July 14, 2014 (AKA "D-Day")

Pardon my French, but today's the day when shit got real.  Exactly one week after my sister's diagnosis, it was finally time for me to meet the specialist, Dr. A. Jeremy and I headed to her office for a 7:45am appointment.  We tried to talk and joke like normal, but we were both distracted.  The office is beautiful and calm and we were the first people there. Going back into the exam room, I answered all of the basic questions for the nurse, she checked my blood pressure (which is usually good but was high today) and then said the doctor will be in soon.  

Five or 10 minutes later, Dr. A. walked in and I immediately began to judge her.  Does she look competent?  She looks kind of young...40-ish maybe?  Has she had her coffee yet? She made friendly small talk with both of us and read over my history.  I made sure she was aware of my sister's diagnosis, which by this point we had learned is stage 2.  Dr. A. commented that stage 2 breast cancer is "very treatable" and I remember being excited to relay this comment to my sister.  

She then performed a physical exam as I pointed out all areas of concern.  She didn't say much during this time, but took some measurements and jotted a few notes.  When she finished, she looked at Jeremy and I and said something I won't ever forget. 

"I am very concerned that this is malignant."  

I immediately started to cry and Dr. A. gave me a hug, offered me a cup of water, and left the room.  Jeremy and I had a few minutes alone to let things sink in but everything past this point was kind of a blur.  All I could do was stare at the floor because looking at Jeremy resulted in uncontrollable sobs.  The nurse came back with some water, said "I'm so sorry," and patted me on the arm.  I suddenly felt like this was a Lifetime movie.  I was in shock that the doctor could even make such a bold conclusion just based on a quick physical...how much can you really tell from that? So when she came back in the room, Jeremy decided to ask.  After a brief pause, she gave us a percentage:  she's 90% certain. Here's another fun fact she revealed:  she's never worked with a pregnant patient before.  Let's sit on that information for a while.

She wanted me to have a biopsy right away, and made some phone calls to get me in at another office in the same building.  But, they were all booked for the day so she made arrangements to do the procedure in-office.  We're moved to another exam room and proceed to wait.  And wait.  Finally, a nurse comes in and said they've been waiting for authorization from my health insurance, since I have an HMO.  This is where health insurance infuriates me.  I still could barely talk to or look at Jeremy, so we just sat together in silence, continuing to stare at the floor.  

After another 30 minutes or so, the doctor returned and basically said screw the insurance, the biopsy needs to be done now because patients come first and she doesn't care about authorization.  I really started to admire her at that moment.  Jeremy was asked to leave the room during the biopsy (which, for anyone wondering, wasn't too bad).  They used an ultrasound to help guide where to remove tissue samples and the entire area is numbed, though I did feel some pinching/burning at times.  The most concerning part for me was the tool that she used sounded like some sort of staple gun/hole punch combo. She probably took about 10+ samples and it was over in 15-20 minutes.  

I went to the check-out desk and was introduced to a "nurse navigator," who handed me a newsletter with breast cancer information and offered help with scheduling appointments, cancer support groups, etc.  I was still in disbelief that she's handing me all this stuff...am I even officially diagnosed yet?  This appointment had turned into a surreal 4-hour whirlwind. During this time, I should also mention that Dr. A. contacted an oncologist, to get some preliminary information about undergoing chemotherapy during pregnancy.  I was surprised/impressed that she already consulted with another doctor so quickly.  The receptionist set me up to meet the oncologist tomorrow afternoon.

Jeremy and I walked outside and I tried to hold it together long enough to cross the parking lot.   But as soon as we got in the car, I lost it, so of course Jeremy lost it, and so we just took a few minutes to be lost.  All I wanted to do was go home.  I pulled myself together enough to call my mom, but as soon as she picked up, I lost it again.  It was the beginning of a very long ride.