Meeting the radiologist oncologist specializing in breasts

Today I'm thankful for...
Getting to a new year
My back issue staying away from me
That Lulu is feeling physically well
Our so wonderful family to help us through this most difficult time

Last night was a night of rest for both Lulu and I. We were pretty worn out from the stressful new that we had received from the doctors earlier in the day. After room service deliver us a couple of salads, and desserts; I feel right asleep. Lulu had a difficult time with getting to sleep, because the plastic surgeon had given Lulu's breast 125 cc of sterile water into her tissue expanders. These increases to the breast cause discomfort for 24 to 48 hours, due to the fact they stretch out Lulu's skin and muscles. (I'm not sure but I think that Lulu's breasts are looking better now then before surgery?)

Today was to be filled with medical appointments at the UCSF clinic. We were anticipating meeting with the radiology oncologist Dr.Fowble. This is the person that delivers the radiation to treat the cancerous tissues that could be removed during surgery. Lulu had been researching the various radiology groups in Reno and Carson City so she could get a referral to the best provider for her conditions? During this appointment with the oncologist we learned a lot. That the radiology machines used to give the treatment weren't as important as the operator and the technique. Dr.Fowble was pretty clear about the long term results for Lulu's breast structure and the chances of the cancer recurring are closely related to the preciseness of the radiation treatment. After some discussion of whom in Reno area that might provide this special radiation treatment for Lulu, I realized that Lulu would surely get the best treatment for her cancer here at UCSF. I knew at that moment that Lulu would be getting her radiation treatment here. There are so many factors could go wrong during this 5 to 6 week radiation treatment, I just knew that Lulu would want to receive her care anywhere else? I really liked this doctor, and I could tell that Lulu did also. However, this next few months were going to add even more stress to a vary difficult time for the Molina-Wilkerson family. Again Lulu had a number of questions for Dr.Flowble, and to the doctor's credit she stayed for two hours to answer all of them. At the end of the second hour, just after the doctor left, Lulu and I gathered up our things and dragged ourselves from the clinic. We had a long drive home, and a lot of things to discuss in the car on the way home.

As we drove (the rush hour traffic was horrible and our drive home ended up taking us an extra two hours) Lulu and I shared lots of tears. I think that the trip down was very important for answering our questions, but also ended up depressing both of us more then ever. One of the issue that Lulu and I discussed was when one is facing a life threading disease is it better to have care providers that give you only positive news, or is it better to get the real facts without the sugar on top? I think that both Lulu and I came to the conclusion that the later is better for us. We also reminisced about just one year ago we were celebrating being pregnant with out fourth child, and a year later we were in a totally different place. What a year that 2009 turned out to be for us!

We both we in agreement that 2010 was to be a better year, and we couldn't wait to get there.

Our new years with the UCSF doctors

Today I'm thankful for...
Getting to know my wife better in good times and bad
A little time alone with Lulu
My health
Great thoughtful relatives

Thank you and all our wonderful friends for the prayers and the warm thoughts the last 10 months. It's comforting knowing that there are people so caring out there that we consider a part of our family. Lulu and I are blessed to have each other and four beautiful, healthy kids. Everyday we thank the wonderful doctors involved in Lulu's treatment and and God for helping us both get through this difficult time together.

We just returned from UCSF for three days of medical appointments and consultations. Lulu has decided due to her special circumstances that she will receive her radiation treatments in SF at the UCSF treatment facility. This means will we have to work out the details of 5 to 6 weeks of daily radiation treatments in the city by the bay. But this, we both feel, will be the best treatment for her, and give her the best chance at staying cancer free.

We left on Monday morning for the UCSF clinic and hopefully get some of Lulu's questions answered, and be enlighten on her future? The traffic was light on our 4 hour journey to San Francisco, and we arrived just in time for the first of many appointments she was to have in the next three days. We met with Debbie (part nurse practitioner, part psychologist) to discuss Lulu state of being and what she has gone through so far, and what she might expect in the future? She is the wonderful health care provider that has been assigned to follow Lulu through the chemotherapy, the pre-op surgery, and with Lulu's post-op needs. A large portion of this is for the emotional/mental support. Debbie has been instrumental in helping both Lulu and I understand the expectations of this disease and how to mentally manage the feelings that go along with the treatment. I know that one of my biggest struggles during this whole experience has been how to best support my wife? I think through all the stresses of what's next, how is the healing going to go, and will she even be past thinking daily of the cancer that has inflicted her body, I struggle with what to say to her?

We spent 1.5 hours in therapy with Debbie, and I could tell from the tone and the body language my wife was giving off, that this was a part of the treatment that we were missing. As it turns out Lulu has been keeping many thoughts and feelings bottled up, and some of these were brought out during this time. The nurse wanted to see Lulu again the next day, and had presented some questions that she wanted Lulu to answer before tomorrow. I know that I felt a little scared at the end of this hour. Were we doing the right stuff emotionally during this battle, could we have been asking different questions, and why were we both so unsure about the future? These were just some of the issues that Lulu and I needed help on coping with, and right then we knew that we needed help from a outside source. By 3:30 PM we were done for the day both schedule wise, but also emotionally. Lulu and I checked into the hotel and went to do Union Square to drowned our emotions in shopping at Macys (though I was the only one to buy anything during the experience; Lulu told me that she wanted to brag that for the first time J. was the shopper and Lulu came home empty). After having a enjoyable; even intimate dinner together we turned in early as tomorrow's appointments were bound to wear us down?

Tuesdays first appointment was with the oncologist early at 8:30 AM. I was to make sure that I recorded the whole conversation on my iphone. Lulu had come prepared with questions she needed answered. Lulu also had requested and gotten her pathology report from the surgery, so she could review the findings, and possibly formulate a few questions about her circumstances? In the car from Reno Lulu had been reading the pathology report (I think that it's about 6 or 7 pages long). In the report were the post report on the cancerous lesions removed from her right breast. The doctors had told Lulu that the chemotherapy was successful in reducing the size of the three tumors (from 3 to 4 cm to a final 2 cm or so) in the right breast, but the report suggested differently. The surgeon during the procedure recorded that she had removed a tumorous lesion that measured approximately 6 cm. What??? We were confused by the words she had read in the report. How could the chemotherapy be working so well, but the tumor had increased in size? Also, there was a sentence following the size and type of cancer that said, "the course of chemotherapy given to patient was partially successful." We were stunned by this text. Were the doctors just trying to keep our spirits up, or were we just reading between the lines. Lulu added this to the top of her questions to ask the doctors. The oncologist and a Physicians assistant spent between them almost two hours doing a post op check, discussions of the next steps to treatment, and answering our questions. I could tell from the demeanor of the oncologist that we hadn't been getting the whole truth about the severity of Lulu's cancer. The oncologist explained that the next steps for Lulu's treatment would be a 5 to 6 week daily radiation treatment, then starting hormone oral therapy for 5 to 10 years, in which Lulu would be in put into menopause (and for those of you that have gone through this you know the side effects of this), oral chemotherapy for a year, and also due to the "fact that you are at high risk for re-occurrence" you should participate in a trial drug study that in early use has been shown to decrease the occurrence of these types of cancers. Her directness presenting this information was scaring me. I was hoping that Lulu wasn't feeling the same way as I, but I glanced at her to see her reaction, and I could see that she was taking this worse then me? I knew that the future for Lulu had just become more complicated. I just closed down after this part of the consultation, and it seemed the rest of this appointment dragged on forever? Finally, we all said our New Years pleasantries, and we were most eager to get out of there.

Christmas grows near

Today I'm thinking about...
Self motivation
The Christmas season
Truly how much that I have
How I got here?

It has been a very busy week for the Molina-Wilkerson family. This whole last week Lulu and the kids weren't feeling so well. Lulu was complaining of abdominal cramps and just not feeling well in general. I felt really bad for her and the kids, because I can't help them feel better. Through all of the surgeries, the tests, and the preemie baby issues, the hardest thing for me is not being able to take away the pain, and standing by to watch Lulu or Lourdes go through these awful tests, surgery, and appointments. I have heard that people giving support to loved one's with critical health issues many times have as such if not more stress then the sick person. I can tell you this is true for me. Having a strong independent wife that most times wants to do things "her own way" is very difficult to manage. Much of the stress I feel has to do with the fact that I don't feel I can be involved in the process of healing the problems.

Now when Lulu feels sick, like she has this last week, I think that we both secretly think that it could be related to the cancer? Could the chemotherapy depressed the immune system? Did the surgery cause Lulu's body other unseen damage? Once when minor aches and pains effected our family, we just said, "suck it up" it's part of being alive, but now we say, "could this pain be related to the cancer, and what's it all mean?

Yesterday, Lulu make the trip down to UCSF for another follow-up with the doctors on her cancer. I think that they wanted to check her expanders (and expand them), and also she was to meet with the Radiation-Oncologist for the start of the treatment plan for radiation therapy? I was so tried from a long, long, long, busy day at the office that I went to bed early before she arrived from SF. (I was so tired that while I was feeding Lourdes I feel asleep in the chair and was awoken sometime later by my sister) I rarely fall asleep outside of a bed, so I had to be quite tired? I'm eager to find out about the trip, and what was said by the doctors. I'm wondering about when Lulu will start the radiation treatment, where it will be done, what are the side effects she can expect to have? Also, I'm curious about the experimental drug treatment that the doctors have suggested that Lulu do as a follow-up treatment to the chemotherapy, surgery, and the radiation. All these questions we still have, and no answers yet, that's stressful too.

The kids are very excited about the Christmas season, especially Christmas day and Santa bringing the presents to up under the tree. Even Carter is excited for the "big day", and still believes in Santa Claus. (though he starting to ask questions like, how does Santa deliver all those presents in just one night?) It won't be long and the kids will be past this great stage of wonder and belief. This Christmas is shaping up to be just a little more special then all the past Christmas'. When a loved one is facing a potential life shorting event, and you have just experiences the miracle of having baby that struggled for her life, you seem to cherish seemingly simple things just a little more then you might of done in the past.

Our family wants to extend a warm loving Holiday season to you, and my God be looking upon you your family's with loving eyes?

Merry Christmas!!!

Love letter to our oldest

Today I'm thankful for...

Getting some alone time with Lulu

Spending the whole day with my little angel girl, Lourdes

My health

Living in the United States (and having the freedoms I have)

How would you like to change your child's life for the rest of their life? Earlier this year, Lulu and I were asked to do a seemingly simple school project; little did we know that this assignment would end up bringing our family closer together. We were asked, as a school assignment, to write a short letter including our feelings for our oldest son Carter. This story wasn't to be about what Carter might turn out to be 20 or 30 years from now, it was a to be a story of what his parent's true feelings for him are. I think that once you read this, Letter of Love, you will see the power of words put into sentences, and these words can be read again and again throughout your child's lifetime. This was so powerful that Lulu and I are presently writing letters o all four of our children. Please feel free to use the following letter as a template for your child's letter. This letter can be used for any aged child, from infants that will get to read this one day when that have grown, to teens or young adults that can understand how you feel even though you haven't always found the time to voice it.

Lulu and I encourage you to sit down during this holiday season and write your Love Letter? It just might change both your child's view of your love for them, and also you could just opened up that place in your heart that you may not have known was there before?

Here's our letter to Carter:

September 28, 2009

Dear Carter;

On August 18, 2000 it was an amazing day. It was a day we had anticipated and wanted for so long. It was the day we received one of the biggest gifts from God. It was the day you were born. At that moment I knew how much God Loves us. He gave us the opportunity to become mom and dad, to start living a wonderful and special new chapter in our life with you, the new addition to the Wilkerson-Molina Family.

Since that day you have grown into a caring and loving . You have the ability to see someone in need and with encouraging words, you always finds a way to be the person that tells things that make us all feel strong and happy. Just today when mom is not feeling at her best after recovering from medications that will heal but do not feel too great, you said “Mom I am sad for you, I pray for you to feel better’… With these words you made tears and smiles come from our hearts. You are very kind to everyone! You have a great smile that makes people feel better!

Carter we are so proud of what a great big brother you are. We see you encouraging Thomas, when he can’t quite reach the high bars, or is scared to try something new. We love to see you read and play with, Hamilton, and we have many times witness you caring for a booboo that one of you brother have sustained with hugs and love. And we can not forget your love and care for your new little sister Lourdes is so special and gentle.

Carter you have grown to be a mindful and sensitive boy. When and if we have to discipline you (with turns out to be quite infrequently) you become very regretful. We know you care very much about doing and being right most of the time, and if you feel you fall short of the expectations you become sorrowful and apologetic. This makes you, Carter, extremely thoughtful in all your actions and we are so proud of you for this and all your other great values.

But most of all, we enjoy that you are so incredibly affectionate. Our snuggle monster, even at 9 years old, you like to hug and kiss us, mom and dad. We love to smother your cheeks with kisses and tell you how much you are loved. We love to watch you run and play, and grow to this amazing little man. Our first best wish would be that he never out grows this ability to show your love; not only towards your family, but to others that come into your life.

We consider ourselves bless to have a son as bright, smart, healthy, beautiful and loving as you, Carter. You can do anything you set your mind too!

Seeing you smile and looking at your beautiful blue eyes everyday reminds me of all the wonderful blessings God had given us!

When you were little you will say ‘Mom and Dad I love you as big as a tall mountain’… and we will play the game who could say the biggest, tallest or farther thing… Carter…’We love you as big as the universe’… You know you are loved so immensely.

Sent down from God above, especially to fill our home with laughter and with love. You give us so much happiness. We will be always here for you.

We love you, forever

Mommy Lulu & Daddy J

Lulu has put the surgery behind her

Today I'm happy for...

Looks like we might have a white Christmas

My wife's health improving daily

Safe passage to San Francisco and back

Having such cute children

We made the trip to UCSF cancer clinic and back yesterday, but not without having to trek through some difficult driving conditions. Lulu and I got a late start to our trip down for the follow-up appointment for Lulu, and it was 6:45 AM before we got onto the road. The highway down was covered with snow and the CHP had chain controls at Truckee, but because the traffic was backed up for a long way, I decided to take Donner Pass Road. As it turned out Lulu and I didn't make up the time that I figured that we would, and actually ended up on the highway (I-80) at Norden right next to the truck we had been following in Truckee. But the trip over Donner pass was fun and beautiful with all the snow. We made the 11:30 AM schedule appointment at 11:29, and I felt proud that we did that well.

This medical appointment took 2 hours. The doctors were all at a conference in San Antonio so the clinic was close to deserted. Lulu got her three drains removed by one of the surgical nurses, and she was so happy to have them out. During the appointment Lulu ask a number of questions about when she would get the consultation for the radiation treatment, and who she will be meeting the next trip down? I could see the confusion for Lulu on what were the next steps to her treatment battling this terrible disease. There were many unanswered questions that my wife had. Lulu was so happy to be totally done with the surgical part of this journey. How could you blame her?

Getting close to having the drains taken out

Today I'm happy that...
I get to daily have fun with kids, and they call it work
Our families health is good and improving
Lulu has opened up about her feelings
Everyone's help

Tomorrow is a UCSF cancer center trip, and I'm excited for Lulu because she will be getting out the drains and leave all the remnants of the breast surgery behind. This week has been hectic for me. I haven't gotten much time with the family. I haven't been home before 6:30 PM this whole week, and I leave before anyone is up in the morning (we're working a 7 to 5 schedule). When I get home I try to spend as much quality time with the kids as possible, but I'm sure that I haven't spent much alone time with Lulu? I'm really excited about the trip to SF tomorrow for the fact that Lulu and I need some time to talk about our feelings, and for her to open up about her sadness. I know that she struggling with many feelings lately, but I've been avoiding the difficult discussion with her on why and what she feeling. I'm just so mentally and physically drained that I don't want to emotionally be involved during this stressful week. I'm looking forward to being able to recharge the batteries and emotionally be there for Lulu.

Starting this week the Dentistry for Kids team began our "support the cause pink Converse campaign". All 13 employees are sporting their pink converses to show support for Dr. Molina. The patient and their parents really get a kick out of the shoes. I'm thinking about getting myself some of these in other colors for after my pink one's wear out?

Lourdes has been growing really well this last month, and she reached 14 pounds as of last week. She really likes to get "naked" and then is so excited to get her new diaper and clothes put back on. I like to make silly noises as I look into her cute eyes that fill up a large portion of her tiny face and see her smile at me. Lourdes has been losing some of her long black hair and has a portion that has grown out of the side of her head is curls around her ears. Last week we experienced Lourdes rolling onto her back. We are putting her onto her belly and getting her muscles stronger, and she isn't fond of this so she apparently learned how to roll herself over to the back position? This has been the talk of the family now for days. I'm absorbing these little events with Lourdes as much as possible, because I know that for my own kids this is the last chance that I'm going to get with an infant (and I might be too old to enjoy my grand kids in their infancy?).

I'll be hoping that the snow will hold off until Lulu and I have the chance to get over the "pass" and back tomorrow? I'm already thinking about what I'd like to say to Lulu during the trip down and back!

We get the news from the doctors

Today I'm grateful for...
Getting home safely
Spending quality time with my wife
My sister Lori's help
The Holiday spirit

I'm pretty tired after yesterday. I was at the office by 6:15 AM and saw a full schedule of morning patients before Lulu came here and we left for UCSF. The drive to SF when by very quickly. Lulu and I talked about her feelings about the whole cancer thing, and what positive stuff that has come out of this experience. We were in agreement that we both have changed for the better in these last 6 months. We have become more sensitive to each other's emotional needs, and learned to value little things in every day life. We couldn't help but comment on the trees changing color and their beauty during this fall season. We arrived in the parking garage at 3:00 PM, we had made record time (3.5 hours getting here).

I was feeling very confident in the reception room waiting for Lulu to be called back for examination. Weird how I felt because I knew what was a stake with this appointment, would Lulu be cancer free, would she have to have more chemotherapy, more surgery, or worse they hadn't been able to get all the cancer? I was just hoping that the doctors would be on time today, so we didn't have to wait for the results longer then possible? Lulu seemed to be happy, if not a little pensive though? The assistant called Lulu's name at 4:10 PM, and after taking assessment of her post surgery pain, vital signs, and weight, we were shown a examination room. Lulu was to undress from the waist up and lay on the examination table to wait for the doctor. Before the doctors arrived, Lulu wanted to have photos of her upper torso, so I obliged and snapped pictures of the breast drains, bandages, and healing tape that she had on over much of her upper body. As I took the photos I was just praying that under those bandages the cancer was gone?

A few minutes later there was a knock on the examination door and the breast surgeon and the surgical nurse that helped Lulu with pre and post surgery asked to come in (a nice touch over just barging in without knocking or asking whether or not the timing is appropriate). After some of the usually questions were answered by Lulu the bandages were removed to unveil the breasts that had been infiltrated with the cancer cells. When I got a better look, Lulu's breast appeared to me as deflated tires needing a repair and pumped back up with air. Their appearance was what I had remembered of them just they were flat and taped over in the surgical areas. Next the nurse excused herself, and I knew then the prognosis was about to be discussed by the surgeon.

The young woman doctor that had expertly worked on Lulu's infected breasts has really been positive when discussing the details of this disease with us, and today we'd learned was no different. She started by getting right to the issue that was in the forefront of our minds; the cancer. "I believe that in the surgery I got all the cancer from the breasts and the Lymph nodes"? As she continued to explain about the prognosis of the surgery, I became confused. The surgeon mentioned something about the appearance of the cancer; it had a different appearance then expected and the tumors in the right breast had changed shape with the chemotherapy(wider, flatter, and measured 6 CM in width). I wasn't sure what that meant?She didn't seem overly concerned about these findings. The rest of the appointment was about the needed Radiation therapy, when the drains could be removed, and folow up appointments for the long term. These were all clearified between the surgical nurse and Lulu, while I was detacted from the conversation and was thinking about what all this means? Much of what I was thinking about is how far Lulu has come in the process of beating this disease, and how strongly she keep herself during the process? I know that she never had the choice about having breast cancer, but she has made a choice on how to battle it. I couldn't be prouder of the stance she has taken.

We are to return next Friday for the drains to be taken out, and the wounds to be checked.

By the way the "pink support shoes" are giving me strength, and the kids dig them. I thought it was such a great idea, that all the team with be wearing "pink cancer support shoes" starting next week.