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.

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

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!

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

My Journey...Why Share Here?

As I am beginning my journey with breast cancer, I have been doing a lot of research and reading online. The most helpful websites and YouTube videos were written not by doctors or Breast Cancer organizations, but by the actual women going through it.  In many ways, I think it is as therapeutic for the author as it is helpful for the readers.  For that reason, I decided to post my journey here.  If no one reads it, that's okay. But, if it helps another woman on her journey, then that is great!

First of all, every woman's journey is different.  There is more than one kind of breast cancer and lots of treatment options.  Everyone deals with the diagnosis, the treatment, the process, the recovery, etc. in his or her own way.  I was told in my first meeting with the Breast Center that I had to make decisions that I could live with...that I could live with.  That's important because people have a lot of opinions and some of them will want to share those with you.  Most of them are doing it out of love and concern, so try to take it that way, but remember that this is YOUR journey.  

I'm an advocate for educating yourself. For me, I've sought guidance from my physicians and done a lot of research myself.  I also have the benefit of being a nurse and working in the hospital setting.  Seek out friends and family who have been through this.  Many women have reached out to me....I was surprised how many of my friends have been through this themselves.  1 in 8 actually seems low once you start talking to people. 

As a nurse, I'm not squeamish and actually appreciate the sometimes brutal honesty of surgical photos/videos.  That's not for everyone, but I was glad to have found that there are a few women out there who have been willing to share the not-so-pretty before and afters.  I'm still undecided on how much of that I'll share here, but for now, I'll try to tell you my story as it unfolds.  I'll be honest...even if it isn't pretty.

Feel free to comment and ask questions.