Friday Update 9/30

I had my ultrasound at St. V's breast center this am.  The good news is that they didn't find any new areas of concern to biopsy.  The frustrating news is that I had a lot of breast tissue show up on my mri results that could be normal due to hormone changes in breast tissue, but she said she couldn't say with 100% certainty that was the case.  So, I have to have my mri repeated in about a week.  I am okay with that- my goal is still do to breast conserving surgery if possible and I have to wait another week anyway for my breast cancer gene results.  Again, thank you for the prayers and thoughts.  They must be working since I know many of you have been praying for my peace of mind and getting my ultrasound done this am vs. waiting another ten days was huge, especially since I have to have my repeat mri scheduled at a specific time.  Now I am off to work to finish out the day there- man I am ready for the weekend!!!

Thursday 9/29

I can't even begin to explain the survival reaction that kicks in when someone tells you that your life is endangered.  I was given an appointment of October 10th for my next ultrasound to look at the spots of concern from the mri and I lost it.  My wonderful friend and family doctor spent at least an hour on the phone this morning trying to work in an earlier appointment, or trying to get my ultrasound done at Hendricks again, without success.  So much love and appreciation J!  I can't help but panic about the waiting.  The doctors keep telling me that it's going to be okay, but what if it's not?  What if scenarios run through my head constantly.  It's exhausting.  And I know there are people far worse off than me finding out they have stage 3 or 4 breast cancer, and I am so thankful to live in this country with the amazing technology and medical care available.  But my survival mode overshadows all logical thought.  Then out of the blue at 4 pm, the nurse calls and asks if I can make it to an 8 am appointment tomorrow morning for the ultrasound/ possible biopsies.  Um, heck yeah!  Again, good news has become relative.  But I am so thankful that she went the extra step to plead my case for me to help move things along more quickly.  So in case I have missed any information, to recap:
13 mm x 17 mm tumor found at 9 o'clock position on right breast by self breast-exam
Invasive ductal carcinoma, moderately differentiated, stage 1
Estrogen receptor and Progesterone receptor +, HER2 negative
All other lab work and chest xray normal
34 yrs old,  only family history is maternal gma at 90 (doc said it didn't count!)

P.S. Thank you to my friend at work for my beautiful pink ribbon bracelet and my family for the beautiful and delicious cookie bouquet! 

Not what I wanted to hear

So my doctor calls this afternoon to let me know that she has received the mri results.  She said they found two small (5 mm) areas at the 12 o'clock position on my right side that they were unable to determine what they were.  So I have to go back to ultrasound.  I guess it's the best way to diagnose breast tissue abnormalities.  I'm grumpy about it and grumpy about waiting.  I am going to have a much more difficult time if these other areas come back malignant as well.  I know I would be looking at mastectomy vs. lumpectomy and just mentally I would feel like it was so much more invasive.  Prayers and positive thoughts please!!!!

MRI Tuesday- Sept 27th

I have my breast MRI today at 11:15 am.  My housekeeper comes on Tuesdays, so I leave early and head over to St. Vincent's.  It was a great plan until I realize that I forgot my CD of mammogram and ultrasound pictures from last Tuesday at home.  So an hour of extra driving later, it's time for my appointment.  An IV is started in my right arm and my kidney function is tested for the contrast dye.  The table for the test is not terribly uncomfortable.  I lay face down and there are two "cupcake holders" in the table, and a massage-table like cutout for my face.  Too bad I'm not here for a massage!  The worst part of the test was the dye injection.  It was cold and I felt it go through my whole body, I even tasted it in my mouth.  The other uncomfortable feeling was the heat that gets produced from the magnets after a while.  I just kept wondering how much hotter is this going to get?  I have been so in awe of the technology since my diagnosis.  This MRI will be taking a very detailed look at all of the breast tissue on both sides down to the chest wall and including the lymph nodes.  I was told that the abnormal cells absorb the dye faster than normal cells, so a series of five pictures is taken.  I should have the results in 24-48 hours. 

The fun part of visiting St. Vincent's Breast Center was getting the cutest shirt that said "Fight like a Girl!"  They had everything you could imagine, PJs, scrubs, sweat pants and shirts, jackets,etc and the proceeds benefit breast cancer research and prevention.  You can also order things on their website at www.signifypink.com.
Back to teaching Zumba classes tonight...

More results Monday- Sept 26th

I was surprised to hear from my doctor today with more detailed results from my biopsy.  I wasn't expecting this information until next Tuesday.  My tumor is estrogen and progesterone receptor positive, HER2 negative.  It's funny how relative "good news" has become. But from what I understand, the hormone receptor positive breast cancers tend to respond better to treatment and are less aggressive.

My appointment with Dr. Tigges- Friday 9/23

I woke up feeling like a different person today, just knowing I had my appointment.  We met with Dr. Tigges, a surgeon who specializes in breast cancer surgery, and he was phenomenal.  I am reassured that I will be okay to wait the 2 weeks for all of the tests to get done so we can make the best decisions when it comes to my treatment plan.  His nurse coordinates all of the treatment for his cancer patients and I am relieved to have a singular go-to person when I have questions or need results, etc.  Again, I am amazed at all of the resources, help, and support I have been offered.  I have a chest x-ray done to check for metastasis (it came back normal) and blood work done to check my liver, kidney, and bone marrow function.  I also have the breast cancer gene blood work drawn and an MRI scheduled for next Tuesday.  Ryan and I drive out to Danville to pick up copies of my mammogram and ultrasound pictures.  What a tiring day, but I feel like I have accomplished so much in the last 48 hours.

Waking up with cancer- Thursday 9/22

Today has been the hardest day yet.  I wake up in the morning and realize that I still have cancer.  Just still doesn't seem possible.  I wish I could just wear a shirt today announcing my news or have a big sign float above my head so I don't have to keep repeating myself over and over.  I think the look on my face tells everyone anyway.  I am overwhelmed with the care and concern that my coworkers show me...food, cards, beautiful flowers, and tears and hugs.  But as significant as this day feels, I have to still keep on with my normal duties at work.  Unfortunately, the ache that remains from my biopsy is kind of a constant reminder of the news so I can't ever just let it go.  So, continuing with my impatience, I call my doctor at 10:30 am and again at 11:50 am to see if she had spoken with the doctor she is referring me to.  I finally get a call about 1:30 pm and so gratefully have an appointment for 9:15 am tomorrow morning.  An enormous weight lifts off of my shoulder and I feel that I finally have the start of a plan.

Patience is not a virtue of mine- Wednesday 9/21

Thank goodness I have a student nurse in my clinic with me all day on Wednesday.  We have such a busy day that I am okay until after lunch and I start thinking about the status of my results.  I text my doctor to beg her to check with the pathologist just by chance my report was finished.  About 2 pm I found out that the report was complete and just waiting for the pathologist to sign off on it.  My heart did not stop pounding until she called me about 5 pm with the results:  invasive ductal carcinoma, the most common type of all breast cancer.  Unfortunately, I was not surprised to hear the results. I couldn't contain my emotions about the news, so I told the boys that I had a spot in my right breast that wasn't supposed to be there and that I would have to have surgery to have it removed.  J.R. started crying because he didn't like to see me so upset, Brady seemed to take the news okay.  I was so thankful that neither of them had difficulty falling asleep.  I start the exhausting task of telling my friends and family. 

Mortality 101

Tuesday, Sept. 20th at 8:15 am
I am driving to my appointment and I have such a sense of peace today. I listened to a comedian on Bob and Tom all the way and was laughing so hard...a dad talking about the inhuman strength of a stubborn four year old on the toilet and a two year old that started all of his sentences with "Hear this..."  I arrived at the Hospital and  had to wait in an education room with three old women for my mammogram and Seasame Street was playing through my head-"One of these things is doing the wrong thing, one of these things just doesn't belong."  The mammogram itself wasn't bad at all, barely uncomfortable.  But the minute the radiologist came in and started feeling my armpit, I knew he was feeling for enlarged lymph nodes.  I knew at that moment he was concerned about what he saw on my mammogram and I can't even begin to describe the feeling of dread, worry, and disbelief that settled in my stomach.  I was taken to the ultrasound room and the ultrasound tech was so quiet during my ultrasound.  She had to know I was crying by the way my chest would heave as I was trying to suppress a wailing sob, but again, what would you say if you were looking at a screen with information that would change someone's life?  The radiologist came back saying that it definitely appeared malignant on the ultrasound.  He had the most amazing bedside manner and was so caring in the way he was trying to gently unravel my world and tell me that I had breast cancer.  At this point, all I could think about was how in the world I was going to explain this to my boys.  I never stopped crying for the rest of the time during my biopsy, follow-up mammogram or after care instructions.  Ryan said he knew it wasn't good news when everyone in the office was crying-the receptionists, the nurses, me...I just needed the world to stop for even a moment so I could take in what I was hearing, but it never did.  I left knowing to expect the pathologist report on Thursday morning.  At least in the parking lot and in the car I could finally let my sobs out.  Thank goodness for my husband's chest-it's the one place I feel small and completely taken care of.
As I said, the world keeps turning, and the boys come home from school.  Their ignorance comforts me as they run around the house wrapped up in blankets as "The Amazing Burrito."  Everyone I have talked to keeps telling me that the doctor is probably wrong and that it's just a big scare.  I hold on to this itty-bitty fragment of hope so I can keep one foot moving in front of the other.

Dr.'s Appointment

September 14th, 2011
It's the day after Brady's 7th birthday and I bring my concern to my doctor, who is my friend.  I was a little upset by the fact that she said "Yeah, I don't like that," after feeling the lump and offered me no reassurance whatsoever.  Looking back, I guess it's a good thing that she didn't tell me that I would be fine considering she didn't know.  I am starting to panic a little now that I have a mammogram, ultrasound, and biopsy ordered.  When she called the next morning with my appointment, I was frustrated that it couldn't be scheduled until next Tuesday.  I hung up the phone at work and cried.
I felt better after sharing my concerns with my co-workers.  I was surprised at how many women have been through this scare and come out okay.  In the back of my mind though, I was thinking that somebody has to make up the 15-20% in the other category.  It's amazing how I think sometimes you just know.

Subtle changes

Okay, so it's the end of August and crazy doesn't even begin to describe my world at this point.  Setting up my clinic for the year, boys starting cub scouts, teaching four zumba classes a week, J.R. in basketball and guitar lessons, Brady starting a new school, both boys in high ability classes, Ryan overwhelmed at work and busy with an amazing adaptive rowing clinic.  It's amazing I even noticed this subtle change...for some reason after nursing both boys my right breast stayed noticeably smaller than my left, maybe not quite a half-cup.  Strangely, my right breast was suddenly the same as my left.  That's interesting, I thought.  So I performed a half-assed self breast exam and definitely felt something different.  A small irregular lump at about the 9 o'clock position on that side.  Okay, I thought, probably a cyst, or a benign tumor since according to my wonderful internet research, 80-85% of all lumps on women under 40 are benign.  I was surprised at how calm I stayed, but I waited for about two weeks to make my appointment with my doctor.  Partly because I wanted to see if I noticed any change in the lump during hormone fluctuations, but of course, in the back of my mind I was afraid.