Jo Ann’s Journal

I finally get to meet my surgeon, Dr. A, today.  Even though I know my cancer is an early detection from the prior doctors’ describing it as small and very treatable, I am still anxious for a doctor who actually treats breast cancer to tell me what stage cancer it is and exactly what I can expect in treatment.

I go to the hospital at lunch to pick up the mammography & sonogram films and reports per the request of Dr. A’s office.  When I get back to my office, I hold them up to the window and look at them.  I know absolutely no more than I did before I looked at them, but at least I tried.

Then I pull out the reports.  I guess it’s my accountant nature, but I refuse to read the last one first (the biopsy).  Instead I read them in the order they had been taken, starting with my routine annual mammogram that first identified a possible problem.  I just about flip when I get to the sonogram where the tumor is measured.  I have only been told the tumor is really small, but have not been told the actual size.  It is 0.8 cm, which is about 1/3 inch.  I guess the reason that even the diagnostic doctor can’t feel it with her fingers is because it is so deep.  I don’t think of a 1/3 inch tumor as a really small, tiny tumor.

Bob meets me at Dr. A’s office.  I am surprised that Dr. A wants to examine me.  I figured this was just going to be a consultation based on the biopsy and films.  When she sees my very bruised breast, she whistles.  I guess everyone doesn’t bruise as badly as I have.  Half of my breast is black, yellow, green & blue.

She tries to feel the tumor with her fingers, but can’t.  She feels of my lymph nodes under my arms and says they feel fine (not swollen or anything).

Dr. A goes over all the mammography & sonogram film with us, explaining what she sees in them.  She even shows me that my right breast appears clear of dense places.  However, the left breast has several more, small dense places on it.  She says I will need to do a MRI on both breasts before the surgery to be sure there are no more malignant tumors.  She tells me that if there is anymore cancer, it will be visible on the MRI.  I ask her why we do invasive biopsies if a noninvasive MRI can show us the cancer.  It seems MRIs are really expensive.  She will have to justify my getting an MRI to the insurance company before they will approve it.

The prognosis is faxed over to the doctor’s office and I get to see it for the first time with Dr A.  She says the tumor appears to be a stage 1, but we will not know for sure until after the MRI & surgery.  If no more cancer tumors are found in the MRI, if the cancer has not spread to the surrounding tissue, and if the biopsies on the closest lymph nodes are clear, then it is a stage 1.  My tumor is elongate and appears to be contained inside a milk duct.   Chances are I will not have chemo treatment.  I will have radiation after surgery and hormonal therapy after that, because the cancer has estrogen receptors.  The cancer is a slow growing, nonaggressive cancer, which is very good.

We are going to put the surgery off about 2 weeks to let my bruises heal.  Dr. A indicates it will be easier to tell what she is doing during the lumpectomy if we let the bruising clear up first.  Being of the nature to get things done immediately, I wish we could move forward, but such is not the case.

In the mean time, I have an MRI to look forward to.  I am so glad we will be looking at both breast to make sure there is no more cancer present.  I want to get this all done and behind me quickly.

I will survive!  I will thrive! ~ Jo Ann

After I spend the morning and early afternoon at home alone, deepening my education about details of breast cancer, Bob manages to get off work.  I am so glad today was a planned vacation day.  I had the freedom to curl up in my recliner with my laptop and do my research without feeling guilty.

It’s time to get on with the scheduled vacation day.  We finally get out of the city and head across country on the small state and county farm-to-market roads.  I always find it relaxing to take a ride in the country.  Bob and I have several hours together in the car.  I share with him from my notes the details about the disease of breast cancer, the treatments and the possible side effects of those treatments.  While breast cancer is the primary thing on my mind, there is only so much I can say about it without repeating myself.  I know so little about my personal situation and where I am going to fall in the breast cancer matrix.  Surprisingly, Bob and I move on to other topics, coming back occasionally to touch on breast cancer again.

We finally get to my Cousins’ Gathering about dusk, instead of noon as originally planned.  There are 27 of us at the gathering this year.  It is good to be surrounded by people I love and who have known me my whole life, however I am not ready to go public with my breast cancer.  I am afraid they will either make a big deal out the cancer and I’ll cry; or proclaim that I don’t have anything to worry about and then I will fee undervalued, even though I hope I really don’t have anything to worry about.  Sometimes I’m not really sure why I react the way I do, and if it makes sense.

 This side of my family does not have a history of breast cancer in our bloodline, but we have certainly been touched by it.   My cousin Cary is here this weekend.  He lost his wife Donna to breast cancer 3 years ago.  My cousin Paula is also present.  Her sister-in-law had a mastectomy earlier this year.   These people have been hit hard by breast cancer.   I fear how they will react to my news, so I take the chickens’ way out and only tell a couple of my cousins privately about my diagnosis.

My sister Janis gets to the gathering even later than I do.  I meet her in the parking lot and tell her my news with no one else around.   She hugs me and I see tears in her eyes.  I tell her that it appears to be an early find and probably isn’t anything to be concerned about.  (Did I just say I didn’t want people saying that? – Ha!)  She tells me in a hushed voice that she is scheduled for a diagnostic mammogram next week, after having had a questionable routine mammogram this week.  The reality of the possibility of cancer is hitting her.  I feel so bad to put fear in her like that.  I start thinking about the women in my life this will affect – my daughter, my sister, my mother, and my cousins.  They can no longer say that breast cancer is not in our bloodline.  It has raised its ugly head.

As Bob and I go to the room that night, our conversation is centered on my cousins and what is going on in their lives.  Just as in the car earlier in the day, we move in and out of mentioning the cancer as we talk about other things.  I realize that life goes on and this is good. 

I have made it through my first full day of knowing I have breast cancer.  I can’t say I have found that peace that passes understanding that the Lord promises yet, but I have started dealing with my cancer.  In 24 hours I have moved from a state of shock, through a denial surreal stage, to facing this is happening to me, and finally to uncertainty about how other people are going to feel about my cancer.  Boy, I wonder what tomorrow will be like.

I will survive! I will thrive! ~ Jo Ann

I was diagnosed with breast cancer yesterday.  I’ve told my family and employer.    I awoke this morning with my first thought being, “Now what?”  I feel like I’m watching this happen to someone else, not me.  It’s a surreal experience for me.  I’m not angry.   I’m not scared.  I’m in new, unchartered territory for me and I don’t know what I’m supposed to do next.

Today is a planned vacation day from work so Bob & I can attend an annual weekend gathering of cousins at a country site.  Bob’s employer called him into work on an emergency, so we are not able to leave when planned.  That gives me the morning at home alone instead of getting on the road early.  This is a blessing because I tend to be a person of action, and I want to do something in connection with this “thing” that is suddenly in my life.  I decide the first thing I need to do is learn every detail I can about breast cancer.    I feel like I need to know a whole lot more than I currently know.

Since this is an unexpected opportunity, I turn to what is immediately available to me.  I watch the  Beyond the Shock video (see  http://www.nationalbreastcancer.org/About-Breast-Cancer/Beyond-The-Shock.aspx ), which I’ve watched before.  I guess it is only natural that I am much more attentive to every topic and bullet point than I was before.  By the time I finish watching and re-watching it, I have seven pages of notes typed on my computer.  I am especially interested in the stages/types of breast cancer, treatments and side effects of those possible treatments.  It all seems very pertinent now.  I think I must be either a stage 0 or stage 1.  Even though I’ve never heard of anyone with a stage 0, I decide that it is reasonable to hope for.

Later in the morning, my family doctor, Dr. M., calls me with some surgeon referrals.  The biopsy report has been sent to her.  She explains the expected process: 

·         Pick a surgeon & have initial appointment

·         Surgeon will hook me up with an oncologist

·         Have an MRI – it shows everything going on with the breasts

·         Have surgery

·         Start Chemo – probably 6 months, but may not be too intensive with a small tumor

·         Maybe do some radiation as well.

To hear the word “oncologist” referred to in reference to me is a shock.  All of a sudden the experience is no longer surreal, but very real.  Something inside me clicked.  This is happening to me.   I’m going to have an oncologist!   Even with a small tumor, this is still breast cancer and I still have to go through the process to get rid of the cancer.  If it had not been found, it would have continued to grow and eventually taken my life.  I am overwhelmed.

I pick out a surgeon, Dr. A, from the list recommended by Dr. M, and make an appointment.  I just can’t face the thought of the process that  Dr. M. laid out.  I decide that she just doesn’t know how early this detection is and I refuse to accept that my treatment will follow Dr. M’s list. I guess a little of my rebellious nature has surfaced.   

I am anxious to see the surgeon next week so I can find out what my personal treatment will actually be. 

I will survive!  I will thrive! ~ Jo Ann

My mind is numb.  This is crazy.  I just hung up the telephone from a doctor I’ve only met once, and don’t even know her name, informing me that I have breast cancer.  No one in my world knows but me.  I feel like I’m in a huge vacuum in a science lab and the rest of the world is outside my vacuum, unable to make connection with me.

Today is Bosses’ Day and I hear my fellow employees gathering in the kitchen.  It is time for a piece of a big cookie and a little laughter as the staff enjoy each other and honor Janelle, the Founder and CEO of NBCF.  I move to the kitchen, but even as everyone is laughing and enjoying friendship that comes from working together, I continue to feel like I’m in a vacuum.  I don’t feel overly emotional, I just feel empty and like I can’t breathe.  I try to act “natural,” and guess I succeed, because no one notices anything unusual.  I mention to Janelle, herself a breast cancer survivor, that I need to speak with her when she finishes the meeting she’s currently taking a break from.

Not long after we return to our offices, I am called to Neal’s office, the Cofounder, to help him with something.  Neal asks me again if I have heard from the biopsy. 

I answer in a weak voice, “Yes.  It’s malignant.”

Neal responds, “What?!”  I repeat my answer and am somehow strengthened by his response.  I feel like I can breathe again.  I explain that it appears to be an early detection and therefore shouldn’t be too bad.  I head back to my office.

Neal has lived through breast cancer with Janelle, and as Cofounder of NBCF, knows thousands of breast cancer stories.  Fortunately, Neal was wise enough not to believe me as I attempted to convince him and myself that my having breast cancer was not scary.

I am back in my office for maybe a total of 30 seconds when Janelle and the COO, Kevin, are out of their meeting and in my office.  Obviously, Neal had interrupted the meeting and told them my diagnosis.  I am surrounded with emotional care and support from them.  I can’t imagine having more supportive friends and employers. They tell me that my cancer probably has not spread, since it is small, and that it is probably very treatable.

I hope the hardest part is over, I’ve told someone that I have cancer.  I’ve talked about it.  Now, I need to tell my family.

As luck would have it, I have to tell my husband and kids one at a time.  My nineteen year old son, Danny, is home when I get home from work.  He meets me in the living room and asks immediately if I have the results from the biopsy.  I almost feel like he’s been waiting on pins and needles for me.  I tell him that the spot was malignant, but that it is small and probably has not spread.  I work really hard at not scaring him and it seems to work.  Danny is a very caring young man and I can just feel his love.  I’ve told one of the three most important people in my life that I have cancer and have survived the process without breaking down.  Danny was a good one to start with.

Danny and I meet my husband, Bob, at a computer store to take care of some pressing errands.  Danny wants me to tell Bob about the biopsy results in the store, but I don’t want to tell him there.  We head over to a burger shop for a quick dinner.  Once we are at a table with the food, Danny again prods me to tell Bob.  For some reason, I was afraid he would fall apart on me.  After all, this did not turn out to be benign like we thought it would.  I finally tell him that I got the results on the biopsy.  He responds calmly, caring and with strength.  I should have trusted Bob to be himself and respond the way the Lord has made him.  I don’t think he can get his mind around it yet, but he is definitely the man God provided as my help mate, to help me through this.  I feel so blessed, for the first time since I got the call from the doctor this afternoon.

Later in the evening, Laura, my 22 year old daughter, comes home from school.  She sits on the couch and asks what I know about the biopsy.  She asks a few questions and starts trying to figure out what happens next.  She seems so strong.  Laura is going to be a major help to me through the coming months.  I can tell her things and be comfortable that, although she has not experienced it, she understands.  Laura is engaged to be married and we are planning a wedding for in the spring, May to be exact.  There is much to do and she is excited and full of life. 

I have told the most important people in my life, my family.  I have told the people who are in my life daily at work.  Somehow, this makes my breast cancer real.  Tomorrow I start working on becoming a breast cancer survivor instead of a patient.

I will survive!  I will thrive! ~ Jo Ann

P.S. Please forgive me for being so long posting this blog.  I had a really hard time sitting down to write about sharing my news with others.  It was a very emotional blog for me.  Since I have drafted the next few blogs while I was trying to bring myself to write this one, entries should come faster now. ~ Jo Ann

I’ve just been diagnosed with breast cancer. 

My name is Jo Ann.  I am 55 years old, have a husband & 2 college age kids and am an accountant for the National Breast Cancer Foundation.  Our mission at NBCF is to help women get early detection of breast cancer through mammograms, because early detection saves lives.  I suddenly find myself betting my life on that statement!

I didn’t choose to have breast cancer, but since I do, I am going to share my experience as I walk through this, in hope that it will help someone else.  As I said, I’m an accountant, not a writer or orator, but sometimes God chooses odd voices.  I do not believe in luck or coincidence, so this must be something I’m meant to do.  I know one person this journal will help – me.  My voice is my own and NBCF is not responsible for my views or emotions as they may be recorded in this journal over the following months.  I will try to be transparent.  Here is my story.

A few weeks ago I signed up for the new Early Detection Plan (see http://www.nationalbreastcancer.org/edp/ ) on the NBCF website.  As I filled out the short form, I looked up to see when my last mammogram was.  I realized I was 6 months late on my “annual” mammogram.  Like many women, getting a mammogram is not something I look forward to. In the past I have been bad about doing my “annual” mammogram every 2 or 3 years.   I had committed to myself to be more diligent since joining the NBCF staff.   I was somewhat embarrassed to realize I had again let the date slip so far and I immediately scheduled my routine annual mammogram.

I got a call to come in for a diagnostic mammogram less than a week after my annual mammogram.  I was not worried because I have a history of fibroid tissue and no history of breast cancer in my immediate family.  I have had follow-up mammograms before to confirm that fibroid tissue was not a tumor.  It’s never been a problem. 

This time the diagnostic doctor wanted to follow up the diagnostic mammogram with a sonogram to look closer at the 2 spots in question.  This was something new, but I still was not very concerned.  After all, I knew it was just the fibroid tissue, not a malignant tumor.  I was put in a small waiting room designed for only one or two people, away from the other women in the main waiting room.  I felt like I was being isolated to not upset the other women waiting.    I was beginning to get very concerned.  I only had to wait about 15 minutes for the sonogram.

The doctor mentioned while she was doing the sonogram that one of the spots had changed since my routine annual mammogram 7 days earlier! The diagnostic doctor said one of the spots in question was indeed fibroid tissue per the sonogram, but that we would do a needle biopsy on the other spot.  As I left the diagnostic center, I rushed to my car to call my husband.  This was not going as anticipated.  I took an early lunch before going into the office to get my wits about me again.  I was really shook up and wanted to be calm and stop shaking before I got to work.

My biopsy was several days later.  I would have loved to just stay and get it done that day, but the diagnostic center’s schedule was, of course, already full.    The actual biopsy was not as bad as I feared.  There was only a little discomfort while I got the shots to deaden the area, and no discomfort while the actual sonogram guided needle biopsy was done.  The “needle” was more like a vacuum tube.  I’ve since found out that a needle biopsy is done if the tumor is deep or hard to reach.  I spent the rest of the day at home taking it easy and mostly sleeping.

The next afternoon I got a phone call at work from the diagnostic doctor.  She told me, “The spot in your breast is malignant.  You have breast cancer.”  The shock of those words can’t be expressed!  I felt like the world stopped and I had trouble focusing on what else she had to say.  I felt very isolated in my office, by myself, receiving such a report.  I always thought that you were called into the doctor’s office, and asked to have a loved one with you for support, when such a report was delivered.  She went on to say tumor is small and the cancer does not appear to be an aggressive type.   I wanted to drop the phone, but somehow managed to hang up the receiver in a controlled manner.

I have breast cancer.  My mind is having trouble wrapping itself around that.   I may be the first person whose breast cancer was found because of the new Early Detection Plan program at NBCF.  I keep thinking about all the times I put off mammograms, and what if I had waited another year or more this time.  Logically, I know that this is probably an early detection, and that my treatment should go well, but it still feels like a really, really big deal to me. 

I will survive!  I will thrive!  ~ Jo Ann