Cancer--The Back Story

I was diagnosed with breast cancer today.

I'm shocked and completely blown away by this news.  I feel like it came out of nowhere, but there has been a short history behind the discovery of my tumor.

Back in November, Stephen found a lump in my breast.  I also had a little bit of discomfort and pain, but assumed it was from starting to work out again, maybe irritation from my bra, or just the pain of checking and rechecking the lump.  I actually felt pretty stupid even making any kind of big deal about it because I had fairly recently stopped breast feeding and thought the "lump" might just be remnants from the change in breast texture when pregnant/breast feeding, or it was just a lymph node, enlarged from being sick.

I called my OB/GYN because it was close to the time for my annual check-ups, anyway.  The official year date was right around Christmas, and they were booked until January.  At the last second, I just casually asked, "Would it make a difference in scheduling to mention that I found a lump in my left breast?  Should I just wait until January, or do you think it would be worth coming in earlier?"  The nurse recommended coming in for a breast exam ASAP, "just to be sure."  During the next few weeks, I asked Stephen several times to check that the lump was still there, thinking it might shrink before I went in and I'd be the girl who cried wolf, or in this case, "breast lump!"   

At that November exam, my doctor--whom I LOVE--felt the lump, said that it was probably lymph nodes, but we should schedule a mammogram/ultrasound to check it out further.  I scheduled a mammogram, but the soonest I could get in was a FULL MONTH, December 18.

One day before the mammogram, the billing department called to inform me that I would be responsible for $832 for the mammo the next day because that was the negotiated rate with our insurance and it was subject to the deductible that we had not met for 2012.  I decided to cancel that appointment and at least wait until January when $832 would go toward a deductible that would apply to something for more than 2 weeks of medical care.   {Hindsight says that $832 is better than letting an aggressive tumor potentially double in size, but at that point, I was still convinced that this was going to be a whole lot of hullabaloo about a lymph node.}  

I ended up finding another women's imaging center that would only charge $254 for my treatment, and set the date for January 14, 2013.  I went about as normal through the holidays, through my entire family being sick, through regular life, and the day of the mammogram arrived.  I went while Stephen stayed with the boys.  I had the mammogram, which wasn't nearly as bad as I've heard people describe.  The tech went to discuss results with the radiologist to determine if the mammogram indicated that an ultrasound was necessary.  It was, since there was quite a bit of calcification in my left breast, and the lump was suspicious.  The ultrasound was very thorough.  The tech went to discuss the pictures with the radiologist again.  He actually came in and did some more pictures.  He explained that there was calcification all over and that the lump is an area that we need to look at more closely.  He told me that in the 30 years he's been doing this that he's never seen a mammogram or ultrasound like mine and that he wanted to discuss with some colleagues for some second opinions.  {I just assumed that he meant---for my age, that amount in only one breast, etc. but NOT cancer.}  Dr. Abdo suggested doing a biopsy, and we scheduled it for Wednesday, 2 days later.

A friend watched the boys while I went in for the biopsy.  It was ultrasound guided and more painful than I had expected.  A needle with Lidocaine numbed me up.  Dr. Abdo covered my eyes, explaining that I probably didn't want to watch the collection and it would be better just to close my eyes and relax.  Each collection was made with a larger needle that was inserted to withdraw small cylinders (or cores) of tissue.  Each time the core sample was withdrawn, the needle made a loud-ish snapping noise.  Dr. Abdo took 3-4 specimens first and looked at them under x-ray to confirm that he collected calcium.  He gave me more local anesthesia because I was feeling some pain in holding pressure to stop the bleeding on the insertion spot while he was x-raying samples. He took more samples to make sure he had enough cells for pathology.  Finally, a small metal clip was inserted into the lump to act as a marker for future testing or possible surgery. 

I guess when the procedure was explained to me, I imagined the anesthesia needle and one or two samples going in, then one more needle to put in the marker.  I wasn't expecting 7 cores of cells being sucked out of my breast, all the maneuvering of needles to collect in the exact spots, the 'pop' of the core sample needle, and the emotional stress.  Toward the end, I just kept wondering how many more times they needed to dig out tissue.  How many more of those jolting clicks was I going to hear/feel?  I tried to keep it all together, but during the 2nd round of sampling, tears started to spill from my eyes.  I couldn't wipe them away because I had to hold still during the biopsy.  I kept thinking, "it's got to be almost done.  If I can just keep it together and they don't talk to me or notice the tears, I'll be fine."  But, the nurse and the ultrasound tech asked how I was, was I in pain?, and mentioned something about my boys.  I couldn't hold it back any more.  I started crying---bawling.  Luckily, the last sample was out, and I could move and wipe away the tears.  I just felt so stupid, alone, overwhelmed, embarrassed crying in front of practical strangers.  I'm so independent and try to keep it together.  But, the nurse and doctor stood there and held my hand, saying things like, "it is overwhelming.  It's a lot to deal with so soon into a new year.  You're an amazing patient."  {I do remember looking at the ultrasound machine and seeing a list of the rest of the day's patients with their birth dates---me at the top: 1979, x--1948, y--1955, z--1945.....the closest in age to me was someone born in 1961.  I just kept thinking, "I'm too young to be dealing with this crap!"  

Other than just feeling emotional after the procedure, I really still felt positive that the results were going to come back clear and benign.  The worst part was the unexpected amount of pain after the lidocaine wore off.  And that I couldn't take a bath {my daily relaxation ritual} for 7 days! I picked up my pain meds and was able to rest that afternoon.  {I also was kind of shocked that my breast looked almost "deflated" at the amount of tissue that was removed.  That image gave a few people a little chuckle!}

The results were scheduled to take 48-72 hours.  I was told that we MIGHT hear something by Friday, but to not count on it.  I still felt that it was just waiting and being on pins and needles to hear that it was nothing to worry about.  Stephen {and pretty much everyone else} felt the same way.

The shock came when I got a call the next afternoon that Dr. Schmidt wanted me to come in ASAP to discuss some initial verbal results from the radiologist and to get me set up with a specialist.  At that point, Stephen and I knew that it was something not good.  I still wasn't 100% sure it was cancer.  Maybe I just needed to have the lump removed and the "specialist" was "just" a surgeon.  {Part of the rush to meet with Dr. Schmidt included her giving birth on Friday.  So, maybe she was just tying up loose ends with my case before she was out on maternity leave, I told myself.}

Positive thoughts AND wearing pink "to ward off evil spirits," as Stephen put it just weren't enough this time.  The initial verbal diagnosis was breast cancer.  She didn't even have the final pathology results, but there were cancer cells present, and they wanted to get me on to the next step immediately.  Dr. Schmidt told me that if she had this diagnosis, she would see Dr. Pollock and Dr. Naqvi.  That recommendation was good enough for me.

We walked downstairs--in shock--to find out the next step in the process.