December 30, 2016 - Anything you want it to be

Mom said I deserve good news. She's precious like that. She really is my best cheerleader. She consistently follows, and comments, and checks in. If there is an appointment to be had, she is texting me that morning with reminders to let her know as soon as I get out. If I am awaiting a result, she sits on the edges of her own chair in wait as well. If a post is made here on these pages, she is responding. So when I texted her from the clinic office chair, that was her reply: "You deserve good news!". And good news is what I got.

I went back to that clinic (lung transplant) earlier this week for those followup test, and low and behold if I didn't out score myself. I dare not say valedictorian, because you would outscore me, but I did outscore myself. I am keeping a chart of my 9 or so "symptoms" and charting along the months of "worsening" or "improving". Ron and I had noticed a few categories of improvements, if not all together resolution (mainly shortness of breath when crossing a room, yes, it had gotten that point a year ago back when we have the fibrosis diagnosis), this past summer so we were intrigued to see what this round of testing would show. Well, as I said, low and behold, I had a 30% improvement in my obstructive lung function almost back to a normal lung. I still have the very bothersome (to me) symptoms of a reactive airway when climbing hills or even one flight of stairs and have absolutely no reserve during a respiratory infection, but no longer have symptoms when crossing a room or even changing clothes. We have some thoughts as to why this might be the case (6 chest surgeries back to back and multiple anesthesia exposures), but the lung test are corresponding with the symptom resolutions. Hallelujah! And you know what else!?! This definitely seals the deal on radiation induced fibrosis instead of idiopathic fibrosis (had it been idiopathic, the tests would be worse a year later). So you can see why I have utter delight here. I haven't spoken directly to Lung Guru as she is out of the office this week, but we discussed these options prior to taking the tests and will discuss again in greater detail with her next week. We will be switching around some medications to help my lungs get greater reserve during infection and to help me out in winter months and in the mornings (mornings are super hard for me), and see how it goes after 3 months. All in all, I am super delight. And I mean super delighted. See, good news. And now I feel like Fibrosis can fade into my back ground a bit with better assurance that idiopathic is truly off the table. I felt sure this was the case, but it is nice having these improved lung tests as tangible data. We all like proof, don't we? Radiation induced fibrosis, we can now be friends.

This weekend we are flipping into a new year. I've never been one for new year's resolutions. I always found it strange to wait until the end of the year to set new goals. I always found it more reassuring to immediately set the goal as soon as I found the need to have one. That's my "immediate gratification" coming out I guess. I've never been one to procrastinate. Why wait to the new year? But this year in particular (call it being in my forties and better in tune with what life is all about) I do see the value of looking back over the past year and taking "stock" per se. What went well? What didn't go well? Maybe that is what New Years resolutions is really all about and I have simply misunderstood it all these years. Everyone is on this kick about how horrible 2016 has been. There have been some crazy lows for humanity as a whole. I get it, but I really want to dive into the year, and for myself anyway, pick out the highs of the year. I don't want 2016 to go down in the books as a year where humanity rolled over on itself and also tried to wrap me up into a label. And I don't want 2016 to go down as the year where I almost rolled over on myself. (A little drastic, I really loved most about this year. I'm built that way).

For me, 2016 became my "Be Still" year, thanks to the last couple of months, but it's also a year where I learned a lot about humanity. I learned what value I place on other people and how much of my worth hinges on in their perspective of me. I also discovered that people in return also determine a value of me and you never know what that is based on. It was a year where I had to reach far to put my faith in God above my faith in man. I had to put my talk to the test and my walk to the test as well. I was able to prove to myself that standing firm takes far more guts than I ever thought it would and freedom to live and freedom to choose does in fact come at a cost. Words I've heard uttered my entire life now have meaning to me, not because I read them in a book, but because I tested them by standing firm in my belief and endured the outcome. This year has been propelling. It's pushed my limits. It's tested my gut. And it's created an output. Sally is more resilient. Sally is more steadfast. Sally is more faithful. Sally is more thoughtful. Sally is more introspective. Sally is more aware. Sally is more purposeful in relationships. Sally is more easily delighted. Sally is more comfortable in her own skin. Sally is more easily heartbroken by your pain. Sally is not going to be labeled. Sally is seeking out truth through gospel lenses. Sally is not a better person than the person next to her, Sally is simply better than the Sally she was before.  It's not a new year's resolution. It's a past year's summation. We are to leave monuments along the way of what God is doing in our lives. Later we will look back as reminders of where He met of where we were, and when we had nothing left to give, He took us the rest of the way. This monument is rather about finding courage through the Holy Spirit to step out in Faith knowing that He calls us to stand firm even when it feels like you might be standing alone.

You see, 2016 is anything you want it to be. It's up to you. You get to choose. It (and any other year) can be the worst year ever. Or it can be another year of monuments. It even can be a great year if perspective allows it. That's the difference in being a victim or a life changer.  I'm finding the good in 2016 starting with what is happening in me. And 2017, I'm all over you.




To access previous blog posts - click HERE.

December 5, 2016 - Who is your Mrs. Willis?

“I’m so sorry! I just plopped myself down on your bench like I owned it without any regard for you sitting there!” She remind me so much of Paula Deen (had Paula straightened her hair and lessened her makeup and faded her presence bit). I mean really a splitting image in her hair color, her eyes, and her vocal accent. The southern drawl pulled me in at “I’m so sorry” and held me for the rest of the conversation. (It wasn’t until the drive home that I made the connection in the resemblance). She truly had my from the get go. The moment she sat and spoke those words, my laptop lid was closed because I knew this was a lady I wanted to chat with. I simply knew her as “Mrs. Willis” (name changed for privacy; I later heard them call her name) and “Mrs. Willis from Asheville” because later she told me where she lived as we discussed the wildfires in the western part of the state. It was super early in the morning so I wondered how she had driven in from Asheville to which she responded she and her husband (also having plopped down on the bench a moment before alongside her) had driven up the night before for today’s appointment. For once, I’m not in the breast cancer clinic. Instead, almost a year to the day after the first time I sat in this very clinic, I am back in the lung transplant clinic. A more dreary place. A place that affects me in a totally different way. And here is Mrs. Willis, intertwining herself into my story. She wore all black. And it suited her perfectly. Not because of her demeanor, but because it set her shoulder length (gorgeous!) silver head of hair into a sparkle like a tinsel loaded Christmas ribbon a top her head. Then that smile, full of teeth, glared back at you while her eyes stared into your soul. I’m not exaggerating in the least. She was straight off a Christmas card, yet at the same time, she had a North Carolina down-to-earth appearance about her too. She simply was a lady you wanted at your Sunday dinner table eating corn bread and chicken, and for nothing short of 4 hours. I swear I heard her husband utter nothing more than 4 words (all said when he almost fell off the bench when she stood up too quick) and not because she spoke too much (she was soft spoken and meek), but because he was reading the paper while they sat. She simply took in the room and spoke to me while she glanced around.

It was so remarkable to me how she brought up the wildfires within 3 minutes of sitting down. It was the very thing on my mind as she “plopped” on the bench. I could have been thinking about a million other things as she walked up to me. I was working on a work project as she walked over. But my mind was drifting to those fires. Those fires, near and dear for a number of reason had been weighing heavy. How did she know that at the very moment she and her husband plopped, I was thinking of those fires? How did she also know that a few minutes before she plopped, I had watched her cross the waiting room (the jam packed waiting room!) admiring her everything. She had this demeanor that simply spoke to me. And somehow she found herself beside me, out in the hallway, on a bench, waiting our turn, and her bringing up the very thing that was on my mind – wild fires.

As she sat talking about wildfires, and later, other topics, I was becoming aware of how my behavior in the waiting room has drifted over the last 4 years. My being an introvert naturally pulls me to the “nose in a book”, eyes down, no contact behavior stance it’s so easy to take in a place such as this. But I have story after story of women sparking up conversation with me in a waiting room. Some of those stories had a huge change in my life. Maybe some of those stories had a huge change in their life. I think of Ms. Jocelyn (Story Here - November 20, 2015), in her 80s and her “hard boobs” and the hysterical delight she gave me that day, and maybe the information I was able to give her in return. I think of the lady in her 60’s (Story Here - July 23, 2014) and the Joy exuded from her in the waiting room and also the the lady in her 70’s (Story Here - August 13, 2016) fresh out of her procedure and the confusion I observed while listening to her and her husband. Oh how I wish I had struck up a conversation with both of those women.  And I can only imagine how many more stories there would have been had I NOT had my nose in that book, or had I been the one to start the conversation. Then there were the 4 women of the mammogram waiting room (Story Here - August 25, 2015) . Wow, that was a day. There were so many miss opportunities because I sat silent. And then there were so many opportunities granted because some lady didn’t sit silent! I’m working hard to be the person who gets her head out of the book. The lady who sits and waits. The lady who makes eye contact. And the lady who welcomes conversation. I’m wondering what kind of doors that will open by making myself available to other people.

I didn’t do such a great job of that with Mrs. Willis (I had my laptop open as I was tidying up some work), but I quickly remembered to shut the laptop as soon as she sat down to set the stage for whatever God would bring. I’m mold-able. And I love what God is doing with that.  I’m working to be the person that seeks out opportunities instead of hides myself in the introverted world I adore. There’s a time and place for that. But I don’t think the time for that, for me, is the waiting room. And it has taken me 4 years to get there. My story with Mrs. Willis didn’t turn into a page turner, but it got my attention in my hearing God remind me in saying “Sally, remember, make yourself available, and I will use you.” He did this by having Ms. Willis speak the words about the wild fire that were in my head the moment she spoke them. God brings things into alignment at his timing, for his purpose, and we can either be on board or we can thwart the moment by being caught up in ourselves (or our laptops). God, you have my attention. You keep reminding me time and time again. Waiting room after waiting room. I am getting on board. Thank you for bringing me Mrs. Willis as a reminder that you bring us people for a very specific reasons. If it takes the Lung Clinic to re-remind me, so be it. Who is your Mrs. Willis? Who is your Ms. Jocelyn. Who is God continuing to bring to your path as a reminder that he wants you to do something. To be something. To make yourself available. I am stubborn headed. I should have never needed to go all the way to Mrs. Willis. But I did. (I'm kinda glad I did, cause I truly adored her!) I am there now. I'm all in.

So I’m back to seeing Lung Guru. If you need to catch yourself up on that story about the pulmonary fibrosis you can start reading Story Here December 2015. I was scheduled to see her for follow-up back in September, but along came the breast nodule and things got put on hold. I rescheduled and am now back on board with the lung appointments. It’s time to re-do all the testing we did last year to see if there has been any progression so I have that scheduled for next week. The good news is there has not been any symptom progression (and maybe in some ways there has been some improvements with day to day symptoms), but I’ve had monthly respiratory infections since June and that is new. So we want to work that up. The good news is she is the guru, so I am not worried about that at all. We are being thoughtful and will figure it all out. No news for now. Just some more testing.

Writing has been on hold for a bit as October and November were heavy months. I don’t have specific details other than to say the world has been heavy and I have felt the heaviness of it. I’ve been aligning myself with God’s calling me to Be Still, and in that, to also Be Silent. So my words to page have purposely been less. I never want to write simply because I can, but only want to write for purpose. He called me to and through this journey, particularly around mastectomy, but also in everyday life that unfolds after mastectomy. Being still is part of restoration and sometimes part of being still is being silent. Thank you for your patience as I waited that out.

I will update you again soon, I hope. Your ongoing readership means much, and I hope his work in my steps bring even a sliver of light also to yours. 







To access previous blog posts - click HERE.

October 27, 2016 - Kisses on the boo-boo

This is a trivial thing compared to anything else in the mastectomy process, but it should be mentioned because you won't suspect it in foresight. And it catches you off guard. Trust me, I am in for seven times now and I still have the exact same emotion. EVERY. SINGLE. TIME. So this is what you need to know, no matter how many times you have stitches in your boob, it never feels normal. I don't necessarily mean physically, honestly you can't feel the actual stitches. Remember, early on, you have very little feeling your breast after the initial malignancy. It take some time (if at all) for feeling to start to return. and it doesn't return for everyone. So this isn't an aspect of how the stitches "feel", but rather how you feel about the stitches. It's just not normal to be walking around with stitches in your boob. Sure you have stitches in your knee from the tumble you took off your bike as a kid, no problem.  Kisses on the boo boo from your mom and little ice cream and you are good to go. I realize there may be a little obsession with it and the bandaid as kids do, but as an adult, you rarely if ever think about the stitches in your knee. Your boob however, well, a little different story.

First you constantly "think" you feel the tug of the stitches. no matter how big or small the incision. I would say my very first incision (for the mastectomy itself) was/is between 4 and 5 inches long. Not a trivial incision and totally reasonable that it would be on your mind almost every minute of every day for the time period your stitches are in place (even if you have a glued incision instead of actual stitches). What surprised me though was that 7 procedures later (6 surgeries, 1 biopsy), and despite this new incision now being only about 1 inch (a far cry in size from the original incision), It still sits on my mind  a good bit of the time. Particularly in the shower. Particularly when changing clothes, particularly when the bandage comes on and off, but even just as I am going about my day, it is there in my mind. Additionally, while it is in MY mind, I also totally assume YOU can see straight through my shirt, my bra, my bandage and can see every stitch in all it's glory. It's an absurd thought to think YOU can see my stitches, but it goes to show how abnormal your thinking can be while walking around with stitches in your boob. Ron once said to me "I wish I could understand why a stitch can get you all out of sorts". I get it, it's weird that it can always be on your mind. But it is. And I don't have to be able to explain it for it to be fact, but it is something that I think you should be aware of for when/if you find yourself in those mastectomy, reconstruction  or biopsy shoes. You aren't strange, you are just getting through it. And there is no shame there. (You will be surprised how much stuff sits on your mind, but you certainly in foresight don't expect stitches to fall in to that category).

But guess what!? The stitches come out tonight after a day of work (or came out today depending on when you are reading this) and the thoughts of stitches forever being in the back of my mind will be gone with the stitches. And that, my friends, makes me a happy gal. Because with those stitches go the thoughts of biopsy too. It's truly a "throw it all out in the trash" kind of day. And life gets to go back to "Pre-Boob-Lump" mode, complete with it's on issues, but different issues, and sometimes it's fun to focus on something other than boob.

Now, I won't lie to you, all 8 hours of my day today at work will be laden with the dread of stitch removal. I want them out, but don't want to actually be part of the experience of their actual removal. I loathe these things and I detest having stitches taken out. I can take you back to my very first memory of stitch removal when I was six (cleft lip repair), and I can still feel that thread being pulled through my lip. It makes me want to yack. No yacking today. Easy cheesy (and a lot of head holding). By the way, I have no trouble at all watching YOU get your stitches, it's getting my own stitches out that cause me to lose the lunch.  Stay tuned.



(This post is focused with the mastectomy reader in mind. I realize it is less applicable to the average reader. You are a trooper to still be following me. I would have left me a long time ago. Smile. Also, I rarely share pictures because it's the boob and tastefulnees matters. Tried to be tasteful here so you can have an idea what to expect if you have a biopsy. Note, biopsies differ greatly so this is only one of many possibilities.)


To access previous blog posts - click HERE.

How I got to Mastectomy (June 2012)

June – August 1012: How I got to Mastectomy (below is a post from a few years back summarizing how mastectomy landed on my radar)

Back in June, on a Thursday, I was sitting in clinic waiting to see a patient. The Attending Physician I work with had just returned from a national oncology conference and was giving us the low down on some of the hot topics of discussion of the past week. Now let me step back, it's interesting to note I'm only in clinic two days a week. The rest of my week I'm in another building with another life. So had this physician returned on a Monday, I would have missed this discussion in its entirety and be none the wiser for some time to come as the news filtered itself out into the general public. So the timing of these events is not lost on me. Back to the day's events, he was telling us about all the new pediatric oncology research that focused on exposure to radiation therapy and long term outcomes. We've always known radiation therapy is a yin and a yang, particularly when used in children. It's a terrific modality for curing certain tumors, but it carries its own potentially negative risks while propagating the positive curative ones. Historically, Hodgkin's lymphoma patients received very large doses of radiation to the chest region, where primary tumor most likely lived. And we've always known these large doses, while needed for tumor kill, can lead to secondary risks later in life. For female teenagers, breast cancer is one of these risks. We've known this for years. What we didn't know was the magnitude of that risk.

Back to the meeting highlights, the Attending Physician began quoting off the new statics on the radiation data. Well, let's just say my ears perked up when I heard numbers that were much higher than previously published. (I had been treated for Hodgkin's Lymphoma when I was 16 so this was not only professionally relevant but personally relevant.) Simultaneously, while he was speaking to the few of us in the room, I went online to the meeting abstract to pull the data myself. And there it read - females treated with 20 gy doses of radiation carry at least equivalent risk for breast cancer as women who carry the BRCA gene for breast cancer. As I continued to read, and mentally calculating my own dose of more than 40 gy (being double that number reported in the meeting abstract), light bulbs start going off in my head like that on the red carpet. Percentages ranging from 30% up to >90% as you advance in age. What?!?!?!?!? We had thought it like 10-30%. That was a risk I had known and even prepared for. Roll the dice, it may happen, but more likely not. I've done cancer once, surely not twice. But 90%???? Are you kidding me? That's a whole other ballgame. That not a statistic, that's a prediction! That's...terrifying.

I quietly try to gather my wits and think rationally about this data while I am listening to the physician transition over to other topics from the meeting. But my mind keeps racing back to what he has said. I formulated an email to a breast oncologist I work with in my other job. (Reminder, this life altering conversation happened on a Thursday when I happened to be present in clinic; I started working with this breast oncologist  I am now email only six months ago. God's timing in this story is already starting to declare itself.)

"Breast Oncologist, have you seen the new breast data that was just released for Hodgkins patients? What do you think about me doing yearly mammograms in addition to the yearly breast MRIs I'm already getting? I had lymphoma and was treated with more than 40 gy doses of radiation to the chest as a teenager. (details summarized)"

"Sally, yes, I saw the data. I didn't realize you were a lymphoma survivor. I think you need to see a breast surgeon......" And at that very second I mentally checked out. Stopped reading. Had tears pool at the bottom of my eyelids.

Excuse me? What in the world did he just say??? A breast surgeon? What do you mean a breast SURGEON? Didn't you mean to say "yes, please schedule a mammogram at your earliest convenience."? Why in the world are you mentioning a breast surgeon? Ok Sally, check back in, compose yourself. Wipe the fluid from your eyeball and retype the email.

"Breast oncologist, did you mean to write the word surgeon in your email? I'm a little confused. Did you mean to say oncologist?"

"Sally, I think it would be wise for you to meet with the chief of breast surgery to discuss mastectomy options. Let me talk to her today about your case and I will get the appointment set up for you as soon as possible." (Paraphrased email verbiage) 

Hyperventilate. Mind racing. Punch in the stomach. Oh my gosh, please don't let me throw up right here in my laptop in front of everyone. Hold it together. Pull up your boot straps. Got-to-get-some-air-now. Walk out of the room to the bathroom and ball your eyes out. And then it also hits me while standing in that bathroom....Ron!

Let me insert here that all of this unfolded in a matter of about 3 minutes from the time the attending physician walked in all excited about the conference he just attended to me being set up in an appointmentt with a surgeon. How does that even happen?

Email Ron frantically. Email my sister frantically. Wait for response from oncologist. Pull up data on BRCA gene. What in the world, a prophylactic mastectomy? Women actually do that????? I really don't think I had any idea that women were finding out about BRCA gene results and scheduling mastectomies (since the timing of this blog post Angelina Jolly and countless others have scheduled mastectomies to reduce their breast cancer risk). Why do they do that? And why would I do that? That is radical. That is crazy. That is taking matters into your own hands. Do I not trust God's plan for my life? If I'm destined to have breast cancer, we just deal with it when it comes. I'm not someone to run from trouble. I like to roll the dice and trust God in the decisions in life. I've got this. Mastectomy, no way. (This, another free flowing train of thought spanning about 45 seconds).

Keep reading the article, Sally…unlike brca gene patients "hodgkins survivors, having already reached the maximum doses of radiation, will have limited treatment options for secondary breast cancer..." (paraphrased) Let me re-read that. Again. One more time.

Frantically email Ron a second time. Desperately watch the clock. I've GOT to get home! This room is closing in on me. I'm of no use to these patients today. Devastated. Confused. Frightened. Surprised. Blow to the stomach. (Little did I know that Ron was having the exact same experience sitting at his work desk as he later told me).

So it was no longer IF I was going to get Breast cancer, but more likely WHEN. And when that were to happen, my treatment options would be limited to no radiation.

Long story made semi short. Two weeks later, I'm sitting in an exam room with two surgeons discussing my mastectomy plans. Two weeks! Who gets an appointment with the chiefs of breast surgery and plastic surgery in two weeks? God does, with a little of "it's all who you know" thrown in for balance. By the end of the appointment I had a surgery date scheduled for August 7. The delay only because one of the surgeons was headed away on vacation for two weeks. Those four weeks would become very challenging for me with me subconsciously processing the what was to come. The radical procedure was going to happen! I chose the crazy option!

I should insert here, I'm a unique case. I got massive amounts of radiation as a teenager. Dose is everything. Timing and age of exposure is everything. Not every radiation patient has these risks. There is a lot of data that has to be sorted through for any given patient. I am NOT advocating mastectomy for radiation patients. I'm not even advocating mastectomy for hodgkin's patients. I'm advocating that you research the data. Determine your risk. I'd bet for most women, mastectomy is a bit drastic for your statics. For me, it became a very reasonable option that dropped my risk from up to 90% with limited treatment options down to about 5%. Less than that of the average reader reading this post. Then, I'm advocating support for women who choose this crazy life saving option. This is a radical life changing choice, and women need support in that. No judgment. No gossip about the "did you hear". No questions about implants and a boob job. Don't ever ask "how big are you going!" Support! Encouragement. Belief that this hard choice is able to be done successfully. Cheers of "you can do this" should be shouted through your telephone, your open front door, across the restaurant table as she sits there telling you her incredible dilemma and support that she can be open about this extremely personal journey. Understand that this is an awful decision to have to make and that this surgery is not knee surgery. She needs Love. She needs to know what she feels is justified, even if on some levels it seems trivial.

What she (now me) is feeling is something i never previously understood. Fear of the what ifs. Guilt for her thoughts of vanity. Shock that this is happening. Concern over her spouse and what he may think. Disappointment over reconstruction options. Guilt for feeling that disappointment. Shame that having no boobs affects her like it does. Shame that this journey impacts her like it does when she didn't even have breast cancer like some women have to struggle through both BC and mastectomy. Confusion as to why this affects her so drastically. Worry that God may have wanted her to choose differently. Frustration over the physical limitations now present. Anger at her lack of control. And the list goes on. Trust me, it's best to just sum it up and say "She feels a lot!"

Anyway, back to the original point of all if this. In order to process the big picture, I have to understand how those first few weeks played out. How timing is everything. How God chose a Thursday for this discussion to take place. (Reminder, this was brand new literature your average person would not know about for quite some time to come. I work in oncology.) How God, not even six months before crossed my path with that of a breast oncologist that I work on several projects with. That God would grant Ron and I wisdom to recognize His role in placing me at the right place at the right time and his offering this option to us. That Ron would make his decision that I should go through with mastectomy before I would and that they would match up. Maybe God had a specific plan not only to save me from a tremendously difficult journey with breast cancer, but to change me, challenge me, grow me. Was Sally going to let fear of a drastic surgical procedure guide her? Was Sally going to trust that God had big plans for her or even someone else by choosing the hard road? Who was Sally going to put her faith in?

I'm changed. I'm challenged. I'm broken. I'm restored. I'm accepting my new breasts…as strange as that sounds. But most importantly, I'm allowing this journey to be whatever vessel God chooses in growing His kingdom. I may kick and scream along the way, but I'm still moving forward. I take steps back. I doubt things, but I'm committed for the long haul. Come what may.

Now, pray that these next few weeks are smooth. I have a great bit to accomplish in a short amount of time. Pray for my transition back into life. Monday, I start removing some of my restrictions. In two weeks, back to the surgeon to assess everything. Will the skin survive, is my mobility and strength back, have the impostors settled in their new home. Is the swelling and pain gone. Can I handle going back to work? Can I drive? Can I shower in my own without falling apart emotionally in the process?

A lot happened in three short weeks. More than I could ever have imagined. I hope to be a better person on the other side of this. I hope you found a new understanding of preventative mastectomies. And maybe you saw a glimpse of God's provision in the awful (and incredibly amazing.)

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Timeline of events that followed are listed below. You can read posts around that time frame if you find yourself in similar situations and need more information about each event. 

August 7, 2012 - Surgery #1 Double Mastecomy

August 20, 2012 -  Surgery #2 Breast Reconstruction

April 6, 2013 - Complication: Breast Infection (cellulitis); Surgery #3 -implant removal surgery

April 29, 2014 - Complication: Breast dimpling and thinning skin; Surgery #4- lipografting surgery

October 16, 2014 - Complication: Implant Slip; Surgery #5 - Skin tuck to lift implant

August 6, 2015 - Complication: Scar tissue constriction  Surgery #6 - Scar tissue removal surgery
October 13, 2016 - Complication: Breast Lump - Breast Biospy



To access previous blog posts - click HERE.

October 13, 2016 - The Controlled Burn

Good riddance, Breast Lump! Your job here is done. I am back home with my feet propped up while Ron is outside staining the deck. (Poor Ron! I may or may not have a huge grin on my face because I can’t participate). The shocker of the day is I have laughed and laughed and laughed until my sides hurt, all while having something cut out of me. You can thank Ron, you can thank Lead Plastic Surgeon (LPS), you can thank Surgical Nurse, and you can thank our cumulative warped sense of humor. This is how the day unfolded. We arrived and we waited. Then we got called back to the procedure room. Then I got undressed. Then I put on the hideous gown that I loathe….and then… the laughter began. It started first when Lead Plastic Surgeon walked in the room and I made him do his typical promises of “best work ever” (you will have to go back to one of the six surgery day posts to understand the back ground on this). Mind you, this was the 7^th procedure ( #1 double mastectomy, #2 double reconstruction, #3 cellulitis/infection debridement and implant replacement, #4 lipografting, #5 breast tack up for slipped implant, #6 scar tissue removal, and now lucky #7 biopsy) all of which I made him promise to do his best work ever.  So he got a chuckle when I told him I was refusing to sign consent today until I had his promise once again for his work to live up to my expectations.  He rolled his eyes, as he always does when I ask this, and made his promise complete with a high five. (In all seriousness, you will never fully understand the fear I had of mastectomy scars going in to all of this. The thought of those scars would puddle me into tears after I made the mistake of researching them on the internet. Trust me, scars have come a long way in the past decade so no worries there. But my plea to him originated from an intense fear which later drifted to an ongoing joke that he has to continually exceed his previous work with each new surgery I found myself in.) With that squared away we could move on to marking up the area with the trusty green sharpie and then insert the big old needle to numb the area. Now while the ole sharpie markup and needle insertion was going on, in order to distract me and my anxious state seeing a needle come at my breast we all took guesses as to what we thought the lump was going to be.

• Sally: Hubba Bubba Bubble Gum dropped in by LPS during the previous surgery.  
• Surgical Nurse: The infamous Seinfeld Junior Mint.
• Ron and Lead Plastic Surgeon: They teamed up and decided it was a CIA tracking device for which LPS profusely apologized for as he never thought I would find him out.

Ron and him agreed his mistake was putting it on the top side of the implant, where it now could be felt, rather than UNDER the implant. They bantered this back and forth a bit longer than I expected actually, then Lead Plastic Surgeon blurts out “Hey, did you ever see the game show “Let’s Make a Deal?”. Well now we are picturing a boob with all of these random contents in it being pulled out when Wayne Brady (in present day) asks for a pair of panty hose, or a toothbrush, or a roll of scotch tape. We all lost it again in barely controlled laughter.

Now before you scold me for this type of banter in a professional environment, I want to remind you of a few things: 1) The patient, in this case me, was fully involved and also the instigator. 2) I have had a ridiculous week, having lost my beloved pet and after having waited 2 months to know what this thing was in my chest, and I deserved a little laughter. 3) This is my seventh procedure with this surgeon. Usually he sees his patients once in the OR never to be seen again. Well, LPS, Ron, and I are on year 4 of our surgical relationship and we have come a long way. 4) LPS has the same sense of humor I do and it certainly tones down the fact that you are flashing your breast to a room full of people.  5) I needed to cut the tension I was feeling and what does that better than laughter.  Please know he is totally professional until Ron and I push him not to be.  (Side Note: the surgical nurse who I was meeting for the very first time suddenly exclaimed “I like her a good bit”, so she was ok with our banter and started joining in after we egged her on). So it was a day of laughter and I really needed that. After our laughter subsided a bit and before we started the actual procedure  itself, I pressed him for his guess of what he really thought this was going to be.  He voted on a cyst and I agreed that seemed pretty reasonable based on how it felt. This is where he left the room because we had to wait for the area to completely nunb (20 minutes).

Here I am perched up on the table in a gown under a blanket and big OR lights while Ron decided he better run to the restroom before we get started, not knowing how long it would take. I told him he better make sure he takes note of which room I was in because the last thing he would want to do would be to to walk back into the wrong room catching some poor unsuspecting lady lying on a table. He responded with a gesture of holding his hand over his eyes but peeking through and saying “Sorry M’am. But that’s good work!” (flashback to the Christmas Boobs post from a few years back). Well, I just lost it all over again. I was laughing so hard, no doubt everyone in the building could hear me, and just when I would settle down the image would flash right back into my head again and it would start all over. I was out of control laughing! Of course that is the time Lead Plastic Surgeon and Surgical Nurse walk back in again and then they started laughing too and it just went on.  I again refer you back to the 5 reasons above so you don’t pass judgement on our semi-unprofessional demeanor. I also want to take this moment to apologize to anyone who is ready this blog for the very first time. This isn’t my usual writing and you are not yet used to my candid transparency.

Ok, so now back to the meat of it all and what you really came here to find out.. Let me say, this procedure is not delightful. This was the first time I was fully awake for a procedure. It almost took my breath away with the pulling and tugging that goes on when you are looking for something which requires a little digging around because you don’t know exactly what you are looking for . In fact, I will call it pretty awful. The surgical nurse kept asking me if I was ok seeing the look of dislike on my face. Bear down and get through it was my response and my face reflected that! In addition, I kept hearing the snip-snip of the tissue and the pulling of the skin….I almost lost my lunch. I also was the perfect example of a 4 year old asking “Are we there yet? Are we there yet?” over and over again as he continued to poke around.. But then the glory happened when I heard him say “Sally, I found it. It’s the alloderm sling.” (Go back to my August posts to better understand this and what that is). The edges had in fact rolled up on itself and created a peanut shaped fold. He bantered back and forth with us in the room trying to decide if he should cut it out and I very firmly said “yes!” so he did. He found 3 additional spots that had rolled up as well so to play it safe he cut all of those out too. So I will now shout it from the roof top! There is no tumor! And the other silver lining there is no need to send anything to pathology and no more waiting two more weeks for results. We absolutely now know it is the sling! But you aren’t off the case yet. We now need to shift our prayers that this won’t turn into an infection. He exposed the area to open air so there is a risk that the breast could get infected (this happened before for me after my first reconstruction procedure) and we don’t want a repeat.  He wants me to watch the area carefully. The stitches will stay in place for 14 days and then back to see him again to check the area and remove the stitched. Praises as this is the best news we could have gotten today and even he was surprised at what he found. Feel free to clap loudly. This is worth celebrating!

Shifting gears a little, I want to take you back to some thoughts I have been having over the last 2 weeks (this is not necessarily for the everyday reader but targeted  for women who find themselves in these situations. That is the whole purpose of my blog, to equip you with information about mastectomy.) I almost blogged these thoughts earlier in September in the middle of it all, but it didn’t happen for whatever reason.  I’ve been reflecting back on this journey of 6 surgeries and now one scary moment of a breast lump AFTER mastectomy. I’ve done lymphoma and that lymphoma took me to this high risk of breast cancer, which took me to this double mastectomy, which took me to the 6 surgeries, which took me to some very scary moments like the first shower and now 4 years later a lump, which took me through so many roller coaster emotions that I wasn’t prepared for in this journey, and which took not only me, but my whole family, to places we never anticipated. Now, as I reflect back and as I navigated the last 2 months specifically,  I’ve started to see each of these moments as a type of “controlled burn”. I am realizing how God takes us (as believers) or allows us to go through some potentially scary and uncertain moments in life. But unlike a deranged arsonist who is out to create burning flames invoking chaos and evil resulting in mass devastation, instead, God (when we allow him) carries us on a controlled burn with totally different outcomes. Let’s look at controlled burns, as used in nature, specifically and literally for a minute. They are known to:

·         Promote healthy regrowth

·         Reintroduce healthy nutrients back into the soil

·         Prevent massive uncontrolled fires with huge devastation

·         Limit the spread of life-inhibiting plant disease

·         Reinstill forage for wildlife

·         Improve the habitat for endangered species

·         And the list goes on

There is so much richness there in the good of a forest fire, when controlled and done in specified time frames compared to the harm of an unexpected and uncontrolled wildfire. My mind has been mulling this around in how this is applicable in my circumstances these last 4 years (and many more). Aren’t these crazy moments in life the perfect breeding ground for promoting healthy regrowth? Do we not come into the event haggard and full of burn out, emotionally stripped down to the bare bones, and full of worry and fear? And somehow, in the middle of it all, when we give over control we start to see these subtle shifts in our maturity, understanding, and character? Do we not often come out on the other side deepened with more layers and facets? Not necessarily noticeable in the meat of it all  but often when the emotions play out we can see how the burn of life, when we place our faith in God’s plan, becomes a controlled burn saturated and rich with benefits to us and those that go through life with us? Whereas,  when left unchecked,  our worry and fear instead fan the flames and create dangerous shoot-out runners pushing out and away from “controlled” and unfortunately in to a devastating uncontrolled spread.  Any situation can start or become and uncontrolled burn, particularly when left to our own vices, but we have the choice to all God to orchestrate and refine us via a controlled burned. He can take what is intended for harm, from living in a sinful world, and turn it into a controlled burn ripe with life changing greatness. Don’t get me wrong, the ground is still burning. It’s sweltering and unbearable at times (if not most of the time) on ground level.  But as the fire spreads under His control, and then recedes, and is finally extinguished you start to see sprouts of life pushing up through the ash. I’ve said it 1000 times and believe it to my core that if we push aside the worry and fear and instead cling to his promises while we wait it out, His plan for our lives is 1 trillion times better than what we map out for ourselves. God will bring blessing. And triumph. And PEACE! And none of that relies on the circumstance itself, but rather our choice to let him transition our moment to a controlled burn. I’m not saying this because I got good news to day. It has been a whopping 4 years of less than ideal news. But in these uncertain and scary moments God has created a Sally that I never could have conjured up on my own. He has softened my edges and blunted my sting. The burn of life has brought about regrowth. I’m a little less judgmental. A little more understanding. Less afraid of chaos. More embracing of change. An eager seeker of outcomes. More confident and accepting in my imperfections. More resilient in my marriage. And the list goes on and on and on. I am magnitudes better as a friend and a co-inhibitor of your biosphere that I ever would have been before mastectomy….and reconstruction…and complications…and infections….and lumps. (Side note: I am still fully flawed so this is not a personal bragging fest of look how far I’ve come, but rather a testament of the growth that can when we allow God to do his thing His way. I’m simply moving forward on a continuum and if it can happen for me, it can happen for anyone.)

We don’t always have choice in what our circumstances will be. Life is going to happen either out of our control or as a result of our choices. But they key point is that it is either going to happen TO you, or it is going to happen THROUGH you. We can be devastating, unpredictable, ravaging “uncontrolled burns” foraging the forest on a path of mass destruction, OR we can embrace that life doesn’t revolve around our greedy desires within us and instead trust God’s plan for our life (come what may) so that he in turn can transition “uncontrolled” into the most glorious opportunity for restoration, regrowth, weeding out, and thriving that only He can bring. It’s a glorious thing. And mastectomy got me here (coupled with many other things that have happened in life). I’m a better version of me in a day by day trajectory to reflect less of my sinful nature and more of what God created me to be. Hopefully, in the process I am also a kinder, gentler, more understanding person in my relationship with you.  I’m currently under construction and emerging from a controlled burn.  It’s been quite the ride.

Words cannot describe how grateful I am you walked with me. Some of you have been there since Day 1 – August 7, 2012. Others I have picked up along the way as God joined our paths either over a blog page or in person in everyday life. I am fully aware there were several times that some of you individually and all of you as a whole carried me from one day to the next. This most recent chapter is now closed.  Praise God that he not only he gave me this incredible outcome in having no tumor, but praise Him for the cumulative journey this has been for me personally. I have no idea if I am done. I thought I was done after surgery # 2. But I’m confident in the plan.

(If you are still allowing me to ask you for prayer coverage, pray that I remain infection-free. That was a really scary moment for Ron and I and we don’t want a repeat. I’m also having a good bit of pain. And I wasn’t expecting that).   





To access previous blog posts - click HERE.

October 7, 2016- It's time for us to start saying our goodbyes

You know what is weird? Walking around for 2 months with an UUO (Unidentified Unknown-Impact Object; my made-up term of endearment) in your breast. It’s not rare that you sometimes see things on a routine scan that are troublesome, but then usually within about a week you are in for biopsy. So you have about a week of stressing about something that could be absolutely anything (as opposed to the stress of the known once you know biopsy results. The stress is different). What is less rare is having a UUO for months on end. I’ve had this UUO since August 10, and it’s nothing short of a weird and awkward feeling (not physically, but emotionally). Now one would argue that if Lead Plastic Surgeon was suspicious of malignancy, the biopsy would have already occurred under emergency situations, so in that we may find implied comfort. But I am here now to say that two months is too long. Not too long for the surgeon, but too long for this blond 40 something introverted extroverted woman who carries it around in her breast wondering what in the world it will be and what it may bring.

It’s not that I am not peaceful (I am), but rather it’s a distraction to an otherwise stress-free zone. Ok, that’s a lie too. I’m not stress free by any means. I am in end-of-life moments with my beloved, sort of faithful (always faithful to Ron), cat who loves me conditionally (for food; unconditionally for Ron) and has won a place in this heart of mine. I don’t have kids to distract this love. So Oliver gets it all. I keep trying to resurrect him with serial lung taps (he has fluid on his lungs, and we have tapped him 4 times now to see if the new medication was working. It's not. Each time the fluid has re-accumulated to 200-300 mls in just a few days). The fluid is winning and the time is oh so near. This causes me stress. I know, Oliver is a cat, but he is my cat, who quite frankly serves me better than some humans, so he matters. And his dying matters. A dying beloved cat combined with a UUO I’ve been carrying around for a few months, well it just makes the days a little “Off”. I dare not mention the other routine things going on in life and even some of the non-routine things like Ron being out of town a lot that has me off balance.  You all have those same things. But they add up when all placed in the very same bucket of life. I am peaceful (about the boob anyway; I refuse to not be peaceful until I have a reason to not be peaceful), but I am also “Off”. Off kilter. Off balanced. Off my A game. Off course. Off emotions. At any given moment I am totally ok. Then the other moments slide into view. They are short lived, but they happen. I’m sure you can relate. It is totally realistic that we can be ok and still not be ok. It’s this morphing of one into the other and then back again. And it’s fluid. Sometimes it’s barely even noticeable, but it happens. Overall, we are ok, but in any given hour of the day “not ok” may spill into our ok. And I see this happen when you are waiting for biopsy to happen and then again afterwards waiting for biopsy results. You will be ok, but you will also not be ok. (Having fluid emotions does not negate Peace. It just makes it a sad peace. Or a happy peace. Or a longing peace. Or an impatient peace. Or a lonely peace. We often think peace means happy go lucky. We are wrong. Peace simply means we aren’t afraid of the outcome and we know God’s plan will suffice for our lives. But we still may have emotions around that and over time those emotions play.) Don’t beat yourself up for having emotional moments. Instead, expect it.

Going back to my original point, it’s simply not normal to have a UUO for any length of time. Get in, get it out and move on with whatever you find. This “wayward” period of waiting it out is, now in hindsight, against the norm and it creates some collateral fallout. Now I dare not say that maybe God doesn’t have some yet-to-be-identified reason for this waiting, but it is a little challenging on the one lying in wait. Even in the best of circumstances, which I feel sure I surely must be in, there still is this inkling of “what if it is malignancy?” And the waiting out of that leaves me slightly “Off”. Or there is the chance this is a ruptured implant, so guess who would go to surgery #7? Yeah, that would be me. And trust me, surgery #7 (or even #3-6) is most certainly also going to be “Off”. It’s “Off” even to think about that possibility of that. Then there is simply the fact that I am walking around from meeting to meeting and from day to day with an actual nodule in my breast. That simple fact alone causes your mind to focus. Or un-focus. Let’s just agree it is a distraction. And it’s time for that distraction to be gone. It’s long overdue in fact. So there is the other thing. Not only might you have fleeting moments from ok to not ok, but you will also always be fully aware that you have a UUO in your breast while you wait for biopsy. And two months is too long. Take the very first appointment they offer you. Trust me on that. (I did take the first appointment. This was truly an unusual circumstance that you, if ever in my shoes, likely won’t repeat).

Dare say the rest of Sally would have less ebb and flow if UUO was already taken care of? My emotions of potentially having to put Oliver to sleep the same week as UUO biopsy would probably be a smidge less. Just a smidge, but a smidge. And the biopsy itself may be a little easier to walk into would I not be putting Oliver to sleep. One affects the other. Just like my awareness of the storms from Hurricane Matthew would be a tad more easy to face and a little less daunting if Ron were to be in town. My awareness of Ron being out of town would be a little less aware were it not for Oliver dying. See, everything impacts everything. We are stupid to think we can isolate off these little sections of our life into little compartments. Everyone says don’t bring home to work. Impossible! Don’t bring work to home. Impossible! Don’t let the stress of your child being bullied affect your relationship with others. Impossible! Don’t let your overwhelming struggles with infertility affect your interactions with friends. Impossible! God didn’t create us to iso-late. He created us to re-late. Relate can only happen when you live your life in the open with other people (maybe a select group of people in certain scenarios). And relate can’t happen to its fullest when we are compartmentalizing our worlds to death. I am a master compartment-alizer. I work very hard to not let my worlds collide. But lately I have been seeing the futility of that and the wasted energy it ensues. This UUO is intended to change me as whole. The death of Oliver will impact me as a whole. Walking out on the other side of chaos will mold me into a better whole. And each of those influence the other, and I in turn am influenced as a whole.

So if I seem a little “Off”, rest assured, there is no shame there. In times like these we need to remember that “Off” is always temporary. Maybe “Off” is exactly where we need to be in order to create a new “On”.  A better “On”, the “On” we have been waiting our whole life for. UUO, I’m so glad you are here. You’ve grown me in ways I actually can pinpoint and in ways that wouldn’t have happened with you. But I won’t lie, your time is coming near. It’s time for us to start saying our goodbyes. And I guess the same goes for you, Oliver. You stole my heart and made me a better whole. 

(On Thursday, the surgeon will give me local anesthetic (what?!??), he will make about a 1 inch incision into the breast and go in and cut out the entire lump. He will then place some stitches and I will go home. Easy like Sunday Morning. Stitches will come out in about 10 days. Now, it’s also not normal to walk around with stitches in your breast, so I can’t say I am looking forward to that, but alas it’s the means to an end. ((Seriously, picture that, walking around discretely with stitches in your boob. Makes me chuckle.)) Then we will await pathology results to come back in about 1 to 2 weeks. A whole different kind of wait. So you might as well just stayed tuned). 

September 27, 2016 - Leap frog

I've been off the grid, and I've gotten my hand nudged twice now. I know, I know. I've been silent a few weeks. It's not on purpose but rather a reflection of several things:

• I'm in survival mode. It's been a crazy few weeks. And I haven't taken the time to sit down and write anything. Well, I've taken the time, but to work and to sleep, not to write. 
• Oliver (our cat) is "dying". He developed a pleural effusion (fluid on the lungs) that required 4 days in the ICU (Seriously, people) and frequent visits back for fluid taps after his initial discharge. Most recent, I picked him up at 3 am Saturday morning. So we spent a few days sleep deprived and now he needs a lot of TLC and oversight. My weeknights are spent counting Oliver breaths. Sweetest Pookie ever and he's stolen my heart. Prayers for wisdom as we decide when the time has come. 
• There have been lot of "going ons" with family and friends, but as those are not my stories to tell, I haven't mentioned them here. But they have focused me off myself and on to them. 
• I don't have any boob updates as my biopsy is not until October 13, so I am simply waiting that out. The good news is I have had a lot of distraction to keep the boob out of sight and out of mind. 
• I never want to write simply because I can. I try to reserve words on this screen for either promptings where God may have laid something on my heart, or for the benefit of someone facing mastectomy (or whatever else). If I wished I had known it, I try to write it. But i don't want to write, just to write. 

So I just wanted you to know that we are ok. Distracted, but ok. And I will keep you updated as October 13 comes and goes. I'm peaceful. And that is where the praise should focus. It's incredible how trying these last 4 years have been (six surgeries, moving, the death of Ron's father, the death of my grandmother, job transitions for Ron, this boob lump, lung fibrosis, Oliver diagnoses... the list goes on and on as it does for all of us) and just when I think I can't deal with one more thing, I somehow do. I think it is a true reflection of how peace, while it doesn't remove sadness or fatigue or anger, does somehow carry you from this to that. This past year, being one of the most challenging of the 4, has somehow also been my most peaceful. It seems almost impossible, yet it is. There has been peace that has over-ridden all the chaos underneath. Like I said, I have still cried (a lot!). I have wrestled with emotional exhaustion. I have floundered in frustration. I have juggled anxious moments. But the peace was there the whole time. It's as if I am finally able to not only say, but actually live in and believe that even in chaos, there is purpose. And that realization simply carries me through. One of you commented that you noticed that after finding this breast nodule I said  to it "welcome home". And that has stuck with me. I think that ability to accept this lump, come what may, is a true testament of God transitioning me from a person so fully prone to angst and worry into a child of faith who see purpose in every story. It doesn't remove the emotions, but it sure does instill an underlying calm. And calm is where it is at. A friend recently asked me over dinner how I got here, and I wish I had this 10 step plan to finding calm. But I don't. It sort of found me and pulled me in, this reliance on purpose and intent. I'm fully aware that I am a better Sally for my "challenges" than I ever would be for my "easy goes it", and I simply love seeing the before and after in me and in you as you juggle life. I do know Step 1 is realizing the world owes us nothing, and instead we owe God everything, including faith in his plans. I kind of started there with that truth and asked God to get me from there to here. I've also been able to look back at the monuments in life where I saw worry destroy the whole journey, but calm bring about blessing beyond blessing. So I'm keeping that in mind and am doing a daily gut check to keep my focus on calm. It's an active process, and it's working.

You have your own dilemmas. Some of them are doozies. Yet, we all have the same promises from God. Christ came to overcome. That does not mean to remove the situation, but in his promise we can find calm. And we can see life outside of ourselves and what we think the world owes us. We spend our whole lives playing Leap Frog as we leap from one problem to the next (we are no different than the person sitting next to us, we all have our thing), but how we leap says everything. So I'm working on my leap and working on making as little noise as possible. And boy, what a leap it has been.




To access previous blog posts - click HERE.

September 14, 2016 - He promptly denied said allegation

Quickest updates of updates: It turns out I have passed my bachelor's degree and am well on my way to my master's degree in patience. It's not my virtue, for sure, but (or therefore) it must be something God really wants me to work on. So I'm working on it. I've got my book bag in tow and I'm studying hard.

I met with Lead Plastic Surgeon late today, who after a little look and feel session with this pesky little nodule, instead of instantly confirming my hopes of this lump being a piece of my alloderm sling decided he wanted to say " I have no idea what this is".  Well, at least the 3 people have I met with thus far are all in agreement. I asked, do you not think it is maybe the sling (like the radiologist was thinking)? He said the location, shape, and texture made it unlikely. He has seen sling "roll up on itself" but that usually happens in the outer region of the breast at the end of the sling not smack in the middle of the breast where there are no sling edges. Also, in his opinion (and mine as well) it would be unlikely to be this "peanut shape". I also asked him if it could be a piece of half chewed gum that he maybe absentmindedly dropped into my breast while leaning down with scalpel in hand during my last OR procedure. He promptly denied said allegation and moved the conversation onward. When I pinned him down for his serious thoughts we are guessing that maybe it is something that has deposited itself/is growing on the sling, or the implant. Moral of the story: we simply don't know what this not-so-endearing nodule is (after 2 breast exams, 1 ultrasound, and 2 mammograms), but I bet you can now guess who just scored herself a biopsy? Huh, can you guess?

Biopsy scheduled for October 13. (I know, that is a month away; No one is more aware of that than me; But alas the schedule is the schedule;  Mainly because he is out of town for 2 weeks;). He will use local anesthetic and cut a one inch line over the spot and go in and dig whatever it is out. Close it up with stitches and wait for pathology results to come back (1-2 weeks). So by Halloween, we will have this all figured out. What's another month, right? Who doesn't want a pathology result for a  Halloween treat (said no one ever)? 

So that is the super quick version because I am absolutely warn out. Exhausted and needing a very long sleep, so I am working frantically to get there with still very much to do before climbing into bed. But I wanted you to know the "hot off the press" update since you have been so kind and faithful to pray me to this appointment. In efforts to keep it short, I skipped the details about us meeting again and the irony of that after having said out official "good byes" after surgery #6 a year ago. I also skipped the part about him telling me that he is leaving the practice in January (ummm, not that I will ever need him again, but I said that 5 surgeries ago and look where we are). And I skipped the details of the poking a prodding, but as I have said before, there seems to be little dignity in malignancy and breast reconstruction, at times anyway. 

Ron and I are doing ok. A little less confident than we were going into the appointment since Lead Plastic Surgeon derailed the original alloderm sling culprit plan, but as we have been learning so faithfully the last 4 years, God has a purpose even in this nodule. So wait we will do. And come what may, we will do that too.With absolute certainty I can say that breast reconstruction keeps you on you toes and it can be a guessing game. We trudge forward all the same. 

August 29, 2016 - Monday Came (Gena)

It's been a trying week, and as I climbed into bed last night I was eager to see Sunday take it's bow, knowing Monday would bring a new week. Next week would bring me back to feeling better (this respiratory infection was holding a grip!) and I was eager to see the Plastic Surgeon on Wednesday. I simply wanted to hear his vantage point. The ultrasound/mammogram results were still non-conclusive citing "possible implant rupture" (that wasn't on my radar), "possible alloderm sling", "possible" we don't know what it is. Well, I like knowing. I'm a known kind of gal. "Possible" won't work all that well for me for the long term, so meeting with Lead Plastic Surgeon surely can help me narrow that down. We did this mastectomy to be peaceful and sure. "Possible" doesn't meet that goal. I'm feeling a biopsy in my future because "definite" is way more my style. "Definite" is something I can do. You simply pick it up and walk forward. "Possible" is too wayward for my liking. In just a minute you will understand, but we had to push the appointment from this coming Wednesday now to September 14th. I'm trusting God's timing. He's choosing this timing for some reason. So I'm being patient, and I'm pushing thoughts of "possible" aside while we wait. And I thank you in advance for prayers for this upcoming week and on into September as we continue on this path.

Late last night, my grandmother, Gena, passed away.  She would have turned 98 this October. She shares a birthday with my wedding anniversary, and I can still see her smile as we brought her the birthday cake during our wedding reception. She had that kind of smile that was easily remembered. It was soft, and genuine, and seamlessly seeped into the rest of her face. Her soul was quiet, rugged yet softened by life's experiences, yet she had a hilarious candor and frankness about her. As I grew up, I started to detect an endearing pride and astounding faith underneath her surface, not newly surfaced, but newly discovered on my end. It's as if there was this whole side of her I was not mature enough to see before. I like that, discovering new nooks and crannies in people as you grow. It's like a gift that you get to keep unwrapping. But what I remember most about her was that she was resilient. She lived through the hard years of her generation and kept stepping forward. And in that, she was humble. Her last few years in life proved her resilience time and time again as she teetered in her health but continued to bounce back as if death was something she got to choose, when she was ready. She must have been ready on Sunday, and then, Monday came.

I wish I could step back and ask all the questions. I wish I could dig into the stories I've yet to hear. I simply wish. I'm built that way, nostalgic for yesterdays. Fearful of never discovering, or afraid of losing what stories just left this surface. I'm acutely aware today, the morning after, of how my memory of the deep set lines around her face will fade with time. There will be a day when I will have to rely on a picture instead of readily pulling the details of her face back into a memory. But I won't forget her resilience. Or the way her smile pulled you in. She's whole again now and her smile now permanent. It was 98 years of a life well lived, she serving me better than I could ever had served her, and I'm left in awe. This is a tribute that doesn't even begin to do her justice, but it's where my heart landed in these few spare moments I had to write before starting work today. She simply wasn't meant to be captured in the confinement of a few words. Her's is a story that will continue to be told.

She was my last surviving grandparent, so now I step over that threshold from grandchild to simply child. It's a place that may take some time to get used to, but we are all in good hands. Prayers for my parents and aunts and uncles as we all gather this week to celebrate "mom" and "mamaw". Prayers as we pull back into view the memories we've gathered over 98 years. She will be celebrated. Family will be celebrated. And I'm grateful in knowing that even in her death, there are memories still yet to be made. God has an uncanning way of bringing you back to awareness of life outside of yourself, back into a better defined perspective, and back into reliance and trust that his timing is nothing short of perfection. This coming week, that I was so acutely looking forward to last night as I climbed into bed, brought something different than I expected. But I dare say it will be absolutely full of blessings and renewing as only He can do if I just stay focused on His plan. For even in the loss of someone we hold dear and in the ongoing wait of life, he makes all things new.

August 25, 2016 - Life has a way of tweaking itself

I don't even know where to begin. I feel like this has been the craziest morning. Just bizarre with all these little snippets of stories running parallel to each other yet intertwining on beautiful upholstered sofas and then in hallways in passing, then on tables, and under machines. It's a bizarre globe of swirling matter that seems a little surreal in this fog of coughs and sneezes and masks and such. I feel horrible as if this cold is purposely out to contain me. And I am certainly contained. I need some sleep. But despite this swirl of intersections, and weight of snotty noses and barking seal coughs, I feel calm and peace,

I will cut to the chase. You can immediately stop praying for fat. It's not fat, and I don't want that prayer to back fire and me take on fat in areas I don't need it, so let's nix that prayer right now. Don't utter those words again. My hips are counting on that! But thank you for your diligence all the same. So we know it isn't fat, and now we also don't think it is malignancy (more on that below) nor fluid, nor calcium deposits, nor...well to use her words " I have absolutely no idea what this is."

It started with me sitting in a waiting room of 12 women, that number would fluctuate as as I sat, all clad in the same two layers of muddled grey gown. What struck me first about the room was the 3 daisy shaped light fixtures hanging above my head, and then the modern wood paneling draped on the far wall and the sage green paper on the back walls. I felt as though I were in a luxury hotel lobby. I kid you not. This place goes all out to make you forget the sterility of the halls leading to this particular imaging area. After absorbing that awesome scenery, I was left with the utter silence of the room. I mean not a word. Not a spoken voice, not background noise, not a TV or a phone call. Just twelve women clad in gray sitting in silence. The silence would come and go as the morning went on as women exchanged themselves out for another and as technicians called out names thus prompting the exchange. But the silence left in between spoke a novel. There were untold stories in this room. Ongoing stories. And I've never heard such heavy silence.

I went back for my ultrasound and the radiologist poked and prodded. There is was the black blob next to my implant. "Ms. McCollum, I was really hoping I was going to get this up on the screen and immediately say "this is nothing" and send you home. But honestly, I have no idea what we are looking at here."

Me: "is it a mass?"
She: "I don't know. Let's get the mammogram and see what comes up."

So she sent me back out in to the luxurious waiting room where now new faces sat (all staring at the mask I was wearing), but the same silence remained. Then I got called back to mammogram. Shove the boob into the slot - picture. Turn the boob shove back into the slot- picture. Shove the side of the boob back into the slot- picture. "ok, you can go back to the waiting room." Back to the silence and yet more new faces. It's as if they passed out a sheet of paper to everyone who entered asking them to respect the silence. But i knew what it was. It was a room full of worry.

"Ms. McCollum?"

I go up to meet the radiologist who says we need to re-do the mammogram. "I am seeing something and I just can't tell what it is." Ok, at this point she had my attention. I was perked first when she said the ultrasound is non-conclusive and sent me to mammogram. But now TWO mammograms? You have my attention.  Insert boob, squish boob - picture. Insert boob , squish boob- Picture.  Back to the the luxury waiting room.

Now we have found ourselves down to 4 women (myself included). Also in silence. Until....Until the lady next to me turns and looks at me and says, "you look like you feel really bad. I hope you are ok? (me, yeah, I just had a cold that won't let go) I know this sounds crazy but, do you believe in heaven?"

What?!?! No you can't make this stuff up. I sputtered, then clamored to think quick on my feet and said "yes, It's what gets me through these kind of waiting rooms. It's amazing how you can find peace in the knowledge of a heaven". Well, the flood gates opened and the whole waiting room started chiming in. Some told stories about how they got there. Others talked about how heaven played a role in their journey. The women kept asking the touch questions. And I just kept praying God would give the words she needed to hear. Right smack in the middle of that rush of conversation "Ms. McCollum?" I got up and grabbed my stuff and walked over to her and said, "I have to go now, but whether or not you ever believe there is a heaven, you can believe in relationship here on earth and that as a result I will be praying for you and let that give you hope." Mercy, I'm sure I flubbed that up but it is what I had in the 4 second walk out of that room to meet the radiologist! Surely, I could have laid out the saving grace of Christ and all the grace of that, but alas my mind landed where it landed in the split second I had. What a crazy dialogue at such a time as this!!! I'm hoping the conversation continued after I left the room, I'm hoping just the right words were uttered to get her through her day. Something to give her the hope she must have been looking for. Those 4 women will be permanently etched into my brain. Their stories. Their search for hope. Their hunger for more. I was broken by that. On my way out, another women stopped me and said "I'm praying for you, and crossed her heart." Here I was feeling like death warmed over with this awful infection and the mental strain of being anywhere but in my bed and God brought me this little nugget. I know this isn't what you opened this page to read, but it truly is the highlight of the story. Relationship. Trial is a lonely place. And if you don't hear me say anything else today, here me say that. We absolutely have to support people in trial. I've never felt more lonely then in the middle of "stuff" and I know you feel the same. These women proved that to me.

Ok, now I am back with the radiologist in a dark conference room. "Sally, I have no idea what this is. I can say with certainty it is not fat. It is not calcium deposits. And it's not a malignancy, because I have never seen malignancy look like this. I called Lead Plastic Surgeon and spoke with him on the phone about you. I wanted him to look at the scans, but he is out of the country right now, so we decided to have you go see him for an exam and for him to look at the scans with you. He's going to call you to set it up. I'm suspicious it is the sling that is under your implant (to help hold the weight of the implant), but I have no idea what a sling looks like on imaging. I even googled it and there are no pictures out there. So I want him to see it. But for now, rest that we don't think it is malignancy, because if it is, I have never seen one look like this. It looks 'man made' in a lot of ways because it is so dense. Very dense. But it's not the implant itself" (paraphrased slightly off my memory). No malignancy from what we can tell, that's really all I needed to hear.

So, I'm now back in normal clothes, sitting on my bed, very eager to climb under the sheets and take a nap for I feel rough, but I totally feel at peace. This whole day was somehow peaceful, despite 3 sets of imaging, despite knowing they were seeing something, and despite having no idea what it is. God totally orchestrated this day. And I now have 4 women who broke the silence to keep my mind company. That's a score!

I will keep you updated. I imagine my plastic surgery appointment will be next Wednesday. Maybe a biopsy is in my near future, but definitely another exam and lookey loo (there's little dignity in malignancy as you pull out body parts at every turn). I've emailed him and Lead Breast Surgeon who I saw yesterday and am waiting to hear back. He's going to laugh, because I had promised him at my last visit over 6 months ago that I planned on never seeing him again and to not take it personal. Be careful what you promise ladies, Life has a way of tweaking itself as you go.






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August 24, 2016 - "The McCollum"

I've said it many times before. There is something about a cancer center waiting room. You can do the best of interior design, the most brilliant placement of soft lighting, and the perfect combination of artwork and still, your heart skips a beat when you walk in. It's been almost a year since I've been in that waiting room (for a visit, I am often there for work) and it did its thing, changed my mood.Mine was the last appointment of the day so the waiting room was deserted minus one couple also waiting their turn, so the calm of the wait brought me back to center and away from the initial heart gallop. Lead Breast Surgeon was as delightful as usual. She has an almost supernatural ability to put someone at ease. I didn't necessarily need easing, but she certainly maintains status quo. I told her if you are going to have a breast lump, you might as well enjoy the great people along the way. Present company included.

The appointment went exactly as planned. Strip down, bare a boob, touch and feel, get dressed again. She agreed there is something there that shouldn't be there and in her supernatural ability told me she wasn't worried yet. I said "okay then, I won't worry either." To which she responded, "but let's image it." She picked up the phone right then and there and called over to ultrasound and landed me an appointment tomorrow morning. I chuckled at that and made her promise me she still wasn't worried. I pinned her down. "What is on the differential?"  I guess she was expecting that question cause she dove right in with a response. "I'm very hopeful t is one of 2 things: A collection of fat necrosis (dying fat cells),or scar tissue." (Us gals have been laughing that never before have we been so willing to pray for more fat! LOL). I said "and what else?".  She said, "well it could be the negative things: a mass of malignancy or fibroma. If it looks like a mass on ultrasound, we will biopsy it. But let's just assume it won't come to that." See, she is awesome at putting someone at ease. I had to push her to list the last 2 because she wanted to leave on a high note. Despite her super optimistic approach to medicine, I really do think she is leaning toward fat necrosis, or else she has an awesome poker face (and I think she does, but that is besides the point). So we will continue to pray for fat and for a good night sleep and see what comes tomorrow. Oh, and while you are praying, I have the nastiest of respiratory infections going on right now too and could use a pick-me-up from that. It's really pulling me down, and I don't want to be down. I want to be up.

Funny story. During show and tell she says, "I really can't believe how great this all looks (refering to my reconstruction). You've had 6 surgeries and I was expecting to come in and see a railroad of scars. Sally, you should be thrilled. (she went on to remark about my cleavage but I will save face and spare you those details)!" So there you have it, we have a thrilling breast job! I could use that good news. I chuckled a little saying "well he (Lead Plastic Surgeon) told me he was going to do his best work ever! (well I made him promise that)". She said "speaking of him, do you know that we now refer to the procedure we did on you as 'The McCollum? (mastectomy, wait 2 weeks, start reconstruction)". I said "huh?????"  "Yep, that was the first time I had done that (wait to do recon) in prophylactic mastectomy." I don't know if I should be thrilled or not, but it totally got a laugh out of me. So if someone says to you, "do you want the McCollum and all the works?" Know you may be "thrilled" with the results. (Chuckle!) I reminded her I did have 4 more surgeries after that so the jury is still out. She reminded me "The McCollum" was still a huge success.

Oh the joys and ins and outs of mastectomy. It's never boring.

Ultrasound tomorrow. Pray for fat, or scar tissue is fine too if you want to overachieve. and pray for this respiratory infection to resolve too. Might as well shoot big! Hoping to have good news to report back to you in a few days.

Ta-ta for now!





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August 22, 2016 - Wherever we will go

I’m still lying in wait. But I did it “Sally Style” by going to the Caribbean for a week. This trip was planned well in advance, but the timing could not have been more perfect as breast lumps seems almost non-existent while swimming along with seemingly weightless sea turtles in St. John’s. My world was weightless too as I bobbled up and down with the undulating waters around me. I purposely floated alone, away from others. The sea was mine, if only for a few quarters of time, but it was mine as my view held only the waters around me. (I will spare you the intricate details of snorting water up my nose almost sending me into a flopping display of panic, but know that moment was there along with also almost losing my swim bottoms as I dove off the boat). I’m a sucker for creation. And the creation in these incredibly blue waters provide nothing short of mental healing. One rolling tide can sweep away any angst that lie at your back doorstep over to be discarded out over the coral reef that protrudes up from below. It’s therapeutic. And it’s simply glorious to lose yourself in the vastness of magnificence under the water line. But now, well now, I’m back. Back to the ins and outs. Back to THIS side of the water line. Back to the timeline of the ticking clock our society spends so much time trying to tame. There is no clock in the ocean, or rather I found none in my weightless stroll, but now I am back. Back to waiting.

Habakkuk 2:2 has been ringing in my ears non-stop ever since stepping on the plane heading back to my reality. “I will wait to see what the LORD says and how he will answer” (NLT). The verse flooded my thoughts before leaving town and again flood my thoughts now that I’ve returned. Aren’t we particularly horrible at waiting? Do we not conjure up every known horribleness that could possibly be while we wait? Anxiety is real. Worry is real-ER. Fear is real-EST. Somehow, for I know not how by my own merit, I’ve been able to keep these predators at bay. They creep in (mainly in the middle of the night), but then they creep back out. Crystal blue water surely played some role, but I struggled more as the week went on. Flying home was more like flying back to this breast nodule and all it may hold. I’m adoring the statistic of 8 out of 10 (8 out of 10 breast nodules go on to be benign cysts), but I’m finding less comfort around my own statistics for I know not what they are. I did this prophylactic double mastectomy to keep breast cancer at bay. So what does it mean when my risks were so high pre-mastectomy to now find a lump post mastectomy? You can roll that around in your mind until worry is all you know. I’m not there. I am not worrying. But I worry I will START worrying while I wait. See, that is the vicious cycle of worry so easily portrayed by us Type A folks. We truly can worry about worrying. Worry serves no purpose here. Waiting serves all the purpose here.

I’m so gracious in knowing that even through this nodule, and its imposed waiting mode, I am being refined. Ron is being refined. Our “We” is being refined. And for that I give thanks as I lay in wait. In turmoil we get glimpses of our self that we don’t see in the ins and outs of everyday life. There is a camaraderie that can be found in struggle.  There is a depth that can come in turmoil. The lack of guarantee of tomorrow brings a filter which strains out the superficial and brings back a focused lens aligned on the irreplaceable moments of life. I don’t want even a single second of that surreal focus to be muddled with the spoilage of worry. Worry is a predator that lurks behind each corner ready to squeeze out any blessing that lies just underneath. It’s a thief of everything great.  So I very much want to choose to get ahead of that so my lens of perspective remains cleansed by the hope and clarity that comes during refinement.   I want more time in the irreplaceable moments and in the sifter of refinement, and less time flooded by the corrosive nature of fear.

I say all of this out loud on this page as an active process for myself, for if I fall prey to the passive alternate, all will be lost. Sadness may come, pending a specific outcome, but Christ has taken the sting of even that before it makes itself known, so I will choose to see the incredible instead of giving merit to the damning (over and over in my head will I say this until I start to see the fruit! I’m terrible at being purposeful. But I’m getting a lot of practice, and I have as much role in this as anything else does.) My joy will not rely on outcome. For such a time as this, as we lie in wait, his promises are just as true! 

I have the last appointment of the day on Wednesday. The odds lie in getting good news. This “peanut” has just as much right to benign as anything else and I’m claiming that. I’m quite sure the appointment itself will simply be a “touch and feel” session just to get the initial impressions from Lead Breast Surgeon. She is beyond delightful so there is a high probability I will actually show up for the appointment (smile). After that, we will find ourselves back in wait. Then from there, we will go wherever we will go.  




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