Tuesday, November 23, 2010

Happy Thanksgiving

Can you believe Thanksgiving is less than 2 days away?  I can't.  The time passes so quickly it's hard to remember how it all sped by without consulting you first.  It already feels like my cancer happened eons ago even though my treatment just finished up just a month ago.  And just a few months before that my cancer journey began.  I have never gotten around to sharing the back story of how I came to be diagnosed.  If you have been following the blog you know that my gynecologist felt a lump during my annual exam, I had 2 biopsies and in early September I was conclusively diagnosed with invasive ductal carcinoma, a slow growing breast cancer. 

What you don't know is that on June 22nd I had my first mammogram and ultrasound and a radiologist at the Breast Center informed me that same day, while I was still on the exam table for the ultra sound, that I had a benign fibroadenoma.  She said to come back for a follow up in January of 2011 because they had no previous mammograms or films to baseline this finding against.  I was so relieved to have gotten immediate feedback on this mystery lump that I didn't even realize was there the previous week.  The doctor said this happens to women all the time and is very common...nothing to worry about.  And so I didn't.

About a week later I got a call from a gentleman identifying himself as the Medical Director at the Breast Center.  He left a very cryptic message on our answering machine and left a call back number in an area code far away from the Breast Center.  I called back a couple of days later.  No answer.  No voicemail.  Weird.  I got a second message and again, I called back a couple of days later and still no answer and no voicemail.  I didn't think much about it....well that's not true.  I thought it was really odd this person I've never met was contacting me and with a call back number hours from here with no voicemail.  I honestly thought he was trying to sell me something.  I don't know why I thought that.  But my senses were definitely alerted to this odd game of phone tag. 

Another week or so later the post office left a tag on our front door saying I had certified mail to pick up.  I'm sure you can figure out who it was from....but at the time I had no idea.  Work and other things kept me from picking up my certified mail for at least another full week.  The letter was indeed from my mystery caller, Dr. RR.  Dated July 19, 2010, "....The study you had on 6/22/2010 requires further evaluation.  Specifically, I recommend a needle biopsy of the nodule in your left breast.  This is because the finding is new.  It is still probably benign but it should be reconciled with tissue biopsy at your earliest convenience....."  Not the type of news that you like to read about while standing in the post office on Saturday afternoon.  What was going on?  The other Dr. told me everything was fine. 

I started making phone calls first thing Monday morning.  The first to my gynecologists office...did he know about this?  What should I do?  He was on vacation of course, but a nurse pulled my chart and informed me that they had a record from the Breast Center saying, not only did they recommend a biopsy, but I had already been scheduled for one.  Huh????  I then dove into the story detailing the weird chain of events and the nurse recommended I contact the Breast Center and go ahead and schedule a biopsy.  I hung up and called the Breast Center and retold my story again.  "Can you please hold?"  Sure.  Someone came back and said, "We're going to have look into this and someone will call you back.  Where can we reach you?"

Not more than 5 minutes later, mystery Dr. RR called my cell phone (the number in my file and that he should have been calling all along).  I was upset.  I was confused.  I was mad.  Really mad.  Our conversation went something like this....

....How could this happen? 
"I apologize...."
Doesn't your facility follow a consistent standard of care in diagnosing questionable breast tissue?
"There are 2 accepted standards of care." 
Why did your office tell my gynecologist that I had scheduled a biopsy when I didn't even know I needed one? 
"Sorry, that is a coding defect in our system"....

Really?  Ok.  I struggled to process all this.  As pissed as I was (and I was pissed!), I couldn't very well ignore the recommendation of a doctor to have a biopsy.  So one was scheduled for 2 days later...to be performed by the Medical Director himself, Dr. RR.  The biopsy was fast and relatively painless.  And 6 days or so later, I got another call from Dr. RR with the results.  "Inconclusive."  Are you kidding me?  "There are abnormal cells, but they can't be positively identified so we are going to send them to a pathologist at Standford to review."  Ok.  Great (that was a sarcastic great fyi).  Another few days go by and late on a Friday afternoon I was once again was talking to Dr. RR.  He informed me the results were still vague...."the Stanford pathologist detected a few cells that could be carcinoma."  What is a carcinoma?  "Well, it's cancer, but you need further evaluation".  Ok, so what now?  "I'm going to talk to your gynecologist and we will contact you with a recommendation."  So I get to spend Saturday and Sunday thinking about how might or might not have cancer?  (I kept this particular thought to myself).  Wonderful.

Monday morning,  August 16th, I got a call from my gynecologist, Dr. M.  He had spoken to Dr. RR and they both concurred that I should meet with surgical oncologist, Dr. K.  The only thing everyone could agree on is that this lump would need to come out one way or another.  I met with Dr. K on August 23rd and her first order of business was to get me in for an MRI.  The MRI showed one lone conclusive lump approximately 2 cm in diameter.  Dr. K said it was clearly defined and they should be able to get a conclusive diagnosis.  She didn't feel comfortable moving forward until we knew what we were dealing with and neither did I.  So I had biopsy number 2 on September 1st and 2 days later, on Friday September 3rd I got the call from Dr. K finally confirming that unquestionably, I had breast cancer. 

Even though breast cancer isn't the news anyone wants to hear....and the road to finally get that news wasn't as smooth as it could have been, I am thankful for so much this year.  I am thankful that Dr. RR came across my file and persistently tried to reach me.  I am thankful that I was referred to Dr. K.  She is a phenomenal surgeon and expert in breast care.  I am thankful that my cancer was slow growing and was caught early.  I am thankful to be cancer free.   And most importantly I'm thankful for the love and support from my friends and family, most especially my parents, siblings and of course my awesome husband Brad. 

What are you thankful for?

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