is that your final answer?

It's pretty safe to say that "YES" this is my final answer!

First let me back track and give you a little run down ~ Jan. 2012, first consult appointment with plastic surgeon at UNC Cancer Center ~ end result of appointment is Lat Flap (latissimus muscle) with tissue expander on the left and mastectomy with tissue expander on the right. Scheduled a second appointment for the end of April knowing that I would be ready for surgery the end of May.

I didn't really want to have to do the Lat Flap on the left but the surgeon felt this was my only option so that is what we planned to go with. After good advice, I decided to get a second opinion...

April 19, 2012 ~ consult appt. with Dr. Claire Carman in Norfolk, VA
Wonderful doctor who agreed with and confirmed some of the previous information/decisions and yet had different views and opinions on some things as well. She also felt the best surgery for the left was the Lat Flap, so like it or not it looks like there isn't much to decide on that. She did have a differing opinion about doing the mastectomy on the right. This sort of caught me a little by surprise considering that everything I had been told up to this point leaned more toward doing the mastectomy. She had valid reasons to back up her opinion, so I decided to try to be open minded. Maybe I had made a hasty decision (seems highly possible when you are thinking in terms of life/death). Dr. Carman feels that in a lot of cases this is an unnecessary surgery that many women think will change their prognosis. It doesn't change your prognosis! In her words, "the milk is already spilled." A recurrence can happen in the same breast or tissue still present even after a mastectomy or it can occur in another part of the body (liver, lungs, bones and the brain) which is called metastasis. A metastasis is more likely to occur in another part of the body than it is the opposite breast. Another reason she felt that mastectomy surgery was not always the best way to go is because you have no feeling after this surgery. She felt that being able to feel if something wasn't "normal" was your first and best defense in catching cancer early if it happened to occur in that breast.

So I had some things to think and pray about. Nobody said that the decisions I was going to be faced with would be easy ones to make. I would say that I wish I didn't have to make them but in some way I feel that isn't fair. You see, I know God is in control and I know He has a plan for me. I also, firmly believe that all that has happened in the last year will in some way glorify Him.

April 25, 2012 ~ follow-up appts in Chapel Hill with my medical oncologist and oncology surgeon and first mammogram since cancer diagnosis. I decided to not make a final decision until I was able to talk to my doctors at this appt. and refresh my memory with the abundance of information that they had already given me. Mammogram was my first appt. I would be lying if I said it wasn't scary. At the Cancer hospital they read your films while you are still there. The radiologist said that she was satisfied with the way the films looked and as far as she was concerned I just needed to come back in 6 months. Dr. Muss (my medical oncologist) felt that if I didn't have the mastectomy surgery done on the right that I would need to be scheduled for an MRI. Not only this time but on a yearly basis into the unforeseeable future. The rest of his appt went well, other than the fact that I have to learn to live with these HOT flashes! He isn't comfortable with me taking any medication at this time to try to elevate them, so if you see me flapping my hands like I'm swatting at a bug - I'm probably just fanning myself. Poor Stewart probably won't get a good nights sleep either because I'm constantly throwing covers off because I'm sweating and then pulling them back on because the air hits the sweat and makes you cold! Dr. Demore had a lot of good information, mainly studies that showed the advantages/disadvantages to having the right side mastectomy surgery. The two that seemed most important: 1. A study that shows that you have a 95% chance of NOT getting cancer (new or recurrence) if you opt for mastectomy, and 2. A new study that shows that for women under 40yrs old there is a 5% increase in survival for women that opted for mastectomy. This is a very quick rundown of a four hour appointment!

Here's a list of the decisions that had to be made:

1. Do I do the mastectomy on the right side?
2. Do I have my surgery done in Chapel Hill or in Norfolk?

Answer to question #1: YES! I felt like I got really good information from a lot of different sources and when it comes down to it I feel like for me this is just the right thing to do. I'm sure I'll still worry but at least I will know I did everything I possibly could.

Answer to question #2: This was the hardest decision. There were a few differences in the approach and timeline for surgery from each place. According to Chapel Hill I could schedule surgery the end of May, where in Norfolk they wanted to wait until middle to end of summer. In Norfolk they wanted to do a sentinel node biopsy when they did the mastectomy surgery on the right and UNC felt that the disadvantages to doing this outweighed the advantages (a biopsy would put that arm at risk for lymph edema). Norfolk wanted to do a skin sparing mastectomy and insert a fully expanded tissue expander on the right side while the left would have to be slowly expanded (in other words, I would still be lopsided). UNC would do a total mastectomy (not keeping any of the skin) and expand the right and left side at an equal rate. When it came down to it - I'm ready to get all of this done and behind me. At UNC the surgeon and I agreed on just about every aspect of the surgery. I like the timeline. I prefer to not have the node biopsy unless pathology from the surgery shows that we need to go back and do it. I certainly prefer to go through summer with two boobs that at least appear equal. If I am opting for a mastectomy then I don't want to keep the skin or nipple, either of which cancer could pop up in. The final piece of the puzzle in deciding where to do surgery was that up to this point all of my stuff has been done at UNC, and I feel that it is better for the future monitoring of my health to keep everything in one place. I loved the doctor that I saw in Norfolk and under different circumstances I would without a doubt love for her to be my doctor. But things just didn't work out that way, and for whatever reason in the beginning I ended up at UNC and I felt like from the start that I was where I was supposed to be. And so there I will stay!

I am currently seeing a physical therapist up at the hospital that has been trained in dealing with women that have had breast cancer to get the left side ready for the upcoming surgery. Surgery is scheduled for May 31st. I am looking forward to having another part of this journey behind me!

I am an open book! If any one ever has questions about anything I post please feel free to ask. I have learned a lot over the past year, some of it the hard way, and I hope I can use my experience and what I've learned to help others! My e-mail is: angbal96@hotmail.com

God Bless, Angie

it's like trying to catch a falling star...

Trying to make sense of all the information that you receive and making the best decision with the information you have is very difficult. On the way to my appointment Thursday a song that is very special to Stewart and I played on the radio... he played me this song the very first night we met. (Yeah, he DOES have a romantic side! SSSHHH! Don't let him know I told you ;) ) The name of the song is "How do you talk to an angel" and one of the lines in the song is, "it's like trying to catch a falling star." On my trip home that night this one line in the song seemed to sum up all that is going on for me right now. It seems that the finish line I could so clearly see just last week is now disappearing in the distance. My appointment Thursday was bittersweet. I LOVE the doctor, and she had some great information and advice, however some of what she had to say differs from previous opinions and decisions that I had already made. Not to leave everyone hanging here but I have appointments this week back in Chapel Hill and hope to review all that I learned with them. I am STRESSED beyond belief with trying to make the best decisions for ME!! The problem is no one knows the right answers... not even the doctors! So you take the information you have and you make the best choices you can. After my appointments this week I will get into more detail as to the differences in opinions from the two different plastic surgeons and hopefully have all good news from my mammo and dr. visits this week. Please continue to keep me in prayer! The next few weeks are going to be very challenging for a usually very decisive person!

Cancer Support Meeting

Cancer Foundation Support Meeting tonight at Our Lady of the Seas Catholic Church in Buxton at 6:30!

spring break

While school was out for Spring Break I decided to take a few days off to just hang out with my two favorite girls! Over the past year I have had to be away from them too many times, and thought that a few days together would be good for us. One morning we had a yummy breakfast at Sonny's with Nanny!

On Friday we joined forces with Mandy and Hannah on a girls trip to Ocracoke. We hit the Flying Melon for some awesome french toast, did a little shopping, and then made a stop at the Sweet Tooth candy shop.

 Saturday, we attempted a fun filled family day on the sound helping Dad fish his nets...

 and of course, Kimber had to pee!

 Karlene was a great helper, pulling in the lead line while Dad was in charge of the top line and pulling the fish from the net.

A basket with some of our catch of Jumping Mullet! It's a good thing that we caught some fish... because shortly after that our trip made a sudden turn...

This is what happens when I step on the boat... it breaks down and we had to be towed! A big "Thank You" to John McGee our wonderful neighbor who towed us to the creek!

In the big scheme of things, this day was awesome! We spent a wonderful day together as a family, and made a memory that will probably keep us all laughing for a long time. After all, what is life without a few mishaps to keep us on our toes!

Update on my appointments: An addition to my upcoming appointments... I have decided to seek a second opinion from a plastic surgeon in the private sector. I'm not sure what impact, if any, this change will have on the current timeline that I am working with to have my next surgery completed, but feel that it is the best thing for me to do. (Thanks to some great advice!) My appointment is scheduled for this week and I will have more information to report after this visit. Please continue to keep me in your prayers!

got the all clear

Post surgery appointment went very well. All pathology came back perfectly fine and the doctor released me back to my ob/gyn. Thanking God for answered prayers!

In a little over two weeks I have appointments scheduled to start the ball rolling on the next surgery. Can't believe that it's been five months since I finished radiation treatments. WOW! If nothing changes at the upcoming appointments then it is looking like surgery will fall the middle-end of May. Can't really say that I'm looking forward to the actual surgery but I am so looking forward to the results. Shirts aren't made for lopsided women!

Everyone please pray for Kimber... she is still having episodes in the morning even after trying new medicine. She will be following up this week with the doctor and I'm not sure what the next step will be. The one thing that keeps me grounded is that I know ~ Prayer works! I am walking proof!

The girls are out of school this week for Spring Break. Hoping to make a day trip to Ocracoke. We have all been craving our favorite ~ french toast at Flying Melon! Of course, we can't head home until we've stopped by the candy store. SSSHHHH! Don't tell their dentist!

Will keep everyone posted on Kimber and my upcoming appointments! Thank you for all the prayers and thoughts! God Bless, Angie