Final Plans and a Settling of Hearts

Wow...it feels like a long time since I've posted any updates!!  I'm so sorry to have left some of you hanging in regards to my surgery date!  Up until last Friday, we still didn't have a concrete date set, which was very unsettling for me.  Again, we had originally had a lumpectomy scheduled for July 14th.  So to go this long being under no surgeon's "official" care left me feeling a bit like I was trying to swim in the crashing ocean waves all by myself.

I knew that once chemo was complete, there would probably be some hurdles of the heart to jump over.  Like I said before, chemo was oh so difficult, but there was a task at hand.  ENDURE.  Although that was hard for me to do at times, I could keep my eyes focused on the goal (which was always just to get through that particular round of treatment).  Once those treatments were over, then we would have to face the cancer part again.

Talking with the other surgeons was very informative and helpful, and we had decided on a plan of action with one of those individuals.  We had also met with the plastic surgeon (for reconstruction) as well as the radiation oncologist that were part of that group.  I finally felt like there was a team of doctors (my medical oncologist was also part of this group) working together to give me the best possible outcome.  We were good to go until...we heard the earliest surgery date.  August 24th.  It was still over a month away, and it would be 9-weeks total since chemo had been finished. My heart sank.

These past couple of weeks have held some of the most difficult moments for me thus far in the cancer journey.  To be finished with one course of treatment, knowing we still had more obstacles to complete but without a solid plan, created a fearful shakiness in my heart.  It was a state of limbo, and I didn't know how to feel.  The emotions were flowing rampantly as I processed my next steps.  On the one hand, I was BEYOND grateful to be finished with chemo!!  However, I knew it would still be months before I felt good enough to go about my "normal" life.  Fear gripped my heart as I pondered the dreaded cancer cells, wondering if they would really ever get it all.  I've been told that I have several "high-risk" factors in regards to my cancer...could this ever possibly turn out in my favor?  Because cells can metastasize without showing up on scans, was it only a matter of time before the other shoe dropped?

So when they gave me a surgery date of August 24th, I felt as though I had hit a literal wall.  Between 18 weeks of gut-wrenching chemotherapy, countless appointments with doctors and specialists, plans that seemed to shift every few days, and the thought of another month without surgery, I felt like quitting.  I went upstairs, got in bed, put the covers over my head, and cried.

These are the darker moments that all of us go through.  It may be cancer, the death of a loved one, a failed relationship, or any other myriad of difficult circumstances that bring us to our knees.  No matter the outward appearance we display for the world to see, we all have (or will) face the deep throes of suffering at some point in our lives.  And we all come to that point when we pull the covers up over our head and simply cry out for relief.

The most wonderful news, is that because of Jesus Christ, we don't have to stay there.  Our suffering is real, but it doesn't gain victory over us.  The sun came up the next morning, and I pulled myself back out of bed to face the day.  And I remembered that none of these details are outside of the knowledge and realm of a loving God.  He knew that this month would present new challenges that would buckle my knees.  He has a plan for history that is moving towards the return of Christ, and I am just a small part of that ultimate plan.  Yet he cares deeply for each detail of my life.  And he calls me to trust Him, in spite of what I see happening around me.  These verses from Habakkuk feel so relevant...

Though the fig tree should not blossom,

nor fruit be on the vines, 

the produce of the olive fail

and the fields yield no food

and there be no herd in the stalls,

yet I will rejoice in the Lord; 

I will take joy in the God of my salvation.

(Habakkuk 3:17-18)

We had asked the other surgeon who had given us another opinion to pencil in a surgery date for me as well, just in case.  Thankfully, the date they had given us was August 5th.  So we called her to make sure that was still an option, and we contacted our friend up at Sloan Kettering once again (this sweet and brilliant friend of my husband's has been a tremendous blessing and constant source of cutting edge information for us!!).  He consulted his colleagues, and all of them overwhelmingly agreed that I needed to take the earlier surgery.  This would mean meeting with another plastic surgeon and radiation oncologist, and moving out of the umbrella with my oncologist that the other team would have provided.  However, after hearing the recommendation from our friend in New York, we knew it was the right direction to go.

So...here we are!!  The final plan will be for me to have a bi-lateral mastectomy with reconstruction on Wednesday, August 5th.  There was some variation in the two plastic surgeon's approaches to reconstruction; but we are going to do the first part at the time of surgery and the rest a few months after radiation.  Radiation will begin 4-6 weeks after surgery.

The surgeon will also be doing an axillary lymph node dissection to address the cancer in the lymph nodes prior to chemo.  We have learned that things have been a bit more complicated because my cancer required chemo treatments PRIOR to surgery (NAC...neoadjuvant chemotherapy).  The axillary lymph node dissection involves them removing all of my lymph nodes on the one side.  Apparently, having chemo before surgery can create difficulty in doing a less invasive sentinal node biopsy to check lymph nodes (when they test only 1-2 lymph nodes and use those to determine the presence of cancer in all nodes).  There are side effects with this process that can be permanent, such as lymphodema, which makes me nervous.  However, we are grateful that they will not risk leaving any cancer behind in the additional lymph nodes.

I'm wrapping my brain around everything, and I'm grateful that we have a solid plan.  I would have certainly preferred the less complicated (and less painful) lumpectomy with the sentinal node biopsy that the first surgeon had recommended :)  However, after learning so much in the past month about all of these issues, I feel so much more comfortable about the approach these doctors are taking.  And ultimately, we are rejoicing in the fact that according to my MRI, the chemo appears to have been very effective in treating my tumor and lymph nodes!

We actually had a wonderful weekend, and I'm feeling so much better!!  I will post some pictures and share some of the good things going on (there are always good things, even when I want to quit :) in the next few days.  Thank you SO much for continuing to pray for our whole family.  I've learned that it's a marathon, and we appreciate you running this very long race beside us!!

We had the best weekend as a family...more details to come :)

Change of Plans

So, as many of you know, I was scheduled to have surgery tomorrow afternoon.  When chemo was ready to wrap up, we had our pre-surgical consult with our surgeon and left feeling quite unsettled.  We didn't feel like we had a lot of information to help make our decision, which was to do a recommended lumpectomy or to go further with a mastectomy.  We knew that my mammogram contained a lot of calcifications, and the surgeon's plan was to remove about 4 cm of those and test margins for cancer.  If there was any left, she would attempt another surgery (possibly a mastectomy at that point).

Something left us feeling very uneasy about the plan, and the fact that we had very little information on either surgery didn't give us the confidence we felt like we needed to make a good decision.  Last week provided a WHIRLWIND of information as we sought the opinion of several doctors (some surgeons, some in other specialties).  Bryan and I felt exhausted and weary from the many appointments, but we also believed we were becoming so much more informed on my situation.

After discussing my case with these doctors, it didn't take us very long to make a final decision.  Each of them agreed that a mastectomy would be my best option moving forward.  Although we are very encouraged by my recent MRI results, it does not mean necessarily that the cancer is gone.  My mammogram is still very suspicious, and it would be difficult to tell which areas are possible cancer zones and which are clean.  This could also make following my further mammograms and other scans difficult post surgery.  One of the surgeons also still felt something at the tumor site, as well as an enlarged lymph node.

Being that I'm so young, that there was cancer likely residing in multiple lymph nodes, and the fact that my tumor was so large, they all believed that it was better to take a more aggressive approach.  Although the final outcome (statistically) would likely be the same with either a lumpectomy with radiation or a mastectomy, there is a higher risk of recurrence with the first option.  And although I was negative for the genetic testing they performed, all agreed that there could be another gene discovered in the future that may reveal a positive result for me.

The doctors we met with were so encouraging and kind, and by the end of the week, we felt so much more solid moving forward.  Therefore, we canceled the lumpectomy for tomorrow and are moving ahead with a bi-lateral mastectomy.  We are also going to make a switch to one of the other surgeons that our friend at Sloan Kettering recommended.  She works directly with our oncologist, as well as our radiology oncologist, so it seems like a very logical switch (although we are so grateful for our first surgeon and all she has done for me to this point...it was certainly part of God's plan for Him to use her in the ways that He did).  It is definitely not the procedure that I would prefer from a pain/recovery standpoint, but we believe it is the choice that will give us the most peace of mind to know we did all we could do to battle this cancer.

I will update here once we get this surgery on the calendar.  According to the doctors, I will still need radiation after my mastectomy, so we will update the time frame for that process as well (it will likely be further into the fall).

I've said it before in my other blog posts...when we get to talking heavily about the cancer, it's easy for my heart to become anxious.  It's a battle to keep my mind focused on the present moment, knowing that I have all the grace I need for that and that alone.  I have to remember that God is not calling me to navigate this all alone.  He will give me the information and discernment at each moment, even if I can't see the big picture yet.  And if I daily renew my mind with the truths of my God...that Jesus Christ has already accomplished victory for me on the cross, that He has forgiven me and loves me with an everlasting love, that He promises to never leave me or forsake me...I truly have all I need today.

As always, in the midst of our struggle with cancer, there are beautiful windows...little glimpses that God allows me to peer through with new eyes that both refresh and quiet my restless heart.  We had some wonderful time together with our little family last week that provided just that!  Here are some snapshots...

Our two older boys played on the same baseball team together this year, and they had their awards banquet last week.  This was an AWESOME experience for these best buddies to play together and to watch them work hard at home together as well.  They loved it, and so did we :)

My dear friends from childhood came up for another visit this past week and brought many of their kiddos!  It warms my heart each time I see these girls and think about how our paths crossed when we were so young.  God has given us a gift in this life-long friendship, and they have lifted my spirits so many times throughout this journey of cancer.

My sweet Hailey and I left the boys on Saturday and went out for a little girl time!  We went to lunch at Book Bums (an adorable little place that also has yummy food!) and then ventured over to see the play "Broadway Headlines," performed by the Cincinnati Christian Children's Theater.  Anything that contains songs from Les Miserables and Wicked sounds good to me, and we had a blast together!

Thank you all so much for continuing to pray for our family through this journey.  We will post an update once we finalize a new surgery date.  Your love and encouragement are a constant testimony to our incredible God!!

Good times, good news, and God's good grace

Whew...it's been a crazy week and my head feels like it's spinning!!  I'm going to try to keep this short and sweet because I honestly don't have much mental energy left to write :)  But I want to give a quick update on where we are at the moment.

As far as chemo recovery goes, I'm finally feeling much better!!  By Thursday of last week, things still weren't moving in a good direction.  My nurse had me come in again for fluids to help with dehydration, and they tested my blood chemistry as well.  This revealed that my potassium and magnesium levels were both VERY low, so I needed IV doses of both of those electrolytes.  My sweet dad volunteered to bring me, so we had a few hours of great conversation at the infusion center.  I knew this was a sacrifice for him, being that it was a busy work day, yet you never would have known it.  I'm so grateful for his protective nature and his great big love for his kids, and I adored having that precious, uninterrupted time to talk with him.

Our family gathered for the 4th of July at my parents house, and it was fantastic!  I was feeling good enough to eat, and my dad had loaded up on some pretty amazing fireworks (which Bryan and my brother set off almost flawlessly...only one minor hiccup with a malfunctioning rocket that didn't make it up in the air quite high enough :).  The kids had a blast, and it was so much fun to see the joy in their little eyes.

Yesterday brought one more trip to the infusion center, where my magnesium was low once again, and I received another IV dose.  Hopefully, that's my last trip for a while!!  We tried to meet with my oncologist while we were there about my MRI results; but he, unfortunately, didn't have them yet.  A good amount of yesterday was spent in limbo, which was frustrating.  Our biggest question has been, "Did the chemo do it's job?"  We just really wanted to see those results to get a better idea of what we are looking at moving forward.

I'm so grateful to report that those MRI results were FINALLY revealed to us, and they bring very good news!  From everything they can see on the MRI, there is no measurable cancer left that can be seen in my breast or lymph nodes!!  This means that the chemo was very effective in shrinking the tumor and killing cancer cells in my lymph nodes!!  There could still be cancer present and the calcifications are still suspicious, so surgery and (most likely) radiation are necessary.  But it's still very good news!  Once they do surgery, they will send everything to pathology to try to get cancer free margins.

We are still meeting with doctors to determine the best course of action surgically.  You can pray for discernment and wisdom for us as we navigate these waters.  We keep reminding ourselves that God already knows the steps, as well as the outcome, and we can rest fully in that.  We feel like we are getting good, solid information to work with now, so we will make that decision soon.  Thank you so much for your prayers!!  The MRI results were such a confirmation that we have an army of loved ones constantly bringing our needs before a mighty God who hears your pleas.

Paul Tripp, in his devotional "New Morning Mercies" was such an encouragement to me yesterday.  I was feeling so uncertain and overwhelmed, and these words gave me such comforting reminders about God's grace for each moment...

"God has promised to supply and empower, your job is to follow him by faith where you live every day.  You don't wait for the provision before you move.  God has not promised that you will see it beforehand.  You don't try to figure out what God is going to do next and how he will meet your needs; you move forward in the certainty that he is with you, for you, and in you.  This God of awesome power will grant you power to do what is needed."     

The Waiting Game

Just a quick update as we wait...

I'm still having a really hard time bouncing back from this last round of chemo.  We are wondering if I may have some kind of a stomach bug that is holding back recovery, because it seems to be at a standstill right now.  I'm trying to drink as much as I can; but because of lots of stomach pain, I'm not really able to eat very much.  We are going to try fluids one more time this afternoon, and the doctor is ordering another medication that will hopefully get me to turn the corner soon!!

The MRI went well yesterday, in spite of having to lie directly on my stomach (the MRI tech made sure there was a trash can nearby :)  The people at Proscan are so wonderful, and I felt such comfort as they programmed my favorite band "Shane and Shane" to play through the headphones during the scans.  The radiologist will hopefully write up a report by tomorrow, and we should hear something by Monday regarding the results.  Ah, the waiting :)

Please continue to pray as we move forward.  Pray that the chemo was effective in eradicating the tumor, the diseased lymph nodes, and any other cells.  Pray that my stomach starts to heal and that my recovery from chemo begins to head in the right direction.  Pray as we get MRI results, meet with doctors, and solidify a game plan for surgery.  And finally, pray that we remain steadfast as we tether our hearts to the Great Physician who already intimately knows all of our next steps.

This was taken last Thanksgiving, and it just made me happy today.  Love these people so much.