The Dirty Details - for those who want them.

I've been trying to really take one day at a time. All of the treatment plans are overwhelming looked at as a group, and while we have an estimate of timelines, I know all of that can ebb and flow based on labs and unrelated illness that could get me down and slow progress. But, here is the outline we hope we can follow:

I will have a total of four rounds of chemotherapy using Doxorubicin and Cyclophosphamide, given every other week. A treatment day consists of going in for a lab draw an hour before seeing my rockstar of a medical oncologist, having my checkup with her, then getting fluids and two anti-nausea meds: Aloxi and Emend. I also get a steroid, Dexamethasone, and IV Benadryl in addition to the two chemo meds. I get an extra bag of fluids because it seems to help me combat my nausea. The day following treatment day, I go in for a shot of Nuelasta , which is supposed to boost white blood count (WBC - we're going to start using abbreviations here, crew!).

Doxorubicin is nicknamed The Red Devil because it is literally bright red, and because, honestly, it's a real jerk of a drug when it comes to side effects. :-) The good news is that so far, I've done fairly well taming the nausea. This is drug that's made me lose my hair, and it also makes me pretty tired. This last time, I was probably awake for two whole hours the day after chemo. It gives me nasty mouth sores, but thankfully the in-house dentist has prescribed some great stuff that's help with that.

After I've completed my four rounds of this cocktail, I will have two weeks of rest and then start a different chemo drug, Taxol. This drug takes a longer time to push, so my treatment days will inevitably be longer. I will also have four rounds of this, every other week.

Once second round of chemo is complete, I will have another rest period (not sure of its length) followed by surgery. At the most optimistic, the chemo will have obliterated the cancer, and they remove the area the cancer used to be along with a healthy margin of cells around the area. This includes the lump and at least four of my lymph nodes. Obviously, if they find remaining cancer, they take that with a healthy margin. This is generally referred to as a lumpectomy.

Because cancer was found in my lymph nodes, I am required to do radiation. All the research finds that recurrence rates are the same in these two cases when it comes to breast cancer: mastectomy (full breast removal) or lumpectomy followed by radiation. This could change based on my genetics results, which will be coming in the next weeks.

After surgery, I will rest for 4-6 weeks, then begin radiation. This is supposed to obliterate any remaining unseen cancer cells in the vicinity. I will need radiation both in the area of my breast and underarm, as well as the lymph nodes in my neck, due to the proximity of cancerous lymph nodes. Because my cancer is on my left side, it is closer to my heart. My stellar radiation oncologist, (I'm not blowing smoke, guys. I really have an amazing team.) mentioned me being "on a line." I would probably be fine doing traditional radiation. If I were younger, 30-35, she would suggest looking into Proton Radiation, which is a more focused form of radiation with smaller margin of "collateral damage." Her exact statement was "if it were me, I would want to know about it," and she committed to putting in the referral to Mayo if I wanted to go that route.

First of all, I don't feel any older than 30. Some days I still feel like I'm playing house in my real life. I can't believe I'm an adult responsible for two, only slightly-smaller-than-me humans. Second, I probably don't act 41. Third, the women on my maternal side tend to live long, full lives. Fourth and most important, my cousin (one of only three cancer cases known on both sides of my very large family tree) had Proton Radiation at Mayo for a super rare form of cancer years ago in a much more sensitive facial area and is doing phenomenal. So we asked for the referral.

The BIG and GREAT news is that this week, insurance approved it! I will live in Rochester for a month at some point this summer. Radiation will be every day for 5 days, for 4-5 weeks. I'm not at all looking forward to leaving my home, my husband, my kids, and my friends. I will miss out on some of my favorite things about summer - the lake, Reece's baseball, taking Evie to camp and seeing how excited she gets. I still haven't really even swallowed the reality of this. I do know when you get to choose the best of the best, you say yes. So I will.