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Friday, November 27, 2009

Facing the Knife

So I spoke to the doctor this afternoon.  She said the MRI showed some questionable areas which is what prompted the biopsies.  The biopsies did indeed show a more invasive cancer.  So, the mastectomy looks like a go...  better to take it all to make sure you get all the cancer, than to try and just get the cancer spots and possibly miss some.


As of yet, no chemo scheduled, but it looking like a greater possibility.  They will check my lymph nodes while in surgery and if they show cancer, then they will remove the lymph nodes too.  After the surgery they will know better about whether or not I will have to have chemo.  It will depend on the lymph nodes and depend on how much of the tissue they remove is infected with the cancer, that is what will determine whether or not I have chemo.  I am sure radiation is still a big possibility.

Dr. Tittensor said they want to treat it aggressively to be sure and get it all and hopefully so it will not return.  Because I am so young and it is important to preserve my life--yay, someone really does want to keep me around!

I will keep you posted, as much as I know when I find out.  I go in sometime Wednesday and will stay overnight, at least, to be sure I am doing okay.

Until next time...

Tuesday, November 24, 2009

MRI and Mammo update

Yesterday I had a mammogram and an MRI.

While the mammogram was not nearly as bad as I had anticipated, it was still not the most pleasant thing in the world.

Then the MRI, it was cold and loud.

But this morning, they called and said they wanted me to return to Utah Valley Regional Medical Center (where I had gone for the mammo and the MRI) to have another biopsy, performed with the aid of an ultrasound.  Oh boy, oh boy...

So mom and I trekked off to to UVRMC and the women's center.  The room for the ultrasound was very, very warm.  Evidently, between the radiologist and Dr. Tittensor, they found some other areas of concern in my left breast.  So, the nurse and the doctor today, found two areas of concern and took biopsies of both areas.  I held Nadjya and squeezed her when it hurt.  The doctor numbed it with lydocaine which did not hurt nearly as bad as when Dr. Tittensor did it, but I decided maybe that hurt worse because of the infection.  Then he used a very, very large needle (according to mom, I did not see it) to take a biopsy toward the outside of my breast.  They marked the area too, with some kind of marker or dye or something.  Then he numbed the inside, and took a biopsy from there too.  I think he should have used more numbing agent the second time, cause that one definitely hurt.  After they were done, he wanted two more mammogram views of the left side, so I got to go do that again.  My breast has all this blue color on it from the gel they used during the biopsy.  After the mammogram and the doctor was satisfied with the pictures, the nurse put these cute ice packs on me, to help with the swelling.

Evidently, there is more to be concerned about and I am not having the surgery tomorrow, it seems likely it will be a week from tomorrow.  The radiologist said the results will not likely be back from the biopsies until Tuesday of next week, with the holiday.

I find it ironic that everyone says to rest, relax and take it easy over the holiday.  Um, sure...  While I still remain optimistic, I have found it to be more stressful waiting on the unknown.  But I would rather be safe than sorry.  Mom said she was really proud of me while they did the biopsy.  She said I did really well.  I did tear up a little during and just after, but I know everything will be okay.

The numbing agent has worn off some and I am hurting a little.  I took some Tylenol in hopes of easing the pain some.  I have mints to mold and turkeys to make, but I forgot the Whoppers for the turkeys.  Mom and I came home to rest a bit and then have to go to the grocery store to get stuff for Thanksgiving dinner.  But I am amazed at how much this really is kicking my behind.  I get played out pretty easy, but I believe it is partially the emotional toll this plays on me too.  And we all know there is already psychological issues with me anyhow--so you don't have to tease me or joke... but really, the waiting, I've decided it's the worst.

So I'll keep you posted and updated, still...

Wednesday, November 18, 2009

How life can change in an instant... [in a very long tale]

**Has some not too terribly graphic, but some medical related symptoms and conditions in this post.

Okay, so, let me start at the beginning...

  • Sunday, November 8, 2009:
I hurt. I hurt a lot. I have had infections in my breast previously, some with lumps and some without; some with discharge from the nipple--some clear, some yellow, some pus-like, some bloody and some without; some with pain and some without. However, none of them had a "lump" as large as this one felt to me, nor were any of them nearly as painful. I laid in bed all day with the heating pad. I tried to decide what to do.
  • Monday, November 9, 2009:
Still hurting, agonized, do I go to the doctor, to just have them tell me again it is infection and prescribe antibiotics that aren't strong enough to get rid of it? Do I go to the emergency room so they can be more likely to do an ultrasound or other tests to determine what is wrong? Do I just suck it up and deal with it, go to work, and go on, and maybe it will go away?

Lay in bed. Ponder my decisions. Text messaged a nurse friend. Ask for advice. Pray a little. Pray a lot. Check the time. Take a shower. See a red spot on the underside of the same breast. Looks like someone stuck their thumb in red paint and pressed it to my skin. Freak out a little. Decision made--go to ER.

So, I drive myself to the American Fork Hospital ER. Did not want to go too far from home... Wasn't sure if I would get pain pills and be unable to drive myself home, so being close would help to get my truck home. When I went in, it did not seem busy until just that moment. I had to wait for a few people who were deemed a little more important than I, but I felt I was at the right place at the right time. I knew that whatever happened, it would either allay my fears and ease my pain, or exponentially increase them.

I was ushered through triage, answered questions, and then waited. I was escorted to the exam room. A nurse asked questions about me and how I was feeling, and then I waited. The doctor came in and examined me, asked me questions, and then I waited. Somewhere, I decided I was sure no one ever read what notes the nurse in triage took, or the notes the other nurse took, or any notes the doctor had the nurse take. They decided I needed to have an ultrasound of the area, told me, and then I waited. At some point the nurse, or assistant, or whatever the position, brought me a warmed blankie (honestly my favorite part of the ER), I was thankful, I was cold. Then the radiology technician came to fetch me with a wheelchair. Off to the ultrasound, the wheelchair ride made me a little dizzy--after all, I had been laying down, not feeling well, and really had not had a lot to eat.

The technician asked me questions--again, no reading skills, or just making sure I am not faking, I cannot be sure... Then she performed the ultrasound. She took some still shots with the machine. Then she went to talk to the radiologist. When he came back with her, I was a little surprised. But he went over the area again with the ultrasound and did his own viewing. The tech took some notes and they took me back to the ER. The doctor returned, after some waiting, to tell me I had an 8 cm "mass" in my breast, not too far under the nipple. He also said that as ER docs, they generally left stuff like that up to surgeons, so they made an appointment for me with a surgeon for the following morning. I would be going home with pain meds, a script for more pain meds, and a few doses of antibiotics. And somehow, a little bit of knowledge, and knowing more knowledge and relief would be coming, helped to end some of the pain.

The time while I was waiting in the ER, I had also shared some text messages with another friend. I was not sure of what would happen so I had wanted to have someone supportive who could help if I needed. She came when she got off of work. When she came in, she was crying, and I asked her why. She was worried, she said. I told her not to worry; there was no need to worry. Things were going to be fine, things would work out. Somehow the irony of the moment was lost on us, but she was there and that is what mattered.

Went home. Friend followed me. She took me to the store, secretly buying me a card and a bag of chocolate--see, good friend. Brought me home. She had also called her mom [one of my visiting teachers] who in turn called the Relief Society president in the ward. The support system was already being rallied; she hoped I was not mad.

Came home, called mom, told her. She did more rallying from her end and arranged for RS president to be a fill-in mom with me the next day. I went to bed, trying to think good thoughts, praying a little more, taking my meds and going to bed.
  • Tuesday, November 10, 2009
I got up at 6:30 am to get Jim all set for the day. He had offered to drop me off and pick me back up after class and be at home with me. I told him I would be okay; I had Sister Healey to take me. She took me to my appointment, came back with me to the exam room, folded my clothes for me when I had to change into the top gown, talked with me to help me keep a little more at ease. Carol, the nurse came in and took my vitals, they were a little high, at least my blood pressure, for me, but I was assured that was to be expected. When Dr. Jennifer Tittensor came in, her demeanor, her mannerisms, they just said so much to me. She listened while I told her about my history. She was considerate, but honest and up front, and I felt that she cares--and to me that makes a world of difference.

So she examined me, even using the ultrasound in her office to assist her too, as a map to show her what she was looking for and where she needed to go. Once she was satisfied with her findings, she used something to numb the area. Here is where she really earned some bonus trust points too, she said it would sting, like a bee sting. I told her thanks and I appreciated her candor. She said, what, you want me to lie to you, say this won't hurt a bit...? I laughed and was again reassured at her way of putting me at ease. She was not kidding, it stung, a pinch at first, but then more and more, they had to remind me to breathe... So, to me it hurt more than the bees sting I received as a kid, when the bee got trapped between me and a towel, after I had been playing in a swimming pool at my grandma's. Right in the middle of my back, that hurt, the numbing agent--lydocaine, whatever it was, oh it beat the bee by a long shot. But then there was the size of the needle she was using to try and aspirate the mass. Talk about a big needle. Well, I could feel a little pressure, but I could not feel anything. There was one other time I remembering it pinch, but it didn't hurt, like it surely would have had I not been numbed up. Again, both the doctor and the nurse, Carol, had to remind me to breathe, yeah, breathe. But the darn lump would not give anything up. Dr. Tittensor said it felt as though it had a hard shell. She got a tiny bit out, but not enough to really make a difference in my pain level, but enough to do some culture on the infection. She then gave me two options.

The first option, we could wait and try to perform the aspiration again on Thursday. This would allow for the antibiotics to work a little and see if they helped to reduce the infection. Thus making it easier to try to remove the infection. Or...

The second option, we could go in the next day, despite her having a rather crazy day scheduled out for her the following day--she would make room for me--and remove it surgically. That way, she could really be sure it was all removed and see if there was any further tissue damage.

I chose option two. For me, just getting it out and over with, seemed the far better option for me. She prescribed two more antibiotics and she went out immediately to begin working on the hospital as well as her own business office, because of my lack of insurance, on the details. She did it, not one of the nurses, not another staff member, her. Scoring more bonus points in my book. Carol also helped me out, getting a bandage, giving me the instructions--you know, no eating after midnight....pre-surgery stuff. Sister Healey got me an additional bandage and a gauze pad, there was a little more blood than one bandage could handle and my poor clothes were reaping the rewards. I got dressed and we were off to get my meds at Wal-Mart--all I can positively say about the pharmacy at Wal-Mart is $4 prescriptions. Other than that, I really do not have much good to say about the Wal-Mart pharmacy.

I went home and stayed mostly in bed. Got up to answer the phone umpteen times. Sent emails and text messages. Made some calls myself. Watched TV and tried not to dwell on negative things. It helps to have better pain meds than Tylenol and Motrin. I especially made sure the last thing I drank that night was at 11:30 pm or so, and went to sleep.
  • Wednesday, November 11, 2009
Sleeping in is a blessing on a day when you have to have surgery. Yay, I did not have to be at the hospital until 12:30 pm, but I didn't want to do too much and overdo, especially to make myself hungry... Made dad breakfast. Did some laundry. Did some other things I knew I would not be able to do later on. Called my friend about stopping by his house on the way to the hospital to receive a Priesthood blessing, he was cool with that. Tried to entertain the dog a little before we left. Stopped at Daryl's for a blessing. Went to the hospital same-day surgery.

After checking in, and going back to pre-op, I was blessed again with waiting. So, we watched some TV and laughed about a dumb movie. The nurse confirmed that I was not pregnant--which made me laugh. I told her it would be as much as a surprise to me as it was for her. She checked my vitals, again, blood pressure was a little high for me, but again to be expected. I got an IV in my arm and tried to relax. Bob the guy administering the anesthesia came in, he was funny! And I have yet to run into a Bob I don't really like or care for, all the Bobs I know are pretty good guys. Dr. Tittensor came and chatted with me, she apologized for the wait--see another consideration... I got something to help me start relaxing... Which I did. We went into the operating room, I moved onto another table, put my arms on these foldy-out things and do not recall much from that point on.

I then woke up in post-op, a little coughing going on, but over all very good spirited. I remember trying to talk and hearing my voice, somewhat differently than how I have heard it before and wondering why I was having such a hard time talking. Oh, yeah, just had surgery--a major 'duh!' moment. I spent a little time in there and then they moved me into a recovery room. As she pushed me down the hall I could see dad and waved at him. He got to come into the recovery room. I had an oxometer on my finger measuring my O2 sats and every time I got below 90 the alarm would sound on the machine. I swear I was breathing, but they told me the machine said otherwise. Dad kept doing a funny snake motion [referring to the funny movie he watched and showed me that part of] that made me laugh and cough, but it generally worked to up my saturation numbers.

The nurse brought me water and coke, which dad said he would give me sips of if my sats got up to 95. I had chocolate pudding that he fed me, and watched the news, where they show an inordinate amount of food ads, preying on those who think they are starved or at least haven't eaten since the night before. I talked with the nurse and got my going home instructions. And we were off. I wanted Wendy's for my dinner, so we got that for me and the Italian Place for dad, which offers a discount for veterans and military service members. I came home and only ate about half my food, and rested, dad went to VFW meeting, I was glad for him to go and a little bummed I had to miss Ladies' Auxiliary. And I wanted to be sure my thanks for all military, active, veteran, and deceased was duly noted. I went to sleep, and slept well.

  • Thursday, November12, 2009
I woke up at 6:30 am, well, maybe 6:45-ish and got dad's breakfast and lunch. Had to make sure he matched and was fit for public viewing, and then went back to bed. Don't recall whose phone call woke me, but got a slug of calls and texts, as well as facebook messages and emails. Everyone has been so supportive and I have been so blessed by all the good thoughts and prayers in my behalf, I feel all of that love.

I did receive a call from Dr. Tittensor's office about the preliminary results of the culture on the infection. It turned out to be a MRSA staph infection and the doctor wanted to change my medications. I was to quit taking one of the two antibiotics and begin another one. Okay easy enough. The doctor was confident that the meds would clear the infection and she might have to go back in to be sure she removed all the infection, but there should be no trouble.

This particular day, I was able to do more (or so I thought) and did a few things too many. But I had to; James was coming home from his semi-annual, two-week stint in the hospital. AND, mom was coming home from grandma and grandpa's house in Wyoming. I overdid it. Plain and simple. But, I did get my other antibiotic and my other pain meds. The new antibiotic, super-heavy-duty-horse-pill, was more than just a big pill to swallow. The waves of nausea it produced were far larger than I had already faced. Yay for pain pills and phenegran. I slept well...
  • Friday, November 13, 2009
At this point, I really cannot recall much of the day, I believe I slept most of it.
  • Saturday, November 14, 2009
Another day that I do not recall much of as I believe I slept most of the day, waiting for the nausea to go away.
  • Sunday, November 15, 2009
You guessed it, day number three, sleep, sleep, sleep. Though, I find it hard to sleep well when you have to share the bed the whole day with the husband and the dog. The dog steals covers. The husband makes funny noises. I think I did watch a few movies on Lifetime. So I didn't sleep the whole day.

Now please mind you, I spoke to people via text, phone, not so much with the emails or facebook, as that meant coming upstairs to the computer. I talked to my family too, here in the house, but the poor dog does not understand "mommy doesn't feel well, she has an owie." So part of the day was trying to appeal to the dog.
  • Monday, November 16, 2009
I finally am starting to feel more human. Hooray! The whole not human thing--not the best, but if you sleep through it, it is all good.

I remember doing more this day, making cards, finishing some other cards I had started. I am trying to figure out whom to send them. I did a scrapbook layout, it isn't finished yet, but it uses some pretty pictures of poppies I took back in May. I love poppies.
  • Tuesday, November 17, 2009
Zero hour is coming... I have an appointment at 10:30 am.  I think I slept okay once I finally got to sleep, hello, no pain pills, no phrenegran, racing mind!  Mom and I go to the office. We go back into the exam room. It has a big window that looks to the southeast and has a gorgeous view of Mt. Timpanogos. There is a small area of open land with a horsey grazing on it. With the dusting of snow early in the season, the clear air, the picture perfect scenery, I felt pretty at ease. My stitches were coming out, I was feeling pretty good...

Carol was the one who took us back into the room, she brought me a top gown to put on--ties in the front. I change and a nurse practitioner comes in, and I am a little crestfallen, thinking she is going to take my stitches out and mom won't even get to meet Dr. Tittensor. She tells me she was in the operating room, but I probably don't remember, I tell her sorry, she says it is all good, she understands. She checks me a little, asks me some questions, then she tells me a story about something that happened in the OR. Evidently, when they propped me up a little to place an ace wrap around me I guess I started coughing and acting like I was going to throw up. Freaked them out a little in the OR, oops... I apologized for that too, she said no biggie... I was asking her some questions, but she said she did not know and Dr. Tittensor would be in to talk with me and examine me in a short bit.

Dr. Tittensor comes in. She asks how I am and is pleased to find out that I am feeling much better. She is pleased to meet mom too. She examines me and is happy with how the incision looks. She is satisfied with how the tissue feels. Overall, she is content with the removal and happy that everything seems to have gone well. I ask her about the MRSA and if the antibiotic is strong enough to kill the infection. She goes out to check and the MRSA is reacting to the antibiotic and it is working, so she feels I will be fine.

Here is the kicker [mind you we still have to take the stitches out]. She had just gotten the report back from the pathologist. Yes, it is MRSA... but there is more... What do you mean more? Even as Dr. Tittensor sat there and read it she was floored, shocked, at a loss for words. There is cancer. She tells me there is cancer. She says she is sorry and she hates this part of her job. All I say is okay. I take it in stride. Okay where do we go from here...?

This is where Dr. Tittensor gats an outline and begins mapping out the plan. She goes out and gets Carol on the phone scheduling an MRI for me. While she is out, I tell mom, "oh no, I'm gonna have to get squished." She does not want to do a mammogram because it is too soon after the initial surgery and because I am younger; my breast tissue is still too dense. She wants to do an MRI. This will provide her with more accurate information. The cancer cells are in the mammary ducts, not the breast tissue and the MRI will help to determine if it is located only there, or if it is anywhere else. Then, with another surgery to take another margin of tissue to test for the cells, the results being fewer than three positive tests for cancer cells, assures that it should all be removed. However, only removing the tissue leaves me with a 25% chance of a recurrence. So after the surgery and healing for a few weeks, I will have to undergo radiation treatments, for six weeks. But those radiation treatments in addition to the lumpectomy reduce the chance of recurrence to 5%. Worst case scenario I might have to undergo mastectomy, to remove additional tissue, but the chances of that are slim. So, no chemotherapy, my hair shouldn't fall out [well not anymore than usual, ha ha ha]. But it has been found in the early stages. This is good, very good.

I am positive and upbeat. I can handle this. Me, the hypochondriac, the one with the over-active imagination has just been told I have cancer cells found in my body and I am okay. But I am thinking. It is early, they caught this very early. The treatment is essentially a surgery I've already been through once and did fine with and then radiation. I know people who have gone through radiation, they are fine. I know people who have gone through both, and they are fine, I will be fine.

I also recalled in Sister Healey's prayer before we went to the doctor and in my blessing from dad, asking for Heavenly Father's help. That He might have a guiding hand throughout this process in assisting the doctors to help me in the best way possible. I feel okay, I feel at peace. I have imagined what it would be like to be told I have cancer, after ages and ages of trying to determine why I do not feel well. Visiting doctors upon doctors, to finally have them tell me and then trying to remedy and cure through treatment after treatment. This is nothing like what I imagined. I can deal with this I will be okay.

Later, after leaving the office with a plan of attack... MRI, Monday, November 23, 2009, noon. Surgery, Wednesday, November 25, 2009, the day-before-Thanksgiving [happy anniversary daddy and Carolyn; happy birthday Aunt Nae]. Some healing and then radiation five times a week for six weeks [Monday through Friday]. Not so bad, timing-wise, I could say get done right around my birthday, pretty convenient birthday gift, don't'cha think? ...Mom and I were talking, in-between phone calls to others and such. She tells me when I called to tell her I had to have surgery, she knew then they would find cancer. Okay, a mom knows, and I have always believed my mom knows everything. But then, even later, after I turned off the TV and James was making those funny noises he makes when he sleeps, I thought about things, while my thoughts raced instead of rested. You have been preparing for this. You knew this day would come. You knew at some point you would be told you have cancer. But, you will be okay. You know you are in good hands. Everything will be fine.

The bishopric visited us this same evening. Wanted to know how things were, how we were holding up. They offered us blessings. Mom went first. I really try to listen, but I tend to have a multi-functioning brain that hears things and heads off in another direction with a thought that pops into mind... I know I may recall things later; I really tried to rein in my wandering thoughts. But it was a suitable blessing and if I have faith the blessing will help mom, and I know mom's faith is greater than mine, than I am sure the blessing will work. They offered me a blessing as well. No offense to any future bishops I may have and none as well to any I have had in the past, but Bishop Jones is really my favorite. But there are some other miracles he has performed for me or in my behalf that have truly helped me. I mean, I didn't even live in the ward when he was called to the bishopric, or later when he was called to be bishop, I was not in the ward either. We moved back in, and he picked up as though James and I had never left. How wonderful! Again, even with my own blessings, I try hard to listen, but sometimes my mind wanders. But I have complete and total faith in the Priesthood, the Bishop, dad, the Gospel, the Atonement, the Lord, the Savior, and the blessing. I will be fine.

I could say so much more. I do not believe this was a coincidence. I believe I was to have things happen this way. Had I been treated for the infections differently any earlier, I might not have had this happen. Had I not had all the infections, I might not have realized this time things were different and not gone in to the ER. Had I put it off and not gone in, it could have gotten a lot worse and the treatment and things could have been much worse. Had I been told at a different time, in a different mindset, that I had cancer, I may have fallen apart, been inconsolable, been suicidal. Who knows? The Lord knows, He does things with a purpose and for a reason. Too many things have happened in my life in a certain way. Sometimes I chose to handle them with a positive attitude and take things in stride. Other things I have not handled as well, but I learned from those experiences (I hope) and have grown. They have shaped me into the person I am. Perhaps if I had listened to the Spirit better, some lessons might not have been as painful, or I would not have taken the rough and bumpy road and the hard way to get there. But if we did not have agency, how could we learn? I will be the first to admit I can be stubborn, hard-headed, and slow to catch on. But there are some things I have learned and I really am trying to apply them to me, my choices, my attitude and my life.

I am especially grateful for all of my friends, family, acquaintances both personal and virtual who have sent well wishes, positive thoughts and prayers my way and heavenward. I believe it has been your energy and the Lord's will and influence that I have been handling this so well. I am truly blessed in this wonderful season of Thanksgiving. I am not completely sure why I have to go through this, but I will do so with a light heart, with my thoughts focused on my physical, mental, and spiritual healing, as well as on the Lord. I ask that you please continue your efforts of positive thoughts and prayers in my behalf, as well as for my family, close and extended.

I will continue to keep things updated, especially via this blog. Some may be long, some may be short, but I will keep people posted.

Thank you all, I love you, and God bless.