SPECIALIZING IN UNIQUE GIFTS FOR BABIES AND CHILDREN

Wednesday, April 16, 2014

MEDICAL ONCOLOGIST

My second post-op visit with Dr. Morales was on Wednesday, June 5th. Thank goodness, he removed my drains! I can't stress how irritating the drains were these past two weeks. Now I could take full showers if I had the drainage area sites covered. My surgical incisions were healing nicely.

I did have a "fill". This requires a numbing shot that was a bit painful, followed by the saline filling insertion. That was awful! I had a hard time sleeping that night; it felt like a rubber band was around my chest. The tightness was due to my skin and muscles being stretched for the implants. I reminded myself the end result would be worth it!

The next day, Thursday, June 6th, I met with my medical oncologist, Dr. John Pippen, in the Sammons Cancer Center. After reviewing my medical history, he said I was borderline for chemotherapy, but I would definitely need to take an estrogen blocker (my cancer tumor was positive for estrogen and progesterone). Since he was undecided about chemotherapy, he suggested having the genomic Oncotype DX test on my cancer tumor to determine the chances of it returning. Based upon the results he could determine which type of chemotherapy to give me; if I needed it.

Luckily, the insurance company provided coverage; so they scheduled the genomic testing on my tumor. The results would be in about 2-3 weeks. Another waiting game. This link shows several videos regarding this genomic testing on cancer tumors. I prayed the technicians had the expertise to provide accurate results, so Dr. Pippen could recommend the best treatment for my breast cancer. 

While waiting for the Oncotype DX test results, I had more visits with Dr. Knox and Dr. Morales. I had another "fill" by Dr. Morales. We would continue with "fills" until we reached the desired size. My temporary "foobies" (fake boobies) were developing. The term "foobies" came from Amy. You must keep a sense of humor! I plan to buy this t-shirt for my one-year survival anniversary celebration.
On Tuesday, June 18th, Raven, Dr. Pippen's nurse, called with the Oncotype DX test results. Zero percent chance of this specific breast cancer re-occurring. Unbelievable! Raven said this was the first time Dr. Pippen ever received a report of 0%! Since Dr. Pippen was out of the country on a medical mission, I would see him on July 11th for his assessment. My tears this time were tears of joy. Thank you, Jesus!

Tuesday, April 15, 2014

POST-SURGERY FOLLOW UPS - DEVASTATING NEWS

My oldest brother and sister-in-law, sent me a devotional journal before my surgery. They had my name engraved on its front cover. This was such a thoughtful gift and has helped me keep track of all the events and my feelings during this ordeal. I highly recommend keeping a journal. If I didn't, everything would have been confusing because it was a lot to take in and process. Thanks, Harold and Stella for the lovely gift!

I had the surgery on Thursday, May 22. My first after-care office visits with Dr. Morales and Dr. Knox was on Wednesday, May 29. First visit was with Dr. Morales. He was pleased everything was healing nicely. Another appointment was scheduled for the following week - hopefully to get the irritating drains removed and maybe a "saline fill" to continue the expanding procedure for future breast implants. Next was my visit with Dr. Knox who should have the post-surgery biopsy report. She was pleased with my recovery progress and agreed with Dr. Morales that the surgical sites looked good. 

The post-surgery biopsy report came back with pre-cancerous cells found in the right breast. This validated the wise decision to have a double mastectomy. It also found a 0.4 millimeter carcinoma in the left sentinel node. 0.4 millimeter is "very" tiny, but this was devastating news for me and I completely shut down. My daughter, Cathy, took over for the rest of the office visit. I was so sure I had caught this cancer early. Dr. Knox set up an appointment with Dr. John Pippen, a Sammons Center medical oncologist, for the following week to discuss a treatment strategy that would most likely include chemotherapy.


One of the amenities at the cancer center is valet parking. I was able to hold myself together until we got into the car. Then I cried like a baby. I am talking uncontrollable weeping. Hours later, I had time to process this new glitch in my recovery. My prayers to God had been to give the lab pathologist the skill to detect any other cancer cells was answered. If he hadn't found the 0.4 mm one in the lymph node, I probably wouldn't have had chemotherapy; and it could have spread elsewhere. Now, my prayers were for a skilled medical oncologist to provide a successful treatment plan so I can live a long life with my family. I would not settle for anything less.

"Lord, if you are willing, you can heal me and make me clean."
Matthew 8:2-3

Monday, April 14, 2014

WAKING UP FROM SURGERY

I don't remember leaving the OR holding area - surgical drugs are wonderful! I didn't have time to worry or panic. The anesthesiologist said this was common among patients and one of the side effects of the drugs. As far as I am concerned, whatever went on in the surgical OR and recovery room can stay there!

I do remember waking up in the regular hospital room. Not much fun at the beginning since I was nauseated. We won't go there. The doctors and nurses provided great care. An American Cancer Society representative visited and gave me an information bag including a heart-shaped pillow. The day before my surgery, Amy M. sent me her own heart-shaped pillows to cushion me after surgery. Amy was my personal go-to for answers and reassurance about anything since she had undergone this same ordeal earlier in the year.

I only spent one night in the hospital. Looking back it would have been better if I had a 2-night stay, but that is today's health care system. The ride home was not easy even though I had underarm pillows and cushioning for my back. Luckily, pain meds were working and I don't remember much.

Cathy was in charge of my personal care at home, and Pat helped in other areas. Saturday morning I woke up with a temperature and dilated pupils. I cut back on the pain meds and took Tylenol for the fever. A side effect of the pain meds were horrible nightmares. Yet another reason to quit them!

My aftercare was spent in my bedroom recliner since I could make a "nest" with supporting pillows. Everything I needed was on a tray stand next to me for easy access. Dr. Knox did a great job with the breast removal surgery, and Dr. Morales did a wonderful job on the breast reconstructions. Temporary expanders were inserted behind the pectoral muscles with AlloDerm to reinforce the existing tissue. I had one "fill" in the OR. Drains were inserted for obvious reasons. These were not short drains, these were "long" ones that caused increasing irritation each day. I had to keep them in for almost 2 weeks until the drainage had lessened. I was so ready for the day of their removal!

I must say at this point in time, I was in awe at the love and support from family, friends, and neighbors. So many people and different churches had me on their prayer lists! Neighbors and friends brought in meals every day for two weeks and we received lots of restaurant gift cards to use after that time period. This sharing was a God-send for my family. All I had to do was rest, do my arm exercises, and walk around the house.
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My dynamic trio!

Sunday, April 13, 2014

SURGERY DAY PREPARATION


As expected, I didn't sleep a lot the night before the surgery. I was resolved this was the right treatment plan for me and was ready to go. I prayed for God to be by my side and to guide the doctors and medical staff in their expertise so I had a successful surgery and recovery. I also prayed that we had detected the breast cancer early so it had not spread into my lymph nodes.

My husband and daughter had been by my side since I was diagnosed with breast cancer. They went to every doctor's appointment and procedure I had done. I cannot voice how important it is to have a support team in place while you are undergoing this journey. I appointed my daughter, Cathy, to be my medical advocate. I am a strong-minded individual and usually calm and in control during chaotic times.  No so during this life-threatening ordeal. When you hear the word "cancer" you tune out a lot of information. I hardly ever cry in public. There were several times when I couldn't talk because I was trying to hold myself together and not break down. At these times, Cathy would professionally gather all the information and ask my questions. Naturally, Pat and Cathy were with me for the surgery.


I ordered breast cancer sugar cookies from my neighborhood baker and put Cathy in charge of handing them out to the medical staff. Very early in the morning, our first stop was at the radiology unit to have the radioactive injection for the lymph nodes; then on to the surgical center. Janeen, a children's minister from Cathy's church, met us at the surgical center and stayed with us throughout the day. Not only is it important to have support for the patient, but also support for the care givers. I am so thankful Janeen and our cousins, Mike and Kathy, were there for Pat and Cathy.


In the OR holding area, I changed into the fashionable hospital gown and had all the preliminary work done. The OR nurses were great. Dr. Morales came in to mark me with a sharpie how he wanted Dr. Knox to make the incisions for breast removal. (This is important since he is the one putting the "girls" back together!) Cathy brought with her a large collection of cards and well-wishes from family, friends, and neighbors. We laughed and cried as she read them to me. This helped to pass the time and keep my mind at ease while waiting for the surgery. The last thing I remember is getting the relaxation medication, Janeen praying over me, and saying good bye to everyone. 

Saturday, April 12, 2014

READY, SET, GO

My surgery date was set for Thursday, May 23. Remember, I initially had my mammogram on April 2, so there was a long interval between diagnosis and the surgery date due to the scheduling of doctors' appointments, lab work, scans, and time to get the results.

In hindsight, even though this waiting time was nerve wracking, I think it provided me the time I needed to get centered and ready for the surgery. Admittedly, I am a control freak and I needed to understand the process, feel confident about my decisions, and overcome my fear of the anesthesia.  I needed to get my household in order, and frankly; I needed my quiet time with God. I think one of the reasons I was fairly calm on the surgery date was because I placed my faith in God that he would be there holding my right hand during the entire ordeal. It meant a lot to me that I had a tremendous amount of people praying for me and providing emotional support.

Wednesday, May 22, my daughter and I spent the day together. We visited with Dr. Morales in the morning, had lunch, and just relaxed together. In the afternoon Dr. Knox's nurse called to review everything. That night the anesthesiologist called and explained in detail his part of the surgery. Since this was my major concern, he was able to waylay a lot of my fears and anxiety. My overnight bag was packed.


Let's get this breast cancer out of my body!

Friday, April 11, 2014

BONE SCAN

My bone scan was scheduled for Friday, May 17 at the Baylor Sammons Cancer Center in Dallas.
A bone scan is a test that can find bone damage and cancer that has spread to the bones. If it is found here, then the cancer has metastasized.

During a bone scan, a radioactive substance called a tracer is injected into a vein in your arm. The tracer travels through your bloodstream and into your bones. Then a special camera takes pictures of the tracer in your bones.

In my procedure I initially had a set of X-rays taken, then the radioactive tracer was injected into my arm. I had a 2 hour wait time before I had the bone scan. During this time, I had to drink lots of water.

For the bone scan, you don't have to remove your clothing. It wasn't as bad as the MRI, but you're strapped down with your arms at your sides. It took about an hour. A bit daunting at first, but I held it together. Beforehand, I watched this bone scan video of a prostate cancer patient to understand and familiarize myself with the procedure. 


I didn't get the results until Monday. 
The bone scan was clear. 
Hurray!

Thursday, April 10, 2014

SECOND OPINION

While waiting for a surgical date, I had my second opinion consult set up with Dr. Sally Knox at the Baylor Charles A. Sammons Cancer Center on Wednesday, May 15th. I highly recommend second consults for everyone - this process enabled me to be very confident and knowledgeable about what I was undergoing. Sometimes you just need to hear things more than once.   
Before my consultation, Dr. Knox's office requested the mammogram/ultrasound/MRI films/CDs and biopsy pathology slides including all written reports. She was being very thorough in her assessment. Dr. Knox agreed with Dr. Brian's final prognosis. I felt more at ease with her "bedside" manner and step-by-step explanation of the procedure and aftermath. Her nurses were great in every detail. Dr. Knox scheduled blood work, an EKG, and plastic surgeon consult later that day. A bone scan was scheduled for Friday, May 17th to check if the cancer had traveled any where else and to use as a baseline for future comparison. 

Later in the day, I had a consult with her plastic surgeon, Dr. David Morales. He is located in the Baylor T. Boone Pickens Cancer Center directly across the street from the Sammons Center. Dr. Morales seemed to be a better "fit" for my personality. I decided to literally put my life in the skillful hands of the Knox-Morales team for the surgery which was then set for Thursday, May 23rd in a larger hospital. 

Wednesday, April 9, 2014

BREAST RECONSTRUCTION DECISIONS...

It is very important to choose a skillful breast cancer surgeon who you are confident will remove "all" the breast cancer. The next concern is to find a skillful plastic surgeon who can do the reconstruction. For me, the removal of the breast tissue would be the easier procedure; whereas putting "the girls" back together would be more challenging. Breast reconstruction is a bit more detailed than having "implants" inserted, so it is very important to chose a qualified breast cancer reconstruction plastic surgeon. Your breast surgeon can help provide you with these references.

After viewing this link and video, I understood the various options before I consulted with Dr. Heistein. He explained the different reconstruction methods and what he felt would be my best options. I was able to touch the implant demos, so I could decide on saline vs silicone gel implants. The only concerns my family had was his facility was a 16-patient bed clinic. My daughter who works in a Ft. Worth trauma hospital was concerned with using a small facility. I highly value my daughter's medical opinion, so I became concerned. My fears were not with the skill of either surgeon, but my reaction to the anesthesia and if anything went "wrong" could they successfully take care of it. This is a result of my needing to be in "control". You definitely have no control here!

Before you undergo any surgery, you need to feel confident in all regards. This is where having a second opinion helps in your decision making.

Tuesday, April 8, 2014

BREASTS OR NO BREASTS

Whenever I thought about a plastic surgeon, my wish list would revolving around having my facial skin rejuvenated and/or my eyelids done. Never in my wildest dreams did I think it would involve my breasts! Then along came breast cancer and the decision to have a double mastectomy. Now the question was whether or not to have breast reconstruction.
This was one decision I had mixed feelings about. My husband was supportive with whatever decision I chose. His thoughts were, he didn't marry my breasts, he married me. He just wanted the cancer gone. My daughter had contacts with patients who could provide personal experiences with this decision. I decided to have the breast reconstruction. Looking back, it was the right decision for me. No regrets.

You would have thought once making the decision about reconstruction, I would be ready to go. No, there are lots of different ways to do breast reconstruction. Here is a link to an overview about the various options and techniques.

Monday, April 7, 2014

SECOND-LOOK ULTRASOUND

(This is an ultrasound image of a person with breast cancer.)

On Thursday, May 9th Dr. Brian performed the second-look ultrasound on the left breast as requested in the MRI results.  At this time the course of action changed from a lumpectomy to a mastectomy. I was concerned about the right breast eventually becoming cancerous too, so she performed an ultrasound on it. After much discussion, it was decided it would be in my best interest to have a double mastectomy with reconstructive surgery. Dr. Brian scheduled me a consult with her plastic reconstruction surgeon, Dr. Heistein, for Monday, May 13th. In the meantime, with my daughter's urging, I scheduled a second opinion with Dr. Sally Knox in Dallas on Wednesday, May 15th.

I felt confident this was the correct course of action for my diagnosis and had no hesitation to have a double mastectomy. My breasts or my life? Not a hard decision when it meant the difference between life or death. I was only 62 years old and I was not ready for death to be knocking at my door. I wanted many more years with my family and precious grandchildren.

I woke up Saturday morning thinking of all the things I needed to get done "before surgery." It was a bit daunting thinking my life was solely revolving around this breast cancer. In prep for my appointment with the plastic surgeon on Monday, I checked the internet for information about double mastectomies with breast reconstruction. By the end of the weekend I had my mind "wrapped around" my decision.


Sunday, April 6, 2014

RESULTS OF THE BREAST MRI

I had my breast MRI on Friday, May 3rd and would get the results on Monday. I was going to find out for sure if my cancer had spread. This time the waiting was awful. I was getting closer to a definitive answer. Was the cancer in-situ or invasive? Would I need a lumpectomy or a mastectomy? Would I need radiation and/or chemotherapy? So many unanswered questions!


Luckily, my weekend was filled with overnight visitors, community activities, and Sunday lunch with good family friends. My daughter, Cathy, urged me to post my ordeal on Facebook. By nature I am a very private person - the one in the crowd who listens more than talks, so this was awkward for me to do. I am so glad I listened to her. I was overwhelmed by the love, support, and prayers from everyone. I can't tell you how important it is to have a good support base.

Monday - no MRI results. Ugh! 

Tuesday Dr. Brian calls to set up an appointment on Thursday, May 9th for a second-look ultrasound. The MRI showed 3 more suspicious areas in the left breast.

Friday, April 4, 2014

BREAST MRI


My breast MRI was scheduled for the morning of Friday, May 3rd. I had an MRI in 2010 when I had a mild TIA, so I knew enough about the procedure to dread the loud noise and claustrophobic feeling. I searched the internet and found a video to help familiarize myself with what to expect with a breast MRI. I am a bit of a control freak - okay, I am a full fledged control freak! I hate the "unknown". My husband was out of town on a business trip, so my daughter went with me. (My daughter is an occupational therapist and works at a large trauma hospital.) She plays a major part in my breast cancer journey.

The breast MRI was easier than I expected; noisy but not as confining. The technicians were very helpful and supportive. I had some anxiety about an adverse reaction to the contrast dye, but they assured me of its safety. They mentioned a few patients get a metallic taste in their mouth. I am so glad they told me, because I did and almost freaked out!

Another waiting period. I should get the results of the MRI on Monday.

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MRI = Magnetic Resonance Imaging
MRI scans use magnets and radio waves instead of x-rays to produce very detailed, cross-sectional images of the body. During a breast MRI you may have a contrast material injected into a catheter in a vein (IV) before or during the exam. This improves the ability of the MRI to clearly show breast tissue details.

This first video link is for a general MRI:  
"What Is Getting an MRI Like" Video

This second video link is for a breast MRI:
Breast MRI Video



Thursday, April 3, 2014

"HURRY UP AND WAIT" TORMENT




April 2, 2013 was the date of that fateful mammogram and ultrasound indicating I had a suspicious solid mass in my left breast that wasn't present in my 2012 mammogram. Now came the "hurry up and wait" game. I had a previous biopsy (benign) by Dr. Mary Brian in 2002, so I felt confident in having her perform this biopsy. I wanted it right away, but reality check said I had to wait for an opening on April 24th. You can imagine the angst one goes through waiting. Somehow I knew this time I wouldn't be so lucky, but I tried my best to keep positive. I would deal with it.

Having had a previous biopsy, I knew what to expect during the procedure. I knew my luck ran out when Dr. Brian was very guarded in her initial assessment of the breast tissue specimens she removed. I had the biopsy on Wednesday, April 24th and would get the results on Friday, April 26th. More tormented waiting. Friday afternoon came and I hadn't heard from Dr. Brian's office, so I called. They checked and the lab was not done with its analysis, so I would have to wait until Monday for the results. I did a lot of praying that if it was cancer, that it was detected early and at a low risk. I became very specific in what I prayed for; such as skillful lab technicians, and for serenity and calmness during this waiting time. 

My husband and I visited with Dr. Brian on Monday, April 29th. Not good news. The biopsy report diagnosed it as a low-grade carcinoma in the left breast that was suspicious for invasion. I have a biology major, yet this information brought me to my knees. I felt numb. That one word, cancer; is devastating to hear.

Dr. Brian indicated I would probably need a lumpectomy followed by radiation....possibly chemotherapy, if it was in my lymph nodes. The biopsy wording "suspicious for invasion" was mind blowing. I wanted to know for sure, so Dr. Brian suggested having a MRI. The MRI was scheduled for Friday, May 3rd. Another tormented waiting period. I prayed for skillful MRI technicians, doctors, and that the cancer had not spread.

Wednesday, April 2, 2014

A YEAR AGO TODAY MY WORLD CAME CRASHING DOWN

A year ago this morning I had my annual diagnostic mammogram. After the mammogram and ultrasound, the doctor told me he thought it was probably a benign fibroadenoma, something a lot of older women develop; and not to worry since it hadn't been present in 2012. He suggested a follow-up ultrasound in 3-6 months or a biopsy - choice was up to me. My gut feeling was this is serious and I need to take action now. Dr. Mary Brian did my biopsy and was concerned with the "look" of the specimen, but she didn't want to speculate. The biopsy results confirmed our suspicions - carcinoma. CANCER is an ugly word you don't want to hear. Thus, the beginning of my breast cancer journey. 
Ladies, have you had your yearly mammogram? 
If not, schedule it today - it can be life saving!
From here on, I will make blog posts of my breast cancer journey in hopes that it will create more awareness and help anyone else who hears those dreaded words, "You have breast cancer."