Monthly Archives: April 2013

The Outcome & The Oncologist

4/17/2013

The Outcome:

One week out from surgery.  The pain is intense; the drains are annoying as hell.  My post-op appointment with my surgeon is today, and I am SO hoping that she will remove at least one of the drains today.  

We get to my appointment right on time, and are taken back right away, as usual.  She starts off by telling me that I am actually and officially only a stage 2 with my cancer; and based on the number of lymph nodes affected (9 out of 15), I was actually a 2a.  Initially, just after surgery, she had thought that based on the size of the tumor that she took out, I would for sure be a stage 3, which is what she told me in the hospital – thus upsetting me greatly before I was ready to go home.  But when I went in for this appointment, she told me right off that she had been mistaken, and I was truly only a stage 2.  She said that her first statement was based on the size of the tumor, and that it appeared to be 4 cm upon initial examination in the operating room.  The lab returned a result that it was actually 3.5 cm, and therefore only a stage 2.  I was VERY grateful for her error in judgment!  But this also told us that it had grown quite a bit, in quite a short period of time.  When I found it, my doctor estimated its size to be 2-2.5 cm.  The mammograms and ultrasounds measured it at 2.76 cm, just two weeks later.  The biopsies measured this tumor at 2.8 cm, and the final lab results after removal show 3.5 cm.  This is at least a full centimeter growth in less than six weeks!  She then went on to tell me that she got all of the cancer, to the best of her knowledge, but she suspected that the oncologist would want further body scans and brain scans, to make sure it hadn’t spread to other parts of my body (since it was so aggressive and fast growing).  I pray that the fact that it was fast growing says that it had not been there long when I found it.  I then got her to take out the right drain, which was heavenly; but she said I would have to wait a few days longer for the left drain.  

I was so excited to get a few minutes of snuggle time with my baby girl, since I can't pick her up :)
I was so excited to get a few minutes of snuggle time with my baby girl, since I can’t pick her up 🙂

4/19/2013

The Oncologist:

While on our way to my post-op appointment with the surgeon, I got a call from Texas Oncology – Carrollton.  I made an appointment for my consultation with Dr. Enrique Perez for Friday, April 19th.  The very nice lady, Roxann, emailed me new patient paperwork so I could be efficient and ready upon arrival.  When Friday arrived, we went to lunch beforehand at one of favorite restaurants – Misto Bistro – run by one of my favorite friends, Janet.  We have been friends for a while now, and I have worked with her doing catering (which I love); but our friendship has gone to a whole other level in the past several months, and she is even more special to me than before.  After lunch, we headed to Texas Oncology of Carrollton, where I met the chick who will be my supercool nurse, Amy.  I was ushered into a room, where I was asked a series of questions that I had already answered on all of the forms that I had previously filled out.  Soon, we were being introduced to Dr. Perez – a very nice and very tall man with a wonderful disposition and bedside manner.  He was able to put me to ease by anticipating my questions and answering them before I even got a chance to ask them.  I told him that my genetics testing came back negative, and my hormone receptor testing came back as a triple negative – triple negative for estrogen, progesterone, and HER2.  So now what?  I am negative for everything.  “What does that mean for me??”  I asked the doctor.  It basically means that it is harder to treat; but we are going to fight and we are going to do everything that we need to do to keep me alive.  Well alright.  That’s what I need to hear.  

Dr. Perez went on to tell me that he wants me to have a PET scan, a CT scan, and an echocardiogram before starting chemo.  He also said for me to go ahead and have the port put in, while I am waiting to start and waiting for my scars to heal.  He explained that based on all of my negative results, he was going to do a certain course of drugs (which I can’t remember the names – except that one is the evil red one that I have read about) for four rounds, three weeks apart.  The first four rounds will be two drugs together.  After that I will do another four rounds, three weeks apart, of a third drug.  He said that I WILL lose my hair, and other side effects could include diarrhea.  Yay.

Three days later I was back in Dr. Garner’s office to get my left drain out (FINALLY, thank God!).  I went over my oncologist visit with her, and we scheduled my outpatient surgery for the port placement.  It would be a couple of days later, on Wednesday morning, and she assured me that it was nothing…a breeze.  This procedure would be a walk in the park compared to the mastectomies.  

So I guess here we go.  No looking back.  Part one is done.  And as hard as it has been in the two weeks post surgery, I don’t think it will be anything compared to what is coming with six months of chemotherapy.  

Guess we will see.

The Surgery

4/10/2013

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Holly, Lorrie, me, and Erikka before the OR

The day had finally arrived.  I was ready.  But I was also a little scared.  But I was more ready. Ready to get this thing out of me; this thing that has been growing quickly on its mission to rob me of my life.  I knew that this major surgery was the beginning of an uphill climb, but I willingly signed on for it, just like any of the 5Ks that I have done in the past – and will do more of in the future!

My rock <3
My rock ❤

We arrived at the hospital just before 10:00 AM, where I checked in and waited to be taken back by a nurse.  Holly arrived right behind us, and Lorrie arrived from Oklahoma City shortly after that.  I am so blessed that my three best friends in the world were all there beside me – beside US – on this day that would change our lives forever.  The only thing I had said that I wanted to wake up to was my wife and these three best friends – and they all made sure that it happened.  This meant the world to me.  Kim wasn’t there by the time I got called back, but she arrived before I actually went into surgery.  

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“Fall Risk” – I should have one of these every day of my life

When I got taken back, Erikka went with me and stayed while I changed and went through all of the typical pre-op routine.  They made me wear bright yellow socks with rubber grippies on the bottom (like the socks we put on Harrison), as well as a bright yellow bracelet that said, “FALL RISK” on it.  I can’t really be offended, because on a good day I am typically a fall risk…hahahaha.  The girls all thought it was pretty funny though when they came back….but they know me, too.  After the socks and bracelets were on, then the nurse put my IV in.  I asked for the “calm down” drugs, but she said that I would get those after I talked to a few more people.  Pretty soon, the no-nonsense anesthesiologist came in and went through all of the same questions that the first and second nurses had asked.  Lorrie didn’t like him because he didn’t have a sense of humor when she asked if he was going to share the “good stuff” with her.  He WAS all business, this Mr. Personality.

Mr. Personality...aka the Anesthesiologist
Mr. Personality…aka the Anesthesiologist

 After he left, then the OR charge nurse, Marti, came in.  She was awesome, and had on a cool pink surgical hat – all except for the Texas A&M logos on it.  We all loved it, especially since it was Wear Pink for Tanya day, and everyone we knew was wearing pink, including all of the beautiful women that were with me at the hospital.

Pretty soon, all that was left was signing the boobs away and the good drugs. Yes, I said sign away the boobs. Each person that came back asked me all of the same questions: full name, date of birth, allergies, what procedures were we doing. Then they gave me paperwork giving them permission to lob off my left and right breasts. Somewhere in there they gave me a small bit of something in my IV to “relax” me, and I apparently started talking to my boobies – telling the left one that it was rude for trying to kill me, and apologizing to the right one that it had to be put down all because of the left one. This was high comedy I hear! After he gave me that first little bit, I I remember saying, “Oh I don’t feel ANYTHING!” and soon they were kicking the girls out to take me back. I remember hugs and kisses from Holly and Lorrie, and lastly from Erikka – and that’s all I remember. I don’t remember the trip through the halls of the back hallways into the operating room. I went OUT.

Marti - the cool OR charge nurse with the cool pink hat (except that A&M nonsense)
Marti – the cool OR charge nurse with the cool pink hat (except that A&M nonsense)
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Talking to my left boobie….telling it how “rude” it was…LOL

Hours later, I am in a private room, being awakened by a sweet nurse in pink scrubs; surrounded by Erikka, Holly, Lorrie, and now Kim, too.  I vaguely remember asking what time it was, and it was much later than I thought it should be.  

Erikka trying to talk to me as they woke me up
Erikka trying to talk to me as they woke me up

The surgery had gone smoothly and not taken any longer than it should have; I had been hard to wake up (which is typical for me after any surgery).  I remember looking at Kim and saying, “Hey!  You’re not wearing pink!”  It’s funny where the brain goes when it is in an altered state!  I was so out of it, but was SO thankful for the nice little anti-nausea patch that they had put behind my ear just before I went into the operating room.  I had a drain coming out of each side of my chest, and was wrapped in a compression bra.  I remember looking down and putting my hands on my now flat chest, and thinking, “Oh my God, they’re really gone!”  Then I was in and out of consciousness for the next few hours, while my wonderful and amazing friends stayed and watched me sleep or hung out in the waiting room.

Lorrie and Kim just before they left for the day...I was still pretty out of it
Lorrie and Kim just before they left for the day…I was still pretty out of it

 

Soon, Lorrie would need to get back on the road to Oklahoma, and Kim would need to get back on the road for Ft. Worth.  Holly was going to stay for a while and keep Erikka company and have something to eat with us.  I don’t think that any of them know how grateful I am that they spent the day in hospital waiting rooms for ME, and for my wife.  They will never know, and I could never repay, the blessing that they all were for staying with Erikka and making sure that she kept it together instead of being sick with worry and fear.  After Kim and Lorrie left, I slept for a while more while Erikka and Holly went and found some decent dinner – Subway.  It was so nice to finally be able to eat!  And something that I LIKE!  Shortly after we ate, Erikka needed to leave and go pickup our little Peanut from my mom; and Holly decided that she would stay for a while and keep me company.  I kept dozing off, in and out of sleepiness, so I finally told her to go ahead and get home and rest.  I was good for the night, as long as I had my anti-nausea patch and sweet little pain med button that I could push every six minutes.  

The night was uneventful, and Erikka was back mid-morning that next day.  Over the course of the morning and early afternoon, I had lots of visits from nurses, as well as a Breast Cancer support staff person, who brought me some things to take home.  I also had a visit from an occupational therapist, who came and showed me some arm exercises to do three or four times per day when I got home – those were tough that first time!  The last visit that I was waiting for was Dr. Garner, after she got done with her surgeries for the day.  I didn’t think that I was ready yet to go home, but rumor was that she would probably send me home if she thought I was doing well.  

Late in the afternoon, Dr. Garner and her P.A. stopped by to check on me.  After she checked my sutures and drains, she deemed me to be doing great and said she was sending me home.  She did sit down and tell me that there were at least seven lymph nodes that had been cancerous, and they were still analyzing them all.  She said that based on that and the size of my tumor, I would likely be categorized as a stage 3 – which upset me quite a bit for the rest of the afternoon.  This was not the news that I had been hoping to hear.  

Off to home we went.  It felt good to be back in our bed.  Erikka tucked me in before running Noah to my mom’s for a long weekend, and I fell asleep again, thankful for our amazing family and friends who had gathered around us for this major occurrence in our lives.  I go back to the surgeon a week after surgery, and hope that she takes out one of these miserable drains, if not both.  Then I will find out more information, and probably find out about the next step:  chemotherapy.

 

The Farewell to the Ta-Tas

3/9/2013
Dear Boobies,

Well, my old faithful friends, this is it. Our time has come to an end. After years of pretty much detesting you because of your size, I am finding myself saddened that your end is at hand. Let’s think back to our long history that we’ve had…

I was about 9 years old when you decided to make your presence known. I was in the fourth grade, and not too sure about this whole bra thing. I remember being among Kristal Hodge and Alisha Harvey as one who had to endure teasing for having big boobies. Great. See the internal scarring you created in my young, tender psyche??

You did, however, serve my babies fairly well during their first months, by providing them nutrition, despite becoming larger than even I was prepared to deal with – can we say “ouch?”

Over the years, as you have stayed steady between a C-cup and D-cup, depending on my level of fatness at the time, you have been squeezed and smashed into various stages of uni-boob by sports bras galore, while still managing to pound my chest while running or get in the way of my golf swing. Now that you will no longer be with me, I am hoping that my runs will be swifter and my golf game won’t suck near as bad.

But now, our love-hate relationship is going to come to an end. I have no choice. You are sick and trying to kill me, and I can’t have that. But if it makes you feel any better as you face your imminent demise, you can die happy knowing that I have no intentions of replacing you. Tattoos will one day lie where you formerly resided, and nothing else. And while I spent many years trying to figure out how to smash you into a smaller space, wish that you were smaller, and try to workout until you became more muscular than fatty, I face tomorrow with a sadness that you will be gone forever. You have been a part of me for 42 years, and like anything, it will be tough waking up to look down to your absence.

So goodbye Tanya’s Ta-Tas. Thank you for the life we have shared. Damn you for trying to kill me. I didn’t dislike you THAT much!

Sincerely,
Tanya

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The Surgeon

4/1/2013

It’s April first.  The day after Easter, where we spent a nice weekend out of town visiting with Erikka’s extended family, like we do every year.  Like I hope to continue to do for many years to come.  Today is April Fool’s Day.  I was SO hoping that when I woke up, all of this cancer business would have been a dream or some bad April Fool’s joke.  But no.  Today brought me no joking or pranks.  Today brought me an 11 AM appointment at the surgeon’s office; the one whom I already knew from previous procedures with loved ones.

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Easter 2013

We loaded up and went to Dr. Carolyn Garner’s office right on time this morning, where I was filled with anxiety, ready to see what was coming up for me next.  After the obligatory blood pressure reading, weight report, and listing of meds that I take, we waited a few more minutes for the doc to come get us.  Soon she was there at the door, with greetings and catching up, going on about how big the baby has gotten since she had last seen her (Harrison was 4 weeks old when this doctor performed surgery on Erikka).  She then ushered us into her office-slash-examining room.  This is where she does minimal exams, but mostly consults with patients; we had been in there twice before.

Her first questions were mainly wanting to know how and when I discovered the mass – was it found on a routine mammogram or did I find it myself?  So I told her the details of how I found it, and what transpired from there.  She said, at that point, that “today, unfortunately, we don’t have anything good to talk about.”  Yeah.  I know.  I handed over the large envelope that had pathology reports from my biopsies, reports from mammograms past and present, and two CDs with mammogram images from 2008 and 2013, for comparison.  I told her that I have had the genetics testing done, and that they had put a surgical rush on it, so hopefully the results would be back by the end of the week.  I then told her that regardless of the results, I wanted her to take both breasts off.  She nodded and said, “Okay.  I agree.”  I was a little surprised that she was so agreeable so fast!  I proceeded to tell her that I understand, being a Medicaid patient, that there are stipulations based on the genetics testing to what will be paid; but I don’t care.  I don’t ever want to go through this again.  She said that given my family history, it will probably be paid for, but in the case that it isn’t, they will have me sign a form that basically states that IF it isn’t paid by Medicaid, then I will be responsible for the difference.  Fine.  I will sign it.  My next question:  When can we do this?  She said, “Well, I can’t do it today.”  Ha!  Funny lady.  “I do breast surgeries on Wednesdays, so I can do it this Wednesday, if you want.  Or I can do it next Wednesday.”  So after a moment of thinking, I said, “Next Wednesday it is.”  Within a few minutes, my surgery was scheduled for Wednesday, April 10th at Denton Regional Hospital:  a Radical Modified Mastectomy on the left side, and a Simple Mastectomy on the right side.

I then went on to tell her that I do not want reconstruction.  I am not interested in having fake breasts, as I am not a girly-girl who really cares about my curves; to which she responded, “I understand.”  From there we discussed the details about the surgery:  how she will remove the breasts (how the cuts will be done), the fact that she will be removing ALL of the lymph nodes on the right side under my arm, and what the scars should look like, given the fact that I am not doing reconstruction.  I will basically have scars across each side of my chest, and no nipples.

My scars should look similar to this
My scars should look similar to this

I can either have them tattooed on, or I can have other cool looking tattoos done if I don’t want to leave it plain.  We discussed the time frames:  length of stay in hospital, recovery time, visit to oncologist, and approximate time for chemo to begin.  Radiation will probably not be necessary, unless the cancer has invaded the chest wall.  She said I should be in the hospital for one night – what??!!  One night??  Her response to my surprise?  “Welcome to drive-thru surgery.”  I’m not sure if it is a Medicaid thing or just an insurance thing.  When my mom had her mastectomy and reconstruction, they tried to send her home after one night; to which I bitched and told them that I REFUSED to take her home that early….so they kept her a second night.  So the plan is one night, however, I typically get a fever every time I have surgery, and end up having to stay an extra night.  She said that recovery time is about two weeks, but I find that highly optimistic.  I’m betting it’s more along the lines of 2-4 weeks.  That’s 2-4 weeks of trying to recover a range-of-motion in my arms.  That’s 2-4 weeks unable to drive, raise my arms above chest level, pick up my sweet baby girl, work out.  She said that after that time, I can go back to cardio activities, but no weights for a while.  I will have to find an oncologist and plan to go a week or two after my surgery; and will likely begin chemo 4-6 weeks after surgery, depending on how the healing is going.

After that, she took a few minutes to examine the “affected breast.”  She barely touched me and responded, “Oh wow.  That really IS big.”  Um, yes, I know.  After her exam, she told me again that she thought that mastectomy of both sides was definitely the way to go, and she would tell her own sister the very same thing.  Soon we were on our way out with paperwork to take when I go to register.  By the time we reached the Jeep and got loaded up, we were both in a much more somber place.  As I tried to discuss some of the details of surgery day (who can keep kids, etc.), my beautiful and strong wife became a little overcome by emotion.  This was the first time that I had seen her show anything but positive words or strength through all of this.  But yeah.  It hit us both.  This was overwhelming for her – for us.  And as the day went on, it became way too “real” for me.  This is really happening.  I REALLY have cancer.

And I’m not going to wake up and it just be a dream.