A Trip to the ER, aka, the Day the Shit Hit the Fan

I actually was having a breast reduction. I always worried about breast cancer because my mother and grandmother had it. I was very faithful with my mammograms and exams. But never once did I think I would wake up from anesthesia to find my husband and son on one side of the stretcher and the surgeon on the other side telling me they found breast cancer! It was a blessing that it was found because the type I had was difficult to diagnose on mammogram. But it was also very difficult because here I was with this breast reduction that I had been waiting years to have and not really sure if I would be able to keep those breasts because they were not able to remove the entire tumor. I needed further surgery 2 months later but thankfully a lumpectomy removed the rest of the tumor.

It's hit the fan more than a few times in my life so far. Witnessing my mother die of a chemo-induced pulmonary embolism in her 40's after years being treated for BC was pretty horrific. Seeing her sister waste away - cancer cachexia so no hair, no flesh, no strength - through brain and bone mets (which finally broke her hip and caused her death) was also pretty shitty. Three late miscarriages for me wasn't great, though I'm eternally grateful for the son I do have. Then there's my own run in with BC - tiny dimple, barely noticeable lump, clear mammo but something suspicious on diagnostic ultrasound and before you know it I'm diagnosed grade 3 HER2 positive with a " moderate" prognosis whatever that's supposed to mean. Finding a new job during treatment and seeing first hand what really happens to people with cancer in spite of all the legislation was quite an eye opener too!

Sorry this is so long - I think I needed to get a little off my chest! My mother died of brain mets (original may have been ovarian, but breast also possible) at age 28, and my dad died of lung mets at age 54 (origin was never determined; he was diagnosed when his spine started collapsing, but they could never find the primary). So I always expected to get cancer and die young. As I got into my late 40's I thought maybe it wouldn't hit me after all. Then shortly after my 49th birthday and my annual mammogram, I got the call to come back for a follow-up mammogram. I wasn't particularly worried until the nurse called me in to take more images for the third time. It was a Friday, and I sat in the waiting room for hours in between. They finally told me the radiologist saw something, probably just 'folded breast tissue,' but they wanted to do an ultrasound. So they did that the same day, and weren't sure there was anything there, but wanted to do a biopsy. So I scheduled the biopsy for Monday, was a nervous wreck all weekend, and then on Monday they couldn't find anything on the ultrasound, so told me there was nothing there and no biopsy was necessary. Then the next morning the surgeon called back and said the radiologist was insistent that a biopsy be done because he believed there was a problem, and could I come in right away. Talk about going from high to low in 24 hours! Went in, had the biopsy and was again a nervous wreck until Friday when I went back for results. I knew the surgeon's nurse, so as soon as I got in the room I asked her how the biopsy was. She said 'oh, it was fine.' I was so relieved, and said, 'good, I don't have cancer.' She said 'oh no, you do have cancer.' I've never quite understood that exchange. I was very calm, because I had never really done any research into breast cancer (was BRCA tested years previously and was negative), so I had bought into the pink hype, and said to the surgeon, this shouldn't be a problem, right? They can do a lot against this now.' She said yes, there have been many advances. After double mx that revealed stage 2A lobular (and then a hemorrhage a week later where I lost 25% of my blood requiring 3 transfusions, then two infections requiring removal of the right expander, a DVT from the IV antibiotics for the infection, and 3 hospitalizations for c. diff., then replacement of the expander, oophorectomy surgery, and exchange surgery), I hoped I was ok for the time being. But my hip started hurting, so I asked for an x ray. That was inconclusive, so I asked for a bone scan. I got a call from the oncologist's office on a Friday morning last November exactly a year from the date of my diagnosis that the bone scan showed nothing. I decided to look at my online records that afternoon to see a copy of the report .... and it said 'diagnosis of secondary metastatic lesions to bone.' I thought I was going to have a heart attack on the spot. And of course, my oncologist's office closes at noon on Fridays. So I called my surgeon's office and she told me to come right away. When I got there, my blood pressure was 176/115. They kept telling me to calm down. Right, like that was going to happen. My surgeon looked at the report and said 'why didn't anybody tell me you had been diagnosed metastatic?' I said 'why didn't anybody tell ME I had been diagnosed metastatic?' So she called the radiologist who originally diagnosed me (he wasn't the one who read the bone scan originally) and he looked at the bone scan. He said he had no idea where the diagnosis came from, because all the scan showed was arthritis in my back. So they told me it was a mistake. I was somewhat reassured, but still a nervous wreck all weekend. Monday morning marched into oncologist's office waving the report, and said 'somebody needs to explain this.' Oncologist called that afternoon and said 'this is going to sound really lame, but ...' It turned out a clerk had put in a diagnostic code for the bone scan that she knew would ensure that the insurance company would approve the bone scan. The code was for previous metastatic lesions. Yes, I did think it sounded really lame. My PCP thinks that was the final straw that pushed me into PTSD. She may be right. And my hip still hurts. That lobular is sneaky stuff - I'm not convinced it isn't really in there chewing away ....

I was not quite myself the whole summer prior to DX. Not quite sick, but not well, either. I just kind of felt "off". When my aunt was DX'd and then I asked for my first mammo, I did not connect the dots. Of course, that first mammo came back clear, I didn't really give it much thought until a few weeks later when my nipple inverted. I took a morning off from work to get it checked (not dreaming it would be an issue--hey, I just got a letter from that radiologist saying there was nothing to be concerned about)--and, well, I never did get to work that day. My gyno made sure I went straight over to the breast surgeon, and suddenly I was having another mammo, an ultrasound. I was alone too. After all, I did not really think I had to be worried. What were the odds both my aunt and I would have cancer simultaneously? Her under 50, me at age 38? After all the testing, I thought back to how "off" I'd felt that summer. But I was under a lot of stress, extremely unhappy--I thought that slightly sick feeling was just a result of that. I don't like to remember those times.

It's amazing that as time passes, and our memory is crap due to the treatment, but one thing remains the same is our ability to recall that day as if it were only moments ago.

It was on 9/11 (I honestly thought I couldn't despise that day any more) and I was at home alone with my then seven year old son when I received the phone call.

My entire world was shattered, as I have three daughters and I know that they were immediately threatened.