This Blows

So many of you have mentioned that I am positive and spunky and strong.

Thanks.

I suppose that you're right ... most of the time. But, I'm bored. I'm tired of having to have help from everyone and I'm tired of being in pain and I'm tired of these stupid drains. I'm trying to keep my spirits up, but ugh.

Suck it, Cancer.

Surgery went well on Tuesday. As the plastic surgeon accurately predicted, there is so much other pain that I don't even feel the incision from the latest slicing. The pathology came back and showed no cancer in the sample. They did find the clip and the tracks from January's biopsy, but no cancer cells. My surgeon tells me that this is good news.

There were, indeed, two tumors. One that we knew about (but that was all removed during the biopsy) and another that they didn't even see before the mastectomy. This does not great confidence instill. I would have felt much better if they HAD found cancer on Tuesday. At least we would know that we have clean margins and that it is out. But, instead we have to trust that ALL the cells ... every single one of them ... were removed in the exploratory part.

What else don't they know is in there?

Frightened, but trying to stay strong,

Liz

The Battle Continues...

Good Evening Everyone, Scott here. I know that this will disappoint many of you, as my writing/blogging skills are no where near Liz's caliber, but I am filling in as a ghost writer for the day. Don't worry, everything is fine with Liz. She is just a little tired after another long day and asked me to fill in for her. So here is goes...

Oh, wait, before I get into today's events, I need to share something. I was pissed yesterday. Actually, that is an understatement. I was more than ready to wallop someone for making Liz go through another procedure. While she is extremely strong, and doing very well (all things considered), I hate to see her in pain. I couldn't comprehend how one has a mastectomy, gets the pathology report back that says there are clean margins, and then get a call saying there may be some more breast cancer in there. ISN'T THE POINT OF A MASTECTOMY IS THAT THERE IS NO MORE BREAST TISSUE?!?! Thankfully for everyone at St. John's Hospital and the Maplewood Surgery Center, I had a day to calm down (complaining to several of you also helped - so thanks to those of you that had to suffer through my tirade yesterday).

OK, on to today's events. We started the day at the Breast Center at St. John's hospital where the head of the Radiology Department performed the ultrasound on Liz. Almost immediately, she was able to locate the infamous "missing marker" from the day before. She gave Liz a quick little spiel about how she needed to insert a guide wire into her breast and there was a possibility that she might puncture the implant (thanks for calming her nerves Doc).

From there, we went to the surgery center where Liz's surgeon talked to us about what was going to happen (and continue to "calm" our fears by telling us there was only a 10% chance that she was going to puncture the implant). Before the surgery, she went back to the Pathology Department to review the breast tissue from last week and the location of the tumor they identified. If I heard the surgeon correctly (which it is entirely possible I did not), she feels that the tumor from last week was in a different location than the marker they placed during the original biopsy. I interpret that to mean that there were in fact two tumors. The location of the original tumor was in the sub-cutaneous tissue near the bottom of Liz's breast - in her chest wall really (this is the one the surgeon went after today). The one the pathologist found last week was in a totally different location and never showed up in any of the 75 ultrasounds, 23 MRIs, 81 mammograms, or 52 gamma-scans Liz has had over the last 7 months. We won't really be able to confirm the number of tumors until after the final pathology report.

After surgery, the surgeon told us that she had to take a little skin and tissue down to the implant (we said a little prayer of thanks before dinner tonight thanking God for making today an implant puncture free day). We now have to wait until the pathologist can review this specimen to ensure that there are clean margins around it. We hope to get those results back this week, but we may not hear until next week. We are praying everything comes back clean...

Pop Quiz

How many of the following things can you do?

• Wash your hair.
• Use a soap dispenser.
• Buckle your seatbelt.
• Sit up after a nap.
• Pour a bowl of cereal.
• Put on a shirt.
• Tie your shoes.

Show off.

False Alarm

Sadly (and happily) we were not finished with the ultrasound in time to make our time slot in the operating room, this morning.

So, we go in again tomorrow.

This is nice, because one week after major surgery, what you really want to do is be shuttled between different waiting and procedure rooms.
It's super-fun.

During today's ultrasound, the radiologist could not find a tumor. But, she "thinks" that she found the clip, which is the little bit of metal they put in to mark the tumor for last week's surgery. If the clip is, indeed, there, then the tumor may still be there. Thus, the one removed during the mastectomy may have been a second one. So, just to be safe, they are going to take "a bit more."

My plastic surgeon said, and I quote: "with all of the pain that you're in right now, the discomfort from this surgery may even go unnoticed."

Yeah. We'll see.

Possible Surgery Today

In order to have the radiologist who found the cancer in the first place, tomorrow's procedures have been pushed up to this morning.

My appointments are:

• 9:45 check-in
• 10:30 ultrasound
• 11:30 surgery, if we make it. Otherwise, we'll have to go back later this week.

Suck it, Cancer.

They Spoke Too Soon

We got a call from one of my surgeons. I hate her now. She is a really good doctor and has EXCELLENT bedside manner, but I think I might have to hate her.

When the pathology report came back, it did show that the cancer was removed with clean margins all around. However, the pathologist found the tumor in a slightly different place than was expected. SO... I have to go back in on Tuesday for another ultrasound (the fifth one, if you're counting) to see if that was the same tumor that we had originally seen, or a new one. If it was the same one, then my recovery can continue at the achingly slow pace at which I was already suffering.

If it is a new tumor, then we can relax and panic with renewed fervor. There is relief in the fact that a malignant tumor was successfully removed on Monday, with the rest of the tissue. But, there still may be some tenacious cancer cells hanging out at the original site. In which case, I would go back in for a surgery that my doctors call "an unfortunate inconvenience." Um, yeah.

We'll know more on Tuesday.

Please pray for me.

Please pray for my family.

Please pray for my surgeon ...

• that she locates and removes all of the offending cells
• and that she recovers quickly when I wallop her with the ultrasound wand.

Update

This is Liz. I am displeased to announce that I am still in the hospital. We were planning an afternoon departure, but it is now 4:30 and I have spent the last six hours lying here watching two pints of blood drip into my veins. I'm not having a super-awesome time, but I do have good news: the pathology came back today and the surgeon got out all of the breast cancer. Clean margins all around! So have a beer for me. I doubt that the hospital looks very favorably upon the combination of alcohol and narcotics. I could be wrong, I suppose, but that almost never happens.

My pain is rotten, but manageable (when I'm holding still or am asleep.). I'm now on my third round of narcotics, because of nausea and horrible itching caused by the first two. I'm also on my third i.v., because the first two became blocked with clots which, apparently, inhibits the efficacy of the medication transfer. I have internal and external sutures on my back, my front, and my side. Also, inexplicably, at the top of my chest, where the surgeon's scalpel slipped trough the skin while removing the breast tissue. We're watching my temperature closely, because it is currently spiking AGAIN. Two nights ago, it climbed to 102.2, which no one found to be an excellent report.

I'm pretty much fed up with people coming to check my vitals, re-stock the room, ask me if I'd like margarine or butter on my roll, and offer to pray over me, but instead stare at me as though they wish to be entertained. I am also tired of being unable to do things for myself. My catheter is out, so I can go into the bathroom by myself (well, myself and my beautiful i.v. pole.) But, I don't have the strength to flush the toilet. I can type this post, but the computer is much too heavy to lift off my lap. I think that it's safe to say that I am not my usual chipper, spunky self, although I do take comfort in the fact that, based on all of your comments, I have all of you snowed.

Go me!

Hopefully, we will have good news after the blood transfusion and will be at home sometime tomorrow. We'll keep you posted and let you know when we are ready for visitors.

Thank you for all of your support.

Liz and Scott

The First 24 Hours Out of Surgery

We officially now have 24 hours post op under our belts! There has been a great deal of pain, but Liz is doing remarkably! Her doctors have checked on her numerous times, and they have all said that everything is looking really well.

She is still very tired, but that is because she is loaded up on morphine. The doctors keep telling us that she won't remember anything of the last two days, but I don't buy it for a second. Last night at about 3:30 AM, I called Liz's nurse "Amanda" and Liz was the one that corrected me to say that her nurse's name was "Amber." Amber was her third nurse since we got out of surgery. Great, just what I needed, one more thing to prove that Liz is smarter. Even after major surgery, I don't stand a chance against her.

Between the breathing tube that was in her throat during surgery, and the fact that her chest hurts every time she breaths, talking is very difficult for her. I know that many of you want to come down and see her, but I think that if we can wait until she is home, that would be best. Besides, Liz has already told her mom, "If I could move my arms, I would punch you in the face." That was just because Nona wouldn't scratch Liz's face hard enough. I can't imagine what she will do to me if I make her talk more than she wants.

Thanks for all the prayers, calls, emails, and overall positive good vibes. You have all been amazing!

Out of Surgery!

The plastic surgeon just came out to tell us that Liz has been moved to the recovery room. His words were, "I'm not really sure what to tell you; things went smoothly. There was minimal blood loss and the results look great."

We still have at least an hour before she heads to her room. I will update the blog again later tonight.

Oh yeah, and as so kindly pointed out by Mr. Miller, my choice of words in the last paragraph of the previous post should probably be amended to read, "a weight has been lifted off our shoulders." Thanks Nate!

O.R. # 10, Treat Us Well

First, I want to apologize for the delay in getting this posted. I know that many of you are anxiously awaiting an update. Just so you are no longer in suspense...things are looking great! Also, this post might seem very boring, but I want to get as many details down as I can remember.

We started our day bright and early at 5:00 AM. O.K., bright isn't the right word since it was still pitch black out, but you get the idea. Liz wanted to make sure that her legs were shaved, toe nails polished, etc. She even tried to teach me how to wash and condition her hair so I could do it after we got home. Did you know that you don't use conditioner on all of your hair like shampoo? Seriously, who knew?!?! She also tried to teach me how to shave her legs, but I told her that she was going to have enough cuts and scares after today and that there was no reason to add any more.

We got to the hospital at 6:30 AM, and Liz was taken back almost immediately. Nona, Liz's mom, joined me in the waiting room at 6:45 AM. While we waited to be able to go back and be with Liz, our under cover agent snuck out and gave us a status report. Dr. Nick, surgeon and friend extrodinare, had a surgery here this morning. Before his surgery, he tracked Liz down to make sure that she was doing well.

Finally around 7:30 AM, Nona and I were allowed to see Liz. In typical Liz fashion, she was keeping the medical staff entertained in back. We didn't get to spend too much time with her though, as she still had to go for her sentinel node biopsy. I will let Liz fill you in on the details of this, because is wasn't actually a biopsy - just an injection of dye and the insertion of a guide wire for the surgeon.

Once Liz was taken to Radiology, Nona and I staked out a corner of the waiting room. We were sitting there for about 45 minutes when Liz came walking around the corner. Apparently the individual tasked with taking her from Radiology to Prep-Op didn't know where she was going, and got a little lost. Don't worry though, Liz didn't use that as an opportunity to bust out of the hospital and jump in a taxi.

After getting her back to Pre-Op, her doctors showed up to discuss the the day. All in all, 7 different professionals came in and examined her, wrote on her body, asked her for her name and date of birth, or did something else that was in preparation for the surgery. During one of the lulls between docs, the three of us said some prayers. While both Nona and I were sheeding tears, Liz remained strong and stoic. She is a rock!

Shortly after 9:30, they came to take her to surgery. Right before they were ready to wheel Liz out of the room, the nurse anesthetist asked Liz the age of our kids. She started to answer and then stopped, looked at the anesthetist, and said, "Did you just slip me something?" He smiled, and said that he did in fact give her something to relax when she wasn't looking. Her response, "Nicely done Matt. That was very sneaky." Cracking jokes until the very end - awesome. It was at that point that they wheeled Elizabeth to Operating Room #10. The time was 9:45 AM.

At 10:30, the volunteer in the Surgical lobby came over to inform us that surgery officially began 10:15 AM. It was at about this time that our first visitor showed up - our neighbor Jim! Jim sat with us for a little over an hour. Then around 10:45, Sister Mary Denise from Vis showed up (she is still with us now, praying, laughing, and pretty much anything to keep us distracted).

Nick found us around 11:30 to let us know that Liz was doing fine. A little over an hour later we got out first great news of the day. Dr. Schmidt came out to tell us that the mastectomy went wonderfully. The sentinel node came back negative, which was awesome, and according to the pathology reports, everything else was looking good. To celebrate the clean node and success of the first phase, Nick took me out for a beer and lunch! Thanks again Nick!

Upon getting back from lunch, Nick checked in on Liz again for us. The plastic surgeons where just completing the portion of the surgery where they move the skin and muscle from Liz's back to her front. The plastic surgeons told Nick that things were going wonderfully.

I have to say that while we are not done yet, it feels like a weight has been lifted off our chests. Keep up the prayers people, we are almost there!

Here We Go!

This is me.

"This is My Cancer Fighting Shirt."

This is cancer getting trounced.

Despite my growing nausea, I am ready for this.

Throughout the day, Scott will post updates as they become available.

Wish us luck and prayers. If you're not the spiritual type, here's one from Laila. Use it as inspiration, if you like.

May God help the scars not hurt for a lot of your life.

We pray to the Lord,

Lord, hear our prayer.

Amen

What to Say?

I feel like all that I have done since I was diagnosed is talk about cancer. I have had A LOT of doctor's appointments and a huge number of face-to-face and phone conversations with many of you. We have been reading and researching and questioning and consulting. Scott and I are both much more well versed in the ways of cancer cells than we ever hoped that we would be.

But, I feel at peace. I feel supported and loved and uplifted by all of your prayers. I feel powerful from all of the knowledge that we have gained and by acknowledging that this is my battle to fight. My team of doctors (and it is a sizable team) is responsible for taking out the offending cells and doing all that they can to restore my body to health, but I am the one who gets to decide the spirit with which I enter the war. (Isn't it strange to think that my body is struggling against itself? Weird.) I can be depressed and disheartened or I can offer this up and know that I am strong and that cancer doesn't stand a chance. Poor cancer. Good effort, old chap.

Also, suck it.

So, where are we in the process? We have decided on an initial course of action. On Monday morning, I will go in for a sentinel node biopsy followed by a double mastectomy with immediate reconstruction. What does all of that mean?

• The node biopsy will determine whether or not the cancer has spread outside of the breast tissue. If it has, some of the infected lymph nodes will be removed. Of course, we are hoping for a negative result.
• The double mastectomy is a radical step, but one about which we feel very confident. First, it is our best chance to avoid a recurrence down the line. Second, the mass of in-situ cells (the cancer that has not gone beyond the duct walls) appears to be about two inches across. Getting it all out without a mastectomy would be very disfiguring. Third, because it took six months to diagnose this, I want to do all that I can to avoid looking over my shoulder all of the time, wondering if I am really safe.
• The immediate reconstruction will be in the form of a latissmus flap procedure. This means taking some muscle and tissue from my back, tunneling it through to my chest and using it to reconstruct the breasts. Click here if you want to read more.

Comedy break: In case you wanted to know, my plastic surgeon told me that (despite my valiant attempts to sway him) I am not a candidate for the surgery that takes tissue from the abdomen, thus creating a tummy tuck. Boo. Also, he said, and I quote: "if you told me that you wanted your breasts to look exactly the same after surgery, I wouldn't be able to do that, because you are too small." Awesome. Thanks for that. Perhaps you should pump up your bedside manner. I do have cancer, you know.

I have been told to expect to be out for five weeks, and that I will feel "like I've been hit by a truck" for at least the first one. We are doing all we can to prepare for the worst and hope for the best. Thank you for all that you have done to cheer us up when we are tearful and to reinforce our battle stance when we aren't.

But, I must tell you, Laila has trumped you all. She has been busy making cards and signs and valentines for me. My favorite two so far are:

• The note card that reads: "Mom, I am sorry about the cancer. Be mine." One the back, she drew a bunch of breast cancer ribbons.
• And the one that I am carrying with me all the time is a little pink heart. It reads: "Nice try, cancer. But Liz wins the battle. Love, Laila."

So, I have cancer ... but I'm still awfully lucky!

News

Some of you have been waiting for this information and some of you are probably getting blind-sided by it. I'm sorry. I just thought that it would be easier to put it all out there once, than to re-tell the story a million times.

So, the deal is this: yesterday I was diagnosed with breast cancer.

This news has been a long time coming for me, but I guess I haven't really shared it with most of you. I just kept waiting for the all clear, because I was planning to deserve a celebration. But, I didn't get the all clear, and I suppose it is time to share the story. It's terribly long, but here goes.

Last summer, I noticed two lumps in my left breast. I went to my doctor, who thought that everything was probably just fine. I believe that her exact words were: "some women just have lumpy breasts." Right. A month later, I went back. The lumps were causing a bit of discomfort and I didn't buy the diagnosis. They sent me to the breast center at Saint John's hospital where I had both a mammogram and an ultrasound. All results were negative.

Next, I went to see a breast surgeon who also thought that everything was just fine. But, to be sure, she sent me back to Saint John's hospital for a gamma scan. In case you don't know what this is, I will enlighten you. It's kind of like a mammogram, in that you are crushed like a pancake, except that the photos take about five minutes each. Oh, also, you have to have radioactive dye injected into your veins. Really, radioactive. I have a card in my wallet detailing my nuclear medicine exam, on the off chance that I set off the metal detectors at the airport. And, in case you can't picture the severity of this procedure, I will also add that the technician brought the syringe to me in an lead pipe, lest the material that they were about to use to populate my blood stream come into contact with anyone. Very comforting.

After the gamma scan, the technician left the room to develop the photos. She told me that she would be back in a few minutes, at which time she might need to do a few more photos or we would be finished. Instead, she came back with a doctor, who introduced himself as the head of radiology. Super. He told me that the left side (with the lumps) looked fine, but that there was an area of concern on the right. So, guess what then? Another ultrasound and another mammogram. And guess what the results were ... negative.

Great news? Not really. The gamma scan looks at the breast tissue on a cellular level. Since the area of concern was found on the gamma, but not on the other procedures, there was no way to biopsy it. So, I had to wait three months and then come back.

At the end of December, I went back for another smush test, I mean gamma exam. The results were the same. The spot on the right had not grown, which was good, but it hadn't gone away either. So ... more tests. Next, I went in for an MRI. On January 22, I climbed into the horrible tube of claustrophobia known as the MRI machine. If you have never had one, let me tell you: it is loud. REALLY loud. They offered me some headphones, but they also told me that I wouldn't be able to hear the music very well, so I opted for the earplugs.

Oh, also, there was some contrast dye injected near the end of the 30 minute procedure, but no one was in the room with me. So, all of a sudden, while I was not allowed to move, I could feel a foreign substance crawling through the i.v. tube into my arm. It was very surreal, and a bit disturbing.

After that, I got a call from the surgeon. I was expecting the all clear, but no dice. Also, no diagnosis. But, I DID get to go in for another test, which was exactly what I was hoping to hear. I hadn't been in to the hospital for almost two weeks, and I was beginning to miss it. (That was sarcasm, in case you missed it.) So, this Monday, I went back to the breast center for a third ultrasound. Did I mention that I'm only 33? While there, they FINALLY found the lump that I found in July. And we were finally able to do a biopsy.

Phew ... or not. The results of the pathology report show two types of cancer. I have a small area of invasive ductal carcinoma. It is (or WAS, before the biopsies) about the size of a tick tac. I also have ductal carcinoma in-situ. You might think that the invasive is the more concerning of the two; we did. But, the thing is that the invasive kind is easy to see in surgery. It is fairly clear whether or not all of it has been removed. Not so much with the in-situ kind, which is just a cancer that has not yet developed into the invasive category.

So, we are faced with three options:
1. Have a lumpectomy and radiation for six weeks, five times a week
2. Have a single mastectomy and a biopsy on the right breast to find what showed up in the gamma scan.
3. Have a double mastectomy, thereby decreasing the risk of recurrence.

Between the three options, the survival rate is about the same.

Regardless, I will have a sentinel node biopsy and may or may not need an axillary dissection.

Regardless, I may need to have i.v. chemotherapy.

Regardless, I will likely go on some oral chemotherapy which will both halt the spread of the cancer and will put me into menopause for five years. So, no more siblings for Laila and Owen ... at least for half of a decade.

We just don't have all of the information, yet. We go to see a geneticist soon, to determine whether or not I have the mutation that could cause cancer in other parts of my body and that may increase the risk that our children are in danger, too. We go to see a plastic surgeon on Monday.

In short, we have a lot of information to digest, and one HUGE decision to make.

Thank you for all of your support.

With love,
Liz, Scott, Laila and Owen

Do not look forward to what might happen tomorrow;

the same everlasting Father

who cares for you today

will take care of you tomorrow,

and every day.

Either He will shield you from suffering

or He will give you unfailing strength

to bear it.

-St. Francis de Sales