Sunday, February 24, 2013

Preparing for the Surgery Day

Last week I had my pre-op appointments with both surgeons.  The appointments went very well, and now I know what to expect both during the procedures, as well as after.  My breast surgeon will be performing the left mastectomy and sentinal node dissection first.  She told me that she will be generous with the axillary lymph node removal, since we know many of these were once cancerous as indicated by my first PET scan.  In these mastectomies, both breasts will have breast tissue, as well as the nipples, removed. But, she will try to preserve as much skin as possible for future reconstruction.  Her incision will be around the nipple.  The right mastectomy will be much more simple since I am only have the breast tissue (and nipple) removed--there will be no lymph node dissection.  The right breast is being removed prophylactically, however, the pathologist will still review both breasts' tissue under the microscope.  We are praying for a complete pathological response to chemo, which means we are praying they find no cancer.   My breast surgeon indicated that this part of the surgery will take close to 3 hours. 

Next, the plastic surgeon will place the expanders, drains tubes, and the pain pump catheter.  I will have four total drains placed.  Here is a very short video on the basics of the second part of the procedure:

If you would like to see a real surgery that is similar to mine, click here.   Click here for part two and here for part three of the video series.

The first video, which I embedded above, indicates the expansions are done over several months.  However, my expansions will be "rapid expansion" (over a period of a few weeks), since I will need to have radiation soon.  I am hoping to be able to begin radiation in about 7-8 weeks.  My plastic surgeon indicated that he will fill the expanders only slightly during the operation.  He will give me about 3 weeks for my incisions to heal, and then will begin the expansion process.  I should be able to have the drains removed within 1-2 weeks following the procedure.  Then, I will be expanded weekly for 2-3 weeks. 

I will be staying overnight in the surgical hospital for 1-2 nights.   I love that the plastic surgeon's office is in the floor above where I will be having my procedures.  If I have any issues, he can just go down the stairs and see me.

We are busy planning for me not being able to move my arms up and down and around much.  I had to go purchase some "button up" pajama tops, as well as some "button up" casual shirts and a specific front clasp soft bra.  There are so many instructions to follow both before and after the procedure, so we have been purchasing items so we can comply.  I want to be a good patient and have a speedy recovery.  The nurse who gave me pre-op instructions last week said that if I want to heal quickly and get the drain tubes out as soon as possible, I need to do as little as possible.  She said, "in other words, you have to go to the bathroom and you have to eat.  But, that is about all you need to be doing."  This is going to be so tough for me!  I am one who always likes to be on the go.

Then, following the surgery, I have to be extremely careful with my left arm in order to prevent lymphedema.  Because I will be having many lymph nodes removed, I am at higher risk for getting lymphedema.  Lymphedema causes swelling of the arm, due to the lymph not draining well.  If you google search images of lymphedema, you can see what I am referring to.  The swelling is often very significant.  My doctor told me I need to always make sure I wear sunscreen on that arm, make sure I never scrape it or get cuts on it, I need to wear gloves if I grill to make sure it doesn't get burned, etc.  Basically, I want to be careful to not introduce infection to my left arm or hand.  Radiation therapy further increases the risk of lymphedema.  In fact, my radiation oncologist told me to make sure I do not lift any more than 5 lbs with my left arm during radiation and for some time following radiation.

So, as you can see, my life is about to change on Wednesday, 2/27.  My surgery begins at 10am.  Until then, we are really enjoying our family time and our current "normal".  God has grown me so much throughout this process, and I know I will be thankful during the next steps of this journey as well.  He is in control of everything.

Here are some photos of our recent "normal" family time.

Here is Miss Abbey practicing some yoga moves in our backyard.
This is her "downward dog".

Abbey's favorite toy right now is any ball.  Usually, to play with and not to eat.

Precious little girl!
Lately, it has been very difficult to capture a photo of Luke.  The dude is FAST!  He loves showing us how high and far he can jump, as in this photo.
A rare photo of Luke--still and in deep thought.

I am going to end this post with our current prayer requests.  We are so thankful for the prayer warriors who consistently pray for us.  You encourage us more than you know.  Just knowing that you are praying has helped me through this battle.  Here are our current prayer requests:

  1. Our entire family is sick.  Drew and Luke began battling a cold virus on Wednesday.  Then, on Friday I felt it coming on.  So, I mentioned it to my oncologist's nurse.  Therefore, I am on a z-pack in hopes of this virus not turning into an upper respiratory infection.  If I have an upper respiratory infection on Wednesday, my surgery will be cancelled.  This is a big deal since so many schedules are involved.  Please pray that I am completely healed prior to Wednesday.  Abbey became ill on Saturday, but her illness is accompanied by a high fever.   Please pray for healing of our entire family.
  2. Please pray for safe travels for our family members who are coming to take care of me (and the kids during surgery).  Also, please pray for Susan (my sister's mother-in-law), who is traveling from Iowa to watch my nieces while my sis watches my parents' embroidery business. 
  3. Please pray that the surgery goes extremely well.  Also, we continue to pray for complete healing!  Let's pray that the doctors are "wow-ed" when they find out there is no cancer in my body!
  4. Please pray that I have a speedy recovery with no complications!
Thank you everyone!  We love you!

Wednesday, February 20, 2013

Surgery Planning

We are busy planning for my first of several breast cancer-related surgeries.   For those of you who are interested and for those who are praying specifically, here is the outlook for the next week or so:

Thursday, 2/21, 9am:  Pre-op with Plastic Surgeon (Dr. Haydon)
Friday, 2/22, 11:30: Pre-op with Breast Surgeon (Dr. Martinez)
Friday, 2/22, 4:30pm: Labwork at my oncologist's office
Wednesday, 2/27, 10am-ish: Surgery (bilateral mastectomy (left, modified radical and right mastectomy), with expanders.)

I believe the surgery will take 4-6 hours from start to finish.  I have never been under anesthesia for that long.  The plastic surgeon (which I met on Monday) said I will stay in the hospital for 1-2 nights.  He said that I won't be able to lift Abbey for 3-4 weeks, which should make life around our household quite interesting.  I was just thinking today about how frequently I lift her--it is quite a bit.  I lift her in and out of her crib for two naps daily.  I lift her out of bed in the morning.  I lift her into and out of her high chair several times per day.  Also, I lift her into her car seat (apparently, I won't be driving for a while anyway, so this probably isn't an issue).  Lastly, I carry her up the stairs (which she can climb, so I won't be doing that during my recovery period).  But, she hasn't attempted going down the stairs yet (nor do I think it is a great idea for her to try right now).  So, I currently have to carry her down the stairs as well.  I am not worried about the recovery, but I am trying to plan for it.  :-)

Following my two pre-op appointments, I will write a blog post that has more details about the surgery itself.  But, I wanted to give everyone an update this week on what lies ahead.  Thanks again for continuing to lift us up in prayer!  We're praying for miraculous healing--a complete pathological response!  We're also praying for a great surgery, with no complications, as well as speedy healing from that.  Thanks again!

Saturday, February 16, 2013

Surgical Decisions Confirmed

We have been praying that God would give us peace and make clear the direction we should take for the next steps in my cancer journey.  I can happily say that we are now at peace with the direction we have chosen to take for the next steps.

On 2/27/13, I will hopefully be having a bilateral mastectomy with expanders.   The expanders give me some options for reconstruction down the road.  Without them, I probably would not be a candidate for reconstruction.  My radiation oncologist, plastic surgeon and surgeon are all on board.  After seeking a second breast surgeon opinion, we feel comfortable staying with our current surgeon.  After all, we really liked her for our first two visits to her office.  Perhaps it was the confusion with the surgical direction we should take for next steps, along with the change in surgery dates that muddled things up.  In addition, I guess I am sort of a unique patient (with my stage, size, need for extensive radiation, etc.) and it provides some uncertainty with decision making.  I plan on contacting my breast surgeon's office on Monday to confirm everything.  We have the surgery date set already, but it was originally for a single (left modified radical) mastectomy at another hospital.  So, I am hoping that my surgeon has enough time available for the double mastectomy with expanders.  I also hope that she is ok doing it at the hospital where my plastic surgeon needs to perform the procedure.  He told me he already discussed it with her and confirmed it, but I want to do so also, based on the scheduling issues I have had in the past with the office.  

My recovery is going to be a little more difficult than if I just had the single mastectomy with no expanders.  But, this way I can reduce the number of surgical procedures I have in total.  Given I have a lot of radiation and then recovery from that ahead of me, I don't feel comfortable waiting that long to have the right breast removed.  My radiation oncologist is on board with me having the expanders placed, but I can only expand them to what is equivalent to an "A" cup.  As I mentioned in a previous post, this is due to the need to have my internal mammary lymph node radiated.  This is completely fine with me, and it means that I won't have to stretch my pectoral muscles as much prior to radiation.  Hopefully this will result in faster healing, so I can get started on radiation sooner and without complications.   The purpose of the expanders is really to expand the space behind the pectoralis muscle to fill the skin envelope that my breast surgeon leaves behind, not expand the skin envelope.  This will preserve the space for future reconstruction, since radiation would otherwise damage the skin and not allow it to stretch or create any space for implants if I choose that direction later.

So, I am feeling comfortable and I am so glad God has given us a peace about these future steps.  He has been there all along with way directing us.  This time, He required a little more patience of us than the past decisions.  But he continues to grow us throughout this process, and for that I am thankful.  

Looking back, I don't think my body would have been ready for the original 2/11/13 or even the 2/13/13 surgery date.  I went in for labwork at my oncologist's office yesterday afternoon and found out my white blood count is still a tad low.  I was really surprised by that, but also know that God is in control.  God knows the perfect timing for my surgery.  I can rest assured when "scheduling issues" or other "problems" arise, it is just a way for Him to use circumstances to orchestrate His design (in this case for my healing).  I am so glad He is in control.    

Thursday, February 14, 2013

About My Valentines

Has anyone ever wondered how Valentine's Day began?  According to wikipedia,

St. Valentine's Day began as a liturgical celebration of one or more early Christian saints named Valentinus. The most popular martyrology associated with Saint Valentine was that he was imprisoned for performing weddings for soldiers who were forbidden to marry and for ministering to Christians, who were persecuted under the Roman Empire; during his imprisonment, he is said to have healed the daughter of his jailer Asterius. Legend states that before his execution he wrote "from your Valentine" as a farewell to her.

This holiday has been around for a LONG time (literally, for over a thousand years)!  I know there are a lot of folks that say it is just another "Hallmark Holiday."  But in my opinion, it is just a great time to celebrate love.  Even if you don't have a boyfriend/girlfriend, spouse or significant other, isn't it fun to show other folks in your life how much you love them by surprising them with little treats, cards, flowers or gifts?  I love surprises!  I love LOVE!  I know that sounds so cheesy, but it is also so true!

I also love this guy right here:

A photo of my hubby on a recent date.

He is my best friend.   We enjoy the same activities--whether it be hiking, doing crazy wedding dances, exploring nature or the city, doing something active like playing sports, snowboarding or riding our bikes, or even just listening to music or shopping.  We are literally soul mates.   Any free time I have, I desire to spend with him.  He is an amazing father and husband.  I am truly blessed.

a photo of us doing our "first dance at our wedding".  Click here for a link to a video of the dance. 

A wonderful daddy!

Sometimes I wonder why it took as long as it did for us to find each other.  There are so many years that I missed out on having him as my best friend and companion.  But, I know God's timing is perfect.  I think about how God has orchestrated each of our lives so that we would find each other back in 2006.  We needed to be exactly who we were at that moment in time when we found each other.  This meant that God intended a lot of experiences to happen in our individual lives, both good and bad, to shape us into what would be each others' soul mate.  Also, if we wouldn't have come together exactly when we did, there probably wouldn't have been a Luke and Abbey.  God had a plan and it was way better than I could have created myself. 

Drew and I were blessed by his parents with an AMAZING date weekend last weekend.  They took care of the kids while we had a couple of dates.  Drew and I joke that we have been a 1-2 annual date couple since Luke was born.  Unfortunately, the joke is actually a fact.  We really need more dates, because we enjoyed it SO MUCH!  We made a point of picking things to do that we aren't usually able to with kids in tow.  We went to a couple of fun outdoor malls (for more than just a few minutes), ate out at some nice restaurants, went to a movie and just even enjoyed driving around and listening to OUR music.  It was glorious!  Although we had a blast sans kiddos, by the end of our alone time together, we were missing our kids.  We realized that not only did the dates rejuvenate our relationship with each other, but it also made us appreciate our children even more than we did before.  Thus, we are really going to make an effort to increase our date count over the next year. 
So, onto my other valentines--my children, Luke and Abbey.  It excites me to think about how God has a special plan for Luke and Abbey.  Someday, in a REALLY long time, I pray that they will meet their soul mates.  In the meantime, they are going to be our little Valentines, who we smother with love regularly.  Drew and I had fun taking some photos of the kids on Sunday afternoon.  Here are a few of my favorites:

I thought this was a fun pose, using Luke's feet.  I love the aged photo look, so applied that treatment here.

Our little Valentine and one of his favorite toys--cars!

Abbey is going in for this kiss!  Sweet brother, Luke.  Again--I love the aged photo look.

Happy Abbey!
Can't you tell how much she admires big brother here?
Now mommy is making them laugh!
They both think it's pretty funny.
So funny, that they have to look at each other laughing. 
Happy Valentine's Day to you and the love(s) of your life!  Don't forget to tell them how much you love them today!

Wednesday, February 13, 2013

My Last Oncologist Visit for a While

On Friday morning, I had my last visit with my oncologist for a while.  Well, I get to see her in a month, but that is a lot less frequently than I have been seeing her.  At my appointment on Friday we discussed a lot of things, including my PET results, my upcoming surgery, and even future appointments.

She was thrilled, just as we were, with my PET results.  She showed us before and after images of the cancer--what a significant improvement!  There was SO MUCH cancer in the area before.  However, she also wanted to spend some time preparing us for the surgery pathology results.  She said that although the results on the PET are great, she doesn't expect me to have a complete pathological response.  This means that she expects that there will still be some cancer in the breast and even possibly the lymph nodes remaining.  Apparently, only about 10% of patients experience a complete pathological response with my stage of cancer.  I am still praying for a complete pathological response or healing.  I want all of the physicians involved to be amazed at the results!  She said that regardless of whether or not there is some cancer remaining, she is very pleased with my response so far.  I believe I mentioned in a previous post that a lot of ER+ patients do not have a significant response to chemo like the triple negative, or Her2+ patients do.

Also at the appointment I had blood drawn and a cbc completed.  My ANC was 1.4, which made me just slightly neutropenic. This was great news, because I knew my white blood count would probably be fine by the following day.  Hooray!  I have been looking forward to the day when I don't have to worry about being neutropenic again.

During my radiation therapy, because I will be seeing my radiation oncologist every week (for 6.5 weeks), I won't see my regular oncologist (Dr. H.).

I know I have mentioned this before, but I love my oncologist!  She is great on so many levels.  One of the last things that she discussed with me on Friday was my future appointments.  She said that sometimes we may need an appointment to check up on the cancer, but other times we may just want to talk about how I am doing emotionally.   She said that even after I get through all of this (surgery, radiation, reconstruction, 10/15 years of Tamoxifen, 2 years of ovary suppression), there is a lot involved in being a survivor.  I will always be a survivor.  Once I am finished with treatments, my journey is not over.  I am forever changed by cancer.  For some reason, at this point tears began rolling down my face.   This was one of the few times I had cried since the journey began, and I had no idea why.  I didn't feel sad.  Perhaps my hormones were doing some crazy things that day.  Or, perhaps it was just the thought of cancer always being a part of my life.  I honestly don't know why I had those tears.  But, I felt like Dr. H really cared during the appointment and that was comforting.

My journey continues and I know I am being led every step of the way by my Sovereign Lord.  On Friday, a specific song popped into my head:  "Whom Shall I Fear" by Chris Tomlin.  Here are the lyrics and I am including the video below:

You hear me when I call
You are my morning song
Though darkness fills the night
It cannot hide the light
Whom shall I fear?

You crush the enemy
Underneath my feet
You are my sword and shield
Though trouble linger still
Whom shall I fear?

I know who goes before me
I know who stands behind
The God of angel armies is always by my side
The One who reigns forever
He is a friend of mine
The God of angel armies is always by my side

My strength is in Your name
For You alone can save
You will deliver me
Yours is the victory
Whom shall I fear?
Whom shall I fear?

And nothing formed against me shall stand
You hold the whole world in Your hands
I'm holding on to Your promises
You are faithful
You are faithful

Psalm 27:1 The LORD is my light and my salvation--whom shall I fear? The LORD is the stronghold of my life--of whom shall I be afraid?

Tuesday, February 12, 2013

Decisions, Decisions

All along the first part of our cancer journey, I have felt like we really didn't have to make any decisions.  I mean, decisions in my treatment were definitely being made.  But, I felt like the direction we should take was made so clear that we didn't really even need to think about it.  But, my upcoming surgery has offered some new options and potential directions and we are actively seeking God's direction for these next steps in my journey.

Our previous appointment on 1/8/13 with my breast surgeon (Dr. M.) didn't go too well.  I mentioned in a previous post that we left there with many questions and felt like when we did ask a question, she seemed inconvenienced by having to answer it.  We left the appointment not even knowing what to expect with surgery or what exactly she would be doing in the operating room, besides the fact that it would be some sort of left breast mastectomy.   We also felt she didn't seem as excited at the results of the ultrasound she performed, which showed significant improvement, as we did.  We had heard her bedside manner wasn't the greatest, but we had never experienced that prior to that appointment.  We thought perhaps it was because we had to bring Abbey to the appointment and she was distracted by her, 0r perhaps she was just having a bad day.  So, we decided we would definitely be prepared at the next appointment (pre-op appointment) with a list of questions to ask her so that we felt comfortable with the upcoming surgery and give the doctor another chance.  I was told the scheduler would be contacting me to schedule the upcoming surgery.

Between now and then, my surgery has been scheduled for four different dates and times.  Originally, it was for the early morning of 2/11/13 (today).  Then, the scheduler called to let me know she needed to move the appointment to later that day.  That didn't bother me and I told her that wasn't a problem.  My mom and dad, who own an embroidery business (and are the only employees there), made plans to come down for the first week of my surgery.  They had planned to close their business for the weekdays they were planning on being away.  However, my sister's sweet mother-in-law who lives in Iowa offered to take vacation from her job to travel to Oklahoma to watch my sister's girls during that week so my sister (Holly) could work at my parent's embroidery business.  This is SUCH a huge blessing to all of us.  My parents won't have a loss of income for a week and don't have to feel the burden of having a closed business for a week.  This again is a picture of sacrificial love on the part of Holly's mother-in-law, Susan, Holly, and my parents.  It was all set and I felt peace about everything.  Then, about two weeks ago, the scheduler called me again and said, "I have some bad news."  She told me she had to move the surgery again.  But this time she had to change the date--to 2/13.  Apparently, the original surgical facility she scheduled me at is out of network for our insurance, so it needed to be scheduled at a different facility.  That was sort of a pain, because I will have less time with my parents' help, but at least it was still that same week.  Then, last week, the same scheduler called once again and said she had to move my surgery date again.  Upset by this news, I explained to her how everyone had to arrange their schedules around this date, which had already been changed three times. She explained that Dr. M. is going out of town the following day and needs to be available in case of complications from my surgery--definitely understandable.  The next closest date that was available was 2/27.  This is nearly four weeks from my last chemo.  Also, it is only 5 days from my follow-up MD Anderson appointment, which was scheduled 3 months ago.  I'm not sure I will feel like traveling for several hours in a vehicle just 5 days post surgery.  I had no choice but to book the surgery so that it didn't go to another patient. 

In the meantime, I searched the web for other breast surgeons in town.  I read reviews and found one with some excellent reviews and recommendations (Dr. Nelson).   I contacted her office and was delighted by how friendly everyone was.  I explained my situation and they immediately booked me for an appointment (scheduled for this Wednesday, 2/13) and even blocked off a couple of surgery dates and times for the following week.  This was service!  My current surgeon's office is not this service-oriented and even acts like it is such a chore to answer my questions or accept my phone call.  This surgery is a big deal, and something about which I know nothing.  So, I feel like my surgeon's office should be more kind and accommodating.   When I met with my oncologist, Dr. H., on this past Friday morning (2/8), I explained everything to her.  I asked her opinion on the two different surgeons and the surgery date of 2/27 with Dr. M.  She wasn't concerned with the surgery date of 2/27 and thought it would be fine.  Also, she thought both surgeons are terrific from a technical standpoint.  However, she was most comfortable with me staying with my current surgeon, Dr. M., because she knows my history, my complications, my journey through chemo, etc.  This made sense to us.  So, we thought we would keep this in mind as we attended my pre-operative appointment with Dr. M. that afternoon.

On Friday afternoon, we attended my pre-operative appointment with Dr. M.  We began the appointment with some pre-appointment stuff with the nurse (the same one who has contacted me numerous times to change the surgery date).  She again seemed agitated anytime I asked a question or tried to talk about the scheduling nightmare.  She even said, "well, most of our non-cancer patients don't really care as much about their surgery dates/times whereas the cancer patients all seem to want to just get it over with."  I explained it was important that we know the definite date/time because we have several schedules to coordinate since we have folks coming from out of town and vacation time to be planned, etc.  Then, we met with Dr. M.  We had our list of questions, and it seemed to be going much better than the last time--at least initially.  However, she then asked what type of surgery I would be having--unilateral, or bilateral mastectomy.  We had already discussed this before--I would be having a unilateral mastectomy.  She even asked if I had already had a lymph node biopsy to confirm cancer there.  It seemed as if she knew nothing about me.  Now I was feeling like Dr. H.'s biggest reason for me to stick with Dr. M. had gone out the window.  (Remember, Dr. H. liked that Dr. M. knew my history and everything about me and for that reason recommended I stay with her.)  But, I felt I had to start completely over with Dr. M. at that appointment.  I explained my history and then that I had originally thought we were going to be doing an expander during the mastectomy, but that my radiation oncologist said that she was told there would be no expander after discussing it with Dr. M. and my plastic surgeon.  Dr. M. stated that they all discussed it and decided since I had trouble with chemo and my cancer was advanced, they were going to keep things as simple as possible for my surgery.  This meant no expander and a unilateral, modified radical mastectomy.  That made sense to me.  Then, she asked what kind of reconstruction I planned on having.  I let her know that I was told implants were not an option for me due to the radiation I would be having and that the DIEP Flap would be my best option.  (DIEP flap is where they take your abdominal tissue and use it to construct breasts).  She then asked me to pull up my shirt and showed Drew that there was no way to make two breasts out of my "extra" abdominal tissue.  She said I was too thin for the flap surgery.  This is what I thought as well based on what I was told previously by others.  But, once you have radiation, it is difficult to reconstruct the breast with implants due to the changes it makes to the skin over that breast.  She said that she had never seen post-radiation implant reconstruction be successful. I was so confused.  So now she was recommending expanders during the mastectomy surgery and prior to radiation (to preserve some space, since radiation tightens and damages the skin) and implants (after radiation).  She gave me the name of a different plastic surgeon in town who could perform the surgery for the expanders alongside her following the mastectomy.   She said he would probably recommend a double mastectomy with expanders.  She asked if I would be getting my port out during surgery. I explained that I may be getting more chemo--based on the pathology results of surgery.  Based on that, I can only have a unilateral mastectomy, since the expander on the right side could interfere with the port.  As you can see, things got very complicated.  Now, I needed to try to see another plastic surgeon and possibly coordinate the surgery date so they can both be in the same room at the same time for my surgery.  In the meantime, I am going to keep my appointment with the other breast surgeon, Dr. Nelson.  Perhaps that is the reason all of this is happening--to show me that this other surgeon is the right one. 

I found out that the new plastic surgeon does have some times available for the dates that both breast surgeons are available.  So, that is a relief.  I have an appointment with the new plastic surgeon on Monday (2/18).  I am going to get his opinion on all of this.  I have read contradictory articles about implants and radiation.  Apparently, there can be quite a few complications with expanders and implants and radiation.  I have also seen that MD Anderson recommends completely delayed reconstruction for patients with advanced cancers receiving radiation. So, I am a little leery of having an expander put in.  I also know having the expander placed would delay my radiation treatment, as there will be several procedures between the surgery and radiation to "expand" the implant (expander) to create some space for the implants following radiation.  I would have to wait until this is complete and I am completely healed before radiation can take place.  So, the simplest route to take would just be a left modified mastectomy with completely delayed reconstruction. But, if I do want reconstruction in the future with that breast, I could have some issues.    

Now you can understand why I haven't updated this blog with surgery dates/times or other news.  There has been so much up in the air.  But, because I have received many questions about my surgery date, etc. lately, I thought it was important to document this part of my journey here.  There is a reason for all of this.  I know I will read this post later and it will be so clear what God was doing.  I will continue to pray about the decisions we have to make about reconstruction, which surgeon we will use, and ask for God's direction.   Would you pray along with us that God makes the direction so clear, as he continues to do with this journey?  We have felt at such peace with everything and are expecting the same as we go through this next week of appointments.

Wednesday, February 6, 2013

Nourishing Bytes: Enjoying our Cruciferous Veggies

I mentioned in a recent post that my family has been enjoying cruciferous veggies lately.  They are packed with nutrients, help prevent cancer and are actually pretty tasty.  They are pretty much wonder-veggies! How can you get your kiddos to enjoy these nutritious veggies?  First, have them help you cook them!  It seems Luke is always super-excited to try something that he helped to cook. 

Here, Luke enjoys preparing the brussels sprouts, pear and shallot medley.  He drizzles some olive oil.

Sprinkling some spices on top before roasting them in the oven.

Operating the pepper mill.
The delicious and nutritious result

We also combined some broccoli and butternut squash with some other veggies into a delicious frittata.

Luke shows off his belly.  He cleaned his plate!
I will include a few of the recipes we have enjoyed lately below.  I have taken photos of the recipes with my phone from the recipe books and included them below.  Do you have a delicious recipe that includes cruciferous veggies?  I would love to receive a copy!

from my "Power Foods" cookbook

another delicious recipe from my "Power Foods" cookbook

This delicious recipe is from Heidi Swanson's Cookbook, "Super Natural Every Day: Well-loved Recipes from My Natural Foods Kitchen."  We have loved every recipe we have tried in this cookbook.  Abbey's favorite is the wild-rice casserole, which she devoured!

Just in case you are interested in either of these cookbooks, here are the links to purchase them on Amazon:

Tuesday, February 5, 2013

The Importance of Our Thought Lives

Throughout my cancer journey thus far I have learned so many things.  One of the things that I have come to know is completely true is that our thoughts can either promote health or cause significant damage to our bodies and our lives.   I have had so much peace throughout this journey and actually feel great spiritually, physically (for a chemo patient) and mentally.  I attribute it to focusing on positive things and casting all of my concerns or worries on my heavenly Father.  I know for a fact that thought-life can be damaging, because there have been times that I experienced the physical effects of negative thoughts during this journey.

For example, although I know I am not supposed to look at prognosis statistics about my cancer, it's "advanced" status and my stage (of 3c), there have been a couple of times early on in my journey when I came upon these stats.  They were not good and I immediately felt physically ill upon seeing them.  There have been a couple of times when I decided to search the net for blogs of other fighters of similar stages of breast cancer to see some of their experiences with chemo, surgery, radiation, etc.  At times, when I would find a blog, one of the the first posts that I would see would be a eulogy posted by the cancer patient's husband.  Again, when I would see this I would feel a warmth come across my entire body (probably a hot flash), along with ill physical feelings.  These thoughts that entered my mind when seeing these things were toxic!  Normally, my personality tends to give my all into everything I do, being fully equipped with tons of information by doing plenty of research,  However, with this cancer I have decided to let the Lord lead and then I take a following role.  Thus, I stay away from scouring the web for information on breast cancer.  Instead, the research I have been doing has been focused on my wellness.  I want to do my very best to take care of this body God has given me.  That is my job.   God is taking care of the rest:  my treatments, orchestrating appointments with the best medical staff in the industry, etc.  He is in control and I can tell you that this gives me perfect peace. So, my goal is to keep my thoughts positive.  "You are being healed.  You are healthy, Heather" are phrases I try to constantly utter to myself. 

In Jordan Rubin's book, "The Maker's Diet", he goes deep into discussion about the importance of our thought lives in his "You Are What You Think" chapter.  As he discusses the placebo effect, he quotes Dr. Michael Jacobson, author of "The Word on Health: A Biblical and Medical Review of How to Care For Your Body and Mind":

In a typical study, it is expected that around one-third of the placebo group [the group of subjects who receive a "sugar pill" or fake treatment exactly like the real dose] will actually show as much benefit as if they were on the actual medication.  This improvement may be due simply to the positive physical changes that can take place when a person believes that he is getting better."

Rubin says that he is "convinced that if one hundred healthy people were told by a physician they had an incurable cancer and that they only had six months to live, approximately thirty of them would die--that's how powerful faith, even in the negative, can be."  I completely agree.

Many years ago I read a book by Joyce Meyer titled, "Battlefield of the Mind."   In her book, Joyce discusses the importance of our thought-lives, and how there is a constant battle in our minds, with Satan trying to claim victory.  She quotes SO MANY biblical verses about the importance of our thoughts.  Just to name a few:

"For as he thinks in his heart, so he is..." Proverbs 23:7
 " shall be done for you as you have believed..."  Matthew 8:13
"Yet the LORD longs to be gracious to you; he rises to show you compassion. For the LORD is a God of justice. Blessed are all who wait for him [for His victory, His favor, His love, His peace, His joy, and His matchless, unbroken companionship]!" Isaiah 30:18

Satan attacks with doubting thoughts, fear and paranoia.  She summarizes the situation (with the support of Bible verses) as follows:

1.  We are engaged in a war.
2.  Our enemy is Satan.
3.  The mind is a battlefield.
4.  The devil works diligently to set up strongholds in our minds.  Strongholds are areas in which we are held in bondage (in prison) due to a certain way of thinking.
5.  He does it through strategy and deceit (through well-laid plans and deliberate deception).
6.  He is in no hurry; he takes his time to work out his plan.

Just like Luke's "guys" prepare to storm the toy castle, Satan devises a plan to conquer our minds with negative thoughts.
I know from experience this is all too true.  Satan has tried to gain ground in the battle through my cancer journey with little negative thoughts here or there.  But thankfully, because there are so many warriors in this battle constantly praying for me and because I am spending more time than ever talking to God and in His Word, Satan doesn't stand a chance.  To sum it up:  
  • Negative thoughts lead to negative fruit in one's life.
  • Positive thoughts lead to positive fruit in one's life.
Here is what has become one of our family's life verses recently:  “Do not fear, only believe.” (Mark 5:36).  We choose to cast away all negativity.  God is in control, and we believe what Jeremiah 29:11 says:   "For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future."

There will always be troubles in this world.  But, the choice is yours in how you choose to deal with them: 

1.  You can drown in your troubles and negativity, having self-pity; or 
2.  you can try to look positively at them, asking God to teach you through your suffering, all along giving God the glory.  

  • "Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing." James 1:2-4
  • “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” John 16:33
  • "Beloved, do not be surprised at the fiery trial when it comes upon you to test you, as though something strange were happening to you. But rejoice insofar as you share Christ's sufferings, that you may also rejoice and be glad when his glory is revealed." 1 Peter 4:12-13 
God has taught me so much through the suffering I have gone through in my life. In fact, suffering has in many ways been a blessing to me.  So, I just wanted to encourage others who may be currently suffering.  Try to stay positive and seek God.  Ask yourself what He is teaching you through this?  How can you glorify Him through your suffering? And lastly, be encouraged by Romans 8:28:   "And we know that for those who love God all things work together for good, for those who are called according to his purpose."  Squash all negativity and cast your fears on Him.  He already knows the end of your trial.  He is sovereign. 

Monday, February 4, 2013

Results of PET #2 (Post-chemo PET/CT)

This morning I had the much anticipated post-chemo PET/CT.  It was much anticipated for many reasons.  Of course, the most important reason is that we hoped it showed remarkable improvement over the initial PET/CT that I had prior to the start of chemo.  But secondly, it was anticipated because I had an allergic reaction to the CT contrast last time, which left me with annoying, extremely itchy, hives for several weeks. A prescription of Prednisone and Benadryl over a couple of weeks towards the beginning of my chemo treatment helped to thankfully resolve the hives.  So, this time around we were going to be prepared with some pre-medication prior to my exam.  This involved multiple 50mg doses of Prednisone (13 hours, 7 hours and 1 hour prior to the exam) and 50mg Benadryl one hour prior to the exam. 

Those of you who have ever taken prednisone, a pretty strong corticosteroid, know that it is pretty nasty stuff.  You always want to take it with food to avoid feeling very ill.  So, I took my "13-hour prior to PET" dose along with some delicious scrambled eggs and then went to bed.  Unfortunately, I missed my alarm for the 7-hour prior to the exam dose, which put me into the "no-food 6 hours prior to the exam" zone.  This meant that if I were going to take the dose, it would be without food.  Because I already felt awful from the previous 50mg dose of prednisone, I prayed about it and decided to skip the dose. 

On the way to the exam, I took the Benadryl dose.  When I arrived, they told me that I actually didn't even need the CT contrast this time around.  Praise the Lord!  This meant that I would not have the allergic reaction and didn't have to worry about the other doses of Prednisone I missed.  This was praise #1 of the day.

So, they injected me with the FDG, a radiopharmaceutical, which after injected into me, the PET scanner can form images of the distribution of FDG around the body.  After the injection, you have to lay still and in silence in a quiet room for an hour while it distributes around your body.  As I lay in the room under the warm blankets and in silence, I reflected on what has transpired over the past 5 months.  I was not at all concerned over the results of the PET, because I had an amazing peace that God was at work in me and was healing me.  Instead, I just spent an hour thanking Him for all of the amazing things He has done. I just told Drew this weekend that I am happier right now than I have ever been.  I am just SO happy and have so much Joy!  So, during this hour, I had a lot of "thank yous" to give back to God in prayer. 

The PET exam itself just took about 17 minutes.  Then, the wonderful clinic manager at ARA checked with the radiologist to see if he minded briefly reviewing the exam results with me (I used to work at ARA).  He kindly agreed, so I made my way back to the reading room. 

The Results:

The radiologist showed me the before and after images of my body and the cancerous regions.  To sum it up, he told me (not his exact words, I'm sure, but how I remember it), "see there where there was cancer before... I just can't see anything now."  I said, "wow, that is amazing--miraculous."  He said, "yes, the chemotherapy worked!"  He, of course, qualified his statements with "there could be microscopic cancer that is not detected by the PET."  I quickly said, "yes, but thankfully, I am having surgery to remove the breast and axillary lymph nodes and then I will have radiation for the other lymph nodes that were cancerous before but not removed."  I was so happy to get to see the results immediately and discuss it with him.  The funny thing is, I didn't jump up and down or act elated.  I think it is because I already had a confidence and peace that God was at work at completely healing me. 

I am glad I was able to discuss the results with the radiologist though, because it is much more difficult to tell the results were fabulous by looking at the actual documented report, since it is in medical terms that I do not understand.

So, if you are like me, you are probably wondering what some of the terms in the report mean.  "Interval Resolution" usually means complete resolution in the "interval" of time since the last or comparison exam.  So, in my case, he indicated that the area where there was significant uptake of the FDG (cancerous areas) on the left breast from before were now gone.  Also, there is interval resolution in the right breast, and the lymph nodes that were of concern before (left supraclavicular, left internal mammary and left axillary/subpectoral nodes).   This is all great.  In my mind, this means "No CANCER!"  My oncologist's nurse actually said that every radiologist has a different "style" of documenting findings, and some may even say, "No evidence of disease."  She thought the report was fabulous as well!

To sum it up:  I am SO HAPPY!  I am being miraculously healed.  I have been told that to see complete pathological results (or healing) is very rare with my Estrogen positive cancer.  As I mentioned in a recent post, these estrogen positive cancers usually don't respond this well to chemotherapy.  Keep in mind that I was originally staged at stage 3c--just a hair before being classed as terminal cancer (stage 4).  My tumor was humongous at 14 cm!  The cancer was extensive--in SO MANY lymph nodes and had left the breast area to travel to the internal mammary lymph nodes (sternum area) and left supraclavicular lymph nodes (above the clavicle in my neck).    It is virtually gone--none of these areas were lit up on my PET.  Praise the Lord!

I am looking forward to the next step, which is surgery to remove the left breast and axillary lymph nodes.  It is after surgery, when we receive the pathological results, that we will see what remains at the microscopic level.   I did find out today my surgery date is once again being moved.  So, please pray that we can get all of this worked out.  I am not going to mention the new date just yet though, because I am really hoping everything gets resolved so that I can keep it for next week.

Thank you prayer warriors for your continued prayers during this battle!  I smell victory!   

Saturday, February 2, 2013

Nourishing Bytes: Why Organic Foods Now Take Up More Space Than They Ever Did Before in My Kitchen

Prior to cancer, I knew organic was a better choice over non-organic. For example, I knew organic fruits and veggies don't have all of the pesticides and chemicals that non-organic fruits and veggies have.   But, we were never regular about choosing organic over non-organic.  Sometimes we would, others we would not.  The biggest reason we would not, at times, choose organic was due to the cost.  But, now that I have read what I read about today's foods that are processed, loaded with man-made chemicals, and just full of things that God never intended, I wish we didn't ever have to purchase non-organic, non-preservative free foods. Let me qualify that though:  there are just certain foods that we feel like there is no option in choosing organic over non-organic.  And with some other foods we feel it doesn't make a justifiable difference in choosing organic over non-organic.

So, in today's post I am going to explain the following things:
  • Some of the things I have learned about organic foods vs. non-organic foods.  What does "organic" mean and why choose organic?
  • Which foods I make sure that I choose to eat as organic.
  • How to eat organic foods on a budget
In a separate post, I am going to talk about animal products and why choosing organic is so important there as well.  I am going to focus this post though mainly on fruits, vegetables, and other products.

First, what is the difference between organic and non-organic, or conventional, farming?  It is important to see the difference in order to understand why choosing organic is so important in some instances.  The chart below from the mayo clinic's website is a great illustration of some of the key differences.

Apply chemical fertilizers to promote plant growth.Apply natural fertilizers, such as manure or compost, to feed soil and plants.
Spray synthetic insecticides to reduce pests and disease.Spray pesticides from natural sources; use beneficial insects and birds, mating disruption or traps to reduce pests and disease.
Use synthetic herbicides to manage weeds.Use environmentally-generated plant-killing compounds; rotate crops, till, hand weed or mulch to manage weeds.
Give animals antibiotics, growth hormones and medications to prevent disease and spur growth.Give animals organic feed and allow them access to the outdoors. Use preventive measures — such as rotational grazing, a balanced diet and clean housing — to help minimize disease.
In Jordan Rubin's book, The Maker' Diet, which I have read and from which I am incorporating a lot of it's philosophies into my new diet, he includes a list of how to get sick.  I know--that list sounds strange, but it is pretty interesting and eye-opening.  #24 on that list of how to get sick is "eat grocery store produce and processed foods treated with pesticides, herbicides, animal growth hormones, and antibiotics; don't forget hybridized, irradiated and genetically altered foods."  He says, "Pesticides and herbicides comprise one of the world's most deadly classes of chemical compounds. If a pesticide or herbicides kills one thing, it will probably kill, mutate, or seriously damage a whole host of other things."  He goes on to say, "Most pesticides are known carcinogens, and some of them pose as counterfeit versions of the female hormone estrogen. These xenoestrogens may promote cancer by stimulating estrogen receptors in the body."   Of course, this last statement triggered me as my cancer is estrogen receptor positive and thus grows with estrogen.

Mayo clinic's website states that there are many factors that influence the decision to choose organic food. Some people choose organic food because they prefer the taste. Yet others opt for organic because of concerns such as:

  • Pesticides. Conventional growers use pesticides to protect their crops from molds, insects and diseases. When farmers spray pesticides, this can leave residue on produce. Some people buy organic food to limit their exposure to these residues. According to the USDA, organic produce carries significantly fewer pesticide residues than does conventional produce. However, residues on most products — both organic and nonorganic — don't exceed government safety thresholds.
  • Food additives. Organic regulations ban or severely restrict the use of food additives, processing aids (substances used during processing, but not added directly to food) and fortifying agents commonly used in nonorganic foods, including preservatives, artificial sweeteners, colorings and flavorings, and monosodium glutamate.
  • Environment. Some people buy organic food for environmental reasons. Organic farming practices are designed to benefit the environment by reducing pollution and conserving water and soil quality.
We have been choosing organic foods for the past several months and can honestly say they truly do taste better.  It is amazing just how much better organic fruits, vegetables, meats and eggs taste over conventionally farmed foods.   Also, we have read so many negative things about pesticides and preservatives that we want to seriously limit what we ingest.  Drew and I were recently having a conversation about what foods we grew up eating.  As we were growing up, we didn't even remember such a thing as "organic" vs. "non-organic."  That is because the concern about pesticides and foods was just beginning as we were children.

Dr. Crystal Smith-Spangler of Stanford University, the lead author of a recent study on organic foods and pesticides indicated previous studies have shown lower levels of pesticides in the urine of children who eat organic foods compared with children who eat conventional foods.  Environmental Working Group, says to avoid pesticides and warns that "young children and pregnant women are especially at risk."  Also, the American Academy of Pediatrics similarly says to "minimize using foods in which chemical pesticides or herbicides were used by farmers."  Why are all of these folks saying to limit exposure to these chemicals?  Can you believe that many researchers indicate that increased levels of pesticides can lead to lower IQ's and behavioral problems (such as ADHD) in children?  Three leading institutes of environmental health science recently conducted research which found that the higher the mother’s exposure to pesticides, the lower the child’s IQ score once the child reached school age. In the Berkeley study, for example, children with the highest levels of prenatal pesticide exposure tested 7 points lower than children exposed to the least. There was no threshold or base limit of exposure that did not produce an effect. Even by age three, the children showed neurodevelopmental problems. Prenatal exposure was measured by testing the mother’s blood and urine, or by testing the newborn’s umbilical cord blood.  These reports further substantiate a report from Harvard University last year, indicating that organophosphate exposure, at levels common among US children, may contribute to ADHD prevalence.

After numerous studies, pesticides have also been linked to cancer, Alzheimer's Disease, ADHD, and even birth defects. Pesticides also have the potential to harm the nervous system, the reproductive system, and the endocrine system. Although one piece of fruit with pesticides won't kill you, if they build up in your body, they can be potentially detrimental to your health and should be avoided as much as possible.  I still go back to Jordan Rubin's point--if the pesticide or chemical is sprayed on the crop with a purpose of killing the pests, what will the residue remaining on the crop when I eat it do to my body?  To sum it up--I want to consume as little pesticides and man-made chemicals as possible! 

How do you know if a product is truly organic? According to the mayo clinic's site, if a food bears a USDA Organic label, it means it's produced and processed according to the USDA standards. The seal is voluntary, but many organic producers use it.   Products certified 95 percent or more organic display this USDA seal.  Products that are completely organic — such as fruits, vegetables, eggs or other single-ingredient foods — are labeled 100 percent organic and can carry the USDA seal.

Foods that have more than one ingredient, such as breakfast cereal, can use the USDA organic seal plus the following wording, depending on the number of organic ingredients:

100 percent organic. To use this phrase, products must be either completely organic or made of all organic ingredients.
Organic. Products must be at least 95 percent organic to use this term.

Products that contain at least 70 percent organic ingredients may say "made with organic ingredients" on the label, but may not use the seal. Foods containing less than 70 percent organic ingredients can't use the seal or the word "organic" on their product labels. They can include the organic items in their ingredient list, however.

Another term you may see often on products is "natural".  "Natural" and "Organic" are not interchangeable though.  Only foods that are grown and processed according to USDA organic standards can be labeled organic.  So, manufacturers can label just about anything “natural,” while “organic” comes with a guarantee that the product has been certified by the USDA.

I think the biggest deterrent for most people to choosing organic is the price.  It is more costly than conventionally farmed foods.  So, there are certain items that we always purchase as organic, and others that we don't feel badly about purchasing as conventionally farmed.  This handy-dandy list below is extremely helpful in the organic vs. non-organic decision making process:

Preferably Organic
—Most Commonly Contaminated*

If Budget Allows, Buy Organic

It’s Your Call
—Least Commonly Contaminated

  • Apples
  • Celery
  • Strawberries
  • Peaches
  • Spinach
  • Nectarines
  • Grapes
  • Sweet Bell Peppers
  • Potatoes
  • Blueberries
  • Lettuce
  • Kale/Collard Greens
  • Green Beans
  • Summer Squash
  • Peppers
  • Cucumbers
  • Raspberries
  • Grapes - Domestic
  • Plums
  • Oranges
  • Cauliflower
  • Tangerines
  • Bananas
  • Winter Squash
  • Cranberries
  • Onions
  • Sweet Corn
  • Pineapples
  • Avocado
  • Asparagus
  • Sweet Peas
  • Mangoes
  • Eggplant
  • Cantaloupe
  • Kiwi
  • Cabbage
  • Watermelon
  • Sweet Potato
  • Grapefruit
  • Mushrooms
*Listed in order of pesticide loadSource: Environmental Working Group. Go to for updates. Updated June 2011.
The list above is pretty much what we use in choosing which fruits or vegetables to purchase as organic. (Click here to view a great video from Dr. Oz on going organic on a budget.)  We always try to purchase the items from the far left list as organic.  Also, all berries that we purchase are organic.  The items on the middle list and the right list we sometimes purchase as organic and others times do not.  

In conclusion, I love the following quote by Alan Greene, MD, FAAP, pediatrician and author:    "Every bite of food is an investment in our bodies – or a debt of some kind that we will have to pay back. Good food – organic food – is a delicious investment."  This has pretty much been my philosophy for the past few months. I try to ask myself as I put something in my mouth whether the item is an investment or debt to my body.  Several family members and friends have generously given us whole foods market gift cards over the past couple of months, which have seriously made it an easy decision to shop organically.  I love whole foods and we can definitely even taste a difference in the quality of food we purchase there.  So, these folks have truly blessed us!  We aren't eating out much at all either, so we are spending less money on food than before even though we are choosing organic over conventional foods.  

Friday, February 1, 2013

My Last Round of Taxol!

I was back in the chemo infusion room for the 4th time this week.  But, today things are different.  My white blood count looked great today as my ANC finally jolted up into the 4's (needed to be at least 1.5).  I actually received my last round of Taxol today, and hopefully it will be my last day of chemotherapy forever.

I am extra happy today.  Can you tell?
Still sleep deprived due to the steroids I have had injected every day this week, but SO HAPPY!

I want to give a shout out of "thanks" to Drew's parents.  They came up on Monday night to help watch the kids, knowing I had my labs on Tuesday and then we all hoped for chemo on Wednesday.   They were planning to leave Wednesday after my chemo.  Well, as you know, I didn't get to have my last round until today.  They really blessed us this week by staying until today, so that Drew could be here for my last chemo infusion.  Again, they are a huge blessing to us and we are so thankful for them. Luke and Abbey were especially happy to get to spend some more quality time with them.  They had a blast; Luke learned all about "wrestle mania" from Papa (now it is Luke's favorite game) and Abbey loved bringing Mimi countless books to read to her over and over....and over. 

Luke and Abbey with Mimi and Papa

We are all celebrating today, hoping it is my last round of chemo ever.  We will find out if this is true next week, when we review the results of my PET/CT, which is scheduled for Monday morning (2/4).  After Dr. Hellerstedt (my oncologist here) reviews the results with Dr. Litton (my MD Anderson oncologist), they will decide whether I should get more chemo after my surgery.  The pathology results from surgery will validate their decision even more though.  Surgery is scheduled for Wednesday morning, 2/13.  Again, we pray for a complete healing and that all of the physicians are amazed at how the cancer has just vanished. A really sweet lady that I met for the first time today in the infusion room also has breast cancer (stage 4).  Before she left the treatment room, she asked if she could pray with me. I, of course, said "Yes, I would love that!"  I know what a difference it made to me, so I sort of wish I had more time in that room so that I could pray with others.  Instead, I will seek out other opportunities to do so.  There are opportunities around us daily if we look for them!

So, we have a busy road ahead of us with lots of appointments, surgery, etc.  But, for now, we are going to take a little time to celebrate the first big milestone: my last round of Taxol, and hopefully last round of chemo!

I received this certificate today, along with a little party in the chemo room!
Click here or view below to see a little clip of my last day of chemo party in the infusion room!

Celebrating with a smoothie, my certificate, beads and confetti hair!