"And Give Him the Glory Great Things He Hath Done"

I've been recovering for a little over a week now from surgery, and I have to be honest...it's been so painful.  Between the mastectomy incisions, the axillary node biopsy, the drain insertions, and the tissue expanders, I'm never quite sure which part is hurting more!  We are still trying to figure out a combination of medications that makes it more comfortable, particularly through the night.  It WILL end (hopefully sooner, than later :)!!

However, we met with my surgeon this morning, and the news from my surgery could not be better.  I cannot believe I even get to write these words!  The pathology report showed NO cancer present in ANYTHING that was biopsied.  This means that both breasts, along with 10 lymph nodes that were removed on my left side contained not a trace of cancer when examined under the microscope, which is hands-down the BEST CASE scenario for my case!!  The left breast and lymph nodes contained "extensive stromal fibrosis with chronic inflammation...consistent with therapeutic effect," meaning my chemotherapy went in there and did EXACTLY what it was supposed to do to the cancer!  My risk of recurrence (local/regional and distant) is now significantly lower because there was a "complete pathological response" to the chemo.  My oncologist told me in the beginning that his goal was to get me cancer-free by surgery, and that's what he did!

We knew from the MRI I had back in June that the chemo had been working.  There were no longer any visible signs of the tumor on the scan.  However, it was still very possible that cancer cells were hiding amidst all of the calcifications, and they needed to remove those questionable areas in order to confirm a complete response to the treatment or not.  God has been so faithful through each step of this journey, and we knew He would continue to receive glory whether there were tears of joy or tears of sorrow with the results.  This time, we would be humbled and in awe that He saw fit to heal me.  Our surgeon nearly had tears right along with us and described this news as simply "awesome."

This was our ultimate desire, and we prayed desperately that cancer would be removed from my body.  But we knew this very easily could have gone the other way.  My tumor size, grade, type, and the fact that it had moved into my lymph system were risk factors that didn't weigh kindly in my favor.  Yet we rejoice in all that He has done and know that He continues to hold all of my days in His mighty hands.

This has been a tremendously difficult road to walk, and we are not quite at the finish line.  From everyone we have spoken with, there has been a consensus to still do radiation about 4-6 weeks from now.  Although there was no cancer on anything biopsied (which was in fact, awesome news!!), my surgeon still hesitated on calling me "cancer-free."  Because of the size of my original tumor and the fact that it had spread to lymph nodes, radiation will still likely be in the plan as one last means of battling the risk of recurrence in the lymph nodes, chest wall, or somewhere else distant.  We will know that decision once we meet again with the radiation oncologist.

We also need to complete my reconstruction, which if all goes well through radiation, should be finished about 3-6 months after my last radiation treatment.  The last little reminder of cancer will be my Herceptin infusion every 3 weeks until March 2016.  This is the targeted therapy component (for the Her2 positive status) of my chemotherapy regimen that they say has done most of the heavy lifting against my tumor.  Had I received my diagnosis 15-20 years ago, the outcome would have most likely been dreadfully different.  The chemo regimen I received (TCHP) is proving to be very successful in treating my type of cancer.

I will continue to post updates here as I progress towards the end of my treatments (there is a finish line that's almost in sight!).  Hopefully, normal life will resume sometime in the not so distant future :)  The Lord has opened my eyes to so many things through all of this, and my heart overflows with thankfulness...both for the works He has done and for the hands He has used to serve us.  These are the lyrics to a hymn that has been flowing through my mind this afternoon.  He has truly done great things...

To God, be the glory great things He hath done

So loved he the world that he gave us His Son

Who yielded His life our redemption to win,

And opened the life-gate that all may go in.

Refrain:

Praise the Lord, praise the Lord,

Let the earth hear His voice,

Praise the Lord, praise the Lord,

Let the people rejoice;

Oh, come to the Father, through Jesus the Son,

And give Him the glory, great things He hath done.

Oh, perfect redemption, the purchase of blood,

To every believer the promise of God;

The vilest offender who truly believes,

That moment from Jesus a pardon receives.

Refrain

Great things He hath taught us, great things He hath done,

And great our rejoicing through Jesus the Son;

But purer and higher, and greater will be

Our wonder, our transport when Jesus we see.

Refrain

(Fannie Crosby: 1820-1915)

Home Sweet Home

Psalm 46 (ESV)

God is our refuge and strength, 
a very present help in trouble.
Therefore we will not fear though the earth gives way,
though the mountains be moved into the heart of the sea,
though its waters roar and foam,
though the mountains tremble at its swelling.

There is a river whose streams make glad the city of God,
the holy habitation of the Most High.
God is in the midst of her; she shall not be moved 
God will help her when morning dawns.
The nations rage, the kingdoms totter;
He utters his voice, the earth melts.
The Lord of hosts is with us; 
the God of Jacob is our fortress.

Come, behold the works of the Lord,
how he has brought desolations on the earth.
He makes wars cease to the ends of the earth; 
he breaks the bow and shatters the spear;
he burns the chariots with fire.
"Be still and know that I am God.
I will be exalted among the nations,
I will be exalted in the earth!"
The Lord of hosts is with us; 
the God of Jacob is our fortress.

I thought I would have a lot to say after coming home from surgery...so much has happened to my body in the past several days!  However, I've also been taking so much pain medicine that I hardly remember any of it!  In fact, I went to make a phone call to one of my doctors yesterday afternoon, and my mom informed me that I had already talked to her last Thursday when I was in the hospital.  My world is fuzzy and filled with these "dream-like" conversations, the result of the much needed medications to keep up with the intense pain.

On the day of surgery, God provided all of the peace and rest that I needed to face those uncertain moments.  I had meetings with all of my doctors that morning, and the fearful anticipation faded into determined strength as we went over each procedure.  It became so clear that we were with the right team of doctors, and that the Lord would hold my shaky hand each step of the way.

My brother came to the hospital before surgery to pray with Bryan, my mom, and myself and to read some scripture with us (including Psalm 46 above).  How comforting to know that I can "be still" before God.  To recognize His character and to find complete and total peace in Him.  My heart was restless up until the day before surgery.  But once it was time to go, I could rest that His plan for me was solid.  Would it mean that I would have no further pain or difficulty?  No.  Would it mean that things would work out in perfect order, just the way I planned them to?  No.  But could I trust in a powerful God who not only put this magnificent world in motion, but also cares deeply for each and every detail of my life?  Absolutely.

O Lord, you have searched me and known me!

You know when I sit down and when I rise up;

you discern my thoughts from afar.

You search out my path and my lying down

and are acquainted with all my ways.

Even before a word is on my tongue,

behold, O Lord, you know it altogether.

You hem me in, behind and before,

and lay your hand upon me.

Such knowledge is too wonderful for me;

it is high; I cannot attain it. (Psalm 139: 1-6)

The surgery was performed by a surgical oncologist (for the bi-lateral mastectomy and axillary lymph node dissection) and a plastic surgeon (to put in tissue expanders for reconstruction).  It lasted almost 7 hours, and I was told that everything went very well!  I had a very sweet nurse who apparently, according to my instructions, was not allowed to leave my side.  Early in my chemotherapy, my body had allergically reacted to one of my chemo drugs (my throat swelled up, and I couldn't breathe).  Although that didn't happen this time, I think that some of the anesthesia gave me a similar feeling when I woke up from surgery.  But she was wonderful, as were all of the nurses that cared for me during my time in the hospital.  It was an extremely painful few days and nights, and I was so grateful for such fantastic care from all of my doctors, nurses, and other assistants.

So, I've been home now since Friday evening, and it's just been crazy foggy and painful!!  I will be seeing my plastic surgeon and his team later this afternoon and will see my surgical oncologist on Friday.  We should have pathology results back when we meet with our doctor on Friday.  Hopefully my body is beginning to heal and things will be moving in a good direction soon!  Thank you so much for all of your prayers for us.  You can pray, specifically for my mom and Bryan, as they are the people that are caring the most for me on a daily basis right now.  Pray for strength, patience, and energy as they care for not only me, but our sweet kiddos as well.  Pray, also, that I would not get discouraged with the pain, but would endure and "fix my eyes on Jesus, the founder and perfecter of our faith, who for the joy that was set before Him endured the cross" (Hebrews 12:2)

My sweet nurse, Angie, took care of me for the final round before I came home.   

Ready or not...

Tomorrow marks another hurdle in my cancer treatment...surgery!!  It's after midnight, and I'm still up (mostly because I had to take advantage of the last available eating minutes until midnight, when I'm cut off :).  My heart is steady tonight, but today was a different story.

I would love to go into detail, but I really need to rest tonight.  Bottom line...sometimes God makes us wait for peace.  It causes us to trust Him, to rely on Him alone, and to put our hope in Him.  My heart was apprehensive this week about surgery; but today, I was all over the place.  I prayed all day for peace, only to find my mind constantly chasing another rabbit trail.  There have been several times in the past 24 hours where I was close to pulling the plug on tomorrow.  Things just didn't feel "right" enough.

Would another set of circumstances be better?  Should we go back to our preferred team of doctors, even though it would be a later surgery date?  Should I scrap reconstruction and try to do it later down the road?  These were just a few of the questions giving my heart grief today and I battled uncertainty and fear.  

However, God has led us to this point.  At every other crossroad, there was a clear indication of which path to take.  And that road has led to doing surgery on this date, with these doctors, doing these particular procedures.  We have thought through, researched, and prayed through all of our decisions.  And ultimately, He is in control of all of it anyway!  He provided people in my life to listen and walk me through the valley today; and by the end of the day, that sense of peace finally came.  I'm learning that keeping my heart focused on Jesus is something I truly have to fight for, particularly in the midst of such uncertainty.

So, my surgery will be tomorrow at 11:30 a.m. at UC Hospital.  It will be a bi-lateral mastectomy with the first stage of reconstruction (2nd stage will be after radiation).  I still feel a bit anxious about all that is coming, but I know grace will meet me there on that operating table tomorrow.  And in the coming weeks of recovery, He will continue to sustain me with that same unfailing grace.

Since my husband's birthday is the day after my surgery, some friends and I decided to throw a surprise party tonight for him.  This man is simply amazing to me, and I'm so grateful that he chose to walk through life with me.  I've always admired his attitude, his incredible faith in Christ, and his overall perspective on life.  These last several months have tested him in new ways, but none of these things about him have changed.  He's still the most joyful person I know, even when his wife has cancer.  So it was CRAZY fun to be able to bring so many of his friends together tonight to show him how much they love him too :)

We have such precious friends.  After a sweet time of prayer together, I feel settled and ready to go tomorrow.  Uncertainty still looms a bit, but I can rest knowing that I'm in the hands of a loving God who knows all things and calls us not to worry about the future.  

Thank you so much for praying!!  I will try to have someone post an update tomorrow after surgery is complete.

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.