The Breast Cancer Gene

A note about breast cancer.

It is Breast Cancer Awareness Month after all...  I have a ton of breast cancer in my family: my mom (survivor), aunt (survivor), and Maternal Grandmother (deceased, lung and breast cancer).  My mom was only 43 when she was diagnosed.  Because of our family history, my mom got the whole genetic scan for the BRCA breast cancer mutations and was found to have a mutation on the BRCA 2 gene (or is it a chromosome?).   Since then my aunt, uncle, sister, and myself have all been tested for that specific mutation and we are all positive for it.  I really am totally fine with this.  Because of my family history I have always known that I have a very increased risk for breast cancer and the gene just confirms the risk.  The upside is that is qualifies us (my sister and myself - we got tested together and are following the same preventative treatment plan) for closer monitoring which is great.

There are 3 basic options for women like my sister and I. 

Option 1: prophylactic surgery
The most aggressive option is a prophylactic double mastectomy and oophorectomy. (Remove the breasts and ovaries before they have a chance to become cancerous.)   I know that some women choose this option, but it's not for me.  Although, I will have my ovaries removed after I have kids since cervical cancer is very difficult to detect. 

Option 2: chemoprevention
Taking one of the breast cancer drugs as a preventative measure has shown success.  But these drugs also have side effects and they haven't been studied over very long periods of time.  Maybe we will consider this when we are older. 

Option 3: increased monitoring
This is where my sister and I are starting.  We both had our baseline Breast MRI this past summer which we will repeat each year following.  Our doctor suggests this starting at age 25 for women who are positive for the BRCA mutation.

Mammography is not very successful on young women because our dense breasts make it harder to detect cancer.  The breast MRI is clearer, but has a high rate of false positives.  This is why women with a normal risk do not receive screening before age 40.

The bottom line: You are a better breast cancer detector than a mammogram or an MRI.  Check yourself at the same time each month and do not ignore suspicious lumps!

A final note.  I think it's great that so many companies support breast cancer research, but please make sure that you read the fine print before buying "pink" products.  I only buy products where 100% of the proceeds go to the cause.  It's not right for companies to be making money off of "causes" like cancer prevention.

Jennifer Anniston's shirt for Ford's Warriors in Pink is a great option.  100% of the proceeds go to Susan G. Komen.

This post is dedicated to Giuliana & Bill

Wow...this woman really is inspirational.  It's hard to feel sorry for yourself when someone else shares their way more difficult story.

I knew Giuliana & Bill were going through infertility treatments, but never watched the show.  For some reason, I came across it last weekend.  The episode I saw is their first IVF treatment.  They are so excited to find out that they are pregnant.  I didn't know the exact outcome, but knew that this episode was in the past and that they are not pregnant now.  So I googled the whole story while watching.  I found out that this IVF would result in miscarriage during week 8 and that the next attempt will not work either.  Then on their third attempt, the doctor says she must get a mammogram first because pregnancy can speed the growth of cancer.  She is 36 years old and finds out that she has the early stages of breast cancer.  What more can this woman go through?

It was heart-breaking to see their joy, knowing the pain they were in for.  That's the scariest part of having this process take a long time.  When it happens, you can barely believe it.  you don't want to get too excited in case it doesn't work out.  I got a packet of info in the mail from the RE I will be going to next week.  And it in they explain that even if you go through IUI, IVF, etc., the risk for miscarriage never changes since it's the bodies way of making sure everything is right. 

Thank you Giuliana (& Bill) for being so open during this extremely painful process.  Sharing your story helps countless others going through similar situations.  Through the tears and the pain, we are rooting for you!

Giuliana went back to work this week after having a double lumpectomy and she still has future radiation treatment. 

I truly hope the Rancics are able to have their healthy baby soon!

*More Breast Cancer Awareness Inspired posts to come.*

Skincare while TTC

So when I went off of birth control, my face EXPLODED.  I mean I was walking around like an embarrassed 16 year old. And trust me; it's even worse when you are actually teaching 16 year olds every single day.  (Digression: when I was student teaching, an 8th grader left a note on my chair during class.  The note read: "Your armpits are sweaty."  My internal monologue: "Thanks kid. I know my armpits are sweaty!  Why do you think I've been trying to teach without lifting my arms.  Jerk.")  Kids are extremely honest and I was just waiting for a new note on my chair, this time about my face.  Luckily I teach high school and these students are slightly more tactful and respectful.  No one ever mentioned my disgusting face, but I worried about it every. single. day.

When I went to the dermatologist, I mentioned that I was TTC because I knew that many medications were not good for babies.  This was back in the days when I thought I would be pregnant any day...ah my blissful ignorance of the true TTC journey that awaited me...

Anyway, he told me that all medications are rated from A-Z on a safety level for pregnancy.  Accutane is a Z.  There is a warning on the bottle (and even pictures I've heard) about severe birth defects.  There are no medications that are an A.  But the doctor proscribed Clindamycin Gel for me that is classified as a B.  He said that he would be comfortable with his wife taking it while pregnant although he said I could always stop if needed.

It was slow, but my face really did clear up; at least the crazy oil sheen disappeared.  My skin had been clear and basically normal for about 11 years.  I often got compliments on it.  Coping with my "new skin" was really difficult!

Here's how I know it worked.  When I got pregnant last month, I stopped using the gel.  I didn't really think about it.  But a few days ago I noticed that my face was getting really oil and ridiculous again.  I thought maybe it's just the time of year, since it was September/October last time too, but then I realized...it's been a month since I used the Clindamycin.  Duh!

I also started using the cleanser/moisturizer combo of CeraVe.  My skin never really liked the uber-popular, Cetaphil and it's been really hard to find the right cleanser.  Also, I have very sensitive skin.  Many products feel like they burn and I get red easily.  I LOVE the CeraVe cleanser.  I have also tried 3 of their moisurtizers.  I like the PM moisturizer, do no like the AM moisturizer, and am unsure about the big bottle of moisturizing lotion.  Overall, I highly recommend CeraVe. It's a little expensive, but very gentle and worth it!

I was hoping my face would correct itself, but apparently not.  Thank goodness for dermatologists!

What's your face routine post BC?

My Life Outside TTC

I need to step away from baby talk for a day I think.

So I won't mention that I confirmed yesterday that both women at school who got married significantly after me are both noticeably pregnant.  Good for them : /.  And I won't talk about the fact that my temp dropped today and that this cycle is just about over.  Good riddance.  I hate this cycle anyway....

Let's talk about the fact that I am a Champion!  No, really.  My indoor soccer team won the playoffs last night.  It was quite exciting.  The first game was competitive but we won 2-0, a very low score for indoor.  But the second game was against our arch-nemesis the Yellow team!  I hate that team.  A lot.

They scored first and second, both on mistakes we made.  There were also 2 blue cards issued in the first 5 minutes (where a player is ejected for 2 minutes, kind of like hockey).  The second blue card foul was committed against me because this girl checked me into the wall.  Ouch.  I might have called her an F'ing Biyatch.  Whoops! (Totally out of character for me.  I was pissed!). 

By half-time, we were up 4-3 after scoring some awesome goals, one right after another.  I had the assist on one : ).  We worked super hard to keep them from scoring the tying goal, but we got lazy for a second and they scored with about 2 minutes left, which took us too....penalty shots!

I really did not want to take one of the penalty shots.  I can make them occasionally, but the last time I missed, I re-played the shot over and over in my mind for at least the next 24 hours.  I can be pretty hard on myself.  So the plan was for me to go last.  First shot, in!  Second shot in! Third and Fourth - not in.  It's now 2-2.  We make our last shot, they miss....AND WE WIN!!!!!  It is kind of exciting even though it's just a co-ed YMCA league.

Today I can't move my neck, I have turf burn on my thigh, a scrape on a bruise on each arm respectively, an ankle that is slowly turning blue....and a Champion t-shirt!  Woo Hoo!  Hopefully I'll still be able to play in my other league tonight!

Thanks for reading my totally un-baby-related stress-relieving recap : )

How do the rest of you stay in shape?

Lots of Tears, a Latte, and a Blueberry Scone.

Those of you who know me from the Weddingbee Boards know that I am pretty rational and level-headed most of the time.  I've read other people's posts about breaking down in the doctor's office with a mix of pity and embarrassment.  Well, today was my day....

Yesterday, after writing a draft of my doctor rant and after calling the "scheduling line" once on Monday and two times on Tuesday and after not getting a call back, I decided to go to the office and talk to them in person.

This is bold for me; very bold.  I don't like to seem pushy because I don't want people to think I'm rude.  I don't like to get in trouble.  I feel like people are yelling at me when they are just talking about something serious.

So I show up, I'm super polite.  I explain the situation (for the 2nd time that day).  Seriously do those of you with infertility issues type up a card to have every new person read?  "We've been TTC for 14 months, charting for 7, I spot every month before AF, chemical pg last month, have done Day 3 labs, SA, HSG..." 

What I really want is a blood test to check my progesterone levels since I suspect they are low because I spot every month.  I think the old doctor might have ordered it if I had gone back, but you've read that story already.

The receptionist comes back and says that I can come in for an appointment tomorrow at 8.  I say thank you and find teachers to fill in for 2 periods of classes, then spend the rest of the night creating lessons that my students can do with out me.  Missing class is much more stressful than being there!

Almost to the point, stay with me...

So I get in there this morning and the nurse offers me a pregnancy test.  I'm 8dpo, this is totally against my rules, but I say ok, probably my first mistake.  Then the Nurse Practitioner comes in.  She's really nice and listens to my story, but basically all she has to say is that she can't do anyting and that I need to meet with an actual doctor. Um. Yes, I kinda figured.  But can't I at least have the blood test? (internal monologue)

Cue tears.  I was able to manage "I think I'm going to cry" and then just started bawling.  She felt so bad!  Of course I had to talk to 3 additional people through tears before I was finally out the door.  I got an appointment with the actual doctor (3 weeks from now, the doctor I wanted doesn't have anything until next year!), then they returned my copay since I should have never seen the NP in the first place.  Oh yeah, and then I had to pay the parking guy on the way out. 

I cried all the way back toward school to the Starbuck's parking lot.  I still couldn't decide whether I could handle teaching the rest of my classes today.  But after a long call with DH, I was able to finally calm down, treat my self to a decaf non-fat latte with one splenda and my ultimate indulgence, the 460 calorie blueberry scone and head back to school.

Want to know my sneaking deep-down suspicion about what caused the massive flow of emotion?  I was supposed to have my 8 week pregnancy check-up at the same office, with the same Nurse Practicitioner today. F.M.L.

Oh! And can't they treat those of us pariahs who can't have babies in a separate building so that we don't have to see pregnant moms and moms with babies at every angle while leaving the office crying? That would be nice, thanks.

Doctor/Insurance/HMO Rant. Grr.

**I wrote this post yesterday although it was long overdue.  I just hate this issue so much I didn't even want to deal with writing about it.  Well...you need a read it, because there's a lot more to come when I tell you about what happened at a last minute appointment I had today.**

Even though I am incredibly concerned about getting pregnant, I haven't had a doctor's appointment since July or August.

In February (6 months TTC) I had my last regular yearly exam.  I mentioned that I was TTC without success.  I had my calendar with all of my cycle info with me.  But he basically said there was nothing major to worry about and didn't really ask other questions.

In June (10 months TTC) I met with the same doctor again, this time focused on conception.  Again he did not look at my info or ask any questions.  I'm not sure how forceful I was about showing him my documents, but I remember being frustrated after.  I feel like an idiot when I walk out of a doctor's appointment feeling like I didn't say what I wanted to say.  I'm not a passive person, but I also don't want people to get "upset" with me for being pushy.  I don't know what happens.  At this appointment he also told me that he would be retiring.

We had another appointment two weeks later in June and I honestly can't remember why!  I think I wanted to talk to him one more time before scheduling the "infertility appointment" since I knew that I had no coverage for it and the appointment itself was $400!

In July (11 months TTC) Mr. GG and I went together for our first Infertility appointment.  The nurse told Mr. GG he was not the important one in this process, basically just an accessory, and that set the tone for our interactions with her.  More on that in a sec.  The doctor was pleasant and ordered the SA for Mr. GG, Day 3 Blood Tests for me, and an HSG.  He knew that we didn't have coverage and chose specific places for us to go (outside the system) for cost effectiveness.  I thought that was nice.  The problem with this appointment (again no looking at my calendar or the charts that I took two hours to recopy by hand) was that there were no real "next steps" beyond getting the test results.  I do remember him saying that basically the RE would be next, but I just felt unclear.

I got my test results online and they were normal.  But getting Mr. GG's SA results was a bitch!  The office he went to wouldn't release them to him because he's not a doctor and we couldn't get the results online because the original appointment was under my name, not Mr. GG's, so it was like they didn't exist!  Eventually the nurse called Mr. GG, but come on!  DH has a slight morphology abnormality, but it's not major.

Because the results were good, we weren't sure what to do.  We didn't want to go back and pay for another appointment if there was no need, but we needed more guidance.  After a series of emails with the nurse, I decided I never wanted to go back to that office.  She was never overtly rude, but I felt that she was intercepting my emails and answering them myself without consulting the doctor.  I'm sorry, but I don't want your opinion, I want the doctor's!!  When I asked her about progesterone testing, post-ovulation, she said that she had never heard of it.  Seriously?  It's not that uncommon lady.

Then school started and I did nothing.

Ugh.

Infertility Testing: The HSG

One of the first things your doctor will ask you to do if you are having difficulty getting pregnant is the HSG, the Hysterosalpingogram (you better believe I had to look that one up!).  It has to be done about 7-10 days after the first day of your cycle, when your lining is the thinnest.

The HSG is an x-ray test that is used to check the "plumbing."  The doctor injects dye into your tubes and then checks everything out on a screen to make sure there aren't any blockages and that everything is present.

I was totally freaked out about getting an HSG because I had heard some girls have major cramping during and after the test.  I put it off much longer than I should have.  I had forgotten that somewhere in my endless hours of Google research I had learned that the HSG can actually increase your chances of getting pregnant for the few months following the procedure.

Here's how it went: I got the test done at a place that only does radiography.  I checked in and paid my $300. (I will go over my insurance situation in another post.)  I wore a cotton skirt and shirt and was allowed to keep them on during the exam.  You have to put your legs up kind of like the OB/GYN stirrups, but under the knee and your whole leg is in the air.  There are two people in the room, just like during OB/GYN exams.  They insert something (like a speculum but don't remember exactly) then put a smaller tube through your cervix.  This part feels a bit weird.  For me it didn't hurt exactly, but it was not comfortable either.

KEY: Take 2 Ibuprofen before the appointment.  I did this and that might be why I had no problems.

After the dye is inserted it slowly makes it's way through your tubes and YOU GET TO WATCH!  It's totally weird but cool.  I had no idea that fallopian tubes are really long and look just like angel-hair pasta. They are super skinny and stringy.

I passed the test with no problem.  I had to wear a pad for a few hours for the dye, but honestly not much came out.  I had mild cramping but nothing too uncomfortable.

And...we got pregnant during the same cycle, so maybe it did clear something out?  Here's hoping it works the cycle after also!

Did anyone have a similar experience or was yours of the painful variety?