Trust in the Lord...

Graphic from lesleygrainger.com

Tomorrow is another big day for me.  Surgery is scheduled bright and early. Although many women have hysterectomies at age 40, mine is a direct result and recommendation from my breast cancer diagnosis.  It's another "what now" added to the "will this ever be over?"  Over the past few days, people have asked, "Are you scared?"  Truthfully, the answer is NO!

Since I was a teenager, my favorite Bible verses have been Proverbs 3:5-6. We have most likely all read these verses in Proverbs and perhaps even committed them to memory.  Over the past two years, these verses have come to have an even bigger significance to me, and their meaning guides all of my decisions.  My prayers have been answered, and I know without a doubt that God led me to some incredible people in my life.  

My surgeon, oncologist, radiologist, gynecologist, health personnel and new friends have all been placed in my life for a reason.  I have been blessed with my medical referrals, and I truly believe that the Lord led me to these individuals.  Therefore, when told I need surgery, I am trusting in the Lord.  (I still get on the Internet and educate myself, but it is not to second guess the decision that has been made.)

In some ways, I am looking forward to the benefits of having a hysterectomy and oophorectomy (removal of the ovaries).  Since chemo began in October of 2011, I have been in what I like to call "Chemo-Pause".  My cancer is fed by estrogen and progesterone,  so I have also been on Tamoxifen for 18 months.  That medication stopped my ovaries from producing estrogen...so I have been experiencing all of the menopausal symptoms.  I have extreme mood swings (just ask Jeff and the children), my own personal summers (love my little fan that sits on my desk at work), and no cycles.  The lack of cycles has led to endometrial hyperplasia, or a thickened uterine lining, which can lead to cervical cancer.  I had a biopsy back in July, and the results were benign.  Having surgery will eliminate the pelivic pain I have been having, and more importantly remove another site that cancer might grow in my body.  Unlike Angelia Jolie, my cancer is not genetically linked, so I didn't have a hysterectomy immediately after diagnosis with my mastectomy.

A hysterectomy won't solve all of my problems (I will still be an overweight, stressed out wife and mother with curly hair, one breast, a right side that is covered with a mastectomy scar, radiation scarring and hard as a rock - what the doctors call "woody"), but it will eliminate many.  Are there complications, yes...more than I wish to think about, but I am choosing to "Trust in the Lord".  When we turn problems over to God, we can't keep "taking them back" to work on ourselves.  Does God present us with opportunities to help ourselves, yes...but I choose to trust HIM to lead my path and make decisions.

Report time is 5:30 a.m. Monday morning.  My surgery will take place at the Medical Center of Central Georgia.  Dr. John Slocumb is my gynecologist who will perform the surgery. He is very personable and has a wonderful southern drawl!  The plan is that I will have a robotic hysterectomy, using the daVinci system.  This is minimally invasive and has a quicker recovery time.  However, until Dr. Slocumb scopes around, he won't know for certain if that method can be used or not.  Fortunately, he is going to "look around good" for any other possible issues while inside my pelvic region.  My wonderful mother is here to be my personal nurse-maid, so I know that I will be in great hands.  After surgery, I will have to spend one to two nights in the hospital, and then will be released.

As I begin my list of things to do prior to surgery, I have a sense of calmness.  I am trusting in the Lord!  If there are complications or issues tomorrow, I know that with His help, and the love, support and prayers from my family and friends, things will be ok.

During my vacation over the next few weeks, I plan on catching you up on everything that has happened and the future plans.

Please remember me, my surgeons and my family in your prayers tomorrow. I know that I will be surrounded by your love!  (Also, say an extra prayer for me this afternoon / evening as I begin my pre-surgery requirements. Spending the evening with a bottle of Miralax and a gallon of Gatorade will be so much fun!)

TTFN,

-S

Woman With a Power Port Coming Through

Monday morning, at 5:45 a.m., I report to the hospital for outpatient surgery.  Dr. Martin will be inserting my "Power Port", which is an implantable device that will make life easier...or so I've been told. 

One of the side-effects of chemotherapy is that your veins are often damaged during the process.  This especially happens when drugs are administered intravenously.   My oncologist wants me to have an implanted catheter inserted to assist with chemotherapy, as well as with blood draws and injections.

The surgery takes approximately thirty minutes, and is performed as an out-patient procedure.  While under general anesthesia, a small port will be inserted into my chest.  An incision will be made on my left side, and the port inserted.  Looking at the picture, you can see how the port inserts directly into a vein.  Think of it like a permanent IV for a while.  The port will be one of my lifelines.  Chemotherapy treatments and any "sticks" will use the port after it is inserted.

It is a triangular shaped object, and has three raised "bumps".  Providers and nurses can feel the bumps under the skin, and then know where the "hole" is.  One of the best things is that I have been prescribed numbing cream when the port will be inserted.  The cream is applied approximately thirty minutes prior to my appointment, and will numb the skin over the port.  After the cream is applied, I have been instructed to place a piece of plastic wrap over the site.  There will now be a roll of plastic wrap in my first aid supplies!

Monday afternoon, I have another appointment with Dr. Jones, my oncologist for final instructions before chemotherapy.  My first chemotherapy treatment will be Thursday, October 6. 

After Monday's surgery, I may have the power to set off security alarms, due to the small amount of metal in the port. Security systems may or may not pick up the metal, but I will have the medical information card to show authorities.  It's not a weapon setting of the security system, just another one of the perks I'm getting during this cancer diagnosis!

TTFN,
-S

Down the Drain

When I began blogging about my journey with breast cancer, I wanted to make certain that I was real.  My feelings and emotions expressed through my writing are real, and I don't want to sugar-coat the experience.   This is as real as it gets...I can't just pick the days that I want to have breast cancer, nor can I just pick the parts of surgery, recovery or treatment that I want to experience.


As I asked other survivors, patients who had breast surgery, and researched on the Internet, everyone and every article mentioned the dreaded "surgical drains", and how they were the worst part of the entire experience.  You may think this is too graphic, too much information, or that I shouldn't include this, but as my goal has been all along...this is real.  Drainage tubes are a very real part of my recovery...and therefore my blog.


A drain was inserted underneath my arm.  It is secured with a stitch, and apparently ropes through my breast area, underneath the skin.  The drain helps release blood and lymphatic fluids that could build-up up in my breast area, causing swelling, discomfort and possible infection.  You can read more about mastectomy surgical drains here.  The empty drain looks like a grenade, and the suction pulls down fluid through the drain.

  

 My surgical camisole has pouches for the drain, but I also received several hand-made pouches from the hospital.  Volunteers make the pouches and give them to mastectomy patients.  These are just cloth pouches with a ribbon that hangs around your neck or arm.  They are machine washable, so it's not a big deal if you get them wet or fluid on them.

 The drain has to be emptied, and the contents recorded.  The color will change from dark red (Wednesday and Thursday) to a more light color; right now it's turning orange-red.  There may also be solid bits of clots or tissue mixed in the fluid.  Each time the drain is emptied, the amount and time must be recorded.  The drainage tube usually remains in one-two weeks, so I hope that it will be removed at Thursday's appointment.


It has been a family effort to empty the drains.  I find that I like them emptied every 2-3 hours, as the weight tends to start pulling a bit on the stitch.  We've attempted several different things today, and have discovered that a piece of gauze cut around the point of insertion helps distribute weight evenly.


After each empty, the amount is measured in a specimen cup, recorded on the log and then discarded.  Arleigh has taken it upon herself to be the official "disposer"...and tells everyone it's "her job" to pour the contents into the toilet and flush!


I am very fortunate that my parents have been able to be with us during my recovery.  Mom and Dad were able to attend the "Grandparent's Day" breakfast with Griffen yesterday, and then watch Adelia perform with the "Marching Greyhounds" last night at the home football game.  Arleigh is enjoying having full access to Nana's jewelry and perfume, too!  Many of you know how Jeff's work schedule is, so having him home 24/7 is a great treat for the children.  Spending time with my family are sprinkles on my day, as are the prayers, cards, messages, emails, flowers and homemade goodies that friends have gifted us with.  Thank you!


As with most pain medications and surgery, I'm a little "behind" schedule in certain areas.  So far, no amount of Colace, watermelon, mixed green salad or raisin bran has helped.  Please pray that this will be remedied soon!

TTFN,
-S

There's No Place Like Home

The past two days have been a blur, as you can imagine.  I'm on painkillers (Jeff is spinning a little as I'm typing this), so you'll have to forgive any incoherent sentences or thoughts in this post.  Maybe it's the drugs, the experience, or exhaustion, but my last few days have been very similar to The Wizard of Oz.  Part of it is in sepia, and part in technicolor.  I'll try to share as many details as I remember, and get you "up to speed" on the details.


First, THANK YOU to my incredible guest blogger, Adelia.  Her post was great, and I hope you enjoyed reading it!  (Adelia generally edits my posts after writing, so she is very familiar with my blogging process.)  Hopefully, I can convince my daughter to write additional posts and share her thoughts with you, as cancer is a diagnosis that affects the entire family.


 We reported to the hospital at 8:45 a.m. on Wednesday, and were assigned a room in the day hospital. 



There, I received a fabulous new outfit!  As Arleigh would say, they certainly didn't match!


 As with the entire experience at Coliseum, everyone was so nice and attentive.  I felt like royalty.  Two special nurses  kept coming in checking on me and my family. One is a fellow band-mom and the other is a relative of a co-worker.  The fact that they took the effort to seek me out and ask if my family or I needed anything made me feel very special.  Thank you ladies!

About 10:00 a.m., Dr. Martin came in, carrying a little radioactive lunchbox...or that's what it looked like.  (Kind of reminded me of my old Snoopy lunchbox that I had in elementary school.)  He cleared the room, and then injected the tumor and right breast with a radioactive material.  I have a fairly high pain threshold, and it was painful!!!  Dr. Martin apologized, and said that was the most he would hurt me all day.  The injection itself wasn't painful, but as the material spread throughout, it was agony and brought tears to my eyes.  Dr. Martin was ahead of schedule at that time, and stated it...well, you know what happened next...one thing led to another, and finally around noon they took me to the area "waiting" for surgery.

 In the waiting area, I really wished I had my cell phone with me.  Dr. Martin had to come in and initial the "area to be removed, per hospital policy.  That would have certainly been a "Kodak Moment"...there is my black and blue breast (still bruised from the biopsy three weeks earlier), and he has to write "KM" on it.  Like I said, it was a Kodak moment.  I had to wait for what seemed like forever in the surgical waiting bay.  Lots of women were in labor, and it seemed as if every anesthesiologist was busy putting in an epidural somewhere in the hospital.  I finally had my anesthesia consult, and then it was show time!

Another nurse wheeled me from the surgical waiting area into the operating room.  I remember going through double doors, into the operating room, and seeing my nurse anesthetist (because she had a funky skull cap on).  There was another surgeon in the room (I think I recognized him as a plastic guy, asking something about staples) and that's all I remember!  (Guess this would be the end of the sepia part in The Wizard of Oz.)

Cue music, and then I open my eyes in the recovery room, and everything is in technicolor!  (Did you know that it is no longer called "recovery", but "PACU"?)  PACU is the acronym used for Post-Anesthesia Care Unit.  I remember waking up, then Jeff being there.  After a while, my Mom, Adelia and Daddy all came in to see me, also.  As time passed, we are told there was no room on the postpartum floor (where mastectomy patients are usually placed after surgery), so I would be put in a room on the surgical floor.  (Remember earlier, when all of the anesthesiologists were busy putting in epidurals???)

I do remember speaking with Dr. Martin in PACU.  He was very pleased with the amount of skin he was able to save, and even mentioned that he told Dr. Powell (the Plastic Surgeon) that he left him a good bit for reconstruction.  Dr. Martin said that he expected my cancer to be staged at IIA, (but then he said he heard I already knew that!)  He also put a compression bandage on my chest after surgery, which is not usually done.  Apparently during the radioactive tests, five nodes absorbed the dye.  Of those, two lymph nodes were positive.  During surgery, six lymph nodes were removed from under my right arm.  (I'm still fuzzy on all of this, and will get clarification during next week's appointment).  Just because there were cells in those lymph nodes, Dr. Martin stressed it did not mean there were cancer cells elsewhere. 

I was placed in my hospital room around 5:00 p.m., and this sign was directly at the foot of my bed.  Thing were going ok, pain was minimal, and then the nausea began.  Anesthesia always makes me nauseated, so they administer extra meds during surgery and after.  I've learned this the hard way through the years with dental, sinus and even my tubal ligation surgery.  (If you haven't experienced the terrifying experience of vomiting after surgery, I pray you never do.)

I began getting sicker and sicker.  They were administering nausea meds, in addition to Demerol, but it just wasn't working that well.  It would come on, and then ease off.  One nurse even had me "sniffing" alcohol pads.  She recently read a study where the smell of alcohol helped with nausea, and I have to admit that there were numerous times throughout the night that it did help ease my nausea. A call to Dr. Martin late Wednesday evening added some additional nausea medicine, but it was still a very long, long night.  (How I longed for some Phenergan.  Did you know that it is not used in hospital IVs, due to damage sustained when administered via veins?). 
 
After a very, very, very long night, my pain medication was changed, as perhaps the vomiting was due to a reaction to the Demerol.  Dr. Martin came in for morning rounds, and was very pleased with the incision, and removed the compression bandage.  He said I was ready to go home and rest!  After Dr. Martin's visit, a representative from Chichesters (a local medical supply business) brought my surgical camisole, a medical case worker and Kim, my Oncology Nurse Navigator, all came to visit around the same time.  Kim continues to impress me with each visit, and this one was no different.  (She even took over "basin duty" from my Mom and Jeff, during several of my episodes while visiting.)

A change was made to my pain medication, and we were able to leave the hospital around 11:15 a.m.  I had on my new breast insert, inside my post-operative camisole, as we left the hospital.  On the way home, I took a Phenergan, per Doctor's orders.

Saying "Thank You" for your prayers and support is just not adequate, as I finish this first phase of my breast cancer treatment.  My next appointment with Dr. Martin is Thursday, September 15 at 1:40 p.m.

 We finally made it home, and just like Dorothy, I had to admit that  "there's no place like home!"

The Transition from Two to One

So, Mom asked me to be her guest blogger tonight while she is in the hospital.  This will probably be nowhere near as good as her previous blogs, but I'm going to attempt it anyway.  Here goes nothing!

After Mom woke up and battled a case of hiccups for 20 minutes this morning (it took so long because she couldn't drink anything!), we made it to the hospital around 8:45 a.m.  She then got checked in, was given her "hospital jewelry", and taken into a Pre-Op Room.  We waited for 4 hours while Mom got her IV started, followed by her radioactive injection, which would be picked up by the lymph nodes so that they could be examined during surgery.

Around 12:45 p.m the nurse came and wheeled her into Holding.  There, she had to wait forever (or so she says...:) until an anesthesiologist was available, because so many of them were doing epidurals in Labor and Delivery.  To pass the time, we all went and ate in the Cafeteria (my first and last time), came back, and then waited.  And waited.  And waited some more.  At about 2:15 we got a call saying that Mom had been been in the OR for around 10 minutes, and that we should be getting another call soon about the lymph nodes status.

It never came.

We waited (anybody else sensing a familiar theme here?) until about 4:15, when there was a knock on our door.  Dr. Martin himself walked in to update us on everything: Mom had minimal bleeding, no complications, etc: a good surgery in general.  The lymph nodes, however, were another story.  During the MRI, a suspicious-looking node was detected.  Out of five lymph nodes that absorbed the radioactive injection, two tested positive for cancer.  Dr. Martin said that as a precaution, he removed other additional nodes under her arm.  He also said that if he had to guess, her cancer would be at Stage 2A.

From that point on, things went pretty smoothly.  Mom woke up from the anesthesia in Recovery with limited nausea, which was fixed right away with some medicine, along with painkillers.  (Her pupils were so small it scared me!)  An hour later, she was transferred to her room for the night.  She threw up a little and felt very dizzy, but it soon passed; when I left around 7:15, she was doing fine.

Since then, Mom has thrown up more and had lots of dry heaves, but is now asleep. We are so appreciative of all the prayers, love, and support that have been received -  Mom is amazed by it every day.  We now pray for her to have a speedy and relatively easy recovery, so that she can be one step closer to winning this battle.  Thank you again for helping us get through today, and hopefully Mom will be able to blog tomorrow night!

TTFN,
-Adelia

Thirty Six Days...From M to M

Tomorrow is THE day...the day that I have my right mastectomy. The day that my breast will be removed, due to Invasive Ductal Carcinoma.  After surgery tomorrow, I will no long have breasts, but a breast.  For 38 years, my breasts have been part of my body.  They have been part of my sexuality, and have given my children nourishment, comfort, and a built-in pillow (as Griffen says!).  Apparently, my right breast is also trying to kill me.

In 36 short days, I will have gone from my first mammogram ever, to a skin sparing mastectomy of my right breast.  A self-breast exam most-likely saved my life.  (Speaking of that, have you completed your SBE lately?)  As much as I think I am prepared for surgery tomorrow, I know that I am not fully prepared for the realization that I will wake up from anesthesia, with only one breast.

I am to report to Coliseum Medical Center at 8:45 a.m., Wednesday morning.  All of my pre-op admission paperwork, blood work, EKG, etc., were completed on Friday, so that's out of the way.  From what I have been told, I will receive some IV fluids for approximately two-hours.  I will then receive an  injection of a radioactive substance for the sentinel node biopsy.  Read more about it here.

My bag is packed, and I have a list of last minute things to pack in the morning.  I'll wake up in the morning, and try to have a "normal" school morning for Griffen and Arleigh.  We have decided to let Adelia accompany us to the hospital, as she certainly won't be able to concentrate at school tomorrow, anyway.  My wonderful parents have been here for a few days, and will be there for support and comfort...not only for me, but for Jeff and Adelia, also.

I am humbled my the continued outpouring of prayers, well-wishes and love from my friends.  To say "thank you", is not sufficient.  As always, I know that the journey I am traveling, is much easier knowing that I have God and the support system that I do.

My Facebook will be updated throughout the day tomorrow, and maybe I will be able to blog.  If not, look for a guest blogger!

God bless you,
TTFN - (guess that tomorrow I'll be TFN!)
-S

The Results Show - Part One

My children like reality shows.  Adelia and Arleigh love "So You Think You Can Dance".  (They even picked Melanie as the winner from day one!).  Griffen loves the survival type shows, especially "Top Shot" on the History Channel.  Jeff enjoys  some of the BBQ / Cooking shows.  You might also find our television on America's Next Top Model or American Idol.   Generally, after the season is over, there is a "Results Show".  The show is over-hyped, advertised widely, some entertainment factor, and then you find out who wins.  That was kind-of like my appointment today...

In my mind, today was going to be a traumatic event.  I was going to schedule the removal of my breast.  Through my blog, my fears were shared with you, and I felt your prayers today.  My parents came to the appointment with me, and there was a calming peace throughout the entire process.  I know that my peace came from the blanket of prayers surrounding me.

So, here's Part I of my "Results Show"...

Tentatively (confirmation will be received tomorrow), I am scheduled for a right breast mastectomy on Wednesday, September 7.  The left mastectomy will be performed at the time of reconstruction, at a later date.  My HER2 results are negative, which is great news! (HER2 positive breast cancers are much more aggressive and less responsive to hormone treatments.)  Dr. Martin will perform a "skin sparing mastectomy".  This type of surgery conserves as much of the breast skin as possible, for later reconstruction.

From my MRI, there is an additional suspicious area and lymph node.  Dr. Martin believes that these areas are a result from trauma the breast received from the core needle biopsy.  Regardless of the outcome, the surgical procedure will remain the same.  The surgery will last approximately 90 minutes.  Only the breast tissue is removed, not any of the muscle beneath the breast tissue.  I will stay overnight in the hospital, and then be released.

The morning of surgery, after routine IVs begin, I will be administered a radioactive injection (more glow sticks!), and then during surgery, a medical-type geiger counter will be used to identify the suspicious areas.  They will also take a biopsy of the Sentinel Node during surgery.  This sample will be frozen immediately in the operating room, and then tested.  The results will be known prior to the completion of the surgery.  If the biopsy is positive, then the lymp node will be removed.  This is very important, as it will determine treatment.

The pathology results will be known 2-3 days after surgery. (That will be Part II of the Results Show)  From the results, the oncologist will determine the best treatment plan.  There is a possibility of just chemotherapy, or a combination of chemotherapy and radiation, depending on the results.  The best part is that recovery from the surgery will be less than four weeks, and that pain is minimal...compared more to muscle pain after strenuous exercising.(Like I'd know anything about that!)

Dr. Martin was very reassuring to my parents, and they are very impressed...especially the fact that he shared his faith with them during the appointment.  He stated that God is the Healer, he is only the tool, and that he uses his God-given gift  to help others.   Any surgeon who doesn't believe in God, is just one blood-vessel away from knowing differently!  (How's that for a testimony?)

The Cancer Center is calling tomorrow to schedule my Breast Cancer Gene Test (BRCA).  I'll write more about that in a later blog.  The results of the genetic testing can affect my mother, sister, and daughters, as well as my ovaries!

Dr. Martin assured my Mom and Dad that he would take very good care of me during surgery, and would make certain that the other members of my treatment team would continue in the same manner.

I don't have all of the answers to my questions, but I have the ones that matter.  It reminds me that everything is in HIS time, not ours!

TTFN,
-S

Search for Tomorrow

This soap opera ran from 1951 to 1982 on CBS.

When I was a little girl, my days were spent with my "Grandma McCracken".  Grandma was of no blood relation, but a relation by choice.  My Mom or Dad would take me to Grandma's house in the morning, and pick me up in the afternoons.  She would sit at her dining room table (which was situated so she could see into the living room) in one of her "house dresses", and I would sit or sprawl on the couch.  I loved the couch, because if you sat in the right place, the chilly air from the air-conditioning window unit would blow directly on you.  As you can imagine, she spoiled me, though I prefer to call it "overly-loved". 

Thirty-plus years later, when I think of my days with Grandma McCracken, I think of buttered rice, cake batter (no beaters for me, she gave me my own small bowl of batter), and soap operas.  Some days, we spent running errands in a twenty-mile radius, lunching at coffee shoppes (she with her coffee and me with my hot tea), or visiting with her friends, but generally we were always back home in time for the "Soaps".  Right after the "Mid-day Report" on WCTV,  the stories began.  I remember watching Search for Tomorrow, Young and the Restless, As The World Turns and Guiding Light.  Referring back to my old soap opera watching days with Grandma McCracken, I think a fitting title for this episode of my life would be "Search for Tomorrow"!

Tomorrow is my doctor's appointment with Dr. Martin.  It's the biggie!  The appointment where I find out the official results of my tests, hear my treatment plan, ask my questions, and schedule my surgery.  Jeff is finishing up training out of town, so Mom and Dad are going to the appointment, also.  (I think it will also give them peace in meeting the man who will operate on their "baby".)

I've been researching, emailing other breast cancer survivors, and reading to compile my list of questions for tomorrow's appointment.  This is what I've come up with.  (If you can think of others, please email them to me!)

Shelby's Questions (AKA "Search for Tomorrow")

1. Cancer Type:  Invasive Ductal
2. Location:  Right Breast
3. Tumor Size:  2 to 3 cm
4. Grade:  2 (medium growth)
5. Stage:  ???  (I'm guessing possibly Stage IIA, based upon my research)
6. Hormone Receptors:  Estrogen 100% +, Progesterone 90% +
7. HER 2 Status?
8. HERS2 Status based upon what tests?
9. Lymph Node Status?  (So far, he has said none, but I want to be certain.)
10. Second opinion for Insurance status?
11. Length of surgery?
12. Reconstruction at same time of mastectomy?
13. Length of Time in Hospital?
14. Recovery time?
15. Recovery advice?  (Drains, I know, but what else?)
16. Chemotherapy details?
17. What type?
18. Begins when?
19. What side effects?
20. PET scan of entire body when?
21. What about my daughters?

Please pray for my strength during tomorrow's appointment.  I also pray that my parents and I have a peace about the treatment plan, that all of my questions are answered, and that surgery is scheduled in a way that accommodates all parties involved :)

Tomorrow is as real as it gets, folks!  Presumably, when I walk out of Dr. Martin's office Tuesday afternoon, I will have a date and time to have my breasts removed, and my search for answers will be over.

TTFN, (Literally, only for a while longer!)
-S