8 Days Later - The Results

All good news! There was a small papilloma, not visual on the ultrasound, that was causing the bleeding. The cells had changed, but were not malignant. That is all I wanted to hear! This is indeed a wonderful way to end 2009. So...out with 2009. Let's all ring in a happy and healthier 2010!

So Tomorrow's the Surgery

I have to be at the hospital at 7:30 AM for the duct surgery. I'm unbelievably worried about the outcome, but warmed by the support of friends of co-workers. There are three of us that have desks in the same area who have had breast cancer. They have been simply wonderful as we have shared our trials and tribulations over the past year together. One of the woman gave me a guardian angel token to take with me tomorrow. It's been in my pocket for three days as a reminder that people do care, and that sometimes faith is a better protector than we give it. Pray for me tonight...please.

Pre-Operative Testing Day

I was really hoping that the bleeding would go away and I could cancel everything, but I knew it just would not happen that way for me. The reality is that I'm scared I'm going to go through the cancer vortex again, and it's just one place I don't want to go!

It was quite surprising that after 30 years going to my internist, his office could not accomodate me for a pre-op physical. I'm still reeling from a little anger and surprise. Luckily, the hospital where I'm having the surgery on Monday could take care of the exam.

So...I took my letter and went to the hospital this morning. Of course, they screwed up my records. I've become accustomed to not having things turn out the way they should. Ninety minutes later, the admitting officer tells me the problem is fixed, but that was after two chats with the supervisor with my coaxing. We go downstairs for the exam, and the nurse practitioner notes that my name is still wrong with wrong info behind it. She smartly documents manually using my name and birthdate. The exam was fine, as expected.

I sure hope that things are right on Monday...

Nipple Bleeding 14 Months Later

A few weeks ago, I noticed a small blood stain and thought maybe it was from our sweet bichon, Daisy, who had had surgery for torn knee ligaments. A week later, I noticed a similar stain in my bra and on my nightgown in the area of my nipple.

Noticing a dark area at the entrance of one of my nipple holes in the breast where I had been diagnosed with breast cancer last year, I expressed my nipple and out came bloody discharge. Panic was probably the first reaction. This has been a difficult health year up to now, and quite frankly, I don't have the mental energy to handle another crisis.

As soon as I could, I did contact the breast surgeon's office and was sent for an ultrasound of the breast as well as another mammogram. This was a follow-up to a very successful yearly mammogram only 2 months ago. The test results showed that nothing changed. So I am really no more knowledgeable of what is causing the problem as I was before the test.

Per the physician, it could be caused by one of 2 things: papilloma (benign wart-like growth) causing distended breast ducts that bleed or cancer. Usually the papilloma would show on the ultrasound, but it may have been so small it didn't display on my test. So the plan is to remove all the offending ducts and send them to pathology on December 14. I'm very comfortable with this decision, and will have an answer regarding the cause when I go back for my surgical follow-up.

The question then becomes how can DCIS come back so soon since it takes 15-20 years to develop? My understanding is that it may have been there all along, but not been diagnostically visible.

Finally, there are 2 ways to view...if the bleeding is caused by papilloma, the surgery will remove the cause and all will go back to the way it was. If the bleeding is caused by cancer, then I was very lucky to have symptoms to look at this further since diagnostically nothing showed on the tests.

I'll be sure to update as soon as I know more. Happy Holidays to all!

Mammograms are Saved!

The federal government health czars have assured us that the surveillance of mammograms will continue as is. For once, common sense and research results prevail! Of course, this should not prevent any of us from being advocates for our own health care needs.

Please Don't Stop the Mammograms!

New recommendations have been released that are recommending that regular mammograms do not commence until age 50 and then at two year intervals. Two thoughts on this one:
1. This recommendation was made by number crunchers who only look at statistics and cost, or 2. This recommendation was made while ignoring the phenomenal strides made in breast cancer awareness, prevention, and treatment.

As for me, if it were not for a yearly digital mammogram, my breast cancer would not have been "found" before it likely would become a lump, I would have found in a self-breast examination. And who knows? By then, it would likely be invasive, and I could end up dead like my mother of this beastly disease in a short period of time.

The mammogram pointed out a few years before the actual diagnosis that the area where the cancer was found was starting to change. The changes were not significant enough to biopsy but they warranted diagnostic attention. Luckily, for me, I had terrific providers who had the knowledge and expertise to find it early. At this time, my chances of survival after 5 years are close to 99%. I'll probably be more likely to die from something else than breast cancer.

My twenty-something daughters are at a bit higher risk than the general female population due to generational breast cancer and female hormone cancers. Will they be barred from having the surveillance they have been advised to start at age 30? This is totally unacceptable!

Don't let this slide by without taking a proactive stance if you truly believe this is wrong. 1 out of 12 women will have breast cancer in a lifetime. Don't we want all of them to have the opportunity to live as along as they can as healthy as they can?

Oncology Visit - One Year Later

The mammogram was purposefully scheduled a few days before my oncology visit in case there was any discussion to be had over the results. Luckily, all was good. A breast check, review of my latest labs, and a discussion about general health resulted in another year's prescription for Tamoxifen and another appointment in six months. I am grateful that I am one of the lucky ones who doesn't have issues with Tamoxifen and can enjoy its benefits!

First Mammogram After Diagnosis

On October 7, I had my first mammogram since my diagnosis 13 months before. Talk about nervous! I could not wait until it was over. At this point, my radiated skin issues had dissipated and I wasn't having weird pains in the affected breast anymore. I was feeling pretty optimistic.

I get to the Breast Center early hoping to get it over with asap, but one of the techs was late, and all appointments were delayed an hour. I did get a very competent tech who did not mind when I questioned everything I saw on the digital x-ray. She even showed me the x-ray of the actual tumor that was removed during the surgery last year. They use x-ray to determine if they got enough of the tumor out or have to remove more tissues.

After the first go-round, I was called back for more views of the "good" breast. I told the tech that if this was cancer, both breasts were going bye-bye. No more playing with lumpectomies. I don't think my nerves could take it.

While waiting, I went back to the waiting room, and got into a discussion with some of the lovely ladies about breast cancer and recurrence. Finally, the tech called me back and told me everything was fine! I let out a whoop and started to leave...as I was walking out the door in my x-ray gown, the ladies asked me if I wanted to get dressed before I left. It was a good giggle for everyone. Imagine being so excited you forget to put your clothes on!

The good news is that I don't have to return for another year. Things are definitely looking up!

One Year Later ... More Surprises!

Hooray! I survived the first year of survivorship, the last few months being so easy, it was as if I never had any problems. My scar is almost translucent, and all the skin problems from radiation are gone. While going through it, I never thought it would end, but as always, tincture of time cures most of the little things in life.

So one year later, on the anniversary day of my diagnosis, I was in for another surprise. We had gone out to dinner to celebrate, and it was time to go to sleep when I started to get a tummy ache. It started to feel like there was a pump in my tummy being blown up. The pain went into my back and I couldn't get comfortable. This unrelenting pain went on and on, and after 2 hours, I told hubby that we needed to go to an emergency room. Of course, the first thought through my mind was that I had liver mets and my life was over...talk about making a mountain out of a molehill?

So we went to GBMC, where the cancer treatment took place, and I was triaged to wait nearly 7 hours in the waiting room and before I saw a physician. Rule 1: Never get sick on a holiday weekend...even though illness happens 24/7, hospitals still celebrate holidays with skeletal crews. During the time I wait, I finally fell asleep (probably my body's way to deal with the pain) after 4 hours of this awful discomfort. When I woke up, the pain was gone, but I felt we should still see why it happened since it was so unusual.

Turns out I had gallstones that I didn't know about, and one of them had dropped into the common bile duct that passes by the pancreas and blocked the pancreas as well as the bile duct. As a result, pancreatic enzymes used in the metabolism of foods and bile were unable to get to their destinations. This created havoc with my lab values, and I was diagnosed with acute pancreatitis.

Luckily, being a nurse has its privileges. I got absolutely fabulous care, and all the nurses were super friendly and supportive. After 5 days of rest, hydration, and a procedure to roto-rooter my bile duct and put a slit in it to prevent further stones from blocking it, I was sent home. The next step is gallbladder removal, which will happen tomorrow.

If you're reading this today, say a little prayer for me tonight. I really hope this is the end of illness for me for a LONG time.

Back to Being Me...

This year has been one of tremendous personal growth. I know now what is most important. I gave up my Internet business, because I realized I was spending every waking moment working, and more so in a dark crowded environment, that was just depressing. Did some soul searching, and realized I missed some of the hobbies I used to do in the past, so I started needlepointing again with the intent of creating something for the house. Aside from the joy of creating, it is very relaxing.

Not a big fan of taking photos of myself, I recently bit the bullet and David, Rachel, and I took advantage of getting portraits taken with our dogs at the local PETCO. Our only regret was that Carol lives out of town and we could not have all of us in that picture. When we went to pickup the finished photos, I was thrilled! We were all glowing. The dogs were freshly groomed that day and looked beautiful. I ran out, bought frames, and David hung them on the wall last night, so uncharacteristic of my former self. I now want to see life and joy all around me. This morning, when I saw the pictures in our family room, I had a big smile on my face.

These times are very good times, far better in many ways, then the pre-cancer days when I did not know myself as well, and did not appreciate the goodness in my life.
I really believe that the breast cancer was G-d's way of hitting me on the head to say, "Wake up and enjoy all that is around you. You are blessed. Appreciate all that you have. Take better care of yourself. You are loved."

Just When You Think Your Head is on Straight...

This week has been a rough one from an emotional point of view. I was thinking I was really settled about the breast cancer impact on my life, and then a woman my age in my community, with children who are the same age and friends of my children, dies of breast cancer. She and I were acquaintances. We would always say hello and make small talk when we bumped into each other, but her death threw me for a loop.

Combining that with other stressors, I started to sob last night...for two hours. I couldn't stop crying. Poor David did not know what to do to comfort me. My dogs climbed on my lap and licked my tears. I was inconsolable, and finally, the last drop fell, and I was totally drained, exhausted, and feeling like some of the pent-up angst that has been following me since my diagnosis last September was gone. Cathartic for sure, but also for sure to happen again.

I HATE this disease. It robs families and communities and steals your courage. It takes your free spirit away with the worry that this "beast" is lurking somewhere.

Climbing Over the Mountain

Last night, I went to the Hopewell Cancer Center Support Group after a brief hiatus, and noticed how very far I have come from an emotional perspective. There really is another side to the mountain, and I am seeing the world in a much happier and positive way.

Ten months ago, my world seemed pretty bleak, particularly, since I couldn't take my thoughts away from my mother's death, and wondering if that was going to be my demise from this beastly disease. I fretted that I was never going to see my daughters married or grandchildren or live to enjoy the retirement, we have carefully saved for. The future did not look very positive at the time.

Today, while I think about the cancer, it's not an every day, every hour focus of life. It happened. It was treated. It continues to be treated with Tamoxifen. It's the best it can be. Like I said in the last blog, I'm looking at it as a message to reevaluate my life and appreciate what is most important.

I have been so lucky - terrific and loving husband, wonderful daughters, adorable dogs, great friends, and life's comforts. I am blessed.

How Did I Get Breast Cancer?

I think all of us who have been diagnosed wonder what triggered it and when it started. They say that DCIS takes 5-10, 10-15 or 15-20 years to develop to the point where it can be diagnosed. That's a wide range of years and who knows which one is right, but I can pinpoint events during each of those time frames that may have created enough stress to affect my immune system enough to make it incapable of fighting the cancer cells.

Fifteen to twenty years ago, my mother had 2 strokes and died of recurrent metastatic breast cancer. She had been sick since I was 15 years old with a multitude of health issues, mostly centered around her circulatory system. My role changed from daughter to pseudo-caretaker. My mother really took her sick role seriously. She stopped working. She was afraid to do anything that may stress her. However, the stress was redirected to everyone else. My father, in turn, was not used to not having his wife do everything he wanted when we wanted it. It's like taking a stable table with four legs and moving the legs around so that it wasn't quite as stable, nor did it stand up as straight anymore. The outcome of living in that environment over a period of time resulted in an uncomfortable level of anxiety and some hypochondria based out of fear of becoming sick like my mother.

Twenty years ago, my children were also in elementary school. I was working in a job I wasn't crazy about, but it afforded me a schedule that would permit me to be home with my children whenever they were out of school.

Fifteen years ago, I found a job where I could work from home. I decided to go to graduate school full-time during that period, and while the children were a little older, my role as a mom was more important than ever. The children were the easiest part of my life at that time. The overload of school and the job caused my hair to fall out of my head in clumps, resulting in 6 months of cortisone treatments to my scalp to prevent further damage. Lessons learned: I reduced the school schedule and still graduated within the time frame I had orginally planned. I also went back to work in a structured environment where I could separate home and work responsibilities when the home job contract ended.

Ten to fifteen years ago, my daughters were getting ready for college. It was a tough financial hit, but not unexpected. It was during this time that I also experienced a bad business relationship that really stressed me out.

Five to ten years ago, I was in another job where the workload was totally overwhelming, and most of us in the department were treated badly. I was the first of 23 people who left that department over the next five years to find peaceful employment elsewhere.

Add it up, and any of these events could have thrown my body over the edge. Include a dash of family genetics, bad eating habits, and erratic exercise. Is it any wonder that I developed breast cancer? How many times do you have to get hit on the head to know that you have made bad choices?

Looking Back - 9 Months Later

Most of the past nine months has been a whir of activity, primarily focusing on breast cancer - diagnosis, treatment, side effects, and survivorship. Only now am I starting to see the forest through the trees, but there are certainly many lessons I have learned along the way.

My daughter commented recently that my point of view on what is important in life has definitely changed since my diagnosis. She is pleased to see that I am focusing less on work, and more on taking care of myself. That I am focusing less on taking care of everyone else, and treating myself better in the process. These are things that I have always strived for, but could never justify in the past. Why does a cancer diagnosis finally justify it? Why did I ever have to justify focusing on myself?

Here I am, the nurse, the caregiver, the family anchor, the daughter who looks after her ailing father taking care of his bills, his medications, and listening to his daily "organ" recital, the daughter-in-law, who worries as her aging deaf 95 year old father-in-law lives day-to-day in an assisted living facility, the wife who worries that her husband's 4 hour commute each day is too stressful, making him tired and unable to do the things he used to do, the mother who worries that her daughters, now in the work force, are spending way too much working and not enough time playing. How can I blame them, they learned from the best ;->.

My daughter also commented that my life history has been filled with little "bumps" that have made me stop for moment and take notice of my choices. So that while cancer is not something I would have ever wished for, it did make me stop, take notice, and make decisions to change the course of my life in a positive way. I have learned to take the lemons and make lemonade.

Back to the Breast Surgeon

After two bouts of antibiotics which helped to reduce the inflammation, heat, skin redness, and pain in the radiated breast, the symptoms are back. The radiation oncologist sent me back to the breast surgeon, whom I really trust. After careful review of the history and extensive palpation and questioning, she advised me to use "tincture of time" to let nature move forward to try to resolve the ongoing problem.

She wasn't blowing the situation off, but felt a very conservative approach is the way to go for now. Unless of course...I develop more inflammation and pain. Then, I'm to call her back.

I feel comfortable with this decision, because she took the time to review the situation, the past treatment, and synthesize it all to make a decision about the best way to move forward for the time being. Works for me!

Stay tuned...

Infection is Back Again...

So...now I'm 10 days out from the finishing the 2nd antibiotic, Cipro, which I was on for 10 days and the symptoms of breast infection are back again - itching, inflammation, and swelling under my armpit. It's getting REALLY old. The Radiation Oncologist wants me to go back to the breast surgeon. He is not convinced it is all from the radiation at this point. What we do know is that it is likely an infection since it has responded to the antibiotics. Here we go again...sigh

Finally...Some Answers

I'm finally turning the corner - emotionally that is. This week I have better direction on what is causing the radiation effects and an answer to the swelling in the my left neck which has gone on for two years. All are fixable...so much to be grateful for.

I've also decided to turn my focus away from the cancer and more on making my life even more meaningful than it is already.

Radiation After Effects

So it's now 5 months post-radiation treatment. If you recall, when the treatment ended at the end of December 2008, I experienced a folliculitis of the treated skin area that took nearly 2 months to resolve. The dermatologist tried 3 different approaches to resolve it, including a biopsy (just showed inflammation and nothing else), and finally it went away when all three medications (topical antibiotic, steroid cream, anti-fungal cream) were applied.

Fast forward to this week... My affected breast is very warm to the touch, still pink, and painful at the boost site area as well as under my armpit where it feels swollen at times, particularly in the morning when I swear I can feel the lymph nodes. The pain is becoming more constant, particularly after the breast has been touched. So I called the breast surgeon, whose nurse referred me back to the radiation oncologist, whose office arranged for a visit that day.

The radiation oncologist advised me that it was NOT cancer, but rather a hyperreaction to the radiation treatment which occurs in 1-2% of all people who receive radiation (aren't I the lucky one?). He recommended 2 courses of treatment -heavy steroids (8 weeks) which would provide optimal results or Motrin 800 mg three times a day for 3 weeks. I made no treatment decision at the time of the visit because I think the treatment is a bit harsh to start out the gate with, and will follow up with him again in August since he says there is no harm in waiting it out a bit longer.

The day after that visit, I received a call from the radiation oncologist, who had done a bit more research, and recommended that I should try a short course of antibiotics for 10 days to make sure that the inflammation is not bacterial in nature. He ordered a broad spectrum antibiotic. If it improves the situation, I'm to see him at his office. If not, I'll give him a call to advise.

Now...with my 20/20 hindsight, maybe I shouldn't have done the radiation, but then I wouldn't have done the full battle plan and would have more about the cancer returning. Too late now to speculate about what could have been.

Psychological Support

Last weekend, David and I participated in the Hopewell Cancer Center's Annual Fundraising Walk and Run. It was joyous to see my new Hopewell friends with their families and to see some of my old treatment buddies, now being active and looking healthy!

The Hopewell Center has really been a terrific place for me. It is a non-affiliated non-profit grass roots organization that provides supportive services to anyone with cancer. Services are all free of charge, and they rely entirely on donations. They recently purchased an old comfy home where their meetings take place and built a barn on the property for their spiritual classes in yoga.

Every other Monday night, they have a Breast Cancer Support Group. Last night, I went for the second time. The women change each visit, because it is a networking group, and attendance is not mandatory. It's so inspirational and freeing to talk about the cancer and learn from others' experiences, fears, etc. And it's not all cancer either...it's the fallout from the experience that is discussed as well. I highly recommend this type of activity for support.

Last Thursday, I also started weekly support group sessions at the Hopewell Center. This includes people in all stages of cancer with all types of cancer. Again, another opportunity to talk freely about cancer and never worry that someone will run away from you because you have that need. The reality is that none of us who have been through this want to burden others who have not with all the details, but sometimes there is a personal need to do just that. The weekly group is diverse, but we all connected. This will definitely be helpful for me.

If my Mom had not had breast cancer and died from it when we thought she was cured, I don't think I'd be so fixated...but it is what it is and I have to live my life with that knowledge. I feel certain that these groups will help me get over the psychological hump. How lucky I am to live in a community with so many fabulous resources!

Six Months Follow-Up

Today was six month post-cancer diagnosis visit to the oncologist. Since the radiation ended, I've been having swelling in my left armpit every morning. I realized, through all my reading, that pain in the breast after radiation was really quite normal, so those pains have not scared me. The oncologist was not concerned at all. She palpated my armpit and told me that my lymph nodes were NOT enlarged, and that it is really quite common to have axilla (armpit) pain after radiation.
My blood work came back normal in all areas, and she is pleased with how I'm doing with the Tamoxifen. My breast is still a little red and a little warm from the radiation, which she says is also common, and no, it is NOT IBC. That was a relief.

My next appointment is scheduled in 6 months, one week after my next mammogram. Lots to celebrate...all is going as good as it can get!

Fast Forward...

The months have flown by. Since radiation finished, I've been dealing with a residual skin problem as a result of the radiation. I was hoping it would disappear, but it has spread. The dermatologist took a biopsy last week and told me not to worry...it's not cancer, more likely something that can be easily treated. The first two medications he gave me didn't work, but last week he added a third and I'm noticing that there is less inflammation and no new spots. I'm crossing my fingers.

This past Monday night, I went to a meeting of SOS, a volunteer group of survivors, who meet with new survivors to talk about different issues such as fears, recurrence, relationships, etc. It was very uplifting, as I have been a little down in the past month from the skin issue and recurring fears. One of the messages of the meeting was to recognize that I am the top priority now and to take care of myself first before others. Of course, it's not realistic, but it's a message that I've heard a zillion times, but this time it stuck a little better. The other message I took home was to reach out for more help if you need it. It was calming to talk to others who have been through it and are surviving with the same feelings and emotions.

So...I decided to call Hopewell Cancer Center...they provide support services and have a breast cancer support group that meets twice a month. I'm looking forward to learning about their services next week. There is a sense of relief that I'm doing something to move forward. I never dreamed this would be so mentally debilitating. It doesn't make sense since the cancer is gone, but at the meeting the women said it can take a long time - 1 to 2 years until you really move forward with your life.