Meeting With the Oncologist (a.k.a. the Devil)

June 13, 2013

If you read my earlier post about choosing an oncologist, I decided to see an oncologist whom I had heard was very good, even though one of his patients thought he was evil (compared him to the devil.) Unfortunately, I think she really was just feeling overwhelmed by her fight with cancer, the evil, invisible foe that she had to battle on an uneven battlefield, and her feelings were transferred to the doctor who oversaw her care.  On Thursday, June 13th, I met with this doctor.  It was a pretty standard checkup.  I began by filling out another set of new patient forms.  The nurse called me back and recorded height and weight.  She then checked my vital signs—blood pressure, heart rate, temperature, and oxygen saturation.  Then the doctor came in (he didn't evenly remotely resemble the devil) and asked me in person most of the same questions that I had answered on the new patient forms.  I guess he didn't have time to read them before he came in.  He gave me copies of my pathology reports from the biopsies and surgery.  He reiterated that he saw no need for me to have chemotherapy or radiation, which was welcome news.  He said there is a slight chance that some women may develop the same cancer on the other side in the future, perhaps 10%.  He explained the option of taking oral medication (called chemoprevention medications) for five years that could reduce the probability to about 5%.  There are some side effects, however, which could include higher risk for blood clots, stroke, and uterine cancer. I elected not to take the medicine, and he was okay with that.  I will just use watchful care.

I asked the doctor about having a letter of medical clearance signed so that I can go on my mission.  He said he thought by the time I got my bags packed I would be healed enough that my surgeon would  give me clearance.  I told him that the surgeon told me I would most likely get clearance from the oncologist.  Which one was going to give the final word so I could go?  He said, well, if you have the form I can sign it right now.  Of course I did not, and I wasn't even sure what the procedure was.  So I went home and called the Senior Missionary Department and asked them.  I was told that the doctor just had to sign a letter stating I was healthy and fax it to their office.  One office or the other will fax a letter by Monday or Tuesday, the 17th or 18th, and then the Mission Department representative will contact the Mission President and find out if and when they are ready for me.  At first, this made me a little anxious.  I hope that they didn't decide that I would need an office mission or to sit on a chair and greet people at the temple or visitor's center for two years.  I really hope I can have my original assignment.  After thinking more about it, I will just wait and see what they decide.  I am sure that whatever they want me to do, it will be a wonderful experience.

I don't have any regrets about my decision to skip reconstructive surgery, but the harsh reality is that it is kind of hard to look in the mirror every morning and every night now, and I have not been too keen on going out in public either.  So Friday morning, Teresa and I went to a post-mastectomy specialty store in Salt Lake City.  It only took one hour and $400 to provide a new look that makes me feel almost normal.  The English language has a lot of interesting sayings, but from here on out you probably don't want to tell me that you need to "get something off your chest."  I am not certain how I would respond, but one or the other or both of us could end up being embarrassed.  At the very least, we will have a good laugh.

On the way home from Salt Lake, we stopped at the Outlets at Traverse Mountain and purchased a few more items for my mission.  Just a few blouses, some slacks, and some shoes left to buy and I am almost ready to go.  I finished out the weekend doing a lot of running around and hanging out with family.  Friday afternoon I babysat for Ammon and Abby so they could go to the temple.  As soon as they got home, I drove two hours to Richfield to attend the Miss Teen Sevier pageant that Kadance was in.  By the way, although she was one of the youngest girls in the pageant, she did an excellent job.  I was so proud of her.  We stayed up until 1:00 a.m. talking and then I went to bed for a few hours.  After my morning walk (about 2 1/2 miles) I ate breakfast, visited a while and then drove back to American Fork to get ready to go to Tycen's wedding reception in Stansbury Park (about one hour away).  Teresa went with me also.  I enjoyed her company this weekend.  It was fun to see Jim and Marilyn and all of their children and grandchildren as well as Danny and Joan and their boys.  We visited about 1 1/2 hours and then drove back to Teresa's and picked up her boys and I took them to dinner to celebrate Teresa's birthday (which is actually Sunday).  Sunday morning I volunteered to sit with Teresa's boys while she and Brian went to church.  They both enjoyed being able to attend their meetings without the rowdy boys.  After I attended my meetings in my home ward in the afternoon, I went back to Teresa's and ate a Father's Day/birthday dinner with her family, complete with "birthday pie" and ice cream.  What a busy, fun, fun, fun weekend.  I feel almost normal again.

Random Thoughts

Have you ever experienced an increased awareness of how many of the same make and model of your current automobile you seem to notice on the road?  When we started driving a Suburban, I began to notice how many Suburbans there were on the roads.  (Well, in Utah, that may not be a good example.  There have always been lots of Suburbans on the roads because that is a great vehicle for large families!)  Now that I drive a Subaru, I seem to notice every Subaru that drives by.  Is it because of a human need for commonality with others?  

Yesterday when I went to the doctor's office for my first postsurgery appointment, I felt a bit uncomfortable being in public for the first time since surgery.  I tried to look inconspicuous so people would not notice that something seemed to be missing.  At the same time, I found myself casting furtive glances at other women I passed to see if there was any indication that we had recently been through the same experience.  I smiled to think I was just looking for "Subarus".

Last night before I went to bed, I was looking at family Blogs.  I came across news items and pictures that reminded me of Anson's two-year battle with cancer many years ago.  I tried to imagine the impact it had on him at that moment in time.  Even though I silently watched his struggle, I don't think I fully comprehended how hard it was for him.  I am so thankful that he is a survivor.  I think he has more compassion because of it.

When I was driving down for my first doctor visit after receiving word that I now had cancer, I received a confirmation that everything would be okay.  Heavenly Father just needed me to have this exercise in compassion so that I could be a better missionary and representative of Jesus Christ.  Looking back, although it was a hard thing to go through, I can't help but feel like somewhat of a "cheater" as a cancer survivor.  Unless there is a sudden change of opinion, the doctors do not think I need to have either chemotherapy or radiation.  In a matter of weeks, the threat of the beast has abated, and I can look forward to pursuing my goals with only minimal interruption.  I began to wonder if I can call myself a cancer survivor at all in a battle where I didn't even have to draw my sword.

The Week After

The Week After

June 5th, marked one week since surgery.  Time seems to go so slowly when there is nothing to do but sleep, read, eat, sleep, watch TV, and sleep.  Although I feel like I am healing quickly, my strength is not returning as quickly as it did after I had a baby.  The lapse of 25 years since my last baby may have something to do with that diminished capacity to rebound.

I waited the recommended 3-4 days before removing the dressings to take a bath or shower.  I thought it might be an emotionally disturbing event to view my altered image in the mirror, but it wasn't so bad.  I think I can live with this.  I bathed, and then contemplated leaving the Ace wrap off afterwards because it was a bit uncomfortable.  Without it, there was really no easy way to hang the JP drain pump, so I replaced it the best I could without help.  Only a few more days and then hopefully it would be gone along with the drain tube that caused a certain degree of disfigurement as well as discomfort. 

On Thursday, the 6th, I went to my followup appointment with my surgeon.  While I sat in the waiting room, I decided to look up the oncologist that I had been thinking of requesting for my postsurgical care.  One site caught my attention as it promised some reviews from previous patients.  There were only four reviews.  Three of them were pretty much standard reviews-just mark the categories as agree or disagree.  The questions dealt with things like was it easy to get an appointment, was the wait time short during my visit, was the staff professional and friendly, was my problem accurately diagnosed, did the doctor spend enough time with me.  As I said, three reviews were excellent.  The fourth was a bit strange, but I was interested to see why this patient did not recommend the doctor.  She said things like:  He was evil.  Sitting in his office was like being in the room with the devil.  He has nothing on his mind but to sign you up with death,   She went on about the poison and radiation that they try to fill your body with.  In spite of her warnings, I decided that I would like to see this doctor.  Maybe I am just a bit curious about the devil thing

Another search brought me to a blog page of a person who had experienced double mastectomy.  She had a very good outlook on her experience.  She also had the same doctor that I did and the same oncologist that I chose.  She went into great detail about the procedures such as the MRI and the PET scan.  After surgery, she described the office experience of having the drains removed.  After reading her description, I had almost decided to inquire if mine could be left in permanently.  Why didn't I think of bringing along someone who could squeeze my hand during the procedure?!  I took comfort in the fact that this lady revealed in her Blog that she is an actress.  Maybe she was just being dramatic.  But before I could change my mind, the nurse called my name and took me back to the exam room.

The first part of my visit was with the nurse.  First item of business was to determine if the drain could be removed.  The conversation went something like this.

Is there a reason that you are still wearing the Ace wrap?  Do you feel more comfortable with it on?  Not really, I reply.  It is actually kind of uncomfortable at times when it pinches the tube against my flesh just right.  I didn't tell her that I just couldn't figure out how to keep the drain pump in place without it short of pinning it to my skin.  I told her that I did not want to keep it as a souvenir and we moved on to the examination.

Well, things look good.  I think we can remove this drain.  First I have to remove a few stitches.  The doctor puts them in so tight it might hurt a little bit.  I apologize ahead of time.  There, that's the first one.  (I kept waiting for the pain.  It really wasn't bad at all).  The next one is a little tighter.  (Yes, that one pinched a little.)  There we go.  Okay.  Now, we want to establish a pattern of deep breathing.  (The last time I heard that was during childbirth.  After all that I have been through in the past month, is the worst part going to be removal of a little drain tube?)  Okay, deep breaths.  In and out, in and out.  This really doesn't hurt that bad.  Most people say it just feels kind of weird.  (With that, there was a little flip-flop movement similar to movement of a baby in the womb—or gas—only higher in the chest area, and the drain was out.)  "Is that all?" I asked.

After the drain was removed, the doctor came in and inspected the incision.  Things look good to her also.  The visit was short.  She assured me that there were no hormone receptors indicated in the pathology report, which meant no chemotherapy or radiation was necessary.  To be sure, she referred me to an oncologist, the one I requested (in spite of his similarities with the devil).  She also gave me a prescription and referral to a place in Salt Lake City that could help me with a prosthesis in a week or so.  She gave me a big hug and told me to enjoy my mission.  It took a second before I could swallow the lump in my throat and respond.  "I am sure I will."

"I am sure you will too."

Thirty-One Days

Thirty-one days ago, I sat in a dermatologist's office following up on an impression that I might have breast cancer.  She did a punch biopsy that day to get the ball rolling.  The eleven days between the biopsy and the call from the dermatologist about the results was such a long time.  Looking back, it seems like an eternity.  Since May 3rd, so much has happened; has it really only been 31 days?  An ultrasound, an MRI, another ultrasound, another MRI (with biopsy), chest x-rays, blood draws and finally surgery.  Today, the pathology report came back.  The doctor called and was very happy to report good news.  The lymph nodes were clean.  10 of the 13 biopsy samples had DCIS (ductal carcinoma in situ) so it was a good decision to do a mastectomy.  However, there was no invasive cancer.  No hormone receptors were indicated.  For followup care, there really is none!  No radiation.  No chemotherapy.  I will see the doctor on Thursday to have the drain removed.  She will refer me to an oncologist, which is basically a formality to receive medical clearance.  As soon as I am strong enough, I can proceed with mission plans.  I am so blessed.

Levels of Recovery

Friday, May 31, 2013

Besides quite a few phone visits, today more family came to visit me: Teresa and her boys, Aaron and Sherri and their kids, and Heidi and Bryce and their boys.  I probably overdid it, but I enjoyed a short walk outdoors, sitting and visiting, eating pizza, and playing Ticket To Ride for a while.  All in all, it has been a great day.

Saturday, June 1, 2013

Whoa!  I'd better slow down a bit.  I still feel pretty good, but there is more "pinching" pain around the drain tube that makes me not want to move too much.  I spent a good part of the day in bed and slept a lot.  No walks today except to the kitchen and back.  Frank and KayLyn Shaw stopped by in the evening to bring some flowers from Anson and Lora.  We had a nice visit about the great thing we have in common—our amazing grandchildren.  I like them and enjoyed our short visit.

Sunday, June 2, 2013

I slept really well last night.  I could enjoy sleeping on my side again, so that is probably part of the reason.  I seldom sleep on my back, and when I do I often wake myself eventually with snoring.  The pain is so much better now with only occasional pinches and good range of motion in my arm.  I just still feel kind of weak and get tired easily.  I took the time to take a sponge bath and wash my hair.  It was a little harder drying it than I thought it would be, but I managed.  Maybe I should have waited a little longer.  Teresa called to see if they could come keep me company while Ammon's family is at church.  Another enjoyable visit.  

I finished reading the book that Teresa loaned me, Remembering Isaac by Ben Behunin.  I enjoyed it, light reading I would say in the range of young adult fiction.  There are two more books, Discovering Isaac and Becoming Isaac.  Hopefully reading the other two won't change my opinion of this author.

I think one of the important lessons that I learned from reading this book is about the worth of all men in the eyes of our Creator.  Isaac, the potter of Niederbipp, had a collection of flawed pottery that he felt was his most prized possession.  Each piece had something wrong with it.  It was either unintentionally created with a flaw or had become flawed with use.  Most people would just view it as a bunch of broken junk.  I think the potter cherished it in much the same way that Heavenly Father loves each of us, even though not a single one of us is perfect.  We all came with flaws or developed them by our own choices or the actions of others.  But in spite of it, he still loves us.

I watched The Tabernacle Choir and the Spoken Word this morning.  A few scenes from the new series, Granite Flats, was shown so I checked to see if I would be able to watch the episodes starting with the first one on BYU TV online streaming but couldn't access it.  I don't want to start in the middle of the series so will have to figure out how to watch that another time.

I picked up the book again that Heidi gave me for Christmas, For Times of Trouble by Elder Holland.  Each time I pick it up it seems that the particular verses in Psalms are just what I needed that day.  Today, I picked it up and read "I am like a broken vessel" (Psalms 31:12).  "The sacrifices of God are a broken spirit; a broken and a contrite heart, O God, thou wilt not despise." (Psalms 51:17) 

Elder Holland says "Sometimes the events of life can damage our highest hopes and dreams.  Some of our sweetest possessions and most cherished ideals end up being bruised, and sometimes they are broken….We are certain that as with Humpty Dumpty all the king's horses and all the king's men will never be able to put us together again.  But someone wrote once that God apparently loves—and turns to our benefit—broken things.  It takes broken clouds to nourish the earth, it takes broken earth to grow grain, it takes broken grain to make bread, it takes broken bread to nourish us, and so are the cycles of life..." 

We are still required to sacrifice, but not in the same way that the children of Israel sacrificed. 

"…we were commanded to offer newer symbols of Christ's Atonement:  "Thou shalt offer a sacrifice unto the Lord thy God in righteousness, even that of a broken heart and a contrite spirit."

   "It may be that among all the broken things God loves, He loves a broken heart most of all…Know that God will accept your offering and that, through the great miracle of the Atonement of Jesus Christ, He will give your heart back to you healed and whole.  That is the ultimate truth taught by the Resurrection.  Christ, the Great Healer, will make recompense for us in time and in eternity.  By His grace and the goodness of God, all broken vessels are fully repaired."  (Jeffrey Holland For Times of Trouble, p 69-70.)

Surgery and Beyond

Surgery

May 29, 2013

I rose early on Wednesday and showered and dressed.  As instructed, I used no hair products, lotions, perfume, deodorant, or makeup.  Maybe I should adopt this grooming style permanently.  It could be a bit scary to others, but it sure cuts down on time spent getting ready.  I was ready to go well before Heidi arrived at 7:15, and we arrived at the hospital before our appointed 7:45 check-in time.

First item of business was to go over to Radiology for a chest x-ray and a blood draw.  I was given the usual hospital gown that ties either front or back depending on the procedure.  They are considerate enough to provide two gowns now so that one can be worn frontward and the other backward, thus providing maximum privacy when ambulating the hallways.  After x-rays, we went back to Same Day Surgery for preoperative preparations.  Here I was provided a lovely new ensemble consisting of a pair of stylish one-size-fits-all "privacy briefs" and a gown that opened in the back.  This was not the normal cotton gown but a paper gown, lilac in color, with several openings similar to those in disposable vacuum cleaner bags.  Once I was dressed I resembled a lilac Stay Puft marshmallow man.  Heidi and I had a good laugh over that.  Once I crawled onto the table and the nurse plugged a "vacuum hose" into one of the openings, we discovered the true use of the gown.  Warm air was pumped into the gown that I could control with a dial for more or less heat.  No more complaints of being cold!!  This was awesome!

We had an unexpected wait before surgery because the surgeon had to perform an emergency appendectomy, which set her other surgeries back.  About 11:30 or 11:45 they finally wheeled me to surgery and Heidi went out to the waiting room to wait.  It was sometime around 2:30 or 3:00 when I first became aware of my surroundings again.  I was surprised that I had no recollection of going into the operating room or being transferred to the operating table.  I met the anesthesiology team one at a time while still in preop, but that was the last I remember seeing them.  I am just guessing when I say it was the most amazing experience I never remembered.  The left mastectomy was performed as planned, and the doctor removed three lymph nodes, none of which appeared to have cancer cells, so that was great news.

The next thing I remember I was comfortably settled in my room for an overnight stay.  A bouquet of flowers from Brian and Teresa sat on the night stand beside me.  The familiar quart-size water cup with the big fat straw next to the flower vase brought back memories of previous stays in the hospital when each of my children were born.  Those water cups never change.  With all the advances in medicine and science, I guess no one has been able to come up with a better design, or maybe it's the idea "if it's not broke, why fix it?"

The afternoon passed quickly.  Heidi stayed for a while and then returned to rescue Bryce who was watching the boys (with his mom's help I think).  Marilyn also came to spend some time with me.  Jim was on the road so was unable to come.  It was good to visit with her for a while.  When she left, KayLyn Shaw came over and visited.  She took me on a short walk around the hospital corridor.  When I was settled in for the night (as best as one can be in a hospital) I received a short visit from two dear friends who also happen to be in the Ward Relief Society Presidency, Molly and Kathy.  They apologized for not coming sooner but they couldn't find a patient named Colleen Hatch.  They forgot that I might be admitted under my first name.  It was kind of them to come and visit.

I don't know why I thought that I would get a good night sleep.  I settled down early enough, but the nurses had to check vital signs about every four hours, and in between those assignments, they checked about hourly to see if I needed anything and check on my pain level.  Each time I told them I was fine, I didn't need any medications, I just wanted to sleep.  They would say okay, get some sleep, but they didn't really mean it.

Thursday morning around 8:30 I talked to the doctor for a few minutes.  She said things looked good; I should be able to go home shortly.  She just needed to do the paperwork.  I called Ammon and said plan on probably more like an hour.  It was closer to 1 1/2 hours when he came to pick me up but I finally settled in at home by about 10:30.  I finally got to sleep for a few hours without interruptions.  In the afternoon I read a book that Teresa gave me and did a little tatting.  Then I turned in around 9:30 for the night.  It was probably the best night sleep I have had in a long time.

MRI Guided Biopsy

May 28, 2013

MRI Guided Biopsy

Appointed time—8:00 a.m.; arrive at 7:45.  Because it has been six years since I was at Utah Valley Regional Medical Center (for Verlin's end-of-life care) I wanted to arrive a bit early to allow for getting lost between the parking garage and the MRI wing of the hospital.  So I left home at 6:50.  I arrived at 7:15.  I had plenty of time to find my way, fill out paperwork, and get checked in.  It was probably closer to 8:30 when they took me back to get dressed and put in the IV line for the purpose of delivering contrast dye.  More waiting. 

"We're just about ready.  The doctor should be here by 9:00."

I'm cold. 

"We'll warm up a blanket for you."

(I began to think back on deliveries of my babies and how cold I would get.  I am not sure if the shivering was due to the cold or the fear/anxiety.  Having done it nine times before, I was especially conscious of this when I had Teresa.  I told Verlin that I didn't really think I could go through it one more time, but I sure am glad I did, Teresa!!)

They did warm a blanket for me today but it took a while before they could actually put it over me.  First they had me climb up on the table, put elbow pads on my arms, hooked up the contrast feed to the IV tube, and positioned me and repositioned me and repositioned me on the table.  Then they had me sit up again while they made adjustments to the table to accommodate my body habitus.  Finally they were ready to begin.

The nurse helped me put the earplugs in this time, and they were in much better than last time, so the noise was actually tolerable.  After a few pictures were taken to locate the mass of interest and what seemed like a very, very, long wait, the techs and the doctor came back in and performed the biopsy.  They placed a marker in the predetermined site and then went out and checked with the MRI again to see if they had it placed where they wanted it.  They came back and said we need to make a little adjustment.  They placed a second marker and rechecked with the MRI.  Deciding that they were in the best spot, the doctor then used a core needle and withdrew about a dozen tissue samples.  By the time he stopped, I felt like there would be nothing left to be removed with the lumpectomy tomorrow.  The doctor tried not to make comments about size, but he did say something about things being very tight because of the "small margins".  The tech said if it had been 1 mm smaller, they probably wouldn't have been able to perform the biopsy.  Well, it was accomplished, and I then went to mammography for a couple images to check the position of the markers.  That was all there was to it.  It was now 10:45.  All that remained was to figure out which way to the parking garage so I could go home.

Now on to my next appointment.

The Bone Scan

My afternoon has not been extremely hard, but neither has it been extremely uplifting.  About 12:00 noon, the doctor's office called me and left a message that I should call them back after their lunch hour, which ended at 1:30.  My bone scan appointment was at 1:30, so I told them that I would be ready as soon as I called my doctor.  The nurse told me that the doctor who did the biopsy was concerned about the tissue samples that he had removed.  Even though he couldn't say if they were malignant or benign, it was his recommendation that I have a mastectomy, not just a central lumpectomy.  That means an overnight stay and more recovery time, but I won't let that get me down.  I want to be sure we get all unfriendly tissue removed.

The bone scan was not nearly as uncomfortable as the MRI and it was fairly brief.  Well, actually, it wasn't uncomfortable at all.  The results showed that there has been a bit of bone density loss since my last scan five years ago.  The spine area is now designated as having osteopenia, which means pre-osteoporosis stage.  I will just continue to use calcium supplements and exercise to try and maintain skeletal health

After I came home from the clinic, I decided to go pick up a couple items at the grocery store.  I took one of my new umbrellas with me in case there was a downpour while I was in the store.  In retrospect, that wasn't such a good idea.  My mind was not too focused on what I was doing, and when I left the store, I left my brand new umbrella in the shopping cart.  I realized it when I got home and immediately returned to see if I was lucky enough to find it still sitting in the cart.  No such luck.  I checked with Customer Service and with the baggers who handle the carts.  No one had seen the umbrella.  I felt like the person who found it might still be in the store, so I wandered through the store to see if I could spot it.  No.  I guess it walked out of the store shortly after I did, because I could not find it now.  I hope the new owner appreciates it as much as I did.

About 4:00 p.m. I got a call from Same Day Surgery to inform me that check-in time on Wednesday is 7:45 a.m.  First, I must start a fast after midnight tonight--nothing by mouth including water, gum, or mints.  If I can brush my teeth without ingesting any of these things, that is okay.  I have been given further instructions, which although I know they are necessary for safety and sterility, they seem to add insult to injury.  I can bathe or shower and shampoo my hair prior to surgery, but no other hair products, no makeup, no lotions, no deodorant, no perfumes, and no powders.  So where does that leave my self-esteem?  I will be going into surgery with very little dignity, and will come out with even less, losing part of my person, part of my womanhood.  But do you know what?  I think it is okay, because I know who I am.  I am a daughter of a Heavenly Father who loves me, and no one can take that away from me.  The wonderful blessing of family is evidence of His love for me.  One by one my children all contacted me this evening to check in and see how I am holding up and to offer me their support.  I am truly blessed.

Like a Whirlwind

May 19, 2013

A Blessing of Comfort

Although the first two weeks between having my breast biopsy and receiving the results seemed to go so very slowly, the last week has been a blur of activity that has found me literally gasping for air at times.  On Sunday, the 19th, I drove from Clearfield to American Fork, met with my Bishop and let him know that I had cancer and would have to postpone my mission date.  I then attended Sunday meetings in 12th Ward.  I was reluctant at this point to say anything to others about my condition because I didn't want to have to do a lot of explaining.  I knew that once one person knew, everybody would be asking questions and casting sympathetic glances.  I wasn't quite ready to explain things over and over again, so I just kept silent.  I almost decided to slip in the back of the chapel for Sacrament Meeting and then just go home until 5:30 when I would go to Ammon and Abby's.  Pearl Bown came right over and gave me a big hug and we talked for a few minutes.  Then Pres. and Sis. Clarke came and sat down next to me.  It wasn't long before I felt like my eight months of absence from 12th Ward was swallowed up in warm greetings as if I had never been gone.  I enjoyed attending all three meetings and was greeted warmly.

Ammon and Brian said they would give me a Priesthood blessing after church.  I invited the Bishop to attend as well and take part in the blessing.  I am always grateful for the peace of mind that I am given whenever I have a Priesthood blessing.  My feeling afterward was that I am not going to have a long, difficult ordeal.  Well, I don't know about the difficult part, but I will still have the opportunity to serve a mission, whether now or later. 

While I was driving to American Fork from Heidi's, the thought came to me that this delay was necessary to help me learn some lessons that I have not yet learned.  It has everything to do with learning to be charitable and seeing others with pure Christ-like love.  The service that is rendered in my behalf at this time I need to turn around and give to others when I am on my mission, so I had better pay close attention and figure out how to give freely.  I know that I am going to have to accept help from others, which is hard for me to do sometimes.  I don't want to impose.  I know that everyone's time is valuable, and I don't wish to take away from others to fulfill my needs.  I found out that it is really hard for me to accept gifts of love from others.  Ammon and Abby have reached out with that pure love to help me feel comfortable while I am going through preoperative procedures, surgery, and recovery.  I scarce can take it in.

May 21, 2013

Meeting the Surgeon

The remainder of the week passed quickly.  On Monday, the surgeon's office called to confirm my appointment at 9:00 a.m. on May 21st.  I was surprised by this because I had asked specifically for the 2:30 appointment to give me a chance to drive to American Fork without dealing with rush-hour traffic.  They had placed my name in the wrong slot, so I went down Monday night, stayed with Teresa, and then the two of us went to my appointment together.  The surgeon performed a quick evaluation and then did an ultrasound with her portable machine, which did not reveal anything.  We talked about options for surgery which would be based on the outcome of additional tests and findings at the time of surgery.  I would be looking at the best case option of lumpectomy with lymph node biopsy or in the most extreme case a mastectomy with removal of all breast tissue and all lymph nodes.

The surgeon's nurse asked me to drop off a registration form at American Fork Hospital in preparation for surgery on Thursday, the 23rd.  Since I would need an EKG before surgery, I had that done after I completed the paperwork.  Later that day I was scheduled for the MRI at American Fork Hospital on Thursday, the 23rd, 1:00 p.m.

At this point, I was thinking that I would be making a lot of trips to American Fork in the next few weeks, so I moved from Heidi's to Ammon's a little sooner than I was thinking.  It was just easier as far as scheduling to be here and be able to accept any times the doctor and hospital may set for procedures.  When I came Tuesday to see the doctor, I brought some of my things with me.  Wednesday night, Heidi and I sat down together one last time to watch a Netflix show, something we did often to unwind after the boys were in bed.  On Thursday morning, the 23rd, I brought everything except my desktop computer and table, which Heidi said she would bring when she comes.  It was a lot harder than I expected to leave Heidi's that morning.  I have enjoyed my time with her so-o-o-o much!  No, it wasn't always easy.  There were schedules to juggle often, and challenges with trying to help Isaiah understand that Grandma wasn't there to take his Daddy's place, just to help out until he came home.  Before I left, Isaiah was very loving and accepting of me and we had a great time.  I would like to think that he might miss me a wee bit, but in reality, I think he is just eating up all of the special time he and Bryce are spending together and not giving Grandma Hatch much thought.

MISSION ASSIGNMENT CHANGE

I had told the Missionary Department contact that I would let them know as soon as I had a possible schedule for my surgery, recovery, and followup treatment so that they would know how to proceed with adjusting the schedule for my mission assignment.  They decided to change my mission start date to September 1, 2013.  I think I will still be in the Washington D.C. North Mission.  I hope this date will work for all of us.

  

May 23, 2013

The MRI (Magnetic Resonance Imaging)

On Thursday morning, I arrived at American Fork Hospital a few minutes early, checked in, and proceeded to the Radiation Department for my MRI of the breast region.  The technician was very congenial.  She explained everything that was going to happen and kept up a dialog during the 20-30 minute procedure to make sure I knew what was going on and what to expect at each stage.

To say that it is a noisy machine is an understatement.  Even with the earplugs that she provided me, it was hard to hear myself think, but I could hear her talking to me via a microphone, I think, when she was not taking pictures.  I was a bit concerned going in that I might have an episode of dry cough that I sometimes get.  But I did not cough and was able to hold completely still the entire time.  Well, as still as possible.  I tried to breathe normally, but found myself breathing with shallow breaths so as to not move my chest too much.  After a while, I had a feeling almost like hyperventilating and decided I had better breathe normally.  This helped.  To help me relax when I was getting too anxious, I recited in my mind The Family:  A Proclamation to the World and The Testimony of the Living Christ which I had memorized but not reviewed in a long time.  Sometimes it was hard to stay focused, but it allowed me to escape the noise and chaos in the room that was drowning me and concentrate more on the words of these wonderful documents.

About 4:00 p.m. the surgeon called me and told me that the MRI had revealed a lump directly under the nipple and an additional area of concern away from the nipple that was questionable tissue.  She said the radiologist was good and she trusted his interpretation, so she wanted to find out more about the tissue he had seen which was inconsistent with the right breast.  So she scheduled an ultrasound for the following day with a possible biopsy if the more sensitive hospital machine happened to pick up the "abnormal" tissue.

May 24, 2013

Ultrasound with possible biopsy

I arrived at 12:45 and went directly back to Radiology again.  This time I was taken to a room that was set up for me to get an ultrasound.  If they were able to pinpoint a questionable mass or tissue, they would do a needle biopsy to see if it was malignant or benign.  The technician seemed surprised that nothing was clearly visible on the ultrasound images to indicate a mass.  She called the radiologist in (who just happened to be my former Bishop), and he tried to identify something also.  He said he was very certain that they would find something with the ultrasound.  Since they did not, the surgeon wants me to get another MRI, this time with biopsy.  American Fork Hospital does not have this type of MRI machine, so I will be going to Utah Valley Regional Medical Center for this procedure on Tuesday, May 28th, the day before surgery.

Two things I have learned

Too much time on my hands, and too many days of waiting have led me to seek information from the oh-so-wise internet.  It has been helpful to learn a little more about Paget's disease, how it is diagnosed, what the indicators are that determine the path of treatment, how it has affected others, and what the prognosis is based on the timeliness of the diagnosis.  Here are two sure things I have learned (so far):

Culprit--Paget's disease is like a thief in the night that tiptoes silently and then lets someone else take the blame.  In the majority of cases, it is not discovered until it has advanced to an invasive form of cancer for which the patient is treated, not Paget's, often not aware it was even there.  I am oh so hopeful that since it has been discovered in my body with no outward signs, maybe it is early enough to give the thief a fair and speedy trial and eradicate it swiftly.

Relief---I don't like it when I am not in control.  I did have control of the fact that something bothered me and I consulted a physician.  Even when that physician did not agree with me, I persisted, and he said by all means get a biopsy.  That is when I began to relinquish control to the doctors.  I went to the doctor according to their timeline and waited.  I went to the dermatologist according to their timeline and waited.  I received news of the pathology results---on their timeline.  I was referred to a surgeon---and waited, again on their timeline.  I will have to make many more concessions in the future, I am sure---BUT at the first sign of the gravity of my situation, I freely relinquished ultimate control to the Lord, and that is a good thing.  I just need occasional reminders that although I have not chosen this burden, I can choose to lay it at my Savior's feet, because He has already experienced my pain and sorrow in this matter and is therefore able to walk me through it unscathed.

In the interim...

May 16, 2013

The dermatologist told me that if I hadn't heard from the surgeon by Thursday to call her back.  I waited for a few hours on Thursday, still hopeful that the surgeon would call as soon as she received my results.  I guess she didn't receive a note from my dermatologist saying that this matter should be handled in STAT fashion.  Maybe I should have volunteered to courier the report from the pathologist's office to whomever would be most interested in it.  (That would have been me.)

When no call came by noon, I called the dermatology office and said I hadn't heard anything yet.  Her receptionist assured me that she had faxed the reports over but if I wanted to call them myself (as in "you are being very impatient, but...") she would give me the surgeon's phone number.  I called the number and stated specifically that I wanted to talk to the doctor or her nurse.  She said, "it's the doctors' lunch hour.  You will have to call back after 2:00."  When I called back, I was told, "Oh, she is not at this location."  And she gave me the number for her American Fork office.  When I called the American Fork office, they did not "have me in their system" so it didn't appear that they had any information from the pathologist yet.  Since the dermatologist gave me a Provo office number to call, I assumed that they had also sent the pathology report to the wrong office, so I asked if  she would please check on that for me.  She said she would do that and get back with me "in a few minutes."  Two hours later, I finally called back to see what she had found out.  She said "Yes, we've got the report now.  I will show it to the doctor and get back with you."  After talking to the doctor, she said "The doctor can see you next Tuesday at 9:00 or 2:30."  I was disappointed that I would have to wait another five days, but I accepted the 2:30 appointment.  In my head I am screaming--"Don't you know that I only have 44 more days before I am supposed to be going on a mission?!"  Parker, I guess you were right about seconds being longer for girls than they are for boys.  And I think seconds and minutes and days are VERY different for doctors!  They may think they are being prompt, but I think they need to try and view things from a patient's perspective.

The Diagnosis

May 14, 2013

The Diagnosis…

I have been waiting almost a week and a half to hear from my dermatologist.   It has been a very long wait.  On Friday, the 10th, I called their office to see if they had heard anything.  It had been a week, so just maybe the pathology report was back.  No luck.  So I waited over the weekend.  I decided to give them one more business day to give me a call, and if they didn't call on Monday, I would call them again Tuesday.  Monday night I received some transcription work to do the next morning so this took my mind off of my worries for a while.

I began Tuesday morning with my usual routine--prayer, scripture study, and exercise--before I began to do my transcription work.  In addition, this morning I was prompted to take out the book that Heidi had given me for Christmas, a book by Elder Jeffrey Holland entitled "For Times of Trouble."  It is a collection of short writings about some of his favorite passages from the Book of Psalms.  Instead of reading a chapter, I took out the DVD that came with it and listened to a couple sections of the video.  The first one was "How do I lay my burdens at the Savior's feet?"  The next one was "The importance of following promptings."  One of the passages that he mentioned in this second discussion is in the eighth chapter of Romans, two thoughts in particular that can help us get through tough days.  First is Romans 8:28.  "And we know that all things work together for good to them that love God, to them who are the called according to his purpose."  The other thought is verse 31 in the same chapter:  "What shall we then say to these things?  If God be for us, who can be against us?"  Those two verses can go a long way to sustain a person in times of trouble.  With God on our side, it doesn't matter who or what is against us.  And remember, ALL things work together for our good if we love and trust the Lord.  We may not like what comes our way, and we may not understand it yet, but it will always work out for our good, whatever that may be.

Having listened to those two talks by Elder Holland, I was armed for the day before me.  However, before I took the time to give Dr. Eberting a call, I received a call from her at 10:38 a.m.  She got right to the point and said "Unfortunately, you do have Paget's disease as you suspected.  Fortunately, you caught it very early."  It seemed strange to feel a sense of relief, but that is the first feeling I had.  I was pretty certain that this would be the case; I just wanted to hear the official diagnosis and get on with the treatment.

Dr. Eberting recommended a capable breast surgeon in American Fork, Dr. Jennifer Tittensor, and said she would send the report to her via email and ask her to contact me as soon as possible.  Hopefully I will hear from her in a day or two or I will be calling again.  When I got off the phone with Dr. Eberting, I took a minute or two to collect my thoughts and then called each of my children who were as anxious as I was to hear the pathology results.  I am so grateful for such great children (and their spouses).  They have always been so supportive and concerned about my welfare.  I don't doubt that we will get through this valley somehow and the next vista will be grand.  Towards the end of Romans 8 Paul says "Nay, in all these things we are more than conquerors through him that loves us." (Romans 8:37)

To Be or Not to Be

April 29, 2013 - Suspicion...

My mind has been clearer the last few days and my heart has been lighter since receiving and accepting an offer on my house on April 24th.  (Addendum:  That relief did not last long when I received a list of To Dos from the inspection.  Hopefully it does not hinder the sale of the home.  I am trying not to worry about that right now.)  Well, one less worry has allowed me to concentrate more on the direction of my life going forward as I anticipate my July 1st MTC date marking the beginning of a 23-month mission in Washington D.C.

Today I was reviewing the many uses of essential oils and formulating a daily regimen for the oils that I have purchased since being introduced to them.  I have come to love these oils.  Some do not smell the greatest, but I have seen positive results from the ones I have used to treat the symptoms of colds, nausea, headaches, anxiety, and sore, achy muscles. 

As I spent this morning reviewing the uses of my essential oils and how to apply them, a thought came to my mind to look on the internet for the answer to a little nagging question that has been in the back of my mind for a couple months since I noticed an irregularity in one breast that I kind of wondered about.  But wondering was soon pushed aside by the tasks of my transcription work, busy days and nights with Heidi and her boys, and thoughts of my mission.   It was apparent to some of my children (especially my daughters) that the worry about being able to sell my house and get things in order in time for my mission weighed heavily on my mind.  They often observed me when I was doing my best to enjoy their company, but I was actually far away in another place with my tumbling thoughts.  At last, knowing that I would be closing on the house on May 24th, I could now think of other things.  Things like what clothes to buy for my mission; do I keep my cellphone plan active; what company will I use for my car insurance in Maryland; when am I going to receive more information from the Mission Home; and when should I finally follow up on the recommendation to call the sister missionaries and get some questions answered?

Today, out of the blue came the thought once again, "look on the internet."  I typed in a brief description of the symptoms I had noticed.  One phrase stood out as though it was in boldface type—Paget's disease, a rare breast cancer occurring in only about 1-4% of all breast cancers.  A quick survey of several of the sites was enough to convince me that this was the most probable diagnosis of my symptoms.

A flurry of emotions passed through my mind in the space of a few seconds.  First and foremost was the realization that there would be no way for me to serve a mission now—not in two months.  Why couldn't I have discovered this sooner?  Why didn't I check out the symptoms earlier?  I really think that in His mercy, the Lord knew that I could not handle one more worry until others were resolved.  In an instant the petty annoyances of graying/thinning hair, teeth that are not as white or as straight as I would like, wrinkles that makeup cannot hide, and glasses that make me look too old suddenly paled in the presence of the realization that I may not be able to go on a mission after all.  After further reflection and on a more serious note came this thought after which I had to stop myself from further reflection and take action:  "Maybe my call to serve a mission was just a way to put my affairs in order for my family, and my time here is going to be shorter than I thought."  Well, worrying doesn't solve anything, but it sometimes motivates people to action.  I picked up my phone and called my doctor's office to set an appointment for a consultation and exam.  I explained that I wanted to have an appointment as soon as possible because I only have two months to resolve my health issues so I can have a clean bill of health to go on my mission as planned.  I was given an appointment for the next day at 3:20.

April 30, 2013 - Consultation…

My daughter drove me to my appointment, not so much that I felt I needed her, but that she felt the need to be with me so I wouldn't be alone with my thoughts.  Nonetheless, I was grateful for her companionship.  I arrived at 3:20 for what I thought would be a short visit.  The visit was very short, but the waiting was long—40 minutes in the waiting room and another 20 minutes in the examination room before the doctor came in.  We talked briefly.  I explained my condition and suspicions and stated that I would like a biopsy to know for certain if I had Paget's disease or a simple case of dermatitis.  He did a quick examination and told me "Well, if that's Paget's disease, I'm a monkey's uncle."  If I didn't already have a good feeling about this doctor, his sense of humor, and his compassionate manner, I might have taken offense at his words and the way he refuted "my diagnosis."  He did agree, however, that it is best to be sure.  Cancer is not something that should be taken lightly.  However, he said he would rather have me see a dermatologist for a more extensive examination and possible biopsy.  The clinic's patient advocate provided me with a list of providers in the area who are on my insurance plan.  My first choice is the dermatologist who treated my children over the years, but unfortunately he was booked until October.  That definitely wasn't going to work with my plan.  I made a call to the first person she recommended, a female dermatologist in Alpine, Utah.  I was disappointed that her first appointment was not until May 10th.  That didn't serve to expedite matters either.  I would lose a precious 10 days.  Then she said, "Wait, there is an 11:45 appointment on the 3rd, this Friday."  I said I would take it.

May 3, 2013 - Second Opinion…

I arrived for my appointment with the dermatologist a few minutes early so I could fill out the necessary paperwork for a new patient.  After another interminable wait (that is a cool way of saying it was seemingly endless), I was called back.  The nurse who helped me sat down with me in the examination room and began asking questions.  A darkened computer screen sat on the desk in front of her as she scribbled notes on a piece of paper on the clipboard with my check-in papers.  She explained that the computer was not working and she didn't know how to get it to work.  She struggled to remember all of the questions that she was supposed to ask me since she didn't have the computer to prompt her.  After a long pause while she tried to remember the term "melanoma", she said, "This is my first day.  Give me a break."  Not please give me a break, just "give me a break" as if I was heckling her or something.  I wasn't even being critical, just sitting patiently and trying to make her feel comfortable.  Ironic, it should have been the other way around when I am the one facing the possibility that I may be facing a life-changing condition?  I was relieved, however, to hear that this was not the dermatologist, who I was told had more than 25 years experience and was an excellent doctor.

After another "short" wait, the dermatologist entered the room.  I briefly explained why I was there.  She had me sit on the examination table and she began her assessment of my symptoms.  I really don't know which would have made me feel better, if she had laughed in my face and said something about being a monkey's uncle, or if she had told me that I was very astute in my assessment.  Nonetheless, since she was more than a little concerned, she too felt it would be best to obtain a biopsy.  In relatively few minutes, she did a punch biopsy and applied a dressing.  She told me that it would take about a week to get the pathology results, but if I don't hear from her in two weeks, give her a call.

The Wait...