10 Days to The Rest of My Life

This is a VERY long overdue post, and I hope to share a little bit about what is about to happen while not overwhelming you with a very long post...so here we go.


On February 29th of this year, I received a startling, yet very honest email from my wonderful lung doctor in Chicago.  We had been having some dialog about my breast cancer genetic testing and results for some time, and I didn't understand why she was so persistent on knowing the results.  Come to find out, those results I found out many years ago that were hidden in the back of my brain, surfaced again in a way I never really thought possible.  You see, my family history of breast cancer is beyond significant, with each generation starting with my great grandmother, having a diagnosis of cancer.  For some reason, I knew in my gut, that I would be BRCA positive.   The BRCA genes have been identified as the "breast cancer genes".  I'll never forget sitting in the oncologist office, hearing the news, "you're BRCA1 positive".  It wouldn't hit me until many years later, on February 29th, that it could really impact my survival, beyond just breast cancer.  (Being positive for this gene increases my risk of getting breast cancer over my lifetime by about 85%).  


So, this email from my doctor came as a shock when she correlated the two major issues I am dealing with; breast cancer and lung transplant.  I will need a lung transplant.  I may develop breast cancer.  But where the connection lies is that if I develop breast cancer before I need the transplant, I would be in a lot of trouble. If I were to be diagnosed with breast cancer pre-transplant, I would have to wait for 5 years after completion of treatment and being cancer free, before even being considered for transplant again. Also, if I were to be going through the transplant evaluation where they do an extensive cancer screening, and something were to come back "abnormal" on my mammogram or breast MRI, the transplant surgeon could refuse to operate based on my genetic predisposition and the abnormal results, therefore making the option of a lung transplant, not an option. 


So, I have two options.  First, I could wait and hope that I do not get any type of abnormal breast imaging readings/cancer up through time for transplant, which we aren't sure when that time will be.  This would consist of screening every 6 months (which I've been doing), with the agonizing anxiety surrounding the fear of what they might find (which I have, every 6 months). Knowing that I will likely need a transplant within 5 years or so, I would risk being a candidate for a lung transplant and therefore risk my life at a time when I will need "life" (a lung transplant) the most. 

Or option two, I could take some rather drastic but proactive step to help eliminate my elevated risk of breast cancer.  This is called a preventative bilateral mastectomy.  And this, is what I will be facing next Friday, August 3rd...in 10 days.  After many months of debating, crying, fearing, challenging and investigating, I have chosen to go through with this life changing operation. In doing this, I will reduce my chances of getting breast cancer by 95%.  I will also eliminate the possibility of having breast cancer ruin my chances of having a second chance at breathing freely.


The surgery does not come without risks of course.  With only 32% lung function, the team of surgeons and anesthesiologists have chosen to operate without me undergoing general anesthesia.  This will help to reduce risk of post-op lung related issues (pneumonia, aspiration, etc).  They will attempt what is called a "paravertebral nerve block" which will eliminate sensation to the chest nerves, and hopefully provide me with significant pain relief post-op.  The hope is to avoid having to intubate me (put me under general anesthesia), but provide pain relief and sedation so that I can withstand the surgery comfortably.  I've made it very clear that I don't want to hear, see or feel a damn thing, and I am very confident in the team we have chosen.  In fact, I couldn't have asked for a better team.  I've chosen to do what is called a "skin sparing, nipple sparing, one-step direct to implant mastectomy with reconstruction".  If all goes well while I am on the operating table, I will go in with boobs and come out with boobs, just a little bigger (wink, wink) and full of silicon rather than potential cancer filled tissue.  I've had quite the experience trying to determine what size and shape I want my new "foobs" to be.  Let me tell you, "testing out implants" with your husband and mom in the room can be quite entertaining ;)  I have some limitations of course and can't be the "Dolly Rebs" with double D's.  I have to trust the plastic surgeon that he will make me look good.  Since I am keeping the "outer layer" and the incision is made in the underneath fold of your breast, I'm hopeful for good cosmetic results. I figure, if I am going through all this, why not make those babies a little bigger if possible!?! 


Bob and I will be traveling to Chicago by car starting this Saturday, July 28th, so we can bring our pups with us.  We will be staying in Chicago for likely a month or so.  We've got an amazing support system and I feel that this is the right decision for me.  I only ask of you to help keep the positive thoughts and prayers coming our way.  My recovery will likely be different and possibly longer than the "average" woman considering my existing condition.  We'll need prayers for a safe operation and an uneventful recovery.  I will likely be in the ICU after surgery so they can keep a close eye on me and I'll remain in the hospital for another few days to ensure my lungs and new boobs are okay. After I am discharged from the hospital, we will be staying in Western Springs, IL until I get the "okay" to make the road trip back to Houston.  


Many of you have asked if there is anything we need. To be honest, all we need at this point is what I mentioned, positive thoughts and prayers.  Not only for me and the operation/recovery, but for Bob, my parents and my brother who will all be by my side next week.  I will make it through this and be stronger for it, but the fear and the emotional/physical toll extends beyond me ... to those who I love and care about so much.  I ask that you pray for them during this time, to help them remain strong. To help them emotionally and physically.  They will be my caregivers and they will need patience and strength. I ask that you pray for the team of doctors who will be a part of all of this.  


Lastly, I encourage you all to follow this blog.  We use this blog as our primary means of communication.  I will surely love to hear from you all via calls, texts and emails, but please be patient as I might not respond in my usual quick way.  Thanks for all of your continued love and support as we embark on this crazy journey life is taking us on.  


With Love,
Bob and Rebecca