What to do after #2???

Second surgery is done and I am at my sis-in-law's house recovering. It went well, from what I understand. All of the people who were involved with my care at Vanderbilt today were very kind, helpful and friendly. And since I hadn't taken two Xanex, I was much more aware of what was going on around me.

In fact, I told Troy that I was concerned about another patient who was awaiting some sort of surgery. She was just across from me (the holding rooms were full so I was in the recovery room both prior to and after my surgery). She was crying and I overheard her saying she was really nervous. I wish I could have gone over there to give her a big hug. All I could do was pray.

I took some time while I was still coherent and listed to a version of "It Is Well With My Soul" on the iPod and prayed for her. I prayed for my surgeon and other personnel who would be in the OR also, but I really felt like I needed to pray for her. I have been thinking of her all afternoon and pray she is feeling peaceful and recovering well. God knows who it is and I know He hears my prayers.

Thanks to all of you who prayed for me during my surgery and also anyone who has prayed for my family, especially my little ones as they handle all of this. We don't expect pathology results until next week (about 5 business days). I will update with the information as soon as it is available.

Please also pray for my new friend, Stephanie (also a Knoxville girl), and someone (Susan) I knew many years ago at the church I attended. Both of these women are also in Knoxville and fighting a similar battle. I just can't believe how many women are being diagnosed with breast cancer.

When I am up to it, I intend to do something to make a difference. It might be a year or two before I can put too much energy into this other fight, but I feel like God put this challenge before me for a reason. Now I just have to figure out why.

Peace.

Normal?

I am just two days away from my next surgery. It's really not much more than one day, but I'll call it two just for kicks.

Check-in is 5:30am on Thursday. Whew. That is going to be a rough morning, although it will be nice to get past the no drinking or eating anything much earlier in the day this time.

Kendall seems to be having a tough time. She has been very adamant that she does not intend to stay elsewhere while Mommy has another operation. We've tried to remind her that staying with Barb and Jerry is like going to Disneyland, but that just isn't working. Tonight she started crying about not wanting to go to their house and not wanting to be away from me. And that lead to my tears and then I decided to be honest with her. I don't want this operation either. And I certainly don't want to be away from her. i explained that the doctors were going to work to make my boo-boo better. In my mind, I thought...But unfortunately, this stupid cancer-thing is going to force us to do things we don't want to do in order to be sure that I whoop some breast cancer booty. Stupid cancer.

It was hard to cry in front of her because I want her to think that it is all OK and Mommy will be fine, but I think it might have helped her realize that I'm sad too. Maybe that will help her process the whole thing? I don't know.

How can a 4 year old process cancer? They have seen this gigantic "boo-boo" and keep asking if it is getting better. Well, yes. And no. I mean, it's sort of been cut away. But the threat is still there. Cancer cells might be lurking and they must be DESTROYED. First there has to be another surgery to check the lymph nodes. And in order to really destroy those cancer cells, this means chemo. And chemo means that I will probably look MUCH worse and feel even worse before I really get better. I think it must be so confusing to them because I always feel confused.

A 4 year old gets a boo-boo and we offer a Band-aid and maybe some Neosporin. Then it heals quickly and we can take away the Band-aid. But with cancer, it just isn't that easy. Though I'd like to think that I got the "easy cancer", I'm really starting to wonder if any cancer is easy? It certainly doesn't feel easy.

And I know that the kids think this whole thing is probably pretty ridiculous. Odd schedules. Meals from people they have never met. Some visitors they don't really remember from prior contact. We've had more people in and out than we have had since the first year (and they don't remember that at all). As much as we would like to keep things "normal," they aren't (and now there is a schedule-change since the school year ended). It will take some time to get back to some sort of "normal" routine. I'd expect that maybe in a year we will be settling back into life as it was before? Yet I guess it will never be as it was.

Cancer changes you. It changes your outlook. Your perspective is different. Priorities are rearranged. Plans are suddenly different or even cancelled. Life is definitely not going to be "normal" ever again for me. I hope that it WILL be normal for them. I'm counting on them to be resilient and barely remember this time. I'm praying that this will be just a blip on their "timeline" so that it just doesn't cause long-term issues.

I can tell that I am rambling so I am going to shut it down for the night. I would like to be selfish and ask for prayers for me - I need sleep tonight. I was very restless last night and stayed busy today getting bills paid, negotiating payment schedules with various medical facilities, getting laundry done and just getting prepared to be back in the surgery-recovery mode for a couple of weeks. And I'd like to ask for prayers for my little ones. Please pray for peace for their little hearts and minds and I pray that they will find a lot of joy this week/weekend with Barb and Jerry and not be worried at all about anything else.

Thanks so much and peace to all of you, friends.

Update: Still Feeling Cancer-iffic

My follow-up appt was last Wednesday, May 16th. It went really well, except for the fact that we already knew there was cancer in one of the four lymph nodes removed. The good news is that the radiation plans have been scratched. There were no cancer cells detected in the chest muscle that was removed (near the larger tumor). Initially, they thought that this tumor was so close to the chest wall that I would need radiation in order to be sure that they "get it all." So I should note that there are BIG AMENS going up for that news.

Back to the lymph node issue. It is not ideal. We do not want to believe that the cancer was anywhere outside of the right breast, but it looks like it was trying to make its way elsewhere to spread more cancer-cheer. The doctors need to determine if there is any cancer in the other lymph nodes on my right side (arm pit) because they just have to know this. Why, you ask? Well I just don't quite understand that myself except that it just helps them know what was going on in there. You see, there are 3 layers of lymph nodes and they will remove some fatty (What?!?! Fat?!?! Under MY arm?!?! Oh no they didn't just say that!!!) layers of tissue from under my arm that will comprise the first TWO layers of the lymph nodes. Those nodes will be examined. If there are NO cancer cells present, the plan to proceed forward with chemo, etc will continue.

NOTE: The third layer is just different and there is NO plan to check those nodes at this point. It is closer to your collarbone and can have many more negative side effects that just the removal of these first two layers, so I'm going to let the experts make that call and say I'm good with that decision.

IF there are more cancers cells, (a very big "if" because the surgical oncologist and the medical oncologist do not think they will find more) then they will have that information, which is important. But the current course of treatment with chemo will not change. They will most likely add back the plans for radiation just to get a more targeted treatment. For whatever reason, they just NEED to know if there is more. Again, my non-oncology-mind tells me to just take their word for this and go with it.

So right now, I am at Stage IIb (2b). This is not as "easy" as I had originally thought, but it is still VERY survivable. I will go with the treatments that they recommend. And I will also participate in a clinical trial. I will go into more detail about that and my pathology results in another post, but I just wanted to get the latest out here so that I don't forget to share the info that I am going to get to avoid radiation.

And I wanted to be sure that I posted that my second surgery has already been scheduled for Thursday, May 31st, at Vanderbilt. It is an outpatient procedure, so it will be a long day, but I will not need to spend the night in the hospital. Instead, we will be imposing on my sister-in-law who lives very close by and staying with them for a few days. I expect to spend those days blissfully unaware of everything as I did for the last surgery, so please don't expect to hear much from me for a few days afterwards. I DO appreciate the prayers being offered up on my behalf. And please keep my children and my family/caregivers in your prayers. I'm pretty darn useless these days so I'm sure they are ready for both arms to be in working order again soon.

Peace.

Tomorrow. Tomorrow. I love ya?!?! Now, when exactly will you get here?!?!?!

We return to Vanderbilt for the post-surgery follow-up appointment tomorrow. Appointments are scheduled with both the surgical oncologist and the medical oncologist. I am nervous but hopeful. We are expecting to find out whether there is surgery planned in order to check more of the lymph nodes (an axillary dissection) and also whether the plans for radiation remain or if they are off of the table since there was no indication of cancer in the chest tissue which means none in the chest wall.

Based on what I have been reading, I feel like there is a possibility that I could skip the surgery and possibly receive radiation that would potentially take care of any cancer that might exist in the lymph nodes (and wouldn't the chemo do the same?). I am CERTAINLY not an expert and probably don't quite understand all of what it is I am reading, so I don't want to put all of my eggs in that basket.

I believe that we will also find out what the course of the planned chemotherapy treatment is but I doubt it will change from what I was told back on April 4th. The number of treatments might increase since there is lymph node involvement, but I am not sure. We will also discuss with her the possibility of being referred for chemo in Knoxville instead of making the drive to Nashville/Vanderbilt for each treatment. I still have reservations about that because it is the chemo doctor who really "sold" me on Vanderbilt. While I liked the other two doctors, it was this particular person who seemed to "get me" and she understood my questions about how this would impact my young children since she, too, has little ones.

Maybe that is the connection? She is a mother of young children as well, so I feel like she knows that I NEED for her treatments to kick this breast cancer to the curb. It's not that other doctors wouldn't try just as hard, but maybe, just maybe, she will try a little harder to be sure that we do exactly what I need in order to become cancer-free and never have it return? I don't know. I really wish I could get the chemo in Nashville, but that seems unlikely and like a logistical nightmare.

I don't know how to "know" when I am making the right choice. And lately, most of these choices leave me feeling like the family takes the back seat while I deal with the cancer. And that just plain sucks. It isn't fair to them. It isn't fair to our future to think of how this stupid cancer thing could really mess things up across the board. My kids are young, and hopefully very resilient, because I don't want this to screw them up. And it puts our marriage somewhere even farther away than the back seat. I mean it isn't even in the driveway. We're talking maybe around the corner in the driveway over there, but certainly not something we can really pay much attention to at the moment. We just have to hit "auto-pilot" on most things and hang on hoping (and praying) that we will come to the end of this ordeal stronger as a family because it would suck to have cancer take anything else away.

Once again, I'm left waiting, wondering and feeling completely out of control. This is so unsettling and frustrating. I'm a planner. I like advanced notice of any changes. And all of this has me wondering how we will manage things, financially, emotionally, spiritually. Honestly, I feel like I'm having a spiritual crisis. I want to feel closer to God because I know in my soul that He is the one who will walk through this with me every step of the way, even when I feel completely alone. And yet there are times (most of the time lately) when I feel like I'm so caught up in all of this that I can't even think about praying (or just being still and waiting to hear Him) to help it all make sense.

Today, my sister gave me a card with a copy of a devotional she read many years ago. It referred to the following scriptures and I wanted to share them because they definitely came at a time when I needed to be reminded that He will give me all that I need....when I need it and that I need to trust in Him for everything:

Exodus 16:1-5

New International Version (NIV)

Manna and Quail

16 The whole Israelite community set out from Elim and came to the Desert of Sin, which is between Elim and Sinai, on the fifteenth day of the second month after they had come out of Egypt. ² In the desert the whole community grumbled against Moses and Aaron. ³ The Israelites said to them, “If only we had died by the Lord’s hand in Egypt!There we sat around pots of meat and ate all the food we wanted, but you have brought us out into this desert to starve this entire assembly to death.”

⁴ Then the Lord said to Moses, “I will rain down bread from heaven for you. The people are to go out each day and gather enough for that day. In this way I will test them and see whether they will follow my instructions. ⁵ On the sixth day they are to prepare what they bring in, and that is to be twice as much as they gather on the other days.”

Lamentations 3:22-24

New International Version (NIV)

²² Because of the Lord’s great love we are not consumed,
for his compassions never fail.
²³ They are new every morning;
great is your faithfulness.
²⁴ I say to myself, “The Lord is my portion;
therefore I will wait for him.”

Matthew 6:33-34

New International Version (NIV)

³³ But seek first his kingdom and his righteousness, and all these things will be given to you as well. ³⁴ Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

Going Fishing

[Note: A portion of this has already been posted on the other website.]

The surgical oncologist called late this afternoon with pathology results from my surgery. The news is not all good, but there is definitely reason to celebrate as they did get clean/clear margins and the cancer in the larger tumor (3.2cm - which IS better than being over 5cm) had not spread to the chest muscle or chest wall. This was a concern and had originally meant that radiation would be unavoidable. This is good news for sure!

But the bad news is that they removed four sentinel lymph nodes (I'm linking a description for the biopsy but you can google for more information) and one of them did have cancer present. This indicates that the cancer has moved outside of the breast, but it doesn’t necessarily mean that it has gotten very far.

It leaves the next step in limbo until we meet with the surgical oncologist and medical oncologist (chemo dr) next Wed, 5/16. In the meantime, both of them, along with the radiation oncologist will review my pathology results and discuss what course of treatment they would recommend. In most cases, when cancer is found in the sentinel lymph nodes, they would do more surgery (an axillary node dissection – again, feel free to google it) and remove a sampling of MORE lymph nodes from under my arm to see if there is any cancer. This is all just to get a better understanding of exactly where this cancer may be moving. The detection of cancer in other lymph nodes can help doctors find microscopic areas where the cancer may be trying to grow. Or at least, that is how I understand it.

What does this mean for me? Again, potentially more surgery under my right arm. Yuck. But really it just means that things remain uncertain until we meet with the doctors at Vanderbilt next Wednesday. And it allows more time for God to hear my prayers. And in the meantime, it means that I have to ask for even MORE PRAYERS. I am hopeful that they might wait and just start chemo first. And then I can only pray for lots of miracles and healing so that the doctors will find that no other cancer cells exist and radiation and additional surgery would not be necessary. THAT’S what this means for me.

More details for those who seek out the technical information:

The cancer has now been diagnosed as Stage IIb (2B). This doesn't mean much except that there are more standard courses of treatment (see NCCN Guidelines p 64, p69 - cancer spread to 1-3 lymph nodes so far, p76 - hormone receptor and HER2 positive and tumor is greater than 2cm but less than 5cm).

The doctor did mention something about possibly doing chemo prior to any additional surgery. And she also said that based on the tumor pathology, she would not recommend radiation therapy. BUT she wanted the radiation oncologist to weigh-in on the pathology reports and also get input from the medical oncologist. Apparently there might be some sort of radiation that could be done instead of more surgery to remove/test more lymph nodes? I am not clear on the details of that since she planned to discuss with them first and then meet with us next week. And she might have said something completely different than a radiation treatment as I am still taking pain meds due to the surgery last week, so I cannot be held responsible for any erroneous information. :)

That's about all I can manage to put into words this evening. I'm exhausted. Disappointed. And distressed. Initially, I really believed this was going to be the "easy" cancer. It was very treatable and somehow I felt that I could come through this quickly and with very little struggle. Obviously, that is not the case and it seems that each time we take a few steps forward, we end up getting throttled backwards by additional news that shocks me. Why? I have no idea. Why would this be easy? Why would I be spared any sort of suffering? Am I somehow more special than any of the other cancer patients? Nope. I am just another cancer patient dealing with this ridiculous cancer crap and wondering "How did I get here?" And clearly, I should jump right out of this delusional river of denial and into the cold and choppy ocean-like waters of reality. It's going to be a bumpy ride. I feel like I am going deep sea fishing on a raft.

Blessed

I had my mastectomy (right-side only at this point) on May 3rd. I was discharged from the hospital before lunchtime on May 4th and spent the rest of the weekend recovering at my sister-in-law's house in Nashville. My sister and her hubby were in Nashville to be there with me as well.

Thursday just didn't happen for me. Seriously, I barely remember anything from that day as a result of the Xanex that I was given to deal with my anxiety prior to surgery and then the anesthesia for surgery. I do remember when they told Troy he should say goodbye to me because they were going to get started soon and that was it. Lights out. Apparently I was awake around 4 or 5p and we spoke, but I don't remember it and the next time I remember communicating was later that evening.

It is so odd to feel like an entire day went by and you missed it. On Friday, I kept referring to things "yesterday" and was corrected (more than once) that it was really Wednesday when these things happened because "yesterday" was the day of my surgery.

"Yesterday." It was the day that they removed my right breast. At the time, I was so relieved that I had it behind me that I barely noticed what things looked like in front of me. I haven't paid too much attention to what I look like, though I have my moments. Today was one of those moments that I am not proud of and wish I could erase. I woke up irritated and uncomfortable and angry that I had been maimed. The "why me" thing kept running through my head.

And then this afternoon, showers of blessings fell (again). And I was reminded that God knows all of this that is happening right now. He knows the reason. For that matter, He knows the outcome, I think. So, HE is working on me. Through my illness, He is working through me. I am already finding so many ways He has blessed me, despite my cancer diagnosis...BECAUSE of my cancer diagnosis. And I am finding ways that I can bless others. And that, my friends, is huge. I want to be able to bless others. He can make it happen.

Tick Tock

The countdown continues. Surgery in less than 48 hours. I am relieved to get this process underway, but I am also thinking that I need more time to prepare.

Emotionally.

Physically.

Financially.

But who can really prepare for cancer? Sure, you can buy life insurance, disability insurance, even cancer insurance. But does that make you "prepared?".

Are you prepared to turn your world upside-down? Would you re-evaluate your decisions and choices? Are you ready to leave your job in order to focus on your health and your family? Would you sell stuff to pay for more important things?

These are the things I am doing...or thinking about doing...or wishing I had already done.

But I am glad that I know God is my Father and that Jesus is my savior. Do you? Have you thought about it? Because now is the time. We don't know what tomorrow will bring. And we can never be truly "prepared." But we can find peace in the fact the our God will be there with us.

That's all I have for now friends. I will be sure to get someone to post an update on Thursday.

Peace.