Update Jan 28th

I'm just so grateful that this is almost over. I can see that God is teaching me to be patient and persevere at the same time. Hmm. Maybe that's the endurance that is talked about in James 1. I sure hope so, because at the end of it is maturity, not for my sake (although that is nice) but so that God can show who He is in us by the way that we trust, we hang in there, we persevere and it's worth it. That was the one prayer that I uttered to Christ when I was first diagnosed: "Lord, I just want it to be worth it." So, if God has used me somehow to show more of Himself, I am grateful. Furthermore, I'm so grateful for the many lessons that I'm learing now that I both am and am not aware of. I'm also so excited to be able to tell of His deliverance from cancer via medicine and skilled doctors and prayer of so many faithful and wonderful people. Often, I am able to share with other doctors (residents at the teaching hospital), other cancer patients, and people at the grocery store or waiting in line somewhere when I'm asked about my hair or whatever. It is so exciting to give all of the honor and praise that is due to Him, becuase it was His healing hands that truly have set me free both in my soul to have eternal relationship with Christ, but also physically healed.
I am grateful for all of you who are praying for me. Truly. What an example you are to me of what it means to be faithful and fervent, and the fact that I'm healed is evidence that your trail is not in vain. Thank you so much. As for current happening, the pain is beginning to subside a bit and my body doesn't feel quite as "kinked" as it has been. My neck shoulders and sides are still out of whack but not nearly as ouchy as the last week has been. I still had to take 1/2 vicodin yesterday and the day before, but it really worked and I didn't feel really out of it, so I was grateful.
I went to the doctor on Friday and he checked me out, and explained that they had done some stitching in the infra-mammary crease and that was likely the reason for my discomfort. The tape is there to provide support and he said that I needed to find some kind of support to help the implants move in the right direction. They need to move together and up slightly. I asked him about the size, in that if over the next couple of months if I wanted to be a little bigger if that were possible. He said yes but it would mean another operation. I have to get my port out in August, so maybe we can do it as a combo, well see. I'm not even sure what the size is since I can't really wear anything normal with the drains hanging underneath, etc. Maybe it's just a big contrast from where I was before surgery which was too big. Anyway, the drains will stay in until Tuesday and hopefully then I'll get them out. I needed to milk them more often than I had been doing in the beginning, so I am diligently doing that and have found a great sports bra that is zip up to help out keep everything together, drains included. It actually helps with limiting pain, too becuase then the tubes don't move around. They are small tubes that come out of each side of my body where my ribs are. That's why theyre uncomfortable, but it is subsiding. I have to say that, looking at the incision sites, I sure look a lot more sliced up this time. Perhaps it's becuase of the incision sites having stitches, and then the wire also connected to the drain site on each side, keeping htem in place whereas last time they used a kind of dermal tape instead on the incision site and only used a stitch on the drains. I hope it will look better when they heal in a few months. I'm just glad that it's pretty much done :-)
Okay, so in light of the fact that I didn't have to be at the doctor until next Tuesday, and my mom was going to leave on Saturday, and my energy was really good, I decided that I would come home for a couple of days. I was able to drive, not like last time where I literally couldn't. I was in pain a little but took some meds when I got home. So I did come home yesterday and it was so nice to try to take a bath and wash my hair in the sink (can't shower until the drains come out-lovely) and sleep in my own bed last night. I also made a big pot of chicken noodle vegetable soup so now I'm set for a few days :-)
I have been quite energetic and wanted to go to the gym, so I went, drains and all this morning. Of course, NO running and even just could walk on the treadmill and then not with a lot of arm movement. Nonetheless, I went and it was great to go. The thing I'm looking most forward to when this is through, frankly, is getting my body back. I feel like it's been out on loan for a bit, and had so many limitations and i don't like how things have shifted around, so I'm looking forward to working on it when I get it back. Dr. Sherman said that I can't run for a couple of weeks or so. So, again I have to be patient but it's okay.
I'm still doing the "up in the middle of the night for two hours" thing that I did with the last surgery but the cool thing about it is that I find myself praying while I'm waiting for my body to want to go back to sleep, and it's nice. Maybe that was part of God's plan. Who knows.
Well, I'm running out of steam and I'm not sure this post is as fluidly written as some of my other ones, so I apologize for that.
Talk to all of you soon,
Julie

Recovery 1/24 Wednesday

Well here I am again in recovery. It is so funny to find myself with the same JP drains but not quite the same incisions and mobility issues. I mean, this time I actually have more incisions, but ironically more mobility.
They not only accessed the sites through the diagonal incisions they had originally made with the mastectcomies but have also gone in the inframammary crease on both sides. So, now it makes sense to me why I might have more pain in those regions. Further, now I understand why I hadn't been feeling so swift on the right side in particular. I mostly have pain on the right side underneath where the rib cage and side of my trunk meet. I'm guessing that the reason I have more pain on that side than the left is due to the fact that I have more scar tissue due to the prior lymph node dissection on that side that made the prior surgery there more extensive than on the left side.
I find myself just kind of protecting, well kind of clutching, my right side in that area if I'm standing up or sometimes even sitting up becuase of the strain on those muscles. I definitely don't want to sit or stand up straight for that reason either. So, I know I'll have to work on that after this is healed. I wasn't sure what to expect with all of this, and didn't expect a second set of incisions, so yesterday I just couldn't figure out why I had pain there. Now after hving looked at the incisions while emptying the drains this morning, I get it. I've also learned that taking a 1/2 of a vicodin can be really helpful without making you feel so out of it pain wise. I only had a little pain meds in the hospital becuase those meds just make you so "buggy" is what I call it, where you feel like you're looking out of the eyes of a bug rather than yourself. They had given me some dilottid (spelling?) the night before to ease the pain from surgery and I was glad, but when they told me they could give me morphine instead I thought "oy" I don't want to do that, so I pretty much didn't do pain meds unlelss I really needed them.

As my sister Jenni eluded to in the earlier post, we had quite an event just trying to get them to draw blood for my pre-op labs. They had managed to get an iv going on my left hand, but the guy who was supposed to get the blood for the labs was trying to find another one up more by the inside of my elbow and was ouchly unsuccessful. Then the anesthesiologist jumped in and tried to help by getting some from a vein on my right foot since the lab guy didn't know how to do it and wouldn't, making lab guy pretty miffed because anesthesiologist trying to help me out. The vein in right foot only gives us about 1 1/2 tubes and then collapses..So, lab guy tries again this time where my hand connects to my wrist on the topside. OUch that hurt and was also unsuccessful. Oy. Then, the nurse who originally came in to put the iv in my hand came in and quietly was able to access a vein for them from my left arm while they were busy patching up my foot. Whew, they got what they wanted and the drama was over, but boy I have bruises to show for it. I wouldn't let them access my right side becuase of the risk of lymphedema. Since I already have some edema in my right hand, I certainly don't want to exacerbate that situation.
I don't know why I was so hard to access other than I was tired, cold, dehydrated, etc.. Oh well.
The funny thing was that in the middle of the night in the hospital, another guy came to draw labs, and after fending him off from the right side I told him about what had happened earlier in the day and he was able to get it on the first try. I was so grateful and told him such!
Okay so that was the drama with the blood but that's over thank God. One of the funnier things was that, as we were getting dressed to leave yesterday my sister kept finding little electrodes still on my body in about four places and some tape marks on my legs from where they tried to immobilize me on the operating table so that they coud move me from a prone to an upright position to check out their work. That part to me was really funny along with the fact that I still have some "markings" from where they drew on me prior to surgery since I can't get those completely washed off yet (it will take me a few tries I think) and betadine along my backside. Those are the funnier things though and Jenni helped me to clean up a bit as well as get dressed to drive home to the Remy's. I was glad that the ride was short becuase my side really hurt on the way here and I was happy to lay down and relieve the pressure.
Whew, well I'm sure that's a lot more than you wanted to know, but those are the details.
I'm emptying the drains twice a day and their output is about 50-60cc each at each time I empty them. That should decrease over the next few days. I'm set to go to the doctor's office on Friday for them just to check things out and make sure i'm healing okay. As for when the drains come out, who knows. I'll keep you "posted."
That's all for now. Just resting reading sleeping when I need to and slowly eating again.Thank you so much for your prayers!!!!!! I am so grateful for wonderful friends.
Love,
Julie

Still, I have far more arm mobility than I did before, so I'm not quite the penguin I was in the prior surgery, and I can make it up and down the stairs without any help. Already that is a huge leap over where I was before. I spent most of my time before in bed.

1/22 Julie surgery recovery

On 1/22 Julie went into surgery at 2:00pm at USC University Hospital. Surgery went well however encountered a few little bumps before and after surgery. Julie was a bit dehydrated from not drinking all day before surgery so finding a good vein to draw from was a bit challenging and somewhat painful. In addition after surgery Julie’s recovery was a bit slower due to nausea so the doctors kept her over night. In the end the surgery results made for an even distribution of 360cc in each side. She has drains again but hopefully this will be short lived.

This morning she has improved dramatically by her eating orange and red Jell-O, had a cup of coffee and made her first walk around the nurses station and now is reading the LA Times.

We hope to have Julie released from the hospital this afternoon and back at her Aunt and Uncle's for a speedy recovery

Jenni (Julie Sister)

Doctor visit on 1/19 and surgery time info

Hi all,
I went to have herceptin yesterday but also to discuss a few things with Dr. Luke. One really cool thing that happened this week was that my monthly female cycle returned. I know that all of the guys reading this are thinking that they don't need to know that info, but the reason I mention it is that it is an indicator that my estrogen levels have now increased to the normal level that they were before all of this started and that may be a problem. Allow me to explain.
You see, I'm taking an estrogen blocker called tamoxifen. It's purpose is to prevent the estrogen hormones from affixing themselves to any estrogen receptors that might be present on any cancer cells that might possibly still be hanging around. So...with an elevated level of estrogen, tamoxifen may not be able to block it all effectively. I discussed a couple of options with Dr. Luke. One of the options was to take a medication called lupron, which would basically shutdown my ovaries chemically. However, there is no good data about the positive effect of combining tamoxifen and lupron. The studies actually conflict and we won't have any good data on it for a couple of years. Most oncologists who suggest lupron do so based on emotional biases. The other possibility I wondered about was removal of ovaries, but he felt that wasn't necessary and really would be too drastic of a move. After all, there are some good things about having estrogen in your body, it protects your heart, bones and joints. It all came down to thinking abut the fact that the cancer was only weakly estrogen sensitive. So, if it wasn't really fueled that much by the estrogen, I don't want to take the drastic step of taking a chemical to shutdown my ovaries and also miss out on the other beneficial effects of estrogen. Therefore, I'm just going to take Tamoxifen for the next five years as we had planned and cycle until that ultimately ends twenty years from now or whatever. I think if my case had been more advanced, I would have considered doing it. I really don't sense any urgency to do it at this point.

I'm also going to get an echocardiagram and ultrasound just to make sure my heart is doing well since some two of the three chemo drugs I took can be heart toxic. Herceptin can also be damaging, so I thought I would see if everything is doing alright. I think I'm doing fantastically, really. I mean, I'm running again and now am able to lift weights again....however, with surgery on Monday I'm sure that will change again for a little while.

Speaking of surgery on Monday, I was notified at 4:30 yesterday (Friday) that my surgery is now scheduled for around 5pm instead of the original time of 11:15. Imnot sure why I ws bumped, I hope to find out about it on Monday, but I just realized - DUH - God is in control and maybe He wants me to talk to someone or interact with a particular group of nurses or medical staff that won't be around for the earlier surgery. Who knows, maybe another patient may need encouragement. How selfish of me to get all bent out of shape about this. Jesus holds the whole world in his hands and I trust Him for the outcome. Besides, His timing has always been better than mine.
So, that's the scoop for now. If anything changes, I'll let you know. My sister will be the contact person for the first few days and she'll put some posts up to let you know how I'm doing until I can do it myself :-)
love to you all,
Trusting in Him, the author of us all,
Julie

Hair apparent-ly coming in!

Hi everyone,
I have chosen to discard my wig, even though it does keep my head nice and warm and I do like the look of it, but it's time to just deal with the fact that it's growing out. It's not the same, texture color etc and it was assymetrical. What's funny is that there was more on the sides and the back of my neck than anywhere else...So...I went to see my friend Joanna at Mane Attraction in Palm Springs and she trimmed what little I do have and then we decided to play with a little color. Color. Well, it's temporary but it's kind of a dark brownish burgundy. I kind of like it. It's a different look for sure. Definitely more new york than palm springs but the color will wash out in about 6-9 washes or so and then I can try something else if I want to or just let it be. It's actually kind of fun to be able to experiment with it a bit. I'm just becoming used to this whole process and being confident in it. Most peole now just think the hair is intentional - especially now that it's dyed. Anyway, I'm enjoying being kind of a redhead and a different look.
I went to the doctor today after I saw my lymphedema therapist becuase I was feeling really fatigued and I thought maybe my red count was low, but it was fine. Oh well, I guess it must be just that it's cold and dry here in the valley I guess. Other medical news is that everything is a go for the surgery next Monday and I'm scheduled to have an infusion of herceptin on Friday which should be good and I'm looking forward to it all :-)

Blessings,
Julie

visit to USC and upcoming surgery details

Hi all,
It was so wonderful to be in church this past Saturday night. It was packed and the excitement and energy in the room was great. It was just neat to be a part of that. I am so glad that I had the opportunity to sing, too. I really enjoy being able to do it when I can. It was great to see so many wonderful people though I didn't get a chance to visit with everyone I had hoped to, but we'll all catch up at some point.

Okay so regarding surgery on the 22nd:
First the purpose of the surgery is to have the implants put in. I chose saline because, although silicone might have a better cosmetic result in the long run, I feel safer with the saline. I'm going to spend some years with these things inside my body and in the rare chance that they may leak, I certainly would want it to be salt water and not silicone (which is highly immunogenic). Dr. Sherman will access the sites via the same incisions that were made before, which is nice so that there will be no new incisions. I will have drains and be on pain meds and be out of it for a few days. After about a week, they'll remove the drains and then I'll start the rehab process all over again taking about 6-8 weeks to recover. That being said, it's not nearly as rough as the first surgery. For example, I probably won't stay overnight in the hospital. The plan is to do it outpatient so that's great. Also, they won't be accessing my axillary area so that will minimize triggering lymphedema. I should be able to drive as soon as I'm off of the pain meds and that will only be a few days. I'll have the drains in for about a week, and a follow up appointment a week or so after the surgery so I just thought it best to stay in LA for a week. That way I'm close in case there is some kind of complication and also not go to the desert and then have to drive back two days later. I don't really want to go home with the drains in. I'd rather wait until those are out. So that's mainly why I'm staying up there for a week or so. My mom and sister will split up the week so that they are there with me for the first five days or so in case I need help with anything. My sister will be with me the day of the surgery and take me to my aunt and uncles after I'm released from the hospital.
Jenni (my sister) will also call Glynis to let her know how I'm doing after I'm out of surgery and she'll make a post to the blog so that everyone knows what's going on. I'll be able to access my e-mail from LA so you are welcome to email me.
I'm looking forward to the surgery since it's the last major thing in this fight. I think I finally feel like I'm on my way back to being normal, though it's still going to take awhile. It's just really encouraging to see my hair growing in and not needing to take naps every day and just being able to slowly gain more arm strength. Of course, I'll have to go back to physical therapy after the next surgery but hopefully I won't lose too much ground between now and then. My goal in the next two weeks is to be as I can be going into this. I have herceptin the Friday before, so that will be nice to get that infusion done and not worry about it for another three weeks. i'm actually kind of enjoying the time out that it affords to read but also to realte to the other patients that are receving treatment and being able to encourage them.It's exciting that way.
Well I guess that's all for now.
Putting one foot in front of the other...
Julie