While she and husband Bernie left thinking all was ok, in the back rooms of the clinc, experts pored over her pictures. A suspicious spot was found on her left breast. By the time Tiny reached home there was a phone call asking her to go to the Ottawa Women's Breast Screening Clinic at the Maurice Grimes Center attached to the Ottawa Civic Hospital on the 15th of May, just three days later.

There was a little worry, but it was somewhat alleviated by the fact that some four years previous a similar situation happened with the opposite breast. All was clear on the second examination. It turned out the ultra sound found it was just a blip on the mammogram. Remembering this, Tiny and Bernie, promised themselves and each other that they would try not to worry till there was something knowledegable to worry about.

Day 4 - On Thursday, the 15th of May, 2003 Etheleen went back to the Ottawa Women's Breast Center. While there she underwent another mammogram and an ultrasound of both breasts... a small white patch showed up on the ultrasound which Tiny could see as well as the technician moved the ball around her breast... The radiologist came in and took a good close look at the pictures and Etheleen was told they would like her to have a biopsy done on 27 May.

Preparations for the biopsy started a few days before, with her aspirin a day treatment stopped on the 22nd of May so her blood would not be so thin during the biopsy.

What's a woman to do the day before a biopsy for possible breast cancer... Get a haircut of course.

Day 16 - Tuesday, 27 May... B-Day! 09:30 am Etheleen and Bernie show up for the biopsy. They were in this together, no matter what. No room for Bernie in the Biopsy Room so he patiently waited outside. It didn't take long. Soon Etheleen was out of the treatment room with the word that results would be forwarded to her family doctor within 3 to 7 days... a long wait, knowing something had shown up.

Day 19 - Bright and early Friday, 30 May, 2003 there was a phone call from Etheleen's family doctor asking her to come in to see him. Off went Tiny and Bernie, reminding each other that they would try not to worry till they knew what to worry about. The Clinic had faxed her family doctor the results... With kind, compassionate words the doctor told Etheleen and Bernie that she was diagnosed with a cancerous disease called an "infiltrating carcinoma" on the outside of her left breast. Possible actions were discussed; options of possible treatments and options of Surgeons. Along with the diagnosis Etheleen was advised that she had an appointment with a breast cancer surgeon at the OWBC on 17 Jun. 18 days to wait... a lifetime... it seemed.

She was going to see a Breast Cancer specialist Dr Mirsky (the same dr who did her biopsy) on the 17th of June for a consultation of all that is possible and necessary. This consultation would be at the Ottawa Regional Women's Breast Health Center, 200 Melrose Ave, the Maurice J. Grimes Lodge. This is the building to the east of the Civic Hospital, the same place she had the biopsy done. While Tiny's options included which surgeon she could have treat her, both she and Bernie, and her family doctor liked the promptness and care the Ottawa Women's Breast Health Center had given and a decision was made to "go with" the surgeon she had the appointment with. Turns out, it was a great decsion. By all reports he was one of the best in the city, region... province. In the meantime some things would change forever in Etheleen's life. Gone immediately were her hormone pills... Apparently Breast Cancer cells love hormones... There's probably a better technical explanation, but that's it in a nutshell.

Back home, Bernie surfed the net looking for information on "infiltrating carcinoma". The words were difficult to remember. He kept forgetting the techincal term for this breast cancer. Let's see.. he used to be in the army and infiltrating enemy lines was a common theme.. oh and look Bernie and Tiny lived in an area called Carson Grove. This should be easy to remember now... Why wasn't it just simply called Breast Cancer? That's what it was... As page after page came up on the Google Search engine... it became clear that another word for infiltrating was "invasive". Gosh, that sounded so much more scary.

However there were oodles of articles and great diagrams and pictures. it was much easier to understand the make up of the female breast, something we mostly just take for granted. Did you know for instance that it is full of little lobules (milk-producing glands), ducts (milk passages that connect the lobules and the nipple), and stroma (fatty tissue and ligaments surrounding the ducts and lobules, blood vessels. An excellent explanation and diagram may be found here. and another similar article here. Now there was a need to find out which kind of Breast Cancer Etheleen's was... ductal or lobular, in whichever case, it was infiltrating outside of the ducts or lobules. That can't be good! It was invading the rest of her breast, or at least had the possibility of doing so.

Looking over Websites to see what can found was a lesson all of it's own and of course it is always difficult when you have really no idea of what her particular diagnosis would be... (ie size, and age of the mass) The treatments on the websites ranged from a small incision and taking out the lesions mircrosopically leaving only a tiny scar where the penetration was made, to a cut across the breast and removal of the mass, with of course a longer scar, to the worst case scenario, removal of her whole breast, with some kind of artificial replacement. However, we didn't know how this related to Etheleen's cancer. We decided to keep it low key she talks with Dr Mirsky. The surgeon's visit would tell all.

Out of every darkness though, one can find a silver lining. So many caring people in Etheleen's and Bernie's lives surfaced. So many other women who have encountered the same or similar disease came forward. Casual friends, become close... Close friends became closer. It really is a wonderful world.

Day 37 - Tuesday, 17 June, 2003, some 18 days after hearing of the intital diagonsis, the examination and interview with Dr Mirsky at the Ottawa Regional Women's Breast Health Center was upon us. At 8:00 am. Our daughter Cathy joined us for the visit. She works in the adjoining Civic Hospital. Dr Mirsky had a good long talk with us and then took Etheleen and Bernie to another room where he did a detailed examination of Tiny's both breasts and stomach. He filled us with information and confidence. He was both warm, friendly and compassionate, and very professional, exuding confidence in his knowledge and recommendation.

Here it is, here was the gospel according to Bernie... (bear in mind, this is our recollection of the doctor's words, not his) Etheleen has a five (5) centimeter mass of a cancer called an "infiltrating lobular carcinoma" just to the left of her left nipple. It is expanding locally within her breast and must be removed. Five centimeters for those of us who are metric impaired is about two (2) inches, a huge mass in our minds. I mean hold your fingers up with what you guestimate is 5 cm or 2 inches, then place it against your breast first sideways then lengthwise and you can see this is HUGE. His recommendation was for a Mastectomy which means a total left breast removal. He said that based on his experience, it is his opinion that this would be the best option to be certain of removing all of the cancer.

Etheleen and Bernie had discussed the possibilities and believed a lumpectomy surgery would surely be followed by another and possibly another as the cancer is growing, creating more pain and anxiety, rather than an assurance of complete removal of the cells. This guy was an expert with many years experience, he was oozing with professionalism and confidence. We immediately accepted his recommendation.

He will also remove a triangular portion of Lymph Nodes from under her left armpit, a place where if there is any infiltration from the breast it will leave a telltale sign there. (again our words, not the doctor's technical words) Removal of them will do two things... One it will tell him instantly if any cancer cells has passed through the lymph nodes, (this is the only route it can take to spread to other parts of the body) and two, removing these lymph nodes will help prevent it from going anywhere else in her body if any happened to be left behind, unseen.

The operation is scheduled for 10 July at the Queensway-Carleton Hospital in the West End. (Another wait... 23 days, this time!) That is where he does most of his surgery and was the first available operating room in the city. It will most likely be a day surgery, in and out in the same day, but there is a possibility that will only be known in the recovery room that she may have to stay overnight.

He left us with the impression that in so far as operating procedures go, the mastectomy is minor surgery, which will not hurt very much in recovery and there is not much, if any, danger of problems with the surgery itself. He said that he can't remember having to give blood to a patient during this kind of surgery. He was very quick to point out that the emotional side of it is much different and will be up to Etheleen and her family and friends to cope with. Dr Mirsky told us about the "team approach" to breast cancer surgery with Etheleen at the center of it all. Doctors, nurses, family, social workers, technicians, etc will all help with this surgery and her recovery. She, "we" were not alone! How right he was with that assessment!

Etheleen in her own "lovable" way said she accepts his diagnosis, and proposed treatment, because she has a great first impression of him and his manner, and she liked him right away. He appeared very pleased with Tiny's attitude and acceptance. He laughed gently and said "I like you too, Etheleen. My first impression is that you will be a great patient."

Dr. Mirsky is the Program Coordinator of Medical Services at the Ottawa Regional Women's Breast Health Centre. He is on the consulting staff of the Ottawa Hospital, Civic site and serves as a surgical consultant at the Ottawa Regional Cancer Centre. He is also on surgical staff and the Queensway Carleton Hospital, Nepean, Ontario. His surgical practice is dedicated specifically to the care of women with breast disease. His interest and expertise in the diagnosis and management of breast disease, particularly breast cancer has lead to his active participation on both provincial and federal committees creating guidelines for the surgical treatment of breast cancer.

(First impressions) Dr Mirsky is both very professional, and at the same time very down to earth. He has been a breast cancer surgeon for many years. We are very confident in both his and Etheleen's abilities to overcome this cancer. It's like a gall bladder or stone. It it is diseased and it simply has to be removed. We're in good hands.

Day 45 - Wednesday, 25 June, 2003 Etheleen and Bernie spent the morning at the Queensway-Carleton Hospital for a pre-op clinic. She had an ECG, then a session with a nurse to go over details what would happen the day of surgery. The nurse gave instructions of what medicine to take and when to stop before the surgery. She gave us two booklets with all the information written down and sent us off to the Physiotherapy Department to learn some post op exercises for Etheleen's arm. A Physiotherapist sat down with us and went through a set of four stages of exercise necessary to keep the arm mobile, flexible and to help ward off a secondary problem of Lymphoedema which swells the arm beyond belief, causing great pain and concern. Following the physisotherapist we sat down with another nurse to learn about Home Care Nursing after the operation. Oh yes... did I mention this most significant hospitalization in Etheleen's life would be over the same day. geeeeze, can you just imagine. And there we were... In at 8:00 am and out at Noon... a good day of learning. We are to phone the hospital Day Surgery Bookings Office the day before surgery to get our reporting time. And we received a prescription for some drugs to pick up for use by the Home Care Nurses in post op Home Care.

Day 52 - Saturday, 2 July, 2003. A box of medical supplies arrived for the Home Care Nurses from the VON that would be attending to Etheleen after surgery. A huge box by the way!

Day 54 - Friday, 4 July, 2003 Another pre-op clinic... This time at the Merivale Imaging Clinic. 08:00 am an ultra sound on Etheleen's abdomen, 08:30 injecting a die into her for a later in the morning bone scan. 09:00 X-rays and then off to breakfast with instructions to drink lots of water to help spread the die throughout Etheleen's body. but be sure to void as much as possible of it afterwards... Now that's a trick eh? Back at 11:00 for the Bone Scan... It covered Tiny's complete body, head to toe. Another encounter with a sensitive technician who gave Etheleen lots of encouragement and spent time with her. Etheleen is very claustraphoic and when the scan machine had to come down close over her head the technician stayed very close by to give her a sense of confidence and not being alone. Just one of many Doctors, Nurses, Technicians, Therapists, encountered over this ordeal that helped with a great calming effect. (You guys are GREAT!)

Back to surfing the web: What's a bone scan for? Look here! A bone scan, it says here, helps tell if any cancer has spread outside the breast cancer area. Boy they sure are thorough eh?

Day 60 - Thursday, 10 July, 2003. Surgery Day! Two months from the initial mammogram, here we go! I hope the provincial government is reading. This would not have been found without the mammogram, or perhaps found too late for effective treatment. Remember Pre-Op, in at 8:00 out at Noon. Well......... another day, another in and out!

Alarm set for 05:15... Wasn't needed. Bernie said we need to leave by 06:00 to arrive at Queensway-Carleton Hospital in the west end of Ottawa, as directed, at 06:30 am. No bags to pack, Etheleen wasn't staying, she'd be home later that afternoon the Doctor had predicted. showers and dress.. and sit around waiting to leave. Finally Etheleen couldn't wait any longer.. 5:45 am... "Let's Go!" said she. So off they went. "Why are we going so slow?" asked Tiny... "It seems like we're crawling." "Well," Bernie said: "normally it would take us maybe half an hour to get there, but at this time of the morning with no traffic we'll be there by 6:05..." and we were.

Guess what?   The admitting doors don't even open till 6:30! So sit around waiting somewhat impatiently, wanting this to all be over. Finally the doors sprang open and in we went. SARS slowed us down a bit, needing to fill in forms and sign in before even approaching the Admitting Desk. Admitting was remarkably fast and well organized and within minutes we were on our way to the Day Surgery Section down the hall and around the corner. More papers to fill in and time for E. to change into the beautiful gown all hospitals provide along with those little paper slippers too. Bernie waited till she had to go to the pre-op room, where he wasn't allowed in. From now this morning, his part in this saga was to be the worry wart. He was calm. He had faith in the Surgeon and the OR staff. All he could do was wait. an hour and a quarter was the prediction before Tiny would come out of the OR into a first recovery room where she would sleep and recover for about an hour and a quarter more. At the time she came out of the room, Dr Mirsky would find Bernie in the Queensway-Carleton's Quiet Room.

Did you know the Cafeteria service doesn't begin till 10:30 or 11:00. What to do? Well with no Cafeteria they had a modern marvel of science and technology... A Tim Horton's right on site. *grin* That would certainly make the wait a little shorter. It seemed like hours though, waiting to hear... full of good hopes and a bit of worry... Bernie waited till the Surgeon appeared. He was smiling very confidently when he said hello! His first words out were: "Everything went well! The surgery was very sucessful." He then told Bernie as he had told Etheleen just before the operation began, that he received all the results from the Bone Scan and ultra sound. There was no indication of cancer in her bones... or on the ultra sound. What good news... However the biopsy of the removed lymph nodes would take about a week. So still the worry for a bit longer.

With an hour and a quarter to wait Bernie decided it was time to go out into the fresh air, turn on his cell phone and start telling the world how things were going. So off he went. Two daughters and a son to call, sisters, brothers, neices, nephews, friends... it would take an hour Bernie giggled to himself... Just after leaving a message on daughter Cathy's beeper, she called back saying she was just geting off the Queensway at Richmond Road and would be there in two minutes. True to her word she appeared to give father some moral support. What good timing. Back into the hospital, and Tim Hortons... they sat and chatted till E was due to come back from recovery. Upon arrival back at the Day Surgery unit Bernie found that he could not go in to visit and that it would take about 4 to 6 hours before E would be alert and recovered enough to go home. So off went Cathy back to work and off went Bernie home to rest till about three or so... As he drove in the driveway and entered their home the phone rang. Queensway-Carleton... Etheleen had made a remarkable recovery... Come pick her up at 1:00 pm. Can you Believe it? Surgery started at 8:00 am and she was ready to be picked up and brought home at 1:00 pm.

Bernie was waiting at the front door at 1:00 o'clock as they wheeled her out of the Hospital Doors. Gosh! She looked great! Alert, and smiling, almost a look of "hi there! What's all the fuss?"

Of course she didn't say that at all. Into the car and whisked home. As they arrived home a few neighbours said hello, but didn't linger. Bernie was going to get her inside and comfy. This was to begin a long journey of nursemaid and care giver. Just like when a new baby arrives, not much sleep... and lots of diapers to change... but instead of diapers it was dressings. Fetch this, and fetch that! Whatever it took to help E recover.

Within a couple of hours all three of Etheleen and Bernie's children Joanne, Cathy and Dan along with spouses, Ron and Lisa, came by to offer smiles and assistance. It was to be a common theme for days. Along with the children came the grandchildren Matt and Josh (and with Matt the oldest one, his girlfriend who's mother had successfuly undergone the same surgey a year previously). How very wonderful for Etheleen to have all this support from her loved ones. Neighbours dropped by with offers of assistance, meals, laundry, etc. Cathy did the laundry the first and second day and Joanne did it for most of the rest of recovery time. What a boon for Dad to not have to traipse up and down those basement stairs.

Later that evening the Victorian Order of Nurses (VON) home care nurse arrived to change the bandages. They came often over the next 7 days.

Day 67 - Thursday, 17 July, 2003 Drainage Tubes removed by Dr Mirsky. This was supposed to happen 5 days after the surgery, but E was still draining too much on Day 5 so the home care nurse left it in. On Day 6 the nurse worried about infection and tried to reach Dr Mirsky. He didn't answer his phone so she left a message to tell him to meet us at emergency to check Tiny out. Just as we were about to leave he said.. Whoa!... Hold on... Come meet him at the Queensway-Carleton Hospital Thursday evening at 6:00 where he would take a look and see what needed to be done. That was now! He removed the Drainage tubes and said it was just in time before infection might have set in. He said although there was still a lot of buildup of fluids, that was preferable to the "foreign body" tubes staying in to long, creating more problems. He said if the body ballooned up with the drainage to come into the clinic and the doctor on call would remove the excess fluids. He said to come to the clinic on 24 July and the staples would be removed. With a smile and a push he sent us away saying the area of surgery looked great.

Day 68 - Friday, 18 July, 2003 A routine day it would seem till the phone rang at 09:00 am. Dr Mirsky! Waiting till he had both Etheleen and Bernie on the phone he almost shouted into the phone. He had received the biopsy report from the removed lymph nodes... The lymph nodes were Clear! There was no sign of cancer in them! What great news! he reminded us of all the other stuff still to do and be done and suggested that a drug called Temoxin might be necessary but that he would discuss that with us when we came to see him in early August. For now, the best news of all... The lymph nodes were clear, the bone scan was clear, the ultra sound was clear. 68 days since the initial routine breast mammogram. Sometimes it seemed like two weeks, others like two years. *Sigh* A huge relief, but full in the knowledge that nothing is completely predictable with this disease called cancer. Our ordeal lasted 68 days. Is it over? Only time will tell. For now, for us... it is. For others our 68 days was only a drop in the bucket. So while we are smiling happily, we do so with the knowledge that there are others who's ordeal will last many months and for some many years. For them, as other's did for us, we will pray and offer support. Thank you to everyone who came forward to help, to pray, to offer kind words and assistance. May we do the same for others.

Recovery Continues, but that's a story for another day.

to be continued....