Surviving Breast Cancer

Dr. Vaughn: Welcome listening audience. Thank you so much for tuning in to our special podcast here on breast cancer survivors. I’m honored to have Sarah here with us. I am so amazed at the courage and resilience of our patients and Sarah is a testament to that. We’re going to spend some time talking about how she found out about breast cancer and her experience here at HOAF. Hopefully she had a very positive experience and hopefully has some thoughts for others that are newly diagnosed.

So I’d like to open up and just thank Sarah for being here, and I thought we’d just start with a little background about yourself, Sarah, and how the diagnosis came about and what the initial start of the journey was like.

Sarah: So I found the lump myself and was referred to go get a mammogram. At that point they referred me to all of their physicians from the hospital so we kind of went wherever we were told to go. And the diagnosis was Christmas Eve so we really didn’t have – we were kind of going through the motions, whatever we were told. After the holidays we were able to talk to people. I work for a local physician’s office so I was able to talk to some of my co-workers, the physician I work with, and we were given some other names to check out. So we did second opinions all the way around from breast surgeon to oncology and plastic surgery. We met with a second round of physicians and decided to go with our second round of physicians. It just felt like a more cohesive team I guess for lack of a better word. By the time I got here to HOAD Dr. Vaughn had already talked to Dr. Blanchard and everybody was kind of familiar with what was going on and the situation so I really felt like we had a great team going and everybody knew instead of these segmented parts with the first physicians that we went to.

Dr. Vaughn:  With that being said I think – you know when I meet new patients I think it is important to build I think – for that first hour there’s a lot of anxieties about the diagnosis. You’re here and scared. Building this trust and comfort I would say, and it seemed like that was something that was very important. And kind of going through some different offices too; something about the comfort level here at HOAF that you had a feeling about.

Sarah: Yes. Everybody here was great. I know in some of the other offices the second things got emotional my husband was who they spoke to. And that was not the feeling I got here at all. So we definitely felt confident that you guys knew what was going on and what the right path would be for us.

Dr. Vaughn: What was it like – I know going through maybe the initial treatment plan we talked about this is what to expect. But when you come in for the first day of treatment with the anxieties, the unknown; just kind of talk about that and then maybe after the treatment; how you felt leaving. Was it different with the support system here at HOAF and having your family here? Was it a different expectation after we talked?

Sarah: Yes actually. So we came in the day before treatment actually, and met with Liz, the nurse practitioner, and she was wonderful. But that was really reality is here. I believe that was a Thursday and I left here and went and had my port put in and came the very next day for treatment; scared to death. And Ashley is amazing. I absolutely could not have gotten through this without her. She has been wonderful.

Dr. Vaughn: Ashely is one of our infusion nurses who works with me, and I think that is one of the special qualities about HOAF is our team approach. And having Liz, who is our new APP for my team, and then having Ashley we built this bond obviously that helped you through it sounds like the first day.

Sarah:  Yes. From the first day on she and I bonded. She went through everything; this is what I’m giving you, whatever. I was surprised as you’re going through the treatment that’s kind of anticlimactic per se. Accessing the port was not as big of a deal as I expected it to be. As you’re getting the infusion that’s just kind of wasting time honestly. They kind of go through what they’re giving you and they tell you everything – what to expect. But the treatment itself really was just having to be here for many, many hours. I went home and it was fine. The first treatment was like waiting for the shoe to drop. What’s going to happen; what am I going to feel like? The next day was pretty good. I had the – what is the patch – the injection?

Dr. Vaughn:  Oh, the Onpro.

Sarah: Yes, Neulasta.

Dr. Vaughn:  The Neulasta injection the day after; it helps your white blood cells, right?

Sarah: Yes. So pretty much everything was good up until that, and then pretty much after that kicks in then you start to slow down and start to feel it a little bit. But after the first treatment really it wasn’t nearly as bad as I thought it was going to be. The first treatment – kind of I came back I think on Monday and got my blood drawn for my levels, and everything was good. Everything was status quo. We came back for the second treatment; that’s when I had to start getting hydration and that sort of thing. So the first treatment wasn’t nearly as bad as I was expecting.

Dr. Vaughn:   I think just from my experience, not personally but through my patients, it seems to be that the anxiety of the first one I expect is like the day of it feels really bad. But it’s more of the additive treatments, and sometimes just the long-lasting effects of some of the chemotherapy. But it sounds like having the team and Ashley and Liz; the comfort of having someone to reach out to and I’m hoping we’ve tried at HOAF to have sort of these outreaches to get to you for hydration, or for just a visit.

Sarah: Right, and I was here a lot for that. And it was great, and I love how nice it is here. But if you’re having an infusion and you’re not feeling so good or you’re here for hydration, they can call and talk to you or talk to Liz; or somebody will come and see you chairside if it’s needed. It’s not sorry; we’re not going to see for six weeks; you don’t have an appointment kind of situation. It’s you’re taken care of when you’re here. So that was really nice. And honestly, Ashley and those girls are phenomenal and they can handle telling you things that you’re not expecting and that are going to send you on a downward spiral. I was feeling great after treatment four; not expecting anything to be off. And Ashley says your blood count’s really low; you need a transfusion. And I lost it; because I wasn’t expecting it.

Dr. Vaughn:  But I think to build you up and the motivation to kind of keep you on course is such a quality I think for our infusion nurses that it does separate them from other occupations; they’re unbelievable.

Sarah: Yes, they’re amazing. Their compassion and how they get to know you and you get to know them, and it’s just – it’s definitely an experience; it definitely helps.

Dr. Vaughn:   So it sounds like some good relationships built with some of the HOAF team have helped get you through?

Sarah: Absolutely, absolutely. It’s very strange; I was coming every other day for two weeks in a row and then I had a couple days off and I’d come back for treatment. And now I’m here once every three weeks and it’s kind of strange. I’m like where are they? I haven’t seen them in so long.

Dr. Vaughn:  Well we missed you. Luckily you’re over the hard part of the course and now on just an every three week treatment.

Sarah: Yes.

Dr. Vaughn: Sarah, how would you say sort of the journey you’ve been through and how has that just for someone going through it; how as this impacted your family, work? How were you able to kind of juggle this whole thing?

Sarah: Every step of it has been different. Chemo was definitely a challenge. Thankfully I had a very supportive office who I worked remotely for the most part so I would not be exposed to all the germs. So that was definitely very helpful. I don’t think I could have done full days in the office. I don’t know how people that still work fulltime do it in an office. But I tried very hard to keep things as normal as I can since I have a 10-year old, and getting out seemed to help. You know getting out and seeing her sporting events and doing those things. Not sitting at home feeling sorry for myself made a big difference; to be able to get out there and try and keep life as normal as possible.

Dr. Vaughn:  Yeah, that’s a great message. I try – at least when I talk to patients I try. I try to keep life normal as much as possible. Did you rely on the family support or friends to kind of sometimes just pick you up? Or was it…

Sarah: All of the above. I mean I have a lot of fight for my family and my kiddo and my husband. God love him, he had to pick up the slack and do way more than he’s ever had to do. My mom would come up and do our laundry. We had friends help with getting our daughter to and from places and that sort of things. So if a game landed on a night that I wasn’t feeling so good after chemo, we had friends that would FaceTime me and so I would be able to see the game from home.

Dr. Vaughn: That’s awesome.

Sarah: So we had a great support system. Even after surgery people bringing meals and just helping with things that we needed around the house.

Dr. Vaughn: It just shows you how important it is to have that kind of built. It’s important to have that kind of support to help you out.

Sarah: Yes.

Dr. Vaughn: Was there anything you were – I know you’re still going through it but I think on hopefully on the easier course now.

Sarah: I hope so.

Dr. Vaughn: Is there anything you were not expecting or surprised at how well you did? Going through the journey so far has there been something that wasn’t as bad I thought or this was harder? Was there anything that kind of surprised you?

Sarah: Those portions so far have been hard in their own accord. Chemo was hard; not feeling good, being tired, not wanting to eat, but still able to do more than I thought I was going to be able to do. You hear chemo and you think oh my gosh; I’m going to be in the bathroom sick, throwing up, not able to do anything. And that wasn’t the case at all. I was tired, didn’t feel great, but not on my – not in bed all day. It wasn’t that kind of sick. So I was surprised, thankfully, that it wasn’t what you envision in your head when you hear being on chemo. And then surgery is a whole different recovery. I would not be able to do laundry for different reasons than being tired from chemo. You just can’t necessarily reach as far as you thought you could. It’s a physical, almost physical different and metal recovery for both of them.

Dr. Vaughn: Right.

Sarah: So different and challenging at the same time for recoveries for those things.

Dr. Vaughn:  We – because your treatment was chemo – which is kind of a new kind of shift with chemo first and then surgery after. And it is a little bit challenging. I find chemotherapy kind of with most patients is the harder part. But you’re right; you kind of had the hard part first but still then you had to have the physical issues with surgery. Which can be tough.

Sarah: But that was a much quicker recovery than the chemo was.

Dr. Vaughn:  Yes, oh definitely.

Sarah: That was much quicker.

Dr. Vaughn:  What helped you through it at HOAF different than maybe another office or another practice?

Sarah: I think the environment and everybody here. And like you said the way you all work as a team. And the pods; I loved that there’s a pod and it’s your group. You have the same nurses every time and they get to know you and how your situation is. They knew my quirks; they knew halfway through don’t even bother taking my blood pressure until I’ve been here half the time because it’s going to be through the roof when I get here. I just think that the cohesiveness of how you all work together. The fact that the RNs, the infusion nurses, have you guys right at their fingertips if anything – they don’t like how our blood work looks or anything of that nature they have you guys and they have an answer right away. And they can help with any of the things to help battle the side affects you might be having. The ability to come in and get hydration every day if you needed it, or supplement whatever you were lacking. So I think that accessibility was huge.

Dr. Vaughn:  You are sort of a template for our surveillance clinic. The goal is to – if you’re going through treatment there are side effects. One of our missions is trying to avoid as much as possible going to the Emergency Room unnecessarily. And we know our patients well and sometimes you just need a bag of IV fluids or magnesium replacement or anti-nausea medicine; but there are ways of hopefully keeping out patients here and away from potential risks of infection at the hospital. And more importantly staying on a schedule too; I think that’s important. By opening up our clinic, which was in the last 18 months, you’ve been sort of a perfect person too as we envision the reasons behind it. How – if someone were new coming for advice with a diagnosis, what – after going through your journey here and experiences so far, what are some of the insights you could maybe give to someone, maybe on selecting a place or having to go through certain side effects? What would you offer?

Sarah: Yeah. Trust your gut and know if you’re in the right place. Talk to your physicians. If you’ve got side effects going on tell them what’s going on. There’s a lot that they can do to help and counteract that. In the beginning I don’t think I said too much and my husband kind of would fill in for me. Well don’t you remember, you – whatever? So remembering to say and maybe even just write down those things that are going on at home so you do remember when you come in. Because you come in and so much is going on in your head and you’re getting fluids and this, that and the other, and you don’t necessarily remember all of your questions until after the fact sometimes when you go home.

Dr. Vaughn: Well that’s true, because I think one of the things – maybe you could expand on this. You mentioned coming in the day before. How was your experience with – we’ve tried to have this chemotherapy education class, but really it’s a way of hopefully melting some of those anxieties of coming in. I’ve felt before we used to have patients come in the first day and kind of go through everything the first day, but it was overwhelming. By coming in the day before, meeting the team, hopefully that kind of helped ease some of the angst just a little bit to a new comfort level. But can you talk through that day before chemo? What was that experience like?

Sarah: I mean a little bit it did help because I saw where was going to be and that kind of helped the situation to know okay; this is where I’m getting my treatment, these are the faces I’m going to see. But honestly it was a haze. I really don’t remember too much of that day because that was the “this is reality” day. Because I honestly left here and got my port. So it was game on; we’re done with seeing doctors; we done talking about it; it’s game time; let’s get this going. So it was really a haze. I got to meet Liz and she was super sweet, and that kind of put me at ease a little bit. But in all honesty, until you have that first treatment and you see what it’s really going to do to you, you don’t relax a little bit. You’re just kind of waiting for the shoe to drop; waiting to see what happens. And being in that room getting treatment – during treatment or hydration or whatever because I was here so much – the girls are so good and you would know when somebody’s having their first treatment because you would hear the same spiel and you just feel for that new person. Once you become no longer the rookie who’s here for the first time, you’ve been here for a couple of treatments, you just feel for that person coming in for the first time. And I have met not only the staff but some amazing patients in this office; some fantastic people.

Dr. Vaughn: That’s amazing. How has this experience, going through this journey so far; how has it changed you and maybe has it changed your family, husband and children?

Sarah: I mean it’s definitely made us slow down and think about little things aren’t as big of a deal sometimes. And just slow down and enjoy time together. So it’s just kind of made us slow down and take time for ourselves a little bit more than we would have in the past.

Dr. Vaughn:  Well that’s awesome. Thank you so much for sharing with us. It’s an honor; you are a warrior and we –

Sarah: I’ll be glad when it’s over and I get the final all clear.

Dr. Christopher Vaughn:    Well thank you again Sarah.

Sarah: Thank you.

[Musical interlude]

Dr. Vaughn: Well I’m honored here today to be with Amy, another one of our breast cancer survivors, and thank you for joining us today.

Amy:   Thank you.

Dr. Vaughn:  I’d like to just kind of start off just with a little background story about yourself and how you were initially diagnosed, and what you were going through when you were told you had breast cancer.

Amy:   Okay. Well I was just going for my annual mammogram, which had been normal. At one time I had to come back for biopsy and it was fine. But every mammogram – I went every single year faithfully within days of the previous year – and I was always fine. And then I went that year and as soon as I was done the radiologist was like it’s really late in the day and they’d already had several add-ons but he said feel pretty sure you have breast cancer so I want you to come back in the morning for a biopsy. So I just went out to my car and was just stunned as you can imagine. And then the next morning came back and did the biopsy and he said he felt confident in saying that I had breast cancer. So I used a surgeon at that time that’s no longer in the area, Dr. Flynn. I called his office because I knew someone that worked there and I got an appointment and I went and set up my – I wanted to just get a double mastectomy and just be done with it. I hadn’t gotten my past results at that point; I didn’t know what type of breast cancer I had. But I had the double mastectomy; I did fine; it was real tiny; it was a no lymph node, Stage I.

And then when I found out what type I had – because he initially said oh, you’ll just take Tamoxifen for a year; you’ll be fine – then I found out I had HER2-positive breast cancer and hormone negative. So then when I started researching that I felt like oh gosh; this is super aggressive and I was really concerned that it would come back. And I felt like I wished I had had treatment for it, but it was so small that the guidelines weren’t such that you would get treatment for that.

But it did come back; it came back in my liver. And that’s when I really thought okay; now I’m Stage IV. My daughter had just had a baby, our first grandchild, and I had committed to watching the baby every Thursday for her so she could work. And I thought oh, I’m going to let her down. I’m going to totally – I’m not going to be able to do it. And I remember Dr. Menachery saying I think you’ll be fine. I think you’ll be able to still babysit and get your chemo. And he was right; I was able to. I still worked and I babysat on that day that I was off and I trucked on through it. So yeah.

And then after the chemo I had the liver resection and that went super well. I was home in four days; I was at Whole Foods a week later when I went back to get my stitches and I did fine. And then just things have happened along the way. It came back in my brain; I just had that stereotactic radiosurgery. It was just one shot because he has me going for those scans frequently enough to where every three months as soon as they saw it it was super tiny so they only had to do it once and they got it and I never had that again.

So I don’t know. I was telling my mom today – she’s 90 – and there’s no history of breast cancer in my family, on either side. But I guess it has to start somewhere. But I was telling her that this December will make seven years that I’ve been Stage IV and I will have had like 119 of my treatments by then.

Dr. Vaughn: Wow!

Amy:   Yeah. Because I get them every three weeks; I’ve only missed one in seven years and that was only because my echo had dropped and so I missed one treatment.

Dr. Vaughn:  A true testament to a survivor here. It’s kind of amazing where we’ve moved and you’re just a great example of breast cancer and sort of that shift that we have. Particularly the HER2 type.

Amy:   Yeah. I was so grateful that I was in the time frame where those drugs had just come out, that Herceptin and Perjeta. Because from what I had read previous to that it was a death sentence to have that diagnosis. And I’ve done really well. I mean I don’t feel bad from my treatments. I’m able to – as soon as I leave here I’m off and running. And I’m always looking at the clocks and timing my bags because I’ve got to get out of here; I’ve got stuff to do. And I don’t feel bad. So I mean the whole thing has been fairly easy for me. I hate to say that because it sounds like that’s crazy, but it has; it hasn’t been that bad. And my life’s gone on and now I have two grandchildren. And the one that I thought I wouldn’t get to babysit is 7 so it’s pretty amazing.

Dr. Vaughn:  Great story! And again some of the new treatments where you really don’t create so many side effects; where you can just function at such a high level. You’re a grandma, do your duties.

Amy:   Yeah, I still work and everything.

Dr. Vaughn:  That’s such a wonderful story. So initially you were with Dr. Flynn who used to be a surgical oncologist here and he relocated. How did you get tied with Dr. Menachery who is in our office? Was it your own volition or did someone refer him?

Amy:   It was. Actually he referred me to Dr. Essig. Dr. Essig was a great guy but he was an older doctor and I was hoping I would have long history with whoever that I went to see. Because I was only Stage I at that time and I thought okay; I want somebody young enough to see this through with me. And he didn’t retire right away but he did retire after that. And I had worked in the hospital before and seen Dr. Menachery and how kind he was to all of his patients and conscientious and how well thought of he was. And so I said well I’ll just go to him. And I just made an appointment and came over here so I’ve been here ever since.

Dr. Vaughn:  And how has it been coming into HOAF here? How as your experience been with the staff and some of the relationships? If you could talk a little about that.

Amy:   Oh gosh. The staff is great. I have never had to worry about my bill or my insurance or any paperwork. That’s always all taken care of and I never have had to address any of that. It’s always whoever is in charge here of all that, making sure your insurance company pays their bill; it’s always been done. Because that’s very stressful and I haven’t had to deal with that. And then just the way that they made me – especially through the initial chemo, the Taxotere – they give you so many things for just in case you don’t feel well. And it’s so nice to have that on hand and they prepare you for what to expect. And then just the girls over in the infusion suite are so nice. You get really attached to them; they’re super nice people and really care about – like the patients in there. You can tell. You get relationships formed with them and they’re super nice. And then of course I love Dr. Menachery.

Dr. Vaughn:  Yeah, I guess you’ve been here a while where you’ve seen some of the changes we’ve implemented. Because we have tried to make it turn into sort of a team atmosphere where Dr. Menachery has his –

Amy:   It’s nice that you have that continuity of care with kind of the same caretakers when you’re over in the infusion suite. So you do get a relationship with them instead of it being somebody different every time you come in. It’s nice; it makes you feel like you’re able to talk to them or tell them if something’s wrong. Whereas you might not feel as comfortable if it was somebody that you didn’t see but once every couple of months.

Dr. Vaughn:  Right. And that’s exactly the point. I mean the continuity for us as providers makes a big difference. And sometimes you build this relationship, and some of the nurses may know if something is just a little off with you and they can just pick it up easily. So it really helps with the quality of care I think.

Amy:   Yeah. I’ve had little funny things go wrong that I didn’t think anything of. Like one time I had had a port put in on one side and my neck felt stiff. And I just mentioned it in passing and in minutes they were like oh, we’re going to need an ultrasound of your neck and all that. And it turned out I did actually have a clot and so it was their quick thinking and just observing me. And I had another time where I had hurt my leg and they always notice. If you’re coughing or do anything different they always notice; are you okay? Yeah, they’re super thoughtful.

Dr. Vaughn:  Well gosh, how does it feel going through these treatments for so long? Is there still angst?  

Amy:   No.

Dr. Vaughn:  Or nervous at scans?

Amy:   Well I do get nervous at scans. I think everybody does just because that’s the – you know, what you’re looking for, for something. If it’s going to crop back up that’s how you’re going to find it out. So that part is nerve wracking but I don’t feel like it is as nerve wracking as it used to be. Mostly because you all draw my tumor markers frequently and I always watch those. And I feel like they’re okay so your scan is probably okay; just don’t worry about it. And I also find out right away. Dr. Menachery will email me and let me know; hey, your scan was okay, your brain MRI was fine or your CT scan was fine. So knowing you’re going to get your results quickly is helpful too.

Dr. Vaughn: That’s a very good point. I think sometimes I don’t like having a test done but then –

Amy: Waiting.

Dr. Vaughn:  They’re waiting, so I think you try to do a good job getting those results to you as quickly as possible; good or bad.

Amy:   Yeah. Even the tumor markers I get quickly. So it just makes me feel better that somebody is keeping track of it other than just me and that I’m going to find out quickly.

Dr. Vaughn:  How has this changed you by going through this for the past seven years? How has it changed you; maybe your interactions with friends, family?

Amy:   I feel like with family it has made me – it’s been like even when I’m tired I still just drive on to spend time with my grandkids, my daughter, my husband; just because you don’t know. So it does make you appreciate things more.

Dr. Vaughn:  It’s an amazing thing to see how you are a true warrior; battling this and still functioning and just going through everyday life. What would you pass on or relay to someone who is just diagnosed as they’re going through it? Any words of wisdom?

Amy:   Well I think at first you’re just so overwhelmed and you just immediately associate that with okay; this is it. I’ve got to get myself in order here because I’m not going to be around. And that’s not really the case. Look how long I’ve been around, and so many people are diagnosed with Stage I or Stage II, and I’ve had Stage IV. And like my husband says, there’s no Stage V. But I just think that it’s not a death sentence. You can manage it. It’s more I just think of it as being a chronic condition and not a death sentence. And I honestly don’t feel bad from my treatments and I’m able to continue on with my life and do the things I want to do, and spend time with my grandkids and my family. Not what I thought initially. When I heard it initially I just was devastated. And I think if somebody could just know that it’s not going to be that bad; you’re going to be okay.

Dr. Vaughn:  And did that take time to feel that way?

Amy:   Yeah, I think it takes time. I think the more times that you get your treatments and think hey, I’m fine. I’m not laid up or dying, feeling bad. And my scans are coming back okay. I did – I switched my eating to trying to eat more of a plant based diet. I figured that would be helpful and so I do that; and that makes me feel like at least I’m doing something, you know what I mean? And I just feel like if you could just tell somebody it’s going to be okay; but I guess nobody believes it until they’re in the process.

Dr. Vaughn:  Yeah. I was going to ask you, but I guess you kind of described some of the things maybe you’ve changed about yourself. You mentioned diet.

Amy:   Um-hmm. Yeah, I stopped eating like animal products in May of 2012. My husband is always – he still eats them. But he’s always like well, I don’t think it matters. I’m like well, I can’t turn back now. So I figure whatever. I’m doing good so I’m just going to stay with it. It can’t hurt.

Dr. Vaughn:  Well that’s a wonderful story. I mean just like I said, a true warrior. Thank you for joining us.

Amy:   Thanks for having me. I appreciate it.

Dr. Vaughn:  Amazing story.

Amy:   I appreciate it and I appreciate all the good care I’ve gotten here. It’s made the difference, it really has. So you don’t feel like you’re just a number here. You feel like you can come here and you’re going to be taken care of so it makes a big difference.

Dr. Vaughn:  Well thank you.

Amy:   Yeah. I appreciate it.

[Musical interlude]

Dr. Vaughn: So Lura, thank you for being here with us today. We’re going to talk about breast cancer survivorship from being diagnosed with breast cancer awareness in October. I want to open up; I’d like to start with a little background, history about initial diagnosis. But I also would like to get into your nickname, which is supposedly “The Sweetheart of Fredericksburg”, which I was told to bring that up.

Lura:  Okay.

Dr. Vaughn:  That’s a good little background to start I think.

Lura:  All right. Well I’m not so sure where that came from but I’m happy to share. I like that name. I love Fredericksburg. I worked 30 years for the tourism office promoting Fredericksburg to tour groups, bus groups, conventions, meetings, and my heart is here in Fredericksburg. I love the town. So maybe that’s where it all came from.

Dr. Vaughn:  Well that’s a perfect sort of meshing point. We’re trying – that’s kind of our goal is really to kind of promote how well we think we can provide community oncology care in Fredericksburg. In kind of just going through your story or your initial diagnosis and how you made it to HOAF, can you tell us a little about that?

Lura:  Certainly. Well I started back in 1997 and I was diagnosed with Stage I breast cancer and so I had a lumpectomy. And then I did chemo and radiation and then on the pills. So I thought that was going to be it. Well then in 2005 I had a lump in my other breast, so again I had chemo and radiation, and then started on the pills. Well they weren’t – it wasn’t finished with me because in 2012 came either a reoccurrence or a new something in my right breast, and so we elected to do a double mastectomy. So I did that and that all went well. Did the mastectomy and then Dr. Heppy came in right behind it and did the reconstruction so it was all good.

Well then in 2014 a spot came back in my chest and they surmised it was where the radiation was done on the left side and then done on the right side, it was a spot right in the middle that it didn’t get. So I couldn’t do traditional radiation anymore; I’d already had it on both sides. So Dr. Chenault said I can’t do radiation on you but I know who can. And so he sent me to Hampton, Virginia to the Hampton Proton Institute, and I was down there for six weeks and did proton therapy.

So then I came back and everything was good, and then in 2017 I retired from work and in a couple of months my PET scan showed that it had metastasized to my bones and lungs. So I had radiation on my back, my bones; and then I started the Ibrance and the Faslodex, which has kept it under control. And so I’ve been with this organization since Dr. Niemer back in 1997 and it’s always been a wonderful experience. People are friendly, they are caring, and I’ve had great doctors through the years here.

Dr. Vaughn:  Well thank you for that, sharing the story. Just emotionally it’s such a roller coaster ride for some patients. But describe sort of the feeling you went through having treatment being done and then it coming back. How have you been able to keep such a positive mindset through this?

Lura:  I will never forget that when I was initially diagnosed; my surgeon back then was Dr. Daniel. And he was a family friend so when he called me to tell me he said I want you to come to my house today. And I went and he said listen to me; when you hear the C word, it does not mean it’s the end. We’ve got great treatments and we’re going to take care of you. And I just kept that mindset through the years; that with all the advancing medicines, all the new things that are coming about; I just put it in God’s hands and the doctors’ hands and I just let it go. It’s not to say I haven’t had my moments where it’s oh my goodness; again? But I’m a fighter and I’m not going to quit. I’m just going to rely on the good doctors here and the Good Man up above and keep on going.

Dr. Vaughn:  Who do you – like through this experience and journey, who do you turn to? Is it friends, family, obviously spiritual?

Lura:  I say the Three F’s: friends, family and faith are the three things that have gotten me through. Because I’ve had a strong support system with my family; and I’ve always – you know, raised in the church so I’ve always had a strong faith. And friends have always been there for me; offering to sit with me during – you know, those initial chemo treatments, they were rough. Back then 22 years ago they were pretty tough. And I would get treatment and then go back in a couple of days and get a shot. And all weekend you were just aching; it was so – it hurt. But there were always people there to help me; bringing food, doing for me whatever needed to be done.

Dr. Vaughn:  You aren’t just speaking from an oncology standpoint; a true testament of how things have changed. You mentioned two forms of treatment that are new; one is the proton radiation, which is a whole new, different way of giving radiation with less side effects to other areas. That’s quite amazing that you were able to receive that. And then now you’re on a hormone kind of pathway treatment; you mentioned Faslodex and Ibrance, so two different treatments that synergize together and are able to keep things stable and without a lot of side effects. Because you look great; it sounds like functioning at a high level.

Lura:  I just can’t eat as much as I want to anymore. I just don’t have the appetite. And I do get tired. But otherwise I’ve had very few side effects.

Dr. Vaughn:  How has your experience here at HOAF either changed, and how has either support from the doctors, the practice providers, the nurses; how has that helped you kind of stay focused and determined? Because you definitely seem to be on point.

Lura:  Everyone is so upbeat, and that’s I think the thing you notice the most. It’s not – when you come in here you see some sad cases, but nobody seems sad because it’s such an upbeat place that everyone that works here is friendly. They are saying hello, how are you doing. Some of them know you by name. Plus I like some of the services you provide. I take advantage of the yoga and so I do that every week. And today at lunchtime went to the support group and heard a talk. So I take advantage of those things and I try to tell the people at the support group how important that yoga is. I think it’s wonderful that you all provide it to us.

Dr. Vaughn:  Why? Because that is something we’ve started doing the last few years. How has that changed your ability to kind of stay on treatment or just your mental approach? How have those sort of other services helped you?

Lura:  Well I think that they have given me some of the energy that I think typically the medicines would have taken away. I feel good after yoga; it does energize you and it’s good to be around other people. And we laugh; I can’t do everything she wants us to do. But it’s still a lot of fun and it just is an encouraging time to be with others and to take advantage of all that yoga offers you. So it’s that mind and body thing. We sometimes forget that we’re alone in this and having that group lets you know there’s so many others that are fighting too. So I’m very appreciative of all the services that you all offer.

Dr. Vaughn:  Well that’s wonderful. I think that’s kind of what we envisioned when we started to implement these is how we can not only focus on the physical, but the mental and the spiritual and some of the services that treat the whole person and their family.

Well Lura, you talked about starting with Dr. Niemer who was our initial founder of the practice and you since have changed with his retirement to Dr. Moore who is now helping take care of you. Can you talk about your experiences with her?

Lura:  Sure can. I love Dr. Moore. When I was – when it spread to Stage IV – I was already in the practice of course – but I chose Dr. Moore because my previous doctor had moved on. And I’ve just grown to be so confident in her. I feel like she is abreast of all the new medicines. When I asked her what happens when the Ibrance and the Faslodex doesn’t work anymore, she said to me oh I already have a new medicine that I want to try for you. So I feel like she is up on all of the new medicines. She knows about my family; she asks about my family every month that I see her. And I know that if I have had a test done she gets the results to me as quickly as possible and that is so important. She calls me; whether it’s at 5:00 or 6:00 on a Friday night she does it. And so I’ve just grown to love and trust her so much.

Dr. Vaughn:  Speak about – you know, going through this for so many years how this has impacted your family, your children, your spouse, friends. How has it changed your interactions, relationships, or how they’ve helped you in this practice?

Lura:  Sure. I think when I was initially diagnosed my husband was so nervous. After the first treatment I said you can’t go back with me anymore. He was just so nervous about it. However, my 8-year old son would go with me, and back then I had to give myself shots to boost my red blood count. My 8-year old learned to give me those shots and gave them to me every night. So it’s been a part of his life for a long time. He’s now 31. And I don’t know; we just all go with the flow. That’s not to say when something new comes up you’re not anxious and worried; but we’ve just learned to trust.

Dr. Vaughn:  And what would you – considering your vast experience through this; if someone new was asking you for some advice, what insight would you offer?

Lura: Well the first thing I tell everybody is don’t go to the Internet. Don’t read it, because this is just too much. Depend on your doctor; listen to your doctor and go by what they say. So that’s always my first piece of advice to them. I tell them depend on others. Let people help you. And I tell some of my friends too; you don’t have to be strong all the time. If you want to get in the shower and cry then get in the shower and cry. You don’t have to be so strong all the time that we try to be. Because we’re women; we think we’ve got to be strong for everybody. You don’t need to be strong all the time.

I’m very thankful. I appreciate this opportunity and I’m very thankful for everyone that works here and has provided me this care for 22+ years.

Dr. Vaughn: Well thank you. You look great and just an amazing story. You’re such a warrior and such a champion for the fight against breast cancer. Thank you for being with us.

Lura:  You’re welcome. Thank you.

Thanks for listening to Cancer Shop Talk: Behind the Diagnosis.  If you enjoy our show and want to know more, check out HOAFredericksburg.com; or leave us a review on iTunes.  Join us next month when we go behind the role of advanced practice providers.