Getting Back to "Normal"

There isn't much to share here, so I will probably end up retiring this blog for a while (like I did back in 2014/2015 when I was done with treatment then. ) So actually, let's hope I retire it forever, with exceptions for when some noteworthy GOOD cancer-related news or updates pop up.

I feel really healthy. My "optimal health" goal-setting is doing what it was intended to do - exercise and eating well are a priority, and I am doing several things around mental health, mindfulness and stress management, which I have historically been pretty shitty at, so I hope I find some things that work. I've lost weight, per my oncologist's orders, but still hover just at the "overweight" mark according to the BMI tables, so I'll have to continue to monitor that while also not diminishing the joy I get from good food, but overall, my weight is in a better place and I am notably fitter and stronger. 

I have been on the hormones for just over two weeks now, and so far they are OK. Initially I had major headaches and nausea, but those have lessened and I am really trying to stay hydrated to offset both of those things. The one lingering side effect, which I will ask my oncologist about, is just REAL EXHAUSTION. Like by the end of the day 4 or 5-ish, I am DONE. It's hard to make it through the last few hours - like the level of exhaustion you feel at the end of pregnancy or with a newborn - so it doesn't feel sustainable. I am going to bed earlier and aiming for at least 8 hours of sleep a night, but I am still just REALLY REALLY exhausted.  Hopefully my oncologist will have some wisdom on that specific problem when we talk tomorrow.

The big unknown and the thing I need to try to solve is WHAT IS LIFE AFTER CANCER. I had this very comprehensive, very specific timebound plan with steps in place to get me through treatment. I was able to quantify it all - slice it up into smaller pieces and work up the endurance to get through the steps, hard as hell as it was. But now that I'm done, it's not like cancer is behind me or like any of the reassurances or statistics make me feel any more secure in the idea that I'll have a long life, since I recurred when my risk for that was less than 1%. What does that mean?

• I carry fear of death a lot more predominantly in my consciousness. I think about my own death and what it would do to the girls every single day. I think about how I would say goodbye. And stress out A LOT about the fact that I haven't made family photo albums in 5 years.
• It has been 6 months since my post-chemo scans, so my mind plays all these mind games with me about WHAT IFS. Especially if I feel any aches or tugs anywhere. 
• With every milestone, I wonder if it's my last one. Like for St. Patrick's Day...I legitimately thought through the possibility that this would be my last one with the girls, and ordered a holiday box and all the St. Patrick's things and try to think of ways to make things bigger so they're happy in the moment and have happy memories. 
• With work (or volunteerism or learning) I think long and hard about whether the thing is worth my limited time on the planet and won't do things if I think they're not worth it. I'm NOT meeting expectations and breaking "rules" more than ever in my life, and I don't feel guilty like I would have before. 
• I can't deal with mundane shallow complaints or nonsense. And a lot more stuff falls into the definition of mundane, shallow and nonsense.
• I feel desperate to matter. 

While everyone's perception is "Sherri is done, yay," I feel like I should wear a pin that says I HAD CANCER TWICE - NOTHING IS NORMAL FOR ME ANYMORE. I don''t think I'll ever be done or fully recovered. Medically, I still go in to the Cancer Center every month for shots, check-in with my oncologist monthly and will for many years, I have the hormones I take every day, follow-ups with the surgeon and pastic surgeon - I will need to get the second plastic surgery sometime this calendar year. Physically, I still have a hard time with how I look. My hair is back, but it's pretty disastrous, much thinner than before, very grey, very messy and all over the place covered by my perpetual baseball cap. My brows and lashes are back, but even more sparse than they were after the first chemo...the eyelashes are teeny, skinny little nubs and the brows are thin and oddly shaped. I am lopsided on my chest, which has honestly made me off balance - I can no longer do any of the barre3 moves that require balance and have to modify either using my dresser to keep me upright or doing a different move altogether. I have no idea what I'm supposed to do if I wear a bathing suit - I mean that is going to look weird...And as I previously mentioned I am REALLY GD TIRED. But the most significant thing is just the fear, worry and lack of confidence about the future. And musings about abandoning the girls when they are so young. I hate it. I wish there was a funded "cancer survivor" program that WORKED. I found a woman who created one herself but it is SO EXPENSIVE. This might be the nut I choose to crack for my next career. Anyway...that was kind of a lot, so I'll move on!

The kids went back to school yesterday which was a HUGE win for my stress. If you haven't been a parent through the pandemic, it's hard to explain the emotional toll of zoom school, but my kids were at rock bottom emotionally and looked to me as their source of live validation, connection, solace, school support, food, attention, stress management, outfit advice.  It was A LOT. While undergoing cancer treatment. And so the "underlying stress" of just getting through the days for the past year were A LOT.  They have only had one day but they came home happy and relieved and it FELT AMAZING to have silence in the house.

I go back to work next Monday on a part-time basis. This is probably my biggest source of anxiety at the moment. Well, second biggest - the first being getting cancer again. I really need to find the meaning in my work while not taking it too personally or working too many hours. I have never found that balance. I enjoy work - it brings me meaning - but it also causes stress and even despair when things don't go as planned or as idealized, and I need it to not do that. I think that's going to be hard. I am starting out half time, and then will make my way up to 75% time in late Spring/early Summer and take it from there. I am scexcited about going back - scared and excited.  I can't be sedentary for even 4 hours in a row, so I am really going to have to actively manage my calendar and how I work. Please wish me luck.  I need it!

That's about it, I guess. I'm thankful there is hope related to Covid as I desperately need to travel and make some solid memories with the girls as I am living with a sense that my life won't be as long as I'd like it to be. Having to put everything on hold FOR A YEAR feels like a gigantic loss against a shorter-than-desired life, so I need some of this freedom to be available SOON. I have money set aside for a LONG trip to New Zealand as soon as we can make that happen, and I am going to do all the things I was too worried to spend the money on before cancer 2.0. Experiences are sort of all that matter to me right now, and I need some big, good ones. New Zealand first, either England, Paris or Tahiti second. And then we'll go from there. Anyway, now I am just babbling and rattling off random things...so my apologies. Thanks, as always, for reading and for the support this past year.  It has meant so much to me and carried me through some truly awful times.

Stay well!

Sherri

Final 7 and Life "After" Cancer

Hello Everyone - Happy New Year! Happy Belated Birthday to me!  I cannot believe it has been more than a month since I've posted an update.  (The truth is, I think it's good news - because I had less gnarly crap on my mind to post about - but still I know some of you who don't live close by use this to keep up to date on things, so my apologies for falling off the face of this blog...)

Last time I posted, I had completed one radiation of 33. As of today, I have completed 28 so only 7 more to go!  Radiation has gone really smoothly for me. The sessions themselves have been very short. I've been able to hold position and hold my breath to mimic the same shape they created in my holograph so I think the sessions are probably around 6-10 minutes, three deep breaths and some normal breathing in the interim and I'm done. My skin is also hanging in there. Other than some blistering and aggrevation in my armpit and on the left side underneath, I am doing really well.

I also continue to get the monthly shots to keep my ovaries shut down, do my bloodwork and meet with my oncologist. My one lingering issue is my bloodwork, which plummeted this month back to where it was in late September at the end of chemo. My oncologist says it's expected, and may explain why I am so tired, but it's a bummer to see all the numbers go down and have to worry again about my ability to fight off infections. Anyway, still, all up, things are good.

As "active" treatment comes to an end, I am starting to really wonder about "life after cancer"...AGAIN. I feel enthusiastic about the areas I'm focusing on this year (see below) but I do wonder how I move toward feeling "normal" and not stay in hyper fear mode. I mean maybe I don't. Maybe that's the new normal - living with fear and my mortality FRONT AND CENTER...but I certainly hope not. 

In the last post I outlined the 891 health habits I was adopting (ha, ha, just a little exaggeration), but in the early days of 2021, I was able to take a step back and come up with some general themes I'm focusing on in 2021, which the health behaviors sort of fall within. Here they are for your reading pleasure:

2021 Guiding Themes:

1. Optimal Health
2. More Joy
3. New Experiences
4. Cancer Advocacy
5. Budgeted Investments

I covered the "optimal health" pretty well in my last post in December, but I think these themes all taken together are my path forward. Optimal health to prevent another recurrence or other health issue. More joy to make the time that I do have matter, happy, connected, and memorable. New experiences because, for me, that just makes life better and more interesting, and weirdly enough, during Covid I sort of rediscovered how fun it is to just randomly try things. I think it feeds into more joy and learning. Cancer advocacy because I feel that I HAVE to, for my own sanity, use my two cancer experiences to help others and promote progress in cancer research and funding. And lastly, budgeted investments, which sounds super boring, but I actually think is another way to support the other themes because my intention with that one is planning and budgeting for the vacations we want to take, the home improvements we want to make, the large purchases that support health or joy. 

In January, so far. I think I am NAILING these themes and I am grateful to have them because it helps me figure out how to spend my time and energy. I've been spending my time:

• Exercising (75+ minutes every day). My sisters and I and some friends also did a virtual 5K for a cancer org for my birthday which was realy fun!
• Learning how to cook with non-grain flours, alternative sugars, and a lot more veggies and beans
• Listening to the Happiness Lab Podcast (+ Kelly Corrigan Wonders, both of which I highly recommend!)
• Completing SUPER INTERESTING training from the Susan G. Komen Center for Public Policy as I was selected as a District Policy Ambassador for two years starting this month.
• Trying to enjoy virtual school with the kids (which is not at all enjoyable, so this one needs constant work, deep breaths and daily resets!)
• Reading (currently on The Office of Historical Corrections) and watching TV (just finished Bridgerton and am now on Glow)

It's the first time EVER that I have invested so much thought into how I want to live the year and I am excited so far at how it helps guide me.  I hope it sticks!

That's all I have for you today. I'm sorry these posts seem to have become more mundane, but if nothing else, this year has taught me how much magic there is in the mundance (which was the theme of our Christmas card!) So I am going to enjoy the tail end of treatment and how much less dramatic and sort of stable it feels compared to where I was 6 months ago!

Thanks for reading. (As usual, including some inspirational sayings I saved this month below.)

 

These two are from the cancer center who celebrated Elvis' Birthday on Jan 8th. It's so random which made me LOVE IT so much!

Radiation and Anticancer

Happy Friday People!

I started radiation yesterday. See the pictures below of the span of skin they need to radiate (as designated by the blue sharpie) which is QUITE LARGE running from a couple inches above my belly button on the left side, all the way up to my neck and around the side and armpit just until they get to my back. It's a lot bigger than I thought. The good news is that the people who work in radiation at Ridley Tree could not be nicer AND the sessions are REALLY FAST. You get to pick your music, light, and ceiling graphic for your sessions to help you be as comfortable as possible. For my mock run through on Wednesday we listened to Sofi Tukker with blue ambient lighting and an aquarium on the ceiling.  I sort of have to hold my head in a weird position to accommodate the radiation beam so I can't really see the aquarium, but still, it's very peaceful and calming. Yesterday they had classic rock on, dim white light and I think a river, which was fine. Today I'm thinking David Grey with yellow light and maybe a beach scene?  Let me know if you have any amazing combos for me to consider. (LOL) 

In total, I'll have 33 sessions, every Monday through Friday, through February 3rd. My first session yesterday legit felt about 3 minutes long. I have to hold my breath for most of it to avoid having them graze my lungs (and maybe ribs?), and if I did it right, I only counted about 7 breaths total so I think they're quite efficient.  While 33/February 3rd seems like SO MUCH TIME,  it's really only 7 weeks compared with 21 weeks of chemo, so I think it is going to go by quickly. I am also stocked up on VERY RICH, DENSE lotions and balms, so hopefully I can manage to avoid any adverse skin impacts and just motor through the days. Wish me luck!

Outside of radiation, I continue to focus on health and sustainable changes I can make to my diet, stress management and physical activity.  Which brings to me the book I am still reading called Anticancer. I've realized that reading books ABOUT cancer while I am being treated FOR cancer doesn't really work for me. When I dive into the cancer books, I stall out quickly, which is why I haven't made much progress on this one. (And I haven't finished Heal yet either, and I have How Not to Die and Eat to Beat Disease in my queu still so that may take me into 2025...we'll see.)  Anyway - back to Anticancer. The sections I have read have helped me understand that the lifestyle changes being forced encouraged are not about my having done anything wrong or caused my cancer.  They are about giving the cancer invading my body AS DIFFICULT A TIME as possible to come back again, grow or spread. The general premise of the book is that people have natural defenses that exist in their body, the defenses that help wounds heal or fight infection (white blood cells, blood vessels, etc), and that within people who have cancer, the cancer has figured out a way to use those processes to feed itself and grow. The idea behind "lifestyle changes" is to replenish those processes naturally (focused on preventing inflammation) to overcome the power of the cancer, or the inclination of the processes to be led/influenced or overcome by the cancer. It's like creating as powerful an environment internally to combat the power of the cancer, which unfortunately is powerful, aggressive and pretty smart. So these are lifestyle things that really everyone should consider, but especially people who have had cancer or are at high risk of developing cancer because of genetics because their bodies have already learned to grow the cancer. That said, even with everything I do to optimize my health, there are no gurantees it will work, and in fact the man who wrote the book ended up dying of his brain cancer, but where they thought he would only live months, maybe 2 years max, I think he ended up living for 20 or so years longer, and even overcame a recurrence. So these changes (plus the modern miracle of medical cancer treatment) give me the best chance of living as long as possible (and hopefully cancer-free from here on out).  So, that is what I'm what I'm focused on and so far I have found the changes to be pretty pleasant. (I realize many of you may already be doing these things, or even more, so good on you. I feel that I am pretty healthy generally, so I consider these mostly adds and subtle tweeks, not an overhaul,) There are like 20 other possible things/ideas which I had to table for now, so I guess there will always be room for improvement.

Diet:

1. Reduced grains, when enjoying grains, focus on multigrains, nuts, seeds to cut the wheat.
2. More beans (at least one serving a day)
3. More berries, wider variety of sesaonal fruit rather then the standby fruits I eat everyday.
4. At least two cups of green tea daily, increase this to 3-6 on a regular basis
5. A tbsp of ground flaxseeds most days (when I can remember). Add turmeric to my diet.
6. Front load meals with water (not just when I wake up in the morning, but every meal)

Physical Activity:

1. Increase physical activity to at least 60 mins daily, working toward 90 mins daily.  (Work on endurance/duration, physical activity involving the whole body, and BUILDING MUSCLE MASS.)

Psychology:

1. Finding and RELISHING the joy of the every day, continue to work on meaningful connections with people (which is really hard during Covid). The idea here is that immune cells are sensitive to our emotions and respond favorably to to emotional states characterized by a sense of well being and a feeling we are connected to those round us. The also mobilize better when in service of a life objectively worth living.
2. Continue work on stress and anxiety management, assume this will be a lifelong struggle.

On the themes of daily joy and a life worth living, my oncology therapist also challenged me to do an exercise where I talked through what I would do with my time if I had five years to live, one year to live, or three months to live. Sort of surprising to me was the fact that my answer was not super different regardless of the time left, but sadly it was centered on spending my time with my family traveling and having new experiences, which again are not available at this time. So...our latest dream is that following radiation we will take a month and go live somewhere else, preferably in the snow (This is how our summer dream started and then it shrunk to 5 days in Pismo, so we'll see how this plays out). Right now we are looking at Idaho. but are also interested in Utah, Montana or Colorado. We need a new view. And some new activities...We'll bring our cat. We'll make memories.  As dull and uneventful as our time in Pismo was, our kids talk every week about how it was the BEST VACATION EVER bc I think it meant so much for them to see new scenery and just chill away from all the stress.

It also triggered me to start thinking more intentionally about goals across several aspects of my life, which I haven't ever formalized in the past. For me, the major categories I tend to think about my life within are health, family/friends/connection, travel/adventure/experiences, work, giving back and home improvement. For 2021, this is how I am thinking about goal setting. Not sure what I will do intentionally on connection or giving back yet, but I'm thinking about it!

• Health - obvious. Everything I stated before plus continue to scan with No Evidene of Disease (NED)
• I know we want at least two travel experiences/adventures even if it's just us driving to some random place within the state. 
• We have to have our pool resurfaced so that plus some related work in the backyard will be the home improvement goal. (as much as we NEED our kitchen redone, gonna hve to wait til post-Covid, sadly.)
• On the work front, I will need to make my way back into Sonos at some point in early 2021, and I need to find a way to find new meaning in my work AND to find ways to work that don't require me to be sitting in meetings for SO MANY hours every day.  I don't think I can go back to the back-to-back meeting grind so that is going to be an interest challenge.

Hmmmm, what else do I have to share????  Not much. I feel like these blog entries have become more and more boring as time wears on, and less philosophical and insightful.  I'm really tired and short-sighted at the moment, trying to just GET THROUGH RADIATION and continue to have clean scans, maybe that's why...or maybe I am kind of boring and I just never had enough down time to realize it?  I hope that's not it. I'm not sure.

So I guess that's it then.  Happy Holidays if I'm not back with any sort of update before next week.  Thanks for reading and for the continued support.

Sherri

PS - After I finished writing this, I remembered a family goal template I had screen captured from Big Life Journal on Instagram. I am including it below. It falls into the same general categories I listed bove except work. So maybe that is actually what triggered my brain or at least created the connection between the therapy exercise and goal-setting...Regardless, enjoy, hope you find it useful. (And again, many of you may already be doing this and if so, kudos to your superiority. LOL.)

I'm Tired x Infinity + Phase 3: Radiation

My mood/emotions are pretty erratic these days. I'm sure most people's are, considering how long we've been in this shit position with Covid. Mine fluctuate depending on how physically good I feel and the most recent news and updates coming from my doctors. I've started to write this blog three times over the past week...starting with a very depressed version after my radiology consult, which a few days later was a pretty happy and upbeat version as I started to feel stronger after surgery (and not take 23 minutes to walk ONE MILE), and now today's version...which, unfortunately for you, is coming from more of a downer mood again after a call with my oncologist this morning. 

So let's just start with my general state of being which is that I'm really, really, really tired, like EXHAUSTED deep into my bones tired where sometimes I lose time in my day because I'm not exactly conscious or engaged in the day enough to be aware of what is happening or the time that is passing. I assume this is MOSTLY physical as my body continues to recover from chemo and surgery, but exacerbated by the ever-changing Covid status in Santa Barbara which ignites my fear and confusion, complexity of decision-making and SHEER BOREDOM as we continue to stay safer at home with the kids doing virtual school and not a lot of newness, excitement or adventure in our days. I am SO DAMN TIRED. And at the same time restless and antsy to be done with active treatment. (Oh, also, it's Monday and getting back in to virtual school after 5 days off has been ROUGH.)

On the physical recovery side, I think things are going pretty well. I had been struggling more than I thought I would with my very obviously explicit in-your-face misshapen body (meaning living with one boob), but now that I am feeling physically stronger and somewhat capable again, I haven't thought about it as intensely or consciously. I mean, I look weird. Clothes fit me weirdly. I'm sure when I'm out walking people are confused at the shape of me. But I think I've moved beyond my initial shock and depression at being deformed...likely with some help from the books I'm reading (your body is your biggest ally in health!) and my oncology therapist who suggested working to get back to being grateful to my body for getting me through everything it has been through during cancer 2.0. I will eventually need to decide if I want to get reconstruction (if it is determined that I am physically able to get it.)  Once you've had radiation, especially on such a large span of skin, implants are no longer an option so getting a second boob would require a 13-16 hour surgery to use my own tissue from my stomach to reform the shape of a breast, and then 3-6 months of physical recovery. I'm not sure I'm into doing that after a full year of cancer treatment...for the second time. So that will be the debate next Winter, I guess. Thankfully I don't have to think about that for many months, but I do need to find ways to feel good, comfortable, confident in my body again.

My hair has also started to grow back in so I've got like 1/4 inch of growth all around (although I still wear a hat bc I still look sick/bald/weird) and my eyebrows have mostly grown back (I assume thanks to this very expensive but I guess effective brow serum called Vegamour.) I am able to walk for exercise, and am working my way back up to a normal speed and distance (probably more aggressively than my doctors want) and started doing the post-surgery stretches for my arm and chest at the week three mark last week and can already see that I've made progress, although my left arm is less stretchy by about three inches than the right from almost every angle.. I start actual physical therapy tomorrow which I think will continue to correct that.

I feel pretty good, outside of being so damn tired, but for some reason my white blood cells took a dip with my last bloodwork since surgery so I am hopeful that's because of the effort of mending the skin, but I'd like them to get back to the normal range asap. My platelets also continue to be low. Maybe this is contributing to how tired I am. 

The call with my oncologist this morning was about "lifestyle changes" or in more direct terms how to lose weight. My oncologist is so nice, but he point blank told me "everything we're doing from this point forward seems to work better when you're smaller." So I have to figure out how to live my life from the point of view of optimal health...which is depressing considering I think I have been living my life pretty healthily. I started reading this book called Anticancer and have another one in the queu called How Not to Die that go deep into healing nutrition, physical activity and psychology. I'll need to cut down on grains and meat, and increase beans, berries and green tea. I need to insert more exercises into my routines to build muscle mass (which they tell me is going to be more difficult considering everything they're doing to shut down my hormones), and focus on mindfulness, connection and stress-reduction. It's overwhelming to even think about, so for December I'm focusing on reducing grains, eating berries every day (when I can) and starting to add in green tea and flaxseed to my diet. I renewed my Calm membership, which I had just cancelled earlier this month, and I'm starting to think about which exercise routines to adopt to add on to what I'm already doing. 

It also makes me feel super depressed, conflicted, scared, guilty, mad to be thinking about all these changes because I feel like it feeds into the idea that I have been doing something wrong and caused my cancer (and recurrence). That is the worst part of cancer and the worst part of humans and I try to avoid it - people trying to figure out what YOU did to cause your cancer which makes you different than them and reassures them that they won't get it. Sigh...For the record, I didn't do anything. And, if you're thinking this, you CAN get cancer. (Well, and if you are thinking this, maybe you should stop reading my blog...)

Phase 3/Radiation is also going to be its own mini-marathon. This week I have to get the right/non cancer expander which they put in and made smaller after they took out the old implant, shrunk even more than they did in surgery so that the radiation beam doesn't hit it. Next week I'l have my CT radiology mapping where they essentially make a holograph of my body in the radiation position to program the radiation machine to shoot the beam into the right area, and to shut off if my body moves position or changes shape. I'll have to practice holding my breath (which I'll do every session) so the radiation doesn't hit the heart or lungs. Then December 16th we'll have a dry run of a session (without radiation), and actual radiation starts December 17th. I'll have 33 rounds, 28 to the chest wall and armpit/lymph area, 5 to the incision scar, and with the December and January holidays, I believe this takes me to February 4th. Sessions will be every Monday-Friday starting at 45 minutes, but once we get the routine down they should be closer to 20 minutes. I guess about midway through I might start blistering like a bad sunburn...and of course there are all these long term side effects that sound terrible. Whatever. Again, I revert back to being grateful I have so many treatment steps to get rid of the cancer once and for all. But, also, it takes a lot of endurance to get through all the steps, and I AM TIRED. :(

What else is on my mind????? Hmmmm, well Christmas obviously. And the Supreme Court case on the ACA...wondering why we suck on healthcare access in this country....a little disappointed radiation is running into February because I had hoped to be able to do something amazing for my birthday in January. I feel like I've earned it. The Covid vaccine. Wondering why it's so GD hot in Santa Barbara this late in the year (especially when we had a week or two of delightfully brisk weather and were able to use our fireplaces...) Happy to have some TV back (shout out to Greys, This is Us, and a Million Little Things...)

I think that's about it. I don't have anything really inspirational to share, unfortunately, and realize this is a bunch of words about me that are probably boring and TMI.  If you made it this far, thanks for reading. Here is something I copied from the Barre3 page...it's true. Whatever state your body is in, give it a big old thank you for being your ally on this adventure and taking you this far, you never know when you are going to look back and miss the body you weren't thankful for. 💗 

Sherri

Surgery Success

 Just a quick post with all the updates and outcomes from surgery!

• They were able to close my skin without the lat flap!
• The plastic surgeon was able to find a vein to connect with the lymphatic system to reduce risk of lymphedema!
• They got clean margins meaning no sign of cancer in any of the skin margins removed during surgery!
• They removed 21 lymphnodes and only 2 had any sign of cancer...and the cancer they had was .24 mm or smaller!

I am also healing quite well from the surgery. They wanted me to work up to walking 30 minutes per day over the 4-6 week recovery period, and I already got there yesterday, albeit very slowly. The pain and nausea are being treated well with tylenol and motrin. I have found a comfortable way to sleep in my bed with a back wedge. I think my drains will be able to come out tomorrow and then I can be more confident showering!

So, short and sweet today to just say for now IT IS ALL GOOD. 💓

Be back either when I have more to say or when I know more about radiation.

Thanks,

Sherri

Tomorrow's the Big Day (and I don't mean the election)

I don't have much to share, but I was feeling anxious about tomorrow and thought I'd spend 10 minutes just clearing my head on here. Please understand my head is a bit of a messy thinking about tomorrow so I suspect this post is going to be a bit of a mess too.

If you're on Facebook or Instagram, you'll know we made it to Pismo for a relaxing five days between chemo and surgery. We kayaked, which was the highlight for me, and the kids mostly cooperated because I guilted them by telling them I won't be able to do it for a very long time, and maybe not very well depending on my surgery. We rode horses. We swam in a warm indoor saltwater pool, had lots of great meals and ice cream. It was nice to get away, to live in new walls, and not think about cancer. 

Since we came home, it's been appointment after appointment after appointment, starting with getting the stitches out from my many biopsies at noon on the Friday of our Pismo week so it was like, relaxation, relaxation and BAM - BACK TO MEDICAL REALITY!  This past week I had 6 pre-op appts. The good news and bad news is that my blood and heart and Covid status all meet the requirements for me to go into surgery tomorrow, so I guess we're a go! Ahhhhhhhhhhhhhhhhhhhhhh!

I'm ready, really, to walk out of surgery with all the cancer gone. Like for real, this time. I keep saying I think I'm about 90% ready, but still 10% scared. As I watch the clock get later, though, the ratio is maybe moving a little more toward the fear.

I don't feel ready for pain and drains and limited ability to move...although I lived through most of this once before so I feel like I can handle it.  Right? Maybe just text me or email me your belief in my ability. Please? Thanks.

I have been using another visualization my therapist created for me to prep for surgery so once again you all are in the surgery room with me in my imagination waiting for the outstanding outcome.  The recording also reminds me that my surgeons have been training their entire adult lives to do this work, that they are masters in their field and doing the work they excel at. It also goes through how my body knows exactly what to do to relax during the surgery and heal afterwards and that everyone will help me manage my pain...so it covers all the fear areas, and I have listened to it A LOT of times.

I also found this great mantra for surgery prep: “I am relaxed and calm. I trust my surgeon. I see a long life where I am strong and healthy.” I'd add to that - my surgery will be successful.  And I have this on repeat in my brain. But I'm still anxious!

My main worries are: 

• Removal of my lymphnodes...I mean honestly I couldn't tell you what they do, but I know they matter, and lymphatic drainage is a big health thing...so it sounds weird and scary to no longer have that system on one side.  My surgeon told me that part of the process is pretty painful...so...not sure how to reconcile the fear about that in my brain.
• The lat flap. It sounds AWFUL and GROSS. I mean stretching a muscle into a different part of the body...it's like something that would happen in Bugs Bunny...or like Jim Carey slaptick. Not to mention losing movement and strength. So I am hoping that I land on the 50% side of them being able to close me up, even if it means I live without any chance for reconstruction. 
• Pain and drains. I think I have a high threshold for pain, but I don't want to test it. The drains are just gross and inconvenient. I'm afraid I won't be able to sleep on my back or get in and out of bed. Or that something will come undone.
• That it won't work and the cancer will come back again.  But this one is easy enough to shelve while I get through the immediate next step. 

On a more positive note, I'm having the surgery done at a small surgical center close to my house and am the only overnight patient they will have.  They called and told me to pack my robe and slippers, and to remind the staff to have me order my lunch before I go under. So, Chris and I joke about me going to the spa for the night.  It does sound like I will get amazing care, so I'm grateful for that.

I also got SO MANY text messages today from people who remembered that the surgery was tomorrow and wanted to wish me well.  Those were an awesome surprise and much appreciated.

I don't think I have anything else to add. I guess send any healing, positive energy you have to spare my way tomorrow, especially if it helps distract you from the election.  Check on Chris as I am sure he will be a mess mostly due to election obsession but also bc of the surgery and solo parenting our crazy kids. As always, send any funny TV show, movie or book recommendations my way as I am in restricted movement mode for 4-6 weeks...

Thanks for reading this crazy rant!

Sherri

Phase 2: Surgery

As promised, I have more details on surgery and will be sharing them today. Surgery is scheduled for 11/3 (election day). When I let my oncologist know, he was like GREAT, I look forward to celebrating two amazing outcomes that night. I'm glad he is optimistic! My first thought was that Chris was going to die of a heart attack while I was at the hospital between stress about me and stress about the election. I know he is going to be watching all the live coverage and yelling at the TV and generally raising his blood pressure.  Who knows, though, maybe it will be a good distraction for him.  For me, it will be weird to sort of miss that moment with the rest of the world, but maybe good for me, too.

Since chemo, I have been BUSY with pre-surgery appointments. Because the cancer showed up on the skin, my surgeon had me come in this past Monday (10/12) so she could take skin samples and have them biopsied before surgery to ensure she was getting clean margins. She took four skin samples, gave me four sets of stitches, and from those initial samples, 3 were cancer-free. The one at the top of my chest (closest to the tumor, as well as my heart and lungs, eek!) was not. So I went back yesterday and had two more samples taken, two more sets of stiches, and those were both clean so she now has the line for the surgery, which is reassuring and amazing news! Also, how super smart to take the samples before surgery???? Usually they just do the surgery and do their best for clean margins, but if we had done that, I would have had to go back under for a second surgery because the original line of incision would not have been clean. I am so grateful to have such smart people on my care team, who are also really collaborative and open to learning and trying new things. I think it will result in overall better outcomes for me.

I've also had two consults with my plastic surgeon and a follow-up with the radiologist, so that we are all on the same page about the surgery.  Here is what will happen:

1. The Oncology Surgeon (Dr. Mitchell) will remove the skin, implant, and tissue leftover from my original surgery in 2014, as well as all the lymphnodes in the left armpit. Her job is to get out all the cancer.

2. The Plastic Surgeon (Dr. Soares) will be doing three different things, and his part of the surgery will take longer. 

• First, while Dr. Mitchell is working on the left side, he'll work on the right side, remove my implant and replace it with a small over-muscle tissue expander so that the radiologist doesn't hit my skin on the right hand side when I do radiation in December. 
• Second, he will be attempting a procedure that helps to overcome the risk of lymphedema that might result from all my lymphnodes being removed from my armpit. He'll be looking for a vein in my arm that can be re-routed to connect to the lymphatic system to pick up the drainage being impacted by the removed lymphnodes.  There is an actual medical name for this - I don't know it - and I may not even be describing it well, but it's effective in 85% of cases, so I am hopeful. This will help me continue to maintain as much mobility and activity throoughout the rest of my hopefully long life as possible.
• Last, he'll close me up and things get a little tricky. Dr. Mitchell will be trying to take as much skin as necessary to get the cancer out, but also not too much so that my skin can be sewn together to close me back up. If they are able to do that, then Dr. Soares will just close me up like he would any surgical incision. There is a 50% chance he'll be able to do that. If there isn't enough skin to close me up, then he will be performing a lat flap, meaning creating an incision around my side and taking my lat muscle and stretching it over the chest in order to provide skin to close the opening. There is a 50% chance that will be necessary.  If that is the procedure needed, word on the street is that I will premanently lose about 15-20% strength on my left side and may not be able to perform certain activities (push-ups, rowing, climbing...) which will be sad, so I am hopeful he can just close me up without the extra step...but I also want all the cancer out for good this time, so I am fine either way and will deal with whatever it does to my long-term mobility.

All of this stuff can apparently be done in about 4 hours, which is also quitre remarkable! I will stay in the hospital for one night, and then be on bed rest for about three days, and limited mobility for 4-6 weeks. I'll have multiple icky drains. I will be on lots of meds (might be the most mellow days of my life!). But I will be just healing before I move into Phase 3 Radiation.

So I think that's it. I hope I wrote that in a way that wasn't too gross but provided enough detail to explain why I am terrified.  Oh - also, I have to get a damn up-the-nose Covid test before surgery and that is also terrifying so MEGA BOO to stupid Covid!

What's making me happy:

• Next week, we are going to Pismo for 5 days for a change of scenery since we have taken ZERO vacations in 2020 and have diligently been sheltering in damn place since mid-March due to Covid. I can't remember if I shared here, but we thought I would have the whole month of October off and thought about traveling through several states and hitting up several National Parks on a one-month road tour. Then, I had the liver issue with the second stage of chemo, and chemo got delayed a week, so we stopped feeling confident about scheduling anything. Toward the end of chemo, we had reduced it to a 3-week trip to Utah to see their five National Parks, but then my surgeon mentioned pre-op appointments, and I have monthly shots of Lupron to shut down my ovaries and needed to be here on 10/27 for that, and they thought I might be able to have surgery in October, and Covid cases started spiking in Utah, so a long out-of-state trip stopped feeling realistic. Last week, we ended up booking the one house still available that looked nice in Pismo which was available for the five days remaining in October which we had free. I booked a private kayak tour since it might be my last time kayaking. We'll go see the monarchs, and hopefully have s'mores on the beach, and just feel normal for a few days. So, I'm excited for five days - which are of course not as amazing as a month-long road trip - but better than nothing!
• Peloton Outdoor Power Walks: When our hiking trails shut down because of high fire risk, and we'd hd bd air quality for days as well, I just stopped walking at all and it sucked. My sisters have been talking up Peloton for months, so I downloaded the app and have been doing these guided 45 minute power walks and I totally love them. I feel super self conscious about doing the dorky power walk arm swing, but the instructors tell me I have to, and so I do. The first few have made my butt sore, and I think it's been a good add to my workout regiment, especially since there have been several days when I can't do my normal workouts becuse of stitches and things.  (I am going to REALLY STRUGGLE to not workout after surgery! Eek!)
• My surgery "success" guided visualization: The cancer therapist I work with who gave me the great visualization for my scans, created a visualization for my surgery so I am listening to that every day and visulizing a great outcome~!
• The idea of becoming a Breast Cancer Advocate. I reached back out to the postpartum breast cancer specialist who I had the consult with (Dr. Borges) and asked her what needs their might be for a former recruiter with program management skills and a 16 year old MPH...and she suggested I look into getting the education and training to be a breast cancer advocate, and is looking for someone to join her team part-time. A breast cancer advocate is the voice of the patient in advocting for funding, research, legislation related to breast cancer. I think it sounds perfect so I plan to look into the courses necessary to do this. And, it's the kind of job you can work around your regular job, so we'll see if this helps me put all the pieces together of post-cancer 2.0 for my life. I can't imagine what that feels or looks like yet.
• I am back to reading and exploring new shows - let me know if you have recommendations for either. I am going to need things to fill my time after surgery!

I think that's all I have for tonight.  Thanks for reading!

Sherri