Renee - Dr. Marga's March 2013 Mermaid of the Month

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A move to beautiful eastern North Carolina in 2007 was to be the beginning of a new and exciting life for my husband and me as empty nesters. We were getting a chance to live a life of ministry in a small town and a historic church in Hertford, North Carolina. Our daughter had just married in 2008, and our son was engaged to a beautiful young woman he had met at his university with a wedding slated for late 2009. There seemed to be nothing that was wrong in our lives. Since we had moved, I was working two part time jobs and enjoying the freedom I had in both of these positions. One job was at a local womenís fitness facility and the other was as a part time caregiver for a school aged child and two preschoolers. I called the second job my practice position for grand parenting and loved it!

In January 2009 I had gotten bronchitis and was on medication to overcome it. It was winter and I was miserable. The cough seemed to linger and wouldnít go away, so I was taking Prednisone as well as an antibiotic. Around early February I found a lump in my left breast. I didnít think much of it since I was 47 and beginning to enter middle age and had been sick. I assumed it was just my body changing to middle age since I had a mammogram in October of 2008 with a good report and a physical where my doctor declared me as one of her healthiest patients. The lump didnít go away and as I was cleaning my house on a beautiful sunny day I felt as though God was compelling me to call my doctor and have the lump checked. It was almost audible, the thought that I had to call my doctor and not wait another minute! So, feeling rather silly, I called her. She agreed it was probably nothing, but set up an appointment to get it checked. After the appointment she scheduled a mammogram and ultrasound. The doctor who was reading my ultrasound came in the room after the testing and said he thought there was a 50/50 chance that it was a tumor and scheduled a biopsy in a town two hours from our home. The biopsy revealed an invasive ductal carcinoma. I was then referred to a surgeon and he scheduled me for more testing including an MRI. At first, it looked as though I could have a lumpectomy and maybe some radiation. The lumpectomy was scheduled for April 15, which is not only tax day, but also the day my beautiful daughter was saying her goodbyes to her new and very brave husband as he was deployed to Iraq for a second tour of duty. My husband took me for the same day procedure, which included a sentential node dissection to determine if, or where, the cancer may have spread. After the procedure it was revealed that 26 lymph nodes were removed and 13 had been cancerous. The biopsy of the tumor proved that it was a hormone negative, grade three tumor, inflammatory and the margins were not clean after the surgery. This meant that I would need a mastectomy in the future, after I completed six doses of TAC chemotherapy. I would have a mastectomy followed by six weeks of radiation therapy. My husband and I had only lived in our sweet little town serving our precious church for a year and a half at this point! Not only was I far away from my family but also was in virtually a strange town among strangers who were also parishioners to whom my husband had duties. It was a scary time in our home. The first thing I did was pen instructions for my funeral service in my journal and schedule the minister to perform the ceremony if the cancer proved to be stronger than the treatment. I felt perfectly at peace with life or death at this point since I firmly believe that is my real home! I also instructed them that although they could be sad they could not be bitter. I am a believer that all things good or bad are for a reason. If it meant that my children and my husband would be stronger and more able to minister to others though my own death, then my life would not be a loss and theirs would be deepened to a level that allowed them to be more compassionate human beings.

After the chemotherapy it was time to have the mastectomy. I chose to have a bilateral mastectomy for a couple reasons. The first reason was that the lump had not shown up in my mammogram. The second was that the cancer was very aggressive and there were calcifications in the right breast that were being watched. When we had lived in Durham, North Carolina I had mammograms every six months because of the calcifications and no tumors ever showed up. I reasoned that if cancer could have taken over the left side and not show up in my mammograms, it didnít seem unreasonable to think it could happen to the right side too. Because of that, it just seemed like the obvious choice to have the bilateral mastectomy.

I have a friend who had been in our church when we lived in Alaska. She had since moved to a western state, and had battled breast cancer and had a bilateral mastectomy. She called me and encouraged me to get in touch with Dr. Marga Massey if or when I decided to have reconstruction. She had just been through the Stage 1 process and was so excited at the work Dr. Marga had done for her. In fact, this friend and I refer to Dr. Marga as "the artist" whenever we correspond. This friend explained to me the different types of reconstruction and told me of this microsurgical procedure that was natural and did not include implants. This information helped me make the painful decision to have the bilateral mastectomy and really kept me going as I went through the radiation process. My team of doctors advised me to wait three years after treatment to pursue reconstruction. At the end of these three years I started looking at my options. At this point, I had pretty well determined that I would stay in state and in the town where I had been treated for the stage 3c cancer to have reconstruction. At my first appointment with the first plastic surgeon I was told that I could have a latissimus dorsi flap reconstruction with implants. My instinct was that this was not a good choice for me since I also suffer from the effects of lymphedema. The surgeon then referred me to another plastic surgeon in the area that could perform other types of flap reconstruction. I was excited that I could have surgery within two hours of home in a town that I knew how to navigate since I had lived at the Hope Lodge in that town during radiation therapy. When I visited the second surgeonís office he looked at my chart and then said these words to me, "You are fine like you are. Go home and if you still want surgery in two years come back and we will talk about it." Those were fighting words for this southern girl! I cried all the way home stunned by this insensitive response since I had fought so hard to live. My husband and I prayed some more. It was at this point that I remembered my friendís surgeon. I made an appointment with Dr. Massey in Charleston and was scared to death that she would tell me the same thing as the last surgeon. We had decided that her response would be the deciding factor of whether or not I would have reconstruction. I had decided that since God is in control and had allowed me to live through this horrible disease then I would honor whatever happened at this appointment as His will and would not question it. I would be at peace with all things, as a plaque I have hanging in my house says.

When I met Dr. Massey I realized that she too was a southern girl who had connections with the very part of the state where my husband and I live and that was such a wonderful surprise. After her question of, "Is this a joke? Are you really from Hertford, North Carolina?"(And she got over her surprise) she examined me and told me that I was a candidate for microsurgical reconstruction. Since she is also a specialist in lymphedema therapy I knew she would not recommend the latissimus dorsi and that I could trust her. I felt that God was looking out for me from the moment I met my friend in Alaska to the time I moved to eastern North Carolina! There was no denying it. At this point my husband and I went home and were so excited about surgery and the fact that once again, I could look like a girl in every way! For a southern girl like me that meant more than I can ever possibly tell.

On January 4, 2012 I had the first stage of reconstruction in New Orleans. After several more modifications and a few complications that were quickly overcome I am now able to look in the mirror and see a true survivor. I have not let cancer, negative comments or complications stop me from finishing the reconstruction process. I can honestly say that Dr. Marga and her staff are kind and full of patience. I have to admit that I probably havenít been the best patient she has ever had because I do have my own personality foibles that really show up when it comes to dealing with the stress of healing and surgeries and even insurance companies. Thankfully, they never gave up on me when I was, at times, willing to give up on myself!

Reconstruction was a very personal choice for me during one of the hardest times I have ever faced. With faith in a great God, a kind doctor and staff, wonderful hospitals and a husband of thirty-one years who is a prince among men, I have been able to not only survive a locally advanced staged cancer but have been able to have the best doctor imaginable give me the gift of feeling feminine and whole again. There is a verse in the bible from the book of Ephesians that says, "Now to Him who is able to do far more abundantly beyond all that we ask or think, according to the power that works within us...," that has become my life verse during the reconstructive process. I can without fail say that this verse is exactly how I have felt since being diagnosed with breast cancer and having had reconstruction. Although there were many hard days through this process, I have a stronger more vibrant faith than I have ever had in my life. I might add that the power that works through the hands of our sweet doctor is something that is a rare gift not only to me, but to every woman who has ever been honored to call her "my doctor".

Renee' B. Clark

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