Monday, March 3, 2014

Pros and cons

Please bear with me.  I have a lot of news to report, none of which is delightful.  I've decided to break this post up in to a list of pros and cons, to help me get to the end of it.  I'm going to do my best to weigh it down with pros.

Pro:  I exited my PET scan to find my aunt, uncle, and mother-in-law seated in the waiting room.  It was a delightful treat to find these loving people ready to spend their day with me.

Pro:  After another blood draw, they took me out for breakfast.  The best restaurant in town had just today released their new spring menu, and we were among the first to enjoy it.  I had a chocolate croissant for dessert.  Tasty!

Pro:  We all went to my mother-in-law's home to pass the time (about 1.5 hours) until the PET scan results appointment.  I decided to call Dr. Radiologist to see if they had my breast biopsy results yet.  She promptly returned my call to say that yes, the results are in.

Con:  My breast biopsy showed cancer, ductal carcinioma, stage 3, Her2 receptor positive (estrogen receptor and progesterone receptor negative).  I'm calling this a "con" because it is stage 3, and I simply could not truthfully in any way make this a pro.  However, there are silver linings.  There is one thing worse than a stage 3 cancer, and that's a stage 4 cancer.  At least it's not stage 4.  Also, Her2 positive is not the easiest kind of cancer to fight, but even that has a silver lining--there are treatment options for Her2 positive cancers.  Worse would be to have breast cancer with no recognizable receptors (a so-called triple-negative).  I asked her to please call Dr. Oncologist and share this news with her before my appointment.

Pro:  My dad arrived and joined the entourage.  Huzzah!

Con:  I knew right away that it was not going to be a pleasant appointment when Dr. Oncologist started by saying, "let me show you your pictures."  She doesn't usually show me my pictures unless I ask.  She scrolled through the PET results of my entire torso from bottom to top, slowing down on my lungs.  Lungs.  My heart plummeted.  She's always told me that there are three place where you do not want the cancer to go:  brain, lungs, liver.  Everything else is treatable, but these three things are tricky.  And now she was showing me my lungs, and talking about my lungs, but I walked into the room with breast cancer?  Lungs.  Oh God.  

Con:  "Innumerable pulmonary nodules consistent with metastatic disease"  That is what the radiologist's report says.

Con:  The breast cancer has spread to my lungs.

Pro:  Although the nodules are too numerous to count (TNTC in microbiology speak, nerd salute to all of you folks counting cfus today), they are small and faint.  That means that they weren't gobbling up the radioactive glucose, just moderately over-eating.  I'm also hopeful that they will respond to treatment better than something big?  Lots of surface area to be killed by?  I'm ad-libing at this point.

Pro:  The discussion of the pathology of the breast cancer was a poor second act after the lung business.  The good news from this discussion is that they think it's a new cancer, not a remnant of my IBC.  The reason I am taking this as good news is because it is easier for me to think that I responded well to the previous treatments, giving my previous inflammatory breast cancer (IBC) the middle finger and getting it out of me completely.  If I thought that this new cancer was actually a remnant of the old cancer, I would puzzle over why it didn't leave the first time and I would doubt in my ability to get rid of it anew.  Under the model that it is a new cancer, I can believe that I can get rid of it again.  If it truly is new, I can even claim that I'm really good at getting rid of cancer and simply rely on those skills.  After all, I did beat the IBC odds.  I lived so long after IBC that a new cancer had time to develop.  I just have to buckle down and get rid of this one, too.

Con:  Fucking lungs!!!!!!!!!!!!!!!!!!!!

Con:  The PET scan had one more treat in store for me.  A blood vessel in my neck (please forgive me, it's been such a long day that I've forgotten precisely which one) showed a clot.  Dr. Oncologist asked me if I had any neck pain, headaches, etc., and I literally chuckled at her.  After all of this new metastatic breast cancer business, the PET scan decided to reveal a new terrorist:  a blood clot on the boulevard to my brain.  Fantastic!  And just a tiny bit hilarious because of the potential dichotomy it presented:  I will either die slowly and methodically at the hands of metastatic breast cancer, or I will drop dead right now from this blood clot throwing a wrench in my brain.  Bam!  Ian and I shared an odd, choking laugh over this.

Pro:  The entourage was there to walk me to the radiology department to have an ultrasound on my neck.  If ever there was a day for an entourage.  Whew.  Dr. Oncologist called me tonight with the ultrasound results, but I was at yoga and missed the call.  She did not leave a message, so it must not be terribly critical.  The only preliminary result I have is from the ultrasound tech, who when asked said that it is not 100% occluded (blocked).  Yay?

Pro:  Yoga!

Pro:  Husband!

Pro:  Daughters!

Pro:  Entourage!

Pro:  Food made by the hero of the day, my mother-in-law!

Con:  Lungs!

Con:  I think I need to puke.

Here's where we go from here:  appointment on Wednesday with someone in Dr. Surgical Oncologist's department to formulate a treatment plan.  Appointment on Friday with Dr. Oncologist to solidify treatment plan.  I'll try to have normal days on Tuesday and Thursday.  I said I'll try.


  1. you gave the big middle finger to IBC. We all can donate our middle fingers to this new cancer!

    Not sure if you want hugs tomorrow or to be left alone. Either is understandable. If you have a preference, let us know - and we can spread the word. Either way, you know you are loved and supported and we will all help you the best way you can handle at this point.

    Fucking lungs. But hey... brain is unremarkable.

  2. Fucking lungs!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
    You are so good at helping ALL of us see the pros. You are the best.

  3. Sigh . . . . . and oh honey, you forgot the most important pro - you. You are THE. PRO. You are amazing.

  4. Thanks for the update sis. I wish it was riddled with more pro's than cons. Lots of love headed your way from the sawyers household. Heath says hang in there you can get through this one. You have a loving family that is and will be right by your side. Virtual hugs headed your way. And I am sure lots of real ones in the near future. Love you :-)

  5. Heather, I agree with Lori; you are your best and biggest PRO in this equation. Will the next move be to remove the blood clot? Sending you lots of HOPE and LOVE; keep fighting for all those PROS.

  6. Ah it is time for a deep breath. Kate told me she was taking it for you! It won't be easy, well wait, we are talking about HK. It may be a challenge but you will do this. You have so many people praying for you holding you in the light. Dream baby girl as you always have. see the the glorious future that is yours for the taking!!!!!

  7. Sending love and hugs your way from the girls in apartment 224. Wishing there were all pros on that list. I agree with Heath, you can and will get through this. You are an inspiration to all of us. Cancer is a difficult journey but not a journey you have to go through alone. Love you (Squirty)

  8. Deep breath is right....

    Pros: You, Ian, Azela, Nori, Lori!!, your dad, your momma, Holly, Hilary, Ryan, Sandra, Kato...dang my fingers are tired...

    Super Pro: Aunt Jacque channeling her inner Grandma Ah-Ha and a collective laugh today

    Super Super Pro: Do you know the power of YOUR smile.....

    Cons: "Ain't Nobody Got Time For That...."

  9. Oh Heather. I am so upset about the cons on this list, but it is easy to see the silver linings too. I am visualizing an easier course this time that will banish this cancer once and for all. You are so amazing. I miss you guys so much. I hope you can feel my hugs across the miles.

  10. I love you AND your fucking lungs.

  11. You went to Yoga and then wrote a Blog! I get used to you super ways Heather and forget how remarkable they are.

  12. Heather I'm sorry you have to go through this and I wish I could trade places with you. In 2010 the IBC cons outweighed the pros but you did it! Now you are being tested again but If anyone can do it again my girl can. And my girl will.

    Tomorrow we will investigate clinical trial options but rememeber Dr. Oncologist said that today's standard care levels are "really good". Love you kid. Those cancer cells don't know who they are messing with. Stupid cancer cells.

    1. Russ - if you figure out a way to trade places, sign me up! Until then, we'll be taking care of every possible thing we can so all Ian's and Heather's energies can be channeled into serene, positive, and loving healing. So glad there will be two sets of ears and two "unremarkable brains" taking everything in during the visit to Iowa City tomorrow. Safe travels you two - bring back Masala! <3

  13. Oh Heather, my heart hurting for you, but I am also so impressed by everything that you are. Yoga indeed, Martha is exactly right.:) I have faith in you! xx

  14. Hi Heather,
    What eloquent writing about such an inarticulate situation. I'll be sending you strength and peace. You are an amazing person.
    Sally Worley