Thinking outside the box

Akitagirl, Welcome to the BCO community. We are sorry that you have been diagnosed with breast cancer but glad that you have reached out to this group of informed and generous others. Everyone here has personal experiences to share and discuss and we hope that you will find it helpful. Here is a link to some information on our own site on Nipple Sparing Mastectomy. The best of luck to you going forward and please keep us updated on how things progress for you. The Mods

It is obvious from your posts that you're quite eloquent and intelligent.  It makes sense that you would do all possible research before deciding. And, of course you have "one-up" on most of us, being in the health field. 

But you just said you are "at your limit" and "overwhelmed."  After this, you said you're trying not to "cry," "panic," etc. I would counsel you to go ahead and let down your walls periodically.  You're facing a lot. My cancer diagnosis is very close to yours.  I did not have your other challenges, but I had different ones.  I faced them all alone (as a working single Mother), and I did a great job remaining very stoic. Until I didn't. 

I see people who panic at the very first possibility of a result that may require some kind of further testing, and whose life is consumed with worry. I was at the other end. That can be really tough and leave one so drained that it can be hard to accept and acknowledge that this really is a big deal.  Sometimes, it might be best to go ahead and have a night of panic and crying.  If you don't occasionally let yourself do a little wallowing in it, then it can be easy to morph over into your other listed options, concentrating your efforts on irrational thoughts like losing hope and dying.

You have a pathology that provide an incredibly comforting prognosis.  I was very similar to you, age 46 at diagnosis (might have been 45?), with a 1.8cm IDC tumor that was ER+/PR+, and a second primary tumor found in my mastectomy specimen (I don't know much about that one). I believe I recall that my 5 year survival rate after surgery was 95%+ - even before any more treatments.

I was not given much of a choice of treatments, though I could choose radiation plus lumpectomy or mastectomy with no radiation. Knowing radiation can cause its own problems, and being of a "get it out of me" mentality - I opted for mastectomy.  Knowing myself as one who would worry that an implant might hide a recurrence, or cause pain that made me question the cause, I've opted for no reconstruction. I was told I had to do chemo, but I took one treatment and stopped it (long story of extreme intolerance...I even vomited after getting valium for a colonoscopy!). I did end up doing 5 years of anti-hormonal treatments (Tamoxifen and Aromasin).  And I am now 9.5 years NED with no worry that I

I'm so sorry you're here. I personally think you're past the hardest part (waiting).  But that doesn't mean the next few months will be easy.  Lean on those who can help you.  Succumb to an "umbrella drink" once in a while (if you like those).  And check out the thread someone just started in which they're counting their blessings. For me, I like to think about how I live in a time in which medicine is so advanced that we catch some tumors early, and have research that aids in treatment, and that we can, in fact, take part in those treatments. 

One day at a time until you no longer have to think that way (it won't be long).   Best to ya! 

Gosh, I wish I could tell you how long your recovery will take. It depends on your procedures, and everyone responds SO differently.  You mentioned a mastectomy, but didn't say if you're doing a prophylactic bilateral, or unilateral only. That makes a huge difference.  I had only the affected breast removed, no reconstruction.  Did it on a Wednesday and got home on Thursday morning.  I COULD have gone to my daughter's concert that night except I wanted to wash my hair and I knew that would wear me out too much to do both.  Anyway, I had a desk job and I was at work the following Monday (though I was miserable and went home at lunch). But then I was at work full time again.  So I had 5 days, but immediate reconstruction is different I'm sure, and a bilateral is very different.  This is not to say I was "well" at this time, but I had no choice but to work.  I took chemo very hard, but I also had it on a Wednesday and was at work Monday.  But I could not function Wed/Thu/Fri/Sat.  However, I seem to have been affected much more than most people.  And it depends on what kind you get.  Some are harder than others.  I had ACT, which includes "The Red Devil" - nasty stuff, especially for someone with such a sensitive digestive system.  Antibiotics make me nauseated.  I vomited after a cesarean even though they gave me anti-emetics.  I vomited every half hour for 24 hours after one chemo treatment even though I also had anti-emetics.  I vomited after my mastectomy. 

Anyway, perhaps they might not even recommend chemo for you--things have changed a lot, and different oncologists are quite different in what they recommend.  My (2nd) oncologist (I was kicked to the curb by my first doc's front desk staff when I said I wasn't sure I wanted to keep doing chemo) said the anti-hormone therapy was a lot more important in my situation than chemo.  It was very hard to say yes to either, knowing the long term/lifetime risks, when I had such a low chance of recurrence. 

Best luck

Hmmm....I'm very curious about the coagulation factor you mentioned, and stroke risk.  A few months after coming off Aromasin, I began to have severe migraines (with aura).  My symptoms were stroke-like and of course I had to get brain MRIs to rule out mets (and those MRIs were negative).  They got worse and worse of the past several years until I ultimately had to close my 20-year-old business (I have temporary cognitive loss-such as not recognizing my own daughter's name, visual disturbances/loss, inability to see/read/understand, numb tongue, plus the severe migraine pain which comes after these "spells," as my first (of four) neurologists called them).  I'm continuing to look for an answer but my family practice dr. continues to think "heart" due to my shortness of breath.  I didn't have much of the testing that a lot of people get today, though I did have a MUGA scan of my heart before beginning treatment, and it was fine.  I developed a heart murmur during chemo treatment and they ordered an ECHO, but it was also fine and the murmur eventually disappeared.  I also had high cholesterol but Lipitor nipped that in the bud quickly.

So, what does your "coagulation factor" indicate? (I've not heard it mentioned before).