Pathology Report

Yesterday Mom and Dad had a visit with Dr. Faddis to remove Mom's drains and to discuss the pathology report. The report was great and exciting news. All of the lymph nodes that Dr. Faddis removed were clear and cancer free. She also had clear and cancer free margins (the edge tissue). There was no cancer in the skin. The cancer was only detectable microscopically in the breast tissue that was removed. Dr. Faddis told Mom and Dad over and over throughout this visit that this is all great news and a truly excellent report. Dr. Faddis was not able to tell Mom what this means in terms of her future treatment plan. She will have a visit with Dr. Kenyon the oncologist and hear his thoughts about the pathology report and how this new information will impact her future treatments.

Mom is recovering very well. After she arrived home last Saturday it was only a matter of a few hours before she declared that she was bored with just sitting and was ready to DO something.

Prompted by her industrious spirit, Steve and I went out front and dug 40 two foot by two foot holes so that we could plant all the baby roses that we bought in early August at the rose sale. Dad joined us after his nap and helped us with the project. The next day Mom helped us plan where to plant all the different varieties and we completed the project. Now we have a huge front yard rose garden that we will always remember was planted the weekend after Mom's successful surgery.

Mom has spent the week peeling apples from out back to make more applesauce, picking the blackberries that hang over the fence, helping Maya with her homework, and steadily working on increasing her strength by sweeping the floor and walking around the block. You can't keep the woman down.

Mom will have a couple more weeks to recover before she starts in on more treatment. We know for sure that she will continue taking the herceptin at the infusion center every three weeks and also have radiation treatments five days a week for several weeks. This will all start up again at the end of September or early October.

On the home front, Elias is having a great time in kindergarten; Maya is making the transition to the higher expectations of 3rd grade; and I went to the humane society and brought home two kittens. We like to keep busy.

Love, Emily

Surgery Day

Mom and Dad went to Good Samaritan Hospital at 6:30 am on Thursday September 4 for Mom's mastectomy. The first big step in the process was a visit to radiology to have dye and radioactivity placed in Mom. The purpose of this was to help locate the sentinel node during surgery. Then by examining the sentinel node Dr Faddis could determine how many lymph nodes were cancerous and would need to be removed. The first step proved a bit more annoying than expected. The radiology department was on the slow side and had to be moved into action by Dr. Faddis. Mom was taken late to radiology at around 9:00 am. She was supposed to be in surgery at 10:00 am. Dr. Faddis was pacing around waiting for her return to her room so that she could be taken to surgery. When she did not return around 10:00 she lost her time slot in the operating room. She finally returned at 10:20. She was not pleased that she now had to wait longer to start surgery. She had a very painful time in radiology with the injection of the radiation and the dye and the long time she had to spend in "the tube" with her arms above her head having some kind of scan done. Dad, Patty, and I did our very best to entertain her and comfort her as we all waited for the operating room to once again be available. At around 11:20 they wheeled her away to surgery. We moved our group to the upstairs main waiting room and began the long wait.

Our wait turned out to be longer than anticipated. Dad, Patty, Grandma and Granddaddy and I all did our best to talk our way through our anxiety. We had been told that the surgery would last an hour to an hour and a half. That means we started being hopeful around 12:30, were expecting something around 1:00, and started worrying at 1:30. Dr. Faddis finally arrived in the waiting room at 2:04.

Here are the results of the surgery as we know them right now. This is a summary of what Dr. Faddis told us there in the waiting room after completing Mom's mastectomy.

1. He could not find the sentinel node. This is very rare. It has only happened to him a couple of times in his 10 years of doing surgery. He searched for it for a long time. His best guess is that the reason he could not find it is because the chemotherapy has been so effective in the area. It is almost like that in the warfare that has taken place in Mom's breast between the chemo and the cancer that the sentinel node just got wiped out.

2. Because he could not find the sentinel node he had to make a decision about how many lymph nodes to take. He did not take them all. He did not think it necessary. But, he took more than he might have if he had been able to examine the sentinel node. Those that he took will be frozen and examined to see if they contained any cancer. He really does not think they will be cancerous. He really does not think that she will have to have more surgery to remove more nodes. He did not take so many that it will effect the use of her arm.

3. He was pleased about the how her breast looked on the gross level. He did not find any cancerous mass or lump. He found a lot of scar tissue from the work of the chemotherapy. He could tell that the chemotherapy has been effective. On the gross level there was nothing that he saw that he would say was cancerous. But, this does not have a lot of meaning until we get the pathology report.

4. We will get the pathology report sometime next week mid week. This will give us and the doctors more information about how much cancer is left and what will be the best way to fight it.

Mom left recovery and was placed in a private room at around 3:00 pm. She was in a great deal of pain and very nauseous. The nurses were able to help get the pain in control fairly easily, but the nausea was a different matter. She was nauseated and throwing up intermittently all that afternoon, evening, and through the night. She was miserable. She was either swimming in nausea or swimming in over medication. Dad stayed in the hospital with her all night. There was not a lot of sleep for either of them. She also had an allergic reaction to the antibiotic the gave her in the night. That caused more mayhem and discomfort. In the morning a better anti-nausea medication was found and Mom finally had some relief. By early this afternoon her cheeks were pink again and she had hope of surviving. This evening she ate some food. Dad will stay the night with her again. She will come home tomorrow.

I am very tired and that is the best I can do for tonight. Thank you to everyone for their thoughts and prayers. Thank you especially to my Aunt Patty who helped Dad and I in the hospital on Thursday and then came over this morning to watch Elias so I could go back to the hospital. Thank you to my friend Cedar who watched Elias all day Thursday and Lori who watched him this afternoon. Thank you to Steve who has done everything at home. Thank you God even for these hard days and for the hope of more days in the future.

Love, Emily

Surgery Date

Mom had two doctor appointments at the end of this week that greatly informed us about the course of her treatment for the next two months.

On Thursday Mom and Dad went and saw Dr. Fry the radiologist. We all think his name to be quite fitting and funny. Mom and Dad both liked him. He is passionate about his work and very positive. He believes that Mom will still have some cancer after the surgery. He considers it his work to eliminate the cancer that is remaining. After surgery Mom will have seven weeks of radiation. She will have radiation treatment five days a week. Dr. Fry told my parents that radiation treatment has made vast improvements in the last couple of years. She will have a CAT scan that will enable Dr. Fry to develop a radiation plan specific for her body and the cancer that remains. There are very few possible negative health effects. Dr. Fry also encouraged Mom to use her time during radiation treatments as period to recover from the chemotherapy and surgery. He wants her to get back to her walking and healthy living during radiation. Mom was encouraged to hear this. He also told her that radiation will be a breeze after all she had to go through with the chemotherapy.

On Friday Mom and Dad went to see Dr. Faddis to set a surgery date. Mom will have her mastectomy on Thursday September 4. It will be a single mastectomy. They may or may not remove lymph nodes during this surgery depending on what they find. She will have to stay in the hospital one night and possibly two.

That is the news!

Around the home front we continue to work on our home improvement projects. Mom is making lots of applesauce from one of our back yard apple trees and putting it in the freezer. Steve goes back to work on Monday. We are buying school supplies to send the kids off to another school year soon.

Love, Emily

A Change of Plan

When last I left you Mom was struggling with her second dose of the new chemotherapy. About a day and a half after her dose she arose again to join the family. It was amazing to watch her transformation from the retching, hallucinating lump in the bed back to the upright cancer warrior she has become. Resurrection once again.

The following days were up and down for all of us. Mom was on and off the couch as this chemo had now taken her body down to the point where she didn't really feel well any of the time. Steve and I continued to ready the house for the new hardwood floor installation upstairs. The workers arrived the Friday after the second chemo to install the new floor and continued to work the next week. This next week we all mainly focused on getting ready for vacation the following week. Maya and Elias went to OSU kidspirit daycamp for the mornings. This was a new, fun experience for them. On that Friday we journeyed up to Canby for the annual Heritage Rose Garden rose sale. There we had a great time purchasing roses for our new rose garden. Both Mom & Dad and Steve & I left rose gardens we were very attached to at our old houses. It was fun to purchase a new start for a rose garden at Buchanan st.

Our week of beach vacation at Netarts Bay was wonderful. We were joined there by Jeremiah, Nan, and Sam; Aunt Patty and her friend Joan; Grandma and Granddaddy; and my friend Cedar. The week was filled with beach walks, sand castle building, kite flying, movie watching, game playing, puzzle working, eating, and baby oogling. Mom was a mostly happy participant in all of this. She did not get to go on as long of walks as normal and was less tolerant of the constant draining beach wind, but managed the higher level of stimulation with some nice naps on the couch.

Our family of six was a bit apprehensive for a variety of reasons about going home as the week at the beach came to an end. Steve and I were not looking forward to the work we had in front of us to get the house back together as the floors would be done when we arrived home. Also, this would be Steve's last week of summer vacation. The kids could feel the end of their summer vacation nearing as well. Elias had some anxiety about going to kindergarten. Dad had to confront returning to work and all the approaching September programs. Mom of course had another round of chemotherapy waiting for her the Tuesday after we arrived home.

Monday after we arrived home Mom had an appointment to see Dr. Kenyon her oncologist. At this appointment Dr. Kenyon asked her about her experience with the last round of chemo. As Mom related her story Dr. Kenyon had some concerns about how her body was reacting to this chemotherapy. He and Mom both questioned if continuing this chemotherapy is the best plan. He then examined Mom's breast. From this examination he was not able to feel any cancer at all. He and Mom then continued with a conversation about what is the best path forward at this point. Mom questioned him extensively how stopping this chemo or continuing this chemo might impact her outcome. Dr. Kenyon does not really know. He does know that Mom has already done the majority of the work by completing the first 12 weekly chemos. These last proposed 4 chemos were always presented as the more experimental phase of the treatment. Whatever Mom does at this point the research shows that there will be about an 80% chance of there still being cancer in the area after surgery. There has only ever been a 20% chance that the cancer will be completely gone at the point of surgery. This being said, the possibility that Mom will have to do more chemo after surgery is very high regardless of if she were to continue with these 2 more pre-surgery chemos. Also, Dr. Kenyon said that the chemotherapy that would probably happen after surgery could be a different mix of chemo than the one she is working her way through now. So, Mom and Dr. Kenyon took this all into consideration and decided to change the course of treatment. Mom is stopping her current chemo and will proceed to surgery in the very near future. She has an appointment with Dr. Faddis this Friday to set a date for the surgery. Dr. Kenyon said it will take place some time in the next two weeks.

It is very important to us that this change of plans is not seen as negative. Mom is still doing everything she can to beat this cancer. There are different roads to the same end. The doctor and Mom believe that going ahead with the surgery and not taking her down any further with this chemo is the best thing to do. Mom's proposed course of treatment is a work in progress, not a holy document. I know that I found safety in this plan that we were given early on and that giving it up has been another lesson in recognizing that I am not really in control of any of this anyway. My sense of being able to control what life serves up is false. Beating cancer is an art, not a science.

Mom will continue with the biotherapy herceptin treatments because it is so important for beating her herceptin positive cancer. This means she still gets to visit the infusion center. Dr. Kenyon told her that she will probably keep having every three week herceptin treatments through next March. Radiation is also scheduled in her post surgery time period.

September will now be surgery month for us as well as the start of school and the beginning of many fall church programs. Please keep us all in your thoughts and prayers as we keep busting down this path that is in front of us.

Love, Emily

Round 2 Dose 2

Yesterday morning Mom went in to the infusion center to have her second dose of this second round of chemotherapy. She was rather anxious after her experience three weeks ago of becoming violently ill after her initial dose of this new chemo. The Thursday before she and Dad met with Dr Kenyon, the oncologist, to discuss if Mom would go ahead with this course of treatment. Dr. Kenyon asked her, "What do I have to say to convince you to go ahead?" The three of them then proceeded to have a conversation about all the very convincing reasons Mom needs to do this second round of chemo. Most important, is that the survival statistics are better for women with inflammatory breast cancer who follow this specific course of treatment. They also discussed how the medications could be adjusted to hopefully reduce the nausea and other ill effects.





This brings us back to yesterday. I understand that Mom was pretty anxious during the infusion process. When she came home she was able to sleep. Around 3:30 she started to feel sick. Dad applied some of the "magic 4" topical anti-nausea medication. This medication instead of making her feel less noxious, caused her to have hallucinations and become rather paranoid and out of her head. She also developed a rash on her face. Dad called the doctor and struggled with their slow response. Three hours later he was able to talk to an on call doctor who recommended a course of action using some of the medications on hand.





The report I have from Dad this morning is that the night went pretty well. Mom's nausea has stayed at a 3 or a 4 on scale of 1 to 10. Dad says that she is also no longer out of her head, though she is still anxious and troubled.





Aside from all of this, today is my daughter Maya's 8th birthday. Steve, the kids, and I are traveling up to Portland to go to the zoo. We had our family celebrations earlier knowing that today would not be a great day around the house because of the chemo schedule. We are going to try to have a special day out and about. But, because I will be away most of today, I wanted to get the word out to our community about Mom's second dose.





I hope that this day is not too hard on her. I hope that the medications are able to keep the nausea at a low level, while not making her feel like she is going crazy.

Let me explain the pictures before I end this posting. Two of them are from our Sunday school Da Vinci days art project. We made super heroes. Elias is in the "courage" super hero and Maya is in the "love" super hero. Then there is a picture of Elias as the Mona Lisa. The last picture is of Maya's little birthday tea party.

More later,


Emily

Positive Picture Post

Hello Everyone,

Here I am as promised bringing you good news and good pictures. I know some of you were a bit anxious for the good news to arrive earlier, but I do lead a busy, exciting life on Buchanan St. and my blogging time is limited.

To review, last week on Tuesday Mom became quite ill after her new dose of chemo. Tuesday evening new anti-nausea drugs were prescribed. Wednesday Mom continued to stay in her bed and was still very noxious. The three anti-nausea medications together were only able to make her less ill and did not hold it back entirely. Thursday, upon advice from a local nurse friend, my Dad petitioned the doctor for another anti-nausea medication called "magic 4". This medication is made by the compounding pharmacy and is applied topically. Dad brought it home Thursday around dinner time and Mom added it to her regime. Around this same time Mom was able to rise up from her bed and take to the chair for the first time since chemo. Thursday evening Steve and Dad went to a special choir practice where a choir director candidate was to work with the choir as part of his hiring process. I brought the kids in to see Mom before they went to bed and offered them a creamsicle as an evening snack. As I was pulling the creamsicles out of the freezer Mom called out that she would like to try one too. I passed out the snack and was happy to see Mom actually take a few calories in. I left her there as I helped the kids with their shower and jammies and bedtime story. As I was reading to the kids in a different room I heard Mom up and about. Soon she came to find us and was eating a piece of toast. It seemed truly miraculous to have her up and about and interacting with us again. I call it the miracle of the creamsicle.

Mom continued to improve that night. The next morning she got herself up and eating a bit. She was determined to go downtown to the annual summer shoe sale at the local Birkenstock store. This is now called the miracle of the shoe sale. After the shoe sale Dad took her through the drive-thru at Burger King to get an ice cream cone as she was suddenly hungry again after several days of not eating and then the energy expenditure of shopping. In the drive-thru she made the sudden decision that a whopper jr. was what was needed instead of an ice cream cone. This, of course, is now documented as the miracle of the whopper jr.

I might be a little exuberant with my miracle classification, but Mom's resurrection was miraculous to me. Since she has gotten up and about she has struggled with heart burn, shakiness, dizziness, and fatigue. She wants to have more energy. But, she also recognizes that once again she is doing pretty good. She does not look forward to the next round of this chemo, which will be July 29.

Before July 29 we have more exciting times to come. Steve's birthday is July 20 and he will be turning 35 years old. Maya's birthday is July 30, but we will celebrate it early so that Mom can be a happy participant instead of a sick one. Maya will be 8 years old.

On a completely different note, I feel like I need to say a word about a dear friend of my brother. My brother's long time friend and neighbor was found on Tuesday morning in his hotel room in a coma. He also had a broken wrist and they suspect the coma is caused by some trauma to the head. This friend is currently up at OHSU where they will soon try to bring him back to consciousness. The friend is the father of two young children. Jeremiah and the friend's wife have been with him in the hospital since he arrived. I would ask that all your prayers and good thoughts be turned to this man, his family, and my brother as he deals with another trauma in his life.

Love, Emily

The New Stuff

I am blogging away from home so I am not able to attach any great new photos of beautiful baby Sam or any terrific action photos of my kids on their new play structure. Instead I will write about the rotten new chemotherapy that Mom took on Tuesday.

Tuesday morning at 8 am Mom went in for her new chemotherapy. This chemotherapy is one that she will have four times with three weeks in between the doses. We had gotten some information that lead us to believe that this chemo might have more side effects, but others had told us that there was no reason to believe that it would be any harder than the last stuff. Mom and Dad were at the infusion center a bit longer than normal, but arrived home in a very good mood around 1:00 pm. Mom said that in some ways the infusion of this chemo was easier. They did not give her the massive dose of benedryl with this cocktail and thus she was not as sleepy and groggy. She said that she felt fine!

At around 4:00 pm that all changed. Mom made a move from the warm living room to the cool basement as nausea began to take hold of her. She then proceeded to get rather violently ill. Dad called the doctor and his nurse called in two new anti-nausea prescriptions to add to the one very expensive anti-nausea that she was already taking. I stayed downstairs with Mom as Dad ran to the pharmacy. When Dad returned Mom tried one of the new medicines. This was not enough and she continued to be overpowered by sickness and nausea. She then tried the third medicine and this combination was able to slow the vomiting. I believe Mom and Dad were able to go to sleep at around 11 pm.

Yesterday Mom continued to take all three anti-nausea medications. She told me that with all three of these she still feels like she has the very worst morning sickness. The medications are able to keep her from vomiting, most of the time. She is still caught in the grip of the nausea all the time and sometimes she cannot help but completely loose it. She is also, obviously, in the woozy haze of all those medications. Mostly she is in bed or on the couch in the basement. Mostly she keeps her eyes closed and lays very still.

I think that I have heard from several sources that this might last about three days. Part of me wanted to wait to post this blog until she was through it and I could report the good news of her recovery as well as the rotten news about what she has to endure with this new chemo. But, perhaps the good news will get it's own posting with the cute pictures of all her lovely grandchildren to match.

Love, Emily