Stepping Out of the Unknown

After an extraordinarily long office visit – by that I mean that I was told to expect 45 to 60 minutes for this first visit, but spent nearly 4 hours – with Dr. Toma, my oncologist (chemo doctor), I feel a lot better. I think, for me, the hardest part of any crisis is the not knowing – the drawn-out wait for more information. It was the same with my divorce 12 years ago, for the house fire 3 years ago, and, really, for anytime I’ve dated anyone - ever. Yet, as soon as I know the next step and can make a plan, the sooner I feel better. It’s like picking up nuggets of certainty to hang on to during a storm of not knowing anything. But when I think about it, what do I ever know for sure anyways? Life is one big un-knowing-ness. I only have the illusion of certainty. And at a time of crisis, that illusion is shattered, and here I am – being smacked up side the head with the fact that nothing is certain, nothing is for sure.

Pardon me, while I try hold on to my illusion just a little longer. I do like knowing things. I’m a teacher – and as much as I love teaching things, I love learning them too.

Here is what I know… er, think I know, for sure…

1 out of 8 women will get breast cancer. :(

Breast Cancer comes in 4 Stages:

• ·      Stage 1 = caught early, less than 2 cm in size (that’s mine)
• ·      Stage 2
• ·      Stage 3
• ·      Stage 4 = advanced, metastasized into other parts of the body

Because my little bit of cancer was small 1.4 cm, it counts for Stage One. That made me eligible for a lumpectomy (removing a portion) rather than a mastectomy (removing the entire breast). The good news is, that lumpectomy + radiation = the same survival rate as a radical mastectomy (5 to 7% chance of not surviving). Because I chose lumpectomy, that means I also chose radiation.  The surgery with the radiation counts for the primary treatment of my little bit of cancer.

Breast Cancer comes in 3 Grades:

• ·      Grade 1
• ·      Grade 2 (what my biopsy indicated)
• ·      Grade 3 (what pathology of my tumor revealed)

Each grade indicates the likelihood of the cancer returning, of a cell escaping during surgery and finding a new place to grow in my body – metastasizing. The higher the grade, the greater likelihood of the cancer spreading elsewhere. So, the secondary treatment is to make sure we’ve killed any cell that might have escaped from the tumor. So the next part of my treatment involves poisoning all fast growing cells – which include hair follicles (yes, I plan to lose my hair sometime during the 1^st week of August, or soon thereafter), cells lining my GI tract/system (which causes the nausea – but they’ve got great drugs to fix all that), and my blood cells (red blood cells, white blood cells, and platelets), and the possible/maybe cancer cells that might have escaped from the tumor.

Since my cancer cells are He 2 positive, and negative in the other possible areas of receptors, Dr. Toma recommends 4 chemo treatments and a year of herceptin. The worst of the side effects will happen within a 3 month span. I will go for a chemo treatment every 21 days, until the 4 treatments are complete. During that time I will receive the following: Taxotere and Cytoxan. I will take a dose of Herceptin, with each Chemo visit and weekly, in between visits. While in rare cases heart damage could occur, the side effects are minimal. I will be monitored closely, to be sure my heart is safe. My hair will grow back and the fatigue from chemo will subside. Until 2007, herceptin was used only in Advanced stages of cancer. But now, it’s proven highly effective in preventing the spread and return of cancer. That means, I’m going to live a long, long time. J

I have procedures to schedule before my first chemo treatment on July 19^th:

• ·      PET Scan
• ·      MRI of lower back/lumbar area
• ·      RNVG scan to check how well my heart is functioning
• ·      Day Surgery – Dr. Talbert will be inserting a port underneath the skin on the left side of my chest. I will have to keep it in throughout the chemo treatments. Not sure if I’ll need it for the remaining treatments of herceptin. That’s a question for my new list of questions to ask.

The Cancer Center was a place filled with patients reclining in big leather chairs and a very kind staff. The ladies there, ahead of me in my treatment, gave me lots of advise about wigs and scarves and where to find them. The Cancer Treatment Center gave me my first scarf – pictures to follow. The American Cancer Society may provide 2 free wigs. I have to check with my insurance to see if they will cover one, as well. So I’m hoping to find some really cool colors and cuts – to go with different moods on different days. There’s a workshop on how to style my profile while undergoing all this icky stuff….

I could write a lot more stuff … that I think I know, but if you’ve read up to this point, you might be feeling almost as overwhelmed as me. So this is a good place to pause.

In summary: I’ll be done with the worst before Halloween. In a year I’ll be finished with the rest.

Strangely, I do feel better. Even if it’s all an illusion of some maybe-kind-of certainty, it feels good to have a plan.

Thanks for your prayers, positive thoughts, and good light.

Life is good!

P.S. In the meantime, I'm going to archive my present hair and prepare for my hairlessness. So excited about the scarves and hats and cool new looks. ;)

Fabulous News!

Dr. Talbert, breast surgeon extraordinaire, called me yesterday afternoon with the pathology report. At the time, I was enjoying a deluxe pedicure with my mom and my niece, Dani. The report - no cancer in the lymph nodes! :)  The cancer she removed measured 1 1/4 cm - qualifying it as Stage One.  I will still have both radiation and 6 months of chemo therapy. But Dr. Talbert believes I'm a good candidate for the short course of radiation - that means 5 days rather than 3 weeks. Presently, I'm waiting to hear from Dr. Toma, oncologist, or at least someone in her office, to set up my first appointment with her. I still don't know which will come first, radiation or chemo. I'm back to that waiting period before beginning the next leg of this strange journey.

I will still endure fatigue and hair loss, but I'm kinda looking forward to fun wigs, hats, and scarves. :)

I recently made a new Vision Board - and in the lower right hand corner, included an image of healthy breast cells. How do I know what they look like? I googled images for "healthy breast cells." And this was the prettiest one.

So... visualization is a nice strategy to use in prayers and pursuing life goals, I believe. Around the middle of the board are three figures climbing a ladder. They represent me and you. Seriously. Helping each other as we face challenges and overcome hard times on our way to... ? Who knows. I just know that I am blessed to have lots of help getting there. I hope to be that kind of help for you and others when the need arises.

In the meantime, thank you for good thoughts, positive energy, light, and prayers. God is good.

Call Me, "Madonna"

I know. Strange title for an update on my little bit of breast cancer. If you keep reading, I promise to include a pictures.

First, I’d like to express deep thanks and gratitude for prayers, phone calls, words of encouragement in texts and Facebook messages, and F2F (face-to-face) visits. What a blessing this little experience has been, kind of like Christmas. J  There were even flowers! I haven’t seen that many fresh flowers since Ray was courting me.

And a special thanks to my friend, Karen (aka Martha Stewart). She asked if she could bring me a meal the night I came home from surgery. I didn’t really need a meal, we don’t often do home-cooking as much as grab something from Panera or Subway, but I know what a great cook she is… and even though I felt a little guilty for my reply, I texted back “YES!” I made the right decision. She arrived, precisely at 5:00pm (and by precisely, I mean that it awes me how people like Karen are always on time, as opposed to people like me who are generally 10 to 15 minutes late, sometimes later). In each arm she carried a basket, like in a fairy tale, filled to the brim with warm aromas of gourmet lasagna, cheddar biscuits, salad with candied walnuts, raspberry vinaigrette, and a freshly baked apple crisp pie. Since I hadn’t eaten all day long…. it was like I’d woken up in heaven! Seriously, it was almost worth the illness just to have a home-cooked meal, especially prepared by my friend, Karen.

And deep gratitude for the anointings. My sweet husband is friends with some very faithful and prayerful folks. His friend, Mike, is a Methodist minister. Soon after my biopsy, he drove all the way from Lake Eufaula to pray over me and anoint me with healing oil. Ray’s best friend Dave, who was one of the best men at our wedding, and his beautiful wife, Jimmie, who works with Ray – are both charismatic prayer warriors. They drove up from Sterling and brought their own healing oil and prayed over me. And my own church family… at Wednesday night mass, laid hands on me too. That afternoon, it took Father Jack and I about 5 minutes to talk through what would happen at 6:15 mass; then another 65 minutes to debate our opposite positions on politics.  The only thing we agreed on was to take a break from debating. J  But that evening, after communion, Father Jack called me and Ray and Jacob up to the altar. Then he called on all the cancer survivors at mass to join us and lay hands upon me as Father Jack anointed me with the healing oil of our church. I felt such love and such peace – and feel it again each time someone reaches out w/ words or a touch or a gesture of concern.  Thank you.  J  I hope I can return the great compassion and love – or at least pay it forward for someone else in need.

One more shout-out of thanks - for my daughter, Shelby. She gave up her Saturday to care for me. What a great cook I raised. Jimmie and Dave had brought us fresh squash from their garden, along with a huge zucchini. Shelby made me zucchini bread and stir-fry and tidied up my kitchen. We spent the afternoon in meaningful conversation.

So… about the name, “Madonna.”

Bright and early Friday morning, before the surgery, I arrived at Breast Imaging in Edmond. They were to insert a wire that would lead directly to the cancerous tissue. That involved a sonogram and a needle with a wire inside of the needle. Then, Pam, the imaging technician, explained to me, that about 3 ½ inches of the needle would remain sticking out of my breast – maybe that’s the plastic syringe part – I’m not sure – I chose not to look too closely. It wasn’t all that painful. Just a sting.

The disturbing part of the whole ordeal was the way I left the clinic. To protect the needle, and, I suppose, me, Pam taped a Styrofoam cup over the needle and to my right breast. Which is fine… but the loose button up shirt I bought the day before was no way going to fit over that. Seriously. She said not to worry, I could wear the blue poncho. For those of you who have never had a mammogram, the blue poncho is a 3 x 3 foot sheet with a hole in the middle for your head to fit through. When they need to take pictures of your breasts, they toss back the corners over your shoulders like a super hero cape. For me, that morning, it was decided to leave all the corners in place and to wear my shirt as if it were a vest. Omigosh.

Seriously.

I didn’t mind walking out into the waiting area of Breast Imaging, where only a handful of women were waiting their turns for mammograms and such. I was actually laughing at the silliness of the situation. And it wasn’t much of a bother in the car, or at Mercy Hospital parking lot, where Ray took the picture of me. What was just a little uncomfortable, was walking into Day Surgery – which is, evidently, always a packed house on a Friday. I don’t think there was a single empty chair in the waiting room when we walked in – but I’m not sure, because I was busy trying not to notice all the people trying not to stare at my right side.

When I sat down at registration, the nice lady said, “Name, please.” I replied, “Madonna.” She looked up at me, then at my right side, and said, “Mm… I don’t think so. Madonna’s were pointy and she had two of them.” And we all laughed. In fact, I kept laughing until they put me under anesthesia. I might have laughed afterwards, but the nausea got in the way. Other than that, it was a simple procedure.

Dr. Talbert spoke with Ray and my parents – telling them that the lymph nodes looked good – but we’ll know for sure when she gets the pathology report. She will call me by Wednesday, June 27^th, to let me know if the cancer is spread to the lymph nodes or contained. She will also set me up with an appointment with my oncologist, Dr. Toma.

More Good News

Here is what I know:

Cancer is less than 2 centimeters and they are thinking Stage One.

I will be having a lumpectomy, where they remove the cancer and some of the healthy tissue around it. They will also remove some of the sentinel lymph nodes. If they radiate them before the surgery, they do not have to remove as many. 

Surgery is scheduled for 9:50 am, Friday, June 22^nd at Mercy Hospital. This will be in the Day Surgery, so it’s out-patient. I’ll be home that afternoon and able to return to some activity in two to three days.

Afterwards, I will have to have both radiation and chemotherapy, but only one at a time.

The chemo treatments will last 6 months. Side effects = hair loss and fatigue.

The chemo oncologist I will likely see will be Dr. Aleda Toma.

I will know more when Dr. Talbert gets the pathology report.

No reconstruction surgery.

Here’s what I do NOT know:

What kind of radiation or in what order (chemo or radiation first) – we will have to wait for the pathology report (2-3 days after surgery) to find out.

I don’t know the name of the radiation oncologist.

I don’t know when the treatments will begin – soon I think.

Here’s what I’m looking forward to:

Scarves and hats! I’ve always wanted to wear them, but … didn’t think I was cool enough. I think a little cancer makes me cool enough.

Here’s what I’m thankful for:

You and your prayers, mantras, and postive thoughts. J  Life is good!

Somewhere Between Denial and Dread

It is the night before I meet with Dr. Beverly Talbert, surgeon.

Earlier today, G, my therapist, asked me about fear. I told her I was somewhere between denial and dread… and maybe I feel a little fear, but it mostly dances on the edge of my denial and unknowing.

I’m sure it’s there. I see it in the eyes of my friends and concerned folks like my dentist. I saw it in G’s eyes and in the eyes of one of my dear friends who is a breast cancer survivor. I saw it in my Mama’s eyes when she told me she knew I’d be okay, but she dreaded the path that would get me there. All these people know something I do not – they’ve either experienced for themselves or they have had close friends who have been diagnosed with cancer. And they all look at me with the same deep concern in there eyes. A couple of them even teared up.

Sigh.

Soon enough I’ll be in that learning curve, taking in the moments that my family and friends are dreading. I’m not there yet. I’ll let you know when I am.

In the meantime, there is good news to celebrate! J  The abnormal gene that runs in the Grabow branch of my family tree – BRCA2 – does not flow in my blood stream. Yep. A geneticist sent my blood to test for that particular abnormality the same day I had the MRI. She called me this afternoon and admitted she was surprised by the results. Me? I’m rejoicing. That means I’m not going to follow up this surgery and treatment with a hysterectomy.

This also means my daughters will not be need to be tested for an increased risk of ovarian and breast cancer. It means my son will not have to be tested for an increased risk of prostate cancer. 

There’re lots of things I want to pass on to my children. Cancer is not one of them.

So tonight, I am grateful. I'm grateful for no BRCA2. I'm grateful for friends and family who allow themselves to feel the fear I cannot. I'm grateful for the abundance of prayers and prayer lists I've been added to. I'm grateful for those who have prayed over me, for get-well cards and for the prayer bowl from the cancer support group welcoming me into their membership. I'm grateful for 50 cancer-free years. I'm grateful for pickle ladies who wanted to have coffee and pray over me and for Zena's tears. I'm grateful for a principal who is also a prayer warrier. I'm grateful that God has sent me the sweetest husband in the whole wide world. 

I'm grateful.

Rose Abandoned?

I began this poem a couple of weeks ago - on a Writing Marathon. I think it's about aging and that whole life process I find myself in the middle of.


Rose Abandoned?

Floating under a stone bridge

green water shimmering

nourishing what’s left

     of your long stem and

once pink petals

In that movement

     from budding green, then

     bursting forth with color and life

To opening so wide

accepting all

     even the edges of petals

     turning from supple to dry

                             from pink to pale brown

And you just lying there

     suspended in time

     unaware that all life

                 leads

 to death

Ripples from the wake

     of human tidings

     move you suddenly along

     like this must be the

     natural way of things

While a long stemmed rose

     lies dying, fading,

         

Satisfied.

So, I have this little cancer thing...

Before I even knew about the little cancer thing, I went to my annual visit to my ob/gyn and had my annual mammogram. Pretty routine by now. Except that after you turn 50, they add a little more to your routine - not two appoints, but around 5. Bone density, colonoscopy, and if you have allergies, well there are other options. Mom says that once you turn 50, it' all maintenance from there on. Egads.

I've been wanting to blog for a long time now... to move myself into a habit of daily writing. I'm thinking I have important ideas about teaching and parenting and being a friend - ideas that others might want to read about. But I also need a habit in order to finish that darn thesis of mine. Plus, I love the idea of reaching out and sharing my voice with your voices. Connecting.

So... now, I have another reason - cancer. I'm not that afraid, but I am a little. But if I blog, I can talk less and inform more. I'm blessed with lots of folks who are my family and friends. And that means I have to tell the same story over and over and over. That's a little exhausting. Not that you can't ever ask me, please do. It's just that I might reply, "Updated info has been posted on my my blog."  LOL! What a way to build up my reader-ship. :)

Here is what I know today:

Wednesday, June 6, 2012 - second imaging revealed a spot and need for ultra sound. Dr. Mitchell, radiologist recommended a biopsy - and prepared me - at the time it looked like cancer.


Thursday, June 7, 2012 - Dr. Mitchell called and said pathology reported cancer, grade 2 (not stage - that pathology info is to come).


Friday, June 8, 2012 - MRI revealed good news: no other spots or cancer in my breasts. I was also tested for BRCA2, an abnormal gene that runs in the Grabow side of my family. That info will inform my surgeon, Dr. Beverly Talbert, and me about next steps.


Tuesday, June 19, 2012 - I will meet Dr. Beverly Talbert and learn more. 

That's all I know today, that and I have a lot of good folks praying for me. I also know, that I'm going to be okay. :)  I've survived other challenges and I know lots of survivors who already inspire me view challenges as opportunities for spiritual growth.

Don't even think this is going to make me less political. Like I told Father Jack, "A girls gotta have goals."

Life is Good!

P.S. Look for my next post: "Rose Discarded." It's a draft of a poem I began on a Writing Marathon. Ironic that I wrote it then and it seems to be about this now. Not about death, but aging. :)