 Thank you. It's great to be here today. And as Kim said, I'm a science teacher from Oklahoma and this summer we had an exciting experience. First off, in telling my story, I want to show you a picture of my family because they're going to come up a lot in the story. My husband Josh and I have been married for almost 16 years and we have four kids ages 12, 10, seven, and five. And as most doctors would agree, I don't represent a typical kidney cancer patient. When you look at the risk factors for kidney cancer, I don't have any of the typical risk factors associated with kidney cancer. I don't have advanced chronic kidney disease. I've never smoked. I don't consider myself obese. I don't have high blood pressure. In terms of family history of kidney cancer, we don't have any kidney cancer in our family history. My dad and grandmother had had kidney stones. A few years ago, my mom even had a cyst on the outside of her kidney that she had to have drained. But other than that, pretty uneventful history medically. My story actually began last December. We had been out Christmas shopping and I came home and I observed that there was some blood in my urine. It was a weekend and I thought, well, maybe I should have this checked out by a doctor. So given the weekend, I actually went over to urgent med. For those of you that don't know, it's kind of an after-hours-type clinic. They can treat everything from ear infections, bone breaks, accidents that need stitches. The convenient thing for me being a working mother with four kids is that they do offer evening hours and weekend hours. And so I ran over there. I told them that I didn't have any pain, no burning sensation, no frequent urination. They did a test for a bladder infection and it came back negative. And I pretty much stumped the doctor because he thought, well, maybe this could be a kidney stone, but I had absolutely no pain. And at that point, I was 39 years old and he said, you know what? Maybe this is just the results of a bladder spasm. And I thought, okay, I'm about to be 40. Is this one of those I'm getting to be over the hill type things, these old people things I got to deal with? And he said, you know, it can just randomly happen and maybe it just irritated things and you had a little bit of blood. I thought, great, this is gonna be fun getting old. And so I went home just thinking it was a bladder spasm. And over the next few months, this happened two or three other times. They were always single incidences and being very busy with the teaching and the kids, you know, you don't always put yourself first and I'm like, I'm not in pain. So I never really went to the doctor about it. And I just didn't think much of it. And then things changed in July. Once again, I observed blood in my urine and it was a Saturday. But unlike the other times, it wasn't a single incident. It continued to worsen throughout the day. And by the next day on Sunday, July 20th, it was bad enough that I thought I probably should go back to urgent med. And I remember walking through my living room, turning to my spouse and saying, hey, Josh, I'm going to run over to urgent med real quick. I have some blood in my urine. He goes, don't you think you need to go to the emergency room? I'm like, oh no, I'm sure it's no big deal. I'll be back in a little bit. Well, I went to urgent med and there your analysis could read absolutely nothing but blood. It was that bad. And they said, you need to go to the emergency room. So I went to the emergency room. They did some blood work, did another urinalysis. And it came back that I had a lot of white blood cells, which to them indicated an infection. So they diagnosed me with acute hemorrhagic cystitis, which is the technical term for you have a urinary tract infection. And at that point, I sat there thinking, really, you're going to hand me some antibiotics and send me on my merry way. And I mean, there was no pain, no burning. And I thought, you're telling me all these other times this has happened. This is a urinary tract infection. I mean, I've had those before. And they said, if you want to call your general doctor or your urologist and follow up with them in the next few weeks, feel free to do so. And my gut was just telling me, no, this is not it. And the next morning I tried calling my local urologist and their office was pretty busy. They couldn't get me in for a couple of weeks. And I said, well, I've been in the emergency room. And they said, we'll tell you what, we'll have the doctor look at the emergency room report. And if he feels the need to see you, we'll get you in sooner. And they call me back a few minutes later. Yeah, he agrees with the ER doctor. It must be just an infection. I'm going, it's not an infection. So I called my general practitioner and she got me in that afternoon. So I went to go see her and explain my symptoms. And honestly, I thought at this point that I was probably dealing with a kidney stone. And I just had such a great pain tolerance that, you know, I just had a little bit of blood, but I just don't feel the pain from a kidney stone. And she said, OK, fine, let's do a CT scan. So she scheduled a CT scan for that Tuesday, July 22nd. And then on that Wednesday morning at 9 o'clock, I received the phone call. And when I answered it, and it was the doctor, you immediately know this is not going to be good news. Because if it's good news, then the nurse makes the call. If it's a bad news, it's going to be the doctor. And she proceeded to tell me that they had found a three inch tumor or a three inch something on my right kidney. And I said, wait, do you mean three centimeters? She goes, no, three inches. And I'm sitting there in my bedroom because I taught science. And I knew that our kidney was about the size of her fist. So I'm literally holding up my fist in my bedroom going, OK, this is my kidney. And she's telling me three inches, which to me is about the size of a softball. I'm going, how do you fit a softball inside my kidney? And it wasn't making sense to me. And she said, just sit by your phone. I've called the urologist. He's going to order some more tests. And the imaging center will call you and schedule some more CT scans. We want to do the dye enhanced and all that other fancy stuff. So I sit there by my phone, scared to even take a shower that I might miss the phone call. And I'm waiting all day and the kids are wanting to go swimming. And I'm like, no, we got to stay home. We need to wait for this phone call. And finally, at 3 PM, my phone rings. And it wasn't the imaging center, it was the urologist's office. And I said, hey, he has time to schedule. Can you come on over and visit with him? And I thought, oh, this is one of those initial consultation things where he's going to meet me for the first time and say, oh, well, here are the other tests I'm going to be running on you. And his office was literally a mile from our house. So I turned to the kids. I said, OK, I'm going to run over to the doctor's appointment real fast. I'll be right back. And I left the four kids at home. And I sat down with him and I was totally blindsided because he proceeded to tell me, yes, you have a three inch lesion on your kidney. He said, it's a tumor. We're going to need to remove your kidney. I'm like, wait a minute. I thought I was here just to talk about a CT scan. And he said, well, whether this is benign or cancerous, he said, your kidney is going to need to come out. It's so large, you're having negative side effects. And here are your two options. And he explained the two options available to me for surgery. And he said, well, I'm going to step out of the office because we need to contact your insurance company to make sure that they'll pre-approve these other tests that we want to run. And at that point, I really think I went into shock. He stepped out of the room and evidently they went round and round with my insurance company that didn't want to approve another CT scan because I just had one. And he had to explain to them, no, we need to scan her from her neck down to her pelvis. We need to see if this tumor has spread. And, you know, the last thing you want to deal with is an insurance company that's like, oh, she doesn't need that. And it was taken a while. And honestly, I don't think I even realized how long I sat in that little room. He came in one time and said, well, we're having trouble with your insurance company. Just stay here. I want to let you know when the appointment is made. And that whole time I kept thinking, okay, don't fall to pieces, you're in a doctor's office, you're in public, keep it together. At one point, I thought maybe I should call my husband because he's at work 45 minutes away. And I thought, oh, no, I can't use my phone. The sign outside says, don't turn on your cell phone. I mean, I wasn't even making sense. And he finally came in and said they'd had it approved. And when I walked outside his office, that's when it hit me and I just fell to pieces. And my first thought was I cannot go home to my kids because I was bawling. I was hyperventilating. I thought, I didn't even realize it had been an hour with me sitting in this office. I said, I need to have someone to go stay with my kids. And my brother and sister and parents all live in our town. So I called my brother and he could barely understand. He goes, what is wrong? And I said, it's cancer. They're taking my kidney, go stay with my kids. And he's like, OK. And I called Josh. He said, I'm coming home. And I called mom and she was out running errands. I said, go home. I need to see you now. And so she and dad met me at their house. And that's when I explained to them the two options that had been presented to me. Now this is what was available to me in Oklahoma. The first option that Dr. explained was the hand assisted laparoscopic surgery. This is the diagram right there on the left. This is not what he commonly performed. He had done a handful of this type of procedure. And he explained that you would have an incision around your belly button with a few other smaller incisions. He said that this tends to have a quicker recovery time and would allow me to get back to work a little faster. He was a very humble doctor because he flat out told me, he said, if you're going to want the hand assisted laparoscopic surgery, I want to refer you to someone that does it like that all the time. He said, I'm wonderful at the open incision, which is this one on the right, because that's what he had trained in. And giving that the new school year was about to start in a few weeks, my husband and I talked and decided we did want to go with the hand assisted laparoscopic, even if it could get me back to the classroom within a week or two earlier than the other. And you know, we might as well do that. So Monday, July 28th, we met with a surgeon in Oklahoma City that we were referred to. Tuesday, August 5th, I had surgery. On afternoon of August 6th, I was discharged from the hospital and a few weeks later on September 2nd, I returned to work. Now, my surgeon, when we met with him on July 28th, I explained I'm a science teacher. You know, I'm all about learning and educating others and one of the random questions I had was, do you mind taking pictures of this for me? So I teach chemistry, I teach biology and one of the things I teach them is the human body system. I said, normally we kind of fly through the urinary system. I don't teach a whole lot about it, but this would be really applicable to those kids. And he had a wife that was a biology teacher. So he didn't think the request was totally out there and he contacted the Pathology Lab and they were gracious enough to take pictures. So the next two slides, if you don't wanna see pictures then feel free to look away because I do show pictures of my kidney and tumor. This first picture is of my entire kidney. A little educational fact about it is that you can see some of the fat deposits on the outside of the kidney. That's Mother Nature's way of helping to protect our kidney and it is quite large. I mean, normally, like they said, your kidney is about the size of your fist. This next picture shows what my kidney looked like when they opened it up. In the upper left and right hand corners, this is the tumor. When my surgeon gave this picture to me, he did a nice little science lesson showing that in the middle of the tumor, the little white areas where the tumor was already starting to die because it does have a very high blood supply. This picture was actually reassuring to me at the time because I could clearly see the outline, the border of the tumor and it did appear to be all enclosed within the kidney. My first follow-up scan is in a few weeks. We're gonna do CT scans and blood work every six months for the next few years to make sure that it hasn't metastasized and hopefully those results will be good. Now, in terms of anyone out there that maybe hasn't had surgery yet, I do have a few pieces of advice. First of all, I highly recommend writing down any questions that you have for your surgeon to take with you. I always found that when I got face to face with a doctor, my mind would go blank and I would forget what I wanted to ask and then it would always hit me in five minutes after I walked out of the office. Also, find out if the main incision site goes above the belly button or below. My local doctor who had done a handful of these surgeries, when he explained it to us with the hand-assisted laparoscopic, he said that he always did an incision below the belly button. So when I was packing for the hospital, I called my husband and I'm like, oh my gosh, on the way home, can you stop at the store and get me some granny panties? It's like, I need the ones that go really high because I don't want it to affect the incision site and come to find out the surgeon actually went around the belly button and straight up, which was actually more irritating because it hit right where all my pants would fasten even when I went back to work, I couldn't wear normal clothes. I was wearing the drawstring pants and the comfy clothes. I also found leading up to the surgery that I was dealing with a lot of anxiety. I had trouble sleeping. I would wake up in the middle of the night and be awake for three or four hours contemplating, okay, I've done my lesson plans for these weeks, I'm gonna be gone. Do I need to make some casseroles and freeze them? And do how I bought the kids school supplies that my brain would not shut down. And lack of sleep and the stress makes you even more emotional. And I finally just called my doctor, I said, is there anything that they can give me? And she prescribed Xanax, which became my new best friend for those weeks leading up to the surgery and it really helped things. After the surgery, I recommend having a caregiver stay with you in the hospital. Even though we had four kids and if possible, I would have preferred my husband to be able to stay home with them. I was like, no, you're mine for the night. I need you in the hospital with me. And that helped because I was dealing with a lot of nausea. Also, to get out of bed and walk as much as you can with the hand assisted laparoscopic, they inflated my abdomen with a lot of air and a lot of that gas was still trapped after the surgery. And you need to walk and move around to get those air bubbles to work out of your body. And I had intense pain even up in my shoulders. While I was walking, and even after I got home and was walking, I would have my kids or my husband pound on my back and on my shoulders to help kind of move some of that gas around. My one week follow up appointment, I still hadn't slept in my bed. I was sleeping in the recliner all week. And I expressed to my surgeon that I was concerned because I had tried laying down a few times, but every time I would roll over, I felt like all of my internal organs were just tumbling around. I'm like, is everything falling over each other and getting all twisted up? Am I ever gonna be able to go on a roller coaster again? And he looks at me and my husband says, feel free to tell her it's all in her mind. I'm like, no, I'm serious, is everything connected? What's going on there? I've got a big empty space now. And looking back, I really think it was some of those air bubbles still moving because I didn't lay completely flat on my bed very often. And it was very painful and I'd hear a lot of gurgling and tumbling. Also have drawstring pants to wear home. That was very critical for me. And I didn't have this, but if you take a pillow with you to hold against your stomach when you're in the car on the ride home, that makes things so much more comfortable. The hour and a half drive home, I was just clutching my abdomen, trying to keep it from moving and jiggling over every bump that we would go over and subsequent road trips that we would go on, I would take a pillow and just hold against it and it made things more comfortable. And then also don't laugh, cough, sneeze, or do any bodily function after the surgery. There were times I was begging my husband to stop making me laugh because it just hurts your stomach so bad. And he has a great way of making me laugh about things and keeping a positive attitude and even sneezing, very painful. Now on handling kids, whether it's your own kids or maybe even your grandkids, we took the approach that we were gonna be very open and honest with our four kids. We encouraged them to ask questions and express concerns, but we had four very different reactions. My oldest, Alex, who was 12, he took the brave approach. It was, you know, he's 12. So it's kinda like pulling teeth anyway to get him to talk. And I would say, hey, do you have any questions? Oh, no, mom, everything's gonna be fine. And the night before the surgery, he got up and gave me a hug, which is not typical of a preteen anyway. And he's like, mom, you're gonna be okay. And I just brought tears to my eyes at that time and he was just putting on a brave face for everyone. And then we had Chris, the 10-year-old, who absolutely has no filter whatsoever. When we got the kids together and told them that we had news and that mom had been going to the doctor, Alex said, oh, she's pregnant. Before we could even get out the truth, the girls are squealing, yay, a baby. And Chris looks at me and he goes, well, I thought mom was looking a little, and I said, don't you finish that statement. And we explained to the kids that it was cancer, but it wasn't the type that grandpa had died from, which was lung cancer. And it was a type that they could have surgery for. And Josh had to take the three younger kids to meet the teacher night before school started. And I teach in a very small district. And most of the high school teachers knew what I was going through, but the elementary teachers, I guess word hadn't gotten around much. And so they expected to see me at Open House and one of the teachers asked Josh when Chris was standing there, well, where's your wife? And Chris blorts out, oh, she's got the cancer. And he just kinda walks off and Josh is going, oh, okay, let me clarify some of this. And then another teacher, she said, well, where's Jennifer tonight? And Chris said, ah, they cut open her stomach and took out a bunch of stuff, which might be how the rumor got started that I had had a hysterectomy. So he would tell anyone and everyone, oh, mom's got cancer. And I clarified afterwards, I'm like, no, we don't have the cancer anymore, they've taken it out. And then we had Paige, who was seven. She was very nurturing, asked a million questions before and after the surgery. She's the one that slept in the living room while I was in the recliner for several nights. Because in the middle of the night, there were times I had to wake up someone to help me get up out of the recliners so I could take medicine or go to the bathroom. And she loved that she could help her mama. And Maddie, who is five, she was the one that was brutally honest. I mean, I rocked her world. I couldn't give her a bath afterwards because I couldn't bend down like that. I couldn't carry her around and horse play around with her. And she finally looked at me one day while I'm in the recliner. She goes, are you ever gonna get up from there? I'm like, yep, you're keeping me honest, Maddie. So I mean, we had very different reactions from all four kids. And we, again, just tried to keep a very positive attitude. We do a lot of joking around in our family with four kids, we're always laughing at something. And in terms of advice that I have for caregivers, the most important advice for caregivers or family members is to ask the patient, what can I do for you? When we found out the date of my surgery, we had several of my family members saying, well, I wanna be there for the surgery. I plan to be there to support you. And it actually became stressful and overwhelming because I really didn't care who was there for my surgery. My main concern was who can I have watch my kids that day? Because I'm not having four kids sit in the waiting room with my husband while I'm in surgery. And who can bring my kids up to see me that night? And I thought, okay, I need to let my family members be there that want to be there. And it became very overwhelming trying to make everyone happy. And the best words I heard was when I called a fellow teacher, who's a good friend of mine. And I told her, I said, this is when I'm having surgery. She said, okay, how can I help? What do you need me to do? And that was such a huge relief because I have a hard time asking for help anyway. It's like they're my four kids. I said, really, can you just keep my kids that day? I had already arranged with my brother. He could pick him up and bring him up to the hospital that night. And that meant so much to me because I was very overwhelmed. And which also leads me to the second piece of advice as a caregiver, be prepared to deal with extended family and to deal when your spouse gets to the point where she breaks down and is bawling, saying, I can't handle it anymore. You're in charge of scheduling everything. You're in charge of the family. And my husband wants to rock through all of this. I think marriages grow stronger when you go through something like this because you're able to be there for each other in ways you've never had to be there before. And there were times, and remember one time I crawled back in bed at three in the morning because I couldn't sleep. And he wakes up and he's like, are you okay? And I go, yeah. I go, honey. I said, thank you so much for allowing me to break down and fall to pieces because I knew I could and that he would be there to support me and be the rock. And like I said, make me laugh at times. And when I said, okay, I'm done. I'm done scheduling everything. I'm tired of it. It's all on you. He said, okay. He picked up the phone called family members and said, okay, this is what we need done. And he was just phenomenal. Also, either you or maybe a friend of the family, if you can organize a calendar for meals to be brought in, that was a huge help for me and my family. We found that we didn't necessarily need meals brought every single night. Every other night was great for us. We studied tons of food, a website that our community uses a lot is www.mealtrain.com. A lot of people in our church can sign up through this and our other teachers, and they can just pick a day in which they can bring meals. That can be used for anyone that's had a baby or recovering from any surgery. It really did help alleviate some of my stress because I was putting everything on my spouse. Getting the kids to school, getting them dressed, doing everything. And as a mom, giving up some of that control was kind of hard and you feel bad. Even though you just had cancer surgery, you still kind of feel guilty. And it really made me feel like I was lightening his stress a little bit when I had some meals brought in from friends and coworkers. The only suggestion I would have for doctors is to recommend that a patient bring a family member with her to the appointment. Like I said, when I went in to meet with the urologist, I really thought we were just gonna talk about CT scans. I really was in shock when he dropped the bomb on me of, nope, there's cancer, kidney's coming out. And I was crying hysterically when I left the office, driving across town to my parents' house, which probably wasn't the wisest thing to do. And had I known ahead of time, he could have said, oh, bring someone with you, because you may have questions and that way they can help you remember any questions or answers. I think it would have helped alleviate some of that shock that I experienced. So overall what I learned, luckily, if you had your kidney removed, we can all live with one kidney. I also learned that it's okay to take time for yourself and to put yourself first every once in a while and to trust your gut to question when you feel something is wrong. And when they told me that it was just a urinary tract infection, I could have just taken my antibiotics and not followed up, but I just insisted that there's something more here. And then finally, I found that laughter truly is the best medicine. It helped me get through all of this. So I'm gonna leave you with some famous kidneys that you might recognize. And thank you for having me. Thank you.