Trixieland

words about words

Archive for the tag “lumpectomy”

You’re a cancer survivor – a bullet list

  • One day you feel a lump in your boob. Machines create images, doctors test a chunk. It’s cancer.
  • People say you’re a survivor the moment you announce your diagnosis. You think, “huh? What’d I do?”
  • Treatment begins in early May and concludes in late December. Start the new year clean, you think.
  • Through it all no one allows you to talk about the possibility of your death. It’s taboo.
  • 6 rounds of chemo didn’t kill all the cancer, but surgeon got the last bit. Radiation to seal the deal.
  • You think about what else the chemo might have missed. In places the docs aren’t looking.
  • You move from the apartment you’ve inhabited for 10 years to a big house with a huge yard.
  • Your brain feels foggy and you’re sure the cancer’s in your brain. It’s not.
  • You finish Herceptin in April, and begin hormone treatment that will last for five years.
  • Hot flashes ensue, along with joint pain that wakes you at night. Your knees sound like Velcro ripping.
  • You gain 15 pounds from the sudden menopause. Dropping to 500 calories a day doesn’t help.
  • You accept being plus-sized, and buy new clothes. Your age has made you invisible anyway.
  • You visit the oncologist every three months for an injection that shuts your ovaries down.
  • The joint pain is so bad your oncologist switches you to a different hormone medication.
  • Your oncologist tells you the new recommendation is 10 years of hormone meds. Not five.
  • Your joints feel better but you gain another 10 pounds in the space of two weeks. Right in the belly.

b164c2c67d3aabc26c6fefdf946d689c--breast-cancer-quotes-breast-cancer-survivor

  • You go back to college online and take on freelance work for the first time in a couple years.
  • You get a rash on your “bad” boob and panic that it’s Inflammatory Breast Cancer.
  • You consult your posse of  survivor friends. They reassure you, but tell you to go in.
  • It’s not inflammatory breast cancer. Either the antibiotics or steroid cream fixed it. You feel dumb.
  • You pass your first post-cancer mammogram with flying colors. You were expecting bad news.
  • Of your survivor posse, one has stage IV, after “beating it” nearly three years prior.
  • On next oncology visit you complain about weight gain. Obesity increases your chance of recurrence.
  • Doctor switches you back to original meds. You don’t lose any weight and the joint pain returns.
  • You pin all your hopes for the future and redemption for millennia of oppression on Hillary Clinton.
  • On election night you go to bed with a mouthful of marijuana oil before all the votes are in.
  • When you wake up and remember, you briefly consider suicide and settle for stopping your meds.
  • You gain another 20 pounds in anger, disbelief, and heartbreak. You get a safety pin tattoo.
  • In school you study psychology and plan to work with hospice patients and families.
  • You apply to volunteer in hospice, visiting patients. Your Stage IV friend tells you it’s your calling.
  • Your Stage IV friend asks if your brownie troop can come to her house and plant tulips.
  • Before you can gather the girls for the tulip project, your friend goes into hospice herself.
  • On the way to visit you think about what she’ll say. Maybe you’ll make a deathbed promise.
  • She doesn’t speak or open her eyes. You brought a huge bouquet of tulips that seem cruel now.
  • On your first day of hospice volunteer training, your Stage IV friend dies.
  • At the funeral you connect with a coworker from early in your career. She’s a survivor too.
  • That’s four of you, from just one small department in one company. Stats? Or the water?
  • At home you casually talk about what you’d like at your funeral. Your youngest stares at you.
  • You don’t think she knows that cancer kills people. You’d talked about sickness, but never death.
  • After your friend’s death you go back on your medication. Because not to insults her memory.
  • You take on tons of freelance work and study hard. You make money, contacts, and the Dean’s List.
  • Math and a new full-time job defeat you at school and you drop out of college for the fourth time.
  • You go on vacation and don’t take your medication. You don’t bother to start again at home.
  • You move into your dream house in a Norman Rockwell neighborhood where kids roam free.
  • Every night in the new house you dream about cancer. Here’s what you dream:
  • You dream about sobbing and clinging to your mother as you say “Mommy, I think I’m sick again.”
  • You dream about wasting away in a hospital bed, too weak to lift a book to read it.
  • You don’t think you’re psychic or clairvoyant. But what if the dream is a message from your body?
  • Twice, when you’ve dreamed your teeth fell out, you’ve been ill. Mono and pneumonia.
  • A friend dreamed her dead mother told her she had breast cancer. And she did.
  • You say, “I had a weird dream last night” “Was it about cancer coming back? I don’t want to hear it.”
  • You can’t talk to anyone about your fears. You just wallow in it. Silently. Alone.
  • You think about the new house and where you’ll convalesce. You buy a swing chair for the backyard.
  • You plan how to turn your new library into a bedroom and how you’ll watch the birds as you die.
  • You go camping to watch the total eclipse. You wonder if you’ll be alive for the next one.
  • The chest pain gets worse. One day at work you find yourself holding a cold can to your chest.
  • You have trouble catching your breath. You drive to the Emergency Room. You tell no one.
  • Your EKG, blood tests and chest X-ray are all clear. You’re a fool. You’re a hypochondriac.
  • You miss a big meeting, and confess to your boss you’re at the hospital.
  • You don’t want him to think you’re a sick person. You don’t think he knows about the cancer.
  • You’re already the oldest, fattest, most unsightly member of the team. You can’t afford more.
  • Your job is stressful and your brain isn’t as sharp as it was. Is it ageing or chemo or both?
  • Google tells you former smokers have an increased chance of lung metastasis.
  • At your oncology appointment you tell him about your chest pain. He refutes your Google information.
  • Your oncologist orders a CT scan to rule out pulmonary embolism and cancer. Refills meds.
  • He emails you late that night to tell you it’s clear. There’s something in your lung, but not cancer.
  • A regular doctor diagnoses an inflammation in the cartilage between sternum and ribs.
  • Prednisone clears up the lungs, and your eczema, plus your joint pain. But only for a week.
  • You feel relieved that the cancer’s not back so you go ahead with your plans to lead a new Brownie troop.
  • You want to just LIVE, but it’s always there in the back –and often front—of your mind. Cancer.
  • You wanted your life to be more meaningful, but you’ve quit school and haven’t done hospice work.
  • This is how you survive. Living between the recurrence nightmares. Pretending you’re “better.”
  • But deep down you’re convinced that cancer isn’t done with you yet.
  • And the only way to prove otherwise is to die of something else.
Advertisements

Pathology, surprises, and what’s next

Since my last post I have calmed down a bit and also found out more information. The first thing I did was go to Dr. Supe’s office and pick up my pathology report. After much Googling, consultation with my billions of breast cancer books, and knowledge I’ve sucked up over the past six months, I had some answers. Then I had a post-op appointment with Buffy the Cancer Slayer and learned more.

Pathology Report post-surgery

Okay, so the good news is Turdy is dead. I will place no flowers on that fucker’s grave. But, I am grateful to him for being big and lumpy and close to the surface. If I hadn’t felt his gnarly ass in my boob, this cancer would probably still be undetected, spreading its shitty, sneaky doom throughout my body.

RIP Turdy

Let’s go through my list of Stuff I Don’t Know and update:

What I don't know

  1. Well, I guess that was rhetorical.
  2. Um…probably not. Here’s why: The nodes that drain from my breast to my armpit were discovered using the radioactive tracer. Dr. Supe examined three of them (the ones that made the Geiger counter click) and took out two. one showed signs that cancer had been there and been killed off by chemo. The other had some stubborn cancer still in it. (probably because the malignant node was so frickin large. Twice the size of Turdy.) So I guess the rest of the lymph nodes looked okay?
  3. A total of 7 grams. 4 for the former Turdy site and 3 for the little scoop where the DCIS was. Here’s what 7 grams looks like: 7 grams of weed
  4. Nope. Nothing left!
  5. We have to assume not, as nothing showed up in mammogram, ultrasound, MRI, or PET scan. My guess is that Turdy’s fat ass obscured the tiny 1mm DCIS. Could there be more? Sure. But we don’t have any evidence that there is.
  6. Buffy says that additional surgery wouldn’t be more lumpectomy or a mastectomy. The concerning area is my armpit, so if there’s more cutting, it would be to remove more lymph nodes. Or maybe all of them in my armpit. There isn’t consensus on that yet…
  7. Well. Because there aren’t many straight answers. Will the cancer come back? No one knows. You can look at stats and probability all day and night but you just can’t predict recurrence. It’ll come back or it won’t. And then you’ll know.

Here are some more things I’ve learned and realized in the last week:

  • When Dr. Moviestar called in March to tell me my biopsy was bad news and that yes, it was cancer, he told me it was Stage 2. Of course that was before a zillion more tests and scans. What no one told me (and I guess I didn’t ask, though I did speculate) was that once Turdy Jr. was discovered in my lymph node, my breast cancer was Stage 3. Which is scarier than Stage 2 and maybe it’s better I didn’t know until I flat-out asked Buffy. Still. Yikes! The survival rate takes a pretty large dip between Stage 2 and Stage 3. From 93% to 72%.
  • I think my terrible reaction to Dr. Supe’s phone call about the path report is due to unrealistic expectations. I expected to hear something along the lines of “you are cancer-free” or “there’s no evidence of disease.” Which equals remission. (Cancer is never “cured.” Sort of like addiction; substitute “remission” for “recovery.”) Why did I think that? Partially I think because my doctors never discussed possible outcomes with me. Never gave me a range of what could be the result. Did I ask? Maybe not. What I did do, a few months ago, was watch Season 4 of Parenthood in which Kristina Braverman gets breast cancer, goes through treatment and SPOILER comes out the other side healthy. parenthood-monica-potter-peter-krauseShe and her husband Adam sit in her doctor’s office after surgery and chemo and he tells her “You are cancer-free.” (Or that’s what I remember happening). So, to me, that’s how the narrative goes. Prince Charming rides up, kisses your dead lips and BAZINGA! Princess Life! Naive? Yes indeed.
  • I asked Buffy if one more round of chemo would have knocked out the remnants of Turdy Jr in my lymph node. She told me that I’d had the most chemo I could have. So I felt relieved that I hadn’t taken Dr. Cap up on his reluctant offer to lower my dose. And also felt a little bit badass. Like I took all there was to take. My chemo was dialed up ALL THE WAY and I got through it. Go me.
  • What I kept focusing on was the presence of cancer. A tiny DCIS in my boob and some extra-stubborn cancer in my lymph node. Forgetting the fact that those two bad boys were cut out of my body. Not inside it any more. Gone.

So here’s what’s next. Tomorrow, all my doctors (Supe, Cap, Buffy, the radiation oncologist, and whoever else) will review the pathology in a “multi-disciplinary breast conference” and discuss what they should do with me. Yes, it’s every woman’s nightmare: people who have seen me naked will be talking about me behind my back. They’ll discuss the armpit surgery and if they think it would make me healthier/safer/less likely to have a recurrence than just going ahead with radiation (which starts soon), continuing Herceptin until May, and hormone therapy (which starts after radiation ends and lasts five years). One of those Super Friends is supposed to call me after the meeting and let me know what went down.

3947706-super+friends+hall+of+justice.jpg

To be honest, I am more leery of the armpit thing than a mastectomy. The more lymph nodes you take out, the greater the risk of lymphedema, which apparently sucks big donkey balls, and they can’t do much about it. But, it’s not like I get to choose. My armpit is being a dick, not my boob.

As for the surgery recovery, Buffy snipped my little stitches and even I have to admit I am healing like Wolverine.

FullSizeRender (9)I still can’t immerse my boob in water for two more weeks and she warned me not to lift weights (ROFL). The grody part of my fingernails is growing out and should be gone in another month or two.

IMG_3287

My hair…well, let’s just say it’s slow going. I still haven’t had to shave my legs.

The chemopause is worse than ever. The hot flashes are pretty fucking terrible. Buffy says that given my current age and the age my mom was when she started menopausing, I probably won’t come out of chemopause, but will just slide right into legit-old-lady-menopause. So, yeah. It’s not like I was going to have more kids, but this is kind of a tough one. However! She told me that exercise and acupuncture can help with hot flashes, and if those don’t work she or Dr Cap can prescribe something for me.

I still have a terrible battery-acid pine cone in my belly. Well, that’s what it feels like. I chalked this up to chemo nausea long ago, but the chemo’s been over for two months today (!) and the pine cone is still there feeling prickly and gross. I think it’s a ball of anxiety and my next step (well, one of my steps in there amongst radiation and Herceptin infusions) will be to maybe talk to a shrink about that shit.

FullSizeRender (10)

Meanwhile! I have lots more energy than I used to. I changed the sheets on the bed without getting winded and I’m doing almost all the stuff I did before. I can eat food and smells don’t bother me and I’m excited about stuff. Like the Star Wars trailer, and my new kitten Loki, and the Halloween party I’m going to this weekend.

Loki Day One

Bad news, confusion, and a giant WTF


I had nearly given up on getting my pathology report yesterday. I’d started second-guessing my memory about what Dr. Superman had told me. (“He said Monday or Tuesday…maybe he meant NEXT week…”) I’d called my surgeon’s office in the morning to make my post-op follow-up appointment that morning and asked the receptionist about my report. She said it wasn’t in yet and she’d call them and find out what was going on. Then I heard nothing all day. So, I was pleasantly surprised when Supe called me around 5:30. He took a minute to apologize for the delay. He said something about how it was taking longer to process or whatever blah blah blah. Get to the good part, I thought. Go ahead and tell me “Congratulations, you are cancer-free.” bad-news-bears1

Only that’s not what he said. One of the lymph nodes he removed had cancer in it. Still. After SIX ROUNDS of shitty, miserable, fucktatious fuckwad chemo. The other node had fibrous shit in it which he says indicates it probably did have cancer, but the chemo got it.

Then the other thing he said was that in the junk he took out of my boob there was DCIS which is Ductal Carcinoma In Situ, also known as Stage 0 cancer. This stuff I guess can’t kill you unless it escapes your duct and becomes invasive (Turdy was Invasive Ductal Carcinoma). From what I understand it’s a sleeper cell. There is debate in the medical world over whether it is being overtreated currently. Right now protocol usually is to cut it out and maybe radiate it. Chemo doesn’t really work because it targets fast-growing cells. Sooooo this is another cancer that had never shown up before. Not on mammogram, not on ultrasound, nor MRI nor PET scan. It’s an October surprise.

So what now? What do I do now. Here’s were Dr. Superman gets infuriating. (Insert a bunch of words about how he’s nice and a skilled surgeon and I respect him, etc etc). Supe thinks in terms of stats. Overall stats. So when I was wondering whether to have a mastectomy or a lumpectomy, he didn’t offer an opinion, just told me that after ten years there was no difference in survival rates. So it didn’t matter which I chose. And he told me the same thing yesterday. That the chance of recurrence of the cancer statistically, over the long term will be the same whether I just go ahead with the radiation I was going to have anyway or if I have more surgery. The difference will be how I feel about it.

“Well, if I just have the radiation as planned, how will we know it worked?”

“You’ll know in ten years when the cancer hasn’t come back.”

Okaaaaayyyyy. That…doesn’t really work for me.

So here’s what I know from this conversation:

  1. The chemo didn’t work completely.
  2. I am not “cancer-free”
  3. I can’t participate in the radiation research study I signed up for.

Here’s what I don’t know:

  1. What the fuck?!
  2. If there’s any more cancery shit in the lymph nodes that are still in my body.
  3. How much boob Supe took out.
  4. If there was anything left of Turdy in my boob.
  5. If the DCIS was in the scoop he took out, is there any more in my boob that they didn’t find before?
  6. What “more surgery” means. Bigger scoop? Mastectomy?
  7. Why no one will give me a fucking straight answer.

Reading back about HER2 + cancer I noticed something that I hadn’t seen the first time.

“According to The New England Journal of Medicine (NEJM), up to 70 percent of patients with HER2-positive breast cancer respond to treatment. However, total remission for the condition occurs in around 7 to 8 percent of patients.”

Maybe I don’t understand it correctly, but it appears that only 7 or 8 percent of HER2+ breast cancer goes into remission. Well, that can’t be true, can it? I mean, was there only ever a small chance that I would, at some point, be cancer-free? Do I not properly understand the term “remission?”

Why did I think I’d get to hear those “cancer free” words? Why was I so convinced I’d be popping champagne corks instead of shaking my head and wondering what the fuck has gone so wrong?

Dr Supe told me he’s on call this weekend and if I have questions to call his service and tell them it’s an emergency. Which is very kind. But I…don’t know that I can ever get a straight-up honest answer out of him. Unless it’s something that I can’t use. When he says it’s statistically identical for me to have more surgery or just the radiation…what does that mean for me as an individual? That I’m fucked either way? Or I’m okay either way? And just what ARE the statistics? He didn’t mention any numbers…and I could spend all day and all of next week looking for that stat and I won’t be able to find it.

I don’t know where I stand. I have an appointment with Buffy the Cancer Slayer on Monday morning and hopefully she will be straight with me. Also, I need to get my hands on that pathology report and see for myself just what is what.

I’m not a child. I’m not fragile or addle-brained. I don’t need to be protected. I’m not asking for nuclear launch codes; I just want to know the truth about what the fuck is in my body, how dangerous it is, and how to make myself as safe as possible.

Is that asking so much?

Phase Two – Cut it out!

Wow it’s been a long time since I’ve posted anything. I’ve composed many many posts in my head which I intend to get to before long. Posts about my existential crises, about what I got wrong about cancer in my first few posts, the cancer books I’ve found most useful and entertaining, and a list of stuff I can do while I wait out radiation and grow some hair. But those posts are for another time. I want to stick to one subject today: breast surgery. I’m going to try to be pretty detailed while it’s fresh in mind and hopefully it will help people about to go through the same thing have a better idea of what to expect.

So, here goes: I checked in for my lumpectomy (also called “partial mastectomy”) at 7 a.m. The plan was that my daughter Callahan would come with me and my husband would stay home and get our daughter Allison off to school. Then Callahan would go to her college class in the afternoon and Gunny would pick my ass up after surgery was over. Of course none of this played out quite the way we planned. Allison had a minor meltdown in the morning. She was “Sad about that thing” (That thing being the cancer and the surgery and probably the disruption to her morning routine). Daddy asked her if she wanted to help get Mommy checked in at the hospital, if that would make her feel better. It would. So we took two cars to Overlake Outpatient Surgery.

Checked in! Hat by Kiki Lewis.

Checked in! Hat by Kiki Lewis.

I got checked in and the woman looked at the schedule and told us I’d probably be ready to go home around 4 or 4:30. Well, that threw a wrench in Plan A. Plan B was Callahan would return to the hospital after her math class got out at 3:30 so Gunny could pick Allison up from after-school chess club. I kissed Gunny and the baby goodbye and Callahan and I went in the back. I lay down in the bed and the nurses asked me about allergies and what medicine I was on etc. The only thing I’m on really is magnesium. I thought my supplement days were over when Dr. Captain America deemed my hemoglobin high enough for surgery. But I got an email from him last Friday telling me to double up on my magnesium dosage for a total of 1600 milligrams per day. Here’s the deal with magnesium: it makes you poop all the poop in the world. Which is probably why, even though my appetite is back and I’m as physically idle as ever, I haven’t gained a pound since my last round of chemo. It’s like bulimia of the butt. Honestly (and here I am describing shit to you, so what else could I be but honest?) I don’t think my body remembers how to manufacture regular poo. It’s like the enzymes or whatever is responsible for shit-creation are hanging out in my guts and some sushi or hamburger appears and one of ’em says “Food, huh? Uhhh what are we supposed to do with this?” and another one (maybe wearing a tiny construction hat) takes the tiny cigar out of his mouth and jerks a thumb towards my ass and mutters, “Ehhh, just liquefy it and shoot it out the back.”

Um. Anyway, the nurses set up an IV line in my hand and take my vitals and all that. I was tired and kinda punchy and suddenly so very grateful I hadn’t gone off the deep end and insisted we cut off my boobs. Surgery is weird and scary enough…at least I wasn’t saying farewell to those murderous twins. After a while of hanging out in that room, it was time for me to go to the Breast Center (where I had the original mammograms and Turdy (the breast tumor) and Turdy Jr. (the malignant lymph node) were discovered) to get some frickin’ wires put in to guide my surgeon Dr. Superman. I was kinda hoping it would be a fun reunion with Dr. Moviestar, but no such luck. I was hoping Callahan could come in the room with me, but they wouldn’t let her. Mainly because they’d just taken delivery of this massive new machine that looks–I shit you not–like a battle mech.

Get away from her, Turdy!

Get away from her, Turdy!

About seven feet tall, it has these arms that reach out on either side of you, and these plates that flatten your tits into flesh pancakes. There was a grid with markings and the doctor, after getting my boob squashed into the right position, took a surgical pen and marked my skin at position B-10. My response? “You sank my battleship!” Then she stuck lidocaine in my boob to numb it. That stung like a mo-fo. Then she followed that up with a teeny but hollow needle and threaded a single tiny wire through. One end was right on the metal clip Dr Moviestar had dropped in when he took the core biopsy of Turdy. The other end of the wire stuck out of my boob. I looked like a hedgehog with one lonely quill. The doctor liked that idea. She also loved the hat my friend Kiki made me. Being a knitter herself, she recognized quality work. I really wanted to get a picture of my boob wire, but by the time I was reunited with my phone, I’d been gauzed and taped up. We moved into an ultrasound room for the next part: locating the clip Dr Moviestar had put in Turdy Jr in my armpit. The doc had discussed this with Dr. Supe and he’d told her that if she couldn’t find the clip, no biggie, no wire, he’d find it with the radioactive tracer. Well, she couldn’t find the clip and guess what else she couldn’t find? Turdy Jr. That 4 cm asshole was GONE. I saw for myself on the screen.

Toodle-oo motherfucker!

Toodle-oo motherfucker!

I was feeling pretty good. The wire bit was over. They wheeled me back to outpatient surgery where I waited almost an hour for Nuclear Medicine to be ready for me. Callahan was exhausted and I felt guilty for wasting her time since it wasn’t looking like she was going to get to actually see anything cool. So…I sent her home to nap before class. Because I’m a dumbass. When Nuke Med was ready for me, it turns out she COULD have come with, and the tech, Gail, had trained at the exact same program at Bellevue College that Callahan is hoping to get into. AND Gail is friends with the director of the program. So I fucked that up and feel like a stupid, stupid asshole. So, remember me telling you that I was going to have a shot of radioactive tracer in my areola? And that the tracer would flow to my lymph nodes so that Dr. Supe, during surgery could run a Geiger counter over my armpit and see which nodes were cancery and take them out?

Wrong. First up, as the doctor told me, the tracer doesn’t go to the cancery bits like a moth to a flame. It shows which lympnodes are draining from the breast as opposed to another area. These little breast dumpsters are where the cancer would spread. Okay, now I know. The other wrong stuff? It wasn’t one shot…it was FOUR. Not in the areola, but at the perimeter, where the skin changes color from regular skin to nipply color. The placement, as the doctor put it, was three, six, nine and noon. It actually didn’t hurt that bad. Gail held my hand. When the shots were over they had me hold a heat pad to my boob and massage it so that the tracer flowed to the lymph nodes more quickly. I babbled about being radioactive or become SheHulk or an X-man. They were probably glad to get me out of there.

Damn you, cancer!

Damn you, cancer!

Back in my little room it was still 45 minutes before my surgery was scheduled. I dozed a bit and screwed around on Facebook via my phone. The anesthesiologist came in to introduce himself, the nurses hooked up the IV (fluids, antibiotics, and anti-nausea stuff). Then Doc Superman came in and after I flipped him a bit of shit about the one nuke shot actually being four. He went over what he was going to do: Take out the Turdy clip in my right boob plus a little bit of surrounding tissue, then Geiger my armpit and take out up to four lymph nodes. He initialed the right breast (so, you know, he got the correct boob), and said, “See you in there, kid.”

When I had the surgery to install my medi-port back in late April, I have no memory of the actual operating room. I think the anesthesiologist started me off in the wait-around room with a sedative and I was out of it by the time they moved me. But this time, I was totally alert. The OR was big and REALLY cold. Besides the anesthesiologist there were three nurses in scrubs and masks and I started to get a little nervous. It was REAL. Then I scootched off the gurney bed onto the operating table which is ridiculously narrow! Like skinnier than a dorm room bed. Probably 2/3 the size of a twin bed. Dr. Feelgood put a sedative in my IV and an oxygen mask over my mouth and nose and…

…woke up in the recovery room. Dr. Supe told me everything went great and he’d only had to take two lymph nodes! That’s really good because the more nodes that come out, the higher the risk of this super shitty (and often permanent) swelling and pain called lymphedema. Supe asks who’s picking me up and I say my daughter. Then I look at the clock and it’s only 2:00. Callahan’s about to go to class. So I tell him my husband. Supe has the number and gives him a call.

All done!

All done!

I move to a new room that has a recliner instead of a bed and the nurse gets me a Diet Coke and Saltines. (I hadn’t eaten or drunk anything since 10:30 pm the night before and I was HANGRY). I get my phone out of my stuff and post some updates to Facebook while the nurse calls in a Percocet prescription. After a while she goes to the waiting room to look for my husband. He’s not there. They ask me to call him and I do, obviously waking him up. Dr. Supe had just told him surgery went well, but didn’t mention that he needed to come get me. So he hauls ass to pick me up, feeling terrible though it was no fault of his!

We picked up the baby from school and when she saw me in Jeep she said “MOMMY!!!” We went home and I crawled in bed and Allison gave me this picture she drew for me.

This is me waking up after surgery. The nurse is clapping and apparently we're going to eat cake.

This is me waking up after surgery. The nurse is clapping and apparently we’re going to eat cake.

Gunny picked up my prescription and a Big Mac. It tasted like heaven.

IMG_3206So now I’ve got my Percocet with a Pinktober cap and my boobs are wrapped up in an Ace bandage.

IMG_3205I can take it off and shower on Saturday (48 hours after surgery), but can’t take a bath or swim for three weeks. It’s sore, but really not too painful. The only annoyance so far (besides the sweaty funk I’m sure is brewing inside the boob burrito) is I can’t sleep on my right side. This morning I peeked under the bandage at Turdy’s gravesite. It doesn’t look too bad! My armpit is kinda numb.

Kinda grody, but I still have two boobs!

Kinda grody, but I still have two boobs!

So what’s next? On Monday or Tuesday Dr. Supe will call with the pathology results. That’s when I will find out if there is any cancer left in me. I’m feeling optimistic and am fully expecting to hear that I am cancer-free. And then, friends, we are going to PARTY.

Bad Blood – A Short Delay

hemoglobin-respiratory-molecules-one-molecule-can-bind-up-to-four-oxygen-molecules-34888190This might be the only blog post on the Internet that’s not about T Swizzle. By “bad blood” I mean that my actual blood in my actual body is bad. It’s anemic and my hemoglobin is waaaaay too low. This whole time I’ve been so worried about my white count and if it would get so low it would delay my chemo schedule. So, there I was, at the hospital for my very first Herceptin-only “maintenance” infusion. Feeling like a recent grad visiting her old high school during the first week of school. You know, feeling pretty good. Maybe a little smug. My appetite had just returned and I’d had sushi for every meal for two days. (Except breakfast of course, because I don’t do breakfast. Breakfast food is beyond delightful. It’s eating it in the morning that I object to.)

Delicious Sushi

Anyway I get in there for my appointment that’s supposed to last 30 minutes. And I discover that Dr. Cap has snuck me onto his schedule. “He probably wants to yell at me about my magnesium,” I groaned to the nurses. (NOTE: Dr. Cap doesn’t “yell.” He might actually be incapable of raising his voice.) I can’t remember if I wrote about this before, but my magnesium was wicked low right before my last round of chemo so Cap put me on 800 milligrams a day of the stuff. And I was really good about taking it. And YET this was not reflected in my blood panel! How, I asked, could I be ingesting two 400 mg tablets of that crap every day and it not show up in my blood?! Cap told me to eat magnesium-rich foods. Well, at that point I wasn’t eating jack shit, so I just kept taking the pills and took long baths in magnesium sulfate (bath salts, baby) which I’d read that you can absorb through the skin.

Now, I’ve been anemic for basically ever, which doesn’t make sense to me. I eat red meat. The only veggies I like are the green ones. There’s no frickin’ reason for me to be anemic, but I am. I was a decade ago, I was while pregnant with Allison, I was 18 months ago at my regular doctor, and I have been throughout chemo. Everyone and their dog told me to take iron pills. And I ignored them because they upset my stomach and clog up the works. If you know what I’m saying. Hashtag no poop. Anyway, I wasn’t worried about it, but apparently I should have been.

Because Dr. Cap told me that my hemoglobin was too low for surgery. *sad trombone* To tell you the truth, I wasn’t even sure what the hell hemoglobin was. My first thought was a Spider-Man villain. Apparently that’s not quite right. It is “the iron-containing oxygen-transport metalloprotein in the red blood cells.” It looks like the fourth of July!

hemoglobin  Dr. Cap said we should delay surgery for a few weeks and I needed to start taking the iron supplements seriously. He told me that the official call on surgery belonged to Dr. Supe (my surgeon), but with hemoglobin that low (7.5 if you’re curious. Normal range is 11.3-15.5) it just wasn’t safe. He told me that if the iron supplements didn’t raise my levels we’d have to give me someone else’s blood. Yikes. So I’m taking the dang iron pills and they suck. But I take them twice a day. Surgery has been rescheduled for October 8.

The good news is that my heart is just fine. This is confirmed by an EKG and an echocardiogram. There wasn’t any damage from the Herceptin.

A couple days after starting to take the iron (and more than three weeks passing since my last chemo!) I had an excellent day. I felt good. I ate food. I had energy and did a bunch of housework. I did, however, have a bit of a meltdown at the party store. Gunny and I went to get a Harry Potter costume for Allison and I found this cool pink lady wig.

Bee tee dubs it looks like dogshit on me. I have olive skin and it doesn't go with pale pink. :(

Bee tee dubs it looks like dogshit on me. I have olive skin and it doesn’t go with pale pink. 😦

Now that it’s Halloweentime, all the cool wigs are out and since I’ve got barely a hint of stubble on about 1/3 of my head, it looks like hat and wig city for a good while. I said something to the cashier about how the wig was for me and blah blah bald head and she told me she’d had breast cancer twice. They’d missed something the first time and she got more lumps and had to go through all the treatment again. “You’re going to be okay,” she told me. And I got all teary-eyed. And I asked her “Are you able to make plans for the future?” and as I said this, I lost it and started crying and–thanks Herceptin Drip–my nose ran right onto my shirt. She leaned across the counter and hugged me. “It’s going to be okay,” she said. “I promise. I swear to God it’s going to be okay.” Then she gave me her phone number and said to call her if I wanted to talk.

You just never know when you’re going to break. And I don’t know if I was crying because of cancer and future and will I EVER have peace of mind or because Antoinette at Everything Party reached out to me with kindness when she didn’t have to. BTW she told me that it took her a while, but now she is able to think about and plan for a future.

First Day of 1st gradeSchool has started again, and with the homework packets and library books, Allison brought home the first cold of the season. In the old days, pre-Cancer, everyone would get sick to some degree while I would have a half-day of sore throat and then be fine. My immune system was a rockstar. Well, no more. I got pretty sick. Not go-to-the-doctor sick, but sick enough to stay in bed and watch Columbo episodes on Netflix. I’m feeling better now, but that cough/cold knocked me on my butt for a few days–and just when I was feeling good again!

sick and Columbo

I don’t have to go back to the doctor until the first week of October for a pre-op consult with Dr. Supe, and then my Herceptin action the next day. So in the meantime I will concentrate on whipping my blood into shape, getting Glitched out in paperback, and maybe perhaps I hope doing some work on my next Lexy story which I haven’t touched since July 7.

Chemo Round 6 – The Worst is Over!

IMG_2745Yesterday I had my sixth and final round of chemotherapy!! I’m so excited and happy and relieved. I still have a couple weeks of side-effects to deal with, but the beauty part is that when I finally start feeling better I will STAY better. I won’t come out of it just to begin again. I am convinced that this knowledge will hasten recovery.

Before I tell you the tale of this momentous day, though, I need to bring you up to speed on surgery. I met with Dr. Superman (Oh! And I’m going back and updating all these cancer blog entries with the new improved nicknames. Simply because the ones I used back in the early days before I got to know this amazing team seem disrespectful now.) Anyway, I’m going to have a lumpectomy and sentinel node biopsy on September 15. Here’s how it will go down:

  1. I will go to the breast imaging office (I hope to see Dr. Moviestar, the radiologist!) and have guide wires inserted in Turdy the breast tumor (or probably just the marker clip since we think Turdy has been demolished by the chemo) and that monster malignant lymphnode in my armpit that was twice Turdy’s size. Remember these fuckers?
    Darth Turdy

    Darth Turdy

    Son of Turdy

    Son of Turdy

    The wires will run from the clips to the outside of my body and be taped down. This will help Dr. Supe find the lil bastards (he’s amazing, but does not to my knowlege possess x-ray vision).

  2. Next, I will go to Nuclear Medicine (I’m assuming the same joint I had my MRI, PET scan, and MRI-guided biopsy on Left Boob, They will inject a radioactive tracer into my areola. Yeah, you read that right. I will NOT be asleep for this monstrous act. I’m trying not to think about it.
  3. I’ll go into surgery and hopefully be knocked the F out by the anesthesiologist. Then, Supe will run a Geiger counter wand over my armpit area and mark with a pen the places that react to the tracer. Those will be the lympnodes most likely to be cancery. He predicts 3 at most.
  4. Supe will make ONE incision, and take out the Turdy-clip in my right breast along with a small chunk of surrounding tissue. He’ll remove Turdy Jr. the lymphnode and any of his Geiger-clicky neighbors. He’ll sew me back up!
  5. All the tissue junk will be sent to Pathology for testing. To see if there is any trace of cancer that the chemo didn’t get. This may take a couple days. If there are any lingering microscopic cancer cells then Dr. Supe will need to do more surgery. I guess that’s when we’d talk mastectomy.

About three weeks after surgery I will start Radiation. I’m actually going to take part in a research study if I qualify (and to qualify I need to be cancer-free ie no lingering cancery shit). I’ll be randomly placed in one of two groups: I will either get radiation just on Right Breast, OR on Right Breast AND Armpit. I’m hoping this will assuage my guilt for opting out of the first research study I was offered (which would have me recieving hormone therapy at the same time as chemo. Ixnay on the extra side effects.) A couple things I found interesting about the details of the study was that regarding privacy, the authors of the study warn that in the future, researchers may develop some way to find out my identity just through my DNA and in that case they can’t protect my anonymity just by withholding my name. It was a little Minority Report. This was the other part that was weird but cool. They basically make it plain that this will benefit people who haven’t even been diagnosed yet.IMG_2735

Anyway, the side-effects of Round 5 were dreadful. I got so tired at one point in the middle of grocery shopping that I actually used the scooter. I took my hat off so that my fellow shoppers wouldn’t think I was a faker and that I really did deserve to ride instead of walk. Yes, I know I’m ridiculous. IMG_2634And I think I’m a shoe-in for the Turtle Club. I am most def turtley enough.

the_master_of_disguise

When I could finally eat again I only wanted sushi. My husband completely indulged me. My daughter Callahan even took me for a late night run for grocery store sushi. Remember, I’m not driving, so my sushiquest requires an accomplice.IMG_2659

LAST CHEMO!!

At one point I felt like this day would never arrive. But on the other hand I’ve been planning for it like it’s the freakin’ senior prom. First, the outfit had to be significant. It had to be Wonder Woman. I have received a lot of WW gifts both before I was ever diagnosed but mostly afterwards. My friend Megan gave me a whole fab WW care package on the last day of Kindergarten that contained a book, sunglasses, a shitload of cute socks, and this fantabulous Wonder Woman snuggie. Don’t be too jealous.IMG_2666

Let me break down the provenance of my Final Chemo Ensemble for you:

  • IMG_2777The wig courtesy of Lisa Barbato.
  • The tiara is from Gunny.
  • The t-shirt I bought myself for the gym that I haven’t set foot in since before Christmas
  • The cuffs from my book editor Marti McKenna
  • The socks (with capes!) from my former mother-in-law Kathleen

I also put a lot of thought into gifts for the team. I got Captain America my oncologist a bottle of Irish Whiskey and a copy of my Lexy Cooper: Triple Threat collection. This is what I wrote inside:IMG_2743

For Harley, my favorite front-desker I got a fancy chocolate bar, and a Starbucks card. For three of my chemo nurses and for Cap’s PA Salena I got an orchid, fancy chocolate truffles and a Toberlone bar. I was up late the night before writing thank you notes which I wept as I wrote. I won’t replicate them here but the gist was to point out how each of them specifically helped me get through chemo. I thanked Cap for always listening and never rushing me. I summed up by thanking him for more years with my family. Then I brought in two bottles of champagne for the rest of the staff. Can I just say the gifts were a big hit? Wonder Woman or turtle, they kinda love me at Overlake Medical Oncology.

IMG_2747

Me and Amy. Best friends since 1973!

Me and Amy. Best friends since 1973!

My best friend Amy came to sit with me and my baby brother Dan stopped in for an hour or so. Gunny stayed most of the time except for when he left for a bit to buy me a present. 🙂 There were lots of hugs from the staff and when I was finished with my last bag of medicine the nurses presented me with a “graduation gift” which is a bunch of magnets with encouraging words. Then I got to ring the bell and Michelle said “Congratulations on your last chemo!!!” and everyone applauded. I didn’t cry at the time, but I’m a little weepy writing this now. It was fucking GREAT.

FullSizeRender (7)

From Left to Right: Sherry, Wonder Woman, Judy, and Michelle

This isn’t the last I’ll see of this team. I’ll be in today for my Neulasta shot, and in ten days for a blood count (gotta make sure I’m okay for surgery) and then I’ll be getting maintenance infusions of Herceptin (the wonderdrug that keeps HER2+ cancers at bay) every three weeks. Don’t panic, though. The treatment only lasts 30 minutes and the only side effect is a drippy nose. GOODBYE NAUSEA!

One small wrinkle: I told Dr Cap about my elevated heart rate and that it got up to 180 one day when I was cleaning and I felt lightheaded and short of breath. (I also fudged a little because it was actually 187 according to my Apple Watch). He put in a referral for a cardiologist because we don’t want my heart throwing any kind of hissy fit during surgery. He thinks they’ll have me wear some sort of monitor for 24 hours just to track any arrhythmia. If my heart’s misbehaving then they may have me take beta blockers. But THEN, last night I got a note from Cap saying my magnesium is “even lower than your potassium” and he called in a prescription for magnesium supplements that I am to take daily ASAP. Apparently lack of magnesium can cause irregular heart beat plus a bunch of other shit (shortness of breath, high blood pressure, and nausea unrelieved by medication!) that I’ve been blaming on the chemo. SO, I’m going to be a good patient and take that shit like I’m supposed to.

Tomorrow we leave for a week at the beach house in California and I am full of happiness. Yes, I will most likely have some bad days while there, but I’ll be in the beach house bed instead of my boring old bed at home!

What To Do About the Boobs

shehulk1First of all, this round of chemo can kiss my ass. Just in the last couple of days have I been able to eat meals, and it’s time to do chemo again. As each round gets progressively shittier, I will not be surprised if the awful nausea/gross taste lasts the full three weeks between rounds. Pissed and disappointed, but not surprised.

I also have two new side effects:

1. My thumbnails are doing this.

FullSizeRender (5) FullSizeRender (4)Some chemo patients lose their nails entirely. I’m hoping that doesn’t happen, but I also thought I might be spared this side effect.

2. Neuropathy. At least I think that’s what this burning itchy feeling is on my hands. It’s not constant, thankfully, but it sometimes wakes me up at night. What freaks me out about this side effect is that it can be permanent.

So that’s the sucky stuff. Here’s the good news: In my last post I fretted about what to do with my boobs. This past week I met with my breast surgeon, Dr. Superman (formerly known as Dr. Boobcutter) and I have a lot more clarity now. He assured me that “cutting everything off” will not statistically improve my survival rate, but if it will give me peace of mind, he will do it. He also, regarding my “one boob that’s a wonder of science and one that’s had three kids” concern, told me that if I had a mastectomy on the right breast, when they did reconstruction they’d do a little perk-up on the left breast and get them as symmetrical as possible. So that made me feel better.

What the plan is, though, is to start with a lumpectomy. On examining the bad boob, Supe was unable to feel any sign of Turdy the tumor! He said he’s “thrilled” with the chemo. So all he’ll have to remove is the little metal clip that Dr. Moviestar put in when he did the original biopsy. He’ll take that plus some surrounding tissue. It will most likely be a small enough amount that while Right Boob will have a scar, it won’t be the ginormous shark bite disfigurement I was imagining.

Turdy melting

The pathologist will examine this tissue and look for any microscopic cancer cells that may have escaped. What we’re looking for are “clean margins” aka no bad cells in the tissue around where Turdy used to live. If the margins aren’t clear, then we may go back and do the mastectomy after all.

Here’s the stinky part: After Dr. Supe consulted with Dr. Cap, they decided that because I have those four bad lymph nodes under my arm, I will also need to have a sentinel node dissection. They are going to–brace yourself–inject a radioactive tracer into my areola. Yes, boys, that’s Nipple City.

sentinelHopefully, I will already be knocked out for the surgery when it’s Tracer Time? Anyway, the tracer will flow to the lymph nodes and Dr. Supe will run a wand with a Geiger counter over my armpit and see which nodes react to the tracer. Those are the nodes that he’ll remove because they are most likely to have cancer cells. It’s a better option than taking all of them out and checking each for cancer. I can’t help but wonder if a radioactive boob will trigger a metamorphosis from part-time bitch into full-time She-Hulk.

I told Dr. Supe that I wanted to do everything possible to prevent a recurrence. And he told me that with HER2+ cancer, the most critical time is the first five years. With other flavors of breast cancer I guess it can come back within 15 years, but with HER2+, as he put it, “If we go five years without a recurrence, you come back to my office and we’ll drink champagne.”

Deal.

So here’s the tentative schedule:

  • Round 4 chemo July 9
  • Round 5 July 30
  • FINAL round of chemo Aug 20!!!
  • Lumpectomy and sentinel node dissection the week of Sept 7
  • Start radiation (5x week for 5-7 weeks is standard) first week of Oct

And then? I should be done.

Post Navigation

%d bloggers like this: