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June 3-7, 1998

Dear Friends and Family,

I don’t know how to really begin all this, except at the beginning. Several of you have asked me to write down what has and is happening, so I hope for the rest of you, this isn’t too laborious or long. Our lives have seemed to be going along the "normal" course of life. Married young, had children young, had jobs and moves and bumps along the way. The past few years, things seemed to be settling down nicely and the Lord has been blessing us enormously. Our whole family has known the Lord, fortunately, from our adolescent years. He has made the difference for us all throughout our whole existence on His earth.

As most of you know, my mother died of breast cancer in 1965. She had inflammatory carcinoma of her left breast. She was 49. I was her 6th of 7 children. That was 33 long years ago. Being a registered nurse, you tend not to always take care of yourself the way you should, but I have been very diligent about breast self exam and annual mammograms. This last May, I was driving home the Friday before Mothers’ Day and heard on a Christian radio talk show, the host asking for stories about Mothers. "Please call in and tell us about memories of your mother." So, I picked up my cell phone, called in (I have never called in before) and told how my mother had died. I shared how when I was 12, I wanted more than anything else in the world, to wear pantyhose to school. I had laid out my plan and rehearsed what I needed to say. My mother would surely succumb to my simple request. I had her come to my room upstairs and gave a terrific performance. Her answer stopped me cold. I could not believe her denial. I blew up in frustration and told her I hated her. I stormed out of my room and went outside to play, quickly forgetting my earlier rejection. By the time it was dark, dinner time and time to go inside, my mother was asleep. In those days, it was recommended not to be forthcoming regarding terminal illness and I had no idea how sick my mother really was. She was unable to navigate down the flight of stairs from my bedroom. She had to wait until my father and oldest brother had come home to help her down the stairs. The cancer had metastasized to her brain and her balance was off. I did know that her sleep was erratic and when she did sleep, we were not to wake her. When I got up for school the next morning, she was sleeping again. I did not wake her. When I came home from school that day, there was an ambulance waiting outside our house. My mother was being taken to the hospital. I went to see her that night with my family. She did not speak, she was in a coma. I remember her reaching out to each of us to touch our cheeks, saying nothing. I could not speak, I could only stand there as I felt my mothers’ touch for the last time. She died the next day. For years, I lived with the knowledge that the last words I had spoken to my mother was that I hated her. Not until I married and had children of my own did I know that she knew otherwise. I have thanked the Lord for each year that our children have had their own parents alive. Especially more than 12 years. For sharing this story, and telling them that God has blessed me. I now had 2 wonderful mothers, my mother-in-law and my step mother, I won a bouquet of flowers. I had them sent to my step mother. On Monday, May 11, 2 of my co-workers told me they had heard me on the radio and had them both crying.

The following Friday, May 15, I got a call from radiology. I was at work. They were responding to my request for my annual mammogram. I actually was 2 months late. I was due for mine in March, but had been very busy and had put it off. There was a lull at work, so I reported off and went down for the old vice grip. I cheerfully chatted away all the latest Viagra jokes with the tech as she went on with her torturous duty. As I waited for her to return after the films had been developed, I was completely unprepared for what she began to tell me. "Becky, you’re going to hate me." I thought all my jokes had distracted her and the films were too dark or light and I would have to be flattened once again. I followed her back into the room. "I showed your films to the radiologist, and these are your films from last year, and these are your pictures from this year." As she was displaying my films on the view box, my mind was racing as I was at first wondering why the radiologist, why last years pictures, and then the profound realization that this was not routine. Tears began to run down my cheeks as I stood in shock looking at the clear, large, nasty tumor that would set my life, my children’s lives, my husbands life, in a new direction. Lois began to console me and explain that she would need to repeat the pictures with additional pressure and preciseness. I apologized for crying and told her I was terribly sorry to have already told her all of my latest jokes. I really wanted to hide my shock in another joke, anything actually. The next mammogram she did felt like my nipple would surely burst off the end of my breast and if it was a cyst, it would surely follow it -SPLAT- against the wall. She asked if I wanted to wait for them to be developed and for her to show them to the radiologist, or she could call me. I told her I needed to get back to the recovery room. We had a very busy surgery schedule and the hospital has been so full, as the charge nurse, I knew I needed to go. I’d managed to collect myself down the hall and up the elevator. It would feel good to get to work, forget about this rude interruption in my life, my plans. I wasn’t back in the recovery room 5 minutes and Lois was calling me. She told me that they had scheduled me for an ultrasound at 3pm and would that be okay. I turned my face away from where other staff and patients could see me and the tears began again. I wasn’t ready for another jolt so quickly! I hate that! I’m so pale that all of that blood flow turns my whole face and neck beet red and the whole world knows I’m upset! I muttered that I would be there and hung up. I just had to get out of there. People were talking to me, I just kept walking. Dear Sandi, our secretary, who knew where I had been and who was calling put it all together and came right on after me. I cried and she had tears in her eyes as I told her and tried to push it all aside to be able to work. Cold water splash in the bathroom and then back at work again.

What a day. We had so many critically ill patients coming out of the operating room. It was so busy. I was so glad for the distraction. I went from one station to the next to help the staff and make sure they were all doing okay. The business was helping me more than anything. The room was full and there was plenty to occupy my mind. I had decided to not tell Terry anything until after I had the ultrasound. He and I had been both been working so much lately, but he had been doing an extraordinary amount of work. I wanted him to have uninterrupted time. I just wanted to know which office he would be at so I could contact him easily. I went into my friend Allyson’s office, she was making pre-op phone calls for the next days surgeries. I like Allyson so much. She is a wonderful Christian and a dear person. It was quiet in there and I could use the extra phone to call Terry. I told Allyson about my morning and what I wanted to do and she hugged me and then I called Terry. We talked briefly, like we do and I was about to end the conversation and he knew something was wrong, despite my denials. I couldn’t talk, tears again and I handed the phone to poor Allyson. She was so sweet, kind and gentle as she began to tell Terry and I finally began to breathe. I talked to Terry and he said he was coming to the hospital. I protested and said it would not be good. He and I both had work to do. He said okay. Back to work again. By now, everyone in the recovery room knew what I was going through and were so kind and supportive. It was good.

Kalayada came up to me. She’s my friend from Thailand and a Buddhist. I’ve talked about Jesus to her several times, telling her that it’s okay to have Buddha on your mantel, but we need Jesus in our hearts. She asked if she could feel the lump. I told her yes and we went into a private room. She couldn’t find it. I told her I couldn’t either unless I laid on my back and my side and felt deep. I had not felt it before Lois from radiology showed me the films. Then she looks at me and says "you’ll be okay, you haven’t lost any weight." I laughed and told her thanks a lot! After about 30 minutes, she came up very close to me and said, "Becky, nothing bad will happen to you because your God has too much for you to do yet."

Not long after that, Terry appeared. I knew he would come, even though I had hoped he would work. Maybe it was part of the denial. If he doesn’t come, then those weren’t my films, it’s not my breast, not my lump. I’ve been wasting tissues and tears for nothing! But he was there. My boss was there and told me to leave for a while. Terry and I went into the hallway and held each other and told each other we loved each other and no matter what, we would face this together with God and all would be good.

Terry and I went to ultrasound and waited and then I was called in. I laid there as the technician did the procedure. She sighed and said, "I sure hope this is a cyst." "Me too," I said, "but, I just know it’s not." She tried another device and then had me look at her screen. It was easy to see that the tumor was still there and it did not have nice smooth round edges. I dressed while she had the radiologist look at the results. I went into the waiting area with Terry and just moments later, she called us back and we talked with the radiologist. He had all of the films there so that Terry could see everything too. He measured it for us and showed us the criteria for his evaluation that it was a malignant tumor. I know that Terry was in shock as he held me and tears just rolled down my cheeks so freely. I was just a regular water faucet. He explained that the films would be sent to another office and I would be scheduled for a needle biopsy, then surgery, etc. We thanked him as we left in shock. I told the radiologist and Terry that I was going to have Dr. Bodai look at the films. Dr. Bodai had looked at my films in the years past. We called and left messages, but no word.

We went home for a strange Friday night. I don’t remember a lot about the evening. I had a nursing class to attend the next morning. I had stopped on the way home at a friends house. She has lots and lots of geraniums and I was picking up a dozen to decorate the tables at the class and give away. When I got to her house and I could see her garden and all the beautiful flowers, trees and plants she and her husband had. It just gave me such peace. I felt as though everything was going to be okay. I could look at what God had created and given life to and be comforted and reassured in His control over my life. I couldn’t tell Betsy and Troy what had happened that day. Terry told each of them individually. They did okay. I wanted to get a good nights sleep for the early morning class. I was, of course, in denial. As soon as I arrived at work, I went to the recovery room, left my medical record number with Sandi, and told her to give it to Dr. Bodai in between his surgeries. I knew he would be operating all day. Then back to my class I went with all of my geraniums. My friend Arlene came and sat next to me. I wrote her a note asking her to pray for me and what I had been informed of the previous day. The class we attended was good and a good distraction for me. Around 10:00, Anita, the volunteer from the recovery room, came to the door and pointed to me and out I went and Arlene followed me. She said that Dr. Bodai was in between cases and wanted to talk to me.

Dr. Bodai was in his office and after hunting around the empty surgery clinic, found him. He said that my films had already been forwarded to the Point West office, but he had heard the dictation of the report, and did I want him to examine me. It was great that Arlene was there with me. He examined me and said, now, we can do this or this and Arlene and I both said, "Take it out." He asked me when I had last eaten--8:00am and he said, "Well, I can do your surgery at 4:00pm." We quickly filled out the appropriate papers, and went to admitting. He went back to the OR and Arlene and I went back to our class. They had a wonderful lunch that I passed up and then Arlene and I went to the recovery room to use the phone. I called Terry. He was at work. Betsy was at a fund raising car wash for the day and Troy had gone to his karate meet. He had tested for his second degree black belt at a local high school. Arlene and I drove to Cameron Park and left my car and picked up my bathrobe. I called Patty, my neighbor to ask her to look for Betsy and Troy, since they didn’t know about the surgery, we wanted them to stay close to home, when they got home.

We got to the hospital and began to formal admitting procedure. Terry got there shortly there after. My co-workers were great. They were so supportive and encouraging. I can not describe just how busy but at ease the whole day went. I work with the most outstanding staff anywhere. Peoples good wishes, words and prayers are what has almost made this whole thing pleasant. Mom, John and John had all come to the hospital. The operation for the lumpectomy lasted 20 minutes. I woke up without pain or nausea and Terry had my prescription filled and we were home by 5:50pm. Incredible!!! I felt great. We ordered pizza for dinner.

The only reason I didn’t go to work on Monday is because my boss made me take it off. Arlene and I spent the day together and it was great. I went back to work on Tuesday, a big JACHO meeting all morning and then that afternoon, I was back at work, at least for a while. Dr. Bodai called me about 1:30pm. He said "How are you doing pumpkin?" I knew I was in trouble because I am not his pumpkin! Let it be known that if your dr. calls you and calls you pumpkin, it’s bad news. I went to his office immediately and he directed me to this really nice room, a couch, nice paintings and lamps and Kleenex on each table. He said he had gotten the pathology report and that they had identified the cancer as being medullary carcinoma. Medullary carcinoma has a fairly good prognosis. He sounded disappointed though, that the margins had come back narrow or close. He said that if I were a petite woman, (don’t I wish!) the amount of tissue he had removed during the lumpectomy, was equivalent to their entire breast. They had sent the specimen off to Stanford for further microcellular studies. This will also include genetic studies to see if I have a breast cancer gene. They could not be sure that there had not been any metastasis. I have probably had this cancer for 10-11 years. He told me that I had several options and I really did not like any of them except removing as much doubt about cancer dwelling in my body as possible. Since my mother and I are both pre-menopausal at the time of diagnosis, and if you are disease free 10 years after diagnosis, I could only be 55 and be considered cured and have a recurrence. At that time my options for treatment would be very limited. So, I opted to have both breasts removed. The left a modified radical mastectomy (lymph node removal as well as the breast) and on the right a simple mastectomy (breast removal only). I told him I did not like sickness in divided doses and did not look forward to multiple surgeries. He understood and said I could have reconstruction (tissue expanders) done at the same time. Dr. Bodai also insisted on talking to Terry to see how he felt about having both of my breasts removed. There are those that would argue that lumpectomy with radiation could be enough. I do not believe that would be the safest course. I was not ever so vain that I feel I need to keep my breasts to be a woman or attractive. Terry told him he did not care if I had to loose both arms and legs and he had to haul me around in a wheelbarrow, he would still love me and wanted to have me alive. My friend told me she hoped it would be the deluxe wheelbarrow! That night, Terry told me that when we met, at 19, if I’d had both breasts removed, he’d have never looked at me again. (So I know he was telling the truth). But now we’re an old married couple and we realize the important things in life. This December we will have been married 24 years. We hope to have more than 24 years yet to spend together.

Dr Bodai called Dr. Lim, the head of plastic surgery, and I was scheduled for surgery 5-23-98. I met with Dr. Lim a couple hours later. While waiting in his reception area, I ran into a patient that I had taken care of a year ago. She also had breast cancer. She looked great and was brimming with excitement. Then I told her why I was there and she gave me her phone number and told me to call her. I do not believe in coincidence. Arlene came down and was with me again. This was all very new to me. He measured my breasts with his measuring tape and his "cookie cutters" and then took pictures as he explained everything to me. Then I signed more consents. I told Dr. Lim about Terry and my premarital agreement. Terry told me I could gain weight as long as my breasts protruded further than my stomach and I was afraid that was going to change. He assured me that the deflation was only temporary. The next 2 days at work were good for me. I really do not know how effective I was doing my job, but I do know I told everyone that would listen to have their mammograms and to do their breast self exams.

Friday, I was off because of my annual vacation request. That turned out to be a good day to have off. I got to spend time with Betsy and that was very good for me. She and I both cried some and had a great time together. She went with me to run errands and we stopped by the little church Terry and I have been attending. We met with the pastor and he shared scripture with us and prayed with us. I really needed that. It has been so uplifting to hear and see all that are praying for our family. That night Mom and John arrived and Martha flew in from Missouri. Betsy and I made chicken gorgonzola salad and garlic biscuits for everyone. YUM!

Terry and I got up early and bought doughnuts and went to the hospital. The doughnuts were for anyone working at the hospital, not for me. The others came on later. Again, I work with the most outstanding staff. I am so blessed. It went along great. I went to sleep after hearing Dr. Bodai say, "okay, it’s show time." I woke up hearing Dee Ann, my wonderful CRNA, say, "Becky, it’s all over, you’re just waking up." It was great. I felt the flood of tears flow again, for relief this time. Then I looked and Carol, a wonderful nurse was taking care of me and Terry, Betsy and everyone else came in to see me. I was so overwhelmed by gratitude to God for seeing us all through this time. I am so fortunate, there are not words to explain it all. I understand that I showed a lot of people in the recovery room my breasts or rather the absence of them. I was just so happy that the cancer was gone and that I had two surgeries in one and it didn’t look bad at all because I had the best available caring for me. I was in my private room around 1:00pm and Terry helped me to the bathroom as soon as I got there. The IV pain medication was terrific. I had a steady flow of visitors for 24 hours. Since I used to work nights, I know a lot of the night shift. It was great. I made a list and I had 27 visitors in less than 24 hours that were not family. It was wonderful to be able to share how I feel God is working in my life and that His plan and purpose is the most important thing in life. I was able to come home at 1:00pm on Sunday, drains and all.

Terry and I got home and my friend Arlene and her daughter Erin were here and they brought a gift and cards from friends at the hospital. I was overwhelmed. They gave me a gift certificate and a Kinkade print. It was sunny outside and John Sheridan was busy working in our yard, edging the lawn and replanting the sod in a void area. We sat out back and visited a while and then I went to bed and took a nap and visited with Troy, Betsy, Martha, Betty and John. Martha bought Chinese food for all of us and it was delicious. I received flowers and plants and cookie bouquets and cards and calls and pictures and magnets and lotion and soap and oil and candles and books and food and a lamp and prayers. It is all very overwhelming. I know I have needed to have this time off from work, but I have learned just how much I really do love my job. I love taking care of people and helping them to get better and get on with their lives. I also like the people that I work with and like helping them do their jobs and problem solve. I have decided that sick leave is for people needing a day off - playing hooky- not this serious stuff.

Martha flew home to Missouri on Tuesday and Betty stayed the week with Terry, the kids and I. She helped take care of me and fixed breakfast, lunch and dinner and she did the laundry and Betsy helped her clean the house. Betsy had finals and it helped her be able to concentrate on all that she needed to do. Terry helped me bathe each day and washed my hair. He helped me empty my drains and made me use my incentive spirometer. He took me to all of my dr. appointments. He held me when it hurt and when I wanted to cry because this has all really happened and it isn’t just a dream and it wasn’t a mistake. He told me how beautiful I am and that he loves me more than ever. It really was all necessary.

So what have I learned at this point? I’ve learned that when life sends you a couple of lemons, just stick them in your bra, it just might help!! I’ve decided not to wear bras anymore and I am asking all dear friends to burn an old bra in my honor. My nipples are gone (Terry says it’s like a car with custom headlights) and, yes, it really does look strange. I have learned that my lymph nodes came back negative. I have learned to take care of yourself. I will be seeing more Drs. in the days ahead. I have 500cc of saline on both sides of my chest in the reservoirs, so far. I have learned the value of work and that I really like what I do and that I am fortunate to have a job that I enjoy. I have learned that I am not a needy person and I don’t need a lot of things. But I am very grateful for the cards and calls and prayers. I am very rich in family and friends and I have a life without regrets, but one with hopes and dreams of things yet to be. I have a life that evolves around Jesus Christ and He continues to avail Himself to my every need. He is making me repeat that lesson in life on patience and living life one day at a time. I was becoming quite talented at twisting many days into one and forgetting to thank Him for the peaks and the valleys, the rainy days and the rainy days. I don’t want to repeat this class again. I hope I have learned this lesson well.

The thing that has surprised me the most is how others have viewed what I am going through. Many others have endured so much more, so much worse. I think that first, we live in a world where appearances are so important that many see this as much more devastating than I do. Maybe I’m a bit numb yet, it hasn’t yet sunk in, I don’t know. But I believe that what I have gone through, is life saving, not at all life altering. I remember one night before my surgery, Troy coming and talking to me. He was crying, worried about me and would I live and did I know how much he did indeed love me. I think through his agony, I was able to see, I’m not going to die from this mastectomy, but I’m going to live because of this mastectomy and for that I am so grateful. I have a chance to wake up and realize that indeed, half of my life is over, maybe more than half of my life and I have a new chance to make each and every day count for something. What do I want it to count for? Not for nursing, or motherhood or Kaiser or for California, for America, or for breast cancer being stamped out. I know that I do not deserve to live one more day or take one more breath than God would have me endure. I must make it count for Him. He is the giver and taker of life. It is all for His glory. It is all that some day we will be in heaven and be with Him. There is no better reason for life than Jesus. There is no greater cause than the cause of Jesus Christ and His plan for each of our lives. Thanks for reading and may God bless each and everyone of you into eternity.

Love and hugs,

Becky Richards, R.N., SNIII, July 4, 1998


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