Overwhelmed

Today was a long day - we met with the breast surgeon and the oncologist and came home to a pre-op package from the plastic surgeon's office.   My ability to be in denial about all this was really tested today and I kind of feel like I got kicked in the a$$.    I'm too tired to cover in detail but the highlights (or lowlights) are:

• Radiation is definitely on the table more than I thought as the surgeon is worried the tumors might be too close to the skin to get clean margins.  She hopes she'll be able to get clean margins but wants me to be prepared for the worst.  This could make reconstruction a bit trickier but still totally doable.
• I am definitely having the double mastectomy with sentinel node biopsies of the lymph nodes on both sides (mainly due to the 3 spots that showed up on the left, non-cancer, side in the MRI).    The breast surgeon totally sold me on it today.  She said she does not usually feel strongly about one surgical option over another but feels very strongly in my case - age and cancer all over one breast.   She is confident I will have no regrets and based on some people I have chatted with over the last week or so, I agree.
• 2-3 weeks post-surgery I should be feeling pretty good and be back to "normal" by 6 weeks
• They'll give me lots of good pain meds and valium
• My surgery will be at 4pm on March 4 but I have to be at the hospital at 12:30pm for some prep stuff.
• The likely sentinel node looks a little bigger than it normally should be on the MRI but she thinks this could be in part due to the fact that I had 16 biopsy samples taken a couple of weeks before from that area.  The oncologist also did a lot of feeling under my armpit and could not detect any swollen nodes.
• I will almost certainly have chemo due to my age and the fact that there is cancer all over my right breast.   I will likely have a pretty heavy cocktail every 3 weeks for six cycles.  It will start at the end of March and will go on until mid-July.   The oncologist wants to be aggressive to make sure I live healthy for a very long time.    She also suggested having a port implanted, potentially during the surgery to make future chemo treatments easier on my veins.    (A port is installed under the skin between the breast and the shoulder and provide a line directly into the veins so no needle pricks at each treatment.  Ports themselves are not so much fun so I am not excited about this.)
• Because breast and ovarian cancer are very related, we will talk later about whether or not to remove my ovaries.  (Also, ovaries produce estrogen which fuels my type of cancer.)    That is a post-chemo discussion.   Chemo could put my into menopause (although this is less likely the younger you are).
• When the pathologist did the further studies on my biopsy samples to determine the type of breast cancer, only 1 of the 3 known cancerous sites was tested.   This seemed to surprise but the breast surgeon and oncologist.   It is *possible* that different tumors could have different types.   This kind of freaks me out.    The breast surgeon is going to call the pathologist to figure out why they did that.  It is possible they determined that the samples were substantially the same so no further testing was needed.   Everything will be tested very closely after all the breast tissue is removed in surgery.
• The oncologist wrote me a prescription for a "hair prosthesis" AKA a wig but I found out this afternoon upon calling CIGNA that these are not covered under my plan so I will have to pay for it out of pocket if I want one.   
• I cannot eat or drink ANYTHING after midnight on the day of my surgery.  I am sure I will be totally nauseous anyway but I can't even drink water.  
• The oncologist referred to my plastic surgeon as an "artist" and to my breast surgeon as "meticulous."   VERY glad to hear that!
• We really like the oncologist - direct and to the point but very personable and nice.
• Assuming I do not need radiation, the oncologist thinks we will definitely be able to go to Disney at the end of August - a trip we had already started planning.  That is going to be my light at the end of the very long and dark tunnel.

That is all I can make out of my notes.    Keep the blog comments and emails coming as I have gone back to a little bit of a dark place and could use some good vibes and happy thoughts.  I know I will get through this but it really is going to suck!

Oh and a couple of more prayers for my brother-in-law's father would be appreciated.    He has taken a turn for the worse and could use some good vibes and happy thoughts of his own.