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Dear Faithful Friends & Family,

THE SUMMARY:  Thank you, once again, for your prayers for wisdom for Stephen & me.  Dr. Mabry called last week and said that we had a two-week window before beginning chemotherapy because he has ordered one additional lab test.   Stephen and I decided to take advantage of that delay:  We just returned from Gainesville, FL, where we received a second opinion from Dr. Robert Carroll, Breast Cancer Medical Oncologist.  The bottom line is that we have decided to travel to Gainesville for my future treatment [a two-hour trip].

THE DETAILS: Dr. Mabry is a brilliant and highly-respected Medical Oncologist and he has done excellent research on my cancer.  However, we have an opportunity to work with Dr. Carroll, whose entire practice is devoted to Breast Cancer [BC].  Also, Dr. Carroll has invited me to participate in a Clinical Trial, which I have wanted to do ever since I was diagnosed with BC.  

Dr. Carroll agrees with Dr. Mabry that chemotherapy is absolutely essential.  This second opinion was exactly the confirmation I needed to accept the dreaded “chemo,” which I thought I might be able to avoid.  Dr. Carroll explained that, without chemotherapy, the risk of a BC  recurrence, even within two years, is very high.  Worse yet, a BC recurrence would probably be fatal.  You may be wondering, as I did:  “If I have had a bilateral mastectomy, then how can I have a recurrence of BC?” Well, a cancer that begins as BC remains BC, even if it travels outside of the breast tissues, through the bloodstream or lymph nodes.  Remember that the sentinel lymph nodes were clear, after the surgery?  This is a good sign, yet it only takes one BC cell to travel through the bloodstream [or lymph nodes] and wreak havoc.  Now is the time to blast the cancer, at the cellular level.  Dr. Carroll reminded me that my BC tumor was small [1.5 cm] yet aggressive [Grade 3]. 

So, I am resolved to commit to chemotherapy and other treatments [Herceptin, Tamoxifen, for example].  Yet, I am hopeful that my participation in the Clinical Trial will help women who will be fighting BC in the future. 

PLEASE PRAY FOR ME DURING CHEMO:

• for protection from long-term side effects
• for comfort measures to help endure the short-term side effects
• for strength of mind, heart, soul, and body

Exaltabo te, Domine.  [I will exalt you, O Lord  . . . ] Psalm 30

Coram Deo,

Margo

P. S.  Stephen & I had a wonderfully relaxing and care-free weekend with our dear friends, Dave & Sharon Brewer.  We met in Gainesville and went tubing down the Itchetuknee River, just like old times, from our college days together!

Dear Faithful Praying Family & Friends,

I’m back from the Blair Clan Reunion in Beech Mountain, NC, which was a wonderful respite from the reality of dealing with health issues.

Today I called Karen,  my surgeon’s oncology nurse.  She received the test results of the OncoTypeDx, which indicate that I have a 41% risk of a recurrence of cancer.  On Monday, I will call and make an appointment to discuss the results with Dr. Mabry, the oncologist.  Over the weekend, I will come to grips with the bad news:  my cancer was more aggressive than I [or my medical team] previously thought.  The good news [for my medical team] is that I now understand why further treament [which I had postponed] is necessary. 

On a different note, last month, on 09.23.09,  I received this blog comment from Rick & Carole Stewart, our dear friends and [also] Benjamin’s [other] grandparents:

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 Your title for this entry reminded me of Hebrews 12:

“1]  Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us.

2]  Let us fix our eyes on Jesus, the author and perfecter of our faith, who for the joy set before him endured the cross, scorning its shame, and sat down at the right hand of the throne of God.

3]  Consider him who endured such opposition from sinful men, so that you will not grow weary and lose heart.”

. . . We look forward to being your partners in grandparenting for many years to come. Hey! When can we walk to Paradise?

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Well,  I read that phrase, “When can we walk to Paradise?” and thought to myself, “Boy, you have got that right! This world is not our home and we are but sojourners!  [Then I began singing to myself]:  ‘Deep river — my home is over Jordan! ‘  and ‘Gonna lay down my burden — down by the riverside!’ “ 

Then I read Rick’s comment again and realized that he was talking — quite literally — about walking to The Paradise Grill, a restaurant located within walking distance of our home!  In the midst of the sober reality of this journey, I am grateful for these moments of levity. 

So, I’ll pick up my burdens once again on Monday but, in the meantime, I’m thinking [truthfully] about how Walking to Paradise sounds a lot more pleasant than Running with Perseverance.   Pray for me that I would not become weary and lose heart.  And thank you, once again, for reading this blog and for encouraging me.

Dear Faithful Praying Family & Friends,

Stephen & I are leaving for our vacation tomorrow!  We decided to postpone my further treatment [which I described in my post of last week.] Since I did not have the “port” surgically implanted,  I can swim on vacation with Stephen, which I was so looking forward to!  We will be out of town until 08.11.09.  While we are gone, the OncoTypeDx test will be conducted [the lab and my tissue is in CA].  It takes 10-14 days.  The purpose of this diagnostic tool is to provide information which will guide the patient and the medical team in planning further treatment.  So, my chemo is “on hold” at this point, until Stephen & I have an opportunity to do some further research, which we will resume after vacation.

I will probably be “off-line” during vacation but I look forward to writing to you again after I return.  In the meantime, please pray that Stephen & I would be wise and make good decisions about further treatment.  Thank you for reading this and for praying!

Benedictus es, Domine.

Coram Deo,

Margo

Dear Faithful Praying Family & Friends,

A REVIEW:

Three weeks have passed since the most difficult evening of my life, June 28, the night before my surgery.  During that time, your prayers for me were efficacious:  Into my memory came the words of ancient Hebrew Scripture, assuring my troubled mind that my present circumstances do not diminish the character and nature of Almighty God!   During that long night, I meditated upon the words of Psalm 121 [Levavi Oculos].  With the words, came the memory of a composition by Mendelssohn, a tune set to the words of Psalm 121:  “He watching over Israel slumbers not nor sleeps.”  The truth of that ancient Hebrew Scripture strengthened my mind and eclipsed anxiety, doubt, and fear.  Will you continue to pray for me, as I enter the next phase in my journey toward health?  I will need your prayers in order to endure!

 THE NEXT PHASE:

Today, I met with Dr. Mabry, Hematology/Oncology, Tallahassee.  The good news is that I will have no radiation.  However, I will have four rounds of chemotherapy, each round separated by three weeks.  Yes, I will lose my hair. Dr. Mabry will order an anti-nausea drug, which I will take one-half hour before each chemotherapy session.  After these four rounds are completed [12 weeks] I will take [for one year] Herceptin, which targets the HER/2 biomarker, an oncogene for which I tested positive and which is over-expressing.  [This represents the most problematic aspect of my pathology report.]  I will also take Tamoxifen, an anti-hormone, as my tumor tested estrogen-receptive positive; five years is the standard protocol.

I imagine you are disappointed, as I am, that I require further treatment.  However, I am thankful that the treatment will significantly decrease the risk of the recurrence of cancer.  The goal of treatment is to increase my survival.  Here are the details about my path report:  Invasive Ductal Carcinoma, Stage One, Grade Three, Nottingham Score 8, Estrogen Positive, HER/2 Positive.

 PLEASE PRAY FOR ME DURING CHEMO:

*No serious side effects, complications, or allergies.

*No illness that would compromise my suppressed immune system.

*That the anti-nausea drugs would work!

*That I would remain strong in mind, heart, soul, and strength.

*That I would learn to love God with ALL my mind heart, soul, and strength.

 NO REGRETS!

You remember that I opted for bi-lateral mastectomy with no reconstructive surgery [RS]?   Although I have no regrets about either of those two decisions, it was great to hear this confirmation:  Last week, my surgeon and two nurses confirmed that, if I had agreed to RS, I would have been out of commission for five to six weeks AND that I would never have been able to swim as well after the RS as before!  

I am now swimming better than before my surgery!  One, I have the companionship of Stephen and my friends, Steve & Margie Gibbons.  Two, [perhaps] I have less “drag” in the [ahem] chest area and I weigh less!  Third, I am extremely motivated and consider it my focused “job” to stay strong, mentally and physically. Not only am I able to perform the full range of motion for all the strokes, including butterfly, my stamina is also increasing.  Last night, I swam 1000 meters with only a few rest stops. 

A RESPITE:

The good news is that my treatment will not start until August 19^th!  Next week, Dr. Crooms will surgically implant a “port.”  For the next two weeks, I will not be able to swim.  However, I WILL be able to go to the Blair Clan Family Reunion in Beech Mountain, NC.  There I will see my two sisters and their families plus Daniel, Haley, and Benjamin, who will fly in from Waco, TX.  I hope Garrett can join us but he just returned from a two-week vacation to Europe!

I heartily thank you for reading and praying as I go the distance!  Your encouragement and support will keep me afloat!  I will update the blog about once a week and will report any significant news and I’ll post some more photos for your enjoyment! 

Benedictus es, Domine.

Coram Deo,

Margo

Yesterday, I posted a photo of our first grandchild, Benjamin Daniel Stewart.  That specific photo was the one which Haley sent me on the day after my surgery.  That smile seemed to say to me, “Marmee, you did well and I’m proud of you! “

Benjamin was born 02.08.09 to Daniel & Haley [Payne] Stewart, married 05.28.06.  During the first week of August, Stephen & I will be travel to Beech Mountain, NC for our annual family reunion. Daniel, Haley, and Benjamin will fly to NC from Waco, TX:  Benjamin’s first trip to the mountains!  Looking forward to this trip has been a powerful motivator for me to get strong!  Stephen & I continue to do laps at the pool almost every evening.

The nurse gave me the OK to return to swimming and on this past Thursday evening [10 days post-surgery] Stephen sat by the side of the pool, as I took my first plunge.  It was glorious!  I let my legs do most of the work but I did gentle, warm-up motions with my arms.  It was a beautiful evening and I didn’t want to get out of the pool.  Stephen took photos.  We returned to the pool on Saturday & Sunday evening, with friends, Steve & Margie Gibbons, and all four of us enjoyed warm-up laps.  By Sunday, I was able to do the “freestyle” stroke, albeit not as powerful as before surgery, but that IS progress, right?  The Paynes and Gibbons are getting ready to go back to the pool this evening!  Well, perhaps you may remember the motto of the Paynes:  The Fun Never Ends  . . .

 Check back with this blog and I’ll include a report from visit with Dr. Mabry, Oncologist [07.22.09].  Hopefully, we will have an indication of future [if any] treatment.  I won’t consider myself as having “reached the other side” [of the pool, remember?] until I have learned about that.  So, please keep praying for me, until I reach that other side, OK?

And, for a special treat, this week, I’ll be adding a photo to this blog, introducing you to Benjamin Daniel Stewart, our first grandchild!  He has been a real bright spot in this rather uncertain six weeks of our lives but, then, so have all of YOU been a bright spot! 

Thanks again for your visits, emails, comments, phone calls, snail mail, greeting cards, letters, snacks, beverages, homemade bread, lunches, suppers, giant salads [thanks, Kris!], flowers, and gifts — but especially for your prayers!  I am blessed beyond measure because of your friendship!

Dear Faithful Praying Family & Friends,

I looked over my post on 06.22.09 to see how many prayers have already been answered. ALL have been answered save for one: further treatment, which is unknown at this time. Over the next three weeks, I will be meeting with oncologists in order to find out the answer: minimum treatment or none? I will write on my blog as soon as I have any new information. In the meantime, keep praying toward no treatment, will you?

Again, I must express my gratitude for your faithful prayers on my behalf! Of course, you know the lymph nodes were clear, the margins were WIDE and clear, there were no complications after surgery, and my recovery has gone exceptionally well.

Here is what you may not know: I have NOT become unglued as I adjust my eyes and mind to my new [ahem] chest. I did a lot of honest weeping & grieving before the surgery but post-op, I shed not a tear over my loss. I HAVE wept over the overwhelming generosity and kindnesses of my care-takers, family & friends, however!

You who read this blog represent many, many of those family & friends. Words cannot adequately express how much your reading the blog [and leaving comments] and praying for me has meant. You have walked along side me in this journey and I thank you with all my heart.

Love,

Margo

I went to the surgeon’s office today for my one-week post-op appointment. The surgeon was in the OR but Karen, the nurse, attended me and removed the drains and staples.

Karen gave me a copy of the final pathology report and Stephen & I are celebrating the good news:

– The lymph nodes ARE clear!
– The margins around the tumor ARE clear!

My dear friends & family, you who have so faithfully prayed for me during this long journey, I sincerely thank you and ask you to please join me in proclaiming:

“Glory be to the Father, and to the Son, and to the Holy Ghost, as it was in the beginning, it is now and ever shall be, world without end.
Amen, Amen!”

Margo