No Chemo Tuesday...

JUST SURGERY FRIDAY

So Here’s the Thing  (This is a direct quote from my January 31 blog)

I kept the surgery quiet—almost no one knew. Why? I’m not entirely sure. Maybe I thought not talking about it would make it feel less real. Or maybe I just wanted to skip the stress and come back Monday with some good news, like Ta-da! I’m fine.

But what I do know is that I didn’t want a flood of worried check-ins or people waiting on updates I wasn’t ready to give. In a situation that feels completely out of my hands, this was one thing I could control—and I wasn’t about to let that go.

And now? It’s different this time!

• I DID NOT have CHEMO on Tuesday
• I did have surgery yesterday: Friday, May 30th
• AND Monday crew, I’ll see you at your regular times

If you want to hear the story firsthand, this is where it is. No calling, no texting. Here is me with all my emotions laid out for you. But please be assured, I’m good. I wouldn’t be posting if I wasn’t.

---

📆The Appointments That Weren't Just Appointments

It’s been almost two weeks since my last post. At the time, I mentioned three upcoming appointments that I thought would be simple, routine check-ins—just basic info-gathering. Instead, they turned into something else entirely.

I don’t know if I missed something—or just didn’t fully grasp what was coming—but what I now know is this: “No news is good news” has officially become “If you haven’t heard from me, brace yourself.”

I had back-to-back visits with:

⮞ The radiation oncologist (who was amazing and handled me beautifully)

⮞ The breast oncology surgeon (whom I now have a newfound appreciation for)

⮞And of course, my rock, the king himself: Dr. Carty, my plastic surgeon

Each appointment brought something new—some of it shocking, some of it irritating, all of it clarifying. All of it necessary.

I’d originally posted that these were just standard consults, not thinking the news would be anything but routine. I didn’t consider that those of you who’ve been following and listening so closely would be waiting for updates. I didn’t realize I’d suddenly need to retreat. But I did. I needed a moment to myself. I’ve shared a lot on the blog, but this moment felt different—more personal, more tender. I’m still finding my way through it.

After being so open with all of you, I suddenly shut down. Radio silence.

---

A Shift I Couldn't Shake

At my fifth chemo session, I sat down with Caroline, my oncology PA—steady, thoughtful, and one of the few people who never makes me feel like I’m being dramatic for paying attention to my own body. I told her something I hadn’t said out loud before: I don’t think the chemo is working anymore.

Not based on a scan or lab—just this internal shift. A strange quiet where side effects used to be louder. A loss of response. A gut feeling.

She didn’t make me feel stupid. She didn’t brush it off. She just gave me this thoughtful, "huh, interesting" look. Not dismissive. Curious.

She explained that just because the outward signs—like hair loss—start to slow down, it doesn’t mean the chemo’s stopped working. The goal of TCHP is to attack rapidly dividing cells, especially the sneaky microscopic metastatic ones—the ones you can’t see or feel but that can still cause havoc.

It was a reminder I needed: we’re trying to kill the invisible bastards, too.

---

Something in the Mirror

I told Caroline something else: my breast had started doing the weird thing it did last year after surgery—before the tumor became the beast it did. It was forming a ledge, becoming misshapen. Maybe post-surgical changes, sure. But I know my body.

This time, it felt irritable, even slightly painful. Still subtle. Just a maybe-sorta-something that wasn’t there before. Tiny—smaller than a grain of rice—at 12 o’clock, about 3 -4 cm above the nipple.

The same exact spot we've talked about since 2014. And 2015. And 2019. And 2023.

That spot.

She checked it out and gave the same uncertain head tilt I’d given myself in the mirror. Could it be scar tissue? Normal healing? Just nerves? Who knows. But it was definitely different.

And it’s five months post-op. Should this kind of change be happening now? Especially when I was told in January that the tumor grew over weeks and months, not years? Remember, DCIS can linger for years before turning invasive. That tumor was already there in 2024, even though it wasn’t removed until January 2025.

It’s worth noting that I’ve consistently been the “there’s nothing there” girl at every prior appointment. So for me to even say maybe? That was new. And my beautiful new breasts I wrote about in past entries? The left one? No mas. It’s deformed. Again.

---

The Ultrasound No One Ordered

I asked if we could do imaging before surgery. I wanted clarity. She checked—nothing had been ordered. They don’t typically scan unless there’s a clear reason. That surprised me. Surgery without checking first? That didn’t sit right.

I decided to wait for my May 20 appointments with Dr. Dominici and the radiation oncologist. I’d bring it up then.

Fast forward two weeks—and that little maybe-rice-grain? It’s now definitely pea-sized. Both doctors could feel it. Just like that, I was booked for a stat ultrasound.

Because, as we all know by now, my case doesn’t follow the rules.

People try to explain the playbook to me—how it’s supposed to go—and I just smile politely. But let’s be real. My history is extensive. Or, as they like to say: "very complex."

That phrase used to make me feel like the high-maintenance drama queen, choosing surgeries I didn’t need. Now? It just means they weren’t ready. And they know it.

And no—this time, fat necrosis isn’t going to cut it.

---

Déjà Vu: Ultrasound Day

After my appointment on Tuesday May 20^th with Dr. Dominici, she did not dismiss me.  Yes, she also mentioned fat necrosis, scar tissue and surgical changes.  But she also took me seriously. 

Ultrasound ordered STAT and the next day I drove myself to Brigham Boston for the ultrasound. Total déjà vu of the "no lymph node involvement—oh wait yes there is" fiasco. I expected the kind of care I got last time: a radiologist who took me seriously, did an immediate biopsy, and had the bedside manner to match.

Instead, I got this: “Your history is very complex. Why are you talking about 2024? There’s nothing here about 2024.”

WTF, lady? The tumor removed in January 2025 was palpable in 2024. Her response? "There was no imaging, so why are you talking about it?"

Because if you dare tell me this palpable mass is fat necrosis or surgical changes again, I’m going to lose it.

I didn’t say that out loud. But oh, I thought it.

She kept asking me to point out the spot while she took images. It hurt. A vascular, 9 mm mass. Suspicious but cautiously optimistic. Still—biopsy or surgical excision recommended.

And here's my take: it's in the same tumor bed where I did not get clear margins. I want it out.

Even before this ultrasound, my Dana-Farber oncologist recommended completing round six of chemo, waiting four weeks, and having surgery June 24.

Me? No. F***ing. Way.

---

Surgeon, Sculptor, Saint: My Thursday with Dr. Carty

Thursday. Enter Dr. Carty—the man with surgical precision, artistic vision, and more compassion than should be legal in one human.

He and Dr. Dominici are both from New Hampshire, and if their camaraderie is any reflection of my outcome, I’m golden. Dr. Carty walks in on time, gives me a hug, and with total confidence says: *"We’ve got you. The entire team has you."

He’s already thinking ahead to the final outcome but takes a moment to ask what led to the ultrasound. As I retell the story, voice my concerns about chemo possibly no longer working, and blurt, “I just want it out,” I can see him absorbing every word.

Then comes the moment of truth: he sees my left breast for the first time since he made it perfect. His poker face slips for just a second—a flicker of surprise—and then he masks it. He says it could be my body rejecting the fat grafting, maybe post-surgical changes. But I know that look. The artist in him is already reworking the blueprint in his head.

He touches 12 o’clock, the exact spot where the tumor had been. I ask if he needs me to point it out. He doesn’t. He feels it. And I can see it in his eyes—he knows. And for the first time since Tuesday, I feel peace.

He agrees it needs to come out ASAP, as long as it’s safe and not detrimental to my health. He’ll make it happen. And he’ll coordinate everything to make sure I have answers by the end of Friday.

So what does this mean? What’s being taken out? And why is this going to be nearly another year before I have an end result?

---

INTERMISSION - TL;DR – For the Skimmers and the Busy

The week in review …Yes, I had surgery. No, I didn’t finish chemo. Yes, I dragged Jagruti with me. No, I didn’t go rogue. Yes, the team finally got it. And yes, the mass is out. What’s next? Radiation. Pathology. Infusions. More waiting. Still here. Still me.

---

When Plans Change—and People Actually Listen

By Last  Friday afternoon, both Dr. Carty and Dr. Dominici cleared their schedules. Surgery was booked for Friday, May 30. So by the time you’re reading this, I will have already gone under. They made it happen. They actually made it happen.

Now rewind to Tuesday, May 27—the day many of you assumed I had my sixth and final chemo. Surprise! I did not. Instead, I brought my secret weapon: Jagruti.

For those of you who don’t know her, Jagruti is the person who knows my body second best to me. Surgeon. Friend. Advocate. Teacher. Lifeline. She sat beside me as I met with Dr. Schumer, terrified that I’d be told to push through and finish chemo.

But instead? Dr. Schumer was calm, supportive, and had also pivoted to the new plan. She agreed with surgery asap, acknowledged my concerns, and didn’t push back. Signed off, no drama. That moment felt like a breath I didn’t know I was holding.

---

🔪 The Big Slice: What Was Removed

On May 30, I went in for surgery to remove the recurring tumor in my left chest wall. This one was bold enough to come back during active chemo, so it had to go—and fast. Here’s how it played out:

• Tumor + Tissue Removal:  Dr. Dominici removed the visible mass plus five extra “shave margins” around it to make sure there was no leftover cancer hugging the edges. Picture slicing out a bruise in a piece of fruit—then taking a few extra bites just to be safe.
• Lymph Node Dissection:  All level I and II lymph nodes from my left armpit were removed.
• Nerves? Preserved.
• Sketchy nodes? None seen.
• Drama? Minimal.
• Drains? None (hallelujah).
• Markers + Stitch-Up:  Surgical clips were placed to guide radiation. I was closed up neatly and handed off to plastics for the final layer of patchwork. Everything was accounted for. No lost tools. No surprises.

🕳️ The Great Cave-In (aka Ohhh, That’s Why My Chest Looked Weird)

For months, I kept noticing a weird dip in my left chest wall—like a small sinkhole nobody could explain. Well, now we know:

• The Cause?  The tumor wasn’t just chilling near the muscle—it was tethered from the skin straight down to the chest wall.
• Translation?  It was pulling the skin inward from the inside out.  Like a tumor with attachment issues.  Or a tent peg pulling the canvas down.
• The “Ah-Ha” Moment?  During pre-op, Dr. Carty pulled up my image, had me stand and point to the exact spot, and yep—it matched perfectly with where the tumor had been anchoring everything down.
• So That Sinking Skin?  Not in my head. Not aesthetic. Just plain physics…courtesy of an embedded, muscle-invading mass.

 What This Means (Recovery 101)

Let’s break it down—what was involved in this surgery and what recovery could look like:

• Surgery Time: 2.5 hours
• Hospital Stay: DAY surgery, I’M HOME
• The new war wounds: the scar above the nipple cat eye shaped across my breast about 6 ½ inches. The scar under my armpit slightly thicker and very bruised.
• Mobility: Limited arm movement for the first 3 weeks; cannot lift, reach, or carry much. I have my exercises I will be doing
• The Sling: wearing it to carry the weight of the situation, I mean my limb. It hurts and the sling helps
• Pain/Discomfort: Some soreness, tightness, and nerve sensations.
• Lymphedema Risk: With all axillary lymph nodes removed, I’m now at higher risk for lymphedema. I’ll likely need to work with a specialist and start physical therapy early.
• Downtime: Have you all met me. See you all at your regular sessions this coming week. Treat me like I had elbow surgery but this time in my left arm. Treat me any different and you will be fired!

So yes, it’s a lot. But not unexpected. And absolutely necessary.

---

When Will We Know What They Found?

The pathology results will take up to two weeks. I repeat: up to two weeks. So if you’re tempted to text, call, or carrier pigeon me for updates... please just wait. I promise I’ll share when I know.

---

What’s Next: Radiation, Regardless

No matter what pathology shows, I’ll be receiving radiation to the entire left chest wall and armpit region.

• Where: MGH North
• When: Four weeks post-surgery
• How Long: Five days a week for six weeks

So yes, my summer plans include beach reads and radiation burns.

---

Did Chemo Even Work?

Here’s the big question: Did TCHP do what it was supposed to do?

The answer: We don’t know yet.

TCHP is the standard protocol for triple-positive breast cancer. And while it was still the right treatment, it may not have been the only one needed.

---

Why Would a Tumor Grow During Chemo?

A few possibilities, explained in human speak:

• PR-Negativity: My tumor was ER-positive and HER2-positive, but the PR dropped out. PR-negative tumors can be more aggressive and less responsive to treatment.
• Tumor Resistance: Cancer cells can outsmart chemo. It sucks, but it happens.
• Heterogeneity: Not all cancer cells are the same—even within one tumor. Some parts may respond to treatment; others, not so much.
• Microenvironment Factors: Blood flow, immune response, tissue conditions—all affect how well chemo can actually do its job.

So even though I felt something was off—and something was off—this doesn’t mean TCHP was a mistake. It means we’re paying attention. And we’re pivoting.

---

TO SUM IT ALL UP…THIS IS WHAT IT MEANS:

• CHEMO WAS CANCELLED LAST Tuesday. Not because I’m done. Because surgery’s now the priority.
• SURGERY WAS YESTERDAY - Friday. This is the big one. Tumor out. All lymph nodes in the armpit: gone. Bye.
• Radiation is 100% happening. I asked every question, tried every loophole. Denied. I start four weeks post-op. Five days a week, six weeks straight. Mass General North. Each session: 15 minutes of glow time.
• Immunotherapy is happening. It’s part of the plan. The only TBD is which kind. But it’s a sure thing.
• We are officially in pivot mode. Not because it’s fun, but because the original game plan needs adjusting. Dr. Juric, Head of Tumor Targeted Therapy at Mass General is up to speed and officially on the team.
• This is not the finish line. It’s a pit stop, a re-route, and a reset—before the next phase kicks in.

·       💥 And Still…

Still me.

Still standing.

Still being.

I may be stitched, scooped, and slightly radioactive soon—but I’m still here.

---

THIS IS WHAT IT DOESN’T MEAN:

• I’m cancer-free. Don’t say it. Don’t ask it. Not how this works.
• I’m available for a deep heart-to-heart. If I’m quiet, it’s because I’m still processing and managing. Not because I don’t care. Love you. Mean it. Not the time.
• You should be researching things for me. Unless you’re board certified in oncology, you’re off duty.
• You need to explain to me what you think this really means. I’m not decoding subtext—I’m living it.

---

THIS IS WHAT WE DON’T KNOW:

• If the tumor responded to chemo. We’ll know when the pathologist finishes the post-op analysis. But the lymph nodes looked good!
• If there’s live cancer left. They’ll cut it out and test it. Then we’ll know.
• If additional systemic treatment will be added. Depends on what pathology report.
• What the exact immunotherapy drug will be. That’ll be decided post-op, once again from the pathology report.
• How I feel every minute of the day. Trust that I’m dealing, even if I’m not explaining.

---

🫶 Just Send the Emoji

And for those of you who’ve read all the way to the end and stay with me always—send me any emoji. Just one.

You don’t need to say a word—no affirmations, no cheerleading.

Just show me you’re out there, and I’ll send one back.

Quiet company counts.

Post it below or text me. That way I’ll know you heard me… and I hear you too. I’ll send one back, emoji for emoji. Consider it our own silent language—less exhausting than words, and way more fun than another group chat.

Love,
JJ
(Still sarcastic. Still strong. Still not your medical reference guide.)
✨✂️⚡️

 

The Pivot & Deep Dive into Medical Oncologists (To be continued…)