My Breast Cancer Journey Part 21: My Twin Sister is One Month Into Surgical Recovery & Is Headed Into More Chemotherapy (amid the global outbreak of COVID19)

My Breast Cancer Journey Part 21: My Twin Sister is One Month Into Surgical Recovery & Is Headed Into More Chemotherapy (amid the global outbreak of COVID19)
My twin sister and her 14-year-old black lab, Bailey, recovering at home!

This blog post is the 21st in a series about my (and my twin sister's) preventative breast cancer screening journey that began when we were 30 years old in July 2019. The 1st post is about my first mammogram ever; the 2nd post is about my consultation at Mayo Clinic's Breast Clinic; the 3rd post is about my stereotactic core biopsy at Mayo Clinic's Breast Clinic; the 4th post is about my diagnosis with "Stage 0" DCIS breast cancer; the 5th post is about my in-person DCIS diagnosis at Mayo Clinic, beginning thoughts on my surgery timeline, and discovering that my twin sister might have breast cancer, too; the 6th post is about my twin sister's invasive ductal carcinoma clinical stage 2A breast cancer diagnosis; the 7th post is about my breast MRI and two ultrasounds to investigate "suspicious" spots on my right breast and liver; the 8th post is about my second DCIS diagnosis following a week of MRIs, ultrasounds, and biopsies at Mayo Clinic; the 9th post is about preparing for my twin sister's chemotherapy appointments, including details about her egg banking procedure in the city; the 10th post is a summary of my sister's ovarian hyperstimulation syndrome and visit to the emergency room; the 11th post is a summary of my double mastectomy surgery plan scheduled to occur on December 3rd, 2019 at Mayo Clinic's Methodist Campus Hospital in Rochesterthe 12th post is about my twin sister's first chemotherapy infusion at Mayo Clinic; the 13th post is about foobs, photo shoots and nipple tattoos (my plastic / reconstructive surgery plan); the 14th post is a recap of my successful double mastectomy and immediate direct-to-implant reconstruction operation; the 15th post is about my surgical recovery and day full of follow-up appointments at Mayo Clinic in Rochester; the 16th post is about my one-month-post-surgical-follow-up appointment and preventative baseline ovarian cancer screenings at Mayo Clinic; the 17th post is about a suspicious rash I developed a month after my surgery called "pigmented purpura," my consultation with a gynecological oncologist about ovarian cancer prevention, and my sister's fifth chemotherapy infusion; the 18th post is about the end of my twin sister's six neoadjuvant chemotherapy infusions (TCHP); the 19th post was about my twin sister's double mastectomy and reconstructive surgery plan (amid the global outbreak of COVID19); and the 20th post was about my twin sister's double mastectomy with immediate reconstruction. To keep tabs on new posts, sign up for the "A Daily Miracle" email list at this link.

It's been one month since my twin sister's double mastectomy with reconstruction operation at Mayo Clinic's Methodist Campus Hospital in Rochester, which was awesome. Her operation took place a day before Mayo Clinic shut down all "elective" surgeries! We're fairly certain her operation, given it was for breast cancer, would have happened regardless, but we are praising the Lord that her operation was completed before coronavirus caused the entire world to implode!

Because of all of the "shelter in place" rulings all across the world due to COVID19, my sister's surgical recovery has looked MUCH different than mine! All of her follow-up appointments with doctors and surgeons and oncologists have been virtual phone calls and video chats--she hasn't been back to the hospital or doctor's office for one meeting or follow-up appointment! All in all, my sister has done a great job recovering at home! Here are the highlights of my sister's one month of surgical recovery:

  1. Instead of seeing doctors at Mayo in person, my sister's husband played doctor at home! He removed her drains (whoa!), changed all of her bandages, and took care of her "battle scars" in the weeks following her surgery under the virtual directions of doctors and nurses. He gave her showers and made sure her heart rate didn't go above 100BPM. My mom and sister and I helped as well by helping with the bandages, keeping her company, giving her medicine, and taking photos of her incisions and reconstruction to send over to the doctors via the Mayo Clinic Patient Portal.
  2. Mentally, my sister keeps herself busy by reading through the entire Bible in 30 days with the YouVerion "30 Day Shred" planShe's also been playing SimCity on her phone, resting, and taking leisurely walks. She's chatted on the phone and Zoomed with friends around the world as well! She really misses her work as a lawyer but has been on FMLA leave for 4 weeks. She'll be back to working from home in a couple of weeks. She's also not missing much in society because everyone has been sheltering in place anyway.
  3. Physically, my sister's breast reconstruction looks great! It's a bit more swollen on the left side due to the removal of a few sentinel nodes that came out on that side and not the right, but over time, the swelling should go down and everything should be perfectly symmetrical. She's been wearing a compression bra too to keep the swelling down, and we've been shopping for sports bras with extra compression that we can wear for workouts in the future. One of our doctors recommended front-zip sports bras, so we are trying some of those from Lululemon and Under Armour!

christine-caine-joshua-jericho

During my sister's Bible-read through, she got to the book of Joshua during the same week we watched a sermon by Christine Caine about the book of Joshua at Hillsong OC!

Gearing up for 10 more months of chemotherapy

My sister finished her last round of neoadjuvant chemotherapy (TCHP) in February. She lost about 40-60% of her hair during chemotherapy treatment while using the Paxman Cold Cap, and she lost some eyelashes, too. It's been eight weeks since her neoadjuvant chemo wrapped up, and her hair has already started to grow back all over her head and her eyelashes are coming back in, too!

We are all thankful my sister's surgery removed all of her cancer!, but because there was some cancer remaining in her left breast at the time of surgery--a 1.1cm spot and a 9mm spot of 20% cellularity that were initially attached to the original ~4cm tumor--she will need 14 more infusions of chemotherapy starting every three weeks on May 22nd: a new, targeted regimen called T-DM1Clinical research trials prove T-DM1 after surgery reduces the risk of recurrence of invasive breast cancer by 50% as compared to trastuzumab (Herceptin) alone, so my sister's oncologist prescribed her with this! My sister's oncologist calls this "chemotherapy light" because the side effects are minimal compared to what she's already been through with TCHP.

In addition to 10 months of T-DM1 (14 infusions 3 weeks apart starting in May), my sister will also take a daily dose of Tamoxifen for 3 to 5 years to minimize her risk of recurrence (Tamoxifen manages the amount of estrogen in her system). T-DM1 will be 14 treatments: 1 treatment every 3 weeks. T-DM1 infusions only last 2 hours (her TCHP treatments lasted 6 hours each)! Side effects of T-DM1 are that it can cause teensy bit of neuropathy, fatigue, and diarrhea. T-DM1 can also be a bit rough on the heart, so she will have ultrasounds on a regular basis--every three months--throughout her treatments to ensure her heart is pumping normally! 

T-DM1 doesn't cause hair loss!, and my sister's hair has already started coming back on the top of her head, which is amazing! In addition to T-DM1, my sister will start Tamoxifen daily. Tamoxifen is meant to reduce the risk of recurrence for the estrogen-receptor-positive part of my sister's breast cancer as it blocks estrogen from binding to estrogen receptors on cells in the body. Side effects can include hot flashes; a 1/100 risk of blood clots, which can be recognized through any signs of trouble breathing or swelling legs; and a 1/1000 risk of uterine cancer. Uterine cancer always presents itself with a symptom of abnormal uterine bleeding, which my sister and her doctors will watch out for.
Next steps!
On Thursday 5/21, my sister has a blood test and echocardiogram at Mayo Clinic to gear up for her first infusion of T-DM1. She'll meet with her oncologist on Friday 5/22 before her first infusion of T-DM1, which will last approximately 2 hours. We are hoping for no side effects, no adverse reactions, and complete 100% effectiveness of Tamoxifen and T-DM1 so cancer never comes back again!!!
We are also praying for a cure, vaccination, and effective treatments for COVID19. In addition to wanting COVID19 to disappear completely because it sucks, we also are praying for COVID19 to disappear because, even though T-DM1 won't suppress my sister's immune system as much as TCHP did, we'd rather not have COVID19 floating around the world while my sister is going through chemotherapy treatments.

zoom-bible-study

Here we are on a Zoom Bible study discussing everything my sister has learned during cancer treatments!

Going back to work!

"I love my job and I feel the happiest when I'm working, so I can't wait to get back to work!," she told a few friends and me via a Zoom Bible study this weekend. "It hasn't been as hard as I thought it was going to be to take some time off of work, because it's allowed me to slow down and focus on myself and my health and on God."

"What have you learned most about God's character during all of your cancer treatments?," one of our friends asked her via Zoom.

My sister paused thoughtfully, then told us that the most important thing she's learned is that nothing she can do will change God's will for her life. That means that during this season, God's will is for her to battle breast cancer through surgery and chemo treatments. She also said she's discovered the true meaning of surrendering her life to Jesus--surrender that gives her a deep feeling of peace--God's peace that surpasses understanding. She said:

"It was when we were driving back to the city after my sister's diagnosis appointment at Mayo Clinic in Rochester last September that I realized I had breast cancer. I hadn't been diagnosed yet, but after listening to my sister's doctor explain what breast cancer is and why it was so good hers was DCIS and she didn't have a lump yet, I knew I had cancer of some kind. My doctors in the city had found a lump in my breast the month before but told me it was nothing and told me to come back in a year. As I looked out over the farmland and fields as we drove away from Rochester, I thought about the lump in my breast and knew that, even though my doctors in the city had sent me away, that there was a chance I might have Stage 4 metastatic breast cancer and that I could be dead in a year."

She started to cry.

"But it was in that moment looking out over the fields that I realized: Even if I had Stage 4 metastatic cancer and was going to die, it was going to be okay, because I was going to be with Jesus."

She smiled a big smile as she finished her story through tears as all of us on the Bible study Zoom call started crying. That's the bottom line: Jesus loves my sister, has her life in His capable hands, and is working out His good and perfect plan for her life--granting her His peace all along the way, as painful as the journey might be.

My surgical recovery and status update

I'm 4 months into surgical recovery and am still pretty fatigued. I've been sleeping 10 hours per night and feel like I'm fighting off brain fog most of the time. I know this won't last forever and I know exercise is a big part of the equation in combating fatigue--plus Mayo Clinic has a study saying that ginseng helps fight fatigue, too!--so I'm doing my best to walk or bike every day and do some home workouts with Luis Leonardo's LOW Training (which if you're looking for some solid home workouts I highly recommend--you can sign up on the website and follow him on Facebook and Instagram!!).

I am trying to be kind to myself because I know COVID19 is causing a lot of stress and anxiety in people around the world. Beyond that, I am still physically recovering from my surgery and emotionally from everything that unfolded last fall with diagnoses and treatments and surgeries. And then my twin sister is going through some intense treatments in the midst of the most ridiculous global pandemic the modern world has ever seen. All of this is pretty stressful.

But God is bigger than all of it, He loves us, and we know His plans are perfect!

Stay tuned for updates as my sister enters her next round of chemo on May 22nd--and thank you so much for your prayers and encouraging words!!!!! :)

This blog post is the 21st in a series about my (and my twin sister's) preventative breast cancer screening journey that began when we were 30 years old in July 2019. The 1st post is about my first mammogram ever; the 2nd post is about my consultation at Mayo Clinic's Breast Clinic; the 3rd post is about my stereotactic core biopsy at Mayo Clinic's Breast Clinic; the 4th post is about my diagnosis with "Stage 0" DCIS breast cancer; the 5th post is about my in-person DCIS diagnosis at Mayo Clinic, beginning thoughts on my surgery timeline, and discovering that my twin sister might have breast cancer, too; the 6th post is about my twin sister's invasive ductal carcinoma clinical stage 2A breast cancer diagnosis; the 7th post is about my breast MRI and two ultrasounds to investigate "suspicious" spots on my right breast and liver; the 8th post is about my second DCIS diagnosis following a week of MRIs, ultrasounds, and biopsies at Mayo Clinic; the 9th post is about preparing for my twin sister's chemotherapy appointments, including details about her egg banking procedure in the city; the 10th post is a summary of my sister's ovarian hyperstimulation syndrome and visit to the emergency room; the 11th post is a summary of my double mastectomy surgery plan scheduled to occur on December 3rd, 2019 at Mayo Clinic's Methodist Campus Hospital in Rochesterthe 12th post is about my twin sister's first chemotherapy infusion at Mayo Clinic; the 13th post is about foobs, photo shoots and nipple tattoos (my plastic / reconstructive surgery plan); the 14th post is a recap of my successful double mastectomy and immediate direct-to-implant reconstruction operation; the 15th post is about my surgical recovery and day full of follow-up appointments at Mayo Clinic in Rochester; the 16th post is about my one-month-post-surgical-follow-up appointment and preventative baseline ovarian cancer screenings at Mayo Clinic; the 17th post is about a suspicious rash I developed a month after my surgery called "pigmented purpura," my consultation with a gynecological oncologist about ovarian cancer prevention, and my sister's fifth chemotherapy infusion; the 18th post is about the end of my twin sister's six neoadjuvant chemotherapy infusions (TCHP); the 19th post was about my twin sister's double mastectomy and reconstructive surgery plan (amid the global outbreak of COVID-19); and the 20th post was about my twin sister's double mastectomy with immediate reconstruction. To keep tabs on new posts, sign up for the "A Daily Miracle" email list at this link.

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