Wednesday, September 19, 2012

Day 3 following Cancer Diagnosis

Warning--Long post!

Today has been a good day.  We have received an overwhelming outpouring of love from all over the United States.  Of course, most important are the prayers that have been, and continue to be, prayed on our behalf around the clock.  Thank you--we definitely feel your prayers.  [As a side note, even though I haven't been able to respond to each of your facebook messages, emails, blog comments and text messages, please know that I have read each of them and they mean so much.  We have been SO busy scheduling and going to doctor's appointments, requesting medical records, faxing paperwork to MD Anderson, etc., that I have not had a chance to respond.  As soon as things slow down a bit, I will definitely respond.]  I feel like God has already taught us so much during this process.  First, I will provide updates with details on what I know, so far, is going on in my body.  Then, I want to share what God has already taught me since my diagnosis. 

Part 1:  What is going on?

On Monday morning, we received the verbal pathology results of the left breast and axillary lymph node biopsy.  For those who like to know all of the specific details, here you go.  The core needle biopsy of the left breast mass, which measures approximately 14.5 x 9 x 7cm, showed presence of invasive mammary carcinoma, ductal type.  The grade was "moderately differentiated, modified Bloom-Richardson Score of 6 of 9."  We are still awaiting the addendum of the report, which will include the results for ER (estrogen receptor), PR (progesterone receptor) and Her2/neu status.  We should receive those results very soon.  The left axillary lymph node, fine needle aspiration sample came back as positive as well (metastatic adenocarcinoma).

After hearing the news, we moved swiftly into business mode.  We were able to get an appointment with the surgeon the following day at 11am.  This was awesome since we were told to expect to get in by the end of the week or earliest part of the following week at the earliest.  The surgeon was amazing.  She spent probably an hour and a half with us.  She went through the results, reviewed the images with us, gave us the BRAC analysis genetic test to complete, and even used the Ultrasound wand herself to look at the breast.  She answered all of our questions, and told us what to expect as far as treatment goes.  She said to expect 24 weeks of chemotherapy, followed by a surgery and then radiation treatment.   The BRAC analysis test is pretty much standardly administered now in Breast cancer patients, since disease may come from an inherited genetic condition known as hereditary breast and ovarian cancer (HBOC) syndrome. This condition is caused by changes, or "mutations" in the BRCA1 or BRCA2 genes and passed down from parent to child. Families with HBOC syndrome tend to have more cases of breast and ovarian cancer than average families. Cancer often happens at a younger age and across generations.  So, the BRAC analysis test I took will tell me if I have this mutation.  If so, I will likely need a double mastectomy eventually, as well as will need to have my ovaries removed to prevent a re-occurrence once this cancer is beat.  In addition, if it comes back positive, there is a 50% chance my siblings, parents and children also have this mutation.  We are praying that this mutation does not exist in me.  

We asked the surgeon about what she thought the staging might be.  She said, if it is not in any other organ, it would likely be Stage 3C.  This is kind of what I expected based on what I read, but not what I had hoped.  Breast Cancer stages go from 0 to 4.  She told us that if it had moved into another organ, that would be stage 4.  When we asked her about her thoughts on us going to MD Anderson for treatment and opinions, she mentioned that she thought it would be a good idea if it were stage 4, just because they have access to more clinical trials.  She also thought it would be a good idea to go, regardless, to receive a second opinion.  However, chemotherapy is chemotherapy.  There is a standard recognized concoction and dosage, so it doesn't really matter where I receive that.  So, while we were sitting in her office, she even made a physician referral online!!  Again, she was awesome.  She then referred us for a PET/CT and to an Oncologist.

With God's orchestration and the amazing people at ARA, we were able to schedule a PET/CT the very next day (today) at 9am.  We also have an Oncologist appointment scheduled for Friday (even though we were told it may take a while to get in to see her).  Two deacons and two elders from our church came over last night to pray for me.  It was an amazing time of worship through prayer and I now feel completely at peace with everything.  We prayed specifically for complete healing and that this cancer had not spread beyond the breast and lymph nodes in the area.  This morning, the PET/CT exam at ARA went so well. It was a quick process and I received amazing care.  The radiologist even sat with us to review the results personally in his office.  He began by saying, "I am so sorry Heather, this is very extensive."  I immediately was fearful it had spread beyond the breast and area lymph nodes.  When I found that the cancer was covering almost the entire left breast, many left axillary lymph nodes, as well as lymph nodes in my sternum and neck, I said, "That is awesome--Praise the Lord."  I am sure he probably has not heard many patients be that excited to hear they have such extensive cancer, but I was just so thankful it had not spread to another organ.  He did have suspicion that there was cancer in my right breast, but it is so difficult to tell on that particular imaging study on a lactating breast. Again, the radiologist was awesome.  He made a phone call to another radiologist at ARA, who is a breast specialist, to see what she recommended as far as the further evaluation of the right breast was concerned.  Also, he contacted the oncologist who I will see on Friday to get her opinion.  She recommended we rule out the involvement of the right breast.  So, I visited another ARA office this afternoon for an Ultrasound (and possible biopsy of my right breast).  Thankfully, there is no cancer in my right breast!

While all these appointments have been scheduled so rapidly and I have been getting results, we have had so many people helping us out in trying to get into MD Anderson. Drew's best man and college buddy has been such an amazing friend in all this.  He has worked so hard at contacting various experts in the area of Breast Cancer.  He has some great contacts who have helped us get into MD Anderson.  We have an appointment scheduled for October 2 for another opinion on treatment options with a Breast Cancer Oncologist at MD Anderson.  Drew's friend also has a contact who is an oncologist.  She has offered to talk to us about treatments as well.  Lastly, a great friend in our Church Community group also has a relative that works specifically in the breast center.  She is one of the first individuals I would see at my first visit to MD Anderson.  So, perhaps we can get in even sooner with her help as well.  I know the sooner I begin Chemotherapy, the better.

In the meantime, my bronchitis is getting less annoying (slowly going away) and Abbey is taking a sippy cup.  These are also huge answers to prayers.  I have been just amazed at the outpouring of love of our friends.  Several women have either donated or offered to donate breast milk to us.  This has really helped to lift a heavy burden off our shoulders, as going through cancer is hard enough.  Adding trying to quickly wean your baby, who won't take a bottle and hates formula, makes things so much harder both physically and emotionally.  Abbey takes breast milk from a sippy cup at all meals now.  We are slowly adding more and more formula to the breast milk and it seems to be working.        

Drew's parents being here to support us and take care of the kids has been a huge help as well.  We certainly would not have been able to attend all of these back to back to back doctor's appointments without their help staying here and taking care of the kiddos.  Another huge burden was lifted here.  

Part 2:  What has God taught me so far?

1.  He is Sovereign, in complete control, and for that I am thankful.  As I sat in the chair this morning receiving the FDG (radioactive solution) intravenously prior to my PET/CT study, I prayed and reflected.  I had an hour to do this prior to the study.  I thought back as to how God has orchestrated my life.  His orchestration has lead up to how he sent me to Austin and I began employment at ARA, one of the top radiology groups in the nation.  I then found and fell in love with someone who could not be a more perfect husband for me, Drew.  We have two beautiful children when I thought having children was not even possible for me, according to a previous medical opinion.  And, then I was stricken with cancer.  I have been able to get into each of these doctors' appointments so swiftly.  This has been due to the help of many involved--contacts at ARA and friends of mine and Drew.  Drew's parents happen to live in the Houston area (if we need to go to MD Anderson).  Five of my friends are breastfeeding right now-they have helped out with Abbey's transition from breastmilk to formula.  So, Drew and I have moved from a mindset of, "why did I get cancer?" to "wow, God has totally orchestrated everything in our lives, knowing I would get cancer, to help me beat it."

2.  God has taught me to not sweat the small stuff.  I know, that sounds so cliche'.   But seriously, when you are faced with the possibility of death, a lot of things that mattered so much before no longer matter.  My perspective has completely changed.  I am going to make the most of every moment I have from here on out with my family and focus on spending my time loving others. 

3.  God has taught me that there really is a good reason to what Jesus said were the two greatest commandments from Matthew 22:36-40:  When Jesus was asked which is the greatest commandment in the Law, he replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment.  And the second is like it: ‘Love your neighbor as yourself.’ All the Law and the Prophets hang on these two commandments.”  I am going to make sure I follow these two commandments all the days of my life.  So many people have been pouring out their Christ-like sacrificial love to us and I know the great impact it has had already on our lives. 
I know there is more, but this post is already so long.  I will share more of what I am learning from this experience in my next post. 

Love, Heather

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