Thursday, June 27, 2013

Coordinate Immediate Reconstruction

Not accomplishing anything today, so, so exhausted, from yesterday's trip to the Oncologist (long day) and the dog waking me up after only 3 hours of sleep yesterday and today, at 5:00 a.m.  That's ok, there was nothing critical to do today other than make a Doctor's appointment for Harry to have his ingrown toenails treated July 9th.
I also phoned the Breast Surgeon and Reconstructive Surgeon's office to inquire about coordinating immediate reconstruction.  The Breast Surgeon will send my information on to the Reconstructive Surgeon and he will contact me for an appointment prior to surgery. This is good news!
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Coordinating Surgeons

Phoned Talbert and Sawan's office to inquire about their coordinating for the immediate reconstruction (tissue expanders) during the mastectomy.  Talbert's office will contact Sawan's office, forward my case information and Sawan's office will contact me to set up an appointment.
Breast Surgeon consultation is July 8th, typically, surgery is 1-2 weeks later, might be a little longer if scheduling conflicts with the Plastic Surgeon.  I think we are looking at the end of July for surgery, sincerely doubt that it would be sooner, but will update after meeting with the Breast Surgeon.
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Stay Busy

Updated Things To Do for Upcoming Week:
  1. Go grocery shopping
  2. Cook - 3 more meals for when the boys come & after they leave so I don't have to cook
  3. Freeze the food I cook  for when I'm laid-up
  4. Clean off my desk - I'm more than 1/2 way finished
  5. Update finance files - I'm more than 3/4 way finished
  6. Shred papers
  7. Copy the CD imaging from the Breast Center to take with me to the Breast Surgeon.
  8. Finish Washing Guest Bedding & Dust the room 
    1. Wash the window & blinds
    2. Vacuum & Power Clean Guest Room Carpeting
    3. Set up Air Purifier in Guest Room
  9. Clean Toilets & Showers
  10. Vacuum, Dust, Clean the other rooms' carpets
  11. Give thanks! :)
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Wednesday, June 26, 2013

Thankful

Went to the Oncologist, what a long day.  Everything was good though, she answered every question I had and made me feel that I could call her with any questions or concerns I might have, and I felt she was very sincere.  I'm noticing that the professional health people working in Cancer Care Centers are truly caring.  
Forgot to mention that she told me that I am so LUCKY, all the stars are lined up in my favor with the type of cancer that I have and that it will be treatable with pills and no chemo nor radiation.
Thank you GOD!!
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Oncologist Visit

Things went extremely well.  I love the doctor!  She had familiarized herself with my situation, and was extremely well-organized with the information she shared.  The best news is that I will NOT have to go through chemo nor radiation, based upon the current test results!Her EXACT words were, "You have lucky stars aligned in your favor!"
Questions that she answered were:
Q:     Will she order an MRI for me prior to seeing the Breast Surgeon?
A:    No, since I want a mastectomy, there is no need for an MRI.
Q:    Who determines the order for a double mastectomy?  Will my extreme family history help in achieving this?
A:    This will depend upon the surgeon and my insurance company.
The family history will play a significant role in the decision.
Q:    What "STAGE" is my breast cancer?
A:     The "stage" will not be determined until after the surgery when all tissue will be examined/tested.
*** The Oncologist did say that my cancer was very, very, very small, a "smidgen".
Q:    Will there be a BRCA test ordered?
A:     She did take saliva for the BRCA genetic testing, but I told her it will probably come back negative since everyone in my family who has had breast cancer was negative.  I then asked her why my family would be so susceptible to cancer but negative for the BRCA gene.  She simply explained that there has to be another gene that my family carries, that science has not yet discovered.  Makes sense to me.
Q:    Estrogen Blockers - I expressed my concern with the side-effect of stroke from estrogen-blockers because of family members who had strokes.
A:    Oncologist said that she would be leaning toward either Femara Oral, or Arimidex Oral, both of which have lesser side-effects and note associated with strokes.
Lots to do Thurday, but I am exhausted.  It was a very long day, the drive and since we arrived early, we had to wait a little more than an hour - waiting is so tiresome!  All in all, it was a terrific day!
**Note:  These are the two different choices of post-op drug therapy, I need to investigate their side-effect further, at least they don't mention "stroke":
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Questions For Oncologist

QUESTIONS  FOR  ONCOLOGIST:
Will she order an MRI for me prior to seeing the Breast Surgeon?  This will expedite this process.
  1. Who determines the order for a double mastectomy?  
  2. Will my extreme family history help in achieving this?
  3. Breast Cancer in Maternal family
    1. Mom
    2. Aunt
    3. Jenna - Niece
    4. Linda - Cousin
    5. Annette - Cousin
  4. Breast Cancer in Paternal family
    1. Agnes - Aunt ** died from the breast cancer
    2. Sally - Cousin
    3. Diana - Cousin ** died from the breast cancer
    4. Ginger's daughter - Cousin
  5. What "STAGE" is my breast cancer?
  6. Will there be a BRC test ordered?
  7. Estrogen Blockers - concerned with side-effect of stroke - persons in family who had strokes:Maternal Grandmother - recovered (non-smoker)
  8. Maternal Uncle Frank - recovered (non-smoker)
  9. Maternal Aunt Jenny - died from stroke (non-smoker)
  10. Does she have any information on the benefits of an Alkaline Diet?
  11. These are all of the questions I have so far, there are still a few more hours prior to my appointment, I may come up with more.
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Tuesday, June 25, 2013

Breast Cancer Pathology Report

PATHOLOGY REPORT

Estrogen Receptor 95% favorable
KI67 MIB-1 2% Borderline
DNA INDEX 1.00 Diploid
HER-2 NEU (FISH) NOT  AMPLIFIED

ESTROGEN RECEPTOR 95% FAVORABLE - PROGESTERONE  RECEPTOR  80% FAVORABLE
The hormone receptor status of your tumor helps guide your treatment plan. If your tumor is ER+ and/or PR+, treatments that prevent the cancer cells from getting the hormones they need to grow (such as tamoxifen or aromatase inhibitors) may stop tumor growth. Tumors that are ER- and PR- are not treated with hormone therapies.

KI67 MIB-1    2% BORDERLINE 
The proliferation rate represents the percentage of cancer cells that are actively dividing. In general, the higher the proliferation rate, the more aggressive the tumor tends to be. The Ki-67 test is a common way to measure proliferation rate. MIB1 is the antibody most often used to label the Ki-67 antigen. You may see these terms on your pathology report. A higher value shows a higher proliferation rate.

DNA  INDEX     1.00 DIPLOID DNA Index of 1.0 means that the cells are diploid and are similar to normal breast cells in their DNA content.  A DNA content that is aneuploid has an abnormal DNA content……… About 70% of breast cancers will be aneuploid and 30% will be diploid.  The 5 year disease free survival for women with diploid tumors is 88% and for women with aneuploid tumors is 68%. The 5 year disease free survival for patients with a diploid tumor and a low SPF is 90% ………

HER-2 NEU (FISH)     1.2 (NOT  AMPLIFIED) HER2/neu (human epidermal growth factor receptor 2), also called ErbB2, is a protein that appears on the surface of some breast cancer cells. It is an important part of the cellular pathway for growth and survival.
  • HER2/neu-positive (HER2+)tumors have many HER2/neu genes inside the cancer cells (also called HER2/neu over-expression) and a large amount of HER2/neu protein on the surface of the cancer cells
  • HER2/neu-negative (HER2-) tumors have few HER2/neu genes inside the cancer cells and little or no HER2/neu protein on the surface of the cancer cells
About 15 to 20 percent of breast cancers are HER2+ [29-30 ]. These breast cancers tend to be more aggressive than other tumors. HER2/neu status helps guide your treatment plan. HER2+ cancers can benefit from trastuzumab (Herceptin) therapy, which directly targets the HER2/neu receptor. This type of therapy is not used to treat HER2- cancers. Both the  American Society for Clinical Oncology  and the National Comprehensive Cancer Network  recommend HER2/neu testing for all tumors. HER2/neu status can be determined in two ways:
  1. Immunohistochemistry (IHC) testing which detects the amount of HER2/neu protein on the surface of the cancer cells
  2. Fluorescence in situ hybridization (FISH) testing which detects the number of HER2/neu genes in the cancer cells
Most often, IHC is the first test and if the score is +2 (or borderline), the tumor is sent for FISH testing to confirm the status.
RESULTS  OF  AN   IHC  TEST
Score is 0 or +1 Tumor is HER2-
Score is +2 Results are unclear and should be confirmed by FISH
Score is +3 Tumor is HER2+
RESULTS  OF  A  FISH  TEST
Positive (amplified) The tumor is HER2+
Negative (non-amplified) The tumor is HER2-
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Monday, June 24, 2013

Prognostic Series of Biopsy Report

Spoke w/ Ashley (in the Lab Dept. at the hospital) this morning, explained that Valerie (another Lab Dept. employee)  had told me to call this morning to see if my prognostic series portion of the Biopsy report was available for pick-up. No, it was supposed to have arrived overnight or early this morning, she told me to check back after lunch.
Meanwhile, today's things to do:
  • Double-check all documents and imaging CDs to take to the Oncologist tomorrow
  • Wash guest bedroom curtains
  • Finish checkbook, filing and shredding
  • Spray showers/tubs
  • Clean toilets
  • Definitely take a nap today, I stayed up way too late last night for the hockey game and couldn't sleep afterward!  Go Hawks!
On another note, I ordered an air purifier for the guest bedroom for Ry, I'm so worried about his allergies out here.  The purifier will arrive tomorrow.
 
 
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Sunday, June 23, 2013

Sunday - Rest Day

My list of things to do yesterday was not completed, but I did cross off a few of the tasks:
  1. Go grocery shopping
  2. Cook - roast beef, beef stew, spaghetti, stuffed peppers
  3. Freeze the food I cook today for when I'm laid-up
  4. Clean off my desk
  5. Update finance files
  6. Shred papers
  7. Copy the CD imaging from the Breast Center to take with me to the Oncologist.
  8. Relax, take a nap, watch a funny movie - Slapshot
  9. CANCEL  STORM  SHELTER  INSTALLATION!!!!!!!!!
  10. Give thanks! :)
Updated list of things to do this coming week:
  1. Clean out Kitty Litter
  2. Call for Pathology Results
  3. Clean off my desk
  4. Update finance files
  5. Shred papers
  6. Copy the CD imaging from the Breast Center to take with me to the Oncologist (6/23)
  7. Visit Oncologist - Wednesday, June 26, 2013
  8. Always give thanks!
  9. Clean guest bedroom carpet
  10. Wash guest bedroom curtains
  11. Wash guest bedroom bedding & pillows
  12. DUST guest bedroom
  13. Spray for insects!
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Saturday, June 22, 2013

Laughter and Loving Sons

Joe, my eldest son phoned to check in on me; we talked for a really long time, nearly busting a gut laughing so hard!!  He informed me that he will be driving with Ryan, my second eldest son,  to visit when I go in for surgery!  
That ought to be a good time, even though I'll be drugged up on pain pills.  It will be so wonderful to see my 40+ year-old babies!!!!
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Planning Ahead

Woke up at 5 a.m. today, laid in bed for another hour, listening to the birdies chirping outside and Opie running around the bedroom like a lunatic, chasing imaginary dragons!  When my thoughts of what I need to do today roused my brain to full consciousness, I got out of bed, had a sponge bath, dyed my hair with non-permanent hair dye, fed the dogs and gave them their insulin shots and had breakfast.   Now, I'm ready for the day.
Things to do today: (not in any particular order)
  1. Go grocery shopping
  2. Cook - roast beef, beef stew, spaghetti
  3. Freeze the food I cook today for when I'm laid-up
  4. Clean off my desk
  5. Update finance files
  6. Shred papers
  7. Copy the CD imaging from the Breast Center to take with me to the Oncologist.
  8. Relax, take a nap, watch a funny movie - Slapshot
  9. CANCEL  STORM  SHELTER  INSTALLATION!!!!!!!!!
  10. Give thanks! :)
::::::::UPDATE::::::::
Vayda has not been eating her food in the mornings. Her left back paw pad is terribly raw, she's been chewing on it, this happens every year and we thought it was from allergies. We just noticed a HUGE lump in her right side by her shoulder.  Damn!
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Friday, June 21, 2013

Two Down and Waiting

I don't remember what I had to do this morning, but I did reach the Surgeon's office and pressured to make an appointment.  The next available opening was at 1:30 p.m. July 8, 2013.  Crap!  That seems like a lifetime away and what if this cancer is an aggressive type?  I accepted the appointment and figured that after I get the pathology report and see the Oncologist  next Wednesday, she'll let me know if I can or cannot afford to wait.  I need to be smart about that which I choose to worry.
Waiting is going to be a big part of this journey.  Ugh!
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Sleepless With My Fears

© Google Search
I’ve been upbeat about this whole episode in my life, honestly, my attitude is that I have already won, I just need to inform the enemy that he’s already dead. So… it’s like clean-up.  But, I’m really, really tired because my brain just won’t shut off when it’s bed time.
To this point, there was so much to think about, finding good doctors, forcing my doctor to refer me to these doctors that are not part of his hospital system, researching my health insurance plan to be sure that these doctors are within my insurance network.  Obtaining imaging CDs and reports, only to find that the Breast Center had duplicated one of the CDs and I’m missing one report dating back to 2009.  I don’t think I’m going to bother with that one because it had been declared normal and healthy.
sleep-18
© Google Search
I think I’ll sleep very well tonight, knowing that I’ve got 2 appointments confirmed.  I know those could change if the pathology report comes back really bad and I need to get in to see the Surgeon sooner than 2 weeks from now.   At that, I don’t know how much of a wait there will be after I get in to see her!
Meanwhile, tomorrow, my husband is taking me grocery shopping,  something we have NEVER done together! I am making a menu and grocery list for meals that I am going to cook in advance and freeze so that no one has to worry about making dinners.
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Thursday, June 20, 2013

Confirmation and Planning

No appointments, nothing scheduled other than searching local hospitals and surgeons and their reputations.  That's an overwhelming task, but, I had no other choice, I was determined to NOT use the "house" surgeon.  By 8:30 a.m., my husband phoned to tell me that he had a "lead."  A fellow with whom he works, knows a woman, a close friend of his wife's, who had breast cancer last year.  Kevin offered to get all of the doctors' names and phone numbers for me.  He further explained that Nicole, the breast cancer survivor, was a very credible, upstanding, intelligent, successful woman and did her own in-depth research before choosing her doctors.  My husband took the information and called me to explain that she will be expecting my call.
When I tried phoning, her line was busy.  A few minutes later, she called me.  Cassie told me as much as she knew about Nicole's journey adding that she had asked Nicole if it would be alright for me to phone her if I had any more questions.  Of course, Nicole said she would gladly answer any questions I might have.  And Cassie gave me the names of Nicole's Breast Surgeon, Oncologist and Plastic Surgeon.
I tried phoning Nicole, but there was no answer, I left a voice message and returned to my computer to research the names of the doctors which Cassie had given to me.  WOW!  I was impressed!
***
9:00 a.m., I phoned our family doctor's office to see if they could refer me to doctors who are not a part of their hospital system.  The scheduler told me that they don't like to do that.  She asked why I didn't like the surgeon that they had and I said that I wasn't impressed with her credentials.  Nothing was accomplished with this phone call.
9:15 a.m., my family doctor phoned me, with a shaky voice, he told me that he had bad news.  I stopped him mid-sentence and said that I knew and asked for particulars about the cancer.  He explained that they did not yet have the pathology report but the biopsy doctor phoned my doctor, telling him that I need to see a Surgeon and Oncologist.  He was going to transfer me to his scheduler, when I stopped him again, telling him that I didn't want the doctor at Saints, I wanted different doctors.  He was fine with that and told the scheduling girl to do what I wanted.  WHEW!
2:00 or 3:00 p.m., the Oncology doctor's office phoned to schedule an appointment for next Wednesday, June 26th.  Whew!  One down, one to go.
3:30 p.m. I took it upon my self to phone the breast surgeon's office to expedite my appointment scheduling.  The girl who answered was 'new' and couldn't help me but promised that the nurse would phone me back that day.  Never happened.
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Wednesday, June 19, 2013

Ready, Set, Worry

The Stereotactic biopsy was performed.  If anyone wants to know or see exactly how the procedure is performed, YouTube has an excellent video of it here: 
After the procedure, the attending doctor told me that he is certain this is cancer.  He said that my primary care doctor would receive the reports by Monday, June 24th and that my family doctor should call me with the results to schedule a lumpectomy.  He stressed that if I didn't hear from my family doctor early Monday morning, I would need to phone them for the results.  His attitude was very, very emphatic!
I was also given after-care instructions to apply an ice pack to the area for 15 min. on and 15 min. off throughout the rest of the day and not to lift anything other than the television remote control!  "Just sit and watch t.v.!"  So, I did kind of...
I thought that I might be able to expedite things, so I phoned my family doctor's office to speak with the scheduling nurse.  My intention was to ask her if she could start the scheduling already.  I know, I know, that's impossible without the biopsy and pathology report, but, I tried anyway.  Of course, what I was asking was impossible, so I asked the nurse if she could give me the names of the Breast Surgeons that are part of their hospital network.  She gave me the name of one.  This whole hospital system only had ONE breast surgeon!  I wrote down the name and began my research.
I did not like the fact that there was only one breast surgeon and no other choice/option. The breast surgeon did not have outstanding credentials nor experience.  I was adamant that I would research and find the best doctors, but how could I do that with my limited local-people-networking???  That's when I really started to worry.
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Monday, June 17, 2013

The "Bad Guy"

After the mammogram and ultrasound, the doctor told me that he wanted a biopsy because he saw something that looked like a “bad guy”, meaning, cancer.  My next appointment, stereotactic biopsy, was scheduled for the 19th.
Hmmmm, at this point,  I was actually beginning to think seriously that there might be something wrong.

Thursday, June 13, 2013

Mammogram Suspicious Finding

I received a call that “something suspicious” showed up in the mammogram and I needed a second mammogram and ultrasound.  The appointment was scheduled for Monday, June 17th.
The same thing happened to my husband's secretary and I felt annoyed that the hospital was calling back patients for 2nd tests, just to make more money.  I was so sure that nothing was wrong with me!

Not Me!

Mammogram was scheduled and performed. I hate mammograms and have not been good about going to them yearly because I always felt that… it wasn't going to happen to me.

Friday, June 7, 2013

Confusion

The calendar shows an appointment for 12:30 p.m.  I thought I went to this appointment, but my husband disagrees because of the time of day.  If I had gone to this one, we would have met at our favorite hamburger place for lunch and we didn't.
It is all becoming so confusing now.

Tuesday, June 4, 2013

The Whirlwind Begins

A scheduled mammogram for 10:00 a.m. was cancelled and I cannot remember why this was written on my calendar and cancelled. I cannot remember why I had to cancel this!  Looking at the calendar, I must have re-scheduled this appointment for Friday, June 7th at 12:30 p.m..
Typically, I've got a pretty good memory, but over these past few weeks, so much has become a blur.

Monday, June 3, 2013

Testing Begins

I phoned the Midwest Regional Breast Center to schedule a mammogram.  They scheduled me for the next day at 10:00 a.m.



Sunday, June 2, 2013

The Beginning

Sunday morning I awakened with a pain in my left breast.  Upon inspection, I felt a pea-sized lump that was painful.  I determined that I’d better schedule a mammogram since it had been a while since my last one.