It has been one year since Rob left this mortal world and he is greatly missed.

He was exceptional.

September 2008

Rob “found a way into [our] hearts” and my go-to guy for everyday life and so much more. I am so blessed to have known him. The heartache is real but we are sustained by the grace of God.

Here is the video of Rob's Memorial Service. I am so grateful for his friends and mentors who graciously spoke at the service.

Much has happened over the past month with my surgery, recovery, spring break, and Easter. My surgery went well without complications and thankfully, I went home the same day. The surgeon only had to remove four lymph nodes and all were found to be cancer-free. Even more amazing, at my post-op appointment, the pathology report stated that cancer was not found in any of the removed tissue, breast or lymph nodes! This is called a complete pathological response to the chemotherapy. This is the best possible report, specifically in terms, of increasing survival and minimizing chance of recurrence. With this report, the question of whether radiation therapy was a necessity crossed my mind. I researched, had good friends research, asked second opinions, and had a forthright discussion with my radiation oncologist, all pointed in the same direction. At this time, since my tumor was over 5 cm and I had multiple lymph nodes involved at the onset of diagnosis, the benefits of radiation still outweigh the risks to my body. I have had my planning appointment and will begin radiation treatment on April 19^th. My treatment plan is to have radiation every weekday for 33 times. I will have my left chest wall, axillary node area (under the arm), and the supraclavicular lymph node area (near the collarbone) undergo radiation. The side effects tend to develop around two weeks and are fatigue and skin irritation, burning, etc. at the site of treatment. Also, because so many areas of my lymphatic system will be assaulted, I am at an increased risk for lymphedema (swelling and fluid retention in my arm due to a blockage in the lymphatic vessels). The early signs are numbness and tingling in the arm. Unfortunately, I am already experiencing some of these symptoms, so in the coming weeks I will meet with a lymphatic therapist to hopefully minimize any further complications.

Our lives have not been consumed by cancer and treatment. My surgery happened to land on my spring break, so we spent the first part going to the zoo, hiking in a nearby state preserve, and during surgery, my children got to stay at their friends’ home for three nights. They thoroughly enjoyed the family “sleepover.” (Big thank you to Chris, Ashley, Elliot, and Isaac!!) The Thursday through Saturday before Easter Sunday, we traveled with my dad to Glen Rose, Texas where we jumped on big rocks, walked barefoot in the river, saw some safari animals, and played for hours in the indoor swimming pool.

Thank you for your prayers and support and rejoicing with us at the good prognosis. In all things, God is faithful and true.

- Praise God for effective chemotherapy treatment and a successful surgery

- Pray for minimal side effects of radiation and continued healing

The last round of chemotherapy was successful without too many complications in the week right after the infusion. I am dealing with some long-term side effects of the treatment as my fingernails have continued to cause problems. The best I can describe the situation is that each of my nails have bruising underneath as if I have hit them or slammed them in a door. This has caused each of my nails to lift off the nailbed and there is some form of fluid forming under each one. Two weeks ago, both my index fingers got infected from this complication and I was placed on antibiotics. The infection is gone but each of those nails has completely disconnected to the skin around it except for a small area on the bottom. I am regularly soaking my fingers to discourage any more infection. It has been a painful and annoying process but it seems the worst is behind me and now I just wait for new nails to begin growing underneath.

I have had one round of only Herceptin with minimal short-lived side effects. I will continue with this treatment every three weeks for 11 more times.

My surgery is scheduled for tomorrow, Wednesday, March 14^th at 10:15am. I will be having a single mastectomy (removal of breast tissue) and a sentinel node biopsy (checking for cancer in the main lymph node(s) and removing those found with cancer). If all goes well, I will spend only one night in the hospital (maybe less). I may have some movement and lifting restrictions for a few weeks but the surgeon seemed positive on a speedy recovery and the possibility of starting the radiation treatment within 10-14 days. I have yet to meet with the radiation oncologist to gather specifics of my treatment but the normal radiation therapy duration is everyday Monday through Friday for six to seven weeks.

Please pray for:

the procedure, minimal lymph node removal, and no complications with recovery,
peace and understanding for my children and family, and
those who are caring for my children while I am in surgery and recovering.

I thought I would be better at updating the blog but I have found myself sick or resting more than expected with each round of chemotherapy. The good news is that I only have one more round of chemotherapy! Below is a recap of the last few months but here is the update of next steps. My last round is scheduled for February 9^th. My platelets dropped a little bit this last round, but as of now everything is still on track to continue as scheduled for round 6. Tomorrow I have my pre-consultation with the surgeon, as surgery will be my next action in removing the cancer. From this appointment, I will get more information on what scans will be needed and a timeline between the end of chemotherapy and a surgery date. Scans after round 3 did show that the chemotherapy and immunotherapy were working well to shrink the tumor.

These last few months have by no means been easy for any of us. However, it has been in times of desperation and need that I see God’s greatness and my humility. I am continually grateful for neighbors, school families, and small group members providing meals for us on a regular basis. Each round, a friend from out of state as graciously left their family or work and given up their time to serve and care for my family. I could not have made it through many of my rounds without their help and the help of friends nearby packing a bag and staying with us overnight. Thank you for the constant upholding of our family in your thoughts and prayers.

Our current specific prayer requests are:

1. A solid finish to the chemotherapy,
2. A productive and clarifying appointment with the surgeon, and
3. Peace of mind and heart for my children and family as I have the surgery.

Round 5

Overview of the last few months:

After my bought with mucositis in my throat and intestines during Round 1, I contracted a stomach virus the following week. I continued with my second round of treatment November 17^th even though my body was not fully recovered from the mucositis and virus. Round 2 ended up being my worst round. I was in bed almost all the time for 12 days straight with severe side effects and abdominal pain. Over Thanksgiving break, the pain was severe enough that I was unable to drink water without intense pain and spent six hours in the local Emergency Department receiving fluids. All these events led to many discussions with my doctor about how best to manage my care. My pain management was modified, as well as, the chemotherapy drug doses reduced slightly. With these changes, I had a mild Round 3 in early December. I was able to enjoy all of Christmas break with the children. We had wonderful visits with grandparents and friends. Matthew was even able to enjoy his first musical, The Grinch, with Uncle Matt Moore and had a wonderful time. We were also able to go indoor sledding (because that is about the only way it can be done in North Texas)! Round 4 started off fairly calm but then all three of us came down with an upper respiratory virus. Although my intestinal side effects were minimal, I was unable to drink enough fluids to stay hydrated and keep my blood pressure at a safe and normal level. Fortunately, I was already scheduled for daily hydration the following week. Also, my friend, Amy Reno, graciously gave of her time, energy, and resources to fly in from Washington, DC and be with us for the whole first week of chemotherapy. Recovery from Round 4 was a little slower but we are all relatively healthy (the kids) and on the mend from the chest cold and sinus infection. Round 5 was still a battle of hydration but the intestinal discomforts were more managed. I can feel the accumulation of toxicity and other side effects (e.g., bruising under the finger and toe nails along with numbness), but know the end is in sight!

An airport layover visit from my good friend Holly

The last full week of October was a hectic week of appointments and planning. However, I am thankful that there was speediness in the process. I had a follow-up with my oncologist on the 24th and nothing was in place for my port placement, PET scan, or chemotherapy approval. My oncologist, Dr. Juvvadi, was still optimistic to schedule my first treatment for Friday, October 27^th. On Wednesday, the 25th, I had my port placement procedure. Thursday, the 26th, I had my PET scan and received a phone call that my chemotherapy treatments had all been approved and I was set to start treatment on Friday as scheduled. 

The results of the breast MRI showed more clearly that there was one large mass (6.5x3.8x6.2) in my breast instead of two smaller ones. A PET scan is necessary to monitor the spread of the cancer to other lymphatic areas or organs. The scan showed two small nodules in my lungs but they were too small to biopsy. Therefore, the oncologist went forward with the assumption that the cancer has not spread beyond my left breast and left axillary lymph nodes. 

My treatment regimen is shortened to TCHP. It is a combination of two targeted therapies, Perjeta and Herceptin, and two traditional chemotherapy, Carboplatin and Taxotere. The schedule for TCHP is one treatment day every three weeks and I will have six rounds. I am praying that this treatment is found to be 100% effective on the cancer. After the six rounds, I will be evaluated for surgery and radiation treatment. I will also continue with Herceptin for an additional 12 rounds (occurring every three weeks). 

The side effects are varied but the most likely are fatigue, weakness, diarrhea, nausea/vomiting, and hair loss. The side effects do not normally hit until day 3 or 4 of the cycle/round and last for 5-6 days. On day 8 and 9, I was on track with this normal progression, I had the full list of side effects, but nothing had been too extreme. I had still been able to be with my children for the important parts of the day. After a relatively positive 24 hours, I began to lose my voice, followed by intense abdominal cramping, unable to eat, and other side effects. I went back to the doctor's office on Monday, under the assumption that I had caught a virus. However, all of my symptoms aligned with another chemo-related side effect called mucositis. It normally occurs in the mouth but can occur anywhere there are mucous membranes along the digestive tract. For me, they presented in my throat and intestines. Fortunately, the doctor ordered me to hydration for two days and gave me some extra medications to help with the abdmoinal cramping. Although, I am still feeling some side effects, the mucositis is calming and I have more energy every day. 

My next treatment is scheduled for November 17th.

I am so thankful for friends and neighbors to quickly step in and help me take care of Matthew and Raegann especially these last few days. Matthew and Raegann are doing relatively well with the changes, although I know deep inside, especially for Matthew, he is scared and does not understand all that is happening. I have been surrounded with support in caring for my children, meals, and housework. Although I do not desire this journey, God has made it very clear that I am not walking it alone. I am very grateful for each kind comment, letter, gift, and prayer being sent our way. Thank you.

Prayer Requests:

-          Beyond belief effectiveness of TCHP with minimal side effects in the coming rounds

-          My family and friends who are sharing so willingly in this fight