In the midst of TRIALS...

As you know, most of Sara's tests have yielded predominantly bad news. However, one of her tests recently showed a little bundle of HOPE!

Baby Sullivan

That's right! We are expecting a baby on October 22, 2009.

We found out 2 days prior to the mammogram (back in Misawa) that Sara was pregnant. The doctors are hopeful and think that she will be able to carry this baby to term. Surgery is being delayed a few weeks to allow for the baby to develop all of his vital organs (I think it's a boy). Sara will be through her first trimester by the time she is put under anesthesia for surgery.

The doctors have assured us that delaying surgery a few weeks will have no ill effect on Sara. The oncologist told us that, based on the size of the tumor, she has "had cancer for years." We were shocked when he told us that.

So, the upcoming surgery is going to be as simple as possible. We have opted for a single mastectomy with no reconstruction for the time being. They tell us that the shorter the amount of time she is on the operating table, the better the chances are for the baby. We will deal with reconstruction at a later date. There are TONS of risks associated with this and there are not too many case studies of pregnant women with cancer. We are going to treat Sara aggressively and trust that the LORD will take care of the little one. The docs have told us that the placenta will protect the baby from the chemotherapy, and that our primary concern is going to be a low birth weight.

I'm having a hard time contemplating how there can be destructive cancerous cells less than 12" away from a new life inside of Sara. It is as if there is a battle going on within her. We hope and pray and trust that the new life forming in her belly will overpower those which are attempting to destroy.

So, in the midst of trials...there is JOY!

Please add this to your prayers. Hopefully, this will be the last "shock" that we drop on you for some time.

Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing if your faith develops perseverance. Perseverance must finish its work so that you may be mature and complete, not lacking anything. --James 1:2-4

Let the FIGHTING begin...

We just got home from the hospital. Our concerns were confirmed today...Sara has Stage IIB Infiltrating Ductal Breast Cancer. The lymph node biopsy also came back positive, meaning that there are cancer cells in her lymph nodes. We had mentally prepared ourselves for this, and the discussions with the doctors were "emotionally stable".

Sara will undergo surgery at Tripler (here in Hawaii), followed by chemotherapy and follow on treatment at Wilford Hall Medical Center in San Antonio, TX. We're happy that we will be close to home, but the fact that we are leaving Japan early is VERY difficult on both of us.

The LORD is my STRENGTH and my SHIELD. My heart TRUSTS in HIM and I am helped. My heart leaps for JOY and I will give THANKS to him in song.
--Psalms 28:7

Biopsy & Genetic Testing

Hello all,

Tuesday was another day full of pokes and prods for Sara. The doctors allowed me to stay in the room for the entire procedure. I've often said that if I was unable to fly that I would want to be a doctor. My experience in the hospital on Tuesday confirmed that fact.

Here is the info on the biopsies. The doctors had Sara lay face down on a table with a hole cut in it (at breast level). Once situated and in the correct position, her boob was compressed and X-rays were taken of the mass. Then the X-ray machine was rotated +15 degrees and -15 degrees from center and more pics were taken. Once the location of the tumor was derived, the largest needle I have ever seen was positioned for entry. I had to look away when the doc scalpeled her where the "needle" was going to penetrate. They numbed her up and started the countdown. "3...2...1...Deploy the probe." A large blast of air released and the pencil sized needle was jabbed into the lump. There was some cutting noises and then suction as the sampled tissue was removed. They dumped the tissue (6 pieces about pencil eraser sized) onto a tray and then took that for X-ray (to ensure the calcifications were in the sample). Biopsy # 1 complete.

Then, it was over to the other table for the lymph node biopsy. Sara was positioned on her right side with her left arm up over her head. With the ultrasound, they found the largest lymph node and got 4 syringes ready for the FNA (fine needle aspiration). They numbed her armpit and inserted the needle into the lymph node. Once it was in the middle of the node, they pulsed it back and forth to get some cells in the needle. The needle was removed and the sample was extracted onto a glass slide for viewing under a microscope. The cytologist (lady who studies cells) was there with her high powered microscope to ensure a valid sample was taken. I got to look through the microscope at all the lymphocytes (it looked like 100s of tiny tadpoles). Once all the samples were taken, the pathologist came upstairs and looked at the samples to confirm that there were enough cells for a diagnosis. Biopsy # 2 complete.

On Wednesday afternoon, we went in for genetic counseling and decided to have her blood sent away to a lab in Salt Lake City for DNA testing. Here is what they are going to be looking for...

Location of BRCA gene

BRCA1


BRCA2

For those of you interested in Abstract Art, I think a large painting of BRCA2 would look good on the wall in your living room.

Following is a paragraph from the pamphlet we received from the genetic counselor...

"Two specific genes called BRCA1 and BRCA2 play a big role in preventing breast and ovarian cancers. Normally, these genes act like brakes that help stop abnormal cell growth. However, ALTERATIONS, or MUTATIONS, can occur in these BRCA genes. When this happens, the genes do not work as they should, and there is a loss of control on cell growth. Certain groups of cells can grow at an abnormally fast rate, and cancer may develop."

We found out yesterday, that surgery is NOT going to occur on Friday. On Friday, we will find out the pathologist's findings from the biopsies and develop a plan with the surgical oncologist. We need to wait to get the results back from the DNA test prior to surgery (if she has the gene mutation, she is probably going to get a double mastectomy). The genetic counselor put a "rush" on this sample and we are meeting with her next Thursday.

I promise to update the blog on Friday, once we get the results back from pathology. Our hope and prayer is that the mass is contained within the breast and that the lymph nodes are clean.

Keep praying! Thanks, B & S

More Tests

Hello there...
After a fun weekend exploring Hawaii with Sara's family, it is time to figure out what "the lump" consists of. Sara is having a biopsy tomorrow morning. The surgeon is going to use an ultrasound machine to find the densest portion of the mass and take a "plug of tissue" out. He is also going to take a needle biopsy of the lymph nodes in her left armpit. Then on Wednesday, we are meeting with a genetic counselor. They are going to "sample her DNA" to see if she inherited a gene mutation called BRCA 1 or BRCA 2. Basically, the BRCA mutation increases the likelihood that breast cancer cells will form at some point (in Dr. Brad terms).

At this point, we know that there will be surgery (the operating room is scheduled for Friday morning), but the extent of the surgery depends on the outcome of the biopsy results. Here are the options.

1) The entire mass is contained within the breast tissue...Sara gets a mastectomy (normally, they would do a lumpectomy, but based on the size of the mass relative to the breast, she has opted for a mastectomy).

2) The lymph nodes show some cancer cells...Sara gets a radical mastectomy (entire breast and lymph nodes) followed by chemo (more details later if this is the case). PRAY THAT THIS IS NOT THE CASE!!!

3) If genetic testing shows that she has the BRCA mutation...Sara gets a double mastectomy. We have decided that we would rather them take both boobs now, rather than go through this again in the future. The docs will "reconstruct" during the same surgery.

So, this week, we should finally have most of our questions answered. We are ready to get past the UNKNOWN portion of this journey.

THANK YOU for all your love, support, and prayers. We are still feeling a complete peace about this entire ordeal.

We have not had internet access during the past few days, thus the delay in updating the blog. I'll update it once we hear back from the docs in the middle of the week. Take care and THANK YOU!

Love, The Sullivans

Contact Info

If you want to send something, use...

The Sullivans
c/o Steve and Holly Williams
105 Beard Avenue
Honolulu, HI 96818-5120

ALOHA!

Well, the journey to Hawaii is complete. After 12 hours of flying and an 18-hour stopover in Okinawa, we are now in Honolulu. The medi-vac operation was rather impressive. The flight crew and nurses were GREAT! The Air Force was airlifting a pre-mature baby (along with an entire NICU team), a patient from Korea, and Sara. We dropped off the baby in Okinawa and the rest of us flew on to Hawaii.

Sara and her own personal jet

We got off the airplane this morning and headed straight to Tripler Medical Center for the initial appointment with the Surgical Oncologist. The surgeon is not going to operate until they are sure what "the lump" consists of. We are going in tomorrow for some blood work and a chest x-ray (to make sure the lungs are clean and clear) and then on Tuesday, she will have a biopsy of "the lump" and lymph nodes.


Col DeLong (my boss from Osan) and Holly met us at the hospital and made sure we were taken care of. It's nice to know Colonels who get stuff done! We got a car from the Williams and then met Sara's family (who had flown in on Wednesday night). We're getting settled in and are hoping to get some beach time tomorrow.

So, there is your latest update. I rescind my previous statement about updating on a daily basis, but will update it when we get pertinent info regarding Sara (or do something neat in Hawaii).

Next Journey

Instead of sending multiple emails to different groups, we're going to consolidate efforts and update the Sullivan Blog as we take on the next hurdle of life...we will try and update this daily. Feel free to keep sending emails to saramarisesulli@yahoo.com and bradsulli@gmail.com.

Here's the latest...

We are leaving Misawa this afternoon on our way to Tripler Army Medical Center at Hickam Air Force Base, Hawaii. Sara has an appointment with the surgery clinic on Thursday morning and we'll know more then. Right now, there is so much that is unknown. The doctors don't want to speculate, but we get the impression that we might be in Hawaii for an extended stay.

Thank you so much for your thoughts and prayers. It is said that sometimes Jesus calms the storm and other times he calms the child. We feel that there might be a storm on the horizon, but we are surrounded by his peace! Keep praying.