Tough Decisions Four Things I Know

Today I am overwhelmed with gratitude. God has blessed me. Family and friends love me. Life can throw me to my knees, but it never hijacks God’s love and goodness.
He guides my decisions, and receives my praise. He answers my prayers, and receives His glory. He leads my plans, and gathers His harvest. When my own prayers were weak, He lifted me through the prayers of His children. When my own anxiety overshadowed my own faith, He pushed through with His incomprehensible peace. And when the results were in, He not only answered prayers, but graciously allowed me to see that these decisions were not in vain.
Two weeks ago my faith received a booster shot. In the midst of doubting my own decisions, God took the lead. And in the process, I learned a few things about making tough decisions.

1. Some decisions are hard, no lie. Trust God to take the lead. I do not make quick decisions. I research all my options, weigh all the pros and cons, pray and pray, and then mull over it for as long as possible. I just don’t do decisions well. So after a partial mastectomy (lumpectomy) for breast cancer failed to result in cancer-free margins, I was consumed with making my next treatment decision. My procedure options and plans included …

Option 1:
a second partial mastectomy on the cancerous breast. If the margins were clear of cancer cells, I would proceed with radiation. If no clear margins, I would move on to a full mastectomy. Either way would include five years of a hormone inhibitor medication to reduce the risk of recurrence in the remaining breast tissue and non-cancerous breast.

Option 2:
move directly to a full mastectomy of the cancerous breast. Followed by five years of hormone inhibitor medication to reduce the risk of recurrence in the non-cancerous breast.

Option 3:
move ahead with a complete bilateral (double) mastectomy of both breasts. With no breast tissue remaining, this would possibly eliminate* the need for radiation and hormone inhibitor medication.
*All of these plans were contingent upon the non-invasive nature of the cancer. If invasive cancer were revealed in any pathology, the plan would move to a more aggressive means (chemotherapy, etc).

And as if treatment decisions weren’t enough, there were also decisions to be made regarding reconstruction options. Sometimes overwhelming is not a strong enough word. Life can just escalate quickly. I deal best with one decision at a time, so in that fashion, I will leave the details of my decision process regarding reconstruction for a separate post.

2. It is ok to question my own decisions, but I can’t let it consume me. God’s got this. He’s got me. I cannot doubt my way out of His loving hands. I initially chose bilateral mastectomy with immediate DIEP flap reconstruction using my own abdominal tissue. But I second-guessed this decision from the beginning. My cancer was non-invasive and only confirmed in one breast, so wasn’t a double mastectomy overly excessive for the diagnosis? All the what-ifs just wouldn’t resolve in my mind. At least the surgery was scheduled quickly so I only had one week to agonize over my decision – then it would be done. But of course, circumstances occurred that required my surgery to be delayed … by three weeks. Three more weeks of researching, revisiting, second-guessing, stressing, agonizing over my decision. Yes I certainly prayed over this decision, please don’t let that point go unnoticed. But it wasn’t until after the original surgery date was delayed, that I began to feel a peace about my decision. God used this unexpected wait to teach me a few things, including how to wait well. But the biggest boost to my faith came when I received the final pathology report after surgery.

3. When all is said and done, trust God with the outcome, no matter what. The breast surgeon came in to my hospital room late in the afternoon day 2 after surgery. He carried a slight smile, a small observation I immediately clung to as good news. And I was not wrong. The final pathology revealed the three lymph nodes taken during surgery were clear of cancer. Although there were cancer cells present extensively throughout the left breast (where the original tumor was removed), there was no indication of any invasive component, and the margins of the tissue taken were clear. In addition, the right breast tissue, supposedly non-cancerous, instead showed the presence of pre-cancerous cells.

So, was my decision overkill? Did I jump the gun and unnecessarily choose complete bilateral mastectomy for non-invasive cancer in only one breast?

Not in the least. In the cancerous breast, an additional lumpectomy would not have achieved clean margins. A mastectomy would have eventually followed. And for the non-cancerous breast, now knowing pre-cancerous cells were present, I would have most likely been facing the same decision, once again, in a few short years.

God most certainly guides us. I am living proof. He is trustworthy and faithful. Many times He graciously allows us to see the why behind the decisions He guides us in making. In those time our faith is strengthened. Our trust is given a booster shot. And we are reminded why we trust and Whose we are.

4. Trust and tell. Our world needs to hear our stories. And what if the results had been different? I am confident He would have still shown me how He perfectly guided me. I trust Him in the outcome.

No matter what …. He is good.
Even if …. He is good.

Even when we don’t see the why behind His decisions … He is good and trustworthy. But when He does show us the why, I believe we have a greater responsibility to tell. We have a responsibility to tell our stories to strengthen other’s faith. God positions people in our lives who need to hear what we have to tell. People who are waiting to see Him work. People who are hanging on, longing for confirmation of His goodness. People who are not quite sure if He is trustworthy. People who are seeking out His plan, on the edge of their own tough decisions. People who are tired in their everyday, and need encouragement to keep on.

We have a responsibility to tell how good He really is. No matter what. To tell what He has done for us.To tell how He has been tried and found trustworthy.

We are His living proof.

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