A Welcomed Homecomin'

Jim again. Krissy has nominated me to continue her blog on her behalf. Sure, she just had major surgery, includin’ the removal of 20 lymph nodes from her right armpit, which directly inhibits her ability to type, but I suspect that she secretly enjoys havin’ her own personal scribe. Whatever. She just filed tax returns on my behalf, so I’ll call it even.

I apologize for the lack of blog updates. ‘Tween carin’ for Krissy an’ my son, James, a.k.a. J. Cube (James III), a.k.a. JP3, a.k.a. King James, etc., I have had lil’ time to eat, let alone type. (I’ve lost five pounds thus far.) My goal is to write as much as possible, but currently, there just aren’t ‘nough hours in my day.

Providin’ some much needed relief is May, Krissy’s sister, who flew in from Singapore to assist in care. She will be stayin’ with us for one month an’ she has been an enormous help. I wouldn’t have been able to tend to both Krissy an’ James’ needs without her. If anyone has a clonin’ machine, please post yo’ contact info.

Anyway, Krissy was discharged on March 23, 2011 after a six-day stay in the hospital. Our insurance company tried to throw her out on the previous day, but luckily her doctor stepped in an’ ordered more rest. Per her insurance company’s matrix, patients should be recovered ‘nough to leave within five days. (Can you quantify an exact recovery time? Apparently.)

Now that she is home, Krissy’s spirits have greatly improved. For starters, she’s much more mobile. She walks small distances, performs light-impact strengthenin' exercises an' on occasion, stands an' sits on her own. (Bear in mind, Krissy had two major surgeries at once with an estimated eight-week recovery period.)

Secondly, her comfortability with her familiar surroundings is apparent. Although the hospital staff cared for her dutifully, requestin' assistance from May an' I is more to her liken' than to ask strangers. Generally, we're more sympathetic to her pain.

Thirdly, the biggest change since bein' back home is that Krissy was able to see her son for the first time in nearly a week. (Baby James was banned from the hospital due to his parents' mysophobia an' his pension for maulin’ his loved ones, which would have adversely affected Krissy’s recovery.) Given her occupation of full-time homemaker/super mommy, Krissy’s absence from James was traumatic for her an’ she eagerly anticipated their reunion. (James tried to play it off as no big deal, but he later confided that he really missed her.) His mere presence is better than any prescribed pharmaceutical.

With chemicals dissipatin' from her bloodstream, Krissy is more lucid in thought an' enjoys readin' all of yo' well wishes. Thank you for yo' continued concern an' support.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

The (Un)Sweet Pain of Success

Word. This is Jim, Krissy lesser half, steppin' in to update her legion of fans of her current medical condition. (This might not be my last cameo, so I apologize in advance for my obnoxious writin' style, insensitive humor, bad breath, poor posture...etc.)

So, Krissy had her first surgery yesterday, March 17, 2011. She insisted to undergo the knife on St. Patty's Day 'cause she stated that she already associated pain with the taste of Irish food. (She didn't really say that.)

Our day started off at 3:30 a.m. with typical chaos. When we were in line to check-in for surgery, a fire alarm went off. I asked Krissy if she wanted to evacuate the buildin', to which she scoffed. She was motivated to remove this cancer...an' she was probably still half-asleep an' not of sound mind. After 10 minutes of sirens an' flashin' lights, the alarm was deemed false an' we were allowed to enter.

Once inside, we discovered that since a standard arm insertion might obstruct the surgeons' accessibility to her breasts, the nurse stated that he needed to place the intravenous drip (IV) into Krissy's foot. Not known for her vast pain threshold, Krissy squealed an' squirmed to such a degree that he simply gave up an' suggested knockin' her out with gas first. (He was serious.) Luckily, Krissy's plastic surgeon permitted that the IV could be placed in her left arm an' he'd work 'round it. (I liked the gas idea.)

Regardless of the initial (figurative) speed bumps, Krissy weathered the 12-hour surgery like a champ. (Admittedly, she was unconscious.) Both of her breasts were successfully removed an' her belly fat was utilized to make two new ones. As Krissy had previously blogged, when she gains future weight, her boobs will grow, so everybody wins! (Who said cancer doesn't have it's perks?)

Anyway, Krissy is now restin' uncomfortably in the hospital. She's in considerable pain, but has a morphine drip to help when things get too intense. She lies under an inflated, plastic heatin' device, used to blanket her organs an' keep 'em warm. Krissy has to blow in a tube, at least ten times per hour, to keep her airways clear an' prevent pneumonia. Her throat was roughed up from the anesthesiologist's air tube, her abdomen is very sore, she feels nauseous, has a fever an' has yet been able to eat. (We were warned that the first couple of days, post-surgery, would be rough, an' they're provin' to be just that.)

However, she is lucid, drinkin' water an' textin', facebookin' an' talkin' (albeit softly). Each day will pass an' Krissy will feel better/grow stronger. (She'll be back to performin' cartwheels in no time.)

We'd like to thank everybody for the overwhelmin' amount of love an' support that we've received durin' this time of hardship. From offers of free meals/babysittin'/transportation to countless encouragin' sentiments, all yo' sweet efforts have really made a considerable difference in Krissy's demeanor an' motivation. The feelin' of bein' "sick" can be quite isolatin', but when people reach out, it reminds Krissy of her place/value in other's lives an' helps her to keep focused on recovery. Since I need her more than anyone, I applaud you all for actively readin'/participatin' in this blog.

If you didn't keep Krissy's spirit so strong, I'd have to raise a two-year old solo, which is a fate that I wouldn't wish on my worst enemy.

(By the way, if the font size is different in spots, I have no idea as to why. E-mail blogger.com an' complain.)

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

New 'Do for a Cause and Getting Ready for Surgery

I just finished my patient surgery education class today at the breast cancer center. It was so helpful because they showed us what to expect before, during and after surgery. It helps to know because it lessens the anxiety. Now I think I'm ready for the big day tomorrow!

The hospital just called late this afternoon today and told me that I was moved up as the first case of the day so I have to check-in at 4:45 AM. Surgery will be at 7AM and will last for 10-12 hours.

After the class, I decided to finally have my hair cut in preparation for chemo treatment. I might not be up for going to the salon while recovering from surgery so I want to have it done now.

I've also decided to donate my hair to Pantene Beautiful Lengths program. As they have said: "A real-hair wig allows a woman to look in the mirror and at least see a familiar face while she fights to regain a sense of normalcy in her life." I want my long hair to go to a worthy cause before I lose it.

As Pantene Beautiful Lengths wigs are created, they are distributed for free through select American Cancer Society wig banks across the country. Women facing cancer can find out about the availability of a Pantene Beautiful Lengths wig by calling the American Cancer Society at 1-877-227-1596. The Society can also help callers with a number of resources providing educational and emotional support. More info on Pantene Beautiful Lengths. 

So after preparing my hair for donation according to their requirements, here it is:

All 13 inches will go to a woman's wig so it may help her in coping through recovery.

And the final look: 

  

Off to bed now with the new 'do, for a three hour sleep before surgery.
Jim will blog for me while Im in recovery.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Great Doctors, Bilateral Mastectomy and soon-to-be-Foobs!

We finally got the surgery date, March 17.  Next Thursday, I will be having a double mastectomy, a Modified Radical Mastectomy, removing both breasts and lymph nodes with cancer.  I have finally decided to agree to a double mastectomy because I do not want to have a cloud looming over my head with 87% chance of having another cancer for the rest of my life.  I realized the benefit of living longer outweighs any issues I have of not having my other breast. 

We met with the Plastic Surgeon yesterday, Dr. Jaco Festekjian at UCLA, who will be doing an immediate DIEP reconstruction during the mastectomy.  He is a great doctor, awarded SuperDoctor last year.  He is one of the few that specializes in microsurgery of breast reconstruction and he works closely with my breast surgeon.

DIEP flap (Deep Inferior Epigastric Perforator) This is the name of the main blood vessel that runs through the tissue that will be used to reconstruct the breast. In DIEP flap reconstruction, only skin, fat, and blood vessels are removed from the lower belly (the abdomen between the waist and hips). No muscle is removed. This is one of the main differences between the DIEP flap and the TRAM flap--the TRAM flap procedure removes muscle (along with fat, skin and blood vessels) and the DIEP procedure does not. (from www.breastcancer.org)

In other words, Im getting a tummy tuck to reconstruct.  :)  That's one good news for me. I say great news. (These post-pregnancy belly flaps will go to a better place and with a noble cause! LOL)

Dr. Festekjian inspected my tummy and said it can work.  I can get a nice cup B.  Not as much as I would wish it to be but hey, I'll be waking up with FOOBS (Fake Boobs) at least. (Any belly fat donors out there??)  I don't have as much belly fat to reconstruct two foobs but he said when I gain weight, the foobs will grow too because the body doesn't know that these fats were just relocated, it thinks its still belly fats.  Thats awesomely amazing!! Woohoo!  Its amazing how God made our bodies.

Stage 1 will be a 10-12 hour surgery with mastectomy with 5-6 days hospital stay.  I will be in ICU for a day or two to monitor that the flaps are alive because the blood vessels will just be re-attached.  Recovery will be for 4 to 6 weeks. 

Chemo will follow a few weeks after surgery.  We don't have a schedule yet but I will be speaking with my breast surgeon this afternoon.

I was hoping for a nipple-sparing surgery but Dr. Festekjian said my breast surgeon may not allow it because the second tumor is very near the right nipple.  So I might get a tattoo on the right and the left might be kept. I hope so.

Two to three months after surgery, I will go back for Stage 2 surgery, so the doctor can fix the symmetry and remove excess skin and tissues which will take about a week of recovery.  Six weeks after will be Stage 3 surgery, nipple reconstruction.  One month after is Stage 4, Areolar tattooing.

After the Plastic surgeon, I was referred to Dr. James Heaps, an oncology gynecologist, because I need to be monitored for Ovarian Cancer (due to BRCA gene mutation).  My chance of having ovarian cancer is 44% before age 70. I will be checked every three months from hereon.

I was so blessed to be able to get a next-day appointment with Dr. Heaps, just because I was referred by the best surgeons that I have.  I've researched about him and everyone only have great things to say about him.  It takes about 4 months to get an appointment.

He examined my ovaries and they look normal.  I have eggs but my uterus are very thin and quiet, because of the fact that I just stopped breastfeeding last week!  (Yeehaw!  Thats another great news, we are 6 days of not breastfeeding.  I thought it would be a painful process emotionally for baby James and myself but he has been great so far).

Dr. Heaps recommends that we consult with a fertility doctor to consider freezing of eggs, fertilize and freeze the embryo.  With this, the embryo is considered to be from a 34 year old mother and we can implant later on after five years when I am done with treatments.  He said the chances are slim to none of getting pregnant when I'm 39 and have undergone chemo and radiation.  It is a very expensive procedure but at least we have an option.  We are meeting with the fertility doctor, Dr. Mousa Shamonki at UCLA on Tuesday, March 15.

We have to do this option, if we want to, before I start chemo.

Last and definitely not the least news:  my sister is coming on Monday all the way from Singapore to help us out while in recovery.  Best sister in the whole wide world, period. :)

After all these news, I think its a very good day!  Most especially because its Baby James second birthday today!  :) I feel very blessed to be in the hands of GREAT doctors in America, Dr. Chang, Dr. Festekjian and Dr. Heaps. We will kick this cancer's a$$. :)

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Genetic testing and results

I was recommended to get a genetic testing for BRCA (breast cancer gene mutation) by the first doctor we went to.  After transferring to UCLA, it was also prescribed and the test was done quicker because they have it available in the hospital.

I went to see the genetic counselor on February 23.  I was lucky to be accommodated the day after I called because they happen to have a cancellation.

It took an hour of of counseling and learning why I needed the genetic testing.  In a nutshell, I have breast cancer at an early age (<50 y.o.)  and I have a strong family history of breast cancer (2 maternal aunts who passed away).

The genetic counselor told me that not everybody opts to have the genetic testing because when they are afraid to find out that they are positive, then they are faced with more decisions on top of what they already are going through now.

But I decided for it because I think it is better to know now than be surprised again with another diagnosis in the future.

c/o www.myriadtests.com (the test done to me)

Having the inherited gene mutation increases the risk of getting breast cancer, having a second cancer and developing ovarian cancer.  The general population's risk of getting cancer by age 50 is 2% while BRCA mutation increases it 25x, making the risk to 50%.  Without the gene mutation, the risk is 8% by age 70 versus 87% with BRCA.  

Without the gene mutation, the risk of developing a second cancer is 11% versus 65% with BRCA.  Lastly, the risk of getting ovarian cancer is increased 44x, with BRCA the risk is 44% versus less than 1% in the general population. 

So, I was tested for the genetic mutation, a blood sample was taken and sent to the lab that specifically processes this kind of testing.  The result will be given after 7-10 days.

This morning, my genetic counselor called that she has the results. 

So the verdict:  I am positive for the BRCA 2 gene mutation,  which causes Hereditary Breast and Ovarian Cancer (HBOC) Syndrome.

Everyone who are diagnosed with this asks:  so, what's next?

Their recommendation is to have a double mastectomy because the risk of having a second cancer is too high. 

Also, I was asked if we are still planning to have another child.  I said, "of course!".  Their recommendation is to have my ovaries removed by age 40, once i'm done having children.  I don't know how likely that will be to have a child before 40.  By the time I finish Tamoxifen (drug therapy for breast cancer to be given for 5 years), I will be 40.  But who knows?  Maybe we will be blessed with another beautiful baby before they would have to take these ovaries out. 

There is not much disadvantage to having a double mastectomy except I won't be able to breast feed again. :-(  But I think living longer is more important so I can take care of my family. 

Having an ovarian removal will be more tough because one will go through an early menopause and I heard its rough on the body.  Aside from the symptoms, there can be bone loss too.  But I will discuss all these fears with the surgeon this coming week, when the treatment will be finalized. 

I'm glad to have been tested.  Even though the decision laid down before me are overwhelming, it is better to know now than when another cancer has appeared.  It also gives us more treatment options now on how to possibly lessen the risks.  Lastly, knowing this (gene mutation), my sister and mother have to be tested soon because they have a  50% chance of having the gene mutation too.  I am also advised to share the results with the rest of my extended family (aunts and cousins) to have them get tested.  Its now a family affair, as they said. 

I will be most HAPPY if they all tested negative for the gene mutation.  I'm hoping and praying. 

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

MRI, PET Scan, CT and all other tests

Finally, I finished all the tests today, after two days of IV, poking, being inside the machines for hours and the biopsies.

My actual breast MRI. Red spots are the cancerous tumors. 

I had the breast MRI done yesterday where they put an IV line on my arm and made me lie face down on the bed that goes into the machine.  The bed has two holes where the breasts would go in and hang down.  Then the dye was injected and the test went on for 25 minutes.

The PET scan and CT scan followed in the afternoon.  It took a little longer preparation.  I had to fast for 6 hours before the test.  Then when I checked in, I was made to drink three cups of barium sulfate.  Eewww.  It tasted like creamy metal with an orangy twist.  But because I was so hungry I gulped down one cup.  I started to feel a little sick so when I told the nurse, he said I don't need to finish the other two cups.  Might as well keep the one I have ingested already than risk throwing.  Then they injected a radioactive glucose in my IV line which will show up in the scan.  Cancer cells take up the glucose as their food. I rested for 45 minutes while they wait for the stuff to be completely absorbed my body. Then it took about another 45 minutes inside the machine while they took the scans.

I was told that I will be radioactive for the next 24-48 hours.  So I cannot be near or hold baby James during this period.  They said to be safe, dont hold him for 48 hours, but if needed, 24 hours is okay.

It was rough because I have been away the whole day and when I got home, baby James saw me and wanted to be carried.  I tried for a few seconds and had to give him back to daddy.  He was crying a lot wanting to be held so I decided to just leave the house that evening till he goes to bed and I can come home.  I was out till 12:30am.

The next day was mammogram, ultrasound and triple biopsy.  They were also putting a clip on each tumor and a coil.

The mammogram went ok except when the cancer breast was pressed between the paddles, it hurt.  The ultrasound were always the easiest.  Then came the biopsy.

They took samples from the bigger lump again and placed a titanium clip inside the tumor.  They used core needle biopsy on the bigger lump and 5 samples/vials were taken. The ouchiest part is the anesthesia.  After numbing, all I can feel was pressure and clicking of the biopsy gun.

On the smaller lump, vacuum-assisted biopsy was used.  A titanium clip was also placed plus a coil.  This time, there were drilling and vibrating inside the breast that I can feel. They took 7 samples on the smaller one.

Lastly, they tried to biopsy the lymph nodes that are involved.  When they were injecting the anesthesia, the pain was unbearable. The doctor said it was because it was going to the muscles where the lymph nodes are lodged in.  They had to stop and cancel getting the samples because of the pain.  They said it will not change the treatment anyway because the MRI and PET scans confirmed cancer in the lymph nodes.

I felt  dizzy and lightheaded, with some chills after the procedure so I waited a few hours at the hospital before driving home.

I'm still feverish and in pain as of now, (after 24 hours) but hopefully it will go away.  I was advised not to lift anything heavy for a week.

If you can , please help in raising funds for Krissy's Breast Cancer treatment: