(Timeline)How did this all come about ?

Well, here is a timeline of events
(please don't hold the misspellings against me right now. I can't get my word document to interface with this...I'm a blogging nubie)

End of January - I found a lump and made an appointment to see my doctor. I just thought I had a fybroadenoma because my 90 year old grandmother has them as well as my mom and sister. They're just benign growths within the breast that can be removed or left alone. We also have dense breast tissue, so it's hard to even detect them. Becuase I know about our family history, cancer wasn't even something I was thinking about. My doctor thought the same, but asked me to get another mammogram (I had gotten a baseline mamo two years before due to the above family history).

April 4: Mammogram that revealed not only the lump but some microcalcifications (these are sites of calcium in the ducts of the breast that sometimes can be cancerous). So, they set me up for a biopsy

May 8(Mon): Biopsy of the lump and the microcalcifications

May 10 (Wed): Dr. Kerrigan called me to let me know that both sites were maglignant. I was tutoring kids after school at that time, and boy that was pretty shocking.

May 12 (Fri): I went for an MRI and it revealed two sites in the left breast that were suspect and a lump in my right axilla (armpit) that was 2 cm big. At this point we were wondering if it was anywhere else in the body. I also had a pelvic ultrasound to see if there was anything going on with the ovaries because there is a strong relationship between ovarian and breast cancer. Thankfully, that came out clean. I had a pap smear in April and that had come out clean as well. So, at this point we were concerned about the two others in the left and the right lymph node in the axilla possibly being positive.

Preliminary results came in from MRI and Rick Jervis called me since he works in the same office as Dr. Janet Kerrigan (hmmm. you think God arranged that?) and told me to come over for a chest x-ray right away. Because the sites in the left breast were close to the chest wall, he was concerned that perhaps there were sites in the lung. Thankfully, that came out to be clean. I am so grateful that God put Rick Jervis in my life!! He has been able to facilitate so much of this for me and advise as needed. Wow.

May 16: Went to see a local surgeon for a consultation. I won't put his name here. I was not comfortable with him at all.

May 17th: Eisenhower called me at 2:15pm asking me to come at 3pm for the biopsy of the sites that the MRI found, so I dashed out for that. The unfortunate part was that the biopsy was tricky because the sites in the left were so small, it was hard to find them with ultrasound. I wanted to be sure we had the right sites, so I asked for another MRI afteward to make sure that they biopsied the right places. Dr Lanskowski at the breast center and Belinda Zaparinuk were so fantastic. I felt so fortunate to be in their care. They gave me great advice and Belinda even let me drive my original MRI montage over to her house that night so they could compare the sites in the morning to make sure they got the right ones. That was a crazy day. I didn't really get home until 8pm.

May 18th (Thursday): I had a consultation with Dr. Peter Shulz at Eisenhower about surgical options. He was the first to suggest neo-adjuvant (pre-operative) chemotherapy. He leaned toward a mastectomy since the microcalcifications and the tumor were in different quadrants of the breast and he felt that breast conservation would not really be a viable option. In addition, he didn't feel comfortable doing only sentinel node biopsy since it's a newer technique, so he does both sentinel node and partial axillary dissection. There are drawbacks to having more nodes taken out of the armpit area. At the time, I wanted to find someone who did sentinel node biopsy becuase there are far fewer side effects to your arm. That meant that I needed to seek a surgeon out of the valley. However, at this time, we didn't have all of the information since the biopsy results from the axillary node hadn't come back yet. Dr. Shulz suggested that I see Dr. Dreisbach and get his input.

May 22 (Monday): PET scan. This is where your whole body is scanned for cancer. Your body is injected with a radioactive glucose that the cancer attracts and, voila, it shows up on the scan. I wasn't really hungry the night before and I wasn't allowed to eat anything before the scan. Without coffee, it was difficult...I had a raging headache at this point every day anyway, so I was happy to go eat something when it was all over.


May 23 (Tuesday): The "wet" read (initial take) from the MD on the PET scan said it came out looking really good and that only the axillary node on the right and the tumor and microcalcifications in the right were coming up cancerous. The spots on the left were clear-yay! One of the hardest things was going to tell my two dance classes that I couldn't participate and needed to take some time out, but that I would be back. It was hard becuase I was enjoying getting to know everyone and I was enjoying dancing so much. There were some younger girls in the class (even one former student) and it was hard to tell them because I was concerned about their reaction. I just told it in the most positive way possible, but the hard part was just the realization that this was now affecting my life and I had to let go of things that I loved to do.

May 24th (Wednesday): I met with Dr. Luke Dreisbach, oncologist and showed him all of my reports, etc. It just so happened that the results of the biomarkers came back on my very first biopsy may 8th and the timing was perfect. They need the biomarker results to determine course of treatment becuase there are some medications that can counteract Estrogen, for example, or something called Her2/Nu. As it turned out, Dr. Luke had received them before I did even though I was totally anal about calling and picking up copies of Cds and resports and mammograms and having everything all organized etc by date.....This was the pivotal point where I began to consider treatment right away and not waiting due to the agressive nature of the cancer, we needed to start killing it now, and worry about surgery later. Despite the fact that I had made appointments at UCSF, Stanford, and City of Hope, and I had called UCLA and had a name at USC, I talked to my family and that night decided to do it. I would give myself Thursday to get things in place and then treatment would begin Friday. So it did.

May 25th (Thursday): I arranged for a long term sub to come in after consulting with my colleagues and my Principal (I gave her a heads up about a week before about what was going on). That night, I had to tell Scotty Miller at church and my band, Surrender. That was hard, but it was also amazing becuase they were so supportive. My sister flew in and arrived really late so we went to bed around 12:00

May 26th (Friday): I taught the first class, then toward the end, pulled out the armour props that I borrowed from Tucker Pendleton and put on my helmet and shield and held up my sword and told the kids what was going on.
It was crazy. A day filled with innumerable hugs, cards, kind words, flowers. Wow. Wow. I couldn't even teach after the second class. We just hung out together. I had to take a break from hugging people so that my sister could make sure I ate lunch before we went to my first session of chemo. The outpouring at school was unbelievable and something I never even thought would happen. Wow.
So, then off to the appointment for chemo at Dr.Dreisbach's. Karen Pendleton was there with me along with my sister and it went well, I guess.

May 31st (Wed.):Went to City of Hope and met with Dr. Wagman, who is an oncological surgeon who has a specialty in breast and liver. He said we could do a lumpectomy, though they have to do a full axillary dissection because the node is positive and they have to see if any others are. The surgery would happen after my chemo is done (proabably November) and then I'll have radiation. I'll probably stay in LA for about two weeks with my aunt and uncle, and then just drive in for any follow up appointments.

June 12:
Chemo #2 Adriamycin/Cytoxan. My brother was here for this round and he was funny being my house boy...

June 27:
Chemo #3: Adriamycin/Cytoxan. This time my dad came down to help. It was harder physically, but I was also on some killer drugs that made me more out of it, too. BRCA testing has been ordered and it will take about 3 weeks befroe we know the results. Pray that they are negative :-)

June 6th:
Red blood counts are a little low so I'm feeling more fatigued, but that's fine. I'll bounce back, I know!

July 12:
Chemo #4: Last Adriamycin/Cytoxan-wahoo!! My mom is coming down for a more extended time. We may get out to Pasadena again.


What now?
I'll start a different chemo drug on July 27th-taxtiere, which has some different side effects but is not supposed to be as bad. Concurrently, I'll also start taking hercepting which will fight against the "cheerleader" oncogenes in the cancer cells. Yes!! that will be every three weeks for a year, but that has no side effects-yes! That sounds good to me! Inbetween treatments, I'll still go in for bloodwork to make sure that my counts are good. I'll also be receiving the results of the BRCA testing soon so that we can talk a little more about surgery and then I'll want to see a radiation oncologist and consult a surgeon again when I get an updated MRI that shows the current size of the tumor. That will determine whether I'm looking at mastectomy or llumpectomy. I'll want to talk to the radiation oncologist because I want to know what the effects of radiation will be.


Meanwhile, I'm still participating in worship on Saturdays and still endeavoring to sing and play with my band in Video Cafe as my stamina permits :-)

As to whether I'll go back to school in the fall, I'm leaning towards staying out until the surgery and everything is finished because I think that's probably best for the kids as well rather than starting the year and then having to be out due to surgery. It would be easier to have a clean transition for the sub and myself. Plus, second semester the material does get harder and I look forward to teaching that in a way that helps kids to access it. A sub should do fine with the bulk of the first semester material.

That's all for now,
Blessings,
Julie