Yesterday's Appointment

(Previously published July 7, 2010)

Yesterday morning, I had my last appointment with my breast surgeon, Dr. Chang. It was rather uneventful, as I had already been given all of my test results up to this point except the BRAC1 and BRAC2 breast cancer gene test. I really wasn't expecting much, only to go over the details of next week's surgery and hopefully get those results. 

Right before our vacation, I had the bloodwork done for the genetic testing. Dr. Chang had recommended the test due to my age. It is amazing to me that there is even a breast cancer gene that can be a part of our genetic code. The test takes two weeks to run and will tell if you carry this gene that puts you at a higher risk for not only breast cancer, but also ovarian cancer. I knew that breast cancer wasn't prevalent on my dad's side. My dad's sister had breast cancer in her 50's and had a right breast mastectomy, but didn't need further treatment and has been healthy since. Huge praise! I had always been told that for a girl, the greater risk is on the mother's side. My mother never had breast cancer, nor did her only biological sister. But her mother died when she was 13 and their father had deserted the family many years prior. There aren't many more immediate living relatives on my mom's side. My mom told me that her mom had died of liver cancer, but when I spoke with my aunt (mom's sister), she said that her mom had what they called back then "the female cancer." So really, no one knew. For me, this was the wild card and the link that could bring a positive result back from the genetic testing. 

Thankfully, I received a negative result. I do not carry the breast cancer gene. This is good news not only for me, but my sisters and of course my little Faithy girl! 

We spent some time talking through my surgery for next week. Of course, my husband, being in the medical community, wanted to know the knitty gritty details of procedures and incisions. I think he would be in the surgery if they let him! But snapshot overview is that it is a long surgery. I will have general anesthesia and be fully intubated. The surgery will last around 6-8 hours, depending on how many lymph nodes will need to be removed. She will start with the sentinel lymph nodes, remove them, send them to pathology, remove the diseased breast while waiting to hear back if cancer is present in any of the sentinel nodes. If so, she will proceed to remove all of the auxillary nodes leaving only the last row behind. She will then remove the left breast. Then the plastic surgeon comes in and begins the reconstruction process putting in breast expanders that will become my new "temporary" breasts over the course of the next 6 months. Following surgery, the expanders will be empty. Each week for six weeks, I will visit my plastic surgeon and he will "fill me up" with saline injections getting me to the desired size. (not sure yet what that will be!)

I will probably be in the hospital through the weekend, depending on how I am doing. My plastic surgeon has told me that the pain afterward is pretty intense, as did my breast surgeon yesterday, as the breast expanders are put in the pectoral muscle tissue. So the pain is more a spasm of those muscles adjusting. They said I will be on muscle relaxers, (aka valium) as well as morphine and then Percocet. Oh my....for a girl who almost never takes even Tylenol, this will be a lot. I am praying that my high pain tolerance kicks in to overdrive! 

At this point, I have a diagnosis of stage 1 Invasive Ductal breast cancer due to the pathology results thus far and the size of my tumors. (one 16mm and one 7mm, but not attached to each other.) We spent some time talking about the lymph nodes, as those really will put the final picture together. If they find cancer in (I think it was) more than 3 lymph nodes, my staging will go higher and further treatment will be greatly impacted. Thankfully, all of my other tests have been clear: bone scan, chest xray, blood work, left breast and liver function test. Apparently, breast cancer likes these areas of the body, so they check them first for cancer. My chest wall also is clear. 

If no additional cancer is found during surgery, then I will be on the borderline of needing chemo or radiation in the weeks following surgery. If cancer is found in any of my lymph nodes, Dr. Chang is saying that chemo and radiation will most likely be in my future beginning one month following surgery, with chemo first. I have not yet met with an oncologist and will be doing that 2 weeks after surgery, once the full picture is known. I will meet with both a medical oncologist and also a radiation oncologist. They give the body a month to heal from surgery before starting the next phase of treatment. 

So, as there always is in life, there are a lot of unknowns still. But I really and truly rest in the fact that God knows all of these unknowns and I know that God loves me and will walk these steps with me. 

Yesterday was a hard day for me. We all have those days. As the day wore on, the magnitude of the surgery became more and more present. I was on the phone a lot catching up with some friends and talking to my sisters as they were checking in with me. By evening, it all came crashing in as I was talking to my sister, Heather. The wave crested and began to beat down. It is going to be hard. I knew that...but I don't think I have let my mind touch the emotional side yet of losing my breasts. Of looking in the mirror for the first time after surgery and what I will see. Of the whole process....

Of the hospital stay....I've never been in the hospital before without a baby. I'm not one who really likes being alone. I know I am never alone with God, and this is yet another part that God is working through me....the thought of being in the hospital for 3 days by myself.....that in and of itself is emotional for me. I don't like being alone. Call me crazy. I would rather have 20 kids walking in and out of the doors of my home, than 20 hours of quiet. Oh, don't get me wrong, I do like quiet moments, when the children have all gone to bed, or in the early hours of the morning, but I know that at anytime, the quiet escapes and laughter, talking and children will fill the space. So, for many reasons, I'm not at all looking forward to next week nor to the time in the hospital. 

May I again humbly ask for your prayers? Please pray that God's will be done in my life. That my lymph nodes will all come back clear of cancer. That He will minister to my heart and teach me what I am to learn right now. That He will keep my mind focused on Him, and not these details, for He alone will bring me complete peace. 

One of my favorite verses is found in Isaiah 26:3,4...as I am writing this morning, God has brought that verse to my mind once again. I leave it with you today. 

"You will keep him in perfect peace, whose mind is stayed on You, because he trusts in You. Trust in the Lord forever, for in YAH, the Lord, is everlasting strength."

Much love,

Stacy