Well, today wasn't the easiest day. I am working in my coaching and counseling sessions on letting myself feel my fear, rather than giving in to my pattern of pretending to myself and everyone around me that I'm fine. This is good, important work, but difficult. Don was feeling ill and tired and depressed, and we kind of fed each others' low energy for a while. I'm grateful, though, to a new friend Stephanie for driving me to get my pre-chemo tests, and to my awesome fitness trainer Guillermo for his support. I had a bit of a melt-down with him today -- as my energy lifted part-way through the workout, I realized that it has been so hard to begin to see myself as athletic, and would be so easy to just slip back into my former self-image (just doing the minimum amount of exercise recommended to keep from being really unhealthy). I came home feeling much better, which inspired Don to work out too, and I cooked dinner for the first time in quite a while!![...]

Today was much like yesterday -- lovely visits with folks who signed up to be with me while Don was at his meditation workshop; a walk; a nap; and some yummy food. I was in very little pain today, even without any Tylenol. Probably I would have been happy to work, if we hadn't lined up all these visits -- and this was much more fun. And, it helps my processing of this disease, the experiences I'm having, and the choices ahead of me, to talk to people about it.[...]

A common practice for living mindfully and joyfully is to keep a gratitude journal. I've done this for one period of time before, and recently my sister-in-law Sarah, whose mother just died of ovarian cancer at 58, shared with me some things her mother did that were helpful during her 3 years with cancer, and one of them was to keep a gratitude journal. I'll see what moves me to write about each day, but today at least gratitude seems like a good theme. [...]

Well, it was no picnic, and I'm not particularly comfortable now, but I made it through okay. I did end up with two new biopsies, one in each breast. The biopsy results from the one on Tuesday are negative (not cancer). Earlier this morning, on the way home from swimming, I was listening to the radio and heard an interview with some reporters stationed in Syria, about the impact of the civil war there. One of them told about watching an infant die of a simple respiratory infection because her parents couldn't get her to the hospital because of the shelling. I realized, I am incredibly lucky to have easy and safe and affordable access to this very high-tech diagnostic procedure. And, I wanted to try to remember that while in the midst of it. Suzanne coached me to actually tell the medical professionals to remind me -- which I did, and they did. I wasn't able to exactly feel gratitude, especially because it was quite painful for a while at one point, but I did notice things like, at least I'm not in a war zone. No one is shooting at me. I am safe. The medical team were all super supportive, holding my hand through the parts where they were in the room with me. And my friend Anita came with me to support me before & after, which was wonderful (and had the added perk that she could come further into the Breast Center with me -- there are certain areas Don wasn't allowed because they are women only!). After it was all over, a couple different people told me independently, "This is the most difficult test we offer here." And also, "Have a wonderful weekend." [...]

Dr. O'Regan was great. She said "I hope you haven't been googling too much about triple-negative, there's a lot out of bad stuff there, but I always say, ALL breast cancer is curable if you catch it early." And, she agrees we've caught it early, and even labeled it Stage II, which is the first anyone has given it a stage. [...]

Many of you have asked if there was some way you could help. We know that we will be needing additional help occasionally over the next months, as diagnosis and treatment proceeds. [...]

Yesterday and today have been pretty challenging emotionally. Monday morning began with the news that the tumors are "triple-negative," which limits treatment options somewhat and increases the chances that this cancer is resulting from a genetic mutation. Don & I were not on the same page in the morning about seeking out these results, and bickered some about the basement remodeling plan. We did manage to "process" our disconnection/disagreement in the waiting room before the genetic counselors' appointment, which helped. The counselors (Amy Stettner and a student) were great, and were able to adjust their canned presentation to our PhD brains (Don is trained as a botanist and I studied the History of Science including reading Mendel in the original, so they skipped the part about what chromosomes are and how you inherit things...). With the help of these brains and some text-consultation with my MD-professor-sister-in-law Margot, we decided which genetic testing we wanted to get. The main "culprit" that it's likely to be is the BRCA1 & 2 gene mutations which are more common among people of Ashkenazi Jewish heritage. Even though there is no history of the usual cancers associated with these mutations in my family (breast and ovarian), the fact that it is bilateral, that I'm young, and that it's triple-negative makes this more likely. If I do have one of these mutations, it makes opting for mastectomy more likely, and also perhaps prophylactic removal of ovaries (!). [...]

We met with our breast surgeon, Dr. Wilke, today at UW Hospital Breast Center, and the treatment picture is now much clearer to us.

Dr. Wilke is recommending that Becca do chemotherapy first, and then do surgery. This is a protocol that has been developed and tested over the last few years, and has been found to have at least as good outcomes as doing the treatments in the other order (which was the standard previously). It allows treatment to start immediately, while we wait for the genetic testing results which will inform which surgical protocol we choose. It also allows the doctors to evaluate the effectiveness of the chemotherapy from pathology results after surgery - if the chemotherapy is completely effective, the pathology results may not find any cancer in the tissue removed. She said that it is not unusual for fast growing tumors to completely disappear before surgery - and, if we choose a lumpectomy, which only removes tissue around the tumor, they would use the markers placed during biopsy to guide the surgeon.[...]

Collecting more information today -- seeing the genetic counselor at 11:00, and two contractors who might be able to put our basement back together so we can return it to the level of beauty and order that I'd like, and be able to host guests there again. We'd pulled it apart to do mold remediation, partly for the sake of Don's health... and now, with multiple out-of-town family members offering to come help if needed, it seems more urgent. We actually have hired a professional project manager I know through my work to help with that -- so in reality, she'll be meeting with one of the contractors while we go see the genetic counselor...! And perhaps we'll get more test results from the biopsies today.[...]

Good question!

As many of you may know, I have two children from my first marriage who have significant disabilities and medical needs due to being born extremely prematurely. (And Becca is tied for best stepmom in the world, with her sister-in-law Margot.) As a result, I have been in and around hospitals a lot - I joke that I am getting my MD the hard way, one specialty at a time - neonatology, neurology, neurosurgery, orthopedic surgery, psychiatry, and now breast surgery and oncology - I may have missed some. So I have developed a habit of being fairly resilient and positive in the face of difficult medical news. [...]