The rest of the breast story

So one of our first lessons in this whole cancer story came in this moment as Sean and I were sitting in disbelief and waiting for the gyneocologist to call and give us more direction.  We both looked at each other and realized that regardless if this "mass" was cancer or not, we both need to refocus our attention on our life and well-being and stop working so many stupid hours in our jobs.  These moments while waiting for the phone call will be forever in my mind, not because of the anxiety nor the disbelief, but the memory and the knowing that what Sean and I have together is real and exactly the partnership, love, and understanding I have always wanted in a life partner.  We didn't even need to exchange words, we found strength just being together and holding hands.  In those moments our partnership was validated and I knew, regardless of what "it" was we would tackle "it" as a team.  

So the phone rang, and you know when you hear that tone in someone's voice, that indicates,"this is not going to be good any way we look at it", that was the tone of the gynecologists voice.  She somberly explained to me that her nurse was diligently attempting to connected me with the first available appt. with Dr. Ballanoff, who was the best breast surgeon in Kansas City.  It was then explained to me that the "mass" was highly suspicious for cancer and that we needed to move quickly.  The conversation then moved into discussion of lumpectomy, masectomy, and other treatment options.  The tears were pouring at this point, but I sat silent feeling as though this moment could not be more surreal.  The gyneocologist appoligized and was struggling with having to tell me this news, and said, it is not everyday that I need to call a 30 year old and talk about breast cancer.  At that moment I choked out the words, "I can't really understand what you are telling me."  My graduate education and the knowledge from my work experience in health care desinagrated.  I told the gynocolgist, "At 9:00 AM I left your office thinking it could be a cyst or something minor and only had a "slight risk for cancer", and now at 1:00 PM I am being told that there is only a slight risk of it NOT being cancer."  My brain was unable to process.  As I told Sean the content of the conversation, we both stared at each other with no words to even capture what was happening.  

Later that afternoon, the gynecologist's nurse called to schedule the appointment with the breast surgeon and she says to me,"you know honey, I had breast cancer 7 years ago, and....blah, blah, blah" She had went on to say how amazing this breast surgeon was, however, I could not focus or listen to that because I was still stuck on her even mentioning or thinking I was apart of this breast cancer sisterhood already.  I will be honest in my head I thought, "bitch, I'm not in that group you are crazy."  Now looking back on that I can appreciate that that thought was my way of coping with the words breast cancer in the beginning of this whole process.  

After Sean and I sat for a bit we began making those dreaded phone calls that friends and family never wish to receive.  I can't imagine how our parents felt when they heard the news.  It made for a long afternoon.  And you would think that after such and emotionally exhausting day that I would be able to sleep. Wrong, since Nov. 2 when they found the mass I have not been able to sleep.  The magic hour for me seems to be between 2 and 3 AM.  I can fall asleep around 10 PM and then the magic hour arrives and I am up.  I tried hot lavendar baths, milk, reading, and meditation but forget that b/c my mind is the farthest thing from quiet nor having any ability to concentrate.  

This "mass" was all I could think about, but at the same time didn't want to think about.  I would wake from any sleep and cautiously touch it, in hopes that maybe it was smaller or even better, not even there.  No such luck.  I then found that showering was such a place of grief for me.  I was disassociating and wanting to detach myself from my breast all together.  I couldn't even look at it, let alone touch it.  I felt dirty and I desperately just wanted "it" gone.  

I think the waiting process was one of the worst parts so far.  The fear of the unknown was torturous.  You grieve all the "what ifs".  I was a bit pissed too, didn't this "mass" know that I have better things to do, like plan a wedding/honeymoon, than sit around worrying about my stupid boob!  Then I was getting hung up on the disease/dirty part of the mass.  I wanted it gone and it bothered me that this thing was in my body and potentially touching other "healthy" things in my body.  I probably said,"I want it gone!" over a million times in my head.  During this time my friends and family were great, and trying to be optimisitc.  However, over the last 1.5 years I have felt that something was "wrong" with my body, and various doctors made me feel like I was crazy and they couldn't find anything.  I had weight gain, night sweats, uncontrollable hives, mood swings, and lethargy, sounds like menopause right.  I know, then I began to think maybe I am crazy.  So when all my friend and family are now trying to be optimistic about this "mass", I was trying to be hopeful as well, however, I had a really bad feeling about all of this inside, but of course I kept that to myself, because who wants to invite Debbie Downer to a cheer rally.  But I knew.  


So I was scheduled to see this breast surgeon Dr Ballaoff on Nov 10th.  Again, it was the worst waiting. And again, I wanted "this" gone, so if I walked into her office on the 10th and she wanted to complete a masectomy then, I would be down for that!  Now, looking back I can see that I was definitely trying to bargin my way out of this stress/grief, I know that would not have been the most sensible thing to do, but that is all I could focus on.  And of course, when Dr. Ballanoff was collected and calm about the situation and recommended a biopsy first I was pissed.  Sean was the rational one of our team, but you know me, I feel like I need to control everything and I need action immediately, lets not pussyfoot around this thing and just cut it off!  Dr. Ballanoff's assessment on Nov 10th: the mass had a 20-30% chance of being cancer and it was measuring around 4 cm, and not attaching itself to my nipple so a lumpectomy my be possilbe.  Dr. B was confident on two things: she could get all of "it" and that she did not wish to "cut" it until she had biopsy results and knew exactly what "it" was.  So after that appt. the words "highly suspicious for cancer" seemed to fade and we focused on the 20-30%, which seemed so much easier to swallow.  However, my opionion still stood to be, "I want it GONE!"  

Here is a silver lining we have found so far.  Dr. Ballanoff is a great surgeon and can be a busy doctor to get into, but my gynecologist worked diligently to get me in asap, then Dr. B wanted me to go to Dr. Chow at Menorah's Breast Center, who is also highly sought after.  Dr. B's nurse had to work 2 days of talking with various people, including administration, to get me the first available appt. with Dr. Chow for the biopsy.  As I stood back and looked for a moment, I believe that this is a stressful time and unknown territory for us, but it seems that certain people are in my life right now because I need them and I am grateful.  I for the first time also feel confident in my healthcare professionals, for the last 1.5 years I had not, and now maybe I can relax a bit and let them do their jobs.....that's easy to say if you are not OCD!  


Dr. Chow was able to schedule a biopsy Nov 17, I would be the first woman in the office that day.  I was assured that the biopsy would be about 1 hour and pain free(due to medications).  I would be awake, the biopsy would be guided by ultrasound, and most women drive themselves home after the biopsy.  I thought to myself, I better ask Sean to go with me, and take the day off from work, just to be safe.  So here we go, ready for this!  

So I get there, Sean waits for me in the waiting room, I was instructed to put on one of those hideous gowns.  Side note: What the hell, who designed those stupid gowns, oh clearly there was no design effort put into those ridiculous garments.  I just may create a business that actually has some type of style to those things.  You feel like a lab rat in way as you are shuffled through the maze of healthcare at least you could be dressed cute with and option for some accessories right!  

Ok,  I digressed, so an initial ultrasound would be preformed and then the doctor would review and then come into the room and do the biopsy while another ultrasound was being done at the same time.  The ultrasound tech tells me that unless there is suspicious reason to biopsy the lymph nodes then they would just be biopsying the breast tissue.  I told her that while we were all here, why don't they just biopsy everything.  Here is a bit of info that I didn't know, she informed me that if a lymph node is "normal" and they attempt to biopsy the normal node then this could cause a reaction and cause further problems.  So with that being said, I had been told that, on Nov 2 when the original mamgram and ultrasound had been completed my lymph nodes were clear, so I thought there would be no biopsy of the lymph node.  As soon as the ultrasound begins the tech says, "yep, were are biopsying your lymph node." Christ!  I thought they were clear!  I demanded to see the screen....like I even know what the heck I am looking at, but she must be wrong.  Nope, there it was in all of it's stupid glory.  I bright white ring around my lymph node.  At this point I had no emotional energy to cry, be pissed, or even care.  I just want it all OUT!  I lay there and really have no feelings, I guess I felt a bit defeated, and we don't even know that it is cancer yet!  

So before the procedure starts the nurses are 100% confident that the doctor will be able to numb the breast tissue entirely for the biopsy and all will be well.  I ask to see the needle, you know my OCD has to be present in all events, to some degree.  Ok, so the doctor comes in, we go over what is about to happen...blah, blah.  I tell her that my breast is slightly tender already from the intial ultrasound,  the doctor says that women with slight tenderness may be more difficult to numb completley, but not to worry they had plenty of lanican.  Oh and they use epinephrine within the injection b/c the lanicain can burn sometimes.  I tell her I am not worried b/c I have a fairly high pain tolerance.   

And so it begins, the ultrasound tech is on one side providing the picture so the doctor can guide the needles to the appropriate site.  The plan was to take 5 biopsies from my breast and 2 from my lymph node.  The initial injections to numb the breast tissue were not too pleasant, but the reward would be feeling nothing in a few moments, I laugh to myself as I type this.  Long story short....the could not get my breast numb, even with several attempts.  After them digging into my breast with the needle I told her to stop b/c I didn't know which was worse the digging to attempt the numbing or the actual biopsy with no numbing.  I told the doctor, I was going to white nuckle the hospital bed rail as well as my amazingly beautiful gown, and grit my teeth, just to hurry up and get it done!  I was proud of myself, I only had a few silent tears with my pain.  Then the biopsy of the lymph node occured, I was numb with 2 injections and that was that.  Then the nurses pushed down 2 handed on my breast to stop the bleeding, really, really, could they just get off of me already this hurts!  

Things are okay, and all the staff are commenting on my beautiful engagement ring blah blah.  And then I begin to not feel so well.  I began shaking excessively and felt extremely weak.  I had to have another mamagram before I left.  The nurses shuffled me into the room and if you have ever had a mamagram you know that you have to kind of hold onto thses handlebars and hold yourself up to compelte the image.  I was shaking so bad at this point I coulnd't stand or hold myself. Meanwhile, throughout this whole ordeal, the staff act as if they are in shock that all of this is occurring.  They couldn't believe they could not get me numb and now I appear to be declining in some way.  They kept saying,"this never happens!" Leave it to me ladies, I will surely f**#*@* this up somehow, b/c you forget, I am not normal!  

So they rush me into the seperate room and put me onto the gurney.  I am shaking uncontrolablly, I am sweating, my blood pressure was 147/110, and the heat was radiating off of my entire body, my pain level was b/n 4-5.  As I lay there with cold washcloths covering everything but my nose and mouth, I think to myself, I am going to be really pissed if I have to go to the emergency room right now.  Again, isn't it funny how my mind bargins with these tough situations.  I manage to tell the nurse to go get Sean in the waiting room.  This one hour procedure will eventually end in a three hour ordeal!  Poor Sean, he must have been loosing his mind, I had been the first girl in, and by no means showing any signs of leaving after an uneventful procedure.  Sean walks into the room with me in my amazingly glorious hospital gown, cold washcloths covering everything but my nose and mouth all while shaking uncontrolablly with a blood pressure monitor beeping with concern!  I told him to give me my Xanax out of my purse, oh and that I loved him!  

So this story ends with me leaving the biospy with ace bandage and ice packs wrapped around my chest and too weak to walk to the truck.  So in all my glory I was pushed through the waiting room of 50 plus year old women to the truck b/c at that moment I was a debilitated 30 year old....man that sucks!  Thank god I took the rest of the day off from work. I was in pain and needed to change my ice packs every 30 mins.  And I must say I am a fan of Tylenol PM!  My sister Kristan and brother-in-law Donald were in town at the time, and they ran to Walgreens for the Tylenol and some gatorade and promptly left to go to Carthage to visit my mom.  Sean nursed me back to the real world within 24 hours!  My mom was a nervous wreck, calling Sean several times, and at one point hysterically telling him to go check on me every 30 mins b/c I could go into cardiac arrest or get worse that quickly....what...really Carol, I laugh now, but at that moment I may never know, and hope to never have to know, what my mother was feeling as her daughter could potentially begin a battle with cancer.  


NOVEMBER 22, THE "C" DAY.  I had been trying to keep busy all weekend in order not to sit and cry/worry about the unkown.  We had decided with Kristan and Donald in town, before they left to be based with the Army in Germany for 3 years, we would host Thanksgiving at our house.  This would be the first Thanksgiving I would have ever hosted and I would be damned if Martha Stewart had anything over me!  That weekend I made my tablescape, made my own table runners, organized the entire house, grocery shopped, anything other than sit with my own thoughts.  Sean hibernated in his Man Cave with football and beer.  He does that, I craft, hey it got us through.  Again through this entire month I had not been sleeping and inside I just knew.  I was driving to work and the Dr. B's nurse calls and asks if I can come into the office in like an 2 hours and I should bring someone.  I requested that she tell me the results, though I already knew.  Biopsy's indicate breast cancer with metastatic cancer to the lymph node.  It took my breath away, even though I had had that feeling, if was just confirmed.  I felt as though this was too surreal.  I called Sean, my mom, Shelly, Erica, and text Kristan and Sarah.  I drove to Sean's work and we sat in the parking lot, numb and in shock!  

As we drove to Dr. Ballanoff's office I was playing that bargain game again.  I thought I could do this no problem, but the only thing I felt like I couldn't do would be chemotherapy.  As we pull in, Sean is great with knowing just when and how to throw his wit around.  He says, "what are you going to do if the doctor says the cancer was brought on by crafting?"  If you know Sean, you know he is always giving me a hard time about my Martha Stewart like qualities and he despises any type of crafting/decorating!  I needed that laugh.  

As we became informed it was clear that this was no ordinary situation and the next year was about to be very difficult.  Of course the one thing I had bargined about in my head was the chemo, and that was the first thing out of the doctor's mouth.  I lost it!  I cried and said, what about a baby, we have to have a baby.  That is all I could keep saying!  My hair, we are getting married, what about my long brown hair!  Dr. Ballanoff provided the tissues and validated my emotions and we all sat for a bit until I gathered myself.  Sean was the strong, stoic man that I needed in that moment.  However, before we could go on, I was demanding that the doctor talk to us about fertility options.  She said she believed that I may be able to become pregnant one day, they just may need to be creative on how that is done.  I just kept crying and saying we have to have a baby!  I will forever remember the strength in Sean's voice througout that entire day, he kept saying,"we'll figure this out, it will be okay."  I love him and I am so thankful for him.  And again, later I was so thankful for his appropriate timing of wit and humor,as he said,"Ashley, if we can't have kids we will go get a six pack of Chinese girls, they will give them to us because we are so tall we will be like gods to them!"  

So the plan was for Dr. Ballanoff to refer me to an oncologist, and a fertility specialist.  Overall, the plan is 2 rounds of chemo, double mastecomy, radiation, and reconstruction.  I decided to go ahead with the double masectomy b/c I can't wrap my mind around ever having to be faced with chemotherapy or radiation again, so the doctors and I have also talked about after childbearing possiblilities I will most likely remove my ovaries too.  My cancer is a lobular cancer that is driven 97% by estrogen and 81% by progesterone. Hmmmm, is it funny for more than a year I have been trying to tell the doctors I have been feeling hormonal and something was not right.  In finding out the cancer news, I promptly told the doctor that I was going to beat this and get pregnant immediately....oh yet another blow!  She promptly told me that I would be on medication to "shut down" my hormones for 5 years after treatment.  Awesome!  More tears please!