High-Five!

I’m at the oncologist at the moment, and I wish I’d brought some of the things I have to do from my to-do list! All this idle time! I’ve been updating my lists of things to do in between blood draws, meeting with the doc, and now sitting here for my infusion. I feel so organized.

Anyway, things are still looking good for me. I’m going to have to get another echocardiogram soon, so it’ll probably be planned for next week so I can get it done before surgery.

Dr YB told me to eat at least a fist-sized portion of cruciferous vegetables (broccoli, kale, cauliflower, brussel sprouts) every day. I was like, I’m already doing that. I eat 5 portions of veggies, 1 cup each, and one is always cruciferous because that’s what I like. (Thank you Portion Fix!) He also said he wants me exercising, heart rate up to 150, 30 minutes every day. Well, I’m doing that already, too! He said he wants me to build to 150, I told him I’ve been doing this for weeks. He hive-fived me. So yeah, I’m ahead of the game, which is exactly where I hoped to be.

I’ve had 2 appointments with the PT where I’ve done different exercises. I’ll share about that in a separate post.

Some fun stuff…over the weekend I did the autism walk in Hampton Park in downtown Charleston with my nephew. I also attended my niece’s 6th birthday party! Then we had a funeral for a Brad’s Aunt on Sunday. It was a nice weekend spent with lots of friends and family.

At the birthday party was our friend, James, who was diagnosed with colon cancer several months before I was diagnosed. He’s had chemo and surgery, and is starting chemo again because it’s starting to come back. He’s in good spirits, like me, and it was actually really cool talking to (commiserating with) someone I know well, and who is going through something similar. We have a similar sense of humor, which only people going to through cancer or who are close to someone going through cancer understand. It tends to freak people out when we joke or laugh about stuff, but when you deal with the variety of BS cancer brings to the table, you have to joke and laugh. Some people get that and some people don’t. 🤷🏻‍♀️

Anyway, I’m trying to wrap up a bunch of things before surgery…tie up lots of loose ends! Wednesday is our 10 year wedding anniversary, and we’re going out of town for the weekend to a concert in Charlotte. I’m looking forward to the break before the surgery!!

And here’s a cute baby goose butt before I go. My view at the oncologist.

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Super cute siblings!

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Lumpectomy

My bad…I just realized this post was still a draft and never went live. Whoops! Insert this around January 24, mmmkay? Thanks!

Howdy! Everything went great yesterday, but it was a long day and I was pretty loopy last night.

Here’s the rundown:

Arrived at hospital around 9:00am. Let’s face it, it was downtown at the tail end of rush hour, I wasn’t getting there at 9:00 on the dot. I had to hit snooze for the appropriate amount of time, shower, pick up my prescriptions…you know the drill.

After admitting, I went to the waiting room and went to my pre-op room pretty quickly. Did the whole vitals and IV thing.

Then I went to nuclear medicine for the contrast dye injection, which highlighted the lymph nodes the cancer could spread to, the ones associated with the ducts. That was easy and painless. This time while in nuclear medicine, I was singing “Radioactive” by Imagine Dragons in my head.

From there I went down to the Breast Center for the wire locator. The wire locator was literally a wire (two actually since I had an area of calcification that Dr B wanted to go ahead and take care of as well) inserted into my boob via needles. They were sticking out the side after insertion, it was quite weird. They were super thin and bendy though, sort of like a stiff fishing line, if that makes sense. This process stung a little bit, but it still didn’t hurt exactly. And for both this and the dye injection, I had a local anesthetic – Lidocaine. Oh, and this was mammogram guided, so I had another mammogram! Yay…

After that, I returned to my pre-op room. I took a while downstairs, spent a few minutes here and there waiting, so once I got upstairs I had people waiting on me for the next stuff.

Dr H (plastic surgeon) was there, and he marked me up for the reconstructive stuff. In addition to the nipple preservation (which is the reason I am having a lumpectomy and then a mastectomy in two separate procedures, for anyone who was wondering and hasn’t asked or who I didn’t have an answer for at the time), he shifted things around on the right side (reconstruction) and did a reduction on the left to match the right.

Then came the anesthesiologist. My favorite people. I just think the whole concept of general anesthesia is so cool. They’re like magicians…now you see me, now you don’t! Anyway, I got a nerve block for this procedure. He said it’s something they do with major breast surgeries that works a little bit better than general anesthesia alone. So he gave me a little bit of a sedative, Brad said his goodbyes, and they inserted the lines for the nerve block, one on each side of my back/spine. I had to sit up and sort of lean forward with my head on the table how you would for a seated massage. Also painless.

Then Dr JB came in and talked to me for a few minutes about the lumpectomy. Then I was rolled down to the OR, I moved from the stretcher to the operating table, I remember saying something about not having been awake in the operating room before, then it was lights out.

So I woke up groggy and my mouth and throat were super dry. I felt a little nausea, but that could have been due to the dryness from having the breathing tube. They did give me a good dosage of nausea meds through my IV (and morphine) before they removed it, just in case. I felt the meds coming in the IV, it was weird but didn’t hurt. I drank some cranberry juice and felt pretty good after a few minutes. I still have the nerve block, though not as high a dosage. I’ve got these two pouches that each have a bocci ball side rubber belly thing with meds. They give a slow drip of meds to the nerve block to keep things numb and keep me comfy. I increased the right side last night before bed since that side stings a bit. I got my discharge instruction, then I got dressed, and we were discharged. This was around 5:45 I think.

Traffic was a mess going home. Rush hour from downtown, up 61 through West Ashley is never fun. But we eventually made it to my parents’ house where we spent the night so I’d have adult supervision today to ease Brad’s nerves.

I hadn’t eaten since dinner time the night before, so I had half a Publix sub when I got to the ‘rents. I wasn’t sure I’d be able to eat (ha-ha), but I needed to get something inside so I could take the pain medicine. I took baby bites and was able to eat the sandwich over about an hour. I did take some Zofran, just in case, but no nausea.

I slept in the recliner last night because I figured it was the easiest way to stay on my back. Even if I fall asleep on my back, sometimes I end up on my side. Aside from Daisy waking me up to pee at 4:15, I slept well.

Woke up feeling some sting on the right side still, and took another pain pill with breakfast. Hopefully that’ll knock that out.

Overall I feel great. I wasn’t sure what to expect as far as pain goes, and I’m sure the nerve block has something to do with it, but I feel good and that makes me happy. I’m having no trouble with movement, aside from a little soreness in my right underarm area, but I feel like I’ll be back to being (semi-) independence soon! I can’t lift anything for 4 weeks (ugh), but everything else should be good to go in no time.

I’m just finishing breakfast and the pain pill, Nucynta, should be kicking in soon, so I’m going to hit the recliner again!

Adios!

Another Update

My apologies! I usually write my posts from my phone while I’m waiting somewhere for something, like in a waiting room or in the car when I arrive somewhere early. I’ve been on the go so much lately that I haven’t had any downtime like that to share an update from my Monday appointments, so here it goes:

I had my appointment with Dr JB and Dr H last Monday morning. Everything looks good as far as healing goes. We did not schedule the surgery yet, but agreed it would be early May, after mine and Brad’s 10 year anniversary (!!!!!).

I went to the appointment with a short list of ailments, ones I wasn’t sure were a result of the surgery, chemo, or life. Let’s face it, it’s been a while since I’ve felt normal! The list included neuropathy in toes, tenderness and irritation where stitches were still poking out (more on this later), swelling in legs, muscle soreness, and joint aches.

Most of this was related to chemo, or rather the end of chemo, but Dr JB recommended using ointment on the incisions, and she was concerned about the swelling. She referred me out for an ultrasound/Doppler of my legs to check for blood clots. She also said the soreness and aches were probably a result of going from being inactive to active, and that I should just push through it, which is basically what I’ve been doing.

The other thing we talked about was my weight (yay!). She’d like me to lose about 10-20 lbs before the mastectomy because it’ll be better for my healing and I’ll have better cosmetic results, too. So I’ve been working on that and I’ll share more about what I’ve been doing in another post.

I’ll see both of them again April 26th.

I took a break for lunch and talked to the scheduler at Dr JB’s office and scheduled the ultrasound for 3:00.

Then I went to see Dr YB. My bone scan turned out fine. He still wants to do the shot he talked about last time that he feels will have a better long term prognosis than the pill, Tamoxifen. In order to do what it does to battle the cancer, it shuts down ovary production. I thought my ovary production was already shut down since I haven’t had a cycle since September, but apparently not. Dr YB said that’s actually a result of the chemo. I never asked, I just assumed it was the Herceptin causing that since the Herceptin is the hormone treatment, and I associate hormones with periods, but whatever. So they’re checking some hormone levels and we’ll probably start the shot at my next appointment, the 19th.

So I had my treatment, then I was off to the ultrasound. I ended up late because I didn’t leave the oncologist until 3:00, so I got there at 3:30. For the ultrasound, they do the three main veins in the leg (the names of which I cannot remember, but you can Google it if it interests you, or someone can leave it in a comment if they know). Having that goop on my legs was absolutely nasty feeling. I did apologize to the tech for the fuzz on my legs. Still haven’t shaved since September, still nervous to shave now because of the potential for ingrown hairs from the ones that never quite fell out. It’s a wait and see game right now. Fortunately, it’s still jeans weather and the fuzz isn’t obviously long, so I can afford to wait and see. Anyway, no blood clots. Yay!

I ended up leaving the hospital around 5:00, so I missed my Monday class, which sucked considering nothing ended up being wrong with me. I’m lucky my teachers are understanding.

In other news, one of the classes I did an incomplete in, Objective Assessments, I’ll be able to do in the fall, essentially from scratch, which is awesome! Such a relief to not have to worry about that right now. And I’m glad I can retake the class because I don’t remember much about how to administer the tests and stuff.

So I’ll chat more about weight loss and the perfectly timed delivery of Girl Scout cookies later!

🍪 🍪🍪

Hey there

Sorry it’s been a few minutes since I’ve updated. I really haven’t had much to say.

I did see my oncologist the same day as the surgeon. He sent me for a bone density scan, or a dexa scan. The reason for this is because he’s considering a shot or a pill to battle out that little bit of cancer that stayed behind. He guessed that what didn’t go away was estrogen fueled, and my treatment was geared a little more towards progesterone. Or something like that…it’s been a little while and I don’t quite remember now. Anyway, because the add-on treatment would be more hormone stuff, he wanted to check my bone density.

So that wasn’t a difficult scan. I went to the same place I went for my mammogram. I laid on a table, they scanned my hip area and lower spine. There was something shaped almost like an arm that arced partway over the table, and that’s what scanned me. I’ll know those results at my appointment on the 26th.

My only side effect of the Herceptin this cycle was hot flashes. I hate them so much, but it was lovely not having to deal with anything else, and to be feeling progressively better day by day. I swear I’ve been making up for the flavor/texture challenges by eating anything and everything. Ha…not much change there. I did have a couple days of heartburn, but that was probably a result of my wonderful diet, not my treatment. I haven’t taken medication in a long, long time!!

I feel…dare I say it…normal!

Seriously, aside from my leg muscles being so sore from lack of use and my feet being swollen, I feel great! It’s wonderful.

I’ve been to both of my classes two weeks in a row. I don’t think I’ve done that since September! I’ve been working, too. I subbed a couple sessions with some great kiddos today, and I’ve been doing some contracted/as needed office work for an old boss, too. I finally feel like I’m contributing again (or will be once I get paid), and it feels nice! It’s also nice to feel like I have a little bit more purpose.

Things are kind of quiet over here, so I won’t bore you. You’ll probably hear from me next on the 26th, after my next appointments, unless something exciting happens between now and then.

Oh! I’ve got peach fuzz on my head! 😁 I wonder what my hair will be like when it grows back…

Good news!!

Sorry for the radio silence over the last week or so. I haven’t had anything new to report since the bronchitis. I’ve just been laying low, getting well, and enjoying my good days.

I had my ultrasound with Dr. JB today, as well as my consult with the plastic surgeon, Dr. H.

First we did the surgical consult and talked about the lumpectomy, mastectomy and reconstruction stuff. Now remember, I’m not a medical professional and may not use the correct terminology here, but hopefully you’ll get the gist of it.

The lumpectomy would take place about 2-3 weeks after my last chemo treatment (Jan 8). Recovery would be about a week, I believe it’s an outpatient procedure.

About 3 months after that is when the mastectomy and reconstruction would take place. This would involve about a 5 day hospital stay and about 6 weeks of recovery. As I mentioned in a previous post, they can use belly fat (which would be my choice over artificial implants), which would essentially add a tummy-tuck to the procedure. Using belly fat eliminates the need to return to the plastic surgeon in a few years to have the implants/spacers replaced. Dr. H talked about what he’d do, and that includes transplanting arteries to keep the fat tissue alive when they move it to the breast. They also transplant a piece of skin attached to the fat, sort of a lemon shape, that will stay on the outside of the breast and be monitored to make sure the tissue stays alive. I guess if that skin dies, it’s an indication that the tissue has died as well. After a certain amount of time (I don’t remember what he said), they’ll remove that skin from the outside. Please see my horrible drawing below, which is sort of like Dr. H’s drawing at the appointment today. That’s what it would look like when the skin is there, after they remove the skin, it would just be a line-like scar in that same place.

So, the options are still just the lumpectomy, lumpectomy and a single mastectomy, or lumpectomy and a double mastectomy. The lumpectomy alone leaves me with the highest risk of new cancer in either breast, and recurrence of the existing cancer in the right breast. Single mastectomy reduces the risk of new cancer in that breast, but doesn’t eliminate it, and does nothing to reduce the risk in the other breast. Double mastectomy reduces the risk of new cancer in both breasts significantly, but also doesn’t eliminate it entirely.

So, regardless of what I choose to do, there’s still going to be risk. It’s likely I will face this again in the future, but we’re talking many many years into the future when it’s possible there’s some new and (hopefully) less evasive treatment.

So after the surgery talk was over, we did the ultrasound.

And…drumroll please…

There was nothing there!! The cancer is gone!

Yes, we can still feel JP, but he’s not showing up on the ultrasound, which means he’s blending with the other we can also feel that he’s much smaller than he was in the beginning. He was very apparent on the first ultrasound, so this is great news!

I still have three rounds of chemo left, the next one being Monday after my little break for Thanksgiving. Why more chemo if the cancer is gone? Because it will grow back. So before they do the lumpectomy, they want to shrink everything as much as they can so they can get the best margins.

Lots of information today, lots for me to think about. But today we’re celebrating that I kicked cancer’s ass. 😉

Echo and Ultrasound Update 

I had another echocardiogram and ultrasound yesterday. It was my six week follow up for each.

Echo was good. Heart was squeezing just fine and there was no extra fluid. The tech was great, as usual, and they had a new bed in there. It was comfy. Process was the same as the last. My blood pressure was randomly low, but it seemed to be a fluke. 

Ultrasound was great! JP was barely detectable, and that’s just after two treatments! 

I met with Dr JB’s Physician’s Assistant (PA), M. We talked a little about surgery options. I will still need to have some kind of surgery after the chemo is complete because, while the mass may shrink to nothingness, some tissue will still be left and it can grow back. So, at the very least, they need to remove the remnants through a lumpectomy.

If I have a lumpectomy, it’s still highly likely that the cancer will return, so I’ll need to be monitored through frequent mammograms and MRIs…pretty much forever. 

Another option is mastectomy, which is the full removal of the breast tissue, single or double. With single, the other side will still have to be watched. Double, the chances of recurrence are drastically reduced. Also, with mastectomy comes reconstruction, which can/would be done at the same time, and can be done using belly fat rather than implant materials. 

There would also be some node removal, somewhere in there. I’ll have more info on that at my next appointment in November, when I meet with Dr JB and the plastic surgeon for a consult. 

Some of this will depend on what the genetic testing says, too, so I’m not in a hurry to make a decision. I need more facts. But honestly, I’m leaning towards whatever will significantly reduce my future cancer risk, because I would love to not have to go through chemo again. That would be great! That’s sort of my guiding light at this point.

Anyway, I’m still hanging out in bed. I’ve been up for a while, reducing my phone battery to 55% from all the playing I’ve been doing for the last few hours. I feel good, it’s been a great week! Of course I’ve still had some moderate diarrhea, but at least it wasn’t like the lava of last week (thank you, liquid Pepto!). 

My new favorite gif, by the way…

If you haven’t seen bridesmaids, it’s worth it for Melissa McCarthy. 

Anyway, I’m just getting myself hyped up to clean and make some sliders for the football game today. 

Go Cocks!

Have an awesome weekend!

Hello darkness my old friend…

Let me start by saying I’m using that lyric in reference to the original song, not the remake. Mmmkay?

So yeah, it’s that part of the cycle again.

I feel cruddy. My body is sore, my throat is a little sore and tight, my head hurts, I’m tired, etc. Waa waa waa. I don’t want to read or write, so I’m just laying in my bed and occasionally listening to books on tape. I’m bored, but don’t really have enough strength or brain power to do anything productive, which sucks because there’s a lot I could be doing for school and around the house. I finally reconciled my bank account yesterday after about a week, that was fun. I hate falling behind.

I’m hungry, and so far I’ve been able to eat. I get nauseated, but that’s what the Zofran is for. I learned what I could tolerate last cycle, so we stocked up this time. I had Campbell’s chicken and dumpling soup yesterday, the kind in the plastic microwaveable bowl, and it was wonderful. Today I had oatmeal, this time the fruit and cream variety, not the plain cardboard type. It was good. Then I had macaroni and cheese for lunch – a Kraft microwaveable bowl. Not all the healthiest of selections, I know, but I’m managing with what I can. I had a sandwich yesterday with meat, veggies and avocados, so my system seems to be allowing some variety, I just don’t always have the umf to make it fresh. I can also tolerate water better this time around, more so than the Crystal Light that was my saving grace last time. It’s so weird how things flip and flop like that.

Things that are particularly annoying: sounds. Phone ringing, door bell, text tones, dog barking, etc. It’s making me quite irritable, which I’m sure is just pleasant given all my charming characteristics as of late.

Brad has been a real trooper. He’s always been super tolerant of me, but he should get an award after this, even though he’d deny deserving it. “Can you get me this?” “Never mind, not this, that.” “I realize you worked all week and weekend, but I want popsicles.” “I left my puzzle book in the other room.” “Has Daisy been outside?” “I want a popsicle, but a good flavor.” His personal assistant job description does include criteria about mind reading, FYI. And he does it all without whining about it AND giving me compliments, which I’m not so sure I’d manage if the roles were reversed. I’m tired from doing nothing, so I’m sure he’s exhausted.

So kudos to the cancer spouses, caregivers, parents, children, siblings, etc. Your job is hard, too. Really hard.

What else is new? Well, the diarrhea is back. That started around 1:00am last night and continued every couple hours throughout the night. It stopped around 11:00am, I think. Then happened once again since, but it at least seems to have slowed down. I’m taking in fluids and took Pepto, so hopefully we’re on the upside of that, though after last cycle it’s anybody’s guess. I’m doing my best to stay horizontal and not jostle anything.

I mentioned nausea…that’s been pretty persistent, and I wonder if it’s because I’m eating more and trying to be a little more active? The medicine helps, so I can’t complain, but it’s definitely more present this cycle than last.

My tastes haven’t completely become shot just yet, and I’ve been able to taste what I eat, but I do have that horrible taste in my mouth. Yuck. I need some peppermints, the red and white ones, you know? Those seem to help. (*cough*Brad*cough*) The blue and green ones are too close to mouthwash right now, and my gag reflex is ready!

Daisy has had enough of my boring self. She keeps looking at me and sighing these big huffy sighs. Like, “Come on, ma. Get up. Watch me roll on the floor. Watch me chew my foot. Watch me scratch.” She’s just not used to me being home and doesn’t know what to do with herself, or me.

Whoa is her.

But anyway, I’m on the flip side! I should be feeling pretty good by the weekend, so I’m looking forward.

Tomorrow I have labs, so we’ll see how I’m doing, and maybe if I’m feeling like garbage I’ll get some fluids while I’m there. Next Friday, the 27th, I have my six week echocardiogram to see how my heart is doing with all the poison. Then, after that, I’ll have an ultrasound of JP to see what’s happening there.

I think I’m going to crawl out of bed and get a popsicle. 🙃

The Echocardiogram and Other Stuff

Another visit to Trident Medical Center under my belt, and another great person in their radiology department.

An echocardiogram is an ultrasound of the heart. The purpose of this test was to have a baseline, we’ll do more periodically to see if the chemo effects on my heart.

So for the echocardiogram, I only had to put the gown up top. She put the little wand over my heart, then below my heart. I had three wires attached to leads on my chest. It took about twenty minutes total. Easy peasy.

It was neat to see the pumping of my heart on the screen, hear the whoosh whoosh, and see the valves flapping. Cool stuff. I guess everything was OK, the tech said she wouldn’t let me leave if it wasn’t, but she couldn’t really say anything specific – wasn’t allowed. Which is fine, I get it. I’m sure my oncologist will tell me all about it.

In other news, chemo starts Monday!

Originally, the port placement was supposed to be Monday, but that would put off the chemo, and they’d rather do the opposite and get the chemo started ASAP.

I’m a little nervous, mostly because I’m imagine it burning through my veins or something equally as devilish. I know it won’t, but whatever. I can think what I want to think.

I believe I mentioned that the first dose will be a loading dose, so it will be a little longer than subsequent treatments. I’ll probably be there from 8:30am until 4:30pm. I have a bag I’ll be loading up with goodies to keep me (and Brad) occupied and comfortable, like a blanket and snacks. Gotta have the snacks! I’ll probably throw in a deck of cards, Phase 10, Trivial Pursuit, Monopoly. Hey, we have ALL day, we can definitely play some Monopoly!

I’ll share about the chemo on Monday or Tuesday!

Flashback: The Mammogram and Ultrasound

I had the mammogram and the first ultrasound done during the same appointment, so I’ll talk about them together. They actually took place the morning of the biopsy, even though I already posted about the biopsy. So I’m a little out of order, but we’re almost up to date so it’s all good!

When I arrived for the mammogram, I filled out the paperwork and somewhere along the way was told that mammograms weren’t as bad as they used to be and as their made out to be. I thought, “OK, cool. I wasn’t really looking forward to my boobs being smashed like a panini.”

Ha.

It was TOTALLY like a panini press.

I have to give the tech credit, because she handled it—me, ha—like a pro. I don’t know that I could do that…manipulate someone else’s boobs into assorted contraptions. She was really great.

The left side wasn’t so bad. It wasn’t comfortable, but it wasn’t terrible. The right side, where JP resides, eh. Remember I mentioned the tenderness? Well, as much as JP didn’t like me being all grabby-grabby with him, he liked the panini boob press even less. He was irritated, which meant I was irritated.

So the mammogram was a lot of awkward positioning, hands, and squishing.

After that, I went for the ultrasound. Less awkward positioning, more hands, and some gel. At least it was warm.

On a different note, the facility was nice. It’s called The Breast Care Center and it was all about the ta-tas, which, I think, made it a more relaxing experience. Something about being around a bunch of female patients when having boob stuff done was better than when I had to get the MRI in a mixed gender environment.

Girl power.

Flashback: The Specialist, Another Ultrasound, and The Biopsy

Caution: Image at bottom of post. Kind of gnarly looking. No nudity, I have some modesty. (Not much left though!)

Ouch.

But let me back up.

“Concerning” is the term that was used to describe the images from the mammogram and ultrasound when I went to see my original doctor after the mammogram. I was immediately referred out to a specialist, a breast surgeon, who my doc/NP (Nurse J, I will call her going forward) highly recommended. I was able to be seen right away, which was amazing in and of itself considering it was a Friday and it’s damn near impossible to do anything on a Friday around Charleston.

Dr. JB (not to be confused with JP) is as fantastic as I was made to believe, and for that I am so incredibly grateful, and her office staff is wonderful. She’s so positive and she makes me feel positive, too, even though I am still not sure I truly know how I’m supposed to feel about all this.

So she did an ultrasound, and for the first time, I met JP. Stupid little black shadow that he is. He is sort of shaped like a boomerang, though not as slim, more like an elongated kidney shape? Maybe? I don’t freaking know. He’s there, let’s leave it at that.

Next up…biopsy…it seriously all happened that quickly. I was numbed up and biopsied. It only hurt a little bit, that’s the honest truth…a pinch when they injected the numbing agent…it was more the vibrations of what I knew was going on that was unnerving. Also some loud little snaps as they snatched up pieces of JP — I assume that’s what the snapping sound was. I didn’t ask. I was trying not to freak out at the needle in my boob.

So the biopsy was complete and I left Dr. JB’s with a slightly bleeding boob and lots of words of encouragement. She’s a wonderful person. She said all the right things and really didn’t give me the opportunity to feel discouraged. She told me I was going to get through this, that there was lots of support out there for me, and everything would be all right.

I believed her, still do. It’s hard not to.

 

 

 

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This is a couple days after the biopsy. Lots of bruising and tenderness. You can see the small slash from where they went in.