Grady’s First Day of Kindergarten

Today we sent our first child into the wild world of public school.  Grady is super-excited about going to kindergarten, his teacher and school are both great, but Mom and Dad are a little sad.  Here’s the photos (that starts with a short video):

(if you don’t see then video/slideshow above you can view them here)

Reconstruction Options

Friday, Holly declared, “I have arrived! I am grabbing my coach purse, getting in my Lexus, and heading to the Plastic Surgeon.” Of course, it was a fake coach purse, Jamie’s mom’s 10 year old Lexus she was borrowing, and she was going to the Plastic Surgeon for reconstruction, but still it gave us a good laugh.

We have found a great plastic surgeon out of one of the ones our breast surgeon recommended. We’ve met with her twice, and she has taken a total of two hours to teach us about all the options and answer all our questions.

The problem is there are a lot of options. I won’t try to summarize them here, but this website does a great job of describing them all in detail.

We are currently in the process of narrowing down the options, then adding in new ones, then narrowing, etc, etc. The doctor graciously offered to contact patients who had the procedures we are considering to find out if we could call them with questions. So far, Holly has talked to three of them, including one who was in the office when we were there last.

What we do know (as much as we know anything):

• The mastectomy and reconstruction will happen in one big surgery that will take place at Baylor Regional Medical Center of Plano.  It will take from 4-10 hours depending on the option we choose.
• The surgery will not happen this week or next (plastic surgeon is out of town), at the earliest it will probably be the week after Labor Day.
• The recovery time will be something like 6 weeks to get Holly back to something resembling 100%.

Here’s how you can pray for us:

• With thanks that God has given us excellent, compassionate surgeons.
• That we would be able to see through various kinds of fear and find God’s best in this.  (fear of pain, of foreign implants, of not being available be available for our kids during long recovery, of having to redo things later — lots of scary stuff in each option)
• That our faith would deepen to in new and fresh ways we would know that God is actively working for our good in all this.

Thanks to all of you for how loved you’ve made us feel us feel through this all.

Final Biopsy Results and Plastic Surgeons

Last Tuesday Holly had a Sentinel-node biopsy. It was an outpatient surgery where they remove a few lymph nodes and test to see if the cancer has spread there. Generally, that’s where breast cancer spreads to first, so if it’s not there they know it’s contained. This video explains the procedure more:

And… none of the three lymph nodes the surgeon removed showed any signs of cancer. Obviously, this is great news and it means we are as sure as we can be that the cancer is confined to her breast.

So, the next step is picking a plastic surgeon to do the reconstruction. The pool is limited as many plastic surgeons don’t do reconstruction, but the breast surgeon has recommended three.

We met with the first one today and were a little disappointed. We are seeing the next one tomorrow morning, and hoping it’s a better fit.

Based on schedules of all the doctors, it’s currently looking like the mastectomy/reconstruction surgery won’t take place until early- to mid-September. We wish it could be sooner, but don’t have much control over it. Plus, we are trying to work around not missing Grady’s first day of Kindergarten which it coming up in a couple of weeks.

Thanks for following along and for all the prayers. Tomorrow marks the two month anniversary of her diagnosis, and while we are more used to being here, it hasn’t gotten any easier.

Ranch Get Away

The kids spent last week at Grammy and Paw Paw’s ranch, and Holly and I joined them over the weekend.  It’s always good to get out there to relax and enjoy what God made.

Here’s a few pictures from the weekend:

Results of MRI-Guided Biopsy

The doctor called tonight to give us the results of yesterday’s MRI-guided biopsy.   As a reminder, the radiologist took samples in front of and behind where they had previously found the cancer.

The good news is that the sample behind was not cancerous. This lessens the chances that cancer has spread to the lymph nodes.

The bad news is that the sample in front of was cancerous. It’s still DCIS (non-invasive), but it means that a mastectomy is the only reasonable option from here.

The next step is to start meeting with plastic surgeons, to find someone good to do the reconstruction (that will happen at the same time as the mastectomy).

Then after that she will probably have a sentinel-node biopsy.  How many biopsies can she have?  Evidently, she can have one more.   This one will be a little harder ( she’ll be under general anesthesia) and they will check to see if it has spread to the lymph nodes behind the breast.  There’s only about a 5% chance of this, but it seems better to rule it out as a possibility before the surgery.

On the home front, we are kidless.   Holly is very tired but getting lots of rest.  The kids are at Grammy and Paw-Paw’s ranch this week, and we will go join them this weekend.  It will be good to get away for a little bit.

That’s about all we know for now.  Thanks for all the continued prayers.

Summer Fun

In the midst of this calm, we had some fun in a Nanny-provided inflatable pool this weekend. Enjoy the pictures:

More tests, new doctor

On Tuesday, we went to see another breast surgeon for what we thought would be a routine second opinion on Holly’s cancer diagnosis.  It was anything but routine.

From the start, something about this new doctor was different.  First, she put all our test results up and taught us what they meant.  It was during this process we collectively realized something was wrong.

You see, when we first got our MRI results we were told the suspicious area it was confined to just one small area, about 4.5cm long. That was not what we are all looking at on the screen at the MRI results.

It looked pretty obvious to the new surgeon and us that the suspicious area was essentially the length of the whole breast.  This is not good news.

The next step is to have a MRI-Guided Double Biopsy.  That’s a fancy way to say they will use the MRI to guide the needle to take more tissue samples above and below where the cancer was already found.

If the biopsy comes back positive like we are expecting, a mastectomy will be needed to remove all the cancer.

Unfortunately, right now it’s looking like we won’t be able to get this test done until July 29, almost 2 weeks away.  We would obviously want to get it over with quicker, but maybe this will be a nice calm in the midst of the cancer storm.

In the mean time, we have switched to this new doctor.  You see the old surgeon never even looked at the MRI results herself (or any other test results for that matter), she just trusted the radiologist’s report.  It would be kind of hard to trust her after that.

Thanks for all the support and prayers.  Please pray we would has wisdom in the midst of this trial – and with that wisdom the kind of faith that would keep us from being tossed like waves like James 1:2-6 says:

Count it all joy, my brothers,  when you meet trials of various kinds,  for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing.

If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. But let him ask in faith, with no doubting, for the one who doubts is like a wave of the sea that is driven and tossed by the wind.

Life happens

For our budgeting we use an on-line free program called Mint.  We lump all unexpected or hard to predict expenses into a category called “Life Happens.”  We got this email from Mint a few days ago that made us both laugh:

Yes, we have way blown past our mental and emotional budget for “Life Happening.”  It’s a good thing God’s grace is endless.

Terrorist Cells

The picture of exactly what Holly’s cancer looks like is starting to develop more fully.  First, it turns out that fighting Ductal Carcinoma In Situ (DCIS) is trickier than we first thought. If you will allow me the liberty of an analogy here…

Fighting other types of cancer with a large easy to identify tumor is like fighting a traditional war.  The enemy is easy to find, it’s just a matter of picking the right weapon to kill them.

In contrast, fighting DCIS is like fighting terrorists.  The operate in small (ironically named) cells that are hard to identify, and therefore kill.

What does that mean for how we go forward?  It means that even if the alternative medicine methods we are trying work, there’s no way to definitively know it.  The test simply aren’t that sensitive.  The mammogram can detect calcium deposits which sometimes, but not always, hang out with cancer.  The MRI can detect increased blood flow to an area, but by no means detect it at cellular level.

Besides knowing the nature better of what we are fighting, we also learned more details out of the pathology report.  It turns out that the DCIS Holly has is “High Nuclear Grade.”

Here’s how one website explains what that may mean:

There are three grades of DCIS: low, intermediate, and high. The grade relates to how the cells look under the microscope, and gives an idea of how quickly the cells may develop into an invasive cancer (or how likely it is that the DCIS will come back after surgery). Low-grade DCIS has the lowest risk of developing into an invasive cancer, and high-grade carries the greatest risk.

Here’s another one says (it also gives a much more technical explanation of how they determine the grades):

Cancers with a high grade, necrosis, cancers close to the surrounding margin of breast tissue of a lumpectomy sample, or large areas of DCIS are more likely to recur after breast cancer treatment than other breast cancers.

So, obviously neither of these pieces of information are good news.  Stack on the fact that just getting breast cancer so young increase the chances of recurrence substantially.  So, Holly still has the best kind of breast cancer to have — it’s just the worst kind of the best kind.

We’ve been discouraged about this this weekend.  While we have been praying and wondering what this means about how we move forward we have found great comfort in Psalm 147:3-5:

He heals the brokenhearted
and binds up their wounds.
He determines the number of the stars;
he gives to all of them their names.
Great is our Lord, and abundant in power;
his understanding is beyond measure.

Thanks for sticking through a long post.  Continued prayers for wisdom are appreciated.

Death is Not Dying

I just discovered this video today and it was right at a moment I needed it. I needed to be reassured that despite cancer being outside of my plans for my 33 year old wife, God is firmly in control.

It’s the wonderful testimony of a Rachel Barkley — a 38-year-old mom of 2 — gave in March after finding out she had terminal cancer. Rachel died Monday.

From deathisnotdying.com:

But for Rachel the essence of life is found in her relationship with God through Jesus. And that’s why Rachel is convinced that death is not dying.

On March 4, 2009, what started out as a small talk to a women’s group at her church grew into an event attended by 600 women from around Vancouver, giving Rachel an opportunity to share about her hope in the midst of terminal cancer.

Rachel’s honest and thought-provoking talk touched women of all ages and left a hunger for discovering more about Rachel’s journey and the faith that has so deeply affected her life.

It’s long — almost an hour. But it’s the best hour I’ve spent this week. I encourage you to take the time to watch it if at all possible: Death is not Dying by Rachel Barkley on Vimeo (wouldn’t let me embed it).