Journal

Journal entry by Lisa Pollard

All ready to start 25 radiation sessions on Monday.  I will go Monday through Friday for 5 weeks.  I have no fear about doing it other than worrying that through the process I will lose additional mobility and range of motion in my left shoulder and we will have to solve that problem to continue.  My physical therapist has given me lots of exercises to help and it's not unusual to see me randomly throughout the day appearing to "have a question" because I am raising my arm and pulling it behind my head.  I want to get this done.  The other side effects will come and go put shouldn't put going forward at risk.  I should have been on a cruise this week.....that stings a little too.  But that will happen in November now so there is lots to look forward to.  I have a very special shirt picked out for my first day on Monday.....you'll have to stay tuned to see.  ;-)

I continue to be blessed by cards and notes and smiles and hugs and especially prayers from all of you.  God sure has revealed much to me through this.  The church is absolutely not a building and there is power in community.  #godscoollikethat  #letsgetstarted  #nextsteps  #kickinglittlecbutt 

Journal entry by Lisa Pollard

This morning I had my last tissue expander fill with the plastic surgeon and now I won't see him for about 8 weeks.  Then I had PT and learned I made very little progress last week which was no surprise because I was in more pain and discomfort last week related to my last fill and I was a baby and didn't "do the work". So by the time Cari got done stretching and pulling and massaging my arm and trunk she had me within 10 degrees of what I would need to get in the radiation position.(I always laugh a little when she talks about my "trunk" because she doesn't mean my butt - lol  #amitwelve?).  They are so great at the Spielman and everyone works so well together so in the hour I had between my PT and the radiation planning meeting she gave me a couple targeted stretches and put me in an exam room that I could stay in until my next appointment and keep on stretching on my own.   At this point, I called in the prayer warriors and kept on stretching.

Then I went down and over to radiation oncology.....that's where I got the 8th pregnancy test I have received since last September (still no babies for those with inquiring minds), and vitals and my last pre-consult with Dr Bazan.  Every time someone left the room, I stood up and stretched some more.  Dr Bazan thought it was close enough to give it a try but said, "if we can't do it, we could try again on Monday".   Ohhhhhhh noooooo.  If I leave here without this planning, I know I'm gonna cry so I'm going to give it everything I got.

In the radiation room they put you on this table and you put your arms over your head (think "H" in the O-H-I-O poses).  Your bottom goes between two raised sections and there is a mold to hold your knees up a little and your head fits into this cup like space.  Then they make a chin strap mold that holds your head in place against the table.  The idea is to create a position you can duplicate perfectly every time you are there.  I almost get my arms back as far as they want and we wait just a couple minutes and it stretches and falls a little more and then the rest of the gap they make up by raising the arm holder just a little.  We are going to be able to do this!!!!  I was temporarily thrilled.

Then they position me a little more and add some stickers and strips and put some kind of monitor on my tummy so they can tell when I hold my breath and when I am breathing and they leave the room.  I am alone in the room and they are watching through a window in another room.  Then I start moving in and out of the machine and I feel this overwhelming sadness come over me and I start to quietly cry.  THIS room and THIS machine and THIS process.......THIS is what cancer looks like to me.  I have cancer and I can't ignore it in this moment and I am very sad.  They move me in and out of the machine and tell me to "breathe out, breathe in and hold your breath" and then they tell me to "breathe normally" over and over.  I follow all these directions and eventually we are done.  All this is done to build my radiation plan - I received no real treatment today.  We will do another dry run on Valentine's Day and my official treatments will start on February 18th and go five days a week for five weeks and we will finish on March 22.  Those weeks will be hard.....I plan to balance work and treatments and living life.  I may get tired and if I do then I will rest but March 22 is a date on the calendar with a giant circle on it - the end of treatment that requires more than a daily pill. 

So today was a good day.  We made progress.  It had sad moments but they passed.  We have a plan and dates on the calendar and now we just cross them off one day at a time.  Prayers were answered today and God hugged me in that machine and in a strange way, I look forward to meeting Him there everyday at 3:00 for awhile.  You know your life has taken a strange turn when you find yourself looking forward to radiation therapy.  #godwhisperedinmyeartoday #godsgotus #comingafteryoulittlec #blessedwithprayerwarriors

Journal entry by Lisa Pollard

Just realized it has been a hot minute since my last update.  After I got my oncotype score, I did meet with the medical oncologist on January 9th.  We again celebrated the results and he explained again how this meant that I could skip the chemo step of care without having any impact on my long term prognosis.  He prescribed Tamoxifen that I will take daily starting two weeks after my radiation ends.  This is a drug that suppresses the hormones that the type of cancer I have likes to eat to grow.  Basically, we will be starving any future boogers that try to take hold.  I will see him in April after I have been taking this drug for awhile to make sure I'm not seeing any crazy side effects, etc.  Then I will see Dr. Vandeusen annually from there.  Almost done with the medical oncologist.

I have continued to see the plastic surgeon every Thursday for fills of my reconstruction expander.  So far we have put 410cc of saline in that baby.  I am usually sore the day after these fills but this last one (perhaps the last one needed) left me in perhaps the worst pain and discomfort I have had since this started.  Now to be fair, I am trying to work and drive so I may not be taking all the meds available to me to stay on top of this.  For example, I took muscle relaxer and 800mg of ibuprofen last night and today I am feeling better.  I may just need to slow down.  For those interested, the pain is not from the skin stretching (those nerves were killed in the surgery), it is from the pressure in the back against my chest wall.  Coughing and sneezing?  There are no words for how I dread feeling one of those coming on.  

I also have physical therapy on Thursdays.  I have developed lymphatic cording in my left arm and my shoulder is freezing up from lack of use (and old age) so they are working on breaking both of those issues down.  When I started meeting with them my range of motion was just under 90 degrees both to the front and to the side and this week I was 145 to the front and 133 to the side.  Challenge is that I need to get in the 160's in order to get in the proper position for my radiation.  I have daily exercises to do to help with this.

I also met with the radiation oncologist on January 9th and we discussed my radiation simulation and a couple of research studies he wanted to consider for my case.  One could perhaps reduce my radiation from 25 sessions to 15 and the other was for a shoulder study for women who are doing reconstruction and radiation at the same time.  The family was split on whether I should participate in a study that would do less radiation than is the current standard of care at this time.  I just couldn't stop thinking that I was able to skip the chemo because other women who came before me were willing to be part of those trials so I wanted to try it.  But if this beast would ever come back I did not want the kids and Bill to think I hadn't done everything I could to prevent it so I was torn.  Anyway, we prayed about that and within days the research coordinator called to tell me that there were elements of my case that made me ineligible for that study.  So decision made there.  Can't believe how through this whole process it seems that when scary and uncertain decisions need to be made, God has come through and kept us on the right path.  I have also been surprised through all of this just how many decisions are left up to the patient.  At the end of the day, they don't have this cancer thing figured out and there is more than one way to handle it.  I'm so grateful to have Bill and the girls and Mom and Dad and Ben and Lisa to help me work through it......but most especially God.  I don't know how one would get through this without God.

Anyway, next Thursday, I will have my last appointment with the plastic surgeon for awhile.  Once that expander is full, we wait 6-12 months (depending on the damage the radiation does to my skin) and the expander will be removed and replaced with an implant.  I will have another PT session to hopefully loosen me up enough for my radiation simulation immediately following.  This is a "planning session" for the real radiation which we plan to start 12 weeks after my original surgery which is February 11th.  Then it will be daily Monday through Friday for 5 weeks.

More next week when we know for sure that we are good to go to the next steps.  Prayers continue to carry us and we still have a ways to go, but we are getting there.   Love to all who are fighting with us.  #Godsgotus  #prayerworks  #littlecsucks

Journal entry by Lisa Pollard

Dr Vandeusen’s office surprised me with a call today.   I don’t even remember the name of the gal that called because I nearly came out of my chair with her news.   My oncotype score is 10.   This is measured on a scale of 0-100 with 0 being best news and it attempts to tell you the likelihood of cancer recurrence within 10 years.   This is low enough that they do not believe I would benefit from chemo so they do not recommend it for my case.  The words I have been praying to hear.  I will still meet with all of them next Wednesday but unless the radiation oncologist changes his mind I will need 5 weeks of daily radiation (25 treatments total) and when that is done I will start hormone therapy (daily pills) for about 5 years.   So still some work to do but yucky chemo is not going be part of it.  
#livinginGodsgrace.  #sohappy. #perfect10.  #nottodaychemopoison

Journal entry by Lisa Pollard

I have been having weekly appointments with the plastic surgeon's office to fill my tissue expander.  I shared in my last update that at my first post-op for my second surgery, I got the drains out and started the fills.  I saw them last week for another checkup and fill and then this morning all the surgical tape and the last of the bandages were removed.  Yay! Also got some more fill which I am tolerating very well so far.  So all good on that front.

I also had my first PT session today.  My range of motion on my left arm was classified "severely limited" so we have some work to do there.  We suspect this may involve some lymphatic cording based on where my pain and limitations are.  Fortunately for me I am right handed and have help at home so this is not really limiting my life too much but I can't get positioned for radiation in this condition and females in my age range are also most susceptible "frozen shoulder" so I need to get moving before it gets even worse.  I did 4 exercises three times each and before I left I had improved the range of motion in the front 6 degrees and to the side by 16 degrees and the numb part of my arm was tingling so we are very optimistic that all this will work.  I will do those exercises 4 times (at least) a day and see the physical therapist once a week for awhile.   Part of the challenge is that the tissue expander gets placed behind the pectoral muscle so that contributes to the range of motion issues as well. 

Still looking forward to our January 9th appointments where we get that oncotype score and find out how much radiation we will need and if we can skip chemo.   It was nice to not have to think about that through the holidays.......we can get through these weeks with hope that we won't need all that.  Even if it doesn't turn out to be true, the respite of hope through the holidays was a gift.    

Journal entry by Lisa Pollard

This entry may be a little long because I want to capture some of the details that I have about some trials that I will be considering in addition to updating on the progression of our healing.  

I started the morning with Dr Bazan (radiation oncology).  He explained that there is a current "standard of care" based on my post surgery pathology results.  Lymph nodes involved so 5 weeks of 5 day a week (25 total) radiation sessions.  Radiation is to hit the lymph nodes in the collar bone area and along the sternum because unlike those in my arm pit area, those are not removed as part of the mastectomy.  That's what we will do unless we decide to be part of a couple trials underway for research.  
  • The first trial is dependent on the oncotype Dx test I mentioned yesterday.  Because I had less than 4 lymph nodes involved, if the score is less than 18, then I may be eligible for a trial to go into a random pool where I would be assigned to the "standard of care" radiation route or a No radiation at all route.  They are trying to figure out if just a couple lymph nodes involved really benefits from radiation or if it is actually "over treatment" (my words) in that pool of patients with low oncotype scores.  This is something we will decide as a family since there is a little risk that if the hypothesis is not proven, I could "under treat" (again, my words).  Recall with a low oncotype score I might avoid chemo so if we entered this trial and I randomly ended up in the "no radiation" pool, I would just get the hormone therapy and be monitored closely.
  • The second trial I am eligible for is because I am doing reconstruction at the same time.  Because there is a risk of scar tissue and damage to the implants and reconstruction from radiation, there is a trial underway to see if 16 treatments might be just as effective in those patients as the 25.  Each treatment would have a little more "oomphf" in it so overall I would receive just a little less radiation overall with this trial.  Again, put into a random pool where I would have a 50/50 chance of getting "standard of care" or this reduced number of sessions.  Again, some risk of "under treatment" (still my words) so we would decide this as a family.
  • There is another study (not a full trial) to study patients with the range of motion issues that I am dealing with and to see what the impact of radiation is on that.  There is no risk to me at all in that so if they decide they want to include me in that study I am fine with that.  I am so grateful to those who have come before me and been part of these trials and studies that as a result have made current standards of care better all the time.  Some of the research impacting my care are as recent as 2015.  They ARE going to figure this out someday.
I am not at all concerned or nervous about radiation and I love Dr Bazan so if the full 25 is what we need based on the oncotype or we decide to skip both trials I am fine with that too.

My next appointment was supposed to be the radiation CT simulation where they get the pictures to build the plan.  Since I cannot move my arm over my head at all right now, let along for 20 minutes, he referred me to PT, and we will try on 1/9 when I see him again (and we will have the oncotype score then too).

Then I went upstairs to see Dr Chetta.  He is happy with the way things are healing this time.  I think it actually looks alot better this time too to my untrained eye.  They took my last drain out and I can shower tomorrow and give up my baby wipe and washcloth baths.  Hal Lay Lou Ya ! ! ! It was amazing how much better I felt almost immediately because I no longer have that constant annoyance hanging around (pun intended) reminding me I am sick.  They also did my first expander "fill" of 30cc's.  I will see them weekly now as long as I tolerate that pace for more fills to start expanding that skin.   I also joined a trial here "Total Cancer Care Protocol" that gives the researchers access to all my biopsies, tumors, blood and fluids from my procedures.  This is a lifetime study and they will collect these for the rest of my life and at least once a year when I have any blood drawn there will be an additional tube taken to be part of this study.  This is genetic based and they are trying to make connections between genetic make ups, and cancer over a person's lifetime.  There is no risk at all to me or alterations to my care plans.....they just want my "data".  Have at it.  Cure this sucker!!!!

Last stop of the day was to Dr Carson who was also pleased with the healing and the progress of my plan of care. I won't see him again for 3 months.

So for now, we keep healing and try to rehab this arm/shoulder before it completely freezes up, enjoy Kristine's graduation, Christmas and New Years and ease back into work.  Then on 1/9 we get our oncotype score and make decisions about the rest of my care plan.  Very exciting.   #Godsgotus  #prayingforlowscores  #MerryChristmas #TheJamesROCKS  #thankGodforbringingusthisfar

Journal entry by Lisa Pollard

We met with medical oncologist today and he went over my pathology report again.  Two tumors one 4.6 cm and one 2.5 cm.  Due to the 4.6 cm booger my cancer is T2 (stage 2).  I had two lymph nodes with cancer so my N score is 1 and all my margins were clear so we have no mastisizing indications.  And my cancer is strongly hormone positive and HER2 negative. Lymph nodes being involved  means radiation is necessary.  Estrogen and progesterone fed means endocrine (hormone pill) therapy is necessary.  

So this conversation was about chemo.   There are apparently two schools of thought on this.   One is lymph nodes involved (even 1) do chemo.   Another is when the cancer is less than 5 cm and less than 3 lymph nodes involved run a genetic oncotype test on the tumor and score it.  A predictive mode of sorts.   At this point my cancer has been surgically removed so all these steps from here are to minimize the risk of recurrence.   So as you can see I am close on both metrics so my case is marginal.  Normally they would want a score of 25 or less to skip the chemo.   With my case they will want to be even more conservative so he’d like something below 16.   Then because there are two schools of thought even in this group, they will take my case and my score to a panel of 8 medical oncologists who will review it and present a recommendation.   I like this because I will kind of get 8 opinions and will know they are bringing me their collective best shot.   

The testing will take about 3 weeks so I meet with him again on Jan 9th to hear their opinion.   Ultimately the decision will be ours.   In the meantime I continue to heal from surgery and they build the radiation plan so that as soon as I am healed enough we can start with whatever next step we decide on.   

So, prayer warriors, now we pray for the lowest possible oncotype score so we can make good decisions confidently or heck even make it crazy high just solid one way or the other so our decision is clear.  But for now we can go into the holidays with the hope that chemo will not be needed.  

Today was was a good day.   😊

Journal entry by Lisa Pollard

My last post was sad so I feel like I should share an update in advance of our appointments next week.   I did not need another pain pill on Tuesday....Monday night was one of the worst so far but I’m back in my bed at night and today was definitely the best I’ve felt since this whole mess got started.   With Kristine’s help I got my hair washed, cleaned myself up (as best as one can without a shower or tub), and went out to lunch with my brother.  Just being clean and dressed does wonders for the healing.   There have been cards and gifts and food coming from so many wonderful friends.  I have climbed down from the pity pot and started recognizing how truly blessed I am once again.  I’m human.   I went there.   But I’m back and ready to get on with the fight.  Y’all may not have realized it but you were carrying the load this week.  Thank you!    And to Bill.....dude you are a saint and I can’t even begin to thank you for all you are doing for me and the girls right now.  You said “for better or worse” all those years ago but now you are proving you meant it.  😘😘.   #Godsgotus. #blessed. #pitypotsarenotforextendedstays #hairwashednewattitude

Journal entry by Lisa Pollard

I had to go back to the narcotics last night.   So back to dopey fog head.   But good news is fluid level was back down in “take it out” range this morning so if it keeps that up for 48 hours we can get that back out.  And I slept in my bed last night and didn’t have to retreat to the recliner.   I’m sitting up assessing pain levels to be sure I need to take another big dog.  I hate the brain mush.....wish it would just go straight to pain points and not mess with my head.   Have a great day friends!
#praywithoutceasing #godisgood. #foggy

Journal entry by Lisa Pollard

Surgery got started late (9am) but we were home by 11:30 so that’s good.   The first thing I felt with my hand under the wonderful warm blankets as I woke up was A DRAIN.  They did take the last one from the original surgery out but they put a new one in!   I will learn to be more specific with my questions in the future.  And they gave me more heavy duty pain pills AND the nitropaste is back.   But the Dr was happy with the procedure and they didn’t have to remove/replace the expander because there were no concerns of compromised sterility.  So that’s good.   We will think of this as a happy country line dance....a boot scootin’ boogie of sorts.   A few steps up, a couple back, slide to the right but at the end we STOMP STOMP little c out of our lives.    More next week after we have more to report.  
#yeehaw. #thankGodforanesthesiologists #STOMP  #Krismadeusafire

Journal entry by Lisa Pollard

This was the day I felt something during my shower that I knew was new and shouldn't be there.  I went to work and called Spielman Center and explained what I felt and that I wanted a mammogram.  The nice gal on the phone explained that it sounded like what I really needed was a diagnostic mammogram and that would have to come from a referral from my Primary Care Physician.  And since my last mammogram was on 8/22/2017, insurance would likely want me to wait until 8/23/2018 anyway.  Okay......we can do this your way, so I called my Dr and took the first available appointment on 8/22.  I told no one about this.  I just started praying.

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Lisa’s Story

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