30 October 2009

The only thing you can plan on is change

I am sick. Yesterday, I could start feeling the cold symptoms starting. By the late afternoon, I was down for the count. This morning, I can hardly breathe and my nose is runny too. Then there is the coughing and sneezing. I have a call into the oncologists office so they can tell me what meds I can take and what to do.

What I do know is that I will NOT be going down to Beaufort today for the weekend with Elizabeth and my grand-daughters. There is only a slight chance that we will go at all.

Three months!!! Three months is how long we have planned this trip. When we went down to Beaufort for our "stay-cation" the first week of August we knew our first opportunity to come back would be for Halloween weekend and Charlotte's first birthday. It was a perfect plan. No school on Friday, no cakes scheduled for the entire week. Just a leisurely drive to the coast of NC.

...not so much...

I am sorely disappointed.

What this also means is that I won't be with my daughter's for my hair falling out/head shaving party.

On Sunday, I noticed that my head was very itchy and it just felt weird. There was a fair amount of shedding as I washed and styled my hair for church. Every day, when I comb my hair, their is a light dusting of hair on the counter. Each day the amount increases. Yesterday there was significantly more shedding. Not in clumps, just single strands shedding from my scalp. It became necessary to pull my hair into a little bity pony tail and wear a hat so that it wouldn't fall all over.

My son Michael and his fiance Kristin came over for their cake tasting for their wedding cake. That really brightened up my evening. I pulled out what energy I could to help them through their tasting, and then crashed after they left. Here's a preview of what to expect from their wedding cake:
chocolate-chocolate chip cake with raspberry mousse and chocolate ganache
vanilla cake with strawberry mousse
spice cake with cream cheese filling
coconut-chocolate chip cake with white chocolate mousse

I knew I was feeling sick, because I didn't even share a single bite of cake with them.

This week I have called my "off week", meaning there was no chemo treatment. Somehow I had come up with the idea that I would feel normal this week, that every day after chemo would improve until I felt all right again. And, although I did improve when comparing days 3 through 6 to the days after, certain symptoms just don't go away.

Every day I wake up with mild nausea. This is made worse by having to take my medicines on an empty stomach. I have one medicine that MUST be taken on an empty stomach and then wait 1 hour before I can eat. I also always have a headache that can range from mildly annoying to darn-right pounding.

The fatigue is the most consuming thing. I am exhausted all the time, as if I have been working hard all day. And yet, I have not done much at all.

Yesterday morning, Doug and I had appointments for lab work associated with routine appointments with our family doctor that are next week. We left together at 8:15 a.m. I actually felt pretty good. By the time the appointment was over, I said to Doug "This is the absolute best I have felt since my first treatment". So, I decided to drive him to Wake Tech and keep the car so I could go to WalMart to pick up my prescriptions and look for a birthday present for Charlotte.

It was the first time that I had driven alone since October 2nd. It was great. I was feeling free and normal for a change. I arrived at WalMart and took care of my pharmacy items. I started walking around the store, just browsing. By the time I got to the back of the store where the toys were, I began to fade. I had to lean against the cart to help me walk through the rest of the store to pick up the few grocery items we needed.

I got home, unloaded the car and crashed on the couch. There was no more energy. It was just too much for me. When I woke up, I could feel the tingly-itch in the back of my throat that is my tell-tale sign that a cold is coming. About an hour after that, my nose was running.

Kim and her little girls came by to bring some cake stuff and visited with me for a while. After that, more sleeping until the fam got home from school and work.

I am so frail now. I don't LIKE that. It is frustrating to feel so weak.

Benjamin brought in the mail. There were more post cards for me to read. A sister from the Cary 2nd ward, wrote some scriptures that had touched her during her own difficult trials and wanted to share them with me. This one really applies right now:

"...for if they never should have bitter, they could not know the sweet..."
D&C 29:39

I had a little taste of the sweet when I got up yesterday morning and felt so well, after having been so sick. But, I have to realize that those moments for me, during the coming months, will be short lasting. Besides, these days the sweet comes in so many other ways.


24 October 2009

Chemical Warfare!

This last Monday I met with my medical oncologist, Dr. Singh. He had all the results of all the tests and scans that I had the week before. Thankfully, there were no surprises. The biopsy I had on Wednesday did show that the cancer had metastasized to the lymph nodes. That was expected, but now it was confirmed: Stage III Breast Cancer. The CT and bone scan showed no cancer anywhere else in my body. YEAH! But, I did learn that I have a small cyst on my ovary (unrelated) some gall stones, and arthritis in my lower back. I knew all too well about the arthritis.

My heart scan indicated a very healthy heart. You are given a percentage score as your result. Dr. Singh said that the heart of an athlete in training would be in the 70-75 percent range. Mine was 65. Not bad for a plus size 50 year old woman.

Now that all the tests were done, it was time to get down to the business of killing cancer cells. Because of the size and aggressiveness of my cancer, Dr. Singh was putting me on a "dose dense" chemotherapy regime of AC + T. This means that instead of the usual three week cycle of treatments (4 treatments evenly distributed over a 12 week period) I will have mine every other week (4 treatments over an 8 week period) Also, because I have "node positive" cancer, I will be given three different chemicals in my chemotherapy. The cycle of 8 weeks will be a chemo cocktail that consists of Adriamycin and Cytoxan. That will be followed by another 8 week cycle of four doses of Taxol or Taxotere (I don't know which yet).

THE SCIENCE
For those who want to know the science behind the treatment, here's how the chemotherapy drugs work. Pretend you are in your 11th grade science class.

Adriamycin fights cancer by slowing or stopping the growth of cancer cells. This drug gets inside the DNA of cancer cells and prevents cell replication by inhibiting protein synthesis. It also forms oxygen free radicals which can result in heart and circulatory damage. (which is why I needed the heart scan)

Cytoxan works on cancer cells by damaging their RNA or DNA when they are in their resting phase (not dividing). Because Cytoxan causes breaks in the DNA of cancer cells, they can't keep dividing and they die. This drug will also affect normal cells, but will have less affect on those cells, since they divide more slowly and are better able to fix DNA breaks than cancer cells. Some of the normal cells that will be affected include: blood, mouth tissue, digestive tract and hair follicles.

After the AC combination, the Taxol will be administered.

Taxol is called a mitotic inhibitor. Cells grow by a process called mitosis (cell division). Taxol targets rapidly growing cancer cells, sticks to them while they are trying to divide, and prevents them from completing the division process. Since the cancer cells cannot divide into new cells, it can't grow and metastasize.

Taxol is included in my chemo regime because my cancer grew so incredibly fast, and because it has already metastasized to the lymph nodes and that needs to stop to prevent the cancer from spreading further. The hope is to shrink the cancer tumors before surgery, to make the surgery safer and insure that they can remove all the cancer.

Science Class is now over.

PORT-A-CATH
I had a surgical procedure on Monday. They put a Power Port in my upper arm. This is so that they do not have to tap into a new vein for every chemo treatment and blood draw that will be coming in the next months. The chemo drugs are very powerful and can damage the smaller veins. The port is surgically implanted under the skin and then a catheter is fed through a blood vessel.
This was called a simple surgical procedure. For me, this was not simple. I was quite nervous. They give me several shots of a local anesthetic, but I was quite awake for the whole procedure. I could feel a lot of what they were doing, and it was really uncomfortable...and often painful. Some of the sensations, were very unusual and I didn't like it at all. I really wished I had been sedated.

Michelle was my surgical nurse. I could not have made it through this without her. She was so understanding of my fears. I have never had a surgery before. Not one, ever. She held my hand the whole time and helped encourage me. She even wiped away my tears when I started to cry a little during the most difficult part. Michelle was my angel in the operating room.

My arm was in such pain and the bruising was so large, that they couldn't even use the port for my first chemo treatment, which was on Tuesday. Today is Saturday, and my arm still hurts where the port is and where the incision was made. I know it is for my good, but I didn't like this part at all.

MY FIRST CHEMO TREATMENT
On Tuesday, Doug went with me for my first treatment. It took about 3 hours, but should only take about 2 hours for subsequent treatments. Once the IV was in, they administered anti-nausea medicine with benadryl since there can be allergic reactions to the chemo drugs. They also gave me Ativan, an anti anxiety drug that also has anti-nausea benefits. After about 30 minutes, they started working and then they administered the two Chemo drugs over the two hours. I was really drowsy, but did not fall fast asleep. I was groggy the rest of the day.

On the day after each treatment, I go back to the cancer center for a shot of Neulasta. You may have seen this advertised on TV. This is a medication that is supposed to help rebuild the red and white blood cells that have been compromised due to the cell damaging properties of the chemotherapy. Neulasta comes with some side effects of its own.

On each morning this week, I have woken up with mild to moderate nausea and a terrible headache. I have also been so incredibly tired. This fatigue is worse than what I experienced in 2000, when my thyroid function dropped to nothing at all. Today, the nausea is less and the headache is not as bad, but I am still quite tired. I just have to get through today's wedding cake deliveries. That is all I have to do.

I am looking forward to next week, since I only have one appointment to attend. It is also the "off" week and each day I should start to feel better and better until Monday, November 2nd when I have my 2nd chemo treatment.

THE HAIR AFFAIR
By all reports, my hair will have all fallen out by the end of next week. The nurse educator at the cancer center said that by day 7 the skin on my head will start to tingle and itch. During the few days after that, I will noticeably see hair coming out, while brushing or combing, or washing my hair, or just on my pillow case in the morning. By day 12 to 14, larger clumps of hair will come out and by day 15 it will be just a mess and so annoying, that you will just want to take a razor and finish the job.

Fortunately, I will be down in Beaufort for Halloween and to celebrate my grand-daughter Charlotte's first birthday. Catherine will be there too, and so I will have my daughters to help me through this event, and try to make it more fun. We'll go to a salon and have a hair shaving party (they both tell me they will shave their heads too, but I told them it wasn't necessary) get some cute hats and scarves and go out for dinner.

I've been thinking about this. The losing of my hair is a sign and symbol that I have started on the path of healing. It is something to celebrate. My hair will be gone because I have started the treatments that will kill this cancer and put me closer to being cancer free. It really is a small price to pay. And so is nausea, headaches and fatigue. If this were a few decades ago, the outcome would not be as optimistic.

Elizabeth drove up from Beaufort on Monday with my little grand-girls. It has been wonderful to have her here with Amelia and Charlotte. Catherine has also spent a lot of time here with me this week. I love my daughters. I love to see how much they love each other.

Elizabeth and Catherine have both helped me this week on my quest to find a lovely wig to wear. We went to several places and I was getting more and more depressed because nothing looked right. I just didn't look like ME. I don't have much hair to begin with, and everything was so thick and pouf-y. Then the nurse educator at the cancer center told us about Angel Hair.

We went yesterday afternoon. I have about 2 hours of energy in the afternoon between 2 and 4 p.m. Elizabeth drove me to North Raleigh, and Catherine met us there. Krista was my angel at this wig gallery. She was so knowledgeable, and kind and helpful. The choices there were outstanding. The quality was incredible. I can't believe the difference between the other places and here. In the end I found something that I really liked and that looked like how I might actually wear my hair. I was so relieved. And, to make things even better, just the day before they began a "Buy One - Get One" special and so I was able to pick two looks.

The first is the look the girls loved, something fresh and classic. It's a little shorter than I am used to now, but I like it a lot. The second is the most like how I wear my hair now.

"Regan" front
"Regan" side view

"Claire" side view
"Claire" front view
it just looks like "ME"


GOD'S ARMY OF ANGELS
I just cannot begin to express my gratitude to those who generously contributed to make this possible. Every day my life is blessed in some new way by my family and friends and others who I don't even know that well. I am so thankful for all the delicious meals and for the cards that come in the mail each day.

I cannot find enough words to thank Kim Bloomfield, who worked so hard this week on completing the three wedding cakes for this weekend. I baked some cake early Tuesday morning, and had a few hours that I could help on Thursday afternoon, but the side effects of my treatment left me pretty incapacitated to be much help otherwise. I pray that the Lord blesses her with all the desires of her heart.

For my birthday, many years ago, Patti gave me this little porcelain egg that says:

"True friends are God's angels here on earth".

I used to think that a true friend had to be someone that you had known for years and years. But now I know that isn't necessarily true. Many of you I don't know that well, and some of you, who have blessed my life, I do not know at all. But make no mistake, you are all true friends and my angels.

18 October 2009

Showered With Love

On Friday afternoon, my friends Patti and Amy organized a "Casserole Shower" for me. Over 20 of my friends came by my new house between 2 and 4 pm and brought casseroles to put in my freezer so that during the next weeks of chemotherapy, when I am just to sick or exhausted to make dinner for my family, I could just take something from my freezer and bake in the oven for dinner. My freezers are filled with love.

Additionally, they had a "Wig Money Tree" for people to attach donations for me to purchase a wig for when my hair falls out. My son Michael is getting married two months from tomorrow, and I will have no hair. This was so very thoughtful and kind and I am again overwhelmed with the love from my friends.

Here are some of the lovely people that came bearing gifts
video

Tomorrow I will find out the results of my CT and Bone Scans, as well as the Heart Scan. The CT and Bone scan will tell if the cancer had metastasized anywhere else in my body. The heart scan will tell me if my heart is healthy enough to withstand the chemo drugs. Perhaps the pathology report from the biopsy of the lymph nodes will be in as well. It was exhausting last week going to so many appointments.

At the shower on Friday, someone asked if I was scared. All I could say is "yes, but really, I am just scared of the unknown". Today, I have felt at peace. I feel the love of Heavenly Father's arms wrapped around me. I feel the love of my husband and my children and family members. I feel the love of my friends. And in some strange way, I felt the love of all the technicians and nurses and doctors. They understand this is hard. They are kind and helpful and never impatient.

Today in Sunday School I was reminded of a scripture that a dear friend introduced to me several years ago when Doug and I were struggling during a long period of unemployment.

2 Timothy 1:7
"For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind."

The Lord does not want me to be afraid; it is not His way. Once again I find myself with the mindset when I thought of the title of this Blog. The power to over come the world comes from love. And as you can see, I am surrounded by it.

13 October 2009

Radioactive

Yesterday I had a bone scan and a CT scan. I wasn't sure what to expect with either of them, so I went online and checked it out. Both require lying on my back on a sliding bed and being inserted in some sort of donut like contraption while the bed slid up and down so that the scanning device could check the entire length of my body. They also both had my face about 4 inches from the surface above me. Real donuts are much more fun!

But, these scans really can't see anything until you have something called "contrast" inside of you. This was actually the worst part of everything. And let me parenthetically add that I am no lightweight when it comes to pain.

First of all, I had 8 children, with some of the longest back labors on record (56 for my first...no kidding, 22 for my second, 17 for my 7th, really!) Additionally, I had the first 5 all natural, with epidurals administered for the last three, with the last of said epidurals not taking. That was the most painful, because I wasn't anticipating needing all the breathing techniques to survive the dreaded transition portion of the labor. So I didn't practice my breathing. I know, bad call.

Second, I have suffered with fibromyalgia since 1992. If you don't know what that is, click on the link. You'll see just how much fun it is.

Oh, did I mention the 8 kids....well, I am throwing that in just for the emotional pain that is!! (sorry kiddos, you know I love you)

This year it has been incredible pain in my right shoulder and upper arm as a result from overuse from the work of baking and cake decorating.

You get the idea.

Patti picks me up to take me to Rex Hospital for my 11:00 a.m. appointment where I am to receive a dye injected into me in preparation for my bone scan. This is a radioactive dye. I have the worst veins. They are tiny and they are deep and they like to roll. A very nice young man named Bryan is the radiology technician. He can't find a vein in the usual places, so he is forced to use the top of my right hand. OH MY GOSH!!!! It hurt so bad. Fortunately, it only took about 15 seconds for the dye to be injected in, which burned like crazy.

I am to return at 1:30 p.m. for the actual bone scan.

Monday was our original lunch date. So we went to lunch during the waiting period. (I have the good fortune of having received the birthday gift that keeps on giving. Since 1997, each month Patti has taken me to lunch, and sometimes a movie too in celebration of my birthday. It's a great story of how this came to be, so just ask me sometime and I will share it with you.)

After lunch, I had to start drinking the contrast solution (also radioactive) in preparation for the CT scan at 3:00 p.m. For those who have not had the pleasure, this is TWO 16 ounce bottles of a thick white liquid they dare to call a smoothie. It was allegedly flavored apple. Quite honestly, it was horrible.

I had the very clever idea that the colder this stuff would be, the easier it would be to get down. So, I put the bottles in a small cooler of ice and brought that with me. When 1:00 p.m. came and it was time to drink the first bottle, I found that the liquid had actually started to freeze and there were ice crystals in the beverage. It was way too thick and yes, crunchy. YUCK!! Patti coached me through the process, encouraging me on. It took 30 minutes to drink that bottle.

We then go back to Rex for the bone scan. Not terrible, but I kept my eyes closed. Very early in the process I opened my eyes just to find the nearest objects about 3 inches away. I closed my eyes immediately and just imagined that I was laying on a beach. The scan lasted 30 minutes. They bound me up like a papoose baby so that I could not move. It was quite uncomfortable.

Now it's 2:00 p.m. and time for part two of the contrast solution. By this time, it had come to a normal cold temperature, since I had learned from the first bottle to take it out of the cooler. My stomach was feeling pretty full, but I got that bottle down in about 12-15 minutes. I am sorry, but this was worse than when I had to hold my nose to get the baby june peas or squash down at dinner time when I was a little girl. Gag. Really. Geesh.

Patti takes me to the Cancer Center for the CT where Doug is meeting me. Oh, great, MORE radioactive contrast injected into me. She tries the left arm which was holy cow so painful. It was like she stuck in the needle and was just trying to stab at a vein in hopes to get one. And then, the vein blew and she HAD TO DO IT AGAIN ON THE OTHER ARM!!! Just as bad, but it worked, thankfully.

This time I ask for washcloth to cover my eyes, lest I accidentally open them. This sliding bed was not cushioned like the last scan, but it would only be 15 minutes for the CT to be completed. At a certain point, the technician injects the contrast solution into the vein. She had warned me that it would feel warm. No, more like my insides are on fire. I felt the liquid move through the veins in my body, first up my arm and all into my chest and then into my brain. I felt light headed. Then, it went all the way down my torso. I didn't last long, only two minutes or less. I just laid as still as possible, holding my breath when prompted by the voice in the machine.

Done!

We got home shortly after 4:00 p.m. and I rested for a while before piano students came. Lucky for me, it was Julie Housley's kids, and Julie brought dinner. That was a blessing.

With all the stuff ingested and injected, my stomach was feeling pretty weird. I was pretty spent and didn't get any more unpacking done last night.

Dr. Hamad, my surgeon, told me that by the end of this week I would be glowing. She wasn't just kidding. I am radioactive. The Geiger Counter is clicking off the charts.

I get the day off from appointments today. But, tomorrow the fun starts all over again.

On a serious note, I keep thinking how unreal this is. I feel like I am just an actor in a play. Is this really happening to ME? How? Why? It's just still unbelievable. I think that facing the unknown is the hardest part. The big trials for our family since 1997 were always unemployment. It was so difficult, but when it happened for the 3rd and 4th and 5th time, at least I knew what to expect. And I could do something! I found ways to bring in more money. That's how and why I turned a little hobby into a successful wedding cake business.

I can't really fix this. I have to have faith in Heavenly Father and trust in my doctors and do what they say to make this better. It is truly humbling. I don't have the power to make this go away. But, I do have the power to face each day with faith and hope and love. That's the stuff true miracles are made of.

08 October 2009

"Today you will cry. Tomorrow will be brighter"

MRI
On Monday, I faced one of my biggest fears. The dreaded MRI! One night several weeks ago, about a week before the biopsy, I had a panic attack just thinking about what it would be like to be in the MRI tube machine thingy. (I believe that is the technical name) I have some claustrophobic tendencies and just imagining the possibility of having that test done was frightening to me.

Gratefully, my doctor prescribed some Xanax for me to take the night before, so that I could sleep and then one hour before the test, I was to take another. Let me just say something about Xanax: it makes me stupid! To be more accurate, I imagine that if I were ever intoxicated, I would exhibit similar behavior. However, it is the only way I could have made it through the process.

I had my MRI done face down, which I was not expecting. They did a trial by putting me in position and sliding the tray with my body on it in the tube. I felt the tube pressing up against my back, tighter and tighter, and it started to hurt. I urgently said, "OK! I can't do this!" They pulled me out and made some adjustments. We tried it again and that time I felt it touch my back, but it was light pressure so I thought I would just imagine that it was a heavy blanket, or someone's hand on my back.

So, they put in the IV and I went in for real and I didn't feel it on my back at all. The brace that went up the middle of my chest was very hard, and it hurt, but I just did shallow rhythmical breathing and relaxed and 25 minutes later, it was over. Whew! By the way, it was crazy loud!! I could not even hear the beautiful Chopin Piano music I had selected to listed to through the headphones.

Plastic Surgeon
Dr. Hanna, from Cary Plastic Surgery is another member of my Breast Cancer team. I saw him on Wednesday morning. One of the great advances that have been made over the years is that insurance companies will now pay for reconstructive surgery in association with mastectomy. And FYI, he told us (Patti Maxwell came with me to this appointment) that they only wanted pay for the plastic surgery for the single breast involved. But, during the legislative process, it only took four hours of angry women protesting for them to get a clue. So, even if you only have breast cancer in one breast, they will still pay for lifting and matching the other breast to the newly created breast. That was comforting since my 8 pregnancies and breast feeding, along with weight changes that have gone up and down more than a see-saw have left my "girls" with some crazy sagging. (I know you may thing TMI, but heck, it's MY blog anyway)

Dr. Hanna is well recognized in the area for his fine work. Word on the street says that he is responsible for most of the implants in Preston. I am in good hands. :)

He instructed me as to how the reconstruction will be done and informed my of my options. He was a funny guy, and Patti and I were cracking up by the end of the appointment.

Also, I can now proudly say that I have had my nude shots taken. Just like you see on Discovery Health Channel. Oh, no face in the photo. Thank goodness!

Medical Oncologist
I knew that everything was leading to this second appointment on Wednesday. Doug and I met with Dr. Singh, who is the oncologist that treats cancers with chemotherapy. Dr. Singh is a very nice man, who is from India and looks like your stereotype Indian man from a Simpsons episode. Turban, beard tied in a rubber band and folded in on itself, and wearing long muslin khaftan. I felt great compassion from him.

He gave me my results from the MRI. It was as I had suspected, but hoped that it would not be. The area of the cancer is huge. It had taken over more than half of my right breast and has gone into my lymph nodes. He explained how cancer grows, and how it starts in the ducts and then sometimes, it "leaks" out and infiltrates the breast tissue. Breast cancer can also start in the Lobes. I have cancer in both the ducts and the lobes. With the addition of the cancer having spread to the lymph nodes, they are calling it Stage 3. I will have a full CT scan tomorrow to see if there is cancer anywhere else in my body.

In the next week I have to have the following procedures/tests done:
  1. CT scan
  2. Bone scan
  3. MUGA (this is a cool scan of my heart to make sure it is in good shape to receive one of the chemotherapy drugs which is known for damaging hearts. Great)
  4. Biopsy of the lymph nodes
  5. A Port will be put in my chest for the administering of the chemo drugs. (This is so that they do not have to tap into a vein in your arm every time. This is done with outpatient surgery.)

The treatment plan is as follows:
  1. Chemotherapy begins ASAP, probably in about 12 days and will last for approximately 18 weeks.
  2. Bilateral Mastectomy in the Spring following the Chemo (both of the "girls" are going away)
  3. Radiation Treatments for 6 weeks
The treatments should all be complete by June of next year.

At the end of the appointment, Dr. Singh looked Doug and I in the eyes and said "Today is a very bad day. Today, you will cry. Tomorrow will be brighter. And with the Lord's blessing you will be well."

Epilogue
It was all pretty heavy. Doug took me home and went back to Wake Tech. I had to teach my piano lessons and finish up some baking. I have been pretty together and upbeat, considering everything. I mentioned in a previous post that I had not had a good cry yet, but I could feel it coming on. That was last week.

I made fajitas for dinner. We were all at the dinner table eating dinner. I had had a few bites of my first fajita when, like a dam bursting, I began to sob. I couldn't stop. Doug got up and comforted me. In a about a minute, Doug said, "He said you would cry today. I thought that was just a cliche." I cried on and off all evening.

Yesterday, I cried. Today is brighter.

03 October 2009

Taking a drink with a Firehose

My brain has been flooded with information.

Yesterday Doug and I went to my follow up appointment with Dr. Hamad. She went over the results of the pathology report. Preliminary diagnosis: invasive ductal carcinoma. Well, we knew that I guess, but that is the medical name for the type of invasive breast cancer that I have. There isn't much more to say until after I have my MRI, early on Monday morning. This is where they can determine the size of the tumor and if the cancer has spread to the lymph nodes around the breast, or anywhere else for that matter. It will also indicate if there are any beginnings of cancer in my left breast.

This is just part of the information that is needed in order to make a treatment plan. There are other factors, but I am not sure I could explain them yet. The facts are I will at the very least require surgery and chemotherapy. The unknown until all the information is in is whether the chemo starts first to shrink the tumor and then have surgery. Or, have surgery first followed by chemotherapy. Either way, by the time Michael gets married in mid-December, I will have no hair! Radiation is a strong possibility, but again, there is much more information needed to decide that.

After we spend a great deal of time together, we were taken by the nurse to a room to schedule all the appointments for the next week. Today I met with the Radiation Oncologist. Monday is the MRI. Wednesday is both the Medical Oncologist (chemo doctor) and the Plastic Surgeon (for reconstruction). I also did a test to determine if there is a genetic factor to my cancer, which tells them even more about how to treat it. This was probably the most pleasant test I will ever have. I swished with SCOPE mouthwash for 30 seconds, two separate times, and spit it into a cylinder. They use my saliva for the gene testing. I had minty fresh breath when that was done.

I spent a lot of the day on the telephone talking to different people. It was exhausting telling the tale again and again. But, people are concerned and they want to know what is going on. May I remind you also that we are in the process of moving and I have a giant wedding cake along with a groom's cake to complete for Saturday. Oh, and I had to go withdraw Alex from West Cary Middle School so I could enroll him at Holly Ridge Middle School. Exhausting day!

Today was also insane. I really felt the stress of the move and the diagnosis and came close to breaking down several times. My daughter Catherine was with me all of the day and she was a great support to me. It's almost 1:00 in the morning, and I just finished the artwork on the groom's cake. I am tired.

I still have not just had a good hard cry, but I could totally feel it coming on this afternoon.

I have been up and down like a roller coaster ride. Those who know me know that I am NOT a roller coaster person. I hate that feeling in your stomach. It is not fun. THIS is not fun.

At the Radiation Oncologist I learned the side effects of radiation. I was told so many things. But, I left feeling like I was going to need it eventually, probably in the spring, as it will likely be the last of the three types of treatments.

Blah, blah, blah....this is so boring....

Here's the best part of the day.....all the LOVE from so many people!!!

My daughter, Catherine...oh how I felt her love as she filled out all the forms for me at the middle school and at the oncologists office. Not to mention just going with me everywhere else today.

Wendy Holladay, my friend and visiting teacher...who drove the closing papers from our house in Morrisville to the new house in Fuquay because I had forgotten to take them with me so that I had proof of residence to enroll Alex in his new school.

The guidance counselor at Holly Ridge...who was so understanding about having to hurry through the process so that I could get to my doctor's appointment as "on time" as possible.

The receptionist and nurse at Wake Oncology Radiology... who helped me feel so relaxed when I was 7 minutes late to my appointment. They said "you're not late.....45 minutes...THAT's late".

The nice sales man at BIG LOTS...who made sure to mention that the table and chairs that I was purchasing was being discontinued. I was only going to get the table with 4 chairs and gradually add the other 4 chairs. If I had waited, when I went back they would have been gone and I would not have had a matching set.

The Pulsipher Family...for bringing dinner tonight. (and let's not fail to mention all the other dinners provided this week by Mary Ann Pillar, Jennifer Kennedy, Wendy Holladay and Beth Allred.)

My husband, Douglas, my children and spouses (Christian and Mary, Catherine and Bryan, Mark, Daniel and Alex)... who worked so hard today and before today moving items from one house to another.

My daughter Elizabeth...because although it is not possible for her to be here to help, she wishes she could be here.

My dear friend Leann...who just returned from Utah and called me right away when she heard, even though she has her own trial right now.

My sisters JoAnn and Fran...who I finally got to speak with. For their love and prayers.

My mom...who always calls to see how things went. And, while I am at it, for all the days she came and stood and washed dishes and cake pans for hours during the busiest cake weeks this summer.

Kim Bloomfield...who offered to help save me from the ton of cake work that MUST be done this month for all the brides who are expecting a wedding cake in October.

Amelia Bogess...for helping me finish packing the kitchen

There are probably others...but my brain is tired and I cannot think anymore.

I am overwhelmed by the love of my friends and family.

I wish there was a better word than "thank you"

I love you all.