Thursday December 27, 2012

We've written here before about feeling some obligation with this blog.  We know people care, and those of you who have been along on our journey have brought us so much love and support.  It is truly amazing.

But, sometimes something happens in our lives, and we don't know how to share it with you all.  This latest one is almost too much to take.

Quickly let me backtrack - we had a wonderful Christmas Day surrounded by our family.  Just as we had hoped, it was filled with laughter and tears and stories about Shannon. Unfortunately, Dan, Erin, and I were dealing with some anxiety brought on by events earlier in the week.

On Friday, December 21st, I had my yearly, routine mammogram.  I've done it every year since turning 40, and it's always been completely normal.

Not this time.

I was told to call back and make an appointment for further imaging.  With the help of friends who have friends who work in breast imaging, I was expedited and got in first thing on Monday morning.  Christmas Eve.  The hope was that further diagnostic mammogram would show the calcification spots that had showed up on the initial mammogram would be benign and I would be sent on my way, see you next year.

But no.

The diagnostic imaging was indeterminate which meant the next step was a needle biopsy to remove these spots and see if we could determine them to be benign.  So, on Christmas Eve, I had a needle biopsy with the hopes that the results we would receive on Wednesday (12/26) would prove to be benign.

No such luck.

Pathology's findings are that these spots are "severe atypical ductal hyperplasia", which is considered a precancerous condition.  But, such a small sample is taken during a needle biopsy, that they can't completely rule out the possibility that this hasn't crossed over into the early stages of cancer, called DCIS (Ductal Carcinoma In Situ).  In order to determine this, surgery will be performed to remove this area where these calcifications were, and check those surrounding tissues to see what is happening with the cells.  

Now, understand, these calcification "spots" are an absolutely tiny, tiny grouping.  The radiologist who read my initial scan was on top of his or her game that day.  There has been much discussion recently about whether women in their 40's need yearly mammograms.  Here's an example when it worked to my advantage.  Whatever this ends up being, it was caught at a very early stage.

So tomorrow morning I will have a lumpectomy done as outpatient surgery.  We will get preliminary findings tomorrow, but will not receive final pathology until Monday.  Another weekend of waiting for results.  Ugh...

The results will show us one of three things:  Best case scenario is that the surgery shows no residual atypia and the only ongoing treatment may be the need to take Tamoxifen (a cancer prevention method used in women who are at risk) and be hyper-vigilant about screening and exams.

The second scenario is that there are residual aytipcal cells in the area and the surgeon will try to get to clean margins.  Ongoing treatment in this case would be determined by me and my doctor.

The third scenario - I'm not going to call it worse case, because there are worse things - is that pathology shows that this has crossed over into DCIS.  The surgeon will work towards clean margins, but if they are unattainable with a lumpectomy, further surgery may be required.  A diagnosis of DCIS would be an instance where radiation therapy could be used as well.

So that's the physical side, the nuts and bolts of it.  As for the emotional side... how much time do you have?

Erin's first reaction was a quivering lip and a look of disbelief as a tear rolled down her face.  Her second reaction was "Mom, you can't die because Dad and I would be screwed without you."  Dan concurred, and we laughed.  I'm taking it as the highest of compliments.

Dan is handling it pretty damn well.  He knows he can't melt down right now, because I need him.  We joked today as we sat in yet another exam room at the World Famous Mayo Clinic - how many times have we done this? Enough already.

As for me, good God, 2012 cannot end soon enough.  Just to recount in case you've forgotten:  an ovary removed in April, a tooth extracted in June, and oral surgery to remove two more teeth in July. That didn't do the trick, so I ended up in the hospital for 5 days with osteomyelitis, had another oral surgery, and then spent the month of August with a PICC line in my arm to administer antibiotics.  In November, I spent time weekly at the clinic as I worked with a therapist to deal with the upcoming anniversaries and holidays that we would be facing.  And now, a routine mammogram leads me to my fourth surgical procedure this year.  I hadn't had general anesthesia since I had my tonsils out while in college 22 years ago, and now four times in one year?  The same year my daughter died?  How is that possible?

I have a lot of choice words I'd like to write, but children may be reading this...

Now, in the grand scheme of things, even the worse case scenario here is not really life threatening.  DCIS has a 99% survival rate.  I really, truly feel I'm going to be ok.  But, for me, it's just one more thing in a year of things.

So, we are all exhausted and hoping we don't have another fight ahead.  But if we do, we know this:  we'll have lots of support, we'll do it together, and we'll manage to laugh about it along the way.