As Ready As I'm Going to Be

January has been an eventful month for us. Rick is healing up nicely from his surgery and Zoe is progressing with her recovery too. We've posted Sasha's info and picture on three lost pet sites, posted flyers around the neighborhood and contacted the shelters. Meanwhile Gypsy keeps watching for Sasha to come back through the hole under the back fence.

My FMLA was finally officially approved, which is a huge relief (Thank you Lord!) Rick has helped me get some housework done. I've bought some soft seamless, wireless bras that I hope will be comfortable during my recovery and should come in handy during radiation later.

My lumpectomy surgery is the day after tomorrow. Our son, Paul, took the day off so he can pet-sit, which will be a big help and no small task, especially with one dog still recovering from her own surgery. Wednesday promises to be a very long day and a boring one for Rick. He'll take me to the Methodist  Hospital at 8:30 AM.

After being admitted, I'll start my day in the nuclear medicine department, where they'll inject a radioactive isotope to help the surgeon locate the sentinel lymph node. The sentinel lymph node is the first lymph node under the arm that the cancer would have spread to, if it has spread into the lymph nodes at all. That node will be removed during surgery so it can be biopsied. Additional lymph nodes may be removed if they are closely clustered with the sentinel node or if they look suspicious to the surgeon. Lymph node status is a major indicator of my prognosis and determines whether chemotherapy will be recommended. None of my lymph nodes are noticeably enlarged, so I'm cautiously optimistic about this.

After the isotope is injected, a radiologist will do the wire localization / bracketing so the surgeon will be able to locate the tumor with precision and remove it plus a margin of tissue around it. After all this high tech preparation is done, surgery should start around 2:00 PM and is estimated to take about 90 minutes. It won't be like some of the dramatic TV episodes you see where the surgeon comes out and announces to the relief of the anxious family, "We got all the cancer!" I will get the info from the pathology report Monday or Tuesday of the following week, although if there are any preliminary partial results by Friday, I could get that information before the weekend.

After spending time in the recovery room and then in observation, I expect to go home Wednesday evening. Kelly will be coming in late Thursday night from Dallas and staying the weekend. It will be so nice to have her here while I'm waiting to get the results of the pathology report. The pathology report will tell us the lymph node status, whether or not the margins of the tumor were clear, and the "staging" of the cancer more accurately than the biopsy report did. 

Statistically there is about a twenty percent chance that the margins will not be clear, which would mean going back in to have a second surgery. That surgery, if it happened, wouldn't be such a long involved process as the first one. My hairdresser, Erica, says that her mom had that experience and it really wasn't  too bad and she's doing fine four years later. I'm inclined to trust a woman who named her daughter Erika, even if she didn't know how to spell it.

My daughter, Erika, whose name is spelled correctly, will be coming in next Tuesday from Iowa and should be able to stay a whole week. That's long enough to really start missing her husband and children before she leaves, but I'm sure looking forward to having her here.

My heartfelt thanks to all of you who've been encouraging and praying for me, and to the friends who've shared their own breast cancer stories with me. I hope mine will be a help to someone else someday.

In this, as in everything, my life is in the hands of a loving God and I know He'll see me through, come what may.

Sunshine in My Forecast

Yesterday I got some of the happiest news I could imagine. Both of my daughters are coming to visit soon after my surgery. I wouldn't have asked them to. I don't expect my lumpectomy to be a big deal physically and don't think I'll  need much in the way of practical help that my husband and son wouldn't be willing and able to take care of. Both of my daughters have full, busy lives with families of their own. I never would have asked them to come or wanted them to feel like they should.

But, oh, how it lifts my spirits to know my girls are coming! Some of the happiest times in my life are the times I've spent one-on-one with each of them and times we've all three spent together. Neither of them has lived in San Antonio since they got married.

Kelly and Greg have lived in Dallas, Iowa, Kansas and now back in Dallas, where they are raising their three daughters, two of whom are teenagers, and where Kelly works full-time as a speech therapist.

Erika married the son of Kelly and Greg's former next door neighbors in Iowa, so Erika has lived all her married life in Des Moines where she and Darin are raising two active high-energy preschoolers, one of whom has special needs that require them to stay one step ahead of her just to keep her safe.

I am so thankful that both of my sons-in-law are encouraging and helping my daughters to come visit me. This is no small sacrifice on their parts. And I'm also thankful for their friends and in-laws who are also helping to make these visits possible.

Now if you'll indulge me in a little nostalgia, I hope you'll enjoy these pictures as much as I do.

April 1981

 October 1981

1987

1992

1995

2001

2012

How I love those daughters of mine!

All Creatures of Our God and King

I've been thinking that if God's eye is on the sparrow, His eye is also on little cats who are out trying to catch sparrows for lunch.  Thinking about that is comforting to me and encourages me to keep praying for our little lost cat. I keep calling her little, because she only weighs about five pounds and that's how I think of her.

She's little like Granny from the old Beverly Hillbillies show was little, though. She's old and bold, small and scrappy, a survivor. She thinks humans exist to meet her needs and I have no doubt that when she feels a need, she'll approach a human and loudly demand to have it met. Anyone who tried to take her in would probably be getting more than they bargained for.  I think of Sasha as our cat, but she's only been our cat for one of the more than ten years of her life. We're glad at least that the weather has been so nice since she went missing.

Since Sasha left, Gypsy, our mixed breed dog who we also brought home from the shelter, has taken up an interesting habit. She's been lying on the back patio a lot, eyes wide open, scanning the area where she may have last seen Sasha go through a hole under the fence. Gypsy is probably nine or ten years younger than Sasha. She must have a lot of some herding breed in her, because she has strong herding instincts. She doesn't accept the fact that you can't herd cats and she never stops trying.

Sasha tended to bully Luna, so I'm not sure Luna misses her very much.

Meanwhile, we're pleased with how well Zoe is doing after her surgery. If she were human we'd recognize her surgery as a much bigger deal than either Rick's recent hernia repair or my upcoming lumpectomy - more physically traumatic and harder to recover from. We're getting her out for walks daily, increasing the time gradually, and she's slowly starting to bear more weight on that hind leg. We're still giving her pain medication daily and keeping a close eye on her to try to prevent her from hurting herself by falling or jumping.

With Sasha gone, Penny is once again the senior pet in the household. She's the leader of the dog pack anyway and hanging onto that position by a thread. It's a tiring job, but someone has to do it.


These animals add so much to our lives.

All creatures of our God and King,
Lift up your voice and with us sing...

 Let all things their Creator Bless,
And worship Him in humbleness

- Francis of Assisi

Peace and Perspective

I'm feeling so much more peace now. I'm thankful to have family and friends praying for me.

Of course I'm sad and anxious that our little cat, Sasha, is missing and I hope she's not gone for good. I brought her home a year ago from a shelter. She has seemed so at home with us spending her evenings sitting in my husband's lap, waking us up early in the morning for breakfast, rubbing her little head against our hands, purring endlessly. We've treated her for ear infections and bought expensive special food for her because of her digestive problems. But she's probably over ten years old and who knows how many other families she's lived with or how much of her life has been spent fending for herself? Two days ago she went out the dog door, which she started doing months ago. I had intended for her to be an indoor cat, but she figured out the dog door and seemed to enjoy just puttering around the back yard and sitting in the sun. About a week ago I noticed her go through a hole under the fence, but she came back pretty quickly and  I realized she might have done that before. I know lots of pet cats are outdoor cats and do just fine. Being a cat mom is still relatively new to me. Some of  my friends have told me their cats take off for days at a time and always come home, but I still I find myself worrying about Sasha and praying that she'll be alright.

But mostly I'm feeling more peaceful than I was yesterday. I still don't know what's going to happen with my FMLA claim. We faxed paperwork to the doctor's office again and are hoping it's the right paperwork this time and that they fill it out to the insurance company's satisfaction. I probably won't even know if it's approved until after surgery, but I'm determined not to worry about it anymore.

Either way, I am going to have surgery on Wednesday, I have health insurance to pay for it, my cancer was caught early, I have over 200 hours accrued sick time, don't expect to need anywhere near that much and even if the FMLA doesn't come through, I'm sure I wouldn't lose my job for taking time off for cancer surgery. I just don't want to fret about it anymore.

After my surgery I'll come back to a comfortable home and a loving husband and son. I hope Sasha will be here, but there will be at least four other furry friends to welcome me home.

I am reminded once again of my many blessings.

I was reading about how people in underdeveloped nations have such higher death rates and suffer so much more from all types of cancer, because it's seldom caught when it's treatable and there aren't many treatment options available to them anyway. That helped give me some much needed perspective.

God's Got This

Today, I, a customer service representative, make that a senior level customer service officer who takes escalated calls from other reps, yelled at a customer service representative of the insurance company who handles FMLA for my employer. I lost it and I'm not proud of that. I was immediately sorry and wanted to apologize, but I didn't get a chance to. Apparently she was not trained to take rude, yelling customers in stride like I have to in my job. She started lecturing and threatening to disconnect my call if I yelled again, which I hadn't planned on doing, so I just hung up in shame and frustration. Then I did something I haven't done since I was diagnosed with breast cancer three weeks ago. I cried. For a long time.

Bear with me as I backtrack over what led up to this and I know I'm being redundant here. A blog is a great outlet for venting selfishly and I'm afraid you've stopped in on my pity party. My employer changed medical insurance carriers for 2013. I had opted for a more expensive (to me) but lower deductible plan knowing that my husband needed hernia surgery, but having no idea that I would be diagnosed with breast cancer on January 2. For the first week and a half of the new year, insurance company H had no record of us in their system, not when we called, not when our doctors offices called to try to verify coverage. Needless to say, this resulted in much frustration and wasted time on the telephone. That was finally resolved, Thank God, no really, I do thank God for that.

While that was going on, my supervisor encouraged me to call insurance company A, who handles Family and Medical Leave Act claims for our company. He knew as well as I did that regardless of how much sick time I had accrued, I would need to have my absence for surgery and recovery certified for FMLA in order for the absences to be "job protected." So I called insurance company A and told them I thought I'd need "Intermittent FMLA" since I knew I'd miss time for surgery, recovery, followup appointments, pre-op appointments, radiation treatments, etc. I got the paperwork from them, filled out my part of it and took it to my surgeon's office. When I talked to them a few days later, they told me that all they could certify was the day of surgery and continous time for recovery afterward, not intermittent absences. Fair enough.

I called insurance company A back and told them I had been wrong, I didn't need intermittent FMLA; I needed about two weeks for surgery and recovery. Brenda, the rep I talked to that day told me that what I needed was short term disability and that she would cancel my FMLA. (Today I found out that this is where the real problems began. She was wrong. All I needed was continuous FMLA. I don't even have coverage for short term disability nor do I need it.) Brenda transferred me to Frank, who kept me on the phone for about 20 minutes taking information that I had already given previously for the FMLA, but that didn't seem too unreasonable. Then I called my surgeon's office back to tell them to shred the paperwork I had given them and that I'd get the new paperwork to them when I had it.

Then I waited for the new forms to arrive by mail or email or for a new claim to show up on insurance company A's website. I sent several secure messages that seemed to go into a black hole. Finally I called back two days ago to find that nothing had been done on their end. Over the past 48 hours I've talked to at least a half dozen of their representatives, received and printed out three sets of forms, two of which were the wrong ones, and spent hours working on this. As of last night I thought maybe this was finally going to be resolved.

Then this morning, just as I began my work day, I got a cell phone call that went to voice mail. It was "Sean" an A insurance company rep calling to talk to me about my claim for...completely wrong dates. Anyone who has ever worked a call center job knows that every minute spent off the phone has to be documented and explained and I've had to document lots of minutes like that recently. This is Thursday and my surgeon's office only fills out this paperwork on one day a week: Friday. Tomorrow is the last Friday before my surgery. I got off my work phone, emailed my supervisor to tell him why, checked my cell phone voice mail and tried to call Sean back.

When I finally got through the automated system to a live rep, I told her that I was returning a call from someone named Sean. She was not Sean, but asked for my name, date of birth and claim number and then proceeded to tell me that they had a helpful website that could be used for most concerns people might call about. That's when I yelled. They have told me this on every one of the countless phone calls I've made  trying to resolve an increasingly more convoluted situation that the website offered no help for. So this time, when the representative started off by telling me that again, I lost it and yelled, "PLEASE, don't go there!" .

I get yelled at multiple times a day in my job, sometimes cursed at and called names, but I don't ever want to treat anyone else that way. That insurance company representative was not personally responsible for the mistakes others have made and she didn't deserve to have me take out my frustration on her. It still pains me to think about it, but I've asked God's forgiveness, not only for raising my voice, but for the attitude that led me to do it.

After that phone call and after I spent some time crying and praying, I was calm on my next phone call with yet another representative, but they never did get things sorted out. Two emails, one more secure message and another set of forms later, I finally called my HR department. They intervened and they think the problems are resolved. I'd like to think that the paperwork Rick faxed to the doctor's office for me yet again today will result in my FMLA being finally approved so that I can use two weeks of my own accrued sick time for surgery and recovery. I wish I could tell you that when I go to bed tonight I'll be confident that the issue is resolved. But I'm not counting on Brenda, Frank, Colleen, Jessica, Ken, Laura or Sean from the insurance company or my HR department or my doctor's office staff to make this happen.

As my niece, Grace, often says, "God's got this." At some point today I finally remembered that.

Now one of our cats has gone missing. I'm praying that God's got her too and will bring her home to us safe and sound. If you are a praying person, I'd appreciate it if you'd pray for Sasha too.

Weary Wednesday

More phone calls today, more secure messages, faxes and emails sent and receipts copied. More time after work documenting the few absences I've had so far. It's amazing how much time and effort it takes to actually be able to use accrued sick time and employer sponsored benefits like health insurance, short term disability, flexible spending accounts for medical expenses. Of course I'm working full time so this is all being done after work or on breaks.

I'm weary and feeling overwhelmed now at the end of the day. I can't imagine how exhausting and stressful this would be for anyone who was actually feeling the effects of their illness, which I am not. I know I've been dealing with stress by eating too much junk food.

Of course I've also been taking care of Zoe after her orthopedic surgery last week

and trying to prevent Rick from needing to lift anything over ten pounds in the aftermath of his surgery not quite two weeks ago.

I'm still glad they were both able to have their surgeries and be well on the road to recovery before mine.

My surgery is a week away and today a nurse from my surgeon's office called and spent a long time with me going over information about what will happen the day of surgery and afterward. She was very kind and helpful.

I'm still hoping that sometime before surgery I'll have time to get the house cleaned.

Sweating the Small Stuff

If there's anything that irritates me more than breast cancer it's dealing with insurance. Don't get me wrong, I'm truly thankful that I have it. It just takes a lot of work to take advantage of it sometimes.
 
It started with our medical insurance company having absolutely no record of us right when my surgeon, Rick's surgeon and the radiology practice where I was supposed to have an MRI were all calling to verify coverage. My employer had changed insurance companies as of Jan. 1. I was diagnosed on Jan. 2. Rick was scheduled for hernia repair on Jan.10. The new insurance carrier apparently had some kind of mix-up in loading my employer's records. So they deleted us all and it was days, I honestly don't know how many days, until they reloaded our records correctly. In the interim it appeared that we simply didn't have any insurance, except dental, which is not a lot of help when you're dealing with hernias and breast cancer.

That necessitated lots of time spent on the phone getting nothing but frustrated. Finally that issue was resolved the day before Rick's surgery, much to our relief.

Then it was time to certify for my time off of work for my surgery and recovery. Yes I have sick time, but to use more than a few days here or there, you have to get it certified as FMLA or Short Term Disability so that the absences are "job protected." I don't know if this is as critical for salaried employees, but I am hourly and work for a call center where any time off is closely scrutinized. Whether it's FMLA or short term disability, you have to deal with, once again, an insurance company.

So I started by calling to open an FMLA claim, then found out that this was not what I needed. I needed short term disability. So after getting my FMLA paperwork, filling out and signing my part of it and getting that to my surgeon's office, I had to call them back, ask them to shred it and told them I'd be getting the new paperwork to them.  This misunderstanding was probably my fault as much as it was anyone else's.

Then the real frustration began. Last week I called the insurance company that handles both FMLA and short term disability, told them I needed to cancel the FMLA claim and open a new claim for short term disability. A nice lady named Brenda said she had cancelled the FMLA, then she transferred my call to a friendly fellow named Frank (OK, I admit it, I love alliteration) who spent about fifteen minutes on the phone with me taking lots of information for my short term disability claim. I got off the phone feeling that I was at least now making some progress after my initial setback and loss of time.

There was only one problem. Neither Brenda nor Frank did what they told me they had done. I waited in vain for my new short term disability claim to appear on the website when I logged in. I waited for paperwork to arrive in the mail. Finally today I called back and was told that the FMLA claim could only be cancelled if I requested it in writing, a little detail Brenda failed to mention. And there was no short term disability claim pending. So once again I started over from scratch, I think. Surgery is just a week away.

Lord, please give me grace for the little things.