Sunday, March 29, 2009

Waiting, waiting, waiting

You know, when you start a blog, you'd think you need to write something every day, but now I understand how you can "be silent" for a while...

It seems like this past week has just CRAWLED by for me. That's o.k. for now, I guess. I'm still not 100% from the Axillary Node Dissection, but, I'm not in as much pain and I can tell I'm slooooooowwwwly getting my range of motion back. Nobody prepared me for this and I kind of wish I had been better informed of what to expect. You'd figure right after surgery that you'd be sore, but then after 2 weeks, you'd think you can reach up to put glasses away in the kitchen cabinet, make the beds without grimacing, get a workout in without feeling soooo sluggish. I sound like my boys when I say, "I want to feel all better NOW!!!"

We did get the great news about Dave's surgery, clean margins, 95% kill ratio, slowly but surely closing this chapter in his fight against cancer. His drains came out Friday so he's getting around pretty well, still using one crutch...if you haven't seen his blog, you need to...my brother, Mike, nicknamed Dave "Zipper Leg" which is quite appropriate for the time being. I think we've been dealing with Dave's cancer for so long, when we got the good news, it was a HUGE relief and weight lifted from our shoulders. If we didn't have my deal going on right now, we'd almost be totally out of the woods, we'll get there, eventually.

One thing happened this week that I thought was pretty cool. The lab that is running the Onco DX test (out in California) called me to let me know they had received the slides, contacted my insurance company, were going to need 7 - 10 business days to run all the tests they run and answer the questions I had, if any. I was really impressed...seems like today whenever you do have a question, you have to jump through so many hoops to get to speak with an individual and they were just awesome to deal with. Impressively, they are the only lab in the world that runs this test, so I think they'll do it right. I read the testimonials on their website and I trust that the doctor is doing the right thing in my case to have this test run. Hopefully, we'll get a definitive answer, one way or another, if I need chemo or not. I truly do not want to go through it, but if it prevents any spreading or recurrence, then sign me up. I hope this test will make it clear as to which path I'll need to take!

I go in this coming Wednesday for all my scans...pray for clean ones. We figured that this is the appropriate time to get all these tests run, just to be sure.

So, that's all for now...I'll be in touch!

Monday, March 23, 2009

Meet the Doctors

Hi Folks, this is Dave, not Holly. She asked me to update everyone with today's events.

Holly met her oncologist today for the first time. His name is Dr. Anthony Landis (see http://www.cancergwinnett.com/meet_the_doctors.htm for more details about him professionally). Based upon what we know today, Holly has Stage II breast cancer. The purpose of today's visit was to find out more about the Pathology of her cancer and the proposed treatment plan.

What we learned today was the following:

  1. The tumor was positive for stimulation by both estrogen and progesterone. As a result, she will need to take Tamoxifen for the next 5 years. Tamoxifen is thought to block the effects of estrogen on breast cancer cells.
  2. The HER2 IHC test was borderline, then repeated as a FISH test, but was still inconclusive. The doctor plans to repeat these tests using a different lab this time. It will be at least another week before we get results for this. A positive HER2 test would mean that Holly would need to go through some form of chemotherapy.
  3. Regardless of the HER2 status, Holly will for sure go through Radiation therapy. She also met her radiation doctor today (Dr. John Gargus) and they discussed doing 33 rounds of treatment (which is about 7 weeks of radiation). It's just a question of will she need chemotherapy before the radiation or just the radiation.

Dr. Landis has the following now planned for Holly:

  1. As mentioned previously, a different lab will re-run the HER2 tests on her tumor.
  2. Dr. Landis mentioned something about having a HER MARK test run as well, though I have no information on that test.
  3. Oncotype DX breast cancer assay -- see http://www.genomichealth.com/OncotypeDX for details.
  4. A CT Scan, Brain MRI, and Bone Scan have been scheduled for next week.

And now, this is Holly finishing off this entry...I appreciate my sweet, technical-minded, detail-oriented husband so much, he does such a better job explaining this kind of stuff than I do! All in all, I'm very happy with my two new doctors and am glad they'll be close to home (near Gwinnett Medical Center).

Thanks to my neighbor, Joanne for watching Kyle this morning (he stayed home today from school, sick w/ allergy stuff) and to my niece who came down and spent the day to help out. Without this help, it would have been a very difficult day....

Signing off for now...


Holly, Dave (and the boys)

Sunday, March 22, 2009

Signs

Well, let me bring you up to date...Dave's sisters both saw how well Dave was doing on Friday so they took off to get back to their homes and gave us a quiet day at home. We appreciated them being here with us and also appreciated the fact that they saw Dave was well enough and we needed a quiet day here while the boys were at school.

Dave's been up and around with one crutch and amazing all of us with how well he's doing. I'm doing fine, still having some pain in my right armpit area but I'm hoping that in time, I'll get my range of motion back. Just taking it one day at a time and thankful that we've been able to get through so much with little complications in this last month.

Today I took the boys to church (Grace Fellowship, Snellville, GA) and left Dave home...I don't want him to gross anyone out with his drains...anyway, Buddy's sermon was about Signs...I know that God is taking Dave and me through our journeys with cancer so that somehow, some way, we can help others. I don't want to over think it or read too much into it, but all I know, is that through the whole journey we've both been on, I can just see the outpouring of love and care from those around us and I know this pleases God. He wants us to care for each other, this brings Him joy. If there are ways we can help others who have cancer, then we're here to do it. God is granting us peace and grace to get through each day and I'm more aware of that now than I have ever been before.

This coming week is a big week for both Dave and myself. We get our pathology reports, he gets his drains out, I meet with the Radiation Oncologist and the Oncologist. We'll keep you posted on the results and again, thank you for your continued support.

Thursday, March 19, 2009

My Drain Removal Day and Dave's Homecoming!

Well, I'm so excited that today is the day my drain is coming out. This has been such a bother and just really has bugged me for the whole time it's been in. Dave calls me first thing in the morning to say "Hi" and to talk with our son, Bryce. Dave sounds GREAT and tells me he is being discharged TODAY. He's been doing his exercises and the PT is coming to work with him again. He had been fighting nausea the day before, but today, he sounds like a new man.

Diane and I head to Dr. Martin's office to get my drain removed. Oh my goodness...that was one of the weirdest sensations I've ever felt and hope to NEVER experience it again. It hurt while it was being removed and then burned. I find out that the drain went from about 4 inches below my armpit all the way up to the top of my arm pit. No wonder it hurt every time I reached for something. Well, I'm elated to have the thing OUT of my arm and we head downtown to the hospital to pick Dave and Barbara up.

When we get down to the hospital, Dave is packed up and ready to go. He, Barbara and a nurse come down and Dave is walking with crutches! The PT had him walking the hospital floor, doing stairs and he was just amazing us all!

We arrived home by 1:30 or so and my head was spinning that everything was happening so fast. Dave was in some pain, but nothing too bad. He was doing his exercises, getting up and moving around and making me so proud. His doctor predicted this kind of recovery, but we were a little skeptical that Dave would bounce back like he did.

We're so thankful for everyone who has been praying for us, I truly believe that God is getting us through each day and without Him and the support of those around us, we wouldn't be making the progress that we are.

Wednesday, March 18, 2009

Dave's Surgery Day

We're up at 5:00 AM and out of the house by 5:45 AM to go to Crawford Long (now called Emory University Hospital Midtown) for Dave's surgery. Even with everything that I've gone through the last month, I'm so happy that today is finally here and Dave will be getting his Liposarcoma removed from his left thigh. Barbara (Dave's youngest sister), Dave and I arrive at the hospital right on time at 6:30 AM and he goes in for pre-op. Dave's sister, Deborah, and his parents, Rudy & Mary Jo, arrive shortly after we do and we begin the wait.

We see Dave shortly before his surgery in pre-op and wish him well. We see the surgeon, Dr. Dave Monson and meet some more of the operating staff. Again, we've been looking forward to this date from the time he was diagnosed on July 15th, 2008 and are so relieved this day is finally here. They take Dave back to the surgery area and we head out to the waiting area.

His surgery starts right at 8:30 AM and is over by 10:00 AM. Dr. Monson speaks with me on the phone and tells me that he was very pleased with how everything went. He thinks he got good margins and there's even a layer of tissue that was spared (considering the intensive chemo and radiation Dave went through, this is very encouraging news). By 11:15 AM, Dave is in his room and we all go down to get him set up. His sister, Barbara, is an Oncology Nurse and has offered to spend the night there at the hospital. I'm grateful for this because she is so good with Dave and I know that if the PT tells her he needs to do something, she'll make sure he gets it done. Dave's other sister, Diane, arrives from Kentucky and we're all glad to see her too. She stayed with me and the boys during Dave's first chemo round back in August, so it's kind of like we've come full circle. We're glad to have such supportive family and friends.

By 3:00 PM, the PT is there and has Dave standing up and trying to bear some weight on his leg. I'm AMAZED at what she's having him do, but Dave is a great patient and is trying his hardest. She has him doing leg lifts and gives instructions for what he should do every hour.

Soon after the PT left, Dr. Monson and his Resident arrive. They again tell us that the surgery was successful, so much so that Dr. Monson wanted to operate on the other leg (ha ha)...we need to wait for a good 5 days or so before we get the pathology report/kill ratio. Next week will be a big week for us.

Tuesday, March 17, 2009

More Pain than Before but hanging in there

I've been laying low the last few days and trying my hardest to take it easy. Don't get me wrong, I like to do my share of "chilling", but, I'm usually up and about. I like to go out and walk or go to the gym and get my cardio and strength training in 4or 5 days a week. I'm usually running errands, vacuuming, running up and down stairs, lugging lots of heavy stuff around, but right now, I'm under strict orders to not lift anything over 5 pounds and really take it easy. I find it just plain hurts whenever I try to reach for something with my right arm. Lucky for me I'm left-handed, but I do find myself trying to do simple things (like emptying the dishwasher) and just not being able to use my right arm much. Of course, Dave doesn't want me to do anything like this, but I just hate being laid up and letting him do all the stuff around the house that I normally take care of.

I'm fortunate to have a friend in the neighborhood that cleans houses, and she's offered to come over and clean for me on her day off. Since Dave's family and my Mom are coming over later today, I'm elated for her to come and clean...and then she surprises me by not accepting payment and tells me it's her way of helping us out. I'm in tears, grateful as always, and telling her I'd like her to come back, at least for the next few months while I'm going through treatment, but I'm insisting on paying her from here on out. I'm again, touched by the generosity of others and how much people in our lives really do care.

Thursday, March 12, 2009

Follow up with Dr. Martin

My appointment this afternoon with the surgeon went as well as could be expected. He told us he took an additional 5 nodes out (for a total of 6 nodes altogether) and cancer showed up in a total of 2 of the 6 nodes. He was optimistic in that this can be treated with radiation, but, is leaving the treatment plan up to the oncologist (Dr. Anthony Landis) and Radiation Oncologist (Dr. John Gargus) with whom I have appointments with on Monday, March 23rd. He said that these doctors treat about 80% of the breast cancer patients in Gwinnett County and he has worked with them for over 20 years.

I'll go in next Thursday, 3/19 to get the drain removed, but, the doctor did say that I should be o.k. to drive now which will help me be able to get out and about when I need to.

Dave's family is coming into town next Tuesday, as his surgery is bright and early Wednesday morning, March 18th. They'll stay in town as long as we need them. He has 3 sisters, one lives in Cumming, GA and the other 2 are out of state. I look forward to them being here and focusing on Dave's surgery. His battle against his cancer has been going on since last July and we're ready to get his tumor out and hopefully see his treatment end and have him be cancer-free!

As always, thank you for your continued prayers and encouragement and support...we couldn't make it without you.

Tuesday, March 10, 2009

Right Axillary Node Dissection

Today is the day I go back in for the doctor to remove more nodes. They'll take out as many as they need to in order to see if the cancer is spreading. At least this time I am having this procedure in the Day Surgery Department and if all goes well, I should be home later today.

When Dave and I arrive at the hospital, we run into one of the Associate Pastor's from our church, John Baker in the parking lot. He's actually there to see me and another high school student who happened to be at the same hospital. We enjoyed our time talking with John and praying before I went in for my procedure.

When I get back in the pre-op area, the nurses are told that I had had allergic reaction the week before so they put Benadryl into my IV. This knocks me out quickly, so the time passes quickly before I go under for the procedure. They put me out again under a general anesthesia so the next thing I know, I'm in post-op feeling massive amounts of pain under my right arm. It was ridiculous how bad the pain was, I described it to the nurse that it felt like someone just started punching me under the arm and wouldn't stop. They had given me a Lortab which didn't touch the pain and finally they gave me some Demerol. Much better, I usually say I have a high threshold for pain, but not this time. Definitely something I don't want to go through again.

I do end up getting discharged and am sent home, but this time I am in a lot more pain than I remember from the previous surgery the week before. I manage the pain with the Lortab and this time use some ice packs under my arm. Oh, this was the best advice I had received and I kept the ice bags under my arm for the first few days. This really helped reduce the pain, thank God. Again, I'm glad to be home and hope that my recovery goes well so that I can be helpful to Dave next week for his surgery.

Monday, March 9, 2009

Another Doctor's Appointment and Pathology Results

Well, considering everything that's happened in the last few weeks, I think today's doctor's appointment went well. He said that the lumpectomy was successful in removing the tumor and that they got clean margins...yay, no more work on my little boob! The lymph nodes though are another story. I will go in tomorrow at 9:15 AM (Gwinnett Medical Center - Day surgery) for a Right Axillary Node Dissection. He'll remove as many nodes as he needs to (he said it all depends on the patient, how the nodes appear, etc) and this time they will put in drains. They may keep me overnight at the hospital, it just depends on how I'm doing after the procedure. I'll have the drains in until my follow up which will be March 19th (the day after Dave's surgery)...so 10 Days with the drains. This may be a little uncomfortable, but I'll get by.

I do get an official diagnosis for the type of cancer I have: Infiltrating Ductal Carcinoma. Apparently, this is the most popular type of breast cancer out there, I've seen statistics saying it's anywhere from 52% - 70%...so, I've finally made it to an "in crowd", not really the one I was hoping for, but at least I'm confident in the fact that a LOT of research has been done and there are many proven treatment methods. I was also told it's Stage II, could be better, could be worse, but that's what it is.

He did say that radiation will be the way they'll treat my breast cancer, for which I am thankful. I really wasn't too excited about getting chemo, especially after seeing everything Dave went through, although I know mine isn't anywhere as bad as his was. So, suffice it to say, I'm thankful the lumpectomy is over and done with and I'll be glad to get tomorrow's procedure behind me as well. We don't know about the treatment plan yet, again, just taking one day at a time here...

I can't tell you enough how much we appreciate everyone's support, encouragement and prayers during this time. Yes, it's overwhelming, but with the support of so many, the experience is much more tolerable. We're blessed with many friends and family members who make this whole experience more bearable.

Thursday, March 5, 2009

Results of the Surgery

Well, I'm hanging in there and letting Dave take care of some of the duties I usually do...like get up with the boys in the morning, get their breakfast, make sure they get dressed, get their teeth brushed and be ready for the bus, within an hour. Dave usually gets to bed after me and sleeps in a little, but for the next few days, it's up at 7:00 AM for Daddy! Hey, I've got to take advantage of sleeping in while I can!

I'm hurting a little bit today, but, am taking my Lortab and keeping the pain managed pretty well. I was told to elevate my arm with some pillows and my sweet techie husband set me up with a laptop on the couch, so I'm happy as a clam! I actually went out and took a very short walk in the afternoon to get some fresh air and circulate the blood, but I didn't overdo it.

Around 1:30 in the afternoon, Ruthann, (PA to Dr. Martin) called and said my pathology report wasn't back yet. That was kind of disappointing because we were hoping to find out more about the cancer. She said she'd get back in touch with me as soon as they knew something.

About an hour later I get another call and it was Ruthann again. She did say that the mass that was removed had clean margins which is very good news. The doctor did have to take some of the chest muscle and go to the chest wall to get the clean margins, but it wasn't bad and there'd be no more surgery on my breast. The pathology report showed that there were microscopic cancer cells in the sentinel node that was taken out and they would need to go back in and do an Axillary Node Dissection. This didn't sound great, but, at least now, that Dave's surgery was set for 3/18, they could get me in the next week to do this 2nd procedure. So, I now get set up for the 2nd procedure for 3/10 to take out more nodes to see if the cancer is spreading further.

Wednesday, March 4, 2009

Lumpectomy Day

Well, Dave and I are up and out the door and off to the Women's Pavilion where they'll inject radioactive dye into my right breast. They do this first (at 7:30 AM) and then I'm transported over to the hospital for the lumpectomy and sentinel node removal. Dave is right with me, wearing the caregiver shoes now, and he's doing a great job. He does try really hard to be funny and sometimes it works and other times I just have to tell him, "Still not funny." But, he's there with me before I go into surgery and is trying to keep things "light" with all the nurses and staff. I find out that instead of the day surgery, I'll be having my procedure done in the main surgery area of the hospital (at Gwinnett Medical Center), and I'm not being put under with a twilight anesthetic, nope, they are knocking me out, all the way...o.k. by me, I'd rather not know what's going on to be honest.

During the lumpectomy, the doctor tells me that not only will I have the radioactive dye in there (I'm assuming to find the cancer), but they also put in a blue dye right before the surgery...like it'll give my skin a blue hue...I'm very fair skinned, so, great, now tomorrow I'll look like a Smurf? We shall see....

The procedure takes about an hour and a half and while I'm in the post-op room, I have some kind of allergic reaction. The nurses think it's because they had to give me some morphine to kill some of the pain right after surgery, or maybe it had something to do with the anesthesia...they don't know for sure. I'm already allergic to penicillin and sulfa drugs, so I guess I may have something else to add to my list.

So, after some Benadryl and sips of Sprite and a few crackers, I'm given the green light to go home. A nice lady came in to give me a pillow to put between my arm and my breast and to give me a "Breast Cancer Package", which has a very informative manual that explains EVERYTHING you'd ever want to know...Dave was jealous he didn't get any of this kind of special treatment when he was going through his horrible chemo and radiation treatments. I told him I just got lucky and got the right kind of cancer.

Now, it's in the early afternoon and we're on our way home. My mom and sister were at the hospital and came to the house for a while. My niece, Sarah, came to spend a few days/nights with us (she had done this too in the past with Dave's chemo rounds) and we appreciate the help so much. Our boys take a lot of energy and they love having their cousin there to be with them. So, we're at the house for a while, I'm in a little pain, but taking the Lortab on schedule and resting...so far, so good.