Hmmm. Where shall I start? I left off last week from highway 45 as Scott drove us home from Houston. We were, and still are, very thankful for old and new friends there who paved the way, introduced us to amazing doctors, and sent us home with full heads and full hearts. Last week, my heart was more full than my head. But, over the weekend, my head caught up with my heart and it was overflowing as well. As I wrote, the doctors there had a few “tweaks” to our plan so our full hearts were accompanied by full heads. It’s been a bit of mental gymnastics as Scott and I process what we heard, connect the dots with what we’ve learned over these last 7 months (sidenote: I initially typed 6 but realized it was probably closer to 7 so changed it then pulled out my fingers to count and, lo and behold, it’s almost 8 … a reminder that this is a marathon and not a sprint because we haven’t even started some of the key pieces of therapy), read and reviewed the doctor’s notes (both doctors offered to type up their notes and recommendations – a huge help!), and then sort through which doctor in Dallas to call next to discuss changes and move forward. As I read Dr. Tereffe’s notes (would it jog your memory if I described her as my Ethiopian woman crush?!) it was both overwhelming and encouraging to pour over 6-7 pages describing my cancer, the risks, the treatment to date, and the options going forward and actually understand it all. My mom, after reading them herself, asked if I thought I was read for the second year of medical school. And I’m considering applying:)
The good news is that I’ve learned a ton. The bad news is that I’ve learned a ton. And, the good news is that we had incredible second opinions and resources. The bad news is that we had incredible second opinions and resources. In short, ignorance was bliss. We are now far more educated with almost 8 months of a crash course and some rock star physicians in Dallas and Houston who have held our hands the whole way. But, now that we have a lot more understanding and education, it’s much harder to sort through our own opinions instead of just robotically doing what doctors told us to and showing up at the next appointment for blood, shots, drugs, or whatever.
Here are the choices we have been wrestling with:
1. Do we take the oral chemotherapy drugs as recommended by our doctors? There isn’t strong evidence of its effectiveness in breast cancer though it’s a common practice for other cancers. It “amplifies” the radiation which makes it more effective for local control of any possible remaining cancer cells but also amplifies the side effects of skin sensitivity and is known for causing tummy issues. Our Dr. Osborne (I may now have to refer to Dr. Cynthia who is here in Dallas and Dr. Kent who heads breast cancer research at Baylor College of Medicine in Houston since both the medical oncologists are Dr. Osbornes … what are the odds of that?) had recommended it but the others were either agnostic, deferring to one another or “slightly biased towards yes” but not definitively so because there hasn’t been a lot of research done on it that applies to my situation. The good news is that if any of the side effects are a problem I can quit at any time. Scott thought we should do it. I’m just happy someone had a strong opinion:)
2. Do we suppress my ovaries? I think, in my heart of hearts, I really hoped a second opinion would at least open the door for discussion of this one rather than our Dr. Osborne’s rather strong sentiments that this was the best thing to do. Unfortunately, all the other physicians feel the same way. And, when I read about myself on paper in black and white and all the comments about “high risk” and “advanced nodal involvement” and “extensive lymphovascular invasion,” I realize that they are quite serious about doing anything and everything necessary to make sure that this cancer doesn’t have any food. And, since my hormones are its lifesource, they want them off. I still can’t get my head around the idea of permanence on this one so am opting for shots instead of surgery. However, the shot yesterday was B.A.D. And I can still feel it sting as I type though I’m sure that’s in my head. And Scott is quite concerned about the cost at $1000/shot. He keeps asking if I could make a decision before the end of the year because, clearly, we’ve met our deductible. I don’t think I can get there. I expect we will be hitting our $6k deductible for several years ahead. Scott picked up my prescription for the oral chemotherapy at the pharmacy at Baylor and came back to the doctor’s office with his mouth hanging wide open … care to guess how much they cost?! Oh.My.Gosh. $4200 for a month. The costs of medical care are staggering. And this isn’t intended to open up political debate. The truth is, I’m just thankful for insurance and medicine and the opportunity to have both. And real sad about other folks or countries where that’s not the reality.
3. Which drug is the best choice for hormone therapy? I won’t bore you with the details of the drugs and how they work but our doctor had proposed an aromatase-inhibitor but the Houston doctors at MD Anderson and at Baylor both thought tamoxifen was the better choice. Tamoxifen had been our doctor’s original choice before the pathology results following surgery and I was thankful that, after another appointment with our Dr. Cynthia yesterday, she was supportive of the other doctor’s recommendations.
4. When to start radiation? The doctors in Houston didn’t think I should wait much longer to make a decision and move forward with radiation. So, on Monday, I visited with Dr. Cheek (radiation oncologist) and we confirmed a plan to not only radiate the right breast but my the whole chest wall to target the lymph nodes in the armpit, under collarbone, and breast bone. Some of this is also controversial because, obviously, my heart/lungs are right behind the chest bone. And, radiating under my arm doubles my risk of lymphedema (essentially “elephant arm” but that’s my definition and not exactly a medical term used by anyone else). Scott doesn’t usually say much very emphatically but, as we discussed whether or not to radiate the ‘axilla’ (armpit), he said, “babe, I really don’t want you to have one elephant arm!” Well, then that makes 2 of us, Scott, because that sounds pretty painful and unattractive to me as well. But, we’re gonna do it. They keep reminding me that I had 9 out of 19 lymph nodes with “residual disease” after chemotherapy. So, after we finalized the treatment plan, I got scanned and got 6 tiny tattoos that they’ll use to align my body each day for radiation. I start next Wednesday and will go every stinkin’ morning at 7:10 for the next 6 and a half weeks!
So, that’s the latest. But not the greatest. The greatest is the continued encouragement from friends and the Lord. He has answered prayers for navigating through the second opinions in Houston, for conversations with doctors, and for daily strength. We have continued to be supported and encouraged by meals, laundry and babysitting. And, today, after spending a couple hours during Linc’s nap to prepare dinner, disassemble and wash his carseat, clean the kitchen, and sort through some of Linc’s old baby stuff for a friend, I sat down to rest because I was whipped. As I sat down, I picked up a note from a dear old friend from Arthur Andersen and out came precious encouraging words with a check with encouragement to use it for something that would give me rest like housekeeping. I couldn’t wait to call Kristy and tell her that the timing was perfect. She summed it up perfectly: “God’s providence is sweet.”
In other of the greatest news from this week is the sweetness of our neighbors. It’s another sweet gift of cancer. Our interaction with our neighbors has increased dramatically and they have been so stinkin’ sweet! On Friday, one neighbor yelled across the lawns to tell me she wanted to cook us dinner soon, another one texted on Friday night offering to bring us delicious pizza from Coalvines, and another neighbor babysat Lincoln on Monday morning so I could attend a real sad and sweet funeral for friends who lost their 6 week old little boy. Our home is even sweeter when surrounded by people who love us and care for us! And we sure do appreciate and love them. Our street ain’t called Goodwin for nothin’!
And speaking of good, one more good thing was all the sweet love from Big Mama‘s peeps. She’s Big Mama to y’all. Mel to me. It’s real sweet to me that you all love my Mel – and love the people she loves. I’m thankful to be one that she loves and thankful for your love and concern too.
I pray, as you read this, that you are reminded that God is good. Even in the midst of cancer. And, He’s sovereign over all. Even in the midst of cancer. One of my favorite all-time quotes is from one of my favorite all-time authors, Charles Spurgeon. He wrote, “God is too good to be unkind. He is too wise to be confused. If I cannot trace His hand, I can always trust His heart.” By His grace, not only can I trust His heart, I can also trace His hand through this season based on how He’s provided for us, sustained us and reminded us of His goodness, sovereignty and love. But, I know these truths aren’t known or understood by all who may read this. Or maybe you know it but need to be reminded. As I type, I pray that all who read this will have a greater understanding of His goodness and His sovereignty and that, if you can’t trace His hand, you can trust His heart. Cancer is a bad thing. It has the power to destroy cells and bodies and lives. In contrast, God is all about life. Death and sickness were never apart of His original plan. Whether it’s me with cancer or little Austin Meek who died last week, this is not how the world should be. And it’s hard. It’s hard to see folks we love suffer. Or to know folks in another part of the world who don’t have access to medical care (or even safe drinking water) like we do. And sometimes these things overwhelm me. But, I am reminded, God is good and sovereign. And He loves me. His greatest evidence of that is the cross. Where He died so that I may live. So, whether it’s cancer or prodigal children or sick children or job searches or financial concerns or marital problems or whatever it is that troubles your weary heart, I pray tonight that you know firsthand of His goodness, sovereignty and love for you.
Goodnight. With lots of pink, prayers, and love.