Tuesday, June 24, 2014

A Cancer Journey

Sometimes,  one has to buckle up and go for a ride....


 "A Cancer Journey"

 

I have been dragging my feet about blogging again  but, most especially, blogging about my private cancer journey. I decided that, perhaps, it would be a good thing, and helpful to some, to read about my humble experience. Maybe, and I truly hope so, most of you will take good care of yourselves, be checked and have your mammograms.


A few months ago, I was happily recovering from a total knee replacement. I went for my annual checkup and scheduled mammogram. It was late August. Something “abnormal” was observed. There are no words to describe the initial feelings that invade your mind. For me it was mostly a blank space in my brain....with the “la-la-la-la” sound reverberating in my ears.... I should add that I am diligent in my care, never miss a mammogram and did my self examinations regularly. Because I had a spot that was being carefully watched on the left breast, and I felt that a “normal” lump had changed size on the right one, I was sent to the hospital for a more detailed diagnosis. This last lump had been needle biopsied years before. After the x-ray, when you are taken to another room to wait for the radiologist, you know that something is just not right. The radiologist comes in, accompanied by the technician...there is an “unusual growth”, she kindly tells me, and needs to be further tested.... she will contact my doctor and he will tell me what will happen next...I nod, a lot....trying to be composed, while at the same time trying to figure what is happening. I ask the obvious....is it cancer.....I don't know, she replies...it is an a-typical mass....and needs to be further evaluated to know more....


Somehow I made it to my car...but I don't remember how I got there... I developed a desperate need to reach for my faith... so I took a quick detour to my church for a talk with God and picked up some strength...one knows when things are about to get rough.


My personal physician did not waste time. The radiologist called him right away and by the next day  he had arranged for more testing in the next 24 hours. The test suggested that I needed a biopsy. All I knew is that I had a category 5 breast lesion and was going to be scheduled for an excisional biopsy...Again, within a day, my awesome doctor had already made me an appointment with a surgeon, who scheduled me for the procedure. And then the waiting game started.  Time moves slowly when you are under stress...and I wanted, whatever was inside of me that should not be there, to leave my body ... immediately....



I had a lot of time to think...and decided to make this a positive experience to take each moment and find appreciation. I decided that this journey would make me stronger and  realized that being diagnosed with cancer was a blessing...because it happened to me, not my spouse, my children or, their children. And I was grateful that both of my parents were gone from this earth... it would have been so hard for them to see me go through cancer. I spent much time in prayer and meditation, and willed myself to find peace in these, otherwise, very turbulent and unknown times.


The day of the excisional biopsy came...I remember waking up to the sound of..."it is cancer and we need to decide the course of treatment, radiation, chemotherapy and, or mastectomy"....but I was too groggy to entertain conversation and the surgeon said that we would talk about it when I was awake..... A few more days passed...and more waiting....more time to think about life's blessings.....but still cautious about making too many plans....at that time I did not know the extent of my cancer. What was known was that it was an invasive ductal adenocarcinoma, with final diagnosis pending more testing...


We start the education process...my sister in law, a physician, is quick in sifting through all the information...what matters, what does not...what to ask...what to watch for...how to prepare.... I was grateful to have her as my advocate, while husband tried to put it all in some sort of order...


I thought things were going to move fast after the biopsy, surgery would take place soon, and it would all be over.... Not-so-fast. On the first visit with the surgeon, after the procedure, I was informed that, yes, it was cancer and lymph nodes would tell the story of how far it had traveled....Options were presented. I chose  a double mastectomy, since my left breast was already under observation. It was a no-brainer for me,  when I was told that having a double mastectomy would dramatically increase my chances of preventing cancer to reoccur. That decision was made with no regrets and much hope. 
There was more waiting to be done....now I was to see the oncologist...she would make the decision if to undergo chemotherapy or radiation before surgery, or after. She read my chart and said..I don't think you are going to need either. You have caught this very early. We can decide after surgery, but based on what I see, I don't think you need to worry about that. But, let's wait until we can have a clearer picture. She performed a detailed exam, then sent me for a chest xray and labs, to have a baseline for comparison later on. She also ordered a bone density test which, surprisingly, showed that I had osteopenia. Then it was back to the surgeon...and more waiting.....



The day of the mastectomy arrived. I bought a pair of cowgirl “victory” boots and told Joe...I am going to leave the hospital flat as a pancake, but with my boots on.....And as we entered the hospital, very early in the morning, I reminded him that this was a day for rejoicing, a day to fix things and give thanks that it happened to me. I can take this, I am strong, I can handle this.... It was now almost a month after the initial findings.

Maria leaving for the hospital
 
Paper work...
 On the early morning of October 22, 2013, I was prepped for a bilateral simple mastectomy, with right sentinel lymph node biopsy. I was to have a radioactive dye injected on my breast. This would show if cancer had gone to the lymph nodes. I was taken to nuclear medicine for the procedure to begin. Because of my claustrophobia, I was unable to control my anxiety as I was placed in a confined space. The technician was kind to move everything around and made it so I could stand for the procedure. It was not easy for her, I appreciated her kindness.  The technician also went a step further to ease my stress and found another Chilean, who worked at the hospital, to come and keep me company.... that was just what I needed.....what a lovely gift... we talked about our country and we had so much in common....made the time pass...


 
"All dyed up...."
 
Two Chileans....
Then it was back to the pre-op waiting room....which turned out to be an 8 hour wait, until I was taken to surgery. There was some complication that my surgeon had to tend to in the OR ... I mentioned to the nurse that - he must be having a tough time- ...she answered...yes, he is...and you know what the good news are? ..it is not YOU who he is operating on....

Joe kept track...
..of time....
And so on...
And so forth....



 
Time moved slow..very slow...

Lots of time for prayer...and thinking....

..more walking....
Many gadgets...

Fancy IVs
I had arrived to the hospital around 7 am..it was now past 4 pm....and my patience was running thin....anxiety and claustrophobia do not react well to being trapped....besides, there were no windows and I had had nothing per mouth since the previous evening.....I became concerned that the radioactive dye would not be visible and the results not clear....the nurse called the powers that be, and found out that the dye lasts for over 12 hours... In the meantime...I continued to engage in constant prayer.... and I walked around and around the room....for hours on end...

Finally the time comes....

Around 4 pm, the surgeon finally comes in...he brings the geiger counter, checks my chest and underarm and reports that the radioactive dye is still strong....he says...I am going to go get something to eat and will meet you in surgery shortly....and then things start to move fast.

Joe was able to track me down every step of the way....

My last prayer before going to sleep, was for the doctor to come and tell Joe that the lymph nodes were clear and the cancer had been removed...then the surgery nurse asked me if I was nervous...I said, no, just a little stressed...and that is all I remember....


I woke up in recovery...it was late at night. 
I can now rest...
Prayers have been answered...
  All I knew was that my prayers had been heard, and the doctor had told Joe that the procedure had been successful … “and the lymph nodes were clear”..... I was not in much discomfort, except for the drains coming out of my flanks. There was not much pain on my chest and I was tightly wrapped. Throughout the night the nurse emptied my drains twice and I was able to get up a couple of times with Joe's help.

A new me emerges...











 
Radioactive dye is still in the system the next morning!
 
Priorities...must check email ...
 
Morning walk....
 Morning came, the surgeon and his entourage arrived early to check in on things. He felt I was doing well enough to go home. And I was absolutely elated. Got dressed and put my boots on....my victory symbols. And we went home, 14 hours after surgery … cancer free … happy … relieved … grateful... blessed... My diagnosis: lymph node, negative for tumor, and cancer had not extended beyond the markings.....

Drains in place, victory boots on...

Going home....
It is so nice to be home...
  I had to sleep propped up with several pillows for many days. The drains made it difficult to roll.




 Joe took over the duties of emptying the drains, a procedure that included alcohol, cups and measuring of blood removed..... I could do it for someone else, just not on me.... He would valiantly break blood clots clogging the tubes coming out of my sides by massaging and squeezing the tubes with his fingers. And he did it without complaining, dozens of times, while I looked in the opposite direction and sighed. He is a brave man.


The day came when I thought I would have the drains removed....but..not so fast...the doctor felt that I had to keep them for a few more days.....So sorry, he said.....

A week later, his nurse prepped me for drain removal....I asked how was she going to do it...and before she answered, she pull them out fast....a very strange feeling...

And I was drain free....and went home. Joe continued to, expertly, bind me with 2 or 3 ace bandages for many days.


I saw the oncologist, who happily reported that my cancer was a stage 1 and I would not need aggressive treatment.


Unfortunately, I developed a large seroma (fluid filled cyst) and a hematoma (blood filled cyst). They looked like small breasts...had I grown new breasts?
 
Seroma on my left, hematoma on the right....


 I was seen by the Physician's Assistant, who sent me back to the hospital the next morning to be drained... Upon arrival to the surgery room, Joe was allowed to stay with me until the procedure started. The doctor removed several large syringes of blood from one side and more of fluid from the other and put a new set of drains in place. This time they exited from the top of my chest rather than my flanks... And Joe proceeded with the twice a day familiar job of emptying the tubes, again.....I have to say that the drains bothered me more than the mastectomy. I did not need any  pain meds for the mastectomy, but took a couple of Tylenol for the drains.
Back to the hospital...

Time for meditation and prayer...


Time moves slowly....


And the drainage session gets under way...

Nope...not gonna cry...not gonna do it....

Seroma and hematoma are located via ultrasound before inserting drainage syringe....

And the extraction begins....


Syringes are emptied into a container....

Eventually, the new set of drains was removed and I was free from bandages and tubes, and alcohol and blood clots.....


Several months have passed. I still have the seroma and hematoma, just not as big as the first time. The oncologist, my physician and my surgeon, believe that my body will eventually take care of this “minor inconvenience”, naturally. With constant draining and needle insertion comes the increased danger of infection. I don't mind waiting.


The oncologist has been pleased with my progress. I now will take Tamoxifen for 5 to 10 years to block the hormone that has caused this cancer. I have had no side effects and feel healthy and new. I take my Tamoxifen daily with a deep sense of gratitude...that tiny pill is so powerful, so full of goodness, giving me another chance at life.

I was at McDonald's, having breakfast after surgery, while I still had my second set of drains. I was introduced to a lady, who told me that her Mother had participated in the preliminary studies and testing of Tamoxifen, many years ago. She eventually died from breast cancer. Her eyes filled with tears, and I thanked her for her Mother's sacrifice, so I could have this chance. I am so grateful for those who volunteered to try these drugs for me.

***

Before surgery, Joe presented me with a locket...


...inside, a picture of my children and their loved ones ....this is your support system, he said.....

 And yes, they were my constant thought... my eyes were focused on them and my son's upcoming wedding.... 
Indeed, I have been blessed by the care and love of my husband, my children and their families, my husband's family. Many beloved and supportive friends....in real and virtual life. During this journey, I have found out about brave women who are in the process of fighting breast cancer at this very moment. While doing therapy for my knee replacement, I met a woman who was a cancer survivor and had undergone a single mastectomy. She was so very encouraging... life moves on, she said...you will be ok. A few days later, while working at a quilt show, the guest quilter told me that she was a cancer survivor and had had a double mastectomy....life is good, she shared...and then a dear friend from Canada, announced the discovery of her breast cancer. Thankfully, she is receiving treatment at this very moment and making progress...I can't wait for the news that she is cancer free. And while at Weight Watchers, a member came to me and told me that she also had a mastectomy and was doing just fine... you will too, she said.... We are a sisterhood of strong women..... so many of us!


I have had friends ask, why a double mastectomy? Because I did not want to be looking over my shoulder every year at the time of my mammogram, hoping that the place where the titanium chip “marked the spot” had not changed..... My breasts were wonderful...they did what they were supposed to do...I nursed my children and  they looked great in my younger years...I am grateful to have had them this long! I have also been asked about reconstruction...and really, I have decided that I will not have one... I am who I am...and I love who I am....I am not defined by a pair of breasts...


A few weeks ago I had lunch with a friend. She has had many cancers and surgeries, and is a true survivor.....we both agreed that this journey has made us stronger, more appreciative of life and family. And I watched another good friend, not only lose her beloved daughter in an accident, but walk the cancer walk. I told myself, years ago, as I watched her go through surgery and subsequent chemotherapy, that if I ever found myself in that predicament, I would hope to show the same strength, dignity and grace that she has shown throughout. I hope I was able to be a faint shadow of her strength.


I cannot emphasize enough the need for early detection. Know your family history...I had nothing to go by, no real family history to speak of. In the beginning, I said I was diligent in my care, never missing my yearly mammogram...monthly self exams were followed by my doctor's check up...and still, I was surprised with cancer.


Life is bright ahead. I am learning to appreciate the new me, a different figure. I still have some pins and needles on occasion, but such a small inconvenience when looking at the big picture. The seroma and hematoma have not changed...but my doctors keep a watchful eye on me.


I am grateful beyond words. An army of people marched by my side during this war against cancer. My physicians, my friends, my sister in law. My family, my husband's endless support and love.... my children, who, without knowing, turned me into a pillar of strength.... I consider myself one blessed woman. I know my parents and loved ones now in heaven, really watched and showered me with strength.....and my faith carried me through the difficult times....
I don't usually have "strings attached" to my blogs...but I have a request this time....please leave me a comment and let me know that you will always take good care of yourself, practice your monthly self exams and have a mammogram when indicated..... Review your family history....
I credit my medical care,  my diligence in exams, and keeping on top of things for this positive outcome....I realize that we are not all the same...but take NO CHANCES... and if you must fight, fight.....
I am a woman who had cancer....it does not define who I am....yes, makes me stronger, but I have always been determined and pro active...However, I refuse to continually carry a banner that says "I had cancer"... I am one of those lucky ones..and will move forward, and take this stage in my life as a gift and do my very best to be grateful for this chance and help others where I can.
I have found out that people REALLY want to be a part of your journey...I received lovely gifts of delicious soup, flowers, prayers, good karma. good thoughts, emails, prayer shawls, fruit, books...calls, Courage angel figurines and beautiful plant arrangements from my children, who really wanted to be a part of their Mama's recovery....I could feel their love....I was also gifted an I pad with an engraved inscription: "She believed she could, so she did, A Maria-kind-of-day"....
And I was able to be a part of my son's wedding, just as my surgeon said I would....."You'll be done by then"..he told me.....and I was....
And  I danced with the groom...

  ...as we danced so many years ago....

 And daughter and her family from Chile participated via Internet...and they danced too..

And it was lovely and beautiful...and perfect....
Photos by Bryan Hoybook
Take good care of yourselves...



With love,

Maria