The Surgery

On Valentines' Day 2012 I was a few days late for my period but didn't think much of it at the time.  I was at the store that day so on a whim I picked up a pregnancy test, thinking there was no possible way I could be pregnant so fast and it would surely be negative.  To my utter shock it was of course positive and I waited until that evening when Eric got home from work to tell him.  I broke the news in his Valentines card!  That ended up being one of the best Valentine's days yet for us.  I had my first appointment with my OB, Dr. Lorenzo a couple weeks later where the pregnancy was confirmed and measured, I was about 7 weeks I believe at that first visit.  Within a week of the first OB visit I was in the shower and noticed a very tiny firm lump, smaller than a pea, under my skin over my sternum just to the left of midline.  I didn't think much of it but made sure to make a mental note to ask the doctor the next time I saw him, which was about 2-3 weeks later.  I didn't make an appointment with my GP because I figured I was already going to see the OB regularly from this point on so I would just ask him.  The lump was still there when I went back in to see Dr. Lorenzo for my next appointment so I pointed it out to him during the exam.  He didn't just blow it off as some may have done but said, "I really don't know what that is but it's unusual enough that I'll set you up with a referral to a surgeon to have a consult."  I had a breast lump that had been there for many years and had caused me some problems with mastitis with previous breastfeeding so we decided it would be best to go see a breast surgeon who could take both things out at once if needed.  In late March I went to see Dr. Evans in Pasco.  She looked over my records and ultrasounded both lumps.  She concurred with previous assessments about the breast lump that it was what they sometimes call an "oil cyst".  The other lump she assured me was just a sebaceous cyst, something that dogs get all the time so I breathed a huge sigh of relief, for as a Veterinarian I deal with those benign lumps all the time and knew they were no big deal at all.  But she said that sometimes they do rupture and since my lump was slowly but steadily growing she was afraid mine would be one that would eventually rupture so she offered me the chance to just have it removed.  I thought that was a good idea but since I was still in my first trimester and because it was just a "cyst" there was no hurry to take it off.  We decided to wait until I was well into the second trimester to make anesthesia easier on the fetus I was carrying.  On 5/15/12 we had our first official ultrasound at Dr. Lorenzo's office and we found out that our last baby was going to be a boy!  I was so happy and I know Eric was quite happy that he was finally getting his son.
Surgery was scheduled at Lourdes Medical Center, the hospital Dr. Evans works with, for 5/17/12.  That is a date I will never forget.  I was 17 weeks pregnant at the time.  It was a relatively simple outpatient procedure and I was supposed to be done and out the door by 11 am.  I would be very woozy though so Eric took the day off work and came with me to the hospital for the surgery.  The plan was to remove the subcutaneous lump over my sternum as well as the oil cyst in my breast, surgeon said I'd be under for 20-30 minutes tops.  I saw the Propofol flowing into my IV in the operating room and then the next thing I remember was waking up in the recovery room with Eric by my side.  I vaguely remember asking him what time it was and when he told me it was over an hour that I had been in surgery so I thought something must have gone wrong.  The nurse assured me that the baby was ok and they had a fetal monitor on me so I could hear the heartbeat and that was reassuring.  Shortly after that Dr. Evans came in and even though I was still VERY groggy from the anesthesia I clearly remember her saying, "So that lump on your sternum was not a cyst.  We sent it off to the pathologist before taking out the breast mass and they told us that it was a solid mass with signs of malignancy.  I went back in after taking out the breast lump and took wider margins over your sternum and that's why surgery took longer than expected.  We'll submit all the tissue and hopefully get an answer in a few days about what kind of mass it is."   I was completely numb with shock at what I was hearing.  I've had lots of education, including 4 years of veterinary medical school, and 7 years of practice experience up to that point.  I know that when a pathologist says "signs of malignancy" that it can never be a good thing.  My mind started racing with all sorts of possibilities of what it might be, none of them good.  And then I thought about my small fetus.  That morning I thought that general anesthesia for surgery would be the only obstacle the baby would have to face, but now I started thinking about what if this is a bad Cancer, how can the baby possibly survive?!?
I called Dr. Evan's office every other day for 2 weeks after the surgery and I'm sure she was getting really annoyed at me.  She would tell me the answer each time, "We don't have definitive results yet and I don't want to make any speculations on what it might be so that I don't scare you unnecessarily.  Our local pathologist couldn't get a diagnosis so we've sent all the samples and slides to Seattle for more special stains and testing."  Unfortunately I was doing a pretty great job of scaring myself unnecessarily all on my own.  That was the most nerve-wracking tortuous 2 weeks of my life.  The not knowing, the wild speculations of how bad it might be, were driving me crazy.   Then finally on a Tuesday Dr. Evans called me and said, "We have a diagnosis but I don't want to discuss it over the phone.  I've set you up an appointment with an oncologist, Dr. Thomas Rado at Columbia Basin Hematology and Oncology for Wednesday morning, you need to be there.  Someone from their office will be calling you to get your information and give you instructions."  I hung up the phone from that conversation and broke down in tears for the first time.  I knew it had to be bad if she wouldn't talk about it on the phone, and especially because now I was going to see an Oncologist.   I was so very frustrated that I still didn't know, even though she had the answer in front of her when she was talking to me on the phone.  And I was also terrified that it was an aggressive cancer that would make me lose my son or leave my girls to grow up without a mother.  All I had to do the rest of that day was wait for whatever tomorrow would bring, at least I'd have an answer soon.

About ready to go into surgery at Lourdes Medical Center in Pasco.

The lump right before surgery