First Glamorous Biopsy

Yesterday, December 27, I had a nipple biopsy.  It was heart wrenching watching a part of my body being thunked into a sterile specimen container by Dr. No Bedside Manners.  I had two stitches which will be removed next Tuesday.  The specimen, formerly a part of my body, will be sent to pathology and the results should be back in one week's time.  The doctor stated that the hospital is low on pathologists and that if were to be sent out, the timeframe for results would be about two weeks.  This biopsy is specifically screening for Paget's Disease of the Nipple.

I am currently waiting on a breast care representative at the hospital to call and schedule me for an ultrasound guided biopsy to aspirate the two 5mm cysts that according to the mammography are both solid.  Not too sure what that means.  I guess I will find that out soon.

On the upside to all of this, I did score some Percocet!  That should make anyone happy, right??  I am planning on putting a complaint in for the doctor.  He has absolutely no care toward any type of emotion I have.  He is straight forward and to the point and I just think it is inhumane.  When you have a 32 year old female patient going through what I am going through, there should be some compassion on the part of the medical personnel caring for a patient.  He seemed disgruntled when I asked what type of bandage I should wear for the next week until my stitches are removed.  Hopefully next week will be the last time I have to see him.  Hopefully.

When I took a shower this morning I was expecting the worst.  Awful, wretched pain.  I felt nothing so that's a good thing.

Here are a few more pictures from Christmas.  I have been trying to "rediscover" my camera during my break from school.  I am considering taking a photography class in January to help me figure out all of the configurations on my DSLR.  I also want to do this for my upcoming trip to Alaska!!

Me, testing out the lighting for my Christmas family picture that never happened

My Pansy and I

My wonderful hubby!  I couldn't do anything without him <3

My sweet girl turns 9!  I wish the time would quit flying by :-(

 

The Loser's Table of our annual Christmas card game playoff called "Hollywood"!

The Winner's table...

Ho Ho Ho!!

I just wanted to spread some Holiday Cheer in the midst of my gloom and doom.  Happy Holidays!!

The Girls at their Meme's house Christmas morning

My Sweet Pansy

Her $25 spread

My dad with his new watch

Me with my new necklace from my honey

New update! Things are moving along!

So Tuesday, December 20, I went in first for an appointment with the general surgeon, then mammogram, then an unexpected ultrasound based on the preliminary review of the mammogram by the Radiologist.  Let me break it down...

General Surgeon:
Total jerk.  Not interested in my subjective data.  He needs to go to Nursing School.  In NS you are taught to dumb things down for people.  This doctor asked me the same question, without clarifying, like 5 times. "How long have you noticed this excoriation?"  "How long have you noticed this excoriation?"  "How long have you noticed this excoriation?"  Excuse me Doctor No Bedside Manners, what is excoriation?  When I am the patient, my nursing brain just isn't working.  It wasn't until I was driving away that I figured out the meaning of excoriation.
So anyway, he did a clinical breast exam, palpated for lymph nodes, then had his conversation with me.  I assume he never felt anything abnormal.  If he did, he didn't have the decency to say.  He brought up Paget's Disease of the Nipple and Ductal Carcinoma in situ (I am really good at this self-diagnosis thing, obviously) and said that we should proceed with the scheduled mammogram (Duh) and then see him back in one week to discuss a biopsy.  One thing that made him seem a little more down-to-earth was that he managed to force an admission from his mouth that he could perform biopsies all day, but when it comes down to the part that actually deals with cancer, he has no clue.  Thanks Doc for humanizing yourself!

Mammogram:
Arrived promptly at 1350 for my 1400 appointment.  Checked in, all was good (seemingly).  1500 rolls around and I am getting a bit antsy.  I walk up to the receptionist and ask her if they had forgotten about me.  They had!  After apologizing for the printer's mishap, she told me to sit back down and wait.  At 1530 I go back, meet my tech, and put on a cute, pink sheet.  I knew that thing wouldn't last long.  Its purpose is only psychological.  I would like to note that mammogram horror stories are WAY overrated.  This woman  (and machine) smashed me every which way to Sunday.  Yes there is some pinching.  That only lasts long enough for her to run to her button, say "hold your breath", and its done.  If you have an upcoming mammogram (baseline), have no fear.
Nice lady tech leaves the pink, feminine, dimly lit room to go show the Radiologist.  In that time I do some sneaking around, looking at all of the buttons on the machine, wash my hands, think about how bad that wasn't, and before I know it she's back.  "We are going to get you in line for a breast ultrasound".  Nice.  This isn't scary at all!  Just 20 minutes ago she had told me that is the Doctor notes anything suspicious on preliminary review, I would need an ultrasound.
So now it is time to stand in line and wait once again.


Breast Ultrasound:
The technician was nice right from the start.  She used her two patient identifiers and that impressed me.  Gotta make sure we are probing the right boob on the right person who was born on Christmas Eve!!  So I lay down and notice a screen on the ceiling.  I know that this screen is for happier moments such as finding out if your baby is going to be a boy or girl, but immediately ask if I will be able to see the screen for my depressing procedure.  She states that yes, I can, but not to ask her any questions because she will not be able to answer them.  I kinda already knew that too.
So the exam begins.  I am looking at the layers of my own adipose tissue on the screen wondering how she knows what to look for.  I don't have to wonder for long.  She begins placing her digital measurements on the image and I knew that was not good.  The black oval shape at the 9 o'clock position measured 5mm.  So did the same shape at the 3 o'clock position.  5&6 were merely marked, and the exam was over.  She left saying that if the Radiologist needed anything further, she would be back accompanied by him.
I take this time to deliver some important text messages, look at the buttons on yet another machine, and stare at the ceiling until there is a knock on the door.
The Radiologist is young looking, but I can immediately tell he is more compassionate that the other one.  He listened to my concerns, did some probing himself, and then started explaining treatments, shapes, sizes, etc.  He too brought up Paget's and DCIS (go me!) and said that by Tuesday, December 27, he will have had time to fully review all of the tests and give me a more definitive diagnosis.  The 5&6 o'clock positions were clusters of cysts which could be aspirated with a needle easily.  The other two, he wasn't sure about.  Those were the ones that are concerning to him.  Also at that time a Breast MRI would be ordered and the biopsy to screen for cancer cells.
As I was walking down the hall to leave, I heard him doing his recorded dissertation.  "Hyperplasias" he called them.


Summary:
I left the hospital feeling a sense of PEACE!  All that I had expected could possibly be correct.  We will hopefully know on Tuesday.  I am sad, don't get me wrong.  I had fully expected to be bawling my eyes out, but I didn't and felt no need to.
On Tuesday I will go to the hospital prepared to have skin excised under local anesthesia for the skin biopsy.  And then, I think, the scariness will begin!

Nervous about tomorrow...

I am not sure what to think about this mammogram business.  I hear horror stories on the pain involved, but I have a pretty high pain tolerance (I think).  The only thing I worry about is the pain that I already have will be exacerbated by the pressure involved with the mammogram.
What I expect:
1. Cold plates
2. Not worried about the modesty part (I have popped out two kids mind you)
3. Pain.  Pinching.  Bruising?  Who knows!
4. Anxiety in the interim of waiting for test results.

Like I have said before, I would LOVE for this to be a case of eczema or rash or even PREGNANCY!!  Yes!  My secret is out.  I would rather be pregnant and deal with the happiness of a new baby AND the stress of nursing school and having two other kids than go through any of this!!  And by the way, because I know that I will be undergoing tests involving radiation, I went and bought two pregnancy tests which were both negative.  Just trying to take all the precautions I can.

As far as the appointment with the surgeon, I want to press for immediate treatment.  I have no time to waste.  The ball must get rolling.  I need some kind of peace of mind or confirmation so that I can move on and do what needs to be done.

I will update tomorrow!

Strangest Post I never imagined having to write...and DONE with First Semester!

This is THE strangest post I never thought I would be writing.  But more on that in a moment.

I took my HESI Pharmacology Final on Monday.  It was again, a very tough test that I had no idea if I had passed until my score popped up.  I think I may have mentioned in my previous post about HESI that it is essentially a predictor of how well you will do on the Nursing Licensure test to get your official nursing license to practice (NCLEX).  Soo...drumroll please...I made a 94.8!  Once again, I was really thinking that it would have been much lower, like 60-ish.

Team Awesome, as some of you may have remembered from previous rants has officially been dismembered.  The reason I know this is because one of the members had invited everyone to her house for a "kick up your heels, the semester is over, BYOB"party at her house.  Well, the day of the test she posted on her Facebook that the party was cancelled, "Don't ask why".  WOW!!  She failed!  I can hardly believe my eyes!  Another friend of mine failed, too.  I would not have wished that on her for anything.  She was the one that was teeter-tottering back and forth with Team Awesome.  So I ask the question--maybe she should have continued studying with me.  PUT ASIDE the "cool" friends who have gobs of money and love to flaunt it, and come sit beside me who is in touch with my morals and values and who also still cares about other's feelings.  It's not all about how much MONEY you have, PEOPLE!!!  Now, had this former friend of mine stuck with me would she have done any better in the class?  I think maybe it could be a possibility.  Although I wasn't perfect at Pharmacology, I really knew my drug classes and could put things in perspective  overall.

FINAL GRADES for this semester: 1-A, 3-B's.  I'll take 'em!!  That is fine with me!!  I feel grateful for my opportunity to be in nursing school and do NOT take it for granted.  I am also thankful for the WISDOM that nursing school has given me---which brings me to my next, sad subject....

I have completed my semester and I should be relaxing with a book, enjoying a few of my favorite, long lost shows.  No.  I am dealing with some new health issues.  Potentially horrible health news.

Several months ago I had begun to notice some changes in my left breast.  The symptoms started as sensitivity and then later progressed into burning.  This burning was then followed around Thanksgiving by severe itching.  Now this is not itching that you can scratch.  This is internal itching that you feel like you need to grind your chest into the ground to get rid of, however, I don't even think that would work!  Early last week I noticed a brown discharge coming from the nipple.  I really thought nothing of it other than dry skin, so I put gauze and Bacitracin ointment on it assuming it was an episode of winter dry skin.   When I took the gauze off that night it was covered with a brown, bloody discharge.  Immediate cause for concern.  I told my husband about it and he was concerned, of course, and made me an appointment to see the Doctor the very next day.  So I go in for an exam.  She takes one look and immediately defers the exam and began questioning my maternal history of BREAST CANCER.  My mom has had issues, my grandmother had premenopausal BC, and also her sister (My Aunt Bertha) who had a radical mastectomy due to her BC, and later died from it when I was in first grade.
My treatment plan for now: appointment with general surgery (Decemeber 20) for a possible nipple/areola skin excision for biopsy which will require two stitches (OUCH).  A mammogram on December 22nd followed by a beast ultrasound.
My thoughts on the diagnosis: Paget's Disease of the Nipple.  This is a very rare form of BC which accounts for less than 5% of all BC's.  In most cases Paget's presents itself and there is another underlying form of BC.  Only 1% of cases show no other forms of BC.

So WOW.  This is the post that I never in a million years would have imagined posting.  I have no idea of the progression of this cancer.  Lots of tears have been shed.  I have NOT been officially diagnosed yet, and I hope that with God's good Grace and some miracle, it will not be cancer.  The odds, however, are stacked firmly against me.  I have scoured the internet for information.  All symptoms match up.  In most typical cases patients go to their Doctor who blows off their symptoms for a dermatological condition, and in the mean time the cancer has many months to progress.

My final synopsis: If I had not had been in Nursing School I would have let these symptoms fly.  If I had a a tummy tuck as I had planned for last week that would have hindered the surgical process of skin grafting from my abdomen to create a new breast (if it comes to that).  The best outcome, of course, would be no cancer.   Second best outcome would be removal of the nipple and areola.  Third, and most horrible (besides mortality) is that I would have the entire breast removed and go though radiation therapy.

If anyone has any advice or thoughts, please share.  I have been so depressed.
Until next time...I will post this link if you're interested.  http://www.cancer.gov/cancertopics/factsheet/Sites-Types/paget-breast

HESI Fundamentals Exit Exam

Thursday I took my final the the Nursing Fundamentals Class.  Fundamentals is an 8-credit hour class that teaches you the *basics* of nursing.  You begin to *learn* how a nurse thinks, how to think critically, and learn what is within the scope of nursing practice.  NOW, you may think thinking is relatively easy, right.  Well, not thinking like a nurse!  A nurse is supposed to think BEYOND what is presented in front of them.  Shall I give you an example?  Oh sure!  I will!

A brief example case study:  A 17-year old female shows up to see her high school Nurse after second period one morning one cold January morning.  She complains of feeling nauseous and queasy upon waking but after 1st or 2nd period at school these symptoms seem to wane.  What is the first action the nurse should take?
      A) Immediatley administer a pregnancy test cuz this hooker is pregnant
      B) Take a history of immediate family members
      C) Refer the teenager to planned parenthood
      D) Provide materials about abstinence to the teen and encourage her to remain abstinent.

Congratulations!  You have just read your FIRST question that I deal with only a daily basis.  Yep, this is what they are all like.  I remember when I first read a question similar to this I was mind blown.  Remember, you must think beyond.  Answer will be posted at the end of this post.

So I must discuss the HESI exit exam I took on Thursday.  It was so backwards.  Totally not what I was expecting, nor was it anything that I could have "studied" for.  I had no way of knowing if I had answered any of the 85 questions right until my score popped up at the end.  My feelings at the end of the exam were yin yang.  My score popped up and it was 88.09%!!!  With a 980 Benchmark score.  More on that benchmark thing later.  I such a feeling of ELATION, RELIEF, and then, the wailing beside me began.  My neighbor failed.  Failed big.  Failed overall, I assume.  A whole semester for her down the toilet.  I felt so guilty of having any ounce of happiness over my own score.  Our instructor tried to console her to no avail.  How DO you make someone feel better in a situation like that?  It was just a bad situation.  Two months ago I had fully prepared myself for a moment like that.  I knew that she SOOO could have been me.  I still feel bad for her.  I have thought about her (although I don't really even know her name) since then and can feel her pain.  I hope she is going to be okay.

So the answer to our case study: You would take a family history.  The girl is experiencing symptoms associated with Carbon monoxide poisoning.  You are supposed to take into account the month, and that family members would be experiencing the same thing.  Shame to all of you who thought that she may be pregnant!!

Final-ly

I took my last regular exam today in Pharmacology.  It was a Doozie!  I don't know how on Earth I pulled an 82.5 but I did.  Before I came home and checked my grade (as a rule of thumb I DO NOT look at my grade at school--depression) I just knew that I must have made something like 60. But before I left the school I had to turn in my "Who's Who Among College Students" application.  I was nominated for this and still have to be chosen among a pool of applicants.  I don't think it is really a big deal, but I thought it would look good on a resume one day.  Anyway, one of my awesome faculty members wrote me a letter of recommendation.  I picked this up from her, walked across the campus, went to the wrong building first and then turned it in.  I had to do it today because the deadline was 5 p.m.  So I get home and I pull my grade up on the screen.  I turn the screen to hubby who replies, "what exam number was it again?"  His facial expressions are deceiving at this point and then he says "Well you made an 82.5 so that's a C.  That's good right?"  No, silly that is a B!!

That test was wretched and it could have only been the prayers being said in its honor that I passed.  Yes, that's right, I have resorted to having people pray for my test scores!  I need all the prayers I can get.  I would like to point out that since I began asking for Exam Day prayers, my scores have increased.  It HAS to be the power of prayer!

FINALS begin Wednesday, December 7.  I have a test in Health Assessment class covering EVERYTHING I have learned since August 15th.

My Final for Professional Clinical Nursing, which is the trickiest of classes is the very NEXT day!  Thursday.  I shudder at the thought of all the studying I will be doing (cramming) in the next 24 hours.

The part that I hate is that even if I do well on these tests, I will still have a B overall.  It could be worse.  If you review my posts from 2 months ago I was a mess!  In total despair.  I just knew I would never make it.  Look at me now!

So I am officially taking prayers for my upcoming exams.  Please keep me in mind, even if it is even for a quick second.

I would like to mention my *new* friend.  The one that I meet in the dark.  On the stairs.  Late at night.  She told me she didn't like the town where we live until she met me!  Isn't that sweet?  I think it is.  I wish that our schedules were more compatible. She is much more "early to bed, early to rise", where I am "late to bed and wish I never had to rise"!  But with my upcoming Christmas break I hope to spend more time with her.  She is just fun!  We laugh.  It is nice to have someone actually listen to what I have to say.  I get so wrapped up with all the meanies in nursing school and forget that there are actually kind, caring people still left in this world.

One more note, and this is specifically for myself to remember, I started a new journey tonight.  One where I am looking for answers.  I am really hoping to find them.  I think everything is going to be alright.  Curious, are you?