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.

My new shoes help support my wife

Today I'm thankful for...

Hearing great stories of hope

Having such a wide variety of emotional support

Great friends and family

A warm house in this cold weather

I received my new shoes today (see the attached photos). I had been looking for just the right shoes to wear that show support for my wife's breast cancer. Last week, after looking for a few weeks, I found just the right pair of pink Chuck Taylor Converse tennis shoes. I'm planning on wearing these shoes until my wife is cancer free. I really want to show my support for her battle, and as lengthy as it might turn out to be I'm going to be there with my pink Converse until I know that she has won this fight.

I'm working hard to get to that 185 lbs. weight. I have been flirting with the 190 lbs. for the last month or so. I have been walking on either the tread machine or around the neighborhood the last few months to try and shed the last 5 pounds or so, and of course improved the diet. I haven't been missing the Soda (specifically Coke), or the once/week red meat self imposed restrictions. I've always heard that that last to 10 pounds is the hardest, now I know what that means. I was good at the Turkey feast, and didn't get carried away with the abundant fixings that was available (with the exception of the Pumpkin Pie, that was hard to stay away from). Physically I feel good, and I'm glad that I've been serious about this life style change, because with all the other stresses I don't need to feel bloated or lethargic.

In two days we will be traveling to UCSF for the results of the surgery (and for the post operative examination of Lulu's surgical site). The anticipation is the most difficult part of this whole experience. This is one instance that I wish I could speed up time!

Emotions are high this Thanksgiving

Today I'm grateful for...

Family surrounding us and supporting us

Sharing this holiday with loved ones

Having plentiful food on the table

Turkeys

The emotions this holiday are on high. Lulu's older sister Doris' family came out to Reno this Thanksgiving from Puerto Rico, and the visit was filled with crying, tears, and bonding. They arrived late Wednesday November 24th, and we allowed the our kids to stay up until they walked in the door which turned out to be around 10:00 PM. By that time the boys were running on adrenaline and the excitement of seeing their cousins. Our families would normally get together either on Thanksgiving or Christmas, but due to Lulu's illness this year they will be flying into Reno or both of these holidays to support us.

Lulu has been feeling sad as of late, and she's beginning to feel the effects of breast cancer surgery on her body. Her right arm is in pain daily and Lulu can't use it a whole lot. I watch her try to hide the issue of a lame, painful arm; and let me tell you she a master at the art of deception. I'm constantly wondering how and what I should do to give her love and support. I do my best to re-frame of commenting on how she should rest or ask for help, because these just make her think that I'm not being supportive. All this cancer treatment, surgery, family, and stress of having a life threatening disease are running Lulu down emotionally. I know that Lulu isn't sleeping well at night, and I also know that she's on edge much more then usual.

Since the surgery over a week ago, I have been awakened nightly to Lulu's faint crying in my sleepy ear. I so desperately want to ask her what's wrong, but I know that she's stricken by grief and never wants to show her venerable side during the day time (especially in front of the kids). I just let her cry herself back to sleep, and inside I'm crying as I think about how utterly sad (and alone) she must feel? I think all the emotions of having breast cancer and battling the demons that come with this disease they are piling up on Lulu. As her husband and confidant in this fight; I really feel helpless in the battle, and I strive to keep my strong facade from crumbling down.

The last three days have been incredibly tense with emotions. We spent the time together as a extended family, and really enjoyed each other's company almost as if we had just told that this was the last time we would all be together? As the weekend comes to an end, and Lulu's family prepares for their journey back to Puerto Rico, Lulu becomes swarmed over with emotion of loneliness. But true to her past behaviors, I find her crying in our bedroom hiding away from any concerned love one. I sat with her holding her hands at the edge of the bed, just letting her cry out the sorrow, and feeling that in some way that I've let her down. I knew that right then we (Lulu's sister, brother in law, and mother) all needed to rally together at her bedside and pray for her recovery, so I when to ask for everyone's support in helping Lulu by praying as a family over her. You could feel the love for not just Lulu, but for each other as we prayed and gave thanks. We all said what we felt and we just let the emotions spill out. I have to tell you that this was one of the hardest nights for me since the cancer diagnosis a long 5 months ago. I was left wondering if I could hold on for three more weeks (this is when they will be returning for Christmas break)?

I'm sure that weighing heavily on Lulu is the up coming follow up appointment at UCSF breast cancer clinic? The results from the surgery will dictate Lulu's future, and what she will be doing next to beat this affliction? I ask God for the strength to see me through this most difficult time. I never have known sadness like I have felt lately, and with time, prayers, and everyone's encouragement; I will break free from the intense woe that I carry. Keep us in your thoughts and if you believe in that power of God; pray for our family?

Lulu's recovering well

Today I'm grateful for...

Lulu feeling better daily

Loving caring kids

Grandma Nellie helping us

Long weekend

These last two days have been filled with sharing, praying, and healing. Lulu gets stronger each day, and she has much less pain then she thought she'd have. Yesterday she when out to get pictures taken of Lourdes, and some running around with her Mom and sister. I think that she over did it yesterday though, because today she tired and using today to rest. Lulu can't carry Lourdes or anything that ways over 10 pounds. She also can't drive for two weeks.

I want to thank all the parents of our patients at the office. I spent 2 hours calling patient's parents that are scheduled on December 2, because that is the day that UCSF scheduled Lulu for her post op follow-up from the surgery. I really want to be there to find out why the biopsies of the cancer that they found in the lymph nodes during last Tuesdays surgery. This appointment is so very important to the future for Lulu's battle with the insidious disease. Will she have to have more surgery? Will Lulu need additional chemotherapy treatments? How about the length of the radiation therapy, will the findings from the surgery change this? If any thing else I want to be there for my courageous wife. I'm so appreciative to the parents in which have been incredibly flexible with their children's appointments. All that we've been going through would have been so much more difficult with out parents support. Thank you!

The recovery begins

Today I'm thankful for the following...

Lulu looking better one day after surgery

Having a great network of friends

Lovely weather in San Francisco

My great health

One day after surgery Lulu has regained her color and looks better then yesterday. Lulu has been getting nauseous from the time she came out of surgery, so she had requested anti-nauseous medications to keep her from getting sick. However, these medications have really sedated her deeply. She has been either asleep or vomiting since last night. She's been so sleepy that once when she was awake and she was trying to eat some dinner, right as I was talking to her and she was eating she feel asleep with the fork halfway to her mouth. I would have to stimulate her with a nudge in the arm to wake her. Doris and I have been alternating being with her in the hospital during the second day post surgery. One positive is I'm getting to spend lots of father/daughter time with Lourdes. Earlier in the day my sister left to return home, and I know that Doris and I can handle caring for Lulu and take care of the little princess.

I'm not sure that I've mentioned that all of us are getting to stay at a wonderful 3 bedroom/2 bathroom flat in the Cow Hollow section of San Francisco. Donated to us by a caring, very generous family. This has lessened the stress of where to stay and how much it will cost us. Just one less thing that we need to worry about. Let me tell you the accommodations are splendid, and I couldn't think of a better place that we could have stayed? The family normally rents out the space on a daily, weekly or monthly basis, but allowed us to stay for free as long as it took for Lulu to recover from her surgery. This is just one example of how people (even one's that we've never met) are helping Lulu and I get though this breast cancer ordeal.

My hope would be that if anyone needs a place to stay in San Francisco they stay here, and that we would all support the Tate family. Please, help me thank them for their generosity and look into staying here when your in San Francisco.

Check it out. Here's the link to the listing: Cow Hollow Rental Home San Francisco

Tonight is going to be a special night for me. Lulu is getting stronger, will soon be able to go home, and I get to share the night with my little cutie girl Lourdes. Lourdes and I haven't gotten quality time this last week to share each other's company, so I'm going to make the best of our alone time together. I'm sure that I couldn't feel any better then I do tonight? Things are showing improvement hourly, and I just know that the future for all our family is going to be extremely bright!

Surgery Day

Today I'm thankful for...

Lulu's medical team

Having the choice to get Lulu's treatment done where we choose

Doris (Lulu's sister) to be here to help in this difficult time

Lori (my sister) for sitting with Lourdes

Today was a huge day for Lulu in her fight again this terrible disease. We were to arrive at 6 AM at the UCSF (Mt Zions) hospital for pre-op check-in, so we got a very early start. As Lulu, Doris, and I drove the 20 or so blocks to the hospital, I couldn't help but think about how strong Lulu was facing this daily climb of fighting breast cancer. She was only concentrating on the getting better outcomes and what she was going to do in the next weeks to recover from the surgery. I haven't heard any negativity about why she was the one to spawn this cancer, and she seems to believe that all this was meant to help her be a better person, and show her a new life. We arrived to a very desolate hospital at 5:45 AM. I think that the only staff were the security guards from the night shift? We had been shown the routine the previous day, so the checking-in for the surgery was quite smooth.

We were in for a treat this early morning. The pre-op nurse was a happy sole, and she made the whole hour long experience for all of us entertaining (little did we know that she would make the rest of the hospital team that we came into contact with flat and uninterested impaired to her). This nurse we had found out was originally from New York City (The Bronx) but that she had a Chicago accent. It turns out that when she was a young girl she had some difficulty with speaking and needed a tutor to help her in the classroom, and her parents could only afford to have the neighbor lady help her learn to speak better. As she continues her story, as she busily prepping Lulu for the upcoming surgery, she now understands that the neighbor lady was a Chicagoan and had the thick Italian Chicago access to go along with her thick Italian figure. So, this animated nurse was proficient in her job, and at the same time enjoying the interaction with the people that she was caring for. However, I don't think that she realized that she wasn't only taking care of a beautiful cancer patient, but she was making her family feel just a little better the impending surgery. I was left to wonder why we can't all find our happy point, and just like her brighten the days of everyone that we come into contact with?

Next the breast surgeon and the plastic surgeon arrived to answer any questions that we all might have before to disappear to finalize the details of the next 7 or 8 hours. I wanted to ask, "are you really sure that she has breast cancer before you start," but I thought better of it (this was Lulu's time to get her questions answered, not a time for lame comments from the husband). I think one of the hardest parts of all this for me is not being able to handle my stress with quick humor as I normally would. I have found that I respond better to life be cracking one liners, or just trying to make people laugh any way that I can. Though all of these last 5 months I have been cautious with my humor and in the process have lost some of my spontaneity. After biting on my tongue, to keep those comments from flying out, we watched as the surgeon left and the surgical team entered.

I think that Lulu got a little nervous when she found herself being questions and watched by 10 various medical personnel? Being a teaching institution there were resident and attending surgeons, resident and attending anesthesiologists, head OR nurse, and then many other support staff for Lulu. All of them have a specific duty to preform and some were getting educated along the way? I could see some of the repeated questions were wearing on Lulu's nerves, and I think that she was just ready to, "Let's, Get It On, " as the famous attorney Mills Lane used to say. At last they were ready to wheel the gurney back to the operating room and make the cancer disappear. I was very hopeful that the whole surgery was go as planned and the next time I see my best friend, she would be cancer free and past one more of the huge hurtles in her recovery? We kissed and hugged on last time, and then she passed through the automatic doors of the operation room. I felt a rush of emotion fall upon me, and I had to turn from Doris to wipe away the streaming tears that caressed by cheeks. I couldn't help but be angered by the thoughts of, Why Lulu. What has she ever done to deserve this fate? The next 9 hours were to be agonizingly long!

Doris stayed in the family surgery lounge, while I walked back to the flat that we were staying in for the week. I needed to walk off the stress of the unknown. I didn't really enjoy the walk as I'm sure that on any other day I would. How can't you absorb the wonders of a scenic view of the Golden Gate bridge, and all the beautiful Victorian houses that fill the Pacific Heights neighborhood that I passed through. All I could think about is how Lulu was enduring getting her body cut up as the surgeons try to save her life. I really didn't care if the passersby saw my tears or not. I just concentrated on not tripping over my feet as I absently made my way the two miles back. When I finally arrived I saw that Lourdes was giving my sister Lori a hand full, and I helped her with a feeding and a diaper change, before I was to return to the hospital. I surgeon had informed us that she expected to be done by 12 noon, so I wanted to get back a little early so not to miss the doctor's news about her success with Lulu's surgery? I got back to UCSF at 11 o'clock (plenty of time earlier then the doctor said that she might be done, just in case). Doris was catnapping when I walked into the surgery family waiting area, so I quietly slipped into the waiting room chair next to her, and began reading form my iPhone.

We patiently waited for some information on the outcome of Lulu's surgery. 12 noon came and when with no sign of the surgeon. Doris and I talked about Lulu and how stubborn and strong that she is. We re-hashed how far she had come from the first diagnosis and what she still needed to do to recover. We discussed, but couldn't discover, why someone like Lulu gets cancer and others like ourselves don't? How might all this effect the kids, and what I should be doing to help them through this? We were praying that the all the cancer would be done post surgery and Lulu would have a quick, uneventful recovery. Mostly we just reminisced how get a sister Lulu was and how I couldn't ask for a better wife and mother for the children. Before we knew it the time had slipped past 1 PM and still we had heard anything yet. With every passing minute we got increasingly more worried, and each time someone would enter the waiting area's door we both would leap out of our chairs thinking that this was the news we had been waiting for? Finally, around 1:20 PM we got word that the surgeon was finishing up Lulu's surgery and would be in to talk to us in about 15 minutes. 45 minutes later the lady doctor walked in, and my heart leaped out of my chest. I wasn't sure that I could get to my feet and follow her out into the hall for a report? Somehow I got my balance and made it out the door and into the hall where the surgeon was waiting to deliver the news. All I could think was with all this waiting, we better get a complete report on Lulu's status and her diagnosis? I felt mind was detached from my body, and I couldn't tell my legs to function properly. It seemed to take me a hour to get out the receive the surgeon's report, but I eventually took a position next to Doris and a crossed from the doctor.

The surgeon seemed calm and positive as she began to speak about her last 7 hours of work. Was this a look of success, or that well practiced doctor's ability to deliver the gloomy news expressively? She began (as they always do with the positive news first) with how great Lulu had done with not losing as much blood as they anticipated, and that her heart really handled the 7 hour surgery well. Both breasts were removed without much difficultly, and that not much muscle was damaged during the process. Also, they biopsies the left breast tissue, and found no cancer contained within the tissues. Wow, I was really gaining my strength with this news, but then came the less positive news of the surgery. The surgeon spoke of finding cancer in a number of lymph nodes in the right axilla and that they had to remove at least 20 presumably cancerous nodes there. She informed us that they will be doing a complete biopsy on these nodes in the following weeks and that once that's finished, she could give us a better idea of what's next for Lulu? For sure she will need a aggressive radiation therapy treatment and possibly more chemotherapy or surgery at some point in the future. I was just happy to hear that she made it through the surgery and I was to be able to see you soon. All the other information could wait. I wanted to concentrate on one positive thing at a time.

We wanted for another 2.5 hours for the surgery to wrap up and Lulu to pass though the recovery portion of the hospital. We weren't allowed to be with her in the recovery phase, so Doris and I both got a bite to eat (since it had been since breakfast at around 8 AM the last time we had eaten) and caught small catnaps while waiting for Lulu to wake enough to be sent to a room for her 3 day recovery. Finally, at 5:30 PM Doris and I were summonsed by a nurse that we could escort Lulu to hear room on the 4th floor. When I set my eyes on her I immediately felt the tension fall away from my body and I was so happy that she looked alive with relief (but she was very pale, almost ghostly in her appearance). Lulu was quite drugged up and sleeping for the rest of the evening, so I left to return to Lourdes and give my sister a break after the 10 hours day she endured with little Lourdes. I was looking forward to the first really good night of rest that I would have for the last week!

Day before the surgery

Today I'm grateful for...

Only one more day until this surgery is over for Lulu

My sister and sister-in-law for their help

Great care for my wife

Prayers from many

Wow, what a busy and stressful day. We started out early for the UCSF cancer clinic (at 8 AM) and didn't return until 6 PM. It was a day filled with anticipation, trepidation, and frustration for us all. We Lulu, Doris, and I all started with our spirits high and looking forward to getting lots of great pre-surgery information, and mostly that happened; however, I have to say that we're very disappointed in the insurance/hospital game. After a couple of hours and talking with a few different individuals the clinic couldn't give us an estimate on the costs of the surgery. (anesthesia, OR room, 3 nights hospital bed, and the surgeons fees). All that they could tell us is that they would have a better idea after the surgery is done. I was very surprised by this response, and I have to see a bit angered. I spent the rest of the day thinking of what other occupation just tells the consumer that they need a certain service, but they can't tell them (estimate) what is the cost going to be. Why are we putting up with that? Lulu and I got no where with the administration at UCSF. I got to thinking how quickly I'd go out of business as a dentist if I was to tell a patient that I need to place a crown on their tooth, but until I'm finished I can't tell them the cost. No one would come to me. And besides honor and integrity want would keep me from charging whatever I wanted? Do people having surgeries in the US just don't ask these questions because their insurance pays the difference? Lulu and I are paying out of network and we care what the charges are going to be and what portion we will be responsible for. Unfortunately, we don't have the time to investigate the issue as the surgery is tomorrow at 7 AM. Why should patients have to worry about the finances and insurance coverage of their medical costs, especially days before their surgeries?

Lulu was stressed about a few more issues also. We met with the pre-op nurse in the morning to discuss the anesthesia for her surgery. As it turns out UCSF has nurse anesthetist providing the anesthesia for the hospital. While that fact wasn't the main issue, Lulu asked the nurse how's in charge and how many surgeries is are they over seeing? The nurse wasn't exactly sure of this, but said that it was normally a attending anesthesiologist and they were in charge of 2 to 4 cases (nurse anesthetist). Again this wasn't the main factor for Lulu either, but the nurse told Lulu that she didn't know who the anesthesiologist was, so she thought that he was new to the hospital. Because Lulu has a lot of experience with providing patients general anesthesia at the hospital, she's a little more critical about what is the procedures especially since it's her body that's getting operated on. I could tell that she was visibly shaken by these facts, and I did my best to calm her and renew her confidence.

Lourdes traveled along with us, and she helping to keep us occupied. Between Doris and I we managed to keep her happy most of the day. Lourdes has gained so much weight this last couple of weeks. So even though you want to continuously hold her, her size (13 pds) limits you to only 10 to 15 minutes at a time. I ended up walking Lourdes all over the neighborhoods around the UCSF breast cancer clinic in the stroller while Lulu had her pre-op appointments with the surgeons (since I had been with Lulu to all the morning appointments, I thought that it would be nice to have Lulu's sister accompany her). I think that Lulu's just ready to get this surgery over with? I can sure understand that!

After meeting my cousin Chris out for dinner in the city (the last supper), we all retired to the flat to get some needed sleep before having to get up super early to get to the hospital by 6 AM.