And the verdict is...

Today I had a half day of meetings with various specialists related to my care. There was the nurse practitioner (I'm going to call her the Energizer Bunny), the radiation oncologist (The Zapper), the behavioral therapist (Lady Frasier), the medical oncologist (Mr. Wizard), and the plastic surgeon (Tabouli McSteamy). Today was the day for them to meet me (ya know, put a face to the mammogram) and let me know what to expect for their particular course of treatment.

First was the Energizer Bunny. I think she's going to be my go-to throughout a lot of this. She gave me some tips on losing my hair (shave it once it starts to come out so that I don't have to deal with a clogged shower drain on a real bad day), she offered to speak to my boss if I thought he would give me a hard time (he won't), and she also informed me that it would be okay to continue with regular massage treatments (yay!). The Energizer Bunny is also a fellow Wait Watcher - she has lost 70 pounds to date! (good for her - I've only lost about 15 on WW so far - but something tells me I had a bit less to lose).

Next was The Zapper. It took her a little bit to get up to speed with my case, but she informed me that I do, indeed, need radiation therapy. Not much to say about this because it will be a few months before she comes into the picture. One interesting thing I learned is that aside from the armpit lymph nodes that you normally think about there are some in the neck area, too. She will zap these just in case any cancer has spread here because it won't be possible for my surgeon to hit that area. Another interesting thing I learned is that whatever is left of my boob will be tan.

Onto Lady Frasier. This consult was kind of useless for me. Let me summarize - I am doing about as well as can be expected considering I have cancer. End of story. When I heard "behavioral medicine" I was hoping I'd hear about complementary treatments (like yoga, massage, etc) or certain exercises I should do. Instead, it was more about how I was doing and coping. I'm sure there are plenty of other people that don't have as good of a support system as I do, but I'm doing just fine, thank you.

Then, Mr. Wizard. I call him this because he was pretty unanimated until we started talking about some of the more technical aspects of his work. He described how the pituitary gland sends signals (oscillating signals, in fact) to the ovaries to activate them. There is a pharmacological way to neutralize these signals and basically "deactivate" the ovaries (thereby causing them to stop producing estrogen) without permanently removing them. Yay! This got him really excited when he explained it to us. This is important to me because my cancer is estrogen-receptive (meaning estrogen makes it grow) and also although I have zero interest in having children right now this is something I may change my mind about in the future (as a woman, I reserve the right to change my mind about anything and everything :-). As a sidenote, my cancer is also progesterone-receptive, but we don't yet have the results regarding HER-2 NEU (I'm really pulling for that one!). My final question to him was that when we decided to do chemo (which, at that point, was looking to be pretty soon) would it be possible not to schedule it this coming Monday? You see, I have tickets to the Red Sox game that day (Marathon Monday/Patriots Day - I really can't miss this). He was totally sympathetic because he has tickets to Wednesday's game!

Next, the plastic surgeon. I call him Tabouli McSteamy because he was Egyptian and you know that plastic surgeon on Grey's Anatomy, "McSteamy" (can't wait 'till that show starts up again). He was kind of weird. He kept looking at Rusty when he talked about my boobs (might be cultural, I don't know). I didn't really make a connection with him like I did with the other doctors, but he did explain things fairly well. Unfortunately, there are so many different options that may or may not come into play depending on what kind of surgery I have. At this point, I could have a lumpectomy (where they remove the tumor and some surrounding flesh), a single mastectomy (whole boob), or a double mastectomy (you guessed it - both boobs). Clearly, that has entirely different ramifications on the plastic surgeon's job. We decided that as my surgery gets closer, we'll meet with him again at his office where we can see pictures of the different options and actually feel the different implants. Sadly, some amount of disfigurement seems inevitable. It seems small in comparison to dying of cancer, but I've got to look at this every day for the rest of my life. This is one of those things I'll have to come to terms with. Fortunately, the "verdict" means I'll have some time to do that.

So what exactly is the verdict? Well, next week I will begin chemotherapy and that will last approximately 2 months. Treatments will be once every two weeks (or, once a week every two weeks, as Mom would say :-). During this time, they will be closely monitoring how my cancer responds to the chemo. After that, I will have a bit of time off and then I will have surgery. What kind of surgery I have depends on the size of the remaining tumor as well as the results of the genetic test (if I have the BRCA mutation, they will want to be more aggressive... i.e. take more boob). There is something like an 80% chance that I have the BRCA mutation but I think, if there's a .5% chance that a 27 year-old could have breast cancer and I have breast cancer... that 20% is looking damn good. After surgery I will undergo radiation (Mon-Fri for 6 weeks I think), and then it's on to reconstruction.

Well, that's about all I've got for today. You all have to stop commenting on the bitch post. I'm beginning to regret writing that. ;-)

Oh and BTW, you can all be as opinionated as you please (including you, Mom!). I shouldn't be the only one that gets a free pass on that stuff.