March 17th FORCE post, Genetics Counselor Appt.

Hello all. Was incredibly nervous heading into the genetics counselor meeting, despite knowing much of what would be said. Genetics counselor was nice, and helpful. A moment of panic, as I was lead into a normal exam room. I think I would have freaked out a little if I had to gown up for the GC (genetics counselor )appt. Definitely did not fit my vision of a consultation in an academic office across her desk.

Oh well. We did still trade articles. Gave me the spiel about all of my "bad" conservative options. I had not been aware of how little use tamoxifen was for BRCA1 bc(breast cancer) prevention. She made it sound like only 1/3 or less reduction in BC risk, as more of the tumors end up being estrogen receptor negative. Agreed that I am probably too old to get much bc prevention benefit by having ovaries out.

All ( GC, oncologist, and resident) seemed relieved that I was opting for surgical risk reduction. Optimistic news about the gyn onc doing supracervical hysterectomy through the laparoscope. They seemed to agree that no recon fits with my goal of being off work as little as possible. No funny looks. PS appt was briefly offered, but not pushed.

The doc was quite interested in my history of already having a colon polyp removed. I am due for repeat colonoscopy in Sept. (great, one more thing to stress over. Stats are ambivalent about BRCA1 and colon cancer. I guess the stats don't matter that much as a gal with a polyp at 40) My gastroenterologist is praying for me.

The packet of info include several FORCE newsletters and the flyer for the conference. Whitney will be going to the FORCE conference.

Good info about having brothers start high risk prostate screening at 40 instead of 50.

So weird being a patient. So nice to walk into the Breast Center without cancer. Very motivating to keep it that way.

So, it does feel more real, having the folks who know confirm that my research and my FP(family practice doc) and my Gyn are all correct. Sucks to be right. (how could I not be with such good info and advice from the FORCE site)

Arrived at work yesterday to find an article from my local Gyn about ovca (ovarian cancer) in BRCA carriers. Not sure what his point is. I guess, a gentle reminder not to take too long to get mine out. I messaged him back about my concerns regarding BRCA pathology protocol and occult ovca found at rr ooph (risk reduction oophorectomy - ovarian resection). No response yet. Got an email last night from my proactive cousin, urging me to get my ooph soon. While waiting for her mom's skin graft, she got to sit next to a different high school acquaintance who at 36 was alone in the waiting room, ready to get her chemo port in for treatment of ovarian ca.

After listening to my biological clock wind down for so many years, who knew that it was the switch for tiny internal time bombs.

Grieving the impending loss of my fertility, even though I have been deciding for 5 years that a child would not fit into the life that I had, and not willing or able to change the situation enough to make it work.

So what else is going on:
1. still struggling with a challenging "presumed" metastatic bc patient electing not to clarify her dx or take chemo.
2. bought my luminaries for the local Relay for Life event. Scheduled May 18-19. I bought 8, but realized that I forgot one for my high school friend in the Ukraine and my uncle who died of throat CA. 2 years ago it was a shock to count up the relatives with cancer. Now it just raises the curiosity level. No ovca thankfully.
3. Enjoying reading and posting obsessively on the FORCE site.
4. PT. felt like my therapist was trying to kill me yesterday. Turns out my round shouldered posture has been hiding how prominent my breasts actually are. Feels very weird to be improving posture, making them more prominent right before I get them cut off. Trying not to feel guilty for indulging myself in the magical PTs services for a sore neck at a time like this. I know it will help in the long run.
5. obsessively watching my email. Surprised at how few responses I got from my first round of mass emailing people. Very appreciative of the ones who have written back. It makes a great distraction for me. Helps me feel connected.
6. Fretting about my youngest brother, who is usually quite communicative, but who has been too busy to finish a phone call, and has not emailed. I hope he is just busy.
7. Enjoying my sister's blog site with new pictures of her daughters. She is perplexed about how the love of princesses and the color pink is transmitted as both mom and dad have worked hard not to encourage it. Her pre-school is the most progressive ever, with rules against comercial toys, policies against passing on gender stereotyping etc. It was painful for Aunt Margaret to have to buy a disney princess Leapfrog book for her. (And some of the messages in it are horrible. Ariel asking her husband if she can ever go back and visit her family. Yuck.) No offense to the princesses on this site.
8. Being interrupted from typing this post by the 4 deer grazing in my back yard. So nice to get absorbed in the moment. They stayed 10 minutes. Fun to indulge my naturalist tendencies.
9. Told my first menopause joke.
10. Found a new way to make my patients cry. One, who is quite well connected to the hospital gossip network asked me straight out what was going on and then broke out in tears and hugged me. (usually I make them cry by being too blunt or by being a mean pain doc)
11. Practicing golf at the indoor range. Focus, being in the moment. Emotions leaking through. Grieving the loss of part of the golf season. Inspired to be back by August to take on one of my nemesis courses for the Mich women's golf assn state tournament. Last time we played there I think I shot 113, with a 20 handicap.
12. Feeling blessed and amazed by the sequence of events that got me here and able to be saving my life. I do hear you ladies, who remind me that there does not have to be a reason for God to bless me with this chance. Hard to not feel some responsibility from it. More on this in a separate post.
13. Gradually feeling more accepting that BRCA1 + and rr(risk reduction) surgeries are my fate for this spring. When speaking with my therapist, I told her that I can't believe this is happening to me, but can't really imagine who else it should happen to.
14. Feeling very chic. Oprah, Self and Cosmo in the same month. Thankfully the cosmo article is online at BeBrightPink so I do not have to undergo the trauma of buying all three magazines for the first time ever.
15. Wondering whether I should be writing a book. Revising my plans for the blog. Wishing that I was able to take advantage of the current climate and have something ready soon.