Thomas & Caroline's Dedication

We officially dedicated our babies to Jesus on October 11, 2015! In front of our family, closest friends and congregation we vowed to continue to raise them in faith, teach them about Jesus, pray with and for them and set the best example we can for them as Christ followers.

During our baby-less years, Matt and I attended a small contemporary nondenominational church. It had spun off of a mega church and we followed the preacher (who later married and mentored us) over to join them in the startup. However, once we got pregnant we desired to be part of a congregation with a rich children's ministry so our kids would have the opportunity to meet lots of friends in Sunday School through the years. So we began the long process of church shopping. Matt was raised Catholic and prefers super traditional and I was raised nondenominational and prefer super contemporary worship styles so we decided that Presbyterian would be a good compromise. Shortly after Caroline was born we started attending Myers Park Presbyterian Church and in June decided to officially make it our church home. By that time we were pregnant again so we decided to just wait for Thomas to arrive and baptize our babies together. I'm so glad we did.

I had pretty strong reservations about having Caroline sit in the service with us before her baptism but she surprised us all with good behavior. She was chatty, ran up and down our pew row visiting all her favorite people, collected every hymnal, removed her bonnet at least 15 times, colored on every offering envelope in sight and ate at least 40 vanilla wafers...but we made it through!

I was pretty sure I'd keep my composure through the baptism but once it was our turn I pretty much lost it and ugly cried through both dedications.

Thomas slept like a champ through the entire service which surprised none of us.

Meanwhile I was still a wreck as they walked our babies up and down the aisle to introduce them to their church family as the entire family sang "Jesus Loves Me." I should also mention that in our baptism class we were taught the importance of "the church aisle" -- how you really only walk down it 3 times in life -- baptism, wedding and funeral. So all I could think about was blinking and Caroline walking down this same aisle decades from now in a white dress to her husband. Tears. Tears. Tears!

Caroline and Thomas walking out of the church with their Grandad. Such a sweet moment.

We are extremely blessed to have such wonderful people in our lives. It meant so much to us to have grandparents, "aunts" and "uncles" join us for such a special celebration.

A few more family pictures!

  After the service Matt and I hosted a brunch at Napa on Providence for all of our guests. I was nervous to reserve the patio but the weather turned out to be absolutely gorgeous - cool and breezy. We had the very best time sipping on mimosas, brunching and trading babies around the table.

Oh! And we ate cake!

It was the most perfect day.  

The Surgery Details: Prophylactic Bilateral Mastectomy

I am beyond speechless for the words of support, prayers, connections and stories you all have shared with me. There are no words to describe my feelings as the emails continue to pour in from readers who have been encouraged to schedule their annual mammogram, start doing monthly self breast exams, look in to BRCA testing because of their family history and even one super brave mama faced with this same decision move forward with her procedure!

I am trying so hard to respond to the emails I've received but am so overwhelmed (in such a good way) with the sheer volume! Just know that even if you haven't heard back from me I read every email, blog comment and Instagram comment and it has encouraged me more than you could possibly know.

I want to share a little bit more detail about the double mastectomy surgery, especially for those of you who are considering the procedure.

The date. First, we had to decide when it would be a good time to have the surgery after Thomas was born given the 6 week recovery time. We went through every scenario from combining my surgery with my maternity leave (doctors advised against that) to waiting until after the holidays were over. But the truth is there really is never a good time and I am more than ready to turn this page and get on with my life so we opted for the first available date that both of my surgeons were available. That brings us to October 27. And yes, my first thought when I got the call from the scheduler was "wait, will I be able to trick-or-treat with my babies?"

As for everything going on with Thomas, we obviously didn't plan for that! After his cataracts diagnosis we deeply discussed putting the surgery off until 2016 but ultimately decided it was best to still move forward with the date. And thankfully we are past Thomas' surgery hurdles and will have a week or so with contact experience under our belt before Matt has to do them solo for awhile. The eye doctor is also less than a mile from our house and we can walk in any time during business hours to get help with the contacts.

The surgeons. Picking both of my surgeons was a big decision (obviously). Not only do I want the best in Charlotte, it is important that the two surgeons work well together because they will be working on me at the same time.

I wanted the smartest, nerdiest and most experienced surgical oncologist I could find. From there we had the same requirements and more for my reconstructive surgeon. In addition, I wanted my reconstructive surgeon to specialize in well, reconstructive surgery (not just boob jobs)! Bonus points for Duke education.

Anytime I've told someone in the medical community who my surgeons are their response has been "oh yes! you have the absolute best duo!" I'm pretty sure everyone thinks they have the "best" doctors but I really truly believe mine are and I've been so happy with my decision so far.

The options. The amount of options (and decision trees that come with each option) was overwhelming and you can easily make yourself sick analyzing each one. We were peppered with so many difficult questions while finalizing the details of my surgery, many of which kept me up at night. Which procedure should I choose? How do I want my breasts to be reconstructed? Will I keep my nipples? These were not easy decisions. And not that I have boobs that would win any sort of contest, but all of a sudden I became very attached to them once the reality of losing them set in.

The final decision...a prophylactic bilateral mastectomy with nipple and skin sparing, tissue expanders and reconstruction.This requires two separate surgeries.

The nipples were the hardest (and most complicated) decision. I decided to keep 'em since my doctor said I'm a good candidate for a nipple-sparing mastectomy. This does however give me a 1% risk of getting cancer and there's also a slight chance of nipple necrosis, which means they could die from the trauma and reduced blood flow immediately following surgery. Despite these risks, I had read and been warned that this type of surgery can be very psychologically damaging to a woman and this option still seemed more natural than the other options which included no nipples, prosthetic nipples or tattoo nipples. See what I mean about the decision trees that come with each option? Overwhelming. 

The surgery. Very long story short, during the first surgery, the surgical oncologist will make an incision underneath the fold of my breasts and remove every bit of tissue (down to the dermis) in my chest. During this same time the reconstructive surgeon will sew in pockets of surgical mesh between my skin and chest muscle to hold tissue expanders. A breast tissue expander is an inflatable breast implant designed to stretch the skin and muscle to make room for a future, more permanent implant. 

 

The reconstructive surgeon will then sew in 4 surgical drains. These drains consist of a small plastic reservoir bulb connected to about 4 feet of flexible drainage tubing. So I'll have 4 drains hanging out of my chest that are about 3 feet long each. Their purpose is to remove fluid from the surgical wound through mild suction. From what I’ve been told the drains are the absolute worst part. I will literally have these suckers (no pun intended) hanging out of my chest for three to four weeks. Several times a day the fluid has to be measured and recorded until I hit a certain number required for them to be removed. And Dr. Matt will have the lovely job of emptying them and cleaning them. For better or for worse, right? 

The entire surgery should take between four and five hours and I’ll be in the hospital for one to two nights to recover. 

After the drains are removed at the end of November I will visit my reconstructive surgeon every few weeks to slowly fill my expanders with saline. The tissue expanders have a tiny valve mechanism located inside the expander so the doctor can inject the salt-water solution to gradually fill the expander over several weeks or months. Thankfully the expanders will have some saline already in them during the first surgery so I won’t be completely flat when I leave the hospital. I've been told that the expanders feel ridiculously unnatural, uncomfortable when laying down and my breasts will feel (and look) rock solid. However, the perk (killin it with the boob puns) of expanders is that I don’t have to decide on my size up front. With each fill I get the opportunity to test drive the size and see if I want to keep going. After I’ve reached my desired size (TBD!) I have to wait 3 months to ensure the skin over my breasts has stretched enough before my second surgery to have the final implants put in. So, not an ordinary boob job; it's much more complicated. 

That's a lot of information for today so I'll leave it at that! 

Prophylactic Bilateral Mastectomy

So, I’m having a double mastectomy in two weeks.

WHAT?!

Is everything okay? (Yes, I’m healthy. No cancer. Praise the Lord.) What about everything going on with Thomas? When did you decide this? Why? Wait, what is a double mastectomy? What does recovery look like? Will you have reconstruction done? How are you feeling about all this? Are you scared? Will you blog about your journey? How can I help?

These are just a few of the usual questions I’ve received as we’ve told our friends and family the past few months. I had finally worked up the courage to hit "publish" on this post several weeks ago, but then everything happened with Thomas and I didn't want the seriousness of his situation to get buried under my upcoming surgery. Much to your surprise, I've actually been on this breast cancer prevention journey for quite some time now and this surgery has been planned since before Thomas was born (more on all of that below).

So anyway, I will attempt to cover all of those above questions and much more than you probably want to know about my boobs in this post. My hope in blogging my way through this experience is threefold: 1. To spread awareness and remind the ladies to check their tatas and get the genetic testing (BRCA1/BRCA2) done if breast cancer runs in your family! 2. Through this experience I’ve discovered it’s been somewhat difficult finding other women (especially moms with little kids) my age going through this so I hope to help someone else out there facing this big decision and crazy journey not feel so alone. Because I definitely feel alone at times even though I have the strongest support system, an amazing husband, wonderful friends, cheerleaders and more prayers than I could ever imagine coming my way. For all of that, I am extremely grateful. But until you’ve been faced with this decision, this journey, you can’t relate in certain ways and that is where you can begin to feel alone. And 3. Blogging is therapeutic for me and I’ve found so much encouragement from this wonderful community during some of the hardest times in my life. I debated whether or not I would share this journey I've been on for awhile now on the blog but with so much love and support we've received from you all, it felt weird hiding such a big life event from you. Plus, I wanted to explain my upcoming blog absence during my recovery.You know me, I tend to be an oversharer, so I don’t mind blogging about my boobs. Sorry, no pictures included! 

Okay, on to the details…

A little background. My mother, Caroline, lost her battle to breast cancer at the all-too-young age of 30, leaving behind a devastated husband and two little girls. Her mother lost her battle to breast cancer in her early 30’s as well. So I have been aggressively monitoring my cancer risk since I was 19 years old with annual and quarterly tests including 4-D mammograms, genetic tests, MRI’s, breast exams and more. Over the past decade I’ve been poked, scanned and tested more times than I care to count in an attempt to stay on top of my genetic predisposition to breast cancer.

Given my breast cancer risk, I’ve known this procedure was inevitable it was just a matter of when. For the longest time I felt invincible, protected by age I guess. However, as I quickly approach the age of my mom’s diagnosis my doctor’s concern has grown exponentially. Due to the aggressive nature of my mom’s cancer (she passed 6 months after diagnosis) my doctor carefully monitored me during my pregnancy with Thomas. I lived in fear (and had many nightmares) that I would get breast cancer during my pregnancy and would not be able to treat it until after he was born.

During this time my team of doctors used a very conservative risk model to calculate my chances of breast cancer – 40%. Each year that number rises significantly. I don't know about you, but when the weatherman says there's a 40% chance of rain I carry my umbrella! I am the complete opposite of a risk-taker!

The decision. I decided to move forward with the procedure when we were home in Florida earlier this year to celebrate Mother’s Day.  My mom found my baby book while cleaning out the attic and gave it to me. It was chock full of details I’d never known about myself – my birth weight, my first birthday party theme, a list of guests who attended my baptism, a locket of hair from my first haircut, an explanation of the scar across my hairline that I’ve always wondered about (teeter totter accident) and so much more. I am beyond grateful she kept such a meticulous diary of my and my sister’s lives. When I turned to the “first day of Kindergarten” page I lost it. Blank.

That night I laid awake thinking about the blank pages. I was five and Lindsey was three when Caroline died. There have been so many significant moments in my life that I’ve thought about what it would be like if she were present – losing my first tooth, my first breakup, prom, high school and college graduations, bid day, my engagement, my wedding, my pregnancies, meeting her grandbabies and so much more. That night I decided to no longer to let fear win. Matt and I made the decision right then that I was going to have a prophylactic bilateral mastectomy. And soon after Thomas was born.

Caroline -- before diagnosis

The options. Matt and I prayed, researched and discussed all the options with my doctors which range from aggressive prevention to early detection followed by treatment. My dad is currently battling stage 3 lung, brain, spine and adrenal gland cancer and my second (amazing) mom fought breast cancer last year too. I’ve seen firsthand how harsh the treatment of cancer can be on everyone involved and I wanted none of that for my family, especially my rock, Matt. With all of this considered the decision to have a preventative double mastectomy was easy.

I’m a little scared. Okay, maybe a lot scared. To be completely honest, there are many days that my emotions quickly ricochet from strong and positive to sad and worried. I really try to keep my best poker face in front of my friends and family but the truth is I have a lot of silent freak outs and breakdowns. During these difficult days I worry about things like…not having the option to breastfeed any future children I might have. Losing all of the feeling in my chest – forever. Matt having to take care of all of us for awhile. Not being able to care for my babies (especially with Thomas' contacts) during recovery. More medical bills. How will I handle the pain? I’m totally freaked out about the surgical drains and tissue expanders. Will I be self-conscious after reconstruction? It’s easy to fall into a rabbit hole of worry. 

But I’m grateful. Overall I feel incredibly blessed to have this rare opportunity to fight back before cancer can even begin. If my mother would have had this opportunity, I know she'd still be alive. And I know she would be proud of me for making this brave decision (especially during a time that we have so much going on). By choosing this surgery I am proactively reducing my breast cancer risk down to 1%. I can't wait to get past this surgery and never again have to live in fear of test results every six months. Or fight the breast cancer battle. I'll be around to watch my kids grow. And watch their kids grow. Celebrate our 50th wedding anniversary. And enjoy senior citizen discounts. 

Lots more of my previvor journey to come...