Friday, January 9, 2009

The Good News and the Bad

Jan 8, 2009
Well, my appointment at my surgeon’s was cancelled…

I received a call from my Midwife at about 1:30 in the afternoon on my voice mail and it told me that she needed to talk to me about my appointment at the surgeon’s, there were some changes. I called her pager and she returned my call.
“Hello Laurie Jo?”
“Hey, what’s up?” I thought two things. It had spread so far that the surgeon couldn't do anything, hence the appointment was off, or maybe she was calling me to tell me that after the MRI they had realized that the cancer was gone, hence the appointment was off.
“Well Anne (the surgeon’s Physician Assistant) got your report and they found something on your right breast. They need to get it biopsied as well, before you meet with the surgeon.”
“What?” This is where my eyes glassed over with tears…
“They need to do a MRI biopsy to find out what is in the right breast.”
“A MRI biopsy? You mean that they are going to go digging in me while I am still IN the tube?” This is where my hyperventilation kicked in.
“I’m sorry Laurie Jo. Ann will call you either today or tomorrow and tell you when your appointment is at the radiologist and then she can schedule you for a new appointment. I swear one time I will call you with good news.”
We hung up from each other and I called my husband bawling…

“I can’t go through that. In the tube with the needles?”

Side note: My sister always complains that I try to trump her in everything she does. She thinks it is my subconscious competitive side. She had a 9.6 lb baby, I had a 10 pounder. She has MS, I have cancer. She has to spend 3 hours in the MRI machine getting her scans done every year…. I have to be there for 3 hours with needles?? This is one thing I didn’t want to trump her on.
“I’m sorry sweetie,” My husband said, “When is it?”
“I don’t know yet, Anne is going to call me and let me know.”
“I’ll be there for you. I love you.”
“I love you too.”

I went back to work in tears. Malinda saw me at the front desk, asked me what was going on and after I told her, she ushered me to Donna's (our directors) office and we were looking up a MRI biopsy on the Internet.
“You have got to be shitting me.” Was all she could say…
Apparently, they put you in the MRI and while you are in there laying on your stomach with you breast hanging through holes, they press these plates against them and you are in the machine as the radiologist performs the biopsy (as stated in my previous blog).
“I’m gonna need some drugs.” I said crying.

I called Anne and she had told me that she had the report and it said that there was a linear line of masses about 10cm long (that sounds big) and before I see the surgeon I will need to have a MRI biopsy. That way when I see the surgeon, she has all the information she needs to assign a treatment plan.
“But why a MRI biopsy?” I asked.
“Because they couldn’t see it with the ultrasound.”
“Whoa,” I said, “they never checked my right breast with an ultrasound.”
“They didn’t?” Anne asked, I could hear her ruffling through my chart.
“No. they just did the left breast.”
“Oh, I see, they didn’t see anything in the mammogram on your first one, so they didn’t see a reason to do an ultrasound on the right.”
“That is fine, but can’t they try to see if they can see it with an ultrasound before they go for the MRI biopsy? I don’t want to do that if I don’t have too.” I said getting shaky again.
“Maybe they can check it when you go in for your biopsy on the 14th.” She said, let me call one of my contacts over there and see what I can do.
“Thank you.” I said and hung up.

Both Donna and Malinda were fired up, “Why do they need this biopsy, they know it is cancer, take the frickin’ things and be done with it. Why go through all of this?!”

I was not going to wait until the 14th to find out whether or not they are doing a MRI biopsy, I called my Midwife.
“I want to get an ultrasound done on my right breast. It is ludicrous to have a more invasive procedure done when nobody has checked the simpler version!”
“I will call right now and see if I can get you in. They probably cannot do the biopsy then, but at least we will find out if we can see it or not.”
“Oh,” I asked, “ can you please send me a copy of my report. You can fax it to my work.”

I received the fax within minutes and called the radiologist I worked for, Dr. W. To be honest, most times I have to deal with him he can be an ass, but Donna convinced me that he would help me out. So I gave him a call.

I read him my report and we went over it paragraph by paragraph.
“Oh, this is good.” He said.
“Really? What part? I will take anything.” I said.
“You have moderate differential invasive ductal carcinoma.”
“How is that good?”
“All normal cells have the capability to be cancer. A well differentiated cell looks normal, and a poorly differentiated cell means sever cancer. Your cells are moderately, so figure maybe 1/3 bad, but 2/3 good. That is good.”
"Okay." I said, not fully convinced, cancer is cancer right?
"On your right breast, the radiologist doesn't use aggressive words." He told me.
"Dr. W you have lost me."
"Okay, let's look at the first paragraph again. See the word spiculated? That is a very aggressive word, it is highly suspicious for cancer. In the right breast paragraph, he doesn't use these types of words. That is good. It is worrisome mostly because your left breast has cancer. This doesn't necessarily mean that your right breast does. Especially with breast MRIs, the images are very sensitive and gives a lot of false positives, that is why I hate doing them (this is true, he doesn't do them at any of our facilities so I had to go to another radiology group). But all and all, it is not all bad.From the sounds of it, you have stage 2 cancer."

And there it was... Nobody had told me that. Granted this isn't coming from my surgeon, so maybe it will be different, but someone finally gave me an incling of what stage it is.. Stage 2, well it is worse than stage 1, but better than stage 3 or 4, right?

When Dr. W noticed my silence he asked, "They told you this right Laurie?"
"Dr. W, nobody has told me anything."
"Well, from what you read, it probably is stage 2. I am so sorry that you are having to go through this. You aren't very old are you?"
"No sir, I'm 35."
"Any breast cancer in your family?"
"No sir."
You could hear him "humph" with his breath, "I'm so sorry Laurie Jo, if there is anything I can do to help you. If you get any reports and you just want me to go through the gobbly-gook with you I will. Just let me know."
"There is one thing." I said.
"It recommends a MRI biopsy, but I never had an ultrasound on that breast. Do you think it is out of line for me to request a ultrasound on it first to see if they can see it?"
"Absolutley NOT out of line. An ultrasound biopsy is so much easier than a MRI biopsy. You fight for that."
"Thank you Dr. W."
"Bye Laurie Jo. I mean it anytime."
"Thank you so much Dr. W."

I hung up the phone as my Midwife was calling me.
"Hey Laurie Jo, I got you an appointment for just an ultrasound for 9am tomorrow. Even if they see it, they cannot do the biopsy at that time, but we can change you appointment on the 14th, from a MRI biopsy to a ultrasound biopsy."
"Thank you so much!" I said.
"But Laurie Jo," she interrupted, "If they can't see it, you do need to get the MRI biopsy done."
"I know, but mentally I will definitely be more mentally ready for it. Plus, I want drugs."
"Not a problem" she told me.

So now I wait until tomorrow morning to find out whether or not I have to be in the tube for my biopsy.

Please see it on the ultrasound....

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