Marathon Doctors Appointment

I like the idea of having all my appointments back to back to back to back, but man is it difficult.  But cancer is difficult, in more ways than one.

My husband and Dad both joined me at this appointment(on Thursday) so at least I wasn't alone.  I had done a lot of research prior to the appointment and they hadn't, but it is my body so that makes sense.

I saw the geneticist - which was the easiest of the appointments.  He asked my family history and asked if I wanted testing for the BRCA gene.  Only about 5-10% of breast cancer patents have the gene, but why not draw a little blood and give me the results.

Then the general surgeon came in and did an exam and talked a little - it was kindof a blur all I remember her saying is Chemo, at least stage II and a node feels enlarged(yikes!).  I guess I did remember more - she recommended Chemo first to shrink the tumor then a lumpectomy to remove the smaller tumor.  But first is an ultrasound and biopsy of the sentinel node. [please oh please do NOT be in the nodes - pretty pretty please].  We talked lumpectomy vs mastectomy and the survival rate - she said they were the same.  With all things being equal I think I would prefer a lumpectomy.  A lumpectomy does require radiation, while a mastectomy does not.  But I get to keep my nipple which seems to be important to me - It seems trivial, but I would prefer it, even if it means radiation.

Then the oncologist came in and did an exam.  The weird thing about my lump is that it changes size.  I know it isn't "supposed" to change size, but it does.  The ultrasound said 3cm - and it was about 5 or 6 according to the doctors.  Weird.  She told me about the chemo treatments, but since my hormone receptor status was not back she said that will change things.  She also mentioned which ones she was thinking - Start with Adrimycin and Cytoxan for the first 3 months.  I guess it is once every 3 weeks (must be powerful if you only go once every 3 weeks, yikes).  then Taxol(?) the next 3 months.   But that can change based on my hormone receptor status.  I also have to have a heart test because the chemo can affect your heart (oh joy).  And that will change if I am HER2neu positive because that means I will need Herceptin first, but that cant be given with Adrimycin because they both affect the heart . . . got it?  Yeah, right, I understand what I just wrote, heck I don't even know if I got it right - I took notes, but it was a long, information packed day.

She also mentioned several other things that i cannot eat (raw foods, but can eat peeled fruit), stay away from crowds (I forgot to ask if I can work, but I know that I cannot be at WowZville, but i'm sure I'll address that in a later post), and that I have to go in to the ER if my temperature is above 100.5 . . . yikes!  my temperature was 100.1 during this visit, granted I wasn't feeling my best and woke with a slightly sore throat, but still, I regularly have a temperature in the low 99's.

I also asked her about fertility since I have been actively trying to get pregnant for the last 3 and a half years. She said that Chemo can cause you to go into early menopause . . . this can be temporary or . . . permanent.   And if it is Estrogen Receptor positive I will have to be on Tamoxifen for 5 years in which you cannot get pregnant because it will cause miscarriages and birth defects.  And while on chemo you cant get pregnant either - and in fact I will have to take a pregnancy test every 3 weeks (I'm not sure why 3 weeks, but I think it is just before treatment that is every 3 weeks).  Talk about insult to injury.  If tamoxifen is not needed then I may be able to try again after 6months or a year after stopping chemo, but 5 years of tamoxifen put me at 43 and given my past reproductive history (difficulty getting and staying pregnant) I don't see that happening.  I'll have to see how the test results turn out.

Then last, but not least, I met with the Plastic Surgeon to talk reconstruction.  She was leaning towards a mastectomy.  I told her we were talking about a lumpectomy and she was talking about how, depending on the size of the tumor there can be a huge dimple left there.  The most interesting thing she said was that if you do a lumpectomy you have to do reconstruction, or any work before because once you radiate the breast you cannot have any work done.  ever.  The way they get around the missing tissue is to make the other one smaller to match.  I guess i'm lucky I am a C/D cup so that they can do this.  And it seems like they will go ahead and do a little lift too, cause that is the only chance.  But she was recommending a mastectomy which is different that what I was thinking after talking with the surgeon.  Hmmm.  But with Chemo first I am not really thinking too much about that since surgery looks like it is 6 months away at least.

So at the end of the appointment my head was spinning, I was VERY thirsty and I had this box of stuff to take to the lab to have my blood drawn with for the BRCA test.  I did that while my hubby went and got some water from the car.  Then we each drove home.  I was exhausted and ate something and we talked about it a little.  Then I just wanted to not think about it for awhile.  I asked my hubby if we could just watch some tv in bed.  He obliged.

I don't know if this post makes any sense to anyone - I'm not sure I could even get through it, but I feel it was helpful to get it all out there.  I am still confused, but what I took from the appointments was that I needed to have an ultrasound/biopsy of my lymph nodes and we need the results of the hormone receptors before anything is finalized.  More waiting, joy.