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 :)