The Unveiling

Today was the first time that Dawn Ann got a good look at the mastectomy incision.

I tried to prepare her for it earlier in the day. We decided to keep in mind that this is not the final product. That this site is “Under Construction”.

Her own fears and feelings started to come through. She tried to tell me that this wasn’t fair to me. That I hadn’t bargained for this when we got married. She tried to tell me that I married a “woman”, and now she is losing her womanhood, piece by piece.

I countered that I didn’t marry a pair of breasts. I married a person. A person that I love dearly, with all my heart and soul. I placed my hand over her heart, and held her close.

When I married her, I loved her for the woman that she is. I still do. No surgery can change who she is, deep down inside. She is still my soul-mate, and the love of my life. This surgery helps preserve her life. I keep telling her that “We get to keep her!”, and that we look forward to having her with us for a very long time.

The time of the unveiling came later in the day, after the kids had gone to mutual. Even with our conversation earlier in the day, no amount of mental preparation can fully compensate for the shock when you see a large incision, instead of a breast. – Especially when it’s your own. It’s not pretty. It’s stark, and real and cold. Although the cancer is now gone, it has left destruction in its wake.

The plastic surgeon had cleared Dawn Ann to have a regular shower – provided that the stream of the shower doesn’t directly hit the incision or the drain tube sites. In order to take the shower, the bandages had to come off. I took the bandages off the incision myself. As Dawn Ann saw the incision for the first time in the bathroom mirror, there was a pale, scared look on her face. I could tell that she was grimacing, and trying to tough it out. I put my arm around her shoulder, and held her close. I asked her how she was doing. She managed to say something like, “It is, what it is”.

I know it was a real shock to her. We got her all showered, then put on a new dressing over the incision. The plastic surgeon gave us some cloth tape, that will be a little kinder on her skin. We put gauze over the incision, and over the drain tube exit points and taped everything in place. Then we got her dressed.

After a while, she got over the shock of seeing things as they really are for the first time. I gave her a big hug. I let her know that I love her, support her, and that I’ll be there for her no matter what. I must keep showing her this not by my words only, but in my actions as well.

I don’t know what else to do.

Plastic Surgeon Visit - 1 Week After Surgery

Today we visited the plastic surgeon. We discussed where we go from here in the reconstruction phase.

Right now, the immediate goal is to get the drain tubes out. It has been a week now since the surgery. In order for the drain tubes to come out, the doctor wants to see fluid levels of less than 30 cc’s for at least 3 days. At that point, a drain tube can be removed. Dawn Ann is not to that point yet. She is still having more than 30 cc’s per day of drainage in both drain tubes. This is important because the drain tubes cause a significant amount of discomfort.

We asked about when she could take a shower. The doctor told us that Dawn Ann could shower, as long as the water didn’t directly spray directly on the incision or drain tube sites.

We asked about how much she should be doing with her right arm. He said that Dawn Ann shouldn’t be doing much with that arm. No lifting of anything more than 3-5 pounds at this point. He reminded us that a full gallon jug of milk weights 8 pounds. So she is going to have to do things left-handed for awhile. After the drain tubes come out, then we can re-visit restrictions on activity.

We asked about driving. He said that driving would be fine, as long as she is not under the influence of narcotic pain killers. Right now, Dawn Ann is able to get through most of the day on over-the-counter pain relieves (Tylenol, and Ibuprofen). However, she still is taking a Lortab at night to help her sleep. So if she has not taken a Lortab during the day, she can drive Bryan to his ceramics class, which is at about noon time.

We asked about how much volume the tissue expander can hold. The doctor said that it could hold up to 800 cc’s. After Dawn Ann has had a chance to heal, the plastic surgeon will start injecting it with saline, through a little port that is along her rib cage. He said he typically would inject about 100 cc’s at a time. This would be repeated in two week intervals, until the tissue expander is just a little larger than the size of the eventual implant. Then he would let it rest for a few weeks, before removing the tissue expander, and inserting a silicone implant. The body would then close in around the silicone implant.

This process will take several months to complete. We will just need to take it one step at a time.

For now – let’s get those tubes out!

DCIS - In THREE Places!

Yesterday, while Dawn Ann was trying to get a shower, her bandage got wet, and began to peel away from her body. Since it was wet inside, we took off the dressing to keep the warm, moist, dark area under the dressing from being a breeding ground for bacteria.

We had to make a special trip to Walgreen’s to get some gauze bandages and tape. We put on some gauze strips and taped everything down. Dawn Ann’s post-mastectomy camisole, which gently squeezes things together, helped to hold the new dressing in place.

In the process of changing the bandages, I got my first look at the incision and the results of the mastectomy. I knew what was coming, but I have to admit it that it caught my breath for a moment. Obviously what once was there, was there no more.

There appeared to be some skin tucked into a fold for future use, possibly to cover the implant when that time comes. I tried my best to not show shock or surprise on my face as I re-wrapped her dressing. My shock was only for a moment.

She asked me if it was grotesque, or hard to look at. I told her it was all right. As of yet, she has not had the opportunity herself to see a full frontal view of the results of the surgery. She could only look down to see, without the aid of a mirror when we changed the dressings.

When Dawn Ann finally does behold everything for the first time, I want to be there for her.

Today we had our first follow-up visit with Dr. R (the breast surgeon) since the surgery. Dr. R peeked at the incision and stitches. The skin looked good, with no sign of infection. She just left our home made dressing in place. Tomorrow we will visit with the plastic surgeon. We will probably get a new dressing then.

Dr R. reviewed the final pathology report with us. Both sentinel lymph nodes came back clear of any metastases, as the preliminary tests had shown. The cancer has not spread into the lymphatic system. They identified both sites that were previously biopsied, and both of them were truly “In Situ” – which means that the cancer had remained in place, or localized. The cancer had not spread to any of the adjacent breast tissue.

The big surprise in the final pathology report was that there was a third cancer location found! It was in the upper, outside quadrant of the breast, and was found in a random tissue examination by the pathologist. This cancer was undetected by mammogram, sonogram, and MRI – and it was a very aggressive form of cancer too! Fortunately, it too was “In Situ”, or localized.

The finding of the third cancer spot re-confirms the decision to have a mastectomy. This third cancer spot was found by a random sample of the remaining breast tissue – after the known cancer sites had been examined. Who knows, if every section of the breast tissue had been examined there might have been yet more cancer found. The doctor confirmed that there was something about the right breast, know one knows why, that was causing the cancer to form. Even if we had done two lumpectomies now, sooner or later we would have needed to do a mastectomy as other cancer spots would eventually come to light.

Now we have to really watch the other breast carefully. Dr. R. wants to see Dawn Ann in 6 weeks for another follow-up to the surgery. From that point on, we will see her once every 6 months – forever. This will be to check the left breast, and to make sure that no further cancer occurs in any remaining breast tissue from the right side. Even with the mastectomy, there are still some microscopic particles of breast tissue that remain. In theory, (but not likely) it is possible that cancer could return in those remaining particles of breast tissue.

For now, we are glad that all of the cancer that we know of has been removed from Dawn Ann’s body. She will not need chemotherapy or radiation. The only remaining question is whether or not to have Dawn Ann start taking tamoxifen. Dr. R. recommended that we see a medical oncologist for further consultation. Tamoxifen is an anti-estrogen drug, that could potentially lessen the risk of cancer in the left breast. However, tamoxifen also has some serious side effects, including: blood clots, stroke, memory loss, vision changes and liver cancer.

Since Dawn Ann has had a hysterectomy, with ovary removal, there is not that much estrogen in her system to begin with. Right now Dawn Ann is leaning against taking tamoxifen.

Dr. R. presented Dawn Ann’s case to a “cancer board” last Thursday. Apparently there is peer review of cancer cases. Some doctors recommended that Dawn Ann take tamoxifen, and others were indifferent about it. All agree that chemo and radiation are not necessary at this time.

We will make an appointment with an oncologist, and make a final decision on tamoxifen after that consultation.

We also plan to meet with a genetics counselor in the next few weeks as well.

The Mastectomy Surgery

Dawn Ann's surgery was done earlier today. She is doing well, and resting comfortably right now.

The best news is that preliminary biopsies were taken on two lymph nodes, and they both came back free of cancer.

We won't know for sure if the cancer has spread, until we get the full pathology report, which should be sometime next week, we hope. If everything remains clear in the pathology report, we believe that the surgery alone will be the extent of the cancer treatment necessary. She should not need chemotherapy or radiation treatments, if all goes as we anticipate.

The breast surgeon said the surgery went really well. There were no unusual or unexpected findings in the tissue. No indication that the cancer was any more extensive than what we thought.

After the mastectomy was completed, the plastic surgeon came in to the operating room. He inserted a tissue expander under her chest muscle. Later, in about 4 weeks or so, he will begin inflating this tissue expander with saline solution. Every 2-3 weeks after that, he will add to the saline, until the spacing is large enough to insert an implant.

Post operatively, Dawn Ann has been doing pretty good. They have been using some pain medication, which is a very good thing. A little while ago, she was up and around a little bit, and she noticed that all of her pain meds from earlier in the day had worn off. Ouch! She has soreness in her chest, and her right arm. They gave her a half dose of morphine, and that helped her settle down.

Now (about 4:30 pm) she has drifted off to sleep for the first time today, since coming out of surgery.

We got off to an early start today. We woke up at 3:30 am. We had to be at the hospital by 5:30 am. It was about 7:15 y by the time they wheeled her into the OR, and I kissed her goodbye.

The breast surgeon came out at about 9:45 am to let me know how the mastectomy went.

By about 10:45, the plastic surgeon came out and told me that Dawn Ann's surgery was complete, and that she was going to the recovery room.

Dawn Ann now has a couple of drains that have been attached to her chest, and under her arm. We hope that they will be out by next week.

Well, this has certainly been an adventure. An unwanted, and unanticipated adventure, but an adventure nonetheless. I will remain here at the hospital tonight, until she goes to sleep for the night. Then I'll be back up here first thing in the morning, and I expect to bring her home sometime in the mid-morning time.

I must say that the hospital staff here at LDS hospital has been excellent! The doctors and nurses have been caring, compassionate, and professional. It is nice having a private room too. It makes it much quieter, than the 2-party room I had last year when I was in the hospital.

I also must say that we have had wonderful support from family and church members. My mother took our children overnight last night, and she will have them again tonight. She is also shuttling them about to school, and other classes. What a lifesaver. I don't know what we would have done without her.

Last Sunday evening we went over to mom and dad's house and gave blessings to Dawn Ann and to Amy. It seemed to help them calm down, and be comforted.

We also have received great support from the church. Our ward relief society president stopped by earlier this afternoon. The Stake President and his wife stopped by too. I serve on the high council in our stake, and it was comforting to see him. I was going to ask him to give me a blessing last Sunday, but I had to leave right after our council meeting for a speaking assignment. The rest of the day was busy with other meetings and assignments, and I just couldn't get back with President in time for a blessing. So today, I got a blessing from him, and I know it will help me in my role through this ordeal.

Thanks for all of your thoughts and prayers. We look forward to bringing Dawn Ann home tomorrow.

I have been writing this post off and on throughout the day. It’s now just a little after 9:00 pm, and she is settling down for the night. I think I'll tuck her in, and go home for the night.

The Drive

The alarm rang at 3:30 AM. We had an appointment to arrive at the hospital for Dawn Ann’s mastectomy at 5:30. We got ourselves ready and loaded our gear into the car.

We had a word of prayer together just before we left. We asked that the Lord would bless and sustain us through this ordeal. We asked for strength and comfort from the Lord. We asked that the hands of the surgeons may be guided as they operate on her. We prayed that all may go well with her recovery from the surgery. Finally, we prayed that the cancer may be removed from her body.

We listened to some quiet classical music and held hands as we drove to the hospital, which is about ½ hour away from our home.

As a husband, I had very mixed emotions as we made that drive. I couldn’t help feeling that I was taking her into harm’s way. What were they going to do to her? They were going to remove a member of her body. A very personal member of her body, that is so wrapped up in womanhood and femininity, and self image. Four years ago, she had a hysterectomy. After her initial cancer diagnosis, Dawn Ann expressed a fear that she was losing all of her “girl” parts. Now I was taking her in for a surgery that will remove one more of those "girl parts". Things will be different for her from now on, and that is something that we both will have to come to grips with.

Intellectually, I knew she needed the surgery. The cancer must be eliminated from her body. We couldn’t run the risk of having the cancer spread to other parts of her body, and threaten her life. We have to do this thing to save her life – even though it will cause much pain, discomfort, and many adjustments. It would be a huge mistake to not take cancer seriously.

Even knowing this, it is a different matter emotionally. There was a part of me that wanted to run the other way. As we approached downtown, we passed the Salt Lake International Airport. I mussed out loud for a moment that it sure would be nice to be turning into the airport to catch a flight to Hawaii, instead of going to the hospital. Dawn Ann agreed whole-heartedly with that idea!

We went to Hawaii for our honeymoon. Whenever we go through particularly hard times in our life together, we always recall “Turtle Beach”. Turtle Beach (our name for it) is on the island of Kauai. We spent the last evening of our honeymoon there. We rolled up our pant legs and dipped our feet into the water. We watched the waves roll in, and observed fish in the tidal pools. However our most pleasant memory of that time was watching the sunset over the ocean, and watching two sea turtles bob up and down in the waves just off shore. Hence the name: “Turtle Beach”.

We thought of Turtle Beach when the children were born, as Dawn Ann endured two C-Sections. We thought of Turtle Beach when she had her hysterectomy. We think of Turtle Beech whenever we need to picture something calm and peaceful in the face of something frightening, distressing, or painful. It has often times given us a few moments of respite, until we can collect ourselves and face whatever difficulty is before us at the time. Hence, my desire to take the “Turtle Beach Exit” at the airport, instead of proceeding on toward the hospital.

We reluctantly arrived at the hospital. Parking is always an issue there. Most of the on-street parking was already taken, but it was only for 2 hours maximum anyway. I knew I would be there much, much longer than two hours. Dawn Ann would be staying the night, but I would be going home sometime that evening, and returning the next morning to bring her home.

As we got out of the car, I opened the trunk and got the things out that we would be bringing in with us. Then we turned to look at each other. Spontaneously, and almost simultaneously, we both brought our right hands to a salute, in honor of the soon to be departed right breast. Whereupon, Dawn Ann and I began humming “Taps” -- in honor of the breast that would be gone when she would return home the next day.

We joined hands, and walked to the hospital entrance, to begin a new phase of our lives.

His Promises Are Sure

When you, or someone close to you, has been diagnosed with cancer -- you may feel a need to reach out beyond yourselves for hope, and reassurance.

For my wife and I, that means reaching toward the Lord for the strength that we need in a time of trial.

Last night, we went to the temple. It was our first visit there since Dawn Ann’s diagnosis of Breast Cancer. As a result, perhaps our feelings and emotions were a little closer to the surface than usual.

During our sealing session, we were called to the altar first. Dawn Ann and I looked at each other across the altar, as we did for the first time at a similar altar nearly 16 years ago. As the ceremony, which binds a couple together for time, and for all eternity, was pronounced, tears came to Dawn Ann’s eyes. Just a few tears at first, then many more later. The officiator who was performing the ordinance handed us a box of Kleenexes so she could wipe her eyes.

As for me, I looked into those eyes, which I have loved for the last 16 years. She always looks so beautiful in white. I am so grateful for her. For the love she has brought to me. The children she has brought into this world. And all she does for us to provide a home for our family.

As I looked at the tears coming from her eyes, I thought I perceived what she might be feeling, and why the tears. Later, I confirmed with her that what I had perceived was correct. As Dawn Ann heard the blessings and promises of eternal marriage pronounced once again, she felt a peace and assurance from the Spirit of the Lord that no matter what happens in this life, the Lord's promises to us are sure. That she and I will be together eternally.

This was what brought tears to her eyes. The witness of the Spirit that despite the challenges we are currently facing, the diagnosis of breast cancer, that she can be assured that all will be well – no matter what happens.

My turn would come a few minutes later, as the ordinance worker gave a few words of counsel to the group of those in attendance.

He counseled that the Lord wants each of us to return and enjoy eternal life with him. He counseled that the Lord will leave no stone unturned to make this happen. He paraphrased this scripture:

“ . . . For I will go before your face. I will be on your right hand and on your left, and my Spirit shall be in your hearts, and mine angels round about you, to bear you up.” (D&C 84:88)

He then counseled that the blessings of eternal life will come through our faithfulness. Then he explained what that means.

He explained that our faithfulness doesn’t mean that we have to be perfect right here, and right now. What it does mean, however, is that we should continually try to become better people little by little. Not in huge spurts, not mile by mile, but inch by inch.

The goal should be to examine ourselves a few months from now, and to be able to see how we have become a little bit better than we were before. We should always be making that comparison with ourselves over a period of time, never in comparing ourselves against others.

There may be other people, great people, whom we admire, and may even try to emulate. We should not be comparing ourselves with them. Normally we only see them when they are at their best. They are human too. We just don’t generally see them in their weak moments.

As the officiator spoke his words of counsel, I found tears coming to my own eyes this time. As he paraphrased the scripture, I felt that we do not have to face this breast cancer alone. That He will go before us, that He will be on our right side, and on our left, and that His angels will be round about us. He will be there for us. He will not desert us.

The words from the fourth verse of “I am a child of God” best describe my feelings:

I am a child of God.
His promises are sure;
Celestial glory shall be mine
If I can but endure.

(I Am A Child of God, Lyrics by Naomi W. Randall)

All will be well. We have placed our trust in him, and I know we can pass through this trial – no matter what.

If you too, find yourself struggling against breast cancer. Remember, that you are not alone. Trust in the Lord. Go to Him. Pray to Him. And find His peace.

For I know -- His Promises are sure.

The MRI Results

We received some really good news today! The results from the MRI that took place last Tuesday came back: The left side is clear of any sign of cancer!!!

The previous diagnosis was confirmed on the right side: DCIS in two places. However, on the bright side there was no other cancer found in the right breast other than what we already knew about. Here is an example of an MRI image of DCIS.

It was a great relief to Dawn Ann. She has been a little tense the last few days, worrying about what these test results might reveal. This is the best possible news that we could have expected to receive. Our prayers have been answered.

We have been considering various reconstruction options. Later this month we will be visiting with two different plastic surgeons to consider what the best approach might be in Dawn Ann's case. She was worried that if she had a double mastectomy, that having dual reconstruction might be too much to deal with all at once. Her inclination was to not do reconstruction right away, if she needed a double mastectomy.

The good news is that only a single mastectomy will be needed. Now Dawn Ann can better face the challenges that reconstruction will bring. This news was a huge relief for her, and she was jumping up and down for joy.

Some ladies from our church were at our home (visiting teachers) at the time the phone call came from the doctor's office. After the phone call, Dawn Ann was happy to announce that she will be getting a new perky one! They all had a good laugh at the newfound prospects.

I was excited to hear the news when she called me at work. I felt that a little celebration was in order. So I stopped on my way home from work, and picked up some Dots candy, and a package of hostess snowballs.

With a little creativity, I came up with this:




After the kids went to bed, I prepared a little treat and brought it to her. When she saw my piece artwork, she had a good laugh. It was good for her to laugh. I hope to keep her in good spirits as much as I can during the next weeks, months, . . . and even years as we go through this process. Little unexpected surprises will be a good way to keep her spirits up, and to keep from dwelling too much on fear, and worries about the future.

All in all, its been a really good day, for the things that matter most.

The Breast MRI Test

As I write this, I am sitting in the radiology waiting room at the hospital. My wife, Dawn Ann is here for a breast MRI.

The whole family is here. Dawn Ann brought the kids here, after
school. I took off early from work to be there for our 4:00 PM appointment. The kids brought our laptop, and are watching the DVD of Pirates of the Caribbean on the computer.

I got here in time to visit with Dawn Ann a few minutes before she went back into the radiology department.

As I arrived, she was filling out the obligatory forms you always have to fill out for an MRI or a CT scan. One of the forms was a cancer questionnaire. That kind of freaked her out a little bit. It was the first time she has filled out such a form since her diagnosis.

She joked, “I guess I will be considered a cancer survivor from now on.” I
put my arm around her and held her close. I told her, “We wouldn't
want it any other way!”

Then she said – “Well then it must be so, because daddy said!”

Today Dawn Ann is receiving an MRI of her breasts. This will be an MRI with contrast. That means that that she will have to be injected with a dye through an IV prior to receiving the MRI.

The objective if this test is mainly to check for any indications of breast cancer in the left breast - the breast that so far is thought to be cancer free. The MRI can detect the presence of DCIS at a much earlier stage than is possible with a traditional mammogram.

One potential drawback of the MRI is that it is so sensitive that it can pick up 'False Positives' - that is it may pick up spots that may not actually be cancer, but would require further analysis. This could potentially could mean biopsies on the left side.

The MRI is also intended to shed further light on the conditions found in right breast, which has already been diagnosed with DCIS in two places. This information may better help inform the surgeon as she prepares for the mastectomy of the right breast.

Ultimately, this MRI will help us determine if we need a single - or a double mastectomy.

UPDATE: The MRI is over now. Dawn Ann said that it was relatively painless. She said that when they injected the contrast dye into her IV, that she started sneezing, and her sinuses filled up. She also had a few moments of nausea, which she was told was normal.

The sneezing was enough that they had to repeat a part of the test. Each time she would sneeze, she would bounce off the roof of the MRI tube. There was a 6 minute span that they had to re-do.


The MRI test had her lying face-down in the MRI tube, on top of a specially built platform for breast MRI’s. Her arms were outstretched in front of her “superman style”. There was a space in the platform that held her head, with a mirror so she could look forward, instead of having to stare at the bottom of the MRI tube.

Dawn Ann said that the staff was really nice, and they made every effort to keep her modest for this procedure.

We were told that we should get results back this Friday, September 7th.

Meet Dr. R -- The Breast Surgeon

After receiving the biopsy report that Dawn Ann was positive for breast cancer, we met with Dr. R, the breast surgeon the next day.

Dawn Ann dropped of the children at grandma’s house, then we drove together to the doctor’s appointment. As I mentioned previously, we were very grateful to get in to see Dr. R. We knew that she would be on vacation the following week, and that it might take 2-3 weeks after that to get an appointment with her. Fortunately there had been a cancellation, and they were able to fit us in the next day after getting the biopsy results. We consider this a great blessing from the Lord, for which we are extremely grateful.

The doctor’s office was extremely busy. Each of the doctors there specialized in cancer treatment of some kind. One of the other doctors specialized in melanoma. As I looked into the faces of the people waiting there, I knew that cancer had touched each one of their lives. You could see the worried looks on their faces.

Virtually no one was there alone. Whether they were there for melanoma, or for breast cancer they had a spouse or someone else with them. This is a very good thing. No one should have to face a this life-threatening disease themselves.

The going was slow in the waiting room. We arrived at 12:45 PM. Our appointment was at 1:00 PM, but we didn’t actually get back into an exam room until close to 2:30.

After we got to the exam room, a nurse came in and asked us if we knew the results of the biopsy. Apparently some patients are sent there with their radiology films and pathology reports, but without being told what the results were. I thought that was a little odd. I’m glad the Women’s Center let us know right away.

After waiting another half hour in the exam room, we finally met Dr. R. She is a slight woman, in her late forties to early fifties. We talked about the results of the biopsy.

The kind of breast cancer Dawn Ann has is called DCIS – or Ductal Carcinoma in Situ. We learned that of all the types of breast cancer one can have – this is the best one to get (as If there is a best kind of cancer to get!) You can see an example of DCIS microcalcifications here.

From the mammography, and the pathology report, it was determined that the cancer was present only in the milk ducts, and appears not to be invasive. That means that it likely has not spread outside the milk ducts into other parts of the breast, or to other parts of her body. If left untreated, this kind of cancer could eventually become an invasive, life threatening type of cancer.

The doctor reassured us that no one dies from DCIS – which was quite a relief. In our case, the pathology report indicated that the aggressiveness of the cancer cells were at a low-to intermediate grade – which is an indication of the risk of the DCIS turning into an invasive form of cancer.

As far as treatment options go – it appears that mastectomy will be required. Since Dawn Ann has DCIS in two different quadrants of the right breast, doing a lumpectomy would not be prudent. Two lumpectomies, on the two different DCIS spots, would remove too much of the breast tissue to save the breast.

During the surgery, a dye will be injected into the breast. The purpose of the dye will be to determine the location of the sentinel lymph node. The sentinel lymph node will be removed and biopsied to determine if any cancer cells have entered the lymphatic system. If no cancer cells are found there, then it will indicate that the cancer has not spread beyond the breast.

The good news is that if the diagnosis is correct, that mastectomy should get all the cancer. Radiation and/or Chemotherapy should not be required.

Of course, the final treatment plan will not be known until after the final pathology report after the mastectomy takes place. If the sentinel lymph node is clear, and if the breast tissue around the margins is free of cancer cells, then we believe that all of the cancer will be removed from her body with the mastectomy.

If cancer cells are found in the margins of the breast tissue, or if cancer cells are found in the sentinel lymph node, then further treatment will be required, such as radiation, or chemo.

I asked the doctor how soon we need to have this surgery performed. The surgeon replied that it doesn’t have to be done within the next few days, but that we have a few weeks to have further diagnostic testing performed, and to consider breast reconstruction options.

The doctor recommended that we get a Breast MRI screening. This will mainly be done to check out the left breast more thoroughly. The mammogram showed no cancer in the left breast, but the MRI can detect DCIS much sooner than is possible with a mammogram. The drawback to the MRI is that it has many more false positive results – meaning that it can pick up non-cancerous calcifications that might require further investigation or biopsies. The MRI may also reveal further information on the right breast, that we know has cancer cells present.

The doctor also recommended that we may want to meet with a genetic counselor to determine if Dawn Ann has the genetic markers that indicate a susceptibility to cancer.

Cancer does run in Dawn Ann’s family. Her mother was diagnosed with breast cancer (IDC) 8 years ago in 1999, at the age of 61. She had a lumpectomy, and both chemo and radiation treatments. So far she is still cancer free.

Both of Dawn Ann’s grandmothers died of cancer – although not from breast cancer. One grandmother died of ovarian cancer, and the other grandmother died of cancer of the throat and tongue.

All of these considerations need to be taken into account as we plan our treatment options. We need to decide if we need to have a single mastectomy, or a double mastectomy. Even if there is no cancer found in the left breast, we still have to consider the possibility of having the left breast removed also as a preventative measure.

The other big decision we need to make is with regard to breast reconstruction. We are studying various reconstruction techniques. We already have scheduled appointments to consult with two plastic surgeons. Dawn Ann wants to get more than one opinion on reconstruction. We have learned that different plastic surgeons go about reconstruction in different ways.

If we decide on reconstruction, then we could have the reconstruction begin at the time the mastectomy is performed. In this scenario, after the mastectomy has been completed by the breast surgeon, Dawn Ann would be turned over to the plastic surgeon to insert a tissue expander for a future implant. The surgeon would also leave some extra skin to accommodate the reconstruction.
Dr. R stated that we don’t have to do reconstruction right away, if we don’t want to. However, it would get the process underway as soon as possible.

There are also some financial implications involved here too. Our health insurance has a maximum out of pocket expense level – which we will surely pass this year. Once the maximum out of pocket amount has been reached, further surgeries and treatments will be covered 100% by insurance, through the end of the plan year – which ends on June 30, 2008. If we start the reconstruction right away, more of the treatments will be covered 100% since we will have surpassed the out of pocket limit. If we wait until future years, we will have to start the out of pocket expense over again.

I don’t want finances to be the driving force of our treatment options, however it is a reality that needs to be considered.

For now, our next steps are the Breast MRI, and consultations with plastic surgeons. We also may meet with a genetic counselor as well. After that we will meet again with the breast surgeon. Our follow-up appointment with the breast surgeon is on October 3rd. At that time we will make the final treatment determinations, and schedule the surgery.


It was so good to visit with Dr. R. She gave us some great information. It was good to know that Dawn Ann’s cancer has been caught at a very early stage. The good news that Dawn Ann’s DCIS as currently diagnosed, is 99.9% curable.

For now, that is our focus, to get the cancer out, and to preserve the life and health of my dear wife, and the mother of our children. We want to keep her around for a very long time to come.

I Want My Mama!!!

After I hung up from the phone call with my wife, when I first learned of her breast cancer, I was nearly overwhelmed with the new information I was processing. How was this going to affect our family. My wife homeschools our oldest son. How is that going to work if she is recuperating from surgery, or if she is enduring the ordeals of chemotherapy or radiation for months at a time?

Your mind goes wild with speculation at a time like this. What if we were to lose her? I would lose my sweet companion that I hold so dear. I cannot imagine the void that I would feel in my heart, and the prospects of going on through life alone. The kids would be devastated to lose their mother. And how would I cope if I suddenly were to find myself in the role of a single father?

You start getting a better appreciation of just how valuable your wife’s contributions are to the family, when faced with the possibility that she might not have the health to continue doing the everyday things that she does for us -- or in a worst case scenario, not be there at all!

After a few moments of panic and fear, I reeled my wild thoughts and emotions back to reality. We don’t know that any of these worst case scenarios are going to play out. All indications are that her cancer is in its early stages, and that its highly treatable. Now is not the time to jump to conclusions or to start worrying unnecessarily. We'll just have to take each day, one at a time, step-by-step. That's all we can do. We'll enlist the support of God, our family, friends and loved ones. This is something we will have to face together.

At a time like this, I needed to talk to my mother. Even though it was getting late (nearly 11:00 pm) I knew that my mom would still be awake. She has always been a source of strength to me, throughout my life. She always has sound advice and suggestions. She has always been a source of hope and inspiration. I called her on my cell phone as I was wending my way back home from the mountain top. We probably talked for about 45 minutes.

In that phone call, I learned that my mom had heard of Dawn Ann’s breast cancer, even before I did, since I was out of cell phone range up at the campground. Earlier in the day, Dawn Ann had called my mother to make arrangements for the kids while we went to the appointment with the Surgeon the next day (Friday, August 24th) . My mother is always a great one to help out in any way possible.

My Mom commented that Dawn Ann had seemed strangely upbeat during her phone call, as she had been with me as well. We were surprised by her lack of panicking. Her attitude helped us to better grapple with the bad news.

It was a great comfort to talk my mother right away after hearing the news. It was good to just talk it out to help relieve some of the emotions that I was feeling. I am so grateful for her willingness to help out. I know we will be calling upon her for help many times in the coming months. Thanks for being there for us, mom!

The Biopsy

On Monday, August 20th, my wife was scheduled for biopsies on two places on her right breast following suspicious spots found during a routine mammogram screening.

There were two spots of concern on her right breast. One spot was an area where micro calcification crystals had formed. A second spot was a lump about the size of a chocolate chip. The radiologist who conducted the biopsies was more concerned about the calcifications than he was with the lump.

After the biopsy of the micro calcifications was complete, the radiologist turned his attention to the second spot – the lump. First, the radiologist penetrated the lump with a small needle with the hope of siphoning off some cells from it. However, the mass was more solid than liquid, and he felt like the sample was iffy at best. The radiologist was not overly concerned with the characteristics of the lump. In fact, he gave Dawn Ann a choice as to whether or not she wanted to have a full biopsy of the lump. The radiologist was far more concerned with the calcification spots.

Dawn Ann had to make a choice: undergo another full biopsy, or hope for the best on the second site. If it turned out that the calcification crystals were cancerous, then the breast would be more fully tested for other cancer locations. However, if the suspicious calcification spots turned out to be benign, then she would always wonder and worry if the lump was cancerous or not.

Dawn Ann made the choice to undergo another full biopsy on the lump. As the second biopsy took place, the radiologist took 3 or 4 tissue samples from it, which got most of the lump tissue. Now she had complete samples of both trouble spots that could be examined by the pathologist.

Of course I was not able to be with her during this process due to hospital rules. However, I completely supported her decision to get the full biopsy on the lump. In fact, I would have advised her to make the same choice, had I been present. The peace of mind – of knowing for sure - one way or the other, was worth it.

The Phone Call That Changed Our Lives

After getting down of the mountain from my son’s high adventure camp, I found a place just outside the town of Huntsville, Utah where I could get cell phone service. It was Thursday, August 23rd, at about 10:00 at night.

I pulled my truck over to the shoulder of the road, said a prayer, and steeled myself for the phone call that could change our lives forever. I did not want to be driving, and having this discussion at the same time. I wanted to give my full attention to my sweetheart.

I placed the call, and Dawn Ann answered the phone just like normal. She asked me how my day had gone. I told her about the campsite in the mountains (Camp Browning) where I had spent the day with our son, Bryan.

She asked about the activities at the camp. We chatted on for several minutes -- her spirits seemed high. Subconsciously, I was thinking that maybe the biopsies had come back negative, and that she was cancer free! Or, that perhaps no results had come in yet. You could not tell from how well composed she was, or by the tone of her voice that anything was wrong.

Finally, I flat out asked her if she had heard anything back from the Women’s Center. She said that the results had come in, and that it was cancer in both places. She also told me that it was likely that a mastectomy was going to be necessary. Then she said that form of cancer that she has is highly treatable, and that it was detected early.

The news hit me like a ton of bricks. However, I did not want to dampen her seemingly good spirits. So I tried to keep things positive in our conversation. I couldn't tell if her good attitude was from being buoyed up by the hand of the Lord, or if the full force and impact of what she was saying had just not fully hit her yet.

In the end, I think it was the Spirit of the Lord that was holding her up, at least until I could get home to comfort her. Dawn Ann is a nurse (RN) by training, and it would be silly to think that she didn't really understand what was happening here. However, sometimes emotions can have a delayed impact. I'm sure that there are going to be many ups and downs emotionally over the next months, and probably years as we go through this process.

Dawn Ann went on to tell me that the Women’s Center had recommended the same surgeon that my rheumatologist had recommended – the one that specializes in breast surgery.

At first she was told that it usually takes two-to-three weeks to get an appointment with the surgeon, and that the doctor was going to be on vacation during the last week of August (which we already knew from my doctor).

About an hour and a half later, the Women’s Center called back to inform Dawn Ann that ther had been a cancellation at the doctor's office, and they wanted to know if we could meet with the surgeon the next day (Friday, August 24th), which was the last day before the doctor was going to leave town. Dawn Ann had gratefully accepted the appointment for the next day. We both feel that there may have been some divine intervention on our behalf in order to get that appointment so quickly. I would have hated to be in limbo so long before the initial consultation.

As our phone call continued, I expressed my love and support for my dear wife. My only thought was for her health, well being, and trying to keep her with us (and with our family) for as long as possible.

Finally, as I sat there in the dark, on that lonely road in Huntsville, Utah, my chief desire was to hold her in my arms, and to pray with her. We closed out the phone call, and I fired up the truck, and started for the road home – with a prayer In my heart for the welfare of my wife, and for our family.

How It All Began

On Thursday August 9th, my sweetheart, Dawn Ann, went in for a routine mammogram. We didn't think much of it until the Women's center called back the next Monday and asked her to come back in for a more detailed exam. There were some troubling spots on the right side.

The second mammogram took place on Tuesday, August 14th. Dawn Ann brought the kids over to my office so they could stay with me, while she went over to the Women’s Center nearby. This was a "diagnostic" mammogram, which included digital imaging which focused on some calcification spots. A sonogram was also used to focus on a suspicious growth in another part of the same breast.

At the conclusion of the second radiological exam, it was determined that further investigation was needed, and that biopsies were needed of both suspicious spots.

It so happened that on the same day (Tuesday) that I had an appointment with my Rheumatologist. He is my most trusted medical adviser. After our regular visit regarding my arthritis, I mentioned to the doctor that my wife had gone in for a follow-up mammogram earlier that day, and that there were areas of concern which would require a biopsy.

I asked him for some recommendations of good oncologists, should the outcome of the biopsies reveal cancer present. My doctor told me of several recommendations for surgeons and oncologists. He told me that the first stop would probably be with a surgeon, since if cancerous, the spots would need to be removed surgically. Then depending on the type of cancer, chemo or radiation therapy might be necessary.

Then he paused for a moment, before making recommendations for a surgeon. He told me that there were only two doctors in town who specialize in doing surgery on the breast. He said that most any general surgeon could do the job, but that he would recommend one of these specialists if it were up to him. – He paused for a moment, and then added, and one of them is my wife! He gave me a list of recommendations, which included his wife.

Of the two breast surgeon specialists, my rheumatologist’s wife was the only one on the preferred list of doctors from my health insurance provider. He also told me that they would be out of town on vacation during the last week of August, but that they try to get women in as soon as possible, if there is a new diagnosis of cancer.

I felt better having a little more knowledge and some recommendations to draw upon, should the need arise.

The biopsies took place on Monday, August 20th. Grandma took care of the kids, and I joined Dawn Ann at the Women’s Center for the biopsies. Unfortunately they would not allow me into the room where they were doing the procedures. I would like to have been there to comfort my sweetheart, and hold her hand during the biopsies, but I could not. They had a big sign in the waiting room: "FAMILY MEMBERS ARE NOT ALLOWED IN THE EXAMINATION ROOMS!"

One fellow waiting for his wife's routine mammogram made a wry observation about the sign: "Does that mean that only family members are excluded from the exam rooms, but that anyone else IS allowed in there?" We had a good chuckle over that one! It was good to have a moment to smile during an otherwise tense time. I recognized the fellow who joked about the sign. At one time he was a county commissioner. The last time I saw him, he was serving as a sealer in the Temple. I knew I was in good company.

After the biopsies were complete, The Women's Center told us that it would take two to three days for results to come in. I took Dawn Ann home, and made her as comfortable as possible, and then picked up the kids from my mother’s house.

Two days later, on Wednesday, August 22nd was our Stake Temple Day. I took the day off from work, and Dawn Ann and I, along with many of our fellow church members spent the day worshiping at the Jordan River Temple. It gave us time to contemplate, and to pray. We asked for the Lord's help, that if possible, this cup might pass from us. But nevertheless, let His will be done. And if this cup were not pass from us, then we asked for comfort and strength to endure well, and to overcome what trials we may be called upon to bear.

After leaving the temple late in the afternoon, I turned on my cell phone, and checked our home voicemail. No messages from the Women's center. I was kind of relieved. Subconsciously I was probably thinking that no news was good news.

I had previously arranged to Thursday, August 23rd off from work, so that I could spend the day at my son's High Adventure Camp. This camp was located at Camp Browning, just outside of Huntsville, Utah. The camp is about 70 miles away from home, up a narrow mountain canyon. There was no cell phone service at the camp.

Even though I could not talk to Dawn Ann on the phone, I was thinking of her, and praying for her in my prayers.

After the evening activities at the camp, I drove down off the mountain in my truck. I found a place, on the outskirts of the town of Huntsville where I could park, and also receive cell phone service. I did not know what this phone call might portend, but I knew that this it had the potential to be a life-changing event.

I said one more little prayer to myself, and called home.

To be continued . . .

New Diagnosis - DCIS in Two Spots

This week, my dear wife was diagnosed with DCIS or Ductal Carcinoma In Situ. This is a non-invasive form of breast cancer.

The good news is that this form of cancer is virtually 100% curable.

The bad news is that because the DCIS is in two places on the same breast, and quite a distance apart from one another -- treatment will require a mastectomy. At this point it does not look like chemotherapy, or radiation treatment will be necessary.

This is not a battle that we have chosen. However, it is now a reality in our lives, and will forever affect our and family.

I am 100% behind my wife in this. I will support her in any way I can to help her through this time of great challenge and need.

We do not know why this challenge is ours, but we place ourselves in God's hands, and will trust in his plan for us.

Just in the few days that I have been involved in the breast cancer world, I have found minimal resources for husbands of breast cancer patients. In my own small way, I hope to perhaps be of benefit for other husbands who have and will go through this same experience.

This blog will be a place for me, as a husband of a Breast Cancer patient to express my feelings, and to relate our experience with breast cancer as we go through the treatment process over the next few months and years.

It will also give me an emotional outlet as we journey through this experience together.