The results are in

We were scheduled to revisit MD Anderson on July 7th and 8th for test results.  Sarah and Sean accompanied me and the emotionally long journey began.  On July 7th we had appointments scheduled back to back starting at 9:30 in the morning.  Our first appointment was a nutritional consult because I was interested in doing a treatment called Gerson therapy and changing to a vegtable based diet(new way of basically saying vegetarian).  People should check out the Gerson Therapy book, and the Gerson Miracle documentary, oh and Food Inc. documentary and Food Matters documentary.  Anyway, the nutritonal consult really just validated what I was doing dietary wise and we just reviewed ways to get enough protein without dairy or eggs, I am almost going vegan but I am willing to eat some organic eggs, cheese, and fish infrequently.  

Our second appointment was with the fertility specialist.  I was optimistic and excited.  And those feelings were quickly replaced with reality.  I asked the doctor to be honest, open, and blunt, because that is how I am and I expect that in return.  And honestly I have been on her side of healthcare and I know the game, so lets not even go there.  

Her conclusion after reading my test results was this.  That I could harvest eggs and have a gestational carrier for a baby.  However, it would need to be Sean's decision because he would be a single parent, due to the fact that there is an extremely slim chance that I would ever see that child out of it's toddler years.  

At this point, I am pretty sure Sean's mind imploded and Sarah was silently crying, I had tears, but,in true Ashley fashion, I continued on with direct questioning and writing things down in my overly organized self made notebook.   

I asked the doctor what she felt my prognosis was and she start with the statement,"well I don't have a crystal ball".  I promptly stopped her and said I have worked hospice for six years and I know that game, we are not playing it.  I told her I have had hundreds of patients ask me specifically, as a social worker, what I thought their prognosis would be and out of respect for them and their loved one I felt that it was my responsibility to be honest and open with them because they had enough fucking courage to ask.  So don't give me a crystal ball bullshit lady.  What I would tell my patients as a hospice social worker was that if their disease continued at the rate it has in the previous 3-6 months then they could expect "xyz".  I told the doctor she knew this and that is what I needed her to tell us. 

She then gave us the truth, if things continue at this rate I would have 1-2 years and if they could get containment on this it would be "great" to have 5 years.  

Wow, what do you do with that.  I want you to ask yourself.  What would you do. What do Sean and I do. We are a young couple that just wants a normal life and now we will be grateful to have 5 years together.  How would you live each day?  It is the question we are now faced with.  How do you not feel sadness everytime you look at each other or wake up together, but still try to feel gratitude for another moment together?  How do you not wonder how many more days will I be able to get out of be without assistance.  How do you not think about your own death and the sadness you feel for your partner, family, and friends?  How do you not think about the level of unfairness for your partner to be a childless widow at the age of 37 years old.  How do you not say FUCK YOU GOD!  Just some questions that are going on in my head right now. 

So the appointment continues with the fertility doctor discussing the treatment plan.  She suggests an anti-estrogen pill called Tamoxifen to assist in the containment of the cancer.  I look at her and bluntly say the following.  Tamoxifen is a 50 year old drug that was invented for postmenopausal women. I am sitting in the best research/educational institute in the world for breast cancer and there are billions of dollars going into breast cancer research each year and that is all you got for me.  And further more there are AIDS patients living for decades now and you all can't figure out a fucking breast cancer cell, and the best drug you have for me right now is 50 years old....you haven't come up with something bigger, better, and newer since then.  What in fucks name have they been doing?  The doctor sat there for a moment and said, "well I can see that you have educated yourself (no shit lady, this my body and my life you better bet your perfectly non-cancerous breasts I have researched the shit out of this b/c clearly no one knows what the fuck is going on), but please don't underestimate the power of Tamoxifen, that is why is has been around for so long.  

I then said to her, why has no one mentioned removing my ovaries if estrogen is such a problem.  Don't get me wrong it is not like I want to continue amputating pieces of my body off, but common sense would say why not remove the problem, is it b/c they can make more $$$ by making me take a pill for the rest of my life.  Her response was that if they remove my ovaries too soon then my body could potentially make estrogen in other places.  Too early????  Do you hear yourself lady?  You just told me I have 1-2 years and 5 years would be amazing, at what point does removing my ovaries become too early....pretty sure that timeframe was approximately 10 years ago....come on....what the fuck, really.  This is the best we got!!!!  It is no longer about a pink fucking ribbon for me people it is about the reality of what our healthcare system fails to do for us everyday and the scars physically and emotionally they leave.  

Oh but, wait this is just my second appointment of the day I still have 3 more, and it keeps getting better and better.

So that appointment ended and Sean was too overwhelmed to hear any more.  So he sat by the beautiful waterfall outside and got some fresh air.  Sarah and I proceed to meet with Dr. Murray the oncologist.  He was running late so we waited patiently, not out of kindness, but b/c Sarah and I were mostly in shock and couldn't speak and had a million and one things running through our minds.  I tried to laugh at the situation by thinking of things I will do with my 401K....it was really not funny...but I was refusing to allow my true feelings to show themselves, which I continued throughout the weekend(note to self: not a good idea, don't keep the emotions inside).  

So Dr. Murray arrives and quickly explains his treatment plan.  Here is the next shocking part.  The cancer has spread to my liver within the past month.  I have a 1.3 cm mass on my liver at this point.  He was in agreement with the prognosis that the fertility doctor had just given us.  The cancer that was previously found in my bones appears to not be growing right now, however, there have been some new spots found.  There are now spots in both femurs and skull.  
There plan is to start an anti-estrogen pill and a bone strengthening shot for 3 weeks see if there is any containment, if not we will remove my ovaries(my choice/suggestion) and try the next anti-estrogen pill for another 3 weeks.  If after this there is no containment we will consider chemotherapy.  There was brief mention of possible non-invasive laproscopic surgery for laser obliteration of the liver mass.  After I researched this more, it is not a question, they will have to give me a good god damn reason why we would not do this. 

My next appointment was with the Integrative Medicine doctor, which I was excited for because they are attempting to integrate holistic medicine with conventional treatment, which is my cup of voodoo/witchcraft tea...just kidding Carol.  He was very nice and comprehensive with his assessment.  He agrees with my choice for vegetarian/vegan diet with occassional organic cheese, eggs, and fish.  Unfortunately, he felt that chinese herbal medicine would not be effective for me at this time b/c it has the potential to produce estrogen in my body.  He did confirm I have a severe case of neuropathy in my feet and recommended accupuncture, which I received while I was there.  I plan on continuing the accupuncture here b/c the neuropathy is debilitating many days of the week for me, walking is extremely painful.  He also recommended, as did all the other doctors that I have palliative radiation to my spine to assist with this pain.  He also recommended for me to have a palliative care doctor follow my case in Kansas City, at that point it was a bit shocking b/c he was sugar coating the fact that I should have a palliative care doctor on board so when I need hospice it would be an easy transistion....I am not at that point yet. I have faith in my KC doctors to manage my pain at this point...call it denial or whatever....I am not ready for palliative doctor yet.  

Just a note.  I had to advocate very hard for me to receive an appointment with the fertility specialist and the integrative medicine doctor.  I should have to say it once, not repeatedly and not give a reason why I want to see them.  I have insurance, and I am an educated woman who knows what she wants so fucking do it, my god.  It is frustrating.  And what about those who don't know how to advocate for themselves or educate themselves.  Or the generations or people who think that "white coats" mean they know everything....I am here to remind you all....fuck that...they don't know everything....find your voice and use it to advocate for yourself or someone you love!  The fertility specialist said to me you know one of the first signs of lobular breast cancer is abdominal weight gain....I said well isn't that funny b/c while training for a triathlon that is how I knew something was wrong with my body and for 2 years I went from doctor to doctor telling them something was wrong, and they all made me feel like I was the crazy one.....now who's crazy...thanks again healthcare system!!!

So the trip to MD Anderson and the recent prognosis is emotionally exhausting.  It was as if each appointment was repeated punches in the stomach.  We are in a state of shock right now and greiveing.  We are also dealing with a completely shot AC unit and living with Sean's parents while we try to figure out how to replace the unit.  Our wedding venue is closed and now saying that they are unsure if they have enough money to return our deposit, so the wedding will not be happening until the spring now.  And I will have to schedule a surgery soon to replace my leaking breast expander.  So if God could give us a break sometime soon we would appreciate it. I dream of the day that I can update the damn blog with good fucking news!  

I know everyone's initial

First trip to MD Anderson

We were at MD Anderson from June 16-21.  The oncologist wanted testing done there in order to compare what had been done here in Kansas City.  Let me just say that MD Anderson is literally city blocks of a hospital.  I was so excited to be apart of such an institution and was so hopeful to have some great care.  The hospital is a well oiled machine, they know where you are at and what you are doing at all times.  I was scheduled for things all day each day I was there b/c they understood I was an out of state patient that needed to make the most of my time while I was there. I have a whole team assigned to me from oncologist to social worker to even a patient advocate. They did their testing a bit different down there but for the most part they did the same as Kansas City. 

I was anxious to meet the oncologist Dr Murray down there, I was just hopeful that we would click and that he would hear me as a 31yo young woman seeking answers and not medical record number 884464.  That was my only issue with MD, was that you were asked you medical record number before your name, Sean jokingly said all the patients should just wear jail jumpsuits with our medical record across the front. 

I meditated for days prior to our visit to MD, on various subjects, but one was most prevalent.  I was meditating on that Dr. Murry would "hear me" as a patient and understand that I want to explore all options conventional and alternative to cancer treatment. 

When I met Dr Murray for the first moment I felt like there was a bit of disconnect and that made me a bit worried.  He appeared to be a very smart "research" kind of doctor, but that is not what I needed him to understand right now, I am not just another protocol I am Ashley Carol Bilbrey who needed to be HEALED.  So as he spoke rapidly with a closed off energy I nodded and listened but then began to meditate and ask that he HEAR me.  His assessment and verbal recall of beneficial medications and protocols continued.  I told him that I wanted him to discuss fertility with me regardless if I were stage IV or not.  I know that for someone with a 5-10 year life expectancy stamped on their life that they should be grieving that, but I was more focused on my ability to harvest eggs and have a gestational carrier.  Dr. Murray stated bluntly, as I had asked him to do, that children should be put on the back burner.  I was still meditating and asking him to hear me and he continued with a disconnected energy.  Then 15 mins into the appointment all of the sudden you could feel the disconnection dissipate and he looked in my eyes rolled his chair up to my face, grabbed my hand and out of no where stated,"I hear you."  He then really listened.  He agreed to schedule an appointment with the fertility specialist. He hugged me at the end of the appointment, and as he walked out my mom looked at me and said,"What did you do to him?" Sometimes I think she thinks my energy work and meditation could be on the edge of voodoo or something....lol!  As my energy healer/spiritual teacher Shani says, "we are all one, I am you, you are me, and we are God", we just have to stop and be open and listen.

 His plan as far as the breast cancer with bone mets is to attempt anti-estrogen medications first before chemotherapy.  He wanted me to complete testing at MD, they would read the results and then I would return the first of July to determine at treatment plan.

During this time, as if our lives were not filled with enough chaos, our wedding venue called me to inform me that the event space no longer meets city code requirements and that they are trying to decide if the space will be available for our Sept. 17th wedding.  Awesome!!!! 

Oh and the other amazing occurrence, I hope you sense my sarcasim, is that my left breast expander is deflating despite the saline fills, so I have a right breast that is filling fine and you can actually begin to see it when wearing clothing, and I don't look like a lesbian so much.....still a little bit b/c my hair is way short but not short enough for people to understand that it is growing back and that I didn't cut it this way, but now I only have one breast and a flat left chest. Nothing against lesbians...you know I love a gay....I am just saying that is what is happening to me right now. LOL.  So I have an appointment with plastic surgeon anyway to get a fill and we will see what he says.

Oh and right before we left for Houston, our air conditioning unit is on the outs, we may be needing a whole new unit.  Really, really....what have we done.  We are good people, we try our best, could we please get a fucking ease card somewhere!!!!

Juen 8th Bone Biopsy

Well the bone biopsy was the most flawless of all my procedures so far.  I contribute that to my peaceful state of mind, my energy healer Shani Enns, and my physicians who actually listened to my needs.  However, the bone biopsy results revealed that the cancer in my bones is breast cancer cells that are estrogen and progesterone positive (ER/PR +) (HER 2 -).  Not exactly what I wanted to hear.  This cancer is being very aggressive and no one is clear on why this is happening to a 31yo.  So I began packing my bags and all my medical records and actual pathology lab slides for my first trip to MD Anderson.  Surely, the best research/educational hospital in the world for breast cancer will have some answers for me.  It is a 12 hour drive with much anticipation packed with our luggage, fears, and hopes. 

What has happened this week

Tuesday MD Anderson in Houston called me, I have a case manager assigned to my case already.  We discussed what I needed to have sent to them via fax and what I needed to bring in my hands to my first appointment.  They were willing to try to get me down there to see a doctor the week of June 6th, but then I informed them that I have a bone biopsy here in the works, but I could cancel that and come down there for the biopsy if that is what they felt would be most beneficial.  They told me to have the bone biopsy done here in KC first, since it was already in the works.  So, Tuesday, Wednesday, and Thursday I was on the phone or at doctor's appointments from 8:00-5:00, non-stop on the phone coordination in between appointments.  I was so mentally and physically exhausted I hurt everywhere.  I ached all over and could even feel my breast expanders ache under my skin with breath.  Lately, hot salt baths, relaxing music, meditation, and hot lavender tea have been my comfort.  Well my therapist, meds and amazing support system(you know who you are) helps a ton too!  I have been successful with meditation recently and I describe it like this.  I just have a "knowing" about certain things these days, I am more centered, and maybe because my physical body is weakening this allows my spiritual body to be more sensitive and allows me to be more open and to hear what I need to.  I have a knowing that MD Anderson is where I need to be, I told Sean, it is not a knowing that they have a cure for me but it is a knowing that something good/positive awaits me there.  Sean had 3 different stories told to him this week about women in my particular scenario and MD Anderson has been able to put them in remission!  Houston, here we come!

Things are falling into place for us to go to Houston.  I met with the doctor who would be doing my bone biopsy yesterday, I really liked him.  However, some of the things we talked about really brings the severity of my case into my face.  He said that I had plenty of options for biopsy sites, which I asked for clarification on. He said I have 3-4 ribs with enough cancer in them for biopsy, also enough in vertebra 8-11 and then 1-2 vertebra a little lower, some on my left shoulder blade, and some on the tip of my right pelvic/hip bone.  So hearing all of those "significant" sites was sad, and didn't even mention the smaller areas.  The doctor has elected to take the biopsy from my 11th vertebra.  He explained he will use a large needle and hit it with a hammer to get it into my bone.  Awesome.  I said what is the probability that you get into my spinal cord or weaken the vertebra to a point that I have back problems or some other issue.  He said the probability was extremely small and my body should be able to heal itself.  He said that b/c I was young my bone would most likely fill itself back in, but in some elderly patients that he has had and a fracture occurred they are able to go back in and fill the fracture with a bone like cement.  Awesome.  So I am scheduled for this procedure on Wed June 8th @ 8:00.

I spoke with MD Anderson this morning and they said that they would most likely call me by the end of today and schedule my appointment with them for Monday June 13th.  That's all I have for now!  Much love & In Celebration!  Ash

This will probably take your breath away

What I am about to post is really difficult.  I know that everyone loves us and will want to call, come see us, and message us, but Sean and I are trying to gather ourselves and we need some time.  Please feel free to facebook private message us or text message us, but if we don't get back immediately, please understand.  Each time we have to retell this story we grieve it, so that is the beauty of this blog.  Because we love you all so much and we want you to be informed, here it is. 

I had a CT scan on May 18th, because I asked for it soon after I had my mastectomy follow up appointment with my oncologist.  We had done a CT scan and bone scan in December 2010 prior to chemo so we could have a before and after picture to ensure the chemo worked.  If you remember the December results confirmed the mass in my breast, lymph nodes, and scattered cancer cells in my abdomen and a 1 cm growth on my adrenal gland.

I went into the CT scan on Wednesday May 18th and upon leaving the nurse stated that they would call me within 24-48 hours. On my way home I was talking to my friend Shelly and I said jokingly,"oh I probably won't hear anything until Monday." However, something inside of me was telling me I was wrong.  There were other things that I was feeling too but I didn't want to believe, I will get to that in a minute. 

I get home and within 2 hours the nurse calls me.  My heart dropped when I saw Dr.Rabe's name on my caller id.  I knew this was not good.  How did I make the 2 hour call back list, I want to be on the 48 hour call list...you know the call back that has nothing significant to report...you know you are fucked if they call you back in 2 hours.  I answer the phone and the nurse states that the doctor has read my scan and has found something "suspicious" and is wanting to schedule a PET scan, which is basically a high definition scan they use to find cancer throughout the body.  The nurse told me not to worry too much, it could be nothing.  Really, really, don't worry, come on!  The nurse hesitated when I asked her where the "suspicious" situation was in my body and she hesitated and said....well....."in your back".  First of all I didn't like her hesitation and no one ever needs to draw out the word well or use the word "suspicious".  The word "suspicious" means nothing ever...think about it.  The nurse stated that the scheduling team would be contacting me with the first appointment available, again if it is nothing why is everyone rushing around.  I got off the phone sat on my couch and had a good cry.  It's not the cancer that is killing me, it's these damn bad phone calls.  I am tired of this, I don't want to be in this club.  As I sat on my couch and I cried I had that feeling, like I was talking about earlier, and I said to myself, worst case scenario is that it is in my bones. 

I was scheduled to have my PET scan on Thurs. May 26th at 11:30 and results read with the doctor at 3:30 the same day.  As I laid in the scanner that morning I already knew what was coming.  Call it God, call it the universe, call it my own intuition, I just knew. 

Here is the bad part, Sean had gone to Hawaii on the 18th for a friend's wedding that I was suppose to be going to as well but earlier in the year the doctors had said I shouldn't go b/c I might have a compromised immune system at that time.  The night before Sean left, he said to me that he felt bad going without me(but we had already committed to share a house out there with the couple before I was even diagnosed) and he felt weird being away from me for such a long time.  I reassured him, and meant it, that I would be fine, I wasn't even in any serious treatment right now and he needed to go to take a vacation from cancer.  Though, in the almost 6 years we have been together this would be the longest we would be separated, that's either really cool or kind of weird...just kidding.  So Sean was on a plane when I got the results.  We had planned for him to meet me at the house after the appointment.  My mom, and girlfriends Cora, Shelly, and Kressy attended the results appointment with me. 

Dr. Rabe walked into the room and inquired where Sean was and why the room was filled with my girls.  I explained the situation.  She was direct and said she was glad I had brought extra support because what she was about to tell me was not good news.  She directly said the cancer has spread to my bones, I am now stage 4.  There is a mass on my spine covering vertebra 8-11, a mass on my rib, and widespread throughout the other bones in my body.  She then says that she has seen women live up to 10 years with this. 



So the doctor allowed us to ask many questions and it was extremely difficult for her to give us the news.  I felt so sad for my mom, I can't imagine what she was feeling.  I felt sad for my girlfriends too, and most importantly I was already preparing to drive home and tell my husband there is a potential that he may be a childless widow by the age of 40. 

The next day I had an appointment with my radiation oncologist,who is from Mayo Clinic, and Sean and I went to get his opinion of my scan.  I was sure that he would say that I should go to Mayo Clinic, however, he said because the type of cancer I have and the aggressive nature it is moving without a doubt he would tell me to go to MD Anderson in Houston. Again, before he confirmed that for us, I "had that feeling" or that voice telling me that I need to go to Houston. He stated that this is the best academic hospital in the WORLD, for my type of cancer. He stated that most likely they will recommend chemo treatment.  He also said that this our golden ticket.  That we have to get this combination of chemo drugs right this second round because the likelihood that a 3rd or 4th round working would be severely diminished.  He also explained that the cancer in IN my bones versus ON my bones which is a good thing.  He explained that this would be more treatable with chemotherapy.  He explained each case is different and prognosis varies, but my young age is a benefit, and another benefit is that the first rounds of chemo appear to have eliminated the scattered cells in my abdomen, remaining lymph nodes, and the adrenal glad.  Sean and I said that we want the most aggressive treatment possible.  I said bring me to the brink of death if you have to, just be able to bring me back.

So this is the plan Sean and I feel comfortable with at this point.  We have already contacted MD Anderson in Houston and we are waiting for them to call back with scheduling most likely on Tuesday.  Tuesday I have lab work to be done.  Thursday I meet with a doctor here in KC who will be preforming a bone biopsy and within a few days of that consult I will have the bone biopsy.  The consult is needed because we will need to determine which bone will be able to harvest to best bone sample with the least amount of damage.  Apparently, with bone biopsies there can be plenty of complications/infections.  The doctors are all hoping that the cancer in my bones is a different cancer from the cells that were in my breast.  The doctors cannot understand why my cancer is so aggressive right now with only being 2 months out from chemo, this may have been more predictable if I were years out.  Again, I am an atypical case!  That's why we are going to MD Anderson. 

I know this is not the news any of us wanted to hear, but it is what it is and we will deal accordingly.  I will fight this because I love you all and life way too much! Sean and I are spending some much needed time together these last few days and will hopefully get our feet back underneath us soon.  We love you all and thank you for your thoughts, prayers, and positive energy.

The news

When the mastectomy was preformed the surgeons are unable to tell how many lymph nodes were infected with the cancer.  The surgeons could only tell me that the tumor in my breast was about 7 cm and that there are 3 levels of lymph nodes in the armpit which she could reach and she took out levels 1 and 2.  It would be a couple of weeks before the pathology report indicated how far the cancer had spread into the lymph nodes.  The surgeon was confident she had been able to remove all the breast tumor and lymph nodes.

I had a follow up appointment with the breast surgeon in order for her to monitor my wound healing.  She informed us that 12 of the 14 lymph nodes removed were cancerous.  She then gave us the news that my cancer is now a stage 3.  We were in shock.

I know that it is just a number, but it is not the number we wanted to hear.  I cried and grieved all weekend.  The next week I had a follow up appointment with my oncologist as well.  Fresh from a weekend of tears and grief I didn't go into the appointment with a smile on my face.  I was tearful and distraught.  My oncologist spoke sternly to me, which was out of character for her, and told me that I can't worry over things that I don't have control over and that if my mind is not in the right frame then my physical body will not heal.  Really, really, does she know who she is talking to?  I, of all patients, understand the benefits of mediation, balance, but don't forget I am in therapy for my anxiety and control issues.  I left that appointment with Sean driving and I was crying.  I said,"what the fuck do they want me to do?  I see a psychiatrist, a psychologist, and I have a fucking workbook my therapist gave to help me with my anxiety/control issues.  Do they forget that I am a 31 year old woman trying to fit cancer into her fucking planner!"

The next day I signed up for a yoga class for chronically ill patients, which makes me feel like the cream of the crop in society.  There is an organization called Turning Point, that is for chronically ill patients and their co-survivors that provides many different types of classes for free.  So I looked at several different classes and signed up for a few.  I ended up really liking the yoga and the Jin Shin Juysitshu.  So when I saw my therapist that week I told her about the stage 3 news and my odd appointment with my oncologist.  My therapist reminded me that even healthcare professionals have difficulty with seeing a young person struggling and maybe my oncologist reacted this way b/c she was trying to manage her own emotions.  Okay, whatever.  No I am kidding.  I get it.  I also get, that the day I was diagnosed with cancer everyone in my life got diagnosed too and we all carry it around with us differently and we all grieve differently and at different times.

So my therapist then asks me how things are going with the Anxiety Workbook.  I said do you want my honest answer...of course she does.  I say,"I feel like a fucking idiot!" I don't think that is the response she expected to get.  I explained to her that I have a master's degree in this, I counsel patients to do these skills in order to cope.  I am pissed that I have this fucking workbook.  She explained to me that when going through college I was able to always view "them" as patients and that I could never be one of "them", yet that is exactly what I am.  Awesome, I am pretty sure she just labeled me as crazy.  We spoke of other things that day and I said several curse words, and told her I felt like a fire has been ignited within me and I have found my voice.  Her response,"I know you are going through an angry stage right now, and you have the right to do that, but just keep this in mind....don't leave slaughtered bodies behind you."  If I were unsure if she had labeled me as crazy before, I am sure of it now!  I'm kidding, I get it, and I told her I am assertive, I am not a total bitch that no one wants to be around and that will not be my intention, but I'm glad she brought it to my attention with those words.

badass self is draped across the exam table.  There is a nurse on each side of me and they tell me they will pull drains now.  Before they begin to pull I say,"Let's be honest here ladies, is this going to hurt, I don't care if it is, I just want to brace myself." Their response was no it won't hurt, it's just going to feel weird.  My response,"Okay with that being said, I want you to recognize that you have not restrained my arms, so if this does hurt there is good probability that I will reach up and choke both of you and/or pull your hair."  I was serious.  I scared them...they made a nervous laugh!  I win!  It didn't really hurt.

Here's my voice!

So Shelly and Carol drove me home and Sean was waiting to help me inside the house.  My prescriptions were filled, our big bed was prepared with nearly 20 feather pillows, and feather comforter.  I had the nightstand  with my pillbox filled, and any possible medical supplies I might need.  I was drained, I slept for some time.  The pain was getting to be unbearable and we all just kept with the plan the plastic surgeon had given us and I used my alternative therapies. We managed through the night.  Saturday came and the story was the same.  The plastic surgeon called my cell and Shelly answered it and explained that the hydrocodone, as we had told him, was not sufficient and this was unacceptable.  His response was for us to meet him at his office as soon as we could.  I have 2 things to say about this.  Listen dick, you could have seen me yesterday on discharge and listened to me when I said this wasn't a good idea, and second dick, you can come to my house, your office is 20 mins away.  We get me in the car and this time it was Lil Bit and Carol.  Let me explain to you that the mere feat of getting out of the bed, down the stairs, and into the car would be nothing to the overwhelming pain I was about to feel with every turn and pothole on the road.  I am sure Lil Bit was about to have a heart attack herself b/c with every bump the tubing from my drains rubbed against my raw muscles inside.  And little do they tell you that with each drain there is about one foot of tubing "s"ed and circled around your chest to suck the fluid off.  So to say that I was tearful, holding my chest, and breathing in a manor that would mimic childbirth by the time we arrived at the plastic surgeon's office is an understatement.  We three had pre-determined that if the plastic surgeon did not listen to us or "fix" the problem we would leave his office and drive the few blocks back to the hospital that I had just been discharged from yesterday...that's how bad it was.

So the plastic surgeon meets me at the door and the first thing he says to me is,"you have to slow your breathing down or you will hyperventilate." My thought was,"Asshole you better fix this or your about to get a right hook!"  His next statement was,"wow I didn't realize you were so tall" as if that were the reason why the pain medication was not sufficient.  I have 2 problems with this.  1) I was on your operating table for 4 fucking hours and you didn't realize how tall I was nor my weight to prescribe medication. 2) I had seen you twice before the fucking surgery, wasn't like we just met, you idiot.  Those thoughts were my pain talking....I pull it together soon...bear with me.  My only statement to him was this exactly,"You either fix this now or I am re-admitting myself to the hospital because this is unacceptable."  He quickly got on the phone with the pharmacy and got better medication.  He then made some comments that made me feel like maybe I had a low pain tolerance or that I was maybe a baby about the situation.  I didn't have the emotional or physical energy to deal with him at that moment, but his moment would be coming soon.  Really, really, a fucking baby, do I need to remind everyone of the breast biopsy incident in November...if you don't remember go back and read it.  Oh and do I need to remind him that I am mentally grieving many things right now, which includes but is not limited to MY HAIR, MY EYEBROWS, MY EYELASHES, MY BREASTS, potentially MY FERTILITY, MY INDEPENDENCE....do you need me to go on, you dick.  We got the medication and left with his instructions to come back in on Monday. 

And here comes Monday and I am of the right mind now because the medications he gave me worked.  So I am sitting on the exam table, which I hate because you just feel like this weird piece of meat and/or that you could have some weird disease and should be kept at a safe distance from the other respectable humans in the office.  Anyway, the nurses prepare me for the doctor to come in and see me.  Oh let me just tell you about the nursing staff in a plastic surgeon's office.  They all look like supermodels, dress in designer clothing, shoes, and jewelry, and appear to be aging backwards.  Now with that said, let me paint this picture for you.  I have just had my tits cut off, I am still fat from all the fluids retained from chemo and surgery, I can't move my arms enough to wear anything other than "old man" button down pajama tops and sweatpants, oh yeah and don't forget the bald head and eyebrows/eyelashes.  So these supermodel, robotic nurses have my sexy ass out on the exam table waiting for the doctor, oh and telling me my wounds look great....really, really, that's what you think....you are lucky I don't bitch slap your supermodel ass right now....but I can't move my arms too well so I will have to rethink that.  Okay, so doctor walks in, he is all happy and opens my gown up immediately to start the exam and says,"let's see what we have here."  I immediately say,"No, we are going to talk for a minute." and I immediately close my gown back up.

Bahahahaha I win people!!!!  I have found my voice and I know myself, so shit will get done!!!! 

Feeling Physically and Emotionally Raw: My voice will be heard now!

So since my last post many things have occurred.  I am going to break this up into several different post so it is easier for me to write down, remember details, and for you all to follow.

At my last post I was preparing for my double mastectomy and lymph node dissection surgery that was scheduled for April 13th.  The surgeon had explained that one night in the hospital would be sufficient in most cases and it was simply done for pain management.  Also, my plastic surgeon had explained that he was ready and prepared to manage ANY pain once released from hospital. The plastic surgeon was included in the surgery because he placed skin expanders under my skin and muscle in order to stretch my skin back out for reconstruction later.  He also placed a pain pump that had two lines feeding me morphine into each side of my chest.  The pain pump was held in a "fanny pack" kind of thing around my waist.  I would stay in the hospital over night be released from hospital, go directly to plastic surgeon's office for wound care instructions and then happily go home to recover.   So that was the plan.  Now let me tell you what really went down!

Remember, when my last round of chemo had been scheduled for March 21st and I almost didn't get to have that treatment because my white blood cells were so low, but on the day of the last treatment the cells were just enough for me to complete my last round of chemo on that day. Well, my mastectomy was scheduled for April 13th which was on a Wednesday, the doctors had given my body about 3 weeks to recover/calm down from the chemo that is why that date was selected.  On Friday April 8th I was scheduled to have lab work done to ensure I was able to withstand the upcoming surgery.  I had been feeling fine, and didn't have a second thought about the lab work.  About 20mins after I left the cancer center my oncology nurse called my cell to inform me that my white blood cells were so low that they basically didn't exist.  She explained to me that if the cell count didn't improve that I would be unable to have surgery until my counts came up.  ARE YOU KIDDING ME!  Let me explain one thing to those of you that have not had to prepare for a mastectomy.  I had been emotionally preparing for this loss for some time.  I am not saying I am a woman because I have breast, but shit, they are a piece of my body and I was going to feel a bit deformed afterwards.  I'm already bald with not eyelashes or eyebrows, I guess you would think loosing a pair of boobs wouldn't really matter, but again the emotional preparation was extensive.  The nurse says to me that the morning of surgery they will draw labs again just prior to surgery to see if they had recovered any, and if not the surgery would have to be rescheduled.  Oh right.....let me get the fucking straight.  I am to emotionally and physically prepare for a surgery over the next few days that may not occur.  I had to fast, I had to wash my body with special supplies, I had to have people rearrange their schedules to help take care of me afterwards, and they just act like well hope for the best honey. Fuck that!  I asked if there were any things I could do to bring my white cells up to an acceptable count, all the time I knew the answer she would be giving me, "NO" there is nothing you can do!  Awesome, great, I should have expected something like this....why b/c I am always the 5% of the cases that stuff goes unplanned or NEVER happens!!!!!

Here is the other thing, my brother-in-law Ryan had planned this entire bowling fundraiser on April 9th, it was going to be a great time,we would be able to see all of our friends and hang out.  The nurse promptly told me that I shouldn't even go, 1) b/c bowling allies are filled with germs 2) and even if I did decide to go against medical advice that I would need to wear a surgical mask and bring plenty of hand sanitizer for anyone who wanted to touch me.  Again, what the fuck!  I was sick to my stomach at this point.  Of course, I begin calling Sean, my girlfriends, and my mom to devise a plan, all while snot nose crying pissed/sad! 

I get home and I tell Sean that I want to go to the bowling fundraiser for a bit, but I am embarrassed b/c I will be in my wig, with painted on eyebrows, and no eyelashes...oh and now a fucking mask....jesus will any of our friends even recognize me...I know that's a bit dramatic but that is how I was feeling.  And you all know, I hate feeling like the "poor little sick girl".  So I sat a the kitchen table with Sean and he let me cry about it for some time and then he thought of a great plan.  Everyone will wear masks and we will decorate them with funny sayings!  God I love him!  So masks were bought and crafting supplies filled the kitchen table and we began decorating masks. 

So the bowling fundraiser was amazing and I didn't care, b/c it was so obvious how lucky we are to have so many people that love us and it would be worth risking an infection or moving a stupid surgical date in order for me to enjoy our best friends and family! 



I had the best massage every on Monday, the therapist was able to use special techniques that took into consideration that I might still have chemo stored in some muscles and she didn't want to disturb too much and have too many toxins released from my body.  I told her before the massage began that I was open to all alternative therapies and whatever she felt would be beneficial I would be open to that.  As I laid on her table I began repeating the positive affirmation "my body is healing", "I am open to my highest good", and ultimately I was able to begin meditating, which was the first time in 5 months!  When I got off of that table I was floating.  I was centered within myself and allowing the healing energy to flow within me!  I was Home!  On Tuesday I had the healing touch and it went well also. 

So April 13th arrives, I had fasted, meditated, and packed my hospital bag with my aromatherapy oils, meditative music, and left home with a peace about me that this day would be a day of healing!  Normally with surgeries I am really anxious and nervous accompanied with plenty of tears and literally shaking with anxiety.  Not today.  Sean, my mom, Sarah, my dad, Charles, and the chaplain's wife Joanna were in the waiting room as the nurses began surgical prep.  First things first, they drew labs.  As they waited for results they began to hurry/rush around as the doctors had finished the surgery prior to me early.  I could feel the nursing staff's nervous energy filling the room.  I was was still managing to stay in my meditative state, and I asked them nicely if it would be possible for them to continue the work quickly, but in a quiet and soft manner as I was attempting to remain centered in mediation.  I was listening to my music and the nursing staff graciously agreed. Here is the thing, since cancer has been in my life I am finding my own voice.  In my work profession it has been my job to empower patients to find their own voice and better communication with others, and it was easy for me to do this as a professional, but in my personal life I now know that I had struggled with it....not anymore!

Then the news came, my white blood cell count was damn near close to normal!  We all cried, literally, out of happiness.  The breast surgeon came into speak to me prior to me being wheeled into the operating room.  She explained again what was about to happen and as she turned to leave, I asked her if I could see the tumor after the removal.  It literally stopped her in her tracks, she turned around and said, "I have never been asked that, and I don't know, but I will see what we can do."  I explained to her that I wanted to see what was in my body that has changed my life forever. She smiled and agreed. As I kissed all my family good-bye, the chaplain's wife Joanna said a prayer, and I shed a few tears, a sense of peace came over me again.  As they rolled my bed to the operating room I looked back at my husband with tears down his face, I raised my fist and said with confidence,"Today is a day of healing!"

I had excellent nurses just prior to surgery and post surgery.  I had a male nurse Jim who simply sat next to my head and stroked my arm as he told me all the things all the other people in the operating room where doing to me, he consistently reassured me that all would be well, I told him specifically, my gratitude for his kindness, then I feel asleep.  I awoke in recovery with another male nurse named Jose, who was gently feeding me ice chips as he reviewed how the surgery had gone.  Again, I made sure to tell him specifically, of my gratitude for his kindness, his reply,"oh you are sweet, this is my job." My response was,"it is your job to take care of me but your compassion is something not listed in your job description."   After repeated phone calls to my doctors Jose got the permission to move me to my room. 

My loved ones were already in my private room waiting, which they said seemed like a lifetime..to me it felt like 30 mins.  Again, with the mind set of healing and mediating, I asked for the lights to be lowered, my aromatherapy oils and meditative music/speakers to be prepared.  My loved ones were amazing, everyone was quiet and I felt as though the energy in the room was as I wanted it....ready for healing.  And here comes the pain.  I was able to get morphine every hour in my IV, and the pain pump that was attached to me was releasing morphine in my chest continuously.  As the night progressed the nursing staff was great, and they jokingly said they wanted to stay in my peaceful room all night with me, but they couldn't help to dismiss the fact that they were having to come into my room every hour to give me morphine.  Finally, one of the nurses in the early morning lifted my gown to check the pain pump....someone had forgot to unclamp the lines and none had been flowing into me.  Now during this time, to manage my pain I had asked my loved ones to use my lavender aromatherapy oil on my feet and hands while meditative music was played and I focused on my breath....it was almost as if I were giving birth, but it worked, I would be able to focus and get through the pain.  Now, I am not saying there were not some silent tears, a few moans, nor the benefits of the morphine in my IV, but all those things combined I did it...we did it! 

I know it was very difficult for my loved ones to see me in the amount of sickness.  Each of them had there times to breakdown and each of them would leave the room to do so and someone else would step in.  I could feel such love in that room, and I am so grateful for the compassion and experience. 

With the pain management/pain pump being and issue I was unable to be discharged after one night.  The first night I had to utilize a bedpan.  Now working in healthcare, I have seen it plenty of times, but now I am the patient and this was such a humbling experience, that is all I can say.  I felt so child like and helpless, which is not my preference...we all know that!  The next day I would be able to utilize the restroom with max assist but I did it.  Now let me tell you about my second day in the hospital.

So the second day in the hospital starts out like this.  I order breakfast, the surgeon visits me and she kindly brought pictures of my tumor on her phone.  Again, she kind of laughed about it because no one had ever asked her for that.  We spoke about discharge plans and that she would have physical therapy come in and show me the best way to get out of bed.  My mom had gone down to the cafeteria to get breakfast and Sean sat next to my bed and fed me my pancakes and sausage, Lil Bit had gone home that night to take care of Deacon for us and she would be returning this morning. 

Okay, remember when I said I have been finding my voice because of cancer, well this is where I really begin to find it.  So Sean is feeding me breakfast and the occupational therapist Joy walks in, glances at us, and mumbles something disapproving under her breath and gives us a disapproving look.  She introduces herself and says she is there to give me information about lymphedema.  She continues to talk and I am not making eye contact with her from the moment she step foot into my room with her negative energy.  So I stop her mid-sentence and look her right in the eye and say,"You know what Joy, before we go further, I need you to explain to me what that disgusted look and mumbling voice you entered the room with is all about."  Joy responds that she disapproves that Sean is feeding me breakfast.  Now inside my head I was saying some unpleasant things to this lady, let me fill you in.  Thought: "Bitch don't you think I want to feed my fucking self, do you think my 32 year old husband is happy that his wife is in so much pain that she can't move her arms to even utilize a fucking fork, or use the bathroom. Bitch I just had my entire chest cut off and my armpit dug out! Bitch I have not had any food for over 24 hours because I got out of surgery late at night after dinner, so I am hungry and you know that I am already pissed about that.  Oh and bitch if you would have read my chart at the nurses desk like most professional healthcare employees do you would know all of this and the fact that I am a hospice social worker, oh and that my pain has not been managed because they forgot to open the fucking pain pump tubing." Again, that was my thought process, but this is how I managed to condense that version and allow my voice to be assertively heard.  Meanwhile,Lil Bit walks in with a smoothie and I tell her that Joy is upset that Sean is feeding me, Lil Bit knew by the look on my face that shit was about to get real with Joy.  So Lil Bit leaned over my bed rails and said assertively, as she placed the straw of the smoothie in my mouth,"I will feed you all damn day!"  We are winning this battle Joy...here we go. 

So I am laughing inside, because this lady doesn't know what she is about to get.  I talk with my eyes to Sean and basically tell him to continue feeding me, and he graciously does, because he can see where this is about to go.  And the unprofessional and utterly annoying middle aged Joy continues to go on and on about lymphedema and how she is a breast cancer survivor blah, blah.  I swing my head around and said assertively, not aggressive,"Joy, you can stop now.  If you would have read my chart at the nurses desk you would have already have known that I am a hospice social worker, I know exactly what lymphedema is.  You need to leave the pamphlets at the end of the bed because we are done here.  I am waiting for physical therapy to educated me on getting in and out of bed so we can go home, good-bye."  Joy stood in shock, stuttered a few times and said arrogantly well I can show you how to do that.  Me knowing this was not true I, went along with her suggestion just to see what this idiot really thought she could teach me.  She basically told me to cross my arms over my chest and "just roll out of bed".  Now anyone with sense knows this is not acceptable.  And for those of  you that have not had a double mastectomy and lymph node dissection let me inform you there will be no crossing of arms over your chest for at least a week or so, but this dumb bitch thinks she knows everything.  I look at her and simply repeat,"We are done here." 

It's not that I am trying to be a bitch myself, but quite frankly, I have had it, I am done, I don't have time to put up with nonsense and now I have the voice to say so. None of us should have time for things that are unacceptable for us, because life is precious. Who knew I would have lost some boobs but gained a pair of balls...watch out world here I come!

So then later in the morning the physical therapy team came in and educated all of us on the best way to get in and out of bed.  They were great and compassionate.  Because let me just tell you, even with a shot of morphine in my IV, I felt like getting out of bed and shuffling to the bathroom was some awful pain.  I was pretty sure at that point that straight fire was running through my chest!  Oh and the best part was that I had the 2 drains going to my fanny packed pain pump, and 3 drains running out of my chest with large balls on the end of about a 12 in tube each to collect the drainage from wounds.  So, as I was shuffling to the bathroom with fire rushing pain through my chest I was trying to manage holding all my fucking balls and focus on breathing with tears streaming down my face I felt like the expanders in my chest were so heavy they were going to bust through my skin.  Let me just tell you this was not a pretty sight for anyone.  My mom and Lil Bit helped the nurses make my bed and pick up the room while I sat on the toilet and cried holding my balls, drains, and pain.  Poor Sean, had to help me and watch me sit there and cry.  He just kept petting my newly fuzzed head, wiping my tears and saying,"it will be okay, and that he loved me" he probably repeated that statement with each stroke of my head 50 times. 

I made it back into bed, and the nice physical therapist said,"It will get better each time." In my mind, I thought, this bitch must be crazy if she thinks I am getting out of this bed anytime soon, I will go back to be humiliated on the bed pan!  We all know that wasn't true and I did do what I needed to do to go home, which brings me to my next story of my hospital stay. 

The next physical therapist arrives in my room to inform me that I would need to walk the hallway and the STAIRWELL to be discharged.  Now let me just give you a mental image of this physical therapist. His name was Norman and he wore rather large and thick glasses, he appeared a bit socially awkward, he was maybe 5 foot tall and maybe weighed 120lbs soaking wet.  Really, Really, they sent this guy to help me, I mean come on, one false step and I would crush this little dude!  So I calmly look at this timid little creature standing in my room telling me I'm going to need to walk a fucking STAIRWELL, and say,"Norman, you have lost your damn mind if you think that I am going to walk a stairwell right now.  I will be able to do a few steps and the hallway, but not a stairwell."  I am pretty sure he may of pissed himself just a bit as he scurried off to see what the nurses and doctor suggest he do.  He comes back a bit later and informs me that he has devised a new plan....great....this plan was more acceptable but there was still a huge potential that I might crush this little dwarf they sent me for physical therapy.  So here we go shuffling down the hall, I was trying to just focus on my breathing and channeling my pain out that way, it really wasn't working but oh well, I wanted to go home.  So we make it to the physical therapy room and I simply have to go up the "old people" 3 step stairway and back down then shuffle back to my room and Norman would be done with his task at hand, which I am sure he was grateful for, b/c I think I could feel him anxiously shaking as he walked next to me....he knew...I might crush him.  So the steps, well let's be honest they sucked so bad.  It hurt and again I was pretty confident that my breast expanders would bust through my skin b/c they hurt so bad.  So it seemed to take me forever to walk those 6 steps, but I did it.  I didn't complain but I had snot, and silent tears streaming my face.  Norman graciously allowed me to be pushed in the wheelchair back to my room. 

So then it was time for discharge.  Here is the next story.  They had to wean me off the IV morphine, but I still had the morphine pain pump to go home with.  They were going to give me some pain medication in pill form in order to take as break through medication.  My plastic surgeon was the one ordering what I would be sent home with.  The nurse comes in to inform me that I will be going home with hydrocodone.  For those of you who don't work in healthcare let me explain what she just said to me.  I would be going from IV morphine to glorified Tylenol.  Have they lost their damn minds...yes.  Here is why, I explain to the nurse that during chemo and my Neulasta shots(bone pain) I was taking hydrocodone like M&Ms, so this was not going to work for me because they just cut my chest off and scooped out my right armpit so I would need more.  I told the nurse to call the doctor and tell him this and get something different.  At this time my best girls Kressy and Shelly arrive, who are both hospice employees, and get wind of what is about to go down.  Those 2 girls stayed at the nursing station and advocated for me like nothing I have ever seen....okay I had seen it before b/c they advocate for their hospice patients just the same.  In the end the plastic surgeon was set on me going home with the hydrocodone, and so it was. 

So Shelly and my mom take me to the plastic surgeon's office as soon as I was discharged from the hospital so they could give us wound care instructions.  Little did we know that the office closes at noon on Fridays and his nurse was there waiting for us.  I was out of my mind for most of that ride and appointment.  I will tell you this though.  The nurse looked like she was 12 years old, it was hot as the devils ass in there, and I was going to be sick from pain and the heat.  So I am laid out in this chair as she cuts the bandages off, I am not mentally prepared to look at my chest at this point, so I don't.  Shelly is taking notes and Carol is patting me on the shoulder saying,"oh they look fine, they are "A cups".  Carol said this repeatedly over the visit.  Shelly was telling the nurse that my pain was not currently nor will not be managed with current medication, the nurse argued with her and refused to call the doctor again.  At this point I was done.  I told them I was going to vomit.  The nice 12 year old nurse opens the window for me and hands me a 4x4x4 basin to vomit in.  Really, Really, I thought to myself, listen bitch I hope I vomit and you have to clean this up....who in the hell gives anyone a 4x4x4 basin to vomit in....midgets/hobbits they vomit more volume than that!  So I say again I am sick I am going to vomit.  Without warning the 12 year old nurse literally sticks a smelling salt stick nearly up my nose.  I looked at her and said,"what are you doing get that away from me!" She informed me that is was smelling salt to stop vomiting.  I said,"well, if I wasn't going to vomit then I am now, damn.  We are done here, Shelly, Mom get me into the car now!"    And so it was.

More to come....

8th and final chemo, my 31st birthday, and little angels

So my final chemo was on March 21st, my counts were just good enough for me to complete my final round.  I was so happy!  When the nurses made the announcement to the entire chemo room and presented me with my graduation certificate I had tears of joy streaming down my face!  Another great thing happened on my final treatment.  I was able to meet one of my other Young Survivor chicas that I had only been communicating with via emails.  It was her final chemo treatment that day too.  It was awesome to meet her face to face and give her a giant hug!  Seeing other young women being strong and beautiful during their treatment definitely encourages me! 

Completing chemo seems to have lifted a giant weight of my shoulders as well as Sean's.  I know that I have more treatments, trials, and tribulations to conquer.  However, there is something about not having to go every other week to prepare your body for the side effects and knowing that you will be weak, and bed bound. 

I turned 31 on March 30th and I have never been one who gets too excited for birthdays, however, from now on I will be happy and grateful for the gift of each year of life and I will celebrate accordingly!  On my birthday I was feeling emotionally and physically great.  Sean took me to a nice dinner and I was even able to enjoy a bottle of wine with him.  The best part was that we were able to laugh and get a glimpse of our "normal" life versus our "chemo/cancer" life we have been living the last 5 months.  We had a great time, we laughed so much that night!  For a bit more celebrating I requested that we all go camping, because I love camping and since being a captive of chemo and indoors for the past months I was yearning to be outside in the fresh air.  When I say we went camping, I mean we rented a small cabin.  We went to a small little lake outside Kansas City, which was appropriately named Lake Paradise!  I am telling you right now it was the best time ever!  We had a campfire, yard games, lawn chairs, and music!  Our friends were there and of course my brother-in-law Ryan provided ample entertainment.  We all laughed until our stomachs and faces hurt.  Even on the way home on Sunday Sean and I were laughing hysterically about the whole experience!  I really felt like the old Ashley and that for one night I didn't have breast cancer!  To everyone that was there, you gave me the best birthday present ever! 

Here is the little angel part....as we were sitting by the campfire we had some random other campers stroll by our cabin to say hello.  In this group of other campers a girl approached me and asked me if I was Ashley and if I were the one who had breast cancer.  She introduced herself as Nikki and that she was exactly one year to the day of completing her chemo for breast cancer.  Nikki and her friend went with Lil Bit and I and sat in my cabin and spoke about our journeys.  Nikki is an angel because she gave me hope that night.  She graciously showed me her scars and gave me tips on "feeling normal".  She was honest and open about anything I wanted to ask, oh and the weird thing is that she live in the same city and Lil Bit and she has the same oncologist as I do.  Awesome!  and what are the odds that we would all be there at the same time!  I have another Young Survivor that is inspirational and another support! 

So after battling the physiological effects of chemo and the steroids, my oncologist recommended that I seek a psychiatrist and psychologist for more emotional support.  I agreed because I felt as though I was losing my mind and the effects of chemo on my brain/moods were not easy to live with.  I have been in counseling for a few weeks now and I have really appreciated the support.  The psychiatrist has provided me with medications to combat the steroid/chemo effects and the psychologist has allowed me to talk about all the emotions that I am going through.  Mainly we have spoke about all the loss I have experience and anticipate losing because of breast cancer.  I am feeling better and preparing for the next leg of this journey.

I am scheduled for my double mastectomy and lymph node dissection on April 13th.  I have decided to have the plastic surgeon place the skin expanders at that time too, so it is one surgery versus two.  I am trying to emotionally prepare for my breast to be gone. When they told me I would lose my hair with chemo, I was devastated.  Now I have emotionally progressed to a point were I want to go bald, and I only wear my wig when we go out to were it would be more socially acceptable to wear it.  Otherwise, I rock my baldness, I feel like,"Hell yeah I'm bald, I have earned it, going through chemo hell and back, what are ya gonna say!"  I DID chemo, and I know I will DO this next step.  I am prepared that it will take some emotional work to get comfortable with my body again, but someday I will feel comfortable showing some other young breast cancer patient my scars and telling her, "Hell yeah I did it and so can you!" 

7th Chemo video

You know I am sexy with my wig and surgical mask on!

So the 7th round of chemo went much easier than the previous.  The doctor and nurses were prepared with all the right medications in case I had another reaction.  They gave me so much medication that I was able to sleep through most of the chemo session.  We were still there for most of the day, Sean will never let me go without him again, and he patiently sat with me all day as I was tethered to the chemo pole and sleeping away.  I was really tired and emotionally all over the place from the chemo and the steroids.  I vacillate between crying and being raging pissed, so Dr.Rabe(oncologist) recommended that I go see a psychiatrist...appointment has been made for March 17th!  I know I need to go, I am eager to seek the help.  It is torturous to feel the chemical imbalance throughout your mind and body.  Now I know what it is like to feel helpless and in so much emotional/mental pain that punching something or cutting would sound like a viable option....don't worry I'm not going to hurt myself or Sean, but this is the only way to explain it. 

I continue to have about two days of body aches/pain within the week after receiving chemo, which is no fun, but just another part of this journey.  I am focused on the next steps of this journey and that is my last scheduled chemo session on March 21st! 

I had blood work done today, as I do every Monday, in order for the doctor to monitor my white blood cell count because if these go to low then chemo will be postponed until my body can withstand chemo again.  Unfortunately, we found out that my counts are drastically low and that I have been quarantined to the house and away from people in order to avoid any infections.  I had an appointment with the breast surgeon this morning and had to wear a super sexy surgical mask into the hospital, again to avoid contact with germs!  I just hope that my body gets things together so I can have chemo on the 21st, I don't want to postpone it, I am ready to move on. 

So the appointment with the breast surgeon went well.  Dr. Ballanoff is completely confident that she can remove all the cancerous breast tissue and lymph nodes!  She told me that I should only have to stay in the hospital one day if all goes well and that she has high regards for my plastic surgeon and radiation oncologist!  She asked me how I felt about our fertility options after meeting with the fertility specialist in November.  I think about it constantly.  We desperately want children and with every chemo treatment I just sit and hope that there is a chance for us after all of this.  Sometimes I think you know what Sean and I are good people and we deserve children and I will be crushed if that is a gift that is taken from us. So the next time you want to complain about your children or the daily tasks of life, stop and think what it would be like if you didn't even get the option.  Be grateful for life! I told Dr. Ballanoff that in our opinion we will be so blessed to have children, but the other thing that weighs on my mind is that I will be blessed if I am a healthy breast cancer survivor with no recurrences too.  I told her that sometimes I just wonder, will there be a day that cancer is not the center of my life, her response was honest, it will be a long time but it will happen.  I told her that being 30 years old gives me, hopefully, a long life to worry about having a recurrence, again her response was honest, and she said that was true but if I can make it to the 5 year mark without a recurrence my odds will get better and better.  Never thought I would be dealing with this at 30 years old.  This journey is shaping my character and allowing me to appreciate things in my life that may have been overlooked a little more otherwise...there are silver linings when you stop and recognize them. 

Feb. 22, 2011, sixth chemo, and genuine friends and family!!!!

Sorry, I am a bit behind, but don't worry Carol (my mom) took the opportunity to let me know that she thinks I need to update my blog more regularly.  I'm not going to lie, it may not be too much more regular until I'm done with chemo, but I will try. 

So on Feb 22 I had my fifth chemo, and it was rather eventful.  It began with me having chemo on Tuesday versus the typical Monday, but the cancer center was too busy and they bumped me to Tuesday.  Sean was unable to get off work to take me, therefore Mike (Sean's dad) took me.  Since it takes so long for my chemo to drip into my body, I had told Sean that there was no sense in Mike sitting there with me all because it would be so boring for him.  Sean was insistent that Mike stay the entire chemo, I think it is because Sean worries about me and wants everything to go as smooth as possible thus causing less anxiety for everyone.  However, you know me and my amazingly stubborn ability as a patient, I fought him on the issue. It had nothing to do with Mike keeping me company, I love him and he is so easy to get along with, I just know that an 8 hour day tethered to a chemo pole is not my idea of fun and I didn't want to torture him either. 

Mike took me and stayed until the chemo was running fine, my friend Kressy stopped by to smuggle me some soda and chips into the building...just kidding I could eat it she didn't need to smuggle it. The chemo had been running for some time and things were going well.  As soon as Mike and Kressy left within about 15-20 mins I began to go into anaphylatic shock.  It was awful, however, this is the exact reason that all the cancer patients sit in this giant room to get their chemo treatments.  The infusion nurses can monitor a larger number of patients this way, in order to be prepared for adverse reactions.  On a whole though there are minimal patients to no patients that suffer with adverse effects, until we all get home and then we deal with the effects. 

So all of the sudden I felt really flushed, difficulty breathing, vomiting, and as though I was having a heart attack.  The infusion nurses were working on me within seconds and the doctor was paged and they were all surrounding me and working on me.  I could talk, and I was shaking as I vomited into this tiny bag contraption.  I was scared.  They immediately stopped the chemo from dripping into the body and began pushing all kinds of meds from syringes directly in to my port.  As I sat there vomiting and unable to talk I kept thinking to myself, "Oh shit, Sean is going to kill me because he told me not to be here by myself!" Then my very next thought was, "if Sean doesn't kill me I am pretty damn sure I am dying right here tethered to a damn chemo pole!" And let me just say that during the chaos of my episode all the other patients were looking at me with that look on their face like, "oh shit, that's girl is having a reaction and two things, its bad and I hope that doesn't happen to me!"  It was so quiet you could hear a pin drop! The medical staff were able to get my reaction under control and I passed out sleeping in the chemo chair.  I woke a bit later with an uncontrollable feeling to scratch my skin all over, they had started the chemo drip again and I sat up in the chair to plan my attack on itching my skin.  As I sat up and pulled my sleeve up I discovered I was COVERED in large hives.  Right at this time the nurse happened to glance my way and she ran over and stopped the chemo again in hopes that I would not have another reaction. My eyes were not blood shot the whites of my eye were filled with solid red blood....let me tell you I was a crazy site, no wonder all the patients had those looks on their faces and were not making a sound. Again, they began working on me.  I stabilized and they began the chemo again.  I was at the cancer center from 9:30AM to 5:00 PM, it was an exhausting day for me.  Let's just focus on that I survived. 

The steroids and medications that they had to give me during this round definitely effected my emotional well being.  I was vacillating between raging pissed to where I wanted to hurt something to uncontrolled crying.  I jokingly had told my friend Shelly that if we were able to see each other that she could see me as long as she didn't give me any access to sharp objects!  I felt and still do feel like I am losing my mind.  The emotions are beyond my control and again I hate that!  I think that going to the Young Survivor's Coalition meeting in March will help and I decided to make an appointment with a psychologist who works with a majority of cancer patients.  However as the week wore on, my emotions kept get more out of control.  I finally called the cancer center and my oncologist gave me a prescription to help.  When discussing things with her, she informed me that the emotional mood swings were due to the effects of chemo on my body chemistry, the steroids, and the overall emotions of going through cancer treatment. 

To help with my emotional well being I got to spend some amazing time with Lindsay and Sarah and we sat around and talked and had snacks on a Saturday night, the laughter was good medicine!  And a little phone psychotherapy from Shelly never hurts, and I even got to see Cora and Kressy too! 

During this process it is amazing to know you have some really amazing friends and family who are willing to put their own needs aside in order to support you!  In the same thought process, it is amazing that you have some friends and family who you thought would have been more supportive and genuine.  I just know that this process make me really appreciate the relationships in my life for what they really are, good or not so good.  This also makes me think about how I am as a friend and how I can be encouraging and supporting to others in their time of need. People have made comments about me being strong, but I know I could not get through this rough journey without my amazingly loving, genuine, and supportive friends and family!  I will never forget!

I thought stiching my life back together after breast cancer would look prettier!

So on Monday Feb. 21st Sean, Sarah, and I ventured to the plastic surgeon's office to discuss what my options are.  In my mind's eye I had envisioned that reconstruction was going to be as if I were getting a nice boob job.  However, this appointment painted a very different picture for me.  Let's just say I cried many tears and it was an overwhelming emotional day.  Thank god I had Sean and my best friend Sarah with me! 

First of all, I walked into a plastic surgeon's office in Johnson county where the waiting room and parking lot were full.  I sat in the waiting room thinking about how all these other patents were lucky to have the choice for an elective surgery to make themselves more "perfect" and here I am just happy enough to get into the doctor's office without being chemo sick/tired, in "real" dress up clothes, as I hid beneath my awesome wig.  Really I was jealous and pissed at the other patients because they had a choice.  It is funny though, I was determined to get dressed in my best girlie outfit and put on good makeup and made sure my wig looked its best so that the doctor could tell that this reconstruction had to match my fabulous self, even though these days in what Sean calls my chemo life, I had not been feeling so fabulous and further more I am sure it meant nothing to the doctor what I was wearing that day.

So before I met the doctor we spent most of the visit with his assistant who described the procedure.  I think because I have not had my consultation regarding the mastectomy yet, that this appointment was much more overwhelming that what I had anticipated.  I guess that I didn't realize that the mastectomy was such a major surgery.  I didn't realize that I would have two drains attached to me and some type of pain pump as well. However, I was glad to hear that the plastic surgeon would be there during the mastectomy to insert the skin expander at the same time, so I would only have one surgery.  The other good thing is that the plastic surgeon has worked with my breast surgeon and radiation oncologist before and spoke highly of both.  I feel comfortable with this plastic surgeon as well because in the breast cancer community and the health care community he is also spoken of highly. 

Okay, back to the details of the overwhelming appointment.  They obviously allowed me to feel the silicone implant which was fine.  However, the skin expander was extremely weird.  I can describe it as the same shape of an implant, however, the outside of it is hard and comparable to the material a dodge ball is made out of.  They explained that they will fill it about 50-60cc every three weeks after I am done with radiation.  During my six weeks of radiation I will still see the plastic surgeon in order for him to monitor my skin integrity and the skin expander's response to the radiation.  They told me that they will fill the expander until I feel like I am at a bra size that I am comfortable with....my response was Jesus I will be filling for a year if I do it 50cc at a time every three weeks, they didn't disagree.  Another weird bit of information was that during my surgery placing the expanders they will also place some human cadaver tissue to rebuild a "shelf" for the expanders/implants to sit/build on.  They also informed me that after the cadaver tissue had been in my body for about 3 weeks that it would take on my own DNA and no one would ever be ever to tell it wasn't my own...weird.  I was able to see pictures of patients with and without the use of this cadaver tissue and without a  doubt I am going to use it because it looks more natural.  Well, since I mentioned pictures I might as well let you know that this is the part of the appointment that shit got real overwhelming, as if all of that was not enough.

The assistant pulled out the photo album of the breast cancer reconstruction pictures.  I was unpleasantly shocked!  There were so many scars, drains, tubing, and just unnatural looks.  I simply started to cry, I don't think I even said one word.  The assistant, Sean, and Sarah were trying to console me, but there were just tears!  The assistant asked if I wanted to stop, and if I needed some water, I adamantly shook my head yes!  I sat there and cried.  Sean held my hand and Sarah gathered clean and dirty Kleenexs

So then the assistant came back into the room, and of course I apologized for crying like a baby, and we finished with a few more questions.  I met the doctor, who was really great!  I loved him the moment he told me to go home and think about all of this material they had given me and then to make another appointment where he and I could just sit and talk, that was really awesome.  He knew it was emotional traumatizing for me.  He was optimistic that youth would be on my side and after he examined me he was sure things would be okay.  Still it was so much for me to take in, I felt like I wanted to cry for days. 

I have not had a drink of alcohol since my diagnosis in November but I quickly told Sarah and Sean we needed to go get lunch and I wanted either a beer for myself or I would sip theirs, of course they were quick to oblige!  As we drove to lunch I told both of them that I just needed to cry for a bit and then I would be okay.  They were both great, Sarah had a box of Kleenex in the car for me and Sean leaned his hand to the backseat and just rubbed my leg as I snot faced cried, it felt good. We had a great lunch, despite my state of shock.  I had my own beer, maybe two, then we came home and watched comedy skits to lighten the mood. 
So that was that, and now on to the next battle, who knows what it will be, but I will prevail, like it or not cancer! 

Let's be honest

So it has been several days since I posted anything.  I had my 5th chemo session on Feb. 7th it seemed like the longest day ever.  Sean and I were at the cancer center from 10:30 AM until 4:30PM!  The new chemo drug I am taking is required to drip into me over a 4 hour period because it is so strong that if it goes any faster it can make my body go into anaphylactic shock.  I have to take 24 hours of steroids prior to my chemo too, in order to prepare my body.  So the day started with lab draws and then we met with Dr. Rabe.  Dr. Rabe informed us that the mass in my breast had measured .5cm smaller again.  Dr. Rabe cautioned us that the shrinkage may really slow down now and to not get discouraged by this.  We discussed the side effects of the chemo which have included fatigue, nausea, mouth sores, water retention, body pain, and dry skin.  I informed Dr Rabe that I felt like I was getting some type of upper respiratory infection and that I was nervous about this and the effect this would have while doing chemo.  Dr. Rabe gave me an antibiotic and I was back down the hall to start my 5th cycle of chemo. 

It seemed like the longest day ever. Sean sat next to me, he played on line Scrabble and I watched a movie and played Scrabble too.  The cancer center was very busy that day and it was hard for me to watch all the other patients get their chemo and then get to leave as I had to remain "hooked" to my chemo!  There was a new infusion nurse training that day and Sean and I were introduced to her as the "newlyweds"!  There was another couple around our age, a bit older, and they overheard the nurses commenting on our newlywed status and they informed us that they had been married almost a year.  The wife was laying there getting chemo as her husband was on his laptop too.  As I looked at them I thought to myself how unfair it was for them to have to go through cancer as newlyweds and how sick she looked.  Then I realized I might as well have been looking in a mirror.  It just isn't fair any way you look at it.  I hate it for Sean, I think this is the thing I get stuck on the most.  When I am sick or can barely move out of bed I typically cry because my husband should not have to do this right now, maybe when we are older, but not now.  Sean never complains and he is extremely involved with my care/medications/treatment.  Again, it is not fair! 

After the most exhaustively long day getting chemo we made it home and then the week of torture began.  I literally laid in bed from Monday night until Saturday afternoon.  I was so tired I could barely move to answer my phone.  These last four rounds of chemo do not require me to get the Neulasta shot so I was optimisitc about not having any bone pain.  However, the nurses had informed me that this new chemo drug, Taxol, will give me body aches and I will feel like I was hit by a train.  I was taking my antibiotics that Dr. Rabe had given me in order to stop the potential respiratory infection I thought I was getting on Monday, but it wasn't working.  My body could not handle chemo and this possible infection.  I slept and laid in bed and cried most of the week.  This mentally broke me, but at the time I was to sick to care about anything.  All I knew is that the body aches were too great at times to even let me sleep.  I was having sweats and the aches would move throughout my body and I was too weak to move, even going to the master bathroom was an endeavor.  I can only explain the body aches as a sharp shooting pain that when touched felt like when your limbs have fallen asleep and when you touch them it feels like a thousand pins and needles.  My respiratory infection made it difficult to even breath.  I am not going to lie, I cried.  I cried because I was so sick with no resolve insight, and I cried because I was tired of being sick.  My mom came up and cleaned the house, cooked, and did grocery shopping for us, I cried then too.  I cried that I am 30 years old and my mother has to come and help me like this. I cried because I feel like I have nothing to give right now, and I am not even contributing to my own life. I cried because I looked pretty freaking pathetic as I lay there in bed.  Like I said, I am pretty sure that week in bed mentally broke me. 

meds I could have at this point.  So what did I do....I cried.  Didn't my illness get the freaking memo....I am tired of being sick!  Sean came home and nursed me back to health, my friend Cora had graciously placed some chicken noodle soup in our freezer the last visit so that helped me tremendously.  Sean had got some gatorade on the way home, because before cancer I was addicted to drinking tons of water during the day, but since chemo water tastes nasty, so to stay hydrated I drank the gatorade.  Then if that were not enough, as I lay on the couch, because I refuse to be confined to the bed any longer, I began to have some type of rash over my bald head, neck, armpits, and stomach!  Great!  Sean ran me an oatmeal bath and I lay there rubbing a freaking pantyhose filled with oatmeal all over my body. Freaking awesome!  Life is great!  Good note:  I am feeling better this morning, so hopefully I can add some different food to my diet today and I am obviously well enough to update my blog so you know things must be on the upswing. 

Another good note, I met Dr. Coster who will be directing my radiation after my surgery.  I meet with Dr. Ballanoff, the breast surgeon, on March 14th to discuss the surgery and set the date.  Dr. Coster was amazing, he explained my treatment plan and my "cure rate" extensively.  Dr. Coster is from Mayo clinic and appears to be very smart!  He answered all of my questions and his bedside manner is great.  He appears very understanding, most likely because his wife was diagnosed at the age of 32, just after they had married as well.  He explained that I will have six weeks of daily radiation.  I meet with the plastic surgeon Dr. Quinn on Monday the 21st to discuss my options.  And then I have my 6th round of chemo on Tuesday, and I am very nervous but trying to be optimistic. 

I will try to upload a video soon to, because I think it has been a bit since I have done that.  I can't remember if I have posted a video of my complete baldness, I think that I have the guts to post one if I haven't already.  I am fairly comfortable with my baldness now, I think it is because I don't have a choice and I am holding out on the thought that someday it will return.  I will be honest, maybe one of the silver linings of chemo is the hair loss because showering is so much faster and I am lightening fast like a boy getting ready, not like I am going anywhere though!

Cancer makes me excited for Scrabble and fresh air!

Well, I am feeling really good the past few days!  I have even went grocery shopping and took Deacon (our dog) for a small walk when the weather was nice!  It was amazing!  I hope that the next 4 rounds of chemo allow me to feel this way, because I feel more like the old Ashley.  The next 4 rounds of chemo are an entirely different chemo drug, so I have my next treatment next Monday and this will be the first round of that drug.  I just pray that it doesn't send me back to square one with the nausea and other side effects.  I was planning to go to the gym and utilize the seated bike today, because my feet seem to always hurt, so I thought the bike would put less pressure on my feet.  However, our driveway is a sheet of ice and I am waiting for the ice melt to work.  The good news to this is that I got outside, took out the trash, and scattered ice melt over the drive, even though it was freezing cold the fresh air was good.  So now I sit by the window and play online scrabble and watch for the driveway to de-ice, and the moment it does I am going to try to make it to the gym before the 9-14 inches of snow falls in the next 24 hours!  So that is the current and exciting life of Ashley, lol!

The plan

Well, Monday was Chemo #4, which means I am half way to being done with Chemo!!!!!!  Good news, the tumor in my breast measured 1cm smaller horizontally and is softening!  Dr. Rabe and I were really happy! 

We discussed that this aggressive treatment regime of chemo will most likely eliminate those scattered cells throughout my body and that there will be no need for further chemo after these 8 cycles.  I meet with the radiation oncologist in 2 weeks in order to discuss the length, and frequency of my radiation.  Radiation will not begin until after my breast surgery.  I have an appointment March 14th to meet with my breast surgeon again and set the date for the breast surgery. 

If all goes well my last chemo will be at the end of March, I will wait about 3 weeks and then have breast surgery the beginning of April, then wait another 3-4 weeks for wound healing and then beginning radiation. 

Yesterday was my last Neulasta shot, so that is also reason for celebration!  However, Monday night and Tuesday I was really sick, had hot flashes, and my blood pressure was low, so when I went into get my Neulasta shot they had to give me a bag of fluids. 

It has been a bit since I have posted on the blog.  I think that I was going through some depressed moods.  I continue to struggle with being sick.  I hate being weak and in bed.  The bone pain makes me feel like an old lady.  I go to this healing/support group on Thursday nights, and the patients that attend are of various ages with varying types of cancer.  I like the group, but sometimes it is too much.  I really struggle with the being sick and weak myself and then there are some patients that are attending the group and they state that they are still working and that they have rarely been sick.  It is also hard for me to be around those patients that look like death.  The bottom line is is that I am struggling with being a patient and I hate that Sean, my mom, and my girlfriends have to help me so much. 

I think the other reason I have had a bit of depressed mood is because I have had to begin focusing on some wedding details lately.  I have not even got a dress yet and now I am bald and rarely have any energy, so feeling bridal is really not in the cards these days.  So a couple of days that I have felt good I had to go try on some dresses, which has not been the fun experience that most people get to have, oh well!  I will try to focus on September when we will have a big party and cancer will not be invited! 

Good News During Chemo #3

The sound is a little low on the videos, but I want to shout this news out anyway!  Monday at chemo was most likely the best day Sean and I have had in this whole journey so far.  Dr. Rabe measures the breast tumor before each chemo treatment.  The reason for utilizing chemo at this point is not to directly shrink the tumor, it is to "clean up" all the scattered cells.  However, it would be a wonderful indirect benefit to chemo if the tumor did shrink.  Dr. Rabe measured it on Monday and the breast tumor had shrunk 1 cm vertically and .5 cm horizontally!  Sean and I were super pumped, even Dr. Rabe was excited!  We were, and still are, so happy!  Five more chemos to go and then off to the next battle!

Shaved Head Equals Amazing Mohawk Opportunity.....Owning it baby!

This past weekend

The weekend before chemo I am at my physical best. Emotionally it is all about preparing for another round of nausea and intense lethargy.  However, this past weekend I was able to sit on the couch most of Saturday and Sunday...which was a big deal.  I even ran an errand to Walmart with my mother, I begrudgingly utilized the motorized cart.  I hated every minute of that damn cart, I hated it because it was undeniable that I was the "sick" person.  However, my overly optimistic mother refused to let me wallow in my pity party and reminded me that I was strong enough to get out of the house and even able to run an errand.  She was right, I should be happy about that.  My mom was such a good mom, and it was evident that she moved effortlessly in her mother role.  She was able to cook, clean, and I even allowed her to boss me a bit.  It was nice just to have her here.  We were able to Skype my little sister and brother-in-law, who are in Germany, and they were able to marvel in my baldness.  My amazing neighbors came over, and graciously offered to assist in any way.  A couple of my girlfriends came by, and yes Carol was able to feed them...she was so happy she was beside herself!  All in all, it was definitely a good weekend! 

Try these links if you need to print order form

http://www.bluechipwrestling.com/images/GD151LB-Team-Ashley-Whipping-Cancer-OFORM.JPG

http://www.bluechipwrestling.com/images/GD151LB-Team-Ashley-Whipping-Cancer-OForm.pdf

May have trouble with order form

I am realizing people may not be able to print order form from blog.  We are trying to figure out an alternative or to fix this.  We are thinking about a facebook post and/or email as well.  Leave me comments on the blog to let me know what is happening or email me at alee_msw@hotmail.com    Thanks in advance!

TEAM ASHLEY APPAREL

Team Ashley,

 First, we want to say THANK YOU all so much for all the support, kind messages, and offers to help.  It is truly appreciated. At this point, Ashley has completed the 2nd of her 8 rounds of chemo!  Go Ashley Go!

We are excited to say we have the Team Ashley Apparel and order form up and ready!  Please contact Sarah Buchanan if you have any questions. 

1.       Print the attached order form and place your order!
2.       Mail completed order form and check to:

Sarah “The Enforcer” Buchanan

409 SW Parkwood Dr

Blue Springs, MO 64014

*Note; Orders are due by Saturday, January 15^th.  Please email Sarah, senoritabuchanan@gmail.com if you don’t think your order will arrive in Saturday’s mail.

Also, no need to add "The Enforcer" to your check...unless you are looking for someone to boss you around too!  

3.       Orders may be picked up the week of 2/7.  Please specify your pickup location when ordering:

-Sarah Buchanan / Blue Springs, MO

-Ashley Lee Bilbrey / Gardner, KS

-Carol Lee / Carthage, MO

- Stacey Jones Stark / Carthage, MO

*Shipping note; Shipping is available!  Please add applicable shipping rate per your total:

                         -up to $50.00 / add $8.00

                         -over $50.00, up to $100.00 / add $10.00

                         -over $100.00, up to $200.00 / add $12.00

                         -over $200.00, up to $400.00 / add $16.00