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