Breast Cancer Screenings

I feel like a lot of what I say on this blog is about Parker and Kate.  And I like it that way.  They take up the majority of my thoughts and my day to day life revolves around them.  This post, however, is not about Parker and Kate.  It's about me.  And my boobs.  If this gives you the squeamies, then you really should stop reading right now.

I guess you could say I have a history of breast cancer in my family.  My mom was diagnosed at the age of 25 and lost her battle with breast cancer was she was 27.  Her mom (Grammy) was diagnosed at 66 and is currently cancer free!  Grammy's mom was diagnosed when she was 44 and died when she was 45.  Her mom (my great-great grandma) died at 56 of "pernicious anemia," which apparently is a catch all diagnosis and there has been some suspicion that she may have actually had some form of leukemia.

I think I was around 21 when I got my first breast ultrasound and I've had several since then.  It started getting a little tricky when I got pregnant with Parker because you can't have any screenings when you're pregnant and you have to wait six months after you stop breastfeeding before you can get screened again.  So, the window between when I stop breastfeeding and when I want to get pregnant again is rather short.  I knew that I'd have a lot of initial appointments with various doctors because I'm new to Kaiser (my healthcare/insurance provider).  Well, kind of new.  Actually, I'm a returning patient after a several year hiatus.  Anyway, I knew I'd have a lot of appointments, but sheesh, I feel like we're starting to verge on ridiculous here.  So far, these are the appointments I've had:

Appointment #1:  Met with my primary care doctor for an ultrasound referral.  She also referred me to see a genetic counselor to discuss genetic testing.  This is the one and only appointment I took Parker and Kate to.  They were less than angelic.

Appointment #2:  Went in to get an ultrasound, but was turned away.  Apparently they no longer perform ultrasounds as an initial general screening.  They weren't sure how I slipped through the cracks and the appointment got scheduled, but the radiologist told me that they only do targeted ultrasounds if, after getting an MRI, something suspicious is found and they need to follow up with an ultrasound to get a better overall picture.

Appointment #3:  Meeting with a genetic counselor.  I filled out a questionnaire prior to the meeting and during the appointment she asked me for further details and recommended that I be on Kaiser's high risk breast cancer screening regimen.

Grammy has gotten genetic testing for the major breast cancer genes (BRCA1 and BRCA2).  She does not have a mutation of these genes and so it's assumed that I don't either.  In the next month or so she'll get tested for a host of other breast cancer genes.  If she does not have a mutation at these gene sites, it will be assumed that I don't either, but if she does, then I'll also get genetic testing done.  The genetic counselor said that based on the early onset breast cancer of both my mom and great grandma, she strongly feels that the breast cancer is familial and due to a heritable gene mutation.  Purely based on my family history, she said that I have a 34.1% chance of developing breast cancer in my lifetime.

I am happy to get the genetic testing done, although I'm not sure how much that information will change my approach to managing my risk.  She did mention that if they do find a mutation, insurance is more likely to cover the cost of a double mastectomy, but she also said that based on my family history alone, I could fight for coverage of the procedure.  Maybe if I knew I had a mutation I'd be more apt to do it sooner rather than later.  I don't know.  I want to be able to breastfeed my babies.  Paul is all for a double mastectomy.  He calls my boobs the ticking time bombs.  I know they cause him stress.  He has recently lost sleep over all of this and told me that he has a plan for what he'll do if I die.  Ugh.  So morbid.  This may all be harder for him than for me.  I have had an entire life time (well, since I was four) to consider the possibility of getting breast cancer.  It's kind of a new thing for him.  For the most part, I feel like if I'm going to get breast cancer, let's just shoot for early detection and deal with it from there.

Because there is so much research being done on breast cancer, she said that I should check back with her every two years to see if there have been any new gene discoveries that I could potentially get tested for.

The genetic counselor said that I should definitely get an MRI.  However, the official referral had to come from a "breast care specialist," so the genetic counselor gave me my next a referral.

Appointment #4: Appointment with Breast Care Specialist.  This woman was awesome.  She's a nurse practitioner and will be my "go to" from here on out with regards to all things breast cancer.  She explained that I should meet with her every six months unless I'm pregnant or breastfeeding.  She gave me a referral for an MRI and said that I should plan on getting one every year (unless pregnant or breastfeeding) and that once I'm 30 years old, I should get a mammogram yearly as well.  Mammograms aren't a good diagnostic tool for dense breast tissue so they aren't generally recommended for women younger than 30.

Since women at risk for breast cancer are also at risk for ovarian cancer, she also put in a referral to see an OBGYN to discuss a hysterectomy.  After, of course, I'm done having children.

She gave me a referral for an MRI and explained that I would need to get a blood test done prior to the MRI appointment.  They inject you with a contrast dye during the MRI and your kidneys need to be working properly to flush the dye out of your system.

UCSD does the MRI because Kaiser does not have an MRI machine for breast screenings.  She said that if the MRI found anything, I'd know within a few days, otherwise it might take several weeks before I heard from her.

Appointment #5: Blood Test. (My kidneys work!)

Appointment #6: MRI.  I have to say this was not the most fun thing I've ever done.  You lay face down on a table with holes cut out of it where your boobs go.  You are instructed to not move for about 40 minutes and then they push the table back into this cave thing.  Even with earplugs in, it was very loud and the machine shook at times.  I kept thinking that if there was an earthquake I'd never know.  At around minute 30 my face really started to hurt and I was wishing I could just adjust myself to get a little more comfortable.

Appointments #7 and 8: A few days after my MRI I got a call from a Kaiser scheduler saying that I needed to schedule a follow-up ultrasound for both breasts.  I scheduled the ultrasound and then called my Breast Care Specialist to get more information on what the MRI results were.  She only works part time and I wasn't able to get in touch with her before my ultrasound.  Those few days before the ultrasound were a bit nerve wracking.  It's like when you first find out you're pregnant- you just can't stop thinking about it.  I kept going over different scenarios in my mind.   I knew that MRIs are very sensitive- they pick up any lump and bump in the breast that are not necessarily cancerous, and are known to give false positives.  So I knew that a follow up ultrasound was not necessarily a bad thing, but it also wasn't a good thing.

UCSD had ordered the ultrasound for 10:00 on my right breast and 12:00 on my left breast (i.e. location, not time).   A technician did an initial examination, printed off some pictures, then went and showed them to the radiologist and he came in and did the exam himself.  He explained that USCD wanted a biopsy done of what they found through the MRI.  There are two choices when doing a biopsy: you can either do an MRI-guided biopsy, or an ultrasound-guided biopsy.  The MRI one is more difficult and less comfortable for the patient and the ultrasound one is relatively simple and not uncomfortable, so the hope was that whatever it was that they saw would be visible on the ultrasound. He said that he couldn't see anything.

He then recommended that I get a mammogram done.  It would help him to have an overall picture of my breasts.  A mammogram is more discerning than an MRI, but often doesn't pick up on very small tumors.  Even though I'm relatively young (dense breast tissue), he still thought it would be a good choice.  So I said, yes, Doctor, I'm ready to get my boobs squished! and I got the mammogram done right then and there.

Surprisingly, the mammogram didn't hurt at all.  Once the radiologist looked at the x-ray, he came in to discuss it with me.  The first thing he said was, "Your breast tissue actually is not dense, so the mammogram worked really well."  Now, I have to say that whenever doctors would talk to me about younger women having dense breast tissue I would think to myself, "Man, if what I have is dense, then old lady boobs must feel like a bag of applesauce."  So when the radiologist said that to me I thought, "Yes, my bra that's working overtime to keep these ladies off the floor could have told you that."  Truly, breastfeeding has not been kind to my physique.  Anyway, he said that he couldn't see anything on the mammogram either, which I guess is a good thing.


The next step is to schedule an MRI-guided biopsy and then hopefully that will be the end of things for awhile.  Yes, it's been a lot of appointments, but I'm really grateful that the doctors are being so thorough.  What's really great about Kaiser is that they as a healthcare system are the providers of their own insurance, so it's beneficial for them to keep you healthy.  I've hardly had to pay anything out of pocket and I have had a positive experience with all the people I've met with.

Swimming Lessons

Parker started swimming lessons a few days ago.  In the past six months or so, Paul and I have brought up the idea of swimming lessons with Parker several times, but we were always met with extreme resistance.  He likes swimming, but is very careful to not get his face wet.  Before Kate was born taking a bath was a chore, but now that they play while they bathe he enjoys it.  I didn't want to force swim lesson; it just seemed like a battle I wasn't quite up for.  Eventually I would have forced it (I think every kid must take swim lessons for safety reasons), but I was hoping that he'd come around by himself.  Anyway, a couple Saturdays ago Paul went surfing and Parker wanted to go.  We told him that he could go surfing once he took swimming lessons and learned how to swim.  That did the trick.  I signed him up as soon as I could before he changed his mind.

I have to admit that on that first day I was a little emotional.  He's growing up and doing things that he didn't think he could do and it just makes this mama so proud.  Good thing it was bright outside and no one saw me getting misty behind my sunglasses.  About halfway through the lesson they threw rings out into the pool and the teacher took each child individually to "dive" for the ring.  She put the ring on her foot and lifted up her foot so they didn't have to go very deep.  When it was Parker's turn I whipped out my phone to capture whether or not he'd actually put his face under the water.  He did it!  Go Parker!

My Sister the Esquire

Erin graduated from law school!  This is such a huge accomplishment and I'm so proud of her.  Not only did she make it through the three grueling years, she excelled.  She was on the dean's list several semesters and was recognize at her gradation for the extensive hours of pro bono service she gave.

Parker, Kate and I flew into Boise the Tuesday before the graduation and then drove to Moscow with my Dad on Friday.  With all our potty breaks, what we thought would be a 5 1/2 hour drive, turned into 7 hours.  We had considered driving up early Saturday morning (the day of the graduation), but I'm glad we didn't!  Paul flew into Moscow on Saturday.  We picked him up from the airport and if we had blinked at the wrong moment, we may have missed it!



Before the ceremony started, we decided to run a few laps to get the wiggles out.

I guess we need to go over the rules of racing again with Kate.

Here are the graduates walking in... Duhhhhhhhhh da da dahhh duhhhhhhhhhhh  duhhhhhhhhhhh...

The purple cord signifies her pro bono service.  (You have to do 80+ hours to get a cord and Erin did over 120!)

Getting hooded:

The ceremony was short and sweet.  Afterward there was a reception with hors d'oeuvres and cookies.  Here's Erin with an "I" cookie (for University of Idaho).


After that we had dinner and took lots of pictures with our lady of the hour.  I think we had a group of about 16 and it was so nice to get to chat with family and friends that we hadn't seen in a while.

Four generations!

I love this picture of Erin and her boyfriend, Joe.  Carl started humming the wedding march and we were all cracking up.

Congratulations, Doctor Erin!

Last Day of Preschool

Today was Parker's last day of preschool until it starts up again in the fall.  I think I've mentioned it before, but Parker LOVES preschool.  The days that he doesn't have preschool he asks how many days until preschool day.  While we were in Idaho this past week Parker told me on several occasions how he missed his preschool friends and asked if I thought that they missed him too.

Here are his preschool friends and his teacher, Miss Lydia.  Three of these kids will start kindergarten next year, which I'm sure Parker is devastated about.  The two littles are not in preschool, but I know they wish they were!

So Cal Anniversary #7

It's hard to believe that we have lived in southern California for seven years.  I probably would not have marked this anniversary in my mind at all except that we moved to Los Angeles on Cinco de Mayo.  As we pulled up to our new apartment the air smelled of Catholicism and cervezas.  After hitting traffic a few miles outside of LA, we arrived much later than planned- I think it was 7:00 or so on a Monday night and no help awaited us to unpack our truck.  We had asked for help from the trusty EQ, but apparently we didn't coordinate things very well, and we were left to unpack the truck by ourselves.  This was the pre-baby-FJs era, so we didn't have that much stuff, but I recall having back problems for several months afterward.  Sometimes I think I'm strong, but this senorita is just not cut out for moving couches, refrigerators or hundred pound tables.

We finished unpacking and were left with the dilemma of what to do with the truck.  Somehow we had neglected to print off the address and driving directions for where we were to return the truck.  We found a phone book at a 7 Eleven and hoped that by looking at the addresses it would jog our memory as to which one we were supposed to return the truck to.  Then, since this was before smart phones and our GPS,  we would call that location and ask them for directions.  Well, our memories were not jogged and I think I had the bright idea to take it to the airport (for which we had seen several signs on the freeway) because surely there would be a Budget rental office there and if nothing else, they could look in their system and at least point us in the right direction of where to go next.  We went to the airport, but for whatever reason we couldn't get through the gates, or something... the details are a little hazy.  By this time it was past midnight and we decided to try again in the light of day.

We drove back to our apartment... our apartment that only had street parking (if you just had a minor anxiety attack over the term "street parking," you're probably one of our LA friends) and after driving in circles looking for a spot, we ended up parking the truck in a grocery store parking lot that had signs every fifth spot or so that designated the lot as for CUSTOMERS ONLY! and we were assured that our CAR WILL BE TOWED!  We set our alarm clock for 5:00 am and went to retrieve the truck before (we hoped) it got impounded.  (Side note: I consider myself to be a good driver.  I have never received a moving violation, but by the time we moved from Los Angeles, the amount we had paid in parking tickets was over $1000.)

The heavens took pity on us and our truck was still there in the morning.  I can't remember exactly what happened, but Paul was able to get in touch with Budget and we drove to the proper location, though not directly.  I do know that we drove in a lot of circles and I silently cursed Paul every time he took a wrong turn.  (I was following him in our car and was still a novice with the stick shift.)  If I had been able to lift that truck over my head, I would have thrown it from the street into the Budget parking lot and ran from it as fast as I could.

I guess you could say we had a bit of a rocky start to our California journey, but it has only gotten better since then.  With some sadness (bless you, Idaho)  I have to admit that I have lived in California longer than any other place, and by almost double!  This Cinco de Mayo we commemorated the Battle of Puebla and our So Cal anniversary with tacos, churros and a toast to many more happy years in the Golden State.

Paul's 31st Birthday!

Paul usually has a lengthy and rather expensive birthday present wish list.  I thought I was in the clear until a few days before his birthday when he decided he wanted a motorcycle.  I couldn't tell if he was serious or not, but the more time he spent on Craigslist the more worried I got.  Apparently I'm a dream killer because I had to put the kibosh on that idea.  This man needs all of his fingers in order to put our kids through college and one corner turned too sharply could leave them flipping burgers for life.

Paul has a lot of demands put on his time and I really feel that he balances them all with grace.  But the masculine form of grace.

He recently rekindled his love for the ocean after one of his patients gave him two custom made surfboards.  For several nights Paul would put the surfboards on the living room floor and he and Parker would practice paddling out and popping up.

Paul is doing really well at work.  I think it's fair to say that it is consistently stressful, but I think it's also satisfying for him to improve his technique, learn new procedures and turn a profit.  All while navigating an office full of estrogen and big (but awesome) personalities.  Two weeks ago he placed his first implant and just a few days ago he placed his second.  After he graduated from dental school he considered doing a GPR (General Practice Residency) in order to learn how to place implants.  When he decided to start working right away it was with the understanding that the dentists he worked with would help him learn how it's done.  Nearly three years and three offices later, it's nice to have this desire come to fruition.

Paul has had the same haircut for as long as I've known him (except for that one time he grew it out after BYU and looked like a girl... let's not talk about it) and as far as I can tell since his hair was long enough for a razor sharp part.  Well, the last time I cut his hair he requested something different.  It's very similar to his old 'do, but longer on the top.  He said that short hair makes him look too young and that when it's longer his treatment acceptance rate is much higher.

Paul was recently called to be the Young Men's president.  I believe he's currently in the bargaining stage of grieving (kidding... kind of?).  But really, I think that it was initially quite overwhelming and still is, but getting less so.  On my end of things it mostly just means more nights and weekends alone with the kiddos.  If they were old enough to be into House Hunters and Chinese takeout, this might actually be cool.

Currently his favorite meal is carne asada fries (imagine french fries and tacos having a baby).  It's about as healthy and delicious as it sounds.  And still, his favorite dessert is brownies.

As Parker gets older it's fun to watch him and Paul spend time together.  They like to play baseball and soccer, do pretend surfing and go for bike rides.  They also like to wrestle each other and play this hilarious game where Paul throws pillows and Parker tries (and fails) to dodge them.

Kate has Paul wrapped around her tiny little finger and she is definitely a daddy's girl.  She often cries when he leaves for work.  Last Sunday we drove separately to church and when Kate figured out what was going on, you'd have thought someone just told her the world ran out of chocolate.

He is consistently the best husband ever and I ask myself all the time how I got lucky enough to have married someone who balances and complements me so well.  Just like Parker and Kate, my eyes light up when I hear the garage door open when he gets home.  He's just the best!

Happy birthday, Paul!  31 never looked so good!

Parker's 4th Birthday

Per our norm, we had an extended celebration for Parker's birthday.  His birthday was on a Tuesday and the weekend prior Grammy and Reed were vacationing in San Diego.  We met up with them on Saturday at the zoo and they came over for dinner and birthday cake on Sunday.

Parker usually has preschool on Tuesdays, but on that particular Tuesday it was canceled, so for Parker's actual birthday we went to Sea World.  It was nice to go during the week when it's not so crowded.  Paul brought home Chick Fil-A for dinner, which Parker claims is his favorite meal, although he generally skips the food and goes straight for the juice box and toy.  

The following day (Wednesday) was our weekly park day with friends from the ward.  I brought cookies and told Parker it was his birthday party.

Several days later Parker got a special surprise for his fourth birthday: a trip to the doctor's office!  It had been about two years since his last doctor appointment, but he's gone to every one of Kate's so there wasn't much for him to be surprised by.  I told him beforehand that he'd have to get shots and he did surprisingly well. Also, I bribed him that if he didn't throw a fit we'd go get an ice cream cone at McDonalds.

Currently he is 3 feet 5 inches tall (70th percentile) and almost 39 pounds (75th percentile) and is equal parts adorable and aggravating.  He loves having dance parties, which we have almost on a daily basis as soon as Paul gets home from work.  He is a very good brother to Kate and holds her hand when we're out and about and keeps her safe and walking in the right direction.  He loves being with friends and having friends come to our house and play, although sharing is still difficult and the play date sometimes ends in tears.  He LOVES chocolate (didn't get that from me!) and we've had to resort to hiding (not just putting it up high or out of reach- he is a determined soul and quite resourceful)  all forms of it after we caught him eating chocolate chips by the half-bagful for breakfast on several occasions.  He has an amazing imagination and I love listening to him playing make believe with his toys.  His favorite show is Odd Squad on PBS.  It's a show about math and there must be a lot that is completely over his head, but he still loves it.  He gives the best hugs and kisses and we love him so much.