The day you find out you have cancer.

Wednesday, September 23, 2009. I remember that day vividly.  I was at the office in back-to-back meetings.  Two days prior, I had three biopsies and recalled how quiet the radiologist was compared to her perky self the week before.  When my phone rang and I saw her number, I knew.  “I’m sorry, but the exam came back positive.  You have breast cancer.”  As I heard her talking, I was messaging my husband on my computer, telling him everything she was saying to me.  I don’t remember anything else she said after those words, but I couldn’t stop typing.  It was all I could do to keep the crying from consuming me.  The minute I hung up, I shut down my computer, and literally “shut down.”

I’ve heard people describe finding out they have cancer in many different ways.  The rug being pulled out from under you.  Free-falling from a cliff with no end in sight.  A freight train slamming into you.  These were all feelings I felt immediately after getting the news.

I cannot die.  Not now.

That day marked the end of the life I knew, and the beginning of a completely different life.  It also began a two-year battle that included four surgeries, six months of chemo and many, many months of piecing myself back together again, both physically and emotionally.

But I remember that day the most because not only did it represent the death of my former life, but also the birth of the wiser, more tolerant human being I am today.  I remember how nothing else mattered after I received the news.  All of my worries from the week before, be they money, work and the million other trivial things that consume our minds day-to-day, were now meaningless.  Wiped out of my mind.

I knew all I had was “now.”  The past is just that, and I wasn’t sure I would be around for the future, so I had to learn to make the most of each moment.  Every school recital was a celebration, every family dinner a reason to smile.  Every chance I had to be with my three children was a happy one, and I cherished them as if they were my last.

It is unfortunate that an event as drastic and debilitating as cancer made me shift my focus to what is important.  But it was also very empowering.  It is as if I lived in black and white before cancer, and now everything was in high-definition color.  My life became more vibrant, as if I had found the secret meaning.

Cancer gave me this.  And while, yes, it can be fatal, it can also teach you about living.  It has certainly taught me, and I am thankful for it.

Natalia, Breast cancer survivor

About Natalia:
In September 2009, at the age of 34, Natalia discovered she had breast cancer.  After feeling a lump in her right breast, she had a mammogram and underwent several biopsies, confirming the cancer diagnosis.  Her surgeon recommended a lumpectomy, but Natalia chose to have an aggressive bilateral mastectomy instead, to prevent a recurrence.  After determining the cancer had spread to one lymph node, she underwent six months of chemotherapy.  Natalia is the mother of three young children.  When her cancer was first detected, her youngest daughter was just 2 years old.  Natalia hopes that sharing her story will help other young cancer patients cope with the diagnosis and give them hope that there is indeed life after cancer.

PLEASE JOIN THE CONVERSATION
As a part of our mission to make The Journey a powerful voice for everyone in our community, we invite each of you to consider joining the conversation and sharing your journey with comments and feedback.  You don’t have to be a breast cancer survivor, you can be a caregiver, or a friend, or a concerned citizen. What we are looking for is meaningful and helpful conversations that will encourage other people as they travel along their journey. Sharing is caring and very cathartic. I sincerely urge you to take part.

The breast cancer path is commonly referred to as a journey.  What most of us really don’t realize at the outset are all the terms and conditions, trials and tribulations, ups and downs and the incredible number of amazing Soul Sisters with membership in the Club (one in eight women will be diagnosed with breast cancer).

Many newly diagnosed patients don’t even know what breast cancer is.  Just hearing that six-letter word C-A-N-C-E-R sends a chilling shiver down your spine. When you add the other six-letter word, B-R-E-A-S-T, the shiver becomes a quake.  And then The Journey begins!

Thoughts and visions go racing through your head at a mile a minute – there’s much to learn, little time to learn it, and to paraphrase the famous words of Bette Davis, “Breast Cancer isn’t for Sissies!

It’s not a club that discriminates against age, race, religion or gender.  Men get breast cancer, too! Although not as prevalent as in women, more and more cases are being diagnosed.  Today, most breast cancer organizations are including men in the conversation as well.

The Journey is about conversation and community.  We intend to keep our visitors and patients well-informed and engaged as we share personal journeys, the latest research findings and other user-friendly information that can be helpful to newly diagnosed women and men as well as long-term survivors.

Some of the topics we will focus on are genetics, risk management, diagnosis, treatments, nutrition and survivorship.  When important news becomes available, we will share it.  Recently, the U.S. Food and Drug Administration approved a silicone gel-filled breast implant manufactured by Sientra Inc., which now offers patients and physicians an additional choice. We posted the information, and asked for your opinion.

As a breast and lung cancer survivor, I know first-hand how startling those words are and how much they have changed my life over the past four years.   I hope that, together with my own personal experience, the breast cancer community’s participation and the medical expertise of Baptist’s healthcare professionals, our Baptist Health Breast Cancer blog, “The Journey,” will become your resource for your own personal journey.

Live healthy,

Muriel, a four-year, four-month and 13-day breast and lung cancer survivor

PLEASE JOIN THE CONVERSATION
As a part of our mission to make The Journey a powerful voice for everyone in our community, we invite each of you to consider joining the conversation and sharing your journey with comments and feedback.  You don’t have to be a breast cancer survivor, you can be a caregiver, or a friend, or a concerned citizen. What we are looking for is meaningful and helpful conversations that will encourage other people as they travel along their journey. Sharing is caring and very cathartic. I sincerely urge you to take part.

Unfortunately, we have another common bond. We’re ALL candidates for breast cancer.  One in eight women will be diagnosed with breast cancer in her lifetime. Breast cancer ranks second to heart disease as the leading cause of death in women (but that’s another blog).

The first thing you have to know – and you have to tell all the women you know – is that when breast cancer is diagnosed early, the survival rates are good and getting better. According to the American Cancer Society, the 2012 five-year survival rate for American women diagnosed with cancer is 89%, thanks to greater awareness, improved diagnostic tools and better treatment.  Today there are over 2.6 million women living with the disease in the United States.

So, on this Mother’s Day, we dedicate the new Baptist Health Breast Center Blog – The Journey – to all the great women in our lives. May you all be safe and healthy and loved, all the days of your lives; but if you do need us, please know that we’re here for you.

Yes, this is kind of an odd way to celebrate Mother’s Day – talking about breast cancer – but here it is.  If people love you, they want you around. You owe it to them to take care of yourself.

Don’t wait until you hear about someone you know who has been diagnosed with breast cancer.  Be prepared.

The American Cancer Society recommendations are:

• Watch your weight: Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.
• Exercise: Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise five or more days a week.
• Drink less alcohol: Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk.
• Have regular mammograms: I discovered that I had Stage IIA breast cancer during a regularly scheduled mammogram. Then I had the better-safe-than-sorry lumpectomy following a routine PET scan that revealed early-stage lung cancer. The truth is, breast cancer saved my life.
• Do monthly breast self-exams.  Although these have met with some controversy, the American Cancer Society and many other breast organizations have not changed their position.  Breast self-examination is recommended for women starting in their 20s. Women should be told about their benefits and limitations. They should know how their breasts normally look and feel and should report any breast changes to their health professional right away.

None of these practices alone will prevent you from getting the disease, but they will contribute to lowering your risk or getting an early diagnosis. By being alert to any breast changes and having exams and tests according to American Cancer Society guidelines, cancer can be found at the earliest possible stage, when it is most treatable.

• Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.
• Women in their 20s and 30s should have a clinical breast examination by a health professional as part of a regular health exam, at least every three years.
• Starting at age 40, women should have a breast exam by a health professional every year.
• Women with more than a 20% lifetime risk for breast cancer should get a magnetic resonance imaging (MRI) scan of the breast and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

THE BOTTOM LINE: It is important to know your breasts. Become aware of what your breasts look like and feel like. Don’t rely on someone else.  If you ever see anything unusual, RUN, don’t walk to your healthcare professional.

Breast cancer typically produces no symptoms when the tumor is small, so it is important to follow all the above screening guidelines.  The most common symptom of breast cancer is a new lump or mass. There could be pain, but there may not be pain; there are no hard-and-fast rules.

IF YOU FEEL A LUMP, JUMP!
Other possible signs of breast cancer include:

• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness or thickening of the nipple or breast skin
• A nipple discharge other than breast milk
• Swollen lymph node

Your family history (genetics) plays a role in the likelihood that you will inherit the disease. Unfortunately, the widely held myth that you get breast cancer only if someone in your family had breast cancer is exactly that ­– a myth.  According to the American Cancer Society, only 10% of breast cancer diagnosis is genetic – 90% of the diagnoses are not.

Two major risk factors for breast cancer are absolute.  One is age – the older you get the more likely you are to develop the disease; and the second, also an absolute, is if you are a woman.

Some other possible risk factors according to the American Cancer Society are: Ashkenazi Jewish heritage, early menopause, late-age full-term pregnancy, personal history of breast, endometrial, ovarian or colon cancer.

And since we are always thinking of others, let’s not forget to take care of our men. Approximately 2,190 new cases of invasive breast cancer will be diagnosed among men in 2012 according to American Cancer Society.

There is still more to learn about the disease, even among those of us who are living the experience.  I hope we will learn together through The Journey.  For now, you have a thumbnail sketch of the risks and symptoms, a good first step.

And remember, Early Detection Saves Lives!

Happy Mother’s Day!

Muriel , four-year, four-month and 12-day breast and lung cancer survivor

PLEASE JOIN THE CONVERSATION
As a part of our mission to make The Journey a powerful voice for everyone in our community, we invite each of you to consider joining the conversation and sharing your journey with comments and feedback.  You don’t have to be a breast cancer survivor, you can be a caregiver, or a friend, or a concerned citizen. What we are looking for is meaningful and helpful conversations that will encourage other people as they travel along their journey. Sharing is caring and very cathartic. I sincerely urge you to take part.

The answer? There are many different things you can do.

Patients should always ask their physician for specific suggestions and ideas pertaining to their condition and treatment, but here are a few ideas that will help keep things simple:

• Eat fruits & vegetables

• Stay away from fatty and greasy food

• Avoid excess alcohol

• Maintain a healthy weight

• Exercise

Walking a little bit each day gets you started. Slowly increasing the distance or time keeps you going. Think of different activities you can do to stay busy and healthy.

Aside from the tips listed above, you also have resources such as the Cancer Support Community available for you to explore. They offer exercise classes, yoga, tai chi and even cooking classes.

I will be giving a lecture on May 7, 2011, the Day of Caring, on how you can help yourself lower your risk of recurrence and improve your quality of life at the Hotel InterContinental in Miami.

If you’re looking for other support groups to connect with, we have Your Bosom Buddies that meets on the 3rd Thursday of every month in the Victor E. Clarke Education Center at South Miami Hospital.

Please feel free to contact one of our Baptist Health Breast Center CareCoaches at 786-662-4775 (and press 3) for more information.

-Grace Wang, MD, Co-chair, Cancer Committee, Baptist Health South Florida

I’m having some issues that I need to address and I just don’t want to write any more.

I find myself less and less at the computer these days. I have a pile of unread emails. Also, my daughter has been sick with her fifth bronchial infection this year and since it’s her last year in elementary school, I’ve been busy trying to get her into a good middle school. I’m trying very hard to return to my normal, everyday life and writing a blog is not something I would normally do. However, I am glad that I shared my story and hope that the women who read it were inspired or comforted.

All of my life I’ve been a worrier and now I find that I’m worrying about a cancer recurrence. I think what I need right now is to get into a good support group and to reconnect with the breast cancer mentor that I was assigned through the program, A Buddy for You. I’m sure that I’m not the only cancer survivor to be worried about a recurrence. I’m also hoping to find some women to connect with online. I want to talk to other women going through the same thing

It’s not easy being a breast cancer survivor. People look at me and say “Wow, you look wonderful” and “Wow, look at that cleavage”. What they don’t see is the scared person behind the mask of smiles. They don’t see the person that’s just 6 months past a double mastectomy and one month past breast reconstruction surgery. They don’t know that so far, I’m not real happy with my breast reconstruction. They don’t know how difficult it was to decide to get breast implants. I hesitated and now I understand why——The reconstructed breasts remind me too much of my own breasts that were removed. And my breasts remind me of breast cancer. I’m not sure if other women feel this way. They may just see the positive side of reconstruction and are pleased to have new, perky breasts.

I hope you continue to use this blog. I was honored that Baptist Health South Florida selected me to write about my breast cancer journey. Even though another blogger will soon take over, I hope that I can still share news with you in the future. I pray that all of my future news is good news. God willing, that will be the case.

Thank you again for allowing me to share my story because I enjoyed doing so. And, thank you for your comments. But now I must move on and I hope that you understand my need to step away at this time.

I visited my surgeon’s nurse who told me that everything looked good and that my breasts would drop into their final position in a few months. She said that I could use panty liners to soak up the fluid, but I used non-stick bandages instead. She said the nipple grafting looked great and that I could e-mail her with her any questions or problems. I’m not scheduled to see the doctor until late April and that concerns me a bit.

A week later, I e-mailed the nurse to let her know that my right nipple appeared to have lost some of the stitching and was quite loose on one side. I asked to see the doctor, but was told that I needed to heal completely before that could happen. She said that at this point, the new nipple couldn’t be re-stitched. I was disappointed and went to some online forums to see what other women had experienced. Apparently, from what I read, this happens sometimes. Right now, almost a month after surgery, the right nipple has shrunk some and still seems somewhat detached. The left one has not shrunk as much; is turning black /scabbing, which I was told is normal. The tattoo portion on the right is fading some on the top. Apparently when nipples get reconstructed, the part that protrudes can shrink a lot and may have to be redone. And, from what I’ve read, the tattoo can fade and may need to be reapplied. I think most of these fixes can be done with local anesthesia at the doctor’s office.

So bottom line is that I’m not thrilled with the results so far. I think I’ll need some touching up. The scars are still pretty visible and I was hoping they would be less so. I’m sad if one of my grafted nipples is coming off, but who knows, maybe it’ll hold enough to be repaired.

When I do see the plastic surgeon, I’m going to ask a lot of questions. If this whole nipple thing turns out to be too much trouble, I might just get them removed and leave only the tattooed portion. I read online that some women have done this. They go without nipple reconstruction altogether so they can go braless. I read somewhere that a good tattoo artist can create the look of a nipple and areola that has a sense of depth. Maybe that’s what I’ll end up doing.

On the day of the surgery, there were some delays with another patient that caused my surgery to be delayed until 2 p.m. and the waiting made me nervous. The actual surgery took about 21/2 to 3 hours and was followed by a stay in recovery room. I left the hospital at about 7 p.m. Yes, breast reconstruction is an outpatient procedure; in and out all in one day!

The first night, the pain medication from the surgery was still working, so I was OK, except for the bandages feeling really tight and a very uncomfortable feeling in my abdominal area. The next day is when the pain really got bad. The meds I was prescribed were not helping and my neck was killing me; my eyes were shaky; and my entire abdomen felt like it had been used as a punching bag. I saw a scab in my belly button and bruises beginning to form where they had suctioned out fat to use as filler. I knew they were going to take some fat, but I never imagined a liposuction-type procedure or this type of pain. Except for the bandages being uncomfortable, my chest area was actually the least painful part.

The following day, I decided that I needed a hot bath to ease the abdominal pain and, in fact, that did the trick. Unfortunately, my bandages got wetter than I intended. A day later, I was peeling off most of the bandages, but called my surgeon’s nurse first to let her know what was going on. I only left on the ones over the newly reconstructed nipples because I was afraid to see what was under there. I developed a yellow/green leakage from the left nipple for a few days, but that stopped before I saw the nurse the following week. Thank goodness, because it was gross!!!

It’s now two weeks since the surgery and I feel very well, but can no longer sleep on my sides. Just when I was getting used to those pesky tissue expanders, I’m back to square one. I’ll tell you about my reaction to seeing my new nipples in the next blog.

I really thank God for making me strong because I have had two operations in a short period of time and have recovered from both very quickly. I know women who have done their breasts for cosmetic reasons that have been laid up longer than I was. So thank you Lord and thank you friends and family for the prayers that once again helped me through.

When we got to the store, I went to the magazine section and looked under “Men’s Interests,” but couldn’t find it. In my lowest voice, I very discreetly asked a clerk for Playboy. Unfortunately, this store must not train their clerks in the use of discretion, because the clerk immediately went to another clerk and said loudly, “This lady is looking for Playboy. Where are they?” Then, as if that wasn’t bad enough, the second clerk proceeded to loudly ask a third clerk. Who knows, maybe they thought it was funny, but my daughter and I were mortified. I was directed back to the “Men’s Interest” section. But again I had no luck finding it and had to approach the clerk again. This time I cornered him and told him that there were no Playboys in the section to which I had been directed. He responded that they must be sold out. Sold out!!!!! No, I was not going to accept that after all of this embarrassment. I explained my situation to him and asked him to help me find similar magazines. After some searching, he found a magazine that I knew would definitely be more graphic, but it was my only option. I purchased it without even opening it.

Here’s’ what I learned from purchasing this magazine: Porn magazines are very expensive. This one was close to $8. And, they’re not hidden under jackets. If your children read magazines at the bookstore, be careful. An explicit magazine could be looked at by any kid. That should not be allowed and neither should clerks yell out the names of these magazines when a customer asks for help locating them. I plan to write the bookstore’s management a letter about these issues.

Fortunately, even though this was an ordeal, I did manage to find a couple of not-so-explicit photos that I’ll show Dr. Marshall to give her an idea of what I want my breasts to look like. My appointment with her is tomorrow. Wish me luck and keep me in your prayers. My surgery is next week.

January 20th marked the six month anniversary of the day I got the mammogram that changed my life. Strangely, even though I want to put all of that behind me, I sometimes feel the desire to step out of my car and thank the owner of a vehicle with a breast cancer license plate. I wonder if they were affected by breast cancer or know someone who has been affected. I’ve never had the courage to actually get out of my car and ask them, but the thought has crossed my mind.

I also feel compelled to share my breast cancer story and hear other’s stories. I don’t think I’ve connected with enough breast cancer survivors and hope to change that. I’m thinking about going to a Your Bosom Buddies Breast Cancer Support Group meeting at Baptist Hospital and hope to join other groups after my next surgery.

By the way, my boob shopping is a bust. (No pun intended.) I don’t know where they sell Playboy and I’m not sure that I have the courage to buy one anyway. Maybe I’ll do some internet shopping. Wish me luck.

Physically, I felt great, despite 8 hours of sitting on a noisy bus filled with pre-pubescent kids, 6 hours of walking and going on every ride except the newest and scariest roller-coaster. (To my daughter’s dismay.) I was so proud of myself for being able to keep up with the kids and even seemed to do better than them in the sore foot department.

I was also proud that I was able to just let go and have fun. I tried not to think about my breast cancer surgery and the reconstructive surgery that’s coming up. There was one thing, however, that I did worry about:

The medication that I’m taking, tamoxifen. When it was time to take my pill, I briefly wondered if going on those roller-coasters and thrill-rides was a bad idea. Tamoxifen is known to increase the risk of developing blood clots and stroke, so I worried about that. Fortunately, I was able to brush those thoughts away and remind myself that “you only live once”. I know I have to live to the fullest and enjoy every minute, and that’s exactly what I did. I lived. I enjoyed. I realized that my life can be pretty much what it used to be. I felt joy and am hoping for more trips like this in the future. But next time, I might skip the noisy bus full of kids and go to a quiet spa instead.