Getting Things Off My Chest…

Yes… I love to bring humor into otherwise stinky situations. It’s not that breast cancer or leukemia or bone marrow transplants are awesome or funny – they suck; however, once the cards are dealt, you just have to roll with it, dance a little, and laugh a lot! So yes, you should expect lots of good mastectomy puns coming your way in the coming weeks and months!

With that being said, I do want to get something off my chest (not literally… yet).

 A mastectomy is not a free boob job.

It was one of the first things I said when I realized that double mastectomy could be in my future, “Hey! At least I get the boobs I always wanted!” That’s because there was a time, not so long ago, when I thought that a mastectomy was a surgery when the surgeon cut you open, ‘pulled out your boobs’, gave you some implants, and you could go about living your life as it was – maybe just more endowed.  HOWEVER, as Donny and I scoured websites for information, watched Youtube videos, discussed the procedures with friends, and chatted with my physicians, we learned that nothing could be further from the truth.
Now as I mentioned in the previous post, there are different types of mastectomies and it is important to keep this point in mind. What I’m about to dive into, is specifically tailored around a bilateral, total mastectomy – the type I will undergo in only 18 days. However, all mastectomies suck. Period.

Once my physicians scheduled my surgery, I began describing what my mastectomy entailed to colleagues and friends – that is when I realized that I wasn’t the only one who was a bit in the dark. Thus, I am providing a mastectomy crash course.

*WARNING: The below info, pictures, and videos are not for sissies. Proceed with caution.*

In a nutshell, here’s what my mastectomy will look like (if all goes according to plan): 

  • A total bilateral mastectomy with reconstruction is about a 5 hour procedure.
  • The breast surgical team will start off the surgery. When they’re done, the plastics team takes over.
  • The Breast Team
    • My breast surgeon is going to make a marquise type cut above and below the nipple. That skin and all breast and fatty tissue will be removed. My breast surgeon will also scrape the inside of the remaining skin to try to ensure that as much cancer-causing cells are removed.This means the remaining ‘flap’ of skin is going to be very, very thin.

    • It is important to note that my breast surgeon pays careful attention to the tissue as she is removing it, since she likely would be able to spot an invasive cancer. The plan is to leave all of my lymph nodes in place; however, this could change if an invasive cancer is spotted during surgery. This is because invasive cancers typically spread to the lymph nodes before moving around the body. Removing the lymph nodes not only serves to potentially remove cancers but also allows the physicians to determine if additional treatment is necessary (i.e. chemo, etc).
    • To summarize everything I just said, watch from about 1:40 to 3:00…

  • The Plastics Team
    • Once the breast team is done, the plastics team takes over. 
    • In about 1 in 20 cases, the plastics team is unable to begin the reconstruction process (i.e. if the skin appears to be losing blood flow, etc). If this were to happen, they would just close me up and I would come back for another surgery in about two weeks.
    • Some good news! My plastic surgeon was particularly impressed with my skin, despite my prior radiation, and estimates that there is about a 1 in 40 chance that we won’t be able to start the reconstruction process.
    • If all goes well, my plastic surgeon will initiate the reconstruction process and place my drains. The drains are rubbery tubes that allow the lymph and serous fluid to leave my body easily and collect in little bulbs. I will have these in for anywhere from 4 days to 3 weeks. Fortunately, my plastic surgeon is not anticipating that they will be in long since I am on the smaller side. Woohoo! 
    • What does the reconstruction process entail? 
      • In my case, I will be getting tissue expanders. Basically, a fair amount of skin gets cut out so unlike breast augmentation (aka a boob job) where implants are inserted, the plastic surgeon has to stretch the skin over time before putting the implants in. 
      • Tissue expanders are like really thick but empty water balloons. At first, there will barely be enough room in my chest for the expanders. After about 4 to 6 weeks, whenever the skin starts to relax a bit, my plastic surgeon will start filling the expanders with saline. 


      • We won’t know for a while if I will have to see him once a week or once a month to get saline injections. Filling the expanders involves a quick outpatient visit to the plastic surgeon in which he will stick a needle in the little ports underneath my skin and inject saline. 


        • Once we get to a point where I’m happy (likely months from the initial surgery), we schedule another surgery. I’m told this surgery is ‘easy’. My plastic surgeon will just cut along the scar and switch out my expanders for implants. 
        • In regards to picking the type of implant, this is not a decision that needs to be made now. Regardless of the type of implant chosen though, all implants need to be replaced every so often. Thus, I will continue to undergo breast surgery for the foreseeable future. Since we’re not worried about the type of implant at this point, I will revisit this down the road.
    So many implants…
        • Also, since this is not a nipple sparing mastectomy, I will also visit the world of nipple reconstruction at a later point.  



    • Pathology will receive everything that is pulled out, likely while my plastics team is still hard at work. Over the following 2 weeks, they will analyze the sample and provide my oncology team with a final diagnosis. Hopefully, they will not find any new DCIS and/or cancer.
    Inpatient Stay

    • Once the surgery is complete, I will likely be in the recovery room for 1-3 hours. After that, I will make my way to my hospital room. At this point, the physicians are anticipating that I will spend 1-2 nights inpatient. 
    • During the inpatient stay, I will do a lot of resting, receive some narcotics, and learn how to empty my drains – a job that will likely be delegated to Donny since my range of motion will be non-existent.
    Recovery with Drains

    • As mentioned above, the drains will stay in for anywhere from 4 days to 3 weeks. During that time, my primary job is to move my lungs but not my arms.
    • The incisions themselves are not extraordinarily painful, I am told. However, for petite people, the skin stretching coupled with drain tubes and expanders can cause an enormous amount of ‘pressure.’ My physicians have assured me that I will feel “pressure, not pain” which could sound promising. HOWEVER, I was a leukemia patient that learned that ‘pressure’ from bone marrow aspirations (when the MDs pulled bone marrow out of my hip), was very painful – maybe a different type of pain but pain none the less.Thus, I’m a little skeptical.
    • While the drains are in, Donny and I will need to empty them 2-3 times each day. Fortunately, my plastic surgeon removes them as soon as the drainage dips below 30 ml/daily from each drain.
    • Immediately after surgery, my chest is going to look pretty gross. After removing a lot of skin and scraping the remaining skin until it is very thin, my chest will kind of look like a topo map due to the drains and unfilled expanders.
    • Since it is kind of hard to understand this without a visual and because this girl is awesome, I recommend watching the below video, if you would like a better idea.

    Recovery post Drains

    • Since there will not be a lot of room in my chest, removal of the drains is expected to provide a huge relief. However, I won’t be back to my normal self once the drains come out. Full on healing and recovery won’t start for a while longer. 
    • I have had to promise my plastic surgeon that I will do nothing for a couple of weeks and you don’t mess with this guy.
    My fabulous plastic surgeon.
    •  I am not permitted to lift my arms other than to feed myself until he gives me the all clear. Thus, cooking, washing my hair, high-fiving, and even walking are off the list for a while. As you may have guessed, picking up the kiddos and driving is absolutely forbidden for a while longer. 
    • Eventually, I will start up physical therapy to regain my range of motion but for a while, I just have to let everything heal correctly. 
    • To give you an idea of how lousy my range of motion will end up. Here are some of the ‘exercises’ I will be doing post mastectomy…

      Beyond the physical

      • It would be ridiculous to describe a mastectomy and only address the physical component because there is a HUGE psychological component. Any time an individual’s body changes drastically, his/her perception of self is bound to be altered in some way – whether good or bad or maybe it goes back and forth between the two. Therefore, in the coming months, I will undoubtedly be sharing my thoughts on the psychological effects of this process. 


      Fighting Cancer Like a Boss

      … with meditation and bunny food.

      Bunny Food
      It didn’t take long for my amazing work colleagues to notice my super leafy lunches that I started bringing in a couple of weeks ago. Within the first week, a friend commented that my Tupperware of greens looked remarkably similar to the veggies her husband was putting outside for the family of rabbits that lived in their yard. Thus, the contents of my lunches quickly adopted the nickname of bunny food. 

      cilantro, yams, almonds, beets, shoots…

      Why bunny food?
      It’s tough to even scrape the tip of this iceberg in a short blog post and I definitely don’t want to push too much ‘bunny food’ propaganda; however, I can summarize my reasons for adopting this modified diet in 3 bullets.

      1) Your body runs on the stuff you put in it, not dissimilar from a car. The better the fuel, the better the performance.

      2) Certain foods and/or types of foods are linked with cancers. There are boat loads of studies that demonstrate that some foods can promote the growth of certain types of cancers. Cutting out these foods was a no-brainer- Why would I feed the cancer? AND… My Dana-Farber docs fully supports boosting cancer treatment with a good diet.

      3) I love yummy foods and no, I’m not talking about kale (sorry, kale). I’m talking about comfort foods that are chock full of butter. Do I think they taste exponentially more delicious than broccoli sprouts and flax seed? Absolutely! Do I think they taste sooo delicious that I would be willing to give up seeing my kids graduate college – absolutely not. …And that is exactly what goes through my head when I smell or see the delicious food. Yes, this is extreme, but for me, as I sit here typing today knowing that there is likely some ductal carcinoma hanging out in me, it hardly seems like a tough decision. I’m going to starve the cancer!

      Observation studies have linked diets high in red meat with an increased risk of developing cancers (colorectal, lung, breast, uterine, ovary, prostate) and cancer recurrence. – See more at:
      Observation studies have linked diets high in red meat with an increased risk of developing cancers (colorectal, lung, breast, uterine, ovary, prostate) and cancer recurrence. – See more at:
      Observation studies have linked diets high in red meat with an increased risk of developing cancers (colorectal, lung, breast, uterine, ovary, prostate) and cancer recurrence. – See more at:
      Observation studies have linked diets high in red meat with an increased risk of developing cancers (colorectal, lung, breast, uterine, ovary, prostate) and cancer recurrence. – See more at:

      A benefit to eating healthy – fresh, local bread from Iggy’s

      Learning to Be Mindful…

      Cancer or no cancer – most people I know lead pretty crazy lives. Whether it is my personal to-do list, a project at work, or getting all of the kids fed in time, I can be stressed out from time to time. I just call myself ‘type A’ and continue to ignore any stress – after all, I am being super productive! Little did I know that meditation could help relieve the stress and make me more productive. I know it sounds like ‘crazy hippie stuff’ (as a few of my friends have said) but there is some science behind it… really.

      Dana-Farber is a HUGE proponent of learning to be mindful – regardless of your cancer status. The NIH National Center for Complementary and Alternative Medicine reports that regular meditation can reduce chronic pain, anxiety, high blood pressure, substance abuse, cholesterol, post-traumatic stress disorder, and blood ‘stress’ cortisol levels. Meditation may also improve mood, immune function, and fertility.

      It all sounded great but let’s be real, WHO HAS TIME FOR MEDITATION!?! I was getting stressed just thinking about how to find time to meditate – I can’t even shower without one of my kids visiting. Cue my new favorite app – Headspace. I’m not going to launch into a full infomercial about the app but I will say that it requires only 10 minutes. Bonus! The first 10 meditation sessions are free so you can give it a try (OK, that bordered on infomercial).

      The way I see it, even if it is ‘crazy hippie stuff’, you may like it.

      Here’s a quick TED talk that the owner and founder of Headspace, Andy Puddicombe, gave…

      T minus 28 days until the big day!!!

      The Breast Cancer Journey Continues

      Over the past couple of weeks, Donny and I met with the rest of my breast cancer fighting team including the breast cancer medical oncologist and the plastic surgeon.

      As with any serious medical diagnosis (i.e. Crohn’s, Diabetes, etc), there is a lot of information to process when you first get the news; my diagnosis was no exception. At this point, Donny and I were having almost nightly conversations about the treatment options. We would discuss how we planned on managing the kiddos for each of the treatment options and how we saw our lives playing out in 5, 10, and 15 years. I found myself fighting off tears as I wondered if I would actually be around in 15 years…

      Breast Medical Oncologist

      Donny and I had a pretty good feeling that radiation was off the table after my consult with the radiation oncologist but we didn’t really know what to expect from Ann Partridge (the breast medical oncologist who doubled as the director of the adult survivorship program). We didn’t know what specific treatment option she would recommend but we felt prepared to accept whatever she suggested… the truth is, we weren’t prepared for her suggestion – “you have to do what you’re comfortable with,” she said. Although I felt like I had no control when the twins were in the NICU, I enjoyed that our docs felt confident in their decisions and merely told us what was happening.

      Now, I was in the driver’s seat… “This is a life-altering decision. Why am I making the call???”

      BUT, there were two reasons.
      1) Adult medicine in the oncology world tends to focus more on what the patient feels most comfortable doing.
      2) There wasn’t a clear-cut answer. My situation was rather unprecedented. There is research out there for young women with breast cancer, young women without breast cancer but with stinky genes (BRCA1, BRCA2, etc), and young women post treatment for Hodgkin Disease – but none of these women describe me. Don’t get me wrong, young women that have had a bone marrow transplant and TBI do get DCIS/Breast Cancer, BUT there are not many of us running around. (AML has about a 50% survival rate and the low number of women like me is further complicated by the fact that a while ago, the oncologists stopped using TBI for both children and adults with AML due to the plethora of side effects. Thus, we don’t have large pools of data to drive our decision.) So Ann presented us with the options and let us chose…

      The Options

      1) Watch and Wait – The watching and waiting option is something that is a great option for some people. Unfortunately, watching didn’t see feasible since the DCIS did not appear on my mammogram or MRI so we were nervous that this approach would be more along the lines of wait and then crisis. 

      2) Full Lumpectomy with Radiation – This option was really not on the table prior to meeting with Ann but we discussed anyway. If I were a ‘normal’, older, non-cancer survivor this would have been the preferred option. The recurrence rates of DCIS/Breast Cancer are very close for individuals that choose this option and a full mastectomy; thus, it is pretty darn popular. HOWEVER, this option was already axed since the radiation department didn’t really want to give me radiation. Additionally, all of the physicians felt that I was at a high risk for another round of DCIS/breast cancer within 5-8 years so it seemed like a more extreme approach was probably warranted.

      Radiation for Breast Cancer

      3) Single Total/Simple Mastectomy- The lumpectomy with radiation option works because it pulls out any cancer cells and then zaps any remaining trouble cells, essentially ensuring that you killed all of the bad stuff. A simple mastectomy can accomplish the same thing – but it is a little more extreme. The surgeon removes all breast tissue (bad and good) from the skin and muscle. Unlike Angelina Jolie’s nipple sparing/nipple delayed mastectomy, the nipple and areola are removed with a total/simple mastectomy. Nipple sparing would not be an option in my case since I have a ductal cancer and the nipple is the mother of all ducts.

      4) Bilateral Total/Simple Mastectomy – A bilateral total/simple mastectomy just means that the mastectomy is performed on both sides. Given my history of TBI and the fact that I have DCIS at 31 means that I am at a high risk of having another bout of breast cancer/DCIS soon. Thus, Ann felt that it was more than reasonable to take this approach. 

      After much discussion, Donny and I both felt like a bilateral total mastectomy would likely be the best option but wanted to chat with the plastic surgeon.

      Plastic Surgeon
      Our visit with my plastic surgeon was incredibly informative and in many ways, reassuring. We went through the process of the surgery, recovery, and reconstruction (more details to follow in a future blog post). After chatting for over an hour, I had to give my plastic surgeon a decision. At this point, it seemed pretty clear. “I’m going to opt for the bilateral mastectomy” it felt weird saying it. This was a big damn deal but, in that moment, my decision seemed less monumental than when I bought my first car. So, my plastic surgeon started the process of scheduling the surgery with my breast surgeon. Since getting my breast surgeon and plastic surgeon in the an operating room for the same 5 hours is surprisingly difficult, the surgery could not be scheduled until the second week of September. Fortunately, that gives me a lot of time to prep at work, at home, and most importantly, mentally.

      It goes without saying that this is just the beginning of this chapter of my life with cancer but I cannot thank everyone enough for all of the support that has already been sent our way! We are so blessed to have such amazing friends and family. You all rock!!!