Category: No Hill For a Climber, Loraine’s Breast Cancer Journey

No Hill For a Climber, Mastectomy Day

First and foremost, I want to thank God above for Dr. Butler and her surgical team who carried out Loraine’s mastectomy yesterday without any complications. I want to thank God also for giving my dear wife such a brave spirit while facing such a difficult diagnosis as breast cancer. Loraine is quite the trooper, but what else would you expect from a career military spouse. We all know that is the toughest job in the armed forces.

Next, I want to express our sincere gratitude to all the love and support both of us have received. There was plenty of family and friends who came to the hospital for her procedure yesterday, and too many prayers and well wishes by phone calls and social media to adequately address. We love you all!

It would be a humongous understatement if I were to say the last few days have been quite taxing on the nerves. Hell, the last couple months since Loraine’s breast cancer diagnosis have been full of soul eating stress, worrying about the known and unknown factors that come with cancer of any type.  This is her third time and third type of cancer that we have faced down. The stresses that come with a cancer diagnosis when you do not yet have a game plan of exactly how it will be treated is like being on a runaway roller coaster, where the fears can make it difficult to remain focused on what is coming around the next bend, or over the next hill that might very well plunge you head on into the ground below.

Thursday of last week, as a result of a miscommunication or some other factor, we had the fear Loraine’s life saving surgery might have to be postponed for an undetermined period of time. Loraine’s initial breast reconstruction procedure was going to begin as a part of her mastectomy. The plastic surgeon was going to place tissue expander’s under her skin after the removal of her breasts as this normally would be the time to do so, while she was already opened up.

During Loraine’s consultation, neither of us can recall much of a concern being expressed by the doctor about the effect  the tissue expander placements would have on her COPD. Maybe we just missed it, I do not know. Any how, when one has COPD there is a concern that the pressure of tissue expander’s can complicate your breathing, especially once they begin inflating them with saline solution.

The plastic surgeon had sent paperwork to our family doctor to be filled out to clear her for the procedure. Again, as a result of a miscommunication, we were lead to believe her personal physician just needed to sign off on the procedure. Thursday, Loraine found out there was a complication with getting this done. She was told by a staff member that they could not fax the paperwork back to the plastic surgeon’s office. I drove down to find out what the problem was to be informed that Dr. Christiano would need to see her in order to sign off on the procedure. I was told, that all that was needed was a simple blood draw for lab work and an EKG.

Simple enough, right?

I called Loraine and told her to come straight down to Dr. Christiano’s office. The receptionist had her paperwork and said all she had to do was to come in as a walk in and they could do her blood draw and a EKG, the results would be in on time for Loraine’s surgery on Monday morning. We were led to believe that they just needed to do these basic procedures, and she would be on her merry way.

Wrong answer!

Loraine and I arrived at the doctors office and I filled her in on what needed to be done. I sat with her until just before she was called back. I had to go  on the road that night, so I went home to get some much needed sleep. No worries, she would get these last minute requirements done and all would be good. But, that is not what happened at all.

A nurse called Loraine back and from the very beginning of the visit became quite rude with her. With a nastiness to her tone of voice, she informed Loraine that what was ordered on the form was that she needed to see a cardiologist and a pulmonologist to satisfy the plastic surgeons concerns over her COPD. Loraine said that she had no idea and was only doing what the receptionist had told her was required.

How would Loraine know if she had never seen the form and the doctor had not told her? This nurse called in another nurse who was also not the least bit compassionate with her. Loraine told her that she was only doing what the receptionist had told her needed done, and the nurse replied “listening to her was your first mistake”.

At this point Loraine was distraught as there would be no way of seeing these specialists before Monday and it seemed maybe the mastectomy would have to be postponed. She looked at the second nurse feeling dejected and said “I guess my surgery has to be canceled then”. This bitch of a nurse had the audacity to thrust her forms into her face and told her “I guess you will just have to then” and then she sent her on her way home with no blood draws, no EKG nor examination by a doctor. She was sent out the door feeling as if her life had no meaning to these two miserable human beings who disguise themselves as nurse’s. There is more to this story, but I will leave it at these two were mentally abusive to my sweet wife and I am filing a formal complaint to the Kansas Board of Nurses about their abusive behavior.

Friday morning Loraine and both made calls to her nurse navigator Melissa in regards to what had occurred the day before in Dr. Christiano’s office. Loraine and I had talked it over and decided that we wanted the surgery to proceed on Monday as scheduled and she would forego the reconstruction process until a later date. Melissa did her part as liaison between Dr Butler’s office and Dr. Martin. By the afternoon, the dust had settled and surgery was still on for Monday morning at 7:00 A.M. as scheduled.

After a night of restless sleep, we got out of bed at 4:00 A.M. and prepared to head out to the hospital by 5:00 A.M. in order to be on time to check in at 6:00 A.M. We drove to the hospital mostly in silence, but did engage in a little chit chat about life in general. Once we got there, we got her checked in through the admissions desk, and at a little before 7:00 A.M. she was taken back for surgery prep. Shortly thereafter my Dad, our daughter Jennifer and son in-law Terry with our 3 grand daughters arrived as did her brother Howard and her best friend Nicole. I was taken back into the prep room  where we had a private moment together before she was wheeled into surgery. Just before she went back, Jennifer got to come back for a brief visit before surgery.

At 7:30 A.M. Loraine was wheeled into surgery, Jennifer and I returned to the waiting area where our family had occupied one corner to ourselves. We did the usual thing everyone does while waiting on a loved on who is in surgery for something potentially bad. We made small talk, laughed some and essentially avoided the elephant in the room which was the worry each and everyone of us were feeling for our sweet Loraine. Then, at 11:30 A.M. Dr. Butler called my phone from the operating room to inform me the surgery was complete, Loraine had come through it well, but it turns out that postponing the beginning of reconstruction was a good thing after all. There were no surprises in the removal of the right breast which only had a couple of benign lumps. But the cancerous breast was a different story. As Dr. Butler was removing the breast tissue, it was actually falling apart, her breast tissue was disintegrating in the surgeons hands as she was removing it. And then upon examination of the lymph nodes, one was hardened which can only mean the cancer has spread into her lymph system. Hearing this was more than my mind could absorb in the moment. It took my breath away.

How do you comprehend your loving wife’s breast was falling apart during removal?

Hearing the cancer is in her lymph nodes was also one of the things we feared the most.

As Dr. Butler was telling me all of what she had found, I had to get up and leave where the family was sitting. I had to be alone for a moment, I had to regroup, refocus, get my shit together before going back to  tell the family. Once I had told them, the flood gates of my emotions opened and I had a good cry for a moment. I had to get that out of my system before I went back to see Loraine in the recovery room. Thankfully, I did have it out of my system as when I did go back to see her, she kept apologizing  for what she was doing to me. All I could do was reassure her that I still loved her. That because she is the only girl for me, that makes her perfect in my eyes. When you have spent over half your life with a loved one, it takes more than the loss of breasts to make you not still love them. My wife is a strong woman, a resilient woman, she is a trooper at heart As she was climbing further out of the effects of anesthesia, she was starting to cut up and joke as is her nature. Because her recovery stay was going to be in the hospital maternity ward, and children under 13 are not allowed there, the nurses bent the rules a little and we had our 7 year old grand daughter Brianna brought back to the recovery room so Loraine could see her.  This was the only time Brianna was able to see her during her hospital stay.

I had prepared myself for Loraine being in a mental funk after her mastectomy. It is a huge thing for a woman to lose her breasts, a part of of her identity as a woman. But as I have said, she is a very tough woman. They say, the job of being a military spouse is the toughest job in the armed forces. I believe I was fortunate, graced by God above to to be blessed with this strong woman who weathered my military career. This same strength of character was on full display for all to see yesterday as she was recovering overnight in the hospital. She interacted with her visitors all afternoon, while also taking numerous phone calls and answering text messages of well wishes from loved one, family and friends. Her high spirits made it hard to believe she had just underwent this major surgical procedure. Even with the discomfort of having her breasts removed, she still had an appetite and had been craving spaghetti all day. I ordered spaghetti with marinara with olives and mushrooms along with a side order of fried mozzarella cheese sticks from Minski’s Pizza. Minski’s is one of the best pizzeria’s in the Kansas City area. She loved this dinner and ate almost the entire meal with the exception of a few of the cheese sticks.

Last night was a rather sleepless night for both of us, but for different reasons. I slept on a uncomfortable couch in the room beside a window where you cold feel the winter cold emanating in from without. I just had a difficult time with comfort. Loraine on the other hand kept having to get up to urinate. She had been on a IV saline drip all day and was told that if she drank enough water and urinated enough, they could remove the IV. I’m pretty sure she did not need to double down on this challenge. The night nurse removed her IV and after that, it seemed she was getting up about every 30 to 45 minutes. And then, at about 2:30 A.M., she was on a video call with our youngest daughter Molly in Munich Germany. I just rolled back over and attempted to get back to sleep.

Loraine was discharged from the hospital today at about 1:00 P.M. Dr. Butler came in to visit us this morning, and to see how Loraine was doing. While there, she examined the incisions and drain tubes she had inserted and then proceeded to tell us both what she had found. There was nothing said, that she had not told me already, but she did have the time to answer our questions. The first was to affirm that now radiation and or chemotherapy treatments are on the table. We will know the course of action for sure once the pathology reports are complete next week. My other big question was in regards to the breast tissue falling apart. We will not know for sure if this is a result of the cancer, or simply because of her age and the fact she had been a smoker for several years up until 5 years ago. Never the less, we now have a better idea of what we are facing. There is something tangible that we can now begin planning our lives around now.  While none of this is good, it is now easier and less stressful than the last month or so has been where everything was still an unknown entity in the severity of the cancer. Now at least we have a better idea.

The nurse navigator came in a little afterwards and not only went over her discharge instructions, but she taught us both how to drain her four drainage tubes and went over what to do if they get clogged due to clotting blood. It is a pretty simple procedure, you have a squeeze tube where the blood and fluid collects which has to be periodically emptied and the contents must be measured and annotated on a log sheet with the date and time of the draining. It might be a good thing I am not squeamish.

Neither Loraine or myself had ever heard of having a nurse navigator for anything. Nurse Melissa is assigned to Loraine for the duration of her journey with breast cancer. Maybe this is something only provided by the St. Luke’s medical community, I do not know. It would be a beautiful thing if every woman who has had this diagnosis had a navigator to walk her through the long process to wellness. Melissa is an angel, she has been so helpful already, and today she not only  arrived with discharge instructions, she came with a small pillow and pretty bags for Loraine to carry her drainage reservoirs in along with a pretty hand knitted lap afghan her mother had made. Melissa told us that her mother is a breast cancer survivor and that she knits these little lap afghans for every patient that Melissa has under her care. This personal touch leaves us almost speechless. It is more than obvious Melissa is a nurse for all the right reasons. The compassion from this woman is far above and beyond her job requirements and we are most fortunate to have her in this difficult journey. She has answered all of our calls in a timely manner, and has kept to everything she has told us. This kind woman is a true godsend.

We have had a great deal of stress since Loraine’s diagnosis. We have had questions that cannot be answered yet, and we are keenly aware that there are going to be more trying times that we may have little to no control over. My good friend Robert had a talk with me the other night which helped me to regain my focus on what is important and that also made me refer back to a prayer that has carried me through most of my adult life. That prayer is the Serenity Prayer, you may have seen me refer to it on other articles I have authored. This prayer is as follows:

Lord, grant me the Serenity to accept that which I cannot change.

Give me the Courage to change that which I can.

Bless me with the Wisdom to know the difference.

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No Hill For a Climber, Lymphedema Prevention

Today is the beginning of a new year and decade. There will be many triumphs and defeats we will encounter while traversing the twisted and crooked path of life. Some of our battles are entirely within our control, and some are not. It is how we deal with these struggles and hard won fights that define our character, not that they occurred in the first place. Every time we get knocked down by life, it is imperative that we jump back up onto our feet in order to continue our fight.

This has been an interesting week, and an emotionally trying week on many levels for my dear Loraine and I both.

Over the weekend, I connected with a cousin I have never known, despite the fact we both have a great grandmother in common. All of my life, it was common knowledge in the family that my great grandmother Mattie May Turner was part Native American of Cherokee descent. My grandmother believed her mother was part Cherokee all of her life too. Yet, my mother had a DNA test completed a couple years ago which showed zero Native American blood, but did show a percentage of African blood. We have surmised that Great Grandma Turner was actually part black despite her fair skin. Two of her little girls were pretty dark, as are many of her grand children and great grand children. We figure that having come from the south to Missouri, which had been a slave state, life was easier to claim being “Indian” over having even a trace of “black” blood in her. It made me sad to think this dear sweet great grandmother of mine, who passed when I was seventeen years old, had to hide who and what she was in order to fit in with her small community. I can guarantee, if it had ever come out that Mattie Turner was part black in her small town, she would have never even been made to feel welcome in her own church. I was happy to solve the mystery of her ethnicity, yet saddened to think of what life had to be like in order for her to be accepted into her community.

This year as in years past, I made no New Years resolutions. What I have done is to just affirm that I will continue to try to treat others with kindness and to continue with my own self care during this trying time in our lives with Loraine’s breast cancer and her brother Howard’s liver cancer. (Howard has been living with us for almost a year now since he became disabled from his cancer.)

Monday as I was preparing to head out to the Veterans Administration (VA) for my Post Traumatic Stress Therapy, I read an article that got me actually quite upset. I am a retired military man of Navy and Army service to my country. At the young age of nineteen, I was given the drug Mefloquine for the prevention of malaria. This course of drugs ran for eight weeks prior to our arrival in Mombasa Kenya, and then we had another eight week course of Mefloquine after we had left. After receiving this anti-malarial drug, we were not able to donate blood for ten years afterwards, that should say something about how bad it is. But here is what I learned about Mefloquine on Monday morning:

Military authors have noted that that “the significant overlap in symptoms associated with mefloquine toxicity and post traumatic stress disorder (PTSD) obscures the distinction between these diagnoses,” and that mefloquine use may “confound the diagnosis and management” of PTSD. Consistent with such confounding, a recent study finds that non-combat-deployed personnel with mefloquine exposure had a significant and nearly doubled risk of subsequent PTSD diagnosis, as compared to those who lacked such exposure.

As mefloquine exposure is correlated with deployment, and as mefloquine exposure provides a separate causal pathway for many outcome variables associated with sleep disorders, unmeasured mefloquine exposure may serve as a potentially critical confounder in studies of sleep disorders among deployed military personnel and veterans. Unmeasured mefloquine exposure has been previously identified as a significant concern in the interpretation of recent military studies of PTSD and emergence delirium. Owing to the potential for confounding, researchers conducting studies of sleep disorders among veterans should measure prior symptomatic exposure and control for its effects in future analysis. (1)

From Military Times:

Case reports of mefloquine side effects have been published before, but the authors of  “Prolonged Neuropsychiatric Symptoms in a Military Service Member Exposed to Mefloquine” say their example is unusual because it shows that symptoms can last years after a person stops taking the drug.

And since the symptoms are so similar to PTSD, the researchers add, they serve to “confound the diagnosis” of either condition.

“It demonstrates the difficulty in distinguishing from possible mefloquine-induced toxicity versus PTSD and raises some questions regarding possible linkages between the two diagnoses,” wrote Army Maj. Jeffrey Livezey, chief of clinical pharmacology at the Walter Reed Army Institute of Research, Silver Spring, Maryland. 

Once the U.S. military’s malaria prophylactic of choice, favored for its once-a-week dosage regimen, mefloquine was designated the drug of last resort in 2013 by the Defense Department after the Food and Drug Administration slapped a boxed warning on its label, noting it can cause permanent psychiatric and neurological side effects. (2)

The good news is this explains a lot for me. It gives a solid foundation to my PTSD, insomnia, anxiety and depression which can be overwhelming at times. After thirty plus years of suffering mostly in silence, I sought help in this. I am particularly disturbed that part of my suffering could very well be a direct result of brain damage caused by Mefloquine. I may never get completely over my issues, yet I have pledged to continue my lifestyle of healthy nutrition and physical fitness, as well, I will continue my Cognitive Therapy for PTSD as long as it takes to maybe rewire how my brain operates.

The important take away is that if I am to be able to care for my sweet wife and Howard during their struggles with cancer, I must continue with my own self care. As a care taker, it is imperative that one still takes care of themselves, or you will soon burnout and possibly become sick too.

Lymphedema Prevention

Now that I have lead you down a twisted path through a forest to show you a tree, I will get on with Loraine’s visit with her physical therapist on Thursday. I felt it necessary first to set the stage for what life is in my home.

Loraine had an appointment with her physical therapist for 7:00 am Thursday morning. Being as we both thought the sole purpose of this visit was to have her fitted for special sleeves to prevent lymphedema after her double mastectomy this coming Monday morning, the visit did not appear to be important enough for me to take the night off from the road in my semi to be there.

We were both wrong, I should have been there as she received a lot of information that I needed to hear too.

Did I ever say in any of these articles that the abundance of information regarding breast cancer treatment will make your head want to pop like a grape?

Many  family and friends with the best of intentions keep talking like this breast cancer and mastectomy are not that a big of deal since treatments have become so successful over the years in regards to breast cancer.

I get it. They are trying to be helpful and encouraging. I appreciate this.

However, this is a monumental ordeal for us in the moment. This upcoming mastectomy is a very intrusive and disfiguring surgery. This is not a simple matter of just removing two breast and then following up with a few treatments.

Try as we may to remain optimistic about what the future holds, right not we have the stress of not knowing just how bad this cancer might be. We will not know until after her surgery on Monday. This unknown factor leads to a huge stress. And then, as if the removal of two breasts and a few lymph nodes is not enough, there will be the lingering possibility of lymphedema occurring in one or both of Loraine’s arms for the rest of her life. And this is not even taking into consideration breast reconstruction procedures to follow.

Loraine was fitted for her compression sleeves yesterday, and then they went over exercises and other things she will need to do in order to prevent lymphedema from occurring. For any of you who are not familiar with lymphedema and the prevention of it here is the information the therapist sent home with Loraine:

What is Lymphedema, and how can I prevent it?

Lymphedema is a type of swelling that occurs because lymph vessels and lymph nodes are unable to drain fluid successfully. This causes a back up of fluid, old proteins, and old cell particles that can build up over time and make the skin and tissues below it harden and become unhealthy, The swelling can range from a mild case which is not noticeable to being severe, affecting how clothes fit or how a person moves and functions. There is no cure, but steps can be taken to reduce the risk of getting lymphedema or allowing it to get worse.

Lymphedema in the left arm

Although there is no strong scientific proof that these tips prevent swelling, an understanding of how the body is structured and its systems work can help people understand the risks, signs and  symptoms so they can get help sooner and have a better chance of controlling or even reversing lymphedema.

Besides noticing that a body part such as an arm or leg looks or feels bigger, or jewelry or clothing does not fit, early signs can be a feeling that the arm or leg is:

Heavy, Achy

Tired,Tingly

If you feel any of these symptoms:

Stop what you are doing and rest.  Lay down and/or prop up the arm or leg on a pillow. Drink water to help move the fluid.

If these symptoms do not go away or happen often, contact your doctor and ask to see a lymphedema therapist.

Steps you can take to avoid lymphedema or keep it from getting worse include:

  1. Good skin care-Avoid injury and situations that might cause an infection.
    • Keep skin clean and dry and check every day for any cuts, scrapes, or other injuries.
    • Wash injured skin with soap and water and apply antibiotic cream like Polysporin.
    • Watch for signs of infection:
      1. Skin that is red and blotchy.
      2. Skin that is hot to the touch.
      3. Fever, chills, nausea, vomiting or flu like symptoms.
      4. Pain
    • Keep nails trimmed but do not cut cuticles, bite nails, or allow hangnails.
    • Wear gloves, long sleeves, or long pants while doing activities that could break the skin like gardening, using chemicals, washing dishes, or working with tools.
    • Avoid needle sticks, IVs and shots in the arm or leg that is at risk.
    • Use sunscreen and insect repellent to prevent sunburn and bites.
    • Avoid animal scratches and bites.
    • Use soap or shaving gel when using a razor and do not cut the skin.
    • Avoid blunt trauma or bruising.
  2. Keep an active lifestyle without overdoing it.
    • Slowly build the level and length of any activity or exercise.
    • Keep in mind that regular everyday activities (such as raking, moving boxes, carrying heavy laundry) can be as stressful to the body as heavy exercise.
    • Take rest breaks often.
    • Wear your bandage or compression garment when exercising.
    • Pay attention to any changes in the shape, texture, heaviness, firmness, soreness, or size of the arm or leg.
    • Keep a healthy weight. Obesity is a major risk factor for lymphedema.
  3. Avoid temperatures that are too hot or cold.
    • Avoid extreme cold.
    • Stay out of the heat (limit to 15 minutes); do not use saunas or hot tubs.
    • Be careful with hot packs and heating pads which are hot enough to turn the skin red over the arm of leg which is at risk for lymphedema.
  4. Avoid anything that squeezes or causes pressure.
    • If possible, have your blood pressure taken from the arm that is not at risk.
    • Avoid wearing tight bra straps, watches, rings or waist bands.
    • Avoid carrying a heavy bag or purse over the at risk or swollen arm or shoulder.
  5. Compression garments.
    • It is important to have compression garments that fit properly and give the right amount of pressure. If the garment is not right for you, it can hurt more than it helps.
    • Your therapist may recommend wearing a compression garment on an at risk arm or leg to give support during certain situations such as:
      1. Demanding activities like weight lifting, yard work, certain household jobs, standing for long periods and running.
      2. Traveling in an airplane. 

This, to me, is a lot on top of everything else. Like pouring salt into a bloody wound. Hopefully the edema will never become an issue. Maybe at some point we might be able to also minimize some of the issues which come with breast cancer too. But for now, it makes our heads swim with emotion, anxiety and fears of the known and unknown factors that could come into play with this awful disease.

 

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040794/

(2) https://www.militarytimes.com/news/your-military/2016/08/11/malaria-drug-causes-brain-damage-that-mimics-ptsd-case-study/

No Hill For a Climber, Breast Reconstruction Consult

Wouldn’t it just be a wonderful gesture if when the world is crashing down all around us, we could just stop it from spinning long enough for us to hop off for a moment to regroup our thoughts and emotions? It would be quite a generous gift from society too, if all of our bills and debts payments could be forgiven for the duration of a loved ones illness. This might happen if we lived in a perfect world, but a perfect world only exists in the imagination of children and those who are out of touch with reality.

The world is not going to stop for us.

It never has, it never will…

No matter how critically ill you or your loved one might be, the bills keep coming in regardless of your ability to pay them along with your rising medical and prescription medicine expenses. Your utility providers do not give a damn about your family struggles with critically ill health. The bank who has financed your home and automobiles could not give a shit either. These institutions will only let you miss a couple payments before they begin mailing you foreclosure warnings while your pleas for continued leniency falls on deaf ears. Miss a few payments and they will come take your transportation and the roof over your head.

Therefore, no matter that we have a loved who might need us at home, we still must report to work and do the best we can to keep our bills paid during a critical illness. We must do this while also still being able to be lovingly attentive and properly care for our loved ones.

And you had better not take too much time off from work in order to care for your loved ones as your employer too will only show you just as much compassion as policy might dictate.

Fortunately, Loraine’s diagnosis is pretty recent, therefore we have not yet encountered any financial difficulties from her breast cancer. However, we have taken in her brother Howard almost a year ago who is suffering from cancer as a result of also suffering from Hepatitis C. Compounding his problems to another level is he has also developed cirrhosis of the liver. This good man has worked hard all of his life, yet because of his illness, he is now fully disabled. We have a full plate and are doing the best we can to care for him, and now, I find myself with two loved ones in my home suffering from cancer.

If we can’t get the world to stop momentarily, could we at least get it to slow down momentarily while I catch my breath?

Wednesday night, it did not matter that I wanted to, actually needed to remain home. Because of a demanding work schedule I had to go on the road for the night in my semi to deliver construction and industrial supplies for my employer. As I tucked Loraine into bed, told her that I love her, and then kissed her goodnight, I reassured her I would be home in time for her appointment. I slipped downstairs grabbed my road gear and said a prayer that nothing would cause me any delays in getting back to our hub in the morning. I desperately needed to be back in time to be able to clean up and catch a quick power nap before getting Loraine to her 1:00 pm appointment with the plastic surgeon who will be doing her breast reconstruction.

Reconstruction procedures will be started immediately after her breasts have been removed on January 6th.

When you have been married to your soul mate as long as I have been, you find that you are totally in tune to your loved one, even from great distances. While out on the road, about 4:00 am, I got a vibe that Loraine was up and needing me. Say what you want about cell phones being a distraction from relationships, they also keep us connected when apart. I picked up my smart phone and through the magic of technology I was able to see that Loraine was online.  I called her and we chatted for a while before she was able to get back to sleep. We talked about how nervous we both were about the doctors visit later in the day and we also just made a little small talk to distract our minds from the unknown outcome of our consultation with her plastic surgeon.

I left my hub with 535 miles to run and 29,000 pounds of freight to unload myself. No big deal when all goes right, but you never know when your truck might have a flat tire or a mechanical breakdown. You never know when a state Depart of Transportation might pull you over for a random inspection either. My prayers were answered, I returned to my hub with no unnecessary delays Thursday morning.

Loraine and I left our house in Leavenworth at noon, and drove the twenty five miles or so to St Luke’s on the Plaza for her appointment. Not knowing for sure where I was going, I rushed to get there in order to not be late. The Plaza area of Kansas City, Missouri has had a tremendous amount of growth and construction since the last time I had ventured down there and traffic can be off the hook crazy, especially now with all the Christmas shoppers hurrying about their business. Thankfully, we did get there on time, and I must have looked like a total rube when I pulled up for valet parking outside of the valet lane. I backed up to pull in where I should have and managed to run over their valet parking sign in the process. You might not have ever guessed that I am a professional driver…

We did arrive in time for Loraine’s appointment, yet we still had to nervously wait a while before she was called back by the nurse. Once we were back in the examination room, the nurse instructed Loraine to remove her blouse and bra and to don an examination smock, opening in the front, and then she left the room. Loraine and I made a little small talk, coming up with questions to ask the doctor. As much as I thought we were prepared with good questions to ask him,  my mind began drawing blanks. I’m pretty sure Loraine’s did too. There was so much vital information to absorb, too much for a mind that was already fully saturated with fear, hope, dread, and a numbness that comes from overthinking possible outcomes.

Thankfully Dr. Martin is experienced enough to anticipate all of our fears and concerns. We asked a couple questions first, and then he essentially shut us down from asking more. I at first thought this was pretty damn rude, but kept my peace. And I am so glad I did as he gave us a very detailed plan of action for a choice of three possible reconstruction procedures once he had examined Loraine’s breasts by taking measurements from top to bottom, under and across. He informed us that because the tumor had retracted her left nipple in too far, that saving her nipples and areola were not possible. Here are the procedural choices we are looking at:

The plastic surgeon will step in once all of Loraine’s breast tissue has been removed. At this time, he will insert tissue expander’s either directly under her flesh, or under her pectoral muscles of the chest. Placement is going to all be dependent on how thick or thin her remaining breast skin might be, and the blood supply to this tissue. He will not be able to decide the placement until he has seen exactly what he has to work with.

Note: it only makes sense that this is the best time to do this procedure as she will already be opened up for it.

Once he has put the tissue expander’s in place, he will close her back up, and we will be through with any further procedures until Loraine has healed enough, or, not until after six months have passed after the completion of radiation and or chemo treatments should they be necessary.

At the point in time where saline solution can be injected into the tissue expander’s in order to create a pocket for an implant, Loraine has the choice of just having them removed. She can forego reconstruction altogether should she not like the feel of a foreign object in her body. Some women find them to be uncomfortable.

The good thing about having to wait, is it will giver her time to honestly evaluate the pro’s and con’s of breast reconstruction. This will also give us time to do further research regarding reconstruction procedures. Should she decide to forego reconstruction, the tissue expander’s can be removed at the surgeons office under a local anesthesia. Or, he can begin the expansion process over the course of a few office visits before actually placing permanent implants.

Once her new new breast tissue has been expanded sufficiently to accept implants, Loraine will have three choices of procedures:

  • Saline Implants. The pro of saline is that if an implant were to leak, the sterile saline inside would be simply absorbed by her body. If a saline implant leaks, the breast will go flat. The con is, saline implants typically do not look or feel as real as silicone implants.
  • Silicone Implants. Pro’s, silicone implants look and feel more realistic. Yet, are known to cause health issues in women should the silicone ever leak out. Leakage is only detectable by MRI according to Dr. Martin.
  • DIEP.  A DIEP flap is a type of breast reconstruction in which blood vessels called  deep inferior epigastric perforators as well as the skin and fat connected to them, are removed from the lower abdomen  and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any of the abdominal muscles. In a nutshell, the surgeon will remove a sizable piece of football shaped flesh and fat from Loraine’s stomach, cut this in half, and then stitch the left and right sides to Loraine’s chest. Once this procedure has healed, she would then return for liposuction of more fat from the sides of her abdomen which would then be injected into her new breasts in order to shape and contour them. The pro’s to this procedure is her own flesh would be utilized and there would be no foreign objects in her body which could possibly leak their contents. The cons is the procedure will be more painful, and will require a three day stay in an intensive care unit (ICU) for three days of around the clock care of the incisions each and every hour. And then there will be the liposuction and fat injection  procedures to follow. Should Loraine have to undergo radiation and chemo treatments, this is a tremendous step to take. I honestly do not want her to suffer this much in addition to the pain and indignities she will already be suffering.

Regardless of the procedure Loraine goes with, the creation of nipples and areola will be the final step, and this might take up to two years to get to.

No matter what my dear wife, my soul mate, my best friend in life decides, I will stand by her in loving support. Should she decide to not undergo reconstruction at all, I will stand by her. Almost thirty four years of love and compassion is far deeper than a pair of breasts could ever be. My main and only concern for this wonderful woman, my bride whom I committed my life to, is that she gets through this with a full cure and that we have many more healthy years together. We will do this together.

No Hill For a Climber, Being Supportive

Almost 34 years ago, I was out riding my 1964 Harley Davidson Sportser when I ran into my old buddy Howard and his sister. The same sister who a few days previously would not give me the time of day when I had tried to speak with her while she was tanning out in front of her mothers home with a friend when I had stopped by. I guess she thought I was some kind of wild man or something. But anyhow, on this day, once Loraine knew that Howard and I were friends she asked Howard if she could have a ride on my Harley. I said to her, “It is my bike, you should be asking me”.

She then asked me if she could have a ride, and me being me, how could I possibly deny this hot chick. I told her to climb on and we have been an item ever since. We used to have so much fun on that old Harley, we loved hitting twisty roads and every so often I would hear her piping up from behind me imploring me to “ride a wheelie”. We were young and carefree, living life to the fullest. About seven months later, I made this beautiful woman my wife and became Dad to her two small children Michael and Jennifer.

Loraine and I have had a good life together, although not always an easy one. We were married September 20th 1986, our baby girl Molly was born April 20, 1987, and I returned to the Navy in May of 1987.

We had a little Datsun B210 that we packed as full as we could with clothing and other personal items and set off for San Diego to my new duty station at Naval Air Station Miramar. That cross country trip was quite the adventure. The kids were crammed in the back, while our baby Molly rode in Loraine’s lap. That little Datsun was a dependable vehicle, but as soon as we arrived in San Diego, Loraine insisted we were going to get her a bigger car, she was never going to be that cramped in a car ever again. We went out and bought her a 1984 Oldsmobile Cutlass that day.

Being a military wife is a very tough job, they say it is the toughest job in the armed forces. After four years in Miramar, we were transferred to Naval Air Station Norfolk, Virginia where we would spend the next five years before being transferred once again to Dallas, Texas where we were for the next two years before I left the Navy.

Navy life was tough on Loraine and the kids. Not only did she have to deal with our being transferred a few times. She had to cope with the problems that would arise with the kids having to leave their friends behind. Of course, most of their friends were also military brats, so they were constantly moving away too. And then there was all my time spent away from home when she would have to take on the role of Mom and Dad while I was gone. My duties were quite demanding to say the least. Even when I was not gone on a detachment, I would work eighty to one hundred hour work weeks. At Helicopter Combat Support Special Squadron 4 (HCS-) in Virginia, I was on a seventy two hour contingency to deploy anywhere in the world in support of Navy Special Warfare operations. I was in a Navy helicopter special operations command with a mission of Combat Search and Rescue along with Special Warfare support of SEAL teams out of Dam Neck, Virginia. This was an exciting tour of duty, but it was terribly rough on our families who never knew when or if we would be called away. We seemed to always be away…

Military life was pretty hard on my family. May of 1997, I left the Navy involuntarily. I’m not getting into all the details about that, but will say I had issues that were coming from what has now been diagnosed  as severe Post Traumatic Stress Disorder. I had a bad time readjusting to civilian life for several years, and in 2008, I returned to military service in the Kansas Army Reserve National Guard as a Staff Sergeant. I re-enlisted one day without talking to my family about it. I went home and asked Loraine what she would think if I told her I could get back into the military. She looked at me and said, “You already re-enlisted didn’t you”. She knew how important it was to me to finish my career and gave me her full support despite there was full likelihood I would either deploy to Iraq or Afghanistan for combat operations at the age of 46 years old. In fact, I was about to deploy with my unit to Afghanistan when I blew out my spine at L5 S1 in an accident at my civilian job. This injury resulted in me being off of full time work for a year, required epidural injections into my spine, spinal surgery followed by two months of physical therapy. It took me a year to learn to walk normal again after this injury, along with kicking an opiate addiction that came from my prolonged use of prescription oxycodone. I retired for medical reasons October 2010.

This article is not supposed to be about me though. I hope to have set the stage where you can see how tough life has been on my dear wife while being so very supportive of me in all of my endeavors. She has stepped up to the plate and been the best wife a man could ever ask for. She has supported me through my military career no matter how hectic life could be for her and the kids at home. She has supported me through the craziness of my PTSD. She carried the torch when I blew out my spine and kept us afloat when others might have left me when I could not support my family as a result of this painful injury. She has supported me through her two other bouts of cancer, one when the needs of the Navy often came before the needs of my family. Now, with her third go round with cancer, this time breast cancer, I will do everything in my power to be every bit of the support she needs out of me.

No matter what she decides about her treatments with this breast cancer, I will stand by her decisions. Right now, Loraine has decided to go through with a full mastectomy of both breasts and then undergo reconstruction during the same surgical procedure. She has my support.

If she changes her mind about reconstruction and just goes with a full mastectomy, she still has my undying support.

Should she change her mind and decide to go with just a lumpectomy procedure which will for sure require radiation and possibly chemo, she has my support.

No matter what she decides with this breast cancer, I will stand strong at her side and support her in her decisions. It is her body that is being affected. She has to live with this, I will support her. It is her mind that has to get wrapped around a full mastectomy, I will be there for her.

If you have a loved one going through any type of cancer, it is a true act of selfless love to be there for their emotional support. This battle is likely to get hard, but we will prevail. Of this, I have faith. God bless and thank you for reading.

No Hill For a Climber, How Much Does Breast Cancer Cost?

What does it cost to have breast cancer?

Lord, I have no idea how to even quantify the question of how much does it cost.

Since my dear wife Loraine has been diagnosed, what kind of price can we place on the mental burden, the fears, the personal and life changing decisions she must make. What worth can be placed on sleepless nights from pain and worry?

What price can you place on your breasts if you are female?  What price can be placed on a part of yourself that is a large part of your femininity?

What price can you place on coming to grips with your own mortality and the impact all of this is having on your family?

As her loving husband, I only wish I knew the price I could pay to make all of Loraine’s pain and mental anguish go away. If there was a monetary value that could be placed on all of this, I bet it would be so astronomical that it would only be a pipe dream anyhow. But I would make every effort to get there anyhow.

What will the ultimate financial burden be when all is said and done?

I have not a blooming clue, but it is going to be quite high. We are fortunate in that I have a good job that provides top quality insurance that is going to cover a good portion of our expenses. However, here is just a snapshot in the picture below of a portion of what has been billed to our insurance already:

On just this portion, there has been charged $32,493. This does not include some of the other initial costs from our personal care physician.

If you have guessed this is kind of terrifying from a financial point of view, you would be correct. These charges have come before Loraine had even made up her mind whether to undergo a full mastectomy or just a lumpectomy.

Absorb this for a moment. With this insurance statement along with the prior statements we have received, there have been in the neighborhood of $40,000 charged, which despite having great insurance, there are high dollar bills already rolling into our mailbox that we must pay. I am thankful to be blessed with a well paying job, but these bills could easily become overwhelming over time…

Loraine has decided to have a double mastectomy, a decision I fully support. We will be meeting with a plastic surgeon in a little over a week who will be in the room when her breasts are removed. Once the mastectomy has been completed, the plastic surgeon will immediately begin a reconstruction process in order that she may retain her femininity after this horrible surgery. It is an amazing thing that this service is available to her, but there are many questions to be asked before it is actually done. Questions such as:

Will reconstruction increase the healing time or add any additional complications?

If Loraine has to undergo radiation treatments afterwards, will reconstruction have to wait until a later time after she has been through treatments?

What kind of additional risks are associated with reconstruction after a mastectomy?

Right now, we have been having sleepless nights. The burden of the unknown can weigh heavily on the soul. While we do know the type of cancer she has is Invasive Ductal Carcinoma, we do not know if it has spread to anywhere else in her body through the lymph system. We will not know this until her mastectomy has been completed and a few of her nearby lymph nodes have been removed for biopsy. This is worrisome as the tumor is about the size of a golf ball and located at the 2:30 position of her breast, near the lymph nodes under her left arm pit.

As if mastectomy is not bad enough, to add insult to injury is the complications which come from lymph node removal. When you have lymph nodes removed as she must have done, you stand the risk of developing Lymphedema.

What is Lymphedema?

When axillary lymph nodes are removed during breast surgery (with sentinal node biopsy or axillary dissection) or treated with radiation therapy, some of the lymph vessels can become blocked. This may prevent lymph fluid from leaving the area.

Lymphedema occurs when lymph fluid collects in the arm (or other area such as the hand, fingers, chest/breast or back), causing it to swell (edema).

The swelling may be so slight it’s barely seen or felt. Or, it may be so great the arm grows very large.

In severe cases, lymphedema can cause pain and limit movement. Also, it can be quite upsetting to have one arm larger than the other, even if the change is small. (1)

Until Loraine has had her surgery, we will not know for certain the staging of the breast cancer. Until then, we will also not know if she will only have to have hormone treatments only, or if she will have to also have radiation and or chemo treatments. If she were to only undergo a lumpectomy in order to save her natural breasts, six weeks of radiation treatments, five days per week are guaranteed with a possibility of chemo also being needed. With a full mastectomy, provided the tumor is entirely contained and has not spread, hormone treatments that suppress estrogen production are the modern treatment which has been found to be successful.

What it might cost for a loved one to have breast cancer is terrifying to say the least. It seems the sky is the limit in how much is going to be billed to us. My daughter Molly has suggested I set up a GoFundMe page to help offset the financial burden. I have not ruled that out, desperation at a later time could drive me to this, but I do not want a handout from anyone, we are survivors. Currently, Brenda Sue and I are building a Market Place here at David’s Way in order to help out with the massive financial burden Loraine and I are facing. If you feel it in your heart to help, please consider online shopping here at David’s Way. We are marketing breast cancer awareness items, health and beauty supplements, healthy ingredients for our recipes that your store might not carry, fitness gear and much more. We will soon have all our market categories up for your shopping experience. We currently have our breast cancer awareness and CBD markets up and running for you.

Edited: I found out before we got the marketplace fully built, I was not able to proceed. Apparently, I missed some of the small print.

I have dedicated countless hours and hard earned cash, along with all that Brenda Sue has brought to David’s Way. We have built this website as a labor of love to help others in losing and managing their weight through healthy lifestyle changes. I have pledged from day one that all of our informational content to you will be 100% free, and this will never change. Our content will always be free to you as promised.

Please pass the word to family and friends about my website. We have over 665 nutrition, health and fitness articles for you that have all been written by Brenda Sue and myself. We have a wide variety of healthy recipes for you to try as well. Our mission has been to help as many people as we can, please help us by spreading the word.

God bless and thank you for reading.

(1) https://ww5.komen.org/BreastCancer/Lymphedema.html

No Hill For a Climber, Surgical Choices

As Loraine’s husband, I might have some say in what type of surgery she will undergo for this breast cancer. But, because of my love and respect for this woman who has been my everything, the final choice of surgery and treatments will be her choice to make. It is her body, her breasts, she is the one who has to live with the decision she makes. No matter what, I will be at her side, still loving and supporting her through it all.

If you can say there is any good fortune in this, it is that Loraine has the most common type of breast cancer, Invasive Ductal Carcinoma which starts in a milk duct in the breast and grows through the wall of the duct. We are fortunate in this being the most common type as there has been enough research completed to make this one also the most treatable.

Four other types of breast cancer:

From St. Luke’s literature:

  1.  Ductal carcinoma in situ or DCIS, which is a very early breast cancer. In DCIS, the cancer cells are only formed inside the ducts that carry milk to the nipple. The cancer cells have not spread through the walls of the ducts into nearby breast tissue. Nearly all women with DCIS can be cured.
  2. Lobular carcinoma in situ or LCIS, starts in the glands that make milk but does not grow through the walls of the glands. It’s not a cancer, but women with LCIS have a higher chance of getting breast cancer. If you have LCIS, you should be sure to get mammograms the way your doctor tells you to.
  3. Invasive lobular carcinoma, starts in the milk glands. These are called lobules. It can spread to other parts of the body.
  4. Inflammatory breast cancer or IBC is a rare type of breast cancer. Most often there is no lump or tumor. IBC makes the skin of the breast look red and feel warm. The skin can also look thick and pitted, kind of like an orange peel. The breast may get bigger, harder, tender and itchy. Because there is no lump, IBC may not show up on a mammogram. This can make it harder to find IBC early. It is more likely to spread and is harder to cure than invasive ductal or lobular cancer.

Questions to ask the doctor. 

  • Why do you think I have cancer?
  • Is there a chance I do not have cancer?
  • Would you please write down the type of cancer you think I might have?
  • What will happen next?
  • How will the doctor know if I have breast cancer?

What kind of treatment will I need?

There are many ways to treat breast cancer, but the main types of treatment are local or systemic.

Surgery and radiation are used to treat only the cancer. They do not affect the rest of the body. This is called local treatment.

Chemo and radiation treatment drugs go through the whole body. The can reach cancer cells anywhere in the body. They are called systemic treatment.

Doctors use both local and systemic treatments to treat breast cancer. The treatment plan that’s best for you will depend on:

  • The stage and grade of the cancer.
  • The chance that a type of treatment will cure the cancer or help in some way.
  • Your age.
  • Other health problems you may have.
  • Your feelings about the treatment and the side effects that come with it.

Surgery for breast cancer

Most women with breast cancer have some type of surgery. Some types of surgery are lumpectomy, mastectomy, and taking out the lymph nodes from the underarm. Women who have a mastectomy may also decide to have the breast shape rebuilt, either at the same time or later.

Choosing between lumpectomy and mastectomy

Lumpectomy only takes out the lump and a little bit around it. It lets you keep most of your breast. The downside is that you will most likely need radiation treatment after surgery. But some women who have a mastectomy also need radiation afterward.

When choosing between a lumpectomy and mastectomy, be sure to get all the facts. At first you may think that a mastectomy is the best way to get it all out. Women tend to choose mastectomy because of this. But, in ms cases, lumpectomy is just as good as mastectomy. Talk to your cancer care team. Learn as much as you can to make the right choice for you.

A diagnosis of breast cancer is a very stressful and life changing event. If you or a loved one has been recently diagnosed, please do all that you can to keep yourself healthy through diet and exercise that has been approved by your doctor. The healthier your body, the stronger your immune system will be to fight off this evil beast of a disease.  When stress is killing you, do yourself a favor and reach for a healthy choice food instead of some sugar filled, highly processed garbage that will only make you feel better for the very brief moment that you are eating it. Once that sweet treat has been swallowed, the stress of the disease is going to return about as quickly as it left. That is, if it even left you at all.

If you or a loved one have received the diagnosis of breast cancer, knowledge is going to be your friend. Read up and educate yourself as best  you can. It is your body and your life. Have questions for your doctor at the ready.

 

No Hill For a Climber, Emotions, Fears, and Coping

Breast Cancer Prayer

Lord, I have just received the diagnosis of breast cancer.

Still my anxious heart as I seek to understand why.

Teach me to transform this suffering into growth.

My great fear of tomorrow into faith of your presence.

My tears into understanding.

My discouragement into courage.

My anger into forgiveness.

My bitterness into acceptance.

My experience with cancer into my testimony.

My crisis into a platform on which I can learn to help others.

God grant that one day I can embrace this time as my friend, and not as my enemy.

Judy C Kneece, RN, OCN

Wouldn’t it be nice if we could just wave a magic wand and make all disease and ailments just disappear into a puff of smoke?

Abracadabra! Cancer be gone!

I have seen faith healers on television cure the most infirm among us with a simple smack to the forehead while shouting out to Jesus for healing transformation. Works every damn time, I swear! I saw it on television!

Somehow I have not found a way to convince Loraine that all she needs to do to be rid of the breast cancer and all the worry and fear that goes with it would be a little faith that I could tap her on the head faster than she can say ouch while I shout praises to the Lord to cure her. I done seen some stuff on those rattle snake churches in the south too that might help…

Awe never mind with the goofiness. Although we do need to remember to enjoy life during our journey down this difficult and twisted path we have involuntarily embarked down.

Oh God, in my feeble attempt at trying to bring a little levity to this topic, I just realized it might appear I was not taking the Breast Cancer prayer seriously. To the contrary, I believe with all my heart in the power of prayer, and that my Lord and Savior hears them all even if I am somewhat crude in my words. Thankfully, I know I am saved and forgiven.

So, we received the breast cancer diagnosis on Friday. I have a pretty good grasp of where we stand for now. It helps that I wrote about it in great detail in my last No Hill For a Climber article. That being said, I am still living with a great deal of fear for my sweet Loraine, and of course she is also fearful at this time. I’m not sure there will be a true day of rest until we have beat this demon breast cancer. This diagnosis has had us on an emotional roller coaster to say the least. For Loraine, it is not helpful that for about the last ten years, she has been a care taker for so many terminal cancer patients in their homes. She has seen pretty much nothing but worse case scenarios. People who have become well do not require care takers in their homes. Kind of like bad news will travel around the world before good news makes it off the porch, you never seem to hear about all the success stories. Most of what we see and hear about are the tragedies. For some odd reason, despite the fact she has survived two other cancers in the 33 plus years we have been married, this one seems different and scarier than the others. I do not know why, but we are both more worried and fearful than we have been with the last two bouts.

It is only human that we have fearful emotions when faced with a cancer diagnosis. You cannot escape the fear of the suffering that can and does come with cancer, the humiliation that so many suffer from losing their hair to chemotherapy, the financial ruin that can drive a family to bankruptcy. There is a sadness that comes from thinking about how this is going to affect our children and grandchildren. I could probably write a full novel right now regarding the emotions that we are experiencing right now. Last night, neither Loraine or myself slept much. We laid in bed, and snuggled close, talking about how this is likely to impact us and our family. We began to talk about her fears, and mine too. Neither of us said too much about our fears, we didn’t need to. After over thirty three, almost thirty four years of marriage, we do not need to speak words in order to communicate how we feel. We just know, we can feel and sense it in each other. Just holding each other close and tight can say more than can be said in a novel’s worth of words.

I want to share a message from Saint Luke’s Cancer Institute to family members of cancer patients: The one you love has received the diagnosis of cancer. Because you love the patient, you need to understand how you can best help during this experience. Listed below are support components that other patients have said were essential to their recovery.

Support Tips:

  • Assure the patient that you will be there to support them when needed-that cancer will not change you relationship with them. The greatest fear is being left alone to suffer or feeling that they are a burden to the family unit because of their illness.
  • Allow the patient to verbalize fears, concerns, and thoughts without critical or judgmental input from you. A person who cannot communicate openly with family members may not master the emotions the illness creates, and this can impede recovery. Feelings may change as time passes. Please be patient and encourage the patient to share freely.
  • Accept tears as a necessary part of healing. Tears are a common reaction to loss of health status, such as a diagnosis of cancer. A person who does not cry when suffering great change in health is a person who is probably not in touch with the reality of loss. Tears are not a sign of weakness, but a sign that healing is taking place Do not fear that the patient will be upset if they see your tears; instead, seeing your tears gives them permission to openly cry with you. This is often the time that emotional healing begins in a family. Tears serve as a salve to the soul, for both the patient and the family members.
  • Allow the patient time to be alone to sort through the loss and personal feelings. Sometimes family members wrongly believe that the patient must be talking to or surrounded by family members after the diagnosis; but often the person wants and needs time alone to silently think about what is occurring. Do not think that this is a sign the patient is shutting you out Instead, it is a sign that they are thinking through their problems. Some people need more privacy than others. Allow them this silence and offer assurance that you are there to talk openly if and when needed.
  • Understand that the patient cannot talk openly to everyone about their feelings. Often patients will choose only one, or a few, family members or friends for open communication because it may be uncomfortable to talk with everyone about their situation. Do not insist that the patient keep retelling the “illness” story or sharing their feelings. As long as the patient is talking to one or more persons openly they will do well.
  • Recognize that the most stressful and damaging event that can slow the healing process is family conflict. Family stress can alter the patients immune system function, thus blocking the key factor to recovery. If the immune system is compromised it cannot perform properly; therefore, healing cannot take place. Even the most medically advanced cancer treatments cannot work if the patient is under constant stress at home. Attempt to minimize any conflicts in their environment. It is essential that the patient is in an atmosphere where they feel safe and removed from conflict. Do your part to avoid conflict with the patient while not secluding them from normal family life.
  • Support the patient in the way they need and want help. Do not assume you know what the patient needs; ask. Some patients feel stripped of their roles and feel useless when other family members suggest that they are unable to fulfill previous family responsibilities. The patient needs to feel that they are still a vital an essential pat of the family. Do not take away roles or responsibilities unless the patient is too weak or requests relief from the routine family duties.
  • After a cancer diagnosis, there is much to be learned and many discussions to be made about the diagnosis and treatment, If the patient agrees, it may be helpful for a family member or friend to gather accurate, useful information through which the patient can make decisions to best meet needs. It is also beneficial for the family member or friends to accompany the patient to appointments where these options will be discussed to help facilitate and verify the decision making process.
  • Offer to go with the patient to a support group to learn more about illness and to find ways to assist them to effectively cope.

Remember:

  1. This is the same person that you knew before the diagnosis. The patient would like as little change as possible.
  2. Let the patient talk openly and freely when needed.
  3. Do not feel that tears are a weakness.
  4. Allow the patient to maintain former roles in the family as much as possible.
  5. Eliminate as much stress as possible from the environment.
  6. Help the patient learn as much as possible about the disease.

I hope that by documenting this journey in it’s entirety I am able to help others who may one day face this, or maybe those who are currently dealing with breast cancer. For those who want to follow this story as it unfolds, I created a website menu tab specifically for this in order that you will not have to sort through other articles to stay current.

God bless and thank you for reading, and for the tremendous outpouring of love and support we have received in the last couple days. Comments and questions are most welcome and will be answered. Feel free to subscribe to my website and receive all of our nutrition, health and fitness articles along with all the healthy recipes we post. There will never be a charge to access our articles or forum which we hope will soon become more active. This website will always be free to the public. This is my labor of love, with the assistance of my lovely co-author Brenda Sue. We do this for you with no expectations of ever receiving anything in return.

David

No Hill For a Climber, Surgeon Visit Today

My sweet Loraine and I as newlyweds in 1986.

I never dreamed when I began this nutrition, health and fitness website, that I would be documenting my dear wife’s, my sweet Loraine’s journey with breast cancer on these web pages, yet here I am this evening, writing my third piece in this series.

I am doing this in order to share with others the good, the bad and the ugly of this journey. I am sharing this experience in order that maybe, just maybe, it might help someone else in their own struggle with breast cancer. Loraine’s experience may be different than the difficult path you or a loved one might encounter, but maybe it might still answer some of your own questions, or give you ideas of what to ask about if you or a loved one has been recently diagnosed.

To the guys reading this, my intent is to also help you in understanding this tough path we travel with our loved ones. I want you to know that what ever emotions you might experience are completely natural and okay. Brothers. if you need to shed some tears, then by God, let them flow. No one is going to demand you give up your “Man Card” for being a human being with human emotions.

SSG and Mrs David L. Yochim, 2009. One year before my military retirement. The odds are against marriages surviving military careers. I’m so lucky, mine did, even with my having served in two different military branches, Army and Navy

A little over a week ago, we got Loraine’s diagnosis that she has breast cancer. An appointment with a surgeon was set up for as soon as possible which was today. To say the last week has been stressful and an emotional roller coaster ride, would be an understatement to say the least. We have been through her having beat two other cancers over the years already, now we are in for a third and different type. My God, just how much is one woman supposed to endure in life. Lord, when will enough be enough for this kind and gentle woman, my wife, mother of our children and proud grand mother of our four beautiful grand daughters. Why does my dear wife have to suffer these indignities…

This morning, we arose and fussed around each other over our morning coffee as is our norm. Today was the day for the visit with Loraine’s surgeon, where we would find out our immediate coarse of action with this breast cancer. Yet, this was really not the topic of discussion as we went about our normal daily breakfast rituals. We had our coffee and breakfast while sitting in the living room and watching the local news with great attention being placed on the weather forecast. Placing our focus pretty much anywhere and everywhere except from dwelling on what might be said in the doctors office at our noon visit. I believe despite both of us being worried about her prognosis, we simply avoided the topic until it was time to leave. Even then, we found other distractions to occupy our minds until we arrived for her appointment. First we had to run by the bank to deposit a check, then gas up my truck before heading over to the UPS store where we mailed a Christmas package to our daughter and her small family in Germany. We were not consciously procrastinating our arrival to the appointment, but these little side excursions on the way gave us something else to focus on instead of worrying about receiving news of a worse case scenario. I kept stewing on how much it costs to mail packages to Germany from Kansas while Loraine kept telling me the price doesn’t matter, after all, the package was gifts mainly for our two year old grand daughter we have not yet met.  Needless to say, I surrendered to this little battle, as we arrived at the doctor’s office…

This was from about 4 years ago. I was at my heaviest and strongest as a power lifter. I might have been King of the castle, but if the Queen was not happy, watch out…

After battling Black Friday shopper traffic we arrived at the doctor’s office at about 11:30am. The parking lot was almost empty,which I later found out was because they were only working a half day, and the surgeon had actually fit Loraine in during what would have been her lunch hour.

Once inside we were given a stack of forms to fill out, forms wanting the basic new patient information along with more forms that covered Loraine’s entire medical history along with that of her family. I was glad we had actually arrived a little sooner than we were told to after we got this stack of forms. Once these had been filled out, we were led to an examination room where Loraine had to remove her blouse and bra and then put on a medical smock so the doctor could perform another examination of her breasts. Of course the masses were easily felt, but the doctor asked about two other conditions of her breast that I never gave any thought. The first was in regards to an indentation in an area that used to be full, and the other question was in regards to how long her left nipple had been inverted.

Ladies, even if you do not feel a lump in your breast during a self examination, if you have an indentation in your breast that is abnormal, or if your nipple becomes inverted, please get yourself in for an examination. These are signs of breast cancer that many are not aware of. What happens is the tumor will pull these tissues inward as it grows.

Men, if you notice these conditions on your wife or girlfriend, please have them get checked out. Even if there is no pain, these conditions need to be checked out. Breast cancer is not always painful.

After Doctor Butler finished her examination of Loraine, she lead us back to her office where we discussed the diagnosis and treatment options. Is it necessary to say both our minds were swirling at this point and it was a battle to take in all that the doctor was telling us? I’m glad I had the foresight to take a notebook along in order for me to take notes. I strongly advise anyone going through this journey to do the same. With emotions flowing rapidly where you do not know if you are going to break down crying while trying to maintain your composure, you are bound to forget some of what is being said. Also, it is a good idea to write down your questions before hand in order that you do not walk away with unanswered questions.

Now, on with the diagnosis: This is a grade 2 invasive ductal carcinoma, fortunately the most common type of breast cancer. The grade is not a stage, and we will not know 100% the staging until after her surgery in a few weeks. The grade is the average Histopathological Grade of between 1 to 6 being the highest. The average is from grading Tubule formation, Nuclear pleomorphism, and Mitotic rate. Being a grade 2, despite the tumor being about the size of a golf ball means that we have likely caught this cancer in its early stages of growth.

The next part that looks promising for successful treatment is her Estrogen Receptor (ER) marker is positive, her Progesterone Receptor (PR) marker is positive and her HER2 is negative. HER2 stands for human epidermal growth factor receptor 2. When a breast cancer is HER2-negative, it means that the cancerous cells do not contain high levels of the protein HER2. Thank God, there are many treatment options available for this type of breast cancer.

The treatment options we have been presented with are a mastectomy, where the entire breast and all of it’s tissue is removed. If the cancer is entirely contained and has not metastasized, the only other course of treatment will be from an aromatase inhibitor medication to inhibit the production of estrogen. No chemo or radiation will be required unless the cancer has metastasized.

The next option is a lumpectomy where only the tumor is removed in the hopes of preserving the breast, but there will be daily radiation treatments and possible chemo for 6 weeks after surgery.

Loraine was given some time to consider her options, but right now I believe we will do as the surgeon advised and have the mastectomy since the recovery will not involve painful radiation or chemo which will have her sick and losing her hair. On a positive note, we have the option of having a plastic surgeon being on the surgical team who can begin the process of breast reconstruction right away.

Ladies, here is an example of breast reconstruction after a mastectomy:

There is hope that you can retain your figure after a mastectomy.

Do your self examinations! Teach your daughters and grand daughters to do them too! Early detection saves lives!

Self examinations and early detection are critical to your survival. From literature sent home with us from COPE Library:

Some breast cancers grow rapidly, while others grow slowly. Breast cancers have been shown to double in size every 23 to 209 days. A tumor that doubles every 100 days would have been in your body approximately 8 to 10 years when it reaches one centimeter in size (3/8 inch), the size of the tip of your smallest finger The cancer begins with one damaged cell and doubles until it is detected and treated. The cancer must be surgically removed from the body, destroyed with chemotherapy and/or radiation therapy, or controlled with hormonal therapy. Some people believe that cancer grows in spurts and the doubling time varies at different times. However, by the time a one centimeter tumor is found, the tumor has already grown from one cell to approximately 100 billion cells.

God bless, and thank you for reading. Please, if you know someone who has been recently diagnosed, please share this with them. I pray that by sharing our journey with breast cancer we can bring awareness and education to as many people  as we can around the world. If we only help one, the effort will have been worth it, I pray we help many more along the way.

David

No Hill For a Climber, Early Detection

Several years ago, back in my Navy career, I spent five years in a Special Operations helicopter command, Helicopter Combat Support Special Squadron 4, where our mission was Combat Search and Rescue along with helicopter support of Navy SEAL teams such as aerial gunnery and insertion/extraction operations.  Because of the nature of our mission, we were on a 72 hour contingency to deploy anywhere in the world in support of SEAL operations. This tour of duty was quite extreme and very demanding because of  our operating tempo for both training and real world hostilities which there never seems to be a shortage of. One month we could be training in the hot desert environment out in Fallon, Nevada, another month we might be in training in the extreme cold of Vermont in the winter, or close to the Arctic Circle in Norway. We could find ourselves operating out of tents even in extreme weather conditions, or we might find ourselves operating from a Navy ship. No matter our base of operations, we always had to be prepared.

You may be wondering  about now, what does all of this military stuff have to do with cancer and early detection? In this command, we were always prepared to face any foe under any circumstance. The pressures of our operations made it possible for us to deal with any  and all dangerous circumstances life might throw at us. Our training for any and every type of hostility known to man, meant we were proactive in facing these dangers with the confidence that we would always prevail no matter how hard the fight. We were HCS-4 Red Wolves, we were one of the only two most elite helicopter squadrons in the world with our unique mission. Navy SEALS are the most elite fighting force the world has ever known, they only rely on the most elite for their support.

I might have a tough exterior, but inside I am still human with human emotions the same as you. I love my dear wife, she is my best friend in the world, she is my everything. So, the diagnosis of breast cancer was a hard punch to the gut which has had me being somewhat of an emotional wreck over the last couple of days. This beautiful woman has already endured a hysterectomy because of a uterine cancer 30 years ago in the early years of our marriage. And then she underwent the surgical knife once again for vaginal cancer a couple years ago. She still has quarterly cancer checks for the last round of cancer. Now, here we are today, after taking in her brother who is suffering liver cancer, we have received this diagnosis of breast cancer earlier this week. While the diagnosis is quite upsetting, it is also refreshing to know that early detection is the key to beating it, as we have in the past. We are fighters.

Coincidentally, this morning as I checked my Facebook page, I saw a post by my good friend Kenny who has written about finding that he had prostrate cancer from a routine screening. Seeing that reassured me that my muse this morning to write about early detection and screening was the right subject at the right time.

From my good friend Ken LaMaster:

A few months back a very dear friend of mine shared that she was facing an uncertain battle with cancer that her doctors had found. Upon her acknowledging what she might and might not be facing she shared her prognosis with her friends on Facebook. Upon sharing this with her friends she received an overwhelming amount of love, support, well wishes and prayers. Her wish above all us was for her friends who hadn’t had a physical in some time to please do so. It had been 40 years since I had one and I felt compelled to follow through with my dear friends request. I underwent a physical, my first colonoscopy, and prostate exam along with a multitude of blood test etc. In all that it was discovered that my PSA was elevated to 4.7. As a precaution I was directed to an appointment with Dr. Holmes of the KCUC at St. Luke’s Hospital. Approximately three weeks transpire before I see Dr. Holmes where he did additional blood and urine test along with another prostate and bladder exam. In the three short weeks my PSA level had catapulted to 7.0. A biopsy was ordered and was completed almost three weeks later. Today I received the results. After the hardest couple of months of my life including the past ten days I was declared cancer free. A few of my friends, family and associates knew of this and I received many well wishes, lots of love and many prayers. Along the way my dear friend whose wish was everyone get a physical found out her cancer was caught extremely early and she is on the mend. So it is time I pay it forward. My wish and my prayers are that each and everyone of you who have not had a physical for some time please go get one done. My friend and I would be extremely grateful and extend our love and prayers to each and everyone of you. I am extremely Thankful for my friends urging to do so, now its your turn. As they say, the life you save could be your own.

During a training operation once I was talking with a SEAL about physical fitness and training when he said something that has stuck with me to this day;

“We do not own our physical fitness, we only pay rent for it. Quit paying your rent, and you will lose it.”

This statement is  such a huge truth. We must keep working at our fitness or we will not remain fit for long. This becomes even more evident when we not only neglect our physical fitness, but when we add insult to injury by neglecting our nutritional needs with unhealthy food choices too.

Is it enough to just eat clean and exercise? For younger people, this might be enough for a few years. But as our bodies age, it becomes more important to get regular check ups as many cancers and other ailments are not caught until it is too late to do much about them.

Colorectal cancer is one of the most treatable cancers. The overall 5-year survival rate for people is 64%. If the cancer is diagnosed at a localized stage, the survival rate is 90%. (1)  Yet, Colorectal cancer is the second leading cause of cancer death in the United States for men and women combined. It is the third leading cause of cancer death in men and the third leading cause of cancer death in women. (1)

Think about this for a minute, the second leading cause of cancer death in America has a 90% survival rate with early detection.

The average 5-year survival rate for women with invasive breast cancer is 90%. The average 10-year survival rate is 83%. If the cancer is located only in the breast, the 5-year survival rate of women with breast cancer is 99%Breast cancer is the second most common cause of death from cancer in women in the United States, after lung cancer. However, since 1989, the number of women who have died of breast cancer has steadily decreased thanks to early detection and treatment improvements. (2)

Again, early detection saves lives!

The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. For men diagnosed with prostate cancer that has spread to other parts of the body, the 5-year survival rate is 30%.

Prostate cancer is the second leading cause of cancer death in men in the United States. It is estimated that 31,620 deaths from this disease will occur this year. However, the death rate has dropped by more than half from 1993 to 2016. There are almost 3 million survivors of prostate cancer in the United States today. (3)

Can enough be said about early detection?

When I was a teenager, I was a Boy Scout. Our motto was “Always be prepared”. This motto carried forth into my military career where every day was a day of preparing for worse case scenarios. My days with Helicopter Combat Support Special Squadron 4, took this to a much higher level of preparedness. Being on a 72 hour contingency to deploy anywhere in the world in support of military special operations requires never slacking in your preparedness.  For those of us who have lived with this kind of readiness, this type of lifestyle spills over into our personal lives in many aspects too. It is just a given that you prepare yourself to face the many challenges and struggles of life head on. If we want to live a healthy life of quality, we must prepare ourselves every day for what we might face by being proactive in our health.

Being proactive means to only consume a healthy diet and to exercise your body with a type of exercise that both suits you and that has been cleared by your doctor.

Being proactive means getting regular check ups by your doctor even when you feel fit and healthy. Check ups are less expensive than treatments for catastrophic ailments.

Being proactive means that you do not cave to those around you who do not believe that any of this is not necessary. These types are like crabs who will always want to pull you down to their level. If one does not support your health initiative, they are not a true friend.

Being proactive means that you meet challenges head on and that you do not avoid them.

Being proactive means you make it a point in learning positive lessons from your every endeavor and challenge. For example, I am a strength trainer who trains heavy with iron weights four days per week. My favorite exercise is the barbell squat. There is a positive lesson to be learned every time I get that heavy barbell on my back. I un-rack that weight, squat all the way down, and then stand back up. Yes, this lift being done with well over my own body weight is tougher than anything else I encounter in my day to day civilian life, yet I learn something about myself every time I do it. The lesson learned is;

Even with what seems to be the weight of the world crushing down on my body as I squat down, I can and will stand back up. Should I fail to get back up, I will regroup and try again and again until I can stand back up with it. I will pursue this until I am successful in my efforts as I know that if I can stand back up from a heavy squat, I can stand back up no matter what comes my way to weigh me down.

What gets me back up from a heavy squat besides brute strength and determination?

Preparation and intelligent training is what gets me back up.

As we face Loraine’s breast cancer we will become informed of all the treatment options available to her. We will be proactive in the fight. We will do our parts at getting her well instead of relying solely on her physicians to do their jobs. While the diagnosis sucks, we are fortunate with having early detection through being proactive.

Early detection saves lives!

(1) https://www.cancer.net/cancer-types/colorectal-cancer/statistics

(2) https://www.cancer.net/cancer-types/breast-cancer/statistics

(3) https://www.cancer.net/cancer-types/prostate-cancer/statistics

No Hill For a Climber, Our Journey With Cancer

My dear wife Loraine and I have been care takers for the last nine months or so for her brother who has been battling liver cancer. Now imagine the punch in the gut this week when we learned that she has been diagnosed with breast cancer. This, after having already under going under surgery twice in the past for completely different cancers.

There is not too much to write about on this today as we do not know yet just what stage the cancer is, nor will we know the treatment plan until we meet with one of her three physicians next Friday. What I can say is, the last couple days have been an emotional roller coaster for all of us. Loraine and I have promised each other to remain positive and upbeat about this diagnosis and we will fight to do what ever it takes for her to beat it. With Loraine’s permission, I am going to document our journey, all of it, the good, the bad, and the ugly, in the hopes that maybe our journey might help others in their own journey of fighting breast cancer. I never imagined that I would have two loved ones under my roof, both suffering from different cancers at the same time. It is going to be tough, but we will get through this one way or another.

In closing, I want to reiterate how important it is for all to have healthy dietary habits and to exercise as often as we can. We all should be doing this anyhow. My message to any and all whom might also be caretakers of loved ones, remember you must take care of yourself too. You must still give your own health and well being top priority as you cannot take care of your loved ones if you do not first take good care of yourself. If you are a caretaker, you really need to consider just how important it is to keep your immune system strong in order to keep your body healthy. If you have never been one to exercise, consider getting cleared by your doctor to begin some type of physical fitness regimen, even if it is just getting out for a refreshing walk. I have found through my personal battles with depression and post traumatic stress, exercise is the best medicine for resetting the mind when life is tough.

If you are the praying type, please keep my family in your thoughts and prayers as we battle these cancers. I hope that by documenting our journey, we can help others  who are also going through this with information and also to let you know that you are not alone.