Stressed AND Blessed

 My emotional capacity is overloaded.

·         My car has broken down three times in the past few weeks: two sensors and my battery failed, all at different times, of course, but fortunately all at home.

·         I’m giving my seven-year-old cat back to ARF (Animal Rescue Foundation), where I adopted her as a kitten: it was a hard decision, but for the best. I’ve become allergic to her fur; plus, I don’t want to take the chance of her hitting my incision when she jumps up on my lap.

·         In addition to a pre-op appointment, this past week I had a physical therapy appointment which went over post-surgery instructions. I need to do one breathing exercise plus a few leg exercises three times a day and walk around in my house every couple hours. These things will help prevent blood clots and make the amount of time I’m draining shorter.

Drain instructions and not using my right arm are the biggest concerns for me. The thought of emptying my drain twice a day worries me. Not using my right arm (and, of course, I am right-handed) is going to make for a dull couple weeks: no writing, no reaching, no lifting. Well, I am allowed to lift a maximum of five pounds with my left hand, but the less lifting the better. The point is that the more I use my right arm, the longer it will take for the drain to run dry, which is the goal. To prepare for being one-handed, I’ve cleaned and decluttered my bedroom and made changes: pajamas and outfits (must be button-up) are hanging in my closet; underwear and socks are in two containers on the bench at the end of my bed because my antique dresser is hard to open.

Before my son leaves for college or work each morning, he will need to pour my water for the day (I use a water purification pitcher and container with spigot.) and two cups of iced coffee from the cold brew pitcher. If I want to have my bed made, he will have to do it. In the evening, he will have to fill the water chamber for my CPAP machine. There are probably other details I’m forgetting, but I’m sure I will remember them after he leaves each day. Plus, of course, he will have to do grocery shopping, laundry, dishes, etc. while I lounge around in my bed or the new lift recliner.

And that leads to the many blessings that have come my way already, which include these:

·         My pastor made me a purple prayer shawl.

·         My brother and his wife sent me a soft throw and a Ninja air fryer.

·         My daughter and son-in-law’s church purchased a lift recliner for me since I will be unable to pull the handle on my regular recliner.

·         My daughter has taken care of phone calls and arrangements for my cat, Tango, and for setting me up for housekeeping services through Elder Care, a local nonprofit.

·         She and her girls gave me a lovely pink box filled with snacks, personal care supplies, a soft throw, and a panda bear. The next day she gave me some additional clothing for my post-surgery recovery.

·         People from my church have already provided rides for me and signed up last Sunday to take me to my four post-operative appointments. One couple is taking me to surgery this Wednesday. And another person has offered to pay a local errand and transportation service if I’m in a pinch to find a ride to a medical appointment.

·         Hopestone Cancer Support Center is providing gas cards and meals. I also received a large cloth bag filled with all kinds of useful things for this cancer journey.

I feel loved and taken care of by family and friends. And by God, of course. I keep getting reminders from him in daily devotional readings that he is near. For example, today’s reading included Isaiah 30:15, “in stillness and in staying quiet, there lies your strength.” That pretty much describes the next month to six weeks of my life.

Whether I blog or not for the next few weeks depends on if I am successful in using the speech to text feature in Microsoft Word. Thank you, friends, for your prayers and your encouraging words.

                               

The Scan and the Plan

Waiting for my connection in the Atlanta airport last Friday, I checked my email and excitedly opened the message from Oklahoma Cancer Specialists and Research Institute (OCSRI). A link led me to my PET scan results. Put into everyday English, they said no spread of cancer. It is confined to my right breast.

“Yes!” I whispered and set about to give the good news via Facebook. What a wonderful way to start a Kentucky weekend with my brother Bob and his family!

 And a grand weekend it was. But this is a cancer blog, so let’s go on to the next thing: today’s appointment with my surgeon. She is kind, professional, and explained things very well. My mind is still spinning several hours later with new information and what it all will mean for the month of September and beyond.

I have an aggressive invasive cancer, likely triple negative again. It is smaller than two centimeters, which means surgery first and then chemotherapy. I won’t know anything about the chemotherapy regimen until well after the surgery.

To prepare for the September 4^th outpatient surgery, I have a lymphedema education appointment on August 27. (That is just in case I develop lymphedema someday due to the removal of one or more lymph nodes.) I should receive a phone call soon to set the pre-op appointment in which various tests are done.

What follows the mastectomy is not what I expected: weekly appointments for the first month. That is the easy part. The harder part will be being laid up for an entire month. Dr. Flynn summed up the activities to which I should limit myself for optimal healing: rest, eating, and personal hygiene. (But no showers.)

There go my plans to work from home. “Typing?” I asked. “That’s not one of the three,” she answered with a smile. Talk about disappointment! But as I’ve thought about it, I will need lots and lots of rest without the pressure of accomplishing anything. Who knows? By the end of September, I might have the mental energy to do some reading.

Still harder is the thought of not seeing my grandchildren for an entire month. They are young enough and rambunctious enough to make visits unwise. No singing “The Wheels on the Bus” and “Patty Cake” complete with motions for 15-year-old Benjamin, who has Down Syndrome and autism. No pretend play with 11-year-old Joelle and 6-year-old Ava. No big hugs that almost knock me over from 9-year-old Josiah, who has autism. And no dancing with 2 ½ year-old Elijah.  I guess we will visit over FaceTime.

And I’m not thrilled by the idea of limiting my blog updates to rest my right arm and chest muscles. Pray for me during the possible silences. As you can see, the reality of giving up my regular routines is hard to bear.

But I must dwell on the positives, which include meals from Hopestone, our local cancer nonprofit. And light housekeeping from another nonprofit, ElderCare. And rides to medical appointments with various friends and acquaintances. And, best of all, the constant company of the Holy Spirit to comfort and encourage me. I’m quite sure there is plenty to learn in long recoveries.

 

               

Brief Update

 Tomorrow (August 14) I will get a whole-body PET scan at OCSRI, Tulsa.

Today

Today I received my diagnosis: high-grade ductal carcinoma in situ. Let me translate.

High-grade means aggressive/fast growing. Ductal carcinoma means cancer that has formed in the milk ducts. In situ means within the ducts.

Dr. Moussa gave me the starting plan: first, OCSRI will call to set up an appointment for a whole-body PET scan asap to determine if the cancer has metastasized (in other words, spread). If I’m all clear, then the next step is a mastectomy.

I’m somewhat shaken by this definitive diagnosis but also relieved to be back in Dr. Moussa’s care.

The drive to and from Tulsa OCSRI was no problem. I spent it praying and singing and praising God. I needed that time.

And I’m looking forward to a week from today when I’ll be on my way to see my brother Bob and his family in Kentucky for the weekend. 

Timeline

Friday, July 5, 2024

Lump discovered. Tried to schedule a mammogram myself but mentioned the lump, only to learn that I needed a doctor’s referral for a diagnostic mammogram. Appointment with my ARNP. Referral for mammogram sent. Received a scheduling call and found out the referral was incorrect: instead of diagnostic mammogram, it said screening mammogram. Called doctor’s office to ask for another referral.

Long weekend . . .

Monday, July 8, 2024

Received a scheduling call and asked for the soonest appointment possible. Result? 11 a.m. on July 16.

Long week . . .

Tuesday, July 16, 2024

The mammogram technician took multiple views. The radiologist requested an ultrasound. The ultrasound technician had difficulty locating the lump. In consult with radiologist, no one said the “C” word, but he recommended a biopsy and suggested I schedule with breast surgeon. Imaging sent to my primary care to do the referral. I left a note with information at the doctor’s office. Unfortunately, my note led them astray.

               

That week . . . (lost track of days)

A call from doctor’s office that referral was rejected by OCSRI (Oklahoma Cancer Specialists and Research Institute) because they do not perform biopsies. I gave the nurse what was listed online as the breast surgeon’s contact information (in Tulsa).

Call from imaging to schedule me for biopsy locally. Declined, determined to reach the breast surgeon.

Could not find breast surgeon’s office or even phone number despite multiple calls to Ascension St. John’s, Tulsa. Was eventually referred to hospital scheduler and found out that the breast surgeon rarely does biopsies, but he could schedule me for one with someone else at St. John’s in Tulsa. I said, “No thanks,” called the Bartlesville hospital and scheduled. (Why drive the hour to Tulsa when I could have the biopsy locally?) The soonest appointment was July 31^st at 1 p.m.

Gradually realized I had been given incorrect information from radiologist. Temper rose.

 

Wednesday, July 31, 2024

“Lesion” of about one centimeter at the 3 o’clock position very close to chest wall, requiring radiologist to perform biopsy from side instead of top. Learned during pre-biopsy conversation that the last time he had done a breast biopsy was in May. A little rattled, but I put up a good front. Second try was successful, but he forgot to leave the marker, so had to do a third entry. (Fortunately, the local anesthetic worked well.) Radiologist or technician said my doctor’s office would call me when they received the pathology lab report.

Long weekend . . .

Tuesday, August 6, 2024

Called doctor’s office to see if lab report was in. It was, but since my primary care person would not be in until Wednesday, it could not be given to me. (He had to see it first.)

 

Wednesday, August 7, 2024

Stopped by doctor’s office. Pathology report is not yet available to me. Received call in the late afternoon that it was in and I could pick it up in the morning.

 

Thursday, August 8, 2024

Picked up pathology report. Sat in car to read it. It didn’t seem right, only reporting that my estrogen and progesterone receptor classifications were negative. Drove into work and read through it again. Noticed it was titled “Addendum Report Surg.” Realized I must be missing the main report.

Finally did what I should have done (but never thought of) in the first place on July 5: called Tulsa OCSRI to schedule an appointment with my oncologist who treated me for breast cancer eight years ago. Received an appointment for tomorrow morning at 9 am!

Fear and Peace?

Fear slammed into my soul Sunday night with these words:  Recurrence of breast cancer is usually more aggressive and more likely to metastasize quickly.

I prefer knowing to not knowing when it comes to medical information, and this came from a reliable source. So, no; I do not regret learning this even though it frightens me.

On my drive to work Monday morning, I gave voice to my fear. Instead of feeling guilty about it, I told God all about it and asked him to help me remember that no matter my feelings—and no matter the outcome—he is always my loving Father. And then I realized that his peace was still with me.

In my office at Good Shepherd, the two things I’m working on are sermon preparation for August 11 and reading in Sailboat Church: Helping Your Church Rethink Its Mission and Practice for our August 6 Session (translated: Board) meeting.

I’ve never preached on 1 Kings 19:1-8 before, so I’ve been reading various commentaries on those verses. In The Communicator’s Commentary: 1-2 Kings, was this sentence: “Of course, being afraid is no sign of weakness; it is the response to fear that reveals character.” My response: Wow!

But God was not done underscoring his message to me yet. In Sailboat Church, there was an entire paragraph in chapter 3 that gob smacked me. I’ll quote most of it and add emphasis in places:

Through this Advocate [the Holy Spirit], Jesus also gives us peace beyond anything the world can give. The peace that the world gives is a fragile thing built on a foundation of favorable circumstances, plentiful resources, success, and good fortune. The peace that the Holy Spirit brings to believers, however, flourishes in the hardscrabble soil of struggle, danger, weakness, and lack. This peace is built on the foundation of trust and hope in God, who never forsakes the believer. . .. Peace comes not because we are strong but because the Holy Spirit enables us to believe that God is strong.

Today, almost a month since I discovered the lump, is my breast biopsy. And then will come more waiting for the lab results and diagnosis. I’m going to remember that even when (or maybe especially when) I’m afraid, God is strong.

 

The Beginning

      “That’s strange,” I thought to myself. “I don’t remember a crease there.”

                A couple weeks later, it occurred to me that the crease could be a warning sign. To my dismay, my fingertips landed on a small bump leading to a firm mass. I called the office and, to my surprise, got a same-hour appointment. I hurried off to get there in time.

                “I think I have a lump,” I told my new ARNP, and asked for a diagnostic mammogram referral. Then came the week of waiting until my appointment.

                Just like last time—eight years ago—I was quite sure. Sure enough that I told my daughter and son as well as my pastor and church about it and asked for their prayers.

                Just like last time, I pondered how this would affect my life. Immediately, the Author of peace was with me, and the prayer I had prayed for months was answered: “Help me love You more.” Even though I knew from experience the kind of physical suffering that is likely ahead, I found myself singing praises to God, so grateful for His Love, so amazed by his glory.

                Then came today, July 16, 2024. I went in to work as usual, though it was only an hour before I needed to head off for my appointment. What could I get done in an hour? That was easy to answer: continue to read the chapters in Ephesians that precede my sermon text for July 28^th. I marveled at the privilege to center my heart and mind on God’s Word as part of my vocation as a commissioned pastor.

                Having already decided to take the rest of the day off no matter what I would learn, I left the office.

                The mammogram was not as painful as I had predicted, and the technician was both kind and professional. I was not surprised when the radiologist wanted a follow-up ultrasound done. Down the hall I went, and my care was transferred to the ultrasound technician. She, too, was easy to talk to and thorough in her job. Then I sat and waited for the consultation with the radiologist. During the short waiting periods between mammogram and ultrasound and then ultrasound and the consultation, I silently praised God and asked for his continued presence no matter what I was about to learn.

                The radiologist asked the technician to bring up the clearest ultrasound image of the “new tissue.” It was strangely shaped, kind of reminding me of a rather square hourglass, except the perimeter was bumpy. I forgot to ask about its size and the BIRADs rating, but he did say a biopsy was the next step. He and the technician were almost apologetic. I was thankful for their expertise.                 

                The last time I had cancer was in 2016, and that is when I also experienced the “peace that passes understanding” during the grueling treatment that took almost a year. Thus, I know that this waiting time for the biopsy and then for the various imaging and tests that will likely follow before treatment is the easiest part. I can still work and still feel like myself. The chemotherapy will make me feel like I am not myself. There will be twinges of nausea and mind-numbing fatigue along with pain that is impossible to describe. I don’t know what the mastectomy will be like; my previous lumpectomy was pretty much a breeze. But probably the surgery will come first this time.

                After my appointment was over, I went out to my car. First, I called my daughter. Then I called my pastor. When I got home, I told my son. As the day continued, I let my brothers, my church congregation, and a couple local friends know by text, phone call, or email that I have cancer again, and I’ll notify my friends who are not on Facebook in the coming days. I still feel peace, though I know harder days are ahead. This diagnosis rocks my world and changes everything about the coming months, but no matter the outcome, God will be my strength.