Wednesday, August 27, 2014
The News No One Wants to Hear
So I have breast cancer.
I'm reasonably healthy, have no family history of any cancer, and have not taken hormones. I perform self-exams, get regular mammograms and eat my veggies. I remember a saying, Expect the Unexpected. There have been a few Unexpecteds this past year.
It's happened so fast.
Monday July 28. First appointments at the Corona Kaiser. I knew my job would be ending soon and I'd only have health insurance for a short time, so I pushed my appointments up. Got my mammo done, then met my new doctor. Of course I had a list, so besides everything she wanted to look at and discuss, I had my share. Ended up not needing a PAP - if you've had good results then you only need one every three years. Nice.
There was something not on my list that I thought of at the last minute. "It's probably nothing, but I've had this little bump on my nose for a few years." Beware of any time you start a sentence with "It's probably nothing". The doctor looked at it and pronounced, "I'm going to freeze that off. It's precancerous."
Hmmm. I use a moisturizer with sunscreen, and a bronzer with sunscreen. I'm half Mexican and tan easily. Not nice.
She also said that if it comes back, we'll need to have it biopsied. First time I heard that word in relation to me.
Wednesday July 30. Got a voicemail from Kaiser Riverside's mammo department. Had my first inkling that something wasn't right. Called back with my heart pounding, and was told they wanted to do a second mammo for some different views of my left breast. I knew my breasts were dense, in fact I had an ultrasound back in 2012 while in Peru so they could get a better picture. However, none of my mammograms, including the one I had last year, showed any cause for concern.
Monday August 4. The machine at the Riverside Kaiser could squish your breasts in different directions. I was nervous going in, and rightly so. I saw the dark spot on the screen, and heard the technician's hushed voice while talking with the doctor on the phone. We were all looking at the same picture of what looked like a tumor. The techician tried to be optimistic. "Oh, most of these are benign. Cysts, or even shadows." Didn't look like a shadow to me. "The doctor wants to do a biospsy." Hmmm, the second time in a week that I heard that word in relation to me.
The rest of the day was kind of a blur at work. I did not have a good feeling, but put on a happy face anyway.
Friday August 8. Last day of my three month job that was supposed to be a great opportunity. I gave up my part time manager job at the tutoring center that I really liked for a fulltime position with benefits working for someone I trusted. Instead, my position was eliminated without so much as an I'm sorry. "You'll find something. There are jobs out there, right?" from the husband who laid me off. Did not see nor hear from the wife who hired me for the entire last month of work, even though she initially told me that God brought us together.
Monday August 11. Beginning to not like Mondays. Definitely anxious about the biopsy so took a Xanax. I had told a few close friends about the procedure and asked for prayer, although not sure what we were praying for because I think I already knew what they would find. I did not tell my daughters or parents, not wanting to worry my closest family members unless there turned out to be a reason for worry.
My wonderful bff took me to my appointment was a calming influence, as was the nurse who called my name. She's the daughter of a dear friend at my church, and she, too, attends Corona Friends. It was such a blessing to have her perform my stereotatic core biopsy. She provided a detailed explanation of the procedure, a soothing back rub during the procedure, and a big hug before and after. The whole process didn't take too long, it was definitely uncomfortable and somewhat painful, but prayer and my nurse helped me through it.
The procedure, according to my friend Wikipedia, "uses a computer and imaging performed in at least two planes to localize a target lesion in three-dimensional space and guide the removal of tissue for examination by a pathologist under a microscope. It makes use of the underlying principle of parallax to determine the depth or Z-dimension of the target lesion". I don't really know what that means, so in simplistic form, it's like this... They mark the spot on your breast where they are going to take the tissue sample. You lie face down on the exam table with a hole in it for the breast, then they raise the table and work on you from underneath. Your breast is compressed in a clamp (vise, you name it, it's not fun), you are given some local anesthesia, you hear a loud snap and better not move. Then the needle stabs you once but is able to extract twelve tissue samples by rotating its position inside the lesion. Pretty amazing technology actually but not really able to appreciate that fact while going through the procedure. Before it's all over, they insert a tiny stainless steel marker into the spot of the biopsy to locate the exact position of what was biopsied. This is to either let future mammographers (is that a thing?) know that there's no trouble there or to let future surgeons know that's where the trouble is located.
Well after all that, I wasn't hungry but I can always eat breakfast and since my bff offered to take me, I decompressed (get it? haha) over my pancakes.
Wednesday August 13. Not a medical issue but a legal one. Finally finished the divorce paperwork and drove to Riverside to get it notarized and submit it. Almost one year to the date of filing and a little over 30 years from the date of the wedding. Ahhh...
Thursday August 14. My calm and supportive bff again took me to Kaiser to get my biopsy results. My good friend who works at Kaiser told me that the surgeon I'd be talking with is a great surgeon who also happens to be a Christian. Good to know because I already had a feeling of what I was going to hear. The daily devotional that I read before leaving for the hospital was this: "The world you inhabit is a place of constant changes - more than your mind can absorb without going into shock. Even the body you inhabit is changing relentlessly, in spite of modern science's to prolong youth and life indefinitely..."
I don't recall the surgeon's exact words, but he was direct and kind. As kind as you could be when telling someone, "You have breast cancer." After asking me some questions, he did a quick exam and confirmed what I had told him. There is no lump. We then went into his office where he explained my pathology report: 1. INFILTRATING CARCINOMA GRADE 1/3 WITH FOCAL FEATURES OF TUBULAR CARCINOMA, INVOLVING SEVERAL CORES 2. FOCAL DUCTAL CARCINOMA, IN SITU, LOW GRADE 3. NEGATIVE FOR LYMPHOVASCULAR INVASION 4. FOCAL TUMOR-ASSOCIATED MICROCALCIFICATION. Basically I have a 1.5cm tumor in my left breast that has been there for about five years. It never showed up on a mammogram until now, which indicates that it's slow-growing. I'm positive for estrogen and progesterone receptors and negative for HER2 IHC which apparently are good things. And that's about all I remember.
He gave me my choice of treatment options, masectomy or lumpectomy, both have nearly equal success rates. He told me I should think about it, but that lumpectomy required more up-front procedures so he could begin by scheduling that and I could change my mind up to the morning of the surgery. Since I'm so analytical and often tend to overthink decisions with various pros/cons lists, I was afraid of prolonging my decision. My initial thought was lumpectomy. If both have nearly the same success rates, why not start with the least invasive? That was my choice, the surgeon concurred and began the surgery request process. With lumpectomy, I will need radiation after healing from the surgery. Probably six weeks of it. With everything the surgeon said, my decision for lumpectomy, thinking about what was, what is now, and what possibly could be, I didn't flinch. No tears, no feelings.
Back out to the waiting room and my friend takes time out of his busy work day to come up and see me and give me a hug. The friends that I had told about my appointment had by now started calling and texting. They knew my appointment was at 10:15 and it was now after noon. I thought they'd probably figure out why I wasn't responding.
Next was the meeting with the breast cancer nurse. She discussed many things in detail, and gave me a bright pink bag with lots of information to read. She told me that my tentative surgery date would be September 2. Wow, that was quick. I haven't even processed the news and there's already more to process. I looked around her office at all the reminders of breast cancer. The pink ribbons, the American Cancer Society stuff, diagrams and pictures of breasts. Wondering why I was sitting in here, listening to a breast cancer nurse? But still no feelings.
After three hours of numbness, I got in the car and thought about the phone calls I had to make and felt sad for the loved ones who were about to hear my news.
Expect the Unexpected. In the span of one week, I had lost my job, filed final divorce papers, and found out I had cancer. But even though my life had changed, I actually felt some peace knowing that "Jesus Christ is the same yesterday, today and forever." (Hebrews 13:8)
And I can do ALL THINGS through Christ who strengthens me.