The Pregame Warm Up

“The key is not tool, technique or method but the attitude and mindset in which you do those things.”

-Father Michael Himes

So I had a game plan. After countless doctors appointments, a mammogram, 2 MRIs, 2 biopsies, and multiple blood tests I finally had a game plan for treatment. The dynamic warm up of my Pregame Warm Up was Surgery. Now you many be thinking - “This girl is crazy - surgery is the warm up!?” I chose to have a Lumpectomy + Radiation because when it comes to breast surgery, a lumpectomy is the most minimally invasive surgery option. After surgery and recovery I moved on to the “partner pass” part of the Warm Up. This meant that I needed to find the right “partner” for my next stage of treatment, so I held “Oncologist Tryouts”. I say “tryouts” because I met with a few different Oncologists at MSK before choosing one. After choosing my Oncologist she sent me into my final drill of the Pregame Warm Up, my Fertility Treatments. Although my doctor said that I should still be able to conceive naturally she recommended I freeze my eggs as a “just in case” the worst case scenario played out.

Lumpectomy Surgery:

As I mentioned, I chose the Lumpectomy + radiation surgery path. Dr. Gemignani explained that it has the same “cure” rate as having a single mastectomy. My surgery was scheduled for July 1st at the Josie Robertson Surgery Center . I had my pre-surgical testing the Friday before the surgery and announced to the Muni team at Morgan Stanley my diagnosis and treatment plan in our morning meeting. Now this is not a small meeting in any sense of the word, on a daily basis there can 40+ people crammed into a conference room and more on the dial-in. Before making my announcement to the team I spoke with a Social Worker at MSK and someone in HR at Morgan Stanley to find the “right” words to say.

Now, there really is no “right” way to say “I have cancer, I am having surgery on Monday… andddd I don’t know when I will be back in the office, ” without getting 10,0000 questions. So I said just that but added “I am going to FIGHT through this, I have incredible doctors and a great game plan but please respect my privacy. If I don’t bring up what I am going through to you, please don’t bring it up to me.” I did not want to go through the day saying the story over, and over, and over again right before I was having surgery. It would have added even more stress to my already full plate. That was a DAY. I made it to the 5 PM whistle, said good-bye and got so many well wishes and hugs from my co-workers. I knew, I had done the right thing by telling everyone myself versus having them hear through the grapevine.

On Friday I went in for pre-surgical testing when they placed a “radioactive seed” next to the tumor marker so Dr. Gemignani could find the tumor during surgery. After that was over I went home for the weekend to spend time with my family and soak up some summer sun. My surgery was scheduled for 12 PM, Monday, July 1st and everything went off without a hitch. Not only was everything on time BUT I went into surgery EARLY. Now for those of you who have been through any kind of surgical procedure you know that going in early is as good as a miracle. The Josie Robertson Surgery center at MSK was gorgeous, I could have stayed all day. Not that I wanted to stay in the hospital any longer then I needed, but the amenities were state of the art, welcoming and comfortable which is not small feat when entering a surgery center. Before heading over to “Josie” I had to go to the main hospital to have the radioactive dye put in that would “highlight” the radioactive seed. The injection burned a little and the nurse told me that after surgery my nipple would most likely turn blue, yes blue, and she wasn’t wrong.

My surgery from start to finish only took about an hour. When I woke up I was a little groggy and asked the nurse for a few minutes alone before my family came in so I could get up and dress myself before going home. The recovery from surgery was very manageable in comparison to my ACL surgery in 2015, I was so thankful to be able to walk out of the hospital. I experienced swelling under my arm pit and couldn’t put my arm down all the way and that was the worst of it. Dr. Gemignani did an amazing job, I only had one incision and no stitches, they just glued me back together.

During the surgery they took the tumor and sent it to a lab in California to get the ONCA Type Testing. The results of this test would determine whether or not I needed chemotherapy or if I would just need Hormone Therapy.

"Good company in a journey makes the way seem shorter."

-Izaak Walton

Oncologist Tryouts:

I met with 2 oncologists at MSK and decided to continue the next part of my treatment with Dr. Shari Goldfarb. If you are going through this make sure you host a “tryout” with the doctors. If you do not get along or feel comfortable with the doctor you are being treated by it will make the experience that much more difficult. My first meeting with the Oncologist the MSK did NOT go well. I went into this meeting with “guns blazing” ready to put my foot down about chemotherapy, I was NOT doing it. The Doctor walked in gave me a limp handshake and started the conversation with “So we would like to start chemotherapy as soon as possible.”. No, “How are you?”, “Where are you from?” “What do you do?”. Nothing, just right into the WORST NEWS EVER, “You need chemo, here are the options.” I sat in the chair in a puddle of tears. I was not hysterical, I was just sad. The confidence I had walked in the room with was completely deflated without even a “Let’s get to know each other” conversation.

After the meeting was over, the doctor gave me permission for fertility treatments but I knew that this guy was NOT MY GUY. I immediately got on the phone with a woman who was a Nurse Practitioner at Sloan to ask her if there were any other doctors she recommended seeing. She was able to get me in with Dr. Goldfarb the next week but told me to continue on with meeting the fertility doctor.

Needless to say, my meeting with Dr. Goldfarb went significantly better. She was “warm and fuzzy” and made me feel comfortable with what I was about to go through. She spent over an hour with my Mom, Dad and boyfriend Chris answering our questions, explaining my options and introducing me to her team. I met her PA Brittany who was a few years older then me and was planning her wedding and one of the girls I went to high school with was an assistant on the team. My first thought when I saw my high school friend was “Oh $hit, I don’t want to see anyone right now” but it was such a blessing having her there. At each of my chemo treatments she kept me updated on if everything was running on time, helped with my cold cap bag so that I didn’t have to schlep it around the hospital. Above all else, talked to me about “normal” things in the comings and goings of 26 year old life so I didn’t have to think about the impending chemo treatment.

I had found the right “partner” for the next stage of my treatment and now just had to do fertility treatments before the real game could begin.

Fertility Treatments:

Dr. Goldfarb recommended I freeze my eggs due to the fact that some of the mediations I would be taking could effect my fertility and age my eggs. She told me that I should still be to conceive naturally but would be good to do “just in case” the worst case scenario played out. Now let me tell you, at age 26, I was not thinking about having children and was especially not expecting to talk about conception with my Mom, Dad and boyfriend Chris in the same room. It was slightly, VERY awkward, but its over and has not been brought up since.

I met with Dr. Paula Brady at Columbia University Fertility Center. For those of you who have done IVF - like Marguerite said in her Blog- my hats off to you. It is not an easy process and I was astounded to see how many women were cycling through the office for fertility treatments daily. Patients were there to meet with their doctors, for egg retrieval, for exams or for bloodwork. Every time I walked in the office was humming.

My “cycle” took 10 days to complete. In order to “fertilize” the follicles/ eggs each night I did an injection of Gonal-F and Ganirelix and then had to take 2 Letrozole tablets. The first night I was really nervous to do the injections myself but after the first day you get the hang of it. During my “cycle” I had to go into the office every other day for a vaginal exam and bloodwork to see how the follicles were growing and how I was reacting to the hormones. Once the doctor checks the size of the follicles they tell you to either continue with the medications or when your follicles are between 20-25 cm they will have you do a “Trigger Shot”. My trigger shot was Lupron, which also happens to be one of the monthly shots that I have to get for my hormone therapy treatments. My hormones were all over the place during the cycle and I experienced some abdominal bloating. My egg retrieval was on Tuesday, August 5th, 2019 and it was an outpatient procedure. The whole process took about an hour and Dr. Brady was able to harvest 23 follicles and they were able to freeze 12 mature eggs!

Thankfully my insurance covered the full cost of the medications and the retrieval but if your insurance company does not, check out The Livestrong Foundation. Livestrong offers access to discounted fertility preservation services and medications to help cancer survivors build their own families. Now, between Marguerite and I we have over 30 eggs frozen! Hopefully we will not need to utilize them but very thankful to have them… bring on those grandbabies!

The Main Event:

The Pregame Warm Up was over, surgery and fertility were done and I was ready for the “game” to begin.