It would take a long time to describe Dr. Rado and I have so much ground to cover still. I will just say that he has a presence and an air about him that is so wonderful...so strong, yet kind. So intelligent and honest with a twinkle of humor. And so much understanding. I just immediately felt comfortable and safe as we began speaking. After introductions and his deep apology for my having to meet him under these circumstances (so sorry that I have Breast Cancer, in other words), he told me that when Dr. Turner first called to ask him to see me, he had to be honest and say that he just doesn't do that. He has a very long waiting list and it is hard to get in to see him...but that once he heard my story, and talked more with Dr. Turner he knew he had to take me in, and to get me in as soon as possible. (How do you even thank someone for that?)...
We started by going over my history, how I found the lump and what lead to the ultrasound. We did the physical exam before moving forward and discussing what is going on beyond that initial diagnosis. During the physical exam, he measured the lump in my breast which was measuring at 4.5 cm x 4.5 cm. This is very big, but it was right under the 5cm measurement that I did not want to have, as it takes the tumor to an even worse stage. He also could feel the lump under my left arm in my "axillary' nodes. Then we sat down and began to really talk.
He told me that he didn't yet have all of the pathology reports back yet, but we would discuss everything he does know and what I can expect. He told me that this is a "high grade tumor" and a "very aggressive form of Cancer". It has a very high risk of metastasizing. With the rate of growth this is not something that we can wait around to treat. He explained that we are hoping, when the pathology comes in, to find that my Cancer is responsive to hormones (ie: Estrogen etc), because then we can cut off the supply of those hormones with medication. If we know which hormones are feeding the Cancer, then we can just cut off it's food supply, kill the Cancer cells with chemo and radiation (along with surgery, of course). But of course, while we want it to be hormone receptive, this also means that the pregnancy is just dumping these hormones into my system like crazy...and the cutting off the hormones while pregnant, even if it were possible, would not be good for the pregnancy.
We then decided to discuss the pregnancy and the role it plays with all of this. Basically, I am in a terrible trimester because there is so little known, and so little literature (which he had spent the night before looking up and reading). In the first trimester, the embryo simply cannot survive the chemo. In the third trimester the
baby has a very good chance of surviving, and possibly just being premature. Then there is the second trimester. What they know is that besides low birth weight and premature delivery, the chances of fetal demise does rise and the chance of deformities, several different birth defects (some life threatening to the baby) goes up by more than a 20% chance. That it is "bad odds" for the baby. They also cannot be as aggressive as they need to be with the chemo, which effects my prognosis. But one of the issues that are even bigger than all of that is the hormone factor...the very pregnancy that I have cherished and loved could be killing me as we speak.
After going over a ton of information, he decided to go call Dr. Turner and discuss with him what we are up against as far as keeping the pregnancy goes. He wanted to go over the literature as well as get his input. We waited in the room for a good twenty minutes or so (minutes that I was grateful to be waiting for, considering it was so that two amazing doctors could discuss what is best for me). When he returned, he explained that both doctors agree that in my particular case, we really can't afford to try and hang on to this pregnancy. He told me that normally you have to go to Yakima or Seattle to terminate the pregnancy when you are this far along, but that he and Dr. Turner were working together so that I could have it done here.
That they need to get going on my Cancer now and the risks from keeping the pregnancy just outweigh the benefits of having the baby. I could not stop a few tears from creeping out...in fact I was glad they finally abandoned my eyes since my eyes had become so blurry that it became difficult to see. Dr. Rado handed me some Kleenex along with his deep apologies.
Of course, I wanted to just curl up and cry, but I had to stay composed. I had to hear what he was saying and make decisions based on facts and logic, not emotion. I told him I was okay. I understand. I have to live and I have to do whatever it takes to live. I cannot be selfish and make decisions that would hurt absolutely everyone, not just me. I asked him to please continue and tell me what the plan is, then. What is next.
Normally they would begin with surgery to remove the cancerous tumor and any effected tissue and lymph nodes, then follow with chemo therapy. But because of the size of tumor, how rigid it is, and the fact that it has attached to the wall of my breast, they will have to start first with chemo to try and shrink the tumors, and the surrounding Cancer before they could even attempt a successful surgery.(Okay. So when do we start or what do I do?)
He said that I need to have a medi-port http://en.wikipedia.org/wiki/Port_%28medical%29
put in. He and Dr. Turner were working together so that I could have both the port and the termination of the pregnancy done at the same time. I would also need to have a CT scan and (hopefully) a "pet scan" http://en.wikipedia.org/wiki/PET-CT. But insurances, especially DSHS, don't like to pay for that test. (I won't go into how disgusting it is that politics and insurances can dictate whether or not you are allowed a test that can save your life...) But Dr. Rado and his team assured me that they will do everything humanly possible to get every test I need.
Dr. Rado was in the room with us for around two hours. The amount of information was overwhelming, to say the least. He gave me a prescription for Xanax (thank god...), the information on the scans I need and directed his receptionist to start scheduling everything. (I was so frustrated with having no way to express my gratitude to him. How do you thank someone for taking you on, when they don't have to, and for fighting so hard to save your life?) Everyone in his office was just so kind and helpful beyond words, and as I stood at the counter to check out, I was talking to Cynthia, his medical assistant. I told her that before I get the CT and PET scan, I would need to go immediately to terminate my pregnancy and have the mediport put in. She just stared at me for a moment. Her eyes got glassy and she quietly said,"..my god, Kim. I am so sorry...". She got up from the desk, came around and hugged me. It took everything I had not to just collapse into sobs. Then she grabbed her business card and wrote her personal cell phone number on it. Asking me to please call her for anything at all. ...The kindness...it is so overwhelming.
And now, it was time to head home and tell the man I love that the precious gift, that we created together, the beautiful gift growing inside me, cannot be...
