Cancer Coaster: Timeline

February 2015 (approximate): Discover lump in left breast while taking a shower. Ignored it. Worried about it.

May 2015: Lump still there. Ignored it. Worried about it.

July 2015: Thought about calling OBGYN. Decided against it. Convinced it’s nothing.

August 2015: Gut says call OBGYN.

August 17, 2015: Called and made an appointment. OBGYN has a cancellation (very odd for her office) for the following day.

August 18, 2015: Saw OBGYN for clinical breast exam. OBGYN orders baseline mammograms and ultrasounds. Reminds me that most breast lumps turn out to be benign.

August 20, 2015: Mammograms and ultrasounds done. 2 tumors found in left breast during mammograms and ultrasounds. 1 tumor found in right breast during mammograms and ultrasounds. Scheduled for left breast biopsies.

August 25, 2015: 9:00 am-Biopsies done of left breast. Told the lump I could feel was most likely invasive ductal carcinoma. Other tumor looks benign. Told to expect results within 48 hours.

August 27, 2015: 3:40 PM -Invasive ductal carcinoma confirmed for lump I could feel. Tumor 1.1 centimeters. Other tumor in left breast is a fibroadenoma (.7 millimeters). Due to confirmed IDC of the left breast, biopsy scheduled for tumor in the right breast. Told to find an oncologist ASAP.

August 28, 2015: Call OBGYN for referral. OBGYN has me come to her office after hours to discuss results and referrals. Told OBGYN I wanted to do everything possible to see Dr. O at the Sammons Center. OBGYN scheduled an appointment with breast surgeon for me. I tell family members (aunts, uncles, cousins).

August 31, 2015: Biopsy done of right breast. Told tumor looks benign. Results would be available within 48 hours.

September 2, 2015: Tumor in right breast confirmed fibroadenoma.

September 3, 2015: Meet Dr. H, breast surgeon, for the first time. Information: Measurement from ultrasound indicated a 1.1 centimeter tumor. Grade 2. Told subtype: HER2 positive. ER negative. PR negative. Chemo is unavoidable and will require a year of Herceptin treatment. Offered option of lumpectomy with radiation or mastectomy (radiation dependent upon lymph node results). Genetic testing blood draw done. Scheduled for breast MRI, chest and lung x-rays, and EKG. Surgeon scheduled an appointment with an oncologist for me. Told Dr. H I wanted to do everything possible to see Dr. O at the Sammons Center. Felt very positive about Dr. H. Dr. H tells me to keep appointment with oncologist while waiting to hear from Dr. O’s office.

September 4, 2015: Meet oncologist, Dr. T. Dr. T lays out treatment options: Chemo after surgery -protocol AC-TH or TC-H. Perjeta not an option for neoadjuvant chemo at this time due to results from ultrasound and mammogram. Schedules follow up for after MRI, X-rays, and EKG. Husband and I like Dr. T. Tell him I am pursuing a second opinion at Baylor Dallas with Dr. O. Dr. T encourages second opinion.

September 8, 2015: Breast MRI, x-rays, EKG done. Nose itches during MRI and I twitch. REALLY annoys MRI tech.

September 9, 2015: Dr. H calls with results from MRI, x-rays, and EKG. X-ray is clear. EKG is normal. Breast MRI shows tumor in left breast, confirmed IDC, is larger than ultrasound measurements at a little over 2 centimeters (2.4 at largest measurement). Tumor is seen sending out “fingers” towards nipple area. Lumpectomy still an option but clear margins could be an issue. Breast MRI also shows a tumor in right breast not seen on mammogram or ultrasound. Decision made: Bilateral mastectomy. I refused biopsy of second tumor in right breast since chemo will now be neoadjuvant. Due to size increase of tumor,  Perjeta is now an option for neoadjuvant chemo. Port surgery scheduled.

September 10, 2015: Dr. O’s office calls! Schedules appointment for 5:00 pm, September 15, 2015.

September 14, 2015: Appointment with Dr. H to discuss genetic testing results and port surgery. Genetic testing results: No abnormalities. Unhappy coincidence.

September 15, 2015: Appointment with Dr. O. Conducts physical exam of breast and lymph nodes. Discusses options. Recommendation: Neoadjuvant chemo regimen. 6 rounds of TCHP every 3 weeks based on research and study information. Herceptin to continue every 3 weeks for year. Husband and I like Dr. O very much. A asks me to stay with Dr. O so that if something were to happen during treatment, A would be less than 20 minutes away versus being over 1 hour away with Dr. T. Decision made. A doesn’t ask for much.

September 16, 2015: Dr. O’s office calls to schedule a baseline echocardiogram. Herceptin can cause heart damage. Heart must be monitored every 3-4 months while on Herceptin.

September 16, 2015: Port surgery in the afternoon. Power Port placed on right side.

September 21, 2015: Echocardiogram done. Heart function-normal.

September 25, 2015: Receive phone call from Dr. O’s office. Chemo is scheduled to begin September 28, 2015. Must be in Dallas by 8:00 am. Panic ensues…feel unprepared. Call husband. Get a sub for my classes. Write sub plans. Call best friends. Immediate girl’s night. Dinner at Cheesecake Factory with them.

September 28, 2015: Chemo 1. Pack bag (Chemo Essentials). No idea of what to expect. Going on research and friends who have been through chemo with Dr. O. Arrive at the Sammons Center at 8:00. First blood draw done at 8:15. Appointment with Dr. O at 8:30. Make follow up appointments for exams and chemo with scheduler. Sent to infusion for the first time. Former student runs the infusion check in and sets me up in a private room. Meet my chemo nurse. Talked through each step. First chemo begins at 11:00 and runs for 6 hours. I grade papers and watch Food Network while A works remotely on his laptop. Get home a little after 7:00 pm.

September 29, 2015: Go to work. It’s important to me to keep my life as normal as possible, and I’m convinced I can work throughout chemo without needing considerations. Very few people at work know about diagnosis at this point. Greeted by Get Well cards from my students posted on the wall behind my desk. Word begins to get out.

October 16, 2015: Chemo 2. A little clearer on what to expect. First chemo treatment was not horrible. Side effects were a terrible headache, a gross taste in my mouth (think brushing your teeth then drinking orange juice), digestive issues (thanks Perjeta!), fatigue (thanks TC and Neulasta!), and a skin rash (thanks Perjeta!). A stays with me throughout treatment. .

Week of October 26, 2015: Catch a cold. Hair begins to fall out

November 6, 2015: Chemo 3.  Cold still hanging on. Cleared for chemo. A stays with me throughout treatment.

November 9, 2015: Cold worsens. Chemo side effects are bad for Round 3. Digestive issues abound. Skin rash with pustules. Try REALLY hard not to scratch or touch the pustules. Epic fail. Throat aches. Voice begins to go. Sees Dr. H for a follow-up. Dr. H does in-office ultrasound. Tumor is barely noticeable. Dr. H orders an ultrasound at women’s center. Dr. H recommends a plastic surgeon. Appointment made for January 13, 2016.

November 10, 2015: Chemo side effects continue to worsen. Digestive issues worsen. Skin rash worsens. Scratched one of the pustules in my sleep and broke it open. Pustule turns red and angry. Voice gone.

November 11, 2015: Call Dr. O’s nurse to report digestive issues and red, angry pustules. Put on an immediate antibiotic and scheduled with a doctor to help with the digestive issues. Epic meltdown ensues due to pain (pustules and digestive issues) and feeling terrible from other side effects (fatigue, headache). Thankful for family who take over for me.

November 12, 2015: Misses day of work. No voice. Can’t teach. Red, angry pustules and digestive issues make it impossible to stay at work. Go home. Feel defeated. Family members come over to ensure I don’t overdo and actually rest.

November 13, 2015: Antibiotics kick in. Red, angry pustules chill out. Voice begins to come back. Go to work. Teach classes. Feel better. Go to digestive issues doctor. Could’ve been worse. Come home. A puts his foot down: I stay home all weekend and rest.

Week of November 16, 2015: Much better. Digestive issues improve. Red, angry pustules gone or almost gone thanks to antibiotics.

November 23, 2015: Follow-up ultrasound at the women’s center.

November 24, 2015: Chemo 4. Dr. O is out of town, so I see her nurse practitioner. Doctor’s office will be closed on November 27, 2015 when chemo was scheduled. Secretly glad chemo is a few days early so that I have a few days at home to recover since school is closed for Thanksgiving Break. First appointment and chemo A cannot make. Mom comes with me. Dr. H calls with ultrasound results. Tumor is much smaller. Side effects were very minimal for Round 4. Worst side effects were taste in mouth and slight skin rash.

December 18, 2015: Chemo 5. Dr. O is back in town! Cleared for chemo. A is there for doctor’s appointment but cannot stay during treatment. Don’t mind being there by myself for treatment. In private room. Side effects were minimal for Round 5. Worst side effects were slight skin rash (on my head of all places!) and fatigue.

January 8, 2015: Chemo 6. Dr. O is thrilled with progress based on clinical/physical exams. Herceptin will continue every 3 weeks. Dr. O wants to see me again after surgery. I’m given orders to call her office as soon as I have the surgery date.

January 13, 2016: Meet plastic surgeon, Dr. L for breast reconstruction consultation. Given three options for reconstruction if I decide to use Dr. L. After talking about the options with A, I decide to use Dr. L who can do a DIEP flap reconstruction. Dr. L’s office does approximately 70 to 100 DIEP flap reconstructions a year. I trust him and his experience.

January 19, 2016: Final pre-surgery appointment with Dr. H. Surgery is scheduled for Feb. 3, 2016.

January 29, 2016: Saw Dr. O for pre-surgery appointment and blood work. Received first solo infusion of herceptin.

February 1, 2016: Dr. L met with me for a pre-op appointment. The appointment lasted five minutes. The conversation was, “Do you have any questions?” Me: “Not really. We covered everything already.”

February 2, 2016: Spent most of the evening at basketball games for my high school. It was a good distraction.

February 3, 2016: Surgery…did not go as planned. Bilateral mastectomy done. Reconstruction delayed indefinitely. Sentinel nodes positive for cancer. All auxiliary lymph nodes removed on the left side. Waiting for pathology reports.

February 10, 2016: Saw Dr. L for surgery follow up. Two drains removed. Two left. Scheduled another follow up for February 17 to (hopefully) remove the remaining two drains and add to the tissue expanders.

February 10, 2016: Dr. H called with the pathology results. 2/16 lymph nodes positive for macro disease. The two nodes were the sentinel nodes. No further nodes showed disease according to Dr. H. The tumor in the left breast Swiss cheesed itself, or that’s how Dr. H explained it. Largest remaining piece was 5 millimeters. No disease found in right breast or in right lymph nodes. Cystic changes were noted in the right breast. Unknown tumor in right breast was another fibroadenoma. Scheduled follow up with Dr. H for February 25. Dr. H set up a consultation with a radiation oncologist  my request for the same date. The final stage, as of now, is IDC Stage 2A ER-/PR-/HER2+ Grade 2 2/16 nodes. Now, we wait for my appointment with Dr. O, who will review the pathology in depth with us on February 19.

February 19, 2016: SURPRISE! The cancer left behind in the left breast and found in the sentinel nodes was not HER2+ cancer. It was ER+. All the HER2 cancer was gone. Unsuspected, and not found in any of the core biopsies, estrogen receptor positive (strongly estrogen positive) remained and requires treatment. I began tamoxifen and lupron on 2-19-16. The final stage, as I know it now, is IDC Stage 2A ER+/PR-/HER2+ Grade 2 2/16 nodes.

February 24, 2016: Dr. L added another 100 cc of saline to the tissue expanders. They’re now full at 500 cc. Super uncomfortable. Dr. L wants to see me a month after radiation ends to discuss reconstruction options and surgery.

February 25, 2016: Met Dr. D, the radiation oncologist. 28 sessions of radiation are recommended beginning immediately. Saw Dr. H for post surgery appointment. Dr. H pleased by healing progress.

February 26, 2016: Mapping and radiation simulation.

March 2, 2016: Radiation begins.

April 14, 2016: Radiation ends.

July 27, 2016: DIEP flap reconstruction done with no major complications. Some healing issues with abdominal incision.

August 11, 2016: Returned to work for teacher in service. I sat. A lot.

August 25, 2016: New school year begins.

September 16, 2016: Last Herceptin treatment.

December 15 2016: Met with new OBGYN

January 30, 2017: Saw Dr. O for first post-treatment appointment. Blood work is finally normal.

February 3, 2017: Bitch-slapped by the flu.

March 13, 2017: Oophorectomy and Fallopian tube removal