Ch. 7 - Preparing for Treatment

Ch. 7 - Preparing for Treatment

Date of entry: Tuesday, September 25, 2007

Recovery continues to go well. Thank you to you all for all of your continued support. I appreciate everything and will continue to need your thoughts and prayers. The past few weeks have gone really well. I returned to work on September 18, 2007. It felt good to be back at work, but a little weird too. It was like I had been gone forever. On the second day I returned, the Rehabilitation Department gave me a surprise breakfast. It was so nice to have all of my immediate co-workers around me and giving me such good food and warm wishes. I also had some patients that were still in the hospital from before my surgery. They were also glad to have me back as well. It was strange receiving encouragement and support from the very people that are normally on the receiving end. Although strange, it made me feel very special. It reminded me to always go above and beyond to make people feel special each and every day. We never know what burdens someone may be carrying around.

At this point it would seem that returning to work would be one of my biggest challenges, but it has been really easy. I have occasional discomfort in my right axilla, but it does not bother me all the time. My strength is good, but I do tire a little more easily than I am accustomed. The tough part has been keeping up with work on top of my busy physician schedule and cancer related activities. I returned to work on a Tuesday. Every day that went by I reminded my husband, Clayton, of my upcoming appointments. Friday was a big day for me. I had my first appointment scheduled with the radiation oncologist, Dr. Ana Grace. When Friday finally arrived, Clayton and I had it all worked out, i.e. when and where to meet to walk into the physician's office together (her office is located at the hospital that I work). Clayton was on his way and I decided to go ahead to her office in order to meet him there. Upon arriving, I did notice that the office was a little quiet, but there were two ladies sitting in the office. I asked them for the sign in sheet. In return they asked me if I had an appointment, etc..... Long story short, I had written the appointment date down on the wrong day in my day planner. My appointment was yesterday, and I had MISSED IT! I was in shock. Inside I am thinking, how could I have done this to myself!?! I was so very disappointed. Without even thinking, tears started to roll down my face. I was speechless. I explained to them how important this visit was to me. Of course they tried to get me to relax and realize that it was not the end of the world, but for some reason, it sure felt like it!! After continuing to have tears roll, they gave me a new appointment for Monday. I would see her at 11:00 am. I attempted to compose myself and told them thank you. I then proceeded to call Clayton on his cell phone to let him know not to walk into the office. When he did not answer and I got his voice message, I really began to cry. I told him in the message what had happened and that I did not know why I was so upset, but I was really upset. I hung up, and he called me right back, he was in front of the hospital. I did not even talk to him through the phone because he was close now and I just hung up and sobbed in his arms. He calmed me down after a little while, and now... I can laugh about it. Thank goodness!!! It is really crazy how much my emotions have been all over the place at times during this challenge with cancer.

On Monday, September 24, 2007, I had two doctor appointments. At 9:00 am I saw Dr. Zhang, the oncologist who will be determining my chemotherapy course. He gave us good news. I will only have to have chemotherapy for 3 months instead of the anticipated 6 months. I will have four cycles, one treatment every 3 weeks. The drug combination he will use is Taxotere & Cytoxan. All the normal chemo drug side effects apply, but he reminded me that everyone reacts differently. With Taxotere the common side effects include neutropenia, leudopenia, anemia, hair loss, fluid retention, mouth sores, weakness, and nerve pain or unusual burning or tingling sensations. Other common side effects of taxotere include low platelets in the blood, diarrhea, nail changes, muscle pain, vomiting, and joint pain. The common side effects associated with Cytoxan include hair loss, vomiting, diarrhea, mouth sores, sterility, and jaundice. For the nausea he provided me with 2 prescriptions for anti-nausea medicine including Decadron & Zofran. Both of which I have already had filled. He stated that chemo could start at any time, just to let him know when I am ready. The only reason for the delay is that I have an appointment with my OBGYN regarding harvesting of my eggs and other fertility issues on Thursday, September 27, 2007. Dr. Zhang also mentioned that I may need a port-a-cath so that I do have not to be poked so many times during the chemo process. This sounds good to me. I just have to follow-up with the infusion nurse sometime later in the week. Also during this visit, he explained that after the 3 months of chemo, I would follow with 6 weeks of radiation, and THEN 5 years of hormonal therapy. The hormonal therapy will be in pill form and the name of the drug is Tamozifen. This was the first I had heard of this being in my treatment course, but whatever it takes is fine with me.

After leaving Dr. Zhang's office, Clayton and I headed to see Dr. Ana Grace for the radiation visit. She explained radiation in general and stated that my radiation would be for 6 weeks to the right breast only. She will be treating the entire breast with the radiation. The treatment will be daily (Monday - Friday) for 33 visits, totaling 6 weeks. When I arrive for my first visit and they do the alignment for the radiation machine, they will tattoo me to ensure proper alignment each and every time. The tattoos will be 3 small (freckle sized) blue dots. I though this would be kind of cute, like a conversation piece later in life, although only Clayton will be seeing them, it put a smile on my face. I had no idea that radiation oncologist were also tattoo artist.!?! She stated that after about 3 weeks, my skin would begin to appear like a sunburn. When this happens, she has a cream that she prescribes to aid in healing and reducing discomfort. She also stated that during radiation I cannot wear deodorant under the right arm. And overall during this time she recommended for me to purchase a metal-free deodorant from Trader Joe's (I have not purchased this yet). Each treatment should only take about 20 minutes. She gave me a booklet covering all the aspects of radiation in general and encouraged me to read in before radiation begins. She gave me an appointment for December and stated that the radiation should begin sometime at the first of the year, after completion of the chemotherapy.

All in all, I think that is everything that I know up until this point. I have two more appointments ahead of me this week, one with my OBGYN regarding fertility issues and the other is with Josephine to set up the date to have the port-a-cath inserted, if she feels this is necessary (I hope I get to have one, it should make life much easier during chemo).

Date of entry: Wednesday, September 26, 2007

This morning I went to see Josephine in the infusion center to check my veins. She said that my veins are small and would recommend a port-a-cath to be inserted. With that information, I went to Dr. Zhang's office to let him know what she said. He will therefore order for the port-a-cath insertion. This will be done by Dr. Shirazi, my surgeon. Her office will call me to set up an appointment to see her in her office and then she will schedule the out-patient surgical procedure after the visit, upon insurance verification and approval. I also did some research regarding fertility issues and feel more prepared for my visit with Dr. Spencer-Smith tomorrow.

Ch. 6 - The Pathology Report

WHITE MEMORIAL MEDICAL CENTER

DEPARTMENT OF PATHOLOGY Location: 4511

1720 Cesar E. Chavez Avenue Patient Name: BAILEY, JENNIFER

Los Angeles, CA 90033 Date of Birth:

Telephone: (323) 268-5000 Sex: F
Attending Phys: Shirazi, Sherin K MD

PATHOLOGISTS/DIRECTORS Collection Date: 24AUG07

M. Cosgrove, MD K.U. LEe, MD Received Date: 27AUG07
G.E. Dalgleish, MD D. Sahmedini, MD

J.B. Harris, MD C. Seneviratne, MD

D.V. Kon, MD

SURGICAL PATHOLOGY FINAL

SOURCE OF TISSUE:

1. RIGHT BREAST SENTINEL NODE

2. RIGHT SENTINEL NODE

3. RIGHT BREAST MASS

4. RIGHT BREAST ADDITIONAL TISSUE

CLINICAL INFORMATION:

Rt. breast mass

INTRAOPERATIVE CONSULTATION:

1RFS: NEGATIVE FOR METASTASIS.

2RFS: NEGATIVE FOR METASTASIS

3RFS: INFLTRATING CARCINOMA

4RFS: NEGATIVE FOR METASTASIS

GROSS EXAMINATION:

1. The specimen is received fresh for frozen section labeled "rt. breast sentinel node" and consists of a 2 x 1.5 cm. portion of fibroadipose tissue containing a single node. A representative section of this node is submitted in 1RFS; the rest of the node is sectioned and submitted entirely in 1A and 1B.

2. The specimen is received frest for frozed section labeled "rt. breast sentinel node" and consists of a 1 x 0.6 x 0.4 cm. tan/yellow node. Submitted entirely in 2RFS for frozen section.

3. The speciment is received fresh labeled "rt. breast mass" and consists of a 5.5 x 4 x 3 cm. portion of fibroadipose tissue with dense stroma. A short suture is tied to the "superior" margin, and double long suture is seen at the "lateral" margin. Dense white stroma extends to all of the margins. A distinct mass is not grossly identified; however, indistinct induration involving an approximate 0.8 cm. area is seen approximately 1 cm. from the deep margin and 0.8 cm from the inferior margin. This area of induration is 1.5 cm from the cuperior and lateral margins and 1 cm from the medial margin. Representative sections of the frozen sepcimen are labeled 3RFSA and 3RFSB; additional representative sections submitted in 3A-3H.

CASSETTE SUMMARY

3A, 3B - inferior margin

3C - area of induration, deep and inferior margin

3D - deep margin

3D - superior margin

GROSS EXAMINATION:

3F - superficial margin

3G - medial margin

3H - lateral margin

4. The specimen is received frest for frozen section labeled "rt. breast mass" and consists of a 3.8 x 1.5 x 1 cm. portion of fibroadipose tissue with a suture attached. The area of this suture is dyed black. The rest of the specimen is not linked. A representative section is in cassette 4FS for frozen section. Dense white stroma is seen through approximately half of the specimen. Representative sections are submitted in cassettes 4RFSA-4RFSC.

MICROSCOPIC DESCRIPTION:

1. Multiple sections show a benign lymph node with focal sinus histiocytosis and focal fatty infiltration. No evidence of malignancy is seen.

2. Multiple sections of the entire specimen show fibroadipose tissue with no evidence of lymph node.

3. The frozen section shows a somewhat ill-defined infiltrating malignant neoplasm measuring 0.9 x 0.6 cm. This area is infiltrated by small and partially spindling malignant neoplastic cells in the dense fibrous tissue. At the peripheral portion of the invasive duct carcinoma are multiple dilated ducts showing intraductal carcinoma, small cell type, with occasional centrol necrosis. Tumor cells are basically small in size with occasional focal areas of spindling transformation. No evidence of tubule formation is seen. Tumor cells show very few mitotic activities. Multiple sections from different areas of the specimen show no evidence of residual infiltrating duct carcinoma. All the sections show fibrocystic changes with occasional sclerosing adenosis.

4. Multiple representative sections and frozen section show benign breast tissue with focal areas of old hemorrhage, fibrosis and lymphocytic infiltrates. No evidence of malignancy is seen.

DIAGNOSIS:

1. BENIGN LYMPH NODE (1) - RIGHT BREAST SENTINEL NODE

2. FIBROADIPOSE TISSUE WITH NO EVIDENCE OF LYMPH NODE - SPECIMEN LABELED AS "RIGHT SENTINEL NODE".

3. INFILTRATIN DUCT CARCINOMA, MODERATELY DIFFERENTIATED;

NOTTINGHAM HISTOLOGIC SCORE (6) WITH TUBULE FORMATION (3), NUCLEAR

PLEOMORPHISM (2) AND MITOTIC COUNT (1).

SIZE: 0.9 X 0.6 CM.

FREE RESECTIONS MARGINS.

ABSENT VENOUS/LYMPHATIC INVASION.

MICROCALCIFICATIONS NOT IDENTIFIED.

DUCT CARCINOMA IN-SITU, INTERMEDIATE NUCLEAR GRADE (NG2)

4. BENIGN BREAST TISSUE - RT BREAST ADDITIONAL TISSUE

Cancer Shecklist Summary: Breast

SPECIMEN TYPE:

_x__ Excision

___ Mastectomy

___ Other (specify): _____

___ Not specified

LYMPH NODE SAMPLING:

___ No lymph node sampling

_x_ Sentinel lymph node(s) only

___ Sentinel lymph node with auxillary dissection

___ Axillary dissection

SPECIMEN SIZE (for excisions less than total mastectomy)

Greast dimension: 5.5 cm

*Additional dimensions: 4.0 x 3.0 cm

___ Cannot be determined (see comment)

LATERALITY

_x__ Right

___ Left

___ Not specified

TUMOR SITE (check all that apply)

___ upper outer quadrant

___ lower outer quadrant

___ upper inner quadrant

___ lower inner quadrant

DIAGNOSIS:

___ Central

_x_ Not specified

MICROSCOPIC

SIZE OF INVASIVE COMPONENT

Greatest dimension: 0.9 cm

*Additional dimensions: 0.6 x __ cm

___ Cannot be determined (see comment)

HISTOLOGIC TYPE(S) (check all that apply)

___ Noninvasive carcinoma (NOS)

_x_ Ductal carcinoma in situ

___ Loular carcinoma in situ

___ Paget disease without invasive carcinoma

___ Invasive carcinoma (NOS)

_x_ Invasive ductal carcinoma

___ Invasive ductal carcinoma with an extensive intraductal component

___ Invasive ductal carcinoma with Paget disease

___ Invasive lobular

___ Nucinous

___ Meduliary

___ Other (s) (specify): __

___ Carcinoma, type cannot be determined

HISTOLOGIC GRADE (One grading system required)

Nottingham Histologic Score

* Tubule formation:

* ___ Majority of tumor greater than 75% (score = 1)

* ___ Moderate 10% to 75% (score = 2)

* _x_ Minimal less than 10% (score = 3)

* Nuclear pleomorphism:

* ___ Small regular nuclei (score = 1)

* _x_ Moderate increase in size, etc (score = 2)

* ___ Marked variation in size, nucleoli, chromatin clumping, etc (score = 3)

Mitotic count:

For a 25X objective with a field area of 0.264 mm 2

___ Less than 10 mitoses per 10 HPF (score = 1)

___ 10 to 20 mitoses per 10 HPF (score = 2)

___ Greater than 20 mitoses per HPF (score = 3)

or

For a 40x objective with a field area of 0.152 mm 2

_x_ 0 to 5 mitoses per 10 HPF (score = 1)

___ 6 to 10 mitoses per 10 HPF (score = 2)

___ Greater than 10 mitoses per 10 HPF (score = 3)

Total Nottingham Score:

___Grade I: 3-5 points

_x_ Grade II: 6-7 points

___ Grade III: 8-9 points

___ Score cannot be determined

EXTENT OF INVASION

PRIMARY TUMOR (pT)

___ pTX: Cannot be assessed

___ pTO: No evidence of primary tumor

___ pTis: Ductal carcinoma in situ

___ pTis: Lobular carcinoma in situ

___ pTis: Paget disease without invasive carcinoma

_x_ pT1: Tumor 2.0 cm or less in greast dimension

___ pT1mic: Microinvasion 0.1 cm or less in greastest dimension

___ pT1a: Tumor more than 0.1 cm but not more than 0.5 cm in greatest dimension

___ pT1b: Tumor more than 0.5 cm but not more than 1.0 cm in greatest dimension

___ pT1c: Tumor more than 1.0 cm but not more than 2.0 cm in greatest dimension

___ pT2: Tumor more than 2.0 cm but not more than 5.0 cm in greatest dimension

___ pT3: Tumor more than 5.0 cm in greatest dimension

___ pT4: Tumor of any size with direct extension to chest wall or skin, but only as described below #.

___ pT4a: Extension to chest wall, not including pectoralis muscle

___ pT4b: Edema (including peau d'orange) or ulceration of the skin of the breast or satellite skin nodules confined to the same breast

___ pT4c: Both T4a and T4b

___ pT4d: Inflammatory carcinoma

# Clinical information may be required to designate a tumor as pT4. Dermal invasion alone (without ulceration, satellie nodules, or inflammatory breast cancer) does not alter T category. Such cases are classified as T1, T2, or T3, depending on tumor size.

DIAGNOSIS:

REGIONAL LYMPH NODES (pN)

(Choose a category based on data supplied with specimen. Immunocytochemistry and molecular studies are not required.)

___ pNX: Cannot be assessed (previously removed or not removed for pathologic study)

___ X pNO(i-): No regional lymph node metastasis histolotically (ie, none greater than 0.2 mm), no additional examination for isolated tumor cells

___ pNO(i+): No regional lymph node metastasis histologically, positive IHC, no IHC cluster greater than 0.2 mm

___ pNO(mol-): No lymph node metastasis histologically, negative moelcular findings

___ pN1mi: Micrometastasis (greater than 0.2 mm, none greater than 0.2 mm)

___ pN1mi(+): Micrometastasis detected only by IHC

___ pN1a: Metastasis in 1 to 3 axillary lymph nodes (at least 1 tumor deposit greater than 2.;0 mm)

___ pN1b: Metastasis in internal mammary lymph nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent

___ pN1c: Metastasis in 1 to 3 axillary lymph nodes and in internal mammary nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent

___ pN2a: Metastasis in 4 to 9 axillary lymph nodes (at least 1 tumor deposit greater than 2.0 mm)

___ pN2b: Metastasis in clinically apparent internal mammary lymph nodes in the absence of axillary lymph node metastases

___ pN3a: Metastasis in 10 or more axillary lymph nodes (atleast 1 tumor deposit greater than 2.0 mm), or metastasis to the infraclavicluar lymph nodes

___ pN3b: Metastasis in clinically apparent ipsilateral internal mammary lymph nodes in the presence of 1 or more positive axillary lymph nodes; or in more than 3 axillary lymphs and in internal mammary lymph nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent

___ pN3c: Metastasis in ipsilateral supraclavicular lymph nodes

Specify: Number examined: __

Number involved: __

DISTANT METASTASIS (M)

___ pMX: Cannot be assessed

___ pM1: Distant metastasis

* Specify site(s), if known: __

MARGINS (check all that apply)

___ Margins cannot be assessed

_x_ Margins uninvolved by invasive carcinoma

Distance from closest margin: 10 mm

* Specity which margin: posterior

_x_ Margins uninvolved by DCIS (if present)

Distance from closest margin: 10 mm

* Specify which margin: posterior

___ Margin(s) involved by invasive carcinoma

Specify which margin: __

___ Margin(s) involved by DCIS

Specify which margin: __

* Extent of margin involvement for DCIS

* ___ Cannot be assessed

* ___ Uniforcal

* ___ Multifocal

* ___ Extensive

* ___ Other (specify): __

* VENOUS/LYMPHATIC (LARGE/SMALL VESSEL) INVASION (V/L)

* _x_ Absent

* ___ Present

* ___ Indeterminate

* MICROCALCIFICATIONS (check all that apply)

* _x__ Not identifiey

* ___ Present in DCIS

* ___ Present in invasive carcinoma

* ___ Present in nonneoplastic tissue

* ___ Present in both tumor and nonneoplastic tissue

* COMMENT(S)

FIXATION: 10% neutral buffered formalin X

Other (specify)__

DIAGOSIS:

Fixation time: 6-48 hours X other (specify)

___ unknown __

Breast Prognostic Panel:

ER/PR Ordered Yes _ No _

Complete panel ordered (ER,PR, Her2) Yes x No _

In not ordered, state reason: __

Ch. 5 - The Recovery

After arriving home, I was able to move around the house, but I slept alot. My right upper chest and upper arm were very sore and painful, but tolerable. The hardest part was trying to get comfortable during the night and during my naps. The snug ace wrap felt good as it gave my upper chest support. Up until this point, I had not seen the surgery sight and would not be able to until I went to the MD office on Tuesday. During this time, I just had to take it easy. My husband helped me with everything including bathing and dressing. He also cooked or picked up take-out. I felt good as a whole, but I did notice that my right axilla was numb as well as the interior of my upper arm and the right side of my right breast. This was a little concerning, but I knew that I would be seeing my physician soon and would bring it to her attention.

At the MD's office on Tuesday, she removed the ace wrap, but left the steri-strips in place. She performed a gentle breast exam and noted a slight hematoma at the area where the tumor was removed. She stated that over time the body was reabsorb the material and that it would decrease in size, just to be patient. She instructed me to continue with the pain meds, hydrocodone, as needed for pain. She also requested no showers, only sponge baths to prevent the incision from getting wet until our next MD visit. She left the ace wrap off, but I was instructed to wear supportive sports bras every day until she instructed me otherwise. This would help to control swelling and pain. She gave us an appointment for the following week, on September 6, 2007 at 12:15 pm. Oh, about the numbness, she stated that when she makes the incision through the tissue, a lot of small sensory nerves are severed. This results in the numbness. She stated that the nerves would reconnect, but that the process may take up to 6 months. This news was reassuring.

The healing process was slow, but steady. The numbness continued for the next 4-5 days but I did notice that the area was slowly becoming smaller. The most numb was my axilla. I tried to shave my underarm on the right side and was a little freaked out when I could not feel the razor, like at all. But the goal was accomplished, just with caution. HOWEVER, after about 4-5 days, my arm suddenly began to WAKE UP!!! The numbness was replaced with burning. It felt like my skin had been rubbed RAW. I kept asking my husband to look at it to see it he saw any redness, he repeatedly told me know, but would rub it gently to see if it helped. Every time he touched it, it seemed to make it worse. I then noticed that even my clothes touching my arm was causing me great discomfort!!! I knew about this process, post surgical neuropathy, due to being a physical therapist and working in the hospital, but I had NEVER felt it for myself. I wanted to walk around with my arm held slightly to the side, not touching any other parts of my body, and I wanted to not be wearing any clothes. The burning sensation was terrible. The pain meds helped a little, but this pain was very different from my surgery pain and very difficult to control. As each day went by, it seemed that a little bit more of the area was "waking up", resulting in more burning and irritation, but with no visual problem. I continued to remind myself that this was normal, I knew it was, but I could not believe how irritating!!! I went to the follow up visit with the MD as scheduled. There was a little confusion in the visit place and time obviously because when we arrived at her office, it was closed for remodeling. There was a handwritten note posted on the door with a phone number to call in the case of an emergency. Well, in the life of Jennifer Bailey, this was an emergency. I called and the problem with the office was explained to me. Apparently they had a leak in the office and it had to be closed for remodeling. And, the reason I was not notified about the closure of the office was because my apointment was actually scehduled at her Glendale office, but on the following day. I guess a slight miscommunication was to blame, oh well. The MD was finally tracked down at the hospital and luckily she was able to see me in her office there at the hospital. She explained that the sensory problems were known as neuropathy. She states that all of her patients do not experience this, but a few have. The ones that did have the burning pain, as she stated, were very upset at her because she had not told them this may happen after surgery. I too wanted to be upset, but knew from my own experiences with my patients at the hospital that it would get better. She stated that everything regarding my surgery appeared good. The hematoma was resolving and my range of motion was good. She reported on the preliminary lab results and told me that they were good as well. My breast cancer was graded at ER+/PR+. This meant that the cancer contained both estrogen and progesterone receptors which meant that it would react well to treatment, i.e. the chemotherapy. She gave me referrals for the oncologists, Dr. Ma for chemotherapy and Dr. Grace for radiation. She instructed me to wait on her to obtain the referrals for them from my insurance company and that she would be in touch. We asked her about my paperwork for my leave of absence (we had sent all the forms to be signed by her to her office a week earlier). She stated that she did not receive them. I got nervous and explained the importance of my employer receiving these papers #1 for my leave of absence to hold my job and #2 for my short term disability so that I can get paid. I was not scheduled to return to work until September 18, 2007. She told us to get her another set of forms and she would take care of it. So my husband and I went, again, to human resources at my job, obtained an additional set, went to the cafeteria and filled them out, and then submitted them to her personally. After that craziness, we took a deep breath and went home. We had to pack for a trip to Williamsburg, Virginia. I guess we felt like we needed another weekend getaway while the healing process continues and while we wait on the next phase of the recovery process. Any excuse for a vacation!!

During our time out-of-town, my neuropathy got worse, but then better near the end of our trip. Our condo had a hot tub which was great for my right arm for the pain and for the neuropathy. By this point, I had no restrictions regarding bathing and could get my incision wet at this time. I forgot to mention that she had removed the steri-strips at the last visit. Our vacation was interesting in the fact that it was on the opposite side of the country and my pain was almost unbearable with no pain pills left. So with tears, phone calls to my MD, support from my husband, and patience, we made it through. By the last 2 days of the trip I was on the road to recovery. I could not believe that so much pain would happen 2 weeks into the recovery process, but it did.

On our way home, we got a call from Dr. Shirazi's office. Her secretary needed to know where to send the paperwork we had submitted. She stated the MD had completed them, but she did not know where to send them. This was very stressful. I could not believe this had not been taken care of already. I guess this was so stressful because #1 I am a very organized person and took care of everything I could before we went out-of-town and #2 during this time in my life I am more emotional and sensitive about things relating to my life. So, up until this point, my employer had no record of me being out-of-work except what they were told verbally, and the State of California had not received the request for short term disability. I was aware that this did not start until day 7 of missed work days, but I had submitted all the paperwork on time to my MD. After deep breathing and multiple phone calls, I think everything was resolved. I did talk with my manager, Leonor Diaz at While Memorial Medical Center. Together, she and Marci in human resources, They submitted something on my behaf so that at least I could get paid. Thank goodness for my little angels.

Ch. 4 - The Operation

CHAPTER 4 - My Partial Mastectomy with Sentinel Node Biopsy

The date finally arrived, August 24, 2007. I had to arrive at the hospital, White Memorial Medical Center, at 11:00 am to begin the dye injection for the sentinel node biopsy. I had to lie still on the table for a full 1 and 1 1/2 hour to allow the dye time to "travel" so that it can be seen in the sentinel node once I am on the operating table. This will then be the node that the surgeon will remove during surgery for the frozen section biopsy. If this node is negative, no further nodes would have to be removed. The 1 1/2 hour seem to last forever, but I did squeeze in a nap. Toward the end of the procedure, I received a visit from one of my physician friends, Dr. Barrio, which made me feel more at ease. By the way, my surgery was at the same hospital that I work at. This alone aided in my being more relaxed for surgery. After the dye "traveled" I had a 45 minute break before surgery. During this time, I was able to watch my husband grab a bite to eat. I was NPO, but too nervous to eat anyway, I think. I arrived back at the OR waiting room at 3:00 pm and was quickly prepped for surgery and wheeled away to Same Day Surgery (dont' let the name fool you though, I had to stay overnight). We received a brief visit from the surgeon prior to surgery who reviewed everything with us. The IV fluids were started, and before I could back out, I was in the operating room.

After 2 1/2 hours, I arrived in recovery. Once awake, my surgeon made a visit. She stated that all went well. She was able to do a lumpectomy instead of a partial mastectomy by entering the region of the breast at 10:30 in location via an incision in my axilla which is the same location that the lymph nodes were removed from. She proceeded to tell me that she removed two lymph nodes during surgery but both were negative. She also removed a wide margin around the tumor which only measured 0.7x0.9 cm. She did state that I would be sore from surgery, but everything went well. She asked if I rememberd surgery at all, I told her no and asked "why". She said that while I was waking up in surgery she told me that she had removed 2 lymph nodes and that they were negative. Upon hearing the good news, she said that I put my hands together in a gentle clap and said "Yeah" in a soft voice. She said that gave everyone in the OR a smile.

My husband was finally able to come back and see me in recovery and then I was wheeled to my room. I was tucked in perfectly and was with my tired but very supportive husband. After a couple of hours, I was awake, eating a clear liquid diet, and my husband was able to go home and get some sleep. Throughout the night, I felt like used the bathroom for urination about 10-12 times from all the IV fluids. I also ate about 3 jellos before going to bed. The night was very restless, but with vicodin and morphine, I was able to get some rest.

The next day my surgeon came around for a visit around 11:00 am, stated everything looked good. She instructed me to leave on the ace wrap that had been snuggly applied around my chest during surgery and stated I could not take a shower or bath, only rinsing off at the sink until I saw her in her office on the following Tuesday. I was then released to go home around 12:30 pm. It was great to be out of the hospital and to have received such good news. My cancer was at Stage 1 only due to no lymph node involvement and the surgery was OVER. Now, we just have to wait on the healing process and for pathology to determine the grading of the tumor as well as the other characteristics. A small weight had been lifted from my shoulders. It finally felt like the first milestone was behind us.

Ch. 3 - Email Support from Friends & Family

CHAPTER 3 - Email Support from Friends & Family

The email that I sent to my friends and family during this week awaiting surgery was one of the best things I could of done for myself. Mainly because it was difficult to keep the health "secret" from those who just happened to call during this time. How do you tell them? What do you say? So this is a copy of the email I sent August 22, 2007...

To My Friends and Family-
>
> I wanted to take a minute of your time to update you on my life and health
> condition. I am doing this primarily because I need you guys!!!
>
> I have recently been diagnosed with invasive or infiltrating ductal
> carcimona of my right breast. This is a malignant cancer that originates in
> the milk ducts. It is the most common type of invasive cancers for women and
> maybe men as well. The process started with a lump felt in the breast
> followed by an initial MD visit with OBGYN 6/14/07... ultrasound 7/18/07...
> MD visit regarding results with OBGYN 8/2/07... mammogram 8/2/07... fine
> needle biopsy with vaccuum 8/8/07... another mammogram 8/8/07... phone call
> from MD re: preliminary results 8/10/07...MD visit re: final results
> 8/13/07... diagnosis of invasive ductal carcinoma (IDC)... MD visit w/
> general surgeon 8/13/07... IUD insert to prevent pregnancy 8/13/07... MRI
> bilateral (both) breasts 8/17/07... MRI results from surgeon 8/20/07...
> results conclusive with diagnosis of IDC in right breast... MD visit with
> plastic surgeon 8/20/07... CURRENTLY... awaiting a surgery date for a
> partial mastectomy with sentinal node biopsy.
>
> As far as some of the general questions I have had...
>
> 1. I had the choice of a partial mastectomy or a mastectomy... I chose a
> partial.
> 2. I will need follow-up radiation and chemotherapy depending on the stage
> and grade of the cancer.
> 3. Staging and grading of the cancer will be done on the tissue removed from
> surgery as well as the sentinal lymph node that will also be removed.
> 4. The staging and grading will determine the type and duration of radiation
> and chemotherapy treatment. I will not know the results until after surgery.
> 5. I will not need a plastic surgeon at this point, but will follow-up with
> him at the 6 month and 1 year period. Options at this time will then be
> determined.
> 6. My surgery should be at the end of this week or at the latest the first
> of next week.
> 5. There has been a question of the need for harvesting of my eggs. This may
> be necessary depending on the type of chemotherapy drug required. I will
> know this later.
>
> I will do my best to keep everyone updated as best I can. Please feel free
> to call me or to keep in touch via emails. I really appreciate the support
> during this time. I do want to thank all of you in advance for your thoughts
> and prayers.
>
> With love,
>
> Jennifer Bailey

And the responses were overwhelming. I am enclosing them here for all those other cancer fighters to feel some of the same support that I felt during this time.

1) From a high school friend who I have not spoke to directly in over 15 years, currently in Georgia...

"It took me a minute, but this MUST be Jennifer Smith!!! I'm so sorry you are dealing with this. I know its a difficult time, but also a little coincidental that you included me on the email. I actually have worked for an Oncology Practice- Georgia Cancer Specialists (www.gacancer.com) for the past 9 years. I'm a dietitian and work very closely with pts undergoing treatment and before and after treatment.

I don't want to bombard you, but I'll be more than happy to share some helpful and reliable resources. It sounds like, though you are in good hands and good for you for paying attention to your body! Some internet sites I often use-
www.caring4cancer.com - general info on treatment, prevention, resources, etc
www.cancerrd.com - written by a dietitian who's had cancer - reliable info, frequently asked questions, etc
www.aicr.org- American Institute for Cancer Research - a lot of prevention info but also research and recipes
www.cancer.org - American Cancer Society


Thanks so much for updating me- I really hope surgery goes well and treatment too. Please keep including me on the emails. My work email is laura.snyder@gacancer.com. I enjoyed your letter and picture at the reunion! Hang in there-- you can do it!

Much love, health and blessings to you!
Laura"

2) From a female cousin of mine in Georgia...

"Whow! I hate to hear this. Mom briefly told me what she knew a few
days ago and I've been praying for you but didn't want to intrude. If
there is anything else I can do for you PLEASE let me know. It is
really scary the number of people diagnosed with breast cancer under 40!
It really makes me want to get a mammogram. I'm sure your life has been
turned upside down. Try to stay strong and remember we are all praying
for you and supporting you here! Take care

Love,
Cindy"

3) From a family member in Florida

"Hey Jenn,

You've been in my thoughts continously since I've heard this news. You're such a strong person. You answered all the questions anyone could've wanted to ask. Just know that they're so many people that love and care for you. Nick and I want to plan a trip out to see you soon. But, of course we know this is a time when you and Clayton really need to spend a lot of time just you and him. Just know that should you need anything we are here for you. As soon as you're up for company, we're gonna fly out. It may only be for a day or 2 but, we're coming. If you need anything at all please don't hesitate to ask. You and Clayton are not only our family you are our closest friends as well. You are in my prayers and I can't wait to see you and hear from you.

Remember how much we love and care for you!!!

Mandy"

4) From another high school friend in Georgia...

"Hey Girl! I am sorry to hear that you have breast cancer. You will be in my
prayers daily!!! I wish I was close enough to you to give you a big hug. Even
though we haven't seen each other or talked in a while I still love ya!!! I
would like to call you and have a "real" conversation soon. Is there a better
time of day to call? I want it to be convenient so we can talk. Just let me
know. I am thinking about you!!!

Mandy"

5) And another high school friend in Georgia...

"You will certainly continue to be in my prayers. I will pray for the surgery and for wisdom for the doctors as well as for you as you have some big decisions to make. Please keep me updated and let me know if you have any specific prayer requests or if you need anything!
Take care girl! and please keep me updated.

Susan"

6) From a former PT intern of mine in California...

"I'm so sorry to hear about what's going on! I will keep you in my thoughts and prayers. I hope everything goes well.
Sending you lots of love, strength, courage, and hope...
Love,
Ana"

7) From an aunt and uncle in Georgia...

"Just close your eyes and feel ALL the arms wrapped around you Jennifer. Know
too that we love you every minute of every day - whether there's few or many
miles between us.

I am so proud that you shared this update and the path you've traveled with us.
I pray you feel the weight on your shoulders lighten just a bit with every
thought and prayer.

You've been through some very tough days and I pray forward that each day brings
you the strength, courage and comfort you need to sustain and win this battle.
And I do believe in the power of prayer! Know that we are soooo with you in
our hearts and let this bring you comfort ~ one of the building blocks of
strength I think. Place our thoughts and prayers where you see them every
day!!!!!

Love you sooooooo mmmmmuuuuuuccccchhhhhhhh!!!
Jan and Gary"

8) From a college friend of mine from UGA and later coworker while in Carrollton, GA...

"I am beyond words right now. I just don't know what to say... right now I only have tears. I hope you know that you are not alone and you will get through this with family and friends that love you. I am here for whatever you may need. PLEASE just let me know if I can do anything...... as your treatment progresses I would be happy to come out there and help if you need it. I know you have great family support but I also know that sometimes we need people who are not our "family"! It is so ironic that I got this email from you today because you have been on my mind, more than usual, lately. Dan is now working the Western Division for Home Depot and so his area includes California. He just recently had to spend a week out in LA for work. I was talking to him about going with him next time so I could visit you! Girl, you are strong and I know you are going to get through this difficult time. Please please please keep me posted. I am going to try to get in touch with you over the phone as well but don't seem to have good luck with the time difference. Keep your spirits up and know you are in my thoughts and prayers.
Love,
Dawn"

9) From an aunt and uncle in Georgia...

"We appreciate so much your including us with this email. We are thinking of you
and praying for your fast recovery. Even though you are all the way across the
country, I hope you will feel our thoughts and prayers and those of all of your
family and friends here and that you will be comforted by them. We will await,
and I know you will have, some really good news soon. God bless you.
Love,
Gene & Jane"

10) From a cousin in Florida...

"My family loves you so much Jennifer and I know you will do just fine.Mandy and I wish we could be there for your surgury.But we are planning to come see you ASAP I promise.If you need anything or if i can do anything for you, you call me ok.Or if you just need someone to talk too,I want to help so bad, but I know its all in the Good Lords Hands and he will take care of you.You are a great and strong person and I know you do just fine with this minor stepping stone of life.You are loved very much by our family more than you know.Cant wait to see you. Please keep in touch we us.Love you soooooo much.Nick"

11) From another high school friend in Georgia...

"I am so sorry to hear what you are having to go through. I have been affected
by several people who have had cancer. My mother actually passed of cancer
almost 10 years ago.

There is hope......keep your chin up. I know lots of people that have battled
their cancer and are doing great! You will be in my prayers. Keep us posted.

Tricia"

12) From another high school friend in Georgia...

"I am sorry to hear of your health condition, I know it must be difficult. My thoughts and prayers are with you and your family. I am sure you have really educated yourself about your condition and it sounds like you are on top of things, faith, education, and a strong will is so important as I am sure you know. Continue to fight hard and know many people are praying for you and surround you with love and support. Please don't hesitate to let me know if there is any thing I can do and please keep me informed of any changes. Talk to you soon.

With love,

Crystal"

13) From another high school friend in Georgia...

"My families thoughts and prayers are with you during this tough time in your life. I know you are a very strong person and this will be a small obstacle that I am sure you will overcome. Stay positive and only think pleasant thoughts. This is what I have learned in my life and it will work wonders for you as well. Please let me know if there is anything I can do for you.

Latham"

14) From another high school friend in Georgia...

"OMG - what an ordeal you have been through! I'm so
sorry to hear that you are having to deal with all of
this! You are definitely in my thoughts and prayers.
Please keep me posted on your progress.

Tara"

15) From a cousin in Florida...

"JEN, I LOVE YOU SO MUCH, MISS YOU ABUNDANTLY, AND PRAY FOR YOU DAILY.
CALL ME WHEN YOU GET A CHANCE!"

16) From a high school friend in Arkansas...

"Was just checking my email before bed and saw your email.

I'm so sorry to hear about all of this. But I know that everything is going
to go well in the treatment. Sounds like you have some very good and
thorough doctors that are going to take great care of you! We will
definitely keep you in our prayers!

By the way - I noticed from the "class directory" email that was sent out a
while back that you are living in Los Angeles! WOW - and I thought I went a
long way to Northwest Arkansas! My wife and I will be coming to the LA area
in March for her cousin's wedding in Hermosa Beach. Maybe we can get
together to catch up a little. We just had our first child 3 weeks ago and
we'll be bringing him with us (so I can show him off a little!)

Hang in there and stay strong!

Jay"

17) From a former co-worker in California...

"Hi Jennifer!

Wow! You've been on my mind a lot lately, and on several occasions I sat down to call you, but something would come up and I never got around to making the call. So your e-mail was a happy surprise until I opened it and read your letter.

Just know that I, too, have been through this ductal carcinoma thing, and 15+ years later I'm still going strong. In 1992 I had a lumpectomy in my left breast, went through chemo and radiation and then a few years ago, found another lump, had it removed (along with a bunch of scar tissue) and now I wear a prosthesis because my breasts are no longer the same size. I could go in and have an implant, but I don't want anymore surgeries, and besides, no one really sees these babies except me!

Jennifer, please remember that the decisions you make are yours alone; you have to do what you feel is best for you and no one else. You'll know what's best when the time is right.

Please let me know when your surgery is - I'll call our prayer chain at church tomorrow morning and put you "on the list". I'm certain that everything will turn out OK and you'll get through this trying time intact. I know that it is a VERY scary thing to go through, but I also believe that God doesn't give us more than we can handle (we just think we can't!).

I'll be praying for you (and Clayton). Please keep me posted, OK? If you need to talk, call me anytime .
Blessings,
Cheryl"

18) From one of my Mom's co-workers in Georgia...

"Your Mom forwarded your email to me. First of all, let me set the record straight - this stinks! Having said that, please know that you, Clayton and your Mom and Micky are in our prayers every day. We will do our best to hold your Mom up here at work. Francisco is available to talk with her whenever she has any questions. We love your Mom a lot and will stay by her for as long as she needs us. Please let us know what we can do to help. We are here for you.

Sylvia"

19) From a former boss in Georgia...

"Jennifer,
40 years ago when I was 13 years old my mother was diagnosed with breast cancer.Surgery and radiation were the standard of the day in the 60's. She lived cancer free until 6 years ago when a small lesion was found on the opposite side.She has been cancer free for 6 going on 7 years now following surgery again. IT IS BEATABLE AND WINNABLE. She is 78 ,enjoys life,walks 5 miles a day with her lab puppy. You can do it. My prayers and thoughts are with you.with love ,Bo"

20) From an aunt in Georgia...

"Hey You,

I am so proud that you updated me on everything, but your mother had pretty much told me everything correctly (believe it or not). Sometimes she does not get it exactly right. I have been wanting to talk or email you, but I did not know what to say or do. When stuff like this happens, I feel useless. BUT, I have had you constantly on my mind. If there is anything that I can do for you or Clayton, please let me know. After you get home from your surgery, I would like to order a pizza or whatever you would like to be delivered to you. Let me know the day and time, and I can take care of that on the internet. I have searched the internet to try to find something different other than pizza, but did not have any luck. If you know of something else that you had rather I do, let me know.

It appears that you have done all your homework regarding the cancer, which I knew you would. I just wish we all could be there to help, but Clayton is probably happy that it will be just the two of you. With my recent surgeries, we have told all to not come to the hospital and it has been less stressful on Ted and I, so I do understand. But once I got home, Maw Maw helped with cooking and that has been much appreciated. Hopefully, Clayton can cook for you two or pick up stuff that you like to eat. Be careful after your surgery and do not go back to work too soon and hurt yourself. Are you still doing home health? If you are, be sure you do not pull and tug on patients and mess up your surgery. Well, that is enough of bossing you around. I know you will take care of yourself and do what the DR tells you to do.

I love you,
Ann"

21) From a fromer co-worker in Georgia...

"Hello I am sorry to hear of this about you but I will continue to pray for you and your husband as well. I understand you are going through something I can't even begin to understand cause I have not havd to deal with it. But I can pray for your recovery and that all will be fine in time with God's help. No time is a good time to tell someone disturbing news but I lost my mother on 8/8/07 my Queen. It was and still is hard to overcome but I know with time and prayer things will be better for you and me. I will call you as I am in Maryland right now and I know that we have at least three hours difference. -Brenda"

22) From a friend in Georgia...

"Jennifer,

I am so sorry to hear about this. This is so shocking! It seems like it
happened so suddenly! Did you find this lump doing a self examination? I
am so thankful that it was found. I will be thinking of you and praying for
you and Clayton. I hope your surgery is a success. Please let me know if
there is anything Mike and I can do for you. We love you both!

Keep us updated! Again, I will be praying for you!!

Cindy"

23) From friends of mine and my Mother's in Georgia...

"Jennifer, just wanted you to know our prayers have been with you and will continue being with you tomorrow during your surgery. We pray that God will give you and Clayton peace of mind, strength and comfort. I know you are anxious to have this behind you. We will pray for the rest of your family too as I know they are also very anxious. You are a very strong person and you will be a fighter throughout this whole ordeal.

We love you,

Jim and Diane"

24) From a friend of a friend...

"My name is Sylvia and I am in the class with Nancy, Marsha S. and many others. I just read you email and it is so full of courage and faith,
You have done all you can do and I am sure you will always do what you, your family and the Lord find best.
You are so full of the Lord and you are such a blessing.
Know we will be praying and thinking of you and the rest of your loved ones.

We will be here.
God Bless
With prayer, Jennifer
Sister in Christ

Sylvia"

25) From a current co-worker in California...

"I can't imagine how you must feel right now, but stay strong and I know you will get through this fine. There is no doubt in my mind you can beat this hands-down!

I will be keeping you in my thoughts daily. Please let me know if there is anything I can do for you to help make your recovery easier.

Best Wishes,
Felix"

26) From a prayer group via my Mom in Georgia...

"Thank you. I'll get those details to the class so we can lift her in prayer tonight and tomorrow. Please let her know that my prayers is that God will calm her fears and will give her confidence that she is safe in His Hands, not just today and tomorrow but every day. We're also remembering you and Mickey. It's hard for mama and daddy, too.

MHS"

27) From a friend of my Mother in Georgia...

"We will be praying for you. I am sure everything will go well. Let us hear how the surgery went.

Richard & Nancy "

28) From a friend of my Mother in Georgia...

"Thanks for letting us know. We will be praying for her and the doctors and nurses that things will go as well as possible. Love you.

Jackie"

29) From a friend of my Mother in Georgia...

"I will be praying extra hard--I know she will be glad to have this whole ordeal behind her. She is such a fighter and has a great outlook--that is half the battle. I love you.

Diane"

30) From a friend of my Mother in Georgia...

"Kay - I will be praying this evening. Let us know how everything goes.
Love you.

Sue"

31) From a prayer group via my aunt in Georgia

"I sent Jane Norton Lovvorn a copy of Jennifer's email and she asked if she could put her on Greenway's prayer group. I told her yes, and here is one response. Thought you might like to know. I hope you are doing good and hanging in there today. I would call you and ask but my emotions are raging. In other words, if I talk about Jen, I would cry. Love you, Ann"

32) From a friend in the prayer group in Georgia...

"You can see how quick our prayer group are to react to prayer requests. That sweet girl will have lots of prayers going up for her today!!!"

33) From a friend in the prayer group in Georgia...

"Jennifer, her friends and family, as well as the medical staff are in my prayers.

Prayer is awesome.
- Gayle"

34) From a prayer group in Georgia...

"Jennifer Smith Bailey (daughter of Kay Smith Moon at First National Bank of Georgia) is in her early 30's. She was diagnosed with invasive or infiltrating ductal carcinoma in her right breast. She will be having a partial mastectomy today and will follow up with radiation and chemotherapy depending on the stage and grade of the cancer. Please pray for a successful surgery and her complete healing. "

35) From a friend of my Mother in Georgia...

"Kay, you and Jennifer will be in our prayers during her surgery and her recovery. We are praying for a good result. I know you are so anxious about her. Please know we will be thinking of her in a special way. Anne Louise said that Jennifer sent the class members an email about her surgery. They are remembering her their prayers. Do let us hear.
Sara"

36) From a friend and former co-worker in Georgia...

"I read your e-mail on Thursday evening and it has taken me this long to write back because I am just speechless....(it take a huge event to leave me that way). It's hard to know just where to begin. I am certainly praying for you and you have been in my thoughts and will continue to be in both. <----------See I'm just mumbling.....

You know that if there is anything that I can do for you, all you have to do is let me know. I have spoken about you to some of my patients, who are breast cancer survivors and they are putting your name on their prayer lists. I had one woman tell me to let you know not to read any research that is older than 5 years, because there are so many advances in treatment today.

I know that if there is anyone who can stand up to this and beat it, it is you. Please keep me updated on your progress and know that I love ya like you were my own sister.

Love ya.

Cheryl"


37) From a former friend and PTA student in Georgia...

"Hey Jennifer,
I really thought that this email was going to be news about a pregnancy when I first opened it, but I am in awe when I saw the real meaning. Its amazing to me the number of people I know right now who are struggling with cancer. It is running rapid through my family, so I know a little of what you are going through. My father died of cancer when I was in high school, and I will never forget or get over that. I don't want to seem like the grim reaper, but take everyday and make it something different. I mean just do all of the things you wanted to do, but never had time for, because life is precious. Spend time with your family and laugh a lot. Just take this opportunity to live life like you mean it. I know God is going to bless you and, you will be fine. I have already started praying and asking God's blessings on you and your family. Just remember that with faith, nothing is impossible, God is able to do all things. Just be strong and know that I am always here for you and love you very much.
Delsondra"

38) From a friend and former co-worker in California...
"Dear Jen----SOOOOOOO sorry to hear the news. I am hear for you as a support person always. We just got back from Puerta Vaallarta so I am responding a bit late to this e-mail. I think of you often and wish for the days when we could talk daily in Tarzana. It is definilty Not the same. I know you will have fortitude during this time and I know your wonderful husband (blank right now on his name sorry jet lag)--it will come to me, will be at your side. If you ever want to talk my home is (818) 865-8410 and cell is (818) 631-8410. I will call you soon.

With love and prayers
Siri"

39) From a friend and former co-worker in California...

"I'm so sorry to hear all that you've gone through in the recent months. I'd
been wondering where you were the last time I worked at White. I don't remember
when I was there last, but I missed you, my 7 a.m. buddy!

You are a strong woman, and I praise you for sharing with your friends and
family.

Please keep in touch, keep me informed, etc. I would love to meet you for lunch
or something, once your treatments are done and you feel up to it.

Just out of curiosity, are you getting your treatment done at White or
elsewhere? I've heard St. Joe's has a good breast/women's center. My cousin's
wife went through it successfully last year.

Love and God Bless -0

Denise"

40) From a high school friend...

"I am so sorry to hear how your life has changed. In my nursing
profession, I have seen patients beat the odds with a positive attitude and
lots of support from friends and family. The mind is amazing.
Of course my prayers are with you.

Know you will beat this and you WILL.
Take care
Julie"

41) From a family member in Georgia...

"Hi Jennifer,
Well your email definitely sent an eye-opening message to us. I was unaware so much has been going on the past few months with you. My deepest thoughts and prayers go out to you and Clayton in this time of need.

I understand Penny made the trip out over this past weekend and I am glad to hear that. I know you probably welcomed the visit. Mom went out to visit with Aunt Patsy over the weekend as well and evidently was able to get caught up on the latest news. She told me this evening that surgery went well and it was diagnosed as Stage 1? Angela and I have read over your email a couple of times and have just looked at each other in awe. One of Angela's cousin's (now 44 or 45 years old) is in her tenth year of remission from breast cancer. She, too, was in her mid-30's when she was diagnosed. The similarities just astonish us.

I hate their is so much distance between GA and CA but thank God for email, huh. Thank you for including us in you fight an we too will fight right along side of you! We miss ya'll and we love ya'll! Please keep us updated.

Love ya,
Josh"

42) From a former co-worker in California...

"I just wanted to let you know that I've been thinking about you. I hope that your surgery went well and that you're not too uncomfortable. Please let me know if there is anything that you need or anything that I can do.

Don't worry about responding, I just wanted to let you know that you're in my thoughts.

Best,
Susie"

43) From a friend and former co-worker in California...

"I just got this message. I am so sorry to hear about this. I'm thinking you
must have had your surgery already, how are you holding up? Please let me know
if there is anything I can do.
Love and happy thoughts,
Asia"

44) From a high school friend in Georgia...

"I was pretty sure that was you. I saw the letter and picture of you and
your new husband from the reunion. Great picture. You have not changed.
How did you get to California????

Have you thought about a blog website (I hope I am saying that right). I am
not a computer person, but my 42year aunt went through chemo 2 years ago and
it was a site where we were updated and everyone could share their thoughts
and laughter together. She said it was great for her. - Julie"

AND... the emails continue and continue. And thus, the blog idea "seed" was planted.

Ch. 2 - My IDC Diagnosis

CHAPTER 2 - My Diagnosis

In early June 2007 while I was applying lotion I felt a small lump in my right breast. I was fairly confident that I had not felt the lump before, but I could not be sure. A few days later, I noticed that the lump was still there. It was not painful to touch or with movement, but I could feel it. I had my husband check it out over the next few days. He confirmed that there was something there and said I should make an appointment to have it checked out. The next day I called to schedule an appointment. My regular physician, Dr. Spencer-Smith was out-of-town, so instead of waiting for his return, his office recommended that I see one of his partners, Dr. Reese. On June 14, 2007 I visited the MD and he performed a breast exam. He asked if the lump had been noticed upon the breast exam and I explained that it had only been felt about 2 weeks ago for the first time. He reassured me that it was probably something benign, but that we needed to have it checked further by an ultrasound. He ordered for an ultrasound and sent in the request for my insurance company, an EPO. The ultrasound was then scheduled for July 18, 2007. I had this procedure performed at White Memorial Medical Center. The ultrasound technician stated that most problematic "cysts" are painful. She could not give any ultrasound results, but this made me feel at ease since I was not experiencing any pain. The ultrasound results however came back abnormal. Dr. Spencer-Smith's office called me with these results and scheduled me for an appointment with him on August 2, 2007. At this point, I became nervous. He stated that the results were abnormal and showed "something" that looked suspicious. He stated that even if it were CANCER, it would be treatable, and encouraged by husband and I to stay positive and not to worry. He sent us over to the hospital that SAME day for a mammogram and a fine needle biopsy with vacuum. They were able to do the mammogram, but I had to wait until the following Wednesday, August 8, 2007 for the fine needle biopsy with vacuum. On this date, I had the fine needle biopsy performed. I was so nervous... #1 because I had never had one done before and I thought it would hurt and #2 becauase I also have breast implants which could be punctured during this procedure. I also knew that this procedure would give us definitive results of what was growing in my right breast, at this point I knew I needed to know, but did not know if I was quite ready. When the biopsy was completed, the MD inserted a small metal clip that would show the location of the biopsy when follow-up mammograms are performed. This procedure was then followed by a mammogram to make sure the clip could be seen. At this point, I was happy that all of this was behind me, but very nervous in regards to waiting for the results. On August 10, 2007, my MD called with the preliminary results. He stated that he would not know the final results until August 13, but that the initial results look good, a benign problem that could simply be removed with a simple surgery. My husband and I were relieved, but the MD did caution us that the final results would give the final answer. The pathologist needed to wait for the completion of 2 more of the stains. On August 13, 2007 we received the final results. Dr. Spencer-Smith's office called me at work and stated the MD wanted to see me in his office @ 3:00 pm and he also wanted my husband to be with me. I knew at this point, that the results were not good, but I really did not know what to expect. The MD explained to us that the final results showed a form of cancer known as invasive or infiltrating ductal carcinoma, otherwise known as IDC. He did explain that it was treatable with surgery, radiation, and chemotherapy and that my chances were good. He continued to explain to us that although the cancer is malignant, it does not mean that it is fatal and that treatment options have come a long way in recent years. He shared statistics with us and stated that 1 in 8 women today are diagnosed with some form of breast cancer during their lifetime. We had many questions for him. It seems so strange for me to have cancer... young... no history of cancer of any form in my family, except skin... an active, healthy female. He simply stated that it was just bad luck. He encouraged us to not over-analyze the whys and hows, but now focus on being positive and support each other during this time. On this visit, we were told so much information. He had already contacted a surgeon, Dr. Sharazi, who came to his office around 3:30 pm to meet with me and my husband. She briefly went over the anticipated treatment course with us and proceeded to perform a breast exam. She stated that my left breast also felt a little odd and reported that she would not move forward with surgery until after an MRI of both breasts. This sent panic through my mind. It was hard enough to be positive regarding having cancer in one breast, but PLEASE, not two!! After the breast exam, Dr. Spencer-Smith returned and informed me that he also needed to remove my IUD. I had only had the IUD since November 2006. He explained that this was necessary because my IUD (Mirena) is a progesterone secreting type which is not good for someone with breast cancer because the cancer could contain be progesterone receptor positive which would actually help the tumor grow and spread. He gave us the choice of condom usage or having another IUD inserted that does not secrete hormones. He said that until ALL of my treatment was completed, we could NOT get pregnant. We chose for a copper IUD to be inserted after the other IUD had been removed. This was SO PAINFUL!!! But in retrospect, I lived. I did have severe cramps and vomiting from the pain for about 24 hours, but only occasional afterwards for about 1 week. At the end of our office visit, we still had many questions. We did have a trip planned for Catalina Island for 3 days. We asked it we should cancel the trip, but both MDs stated it would be good for both of us to get away and let everything settle in a little bit. In the meantime, I had mentioned that I had been considering having my implants removed. I felt that this may turn out to be the best time, especially if it were necessary due to my newly diagnosed breast cancer. Dr. Spencer-Smith stated that while away on our trip, he would call a plastic surgeon for us and brief him on my case. We were to get in touch with him the follwing day to schedule an appointment. His name being Dr. Allan Perry out of Pasadena. We were also instructed to call Huntington MRI center on August 15, 2007 because Dr. Shirazi wanted me to have an MRI done at this center on both breasts just to make sure the left breast was clear and she wanted a clearer idea of the extent and size of the cancer in the right breast before surgery. We did as instructed. I had a MRI done on both breasts on August 17, 2007. This MRI was done with contrast and took about an hour. On August 20, 2007, I received a call from Dr. Shirazi. She stated that the invasion in the right breast appeared small on MRI and that the left breast was negative for cancer. YEAH!!! Later this same day, we met with the plastic surgeon in his office. He explained to my husband and I that my implants felt healthy and he did not recommend any action at this time. He stated that without the implants he would need to be present during the operation to insert a tissue spreader in the right breast. This would keep the skin and underlying tissue from shortening after surgery and throughout radiation. The spacer would remain in until reconstruction surgery could be performed. Oh yeah, this would only be necessary if I chose a partial mastectomy. If I chose a total mastectomy, the reconstruction would be done at the time of surgery since this type of surgery did not require follow-up radiation, only chemotherapy. At this point I decided to have a partial mastectomy performed because all the physicians explained that with the partials, the outcomes are good, and I liked that fact of saving any healthy breast tissue that I could. Due to this fact, he said that during the recovery period, there would be no need for the tissue spreader because I already have one, my implant. The surgeon consulted with one of her radiation colleagues and he informed her that the radiation would not damage the implant and that the implant would not cause any harm during this period. So... with all this in mind, the conclusive plan was decided after my visit with the plastic surgeon and consulting with my general surgeon. The operation will be a partial mastectomy of the right breast with sentinal node biopsy. The surgery date was scheduled for August 24, 2007. After surgery, I was informed that I would need chemotherapy (IV vs. pill) and radiation and that the intensity and duration of the treatment would depend on the stage and grade of the cancer. And, since I do not need a plastic surgeon at this point, I only have to follow-up with him in 6 months to a year after everything has settled and I have completed chemotherapy and radiation. Surgical options would be determined, if any, at that time. There was one question regarding the need to harvest my eggs. This issue will be discussed further with my OBGYN after the surgery is behind us. During the time between the MD visits and consultations on Monday, the 20th and the surgery date of Friday, the 24th, I sent emails to many of my friends and family explaining my current health condition and asking for their support. The responses were overwhelming, greatly needed and greatly appreciated. It was very conforting to know that I have so many people who love and care for me and who are willing to do whatever I need during this difficult time.

Ch. 1 - An Brief Introduction into My Life

CHAPTER 1 - Introduction

Welcome to my blog. My name is Jennifer Bailey. I am 34 years old and work in Los Angeles, CA as a physical therapist. I am married with no children. We do have 1 dog named "Katie" and a cat named "Big". I was born in Carrollton, GA and spent most of my life there until I went to the University of Georgia in 1991. I graduated with a degree in Exercise & Sports Science in 1995. In the Fall of the same year, I attended Georgia State University where I obtained a degree in Physical Therapy graduating in 1998. I worked for several years for Southern Therapy Services, Inc. until I moved to Savannah, GA in 2002. I lived in Savannah for 2 years. During this time, I married my husband Clayton Bailey while he studied at the Savannah College of Art and Design. In 2004, we moved to Los Angeles, CA. While he began a career in Real Estate Investments and pursued acting, I continued to work as a physical therapist. Throughout these past 3 years in Los Angeles, I have had a fairly benign medical history. From childhood I have had a heart murmur and suffered some tachycardia around 2005 & 2006 intermittently, and I also developed arthritis in both my wrists earlier this year in March, but otherwise unremarkable. Also during this time I always had my yearly exams with my OBGYN and always had normal breast exams and only 1 abnormal pap smear. With follow-up testing, my pap smear was determined normal. In November of 2006, I did have an IUD implanted, but never had any problems associated with this form of birth control. In March of 2007, I went to my last annual exam with my OBGYN. At this time was when I had the abnormal pap smear, but normal breast exam. By the end of March, I received a clean bill of health with no health problems reported by my OBGYN.