Oncology Appointments

Whew! I'm tired!

It's been a VERY long 2 days, seeing 2 different doctors. Here we go......

Dr. Hunt, Radiation Oncology

Radiation is typically done after a lumpectomy and Dr. Hunt explained that radiation goes one step further than chemo in fighting any remaining cancer cells. He said I would have radiation treatments for 7 1/2 weeks, Monday-Friday, and that each treatment would last about 15 minutes.

I will schedule an appointment for a mold to be made of my arm raised above my head. That is how I will lie in the radiation machine. I will then have a dummy scan so they can point the radiation in the area of the tumor. The first 5 weeks of radiation will be a little more broad. The last 2 1/2 weeks will be directed in the exact spot of the tumor.

He said it's very easy and there is no pain whatsoever. The only side effects will be a skin rash and tiredness. He said the tiredness would be similar to being out in the sun all day; I could get up and do things and go places, but I'd rather just stay home and rest. He said both side effects would gradually get worse as I went along and they would gradually disappear once I finished radiation. He also said they can give me creams to put on the rash to help and that it was more uncomfortable than painful.

I will begin radiation treatments after chemo........

Dr. Yardley, Medical Oncology

This appointment is the one that really wore me out. Thank you to Jennifer Mumphrey and Greta Ward for sticking it out with me.

I arrived at Tennessee Oncology (at the Sarah Cannon Cancer Center) 30 minutes before my appointment, as directed. I submitted all my paperwork and paid my co-pay. About 30 minutes later I was called back. My posse (Scott, Greta and Jennifer) were asked to sit in the hallway in chairs they had lined up while I was swept away to the lab. That place was BUSY! They had 4 stations in a room roughly 9 x 9, each with a chair, a nurse, a computer and a shelf full of tubes, needles, blood pressure machines and thermometers. I was weighed and my height was measured (5' 1" in case you're wondering.....and no, I'm not telling you my weight).

My temperature and blood pressure were taken and then she got out the needle. Rats! She drew about 5 tubes of blood. I commented, "Wow. This place is busy." The nurse replied, "Yes, it is. And sometimes it's busier than this."

I was then asked to sit with everyone else in the hall. They didn't have a room available for me. After a few more minutes of waiting, we were all ushered back to a room. A very small room. And it was stuffy in there. And we could hear the conversation next door. We cracked the door a little bit to get some air and Dr. Yardley finally appeared about an hour later. I was getting antsy at this point.

She started using really big words and it was tad hard to understand her (she mumbled a little) but once she got going, I was able to understand what she was saying and started to relax a little.

Dr. Yardley stated that I had a few things in my favor and a few things working against me. The positive things were that the cancer was caught very early and the lymph nodes were negative. She said the tumor was small in comparison to others. Her exact words were, "It's amazing that you actually found this because it was so small." God and I did a mental hi five (because He's cool like that) and I said to myself, "GOD is the amazing one." She went on to explain the negative pieces: I have a 30% chance of never getting this again if I don't do any chemo and those odds weren't good with her. Also, the type of cancer in my case is very aggressive and very fast growing. She said the tumor hadn't been there long.

Along with the aggressiveness of the cancer, she also said the cancer is estrogen positive but HER-2 negative. Basically a HER-2 negative diagnosis means that the the HER-2 gene is not over-producing protein, causing cancer cells to grow. The estrogen positive factor means that I will have hormone therapy for 5 years after chemo is over.

She is recommending 6 chemo treatments to be administered once every 3 weeks. If I start in the next couple of weeks, I'll be done somewhere around Thanksgiving. I can add that to my list of things to be thankful for.

She went on the explain a drug trial that is available to me. It's a drug called Bevacizumab that blocks a protein that is required to form new blood vessels. Without new blood vessels, the growth of the tumor is slowed. If I choose to participate in the trial, there is only a 33% chance that I will receive the trial drug. Do you know how they decide? It's basically a crap shoot. Seriously. It's completely random. The paperwork even says so: "Research participants will be randomized (similar to flipping a coin or the roll of dice)". There are 3 groups and only Group 3 gets the trial drug. The other 2 receive a regular chemo regimen. In group 3 the trial drug is administered along with a regular chemo regimen. I have to decide if I want to participate in the next few days.

Dr. Yardley also stated that there would be lots of support drugs. She said the chemo would be the easy part. But they give you lots of prescriptions to keep with you for immune support, nausea (about 3 different ones for that) plus drugs to keep infections at bay, etc. I will have to be on several drugs prior to starting chemo and continue a lot of them throughout the 18 weeks. Some will only be taken as needed. She said they want to provide me with everything they can, so that I won't have to suffer through any additional medical problems. They stay on top of it because the chemo can really weaken the immune system. She said not to go to the emergency room for anything, but to let them know ANY other symptoms I'm showing, even if it's just sore throat.

Several tests need to be run before I can begin chemo. Next week is going to be busy. Monday morning I have to be at Imaging Alliance on White Bridge Road at 6:50 to drink the contrast fluid (a powder mixed with Crystal Light). Then the test will begin at 7:50. It should take about an hour. Then Wednesday morning I'm scheduled for an echocardiogram at 8am, then it's off to Dr. Cooper for a surgical consult about placing the port. If he says my incision is healed up enough (it's still open in one tiny spot and still draining) and he has a spot open on the surgery schedule on Friday, I will then have the port placed.

The port: It's about the size of a nickel and it's placed under the skin. It had a long tube on the end of it that will be placed inside a vein. It will look like a knot on my skin. It's placed just under the collar bone on the opposite side of the tumor (mine will be on the left).

If Dr. Cooper can put the port in on Friday the 6th, I will begin chemo on Wednesday, August 11th. I will see Dr. Yardley before each chemo treatment and they will do lab work (draw blood, take my blood pressure, etc). Each treatment (including the labs and doctor visit) will take approximately 4 hours.

After chemo, I can return to my normal activities, as long as I'm feeling ok.

She said around day 10 after chemo I would start to feel tired and my immune system would start to fade. Around day 14 I would begin to lose my hair. I want to thank my new friend Shelly Hackney for giving me all her hats and headscarves. She just finished her chemo back in February and is doing really well. Momma, Angie and I are going shopping this weekend to see what else I can find. There is also a web site (http://www.headcovers.com) that has a boat load of hats, headscarves and other things for women (and men) going through chemo hair loss. Dr. Yardley stated the hair would begin growing back after the last treatment.

Speaking of hair loss, I would like to also mention my brother Ted and his wife, Greta. Greta has really short hair and is going to let it grow out as long as I'm going through treatments. Ted has shaved his whole head completely bald so I don't have to go it alone. And Scott says he's going to do the same thing when I start losing my hair. How sweet is this family?

I think I covered everything for now. I will post another update once I get through all my tests next week.

Everyone have a great weekend! I'm headed to Fall Creek Falls to pick up my niece from church camp tomorrow. I love church camp and plan on going for the whole week next year.

It's good to be alive! -

Follow Up from 3rd Surgery

Praise God that He still takes us out of the mouths of lions. No cancer in the surrounding tissue! WOOHOO!!! All the tissue he took out last week contained no cancer cells.

Dr. Cooper is sending me to 2 oncologists the last week in July. One is Dr. Denise Yardley, who is a medical oncologist, and Dr. Hunt, who is a radiology oncologist.

If I understand correctly, Dr. Yardley will go over my chemo options and Dr. Hunt will go over my radiation options. I will have chemo first, then radiation, but will know with certainty once my appointments roll around.

So.........no more doctor's appointments until I get back from vacation. I have 6 days of work left, then we're off to PCB with my sister and her family. I'm soooo ready for that break. I don't plan on doing anything except plant my chair and my toes in the sand. No swimming for 3 weeks, but that's ok. As long as I can stick my feet in the water, I'm good.

Hugs to all! -

3rd Surgery

Hope this if finding you all well. The weather the last couple of days has been GREAT!

I had my 3rd surgery yesterday. I was about like the others. We got to the hospital at 8:30, I signed in and after a brief amount of lab work, I was called back to my room for the day. I didn't have to get any mammograms or ultrasounds or guide wires placed this time, so it went relatively quick.

The orderly came to get me and put me in pre-op. I got there around 9:30. After the 2nd attempt at placing my IV line (ouch!) they said Dr. Cooper was still in another surgery. This was around 10:20. One of the nurses came by and said if they didn't call me back in 15 minutes, she would let my family come back there; and she did. Scott and Momma came back to see me. It had signs all over the door that it was a sterile area. I assumed that meant everyone had to wear a hair net and scrub up before entering. I assumed incorrectly. I was also flat on my back so I could look at the ceiling tiles. There were 32 within my sight line. I counted them because I was bored. When you are looking at ceiling tiles that are dirty, you try not to think about how "not sterile" the room is. So I decided to close my eyes and take a nap. Around 11, they came to get me and gave me something to help me relax for the ride to the OR. I remember being rolled out of pre-op, into the operating room and someone telling me to breathe deeply. Then I saw that mask go over my face. I also saw some big lights above. I was counting to myself and trying to breathe deep. I got to 4.

Next thing I remember is waking up in recovery. They were speaking my name loudly and telling me where I was and that it was over. I couldn't help but notice how much pain I was in. My lower back was killing me so I tried to move my legs and release some of the pressure off my back. It helped some. But then I noticed my incision felt like it was burning and stinging and just generally painful. The nurse asked if I was in pain and I told her yes. She said, "OK. I will bring you some morphine." THANK YOU!!! is what I wanted to shout. Instead I starting breathing, trying to calm myself. I dozed a little, then was asked again if I was still in pain. At that point, it was dulled a little. I told her that and she gave me more morphine. A few minutes later I was feeling pretty good. She kept telling me to breath deeply because it would help to saturate my body with oxygen (they had taken the oxygen tubing out). She also said they wouldn't give me more pain meds in the room if I didn't. I breathed as deeply as I could, but between each deep breath, I wanted to go back to sleep. She had to keep reminding me to breathe deep.

A little while later they wheeled me back to my room. Momma, Daddy, Angie and Scott were waiting for me. Angie and I were trying not to laugh when she said she'd bring me some Sprite. We had just had a conversation about how Sprite tastes so good in the hospital, along with graham crackers. So when she asked me if I wanted some Sprite, Angie mouthed to me, "And graham crackers!" Sometimes we can just look at each other and start laughing. It happens with my momma and Tammy Lee too. Could've been the drugs making me laugh too. :)

Gary and Dot came in (Scott's parents) and visited with us awhile. After everyone left, I started dozing off again. The nurse came in and I got ready to leave. I think we ended up getting home around 4.

Everyone who was there tried to let everyone who wasn't there know how I was doing. Scott and I have AT&T and there is no service in the hospital. So he didn't get to text anyone until we got home.

I asked what Dr. Cooper said after surgery. They told me he said I did fine and everything looked good. The tissue he took out was sent to pathology and he will let me know the results on my follow-up visit, which is this coming Tuesday, the 6th at 3:40.

I'm feeling pretty good right now. Still a little groggy, but other than that, I'm good. Oh....and the nurse never did give me anymore pain meds. When the recovery nurse was talking to the room nurse, she said they had given me demerol and morphine in recovery. I guess they figured I'd had enough. ha! It was fine though. I wasn't feeling any pain. I took one pain pill around 10pm, then went to bed.

It's now 4:28am and I can't sleep that good right now. But I'm relaxed and am feeling fine. I'm trying not to take too many painkillers. I usually take 1 before bedtime but during the day I try to just use Advil or Aleve. It seems to work fine.

Oh, and I DID get some antibiotics before surgery. Dr. C said that antibiotics afterward shouldn't be needed because the incision is completely closed. The weight of the breast is what caused it to open up and get infected last time. I'm still watching it closely for any signs of infection, but I think it will be ok this time. I bought 2 really good supportive sports bras that he wants me to wear for the next 6 weeks. That, along with the stitches and steri-strips should hold everything together this time.

Everyone have a great and safe 4th of July weekend. I love this holiday. You don't have to buy presents, decorate, cook all that much, or send out cards. It's very relaxing to me.

Hugs to all! -

A Gift & Some Good News

I am completely overwhelmed and amazed and honored and humbled by a gift I received today. (As a friend of mine says, "Do you always have to be overwhelmed? Can't you sometimes just be 'whelmed'?")

My sweet Aunt Evelyn made me a quilt. It's brown and dark pink and has hearts, flowers, paisley and tan colored breast cancer ribbons on it. It's absolutely gorgeous. But the back is what brought me to tears. She sent the backing of it (solid white) to my Momma. And it got passed around to my family and friends, and to some folks I'm only slightly acquainted with and they all signed it.

I honestly think that quilt has been to at least 3 states, maybe 4.

I will cherish it always.

The day got even better when I got a phone call from Dr. Cooper's nurse. The results of my gene test are in. I do NOT carry the gene that causes breast and ovarian cancer. That is such great news and a load off my mind.

To top the day off, I am meeting my best friends for supper: my sister Angie, my niece Megen, my sister Tammy (for those of you who know us, you know we ARE sisters), and my other niece Morgan (Tammy's daughter). My other BFFs are scattered over 2 states....wish they could be here too!

Surgery in the morning should be a breeze. I have to be at the hospital at 8:30 and surgery is supposed to begin at 10:30. I am praying for no infection this go around and for quick healing so I can move on to the next step.

Hugs to all! -

Things Are Rolling Again

Just had my 3rd follow up visit after my lumpectomy.

Things are finally moving again and I couldn't be happier about that.

My next surgery is scheduled for Thursday, July 1st at 10:30am. I have more lab work (yep, I get to get stuck with another needle) this coming Friday, then I have to be at the hospital on the day of surgery at 8:30am. Same things as the other 2 times: no eating after midnight the night before, don't chew gum or mints, etc.

This coming up surgery (just to refresh your memory) is to take the tissue that surrounded the tumor to see if any of it is cancer. I don't know if they'll test it right there or if I will have to wait to get the results at my follow up visit (scheduled for Wednesday, July 5th at 11:45).

The best news I heard today was that I won't have to have any more mammograms or ultrasounds prior to this surgery! I could've kissed Dr. Cooper when he told me that.

GENE TEST: As Karen, Dr. Cooper's nurse stated sarcastically, "This is a very lady-like test." They have a kit that contains a plastic beaker with a cap, some paperwork and a travel sized bottle of Scope. She poured about a cap full of Scope into a small cup and told me to "swish" it around in my mouth for 30 seconds. She timed me. Question: how many of you tend to laugh when it's inappropriate? Like in church or at a funeral or when someone falls down? You just get tickled at the worst times. This is me, raising my hand. That was a LONG 30 seconds. I successfully 'swished' without laughing, then I had to spit it into the beaker. Her next words: "OK, let's do it again." WHAT? I barely got through the last 30 seconds without laughing. So I took another cap full and 'swished' it around for another 30 seconds, then had to spit it into the beaker. Discovery: Scope foams up A LOT when you swish it around for that long. Then she said, "OK, now I want you to run your tongue ALL AROUND your mouth, over your teeth, up over your gums and get as much spit in your mouth as you can and spit it into the beaker." Like she said........lady-like. So I did. Then she smiled at me and said I did good. :) Then, as my consolation prize, I got to take home the remaining Scope.

I still have to change the gauze several times a day on the incision, but Dr. Cooper said the it is looking exactly as it should and now we can proceed.

Please pray for no infection this go around and that it will heal quickly and won't give me any trouble on vacation (in 25 days!).

Special thanks to Greta Ward for making me some really awesome cards to send out. They are on kraft paper with a pink breast cancer ribbon embossed on them and on the inside it has the word "Hope" and "For I know the plans I have for you, plans to prosper you and not to harm you. Plans to give you hope and a future."

Also to Lyn Walker and Carole Purkey for the GREAT make-over and make-up tips and for letting us invade your house (Lyn) last night. We had a great time!!

Hugs to all! -

Another follow up visit

Hey everybody!

Let me say, again, how much I appreciate the prayers and cards and sweet messages I have received from you all. I am fully convinced that without God and you, I could not be getting through this journey as well as I am. Sometimes I think God just reaches out and pulls me through. Sometimes it's a very peaceful walk. And sometimes it hurts like yanking off a band-aid.

I had to explain to a few folks after my last post that the reason for this blog is for information. That includes ALL information. The good, the bad and the ugly. Some of you reading this may have to go through this one day or your wives or mothers or even some of you men may have to go through it. Therefore, I am not leaving anything out. It's gross at times. But I'm not sorry I'm sharing it. Plus.......it's my blog and I can put on here whatever I want. :)

Speaking of ripping off a band-aid........(WARNING: DO NOT READ THE NEXT FEW SENTENCES IF YOU ARE GROSSED OUT EASILY!) Dr. Cooper said the incision IS healing. It looks horrible. Even disgusting. It's still kinda green in some places and it bleeds and it's very tender. But it's healing. (Dr. Cooper's words: It might not look good to you, but it's doing just fine). For the next week I have to take cotton gauze and pat it to the bed of the incision and tape it down. The gauze needs to stick to the incision. Then at least 2 times a day (he said the more the better and the quicker it will heal) I have to take the gauze off. With that gauze comes dead tissue. And blood. And that's what he wants. He said this will actually help it heal. By the way, the part of the incision where it's infected is wide open. It's about 2 inches long and goes from top to bottom (not side to side) and it's raw. It's basically an open wound. Honestly, it doesn't hurt except around the edge where it's tender. Pulling off that blasted tape is the worst part.

I still can't schedule surgery yet. He wants to wait 1 more week to let the incision heal up some more. I go back next Wednesday.

At that time, I am also having a genetic test. There's something out there called a BRCA gene. If you have it, you are more likely to get breast and ovarian cancer. My gynecologist called me last week and said if I carry that gene, I am at greater risk for ovarian cancer and he will need to take my ovaries out. (It's called an oophorectomy). But we'll cross that bridge when.....well, you know.

GOOD NEWS: My cancer is the most common type (please don't ask me what it's called because I can't remember the exact name of it) and it's Stage 1A. He said anything below 1A is no cancer at all. That is VERY good news. It means it was caught very early.

Chemo: Yep. I still have to have it, even though the cancer was caught early. It's still cancer. And I still have it.

I'm taking this all in stride. It's a delay but it's not a major setback.

I'd like to thank Lyn Walker for the "Get Well Soon" tablets from Arbonne that she gave me last week. I'm feeling much better this week. Those antibiotics, along with the Get Well Soon seemed to shorten my sinus and ear infection quite a bit.

INSERT COMPLETELY RANDOM THOUGHT HERE: Is anybody else watching the World Cup? SPOILER ALERT: Uraguay just beat South Africa 3-0. Unless my World Cup knowledge is completely off base, looks like they'll be moving on to the next round.

That's about all I have for this week. Hope everyone has a great last part of June. More updates after next week's doctor visit. Good day everybody!

Follow Up Visit

I had my follow up visit with Dr. Cooper yesterday. It did not go as planned. I'm recalling my words when all this started: "It's going to be muddy and lumpy and stitched together."

1) My incision is infected. Dr. Cooper looked at it, then donned his latex gloves and told me to lay back on the table. That's never a good sign. (WARNING: If you have a weak stomach, skip ahead a few sentences!!) He dabbed at it with some gauze, then proceeded to root around in there with a wooden stick wrapped in gauze to clean up some of the fluid. Did it hurt? Not a bit. Was it gross? Absolutely. With the wooden stick, he pushed some gauze into the incision and by "into the incision" I mean he went about 1 inch in. Then he taped me up and said he was putting me on antibiotics for a few days. By a few days, he meant 10. The antibiotic he gave me was Levaquin. I sure hope they work soon. Those suckers were expensive! And if you've ever been on it and experienced any side effects, WOW.........I feel your pain.

2) More surgery. Yep. You read that right. More surgery. It seems the tumor was larger than he expected. He makes an educated guess at the size of the tumor when he looks at the mammograms, ultrasounds and MRI scans. But seeing the actual thing is what counts. Once he got in there, he saw it was larger than he thought. The best I can remember (it's all a bit of a blur today.....I have an ear infection and things are a little fuzzy right now), he said he took the entire tumor, but was unable to take a lot of the surrounding tissue. He said he took a chunk, but it wasn't enough. He couldn't take as much as he needed to because it would disfigure the breast. I guess once things shift around and resettle, you can go back in and take more. And that's exactly what he wants to do. He wants to be absolutely sure he got the majority of the cancer. The tissue he takes on the next round could be completely benign. But it could also be cancer. And if it is, it could/will change my chemo regimen.

3) Type and stage: I forgot to ask. I completely forgot to ask. And no, I'm not calling them back to ask them because at this point, it means nothing to me. All it will make me do is look it up on the internet and try to figure out what they will do next or scare the life out of me. And as Dr. Cooper told me on visit #2, looking on the internet for information is dangerous. He said you have to ask yourself 2 questions when looking for information on the internet:

1: Does it fit, and 2: Do you agree? Does it fit your exact situation? Probably not. And you have to decide if you agree with what you're reading. Good advice.

I trust Dr. Cooper with my life. Literally. I understand why he has to do more surgery. My head tells me it all makes sense. But my heart is not in it at this point. I don't want to have more surgery. Again, it's not my preference. But it's reality for me at this point. And hey, there are positives to this step backwards:

1. If I start chemo in the next couple of weeks, I could feel horrible on vacation (in 39 days....not that I have a countdown app on my phone or anything).

2. The later chemo starts the more it goes into fall and winter. And maybe chemo hats and headscarves are cuter in the fall and winter.

3. More pain pills! (Just kidding Momma!)

Does anybody out there watch Criminal Minds? (No, this is not random rambling on my part). Don't you just love Penelope? One of my favorite quotes of hers is, 'This job has taken away my ability to laugh.' I don't want to lose my ability to laugh through this cancer. I refuse to allow it to steal my joy. Satan does a good enough job of that. And speaking of that, when did we decide that he has a right to do that and 'that's just the way life is'? Listen up people....we ARE allowed to intimidate the kingdom of darkness and it's high time we make the enemy sorry he messed with us. God's word tells us we are to become armed and dangerous. And as my friend Beth Moore says (I'm not really her friend because we've never met, but if we had, I'd like to think we'd be friends), "Believing God's word is active and alive in me is where the rubber meets the road." (Do any of my Old Hickory friends think of Katherine Lane when they read that?)

God's timing is intentional. Yes, it is a setback. No, it's not my preference. But as my least favorite saying in the whole world goes: it is what it is. "Both faith and freedom will emerge from deliberate acts of the will to shift our focus from all that begs to differ to the great and glorious truth of the living God." Could anybody out there use a little faith and freedom? I could.

Believe God. Let nothing make you quit.