First Cancer Post - The start of my symptoms through November

This blog is a long time coming and I apologize for the delay. I have said parts of this story to so many different people that I never know who knows what or even who really cares about what.  I'm sorry to those that I haven't talked to in person about all the details, hopefully this will answer any questions you may have regarding my diagnosis and progress.  Also, don't feel bad if you aren't interested in reading this crap... it's a long, rambling, catch-all post that I doubt I'll proofread, lol.

Middle of September - I scheduled a yearly checkup... I usually use my birthday (August 24th) as a reminder to set up that yearly appointment.  My appointment is set up for the middle of November.  After I got off the phone I thought, "I should do a self breast exam because Dr. F always asks me if I do them and I want to answer yes honestly."  Ha ha, like that one time constitutes regular self exams.  I find a lump about the size of a grape in my right breast.  I'm not worried because I know lumps can be cyclical so I just decide to watch it over the next month.

Middle of October - My breast lump hasn't changed at all despite my body going through an entire monthly cycle.  I've told Matt about the lump after a couple of weeks of no change and he's worried.

October 24 (Friday) - My lump hasn't changed and I'm starting to get a bit concerned, but Matt is worried enough that he wants me to move up my appointment.  He prompts me a couple of times that this should be my #1 priority that day.  I call to reschedule, but my doctor will be out of the office until November 4 - almost 2 weeks!  During this time, I'm not really concerned because I've had many "fatty tumors" in my body and assume it's just another one of those.  I take the opportunity to tease Matt about my lump.  For example, one night we're getting Cutler's cookies and I order 2 for myself, saying, "I've already got cancer, let's just feed it some more sugar!"  or I'll indulge in a dirty diet Dr. Pepper and say something about the aspartame causing my lump.  Stupid comments like that... 

November 4 (Tuesday) - Matt is really worried and he's starting to freak me out.  The appointment line says there are no openings, in fact, Dr. F is overbooked since he's been gone.  I decide just to pop into the office and see if they can squeeze me in just for a feel of the lump.  Janita (the office coordinator/head nurse for Dr. F says he can't see me but she can tell I'm nervous so she invites me back to the office.  She puts me on the cancellation list for Dr. F but then also proceeds to call Davis Imaging to set up an appointment for a mammogram so I can get in to whichever place has an opening first.  Davis Imaging is slammed because October was breast cancer awareness month but Janita can get me into an appointment on the 11th.  This puts my mind at ease and I'm so grateful for her patience with my nervousness; she probably sees stuff like this all the time and it turns out to be nothing.

November 10 (Monday) - Dr. F has a cancellation so I was able to meet with him the day before my scheduled mammogram.  He feels the lump but reassures me that over 80% of the lumps people feel are benign.  This puts me completely at ease again, especially because of my aforementioned predisposition for fatty tumors.  Dr. F also told me I should get an appointment lined up with a surgeon in the small chance that the lump was cancerous.  He told me (more than once) that the surgeon should do the biopsy and not to let the radiologist at Davis Imaging do it, even though they'd try, because it would be best to deal with the same doctor all the way through treatment.

November 11 (Tuesday) - Diagnostic mammogram and ultrasound @ Davis Imaging:  The ultrasound was uncomfortable and cold but not as painful as others had told me it was... that is, until they used a special attachment just for the diagnostic mammograms - holy cow, it was smushy!  After the mammogram I went into another room for an ultrasound.  I was surprised that in addition to checking my lump, the technician also checked around my armpit.  I just assumed she was checking the entire breast for anything suspicious but I was surprised that armpit area she checked was so tender.  She excused herself from the room and told me she was going to get Radiologist to come into the room. Ok, so looking back on this, I was in la-la land or something, because this should have been a red flag!  The sweet radiologist came into the room and introduced himself, then started using the ultrasound equipment as well.  After he looked at things for a bit he had me sit up and asked me a few questions and then proceeded to tell me that he thought I had cancer and asked how I was feeling.  I smiled with resignation and replied, "Oh I was kind of prepared and expecting it."  Except, the thing is, I WASN'T!  He kept talking and said I showed 3 signs of cancerous cells, but the only ones I can remember are irregular shape and an enlarged, suspicious looking lymph node (the armpit area they were checking).  My brain was going a million miles an hour and what he was saying wasn't registering. He said the only way to be 100% positive it was cancer was to do a biopsy and he wanted to do one right then.  When he said that, I started to freak out a little bit more... my trusted OB that I love and that has delivered all 4 of my babies had told me that they'd want to do the biopsy at this place but that I was supposed to wait and have my surgeon do it.  When I told that to the radiologist he was taken aback and questioned Dr. F's advice, telling me that the surgeon would just send me back there to get the biopsy.  Now my mind really started reeling and I started to tear up not knowing what I should do and said I should probably talk with my husband first. The sweet radiologist realized I wasn't as calm as I was trying to portray and told me that waiting another week for the biopsy would be just fine.  He gave me lots of contact #s and reassurance and I headed home.  Matt was out of town in St. George and I called him with the bad news as I drove home.  It sucked.

November 12 (Wednesday) - I had to meet with my PCP (primary care physician) Dr. K because my insurance (Humana HMO) is stupid!!!  An ObGyn is the only doctor besides my PCP that I can go to without a referral.  Even though Dr. F referred me to get the mammogram, the official referral needed to come through Dr. K and he had to see me before he could legally send the paperwork through.  Despite all the insurance hoops Dr. K and his nurse Sherma have had to jump through for me, they have been so helpful and supportive.  

November 14 (Friday) - Matt and I went to see Dr. O for a consult about the biopsy.  He confirmed that the imaging wasn't positive, my lymph node showed a score of 4/5 for suspicion of cancer and my breast lump had a 5/5 score.  Of course, without the biopsy results, there wasn't 100% confirmation so Matt and I felt like we shouldn't tell anyone yet.  And to make matters worse, he does NOT do the biopsy, he referred me back to Davis Imaging!  I was so upset because if I would've done the biopsy on Tuesday when I was there, I would've had the definitive results by now!!  Dr. O apologized and said that he was the one who'd been telling the ObGyn doctors to err on the side of caution... too many people were getting unnecessary biopsies.  This consultation with Dr. O was at the end of the day so when his nurse tried to get me an appointment for a biopsy the coming Monday, the scheduler was out of the office.  DI said that they did have one appointment available at 9:00 that morning but that we'd need to call first thing to get it scheduled before anyone took that slot.  Dr. O promised he'd call on Monday before he went into surgery and that he'd call us to confirm the appointment.  He also talked with us about removing the lump asap - maybe even the week following the biopsy.

November 17 (Monday) I woke up early Monday morning waiting for a confirmation call from Dr. O.  When I didn't get one by the time he'd promised, I proceeded to call DI myself to set up an appointment.  I left three voicemails on varying phone lines but couldn't talk with anyone directly.  Matt and I just decided to head over to the appointment an trust that it was arranged.  When we got there, we were told the appointment was taken by someone else and that they hadn't heard from Dr. O.  We were also informed that we needed another approval from our insurance before they'd even see us.  It was a long morning... I cried, Matt got upset and yelled that he didn't care about insurance, he'd pay them cash right then if they'd get me back for the biopsy.  They took us back into a room, basically just to ease the tension so we didn't upset the other patients I think.  After talking with another gal, who again confirmed they couldn't see us that day and me crying again, the head office manager came in.  We explained the entire story to her and she told us she'd figure out a way for me to be seen that day.  The biopsy didn't take long and wasn't too painful, although my lymph nodes were sore for about a week afterward.

November 18 (Tuesday) Angelina, who is a Cancer Care Coordinator, called the next day to set up an appointment to review the pathology results.  It usually takes a few days to get them back so she thinks they'll be ready on Thursday.  We set up an appointment for Friday afternoon to go over the results.

November 20-21 (Thursday & Friday) I'd previously arranged a getaway for Matt and I to fly to Portland, Oregon to see Justin Timberlake in concert.  We were planning on staying till Saturday night but changed our flight to accommodate our appointment with Angelina.  It was nice to get away from all the stress and cancer talk for a day, although who am I kidding, that's all we really talked about!
I called Angelina on both days to see if the results had come in... nothing yet.


November 21 (Friday) Matt and I are on our way home and we're eating breakfast at the airport when Angelina calls us with the pathology report.  She understandably did not want to give us the results over the phone, but I told her I'd do better if I had a chance to process things before I met with her.  Obviously, since I'm writing this blog, the results weren't good.

When we got of the airplane we got something to eat and then drove straight to meet with Angelina.   She showed me my pathology scores and told me what everything meant.  I was surprised with all the different varieties of breast cancer that were possible - each with varying kinds of treatment.  I honestly had no idea how personalized each person's diagnosis can be.  Angelina talked me through the entire process of what to expect and what doctors I'd be meeting with.  She gave me an organizational binder and even set up appointments with all my doctors for the following week.  It was a big job for her to accomplish, especially since the following week was Thanksgiving, but I think she'd been working on the scheduling earlier in the week since I'd called her so often.  She had actually never worked with Dr. O on a cancer team before, and although she was super careful with what she said and didn't really make a recommendation, we realized it would be in our best interest to change surgeons to Dr. M because he had more experience with breast cancer surgery.  I wasn't worried about switching in the least because I was angry with Dr. O for not scheduling my biopsy and/or getting back to me about it.  Btw, I loved this meeting with Angelina.  I don't think I will meet with her again, but I can't emphasize enough how helpful it was to have someone hold my hand and walk me through things, teaching me what to do and who to contact at the very beginning of the diagnosis.


November 24 (Monday)  Matt took me to get my MRI @ Davis Hospital in the morning.  The MRI machine was intimidating, as soon as I walked into the room, the size of it kind of freaked me out.  The selfie below was taken before I walked out to the MRI machine.  It sounds stupid now, but to calm myself down, I made myself look in the mirror and smile for the picture, thinking that it would make Matt happy to see that I was doing ok.  It wasn't painful, or as claustrophobic as I'd heard, just a pain to try and hold still for the imaging.  There were a couple of times that the technician told me, "now, don't hold your breath, but your breathing is interfering with the scan, so try to fix that..."  What in the heck does that mean - what am I supposed to do?!

After the MRI and lunch, we went to a meeting with my oncologist Dr. S.  The oncologist is considered the "quarterback" of the cancer care team and I think he is fabulous!!  Seriously, I adore him.  I feel like he has the perfect blend of competency and compassion.  While I was there he explained my results a bit more and then told me that I was considered "Stage II B" which has a 93% five-year survival rate - great news!  Before I left, the nurse drew my blood for BRCA testing.  The BRCA gene is rare, but if you have it you've got an over 85% chance of getting cancer in your breasts or ovaries.  I only qualified for the testing (through insurance) because I am under 40 and because my Grandma died from cancer.  The results take about 2 weeks to get back but we wanted to know if I was BRCA positive so we could decide on lumpectomy vs. mastectomy before we had the surgery.

Chemotherapy will be every two weeks for 8 treatments. So, 4 months total.  The first half of the meds will be Adriamycin and Cytoxan and the second round will be Taxol.

November 25 (Tuesday)  I met with the radiation oncologist Dr. H and really like him as well.  I don't start treatment with him till after chemo.  They've got a cutting edge machine called Tomotherapy that is fabulous at just targeting the cancer and none of the surrounding organs (which caused the spread of cancer in the past).  He was very professional and serious so when he told me that they'd be putting tattoos around my breasts as "markers" before radiation and asked if I'd prefer hearts or stars, I totally thought he was serious!  They actually do put tattoos on your body so they can aim the radiation perfectly every time you come in, however the tattoos will just look like freckles.  I have to admit I was a little bit bummed; I was looking forward to the stars!!

Radiation will be every day for about a half an hour.  It will last for 6 weeks.

November 26 (Wednesday) I met with my new surgeon Dr. M, and I'm so glad I made the switch - I love him!  We set up surgery for 3 weeks away so we can have the BRCA results back and make a definitive plan for surgery.
After our meeting with Dr. M, we packed up the car and headed to Las Vegas for Bradley's Thanksgiving hockey tournament.