Saturday, July 31, 2004
Hanging Tough
By now the chemo drugs are likely flushed from my system. As I write this on Saturday evening, I find that I am feeling better. I rested all day today. Outside of some body aches, minor headache, and a little hint of nausea, I came through this pretty well. I'm not sure if all of the side effects are from the chemo or from the shot I had to self-inject yesterday.

Previously chemo has been administered in three week cycles because it took three weeks for a body to build up the blood counts again. Through the miracles of modern medicine and a drug called Neulasta, it is possible to build your white blood cells and have chemo in two week cycles. I had to learn how to self-inject the Neulasta. After years of giving my mom insulin injections, I just have to apologize to her. Because my mom has never complained, I just thought it was a pretty painless procedure. I should have been more gentle with her! Shots are never fun. Luckily I just need one after each chemo treatment.

The phone calls, cards, emails, and comments on this site lift and carry me. Thanks for your support and love!
Written by Jeannette Vagnozzi
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Friday, July 30, 2004
Windows of the Soul
The oncologist’s office always has an impact me. There is such a range of experiences and emotions for everyone there. The patients in the waiting room tell a story with their eyes. Is it fear? Sadness? Worry? Pain? Hope? I wish I knew their stories.

There was a woman there with her two children. One was a toddler and the other was probably around 6. She was giving him instructions to sit nicely and wait patiently while Mommy went in to talk to the doctor. She would bring the baby because he was too small to leave in the waiting room, but she knew he could be a good boy and wait for her. He couldn’t come in because the doctor needed to tell Mommy something. You could see the worry and nervousness. Was it her? The baby? The older son? Why? Just then I said a prayer for her and for her fragile little family.

The chemo room reminded me of the television room at a fire station: a line up of recliners and a nice television set. Of course this room was a little more sterile and had an assortment of medical supply carts and IV stands and pumps. There were plenty of cheery little stuffed animals and craft items decorating the room and a selection of magazines, books, and videos. Most striking were the eyes of the patients and their family members.

One woman across the room had a look of quiet desperation mixed with pain. “Would this work and is it worth it?” she seemed to say. He daughter lovingly massaged her feet and hands while the woman peacefully dozed off. The daughter's eyes told a different story. Or was it the same?

The woman next to me had enough energy and a smile to light the room. She was in Las Vegas feeling great when suddenly she became very bloated. When they finally diagnosed her she was stage 4 ovarian cancer. She’s been in treatment since last October. She said she wouldn’t know there was anything wrong with her if the doctor didn’t keep telling her.

The man down the way kept talking to people about his involvement with his Catholic church. It seemed be the thing in his life which made him most proud. When someone would talk to him or tell him he looked familiar, he would say it must be from church. It was obvious his faith put that smile on his face and gave him the strength he needs right now.

Another woman came in after obviously crying all the way to the office. She went into a private room to lay down and get her treatment. Another woman was so afraid to make eye contact with anyone. You could see the fear over her face. She didn’t want to look at us or be seen with us because then she might be looking at herself – she’d be one of us. I know that look. I had that look my first visit to the office.

We also celebrated a graduation today. One woman with a beautiful smile, bright eyes, and a gorgeous red hat (that you can’t even attempt to wear without some attitude!) had her last treatment today. It was capped off with a photo of her proudly wearing a graduation cap and holding a diploma. If her smile could heal, we could have all left early.

“What do you have?” would start the conversation in adjoining chairs. It would be followed by stories of diagnosis, treatment, side effects, and helpful tips. It was comforting to see such solidarity. As much as our journeys are separate and distinct, we weren’t there alone. No one walks this journey alone.
Written by Jeannette Vagnozzi
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Thursday, July 29, 2004
Drip, Drip, Tick, Tock. . .
Has anyone every tried a sunless tanner or bronzer?  First you prep your skin and then apply the lotion.  After a few minutes you can't help but check to see if you noticed a difference.  Even though the package says two hours or over night, you keep checking every so often to see if you are tan yet.  You never really notice too much of difference so you go to  bed or forget about it.  All of sudden, the next time you are in the mirror, you notice the new bronze you (or the "new Jan Brady" - for you Julie D.). 

Today was my first chemo treatment.  I watched the endless drip after drip of the many bags that were hooked up to my catheter.  Was that a nose sniffle?  Do I feel a headache coming on?   Hmm....am I tired or is that just the side effect of not sleeping so well last night?  Are the side effects starting?  So far I feel great (4:24 p.m.).  The clock keeps ticking and I feeling great.  According to my wiser and experienced cousins, the side effects might pop up tomorrow.  According to the lovely woman receiving treatment that I was sitting next too, she hasn't been sick a single day and she's been in treatment since last October.  It is like waiting for the tan to show up.  Maybe the second application will do the trick.  Or maybe, I'll continue being blessed.

Written by Jeannette Vagnozzi
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Mammography vs. MRI
Breast cancer is more common than you would think.  One out of every seven women in the United States will be diagnosed with breast cancer.  Ever sat in a waiting room waiting for a mammogram?  Every seventh woman who walks through those doors will be diagnosed with breast caner.  Look around at work.  How many women work there?  Odds are, one in seven will be diagnosed.  It is overwhelming when you think about it.

I just read a news article that I found interesting.  If  you have family history of breast cancer, perhaps you should discuss this with your doctor.

MRIs Better at Detecting Breast Cancer
By Gene Emery, Reuters

BOSTON (July 28) - Women with a family history of cancer may be better off getting an MRI than a mammogram, the more common test to screen for the disease that strikes more than 200,000 U.S. women every year, a new study showed.

A group of Dutch researchers found that MRI scans, which use strong magnetic and radio waves to produce pictures of the body from any angle, have an 80 percent success rate of detecting cancer, far higher than other tests.

"MRI appears to be more sensitive than mammography in detecting tumors in women with an inherited susceptibility to breast cancer," said the team, led by Mieke Kriege of the Rotterdam Family Cancer Clinic in Holland.

The group reported its findings in Thursday's New England Journal of Medicine.
Breast exams found the cancer only 18 percent of the time while the mammograms, X-ray tests that produce an image of the breast, worked in 33 percent of the cases, the doctors found.

Written by Jeannette Vagnozzi
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Tuesday, July 27, 2004
A Little Chemo Savvy for All my "Chemosabes"
For everyone out there waiting to find out about my chemotherapy, here is the plan:

Chemo starts this Thursday.  I will be having treatments every two weeks for the next 16 weeks.  The first four treatments will be a combination of two drugs:  Adriamycin and Cytoxin (AC).  The last four treatmetns will be Taxol.  Chemotherapy works by attacking cells as they reproduce.  The drugs can't tell the difference between healthy cells and cancer cells so it does damage some healthy cells.  This damage to healthy cells is what produces side-effects.  This link I placed on "chemotherapy" above is a great link for understanding how the cells divide and how the chemo works.

Adriamycin -- Doxorubicin hydrochloride belongs to the general group of chemotherapy drugs known as anthracycline antibiotics. It is used to treat non–Hodgkin’s lymphoma, multiple myeloma, acute leukemias, and cancers of the breast, adrenal cortex, endometrium, lung, and ovary.  Doxorubicin stops the growth of cancer cells, causing the cells to die.  (source:  www.breastcancer.org)

Cytoxan --  Cyclophosphamide belongs to a general group of chemotherapy drugs known as alkylating agents. Cydophosphamide is used for the treatment of lymphoma, leukemias, multiple myeloma, mycosis fungoides, neuroblastoma, retinoblastoma, and cancers of the breast and ovary. It is also used to treat some noncancerous conditions.  Cyclophosphamide stops the growth of cancer cells, causing them to die.  (source:  www.breastcancer.org)

Taxol -- Placlitaxel belongs to the general group of chemotherapy drugs known as taxanes. It is also called a mitotic inhibitor because of its effect on the cell during mitosis (cell division). It is used to treat breast, ovarian, and lung cancers, and Kaposi’s sarcoma.  Paclitaxel stops cell division, resulting in cell death.  (source:  www.breastcancer.org)

The first four treatments of the AC cocktail will involve about a one-hour IV drip of the Cytoxan into my groshong catheter and then a 15-minute injection of the Adriamycin.  I may experience tiredness, aches and flu-like symptoms in addition to nausea for the first few days after chemo.  It should take about 2 weeks for my hair to start falling out.  All those things are insignificant if the chemo is doing it's job and killing cancer cells. 

Just remember, I love hugs and visits, but if you have the slightest inclination that you are not feeling well or may have a virus (sniffle, cough, upset tummy - anything), then please call, email, text message, or wave from afar.  My blood counts may drop, making it easier for me to get sick.  If Iget sick, it takes me off course with the chemo and this whole process takes longer.   But I do love hugs, smiles, and visits - just stay healthy so  you can stay close! 

(For the record, and all of you too young to remember "The Lone Ranger," Tonto would call the Lone Ranger his "Kemosabe" which was supposed to be Indian for trusted friend.  Apparently, this doesn't translate as such in any Indian dialect.  I just figured that if anyone was interested in learning about my chemo, they would be my chemo friends or chemosabes.   A person shouldn't have to work this hard for a laugh.)

Written by Jeannette Vagnozzi
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One for my Godson
 
How is baseball like my journey with breast cancer?
Let's see . . . take your pick or add some more!

1.  It's only a first strike; I'm still at bat.
2.  There is a runner at first, but Gagne's on the mound so no chance he'll score.
3.  I may not have said "put me in coach," but I am ready to play this game. 
4.  I'm going to approach breast cancer the way Duke Snider went up to bat -- I'm getting ready to knock it out of the park!

(Note:  I had to go all the way to number 36 on the all time home run leaders' list before I found a career Dodger!) 

Written by Jeannette Vagnozzi
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Sunday, July 25, 2004
This close to a clean get away. . .
After my first surgery, the lumpectomy, I experienced complications of hematoma and infection.  I noticed the symptoms of this on the 7th day following surgery.  Luckily that is all nicely healed now and I have no worries about that any longer.  Yesterday I was thinking that this last surgery has been so different because I have healed well, felt well, hardly used any drugs to get through it, and no hematomas.  Today is the 7th day following my last surgery and I awoke with an infection around the groshong catheter.  I called the on-call doctor from the Oncology office and he was kind enough to call in a prescription and ask that I come in tomorrow morning for evaluation and flushing/cleaning of the catheter.  

What a treat to be able to call an on-call doctor who is able to electronically pull up my files from his home and see my whole medical history while he is talking to me.  The office is so "wired" and technologically advanced.  The doctor was very nice as has been everyone at the oncology office.  One would think that people working with cancer patients day in and day out would become detached and impersonal just to protect themselves.  This office is full of smiles and hugs and warm, friendly service at all levels - staff to nurses to doctors.  It takes very special people to work in this field.   

Written by Jeannette Vagnozzi
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Friday, July 23, 2004
A Day Off and Getting Back in the Swing
I took the day off today.  No worrying about treatment.  No worrying about anything.  Outside of my attached hardware (the catheter port on my chest), I treated this day as a normal day.  I cooked, I visited my mom, I went to the grocery store, I giggled with my sister, I cooked dinner, etc.  While I am not so sure I'll ever adjust to a life of leisure or lounging around, today was the most normal day I have had since May 11th.   Part of that was due to feeling better since the surgery and partly due to the relief of the lymph node biopsy.  It felt good to be normal.

It will feel good to be back in the swing of things again.  I get to start by teaching my Saturday class at the university.    After that I will be back to work Monday, Tuesday, Wednesday.  Thursday I start chemotherapy.  Look forward to postings describing the drugs that will be used and how I will benefit from these treatments. 

Written by Jeannette Vagnozzi
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Thursday, July 22, 2004
The Fortune Cookie Knows All
Earlier this week I had a fortune cookie with the following fortune:  "Fortune Cookie Say:  You Will Soon Receive Good News."  My favorite surgeon gave me the GOOD news today:  My lymph nodes are clear!

Why is this so important?  On Monday, I had the sentinel lymph node biopsy and two lymph nodes were removed.  At the time the doctor thought they looked okay, but they did appear a little large.  If the lymph nodes are affected, it increases the likelihood that cancer cells have spread through the bloodstream to other parts of the body. Women with ductal carcinoma in situ or lobular carcinoma in situ do not need lymph node testing.   As I previously mentioned, I have both lobular carcinoma in situ and extensive invasive lobular carcinoma.  Therefore, it was important that I find out if the cancer was detected at the lymph nodes. 

This does not alter my plan for treatment.  We had hoped for the best case scenario in making the treatment plan.  I, once again, feel very blessed that we get to follow through with this plan.  Thanks to everyone for their prayers and good wishes!  This could not have been a better day!



Written by Jeannette Vagnozzi
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Gene Testing
Yesterday my insurance approved gene testing for me.  This was no small feat and I am grateful for the assistance of my employer (especially Bob), our insurance broker, and the insurance company for moving very quickly on this.  Here are some interesting facts on why this is important.

We are each born with two copies of about 100,000 different genes.  One copy comes from your mother and one from your father.  The BRCA gene normally plays a role in preventing breast and ovarian cancer; however, if you are born with BRCA1 or BRCA2 mutation inherited from either your mother or your father, you are more susceptible to these two cancers.   For those women without the BRCA1 or BRCA2 mutation, there is a 2% chance of developing breast cancer by the age of 50.  Those with either mutation have a 33 - 50% risk of developing breast cancer by age 50 and 56 - 87% by age 70.  (Source:  Myriad Genetic Laboratories, Salt Lake City, Utah)

Other facts about the positive BRCA1 and BRCA2 mutations include:

-Women with a BRCA mutation also have a 27 - 44% lifetime chance of developing ovarian cancer.

-Women with BRCA mutation-caused cancer are at a greatly increased risk of developing a second breast cancer or ovarian cancer.

-BRCA mutations also increase the risk of breast cancer in men.

-Half of all women with a hereditary risk of breast cancer inherited the risk from their father, not their mother.  (Source:  Myriad Genetic Laboratories, Salt Lake City, Utah)

BRACAnalysis is not intended to be a screening procedure like mammograms.  It is intended for individuals with a high risk of breast or ovarian cancer due to family history or because they developed  breast cancer before age 50 or ovarian cancer at any age.  The results of this test will help guide my treatment by indicating whether more aggressive actions are necessary now to improve my quality of life for the rest of my life. 

 


Written by Jeannette Vagnozzi
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Wednesday, July 21, 2004
Pathology, Markers, Personality
I  received a copy of the pathology report on the tumor.  This is one time when receiving the news "positive" is good.   In analyzing the tumor, the pathologist will look for certain markers to determine the tumor's "personality."  Beyond knowing if something is cancer or not, we'd like to know if the tumor is aggressive, what type of treatment it will respond to, etc.   There are three things that are reviewed:  estrogen receptors, progesterone receptors, and HER2.  My results were the best possible combination:  estrogen and progesterone receptor POSITIVE and HER2/neu NEGATIVE

What the heck does that mean?  Well, based on my understanding, estrogen/progesterone receptor positive means that this type of cancer will respond well to estrogen reducing drugs like tamoxifen.  This is good news.  The HER2/neu relates to the growth of the cancer.  Based on my understanding (I can't state that enough), my cancer has a good personality:  not so aggressive and responds well to therapy.  Too bad that didn't describe my last boyfriend!



Written by Jeannette Vagnozzi
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Tuesday, July 20, 2004
The 3-Day Walk
Before I was diagnosed with breast cancer, in fact before I even realized this was a potential issue, I had  started to rally some friends together to train for The Breast Cancer 3-Day Walk benefiting the Susan G. Komen Foundation.  For those that haven't heard about this walk, it is held in several different cities, but all of the walks are 3-day, 60-mile treks.  My goal was to train for and raise funds for the October '05 walk from Del Mar to San Diego.  That is still my goal and I have several friends who are are now interested in forming a team and hoofing it 60 miles in the name of breast cancer awareness and research.  Each participant is required to raise a  minimum  of $2000 in order to participate.

Someone important to my sister Joyce is walking this October '04.  Do you feel moved to donate?  If so, please go to The 3 Day web site.   Enter this name:  Paulette Carnes.   Click on her name, and then follow the instructions to donate. 
  
Thank you for even considering this.    The Komen Foundation does amazing work and is very worthy of every dime it receives.  By the way, next year Joyce and I will be hoping you will sponsor us for this event! 



Written by Jeannette Vagnozzi
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I Should Be Resting . . .
. . .  but I don't know how!  Yesterday was such a long day of waiting.  Waiting to go to nuclear medicine (2 hours), waiting for the  mapping x-rays (from the radioactive injection) (1.5 hours), waiting to get called down to surgery holding area (2.5 hours), and waiting for my surgeon who was held up on another procedure (1.5 hours).  When he asked if I was ready to go, I asked if it would be okay if I waited just a little longer.  At least I got a chuckle out of the man - not always an easy accomplishment.   He happens to be great at what he does.  In fact I read an article about the Neoprobe device he used like a geiger counter to track the radioactive fluid to sentinel lymph nodes.  He was one of the first and one of only a few in the area to use this device and perform this procedure.  This was comforting to find out since the guidelines insist that a skilled and practiced surgeon complete this procedure.
 
The bottom line from the twelve hour day is that the surgery went well.  He removed two lymph nodes and inserted the groshong.  My pain is completely manageable and I get to watch all the television I can handle (which may already be at max capacity).  Family, friends, and co-workers  have been so supportive and caring.  I have lovely flowers cheering me up (perhaps some of the most beautiful I have ever received!) and my sister is taking great care of me. 
 
Next on my itinerary is chemo class at the oncologist's office on Wednesday afternoon and follow-up with my surgeon on Thursday (lymph node biopsy results at this appointment).  Oh yes -- and resting!  Back to the couch . . .  


Written by Jeannette Vagnozzi
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Sunday, July 18, 2004
Too much research . . .
I think I have found myself at a place called "information overload." I have been reading the various studies regarding the sentinel lymph node biopsy vs. the traditional dissection. I'm comfortable with the sentinel lymph node biopsy procedure and the statistics for successfully determining if the cancer has spread to the lymph nodes. With this procedure the surgeon injects a blue die or radioactive fluid into the area where the cancerous mass was located. According to some of the resources, he then massages the breast for a few minutes to encourage the fluid's movement through the breast (um, do I get to be awake for that part?). Other sources state that I would have to wait awhile for the die/radioactive fluid to naturally move through the breast. The surgeon will then follow the trail and remove the first, or sentinel, lymph node(s) where the fluid first drains from the breast.

I have spent the last year or so learning how to accessorize (and I'm getting the hang of it!). Hmmm...let's see...what is the perfect accessory for chemo? Ah yes, the groshong catheter on my chest. I get that tomorrow too. If I could have chosen I would have opted for this whole process to take place during the winter when I wouldn't mind wearing a jacket and a wig wouldn't be so darn hot. Oh wait, if I could have chosen . . . well, you can figure out how that sentence ends.

Talk to you in a couple of days . . . all good thoughts.

Written by Jeannette Vagnozzi
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People . . . Can't Live Without 'Em
There are no words to describe the amazing support I have received from so many people.  I don’t know how I could ever return such kindnesses that have been showered on me.  First and foremost, my mom and my sisters are unbelievable.  I have always known that our family is blessed with strong bonds and strong values; and we have always pulled together to accomplish at times what seems like the impossible.   The only difference in this situation is that they have to rally around me.   I’m so used to being a worker bee that it is hard to watch them do so much for me.   And Joyce, I have never had to ask for anything.  You’ve been my best friend and you’ve been my rock.  There are no words to describe how important our relationship is to me.  I am so blessed.
 
I have some amazing cousins also.  I have my “cugine” Linda who never lets me forget how strong I am and daily demonstrates what it is like to be a strong survivor.  And there are my cousins back east who are breast cancer survivors, Pat and Cindy.  How lucky am I to have such supportive cousins who are unafraid to share their journey and give me guidance.  Since we grew up on two different sides of the United States and only met once, I am blown away by their support.  I am also amazed and how very similar we are.  See, this is where that family bond takes over.  I am sorry we have had to bond over something like this and that they have had to deal with this issue personally.  Strong, dynamic women are abundant in my family.  I am so blessed. 
 
The other place that feels like “family” is at work.  Whoever said that government agencies are cold, bureaucratic places never worked in my organization.  The constant hugs, words of encouragement, and laughter (thanks for laughing at my jokes!) lift me up.  And the cool thing (well, one of the cool things) about Chuck and his yellow “Live Strong” bracelets is that everyone outside of those that Chuck has given them too is wearing them for Lance Armstrong and his Tour de France quest.  When I go out and see people wearing them it makes me think that everyone is wearing them in support of my struggle right now.  Lance who? . . . this is my Tour de Force!.  I am so blessed.
 
My amazing nephews, John, Chris, and Mark (and Theresa and Kristin too!); my fabulous friends (Kathy, Bernie, John, Lynne, Traci, Caroline, Andy, Mike, the Felician Sisters and everyone who offers their prayers and support); my colleagues at the university; Patrick who helped me set up my blog (thanks!) and everyone who has smiled at me when I needed a smile . . . I am so blessed.


Written by Jeannette Vagnozzi
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Saturday, July 17, 2004
Plan for Treatment
This day was different.  This appointment was different.  I was different.  I really felt peaceful.  Whatever attitude adjustment I awoke with and the state of grace that I felt, I know was an answer to my pathetic prayer the night before.  I went into the office and it didn't scare me this time.  When the nurse took my blood pressure and pulse she was shocked that it was so good.  She told me that it is normally high on first appointments because people are so worried.  The doctor was fabulous.  She has more positive energy in her tiny body than should be legally allowed in this field of practice.  I don't know how she does it.  I left there feeling empowered for this journey.   
 
These are the steps and their order as we discussed them:  
1.  Sentinel Lymph Node Biopsy
2.  Chemotherapy
3.  Gene Testing
4.  Bilateral Mastectomy & Reconstruction
5.  Adjuvent Therapy (5 years of estrogen reducing drugs like Tamoxifan)  
 
In addition to this they will also have me scheduled for a bone scan and CAT scan to make sure there is no metastasis, or spread of the cancer elsewhere in my body.   Things can change along the way and any of these steps could be altered or there could be additional steps needed.  Either way you look at it, it is one step at a time.  
 
The choice for the Bilateral Mastectomy & Reconstruction is difficult to face.  Both the surgeon (who the staff at the hospital refer to as the "Booby Doctor" because he does so many of these procedures) and the oncologist gave the same recommendation.  There are so many factors contributing to the recommendation:  the type of cancer, the family history of breast cancer, my age, genetic markers of the cancer itself, and others I'm sure.  In layman's terms, here's the lowdown:   Several years ago it was believed that the best way to treat breast cancer was to remove the breast.  Ater seeing how women with mastectomies dealt with the emotional and physical issues, there was a shift to breast conserving strategies that included only removing the lump coupled with radiation and chemotherapy.  A study was then done that compared recurrence of the breast cancer in both groups of women.  The women (specific age group and type of cancer) who had mastectomies had less than 4% recurrence.  The women (specific age group and type of cancer) with the breast conserving strategies had about 28% recurrence (this number goes way up with certain factors such as family history, etc.).  Although life expectancy was the same for both groups, the recurrence of cancer was significantly differrent.  Don't quote me on this or decide to have a mastectomy without discussing this with your doctor.  I am not dispensing medical advice.  I am just sharing what I have learned based on my research and discussion with my medical team.   
 
When you add to the results of this study my family history (three maternal aunts and two maternal cousins) of breast cancer, the type of cancer (extensive invasive (infiltrating) lobular carcinoma, lobular carcinoma in situ), and my age, it seems to make sense.  The genetic testing, if positive, will seal the deal on this procedure.  I will admit it feels weird and the thought of losing these babies is odd.  But there is a silver lining. . .   We have come so far with reconstruction, which is done at the same time as the mastectomy using your belly fat.  Yes -- I would get new breasts and a tummy tuck just in time for my 40th birthday.  What woman wouldn't want that?  And it is covered by my insurance.  What more could I ask for in this situation?



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Visiting the Oncologist
The summer is a terrible time to get medical appointments because doctors take vacations too.  You'd think they could just prescribe something to feel like they had taken a vacation and then carry out their normal schedule.  Seriously, I want them to take a vacation and be healthy and refreshed so we get the best care.  It was a bit of struggle to be seen at Wilshire Oncology, but I guess I sounded so pathetic they decided to squeeze me in before my doctor went on vacation.  I had to drop off a completed extensive medical history questionnaire.  When I went into the office, the reality of what was happening was quite apparent.  Patients in the waiting room were wearing wigs and patients were coming out of rooms with their chemo IV's and I was shocked.  The patients seemed like shells of their former selves.  No one was smiling, they seemed weak, and there was a desperate sadness hanging around them.  I wanted to turn and run out and never go back.  I didn't want to be one of them.  I dropped my paperwork off and left knowing I had no choice but to go back in just two days.
 
It just so happened that the same day I was dealing with a hematoma (a pooling of blood around the incision) and a slight infection from the first surgery.  I was uncomfortable, in some slight pain, and still in shock from the cancer diagnosis.  I remember laying in bed on July 7th and my breast was oozing and painful and I was just thinking, "God, I don't even have the strength at this moment to ask You for help.  Please, just give me what I need to get through this."  The next morning I awoke and prepared to go back to the oncologist. 
Written by Jeannette Vagnozzi
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Friday, July 16, 2004
From the Beginning...
Once I decided to share my experience, I just picked up where I was at the moment. I think it is important to go back and start my story from the moment it began.

In May I was preparing for a couple of significant events. I had a retirement party coming up one weekend for a co-worker I loved working with so I wanted it to be special. The day before that event I would be facilitating an all-day strategic planning workshop. On Monday of that week, I got sick with the stomach flu. Of all weeks! I really had no time for that -- it wasn't scheduled! In the middle of the night I was trying to get comfortable, but the pain in my stomach was terrible. In my struggle to get comfortable, I found myself in an awkward position withmy hand under my breast (I know it was a weird position that I couldn't recreate if I tried) and felt something hard in my breast. I became completely awake, double checked what I was feeling, and decided I would call the doctor the next day. Which is what I did. Only my doctor could not see me for two weeks. Since I knew the doctor would send me for a mammogram, I asked that they give me the referrals so I could get on the books at the diagnostic center. Of course, the diagnostic center couldn't see me for three weeks. I began calling everyday asking if there were any cancellations -- both my doctor and the diagnostic center. Everyday. Every single day.

When I finally got in to see my doctor she called in and got my mammogram moved up to the next day. Wow -- and there were no cancellations. How was that possible? Amazingly, that test came back normal. Since I had a palpable lump, I still needed to have an ultrasound. I couldn't be squeezed in until the beginning of June. Four hours after I had that test, I got a phone call from my doctor telling me the ultrasound detected a solid mass and I needed to see a surgeon for further diagnosis and treatment. The next morning I was picking up the paperwork and calling the surgeon. I was able to see him within the week. On that first visit he gave me a clinical breast exam (CBE) and agreed that the lump felt different than any other lump in my fibrocystic breasts. It was definitely more solid and defined. Incidentally, 50 - 80% of the women in North America have some form of fibrocystic breast issues. While it doesn't indicate cancer, it does make it difficult to distinguish between benign cysts and cancerous masses. At that time, my surgeon decided to perform a needle biopsy or Fine Needle Aspiration. Guess what? This test came back negative. Because there are some issues with the reliability of this test, coupled with my strong family history with breast cancer, we opted to excise and biopsy the lump.

On June 28th I went in for outpatient surgery for a mass excision and biopsy on my right breast. It wasn't so bad. I was back to work the next day and doing fine. On July 1st I went back for a re-check and results from pathology. Both my doctor and I were shocked when it came back as cancer. His exact words were, "Well we got some bad news back on the results of the biopsy. You have invasive lobular carcinoma and lobular carcinoma in situ. . . The next step is to see a medical oncologist. . . . " I really can't tell you what else was said during that appointment. I guess it really doesn't matter.

The moral of my story is that I caught this early because I was aware, I fought for faster appointments, and I educated myself on what I was facing or could be facing. I questioned every step my surgeon was taking and supported my questions with facts from reliable sources (like the American Cancer Society, the National Comprehensive Cancer Network, and the Susan G. Komen Breast Cancer Foundation). Medical care is in your own hands. We all need to take control of our medical care, ask questions, research, and direct our own destinies. Hiding from reality or going into a state of denial about detecting a lump seals your fate in a different way. From the moment I felt the lump in May, I knew it was different. I knew something was wrong. I had no doubt it had to be taken care of immediately.

My next post will recap my experience with the medical oncologist and the direction my treatment will take. After that I can't wait to recap the amazing support I have received from so many wonderful people in my life. I am truly blessed.
Written by Jeannette Vagnozzi
3 chimed in

Thursday, July 15, 2004
Next Step
Yeah!  My doctor has determined that my incision has finally healed and I am ready for the next step.  On Monday I will have outpatient surgery for a sentinal lymph node biopsy and insertion of the groshong catheter for my upcoming chemotherapy.  Of course the idea of having radioactive fluid injected into me is not exciting, but I am excited to get moving and get on with this.  Knowing whether or not the cancer is detected in the lymph nodes is important.  I also get a week off from work to recuperate and heal.  Expect a lot of posts next week.  I'm sure I'll be bored by Wednesday.  All good thoughts....
Written by Jeannette Vagnozzi
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Wednesday, July 14, 2004
Inspiration
My nephew's girlfriend, Kristin, has this as her signature line on her email:

Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12

Today this passage really speaks to me as I get ready to take the next step in my journey. Thanks, Kristin!

I have a doctor's appointment tomorrow morning. I'll post the next step after I see him.
Written by Jeannette Vagnozzi
3 chimed in

Wig Shopping
I want to be as prepared as I can for everything I'll face in the coming months. Since I know I am facing chemotherapy and will likely lose my hair, I decided to go wig shopping. I've never thought about wearing a wig and had no idea where to find a really good one. I contacted a friend of mine that is a hair stylist and asked him about it. He directed me to this place called 'Wigs & Gifts.' Interesting concept don't you think? You can either buy a wig or maybe a 14 kt. gold ring. Anyway, this shop is in a dive shopping center in Pomona. It was strange walking in and seeing a bank of wig heads lining the walls. A really sweet woman directed me to the bank of wigs in the back. She was very kind to let me touch them and see which ones felt right right. After purchasing a wig cap for 99 cents she allowed me to try one on. It was all wrong. Too short. Too small. For some reason I had this bizarre image that I might feel like Boticelli's Birth of Venus when I put it on. She does look like she is either giving herself a breast self exam or somehow protecting her right breast. It fits, no? Why couldn't I just throw in the flowing hair? I then picked up another wig, put it on my head and was done shopping. It is a little longer than my normal hair, but it's no Venus. Actually, I feel a little like Cher with it on, but it looks fine. This task is done....on to more important things.
Written by Jeannette Vagnozzi
6 chimed in

More on 'Two Hands'
The name 'Two Hands' has much more meaning to me. As much as I can have an irreverent sense of humor, there is a profoundly deep side to me as well.

Traditionally, we join our 'Two Hands' symbolically in prayer.

'Two Hands' is a symbol of the two hands I hold out asking for help and support (a new concept for me).

I ask that you lay your 'Two Hands' on me and pray for my healing.

Jesus used his 'Two Hands' in raising the bread that was blessed and broken for us - the bread through which we as humanity are healed and forgiven.

'Two Hands' join two people together.
Written by Jeannette Vagnozzi
4 chimed in

Why the name 'Two Hands'?
I made an appointment with my primary care physician the day after I found my lump. From there I had appointments for a mammogram and an ultrasound. The mammogram came back normal, but the ultrasound found a solid mass. From there my doctor referred me to a surgeon for further diagnosis and treatment. On my first appointment to the surgeon he decided to do a needle biopsy (fine needle aspiration) in his office. While trying to locate the lump with the needle, he asked his nurse to hold my breast. She placed one hand on it and he quickly said, "No, no, *two* hands." Thus the name - Two Hands. I decided that I should be proud of my girls as chances are, I may lose them.

No one understands what it is like to be told you have cancer until it happens to you. I remember feeling like the air had been zapped from my lungs. I was overwhlemed with emotion the first week, but then on Wednesday night July 7th, something clicked. I can only explain it as a state of grace. My attitude is strong, my faith is strong, and my sense of humor keeps me going. If you don't think you can handle my somewhat irreverent sense of humor, then read no further. But if you want to share my journey, find support for your own journey, or support me, then by all means visit and comment often.
Written by Jeannette Vagnozzi
4 chimed in

Saturday, July 10, 2004
About This Blog
At the age of 39 I was diagnosed with breast cancer. Days after diagnosis I began this blog to record everything and share my experiences in the hope of helping others. Here are the links to blog entries which recount my medical progress.

In between the medical reports you will find other entries about my reconstruction process and my emotional and spiritual healing process. It has been my hope that I keep this as honest and real as possible. I also hope that my witty interludes lighten it up a bit from time to time.

I'd love to hear from everyone who passes through. If you don't want to leave a comment publicly, then please email me. If I can help you on your journey by ansering any questions, don't hesitate to contact me. If you are a caretaker and would like to connect with another caretaker, please contact my sister, Joyce. Thanks for stopping by! ~Jeannette

Written by Jeannette Vagnozzi
3 chimed in

Name: Jeannette
Location: Southern California, USA

This is my story about being diagnosed with breast cancer at age 39. I thought I was out of the woods, but four years late it came back. This is my quest to be a two-time survivor.

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    "Be joyful in hope, patient in affliction, faithful in prayer." Romans 12:12