We just got back from Mayo for a routine follow up and all is GOOD!

The repeat chest CT I had in June showed improvement of the chest nodules that were seen in May and no growth of those that remained.  The scan today of my chest, abdomen and pelvis was also unchanged which is great news.  The oncologist has pointed out that my cancer has historically been quite aggressive and the fact that these nodules have not grown and in some cases have improved—is very reassuring!  We are so very grateful to God for this!!
We were given the option to come back in a few months with or without a scan.  It took Josh and I one second of eye contact to decide it would be with a scan.  I have never physically felt ill or had any indication (other than palpable lumps) that cancer was present.  The thought that it might be lurking inside of me where it can’t be felt has still got us a little uneasy.  So for now, our plan is to go back sometime in December for another routine scan and appointment.

When Josh and I went to Mayo in June, we left there with instructions to just relax and enjoy the summer.  We have followed doctor’s orders fairly well and like everybody else, can’t believe that it’s almost time for school again.  I brought Mia to her literacy assessment yesterday at school and as I was filling out some papers for her, I couldn’t help but think back to last year at this time.  We had just learned the cancer had come back and were planning our first trip to Mayo, filled with uncertainty again.  I remember sitting in the hallway at the elementary school while Tate had his assessment, filling out those same papers, thinking, “I wonder if I’ll be here next year for this.  God, please let me.”
I am so grateful to God that I am!!

I had my scheduled PET scan on Monday this week at Mayo. The results came back kind of suspicious.

A few nodules were noted in both of my lungs that were not there when I was scanned in November. They are quite small—“sub-centimeter,” I believe, is how they were reported. My oncologist said it could be cancer. It could be inflammatory changes from radiation. Or it could be changes as a result of the large surgery I had in January.

We discussed the possibility of a biopsy, but he said the areas are so small that they may be missed. Also, the risks associated with doing a lung biopsy outweigh the benefits at this time. Our plan is to do a detailed CT scan of my lungs at Mayo in four weeks to see if there have been any changes (are there new nodules, have the existing nodules grown, or God willing—have they remained the same or disappeared!) We’ll know more on June 9th!

It was an emotional few hours yesterday as my mind did the typical jump-to-the-worst-case-scenario thing. Physically, I feel very healthy and strong. I pretty much had myself convinced that this scan would be clear, so when it wasn’t—I was a little caught off guard. However, I think I’m good now. The rest of my scan was clear, and I am very grateful to God for that. I am grateful that I had this scan, so that IF it is a recurrence—we’ve found it while it is small. We know this cancer responded well to chemo in the past. I’m not in a hopeless situation here and again, am very grateful to God for that!

We have been uplifted by the kindness and generosity of so many people through the fundraiser and the recent donations from our church family brought me to tears! The love and support from everyone is overwhelming. We are thankful for your help and so very, very, grateful for your prayers. I posted it on Facebook yesterday, but it bears repeating today—we can feel the peace that has been prayed for! Thank you!

I am officially done!

Friday was my last of 15 radiation treatments at Mayo in Rochester. After seven months of treatment for this recurrence of cancer–it feels so good to say:




And if the happiness of coming home wasn’t enough, the last few miles home on Friday were made all the sweeter by some plotting by Josh and my wonderful friends…


By the time I turned in the driveway and saw Josh there waiting for me, I was a crying mess!  Thank you Julia, Jenna, Jill, and Josh for being so thoughtful and doing all of that work.  You really made coming home even more special.

We are all so happy and ready to get back to “normal” life!  The morning school routine, bedtime routine, cleaning, laundry and even work!–I’m excited for all of that day-to-day stuff!  After nearly two months off, I will return to work tomorrow and I’m really looking forward to it.  I miss my co-workers and my job.  I’m ready to get back to nursing and tending to someone else’s health problems for a while!

The plan at this time is to do a PET scan sometime in May at Mayo.  If all is clear, then we’ll keep scanning about every four months.  I am hopeful that the cancer is all gone, but as I’ve said before–I’m also mildly steeling myself for the ‘what if.’  I hope and pray it doesn’t come back, but if it does–we’ll deal with it.  Some say even entertaining that thought is pessimistic, but in one of my favorite books, “50 Days of Hope,” the author, Lynn Eib, calls it positive realism.  Keeping a positive, realistic attitude.  Everyone knows it’s no fun to wallow in pessimism.  On the other hand, complete optimism can set us up for some terrible, gut wrenching disappointments.  She states, “A totally optimistic attitude insists lemons will get sweeter.  A positive, realistic attitude adds some sugar and makes lemonade.”  Ahhh…the old lemons/lemonade saying.  A bit overused–but it does make sense  :-)  Things happen in life that we cannot control, but we can control our attitude.

Lynn Eib also quotes author Chuck Swindoll:  “Words can never adequately convey the incredible impact of our attitude toward life.  The longer I live the more convinced I become that life is 10 percent what happens to us and 90 percent how we respond to it.  I believe the single most significant decision I can make on a day-to-day basis is my choice of attitude.”

How true is that?!

With all of this behind us, that is how we hope to keep on living–with an attitude of positive realism!


I am so grateful to God for giving us all that we needed to get through this life bump.  He gave me a strong, capable, devoted, and incredibly supportive husband who has literally loved me through it.  Loving friends who opened their home to me during radiation.  Friends, family, and even strangers–who have been incredibly generous.  Family and friends to help with our kids.  And the love, encouragement and prayers from so many…

We are thankful and grateful to God for all of you.

Zaps (Take 2)

So far, so good–six radiation treatments down and nine to go.  :-)

I had the techs here at Mayo take some pictures today so Josh could show the kids what the machine looks like.  I’ve had a hard time explaining radiation to them.  Last time–when they were two years younger, it was easier.  I just said I was getting little “zaps” to get rid of the cancer.  That was good enough then, but Mia asked a lot more questions now.  Before I left for Mayo to start treatments, she wanted to know where I would be cut, how long I would have to stay overnight in the hospital, and if they would put me to sleep before they cut me.  Eeeesh…  Those questions kind of made me realize what this has all been like through her eyes.  I guess almost every time I’ve been gone, I’ve come back with another piece of me missing and/or a new scar for her to check out.  Understandable questions…

IMG_3378 The whole process is pretty similar to my last experience with radiation with a few exceptions.  Here, they’re using a breath holding technique during my treatment.  It’s supposed to help minimize radiation to my heart I’m told.  It’s hard to see in this picture, but I wear a pair of glasses during the treatment and through those glasses I can see a computer screen.  The computer screen has two parallel bars–a yellow one on the bottom that fluctuates up and down with my breaths and a thick blue one near the top.  When I’m told to take a breath and hold it, the yellow bar raises up into the blue bar and I have to hold it there.  If I can’t hold it, the radiation automatically stops and starts again once the breath is adequately held.  There’s no chance for dozing through treatments this time around.  :-)

Here at Mayo they have six (!) of these machines running each day.  It is both very impressive and very sad that six machines are required to keep up with all of the patients who need these treatments.  I have to say though, I think the radiation waiting room is definitely the most lively waiting room I have been in.  It kind of feels like a cross between church fellowship hour and the Cheers bar.  (Well, maybe that’s a stretch…)  Volunteers are serving coffee and snacks while you wait and a lot of patients are talking to each other.  Everyone is here, every day, for the same stinkin’ thing–might as well talk about it.  Most patients have gotten to know one another at Hope Lodge.  In fact, one day last week, a lady walked in to the waiting room and it really was kind of like a scene from Cheers.  I think almost 3/4 of the waiting room said hello to her!  She looked around, laughed and said “Wow!  Is anyone left at Hope Lodge or are we all here?”  It was really neat to see the connection these strangers have made in these circumstances!

I keep telling everyone the actual radiation treatments are the easiest part of all of this.  Being away from home is the hardest.  This past weekend, Josh and the kids met me at my sister’s in the cities.  It was so good to see, hug, and kiss them all.  We FaceTime every night, which is great–but nothing beats a proper hug!  It was hard to say good-bye yesterday when they left.  I am really looking forward to seeing them all again on Friday and so thankful to know that by then, there will only be five treatments left and I’ll be home for good after that!

Shark Bites and Other Adventures

The “shark bite” surgery has been done!  I am home, healing, and still feeling grateful.

I finished my last chemo on December 12th so I would be fully recovered and ready for this surgery.  Josh and I went to Mayo last Thursday for all of the pre-op appointments and lab work to make sure I was good to go.  They all agreed I was healthy enough and we were given the green light to proceed with surgery the next day, Friday, January 16th.  We were told to plan on me staying in the hospital for possibly seven to ten days, depending on how the surgery went.

***If you are squeemish you might want to skip ahead to the next paragraph :-)  The axillary lymph node dissection was done on both sides, as planned.  They also removed my right breast (prophylactic mastectomy) and did the big “shark bite“/tissue removal of my left chest wall.  A pathologist was present for that part of the surgery to make sure all of the margins were clear on the skin–and they were.  The pathologist also briefly looked at a few nodes from the left side and saw at least two nodes that still had some traces of cancer–which is not a surprise.  Because they found some that were positive, she proceeded to dig a bit farther down and found five more nodes.  Naturally, a picture was taken at this stage of the operation (and of course, we asked to see it.)  “Shark bite” is a pretty accurate description, but with smoother edges.  The hole on my left side was a fair bit larger than what was drawn on me pre-operatively, but it had to be done.  I think dinner plate size would be a pretty close comparison to the size of the hole on my left chest.  It was huge!  (I’m tempted to post the picture but maybe that’s too much??)  When the general surgeon was done with all of that, the plastic surgeon took over and had the job of getting everything all back together.  The plastic surgeon told us pre-operatively that he might need to use a device called Dermaclose to help get the skin edges back together.  (If you click on the link–click on the “How it Works” section and watch the video clip!  Yuck…)  Basically, it’s a device that is programmed to slowly pull the edges of a wound together.  Sounds awful, right?  Well, fortunately, he did NOT have to use that!!  He and his team were able to close most of the hole and used a flap of skin from my right breast to close what remained.  I now have a large incision that runs from the left side of my back, across my chest, and ends under my right arm.  Altogether, it was an eight hour surgery.  A very long day for all involved and for all who were waiting.

I was really groggy Friday night after surgery and didn’t fully appreciate the extent of what had been done until Saturday morning when the doctors rounded.  I was told normally a surgery like this requires two to four more trips to the operating room until the wound is fully closed.  (Hence the projected seven to ten day hospital stay.)  Since they were able to close everything up, I would likely be able to go home in a day or two.  Their main concern was the condition of the skin flap.  That needed to be watched closely for a while to make sure blood flow was sufficient.  Like a good little patient, I was out of bed, walking (slowly and gingerly) in the halls, and sitting up in my chair for most of the day on Saturday.  Sure enough, by the next morning, I was doing well enough to go home!

I am still in awe of how well the surgery went.  There is no doubt in my mind that God got us to the right place and surrounded us with the right people to make all of it happen.  I am so very grateful for the gifts and skills God has given to them!

The final pathology report has brought more things to be grateful for.  There was no cancer found in my right breast and no cancer found in the 31 lymph nodes removed from the right side. Two of the 31 nodes showed ‘treatment effect.’  This means they can tell cancer used to be there (which we knew since August) but because of treatment–it is now gone.  On the left side, 19 lymph nodes were removed and two had small amounts of cancer (which we already knew from surgery.) Those five extra nodes she dug for towards the end of surgery ended up being negative for cancer.  From the chest wall, there was almost no cancer detectable.  They found one itty bitty residual spot, but it was too tiny to grade.  This is all great news considering that tissue had an awful lot of cancer in it in September!  The chemo was effective and did its job.

It has been about ten days now since surgery and I am happy to report that recovery is really going well.  I have some discomfort in my arms and on my left side, but it’s minimal and nothing worth complaining about.

Today, we finished up the post-surgical and oncology follow up appointments at Mayo.  In the last two days, I saw general surgery, plastic surgery, physical therapy, radiation oncology, and medical oncology.  All are very pleased with how well I’m healing.  The question now is–where do we go from here?

I was kind of surprised, but the plan is now radiation.

I really thought since there was still just a tish bit of cancer left in those two nodes that more chemo would be recommended.  However, we were told that piling on more chemo at this stage in the game wouldn’t necessarily be beneficial.  He said my cancer has been acting very “local/regional” and feels that if there are still some microscopic cells left, they are likely going to be in my armpits/chest wall areas.  Hence the radiation recommendation.  It is comforting to know though that that this cancer responded so favorably to chemo. If it does come back, the option of chemo is still on the table and we know it worked.  It was not fun…but it worked.

Back to the plan.  The radiation oncologist spent a lot of time explaining the benefits and risks of radiating an area that has already seen radiation.  Despite the risks, all members of my team feel the potential benefits are greater and that radiation needs to be the next step.  He recommended five weeks of radiation.  At Mayo…

My initial reaction was to break down and cry because I don’t want to be away from my kids for that long.  Five weeks, Monday through Friday, five hours from home…  Ugh.

I asked him if he could just make the recommendations and I would bring them to Fargo to have it carried out.  He was incredibly kind, patient, understanding, and reluctantly willing to try but said that it just isn’t that simple.  It was kind of interesting actually.  In my mind, I’m just thinking–“you recommend the dose and the settings.  I’ll go to Fargo and they carry it out.  Boom.  Not that hard.”  He explained the differences in machinery, various different techniques, differences in physicians, and then humbly finished with “I’m a specialist in radiation oncology for breast cancer.”  He also said there is new research that has shown three weeks of radiation may be just as effective as five and that might be a possibility.  I left that appointment really bummed and said I would think about it…

Today, the medical oncologist helped me decide.  He basically echoed everything that was said previously, but explained that my situation and cancer are very unique.  Radiating areas that have already seen radiation is not uncharted territory, but it is not something that is done routinely.  It is very specialized.  I think maybe hearing it presented in a different way helped and made it more clear to me why it needs to be at Mayo.  So the plan, at this point, is three weeks of radiation at Mayo starting mid-February.  I don’t love it, but we can deal with it and hopefully it will do its job and decrease the chances of this cancer coming back.  (At Mayo, they all say “cross your fingers” or “knock on wood.”  I say PRAY…)

The last thing that was decided today was–how are we going to monitor and follow-up after radiation?  After reviewing the options, my oncologist graciously left the final decision up to me.  After being burned by that tumor marker blood test, I said I’d feel most comfortable with PET scans.  So, about every four months, starting in May, we’ll do that.  I know a PET scan isn’t perfect (I’m told spots need to be about 1 cm or larger before they can be detected) but I think it will bring me the greatest peace of mind.  So that’s that!!

I know I sound like a broken record, but we have so much to be grateful for.  We are so thankful for the skills God has given to my medical team and SO grateful that He put me in their capable hands!  It is not fun driving to Mayo, but how blessed are we to have it so accessible in our state?!  ***I can’t believe I forgot to add this HUGE thing to be grateful for too:  We have awesome friends who live in Rochester and they have graciously invited me to stay with them during radiation.  This takes away a tremendous burden and we couldn’t be more grateful to Jenny & Mike!***

We are also thankful for the unbelievable amount of love, prayers, well wishes, and financial support that have been given to us.  We are overwhelmed by your kindness and generosity.  Absolutely overwhelmed… There are no words that could adequately express our gratitude.

With deepest and heartfelt thanks,

Cassie & Family





Quick Update

I was just reminded that our power will be shut off at 10:00am for up to 3 hours.  So I have 10 minutes to write a blog post!  (That has NEVER been accomplished by me before!)

Thanksgiving was awesome!  We had a huge table of family and friends to share a good meal, lots of wine, and lots of laughs.  Can’t wait for Christmas to do it all again!  The only bummer with the Thanksgiving gathering, was that several of us got influenza–the REAL respiratory influenza!  Amanda, Hannah, my dad, my father-in-law, and I all got it and boy were we all miserable.  It is a nasty virus this year.

Unfortunately, the influenza happened at the same time in my cycle when my platelets, hemaglobin, and white count drop to their lowest points too.  I was very run down and spent a few days hospitalized in Fargo.  Fortunately, I did not get pneumonia (like poor Amanda!)  I got two units of blood while I was in the hospital and am now feeling more energetic than I have in over a month  :-)  Just in time for chemo tomorrow…

BUT–this will hopefully be the last time I have to get BOTH chemo drugs at the same time.  Next week I will get the taxol and then be done with chemo for a month.  After recovering for a month, the next step will be the surgery at Mayo in January.  I am sooo ready to have a break from chemo and enjoy Christmas!

One last quick thing I have to share:  Mia and I were talking about the surgery and what was going to happen.  She asked if I would “still have a boob” when they were all done and I said, “No.  I won’t have boobs anymore.  Never again.”  She looked at me kind of weird and then shrugged her shoulders and said, “Well it’s a good thing all your babies are out and you don’t have to milk ’em anymore.”  :-)



I am happy to report that our trip to Mayo was very positive!  What I had suspected and hoped was true– was confirmed.  The PET scan showed “resolution of the metastasis noted previously, with no evidence of recurrent or metastatic breast malignancy.”  In plain terms–the cancer that was present before is no longer detectable.

How awesome is that?!

I am so very grateful for the healing that has happened here.  Huge sighs of relief and prayers of thanksgiving are ongoing. I felt like running out to the plaza at Mayo, throwing my arms up in the air, and shouting.  I am so grateful.  I am.

And yet, I hate to admit it–still kind of fearful…  I know, I know–that seems ridiculous!  (Are you thinking–Seriously Cassie?  Can’t you just be HAPPY with this?!)  This is such great news, and I AM happy, but there’s a piece of me that is still scared.  A piece that asks, “Is this just a temporary reprieve or is it gone for good?”  I am celebrating with you, but at the same time, on the inside–I’m kind of steeling myself for the possibility of another future disappointment.  I do realize I can’t live my life just waiting for the next bad thing to happen (and I don’t) but can you understand that little niggling fear?

I do want to convey an inspiring message of hope with each entry, but I think it would be a disservice to portray that I am all strength, courage, sunshine, and butterflies all the time.  Because that’s not how I am.  I have my doubts and my fears too, just like everyone else.  We’re not perfect, right?  Daily, my mind circles around and around–from strong hope to fear.  From strong belief, to doubt.  As I look back and proof read this entry, I can see that I am circling around in here too.  Bear with me…this is how it really goes in the mind of me…

While all of the providers were very pleased to see the results, we were reminded that it’s not over yet.  They all agreed that more chemo is needed to hopefully assure that any undetectable cancer is eliminated and a large surgery is still recommended.  For the time being, the tentative plan is to continue with the current chemo regimen until mid-December.  I will rest, heal, rebuild my counts and immunity for about four weeks and then return to Mayo for surgery, or “the big whack,” as the surgeon refers to it, :-)sometime in January.

After that, who knows?  Depending on the pathology, I may or may not have a course of radiation.  I may or may not have more chemo.  It’s kind of up in the air and I’m okay with that.  We’ll take it as it comes.  Like Matthew 6:34 says–“Therefore do not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own.”  (See how I vacillate between fear and faith?!?  Circling, circling…)

God is so good.  But we have to remember, He’s not just good when good things happen.  He is good through it all.  I can speak from personal experience here and say that it’s sure hard to focus on His good when everything falls apart.  But it is there.  At one point yesterday, the surgeon said, “I understand you’ve had a rough go of it with chemo, and yet here you are, still smiling.  How do you do it?”

I didn’t think of this until later, but my response should have been“Manna.”

I’ve started to read a book called The One Year Book of Hope, by Nancy Guthrie.  In the introduction, the author shares her incredibly devastating experience of losing not one, but two infants.  I want to share what I’ve read with you, because I think it is a good reminder of God’s goodness through everything.  And I want to share it because, clearly, from what I’ve written above, I need to hear it today too!  :-)

“I’ll never forget standing in my kitchen with my sister-in-law, Caroline, after Hope’s memorial service.  ‘How do you do this?’ I asked her, wondering how I would get through that day and keep facing the days to come.  Caroline knew what it was like to bury someone she loved.  Before my brother came into her life, she had dealt with the devastating loss of her first husband when he was killed in a car accident two weeks after they got married.  Her answer to my desperate question was simple:  ‘Manna.’  She explained that just as the children of Israel were dependent on God to provide manna to sustain them everyday while they wandered in the wilderness, I had to depend on God to give me the manna I needed every day to sustain me as I grieved my loss.  After she left, I found a note from her taped to my mirror that read, ‘Don’t forget the manna…‘  She was right.  Manna is what I needed.  Every day.  I needed the nourishment that comes from the hand of God, the words of truth that come from the mouth of God.  In fact, I was desperate for it to soothe my emptiness and give me the strength to keep getting up in the morning… And the thing about the manna God provided to the Israelites was that they couldn’t store it up.  They needed a fresh supply every day–and so do we.  Every day we need a fresh touch, a fresh word to nourish us and sustain us.  Yesterday’s manna, yesterday’s insights may inform us, but every day we need something new to keep us moving forward toward healing.”  (pg. xv-xvi)

It’s important to remember that the manna God provided, was just enough for that day.  Every day He gave them just enough.  Every day, we are given just enough too.  We are given just enough to get us through whatever hardship we are going through.  I need to remember (and maybe you do too!) that whatever comes my way, He will get me through it.  He gives me what is needed, when it is needed.  And it is just enough.

How do I do it?  Manna…