Close to Home

Last summer, I let you know that I was becoming an Oncology Nurse. I started in August, and was on the solid tumor oncology floor for 6 months. I learned a lot and had experiences with patients that I’ll always remember, but I realized that working in oncology was too close to home for me. My BRCA mutation and family history of cancer was what originally drew me to oncology, but working in it in real life, especially the end of life process, was emotionally difficult. Luckily, I worked in an environment where I felt comfortable enough to share my concerns with my managers, who were very supportive. I was very open with them during the interview process about my BRCA mutation and family history, and they totally understood why I was having a difficult time.

I got extremely lucky to be able to transfer within the same hospital to my other nursing passion, and become a Perinatal Nurse. I’m now working in the Postpartum unit and I’ll eventually cross-train in Labor & Delivery. I feel like I’ve found my calling in nursing. I love all of the patient education in perinatal nursing, and being a part of such an important milestone in my patients’ lives. I’m still going to be very involved with cancer prevention and my work in the BRCA community, and I’ll keep you all posted on my ongoing BRCA journey.

What a Year!

I can’t believe it was a year ago that I had my post-mastectomy reconstruction surgery! After the complications I had after my mastectomy (aka boob hole drama), it’s a miracle the surgery went as well as it did, and that I didn’t need to have an additional surgery. As happy as I was, I was constantly worried that I wouldn’t heal properly, or that the necrosis/boob hole would happen again.

But now, it’s been a year, and my “foobs” feel like my own.  Sometimes, I only remember these are “foobs” when they’re sore before it rains, kind of like Karen from Mean Girls. I can lie on my stomach with no pain, stretch my arms all over the place with no problem, and had my first year without a mammogram since 2008. I still have clinical breast exams, yearly appointments with my reconstructive surgeon, and yearly ultrasounds with my breast surgeon (plus all the other non-breast cancer related fun BRCA screenings) – but I no longer have to sit in a waiting room worrying after they ask me to do another mammogram because of a suspicious image.

I’m really happy that I did what was best for me and went forward with these crazy surgeries to reduce my breast cancer risk, even though looking back, doing it while in nursing school was kind of insane. I couldn’t have done it without the support of my family, friends, and community. Special shoutout to my amazing hubby who has always been so supportive and such a great caregiver, my family, and all my nursing school homies who took shifts at our house during this whole process – taking care of me, even helping me shower, and of course binge-watch reality tv with me. I love you all!

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Excision Numero Uno

When I last wrote, I was waiting for the pathology results from the two skin biopsies I had because of 2 suspicious looking moles (I have an increased risk for melanoma because of my BRCA2 mutation and my mom’s history of melanoma). The results came back and both moles were severely atypical/pre-melanoma. I was very relieved they weren’t melanoma, but a bit surprised that both of them were pre-melanoma. My dermatologist explained they would both have to be excised (removed) in two separate procedures.

I had the first excision this morning, which was the site on my left hip. When the surgeon showed me the area he was going to remove – it was a bigger are than I had expected – but he explained that if the pathology comes back as melanoma (which is very unlikely) – they will have excised enough that I don’t have to get anything additional removed. That was a relief to me! Also, I made sure antibiotics were being prescribed (they were) because my breast surgeon had told me any time I have any procedure – even a dental procedure – I need to be on antibiotics. After a mastectomy, the highest reason for capsular contracture is infection.

The surgeon put on some relaxing music and began numbing me with burning needles aka lidocaine – if any of you have experienced the burn of lidocaine, you understand what I’m talking about. The actual excision wasn’t bad bc of the magic numbing lidocaine – but it did feel really strange to feel the pressure and pulling of all the stitches – but not be in pain. I actually felt a bit queasy because of how odd the sensation was.

He finished up and Adam (right by my side as always – best hubby ever) took a picture to show me, and I was really impressed with how good it looked. This mole was right below a huge ass star tattoo that I have (yay first year of college on Haight St in San Francisco), and I was thinking a huge corner chunk of the star would be gone, but the surgeon removed it in a way that now it just kinda looks like one of the edges is crooked – or as Adam says, “looks like a star fish.” I have a bunch of stitches – 2 layers of them – but it is the internal kind so it doesn’t look bad at all. I’m actually really lucky that the mole was below the tattoo so I was able to see it. So if you have tattoos, make sure to take a close look for moles underneath and get annual skin checks at the dermatologist.

It’s gonna be sore while I’m healing since it is in a spot that moves a lot whenever I move up and down – so I’m taking it easy per the doctor’s orders, and switching off between binge watching Dash Dolls while taking pain killers. Adam’s literally a saint for enduring hours of this show.

I’ll keep everyone posted about the pathology results and when I get the next site removed. Here are pictures of the before and after, so click if you wanna see! The pic on the left is the marker site of what they were going to remove (the red stuff is iodine, not blood) and the right is the final result w my starfish 🙂

Practice What You Preach

I’m all about advocacy, and knowledge being power, but lately – I haven’t done the best job of taking my own advice when it comes to my risk for skin cancer. Even though breast and ovarian cancer are the two biggies when it comes to BRCA risks, there are other cancer risks that come with the BRCA mutation as well. Specifically, there is an increased skin cancer risk with the BRCA2 mutation, which is the one I have.

My mom (also a BRCA2 carrier), was diagnosed with malignant melanoma in 2008 (it’s now gone, woohoo), which also makes my melanoma risk higher. I’m usually good about going to the dermatologist for skin and ocular melanoma checks every 6-12 months, which is the recommendation for BRCA2 carriers. I wear face and body sunscreen every day, and makeup containing SPF. I basically stalked Sephora and Shiseido when my favorite foundation suddenly lost its SPF factor on the label (still figuring out that mystery).

The last time I went in for a skin check was over a year ago, in July 2014, before my prophylactic mastectomy. Between mastectomy complications, recovery, reconstructive surgery, finishing nursing school and becoming a nurse – I didn’t practice what I preached – I went over a year without going to the dermatologist. Luckily, my observant hubby noticed a mole that suddenly looked different. He urged me to see the dermatologist and I kept saying “I will, I will. As soon as [insert excuse here] is finished I’ll make an appointment.” I kept delaying making an appointment and he kept asking me to make one. He even ratted me out to my mom who also got on the bandwagon. Flash forward to a few weeks ago, when I went to a 2 day oncology nursing course. We had a section on skin cancer and that put me in check to make a dermatologist appointment.

I had my appointment yesterday and my dermatologist asked if there was anything of concern to me, and I pointed out the mole. To give you some context, the dermatology office has bookmarks they give out that have the ABCDE‘s of melanoma, and my mole definitely fit most of the categories. My dermatologist agreed that she was concerned about the mole, and biopsied it, along with one on my back that she’s not as concerned about. I liked the doctor a lot, she’s a straight shooter and gave me all the information I needed, in case the mole is melanoma. So now I’m a bit sore from the biopsies, and a bit freaked out waiting for my results – which take 10 days to get back. I’m trying to think positive, because the results could totally come back that everything is a-ok, but it could also be melanoma, so I’m just hoping for the best but being realistic about all the possibilities.

If it’s melanoma, I most likely caught it early enough (knock on wood) that all they’d need to do is an excision to remove it, and that’s it. Of course that specific treatment doesn’t always remove everything, so testing/procedures could be necessary. Inpatient, quick, and pretty easy. So, as a reminder to all my readers, make sure to go to all your doctor’s appointments!

If you have a BRCA2 mutation or family history of skin cancer, get those annual skin checks. If you notice a mole that changes or fits the ABCDE criteria, get it checked out!

Please send good vibes about the biopsy results and I’ll keep everyone posted as soon as I hear back!