Wednesday, August 27, 2014

God's Plans and "That Word"

Up until this point I have written mainly on the topic of my kidney journey and organ donation.  The next blog post I had hoped to write was going to be about my whirlwind speaking tour that I was already planning in my head.  I had spoken to Tara Storch of the Taylor's Gift Foundation about doing an event here in my town to raise awareness for the need for organ donors(if you don't know the story behind Taylor's Gift please visit www.taylorsgift.org).  I just knew that spreading the word of organ donation was my mission and I was cruising in that direction.  But once again, God reminded me that my plans are not always His plans.  He stopped me in my tracks with one simple phone call.  And that one word that changes everything....

At the end of July I had a routine physical and a Pap smear.  I have never had a single bad Pap result in all of my life, so I walked out of Dr. Ruta's office that day and didn't think about the test again.  In fact, my biggest concern was only that my kidney function numbers would come back okay.  Dr. Ruta told me that day that all of my blood work and the physical exam looked great.  She went so far as to pronounce me the "perfect specimen".  I was feeling pretty good about my 42 year old self.  The next week I was waiting for my son to get done with football practice and talking with my friend Lisa when my phone rang.  I saw that it was the clinic's number, but it was 7:15 p.m.  Because I work in the same clinic as Dr. Ruta I thought maybe she was calling to talk to me about something work-related.  Imagine my surprise when she told me she had my Pap smear results in front of her and they were "not good at all".  I asked her to read me exactly what the pathology report said(because as a doctor I like to hear the medical jargon!)  She read these words out loud to me, "Atypical glandular cells, favor neoplasia".  I asked if that meant what I thought it did.  She replied, "yes Jill, they strongly suspect cancer".  Now I have had a lot of family members, friends, and family members of friends who have had cancer.  I am no stranger at all to the word, even though I wish I was.  But something about the doctor using that word in relation to my own health....well, there are no words to describe how it feels.  Dr. Ruta promised me she would make me an appointment very soon with my gynecologist in Marshfield and said she was very sorry.  I hung up in total disbelief.  Thank God my friend Lisa was there because I needed to say the words to someone else to make them real.  Lisa too was stunned.  At that time my son Josh came out of the locker room and I realized that I was going to have to tell my kids...tell my husband.  I felt sick to my stomach.  I tried to keep up a brave face for Josh's sake so that he wouldn't suspect anything was wrong before I talked to my husband Mike.  When we got home he went upstairs and I took Mike into our bedroom.  I started crying before I could even get the words out.  He was in shock.  We simply sat there and hugged and cried.  Then we took to the internet.  We looked up the type of cells I had and were shocked to find out that these cells show up on less than 1% of all Pap smears.  Unfortunately we also read that they are responsible for about 20% of all cervical cancers and they are more aggressive than the more common squamous cells.

Fortunately Dr. Ruta called back that same evening and told me she had gotten ahold of Dr. Sampson, my gynecologist.  It just so happened that I was already scheduled for a mammogram in Marshfield the next day and Dr. Sampson agreed to add me on to the end of her day.  Mike and I met with her and she did five biopsies of the cervix and endometrium.  She told us before we left that her gut feeling told her they would find something when the biopsies were sent to pathology, but she was optimistic it wouldn't be much.  That night we told our boys, along with my sisters and parents.  I dreaded calling my mom as she has been through so much herself with her lymphoma, but we wanted them to know.  It was the longest weekend of my life waiting for the results of the biopsies.  Dr. Sampson was gone on Monday and Tuesday. so Dr. Ruta was watching the computer to see if the results came in.  By Tuesday afternoon when I hadn't heard anything I decided to walk down to her office.  Together we checked and saw that the results were in.  She pulled up the report.  As she scrolled down the screen all I saw was, "Biopsy #1: Endocervical carcinoma in situ. Biopsy #2: Endocervical carcinoma in situ.  Biopsy #3:........same".  Only one out of 5 biopsies came back WITHOUT cancer cells.  My heart sank and Dr. Ruta gave me a hug and I fought back the tears. Within just a short time Dr. Ruta had made me an appointment two days later to see Dr. Dale Larson, a gynecologic oncologist in Marshfield.

I have to admit I was a little nervous to see Dr. Larson. I had heard rumors around the clinic that he can be pretty tough.  I wasn't sure what to expect.  But within 2 minutes of him walking in the room I knew right away that he was our guy.  He was warm and friendly and put Mike and I at ease right away.  He spent an incredible amount of time going over all of the details and possibilities with us.  I was scheduled to have a cone biopsy that afternoon with him and he told us that the results of that biopsy would guide our next step. Either way I was going to have a hysterectomy -- the type would depend upon whether or not the cancer was invasive, and that is what the cone biopsy would tell us. He did assure us that he felt this was caught early and it was his gut feeling that the cancer was not invasive.  But he also told us that because I had the more aggressive type of cells(glandular) that any invasion at all would mean that we would go the more aggressive route of treatment -- the radical hysterectomy.  That afternoon I went into surgery and had the cone biopsy done.  And then the "results waiting game" started again.  This time however I was much calmer. I felt that whatever came was what was meant to be.  And I knew that Dr. Larson was the doctor we were meant to have.  And I also knew in my heart that the results would show invasion.  I'm not sure how I knew, except that I knew looking back that I had a few symptoms that I didn't realize were symptoms. And the thing about cervical cancer is that there are no symptoms until it is invasive. So even though Dr. Larson didn't think it would be the case, I just knew that it was invasive.

The next Monday evening at about 5:30 p.m. Dr. Larson called and said he was sorry to tell me that the results did indeed show that the cancer had become invasive -- by about 3mm.  It's crazy to think of 3mm. It sounds tiny, but when you are talking about invasive cancer it suddenly sounds huge!  Dr. Larson told me that I will need to take at least four weeks for my body to heal from the biopsy before he can do the hysterectomy. It sounds scary to leave the cancer that long, but the risk of infection is just way too high for them to go in any sooner.  And he assured me that there would be no further spread in that short of a time. So on September 15th I will see Dr. Larson for a check of the biopsy site.  Assuming all is healed I will go into surgery on September 25th. He will remove all of the "usual" hysterectomy organs, plus lymph nodes and pelvic ligaments.  All of the tissue will be sent to pathology.  If there is no spread to the lymph nodes then my treatment will be complete.  If by some chance(Dr. Larson promises the odds are small) the cancer has spread to the nodes then we will have to discuss chemo and/or radiation.

I have used the word "oncologist" no less than a thousand times in my life.  Now I am getting used to using the words "my oncologist".  The word "cancer" just takes your breath away.  As we have told people what is going on I have had several people(including Sara) tell me that it just isn't fair that I gave a kidney and now have cancer.  But I don't think God works that way.  I don't think He gives us only bad stuff if we do bad things and gives us only good stuff if we do good things. Truthfully I usually don't know for sure HOW God works, but in the words of my husband, "I wouldn't want to serve a God who I could figure out".  How true is that?  If we knew what God was thinking how much less amazing would that make Him?  And I certainly learned on my kidney journey that He does know the plans He has for me. What appears awful in the moment is a blessing in the long run.  People have told me that I have a great attitude.  I'll be honest. Some days I don't.  Some days I am scared to death.  And some days I get just a little mad at God that I have to deal with this right at the time when I thought I was ready to start a whole new chapter of donation promotion.  But He obviously knows what He is doing.  I have to keep remembering that.  And I have to be happy that out of all of the awful cancers out there I did manage to get one with a really high survival rate! Hopefully cancer diagnoses are limited to "one per person" :)  Stay tuned...God's got a plan!!

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