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Tuesday, August 30, 2011

Chemotherapy

Quitting breastfeeding has been one of the hardest emotional aspects of having breast cancer. There is nothing better in this world than cuddling your baby and breastfeeding. I was given the option to pump during chemotherapy and dump the breast milk for 4 days after, but I am also taking decadron, Ativan, neulasta and anti nausea medication. I don't want to risk harming the baby, and I think it will probably be best for me to quit also. Imaging studies are affected by breastfeeding such as mammogram, and breast MRI which I was unable to have. I feel like I am being cheated by this breast cancer! The baby wants to breastfeed every time I hold him and doesn't understand why he can't. It makes my cry too.

My first day of chemotherapy was yesterday, a little nauseated today. Im taking medications to prevent the nausea, and am going to plan on not getting sick:). Paul bought me an iPad yesterday! I have been wanting one forever, so that made chemotherapy much better. There has to be some positive about this right?

RIght now I am waiting for a PET scan to find out for sure if the cancer is limited to my breast and lymph nodes in my arm pit. My Dr. Seemed pretty confident that this would be normal, but I am still super worried. I just drank a bunch of nasty dye and then got a radioactive injection. They made Paul leave so he wouldn't get irradiated by me.

Tonight we are getting family pictures before my hair starts to fall out. The nurse yesterday said it should take about two weeks. I'm not sure if I'm going to be a wig or scarf person. I may want to just go bald, however, Emily has already told me that I can't go to her school in that condition:). After the pictures, I'm going to get a super short haircat. I've always wanted to go short and have been too chicken. Now it doesn't really matter anyway because it's just going to fall out!

I am overall doing better, but still feel like I am on an emotional roller-coaster. We are trying to adjust to our new reality. Emily is taking it the hardest. She has been very intense and doesn't want to leave me to go to school. I feel so bad for her, as I remember being in 7th grade when my mother had a cancer scare. I couldn't eat or sleep and faked an illness so I could stay home with her.

I would like to thank everyone for their concern for me and for my family. We feel so loved and supported. Paul's mother Suzanne is the BEST mother-in-law in the world! I love and appreciate her so much. She will be staying with us during and after the chemotherapy which will be so helpful.

I will update with more news when I get it. I am getting a clip placed in the tumor tomorrow.
I'm not sure why they call it a clip, but it just marks the area of the tumor in case it shrinks a ton with the chemotherapy.

Saturday, August 27, 2011

The Beginning

I never pictured myself (Paul) as a blogger.  Funny how things can change...

The first week of August Nancy noticed a thickening in her right breast.  It was thin, not overly hard, about an inch long and sort of lumpy.  She has been breast feeding now for 8 months and we thought that it was likely a plugged duct or the onset of mastitis.  After a couple of days of no change she reluctantly decided to talk to her doctor about it.  She made the appointment, and went a couple of days later.  He thought that it was probably not anything to worry about, but decided to send her to get an ultrasound anyway - just to make sure.  The ultrasound was schedule a couple of days later during the time that she would be at work on Friday the 19th of August.  She was going to be working a few floors above and would take a short break, run downstairs and have the ultrasound to make sure that there was nothing serious.  I wasn't going to go.  Since she was working and Jake had a football practice at the same time, I planned on going to that.  Needless to say, Neither Nancy nor I thought that in a million years there would be reason for concern.  Just a simple test to make sure...

Unfortunately, That is not how things turned out.  She called me about 4:40 and told me that the Radiologist had informed her that he was "very concerned that she had breast cancer".  She was hysterical as you can imagine and my head was spinning.  She told me over the phone the seriousness in the Radiologist's tone and mad me aware of our likely reality.  The Dr. decided to do a biopsy of her breast lump and a nearby lymph node.  Part of the ultrasound revealed that a couple of lymph nodes were on the upper limits of normal in size.  We would have to wait until Tuesday for the results.

Nancy collected herself as much as possible and tried to return to work.  That ended up being impossible.  She ended up gathering her belongings and heading home.  Once she got home, the Radiologist called to try to reassure her and make her feel a little better because he "felt like he had her leave with no hope".  He reassured her that if possible he would get the results by Monday the 22nd.

The next few days were the longest of our lives.  Nancy worked again on Saturday and Sunday, but would be home all day on Monday- the day we felt like we were to find out about how our lives would change.

Monday finally came, but dragged on forever.  At 4:00 Nancy called the office to find out if any results had come in, and then tried to look up the results online.  The receptionist said that no results had come in and that the Radiologist was not in.  She told us to expect the results of the biopsy either Tuesday or Wednesday.  I convinced myself that she wasn't sure of the conversation that had taken place, but that it would likely be Tuesday at this point.  I even texted the few people that knew of the pending pathology to tell them that it would likely be Tuesday.

Both Nancy and I felt that the results would be positive. A few others including my sister Julie and my Mom both felt like it would be positive, but that everything would be ok.

Dr. Searle (the Radiologist) called Monday at 5:42 PM.  He asked of she wanted to go in to discuss the results, but that we also probably knew what that meant.  Nancy said no, that I was home and we were ready to hear what at the time felt like our fate.  He informed us that she was indeed positive in both the breast biopsy and the lymph. That it was an Infiltrating Ductal Carcinoma, the most common form of breast cancer and at a grade 3.  He stayed on the phone to answer any questions and continued to provide information about what would happen next.  He referred us to Dr Ray Price a surgeon the next day to discuss options.  Dr. Searle wanted us to meet with Dr Price soon because Nancy was having issues since the biopsy.  The biopsy site had originally leaked milk and some blood, but had sealed off.  This caused a seemingly larger mass.  It was likely from milking spilling inside the breast that could no longer escape the biopsy site.

We met with Dr. Price on Tuesday the 23rd of August and my Mom's Birthday.  We had initially thought that surgery was imminent.   He talked to us for an hour or so and then told us he would like to refer us to Dr. Whisenant from the Utah Cancer Specialist.  While with Dr. Price Nancy was also tested for the BRCA gene otherwise know as the breast cancer gene.  We were told of the process in each case of a positive test and were reassured that we were in good hands.

Wednesday I went to work for the first time and we were anxiously awaiting the appointment with the Oncologist Dr. Whisenant. on Thursday.

Thursday came and everyone seemed to be doing a little better emotionally each day.  We had received an amazing outpouring of support and care by friends, family and neighbors.  We felt sincerely loved and we truly appreciate it.  It is amazing how people come together in times of need.  Both Nancy and I feel like we have the best friends, neighbors, ward, and family that we could ask for.  Within moments of the phone call from the Radiologist on Monday night we received numberless phone calls, texts, emails and had several people come by.  Most everyone told us that they would stand by us and support us in any way and all were sincere.  We have been overcome by support and caring from all of you.

We met with Dr. Whisenant for an hour and a half.  He went into great detail about the type of cancer and it's characteristics.  The tumor is medium size 2.5 cm, grade 2, estrogen/progesterone positive, and her2neu positive.  This seemed better in our eyes because initially we had been told that the tumor was a grade 3.  The fact that it was Estrogen/progesterone sensitive was also good because this is something that can be controlled.  The Her2Neu is not really a good thing, but since they came out with Herceptin a couple of years ago, this is not too bad.  Herceptin targets the protein her2neu, neutralizing it.
Here are a couple of links for more:
 http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-staging    http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

Dr. Whisenant told us that we could go one of two ways.  Either Chemo first then Surgery or the other way around.  There are seemingly pros and cons either way.  In Nancy's case we weighed in favor of chemo first.  This was for a couple of reasons; one, the chemo may shrink the tumor/s and any other abnormal cells prior to surgery.  Two,  we will know if the chemo is working.  Three, it shortens the overall process by 2 months because if you go with surgery first, you have to wait to start the chemo for the body to fully recover.  Four,  it allows time to decide which route one wants to take with surgery from a simple lumpectomy to a double mastectomy.

We left there with a plan.  We were going to start chemo on Monday which meant that Friday we would need to get a port-a-cath inserted for the IV chemo.  This is basically a central line which makes it so that they don't have to search search for a good vessel for her IV every time she gets stuck.

The Morning of Friday Nancy was feeling rather rushed and uncertain about all of the decisions that had thus far been made.  She had been told of a support group called The Young Survivor Sisters which is made up of girls under 40 who have had or currently have breast cancer.  http://www.youngsurvivorsisters.blogspot.com/
Turns out, she knows a couple of gals in there.  She emailed a friend her diagnosis and had her ask the group what they thought about surgery first or second.  That was Friday morning before we had to be to the appointment for the echo and the port.  She instantly had some responses from some ladies who had either worse or similar cases to hers and who offered their advise.  This turned out to be very helpful in that stressful situation for her.  Her Breast Care Coordinator also called and reiterated everything that Nancy had been told as well.  That too helped a lot.  Nancy just wanted to be sure that she is doing the very best thing to beat it.

Friday the 26th she got an echocardiogram  followed by the port.  The port went seamlessly.    The plan from here is chemo which starts on Monday the 29th, every 3 weeks for 18 weeks (6 rounds) followed by a couple of months of recovery mid Dec-Feb and Surgery in February.  She'll have tho take the Herceptin intravenously for a year total and it starts on the same day as the first chemo.  We expect 6 months where she'll be very fatigued following the chemo for a few days and otherwise feel ok.  We have been told that the chemo will compound over the time.  In other words, each time she will be fatigued, but increasingly so to the final round.  She will then get surgery (TBD) and will receive radiation therapy for a short time.

Nancy is planning on scheduling her work to fit with the chemo and plans to work throughout.  We want to live as normal of a life as possible through all of this.  Both for us and for our 4 great kids.  We feel this will be possible through the help of My mom, our great neighbors and  friends and the Lord.  We have been blessed so far and expect more blessings to come.

We will try to keep this blog updated and expect it to eventually morph into a normal, non-cancer blog that covers our family's travels, trails, trials, travails and so on...Life will go on!