Friday, February 26, 2016

A Cancer Chronicle : Sandy's Story

I'm so blessed this week to bring to you a story that's very close to my heart.  The story belongs to my sister, Sandy, and it's a strong testimony of how God travels through our lives with us, pulling together details and "happenstances" in ways we think are small, but in retrospect are infinitely vast in their impact.

This story's "anniversary" of sorts is President's Day, and for many years Sandy has been faithful to mark the day with gratitude and share her story publicly in honor of how God made His presence known in her life.  It's my pleasure to share it with you today ...

I'm so grateful for God's grace demonstrated through Presidents Day holiday 25 years ago.  Can’t believe it’s been 25 years!

President’s Day holds tremendous significance to me as it was on President’s Day in 1991 where God showed up…big time. It was the day before I was officially diagnosed with breast cancer. Not that God doesn’t show up in big and little ways every moment of every day, but there are times when His presence and tender care are so significant and evident that it warrants chronicling. It’s like piling up those ‘memorial stones’ as the Israelites did when they were wandering in the wilderness on their way to Canaan. God rightfully instructed them to memorialize His abundant provisions and protections because we humans tend to forget. Being the 25th anniversary of that significant President’s Day in 1991, it is fitting I spend some time reflecting, processing and praising God for extending my life these past 25 years.

In 1991 I was a call center manager for Delta Air Lines in Dallas, Texas. Delta had a management training program in their headquarters in Atlanta, GA. It was a 4 month assignment where you worked in one of the Vice President’s offices (and worked very long hours, and did not get sick much less take vacations). Program participants (4 at a time) lived in an apartment with others in the program, and usually commuted back home on weekends (the beauties of space available travel for airline employees). I entered the program in November of 1990 and was scheduled to complete my term in March of 1991.

The week before President’s Day holiday (which Delta observed) I discovered “a lump.” Like many women I already had some issues with fibrocystic breast disease and lumps would come and go from time to time. Almost instinctively I knew this one was different. This realization brought no small implications and potential fears given my older sister, Karol, had died of breast cancer 7 years before at age 32. Even so, since there were only a few weeks left for the program in Atlanta, my typical response would have been to wait and take care of it after I finished the program and was back in Dallas full time. But Delta observed the President’s Day holiday and Friday I was heading home to Dallas for a 3 day weekend.

Monday morning, I gave my OB-Gyn a call and found they were open. I explained the situation (“a lump”) and was told to come in at noon. I packed my bags so I could be ready to catch the 6pm flight back to Atlanta that evening. When I entered the doctor’s office, the receptionist greeted me and said, “We hope this is nothing, but we’ve scheduled a mammogram for you just in case.” The doctor examined the lump and sent me on for the mammogram. The mammogram showed nothing, which was curious as the lump was clearly prominent through examination. So, they sent me on for a sonogram. The sonogram revealed there was definitely something that needed checking into.

Next thing I knew I was in the office of breast surgeon Dr. Janet Hale. Loved this doctor! She took my history, asking a lot of questions, was interested in life-style and work, so she knew I was temporarily working in Atlanta on an assignment that would end in a few weeks. She looked over the sonogram and mammogram and examined the lump. As we talked through everything and she analyzed the films her thoughts were, “I really don’t think this is anything. Let’s plan on you going back to Atlanta, finishing up there, and then we’ll take this out when you get back.” She was finishing up, saying good-bye and turning to leave the room when she seemed to have a last minute thought and suddenly said, “…but let me check my surgery schedule.” She returned a few minutes later and pronounced, “I have a cancellation at noon tomorrow. Let’s just go ahead and do it then.”

Next step was pre-op down in the day surgery unit, which included lots of paperwork and the pre-surgery blood work. At 6pm I was walking out of Medical City Hospital, my head spinning just a bit. As I mentally prepared for surgery the following day, I was also thinking, “I was supposed to be on a flight back to Atlanta right now.” I believe it was at that time I noticed The Mary Crowley Chapel. I stopped and spent some time in prayer, something that has become a habit whenever I have a doctor’s appointment at Medical City. God was incredibly gracious through all of this in giving me a pretty immediate sense of peace that overshadowed any fears after having watched my sister die of cancer in 1983. Not that I wasn’t keenly aware of the potential outcomes of a cancer diagnosis, but God clearly provided the peace in the face of those fears after having lived through the worst with Karol.

It was now time to start advising those who needed to know what was going on. Starting with my family, of course. Can’t exactly remember the sequence of the calls as to who I called first. My younger sister, Melissa, and her husband lived approximately 30 miles away and I called her to fill her in. We talked for a little while discussing the surgery schedule and other details. Just a few minutes after we hung up she called back to advise, “I’ll be over, I’m spending the night.” Love her, loved her sisterly support! Called my parents and knew the news would be concerning given family history. They took it well, although I believe my mother was terrified at the (unspoken) possibility of losing another daughter to cancer. Next thing I knew she had a flight booked for the following morning so she could be here for the surgery, too. My brother was also brought in the loop and concerned as well.

I chose not to spread the news far and wide as breast cancer is a bit personal (was even more so in 1991), and I ‘didn’t want to burden others with my problems.’  But there were some that needed, or I knew would want, to know.  I contacted my boss in Atlanta who was extremely supportive and wanted to be kept informed. I contacted my boss in Dallas who was equally supportive and concerned. I contacted a few close friends, some who had lived through my sister’s death with me.  And I received wonderful support and concern along with many commitments to prayer.

The next day I reported in for surgery, my sister Melissa at my side. They whisked me off for the surgery preparations and Melissa went to pick up my mother at the airport. By the time they returned I was already in surgery which took maybe 30 minutes. I awakened to the friendly faces of my mom and sister. About the time the cobwebs of anesthetic were clearing the doctor walked in with the news of a malignancy. I can still see my mother’s face as she did her best to blink back the dread. But again, and throughout the whole cancer experience (except for one situation I’ll explain later), God gave the gift of His peace and presence to sustain me despite potential prognoses and treatments.

Speaking of prognoses and treatments…the next day at 5pm the doctor made room in her busy schedule to discuss outcomes and next steps. It was a bit amusing to me that here I was, 36 years of age, and both my parents, in addition to Melissa and her husband, Dan, accompanied me to the doctor. It was also comforting, though, to be so loved and supported. And, Melissa and Dan wanted some education and information given this family medical information that seemed to be rearing its ugly head.

Dr. Hale explained that the tumor was small, less than 2 centimeters, which was good. She advised that the borders were all contained except for one small area where it was difficult to determine whether or not the cancer had broken out (this will be significant later on). Her immediate recommendation was to go back in and take a little more tissue in that area to have it analyzed for cancer cells, and then to do an axillary dissection to remove some of the lymph nodes under the arm, also to determine whether cancer was present. Additional options she presented were to do a full mastectomy of the breast or to do a double mastectomy removing both breasts as preventative action against further occurrences of cancer. She gave me a few moments to think about it and I chose option one, also known as “a lumpectomy” with the removal of some lymph nodes. Her response was, “Ok, are you sure? Because there are no guarantees.” To which I responded, “Yes…because I don’t think there are any guarantees any way you go.” And I didn’t. I had watched my sister, Karol, first have a modified radical mastectomy, go through chemotherapy and radiation, then a full mastectomy when the cancer returned…nothing had worked.

I returned to Atlanta the following Monday to finish my work there. Delta would have excused me from the rest of the program but it was actually better therapy for me to stay busy and keep my mind occupied while I waited for the next surgery. I finished out the next few weeks (providing a little levity when I could by using the “I can’t do that, I have cancer” card whenever it would work or at least be entertaining) and came back home to Dallas for the next surgery.

The surgery revealed no further cancer cells in the tissue or the lymph nodes, thank you, Lord! The recovery from this surgery was more involved because I had one of those blasted drainage tubes…will spare you the details about that but suffice it to say: not fun. And they had to leave those tubes in until the drainage went down to a certain level, and it was not subsiding. I was finally confined to full bed rest (although I felt fine) to help stop the fluid production…OK, TMI, moving on…

Weekly follow-ups with Dr. Hale ensued to check stitches, healing, progress, etc. I learned the type of cancer I had was non-hormone reactive which she said would not involve Tamoxifen or chemotherapy. That was great news! However, after several weeks of follow-up visits Dr. Hale advised, “I’d like you to go downtown to Baylor and visit with Dr. Stephen Jones, an oncologist.” To which I replied, “Whoa, an oncologist…that’s chemotherapy. You said we weren’t going to have to do any of that.” Dr. Hale responded, “He knows more about Breast Cancer than anyone in this city. I’d really like to you meet with him.” Well, what could I say to this woman who I had so much respect for? My appointment with Dr. Jones was scheduled for the next Tuesday which happened to be the Tuesday before Easter.

I don’t remember much about Dr. Jones’ offices on that first visit, except that in the lobby was a large aquarium with some interesting fish in it. I’m sure there’s some type of analogy in there somewhere but it continues to escape me. After filling out the typical reams of paperwork, I was ushered into Dr. Jones' office where he and a nurse discussed my treatment with me. He was matter of factly explaining that I would undergo 3 rounds of chemotherapy treatments using the drugs Adriamiacin and Cytoxin. Adriamiacin would be administered intravenously with an anti-nausea drug, then 2 days later I would start the course of 4 Cytoxin pills for 7 days…or was it 7 Cytoxin pills for 4 days? Regardless, the 3 treatment cycles were 3 weeks apart (depending on how I responded that would be reflected in blood work done several days following the treatments) and I would be taking the drugs both intravenously and in pill form. Side effects would be nausea because the chemotherapy is designed to kill rapidly growing cells – the lining of your stomach, bone marrow, hair…I would probably lose some, if not all of my hair, but they would be using cold caps (like an old style swimming cap that had some type of gel liner that would be frozen and put on your head to block the drugs from your hair roots...yes, it was like when you’d eat ice cream too fast except all over your head…but it did actually help with the hair loss issue if you could stand it).

It was all finally starting to sink in it that, yes, I would be undergoing Chemotherapy and they wanted to start this Friday. Hmmmm. This Friday was actually Good Friday and I had planned on hosting an Easter Brunch on Sunday for all my friends who had supported me during my cancer episode. Starting Chemotherapy would definitely interfere with my little brunch plans. So I said to Dr. Jones, “How about Monday?” He responded, “Friday.” And I said again, “But what about Monday?” and we went through this Friday-Monday, Friday-Monday volley until he said with no small amount of exasperation, “What’s wrong with Friday?” My reply: “I’m busy.” In retrospect, I can’t believe I told the head of breast cancer research at Baylor Hospital “I’m busy” on the day he wanted me to start chemotherapy, but, I had plans and they were important. At that point the nurse intervened and said, “Well, it is Good Friday.” Dr. Jones very pointedly looked at me and sternly said, “Look, you’re 6 ½ weeks post surgery. We consider a rapidly growing cancer one where cells are dividing 7%. Yours were at 22(%). You need to get started on chemotherapy and you need to get started now.” With that I succumbed and agreed to begin chemotherapy on Friday. However, an interesting thing happened that I attribute to the concept of one of my favorite verses, Psalm 37:4, “Delight yourself in the Lord and He will give you the desires of your heart.”

On Thursday morning I woke up with a terrible flu. Fever of 103 degrees, nausea (and what accompanies it), incredible weakness, achiness…it was worse than anything I experienced in the coming months of chemotherapy. I called Dr. Jones’ office and told them what was going on and I don’t know that they connected the dots but it felt like the response was, “Yeah, right…come in on Monday.” That flu bug was literally a 24 hour bug and I was able to host my little Easter Brunch after all (and just for the record, none of my friends got sick either).

My chemotherapy started the following Monday morning and in the scope of what many people experience, it was light weight. That’s not to say that it was any fun at all, it was not. I experienced the predicted nausea, some hair loss, hot flashes (yay! early menopause – it knocked out my reproductive system…but it came back so I got to look forward to doing the hot flashes thing all over again at some point in the future), and since the first dosage is a bit of a guessing game based on your height, weight and body composition, evidently they almost killed me because the nurse took one look at my blood levels after that first round and said, “Uh…we’re going to prescribe you some antibiotics.” According to my insurance billing, those antibiotics cost more than the chemotherapy pills. But, I was able to work throughout my treatments with the exception of the Fridays when I actually went in for the infusions.

During the middle of my chemotherapy, something happened that was a big surprise to my surgeon (not to mention me). A lump came up in the other breast. Because they did not want to cut into someone who had the chemotherapy drugs in their system I had to wait it out several weeks until I finished the full course and was able to have surgery to remove and analyze that second lump. This was the only time I remember really struggling with the whole cancer thing. I can remember sitting down on my bedroom floor with my Bible and strongly complaining (read: railing) to the Lord. “Why are you doing this now?!?” “I’ve trusted you through all this despite watching everything Karol went through and knowing that may be where I’m headed!” “I’ve done my best to live my faith and demonstrate that You are good and can be trusted.” “How can you do this to me when I’ve been such a good girl?” Note there are no statements of thankfulness for bringing me through everything so far or for the grace of the gift of life in general. But thankfully, God takes us how and where we are and I believe He wants us to be honest with Him. I also believe that’s what He wanted from me at the time. It felt like once I got all those feelings and emotions out He was saying, “Good, I just wanted you to be honest with me about where we are here.” With that, it was like His peace returned and continued.

That 2nd lump was removed after the completion of chemotherapy and thankfully was benign. Several weeks later I started the 5 ½ weeks (33 treatments) of radiation. Radiation was pretty much a non-event, except for 2 things. First, every day (Monday – Friday) I had to go to the radiation clinic at Baylor for my treatments. Sitting in that lobby were a lot of other cancer patients that were not fairing so well, some of them were clearly dying. It was a big reality check that this thing was serious and a little depressing to know that could be me one of these days, too. Secondly, I began to feel a bit ‘a-sexual’. It can do a number on your female psyche to have male nurses and doctors working on a portion of your body that is so representative of your sexuality with such professional distance. Don’t get me wrong, they were incredibly appropriate in administering the radiation, and, I began to feel a bit like a genderless piece of meat.

Thankfully, I survived all of that and have been blessed with a very full life since. I was so blessed by the support of family and friends. My parents drove to be here for all the chemotherapy treatments. A friend read in a woman’s magazine that results are better for people on chemotherapy who have a consistent person with them for all the treatments…so she took off work each time I had a treatment so she could be there with me. A couple of funny things that happened during my treatments illustrated God’s sense of humor and the many gifts associated with sharing what is going on in our lives with others. I mentioned at the beginning that early on I elected to ‘handle it’ without bothering a lot of other people. My mother had other ideas. She had already lost one daughter to cancer and was going to do everything she could not to repeat that experience. Seems she told everyone she knew and asked them to put me on what felt like every prayer chain in the state of Texas and probably a few other states as well. I began receiving the sweetest cards from people I had never met that were praying for me. It was tremendously encouraging and uplifting to know these complete strangers (but brothers and sisters in Christ) were actively praying for me. The second situation happened at Delta. We really hadn’t shared much of what was going on with me except with the management staff in Dallas and those I’d worked with in Atlanta, but I knew word would travel. And it did, but a lot more quickly and purposefully than I expected. At one point I suddenly started receiving cards from people in different parts of the country that I had worked with over the years. One day as I was reflecting on a particular card from a friend I had worked with many years before I realized the wording in her card had said, “I was sorry to READ about…” READ. It wasn’t word of mouth; something had gone out in print. I called my boss and asked her about it and she humbly apologized for what had happened. She explained that it is standard procedure to send a teletype (this was before email) to the President’s office in such situations so the President could know to send the employee flowers (and I did get some nice flowers from “Ron Allen and the Board of Directors”). However, in my case, the person who sent the teletype message accidentally used the address for all the bulletin boards in every airport in the country. There was a teletype message posted on airports bulletin boards across the US stating, “Sandy Setliff is at home recuperating from chemotherapy.” So much for keeping it under wraps and ‘handling it.’ God had other ideas and it was a great lesson on the value and benefit of bearing one another’s burdens…or in this case, allowing others to help bear mine.

Here’s the amazing point of this story (if you haven’t already figured it out) and why President’s Day is so significant to me: When the original lump was removed, Dr. Hale said it appeared that it was starting to break out on one border. There were 22% of cells dividing, which is 3 times the rate of what is considered to be an aggressive cancer (7%). If Delta Air Lines had not provided employees the President’s Day holiday, and had my OB-Gyn’s office not been open, if Dr. Hale hadn’t checked her surgery schedule and learned she had a cancellation, any of those things and I probably would have waited several weeks to get that lump checked out. With those cells dividing at 3 times the rate of an aggressive cancer and the border looking compromised, God only knows what that outcome would have been had I not been off work on President’s Day. But clearly He had other plans and President’s Day was part of those plans.

So, on this day 25 years later, I am thankful. Very thankful.

I can't read this story without tears and some spontaneous laughter, too.  Our family walked two very different paths of the cancer story, and we know well that God has His redemptive purposes in both.  If you're dealing with cancer yourself, or love someone who has or is walking with it now, my prayer for you is that God's presence is as abundantly clear for you as it was for my sister.

Shared joy is doubled joy ... let's double the joy for both of us - what are you most grateful for today? Click below to leave your comment. I'll go first :

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