Sunday, March 24, 2013

SMILE

Smile though your heart is aching
Smile, even though it's breaking
When there are clouds, in the sky, you'll get by
If you smile, through your fear and sorrow
Smile, and there'll be tomorrow
You'll see the sun come shining through
If you'll....
Light up your face with gladness
Hide every trace of sadness
Although a tear, may be ever so near,
That's the time, you must keep on trying
Smile, what's the use of crying?
You'll find that life is still worthwhile,
If you'll just....
Light up your face with gladness
Hide every trace of sadness
Although a tear, may be ever so near,
That's the time, you must keep on trying
Smile, what's the use of crying?
You'll find that life is still worthwhile,
If you'll just....
Smile


When I was in high school (many moons ago), I decided I wanted to find all the songs that were about 'SMILES'.  Believe it or not, there was no internet, and the card catalog at the library wasn't helping me much; so I would keep my ears open for songs on the radio or any mention of this type of a song.  The first song I found was this one above.  The music was written by silent film star Charlie Chaplin, the lyrics were added by John Turner, and Geoffrey Parsons.  There have been M A N Y artists who have sung this song Judy Garland, Tony Bennett; Eric Clapton, Nat King Cole, Natalie Cole; Sammy Davis Jr.; Robert Downey Jr., Jimmy Durante, MY FAVORITES, Michael Buble, Harry Connick Jr., Michael Jackson (this was his favorite song), and Elvis Costello {who I think Russell Crowe sounded like in 'Les Miserables', I just kept thinking Elvis Costello, Elvis Costello, and it made his voice acceptable} just to name a few.  (Yes, I am old)

This whole process is a very S  L  O  W moving one, until you get your treatment plan (then I hear it goes faster....we'll see).  I could be frustrated, but am so happy that I have decided to take it day by day.  I am choosing to smile.  I find about my treatment plan one week from tomorrow and yes, it does scare me a bit, smiles shall prevail (talking to myself).  When I tell some people that I am going through with chemo and/or radiation, whatever is recommended by the oncologist, their faces are full of confusion, "you still have to do that?".  I don't HAVE to, I guess I am choosing to.  I said to Keith I guess I could be done with everything and just go on with my life if I chose to?  But, I am not choosing that road.

This week I received a card from a dear friend with a quote from Jeffrey R. Holland which read,

"When you are confronted with challenges that are difficult to conquer or have questions arise, the answer to which you do not know; hold fast to the things you do know.  Hand on to your firmest foundation, however limited that may be, and from the position of strength face the unknown."

I have read and re-read that quote many times, and with a SMILE on my face I think how comforting.


Wednesday, March 20, 2013

Feeling Good

Birds flying high
You know how I feel
Sun in the sky
You know how I feel
Breeze driftin' on by
You know how I feel

It's a new dawn
It's a new day
It's a new life
For me
And I'm feeling good, I'm feeling good
Fish in the sea

You know how I feel
River running free
You know how I feel
Blossom on the tree
You know how I feel

It's a new dawn
It's a new day
It's a new life
For me
And I'm feeling good

Dragonfly out in the sun you know what I mean, don't you know
Butterflies all havin' fun you know what I mean
Sleep in peace when the day is done, that's what I mean
And this old world is a new world
And a bold world
For me, for me

Stars when you shine
You know how I feel
Scent of the pine
You know how I feel
Oh freedom is mine
And I know how I feel

It's a new dawn
It's a new day
It's a new life
For me

And I'm feeling good
I'm feeling good
I feel so good

Yesterday I went and saw my surgeon and he took my drain out.  Hallelujah!!!!  He also took all the steri-strips off the incision area.  My sweet Mother went with me.  This has not been easy on her, nor my Father.  This is great news, except yesterday when I bent down to pick something up, I heard my insides, and it sounded like a bowl full of jelly about to erupt!  (gross, I know; would have been a great party trick, haha).

Dr. Fisher said, "Please live your life CANCER FREE, because you basically are."  Honestly I didn't hear anything else because the tears just flowed.  A second chance?  It made be think of the words of Alma,

 "And now behold, I ask of you, my brethren of the church, have ye spiritually been born of God? Have ye received his image in your countenances? Have ye experienced this mighty change in your hearts?"

So now my next step is with the medical oncologist on April 1st.   I asked "Why does one need chemotherapy and/or radiation if they have had the affected appendage removed?'  The answer I received was, "it is like having car insurance, I don't plan on getting into an accident today, tomorrow or 3 weeks from now, but if I do, I am OK because I am paid up on my car insurance.  Chemotherapy and/or radiation is like that car insurance  I am not planning for cancer to peek its' head up again, but if it does, I am paid up on my insurance."  I am not ignorant to think that it will NEVER come back, even with a treatment plan.   But, later than sooner would be nice.

Today with the all bandages off and the drain and tube out, I have become more aware that I have lost a physical part of me.  I would be lying if I said I have not cried at all today with this becoming more apparent.  It was easier to take with my sweet husband, putting his arms around me saying, 'I love you just the way you are'.  Why has today been harder than the Sunday after surgery?  I don't know, but it has.

I know that prayers have been answered.  I know for a fact my name has been put on prayer rolls around the US, and will be put on the prayer roll in Stockholm by a dear friend in Norway, next month when she attends.  I am in awe of all the support and love that has been shown.  Thank You, Thank You, Thank You.

Friday, March 15, 2013

Everybody Hurts.............Sometimes

When the day is long and the night, the night is yours alone,
When you're sure you've had enough of this life, well hang on.
Don't let yourself go, everybody
cries and everybody hurts sometimes.

Sometimes everything is wrong. Now it's time to sing along.
When your day is night alone, (hold on, hold on)
If you feel like letting go, (hold on)
When you think you've had too much of this life, well hang on.

Everybody hurts. Take comfort in your
friends.
Everybody hurts. Don't throw your hand. Oh, no. Don't throw your hand.
If you feel like you're alone, no, no, no, you are not alone

If you're on your own in this life, the days and nights are long,
When you think you've had too much of this life to hang on.

Well, everybody hurts sometimes,
Everybody cries. And everybody hurts sometimes.
And everybody hurts sometimes. So, hold on, hold on.
Hold on, hold on. Hold on, hold on. Hold on, hold on.
Yesterday I had my post-op appointment with my surgeon Dr. Fisher..  He said that everything was healing well.  The drain couldn't come out.  It can come out when there is 30cc (1 ounce) of fluid in a 24 hour period and for the last two days, it has been at 60cc in a 12 hour period.  Pushing it too much I fear??????? I thought that I had been taking it easy, but realizing that I guess I haven't????
Tuesday is hopefully the day to get it out.

I spoke with the medical oncologists office today and my consultation appointment will be Monday, April 1st.  I will get the treatment plan that day and maybe even start that day or the next.  Things are progressing.

 
I don't know how I would be getting through this without friends and family.  Every time I turn around, there has been flowers, cards, texts, call, and much enjoyed visits.  Thank You.  It has helped so much.  I don't know what people do that don't have support, anybody, family, friends, anybody?

Last night I think that it hit me that I just have had major surgery and I had a little meltdown.  I hear "You need to take of yourself."  "You need to rest."  I am not doing this very well. I feel fine, sure the pain is there, and I get a little tired more easily, but I feel great.  I am not used to slowing down, I am used to going and doing.  This is hard. I have heard the term, 'I / We do hard things', but that is taking on a whole new meaning to me.  I am just wrapping my head around the fact that cancer has come into my life.  What I do with this is up to me......
 

Monday, March 11, 2013

A Child's Prayer

Heavenly Father are you really there and do you hear and answer every child's prayer
Some say that heaven is far away, but I feel it close around me as I pray.........

Yes He is.

Friday was surgery and as the previous post said things went very well. The tumor came right out, and they biopsied the two sentinel lymph nodes, the ones nearest to the tumor. They are taken and biopsied right then by the pathologist. They came out clean.

I was so nervous. I knew that I would have one drain, but if the lymph nodes were malignant also, I would have another drain. Before I went into the operating room, I asked my surgeon if he ever puts a drain in a node to be safe? He said no, and knew that I was scared and told me everything would work out. I was rolled into the operating room and that was the last thing I remembered until I heard my name in recovery. I tried to see if I had two drains, but I was so out of it, I couldn't tell. When I got to my room, there was my sweet husband and loving parents. I asked is there one or two drains? Keith said just one, and my mother said we will tell you in a minutes. When the orderlies left, my mother broke down and said, just one drain, we are so blessed. I just sobbed. I was so worried that it had spread into the lymph nodes. I will get the FINAL results this week.

Yesterday I took off my bandages and saw the incision for the first time.  It was a little traumatic, but got through it.  I am doing fine, it is just the drain that pinches.  It is a suction drain that goes into a clear plastic hand grenade looking object. It burns sometimes, but I know that it is all healing.

Tonight I got a call from Dr. Fisher to talk to me about the preliminary findings for the pathology report:

1.  3.9 cm
2.  Grade 1
3.  The margins were clear (negative or clean) around the tumor
4.  There were 2 lymph nodes taken out, but 3 lymph nodes were biopsied.  2 were clean, but one showed a 1mm cancer cell in one spot, Micrometastases.  1mm is such a small amount (the size of a guitar string) that there will not be a need for another surgery this week of more lymph nodes being taken, it will be addressed with the Medical Oncologist through chemo and/or radiation.

1.  The tumor was 3.9 cm or 1.5 inches, so it was smaller than was seen on the MRI, but definitely bigger than what was seen on the ultrasound.

2.  He said it was a Grade 1.
Grade is a “score” that tells you how different the cancer cells’ appearance and growth patterns are from those of normal, healthy breast cells. Your pathology report will rate the cancer on a scale from 1 to 3:
  • Grade 1 or low grade (sometimes also called well differentiated): Grade 1 cancer cells look a little bit different from normal cells, and they grow in slow, well-organized patterns. Not that many cells are dividing to make new cancer cells.
  • Grade 2 or intermediate/moderate grade (moderately differentiated): Grade 2 cancer cells do not look like normal cells and are growing and dividing a little faster than normal.
  • Grade 3 or high grade (poorly differentiated): Grade 3 cells look very different from normal cells. They grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells.
Having a low-grade cancer is an encouraging sign. But keep in mind that higher-grade cancers may be more vulnerable than low-grade cancers to treatments such as chemotherapy and radiation therapy, which work by targeting fast-dividing cells.
Be careful not to confuse grade with stage, which is usually expressed as a number from 0 to 4 (often using Roman numerals I, II, III, IV). Stage is based on the size of the cancer and how far it has (or hasn’t) spread beyond its original location within the breast.
Grade is a “score” that tells you how different the cancer cells’ appearance and growth patterns are from those of normal, healthy breast cells. Your pathology report will rate the cancer on a scale from 1 to 3:
  • Grade 1 or low grade (sometimes also called well differentiated): Grade 1 cancer cells look a little bit different from normal cells, and they grow in slow, well-organized patterns. Not that many cells are dividing to make new cancer cells.
  • Grade 2 or intermediate/moderate grade (moderately differentiated): Grade 2 cancer cells do not look like normal cells and are growing and dividing a little faster than normal.
  • Grade 3 or high grade (poorly differentiated): Grade 3 cells look very different from normal cells. They grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells.
Having a low-grade cancer is an encouraging sign. But keep in mind that higher-grade cancers may be more vulnerable than low-grade cancers to treatments such as chemotherapy and radiation therapy, which work by targeting fast-dividing cells.
Be careful not to confuse grade with stage, which is usually expressed as a number from 0 to 4 (often using Roman numerals I, II, III, IV). Stage is based on the size of the cancer and how far it has (or hasn’t) spread beyond its original location within the breast.
 
3.  Your pathology report may say that the surgical margins are:
  • Clear (also called Negative or Clean): No cancer cells are seen at the outer edge of the tissue that was removed (the tumor along with the rim of surrounding tissue). Sometimes the pathology report also will tell you how wide the clear margin is — the distance between the outer edge of the surrounding tissue removed and the edge of the cancer. When margins are clear, usually no additional surgery is needed.
  • Positive: Cancer cells come right out to the edge of the removed tissue. More surgery is usually needed to remove any remaining cancer cells.
  • Close: Cancer cells are close to the edge of the tissue, but not right at the edge. More surgery may be needed.
An important note: There is not a standard definition of how wide a “clear margin” has to be. In some hospitals, doctors want 2 millimeters (mm) or more of normal tissue between the edge of the cancer and the outer edge of the removed tissue. In other hospitals, though, doctors consider a 1-mm rim of healthy tissue — and sometimes even smaller than that — to be a clear margin. As you talk with your doctor about whether your margins were clear, positive, or close, you also can ask how “clear” is defined by your medical team.
negative_positive
 
4.  Definition: Micrometastasis is a small collection of cancer cells that have been shed from the original tumor and spread to another part of the body. They can not be seen with any imaging tests such as mammogram, MRI, ultrasound, PET, or CT scans. These migrant cancer cells may group together and form a second tumor, which is so small that it can only be seen under a microscope.

Friday, March 8, 2013

Andrea is out of surgery

Andrea is done with surgery. The tumor came off complete when they removed the breast. Also the sentinel lymph nodes look negative. They will do pathology on both the tumor and the lymph nodes, but the doctor said this is the outcome he was hoping for!

Wednesday, March 6, 2013

Happy to be 'Moving Right Along'

Today I am feeling just like my title, Happy to be Progressing.  My surgery is slated for Friday at LDS (outpatient).  The left side will be removed and then about 3 to 4 weeks later, depending on healing time, I can start treatments (whatever they may be).

Then after that time, I will have the other surgery, the right side removed and reconstruction at the same time. Progressing.

Things I learned today is that I need to have a pillow, like a cough pillow to help get up.  Yoga pants are good and shirts that button up.  Little things that I should know?  NO.  I should write a book.  That's not going to happen.  The old saying is that if you looked at every one's challenges on a line you would go and pick your own.  I feel that way to.  Through this process, IMC, has helped me along the way, every step, making appointments, suggesting who to talk to and my insurance UHC has helped with an excellent nurse who calls with answers to questions I didn't even know I had.  I realize people aren't that lucky.

I was able to go to lunch with some great friends Friday and Monday.  Keith and I were able to go to dinner Friday with family and more great friends on Saturday.  We are truly blessed.  I have an amazing husband, that when the tears start to fall, says it's OK, cry your heart out and we'll move on together.

I see that I am rambling, those of you who truly know me, know that I have 5 stories going on at once.  Now it is in writing.

I wonder, I wonder what people do who don't have the gospel of Jesus Christ do that gives them hope in their darkest hour?  Christ lives, he suffered for us and knows our pain.  Faith is what I need to walk with right now and for the rest of my life.

Tuesday, March 5, 2013

Looks like surgery will happen on Friday. A single mastectomy on Friday with a sentinel lymph node procedure. I have decided to have the other breast removed and have reconstruction during the same surgery at a later time.

Saturday, March 2, 2013

Don't Worry, Be Happy

Happy, Happy Day!!!!!!!

Yesterday I had a talk with Patti to tell her that the tumor was bigger than expected.  While talking to her she said that the reason it could be swelling from the biopsy.  But that would make more sense if went from 1.8 to say a 3 or so, but 6.1?????????

So I called my surgeon Dr. Fisher and he called me back right away.  The first thing he said was that the results had already come back from the right side and it was BENIGN just fibrous tissue.  Good news, no GREAT NEWS!

I told him I was concerned that the tumor was bigger in the MRI report than the ultrasound report and asked if the tumor could be bigger because of the swelling.  Could be but 6.1 is a lot bigger than 1.8.

I asked about doing a double mastectomy instead of a single one because of the feature of the carcinoma (funny I always associated that word with cigarettes since I was little, don't know why) being lobular, (I have a mix of both ductal and lobular) does mean that I have a higher risk to develop this on the right side, not by spreading, but it just happens.



TERMINOLOGY
  • Milk ducts. Ductal carcinoma is the most common type of breast cancer. This type of cancer forms in the lining of a milk duct within your breast. The ducts carry breast milk from the lobules, where it's made, to the nipple.
  • Milk-producing lobules. Lobular carcinoma starts in the lobules of the breast, where breast milk is produced. The lobules are connected to the ducts, which carry breast milk to the nipple.



  • One thing if I do keep one breast, because of what I have just explained, I have been told that I will have to have a mammogram and/or MRI every six month on the right side, which makes me think I should do a double mastectomy?  There are a few decisions to make and we are thinking and praying about them.

    He said that the ultrasound gave us 2-D pictures where the MRI gave us 3-D pictures.  He also said that he wanted to talk to a medical oncologist to see if I should see him before the surgery to do chemotherapy to shrink the tumor down so when he does surgery he won't have to cut the chest.  The MRI showed that it was invasive (that it hadn't spread - contained) but they won't know until they get in there and check the lymph nodes.

    The outcome of all this is that I have an appointment with Dr. Fisher to examine the tumor again, to determine if I need to meet with Dr. Morgan the medical oncologist.

    Who knew when this arises in a person, that there is so much legwork to make sure all areas have been thoroughly examined and know the best decision has been made.

    I had someone ask me today, which do you want to happen the chemotherapy before the surgery or just the surgery this week?  My reply whatever is the best for me?  That can only be decided by professionals, who I am praying for that their minds are clear and focused on the task at hand for me and all of those who are wondering about their next move in their medical journey.