‘TIL DEATH DO US PART
“To love and honor until death do us part” is a phrase often used in marriage ceremonies. On my wedding day, October 17, 1981, death was not on my mind. If I had been asked about it, I would have said that I expected to outlive my new husband. As he is seven years older and takes high blood pressure medication, I figured it was a pretty safe bet that I would outlive him. I had no health concerns, and while my father had heart disease, I took after my mother’s side of the family. My maternal Gram  had a long life, and my mother had no known illnesses.

Fast forward to September, 2007 when our daughter worked as a neurosurgery nurse and our son was starting his junior year in college. I was immersed in my career at a public university and part-time work as a group fitness instructor for the YMCA.  I went for my yearly mammogram a bit late that year. The technician performing the scan asked for repeat pictures.  Due to extensive micro-calcifications, I was sent for a stereotactic biopsy and breast MRI. I was told that I had extensive Lobular Carcinoma in Situ, LCIS , in my left breast and it needed to be removed. I found a specialist in breast surgery, and traveled south to have a MRI guided biopsy. Atypical Lobular Hyperplasia was added to my diagnosis.

Due to a family history of breast cancer (both my mother and one of my sisters had ER+ breast cancer since my wedding), I chose a bilateral mastectomy with immediate TRAN flap reconstruction (skin sparing surgery using tissue from my abdominal region to construct new breasts). I recovered with flying colors and was happy with my reconstructed “girls” as well as my newly flat stomach. I exercised my way back to fitness and a year after surgery I was teaching three consecutive fitness classes on Saturday mornings. I had also accepted a temporary teaching position at the university that filled my lunch hour plus a fair amount of work at home. I had beat breast cancer to the punch line! I was told there was a small chance of chest wall disease, but not to worry about it as it was exceedingly rare after a double mastectomy.

Just two months later, I noticed a red crescent near my left arm pit that looked like chafing from my sports bra. As the redness spread over the next few weeks, I scheduled an appointment with my plastic surgeon, thinking that something was wrong with the transplanted tissue. My PCP put me on antibiotics, which did nothing. I had another breast MRI that showed skin thickening. The surgeon wanted me to see a dermatologist, but offered a punch biopsy in the meantime. Two days later he called with the news. I had Inflammatory Breast Cancer and needed to see an oncologist.  More tests ensued, and on April 25, 2009, I was officially diagnosed with Stage IV, HER2+++ IBC. I had a bone metastasis to L4 on the right.

Our daughter was being married in Los Cabos in just three weeks and our sons’ graduation was in six weeks. The internet told me that many women die within eighteen months of diagnosis and HER2+++ was an aggressive form of cancer.   Suddenly, ‘til death do us part became real. I was an emotional wreck, in shock, angry and depressed.  I would awaken at 2:00 in tears, convinced I would never see future grandchildren, our sons’ wedding or any other important family event.

Instead, I am alive nearly four years later. The journey has not been easy. Chemotherapy every three weeks has taken a toll on my body. I have digestive issues, moderate to severe fatigue, neuropathy in my toes, fingers and lips, and short term memory issues. I had a second mastectomy, radiation to the left chest, and stereotactic radiation to the L4 area. IBC then spread to my right chest with the addition of bumpy skin metastases’.  I had one more progression to my bones, a right side rib. Still, I consider myself fortunate. I have responded to all my chemotherapies and I can still enjoy life. Grandchild number two will be born soon, and our son is in a stable relationship with a girl we adore.  My husband is soon to retire, and God willing, we will have a few more years to enjoy our life.  The FDA recently approved the new targeted combination drug, trastuzumab emtansine (TDM1) and I had my first infusion of it yesterday. “Death” has receded from my immediate consciousness, and I have several trips planned for the rest of 2013.  I have learned that no one is guaranteed tomorrow, and I intend to enjoy my life.