Bosom:
(noun) the breasts of a woman; the breast, conceived of as the center of feelings or emotion; a state of enclosing intimacy; warm closeness: the bosom of the family.

Monday, February 27, 2017

My bellybutton is too high??? First Plastic Surgery Consult

02/08/17
9 days after my surgical oncology consultation, I went to the Plastic Surgery office for my first meeting with Dr. O and his nurse.  

Another pink gown
This was my first time in a plastic surgery office...and very unlike any doctor's office I've been in before!  It is a nice facility and every time I go, there is some little take-home "gift". This first visit I was given paperwork to fill out (just keep your insurance cards in the front of your wallet and a pen handy...there is always paperwork!) along with a pink pen and a pink chapstick (both with their logo).  

Shortly after arriving, I was escorted back to an exam room to wait.  They gave me a soft, knit patient gown to wear....pink, of course.  I was told to keep my jeans on and just take off my top and bra.  

The room looked like any other exam room except one entire wall was a mirror. A big wall mirror...like in a gym.  It also came with the standard fluorescent lighting....not exactly flattering!  Considering all of the reasons folks come to a plastic surgeon, a big mirror makes sense, but it certainly wasn't appealing to see myself in it.  

Once Dr. O arrived, he began the visit just by going over my recent history to find out what I already knew and what I didn't.  
I knew he was an expert with the natural tissue reconstruction and I was hoping that he would tell me that I had enough belly fat to make a DIEP Flap procedure possible.  Something I did not know from my reading and was pleasantly surprised to hear:  During Stage 2, the scar revision and "make it pretty" phase, there is the opportunity for fat grafting...which could add an additional half-cup size if needed!  This was reassuring to me because I was worried about being too small with the natural tissue versus implants.  I am currently a big B-small C.  I definitely don't want to be much smaller.

After going over the DIEP Flap procedure, Dr. O had me stand at an angle in front of the wall mirror while he sat on a rolling stool in front of me.  Yikes!  He took measurements and called out the numbers while the nurse recorded them on her laptop.  

This is when things got amusing...at least to me.  I'm standing there half-naked and looking quite pale in that lighting that shows every flaw. All the while, Dr. O is looking very serious and pinching and pulling.  I am by no means thin and feel that I have plenty of belly fat to spare.  It was amusing to me that as Dr. O is pulling handfuls of my tissue, he says: "Well, you don't really have much fat here." My response:  "You're kidding, right?" He cocks his head to one side and says: "The only thing is.....well, did you know your bellybutton is a little high for you?"  Me: Ummmm.....nope.  Then, I looked over in the mirror and thought, "Well, rats, it IS high!. How'd I never see that before??"  Ugh.  

They are perfectionist by nature, I think, and artists whose canvas is the human body.
I've joked now that if you didn't have body issues before your visit to your plastic surgeon, you definitely will after!!  

Anyway....he was a really nice man and I felt quite positive after the visit.  He told me that I have enough belly tissue to create at least my current size or maybe a little bit smaller.  But, I will have the fat grafting option at Stage 2 if I don't feel that I am big enough.  He performed a Doppler of my abdomen to look for the vessels he will need for the reconstruction.  All in all, he said I was a good candidate for the DIEP Flap and he thinks I will be happy with the outcome. This was great news!

Image from www.uptodate.com
Here's how it is supposed to go....
Stage 1:  Reconstruction using my abdominal tissue.  I will have a hip-to-hip incision and a "lollipop" incision on each breast, plus whatever skin grafting incisions are needed.  This will be done immediately following my mastectomy by Dr. K.  Dr. O said to plan on at least 10 hours in the OR because of the delicate nature of microvascular surgery.  I will stay overnight for 3-4 nights.  I will most likely go home with 3-4 JP Drains that will stay in for 2-3 weeks.  I will have to be off of work for 6 weeks!
Stage 2: Scar revision, liposuction, shaping, fat grafting, and nipple construction.  This will take place approximately 3 months after recovery from Stage 1.  This will be day surgery.
Stage 3: Tattooing of the new nipple and areola.  This is an in-office procedure that should take place 3 months after Stage 2.

The office called me later that same day with a surgery date.....I was put on the schedule for Monday, March 6, 2017!  Good news:  I have a surgery date.  Odd news:  It happens to be on my 41st birthday!  

Those of you who have been following along already know what happened next....I spent more than a week dealing with an insurance mistake and had my surgery cancelled.  In the end, I got it taken care of and even got March 6th back.  You can read that post here


MY TIMELINE:
12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K
02/08/17  Consultation with Plastic Surgeon

Sunday, February 26, 2017

Can you spare a nipple? My Surgical Oncology Consultation

It's Monday, Jan. 30th, and I have known for under a week that I have Stage 0 DCIS (confirmed by biopsy).  Today, I met my wonderful Surgical Oncologist, Dr. K. for the first time.  He was just as great as I had been told.  Here's how it went....

After a ton of paperwork....get used to that....I met with the nurse practitioner.  After reviewing my history, she did a quick physical exam before Dr. K came into the room. Typically, Dr. K would have gone over my diagnosis and treatment options in detail...he is often the first person most cancer patients talk to after their diagnosis; however, I had the benefit of having met with the Breast Center Navigator the week before.  This made my visit a little easier and we could pretty much go straight into my surgical options.  He confirmed that no chemotherapy would be called for with Stage 0 DCIS, but that radiation would be required if I chose the lumpectomy route.
Here were my options again (in case you missed my last post):

Option 1: Lumpectomy followed by 5 days/week x 6 weeks of radiation and 5 yrs of hormone suppression medication (leading to menopause symptoms).

Option 2: Left (unilateral) mastectomy and reconstruction followed by 5 yrs of hormone suppression....no radiation.

Option 3: Double mastectomy and reconstruction ....no radiation, no meds

My thoughts:
Option 1:  With a lumpectomy, there is always the possibility that a cancer cell will be left behind.  This is why radiation is necessary.  The thought of having the cancer come back in the same breast or in my other one is scary.  I also did not want to go through the radiation (and all of its side effects) required with a lumpectomy.  The hormone suppression therapy would come with all of the fun of menopause symptoms too.  

Option 2: Once again, the hormone suppression therapy is required in order to protect the right breast that is left behind.  And, again, there is the possibility of breast cancer recurrence in my unaffected breast.  

Option 3: No radiation...no hormone therapy...no more mammograms....no more breast tissue.  While the initial recovery is longer and it is definitely more intense, the outcome would give me the least amount of recurrence risk.

For me, I felt that even the smallest percentage of risk for recurrence was too much for me. 
This included the less than 4% risk included with saving my nipples.  In order to do a "nipple-sparing" procedure, a small amount of breast tissue is left behind....meaning that there is a little something left for those pesky cancer cells to come back to.  Again, not worth it to me and after seeing the amazing work that can be done with plastics and tattooing, I am not at all concerned with losing the nipples too.  

After Dr. K reviewed the statistics for each of the 3 options and then he said to me:  "I will advocate for you whichever option you choose. I will be on your side."  Those are powerful words to hear from anyone, but especially helpful from the physician who is going to be trying to save your life.

After having spent the last week doing my own research, Dr. K was able to confirm what I knew and give me additional info specific to my case.  In the end, I felt very comfortable with my decision and signed consent for a Bilateral (a.k.a. Double) Skin-Sparing Mastectomy with Sentinel Lymph Node Biopsy and possible Lymph Node Dissection.

Image from https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet
Because if the breast cancer was going to spread, it would spread via the lymph nodes, a sentinel lymph node biopsy will be performed at the start of my surgery.  The evening before surgery, I will go to the Radiology department of the hospital to have a radioactive tracer dye injected into my lymph nodes.  On the morning of surgery, Dr. K will use this to determine which lymph node is the FIRST one from the cancerous lesion...the sentinel lymph node.  He will remove this node and send it for an immediate biopsy.  If it is clear, he will proceed with the mastectomy as planned.  If it is positive, he will have to remove more lymph nodes for a dissection and further biopsies.  Obviously, this will change my prognosis significantly, as well as my treatment plan.  

There are lots of things to consider as you are making the choice for yourself. Take the time to review all of the info and to research each one.  

The only negative about the appointment was finding out that Dr. K was not going to be available on the date the Breast Center Navigator and I had discussed, so my surgery would likely be later.  Not like this was devastating news or anything, but any extension on the process seemed like forever.

My next appointment was going to be with the Plastic Surgeon, Dr. O, in 9 days.  Assuming things went well with him, the two offices would compare calendars and get me scheduled for surgery.

Still felt surreal leaving that office and the next 9 days went slowly.

MY TIMELINE:
12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K


Wednesday, February 22, 2017

Treatment Options & Genetic Testing

So, here we are on 01/25/17....I was diagnosed yesterday with Stage 0 DCIS in my left breast.  Today I am heading to the Breast Center to meet with the Patient Navigator and the Genetics Nurse for Genetic Testing........

In the Breast Center:
A mastectomy pillow (goes under your arm) given
to me at the Breast Center.
I arrived at the Breast Center and was greeted by the Breast Center Patient Navigator, "A". She was very sweet and very knowledgeable.  Please be sure to check with your facility to see if they offer this assistance.  It is very helpful, especially in the beginning to have someone who knows the ropes to guide you through all of the information, appointments, and help you choose the best physicians for your treatment.

"A" started by going over my biopsy results in detail and discussing what it meant.  I had researched some online the night before based on our previous telephone conversation, so by the end of our talk, I felt like I had a thorough understanding.  We discussed my treatment options next.

For me, Stage 0 DCIS, does not require chemotherapy.  No chemo...this was good news.
It does require surgical intervention though because left untreated, DCIS becomes invasive and can spread.  "A" assured me that all 3 of my surgical options were good and produced positive outcomes for patients.  

Here's how my options were laid out:

Option 1: Lumpectomy followed by 5 days/week x 6 weeks of radiation and 5 yrs of hormone suppression medication (leading to menopause symptoms).

Option 2: Left (unilateral) mastectomy and reconstruction followed by 5 yrs of hormone suppression....no radiation.

Option 3:
Double mastectomy and reconstruction ....no radiation, no meds

Additionally, if the latter two, there is
implant vs natural tissue reconstruction.


All of these would be discussed in further detail with the Surgical Oncologist. My Surgical Oncologist would be the one to provide the statistics on the options, but "A" said that none of them would be "wrong".  This is most definitely a personal choice.  

We also discussed the physicians in the area and the ones that the Breast Center recommends.  I had already been told by several friends and coworkers that Dr. K was the absolute best for Surgical Oncology. "A" confirmed this and started working on setting me up with an appointment the following Monday.  "A" told me that I would hear from her or Dr. K's office to confirm my appointment.  She also recommended a Plastic Surgeon (from the group I had already heard about from friends) who works closely with Dr. K and is excellent with the natural tissue reconstruction option.  She would work on getting me an appointment with his office, as well.  She was anticipating that I could have surgery in just under a month...around Feb. 23rd.

I was then introduced to the Genetics Nurse, "E".  "E" explained the testing process and had several charts to show me how it worked and what the results would entail.  Most people have heard of BRCA 1 & 2 testing (thanks to Angelina Jolie), but my test would cover 28 genes.  The genes being tested would cover not only my genetic predisposition for breast cancer, but for 8 different cancers.  This was the one I took:
It was a simple saliva test...basically spitting into a test tube....a lot of spitting!  
We discussed what the findings would mean for my family....like the fact that regardless of the results, my niece should start getting routine mammograms at age 30 (instead of 40) just because she now has an Aunt with breast cancer.  Results would be available in 7-10 days.

I left the office with a ton of information swirling around in my head!  So many numbers and details.  This is one of those times, you want to have something to write things down on (or another person to take notes/listen).

It's all a bit overwhelming, but I felt good after my appointment.  Again, for me, this all signified a working, active, plan...things were moving in a positive direction.  I spent the rest of the day and evening updating family and friends and reading about the surgical options online.

I encourage you to be proactive if you have received a breast cancer diagnosis. 
Arm yourself with information and don't hesitate to advocate for yourself.  
Ask lots of questions!  
Write everything down and start a folder or file to keep all of the paperwork you will gather along the way...there is a bunch!  

Please feel free to comment or to ask questions if there is something you'd like to know more about.  I'm happy to share anything that might help you in your journey.















MY TIMELINE:
12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results postive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing

Tuesday, February 21, 2017

The Life-Altering Phone Call

My biopsy was Friday, 01/20/17...this is Tuesday, 01/24/17.  I was told that biopsy results would be in 72 hours, but figured that Saturday and Sunday wouldn't count.  I tried not to think too much about it over the weekend and just took it pretty easy.  I worked Monday and Tuesday.  I was a little bruised at the biopsy site and still had steri-strips in place, but the only things that really bothered me was my bra rubbing on the site and the swelling causing my scrub top to irritate my inner arm.  Of course, my coworkers and family were asking about my results, but I was trying not to count on them until Thursday.

I'm a NICU nurse.  A typical routine for our patients is an every 3 hour feeding schedule. This shift I had 3 patients...0800, 0830, 0900...1100, 1130, 1200...etc.  I was mid-way through my second round and decided to walk a dirty bed to the cleaning area while milk was warming for my little patient.  My phone was in my pocket.....needless to say, every time it vibrated that past week, I had jumped.  This time was no different.  I felt the vibration and when I looked in my pocket I recognized the extension from my OBGYN's office.  I jumped into the supply closet next to where I was standing and took the call.....time stood still for a moment.

My long-time OBGYN told me he had my results....he didn't make me wait or ask, thankfully.  His words were: "It's the best of the worst diagnosis, Julie."  I was informed that the biopsy showed Stage 0 DCIS....ductal carcinoma in situ.  He went on to briefly explain that this was "the good kind" and that the Breast Care Navigator would be in touch to walk me through this new journey.

It wasn't a long phone call....but it was life-altering.  

In that moment, 
standing in a supply closet in the middle of the NICU, 
I became a cancer patient....a woman with breast cancer.  

I walked out and just started pushing the dirty bed down the hall. While I was in the empty cleaning area, I quickly dialed my mother and told her what little I knew.  She would inform my Dad and Granny since I was at work.  I asked her to wait and let me tell my son when I got home.

Then, it was back to my pod and time to get back to work.  It didn't feel real and I definitely think I was in a bit of shock, even though I thought I was prepared for this possibility.  My two coworkers were working with a patient when I returned with the news.  They both immediately said: "Do you need a minute? Do you need to go?"   My response was something like: "I better not....I think I need to just keep moving.  And, the babies need to eat."

The baby was bottle feeding that round and took his time...I remember sitting there and just re-playing the phone call in my head.  One of the gals asked me what I was thinking and I just said: "I have breast cancer.  That's really weird to say out loud."  

Within the hour, the Breast Center Navigator called me and we scheduled a meeting for the next morning.  She gave me a little more information over the phone and let me know that I qualified for genetic testing and that I could complete it the next day too.

My lesion...~3cms located at 1:00, 5 cm
from the nipple on my left breast
At the end of the day, here's what I knew:
  • "In situ" means "in place". This means that the cancer is usually contained where it is found and Stage 0 means that it appears to be non-invasive.
  • DCIS is furthered contained in the milk ducts.
  • I would meet with the Navigator the next day at 09:00 to review everything and start making plans and appointments. She would help me with surgeons and appointments.
  • Because I am 40 with breast cancer and have a grandmother with a history of uterine/ovarian cancer, genetic testing would be offered, recommended, and should be covered by insurance. It would be completed at 10:00 the following day.
  • Most likely, the MDs would offer me three options: lumpectomy, unilateral mastectomy, or double mastectomy....details to be discussed the next day.
  • I would need to talk to a surgical oncologist for lumpectomy or mastectomy and a plastic surgeon for reconstruction. 
My son took it well that night. Calm and cool as usual. He gave me a big hug and told me it was going to be okay.  Pretty sure I didn't sleep that night but a few minutes here and there. No tears, just a lot of praying and thinking.

It was a lot to take in, but I actually felt better knowing...as crazy as that sounds, it was better than wondering and waiting.  





MY TIMELINE:
12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results postive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing

Saturday, February 18, 2017

Biopsy Day

Let's go back to last month again...still trying to get y'all caught up to present day.

Friday, Jan. 20, 2017....Biopsy day.

This was all brand new...they had just found the lump/lesion/whatever two days ago. My parents insisted on coming.  My friends also offered. This is kind, but not necessary (unless you need/want that).  You are a little sore afterward but not so much that you couldn't drive home.  

On that note:  You will be told A LOT of information at ALL of these appointments. It can be a bit overwhelming and there are details you will want to remember.  Most people will recommend that you always bring another person along with you...someone who can help you remember what was said or take notes for you.  This is something worth considering, but not something I did or plan to do.  I prefer to handle personal stuff myself.  I do always have something to write on with me just in case I want to take note of something.  In my job, I'm used to a bunch of info being thrown at me at once and the medical stuff isn't a problem for me.  If this is not the case for you, then definitely take someone with you as a second set of ears and/or take notes.  The first couple of appointments consist mostly of information gathering and they will give you statistics on your diagnosis, prognosis, your treatment options, etc.

Back to the biopsy......
I arrived at the Breast Center and was taken to a dressing room where they had me change into one of those pink half-gowns...only covers the top.  I was able to leave my jeans and shoes on.  I was told to wait in a small waiting area where I sat on a couch watching the news coverage of President Trump's inauguration with another patient. When it was my turn, I was taken into a room that looked kind of like a dentist office....big reclining chair in center.  The tech started with another ultrasound.  It made me a little nervous because she was only concentrating on my armpit....lymph nodes!  I finally asked if this was different than my previous US.  She replied that Dr. M wanted a closer look.  GULP...I didn't say anything else. I just prayed this was okay.  The previous Radiologist had told me two days ago that the lymph nodes looked clear.

A few minutes later, the wonderful Radiologist Dr. M walked in. She was super friendly and fun.  We had never met at work, but she sometimes reads the X-rays for our tiny patients.  We chatted about that a bit while she continued with the US imaging of my left armpit.  She apologized for making me nervous but explained that the previous report did not label a couple of things and she just wanted to be totally sure of the anatomy before she started.  She then turned the monitor to show me my lymph nodes and the surrounding vasculature, etc.  

Don't be afraid to ask your doctor to do this...ask him or her to point out what things are and what they are looking for.  You might not be able to really "see" it like they do, but it helps to have a better idea.

She then began to explain the biopsy procedure, how she would do it, and showed me the clip/marker they would be leaving behind.  They leave a clip (the kind they use in heart surgery) at the biopsy site so that if there is any question later, they know exactly where the tissue samples came from.  This clip stays in there forever...or until surgery, if that's the treatment route you take.  It is MRI safe and you won't set off alarms at the airport. 

The chair was reclined and a towel roll was used to prop up my shoulder so that I could leave my arm at my side rather than have it above my head the whole time...that was nice.  She numbed the area with Lidocaine...I felt the first couple of needle pricks but nothing much after that.  She told me that she could numb more if I needed it.  I never did.  

My biopsy was a core needle biopsy.  The needle is hollow so that when the outer sheath is "punched" it cuts the specimen into the hollow core to be withdrawn.
http://mediwikis.com/wiki/index.php/Trucut_needle_biopsy

Dr. M explained that she would take at least 6 tissue samples to be sure that she got a good amount of the lesion.  

The lidocaine numbs the sharp pain, but you will still feel the "punch" every time. It wasn't painful, just a little weird.  It sounds like the click of a hole punch or a staple gun.  We carried on a conversation about work and the terrible traffic in the area and it was very much like a dental visit....not painful, but not something one looks forward to.  When she was done, she placed the marker inside and then held pressure for a few minutes to stop the bleeding  at the site.  The techs dressed the spot with gauze, steristrips and then a pressure dressing on top.  I was told to leave that on for 24 hrs.  I could shower and pat dry.  The steri-strips were to stay on for about a week.  (You may be surprised when they come off to find that all that to-do is for an incision the size of a large freckle.)
This is the biopsy site a month later...looks  like a freckle.
Afterward, they took me down the hall for a couple of mammogram images. She was very gentle and did not press the plates down as much as a typical mammogram.  Once the Radiologist ensured that the images showed that the clip was in place where she wanted it, I was free to put my shirt back on and go home.  I was told to keep an ice pack on the site for the rest of the day.  The whole visit took maybe an hour and a half, including waiting room time.

The ice pack is very helpful!  The biopsy site felt like a bad bruise...like you got hit hard there.  The next day after running a few errands, I found that I was sore again and used the ice pack.  My left breast was swollen afterward for about a week.  There was some mild bruising but nothing too bad.  The only thing that bothered me were my bras....the underwire was terrible. I dug out my softest bras and had to wear them for a couple of weeks because everything irritated that side of my breast.  Even, the seams of my scrub top made me crazy for awhile.

Dr. M informed me that their goal was to have the biopsy results to my OB-GYN within 3 days.   I was off of work for the weekend, so I pretty much just took it easy and tried not to think about the results.  I figured that the weekend days probably didn't count in the 3 day result timeline, so there really wasn't any point in getting my hopes up for results until probably Thursday.  

For me, the biopsy was a step forward and getting it done as quickly as I did was a relief.  I'm finding that the waiting is the hardest part on this journey....and there seems to be quite a bit of that.  Patience is a virtue though, right?



MY TIMELINE:
12/22/16  Routine Screening Mammogram
01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy

Friday, February 17, 2017

Insurance Fiasco and Near Meltdown

Today is Friday, February 17, 2017 and  it's been a rough week, folks!


Today I can finally take a deep breath and relax. Today is the first day in a week that I didn't wake up exhausted from tossing and turning all night. Today was a good day!

My brain has not stopped working overtime since they found that lump a month ago tomorrow, but at least it was on a low hum. This week, I feel like one of those memes about having too many browser windows open!

It all started last Thursday.  My surgery date had been set the day before for Monday, March 6, 2017. We had a plan! Yes!
Thursday, I was off of work and happily fiddling around the house, working in my craft room on a project, etc.  That's when the first call came....the Plastics office had verified my insurance benefits and said: "I'm pretty sure you were not aware of this before you came here, but we are OUT OF NETWORK with your specific plan."  

My brain didn't seem to be processing.  I was thinking:  What??!!??  That's not even possible.  The Breast Center referred me along with my Surgical Oncologist. The Breast Center that is affiliated with the hospital I work in!  Not possible.

Turns out she was surprised too--having never had this happen with one of our employees in the past.  But, she was obligated to tell me what she had been told.  I was confident this was an error and let her know that I'd check into it.  I immediately contacted my Breast Center Navigator....who was equally shocked and also started looking into it.  There were lots of long phone calls Thursday and Friday between me and my insurance carrier, me and the Plastics office, me and my bosses, me and my family, etc.  No one could figure out the problem, but everyone felt sure it was an error. Both evenings, my insurance carrier assured me that it was a mistake and that they would let the provider know.  And, the next morning, I'd receive a message from the Plastics office that it was not an error.  

I had to work Saturday and Sunday, but I still received emails from the Plastics office manager and some of the folks I had contacted to try to figure the mess out.  It was a fairly sleepless weekend.  

I knew that everything was in God's hands and I had faith that there was a reason for this stressful situation even though I could not see what it was.  But, it was not easy. My mind raced with thoughts...what would I do?  How could I possibly afford this?  I can't afford this...so now what?  This is the only group of surgeons in the area that do this procedure...ugh.  Do I really have to consider a lesser surgery because I can't afford the one I felt confident I needed?  It was all so smooth, why now, Lord? 

On Monday, I was off of work and waiting to hear some good news....instead, the Plastics office informed me that they could not hold my surgery date while we tried to remedy this.  She told me that she would still be trying to help me, but the date would NOT be held.  This was quite a blow!  I felt like the wind just went out of my sails.  I was clinging to that date...that date meant we had an active plan...that date was hope. And, just like that 

it was gone. I nearly cried right then.  I came close several times this past week.

I reached out to everyone I knew who might be able to help.  And, it turns out it was a good thing I did because it was a much bigger confusing mess than anticipated and it had the potential to affect other employees trying to access benefits.  A couple more days and still no closer to a resolution.  Finally, I reached out on Thursday morning (afraid of going into another weekend) to my administrators.  I let them know how nervous I was getting about this rocking on.  Everyone I knew was praying. And, that morning, the absolute right contact from our corporate benefits called me!  Not only was he a sympathetic and kind man, he instilled confidence immediately. He was finally able to identify where the issue started and address it.  He was so very nice keeping me updated all day on his progress.  By 6pm, as my shift was winding down, I got the final word that it was fixed!  And, not only for me, but addressed with the carrier so that no one else should run into the same issue.

The Plastics office manager called me within 15 minutes and confirmed that my benefits were exactly as I had believed all along and that they could reschedule me!!  My original date had been given away, but just that same afternoon she had cancelled.  My Surgical Oncologist was still holding the date for me, so this morning, I had confirmation from both offices that I was back on the surgery board for March 6th!!  Praise the Lord! Prayers were answered.

All this week, I questioned the reason this was happening to me.  Why everything had fallen so easily in place just to have this horrible, stressful, scary week.  My mother commented that Satan was trying to shake me because I have been so good with all of this.  Nothing has gotten me down until now so he hit me with a big area of concern...finances.  Maybe.  

Maybe, it happened to me so that it wouldn't happen to someone else....someone else whose cancer is more invasive and a delay would have been scarier....someone else who didn't do medical billing in a past job like I did and might not have understood that this wasn't right and questioned it....someone else who needed the stress even less than I did. 



From: https://www.flickr.com/photos/brizo_the_scot/4013939756
It doesn't really matter why it happened. What matters is getting through it...lessons learned. 

You might not face insurance worries, but you are likely to hit some kind of roadblock on this journey....your flock of sheep in the road.  It might be finances, or your significant other getting time off work, or a family vacation that has to be cancelled or a 
hundred other things that throw you for a loop. Just know that you can get through it....or maybe you will have to detour around it....but you will get to the other side if you keep moving, keep pushing, keep going.

I got through my scary bump....or LUMP...in the road this week and I slept better last night than I have all month!  And, tonight, I spent enjoying a night out with my son.

This is quite the journey. I'm learning things I never really wanted to learn. But, say it with me:  
God is good ALL the time!  
And, ALL THE TIME, God IS good!





Tuesday, February 14, 2017

They Found a Lump??!!??

This all began with my very first routine screening mammogram on December 22, 2016.  Nothing out of the ordinary...never felt anything...just the "you're 40 now and need a mammo" mammogram. The tech was very friendly and explained everything she was going to do.  She also explained to me that as a first timer, I would not have anything for the radiologist to compare to so I shouldn't be surprised if I received a call back asking for more images.  She assured me that most of the time it was nothing. 

Sure enough, I received a call back within a few days asking me to come back for more images.  The imaging center couldn't get me in for almost a month....I figured that definitely signified that this was nothing to worry about.

On January 18, 2017, I went back to the imaging center. The plan was to be in-and-out in under an hour because I had lunch plans with some girlfriends that afternoon.  I walked in and the same tech was in the room. As she was setting-up, she started explaining how they just wanted images of my left breast.  This was the first twinge of nervousness I felt. After the images, she had me wait saying:  "I'm just going to show these to the radiologist.  If he is okay with them, you are free to go.  If he wants more, you'll get an ultrasound."

Within a few minutes, another tech came and got me for an ultrasound.  "Ummm....so...he saw something?", I asked.  She responded: "Oh, yes, we want a closer look. But, don't worry, Dr ____ is great about talking to patients.  He will come in when we are done and talk to you."

I tried to act cool, but I was feeling a little confused.  The room was darkened and I was told to lay on the table with my left arm above my head.  She rolled the wand all around my left breast concentrating what seemed like forever on my armpit.  As a nurse, my mind started clicking away at everything I knew about lymph node locations.  I could not see the screen where I was positioned so I stared at the ceiling while the speaker played "Hotel California". I remember thinking what an odd song that was for this office.  Anyway....

Moments later, the radiologist walks in.  He takes my hand in both of his and gives me this very sad and concerned look........pretty sure, my heart stopped for a moment.  

Long story short, he told me he found a 3cm lesion that was "very unusual in someone my age" and "very concerning" and "needs to be biopsied and removed" and "it's VERY concerning" and  then the two-handed handshake again and "I'm so sorry."

I was further informed that a biopsy appointment would probably take 2 weeks and results another week after that. But, he threw in "it's a slow growing kind, so it's okay. Don't worry".  It didn't seem "okay" to me, but everything was a bit foggy at the moment and i really just wanted to get outside.

I made it out to my car.  I shakily picked up my phone and called my mother....the tears started before she answered and it took me a few minutes to gain control.  She called my Dad who turned around and called me right back. My girlfriends insisted that I still needed to come to lunch.  Within a couple of hours, my brother and grandmother knew and my OBGYN (my referring physician) had called me because he had received a message from the imaging center.  

I picked up my son after school and told him the news.  He is 14 and such a calm, even-tempered kiddo.  His response was quiet and full of wisdom:  "Well, Mom, there's nothing worrying is going to do.  All we can do is pray and trust that it'll be okay.  You're young and healthy, it'll be fine."  He was right about the worrying, of course,  but it is definitely easier said than done.

That night, I posted what had happened on Facebook asking my friends and family for prayer support.  Needless to say, I didn't sleep much.  The next morning I got up and went to work in a fog.  As soon as the Breast Center opened, I called to get scheduled for a biopsy. They were busy and were not sure when my report would be read and approved by the radiologist.  There are many blessings in my job as a nurse....one being the close proximity to the Breast Center, the physicians, and being a part of the hospital family.  My friends helped me (and thanks to a patient who cancelled), my biopsy was scheduled the next day.  

Immediately, a small sense of relief washed over me.  I'm a planner.  If I have a plan, I can deal. Now, a plan was forming....get the biopsy, get the results, get moving.

My amazing coworkers rallied behind me and sent me home that night with a sweet card and a goodie bag of snacks, candy, a candle, puzzle book, etc.  I am so blessed to be back "home" in my NICU.








I'll tell you what to expect with the biopsy (or at least how mine went) in a separate post.
For now, GO GET YOUR MAMMOGRAM!!

Ready for the biopsy....get used to pink gowns, you wear them a lot!
MY TIMELINE:
12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy