Tricia Hicks

First post: Jul 21, 2022 Latest post: Mar 7, 2023
Welcome to my CaringBridge website. I am using it to keep family and friends updated in one place. I appreciate your support and words of hope and encouragement. Thank you for visiting. Below is my story. It's long, but it covers a lot of history and I think is very informative and educational! (Not a word, Traci!!) Whenever I update my journal entries, you'll be privy to the latest! 

I've been dreading the day that I actually send this news to everyone... My family and many friends & colleagues are aware, but I'm now letting everyone know about the roller coaster I've been on for the past several years, and most recently, the past year. I was diagnosed with stage 1b triple negative right breast cancer in May 2022. Ugh! Prior to this, I was diagnosed with "baby cancer," DCIS (ductal carcinoma in-situ), in March, 2022. These diagnoses were a surprise and I had been diligently and actively working to avoid such a diagnosis, but fate had a different outcome!

In February 2018, I found out that I have a genetic mutation, BRCA1, that often leads to cancer. Specifically breast and ovarian cancer with a little bit of colon and pancreatic cancer risk sprinkled on top. Immediately, I had a hysterectomy and had all my 'girl parts' removed lowering my overall risk of developing female and hormone-driven cancers, like breast and ovarian/endometrial/fallopian tube cancers. Since then, I have had aggressive monitoring and got a yearly breast MRI and mammogram. ALL GOOD! Now I routinely follow with an oncologist, GYN, GI, and primary care; it's a lot. As you can imagine, I dove in and researched the hell out of all things BRCA 1 (like actual research pouring over peer-reviewed medical journal articles as well as reading what the internet had to say). I weighed my risks of active vs. passive participation; i.e. getting prophylactic bilateral mastectomies vs. keep taking Tamoxifen (a hormone blocker designed to keep breast cancer away) and keep getting the MRIs & mammograms. Jumping into mastectomies with implants wasn't sitting right with me and I put a pin in any decision-making. My inner voice was telling me not to do it! So, I changed a lot of my lifestyle adopting a mostly whole-food plant-based diet, got rid of plastic and reduced household chemicals where I could, and eventually got a Peloton. I decided every little bit would help. Then the insurance battle began!

I won't get into the long and drawn out saga, what should be criminal and it may be, with the insurance company that ensued over about a three-year period. Just know this, I have a good old-fashioned, designed in California HMO! I do not have any other option through my employer-based benefits. As such, buying my own insurance policy, even for a couple of years, would have been cost-prohibitive (and why should I have to?!?! I have worked HARD for this company, but they don't offer anything other than HMO... through them. Meaning I only get to go to the company's affiliated physicians and hospitals. Ugh.). Needless to say, I would call the insurance company, part of the parent company for which I have worked for almost 17 years!, at least two or three times a year asking how they could better accommodate my needs and provide me with the breast reconstruction of my choosing. By the way, breast reconstruction of the patient's choosing has been an actual federal law since 1998 (WHCRA), passed by both the House and Senate, stating if an insurance company covers mastectomy as part of a treatment plan, they HAVE TO COVER RECONSTRUCTION OF THE PATIENT'S DESIRED METHOD! I only received negative responses from the insurance representative with options to see physicians NOT trained in my desired reconstruction. I finally got so fed-up in July 2021, that I filed a formal complaint with the insurance company and had intended on filing a complaint with the state insurance board. I even stated that as part of my complaint! That seemed to have shook a few of my insurance people and I received a call from a "Complex Case Manager" who was now assigned the task of working with me! :) She was very nice and very helpful and I could see us being friends. After having to see and consult with FOUR different in-network plastic surgeons (as part of "playing their game"), I was finally referred to UC San Diego Health in November 2021 and met with my current team of surgeons.

After all of my research, sleepless nights, and overwhelming anxiety at times, I decided the best approach for my reconstruction would be a transfer of abdominal tissue and fat to the chest recreating breasts (fake boobs with the appearance of real ones, plus the GIGANTIC scars...), commonly referred to as DIEP. No implants required, but it is an intense microvascular reconstruction taking the vasculature from the belly and transferring it to the chest with the tissue and fat. This is why I needed a specially trained plastic surgeon who does a lot of this type of surgery and works with a team, not just a solo practitioner. This reconstruction often takes 2-4 surgeries to fully accomplish an aesthetically pleasing result. As part of the process, I had my first "prep" surgery on February 22, 2022. It was following this surgery that pathology revealed the DCIS baby cancer. Shocking EVERYONE, yes, but no biggie since the treatment for this type of cancer is a mastectomy, which I was going to have anyway. I had received additional follow-up imaging to ensure there were no other areas of concern. Nope, all clear and ready for the mastectomies and reconstruction. My sister, Traci, who was supposed to be my assistant following surgery, got COVID a few days before my scheduled surgery!!! Ugh! My head was spinning, but I thought I'd be fine so long as she and friends were a phone call away. I mean, I've always been fine after all my other surgeries, no problem. Hahahahaha!! Fast-forward to May 17, 2022 and I went in for a 10-hour surgery that would become the most difficult adventure I've ever had to recover from!

Uh, brutal. I was fully prepared for a difficult recovery, but this was next level! After all, I had a double mastectomy and was cut open from hip to hip to bring that tissue and fat up top. (Think of this procedure as a built-in tummy tuck! ;) ) Good news, I really didn't have pain. Pre-op I had bilateral epidurals for my boobs and received bilateral nerve blocks that would relieve most pain in my abdomen. But 10 hours of anesthesia... Plus, I had some blood loss that required a blood transfusion the following day. I was doing a good job just being a patient up until then. But, needing to advocate for myself once again, the surgical resident and I reviewed the many reasons I did in fact require the blood transfusion. Ultimately, I won! After three nights in the hospital, I went home. Samantha, my 15-year niece, came to spend the night with me. She took one look at the four drains (each boob, each hip) I had in place and exited the room!! Thankfully, my Aunt June hopped on a flight from New York and stayed with me for a week. Thanks! (My mother was sick and Kevin & Meredith have 4 crazy kids and Karen & Chris have 3 crazy kids!) Shout out to friends Cate, Kathrine, and Lan for jumping in to help at the last minute!

One week following surgery, my oncologic breast surgeon called with the news shocking everyone again. Pathology revealed I had not only an ADDITIONAL TWO DCIS baby cancer sites, but an INVASIVE DUCTAL CARCINOMA 10mm tumor as well. Shit! The pre-op imaging and gross exam in the OR did not show any of this. There were no lumps or bumps giving anyone a heads-up big news was about to knock me upside my head. And to make matters worse, it was all TRIPLE NEGATIVE BREAST CANCER (TNBC). Ugh!!!!!! Meaning, this was not hormone-driven cancer, just bad cells doing was cancer does. Taking special immunotherapy pills or infusions for a few years was not going to cure this. Of note, 67% of BRCA 1 mutation carriers develop TNBC. It's a bit more aggressive with higher recurrence rates and requires aggressive chemotherapy. Ugh!!!!!! Given the DCIS from February, the breast surgeon and I had discussed obtaining lymph nodes for biopsy during the mastectomies and ultimately did not do it. Evidence-based medicine no longer suggests obtaining the lymph nodes for DCIS as only about 5% come back positive. Conversely, of those having their lymph nodes removed, even the first few referred to Sentinel lymph nodes, about 5% develop lymphedema in that arm. Once lymphedema occurs, you cannot close that door and can only manage the symptoms moving forward. I deferred to the surgeon and she was comfortable NOT taking lymph nodes out. I was in full agreement with the decision made. So, now I need to have chemo and when that's done, go back to the OR for my lymph node biopsies. If they are negative, YAY! All done and on to the next reconstruction revision surgery when I'm well enough. If the biopsies are positive or showed signs they were positive but chemo flipped them to negative (pathology stuff), I will need a second regimen of chemo... Ugh! And maybe radiation... Ugh!! And this would change the current stage of the cancer 1b, to a higher stage. Time will tell and I'm not sure if it's my friend or enemy at this point.

So the day has come to start chemo. After dealing with open boob wounds for the past two months, they are finally closed and continue to heal!!!!! I honestly thought I was going to crack a few times!! In fact, there was a day or two I may have. I have been given the green light by my oncologist to start the dread of chemo. I was so anxious for my wounds to heal and get this started so that it can be over. Now the time has come and I'm so anxious to have it!!! Ugh! 

Thanks! Follow for updates.

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