Post Op

     If you are just stopping in, this is the seventeenth post in my 31 Day Series:  I Wear Pink.  I was diagnosed with breast cancer on February 18, 2009.   This series is about my journey with breast cancer.  You can find the previous posts here.

Day 17:  Post Op

       One week after the surgery to remove the cancer in my left breast I went for my post op check up.  I saw the doctor and Sara.  There was a lot to go over and discuss.  I was healing well.  I had good use of my left arm.  The swelling had subsided somewhat. There were a few areas of blue stain remaining from the dye that had been injected and some bruising.  The surgical report was in.  Sara told me that I had a "busy breast."  First I was lumpy, now I was busy.  I preferred busy to lumpy. 

       During the surgery two sentinel lymph nodes had been removed.  They were both clear of cancer.  This was important because it was more likely that the cancer had not spread beyond the breast.  Had they been positive for cancer, a lymph node dissection (removal of the lymph nodes in the breast and underarm) would have been done as well and a drain would have been put in place.  The surgical pathology report confirmed that both sentinel lymph nodes were negative for tumor cells.

     The breast mass had been removed with clear margins.  The surgeons goal is to remove all of the breast cancer along with a rim of normal tissue around it.  This is to be sure that they get all of the cancer.  When the margins are clear no further surgery is needed.  This was also good news.

     In addition to the cancerous mass, the doctor had removed two other areas.  The first was a benign, non cancerous tumor.   The other was a precancerous type of tumor.  

     The surgical report also showed that the cancer was fueled by estrogen.  This meant that the estrogen in my body promoted the growth of the type of cancer that I had.   Hormone therapy would be prescribed for me by an oncologist to keep the cancer from returning.  Standard treatment for breast cancer is surgery, chemotherapy, and then radiation.  Now my busy breast was offered the possibility of a game changer.

      I was invited to participate in the Tailor x study.  This stands for: Trial Assigning Individualized Options for treatment Rx.  My tumor met the requirements for participation in the study. This study was for women with early stage breast cancers to determine if hormone therapy alone was as effective as hormone therapy with chemotherapy.  The tumor would be tested, the test is called an oncotype, to determine if the cancer was one that would be likely to reoccur.  The tumor is looked at the molecular level.  It would be rated.  Higher scores on the oncotype were more likely to reoccur.  A score of 10 or less would receive only hormone therapy.  Scores of 11-25 would be randomly assigned to hormone therapy alone or hormone therapy with chemotherapy.  Scores of 26+ would have hormone therapy and chemotherapy.  Agreeing to participate in the study meant that my tumor would be further examined to determine if cancer was likely to return.  That was information that I wanted to have.  There was also the possibility that I would have a low number and not require chemotherapy.  I agreed to sign up for the study.  I would find out the results of the oncotype at my first visit to the oncologist. 

Fall Camping

      Over Columbus Day weekend, we took one last camping trip.  We went to a Jelly Stone Park Campground in Gardiner, NY.  The weather was cold and a little drizzly.  Still, we managed to have fun.  The kids got in some reading around the fire.

     We had s'mores!  My family's favorite camp food.  This is one of the crispier marshmallows that were toasted.  

Charcoal marshmallow

      There is a lazy river that winds it's way through the back of the campground.  It was the perfect spot for  family pictures.

     The tree was huge.  

      My handsome husband.

      Flags at the camp store.

      Hey, Boo Boo!

     A wonderful weekend.

Caregivers

      If you are just stopping in, this is the sixteenth post in my 31 Day Series:  I Wear Pink.  I was diagnosed with breast cancer on February 18, 2009.   This series is about my journey with breast cancer.  You can find the previous posts here. 

Day 16: Caregivers

Oh, how sweet the light of day,
 

And how wonderful to live in the sunshine!
  

Even if you live a long time, don’t take a single day for granted.
  

Take delight in each light-filled hour,
  

Remembering that there will also be many dark days


And that most of what comes your way is smoke.

Ecclesiastes 11:7-8 (MSG)

      My husband, Pat took care of me after the surgery.  While I was not completely helpless, he helped to keep track of medications, brought me ice packs, and encouraged me like crazy.  He made me cups of tea and took care of the household.  Pat listened as I shared my worries, fears, and questions.  He didn't try to solve everything, which is his usual mode of operation.   He didn't tell me that it could be worse or that someone else had something worse.  He agreed with me that cancer stinks, except we didn't use the word "stinks."

     In every cancer journey there are many decisions to be made.  Pat supported my decisions about  treatment.  He listened carefully as options were explained to us, asked questions, gave input, but allowed me to decide.  This was a blessing to me.

     Having cancer showed me again what a wonderful man God gave me to love.  

     In addition to my husband's support, I was also fortunate to have wonderful friends.  Friends provided us with dinners.  What a difference a meal makes.  Each night our family sat down to a wonderful home cooked dinner.  My kids loved that someone else had prepared the food.  They never once complained that they didn't like it or refused to eat it.  There are nights when they chose to eat a cheese sandwich rather than eat the dinner I have prepared.  Eating something new and different for them was nothing short of miraculous.

     I can't imagine facing cancer without the people who helped me, who cared for me, and who stepped in when I needed them.

     I would like to dedicate the song below to the caregivers.  It is "I'm Gonna Love You Through It" by Martina McBride.

Surgery

      If you are just stopping in, this is the fifteenth post in my 31 Day Series:  I Wear Pink.  Join me as I share my breast cancer journey.  You can find the previous posts here. 

Day 15:  Surgery

     The nurses confirmed my surgery, my allergies, and everything else on their checklist.  My doctor came in, reviewed the procedure with me, and initialed the side of my left breast.  The anesthesiologist  arrived and reviewed everything one more time.  I considered changing my mind about the whole thing, but then realized that all I had to do for the next few hours was sleep.  If I didn't go through with the surgery then my morning was just a waste of time and the cancer would still be in me.  Clearly I wanted it out.  Pat patiently waited with me.  Finally,  the anesthesiologist added a drug to my IV.  He told me it was the "I don't care drug."  Where was he earlier?  

     I lay on the bed with the new drug coursing through my veins.  I leaned over to Pat and whispered, "It's not working."  Just then a doctor was called over the PA system who had the same name as a teacher at my school.  I remember thinking, "Wow, I wonder if that doctor is married to that teacher," and then clearly, "Ahh, who cares?"  Yes! The drug was working.

     Moments later it was my turn to be wheeled into the operating room.  I kissed my husband good-bye, put on my silly blue hat, and went for a ride.  Once in the brightly lit operating room, I was transferred to a much narrower and less comfy bed.  My arms were placed outstretched in a crucifix position.  I lifted my head to ask for the doctor.  She assured me she was right there.  I hadn't recognized her in the masked crowd.  The anesthesiologist placed a mask over my face and asked me to count backward from 100.  For a teacher this is a piece of cake.  I got to 98.

     I woke surrounded by white light.  A nurse was settling a warm white blanket over me.  I groggily listened to the doctor explaining that she had removed the tumor and some additional tissue.  My lymph nodes had been clear.  She had taken only two.  She believed that she had gotten all the cancer.  She continued talking, but I feel back to sleep.  The cancer was gone.

     I woke again when I was being moved back to the Cancer Infusion Center for discharge.  The same nurse who had started my IV first thing in the morning, was still there at around 7:30 that night.  As I was moving from a bed to a chair, I felt as though I couldn't breathe.  I was gasping and laboring to draw air into my lungs.  The nurse nervously watched my pulse oxygen monitor which was fine, and called for a doctor.  I frantically tried to suck air in through my mouth.  Pat's eyes were wide.  Sara arrived and began asking if I had asthma.  I didn't, but I couldn't breathe.  The nurse suggested I try breathing through my nose and raised my right arm over my head.  She slowly lifted my left arm.  Oddly enough this worked.  Although I couldn't breathe through my mouth, I could breathe through my nose.  

     After a few minutes of careful breathing I felt that I could lower my arms.  I was offered a sandwich which I refused.  I couldn't imagine eating.

     Sara reviewed with me how the surgery had gone.  The cancer had been removed and the doctor had taken some extra tissue that she hadn't liked the look of.  She informed me that I needed to be aware of a new allergy.  I had a severe reaction to an antibiotic that had been given to me through the IV right after I went out.  This had caused me to go into anaphylactic shock.  Fortunately, the anesthesiologist had dealt with it immediately and intubated me.  Usually, breast surgery does not require intubation.  My throat might have been irritated by this and it could be why I felt as though I couldn't breathe earlier.  

     Did I want to go home or stay the night in the hospital?  I desperately wanted to go home, but I didn't feel up to going anywhere.  Pat shared that he was afraid to take me home given that I'd had  trouble breathing a few minutes before.  I couldn't blame him.  I wouldn't have wanted to take me home either in the shape I was in.  My IV remained connected.

     I was admitted to the post operative floor.  Pat came up to see me settled and then went home to our family.  I called home to talk briefly to our children.  My friend had brought over a dinner of corned beef, cabbage, and soda bread.  

      I took my "Lucky" slippers out of my purse and pulled them on.  It had been a very long day.  I thanked God for His comforting presence.  That He had walked with me through this fire.  I laid my head on the pillow and fell asleep to the beeping of the machines.  I passed the night without incident.   Joyfully, I was ready to go home.  

God Is In The Details

A heart found in a patch of dried mud.

     Ever had one of those days?  Ever had one of those weeks?  You know where your prayers are more like “Honey do lists,” flung up to God. “Father, can I just make that traffic light, I’m already late.”  “Lord, please let this child sleep through the night, I’m so tired.”  “God help my son understand his fraction homework.”  I’m sure that you’ve prayed one or more of these prayers on occasion.
     Not all of the time, but sometimes, my prayers are just about me, my life, my family, my home, and what I deem to be important at that very moment.  I know that there are much bigger problems in this world than the minutia of my day, but I feel better when I tell God what I need even when it’s silly or trivial.
     I was reading in 2 Kings recently and came across the passage about a floating iron axe head. This takes place right after Elisha has healed Naaman of leprosy and right before Israel’s army is delivered from the Arameans.  Elisha and Naaman were important men and the war was certainly an important event.  But the floating axe was really only important to one unnamed man.
     The men who were following Elisha were cutting trees by the Jordan River to build larger quarters to accommodate their growing numbers. One of the men broke the top of his axe handle and the iron axe head fell into the river. He couldn’t work and to make matters even worse the axe had been borrowed. When Elisha heard the man cry out he asked him where the axe head had fallen into the river.  The man showed Elisha the place. Elisha cut a stick, threw it into the water, and the iron axe head floated right up to the top where the man could reach down and pick it up.
     The man was obviously not a well known person like Naaman, after all history doesn’t record his name.  He didn’t even have enough money to buy his own ax, but had to borrow one. He wasn’t performing a big, important task like fighting in Israel’s army.  But he was doing what God had called him to do – building a home so that God’s Word and work could be furthered.
     As we go about our every day lives, in our kitchens, at work or at school, we sometimes don’t feel we are important or that we are accomplishing anything important.  But we are.  We are building God’s kingdom in our little corner of the world.  And God cares about the details. He wants to hear our little prayers. He cares about our worries and concerns.

  Cast the whole of your care, all your anxieties, all your worries, all your concerns, once and for all on Him, for He cares for you affectionately and cares about you watchfully. 1 Peter 5:7 (The Amplified Bible)

     Many times God will use our little prayers and the answers He gives us to teach us about Himself and His purposes for us. We simply must ask for the spiritual vision to see the lessons. He wants to use our everyday life circumstances to draw us to Him, build our faith and ultimately change us into His likeness.
     The next time you feel your prayer or need is silly or unimportant; remember the floating axe head and that God cares about the details of your life.

Swoon

      If you are just stopping in, this is the fourteenth post in my 31 Day Series:  I Wear Pink.  Join me as I share my breast cancer journey.  You can find the previous posts here. 

Day 14:

I had fainted, unless I had believed to see the goodness of the Lord in the land of the living.  Wait on the Lord:   be of good courage,  and he shall strengthen thine heart:  wait,  I say,  on the Lord.  ~Psalm 27:13-14

    The surgery to remove the cancer from my left breast was set for March 17, St. Patrick’s Day.  Other people would be going to parades, drinking green beer, and eating corned beef and cabbage with Irish soda bread.  Ahhh, the luck of the Irish.  On that morning, I reported to the Cancer Center conveniently attached to the hospital.  Just above it is Women’s Imaging.  I would be in all three places before my day was through.

     The doctor and I had decided on a “lumpectomy.”   The cancer and a margin around it would be removed.  In addition, the sentinel lymph nodes would also be removed.  The sentinel lymph nodes are the ones that are directly connected to the duct where the cancer is present.  If they showed signs of cancer, then all of the lymph nodes in my breast and armpit would also be removed.  It is far better to find that the cancer had not spread to the lymph nodes.  My right breast would be left as is.

     My surgery was set for 1:00 which meant that I had to be at the hospital at 9:00.  The first stop was the infusion area of the Cancer Center.  There I was given two fabulous gowns.  One to wear forward with my fanny hanging out and another to go on like a ‘bathrobe” to shield the world from my fanny.  Modesty gets left at the hospital door, but honestly so many people had now seen my breasts I wasn’t sure a fanny more or less made much difference.  I had brought a pair of gripper slippers that said “Lucky” on them, but I tucked them in my purse when the nurse handed me the regulation blue hospital ones.  I would have to be “Lucky” later on that St. Patrick’s Day.

     An IV was put in.  Nurses seem to have problems locating the veins in my arms so IV’s must go in my hand.  I became very whoozy and gray when the needle was inserted.  The nurse swiftly reclined me so I wouldn’t pass out.   It could have been nerves but I also tend to faint when I am stuck if I am hungry.  As instructed, I hadn’t had anything to eat or drink since the day before.  Pat and I joked about fainting early in the day and getting it over with.  Things could only go up from here.  Silly me.

     Next stop was the Woman’s Imaging Center.  A slender wire needed to be inserted with guidance from a mammogram into the tumor.  This wire identifies exactly where the tumor is so that the surgeon doesn’t cut into the tumor and can get clear margins around it.  Pat got to sit in the now familiar waiting room for this step in the proceedings.

     I had been told by my mother, who had a biopsy many years before, that the wire would be inserted without anesthetic.  I was terrified nervous about this given the location of the tumor.   I knew this would be like being stabbed.  MY MOTHER WAS WRONG!  The wire is inserted only after an anesthetic is administered by needle to numb things up.  

     A confluence of things now conspired against me.  I was seated on a bar stool with wheels and pushed up to the mammography machine trailed by my IV lines.  I had to sit on the wheely stool, while they attempted to get the tumor which was cozily tucked up against my ribs into view on the mammography machine.  Instead of two solid flat plates for compression, there is one solid plate and one plate with a rectangular hole in it that the anesthesizing needle and the wire can be inserted through.  I was wheeled into position, clamped in place, and then the numbing needle was administered, at which point, I promptly fainted.

     I came to lying on a bed that had magically been dragged into the area.   There was a cluster of people in white lab coats peering at me with concern.  A nurse with a delightful Polish accent was whispering comforting words in my ear and smoothing my hair.  My doctor’s nursing assistant, Sarah, had been summoned and was conversing with the crowd trying to determine what happened.  I had been out for enough time for them to find a bed and call Sarah from another part of the building.  One doctor was concerned that I had had a seizure.  I hadn’t.  I was just hungry and scared and people kept sticking me with needles.  There was a possibility of inserting the wire with me laying down, but because of the location of the tumor they weren’t sure they would be able to get it right with only one try.  I wanted to avoid multiple punctures and try again with the upright machine.  I also pointed out to them, very sweetly, I didn’t have the energy for anything else, that it wasn’t the best idea to put anyone on a bar stool with wheels while clamped into a machine.  Sara laughed, told them I had a point and a plan was put together.  The Polish nurse agreed to hold the chair in place.  I would do my best not to pass out and the rest of them would do what they needed to do.  (It occurs to me now, that the Polish nurse may have risked additional x-rays for my comfort.  I have thanked her for what she did that day, but I think I should again.)

     My new friend, the Polish nurse, offered to teach me curses in Polish or to sing a Polish lullaby to distract me while the rest of the crowd were puncturing me and inserting the wire.  I chose the lullaby.   I have no idea what she said but it was a comforting tune, soon the wire was in place with out any more fainting on my part.  

     Pat rejoined me.  He had been worried when he saw doctors, a bed, and Sarah go rushing by.  Sara had stopped on her way back to her office to tell him that I was fine.   

     An escort pushed me in a wheel chair while Pat and I laughed and agreed that fainting twice before noon was a record even for me.  I still had one more doctor with a needle to see.

     The final needle before surgery was to inject blue dye into the breast so that it could be picked up by the lymph nodes.  The blue dye is radioactive and indicates which lymph nodes are the sentinel nodes for the doctor to remove.  This was done with me lying down.  No one was taking any chances on me fainting again.  This doctor was  a cancer survivor.  He was kind and gentle.  He told me that I would survive, too.  Although the injection stung and burned, it was tolerable.  Success!  I did  not faint.  The doctor's parting words were that I should listen to my doctors and to my body.  

     I was given a bed in the Same Day Surgery Center to await my doctor.  I had been poked, punctured, wired, and injected.  I was exhausted, bruised, radioactive, and scared.  I hadn’t even gotten to the hard part yet.

Second Opinion

      If you are just stopping in, this is the thirteenth post in my 31 Day Series:  I Wear Pink.  Join me as I share my breast cancer journey.  You can find the previous posts here. 

Day 13:

     Pat and I took the train into the city on the day of my appointment at Memorial Sloan Kettering.  I had all of my images, tests, blood work, and every little thing that I thought they might want to take a look at.  We found a taxi and were delivered to the hospital.  After completing the required paperwork,  we sat down in the very busy waiting area.  There were couches and little chairs arranged into conversation areas.  

      We hadn't been there long when a woman arrived sobbing.  She had her husband and a girlfriend with her.  Of course, the trio sat next to us.  Her companions tried to talk to her, she however refused to be comforted.  She continued to cry and cry.  Eventually, Pat leaned over to her husband.  "What are you in for?"  he whispered.   I tried to shush Pat telling him it isn't polite to ask people questions in a hospital.

     The woman's husband turned from the two women with a look of relief.  He shared that his wife had been called back for more mammogram images.  Pat, now the expert on mammography, assured him that many women get called back every day.  Most of the time it turns out to be nothing.   He nodded reassuringly.  

     The man turned to his wife and told her the good news.  She did not look impressed.  In fact, she continued to wail.  So he turned back to Pat and returned the question, "What are you in for?"  

     That was when Pat began to understand the wisdom of why it isn't polite to ask questions in a hospital.  "Well," Pat stammered, "My wife has just been diagnosed with breast cancer.  We're here for a second opinion."

     Abruptly, the crying woman stopped crying.  "You have breast cancer?  How do you know?  What will you do?"  Three sets of eyes focused on my chest.

     I tried to explain how I knew as gently as I could.  I didn't want her to start crying again.   I assured her that women were called back for additional images and that usually it wasn't anything to be concerned about.  If in fact it was cancer, finding it early by a mammogram, was the best thing.  I'm not sure that she was convinced, but she had stopped sobbing.  When I was called in to see the doctor, she rested her head on her friends shoulder.  I'm not sure why she was placed in my path, but I do pray for her still.

     The doctor and his intern looked at my images and reports. They spoke together in low voices.  Pat had come in to the exam room with me.  He sat quietly in a corner.  Then the the doctor began his examination.  Let me just say that it was incredibly awkward for me for the two men to be examining me while my husband sat and watched.  The doctor and the intern spoke over me.  They both felt for the tumor, but said that they couldn't feel it.  The central location of the tumor and that it was up against the chest wall made it impossible to detect.  While examining me they had almost forgotten that I was there.  The doctor said to the intern,  "She has really lumpy breasts."

     "Lumpy!  I always thought they were firm!"  I piped up startling both of them.   

     Finally, the doctor summed up his findings.  He drew me a little picture of the location of the tumor. He laid out exactly the same treatment list that the local doctor had shared.  He suggested that traveling after surgery would not be comfortable and that I should consider going to the hospital near my home.  He also said that he knew the local doctor by reputation and that I would be "just fine with her."   He praised the radiologist for finding the tumor.  Once again I was told that he had made a "good call."  

     Pat and I were relieved.  The suggested treatment had been confirmed.  The doctor at Sloan had endorsed the doctor close to home.   We had our answers.  

Source

     I made Pat take me out to lunch at Pershing Square, a restaurant just outside of Grand Central Station.  I had the Maine lobster roll.  It was delicious.  Three years later, Pat still hasn't gotten over paying $24.00 for a sandwich on a hot dog bun.  He did, however,  enjoy his hamburger.