New chemo

I started my new chemo drugs, Adriamycin and Cytoxan, last Tuesday.  My case was discussed at tumor boards, and it was agreed that it would be best for me to switch regimens.  I have been pretty sick this last week with nausea that is worse than in the past.  Adriamycin is nicknamed the red devil (it is red) and I am learning that the nickname is justified.  It is a very scary drug that has a long list of side effects including cardiac toxicity.  I had an echocardiogram before starting the chemotherapy because herceptin (which I was on before the her2 drama) can also cause cardiac problems.  Last Wednesday I had a follow-up echocardiogram and there were some abnormalities.  Since I had it done on Wednesday at 4:30 right before the holiday weekend, I haven't been able to discuss it with my oncologist.  I have been worried about it all weekend, and am hoping that everything will be OK.  I am also getting quite anemic.  My hematocrit started at 45% and is down to 29%.  I have lost 1/3rd of my blood volume which, according to my oncologist, is what is making it so hard for me to run.  I was just starting to get faster this summer after having the baby last December, and now can barely run 10 minute miles.  I have to stop and walk frequently.  

Suzanne, Paul's mother, took the kids to Fillmore on Tuesday night for Thanksgiving.  We thought about driving to be with them for Thanksgiving dinner, but I wasn't feeling well.  It made me feel really down to not spend the holiday with them.  Some neighbors brought Paul and I leftovers from their dinner, but I was too sick to even try anything until the next day.  

I am feeling a lot better, and today is the first day since the chemo that I haven't taken anti-nausea medication.  We picked the kids up and I am hoping that I will be back to normal tomorrow.  I am trying to stay positive, and in the spirit of Thanksgiving, here are the things I am thankful for.  

1- My children.  I am lucky that I was able to have my children before breast cancer because chemotherapy induces menopause and infertility.

2- My supportive husband who constantly listens to my anxieties and is always so positive and strong.

3- Paul's mother Suzanne who has helped me so much with my kids.

4- My friends who help me to stay positive and keep me pre-occupied.  (Thanks Jamie for the shellac nails)

5- My religion.  I am trying to let go of the things I can't control and put my trust in God.  I have faith that He will guide and support me and everything will be OK. 

The haircut

 Mohawk

 Fixing the mohawk

 Final product

 Shaggy (aka Jacob) doing his schoolwork

 Emily (left) and friend Ivey as flappers

 Dr. Evil, Austin Powers, Shaggy, shark, and monkey.

 Shark (Sam)

 Austin Powers looking for Dr. Evil

My parents on their wedding day.  Can you believe these two people had a baby at their ages?  Gotta love my mom's 70's wedding dress.  She wanted me to wear it when I got married. 

It has been exactly 5 years today since my mother passed away. I have been thinking a lot about her, and I wish she was still here. My mom was very eccentric and fun to be around. She was working as a school teacher until she met my dad. They married and I was born when she was 43. Shorty thereafter she quit her job, moved from Salt Lake to Fillmore, and became a full time mom. I could not have asked for a better mother, and she taught me many things. I learned how to read at 3 and supposedly could read from the newspaper. She also made me write in a journal weekly until I was 18 (She picked the topics, a lot of them had to do with politics because she was an ultra conservative right wing republican) She was obsessed with geography and made me memorize the location and name of every country in the world. For a while she thought I was going to be a classical guitarist and I took classical guitar lessons for 2 years. (her dreams didn't come to reality). She signed me up for piano lessons and made sure I practiced. Other favorite memories include fun trips with neices and nephews, secret shopping trips to Provo for clothes, and family dinners. When I was about 18 she started forgetting words and names of people she had known her entire life. This gradually worsened and we found out that she had multi-infarct dementia which is similar to Alzheimer's disease. Her disease was heartbreaking for me, because I lost my mother piece by piece over a period of 10 years. She also developed breast cancer about 1 year before she died.

I thought a lot about my mother and my grandmother right after I had the biopsy. I remember driving home thinking that if they were out there somewhere, maybe they could intervene and somehow make my biopsy normal. I didn't want to go through the same thing they had been through, and maybe they could spare me this trial. I think I just wanted and still want my mother to be with me during all of this. I miss her so much!

I thought I was 2/3rds finished with my chemo until I met with my oncologist for my 4th treatment. Apparently the pathology lab got a new machine that tests for the her2 protein in July. Since then, there have been more her2 positive breast cancers than normal. Her2 testing starts with staining the tumor cells and looking at them under a microscope. Depending on how many cells stain, it is rated 0, 1+, 2+, or 3+. 0 and 1 are negative, 2 is equivocal, and 3 is positive. If the results are 2+, another test is sent called a FISH to look at the DNA. I didn't know this, but my tumor was borderline positive. Because of this and the new machine, they decided in late October to send the FISH test on my tumor and it came back negative. My oncologist wanted a second opinion so he requested that my her2 testing be repeated at another lab. The results came back yesterday. The staining was 2+ and the FISH was negative. So, I guess this means that my cancer is technically her2 negative which is a good thing. (The her2 protein makes the cancer more aggressive and more likely to spread)

The bad news is that I have been treated for a her2 positive breast cancer, and now my oncologist thinks that I should be on a different chemo regimen. I have been receiving taxotere, carboplatin, and herceptin every three weeks for 6 treatments, (I have finished 4 out of 6) then was planning on continuing herceptin every three weeks for a year. If my tumor had not been labeled as her2 positive, I would have received adriamycin and cytoxan every 2 weeks for 4 treatments, and then taxol every week for 4 treatments. Since the taxotere is similar to taxol, he is going to count that as the taxol and wants me to start adriamycin and cytoxan next week. The plan is to do 4 treatments of the adriamycin and cytoxan every 2 weeks. This is frustrating to me because If I would have initially started on this regimen I would have been finishing up the chemo and would possibly be getting my mastectomy in December. Now my mastectomy will likely be pushed back until the end of January. (I had it scheduled for January 10th). Adriamycin and cytoxan are typically harder to tolerate than the chemo I've been on, so I'm scared for that. The plan is still up in the air on what my next step is with the chemo, and I'll know more next week.

I had an ultrasound to make sure the tumor is shrinking, and the radiologist couldn't really find it. She said that if she didn't already know I had cancer, she may have read it as normal. My lymph nodes also look normal! I can still feel the tumor, but it is a lot smaller and softer.

I also met with the Radiation Oncologist Dr Avizones. She recommends that I do the chest wall radiation because it increase survival by 10%. I have decided to do it, so I won't be able to get my mastectomy and reconstruction at the same time. This is because radiation damages tissue and dramatically lengthens healing times. Instead, my plastic surgeon will place tissue expanders. I will then have 25 radiation treatments. Then I can have the DIEP reconstruction which probably won't be until May or even June. It's Depressing that this is going to take that long.

I am intermittently having anxiety, and continue to struggle with my thoughts. For example, while getting my teeth cleaned I wondered if I should even be doing it because I was going to die anyway. I have also been shopping and wondered if it was a waste buying clothes since I am going to die. In events such as birthdays, piano recitals etc, I think that maybe this is the last time I will do these activities. Then I start wondering if these thoughts are premonitions, but Paul says that the spirit doesn't speak to people with fear and anxiety, so I think it's the adversary trying to get me down and test my faith. I had a day last week where I felt negative about everything, and kept feeling that all of this was unfair. Why did I have to get breast cancer at 35 while breastfeeding? Why did my BRCA test come back positive so I have to worry about getting my ovaries removed? I feel like I am so distracted by breast cancer, that I am not even enjoying my baby's first year, or my other kids. I feel like my kids are getting cheated by having to worry about their mother all the time. I decided to let myself have that day, and then move on and try to be more positive from there.

I need to express my thanks to so many people who have been so supportive. We have had countless dinners brought to us on the weeks of my Chemo. My Friends at work have set up a housekeeper that comes every 2 weeks so I don't have to worry about cleaning when I am sick. People have dropped off treats, hats, books, and been very helpful with driving my kids around. We feel so blessed by the outpouring of support we have received. Thank you!

My bald head!

Sick

So I actually wrote that last post on Monday the 10th, which is why everything sounds so positive. I have had a terrible week. I started getting sick on Tuesday afternoon before going in for my Neulasta. That night I decided to try some phenergan for nausea. I also took an Ativan to help me sleep (the steroids I am taking make sleeping difficult). The next day I couldn't wake up and ended up sleeping the entire day. My memory was horrible and I couldn't focus on anything. I was also having numbness in my hands and feet. Then to top everything off I got bronchitis. This lasted through Friday night and now I am finally feeling normal today. I called my Drs office numerous times during this period and I'm sure they think I'm psycho! They have a really great nurse practitioner named Shirley that talked me down from the cliff a couple of times.

Jacob turned 9 on Friday! I asked him where he wanted to go for his party and he said the nightmare on 13th. Yeah right! He ended up inviting some friends to go Thanksgiving Point for the corn maze, which is a much more appropriate activity for 8 and 9 year old boys. I wasn't feeling well, so Paul, my mother-in-law Suzanne, and sister in law Traci went.

I am so thankful to my family and friends who have been so supportive. Especially to Pauls mother who has been spending the week with me after I have chemo. I don't know what I would do without her.

Half way done!

We have been busy running around with the kids and adjusting to my diagnosis.  Did my 3rd round of chemotherapy on Monday which means I am halfway done!!!!  Now I am on the downhill.  I think I have tolerated it better than most, and am a little sick for a week and a half and then feel good.  My hematocrit, white count, and platelets are pretty much normal.  Emotionally I have been having a lot of anxiety on whether I decided to do the right thing with surgery vs chemo first.  The nurse practitioner explained that the reason I was given the recommendation of chemo first is because of the size of my tumor which is 2.5 cm.  It is considered borderline small/medium. With small tumors the recommendation is to do surgery first. With bigger rumors it may be beneficial to shrink the tumor first in order to obtain negative margins during surgery.  Sometimes the tumor grows into the chest wall, and can make surgery more difficult.  Shrinking the tumor should make my surgery alot easier.  I am also having anxiety over whether the tumor is shrinking.  I am pretty sure that it is smaller, but am having this overwhelming feeling of wanting it out of me.  I can't wait until my surgery in january.


I am going to meet with the radiation oncologist towards the end of October and will discuss radiation treatments after surgery.  I am really hoping that I will be able to do my reconstruction and mastectomy on the same day.  This will depend on if I need to have radiation to my chest wall in addition to my axilla.  Radiation can do damage to the reconstruction if done after the surgery.  The procedure I will have is the called the DIEP.  http://en.wikipedia.org/wiki/DIEP_flap The best part of this procedure is that I will get a tummy tuck that is paid for by my insurance.  The recovery will be hard, I will not be able to lift anything over 10 pounds for several weeks after the surgery which will be hard with a 17 pound baby crawling all over.


I went to my first young survivor sisters social last week which is a support group for girls under 45 that have been diagnosed with breast cancer.  We met at the cheesecake factory.  It was really helpful to meet others who understand exactly what I have and am going through. There were about 20 in attendance and I'm sure we were quite the sight.  Several of us were bald and the conversation solely focused on breasts! Im pretty sure we all kept touching our breasts while talking.  I was able to talk with a girl that also has the BRCA 2 mutation and is a survivor.  Her dr recommended that she get her ovaries removed by age 38, I am planning on doing this also because I am so scared of ovarian cancer (people with the brca2 gene have a 20% chance of developing ovarian cancer and the normal population have 1 1/2%)  It feels like my ovaries are ticking time bombs.


I met with the genetics counselor and have pinpointed that I got the BRCA2 gene mutation from my mother.  It was passed to her from her mother.  My maternal grandmothers brother has some granddaughters and great granddaughters that all carry the same gene as I do.  The BRCA2 gene is a large gene and different families carry different mutations within the gene.  Turns out that we have the exact same mutation.  Many members of their family have had breast cancer and several got it even younger than me.  I had absolutely no idea that this gene was carried in our family!  


My hair has mostly fallen out.  It happened about 2 1/2 weeks after my first treatment.  We had a hair shaving party and my kids shaved a Mohawk before they buzzed it all off.  I have been going around mostly bald, but have been wearing hats the last several days because of the cold.  

Zachy and I after the haircut!

Showing off the new bracelets!  Thanks Lisa

BRCA2

So it turns out that I carry the breast cancer gene, BRCA2 to be exact.  I found out last Wednesday at work.   I hadn't been too worried about it because my oncologist said that with my type of tumor (her2neu positive) it would be unlikely.  I started to get a little concerned on Tuesday when the breast care coordinator asked me if I was on pins and needles waiting for my result, and thats when I started wondering if maybe I should be worried.  I called and found the results out the next day.

Finding out this information made me feel like I was being kicked while already down.  For me, it means that I will need to have a bilateral mastectomy.  Also, in the next several years I will need to decide whether to have my ovaries removed because there is a significant increase in ovarian cancer if you carry this gene.  There are implications for others too.  There is a 50% chance that I have passed this gene on to each of my four children.  I only have 1 daughter, but it increases the risk of some types of cancers in the boys also (boys can also carry it, so they can can pass it to their daughters).  I am pretty sure I inherited this gene from my mother because both she and my grandmother had breast cancer.  They were both post-menopausal, but my dad's side of the family doesn't have any breast or ovarian cancer that I know of.  I am meeting with a genetic counselor on the 22nd, so I will know more after that.  Both of my parents have passed away, so they won't be able to be tested.  Right now I am trying to track down family history information on who has had cancer so we can figure it out.  Both of my parents families are huge, so there will be a lot of people who will be affected.  I know that some will not want to know, but for me, knowing that I carried this gene may have made a big difference as I am too young to start routine mammogram screening.

Physically I am feeling fine, I have returned to work and plan on continuing at least for now.  I do understand that chemotherapy will be cumulative and there will likely come a point when I need to stop.  My awesome co-workers gave me the best gift basket ever full of pajamas, scarves, hats, itunes gift cards, mints, mouthwash, nail polish, lip gloss, gift card to get my hair cut (I will talk more about this later) etc.   The best part of it was housecleaning during the chemotherapy ordeal, what a thoughtful gift!  They also had pink bracelets made that say "Team Nancy"  which are a huge hit with my friends and neighbors.  Some little girls came by last night wanting one.  I have the most supportive friends and neighbors ever, and have also received lots of delicious dinners!

I have always wanted to try really short hair, and I decided that this is my opportunity.  So Saturday I used my gift card and cut it all off!  I absolutely love it and wish that I had done it sooner.  I'll post pictures.  The sad thing is now it's starting to fall out.

I met with a plastic surgeon today (Dr. Ferguson) to talk about reconstruction.  I really liked him and am hoping that I can do my reconstruction at the same time as my mastectomy.   He showed me a lot of pictures and it is pretty amazing how normal they look.

Emotionally I am overall doing better, but still have ups and downs.  It helps me to stay busy and I am still running and biking, as my oncologist recommended.  I appreciate the prayers and support that I have received from everyone and am so thankful for friends and family.

I'm gearing up for the next round of chemo which will be on Monday, and hoping for the best!

Side Effects, Side Effects, Side Effects

I (Paul) have always heard that Chemotherapy is terrible.  I suppose that I thought that it makes one fatigued and feel lousy overall.  That was about it.  I didn't ever put too much thought to it.  I guess that in my own world where I did not have to deal with it up front and personally, (along with a healthy lack of empathy) I never gave it the consideration that it deserves.  I understand that Chemotherapy has come a long way in the last several years.  The medications to offset the effects of the Chemo have also made it much more tolerable.  The following is our experience with Chemo and the counter-acting drugs thus far.

Nancy is receiving Taxotere, Carboplatin and Herceptin, a Chemotherapy regimen that is referred to as T/C/H.  She receives treatment every three weeks for a period of eighteen weeks, 6 treatments in all.  So far, she has only received one treatment.

Taxotere and Carboplatin according to some hand-outs that they gave us "disrupt the growth of cancer cells which are then destroyed.  The drug cannot distinguish between cancer and normal cells, so some normal cells are affected, causing side effects."  


Herceptin is a protein that fits like a lock and key with a protein on certain breast cancer cells.  This medication is brand new and considered a game-changer for patients with HER2NEU positive breast cancer.  This is one that Nancy will receive for an entire year.

Aloxi is an anti-nausea medication that is given during the chemo treatment.  It blocks chemotherapy-induced nausea and vomiting by blocking serotonin.  It is effective for 3-5 days.

In all, each chemotherapy session lasts about 3.5 hours.  I was surprised to hear that the first time.  I have found a lot of the details about chemo to be quite interesting and am providing them in hopes that others will likewise.

One of the many things that I have found interesting is how as a system the body reacts when poisoned with the chemo.  When you treat one area it inevitably affects others.  This creates a snowballing effect of medications to counter-act side effects of other medications which require other medications to counter-act their side effects.  I hope that I can adequately describe this in this post.

The side effects of Taxotere and Carboplatin are listed as; Decreased white blood cell count with increased risk of infection, decreased platelet count with increased risk of bleeding, decreased red blood cell count with increased risk of fatigue, hair thinning or loss, diarrhea, loss of appetite, nausea, numbness and tingling in hands and/or feet, taste changes, sores in mouth or on lips, swelling in ankles or hands, fluid retention, fatigue, muscle aches, rash, nail changes, constipation, confusion, visual changes, ringing in ears, allergic reaction, dizziness, sensation of pins and needles in hands and/or feet.  Many medications list many side effects as disclaimers, but believe me, in the cases of Taxotere and Carboplatin they mean it!  If you were to put a check mark next to all of the side effects that Nancy experienced with her first round of chemo, it would litter the list almost entirely.  She at some time or other  had most of them.

I eluded to it earlier, but because of the many icky side effects, they commonly prescribe a cupboard full of other medications to off-set the chemo.  Decadron is a steroid that minimizes the inflammation and they require her to take this the day before, the day of and the day after chemo treatments.  This one is a real charmer. Listed as "common side effects"are; increased appetite, difficulty sleeping, fluid retention, weight gain, moodiness/irritability, high blood sugars, heartburn and stomach ulcers.  They list another 25-30 less common side effects just in case the more common ones don't satisfy you.  In spite of this medication's laundry list of side effects it has dramatically improved the side effects from the chemo.  Nancy's worst reaction to Decadron was feeling buzzed all of the time and an inability to sleep.

When the Aloxi (that is given to her for nausea at the time of chemo) wears off, she needs to take Ativan or Compazine.  Compazine is given to control nausea in patients, but is also given as a "highly potent" anti-psychotic.   Compazine makes her feel crazy and Ativan makes her feel like she is sleep walking.

The day after chemotherapy each time Nancy has to go in to receive a shot of Neulasta which boosts her white blood cell count.  This medication causes bone pain, overall achiness and soreness.  Tylenol is given to remedy that.

Another prescription was for an antibiotic that she is supposed to take if her fever rises above 100.4  She did have a fever for a short time along with chills, but they left rather quickly.  There are other over the counter medications for constipation and/or diarrhea, mouth sores, achiness etc.

As I write this I am understanding more and more why this post was assigned to me. I am much more comfortable talking about her diarrhea on a blog than she is.  On a more serious note, I'll do a better job describing what she has been through.  She'd downplay it.  When people have asked her how she was feeling she did just that.

As far as a timeline, she had her first treatment on a Monday and Tuesday-Wednesday she felt OK.  Wednesday was the beginning of spaciness and lack of sleep. Thursday-Saturday she felt nauseated almost the whole time and took the anti-nausea medications that made her feel "out-of-it".  Her fatigue was mostly gone by Friday and then her diarrhea, head-tingling, mouth and tongue inflation, body aches, bone pain, back spasms etc set in.  By Monday most of these symptoms had been reduced and as of today (Wednesday) she claims to feel pretty well.

We were not quite sure how she would react to the chemo and I have to admit that it was worse than we expected.  Everyone reacts differently and there is no rhyme nor reason as to why.  I was hoping that she'd feel poorly for a day or two and then would bounce back, but it was several days.  Hopefully (there I go hoping again) we can get a routine down and figure out the medication combinations that she responds best to.

I mentioned that she'll receive chemotherapy for a total of eighteen weeks.  After the chemo, she will have 2 months to recover and then will likely have surgery around the middle of February.  Following surgery, she will receive radiation therapy for a period and continue to receive Herceptin intravenously until September of 2012.

Earlier today we received the test results back on her BRCA test.  BRCA is a genetic mutation that some women have.  It is better known as "the Breast Cancer Gene".  My next post will cover the test results and implications of a negative vs. a positive result.

-Paul

Super good news today!

I had a PET scan on Tuesday, which is a test to see if my breast cancer has spread to other parts of my body. The results showed that my bones, brain, and lungs were clear, but there was a possible abnormal area in my liver. My oncologist felt that it was probably nothing, but wanted to get another test to follow up. Today I had an MRI of my abdomen which showed that my liver is normal. YEAH!!!!! I feel such relief. When you receive bad news like cancer, it feels like there is never going to be any good news again.

So far I haven't been feeling too bad following the chemotherapy. Mostly a little tired and nauseated, but not enough to throw up or anything like that. After today I am done with appointments and tests for a while, and am looking forward to having a few days to let everything sink in. I am feeling really positive and grateful for all the blessings in my life, especially for my family and friends who have been so supportive.

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.

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!