The Upside Down

Derrik here again.

Have you watched Stranger Things on Netflix?  If you haven't, put your damn phone down and go binge watch the entire series right this minute.  If you have seen it, congratulations on being one of the cool kids.  Please feel free to continue reading the blog.  And treat yourself to a decadent dinner, compliments of the Schweppe's.  You still have to pay for it though.

I was hoping to add a couple blog updates yesterday but it turned into a pretty tough day with not great news.  I can only liken it to the "Upside Down" from Stranger Things.  Barb wasn't there but it was still dark times.

Picking up where we left off yesterday:

Nicole ended up being in surgery for 9 hours.  Two different surgeons worked on her.  Dr Crofts the Plastic Surgeon did the breast reconstruction and Dr Tittensor the General Surgeon did the mastectomies.  She has a great last name for a mastectomy specialist. She was destined for glory.  Dr Tittensor was in charge of a few things:

1) Removing the tissue out of each breast.  I assume the procedure went something like this but not as delicious:

2) Removing and sampling lymph nodes to determine if the cancer has spread beyond the breast tissue.

3) Being awesome.  Dr Tittensor is fantastic.  We heard nothing but good things about her from Ogden to Provo.  Having worked with her, we get it.  She's great.  Dr Crofts is amazing too.  He's the whole reason we came all the way to Utah Valley for this surgery.

I was hoping to hear from Dr Tittensor around 2-3 hours after surgery started when we expected she'd be done with her portion.  I sat across from the double doors to the surgery area in the lobby watching like a hawk for any movements.  I had the entire hospital lobby to myself. As Bruno would say: Don't believe me, just watch:

I was a bit anxious to get updates because I knew that we would know with 90% certainty if the cancer had spread.  She updated me at around 3 hours then again at 4 hours.  When Dr Tittensor walked out the second time, I immediately knew it was bad news.  Of the two lymph nodes they sample and biopsied from her armpit, one was clear but one was cancerous. This was pretty hard news to receive because the intensity of Nicole's future treatments were riding on the lymph nodes being negative.

Dr Tittensor went back in and removed five more lymph nodes to send in for testing.  She said one looked a little suspicious but the other four looked normal.  These were sent off to pathology and we won't get the results back until Friday at the earliest but most likely sometime next week.  We don't know for sure what these changes mean in terms of the cancer stage and grade.  Before this procedure she was considered to be in Stage 2A.  If the cancer only spread to the one lymph node then she would be upgraded to Stage 2B.  We're hoping it hasn't spread any further and she can remain in Stage 2.  I don't like that I used the word upgrade for that.  It sounds like she's getting promoted to something better.  It's probably more appropriate to say "downgrade".  I could have just gone back and changed the word from upgrade to downgrade but I made it this far and it's too late to turn back now.  We're past the point of no return.  Welcome to how my brain works, it's a bumpy ride but always an adventure.

So that sucked.  It was hard for me to receive the news because I knew that my beautiful wife would have to wake up from surgery to this bad news after going in with so much optimism and hopefulness for good results.  It broke my heart knowing for the final five hours of her surgery that I had to break the news to her.  These results changed the intensity of Nicole's future chemo treatments.  It is assumed that Nicole's chemo protocol will be upgraded to a TCH-P cocktail (I don't have the energy or brain power to explain what that means but Google does so click the link for more info).  This will be a six dose treatment with one dose every three weeks, spanning 18 weeks.  She will then continue to receive antibiotics every three weeks for an entire year.  This treatment will likely wreak more havoc on her reproductive system which could make it much harder to have kids.  This is the hardest part for Nicole.

Nicole was so sweet when she woke up from anesthesia.  She grabbed my hand and just kept saying "I love you so much" and "I missed you so much".  She couldn't open her eyes but had small tears in the corners of them.  At first they were tears of joy.  I knew it was only a matter of time before she asked me how it went.  I kept changing the subject by saying "Just close your eyes" or quickly asking her other questions to divert her attention.  After a few minutes she opened one eye, looked at me, and asked "Did it spread to the lymph nodes?"  I didn't have the heart to lie to her or divert her question.  I just looked her in the eye through tears in my own and said the words that we were hoping we wouldn't have to hear or say, "the cancer has spread to the lymph nodes".  She was still a little groggy from anesthesia but the news shattered her.  She just cried and repeated the same four phrases over and over, "Oh no love, I am so sad, I am so sorry, This is the worst."  For me personally that was one of the hardest moments for me during this whole cancer journey.  It absolutely broke my heart watching that news just crush her hopefulness.

After recovery we were able to go into the hospital room.  Nicole was in a lot of pain last night. To top it off she was nauceous from the morphine.  There's nothing quite like vomiting right after the meat in your chest cavity was ice cream scooped out of you.  It was hard to watch.  Finally around 1:00am she was given an anti-nausea medication that helped with the nausea which also helped her sleep.  We were both able to get a few hours of sleep with the nurse coming in every two hours to check on her.  It wasn't all doom and gloom, there was one fun thing from last night.  Nin's pee was Irish Green from the dye.  So that was fun.

This morning Nicole woke up so happy and optimistic.  It was like she needed those few, crappy hours of sleep to rejuvenate and re-energize her soul.  I was blown away, I thought it would be doomsday when we woke up but it wasn't.  Her bright spirit and positive attitude continues to amaze me every day.  She could have easily woken up and had a pity party for herself but she didn't.  She made the choice to accept the results and prepare herself for the next steps like a complete and utter badass.  Which leads me to one of the best text messages of encouragement she received before surgery yesterday from her boss Adam.  Here it is in all its glory: