This week has been surreal. I feel totally fine and have all my hair. I’m ever conscious of the ticking clock. One more sleep until it all changes…

This afternoon we met with my surgeon, Dr. Priscilla McAuliffe. We really like her. After a quick exam, she explained how I got here, what’s happening, and our next steps. She was prepared with drawings to explain the kind of cancer I have and how it formed. She emphasized that it was not my fault for thinking it wasn’t cancer when I first discovered it. Women’s bodies are weird, and for something to not be there one day and appear the next, of course I wouldn’t automatically think breast cancer. That I noticed it in July and am starting chemo in mid-September is faster than the majority of women, she said.

Dr. McAuliffe disagrees with the radiologist’s assessment of two adjacent masses. She thinks it’s one, in the shape of an 8. That’s what it feels like to me too. The staging is determined by the tumor size, node status, and whether it has spread. My tumor is 4 cm on the mammogram and 3.5 cm on the ultrasound. Because it is between 2-5 cm, that makes it a T2 in size. It doesn’t look like I have anything in my nodes, and the cancer has not spread. So the equation she wrote out is: T2 N0 M0, which corresponds to Stage IIA. Of note: she called this a clinical stage based on the evidence we have. The true stage will be revealed after surgery.

She agrees with Dr. Brufsky’s course of treatment. The biopsy report says the tumor cell proliferation index is 95%. This means that it’s fast growing but also, ALSO! that it happens to be the kind that responds very well to chemo. Because I have a very low ER (Estrogen receptor), this means I’m “Triple Negative Like.”

Unfortunately, there’s still some information we need from genetic testing. I called the genetics program earlier this week, but was told appointments are booked faster when requested by the doctors. Dr. McAuliffe’s office will call and arrange that. I asked the nurse how long it takes for genetic testing results to come in after that appointment, and she said 2-3 weeks!

Genetic testing will be useful for several reasons. It will tell us if I have potentially passed anything on to the kids. If I have a gene mutation like BRCA, then it might inform the kind of surgery I get. There are other gene mutations for breast cancer besides BRCA as well. If there is a mutation, there is a higher chance of recurrence as well as other cancers. But if the gene tests come back negative, then there’s less risk of recurrence.

So, MORE WAITING! You might as well tie me up, gag me, and make me watch people eat desserts I can’t eat! Torture, I tell you!

Midway through my chemo treatment, and after another round of imaging, I’ll meet with Dr. McAuliffe again. At that point we’ll get into the weeds about my options. Surgery will be needed for a lymph node biopsy and removing cells impacted by the cancer. Interestingly, she said most recent studies show that doing more aggressive surgery for TN doesn’t impact outcome – if there’s no genetics issue.

Continuing the trend of getting ALL THE THINGS, it looks like I might have radiation either way. If the breast isn’t removed, then I definitely need radiation. If I have a mastectomy, I may need daily radiation treatments if there’s still cancer left after the chemo. Either way, it would be a month after the surgery, to give me time to heal.

And then I’m still not done! I’ll need to be on a pill after that.

So basically I’ll be on chemo until spring. I can’t fathom that right now! I only have tomorrow and the next treatment scheduled; I’ll ask tomorrow when we line up the rest. My port installation did get moved to the day before my second treatment instead of the same day.

The office will take care of the next appointments. All I have to do is let them know if there’s a delay. They gave me a 3-ring binder with my test results, Dr. McAuliffe’s drawings and schematics, and information about surgery and other things that I’ll probably ignore until I know what I’m getting.

On the way out of the hospital, I saw a woman in a wheelchair with what looks like a new port installation. That’ll be me in three weeks…

On the way out of the parking garage, we saw a pregnant woman smoking. Here I am, trying to save my life so I’m here for my kids, and this woman is killing herself AND her kid.

The next stop was a wig consultation at a salon in Shadyside. Of course they didn’t have any curly wigs in stock but I tried a wavy blonde wig on to get a sense of how it feels. Gabe, the stylist, put Bobby pins in my hair so it would be easier to get the wig on. He said the wigs have some give which meant it felt ok with my CI. It’s not worth getting real hair (very pricy and high maintenance). Synthetic wigs are low maintenance and have a wide price range.

And no, I did not look better as a blonde!

We narrowed in on one possibility though it’s actually too short and curly. But he said it stretches so he can brush it out a little. If I don’t like it, I can try a different one. We determined that my hair color match is medium brown.

He gave me a web site to check out, which has some newer styles. If I go forward with them and place the order (with a deposit) it’ll only take 2-3 days or a week, depending on the company.

I have a virtual consultation on Wednesday with AHN, which offers free wigs to cancer patients even outside their network (which I am). I might see what those options are before I order from the salon.

I don’t know how often I’ll wear a wig but can see it being useful, especially if I don’t like how I look in other head coverings! During this period when not much is under my control, hanging on to any shred of vanity gives me some agency.