Hair Regrowth

I had my last chemo on March 7, 2014.  Like every other patient who has lost their hair, I began scouring the internet to find out how long it took for hair to begin appearing after the last chemo.  I wanted to know what was a reasonable expectation.  I couldn't find a lot, so I thought I would document my hair growth; and perhaps, it would help someone who is looking like I did.

1 Month Since Last Chemo (April 7, 2014) 

• My Head:  I could feel more stubble on my head.  However, it's coming in blonde; and it isn't very visible.  My hair was dark brown, so seeing blonde peach fuzz on my head isn't too encouraging.  
• My Eyebrows:  I'm still drawing in my eyebrows, and no visible hairs so far.  
• My Eyelashes:  I have eyelashes poking through!  I only noticed it while putting eyeliner on my top lid (I have been lining my top lid heavily to hide the fact that I don't have eyelashes).  They are barely there, but they are definitely growing!
• Body Hair:  I still don't have any hair growing on my legs, pubic area, or under my arms.  I'm okay with this though!

1 Month & 1 Week Since Last Chemo (April 17, 2014)

• My Head:  My hair on my head still feels the same to me.  I look every day to see if it's growing or gaining color, but so far, I don't see it.  
• My Eyebrows:  I can feel eyebrows and you can see it!   Last night, I was washing my face, and I had what looked like dirt smudged in my eyebrow area.  When I tried to wipe it off, I realized it was my eyebrows coming in.  I was so excited to see the beginning of my eyebrows coming back I almost cried.  My eyebrows are dark brown as they were before.  It currently looks like a "5 O'Clock Shadow".  
• My Eyelashes:  My eyelashes continue to grow!  I am seeing more and more hairs as they thicken up and continue to grow.  They are not as dark as my former lashes so far.  They are almost blonde like the hair on my head.  I can put mascara on them when they get longer, so the color doesn't matter to me at this point.  I'm just happy to see eyelashes!
• Body Hair:  I still don't have any hair growing on my legs, pubic area, or under my arms.  I'm okay with this though!

5 Months Since Last Chemo (August 7, 2014)
I am way behind updating this portion of my blog, and to all my readers, I apologize.  I KNOW this is a topic I looked for guidelines on what to expect for hair growth, so I'm kicking myself for not keeping up with this a little better.  I'm going to attempt to catch up via this one update to include photo documentation, which I HAVE kept up with!

• My Head:  I began seeing very noticeable and unmistakable hair on my head near the end of April and beginning of May.  One more came in, it was actually very dark.  I'm not sure why it seemed blonde at first, but the more that came in, the darker it was.  It's now barely over an inch long after 5 months of growth.  It's longer on top than it is on the sides, and I don't have an inch of "bangs" yet. I take Biotin to encourage growth plus I use the Nioxin shampoo and Conditioner, which you can get at any salon.  This is for thinning hair, but it also works great to encourage growth for chemo patients.  It's a little pricey, but worth it. 
• My Eyebrows:  As I stated above, I began seeing my eyebrows coming in a month after chemo ended.  Within a month of them starting to grow, they were pretty much back, but they were not as thick or as filled in as they had been prior to chemo.  I don't mind filling them in when I have my real eyebrows to guide me regarding my natural shape though.  It's very hard to draw eyebrows on a blank canvas and get them to look natural.  Now for the bad news--about a month ago (4 months after chemo), I began noticing it seemed my eyebrows were thinning again.  Especially my left eyebrow.  At first, I felt like I was imagining things, but a month later, I now know I wasn't.  New and much fuller (more like my eyebrows before chemo) eyebrows are growing in now.  The left side is still a little behind the right, but it's not bad.  I just use eyebrow filler, and don't even notice it. 
•  My Eyelashes:  My eyelashes were just barely long enough to start putting mascara on about 2 months after my last chemo.  They weren't very long, but I was just happy to have something.  They seemed to grow out quickly, and they were pretty long.  Longer than I remember my former lashes?  They got darker as they thickened up.  However, as with my eyebrows, I began noticing them thinning out or even falling out again over the past month or so.  New eyelashes were growing in as I was slowly losing what first grew, so it's not like I was completely without eyelashes.  My eyelashes on my right side are worse than my left.  I had read somewhere that some chemo patients lose their eyelashes and eyebrows a second time if they come in right away after chemo, which is exactly what happened to me, but it really wasn't traumatic.  It was a gradual process as new was coming in, so it's been bearable. 
• Body Hair:  Not longer after my last update at one month post chemo, the body hair came back full force.  I wish the hair on my head grew as fast as the hair on my legs and other "regions" on my body.  I would have long hair already!  I'm back to shaving every single day of my life.  I also want to point out that do not be alarmed when you see peach fuzz on your face after chemo.  I promise it was always there.  It just becomes very noticeable when it's growing back in.  I feel like the hair on my arms (blonde and "invisible") is back to normal now. 

Pathology Report

My surgical oncologist called me this morning with my pathology report from the tissue and nodes removed during my mastectomy surgery completed last week.  I've been praying I would be told no additional cancer areas were found, and all the nodes removed during surgery would be all clear.  I didn't get the good news I was hoping to get; but overall, the news was good.  I remind myself it could be worse.

I had a bilateral mastectomy, meaning both breasts were removed.  My breast cancer was only in the left side; but I chose to have the tissue removed from both breasts due to having the BRCA1 gene, which increases your chances significantly for a recurrent in your other breast.  The tissue removed from the right side was completely clear of cancer.  This was fantastic news as I constantly had a nagging worry that there was a tumor hiding on that side.

I had a MRI of my breasts after I completed chemo.  This revealed the tumor, which was 8 cm before I began chemo, had responded very well to my chemo treatments and had shrunk to being smaller than the size of a pea.  I was told I had responded very well to my chemo treatments and I was very near a response of 100%.  The lab, however, did find scattered tumor cells in the area in which the tumor was.  These scattered tumor cells were residual cancer cells from the original tumor.  While they did find scattered cancer cells we didn't know were there until the tissue was put under a microscope, the margins around the breast tissue that was removed were 100% clear of any cancer cells.  This is very important as it means the cancer cells were all removed from the breast tissue.

I had a sentinal node biopsy October 2013 before I began chemo.  This consisted of my surgical oncologist injecting the tumor in my breast with a radioactive dye.  During surgery, he then used a light while looking at my lymph nodes in my arm pit.  The dye, which was injected into my tumor, would drain into the first lymph nodes in which the tumor drained.  The idea is to determine which lymph nodes the tumor first drains into so they can be removed to look for cancer cells.  This is how the physician determines if the cancer has spread to your lymph nodes.  15 nodes were removed during this sentinal node biopsy, and 5 of the 15 contained cancer cells.  1 had a small tumor on it, and the other 4 contained micro cancer cells.  This news devastated me as I wanted to hear I had no lymph node involvement; but after the initial shock of hearing this, I accepted this as MY personal results and found the positive in this news.  5 out of 15 isn't bad odds.  That meant 33.3% of the nodes removed had cancer.  That's less than half, so I was thankful for this.  During this surgery, only the nodes that lit up using the light were removed.   Therefore, there were still lymph nodes remaining in this area.  These would be removed during my mastectomy surgery.  This is called an auxiliary dissection.

During my auxiliary dissection last week, 15 additional lymph nodes were removed.  3 of the 15 removed revealed microscopic cancer cells.  Once again, I was hoping and praying I would be given an all clear on the remaining lymph nodes; but once again, I wasn't given the exact news I wanted.  However, I am thankful for the results I was given as 3 out of 15 isn't bad, and it certainly could have been worse.  Additionally, the cancer cells found in these 3 nodes were micro cells meaning it was such a small amount it could only be found under a microscope.  Based on my results from my first node biopsy and the remaining nodes, I had a total of 8 nodes positive for cancer out of 30 total nodes.  This means 27% of the total nodes removed were positive for cancer.  I was upset at first to hear the news that I've been walking around with nodes that had cancer for the past 6-7 months.  To me, this meant the cancer has had 6-7 months to be spread from my lymph nodes by my lymphatic system to other areas within my body--meaning metastasized cancer is a very real possibility in my future.  However, after a few moments, I forced myself to stop focusing on this and consider the overall odds.  My overall odds are now better than they were before.  Having 33.3% cancerous nodes before compared to my overall rate I now have of 27% is actually good news.  My overall node involvement is lower than it was before.  THAT is what I choose to focus on.

I'm healing well from surgery.  It's been 8 days since my surgery, and while I am still doing nothing besides sitting on my couch letting my body heal; I am slowly feeling better.  I can now stand up from the couch on my own without someone assisting me.  Yes, I still have pain on my chest, and I'm still very sore overall; but it's much better than it was last week at this time.  It is tempting to begin doing some things around the house, but I still have three drains intact; and if I begin doing things too soon, it will increase the fluid draining (which we have to dump and record for review) into the drains.  They won't remove drains that are putting out too much fluid.  Therefore, I will keep my butt planted on the couch, so I can hopefully get these three drains out at my upcoming appointment on Wednesday.

I get my first expander fill on Wednesday as well.  For those that don't know what this means, tissue expanders were placed during my surgery last week.  Only 40 cc's of saline was placed in my expanders, so I essentially came home very flat chested.  My surgeon had to remove a great deal of skin from my breasts to ensure he got clean margins around the tumor.  This didn't leave a lot of room for the expanders to be filled much at the time of surgery.  I don't know how much my expanders will be filled on Wednesday.  They will base it on what I can tolerate and what won't put too much pressure on my incisions, which are still healing.  the expanders will continue to be filled weekly until my desired size has been reached.  I will then have surgery to remove the expanders and replace them with silicone implants.  I hope this process doesn't take too long as expanders are not comfortable at all.  They feel nothing like implants and feel very hard beneath your skin.

Mastectomy Surgery with Tissue Expander placement.

I haven't been as diligent at updating my blog since I finished with Chemo.  The first two weeks after my final AC treatment, I was struggling to overcome that last chemo and simply feel "good".  Then I began to feel more and more like myself and began having energy to do more than walk from my bed to the couch.  I simply couldn't stand the idea of sitting on my couch or computer when for the first time in months, I had energy and the desire to leave my house.  I had four weeks between my last chemo and my mastectomy surgery.  However, only the last two weeks were "functional" times.

My mastectomy surgery was on April 10, 2014.  I had to report to the hospital at 6:15 a.m., and my surgery was scheduled to begin at 8:30 a.m.  I was extremely nervous about the surgery as I had never been under anesthesia for more than two hours in the past.  I had already been told I had heart damage from the chemo, so I couldn't seem to stop worrying that something would happen during such a long surgery.  My doctor's were anticipating I would be in surgery for about 6 hours.  My Surgical Oncologist, Dr. Povoski, would first do the mastectomy and lymph node dissection.  After he was done, my Reconstructive Physician, Dr. Chao, would insert the tissue expanders and close up.  I was a nervous wreck the morning of the surgery although I tried hard to hide it and keep my whits about me.  I was sitting in the waiting room with my husband, sister, brother-in-law, and two of my children, when I went to the front desk to let them know I needed to use the restroom (they had told me to tell them before I went because they needed a urine sample).  Rather than giving me a cup and sending me to the restroom, they decided to go ahead and take me to the Pre-op area and get things started.  I had to walk back to my family and quickly tell them goodbye.  Maybe it was best it worked out that way, but I was struggling to keep it together as I walked to the pre-op area.  Chuck went with me as I was allowed one person at a time.  He kept trying to reassure me that I was going to be okay, but I couldn't seem to stop the tears from coming.  Fear had a grip on me.

After some time, Chuck went out and sent my sister, Cindy, back.  When she walked in my room, I instantly began crying and she gave me a big hug assuring me everything was going to be fine.  As always, I felt better just having her there telling me it was okay.  The nurse came in to go over some pre-op questions before they took me to the OR holding room.  She told my sister to get both of my kids and bring them back so I could see them together before she took me to the OR area.  This also made me feel so much better.  I was able to hug and kiss them and reassure them (or maybe I was the one who needed reassurance) everything was going to be okay.  After hugging and kissing my children and THEM reassuring me it was going to be okay, it was time to go.  Cindy and Chuck got to hug me one last time before they were ushered out.  They then began wheeling me to the 5th floor OR room.  I was taken to the waiting area where they got my IV started.  Thankfully, my veins cooperated and there were no issues with that.  I was worried my veins would blow or there would be a problem; but, I had worried for nothing.  I lay there waiting to be taken to the OR, and I just prayed.  I prayed God would watch over the doctors and nursing staff responsible for my care.  I prayed God would watch over me and keep me safe.  To allow me to say I was cancer free when this surgery was over.  I prayed God would give my family peace of mind and comfort them while I was in surgery.  I just prayed!

A nurse came by shortly after to tell me she was giving me a shot of "happy juice".  She patted my hand and said "I know you're nervous and scared.  This will help with the fears and allow you to relax. We will be taking you to the OR soon".  She was right.  Within moments of her giving me that shot in my IV, I felt relaxed.  Once I was in the OR, they had me scoot from the gurney to the operating table.  There were people everywhere all around me; but I couldn't bring myself to look around.  The nerves were back.  Dr. Povoski was standing right by my bed and began talking to me.  I've had my share of surgeries; and he is the only doctor that's EVER been in the OR room with me before I was knocked out.  I can't think of a single doctor or time where I saw the doctor in that room prior to going under.  But there he stood--comforting me and truly concerned about how scared I was feeling.  I told him he was seeing my childhood friend, Stephanie Buckley, and he instantly knew whom I was talking about. We had previously talked about Connie Nelson, my sister's mother-in-law, who was also seeing him since I had been diagnosed.  The last thing I remember talking about with him was Stephanie.  I remember them putting the mask on my face and telling me to take a few deep breaths, and then my eyes got heavy--and I don't remember anything else until many hours later I woke up in the recovery room.  A kind, male nurse was sitting by my side asking if I was in pain and wanted something for the pain.  I said yes or something close to that; but he got the message well enough.  I remember waking up a few times before they finally told me they were going to transport me to my room and once I was settled in my bed, they would give me more pain medication.

Once they wheeled me to my room, I had to scoot from the gurney to my bed in my room.  I cannot BEGIN to describe how painful this was.  My chest felt like a truck had hit me, and every movement I made hurt.  I gave myself a pep talk to just grit my teeth and do it as quickly as I could.  Pain medication would be my reward.  In a few movements, I had myself in my bed; but tears were streaming down my face because it hurt so badly.  But I did it!  I also was extremely thirsty and begging for water.  They offered me crackers, and I do remember smartly saying "my tongue is sticking to the roof of my mouth because my mouth is dry.  There is no way I can eat crackers.  Water!".  My sister said after only a few minutes, I was loudly complaining wanting to know where my water was because it had been a long time since I had asked.  My sister said it had been about 1 minute.  LOL  Finally, I did get my water, which I downed most of it in one gulp and asked for more.

While I slept a lot during that night and into the next morning, I was also in a considerable amount of pain.  My chest was VERY sore, and it really did feel like I had been hit by a truck.  It wasn't necessarily the incisions across my breasts that hurt.  My breasts themselves were somewhat numb; but I was quite sore in that area that is comparable to the absolute worst bruise possible.  I had three drains on the left side as well as two drains on the right side coming from my sides.  The drains hurt like hell.  There is no other way to put it.  Every move you make pulls and tugs on them, and it burns and stings.  The expanders that were put in my breast were awkward and tight feeling.  They are nothing like implants.  I've had implants for ten years, and expanders are not even close to an implant.  They are a more rigid plastic and a bit uncomfortable.  During my pre-op appointment, my plastic surgeon had agreed to fill my expanders as full as he could so I wouldn't come out of surgery flat chested.  Not because I care about having boobs right at this moment, but I didn't want the shock of looking at my chest completely flat with no nipples at the same time.  So, you can imagine my shock the first time the nurse peeked at my incisions and I saw myself--completely flat chested with huge, ugly incisions across my breasts.  What happened to coming out of surgery with the expanders somewhat filled?!

My sister was standing there when this happened, and I looked at my sister while saying "Why am I so flat--what is this"?  Yes, I realize beating cancer, coming through a major surgery, and surviving this mess are the most important things; but I would also like to look and feel good as well.  Cindy immediately spoke up and said "Dr. Chao explained to us that he was only able to put about 40 cc's in each expander because the skin was pretty tight over them.  He didn't want there to be a lot of tension on your incisions while they are healing."  While this explanation made perfect sense, and I understood the reasoning, I was struggling with accepting a change from the plan I had in my mind.  As I've said before, I'm a planner, and when things deviate from the plan, I struggle to keep up.  Thank God for my sister who knows me so very well and got all the information to questions she knew I'd be asking when I was awake.  She didn't want me to freak out not having answers, so she made sure she asked them for me.

My sister, brother-in-law, and my children left to head home shortly after.  Chuck stayed in my room with me.  I couldn't reach or more my arms more than an inch from my body, so having someone in the room with me was pretty important--and an exhausting job for them.  I quickly became frustrated not being able to even reach for a drink myself without help.  I hated constantly asking him to get up to hand me things; but I honestly had no choice.  I simply couldn't do it myself.  I'm very thankful he was there to help me.  I had a roommate on the other side of a curtain who snored very loudly, talked very loudly to the nurses and cried, moaned and wailed often.  I tried very hard to be sympathetic toward her; but I quickly became frustrated because she would sleep easily without interruption yet every time I tried to sleep, she would make tons of noise and wake me up.  So, while I wanted to sleep that night, I didn't get much of an opportunity between her and the nurses coming into my room.  At one point, Chuck was making movements and body gestures to match the sounds she was making, and it was quite funny.  I finally had to tell him to stop because laughing truly hurt!

I was released the day after my surgery, and we headed home about 1:30 p.m.  The ride home seemed endless, and I felt every bump in the road during the 2 hour drive.  The next few days are a blur to me.  I hear the weather was glorious and warm.  I wouldn't know.  I spent it sleeping, eating, and taking pain medication.  I began feeling less pain and stiffness on day 4 after surgery.  By day 5, I was finally able to sit or stand up on my own without being pulled up by someone else.  Yes, you read that right.  I wasn't able to stand up from the couch or get up without being helped.  I simply couldn't do it alone.

Today, April 16, 2014, I had a check-up appointment with my surgical oncologist and my reconstructive surgeon.   My reconstructive surgeon removed 2 drains today.  Yes, I still have 3 drains, but I was happy to get two taken out today.  It's a start!  He said as long as my fluid levels stay low in the drains (which means I have to keep my activity level low), I will likely get the other three out next week.  My incisions were checked, and he said everything looked good.  I will get my first expander fill at next week's appointment.  The amount I am given will be determined by what I can tolerate and what feels safe to my doctor.  I then went to my surgical oncologist, and he informed me my pathology reports were not all back yet.  I am to call him on Friday to get my pathology report from the tissue that was removed during surgery.  My doctor did tell me there was no cancer found in the tissue from the right side, and the margins around the tumor from the left side were very good and clear.  He said he removed 15 lymph nodes during the dissection (15 were removed during my sentinal node dissection as well).  Of the 15 removed this time, 4 nodes were being tested further for cancer cells.  This tells me something in these 4 looked questionable, but no answers will be available until the final report comes in.  Therefore, I simply ask for prayer from each one of my readers that none of the nodes removed during this surgery contained cancer.  My first biopsy showed 5 out of 15 had cancer, and I would LOVE it if that did not change for the worse.

I will update again when I have further news.  Thank you to all my readers!

Teresa