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Mrs. Springville Utah America- Toni Allman

I now affectionately refer to this picture, from my wedding day back in 2014, as “Tune in Tokyo”. Full disclosure: I was putting my husband’s wedding band on when the picture was taken. However, the timing couldn’t have been more hilarious because it looks as though my husband is using my breasts as radio tuning knobs to “Tune in Tokyo” just like in the 1985 movie Girls Just Want to Have Fun. All joking aside, my husband deserves all the credit for discovering a very subtle lump on my left breast back in 2021 and saving me from a far worse outcome!

I remember him telling me one morning he felt something on my left breast that I should have checked out. I kind of laughed because I’m not well-endowed and I said out loud, “you sure you weren’t feeling my actual breast?” But he didn’t really laugh. Instead he took my hand, located the lump and I felt it for myself. It didn’t alarm me. It felt no bigger than a pea and there was no pain from it. However, to give my husband peace of mind - I promised I would have it checked out which didn’t happen for a couple more weeks until I got back from a trip with my mom to Cancun, Mexico.

When I called my OBGYN’s office on the Monday following the trip with my mom, the earliest they could get me in was that Friday. I took the appointment. A few minutes later, my favorite nurse from that office (Susan) called me back and said, “Toni, we can fit you in tomorrow!” And she told me the time to be there. Susan had lost her sister to breast cancer and I instantly appreciated her willingness to take this as seriously as she did. When my OBGYN did a breast exam, he located the lump and ordered a diagnostic mammogram (which I saw from his notes included an ultrasound).

The hospital staff were so kind to me when I went in for my diagnostic mammogram (my first ever mammogram and I was 40 at the time). I waited for the images to be seen by the doctor before we moved on to the ultrasound. The nurse called me back in to capture a couple more images from mammography which the doctor wanted. When we moved onto the ultrasound, that’s when the doctor came in. Though the lump felt like a pea-shape, it looked quite different from the ultrasound images (e.g. bigger, not well-rounded). The doctor very calmly said he would like to take a biopsy of the lump which they could do that day or if I was in a hurry to get home I could schedule it for a different day. I stayed to have it done right then. The ordering of the biopsy stood out to me. I knew the doctor hadn’t ordered it, so I figured something must have warranted this further investigation. That’s when the tears started to swell up in my eyes. Might this be more serious than I thought? What if my husband hadn’t caught it? Because I certainly wasn’t doing self breast exams and I was done having children so my routine trips into the OBGYN weren’t so routine anymore which meant no breast exams. The doctor numbed me up and then warned me it was going to sound like a jack-hammer and sure enough it did! The doctor told me they were leaving a metal marker inside the breast to mark where the lump was so it could easily be spotted in the future if needed. I was bandaged up and told I would hear from the hospital with the results within the week.

A week went by and no word from the hospital. I got busy with life again after the biopsy and had not given it much more thought until I received a call from a number I recognized: my OBGYN’s office. When I answered, my OBGYN asked if the hospital (where I had the mammogram, ultrasound and biopsy done) had called me. They had not. He told me he got my results back and it was cancer but if I had to choose it was the best kind to have. It’s what they call ductal carcinoma in situ (DCIS) which meant it had not spread (from what they could see). It was inside a milk duct. He then referred me to a surgical oncologist (Dr Tittensor). I was impressed with her before we even met. I read reviews about her which all spoke very highly of her and her work. I spoke to others who used her as their surgical oncologist and they all loved her! From the time I set up the appointment with her office, her staff ordered a genetic test and an MRI. I received the genetic test results before my appointment with Dr Tittensor which revealed I did not have any of the genes associated with breast and/or cervical cancer.

When my appointment came with Dr. Tittensor, she first apologized for meeting under such circumstances. Then she explained I had stage 0 DCIS, grade 2 (meaning it was not invasive from what information they had up to that point and the grade represented the size). She told me the recommended treatment options; all of which included some form of surgery starting with lumpectomy, then mastectomy without reconstruction. As soon as she got to, “mastectomy with reconstruction” I thought to myself, “so you’re telling me I could walk away from this with a chest?” I was no longer seeing a downside to any of this! I told her I was leaning towards the mastectomy with reconstruction option but I was worried I might be choosing it for vain reasons. She smiled very kindly and pointed out this involved a lot more than cosmetics. This would be a life change and I was only 40 years old. It was important to think about the future. I asked if I could take some time to think about it. She assured me that was just fine and encouraged me to give it some thought. When I made up my mind they would get me on her schedule for the next step: surgery. That reassurance from Dr. Tittensor empowered me to know I was in charge. I opted for the mastectomy with reconstructive surgery. Though having a chest in the end was my initial draw, other factors came into play: (1) my risk of recurrence was lower with a mastectomy, (2) I would not need radiation which is mandatory with a lumpectomy, (3) lumpectomies are designed to conserve the breast (meaning keep whatever you can after the cancer is removed)...well, when you have little breasts - there’s not much leftover after a lumpectomy and (4) self-confidence - I desired to look like a woman. I already naturally stand out due to my petite height (I’m 4’10”). I didn’t want to stand out in this way too by lacking one more thing that made me feel “normal”.

My next consultation was with the plastic surgeon, Dr Mark Jensen. I read many reviews about him. His patients referred to him as an incredible artist, fixing mistakes other plastic surgeons really botched. I think what brought me the most comfort though was after my first consultation with Dr. Jensen, I left his office with a “goodie” bag for lack of a better word; and in it was this card. This disease hits home for him personally, after watching his own mother fight her way through it.

On June 9, 2021 I went in for a mastectomy of my left breast and to have an expander put in to begin the process for reconstructive surgery. Lymph nodes were also removed and tested which confirmed nothing had spread. I spent that night in the hospital. I remember getting up at one point to use the restroom and taking a glance at the surgical site. I looked like “Edward Scissor Boob”. I went home with one drain.

On June 29th, I went in to have my drain removed but unfortunately it was not ready to come out yet. The expander was filled and during that appointment Dr Jensen’s Nurse Practitioner strongly advised me to let them know if I noticed any signs of infection (e.g. redness, pain, swelling, etc). She said most patients think they’ll just mention it when they come in again, but not to do that!

Over the 4th of July weekend I started to notice what looked like a hotter pink color on my chest, but I had no fever. I didn’t feel sick and it was a holiday weekend so I broke the cardinal rule and waited until my next appointment (which was Thursday July 8th) to say anything. When I went in for my appointment with Dr Jensen on the 8th, I asked the same Nurse Practitioner if what I was seeing was an infection. She looked at it and said it was clearly an infection. She didn’t seem happy with me at all because I’m sure this didn’t look good on her, after she warned me to call if I noticed any signs of infection. I felt like a failure! In my attempt to not inconvenience anyone, I inconvenienced a lot of people! Dr Jensen was quite nice when he came in to explain they would be admitting me to the hospital. I spent two nights there in an attempt to fight this infection I had acquired. The pain from the infection definitely became noticeable. When I asked the nurse (who was the same one who cared for me after my mastectomy, her name is Madonna) if the sharp pain in my chest was normal with this type of infection she responded, “Yes. Most people would be screaming in pain!”...I guess that’s the advantage/disadvantage to not having much feeling (post-mastectomy) in the left side of my chest. I don’t remember feeling very sad or lonely in the hospital after my mastectomy but this time was dreary. I cried myself to sleep both nights I was there. I remember Dr Jensen saying, “if I take the expander out, I won’t be putting it back in.” I assumed that to mean - like ever which would mean no reconstructive surgery. My second night in the hospital I received a PICC line so I could be discharged the next day and receive home health care to administer a heavy duty antibiotic (vancomycin). A dear friend came to visit me in the hospital that same night. Before she got there my forearm started to inflate like a balloon where the IV was. I hit the button for the nurse to come in and check it out. Turns out my vein had burst and a new one was needed for the IV. My friend arrived shortly after they got the swelling in my arm to go down. She brought her ipad with a number of movies downloaded for me to watch. Funny ones to lift my spirits and they definitely did help so did the brownie she brought me! I went home the next night and my first delivery of vancomycin was delivered by home health and a nurse arrived to teach me how to give myself this antibiotic through my PICC line. It was intimidating but I learned.

The next day on Sunday, I stayed home from church while the rest of my family went. I noticed my shirt felt really wet around my chest. I looked down and noticed I had infection leaking from my surgical site on the left side of my chest. I didn’t hesitate this time and called the doctor’s number. He picked up and I explained what was happening. He asked me to text him pictures using the number I was calling him on. He assured me it was a HIPPA protected number. I remember thinking to myself, “please don’t get the number wrong Toni. This is not a time to text the wrong person!” Could you imagine receiving photos like that from a wrong number?! Yikes! After Dr Jensen saw them, he called me back and told me to plan on having surgery the next day to remove the expander. I was devastated because in my mind that meant - no chance of reconstructive surgery (everything I was actually looking forward to).

As the nurses at the hospital were preparing me for surgery Monday afternoon/evening to remove the expander, I was asked to take a deep breath. Tears just came to my eyes. I couldn’t. The pain hurt so bad in my chest to breathe. It was a same day surgery. My current reality at that point was an acquired taste. I felt so far from feminine without the left side of my chest. I continued to receive home-health nurses until I finished vancomycin which took a few weeks. Then it was a waiting game to allow my body time to heal and recover from the infection. During that time, I purchased breast forms from Feminine Forms which were partially covered by my insurance.

On February 16, 2022 Dr Jensen operated once again to put the expander back in and on June 22, 2022 Dr Jensen performed the reconstructive surgery which included liposuction. I continue to take Tamoxifen but only half a tablet per day due to a blood-clotting risk factor and me having Factor IV (making me more prone for blood clots, even having one during my first of four pregnancies).

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