Update 8/20

Hi everyone,
Sorry that it has been about two weeks since I've updated everyone on the scoop. I had a chance to get out of town for a bit and I was so glad to. Now that I'm back, I can update you all on the latest....
1) I did indeed see Dr. Schulz to have one of my stitches out. He seemed puzzled that I hadn't made a decision about surgery yet, but was supportive about my decision to see Dr. Silverstein (which will happen on the 28th). What's funny is that I've noticed a small stitch that is poking through the skin in a different place, and I'll see him on Tuesday just to make sure it's not a problem. My mobility is better and I can lift weights pretty well now.
2) I met with my Principal and Maureen Thompson from personnel at the school district office. We looked at the options financially for the upcoming year. I will have enough days to take off the first semseter without any problem. However, I will have to ask my colleagues throughout the district to contribute a day if I need to take the second semester off, since I won't have enough days. I think this is really realistic since we have about 50 teachers on staff at our own site and I know that I have some incredible friends in the district that wouldn't mind helping. The kind of silly thing is that I can't request days until I've almost reached that point. So, I'll likely contact Mike Duran (President of DSTA) to assist in the "all call" before Christmas Break. It is indeed looking more like I'm going to have the double mastectomy...
3) I met with Dr. Monica Khanna, a great radiation oncologist who practices at the Curci Cancer Center (Eisesnhower) and the discussion with her was exceedingly helpful. First, she said that no matter what surgery option I elected I would have to undergo radiation. Typically, only lumpectomy candidates undergo radiation following the surgery, and mastectomy patients do not. I asked her why, and she said that due to my age (i.e. younger than most ) I would need radiation either way. That was, to me, more evidence to have a double mastectomy. My next question to her was regarding reconstruction. It had been my understanding that radiation wasn't possible following reconstruction. However, if I do the tissue expander reconstruction, then it is possible for me to do immediate reconstruction at the time of the mastectomy surgery, have the expansion and then undergo radiation following. Some people have the more elabaorate TRAM flap surgery (which I do not want because, while it uses autlogous tissue, i.e. your own, you compromise your muscle power in the abdomen, or bak where they take the muscle from) but the TRAM is not for me. Following the radiation, then I'll need to wait soe time for my tissure to heal and hen I'll have the urgery for the implants and then beyond that if I want to have an areola or a nipple added to it (sorry if this is too much information for you...). Anyway, the discussion with Dr. Khanna really seemed to make the mastectomy with reconsruction a reasonable option and the most agressive as well. The more I think about having some of these "suspicious" areas (one in the left breast and one in the right adjacent to where the current cancer lies), the more I don't want to have to deal with being followed so closely mammography-wise when my breast tissue is difficult to follow in this regard in the first place. I think I will have more peace of mind knowing that I've eleced to remove all of the problematic, or possibly problematic tissue. I mean, why have the less drastic surgery if I'm only going have to have surgery again later on. It just doesn't seem efficient or even prudent to leave myself open to developing a cancer that can't been detected very well.
So....I called Jean today (Jean Carroll, my Principal) and let her know that I was seriously thinking about choosing the double mastectomy route with reconstruction, and that the timeline would basically take me out for the whole school year. I wanted to tell her this so that she could look at hiring a credentialed teacher in my stead rather than just a long term sub. A credentialed teacher would be much better than a sub for kids, parents, other teachers, and I want to do things honorably. In addition, I need to make the best decision health-wise and I want to be agressive. I spoke with my friend Tim Tyler today and asked him what he thought about all of this (he directs the pharmacy at the cancer center in Palm Springs and is extremely knowledgeable) and specifically if he though there was anything more agressive that I could be doing. He said no, that the chemo plan I'm on, plus the decision to do the double with radiation is agressive. That made me feel good. I don't want to go through this again, or have it recur if I can help it abate in any way, then I want to do that.
I'm still going to keep my appointment to see Dr. Silverstein because, although I know in my head that it's a good decision to make, I can't seem to gete my head and my heart to connect on this, and i think that seeing Dr. Silverstein, since he is an expert in this field, will help me embrace it. That is, I think that hearing it from him will be the confirmation that I need to do it. I'm about 70% of the way there, but not all of the way. I think just becuase it's such a major decision that affects the next nine months of school bundled with it that makes it difficult. Somehow just blogging about it helps as well. Anyway, if any of you have any input on this you're welcome to write me.
I let Jean know that I would be calling her on the afternoon of the 28th to give her my decision.

4) Meanwhile...I still have to have those other two areas biopsied and that will happen on Friday, September 8th. Dr Lanskowsky has been on vacation so I won't be able to get in to see her before then. It would have been great to see her before seeing Dr. Silverstein, but oh well, my plnas aren't God's plans...
5) Ultimately, this is an exercise in faith. Faith that this decision is the right one and that God will provide the sick days that I need to make it through the year, faith that this is the best decision health-wise, and just trustin God in general. I know that this is just such an opportunity to trust Him. He regularly gives us these opportunities, and it's very apparent to me that this is definitely one.

Thank you for your prayers and your friendship!
Julie
p.s. Chemo #6 tomorrow at about 2pm. I'm hoping for a good result like I had last time. Just in case, I've cleaned the house today so if I need to be house-bound for a couple of days I should be fine. Glynnis is going to go with me :-)