Awful Pain from the "Vampire Machine"

The Vampire Machine that attacked me!

My life has a new nemesis...it's what I refer to as the "Vampire Machine", and it lurks in the treatment room at Dr. Martin's office.  In real life, it's not anything out of a Charlaine Harris "Southern Vampire / Sookie Stackhouse" novel, or even related to Bill or Eric from "True Blood", but a medical grade vacuum.  Unfortunately, I had an appointment with the Vampire Machine on Tuesday.

 I noticed Monday that I began retaining fluid around my incision, and under my arm pit, so I called Dr. Martin's office.  It is fairly normal for mastectomy patients to need additional draining after the drainage tubes are removed.  Yours truly, was no exception, and had to undergo treatment from the fang-ridden, blood sucking, pain machine!
 

The covered needle and plastic tubing

Dr. Martin used the Vampire Machine to drain lymphatic fluids, blood and other juicy stuff from my breast area.  A sterile needle and tubing is attached to the vacuum, and then inserted into the breast area.  The vacuum was then turned on, collecting fluid into a canister.  I may complain from time to time, but I was not prepared at all of the pain that was inflicted by the blood sucking machine.  The needle was moved in different direction to suck fluid from different areas, and it was by far the most painful thing I have experienced.

I am at the stage in my recovery where much of the "feeling" is returning to my breast and arm area from surgery.  Regardless of whether it was the sensation of regenerated nerves or not, this was extremely painful.  Let me say that once again....it hurt!  I had to take pain medication all night, and even bled through my bandages.  Please pray that I do not need to meet the Vampire Machine any more during recovery!

More than 100 cc of fluid was collected

Dr. Martin is very pleased with the way my incision is healing, and was excited about the range of motion that I have regained already in my arm.  My exercise booklet is from the American Cancer Society.  You can see the exercises here.  This appointment also served as my pre-surgical consult for my chemotherapy port.  My port will be inserted by Dr. Martin on October 3, as out-patient surgery.  Pre-op for outpatient surgery will be on September 27.

My stamina is improving everyday, as is my ability to move my right arm.  There are still some issues with tightness and swelling, but perhaps some of that is strictly from nerve re-generation.

Regardless of the reason, please pray that I have no more encounters with the Vampire Machine.  I'm traumatized...scarred for life, from this little" blood sucker on wheels".  Please pray that there is no "next time" encounter for me and this horrid machine!

TTFN,
-S

It's official...I Have a Calendar!

This calendar is just for doctor visits, treatments, tests, etc...

It's official...I now have a calendar just for medical stuff!  I'm an organized person (or try to be), but the reality of having a mini-calendar just for medical related stuff is kind of hard for me to accept.  That's the point that I'm at in my life...

Friday morning, I had my appointment with my oncologist, Dr. Cheryl Jones, who practices at the Georgia Cancer Center - Macon office.  It was great to walk in and see a smiling face!  Adelia's best friend's (and my second son) mother is the receptionist there, but I noticed that everyone was treated like a "person", and not just a $ sign.  Walking into the cancer center, you knew that every person there was touched by the disease in one way or another.  I found myself wondering what their stories were... were they there due to a spouse, child, sibling, relative, friend, or were they the cancer patient?

My notebook from the Breast Health Center

Dr. Jones is highly recommended, and was very informative.  She asked me what I knew about my diagnosis...and I told her.  I've discovered that many cancer patients either know nothing of their diagnosis, know some, or are well-informed.  I realize that I am generalizing all people into a category, but that is my opinion.  I (just in case you doubted) fall into the well-informed category.  I can't imagine not knowing about the disease that is affecting your body and your family, but I know many who choose not to.  Plus, it's just part of my nature to know as much about something as possible...it's one reason why I chose my career!

Dr. Jones is a soft-spoken lady, but the wealth of knowledge behind her rimless eyeglasses is apparent.  After she reviewed all of my pathology reports, we found out additional information that wasn't apparent earlier.  ( Dr. Martin is a well-informed surgeon, with great knowledge about breast cancer, but Dr. Jones is my "cancer doctor", or oncologist.) Dr. Jones immediately saw my list of things to ask, glanced at it, and then handed it back to me.  (in the course of the appointment, she answered every single question on my list...and then some!)

Based upon my surgery and pathology reports, there are some major factors in my diagnosis that have changed. These factors will contribute to what weapons are used to fight my cancer.  The grade of my tumor, vascular & lymphatic status, lymph node involvement, staging and my HER-2 (human epidermal growth factor receptor 2) status have changed.  You can find out more about HER-2 from this website.  The core needle biopsy was just a "snapshot" of the tumor, whereas the mastectomy produced the entire "well-circumscribed 2.6 X 2.1 X 1.8 cm firm white mass". (page 4 of my 23 page pathology report)  This is why there are changes from the initial report.

My "doctor bag", which I now carry to all appointments!

The grade of my tumor is now 3. Grade 3 cells look very different from normal cells, as they grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells. (www.breastcancer.org)  As shown by the positive lymph nodes, the cancer had invaded my vascular system.  Of the 18 lymph nodes removed, only 2 showed a presence of cancerous cells.  One lymph node is considered  to have "extracapsular extensions", meaning that the cancer has spread outside the wall of the node.  My report shows the size of the largest metastatic deposit is 1 cm.  The fact that the cancer had spread to my lymph system is a "whole new ballgame". 

I asked Dr. Jones how to respond to my children when they ask, "Mom, are you cancer free now that your breast is gone?"  Her suggestion was to tell them, "the doctors removed all of the cancer that they saw, but that there could still be cancer floating around in my blood."  It's kind of a different perspective when you think of it that way, as opposed to be cancer-free when you breast is removed.  My cancer stage is IIb.  You can read about breast cancer staging here.  I am just over the IIa mark, with my tumor size.  Treatment really doesn't vary from IIa to IIb.  The suggested course of treatment for me is chemotherapy, followed by radiation.

Apparently when we thought I was HER-2 negative, the tests actually showed that additional testing needed to be completed.  Generally, you receive a score of 1-3 on this test.  1 being that you are negative for the HER-2 gene, and 3 being positive.  I received a 2.  According to Dr. Jones, both the FISH methods and IHC testing methods have come back inconclusive.  The report refers to "Because of a possible interference by chromosome 17 polysomy noted on the previous HER-2 analysis, the HER-2 analysis will be repeated by another method."  HER2-positive breast cancers tend to grow faster and are more likely to spread and come back compared to HER2-negative breast cancers. (www.breastcancer.org)  If it is found that my cancer is HER-2 positive, then it will involve a weekly infusion treatment of Herceptin, for one year.  As a friend of mine told me, that's just one more arsenal in my warehouse.  Cancer is a family diagnosis, but looking at weekly infusions for a year...that's just hard to imagine.  Hopefully the results will be back later on this week, but certainly by my next oncologist appointment.

Speaking of appointments...my calendar is filling up.  Today, Jeff and I attended a chemotherapy class at the Cancer Center. Thursday is my two-week post-op and port insertion consult with Dr. Martin.  Next week, Adelia and I are attending a "Look Good - Feel Good" class at the hospital on 9/26, which focuses on scarves, make-up, accessories, etc. after chemotherapy hair loss.  Between now and my appointment on the 30th with Dr. Jones, I have to get a chest x-ray and will have an echocardiogram on 9/27.  I'm not sure where it will fall, but somewhere between my appointment with Dr. Martin and my first chemotherapy treatment (which can't be prior to 4 weeks post-op), I will have my port insertion.  As the day has progressed, I noticed that my surgical site and under my arm seems to be swelling, possibly filling up with fluid.  (Remember my surgical drain was removed last week.)  This is completely normal, but rather than waiting until Thursday to see Dr. Martin, I now have an additional appointment with him tomorrow.

Griffen in his new "Weeblo" uniform!

In the meantime, between my "calendar appointments", I'm trying to be normal: a mother, wife, daughter, sister and friend.  Friday night, I enjoyed watching Adelia and the awesome JCHS Marching Greyhounds perform pre-game and during half-time.  (The JCHS football team won, too!)  I've been doing my post-surgery exercises, visited a great wig shop (that deserves its own post, though!), put patches on a new scout uniform, and have read bedtime stories.  Everyday, my stamina is improving.  I have had such a great support system of my parents, husband and children, but it's nice that I can actually help to cook, fold laundry, and do dishes!  (I think I might still be too sore to clean the bathrooms, though- how long do you think I can use that excuse? :)

TTFN,
-S

Deliveries, Doctors & Drains

As I write this post tonight, I am feeling blessed...blessed beyond measure.  (Ok, so maybe I did take a pain pill since I over-exerted myself today...but my blessings greatly exceed prescription narcotics!)  Today has been an eventful day, one full of special deliveries, appointment with the surgeon, drain tube removal, and even a Pre-K event.  It is so hard to believe that just four short weeks ago from today, I was told that there was an 80% chance my tumor was malignant.

 Four weeks later,  I have one breast, eighteen less lymph nodes and two armpits (or so it seems, from where they removed tissue and lymph nodes from under my arm!) as a result from surgery.  I know that I am supported by family, friends, co-workers, and even strangers.  Over the past few weeks, you have prayed with me, cried with me, laughed with me, and rejoiced with me.  For that, I will be eternally thankful!

This morning, I received a special delivery...all the way from New Hope Baptist Church, in Jennings, Florida.  New Hope is my "home" church, over 200 miles away from Gray.  This is the church where I was baptized, and the church I was married in.  Karen Goolsby delivered two gift baskets from the wonderful "New Hope Ladies" this morning.  These are the ladies who have been there for me throughout my life...from VBS to baptism, my wedding, to the birth of all three of my children, their love and support has been as solid as the oak trees that grow in Hamilton County.  These women have shown me how to host memorable bridal showers, make the best punch in the world (can I get an "Amen" about that New Hope Punch), and have demonstrated how to be women of faith.  Now, they are specifically  praying for me and my family as I battle cancer.

The gift baskets are full of items that are very thoughtful and have such meaning to me.  Ranging from plastic flatware and tissues to relaxation candles and therapeutic pillows, the baskets were just amazing.  As I looked at each item, I wondered what sweet friend knew I would need that item.  Candy, candles, mints, journals, inspirational books, notepads, jewelry, and gift cards are just a few items included.  More importantly, I know that the baskets are full of prayers and love...which can't be purchased at any store.  To my New Hope Ladies - Thank you will never suffice.  I love you!

Arleigh enjoying a treat, while wearing her fake glasses.

The children enjoyed the sprinkle marshmallow pops that accompanied the gift basket... which I must share with all of my crafty friends.  They were the large marshmallows, dipped in chocolate and sprinkled with "sprinkles".  Rather than using a sucker or popsicle stick, they used a "crazy straw" for the stick.  These were great treats, and one that I will certainly have to copy in the future!  (Won't those make great classroom and birthday party favors?)

My mailbox has also "runneth over" with well wishes and greetings from friends, family and co-workers.  It is so nice to have brightly colored envelopes and messages...makes me feel like I'm back at summer camp and it's "mail call" time!  Greeting cards and letters are so much better than getting the electric bill or insurance explanation of benefits in the  mail!

This afternoon was my one week follow-up appointment with Dr. Martin.  He was very pleased with the surgical incision, and removed my drainage tube.  Thank God!  I found that the drainage tube was the most horrid thing about surgery, even worse than the incision itself.  If you look at the picture at the left, you will see the black sutures still attached to the tube.  Everything to the left of the black thread was outside of my body, and everything to the right was inside.  He even laughed about me wanting to take a picture of it...but then we've shared everything else, haven't we.  (Speaking of that, I'll post a picture of my incision this weekend.)

Dr. Martin referred me to an oncologist, Dr. Cheryl Jones. He was adamant that I be seen as soon as possible, and between God and Dr. Martin working together, my appointment is Friday at 10 a.m.  After the appointment with the oncologist, I will have a better understanding of when chemotherapy will begin, and can plan accordingly.  I will return to Dr. Martin in one week for a check, and possibly even schedule the out-patient surgery for my chemo power port next Thursday.

I am now clear to begin exercising to regain my strength and range of motion on my right side.  My nurse navigator, Kim (who I can not say enough wonderful things about), spent a great deal of time talking with Mom, Jeff and I after the appointment.  She demonstrated exercises, went over pathology report details, and answered many questions we had about upcoming chemotherapy treatments.  I realize that everyone is different, but I can not imagine going through a battle with cancer, and not being as prepared as possible.  I want to know what I'm up against, and how to face it head on for the defeat.  How someone can choose not to be an "informed" cancer patient is beyond my comprehension.

The pathology report from my mastectomy is 26 pages long,  I'll post more details about the report at a later date, but 5 sentinel lymph nodes were removed, with only 2 testing positive.  An additional 13 lymph nodes were tested, but were all negative.  I also received the BRCA testing results today, and they are negative!  Another Praise, in that my cancer is not genetic and will not affect my Mother, sister, or children!

Since I was still dressed from "going to town", I mustered up enough energy to attend a Pre-K workshop at Arleigh's school.  The workshop was about their "Animated Literacy" program, which is used for instruction.  Visit the Animated Literacy web site here for more information.  Even though I was exhausted by the time I returned home (to a wonderful home-cooked meal, prepared by my hubbby), it was nice to get out and see people!

My pain is a bit higher this evening than it has been.  I'm not sure if that is due to taking fewer pain pills, healing, exercising, or a combination of everything.  Tomorrow I'm switching over to Alleve for pain, and pray that it will be minimal as I continue to heal.

From deliveries to drain removal, today was a great day.  I know that all days won't be as great, but I will continue to celebrate!

TTFN,
-S

There's No Place Like Home

The past two days have been a blur, as you can imagine.  I'm on painkillers (Jeff is spinning a little as I'm typing this), so you'll have to forgive any incoherent sentences or thoughts in this post.  Maybe it's the drugs, the experience, or exhaustion, but my last few days have been very similar to The Wizard of Oz.  Part of it is in sepia, and part in technicolor.  I'll try to share as many details as I remember, and get you "up to speed" on the details.


First, THANK YOU to my incredible guest blogger, Adelia.  Her post was great, and I hope you enjoyed reading it!  (Adelia generally edits my posts after writing, so she is very familiar with my blogging process.)  Hopefully, I can convince my daughter to write additional posts and share her thoughts with you, as cancer is a diagnosis that affects the entire family.


 We reported to the hospital at 8:45 a.m. on Wednesday, and were assigned a room in the day hospital. 



There, I received a fabulous new outfit!  As Arleigh would say, they certainly didn't match!


 As with the entire experience at Coliseum, everyone was so nice and attentive.  I felt like royalty.  Two special nurses  kept coming in checking on me and my family. One is a fellow band-mom and the other is a relative of a co-worker.  The fact that they took the effort to seek me out and ask if my family or I needed anything made me feel very special.  Thank you ladies!

About 10:00 a.m., Dr. Martin came in, carrying a little radioactive lunchbox...or that's what it looked like.  (Kind of reminded me of my old Snoopy lunchbox that I had in elementary school.)  He cleared the room, and then injected the tumor and right breast with a radioactive material.  I have a fairly high pain threshold, and it was painful!!!  Dr. Martin apologized, and said that was the most he would hurt me all day.  The injection itself wasn't painful, but as the material spread throughout, it was agony and brought tears to my eyes.  Dr. Martin was ahead of schedule at that time, and stated it...well, you know what happened next...one thing led to another, and finally around noon they took me to the area "waiting" for surgery.

 In the waiting area, I really wished I had my cell phone with me.  Dr. Martin had to come in and initial the "area to be removed, per hospital policy.  That would have certainly been a "Kodak Moment"...there is my black and blue breast (still bruised from the biopsy three weeks earlier), and he has to write "KM" on it.  Like I said, it was a Kodak moment.  I had to wait for what seemed like forever in the surgical waiting bay.  Lots of women were in labor, and it seemed as if every anesthesiologist was busy putting in an epidural somewhere in the hospital.  I finally had my anesthesia consult, and then it was show time!

Another nurse wheeled me from the surgical waiting area into the operating room.  I remember going through double doors, into the operating room, and seeing my nurse anesthetist (because she had a funky skull cap on).  There was another surgeon in the room (I think I recognized him as a plastic guy, asking something about staples) and that's all I remember!  (Guess this would be the end of the sepia part in The Wizard of Oz.)

Cue music, and then I open my eyes in the recovery room, and everything is in technicolor!  (Did you know that it is no longer called "recovery", but "PACU"?)  PACU is the acronym used for Post-Anesthesia Care Unit.  I remember waking up, then Jeff being there.  After a while, my Mom, Adelia and Daddy all came in to see me, also.  As time passed, we are told there was no room on the postpartum floor (where mastectomy patients are usually placed after surgery), so I would be put in a room on the surgical floor.  (Remember earlier, when all of the anesthesiologists were busy putting in epidurals???)

I do remember speaking with Dr. Martin in PACU.  He was very pleased with the amount of skin he was able to save, and even mentioned that he told Dr. Powell (the Plastic Surgeon) that he left him a good bit for reconstruction.  Dr. Martin said that he expected my cancer to be staged at IIA, (but then he said he heard I already knew that!)  He also put a compression bandage on my chest after surgery, which is not usually done.  Apparently during the radioactive tests, five nodes absorbed the dye.  Of those, two lymph nodes were positive.  During surgery, six lymph nodes were removed from under my right arm.  (I'm still fuzzy on all of this, and will get clarification during next week's appointment).  Just because there were cells in those lymph nodes, Dr. Martin stressed it did not mean there were cancer cells elsewhere. 

I was placed in my hospital room around 5:00 p.m., and this sign was directly at the foot of my bed.  Thing were going ok, pain was minimal, and then the nausea began.  Anesthesia always makes me nauseated, so they administer extra meds during surgery and after.  I've learned this the hard way through the years with dental, sinus and even my tubal ligation surgery.  (If you haven't experienced the terrifying experience of vomiting after surgery, I pray you never do.)

I began getting sicker and sicker.  They were administering nausea meds, in addition to Demerol, but it just wasn't working that well.  It would come on, and then ease off.  One nurse even had me "sniffing" alcohol pads.  She recently read a study where the smell of alcohol helped with nausea, and I have to admit that there were numerous times throughout the night that it did help ease my nausea. A call to Dr. Martin late Wednesday evening added some additional nausea medicine, but it was still a very long, long night.  (How I longed for some Phenergan.  Did you know that it is not used in hospital IVs, due to damage sustained when administered via veins?). 
 
After a very, very, very long night, my pain medication was changed, as perhaps the vomiting was due to a reaction to the Demerol.  Dr. Martin came in for morning rounds, and was very pleased with the incision, and removed the compression bandage.  He said I was ready to go home and rest!  After Dr. Martin's visit, a representative from Chichesters (a local medical supply business) brought my surgical camisole, a medical case worker and Kim, my Oncology Nurse Navigator, all came to visit around the same time.  Kim continues to impress me with each visit, and this one was no different.  (She even took over "basin duty" from my Mom and Jeff, during several of my episodes while visiting.)

A change was made to my pain medication, and we were able to leave the hospital around 11:15 a.m.  I had on my new breast insert, inside my post-operative camisole, as we left the hospital.  On the way home, I took a Phenergan, per Doctor's orders.

Saying "Thank You" for your prayers and support is just not adequate, as I finish this first phase of my breast cancer treatment.  My next appointment with Dr. Martin is Thursday, September 15 at 1:40 p.m.

 We finally made it home, and just like Dorothy, I had to admit that  "there's no place like home!"

The Results Show - Part One

My children like reality shows.  Adelia and Arleigh love "So You Think You Can Dance".  (They even picked Melanie as the winner from day one!).  Griffen loves the survival type shows, especially "Top Shot" on the History Channel.  Jeff enjoys  some of the BBQ / Cooking shows.  You might also find our television on America's Next Top Model or American Idol.   Generally, after the season is over, there is a "Results Show".  The show is over-hyped, advertised widely, some entertainment factor, and then you find out who wins.  That was kind-of like my appointment today...

In my mind, today was going to be a traumatic event.  I was going to schedule the removal of my breast.  Through my blog, my fears were shared with you, and I felt your prayers today.  My parents came to the appointment with me, and there was a calming peace throughout the entire process.  I know that my peace came from the blanket of prayers surrounding me.

So, here's Part I of my "Results Show"...

Tentatively (confirmation will be received tomorrow), I am scheduled for a right breast mastectomy on Wednesday, September 7.  The left mastectomy will be performed at the time of reconstruction, at a later date.  My HER2 results are negative, which is great news! (HER2 positive breast cancers are much more aggressive and less responsive to hormone treatments.)  Dr. Martin will perform a "skin sparing mastectomy".  This type of surgery conserves as much of the breast skin as possible, for later reconstruction.

From my MRI, there is an additional suspicious area and lymph node.  Dr. Martin believes that these areas are a result from trauma the breast received from the core needle biopsy.  Regardless of the outcome, the surgical procedure will remain the same.  The surgery will last approximately 90 minutes.  Only the breast tissue is removed, not any of the muscle beneath the breast tissue.  I will stay overnight in the hospital, and then be released.

The morning of surgery, after routine IVs begin, I will be administered a radioactive injection (more glow sticks!), and then during surgery, a medical-type geiger counter will be used to identify the suspicious areas.  They will also take a biopsy of the Sentinel Node during surgery.  This sample will be frozen immediately in the operating room, and then tested.  The results will be known prior to the completion of the surgery.  If the biopsy is positive, then the lymp node will be removed.  This is very important, as it will determine treatment.

The pathology results will be known 2-3 days after surgery. (That will be Part II of the Results Show)  From the results, the oncologist will determine the best treatment plan.  There is a possibility of just chemotherapy, or a combination of chemotherapy and radiation, depending on the results.  The best part is that recovery from the surgery will be less than four weeks, and that pain is minimal...compared more to muscle pain after strenuous exercising.(Like I'd know anything about that!)

Dr. Martin was very reassuring to my parents, and they are very impressed...especially the fact that he shared his faith with them during the appointment.  He stated that God is the Healer, he is only the tool, and that he uses his God-given gift  to help others.   Any surgeon who doesn't believe in God, is just one blood-vessel away from knowing differently!  (How's that for a testimony?)

The Cancer Center is calling tomorrow to schedule my Breast Cancer Gene Test (BRCA).  I'll write more about that in a later blog.  The results of the genetic testing can affect my mother, sister, and daughters, as well as my ovaries!

Dr. Martin assured my Mom and Dad that he would take very good care of me during surgery, and would make certain that the other members of my treatment team would continue in the same manner.

I don't have all of the answers to my questions, but I have the ones that matter.  It reminds me that everything is in HIS time, not ours!

TTFN,
-S

Search for Tomorrow

This soap opera ran from 1951 to 1982 on CBS.

When I was a little girl, my days were spent with my "Grandma McCracken".  Grandma was of no blood relation, but a relation by choice.  My Mom or Dad would take me to Grandma's house in the morning, and pick me up in the afternoons.  She would sit at her dining room table (which was situated so she could see into the living room) in one of her "house dresses", and I would sit or sprawl on the couch.  I loved the couch, because if you sat in the right place, the chilly air from the air-conditioning window unit would blow directly on you.  As you can imagine, she spoiled me, though I prefer to call it "overly-loved". 

Thirty-plus years later, when I think of my days with Grandma McCracken, I think of buttered rice, cake batter (no beaters for me, she gave me my own small bowl of batter), and soap operas.  Some days, we spent running errands in a twenty-mile radius, lunching at coffee shoppes (she with her coffee and me with my hot tea), or visiting with her friends, but generally we were always back home in time for the "Soaps".  Right after the "Mid-day Report" on WCTV,  the stories began.  I remember watching Search for Tomorrow, Young and the Restless, As The World Turns and Guiding Light.  Referring back to my old soap opera watching days with Grandma McCracken, I think a fitting title for this episode of my life would be "Search for Tomorrow"!

Tomorrow is my doctor's appointment with Dr. Martin.  It's the biggie!  The appointment where I find out the official results of my tests, hear my treatment plan, ask my questions, and schedule my surgery.  Jeff is finishing up training out of town, so Mom and Dad are going to the appointment, also.  (I think it will also give them peace in meeting the man who will operate on their "baby".)

I've been researching, emailing other breast cancer survivors, and reading to compile my list of questions for tomorrow's appointment.  This is what I've come up with.  (If you can think of others, please email them to me!)

Shelby's Questions (AKA "Search for Tomorrow")

1. Cancer Type:  Invasive Ductal
2. Location:  Right Breast
3. Tumor Size:  2 to 3 cm
4. Grade:  2 (medium growth)
5. Stage:  ???  (I'm guessing possibly Stage IIA, based upon my research)
6. Hormone Receptors:  Estrogen 100% +, Progesterone 90% +
7. HER 2 Status?
8. HERS2 Status based upon what tests?
9. Lymph Node Status?  (So far, he has said none, but I want to be certain.)
10. Second opinion for Insurance status?
11. Length of surgery?
12. Reconstruction at same time of mastectomy?
13. Length of Time in Hospital?
14. Recovery time?
15. Recovery advice?  (Drains, I know, but what else?)
16. Chemotherapy details?
17. What type?
18. Begins when?
19. What side effects?
20. PET scan of entire body when?
21. What about my daughters?

Please pray for my strength during tomorrow's appointment.  I also pray that my parents and I have a peace about the treatment plan, that all of my questions are answered, and that surgery is scheduled in a way that accommodates all parties involved :)

Tomorrow is as real as it gets, folks!  Presumably, when I walk out of Dr. Martin's office Tuesday afternoon, I will have a date and time to have my breasts removed, and my search for answers will be over.

TTFN, (Literally, only for a while longer!)
-S

My Television "Medical Drama" Day (& The Results!)

Today was my medical drama day!  It's the day that my surgeon presented my case at a breast cancer symposium.  I've tried to picture all day what it was like...surgeon, physicians, oncologists, plastic surgeons and other medical professionals gathered together.  They are gathered together in a room, coffee and a danish on the table in front of them (I would have preferred cream-cheese), and then the spotlight is on me...or the C-sized parts of me. 

I've been thinking of medical drama episodes on television:  Grey's Anatomy, House, and ER...might even add in some Guiding Light, General Hospital and Young and the Restless. McDreamy, McSteamy, House, George Clooney, and Rick Bauer all sitting around discussing my case.  I suppose as films and ultrasound results of my chest are flashed up for all to see, someone says, (I think it might sound better if you imagine this is in a deep, masculine voice -kind of like Chief Webber on Grey's) "... 38 year old female, recently diagnosed with IDC*. No family history, no alcohol use, no drug use, no tobacco use.  Breast-fed three children, with first live birth at age 24.  Patient is not peri or post-menopausal."  Then they use a lot of terminology that I haven't learned yet (or don't know the results of yet), and then proceed to discuss how they believe my journey should proceed.

IDC is Invasive or Infiltrating Ductal Carcinoma.  The "I" portion refers to the fact that the cancer has spread outside of the duct, invading the surrounding tissues.  With this type of cancer, the cells may travel to other parts of your body or lymph nodes. (We don't know if mine have yet.)  The "D" portion refers to the origin, which means that the cancer originated in the lining of a milk duct within my breast, and I think you can figure out what the "C" stands for.  

More than180,000 women in the United States are diagnosed with Invasive Breast Cancer each year, according to the American Cancer Society.  The majority of those diagnosed have invasive ductal carcinoma.  Generally two-thirds of the women diagnosed with  invasive breast cancer are aged 55 or older when diagnosed.

It has been my prayer today that God utilize the knowledge and wisdom of the physicians gathered together, and that collectively, harmoniously and unanimously they decide the best course of treatment for my cancer.  (Think otherwise; Who wants to hear that by a vote of 8-6 your treatment was decided ???) 

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 Earlier this evening, I was ready to publish this post, and Dr. Martin called with great news!  Thanks to God!

My Estrogen Receptor (ER) is positive at 100%, and the Progesterone Receptor (PR) is positive at 90%.  I'll share more about what this means tomorrow (as I research myself), but apparently it's great news!  HER2 results are not available.  My tumor is between 2 and 3 cm.  Dr. Martin was very excited and said those were the best results we could have received!  He said he called Saturday with bad news, but wanted to call today with great news : )

He also reported on the symposium.  The symposium was held this morning, with surgeons, oncologists, plastic surgeons, and radiation oncologists (I think that's what they were called?).  They were all unanimous and agreed with Dr. Martin's proposed treatment plan of a double mastectomy followed by chemotherapy.  If my lymph nodes are indeed negative, there is a high chance that after my mastectomy, I will be cancer free!!!

Chemotherapy would be done as an added measure to prevent possible recurrence.  "If you have a garden, you pull the weeds, but you still might spray the garden after", said Dr. Martin.

Tomorrow is my MRI, and I pray that the results of it will be as positive as the ones I received today.

It was a "sprinkle day" after all...THANK YOU for your support and prayers!

TTFN,
-S

Suspicions

Today was the consult with the surgeon, or so I thought...

Jeff and I went to our appointment with Dr. Martin. As if we weren't apprehensive enough, several procedures had thrown the schedule off, so waiting for our appointment time seemed to take forever. Dr. Martin performed another ultrasound, and then a core needle biopsy. During the ultrasound, I could immediately tell that he was concerned, and he verbalized his worries. From one angle, the tumor appeared to be a benign fibroadenoma, but another angle showed a very suspicious tumor with malignant characteristics.

I refused to look at the needles during the biopsy, but it was not an enjoyable activity. Jeff was instructed to sit down, so they wouldn't have to pick him up off of the floor! That part still makes me laugh. A hollow needle is placed into the breast, and then core samples are retrieved through the needle. I explained it to Griffen like a really big straw or tunnel, that is used to transport tissue samples through. The portion was deadened prior to biopsy. The first two samples were uncomfortable, but not painful. The same couldn't be said for the third one. It was extremely painful, and even the doctor realized it. After the tissue samples were collected, they were placed in a specimen container, and apparently sank rather quickly. Just like the Titanic, that is a bad thing.

Our previous experiences with Dr. Martin when he removed Adelia's appendix, is that he is a "tell it like it is" Southern gentleman. His reputation and experience is that he can pretty much call it, prior to the official results. You can only imagine how we felt as Dr. Martin soberly told us how worried he was about this tumor, based upon my age, and the characteristics and density of the core samples. Not taking away complete hope, but his professional opinion is that my tumor is 80% malignant. There's still a slight change that it is a fibroadenoma, but not likely.

Because of the kind and caring nature of Dr. Martin, he immediately began making plans to rush the biopsy to pathology. After speaking with the Pathology Department, the results will be rushed, and he will be notified early Saturday morning with the results, which he will then pass onto me as soon as possible.