Saturday, April 28, 2012

Last Chance for the Traitor

My hubby won an amazing trip to Orlando from his place of employment. We have enjoyed an incredible time at the Walt Disney World Yacht Club. I have never spent time at any of the Disney resorts despite MANY trips to the happiest place on Earth. What an extra special dose of Disney Magic!
Anyway, this is sort of a last chance to vacation before my surgery and treatment begins, so it was just the adults this time. We had JUST planned to bring the kids to Disney for their 5th birthday and then came the diagnosis. It has been a bitter-sweet trip as we can't stop thinking about all of the things the kids would love if they were here with us. But we have also had a great time with a few of his co-workers who also won the trip. And we have met other people from within the company who are just awesome! What a great group of people and meeting some of the corporate management team has been a wonderful opportunity for Troy as well as a treat for me.
Yesterday, I was able to soak in the tub after a lot of walking at the Animal Kingdom. I managed to have a chance to say good-bye to my right "traitor" and it was sort of a nice feeling. I'm sure I will struggle this week with the reality of what will be, but it was a good-bye that was just slightly more on my terms than the terms of this stupid cancer.
I will be posting more as much as possible. It is going to be a crazy few days, but I'm hopeful that I can keep up with the blog. I feel like I have so much to say and so very much that I'd like to remember someday.


Wednesday, April 25, 2012

Not Forgotten

I have been away but I hope that you know that the cancer has not been forgotten.  Instead, it seems that this cancer thing has taken over almost every thought that I have each and every moment of the day.  I am in the process of leaving my job, at least temporarily, so that I can focus all of my energy on beating this stupid cancer and also spending time with my kids when I can.  And, while I'm in the midst of that, I'm preparing for my mastectomy scheduled for next week.

May 3rd is green-light day.  The race is on at that moment when the scoreboard changes.  It will no longer appear that cancer might be "ahead" because I am stepping up the fight and having the mastectomy.  Once I recover, I will move right into chemotherapy, though I've been told this could be another 6-8 weeks down the road.  I was so ill-prepared for the "mastectomy" news that it was a couple of days before I realized that I would not be able to drive...for a while.  The RN for the surgeon said to plan for no driving during the month of May.  I HATE this idea.  But, I hate the idea of cancer even more, so I'll do what I have to do.  I have prescriptions to be filled, post-mastectomy camisoles to purchase, schedules to coordinate and crap to clean-out at home.  I am in panic mode that I will not be able to lift things for a short while so I have a need to clean out as much as possible.  I've also tried to read up on the whole surgery and recovery process so that I will be able to make many informed decisions and choices as I move through this first phase of kicking breast cancer booty.

The other big news at the moment is our pending trip to Orlando tomorrow morning.  Troy won an all-expenses paid trip to the Beach and Yacht Club on the Disney property.  We will be flying out early tomorrow (just the adults THIS time) and will spend four days in sunny Florida.   The company has provided us with 3-day park hopper passes and we intend to spend some quality time in the Disney parks!

Needless to say, it has been busy and I hate feeling this out-of-sorts, but most likely, if you know me at all, you know that I always seem to be out-of-sorts and trying to keep up with the daily routines of our little family.  Add to that this stupid cancer-thing and I feel like I am working three full-time jobs right now.
In any event, your kind words, thoughtful posts (on here and on Facebook) and prayers are all greatly appreciated.


Monday, April 16, 2012

Betrayed by the Boob

That is how I am feeling right now. Boob-betrayal. I feel like my right boob is Judas or something. The bruising from the biopsy the other day looks terrible and I have scolded my right breast telling it that it deserves to look like that after the hell it is putting me through. Really?!? Did I just admit to having a conversation with my boob?!?

Anyway, I finally heard back from Vanderbilt and they were very kind. The Nurse Practitioner, Katie, called to tell me what I had expected to hear (and, by the way, this woman is well on her way to being 41 weeks pregnant and I told her I did NOT want to talk to her again before the baby arrived). There was no "kick in the gut" or "punch in the stomach" just words to confirm what I already understood. This new issue is diagnosed as DCIS (or ductal carcinoma in situ). As I mentioned in a prior post, this is certainly not the worst news in and of itself. But because this 5-7 cm area of microscopic calcifications is not close enough to the tumor that has already been identified as invasive ductal carcinoma, it will require a mastectomy in order to remove both the tumor and this other area in question and also get the clean margins plus the two sentinel lymph nodes (and hope those are the only lymph nodes removed). This means that the "easier" lumpectomy surgery option is off of the table.

Once I knew this other area was indeed cancer, the question then changed to "Should I get a single- or double-mastectomy?" and "What about reconstruction?" I was worried because my surgeon was on vacation, but was relieved when she called (twice actually) to discuss what was happening and try to go over the options and ask me how I was feeling. Basically, I have decided that I will go with a single-mastectomy for now. It will still occur on May 3rd. If I elected the double-mastectomy, it would require specific insurance approval since the left side does not show any evidence of cancer. While she feels confident that they will approve the surgery to remove the left breast as well, she also said that it could take 4-5 weeks before the situation would be settled with insurance and I would be ready for surgery. She didn't feel like it would be wise to wait that long.

My surgeon also pointed out that reconstruction is not possible during the first surgery/mastectomy. The original tumor location is near the chest wall and there is a good chance that it could prove to be a challenge to get "clean margins" when removing the tumor. There is a very small separation between the tumor and the actual chest wall, so there is a very good chance that radiation cannot be avoided. Radiation is not recommended with any sort of implant (assuming that I go this route). It also means that having the left breast removed increases the chances for infection and we definitely don't want any sort of infection to occur that could delay the chemo treatments. It is important that I move forward with the chemo and radiation, especially since there is another area in question.

Once the chemo and radiation therapies are complete, I would then be just about ready for the surgery to do reconstruction. I would be able (assuming I've still decided to remove the left breast as well) to get the left one removed and then get reconstruction for both sides at the same time. It means another surgery, but it also allows me to take my time making the decision about the left side. I'm also able to get the chemo going which, while I dread it, is the way I can really start taking some pretty big hard kicks at this whole breast cancer thing. Cut off the right one and then chemo the crap out of my whole body in order to kill of those stupid cancer cells. I want the cancer out. Now.

I have been reading another blog, Anderson Family Zoo, because she was diagnosed at about the same time. I've found so much hope and inspiration through her words. And her discussion about telling the kids about "cancer" and "chemo" rather than saying that "Mommy is sick and needs medicine" was eye-opening to me. I hadn't begun to think about how they might process the "sick" and "medicine" words and potentially be scared later as a result. I've also appreciated her positive attitude. And she has addressed that this breast cancer thing is like a "job" and I can totally relate as I try to balance appointments, information, tests, plans, treatments, insurance questions, etc, on top of an already busy and hectic life with three four-year-olds. And regarding how to keep going and stay on track, I like this post here. Yes folks, cancer is "craptastic". I sort of like "craptabulous". But either way, I can just sit here and think about it and wonder how this happened (trust me, I DO wonder), or I can just do whatever I can to fight back and kick it's ass to the curb. I choose booty-kicking..

I am hoping that I got all of the details right. This isn't very interesting to most, but some people want more details and it is MUCH easier to explain it once here and refer them to the blog. It is my hope that I can one day help someone else who might have to travel this same road. But of course I really hope that one day NO ONE will have to.

Friday, April 13, 2012

Houston, We Have a Problem

Well, my trip to Vandy on Wednesday was going along swimmingly until they did the diagnostic mammogram. I didn't even worry about it prior to being escorted to a different room and the VERY pregnant Katie (nurse practitioner) came in to tell me that they found something else while reviewing the pictures. My sister and I were in shock, sort of. I mean, just a few minutes before I started to ponder why they were bringing us in this room and said "watch, it's probably something that is wrong on the LEFT side." Well, it wasn't the left side though they did say it was and then corrected themselves about 20 minutes later. There is an area of concern on the right side and they wanted to do another biopsy. Yes, this would be THREE separate biopsies and now handled by THREE different facilities. This is an area that is approximately 5-7 cm with numerous small, microcalcifications (see the section under "Mammography" where it discusses these microcalcifications).

This time, they would do a stereotactic breast biopsy. I had read about this procedure and had previously felt like I had dodged a bullet. But now, my next challenge awaited me. Karen and I had a nice meal at The Cheesecake Factory and did some shopping at Target (primarily for the necessities since we had not even thought of staying overnight). I am SO lucky that my sister-in-law, Marsha, and her family live nearby and they graciously allowed us to stay overnight. It was one of the first times I can remember of my sister and I having a night with just the two of us. The circumstances were not ideal, but I was so relieved to have her with me.

The procedure did not go as smoothly as I would have preferred but I did survive. :) I felt like I was told (more than once, actually) that the issue we had (lots of bleeding and a hematoma) were because I did not want them to use epinepherine (which helps control the bleeding) during the biopsy. I had a bad experience during the first biopsy with a racing heart, sweats, nausea, etc, so if we could avoid the epi, I would be much more comfortable. Apparently, a blood vessel was in the way and just "got mad" so they had to do a lot of compression efforts to get it to settle down. Today, I look like I served as a punching bag or something.

Unfortunately, the radiologist has indicated that he feels that the suspicious area is DCIS (ductal carcinoma in situ). While this diagnosis in and of itself is not particularly threatening, when added to the prior tumor location, it would remove the lumpectomy option and require a complete mastectomy on my right side. I am not completely freaked-out. Just mostly frustrated that we are still trying to figure out exactly where it is (and is not) and how bad it is. I'm just ready to move on at this point and want to get the surgery behind me so that I can begin the chemo and start kicking this breast cancer to the curb! I have moments where the idea of losing a breast is completely shocking, scary and gross to me. And other times, I just don't care at all because I feel so completely betrayed by the dern thing right now. It has cancer in it and it just needs to go.

I will be sure to post once I hear anything, but wanted to share the latest info. It has been a crazy week, so I'm thankful that some friends took Clark and Kendall camping and we just have Emma at the house for the next day. It will offer me some one-on-one time with her. Daddy and Mr. Jerry will begin building our sunroom (a freebie that had been dismantled from another house and will be reconstructed on our back porch) this weekend. And I hope to get a little work done at the office and maybe some cleaning done at home.

Good night and I continue to be SO grateful for your prayers and support.


Saturday, April 7, 2012

Update: Life...Cancer Sucks, but Life is Good

Life goes on. My second biopsy had me a little nervous, but in the end, the other area that the radiologist was concerned about was just a fibroadenoma (benign). I have now also met with the amazing doctors at Vanderbilt Breast Center and would love to just get my surgery and all chemo and radiation treatments done there. Unfortunately, since we are in Knoxville, the logistics are just all wrong.

I did decide to go with the surgeon there because I really felt comfortable with her knowledge and personality. We have scheduled the surgery for Thur, May 3rd. The decision is for a partial mastectomy/lumpectomy. She is fairly confident that the tumor can be removed and hopefully the area with clean margins without causing too much damage (from the outside). According to the scans, this tumor sits VERY close to the chest wall, so it means that there will be some muscle (pectoral, I believe) as well which will mean a little extra effort in terms of recovery as I am right-handed and the tumor is on my right side.

The chemo would probably begin about 3-4 weeks after the surgery, so I'm thinking late May or early June. The plan is to manage chemo and radiation in Knoxville at UT Hospital. We really were amazed by the staff and doctors there during our visit. I'm told that the hair loss usually occurs around the 14th day after chemo begins. This is still one of the scariest parts for me. I know that this cancer won't kill me. But living without hair will be hard for someone with self-image issues. I've almost always had medium or long hair and the idea of cutting it off is pretty terrifying. The kids seem to like my hair also and I wonder how they will handle mommy's new "look."

I asked the medical oncologist (did I mention that I LOVED her?!?! Seriously amazing.) about it because she has a 4 y/o and an 18 m/o and she encouraged cutting it short soon and possibly including the kids in order for them (us/me) to get used to it a little more gradually. I've also read that cutting it ( and even shaving it) sometimes seems to throw the control back to the one with the cancer, rather than the cancer controlling when the hair comes out. I can sort of understand that right now since I feel like things are completely out of control and definitely out of my control!

While visiting Vanderbilt, I was confronting my fears when I passed more than one relatively young woman who was wearing a scarf or cap and was obviously bald underneath. The number of YOUNG women I have read about or noticed while going to these appointments has been unsettling and upsetting to me. Many are much younger than me. And I tried not to stare but it was hard not to because that "look" is just around the corner for me.

Just around the corner. Cancer is here and there are so many new things waiting just around the corner for me. Surgery for a lumpectomy and hopefully only the removal of two lymph nodes plus the addition of a port. Hair cuts. Chemo. Hair loss. Nausea. Weight GAIN?!? (I thought this was a chance to get skinny - as I was trying desperately to find the silver lining in this - but now I've heard that most younger women gain weight because of the anti-nausea drugs.) Beyond chemo, there will be infusions of Herceptin every 3 weeks for a year. Plus radiation will begin after chemo. Then there are the visits to be sure that the cancer hasn't come back. Being afraid that cancer could once again be just around the corner, but I have to find a way to keep that fear at bay. Life is just around the corner. It's a new life. But it is life.

Tomorrow we celebrate that Jesus has risen. He has risen indeed and HE gave His life for me. Me? I can't imagine the torment He went through knowing he would have to die. Just these last few weeks have been enough for me and I knew that this cancer wouldn't be a death sentence. But He KNEW HE WOULD DIE.

Yes. Life is good. He is my savior. And this cancer is NOT going to kill me.

Two friends posted this link on my Facebook page. It was a good reminder.

Thank you to friends and family who have been praying for me and have sent messages of encouragement. It means more than you could ever know.


Sunday, April 1, 2012

Breast Cancer 101 (AKA "What the ?!? Part 3)

Once we knew the scans were clear, I think we all began to breath a sigh of relief. It seemed that maybe things would be easier than we thought. Nope. Not so much. We had a big consultation this past Tuesday (when I received the stats that I posted on 3/27) and I feel like it was more like Breast Cancer 101. This is definitely a course I did NOT plan on taking and I felt very tense going into the appointment.

On top of that, the dr was almost 45 minutes late getting started. They didn't really update us or anything, so we were left waiting in a small conference room. When the dr finally arrived he began to explain all that he knew about the specifics of my tumor. Of course, there are still two important missing pieces of information 1.) the actual size which can't really be determined until the surgery is done to actually remove it and 2.) whether the cancer has spread to the lymph nodes.

The dr discussed surgery options (partial mastectomy/lumpectomy or modified radical mastectomy), recovery time, chemo and radiation. Needless to say, it was overwhelming to all of us. And I felt like I had now been to battle because I had hoped to avoid chemo and this was a definite slap in the face for me. I am still working to balance out the options in order to determine in which direction I will be heading. And I need to get a better understanding about whether chemo and radiation are avoidable if I choose the modified radical mastectomy. I'm under the impression that radiation might be avoided, but that chemo is still going to happen.

We have now also met with another dr to get a second opinion. We LOVED the facility and they would be able to offer the chemo and radiation on-site, as well as the reconstruction surgery at the time of the original surgery should I choose to go with the mastectomy (vs lumpectomy). This could mean fewer surgeries though the recovery time (because of the reconstruction) would definitely be longer and more complicated. They have also offered to schedule appointments with a Radiation Oncologist, Plastic Surgeon, Genetic Counselor and Medical Oncologist in order to try to answer any questions or concerns we might have had while speaking with the dr. He is a Surgical Oncologist, so he is highly qualified, but was definitely not willing to discuss the details of radiation and chemo as he preferred to leave it to the experts. While it means scheduling more appointments, I appreciate the fact that he doesn't try to know EVERYTHING and wants to be sure that we get our questions answered by the most qualified people available.

I am also scheduled to meet with doctors at Vanderbilt Breast Center this Wednesday. It IS another opinion since there were a few things that were not clear and also not quite the same between the two doctors so far. I need to find another opinion that might agree with a prior version. Additionally, Vanderbilt is recognized as a "center of excellence" by our health insurance company, so they offer some perks in order to consider treatment at that facility. It is about a 2.5-3 hour drive each way, so if we like what they have to say, we would probably ask that the treatments occur here and surgery there. I have a wonderful friend driving me to Nashville for the appointment on Wednesday and she will join me for the appointments also. I hope to have more questions answered at that time.

Right now, the Wednesday appt is the only one scheduled for this week. I am SO far behind at work and with the Easter holiday fast approaching, I am hoping to keep my appt schedule to just the one. :) Another reason that we liked the 2nd opinion dr was because he told me I could take my time to make the decision. We could get appts with all of the other specialists and I could take the time to be sure about my surgery decision. There is no major rush to get the surgery done before our trip to FL at the end of April. This is a HUGE relief to me as I am really struggling to decide how to proceed and everything else depends on this particular decision and then moving forward. The first dr indicated that we really should schedule the surgery BEFORE our trip and I was worried about the recovery, etc. Now I am just worried about the cancer, the surgery decision, the childcare decisions, the work issues, the laundry, the dance recital, the house cleaning, the banking and get the idea. There are just so many things that need to be decided right now.

And though all of this is quite enough, I even received a call on Thursday because the 2nd opinion facility had my MRI and the radiologist wanted to schedule another biopsy on a second mass that showed up. All indications are that this is just a fibroadenoma (per 1st facility and 2nd opinion dr), which is benign, but he would prefer to confirm it, so tomorrow morning at O-dark-30 (actually, 7:15am), I'll be having another of my favorite procedures. And the call to set this up sure set my mind racing because now I HAVE cancer and every time there is something odd or potentially benign, but possibly malignant, I am going to have to get it confirmed. And I'm going to go through the stress of worrying if it is cancer.

So, just in case you weren't sure, cancer SUCKS!