When Dad Undergoes BRCA Testing

* UPDATE: I am negative for the BRCA gene.

Breast Cancer Awareness Month means a great deal in our house. It’s not just another reason to re-post something on Social Media and forget about it. Here’s why. 

My wife, Heather, lost her Mother to cancer. Susan was 41, and Heather was only 13. Heather’s grandmother also had cancer in her lifetime, and if you’ve read Heather’s blog and social media posts, you’ll know about the elective, preventive measures she’s taken to reduce her risk. She has also written two children’s books based off the conversations we’ve had with our own kids. The goal is to help other kids who might be going through the same issues and having the same questions. 

I’m so proud of the active stance Heather takes related to matters relating to breast cancer. She gets herself out there and tries to help who she can by sharing her story. She uses social media, blogs, shows up as a guest on podcasts and video interviews. She really walks the talk. So, what can I do to show my support this October? Well, I decided to get tested myself. After all, my paternal grandmother died of cancer, and both my father and his only brother have dealt with prostate cancer themselves. So today, I spit in a test tube and my doctor will ship my DNA off for testing for BRCA1 and BRCA2. 

Genetic testing isn’t new to our family. Heather was tested for the BRCA mutation years ago as was her Grandmother while she was still alive. Fast forward to last year, I myself was tested (via 23andMe) in search for explanations regarding my own health. I learned a few things related to my own health, such as a genetic variant in the MTHFR gene which won’t allow my body to process folic acid the same way “normal” people do. But I digress. 

This isn’t just a test for how my body metabolizes a B Vitamin. We’re talking about looking for a predisposition to deadly disease. I must admit that I’m a little nervous. However, I’ve always preferred knowing. I’m the guy who would rather people be honest and upfront with me now, even if potentially difficult to accept, to avoid hurt feelings later. I’d rather know, and as the G.I. Joe series told me when I was a kid, “Knowing is half the battle!” Go Joe.

Oddly, the anxiety I have is from what the results means to those around me. My wife has already been through so much. Because she’s positive for the BRCA1 mutation, she already worries about the 50% chance each of our kids carries that same mutation. What happens if I, too, have that mutation?  What about any of the other 30 genes that for which Colors tests? I really don’t want her to stress even more, but I also know she’s happy she found out. And of course, we’ve discussed this, so I’m confident she’ll be okay.

What about telling my kids? Yes, I want to know, but do I share my results with our children? They already have some burden knowing that they have increased risk. At 10, 12 and 14 years old, are they ready for the additional weight on their little shoulders of knowing there could be others? We’ve asked about BRCA and whether they would want to know, and when. Two of them want to know. One, the youngest, doesn’t want to know her own results. The good news is that they are all willing to talk about it. At least we’re talking about it.

Then there’s my only sibling; my brother. Obviously he potentially carries any mutation or variant that I carry since it would have been passed from one of our parents, and he also has three kids of his own. The weight of this decision spreads across the branches of the family tree. 

Lastly, something my wife hasn’t experienced herself as her parents died many years before genetic testing was available; the guilt my parents could carry from knowing it’s passed from them. Not that they should feel guilty, of course. It’s nobody’s fault. If we worry about passing on “broken” genes we’ll stop populating Earth altogether. Probably not a good choice. However, I already know that it’s difficult to know that my son has the same MTHFR variant as me, and I can’t help but feel some responsibility. 

Occasionally this Winston Churchill quote surfaces;

“The truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is.”  

It means we can’t deny truth, whether we choose to know it or not. Facts don’t discriminate. Sometimes we fool ourselves into thinking ignorance is bliss, but the fact is that ignorance can harm, or even kill us. 

Truth empowers us. It allows us to take meaningful action, even if at first it hurts.

Heather and I made the decision to KNOW all those years ago so that she could do everything in her power to live a long  life with our kids, something her mom and dad were denied. I’m sure that they would have done exactly what Heather has done; they would have taken every measure available to them to extend their own lives. It goes without saying that Heather wants to be there for every graduation ceremony, wedding, and someday the birth of our grandchildren. So do I. And if I can be given information on how to increase those odds, I’m game. 

Another important thing for me, and my advice to anybody making these choices, is to seek genetic counseling. As I read the Color Genomics consent form this morning (I know, who ACTUALLY reads those?), I noted that they offer genetic counseling at no extra cost. This is a huge bonus in my opinion. My doctor provides great counsel in the context of how we can use it to holistically address my health, but I will absolutely contact Color and take advantage of that genetic counseling service. Our BRCA journey started with an amazing team of counselors and physicians from Huntsman Cancer Institute in Salt Lake City, Utah. The team there, over 13 years ago now, set the stage for taking an informed approach to all we do. They helped us navigate considerations that we hadn’t thought about. These thought provoking discussions have helped us better manage our own expectations and those of our loved ones. 

So for now I’ll wait for my results and consider these questions with my wife. Until then, I’ll be satisfied that “knowing” is in my future, and for me, knowing is half the battle. 

Losing My Mother, Previving For My Children

Thank you to Grey Genetics and Patient Stories for having me on to discuss my journey with BRCA and surgery, but more importantly, for allowing me to discuss my children, who were/are a big part of all the decisions I made along the way.

Please click the image below to hear this podcast.

Show notes from Grey Genetics

At just 13, Heather lost her mother to breast cancer. Fifteen years later, a mother herself, Heather had genetic testing done and learned that she carried a mutation in a BRCA gene. Heather shares her experience as a previvor–from genetic counseling to finding the right doctors to her continued involvement in the BRCA community and the many changes she’s witnessed since she was tested in 2005.

Interview Reference Points: 

Heather learns that she carries a BRCA1 mutation @ 1:20

Making major medical decisions and finding the right doctors @ 7:54

Heather’s children’s books @ 19:59

Heather remembers her mother @ 22:19

Heather’s surveillance today and memories of scanxiety @ 27:24

The Breast Advocate app @ 29:14

Life after an oophorectomy @ 31:30 

Heather’s children’s and their BRCA risks @ 36:07

BRCA resources: then and now and the shift toward shared decision making @ 41:00

Heather’s advice to individuals considering genetic testing @ 43:35

Heather’s advice to individuals looking for the right doctors @ 45:08

My BRCA Story (Heather’s blog)

Heather on Twitter: @expattravelmom

Heather on Facebook

Beyond The Pink Moon Facebook Group

The Breast Advocate app

Breast Reconstruction Resources:

Terri Coutee on Twitter: @6state

The Diep C Foundation

The Diep C Journey Facebook Group

Heather’s books on Amazon:

Why is Mommy Having Surgery? She Looks OK to Me: For families with BRCA risk and undergoing prophylactic surgery and implant reconstruction

This Much I Know

Long Term Surveillance...Yes or No

This past week, I was fortunate enough to be asked to sit down for an interview and discuss BRCA as an expat.  One of the questions I was asked focused on the choices out there for women who find out they are BRCA+.  The one I always discuss, is the preventive prophylactic mastectomy, because, well, I had one and that was the topic everyone was curious about!  I didn't focus as much on the 10 years I spent doing surveillance due to having babies and being an expat.  But I feel that needs just as much discussion these days, because there are a lot of women out there who want nothing to do with surgery...just yet.

I look back, and I think about how crazy it is that I went through all this testing and getting my BRCA+ results before the Angelina Jolie Effect.  I had nothing to read online, no one to guide me and certainly no one to see photos of who had had a mastectomy and direct to implant surgery.  What I did have was a great team of doctors and a genetic counselor at Huntsman Cancer Institute in Utah, who were able to talk to me about my options at the time.  

Because I had just had a baby when I got my results, and I fell pregnant again, it was recommended to delay any surgeries for a while, and because I was breast feeding, even my mammograms and MRIs would be delayed.  That was the hardest part for me.  I knew for sure that I was BRCA+, but I still couldn't do anything about it.  I honestly would have had the surgery that day if I could have.  I was on self breast exam surveillance mode, and as soon as I could, I'd begin alternating MRIs and mammograms every six months.

Photo from Pixaby

I finally had my first mammogram in 2007, 2 years after learning I was BRCA+.  That was a long time to keep wondering, will I get cancer before I try to prevent it?  I was done breastfeeding my second child and I hadn't yet fallen pregnant with my third.  I held my breath before, during and after as I waited for results.  Luckily, it was negative.  After my third child was born and I was done breastfeeding, I had my first MRI, in 2009.  I hated every minute of it, and wished more than anything that I would never have to have another one again.  That began my surveillance, on a regular six month cycle, for the next six years.  Why did it take me six more years to finally have surgery?  Because we decided to pick up the family and move to the United Arab Emirates for a teaching position in 2010.

So, there we were, plopping down in the middle of the desert, and the first task I had was to find a new medical team, let alone, how to get a mammogram or MRI under my new, foreign insurance.  It took A LOT of talking, A LOT of doctors offices, and A LOT of panic.  I was an anomaly.  Doctors in the Middle East didn't have much experience with BRCA in 2010.  They honestly didn't know what to do with me.  

Thankfully, persistence paid off, as I found Tawam Hospital in the Emirate of Al Ain, a partner of Johns Hopkins.  Finally, people who knew what I needed.  They set me up on my six month schedule of MRIs and mammograms, and actually told me NOT to have reconstruction surgery in the UAE, as they just weren't proficient in it yet.  I couldn't go back to the States for it, due to insurance, so surveillance it was.  I continued my six month routine, holding my breath before, during and after every scan, developing scanxiety, and just worrying more and more that I was playing with fire.  Would I develop cancer before I could actually do something about it?  It wasn't a way to live.

I felt like a clock was ticking as entered my 30s.  My mother and grandmother were diagnosed by 40.  I was getting closer and closer to that age with each passing year and each passing scan.  From 2010-2014, I lived in the UAE and had no choices for preventive surgery.  But, in 2014, we moved once again, to Singapore.  I found a doctor who referred me to my first MRI and mammogram in Singapore.  Unfortunately, it was my first abnormal scan, they found a cyst.  All that went through my mind was how I waited too long and I shouldn't have done surveillance for so long.  I should have been more proactive.  As I discussed the results of the scan with the doctor, her response was to do a lumpectomy or watch it for six months to see what happens.  WHAT?  I'm BRCA+ and you want to "sit on it"!  I was out of there and began a furious search for an expat doctor.

It was here that I met a phenomenal expat doctor who trained in genetics and oncology at UCLA.  We discussed my recent scan and my history, and he was shocked that I had lasted this long with surveillance.  He was putting wheels in motion after our first meeting.  Luckily, my husband's new insurance covered me in the States, and I could pick the doctor of my dreams and have the surgery I had been waiting for after 10 years.  In 2015, my six month scans were over, and I had my preventive prophylactic mastectomy.

Surveillance isn't for everyone.  As I mentioned earlier, I wished I'd had my surgery right away.  Those 10 years were awful for me.  I hated wondering and not knowing.  I hated taking that risk of waiting.  It's an internal conversation you need to have with yourself, but also with your genetic counselor and doctor.  Do what's right for your situation.  If you have questions and are wondering about how to navigate all this information, please download The Breast Advocate app.

Three Year Checkup After Mastectomy and Reconstruction

On Saturday, March 17th, the day of Irish luck, I had my three year post mastectomy and reconstruction scans.  While my surgery wasn't until the month of June of 2015, I felt like I needed to get my check up slightly early due to some pain and burning sensations I've been having in my chest.  So, I was lined up for the fully gamut of tests...MRI, mammogram and ultrasound.  Enter stress and anxiety.

MRI

Let's flashback to 2013, which was my last MRI I thought I'd ever have, ever.  It was the beginning of the end when it comes to anxiety and claustrophobia.  I'd had MRI's before, as part of my surveillance, but something about this one was different.  I have no idea why I began to panic inside the tunnels.  Not sure if it was the constant clanking and banging noises, if it was because I was face down and couldn't see for so long, or if I was just plain scared, but I panicked during that one, unable to continue, stopping the scan early, and that was the end of them, or so I thought.  

I'm now 3 years post mastectomy and reconstruction, so it is needed to check on residual tissue as well as the implant integrity.  This time, I took a Xanax 30 minutes before entering the tunnel.  I was positioned and ready in the tunnel, where they then inserted the port for the dye, since I have a high fear of needles.  Well, apparently my vein jumped and she missed, causing a lot of pain, and a mess.  She then tried for my arm, not before saying "you have impossible veins."  Thanks lady.  Way to soothe me.  Anyway, port in, I'm in, we're ready.  I did my breathing exercises while in there, in through the nose, out through the mouth, over and over and over.  I'd feel the panic creep up, and go back to focusing on my breathing.  "Now we're injecting the dye so the next 5-10 min are really important that you don't move."  That did it, I felt trapped.  I had had enough of the banging, clanking and noises, enough of the sensation of dye being released, and my breast bone was killing me.  I was wiggling my toes, I was playing with the panic button in my hand, and I was about to explode.  Just as I grabbed the button to press and end it all, the 45 minute session was done.  

I don't think I'll ever get used to an MRI machine.

 

Mammogram

After the MRI, they walked me to the mammogram room, where I was informed that instead of the normal four images, I would be having eight.  Apparently, once you have implants, you have an additional four which are called 'pinching' images.  This is part of the American Cancer Society's recommended procedure.  Several views must be taken to see both the implant and the tissue.  So, the first four are what you're used to, regular squeeze, two angles on each breast.  

The pinch is different.  They literally squeeze the tissue, pushing the implant back and getting as much tissue forward as possible for the scan, and then take an image of just the tissue.  Imaging can only see 75% of your tissue with an implant in place, so 25% is nearly impossible to see...therefore the pinch.  I will say, the regular image hurt more than the pinching, and overall, I felt more discomfort with these images with implants than without.  

http://www.imaginis.com/mammography/
breast-implant-imaging

http://www.imaginis.com/mammography/
breast-implant-imaging

Ultrasound

After the mammogram, it was time for the ultrasound.  My last ultrasound is the entire reason I finally stopped putting off surgery and ran straight to the doctor for a surgical appointment.  Remember, I was diagnosed with BRCA1 in 2005, but due to having children and moving Internationally, there was never a time or a doctor where I was, where the reconstruction part of the surgery could happen.  In 2015, I went in for my routine mammogram and ultrasound, but this time, they made me wait in the waiting room...for a long time.  They finally said they wanted me to see a breast specialist that day as they found a cyst of some sort.  

Now, where I am, preventive mastectomy is not practiced, it's radical.  So, they opt for a lumpectomy and surveillance.  Yeah, not for me, no more, not happening...off to surgery I go.  I went back to the States for surgery.  I was never going to feel that way again...except, well, at March 17th's appointment.  There I was again, same exact room, lying on the bed, praying and hoping all would be fine.  I don't think anyone can ever truly explain the fears and worry we have going through this for most of our lives.  I started mammograms and ultrasounds in 2005....holding my breath every six months, wondering when I'd hear the C word.  I don't think it ever goes away, as it's now 2018, and I'm just as panicked, even with surgery having happened.

The right breast scan took a long time, and she hovered over one area for a very long time, taking still shots and showing the thermal spots.  She hopped over to the left breast, was done VERY quickly, but went back to the right breast.  At this moment, I really started to worry.  She was taking measurements, taking more still photos and staying in the same spot.  Now my pessimistic side appeared.  I just lay there calmly, thinking she'd say something to me, and after last time, surely they would.  But nothing.  When I asked, she simply said the doctor needs to read it.  

It's now two days later, the 19th, and I'm still waiting for results.  All I can think of is that if it was serious, they wouldn't make me wait this long, right?  

I'll be back with an update as soon as I hear, but for now, send all the good juju vibes you can.

Results are in!

I just got the scans back and they are normal.  There are no sinister or suspicious findings.  3 small right benign breast nodules on ultrasound - all normal.  MRI is normal.

Breast Advocate App

As a patient advocate and a Previvor, I'm so excited to be a part of this announcement of the Breast Advocate App.  

From https://breastadvocateapp.com/

Back in 2004, I had VERY limited options for connecting to research, people and options when I received by BRCA1+ results.  I didn't have the luxury of being able to reach out to an extensive group of doctors and women to ask questions, seek opinions and benefit from shared decision making.  I lacked the knowledge and feeling of empowerment I needed.  I think that is why I waited so long to make any decisions about my high risk surgeries.

In 2013, I joined a group on Facebook called Beyond the Pink Moon, which was, at the time, an International private support group for women who are high risk, Previvors, Survivors and supporters.  The group was amazing in sharing stories, supporting each other and sharing some research based evidence.  It was in this group that I finally found the doctor I'd use for my surgery, because of how many people were talking about his work and their satisfaction.  That was exactly what I needed. 

Fast forward to 2015, when I was finally planning my surgery.  Beyond the Pink Moon had grown into an all encompassing network of patients, supporters and medical professionals, all working together to help anyone and everyone make the best decisions for themselves.  At the same time, my Twitter network was growing and growing, connecting more patients, supporters and medical professionals.  The "Shared Decision Making" network was amazing and becoming a norm, quickly.  No longer were people stuck with one doctor making all the calls and leaving patients with no other information, references, options or input.  It was increasingly evident that patients needed each other, they needed to ask questions from multiple sources and they needed to come to decisions with all the information possible.

Now, I'm so happy to say, that the answer to my one wish during all of this, is coming to fruition.  An App is in development, where everyone can get research based evidence, surgery and reconstruction information and options, expert input from a network of highly regarded doctors (including my very own Dr. Chrysopoulo), and a support network of other people walking in your shoes, no matter what part of the journey you're on.  The amazing part, is while this App is in Beta, YOU have a voice.  Sign up and tell them what YOU want in an App. What would have or will help you in your journey?  This App wants to be the resource for connecting our large community and allowing patients to feel empowered with knowledge and resources, no matter what decision they make.

 from https://breastadvocateapp.com/

Please share this news with anyone and everyone who has been searching for more information, support and community in what can be a very difficult and lonely journey.  

2 Years Post Bilateral Mastectomy and Reconstruction

I'm calm.

That's all I can really say.  The past two years have given me a calmness I haven't known since my mother was diagnosed with breast cancer when I was a child.  I always had that fear of the unknown in my head.  I was always thinking of myself as a ticking time bomb, just waiting for the diagnosis.  Because, lets be real, once you have a grandmother and mother go through the breast cancer diagnosis, and you get his with the confirmation that you carry the BRCA1 gene, how could you not?

So fast forward two years from my surgery, and I no longer fear anything with my health.  I made it through my 40th birthday with the biggest sigh of relief, as it was just after my mom's 40th that she was diagnosed.  I don't have to go to appointments every six months for MRIs and mammograms.  I'm "normal".

As for my implants, I haven't had any issues since the "lump" I had in my last update.  It was just surgical scaring.  But lets be real, when you're in a position like mine, you react quickly and get EVERYTHING checked out.  I was relieved to know that my lump was nothing to worry about and I could continue moving on.

The implants themselves look great.  You can't see my scar as its so well hidden underneath the breast, and they feel great.  They look like they did when I was younger, before having kids, not like having implants.  I have no more pain, no more nerve twinges and I even got some feeling back in areas that I thought would be numb forever.  Now don't get me wrong, there are still numb areas, but I'm just happy its not all of it.

Feeling great and traveling the world with a new view of life.

I know there are so many options these days for reconstruction...you just have to pick the option that works best for you.  If you'd like more information about DIEP surgery, using your own tissue instead of implants, please visit my friend's page, DIEP C Foundation.  She has a wealth of information.  Also, reach out to any of the doctors at PRMA, mine being Dr. C, as they truly are miracle workers and family for life.

As for reconstruction updates, I think this is it!  Two years out, doing great!  If anything changes, I'll be back, and if you have questions at any point, please feel free to reach out.  I'm always here, even if I'm not updating on my mastectomy.  Make sure you check out my oophorectomy posts if you feel that you're going down that road as well.

Lots of love.

Heather

9 Months Post Oophorectomy

It's been a while since I've updated on either my breast reconstruction or my oophorectomy, but figured now is as good a time as any.  I'm starting with my oophorectomy update, as it's been the most life changing.  And since I'm sitting here getting reflexology, I'm nice and calm which puts me in a good mindset for this discussion.

Which One is Harder?

Everyone seems to think the breast reconstruction would be the harder of the two to go through.  I'll give you this...surgery wise, yes, it's a complicated and long one.  Immediate healing and recovery, yes, it takes months to feel healed.  Long term effects...for me, no, the reconstruction was over and done.  But I'm still in the thick of oophorectomy healing nine months later.  The oophorectomy wins as being harder...physically and emotionally.  The effects have been far more difficult for me to deal with on a day to day basis than the mastectomy.

I was very upfront in my previous posts about the oophorectomy preparation and the first couple weeks after the operation.  But then I stopped writing.  I was having a very hard time with all of the changes that were happening to me and didn't feel it was the right time to write through those emotions.  But after time has passed, I'm realizing I might never feel like I used to, and it's time to accept it and let others know just in case someone else feels like I did...do.  

I took extended leave to start.  Originally, I requested a couple weeks, but when it was time to go back to work, I couldn't.  I was having anxiety attacks, couldn't handle the hot flashes and my belly button wasn't healing.  I extended my time off by another week, just to try and settle everything and deal with my emotions.  With my mastectomy, I knew I had the 8-10 weeks I needed for healing, and truth be told, I was in Bali in week 6, so recovery was great.  The first thing with the oophorectomy I had to acknowledge were the hot flashes, then I could figure out the other things happening in this new body of mine.

Hot Flashes

I'm going to do my best to explain how they feel, to me.  For someone who has recently been told, in the last year, that I suffer from claustrophobia, the hot flashes actually made me feel trapped in a way, temporarily, and cause great anxiety.  First, I feel nausea.  Like I'm going to be sick.  This is when my brain starts saying, "no, no, no," and I get uneasy.  But after maybe 30-45 seconds, when my heart begins racing, I realize it's a hot flash coming.  The nausea subsides and I start feeling this warmth radiating through my core, up and into my chest/arms/neck, then finally into the head.  My body glistens and this lasts for about 3-5 minutes.  I grab anything near me to fan myself through to the end. I don't feel any cold air around me, even if the AC is cranked and the fan is blowing on me.   And then, it goes away.  This happens 8-10 times during waking hours.  I don't know why I even bother putting makeup on as I wipe it off with each dab of sweat with my Kleenex.  My daughter once went to lie on my in the midst of a hot flash, and as soon as she put her head on me, she exclaimed, "mommy, you're hot!"

Other Side Effects 

Another side effect of the surgery is the weight gain.  I wasn't aware of this one.  But I can't fit into any pants I wore pre-surgery.  Nine months later, eating healthier and quitting alcohol consumption during the week, I still can't get into my pants.  Luckily, we don't have winter here in Singapore, so I can live in my dresses and skirts, but honestly, nothing else has changed, so hormones are definitely to blame.  It sounds petty to be so concerned about this after everything I've gone through, but it weighs in (no pun intended) in the back of my mind every morning I get dressed.

Skin elasticity, tone and increased overall skin pain is another strange side effect I'm dealing with.  I noticed over the first few months after surgery that my skin gradually started losing it's shine and tone.  It was looking more like my grandmother's skin than my own.  And then massages started to hurt, both in the layers under the skin and on the surface.  My skin was sensitive.  Of course I still get massages, but I grimace through certain areas of my body being touched.

Sleep?  I was the queen of sleeping, ask my husband.  I could nap 2 hours then sleep a full 10 hours at night, no problem.  I loved sleep.  I could have married sleep. But almost immediately after surgery, I had lost the ability to fall asleep, let alone stay asleep.  If I was lucky enough to fall asleep, the hot flashes would wake me instantly.  So, I now take half a Unisom nightly just to get me through the night.  Not a great way to live by any means, but a good night's sleep really is important for the body in so many ways.

Leg Cramps have been awful.  I will just bend my toes slightly, and my foot goes into spasm.  In bed, if I stretch too much, immediate cramping surges through my legs.  I jump out of bed at night, walking around the dark room, silently  wincing at the pain I'm going through so as not to wake up my husband.

Lastly, and it has to be discussed if we're going to be honest, is libido.  It went out the window, never to return in the past 9 months since surgery.  And not just libido, your body stops producing any sort of moisture at all.  It sucks, and I'm not going to lie, be embarrassed nor sugarcoat this one.  You must be fully aware that this might happen and you need to prepare your spouse or partner for the possibility. I don't think this is something easily discussed and it can really affect a woman's self-perception, as well as the relationship.

So, it's quite a list of things I now deal with on a daily basis.  All this because I traded the uncertainty of my future for peace of mind that I'd be around for my kids.  I don't regret that at all.  But why grant myself this peace and longevity if it was going to leave me miserable?  That's not right either.  It's about quality of life and I want to enjoy mine. This leads me into the hot and often volatile topic of HRT.

HRT

About a month ago, I finally decided enough is enough.  I was tired of menopause making me feel miserable, and quite frankly, old.  I went to my team of doctors for help, and three out of four said HRT would be totally fine.  They brought up research articles in the offices, they took my blood to check how I was doing since surgeries, they ran ultrasounds, did fat analysis, etc., and concluded...it was ok.  I walked out of one doctor's office with my progesterone pill and estrogen cream and felt good about it.  

However, that bag with the prescriptions has sat there untouched for the past month, haunting me.  I was nervous.  What if it was the wrong decision?  Would everything I've done be reversed all in vain?  I was listening to the devil on my shoulder as well as the many believers of the 'no HRT' camp, telling me not to do it.  But what about the other camp?  You've got to read both books and make an educated decision.

A month later, yesterday, I had yet another appointment and this time, I got clarity.  The most recent article shown to me being from August 2016, approving HRT to people like me...no cancer history but BRCA+.  I just had to dive in and make a decision.  So, tonight I did it.  I took my first pill and my dose of estrogen cream.  It feels weird to make this decision, but I'm also hoping and praying for the best.  I know I'll always have nay-sayers, but who doesn't?  No one can really tell me what's best for me, but me.

Ongoing Journal Updates

• Three days after starting HRT, I noticed my hot flashes were getting better.  I went from 8-10 a day, to around 5.

• Five days after starting HRT, my legs cramps are gone.  I can stretch to my hearts content without spasms.

• Six days later, I'm an emotional wreck.  I fear this one because I have to be very careful that I'm not slipping into depression.  Everything is making me cry and I'm feeling quite alone.  I know this is the hormones, because for the last 9 months, I've barely shed a tear since the estrogen was removed from my body.  

Two Weeks Post Oophorectomy

"Its as if you woke up!"

This is what my husband says about me now, ever since the surgery.

I've got this lack of sleep thing happening still.  It's technically 17 days post-op, but close enough, and I can't sleep.  Really, its awful.  If I weren't to take any supplements or meds, I'd probably stay wide awake till midnight or 1am!  With Unisom or Xanax, I can sleep off and on through the night, waking only 3-4 times to hot flashes.  But because my doctor doesn't think either of those are good options long term, she had two mixtures made for me.  I picked them up two days ago, so I've only had two nights taking them.  You can see the labels below to get an idea of the strength and what's in them.

For the melatonin, I'm taking 10 drops under the tongue for two weeks, I'll then go down to 5 drops for as long as I need.  Melatonin is completely safe, so she feels this is the best option.  However, she did warn me of one thing...vivid dreaming for the first few nights.  Well, lets break down night one and night two thus far.

Night 1:
I took the pills right after dinner, and the melatonin 30 minutes to bed time (I was shooting for a 9:00 bedtime because I'm really so very tired.)  It took me a while to fall asleep, and once I did, I was up again about 20 minutes later.  This persisted ALL NIGHT LONG.  I think I watched the clock go through every hour.  And because I wasn't sleeping, I was feeling every single hot flash.  My arms are getting stronger from tossing the covers off and pulling them on all night.  Needless to say, the next morning I felt like I was hit by a truck, suffering from overall exhaustion.

Night 2:
I took the pills after dinner, and the melatonin 30 minutes to bed time.  I was up off and on from 9-1am.  But come 1am, I was able to sleep pretty soundly, only waking maybe 4 times to hot flashes, till 6am.  The strangest part was how vivid my dreams were.  Wow!  I woke up and told my husband everything.  I feel so-so today as I'm still very tired and not getting my normal amount of sleep.  The lack of sleep is also causing me to be pretty weepy.  Tears right behind my eyeballs at all times.  I'm supposed to give it two more nights for my brain to figure out this melatonin thing and learn how to sleep again, and the dreams should calm down and I should begin sleeping better and better.

Some may wonder why this is such a big deal, this sleep thing.  My doctor is concerned not only for my overall health and sanity, but because this is nothing like pre-surgery, when I was a sleeper.  I'm a natural born sleeper.  Doctors have tested me all my life for anemia because I sleep so much.  Whether as a little kid, in high school, in college or later...I sleep.  I can sleep for 9-10 hours at night, and still take an hour nap during the day.  I love sleep.  I really, really miss sleep.  What's happening now is not me.  However, my husband loves it as he finally has a partner with which to watch movies and late night TV.

Other than the sleep, everything is pretty ok.  My scars have healed beautifully, my stitches have fallen out, my tenderness is getting much better and my overall health is great.  I'm now on constant monitoring though, with more frequent check ups to make sure my heart stays healthy (higher risk for heart problems), my cholesterol sorts itself out and my bones remain as strong as possible.

Day 10 Post Oophorectomy

Rather than the day by day play at this point, I figured it was ok to let a few days go by before filling you in again.  So, here I am, in my normal writing spot (my bed), ready to fill in you in on the last five days since we last chatted.

I ended up having a second follow up appointment yesterday, as there are some things we're still working out since the surgery.  The number one thing is the fact that I was once a HUGE sleeper, naturally.  Now, I don't get tired.  Seriously, at 11pm I'm asking my husband, "ok, what movie should we watch next?"  This is a problem as it has totally altered my daily norm, including my ability to feel rested and well healed.  My doctor feels this is a problem too, for the exact same reasons.  We've decided to work on this side effect from surgery first.  As we speak, a compound pharmacy is concocting a mixture of a higher dose of melatonin mixed with some tryptophan...yes, turkey sleepy juice.  I will start with 10 drops under the tongue each night and then ween to 5.  I can take it for as long as I want, if it works.  No side effects.  I was going to go on Effexor, but after reading all the negative side effects, I decided to start with this and give it a try.  I'll let you know how it goes.

I've been out and about three times, and all three times were full on long days of walking and being out with the family.  I noticed that about two hours in, my abdomen begins to ache and I'm reminded that I actually had things cut and removed from inside my body while all I focus on are the incisions on the outside which seem to minor.  The scars looks GREAT!  Pin pricks really.  They are very tender though, and as clothes rub on them and I bend and stretch, they get agitated and everything aches.  My fear right now is getting bumped or hit in the stomach...I'm a school teacher.

I've had some major hot flash attacks occur, which has lead me into my second obstacle throughout recovery...anxiety.  Somewhere within the past two years, I've had about ten to fifteen incidences of what I call, panic attacks.  These same feeling are also happening during some of my hot flashes.  After a long discussion with my doctor, she has identified me as having claustrophobia.  My first experience was in an MRI machine 1/2 way into my 45 min. scan a couple years ago.  Apparently, according to my doctor, the major hot flashes I have every so often, put my body into the same exact feeling I get when I have a claustrophobic attack, and my mind therefore reacts the same...I want out.  This has been hard to deal with, but for now, I'm trying to deal with this med free.  As of now, my doctor has given me a full month of recovery time off work, I'm in week two.  I think I'll only last a third week off, and I'll want to go back to work from sheer boredom already.

Other things to note at this time:

Sleep:
Still not sleeping without the assistance of Unisom or Xanax.  A compound pharmacy is making me a strong dose of melatonin and tryptophan as we speak.  I'll let you know how this works.

Pain Killers:
No pain killers, not even Panadol, for the past five days.  The pain isn't bad enough, just achy and tender.

Hot Flashes:
Well, as you read above, I am having them, and they do wake me up when I've finally managed to fall asleep.  I have purchased a recommended product called a cool pillow.  I used it last night, and yes, it did make a difference in my head temperature, but my lower body still got hot, obviously.  However, it was nice to have the coolness against my face.  I really need to work on the panic attacks during these flashes.  I'm constantly throwing the covers off and on throughout the night, so I know my sleep is interrupted no matter what.

Crying:
I don't cry regularly by any means, but I can feel that I am very emotional and if the right thing was said, I'd cry right then and there.  

Physical:
Feeling ok.  Able to go out for a day at a time here and there, although the next day I'm totally exhausted.  Bandages were off two days ago, no real pain...just aching.

No HRT?:

Nope, no HRT for now.  We did talk about the possibility of the progesterone cream if my hot flashes don't work themselves out in the next couple weeks.

Bleeding:
Still bleeding, but doctor says its normal.  It's more of a pain in the butt right now.

Thank You 2015, For Saving My Life

2015.

I could say this was the worst year of my life.

I could say I want to put this all behind me and forget about it.

I could say so long 2015, bring on 2016.

I could say "why me?"

But I won't.  Instead, I will say thank you to 2015.

This year has happened for a reason.  This year makes me, me.  This year is an important marker in my life...and important year in my dash.  On March 3, 2015, I blogged for the first time on this site, when I truly began my journey of healing and saving my life.  I had finally made the decision to have a preventive mastectomy with reconstruction in June 2015, ten years after finding out I was BRCA1 positive.  It was Thanksgiving Day, 2014, when I received my first abnormal mammogram, and I was tired of playing it safe through screenings.  I wanted more assurance, I wanted to rid myself of the possibility of cancer.  I wanted to focus on living, not live in fear of dying.

My mastectomy journey was actually a beautiful one.  I was connected to the most wonderful team at PRMA in San Antonio, Texas, including Patient Liaison Courtney, Nurse Denise and the amazing Dr. Chrysopoulo...all friends still today.  This is my dream team who supported me before, during and after surgery.  My friends who are still here today, checking in on me, sharing new studies of information and who are truly invested in me as a patient.  They helped make Wonder Woman possible, because even Wonder Woman needs a dream team.

I did it for her.

Choosing a mastectomy wasn't easy, nor did it come lightly.  I researched a lot, blogged a lot and had a huge support system from friends and my online community.  It was a long road to recovery, it required a lot of strength and positivity (as much as possible) and it was the best decision I ever made.  I had made the choice to save my life and it was the right one for me.  I went from an 85% chance of breast cancer to 1-2%.  My fears of getting breast cancer are gone.  My fears of having my children watch their mother suffer, like I did mine, are gone.  My fears in general...are gone.  And in return, I was fortunate enough to have an amazing microsurgeon take away my mutations and give me my beautiful womanly body back, all while I was sleeping for what seemed a short moment in time.

My recovery and my blogging from my mastectomy turned into a blessing.  My voice reached far, letters and words of support poured in daily, women confused turned to me asking for advice...and three bucket list items happened within the next few months of recovery.  1.  I published a book based on my own experiences with my mom.  2.  I was asked to write an article for Parenting.com.  3.  I went to Bali to complete my final healing...physically and mentally.  I'm often called brave.  I don't see it as brave.  I see it as a choice I made and went through with for a brighter ending.  Wonder Woman...I'll take it.  Not because I have super hero powers, but because I made myself wonder just how much I really am capable of doing and how much power I really do have inside.  Anyone can be a Wonder Woman...or any other inspirational character you choose.  Dig deep within and find what makes you happy, feel strong, feel womanly and most importantly, makes you feel like you.

I did it for her too.

In July of this year, I was back in the doctor's office, just over one month after my mastectomy, preparing for my bilateral salpingo-oophorectomy.  I tend to do things all at once, both feet in and jump.  I went from college to post-graduate school to earning my Master's all in sequential years because I just wanted it all done.  I set my sights on a vacation spot, and before my husband can answer the question "do you want to go there?", I've already priced it out and am asking for the credit card.  I get an idea and I go for it.  I'm a doer, so it really didn't surprise anyone that I decided to have my oophorectomy within the same year as my mastectomy.  Let's face it, I was turning 39 in November of this year.  How cool would my 40th birthday be, in 2016, knowing all of this was behind me?  So, in for the pre-op appointment I went, learning all about my next steps.

While my oophorectomy would be done laparoscopically, requiring a mere two weeks recovery vs. the six to eight for the mastectomy, I was more nervous about this one...even in recovery.  While I would yet again be in great hands with the wonderful Dr. Dharshini, there were so many more side effects from this surgery which could affect me for the rest of my life; Heart disease, lung cancer, calcium deficiency, hot flashes, dementia...just to name a few.  But I had to have faith that once again, I'd be reducing my chances of ovarian cancer, from a whopping 50% to 1-2%.  Those mutated genes would once again, be defeated.

And I did it for them.

Three days ago, four days before 2016, I had my oophorectomy and everything went textbook, so I'm told.  I left the hospital the next day, am able to walk as much as I want, have minimal pain (despite the gas) and am very thankful for the opportunities that exist for women like me.  Yes, there are many other things I'm going through as side effects to the surgery that cause me tears today, but let me focus, while I can, on the blessing the surgery has given me.  I'm alive, I'm here for my husband and children and I will be for a long time.  Now, after two surgeries, I've done all that I can to save my life from BRCA1.  I have defeated it.  I can finally breathe.  I can exhale.  I can live.

So, here I sit, in my living room on New Year's Eve, looking at my three beautiful children, and I find peace in 2015.  I made MANY new friends, I accomplished things I only dreamed of, I found peace with my past and I'm now thankful for my future.  I send strength to all of my lovelies out there who are searching for answers, facing their struggles and looking for comfort or peace.  A warm hug from me to you for 2016.

Day 3 Post Oophorectomy

Not horrible, but not great.  This is a long one...settle in.

Yes, my dears, there are ups and downs in this journey.  The ups are when you think you're having a good day, you feel good, you're experiencing little to no pain, you can get on with your normal daily routine and you're happy you've taken the steps towards a healthier future...getting rid of the mutated genes you inherited.  It's what I call my Wonder Woman days, and I'm very thankful for them.  This surgery was definitely, hands down, easier than my mastectomy.

The downs are everything else...the moments in between the ups, the moments most of our friends and family don't know about because we keep it inside or we turn to our community of like women going through the same thing because they'll understand.  The downs can make you cry in an instant, can leave you foggy minded and can leave you feeling alone and asking "why?".  These are the days that make me feel weak and question just how strong I am.  I hate these days.  I try to avoid these days, pushing them aside, gathering strength from within to get through them and put on my happy face for my husband and kiddos.

No one can write the perfect recovery book for having a mastectomy with reconstruction or a bilateral salpingo oophorectomy.  We're not the same.  We don't heal the same, feel the same nor even go into the surgeries with the same bodies.  We're all different, and we all need to realize that what we are going through is perfectly fine, for our bodies.  Stop comparing yourself to others and their glorious recoveries if you think you're not having one.  There's no rhyme or reason to it.  It's like labor and birth...some go to plan, some don't.  Some women wear their pre-pregnancy clothes home from the hospital, some wear maternity clothes for months after.  Some have postpartum depression, some don't.  But each journey is unique, and again, there's no perfect book.  I read through blogs, picked and chose experiences that are like mine, felt some relief that someone else out there experienced the same as me and felt somewhat normal again.

But Angelina did it.  Angelina had the "perfect" mastectomy and reconstruction experience and the "perfect" oophorectomy.  She was back to work quickly, looks amazing and photographed beautifully throughout.  Is that what we're holding ourselves up to?  The idea of perfection?  It's actually been said to me, several times, by many people..."Angelina did it, so can you."  What does that even mean?  I rack my brain to figure out how that comparison or those words even begin to help someone like me in my position.  It's fine to say, "hey, you're having the same surgery as Angelina," because people then get it due to all the media coverage.  But to say I can do it because she did?  That's where we begin holding ourselves up to other's standards.  I'll guarantee she cried at some points.  I'll guarantee she felt weak in a moment or two.  I'll guarantee she probably even wished she never had to go through any of this at all.

The first two days of my recovery thus far were pretty good, they were up days.  Despite some pain and discomfort from the actual surgery, I was in otherwise good spirits.  I was feeling like everything was going to "plan" as I perused other blogs and stories of recoveries.  I wasn't taking the full dosage of medications prescribed, which had to be a good thing, I was eating, drinking and walking just fine and I just felt good.  Tired, but good.  I even felt well enough to go outside and do something, but I don't walk very quickly at this point, so I wouldn't get too far.  Then, somewhere during the evening last night, things started changing and I started questioning how well I really was doing, acknowledging the hugeness of the situation.  There's things people don't tell you or you won't find on blogs, unless you know exactly what to ask or which key words to type.  I had an idea of what recovery would be like, but these little surprises are happening, ones I wished I'd known about prior so that I would be as mentally prepared as possible.

Night Sweats:

Last night, for the first time, I woke up several times, sweating.  I was so hot, uncomfortably hot, and I couldn't seem to get regulated.  The sheets came off, the fan was pointed right at me and my hair went up into a ponytail.  My insides were hot...if that makes any sense.  It wasn't the air around me, it was me, but different than having a fever.  I wanted nothing touching me or on me.  I didn't know this happened.  I understand that hot flashes are part of the deal now, but when you've never had one, and you don't know what to expect when you do, its kinda scary and uncomfortable.

Gas:

I've touched on this a few times, but not once was I told about this prior to surgery.  It is horribly painful.  I'm on day 3 now, and its beginning to subside, but the gas hurts more than anything.  There's a bunch of gas pumped into you and it has nowhere to escape anytime soon.  It slowly gets passed or absorbed into your tissue, but the process is long and slow.  Since its trapped, its pushing, causing pressure on your ribs and your shoulders.  The shoulders hurt the absolute worst.  You feel like you want an intense massage but that doesn't do anything as its the gas inside, not your actual muscles.  I have been using Gas-X (must do) and a combination of heating pads and heat strips to at least try and ease the pain.  Its getting better, but have some meds on hand for this.

Spotting/Bleeding:

Ok, I just had my ovaries removed and completed my last period, so why in the heck am I spotting?  Yep, another thing I wasn't told about and didn't know would happen.  In the hospital, I was spot free.  Days 1 and 2 after...spot free.  So why, on day 3, am I spotting?  Where in the heck is it coming from?  This is a little scary if you aren't prepared for it or even know it can happen after the surgery.  But yes, you might spot and its ok.  If its more than that, consult your physician to find out what's going on.  Better yet, ask your physician about the possibilities before your surgery so that you're prepared.

Crying:

So, this morning, all I had to do was wake up from sleep and the tears started flowing.  No one had said anything, I hadn't read anything, heck, I wasn't even having bad dreams!  It was simply the act of waking up that sent me into tears.  I felt a bit foggy in the head and just let it all out.  I think this caught my husband off guard, but man he's good when it comes to jumping right in and just being there.  He knew there were no answers he could give me, it was just me and my body trying to make sense of that hour of waking.  Ladies, you have just lost a part of you, a major part of you.  For some, this will be an emotional journey, one no one else can understand until they go through it.  For younger women like us, we've had to do this out of necessity, and in that, we've given up our ability to reproduce, whether we wanted to or not.

Let me tell you, it hit me very hard having my surgery and recovery in the same wing of the hospital as the maternity ward.  Newborns were crying all around me, babies being wheeled in and out of rooms and pregnant bellies being cradled by anxious mommies.  It hit me.  It was surreal.  This was it for me.  I was ending my chances as they were beginning theirs, not that I had any plans of getting pregnant again.  Anyway, who knows why the tears flowed this morning.  Was it hormones already making changes?  Was it the bad night sleep with night sweats freaking me out?  Was it the fear of what I would experience next in the form of side effects?  The crying only lasted a mere ten minutes, but it was definitely something trying to get out.  Acknowledge your feelings.  Let them happen.  You've been through a lot.

Headaches:

I had a pretty bad headache throughout yesterday.  Not sure if it was due to the medicines, the surgery, my anxiety or just being tired, but it ached a lot.  I finally asked my physician if I could take something for it since I was already taking the pain killers.  She suggested some caffeine.  Here I was, trying to be a very good girl, caffeine free, and its exactly what I needed.  A little caffeine and my headache was gone.  Again, ask your physician if its ok, but I've heard headaches are common during this stage after surgery.

Anxiety:

With my mastectomy, I was prescribed Xanax as a precautionary since dealing with major events like these can cause a lot of anxiety and/or depression.  I was glad I had it.  I experienced moments of fear...fear of pain, fear of recovery, fear of everything...I didn't want to move.  The Xanax allowed me to relax, let my body relax, and just heal.  I noticed yesterday, during a nap I tried taking, that my mind was racing.  I could't settle down, I couldn't just breath my way into dreamland.  I then started psyching myself out, thinking of all the things I had just been through and all the things that could still happen via side-effects of the surgery.  It was time to pull the Xanax out.  I have learned, in talking to some friends in the same position, that Xanax or Zoloft has actually been prescribed to them as part of dealing with menopause symptoms beyond anxiety, such as the hot flashes.  Don't be afraid to ask for a little help to get through this.

Walking:

I'm good to go.  I can stand up for long periods of time, I can walk, albeit slowly, around the house just fine and I can sit on the couch and watch a show with the family.  Again, the pain in centered in the belly button, but only when strained or touched.  Otherwise, I really wouldn't know I had had surgery.  Keep your energy up and allow yourself these walks and being upright.  They will help your recovery and overall spirits.  Vitamin B is a good one to take in the morning to keep your energy up if needed.

Thank you, Facebook, for my word of 2016.  I believe this one.

Sometimes I fear I ask too many questions of my physician, but then I remember, its my first time, not hers.  She's the expert, the one with the answers.  This morning, she sent the most wonderful message to me that helped put me on the right foot for today.  And yes, it made me cry, because yes, I'm now learning to exhale.

"Try to get yourself out of the house and to a park or somewhere open aired with fresh sunlight.  You are so not the cooped up in darkness kinda girl, so being up and about will do you wonders.  Big stuff has happened and passed, the new year will bring so much awesomeness you won't know what to do with it.  You are great, family's great, everybody is healthy and its time to exhale...finally."

Pre-Op Oophorectomy Appointment

Today I got to meet with my amazing gynecologist, Dr. Dharshini, as well as my overall medical doctor, Dr. Tucker, who has been the keeper of all my diagnostic information, magical appointment maker with all the best specialists in town and now my nutrition advocate.  These were the two appointments I had been waiting for with anticipation, as I'd find out the results of some important pre-surgery tests I had done last week, as well as learn all about my surgery and recovery in detail.

Dr. Dharshini...Beacon of Light, Master of Comedic Relief and Extremely Patient!

My first appointment today was with my gynecologist, Dr. Dharshini Gopalakrishnakone, who will be performing my bilateral salpingo oophorectomy (say that five times fast!).  Just Google her and you'll find out just how passionate an advocate she is when it comes to women's healthcare as well as being a mom.  I just love my appointments with Dr. Dharshini as she puts me at ease every time, just by being REAL.  She's human, not robotic, and she has a way of making everything palatable and relatable.  I don't leave feeling like I had a bunch of medical jargon shoved down my throat with zero understanding.  And I'll be honest, we laugh...A LOT.  Don't get me wrong, I take this whole process very seriously, but if I don't laugh, I'll break down into a pool of tears, and that's not going to get me anywhere when I need to pay attention the most.  So, I save the tears for the glass of wine later.

The Surgery

We first talked about the surgery and the proposed plan at this point.  I'll first relay what the ideal surgical scenario is, and then I'll relay what happens in that 1-5% chance something else is wrong.

After being sedated and pumped full of air (to open the abdomen for easier viewing and maneuvering), an incision will be made in the navel which will be the site for removing the fallopian tubes and ovaries.  And additional three small incisions will be made, one below the navel and one on each side of the abdomen.  These will all allow for the microscopic surgery to take place.  During this 1.5 hr surgery, basically the fallopian tubes are cut away from the uterus and the ovaries are separated from their blood flow.  This sounds easy, but its quite delicate being that all of this lies dangerously close to the bladder, bowel and appendix.  While the surgery is taking place, a cross-section will be frozen and sent to the lab for immediate results (looking for abnormal cells).  At the same time as the removal of the fallopian tubes and ovaries, a peritoneal washing will be given as well.  Think of it as a large protective sheet spanning your abdomen, holding back and protecting your uterus and ovaries.  This sheet has potential for carrying cancer cells as well, and thus will be "sprayed off", much like the windshield of your car.

Assuming all goes well and textbook, I'll be stitched up, sent to recovery and left to rest with a night or two in the hospital.  While it's major surgery, I won't have the same limitations as I did after my mastectomy.  I will be limited to 5kg lifting for the first month and no intercourse for six weeks, but other than that, I just need to listen to my body and take my recovery at the pace I feel comfortable.  So, here's hoping for just 1-2 nights in the hospital and a quick recovery at home lasting up to two weeks.

IF something doesn't go right, then things get more complicated.  Remember the frozen section sent off to the lab during the surgery?  That will be analyzed, and in 1% of cases, it comes back showing cancerous cells.  If that happens, I will immediately be opened up vertically down the center of my abdomen, and the uterus, appendix (because of close proximity to the ovaries) and the Omentum (fatty apron) will all be removed, and my recovery goes from 1-2 weeks to 6+ weeks.  Remember, we're praying this does NOT happen.

There are a few other complications which could arrive during surgery and would mean opening me up like a cesarean:

1) If the ovaries are somehow fused to parts of my body and the doctor can't access them well
2) Excessive bleeding during the surgery
3) Perforation of the bladder or bowel

And lastly, a few other complications would be infection or trouble with the gas pumped into the cavity.

The Testing, Before and After

What exactly happens now that I'm in surgery induced menopause?  Well, it all seems pretty simple, for the most part.  In order to prepare for the surgery, I had to have a few tests done to see how my body is performing at this stage, pre-menopause and pre-surgery.  A baseline if you will.  Last week I had three tests done, a blood draw, a bone density scan and a pelvic ultrasound.  Today I received the results of all three which lead to a few extra discussions I didn't think I'd be having.  These results were discussed with both Dr. Dharshini and Dr. Tucker.

The blood test-  There were a few scores that came back higher and lower than we'd like when it comes to overall health.  The one immediately affecting this surgery would be my CA 125 marker (ovarian cancer indicator).  This one came back slightly elevated at 36.5 (normal would be < 35).  We are attributing this to the fact that I was mid-cycle during testing, which has been seen to elevate the numbers.  We don't want this number growing as that would indicate a much bigger problem with my ovaries (which we're thankfully removing anyway). Other things I learned: I metabolize foods quickly and have a low glucose level, I need to work on my LDL number (reducing carbs and increasing healthy fats and proteins) and I have low iron (probably due to heavy cycles which will all be history after the surgery and therefore increase my iron).  I'm being sent to a nutritionist this month just to get my eating all sorted out and get my body functioning more optimally.

The Bone Density test- Sadly, my bone density test did not come back like I had hoped.  While my spine is fantastic, my left hip showed that I'm in the osteopaenic range.  This means I'll be starting weight bearing exercises ASAP as well as taking heavy doses of Vitamin D and calcium.  The bone density screen will now occur yearly for me due to the results.  If osteoporosis develops, I'll then be put on Fosamax for a maximum of five years.

Osteopenia is a condition in which bone mineral density is lower than normal. It is considered by many doctors to be a precursor to osteoporosis. However, not every person diagnosed with osteopeniawill develop osteoporosis.- Wiki

Pelvic Ultrasound- Nothing abnormal, all good.

The Other Stuff

I'll begin taking Aspirin after the surgery, for the rest of my life.  This is apparently recommended no matter who you are at about the age of 40 and it reduces risks for heart problems, blood complications, cancers, etc.  We're sticking to non-hormone therapy for now to see how I do after surgery.  If I really need it, we'll do low doses of hormone replacement therapy with a bioidentical hormone cream.  And as for the good 'ole sex drive...IF it decreases due to the surgery and hormone changes, I can use a testosterone.

And there you have it.  Surgery is scheduled for the 28th of December, so keep me in your thoughts and prayers.  This has been an exhausting and emotional day for me and I want nothing more than to sleep the rest of it away, but I'm off to be mom now.