy with tissue expanders placed (these are like place holders that they will expand until I get to my desired size), so that I can get radiation and chemo if I needed. The other option is to get the implants right away, but then radiation would destroy the implants. Oh and all of this was decided on Valentine's Day! Surgery was scheduled for 2/21/2014, my baby would almost be 2 months old, as was how long it had been since my last surgery (C-section), and this would be almost a month since my diagnosis. This felt super slow to me, but I understood that this is how long these things take.

More Tests and Results! (2/4/2014)

So the next week after my diagnosis, I had an MRI of my breasts to see if the other side had any cancer, and thank god there wasn't. It also takes a better look at your lymph nodes and I had one questionable lymph node in the left, on the side of the tumor. So when I went in for my second set of biopsies, they also biopsied my questionably enlarged lymph node. Well after they poked what seemed like a million holes in my left breast and armpit, the results came back DCIS again and my lymph node was negative, good news again! Although this was promising, my oncologist and breast surgeon was still skeptical, think that this is really invasive cancer that we keep missing because it is common to have both DCIS and IDC together. Who knew!

By the way, I am a doctor, but had to learn all of this just like any other patient. I think being a doctor made me understand things easier, but also probably made me worry more because I think it inherently made me more pessimistic because of all the sad stories I see all day as a doctor. I really didn't ask why me, because in my profession I have seen horrible accidents and diseases happen to the nicest people and I understand that these things can happen to anyone and no one person is immune. I wasn't ready to have a pity party for myself yet, why not me?

I should take a moment to explain the difference between DCIS and invasive cancer (IDC). DCIS is ductal cancer that is still within the duct, which means that it has not had the opportunity to spread because it has had no access to the blood or lymph system- I'd say best case scenario and considered Stage 0. IDS is invasive ductal cancer, which means that it has broken itself out of the duct and is now free to rome to other places via the blood or lymphatic system.

So the next step was to go straight to surgery, because they had no reason to do chemo first without being able to prove that I have IDC, which is the indication for chemo first, even though they really thought that is what I had. The only way to know exactly what I had was to take the entire tumor out and do a lymph node biopsy to confirm my type of cancer and the stage that I was in. I had to decide if I wanted a single mastectomy or a double mastectomy. A lumpectomy for me was not really an option because the tumor was about 4-5 cm on palpation and as seen on ultrasound. Well I really didn't think about this for very long, take them both! I'm 31, its aggressive, no need to worry about it coming back into the other breast (although there is still a small risk of breast cancer even with bilateral mastectomy, I felt that I should clarify that, the risk isn't zero, but its reduced by about 90%), and for symmetry purposes, its better to take them both. The other consideration into single vs double also depends on genetic testing with BRCA 1 and 2 (yes the Angelina Jolie gene), of course so many other people have it, but she is the most recognizable face of this genetic mutation that predisposes you to breast, ovarian, prostate and pancreatic cancers. So if you are positive for this gene mutation, you are gonna want a bilateral mastectomy, I chose the bilateral before I even got the results and I was negative for the gene, another thank god moment!

So I was off to the plastic surgeon to decide what kind of reconstruction I will choose to have...

The Beginning (1/25/2014)

Let me start by saying I have never written a blog, nor did I ever think I would be a person that would blog. The reason for my recent interest in blogging is because I think that I now have something important to talk about, I think it will help me cope and possibly heal, and also because I have recently been reading others blog posts about breast cancer and I have found their posts helpful, uplifting and their words really do give me strength. I hope that by the end of this blog, I will be able to do the same for someone else. I am writing this blog from the perspective of the patient, although for most of my adult life, I have been on the other side of the table as the provider. Needless to say, this will be an interesting journey.

So, where do I begin...my life took a dramatic turn 2 days ago. Something I never thought would happen to me (we all think this way) I received the dreaded diagnosis of breast cancer. I first noticed a lump in my left breast while I was 7 months pregnant with my first baby. I got it looked at right away and had an ultrasound and was told it was just dense breast tissue. I was so relieved and wanted to believe the radiologist, but in the back of my mind I was still concerned. I mean I am a doctor, I know at least a little about scary breast lumps, and mine was firm, hard, felt like the end of an eraser tip (like we learn in medical school), and still I believed that it was likely just a milk duct related to my pregnancy. I read online about all the things it could be, including the fact that breast cancer is often missed in pregnancy.

A few months later, I had my beautiful baby boy, Finn and have been lucky that he was born healthy and has been a wonderful little boy. His labor and delivery was difficult and traumatic, but well worth it. During this time, I was obsessed with breast feeding, my milk took a long time to come in and I never really made enough milk for my baby, which was sad for me. I also noticed that my lump had become much larger. I thought it would get better once my milk came in but it didn't and within a few weeks of my baby being born, I brought this up with my OBGYN again and got another ultrasound. This time, the radiologist saw a large mass on the screen, very irregular, she looked concerned. They also checked my left armpit for any grossly enlarged lymph nodes. I new that was not routine and started to instantly panic. She wanted a mammogram, I did the regular mammogram, then she wanted 4 more pictures so by then I was crying through the mammogram. She told me that she was hoping that this was a lactating adenoma, but it could also be cancer. I needed a biopsy to be the tie-breaker. By now I was extremely concerned, worrying that it was the worst. I had to wait one week to get the biopsy...this was the longest week of my life. And then when I went for my biopsy, I could see it all over the radiologist's face. I knew at that moment that the biopsy was going to be positive. I again cried through the entire procedure, not because it hurt but because I knew my life would never be the same.

The radiologist tried to distract me by asking about my baby, but that just made me cry even harder. How could I possibly have cancer and a new little baby, the possibility that I may not be able to see him grow up was all I could think about. And then of course the biopsy results came back positive for ductal carcinoma in situ. My OBGYN called me and told me over the phone at 9am and I already had an appointment with a breast surgeon by 12:30 and I saw the oncologist right afterward that same day. I was impressed and thankful for this fast response. A little part of me didn't want to know what this all meant, and the other/bigger part of me needed to know what we were going to do about it. Of course I called my heme/onc colleagues that I knew to see what I should do and the everything snowballed from there.

My husband, son and I went to the hospital for 2 doctors appointments that took 6 hours total with labwork and a trip to the pharmacy. It was a whirlwind. During my appointment, both my surgeon and oncologist explained to me that they believed, based on the size of my mass that the cancer was more invasive than the pathology report made it seem. DCIS would be one of the best breast cancers to have, but they were convinced its invasive ductal carcinoma (IDC), which is just how it sounds. So now not only do I have breast cancer, but I likely have a more aggressive form. Well great, somehow I already knew that it was aggressive, it has to be if I'm 31 and have breast cancer. So they sent me for another biopsy and an MRI, and it took another week to get that. What part of time is of the essence did these people not understand! I knew I was a patient but acted like their worst nightmare physician. I figured I did the same for my own patients, I had to find the guts to do the same for myself, so my appointment was for earlier in the week.

The next day, I went in for a bone scan and CT of the chest/abdomen/pelvis for staging purposes. This was the scariest part. This would determine whether I had metastatic disease, which would be a whole entire ballgame. I experienced what it was like to be a patient, and it sucks sometimes, its scary, and the people that take care of you, the techs and the nurses have so much influence on your experience. I was thankful I had great ones. As I lay in the CT scanner getting IV contrast that made my entire body feel like it was on fire with an intense burning that makes you feel like you are gonna pee your pants...but you don't! Then I had the bone scan which was longer and harder to stay still.

Well since I had all this poison  in my body including radioactive stuff and my oncologist had convinced me by that point that I was going to start chemo like tomorrow, I gave up breast feeding and of course felt like a failure, but you gotta do what you gotta do!

That same night of my scans, the day after my diagnosis, my oncologist called me on the phone and gave me the best news ever, that I had no sign of cancer anywhere else in my body! Now off to do more testing and biopsies next week, because nothing in medicine happens on the weekends!