Tuesday, June 11, 2013

Pre-Occ-U-Pation (hum the title to the tune of Anticipation...)

Just found the ice cream in the refrigerator. It's been that kind of day.

I realized that usually by the time I sit down to write, I have worked a lot of things out in my head and may seem relatively focused, stable and confident. And if I'm not, writing helps.
What may be missing in my posts (or at least just buried under the amusing stories) are hours of rumination, the flip-flopping, the multi-directional frustration and, of course, the neurotic behavior the aforementioned 'features' trigger.

In just about any 24-hour period over the last couple of weeks, I have laughed; cried; pretended I don't have cancer; made a cancer-related joke (that usually only *I* think is funny); worried about my treatment decisions; changed my mind about my treatment decisions; conquered rational fear; become mired in irrational fear. Oh, I've also prepared dinner, washed laundry, driven kids to rock climbing and TKD and done some grocery shopping in an effort to distract myself and keep the wheels turning at home. 

But then the ice cream ends up melted in the fridge. Or the dirty dishes go in the clean dishwasher. Or I forget the water running in the backyard for eight hours. Yep. That happened.

So now it should surprise no one that my written moments of bravado are tempered by utterly random, but thankfully silent, freak-outs. Oddly, many of the silent freak-outs revolve around my treatment decisions. 

Mastectomy is a given. 
But one or both? MRI evidence points to a healthy right breast. But there is always the chance... 

To reconstruct immediately or delay?  Or to reconstruct at all? Immediate reconstruction seemed like a no-brainer at the get-go. But surprisingly (to me), reconstruction is only conducted in a minority of mastectomy patients according to http://ww5.komen.org/KomenNewsArticle.aspx?id=19327356181 and about 100 other briefs I've read.

Immediate or delayed reconstruction? There are advantages and disadvantages to both. Fewer surgeries and feeling 'whole' more quickly versus potential for improved results once the skin recovers and allowing for adjuvent therapies without compromising results.
NOTE: Adjuvent is a big word that in the world of breast cancer refers to things like chemo, radiation and hormone therapy!

Hormone therapy? Greatly reduces my 'on paper' chance of recurrence in the removed breast area as well as the incidence in the healthy breast. But tamoxifen increases odds of ovarian cancer (which is a doozy).

Genetic testing? Would be good to know breast wise but there are downsides to knowing there is an increased risk of all the other associated BRCA1 and BRCA2 cancers.

So these are the questions I turn over and over in my head. These are the questions I answer and then reverse my decision. These are the questions I'm usually pondering when someone asks me for the time, tells me a joke or tries to have a conversation about current events and I laugh inappropriately. I am just preoccupied. Completely preoccupied.

The good news? Ice cream is easily refrozen.

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