I am currently in the truck on the way home from a long yet successful day. After dropping the kids off at the bus stop at 6:45am Lenny and I headed down to Evergreen to drop Charlie off with my mom for the day.
My first appointment was with a Medical Oncologist. Going into the appointment I was not sure why I would need two oncologists. He explained to me he takes into account the entire body and how cancer has affected the body and radiation is just about the exact location and treatment of the cancer. He took the time to review my biopsy report and go over the same things my General Surgeon had explained. He explained each section with diagrams and great detail. He took over an hour with me to explain the importance of chemotherapy along with the two different types and to answer all my questions. I have an aggressive cancer where he believes chemotherapy may be part of my treatment. We have to wait on the pathology report from surgery to compare further results before I know for sure. He went over the short term and long term effects of chemotherapy.
- (Further detail on exact findings. This is for the friends and family who are asking exact percentages and details.) My estrogen receptors are 95%, progesterone receptors are 5%. I will be put on hormone therapy for 5-10 years. More than likely I will be on Tamoxifen. My Her2/nu cells are negative or not present. Her2/nu responds the best by chemotherapy. My KI-67 is 70%. Anything over 20% is unfavorable and anything over 40% is considered aggressive. This number alone can add chemotherapy as part of my therapy but the Medical oncologist wants to compare it to the Oncotype-DX test that will be conducted on the tumor once it is removed and will be included in the pathology report after surgery. Oncotype DX test can tell us the likelihood that I may benefit from chemotherapy, as well as the chances if the breast cancer will return.
I then met with a Radiation Oncologist. He too wanted to provide me with detailed information about what was going to take place and even stated he wanted me to leave feeling comfortable and knowledgeable about the road up coming. He told Lenny and I he was about to ask me a bunch of silly questions. Lenny responded well we are silly people. He chuckled. After the lengthy questions (which he only had a pad of paper and a pen to record all my answers.) he went over the certain types of radiation. Even said I may be a good candidate for a 5-day radiation (this would only be if chemotherapy is not involved and only if I have a partial mastectomy/lumpectomy vs. mastectomy). This 5-day radiation also known as brachytherapy or more specifically the SAVI implant. This would entail creating a cavity where the cancerous tumor will be removed. Then an implant of multiple wires/catheters would be inserted into the cavity and be left to hang outside of the body. It would deliver individualized radiation treatment from inside the breast vs. radiation from the outside in. It minimizes exposure to healthy tissue and reduces complications. (picture below shows an example breast with the cavity that has been created around where the tumor would be removed. The white marker in the middle of the implant represents how far it would go inside the body. The wires left outside would range from 7-14 channels.)
I would come to his office two times a day (6hours apart) for radiation treatments, which deliver the radiation through the external wires into the cavity. The bonus of this is that it is only 5 days vs. 5 days a week for 6 weeks, and that it allows for the radiation to be done only inside the body. This treatment has usually only been for 45 years and older but now they are doing a study for younger women. It sounded like a great option if it turns out I can go this route. He took one and half-hours with us, to explain so much and to answer all my questions. This was impressive to me and he had radiation patients coming in every 15 minutes and certain ones required his attention and he would politely excuse himself and quickly return. He gave me a hug when we departed and asked me how I was feeling. I felt like I wasn’t just another patient to him but one who genuinley cared about my health. He made me feel comfortable and I left his office feeling confident he is going to be yet another great doctor to work with.
It was approaching 1:30 and I was already behind on my appointments as I was to check in at the hospital for my pre-op appointment at 11:45. I had called before going into the radiation oncologist’s office as I was thinking I might get behind. My patient navigator was very flexible and said she would arrange the pre-op appointment around my other appointments. So I went straight to the Breast Care center where I was checked in for my first Mammogram. As I waited to be called back a lady came in and asked me if I was Tara. It was my patient navigator. She told me she wanted to come meet me here (claimed she was stocking me..lol) and asked me if I needed any lunch. We just went through the drive through but yet another reason I have been thankful to work with her. She had a huge bag of goodies for me. Ranging from a nice plush robe, 2 pillows to help with the seat belt and ride home after surgery, to many hand sewn bags I may need for drainage tubes if I have a mastectomy and a camisole that will help for comfort after surgery. She has been so helpful with so many things. She asked how my kids are coping with it all and said cancer is a big deal and kids need resources as well. I told her we have been treating this whole situation as just another obstacle in life yet not a big deal. She explained the importance of including the children. I know it has been affecting Austin a lot. I look forward to learning more about how to better accommodate our children’s needs. She sat with me also speaking about the importance of meeting with a genetic counselor if the BRAC 1 or 2 tests comes back positive. I explained to her I am starting to feel overwhelmed and am feeling rushed with so much packed in. If it turns out the best surgery is a mastectomy I will also need to meet with a plastic surgeon this week as well. She completely understood and said I will get all answers back this week in time for surgery Monday, just seems hard to digest if certain things go one way. The hard thing is just not knowing what surgery I’ll have and what treatment I will need. Everything seems to piggy back on the next thing. She hugged me as I was called back.
When I was taken back to the Mammogram I was again given the nice warm pink gown. Loved that part. I have heard how awful mammograms can be and was expecting pain with how hard the machine will press my breasts. She took 8 pictures total and in all honestly there was no pain just a slight discomfort but not bad at all. However, I was glad when it was over. The nurse who conducted the mammogram then waited for me to get dressed and said she would take me straight over to the MRI check-in. As we walked the hospital halls she told me I must have a “guardian angel in heaven.” I told her I believed it.
At this time I waited by myself to have the MRI. When the tech took me back I again had to change (4th time today). This time I had to put on scrub pants, two gowns and the awesome fall prevention socks. I felt fashionable! I then had to have an IV for the dye that would be administered during the MRI. The machine had two large cut outs where the breasts are to be inserted. The tech explained how to get onto the machine and left while I got situated. I had a lot of pressure on my face as most of the weight was distributed there since there was no support under my chest. It was awkward. I asked him if I was on the machine correctly as it was a bit uncomfortable. He said I was. He asked what type of music I would like to listen to and I said I don’t mind not having any. He said the machine makes a ton of noise and so I accepted the headphones. I have had one MRI previously when I tore my ACL in 2008. I completely forgot how loud the machine could be. There was no point in the music; the machine was louder most the time. I had to laugh, as I would catch some music every few minutes. Even going into the machine with my head down and eye closed I felt the closeness of the machine and by the way I was to be in this machine for an hour. I started to feel a bit anxious at the thought but just prayed and took a few deep breaths. Before I knew it the test was over. As I peeled myself off the machine, I felt sore and achy. I had to tell the tech my age is catching up with me.
I asked him when I would hear back with the results and he said my doctor would be calling me tomorrow. I asked how the IV dye impacted breast-feeding and he told me I was to pump and dump for the next 48 hours. There it was the hardest news of the day. Boom, just like that I can’t breast-feed. There would be no reason to return to breast-feeding in 48 hours as I am to be completely done by surgery. I thought ok, this is it, but it will all be ok.
He then waited for me to change before he took me to the pre-op office. The volunteer at that desk explained the nurses were gone for the day, as it was nearly 6pm. I did explain I was told to come straight here after the MRI, as someone was to do my lab work. She found a nurse for me and it was the nurse who said she had been waiting for me. Everything had gone so smoothly today it was wonderful. Since this appointment was to take place at 11:45a I had skipped checking into the hospital so we had to back track and the nurse said to come back after we had checked in. The check in process wasn’t just checking in, it took another 30 minutes, as I had to sign many more consents for surgery and go over the expected expenses. The business associate asked me if I had any recent falls. I told her I had fallen in love just recently with this guy (pointing to Lenny.) She didn’t seem to be in the mood for humor. We both laughed however.
I then met with the Nurse who had been waiting for me. She seemed so kind and thoughtful. She too said I know it’s been a long day for you and I hear you have a ways to travel home still. I told her I couldn’t explain enough how great everyone has been today and how appreciative I was for everyone to get me in and get everything completed in one day. She too had such a lengthy health history to go over with me. I have been asked a lot of questions today, many, which I don’t think, I’ve ever been asked. She then started another IV in the arm that wasn’t used for the MRI IV. I had labs taken and she went over instructions for surgery. I will have a procedure done first to inject dye into my lymph nodes before they are to take a few out during surgery on Monday. After my visit with this Nurse I was then to meet with a Physical Therapist. She too was great and had to take about 45 minutes to go over exercises for either a lumpectomy or a mastectomy. I felt confident Ill be able to do these exercises. The biggest draw back is with either surgery I can’t lift over 10lbs, which means no lifting Charlie. This is going to be a double whammy in her world; no breast-feeding and I wont be able to pick her up. However, we are praying I only need a lumpectomy as I can then carry her with my left arm within a few days after surgery. That will be grand and will work out well.
Lastly was a chest x-ray. I was taken by wheelchair there. Really? I surely didn’t need a wheelchair but its how things work there they said. So I asked Lenny if he wanted to ride with me as the wheelchair was like a mini loveseat on wheels. The chest x-ray was the quickest and easiest thing I did all day. Saved the best for last I guess.
We left the hospital closer to 7:30pm. I was hoping to be back to Granby no later than 6:30p. We grabbed a quick bite to eat, and that’s when it all hit. The day went perfect and now I was left with a bunch of mixed emotions. I felt the tears coming. I just needed a hug is all I told Lenny. I think the hardest part is just knowing Charlie won’t understand I can’t breast-feed her any longer. I’ve drug it out longer than expected. With plane rides and a busy schedule last week it wasn’t the time to try to wean and now I will stop cold turkey. The thought of my last breast-feeding was earlier this morning was to be the last was hard.
Charlie did wonderful all day with Nana. It was the longest I have ever been away from her. She took a long nap and went to bed for the night on time. She had a great time with no tears through the day. That was wonderful news. We grabbed Charlie from Evergreen and headed up the mountain.
I took the time to start this entry on the drive back and Lenny and I just spoke of things to come and things we need to get done as we are also going to be moving. It was a huge decision and really hard but its going to be the best thing for our family at this time.
We got back to Granby just before 10:00pm. Austin and Bailey were at our friend’s house. They took them home after school, let them play, do homework, read and cooked them dinner. Great thanks to Amy and James who were a huge blessing to us yesterday. They even cooked Lenny and I dinner and baked cookies.
I should be receiving answers today (Tuesday) and hope to get more things under way. I can’t even explain how appreciative Lenny and I are to have been treated with exceptional care yesterday. I thank everyone for the texts, support and love. The unknown of what surgery, and treatment lies ahead I still feel I am at peace. I know God is in control and has a plan just for me. The overwhelming part is the “to-do” list but taking one day as it comes with the patience God has given me, we will get through it all. I hope this entry finds everyone having a great day, and thanks to everyone who is reading this, please know you matter to me.