Monday, December 31, 2012
Pathology Results :-)
"I am pleased to inform you that the pathology from your surgery showed no remaining cancer. This is the best possible result!" . . . direct email quote from my surgeon on 12-11-12. :-) I later found out they tested the "good" one too and there was no cancer their either :-)
Monday, December 10, 2012
Oncoplastic Breast Reduction Surgery
I had surgery on December 4th. The surgery was given several different names - Oncoplastic Breast Reduction, Needle Guided Breast Lumpectomy with reconstruction, breast preservation surgery, etc. Back in April when I was diagnosed I wanted to have a lumpectomy. To me, having a lumpectomy was the best way to still feel like me after cancer. My tumor was considered larger, 3cm (anything over 2cm is considered larger) and if I wanted a lumpectomy I would have to do chemo first to shrink it to a size that can be removed by a lumpectomy. So that is why I did chemo first, also called neo-adjuvant chemo (chemo after surgery is called adjuvant therapy). For me, having nipples (and the areola) was really important . . . the thought of not having nipples (as is the case with most mastectomies) was a scary thought and not something I wanted.
I changed my mind several times and I really did give some thought to having a mastectomy, and even asked my doctor about a nipple sparing mastectomy but she is not comfortable with nipple sparing mastectomies and wont do them so my only choice to save my nipple/areola was to have a lumpectomy. The advantage to doing neoadjuvant chemo is that you can actually feel the tumor getting smaller as you have more chemo. I will say that was an added benefit that I didnt really think about when I made the decision. After talking with several women who had surgery first and were wondering if the chemo was really working, I realized this benefit.
I noticed the tumor was shrinking a few weeks after my first chemo and it continued to shrink while I was on AC chemo. I even got to the point where I didn't really feel it anymore. I did stop feeling my breast after awhile. Then I started having these weird pains, mostly when I woke up and was sleeping on my cancer side. I had similar pains during the first few weeks of chemo and I thought they were the tumor shrinking, but really I have no idea what it was. A few weeks after I declared I could barely feel it I did start to notice other weird differences in my cancer breast compared to my "good" breast. I tried not to freak out about this, with some success, mostly because I stopped feeling it. But there was something else there, and it seemed to move or be a little different each time I felt it. During my first ultrasound I was told I had fat necrosis, or dead fat cells in my breast, likely from when I hit my breast as I was hurriedly going out a door. But there was still something there and whatever it was would be removed during surgery. This also meant that there was a high likelihood I would have a dimple or divot in my breast. My doctors offered me an option - Oncoplastic reduction or basically a lumpectomy with a breast reduction to make them match. After much deliberation I decided to go for this, even thought it meant I was going to cut the good one.
I have never been into big breasts . . . in fact in the past I have wished to have smaller ones but never would have had a reduction unless I was already having surgery on them and thought I would later regret that the they were no longer a similar size. I also only had one shot at this . . . cause with a lumpectomy you have to have radiation to get the same survival rate as a mastectomy and radiated tissue does not heal the same. My plastic surgeon will not do reconstruction on radiated tissue, so it was either now or never. I took the proactive approach and decided to go for it because I thought that later on down the line I would regret that I didnt do it when I had the chance. There is a risk that I will have to have a mastectomy if they dont get clean margins of the tissue surrounding the tumor. This was not a decision that was taken lightly and I worry that I made the right decision.
Prior to starting chemo, they inserted a titanium clip into the tumor so that after chemo has shrunk the tumor to almost nothing that she can still find it and know what tissue to remove. I am a little sketchy on the details of the surgery, but I do know that I had to get a wire inserted into my breast to help with the surgery. That was fun - NOT but I'll go into details later.
I was told to arrive for my surgery at 6:30am . . . the night before and again the morning of surgery I had to wash my chest area with a special soap that was in these scrub thingies. When I looked closer I realized it was the same soap that doctors use to scrub their hands prior to surgery. So that morning I got up and washed again with that soap, which kindof seems redundant cause I just did it hours before, but I'll do anything to prevent infection.
When I showed up they called me back in right away (unlike my SNB where I had to wait), had me get into the lovely paper gown, gripper socks and hairnet. The nurse didnt call it a hairnet, she called it my "party hat" which since I dont really have hair I appreciated that :-). They also started my IV on my battered left hand while noting how beautiful my right hand veins looked. I noted how different things were than when I was there for my SNB in that I am more comfortable with people poking and prodding me and I even knew that my hand was the best place to start an IV Then she allowed my hubby and his Mom to come back and be with me. At 8am I had an appointment in the Ultrasound/Mammogram area. Someone promptly came and took me downstairs to that appointment where I waited in the hallway. This is the same area where I had my inital ultrasound and mammogram so while they left me sitting there to think, not fun.
The ultrasound technican then came and got me and got me ready to do the ultrasound and insert the wire. She then scanned my breast several times and couldnt see the tumor at all so she had to order a mammogram assisted wire insertion. I had a general amoutn of fear at this point . . . but the technican just explained that the wire had to be inserted under mammogram compression and now I was scared. Really scared. And she got me in the wheelchair and put me outside the door to wait for the mammogram room to be available. Oh boy, more time to freak out about my surgery and that I will soon be under mammogram compression for like 10 minutes or so. For those of you lucky enough to never have a mammogram, take your breast and put it between two 2x4 pieces of wood and then clamp them down. Sounds like fun, right? If you have breasts and didnt wince at that analogy then you probably didnt really think about it. Finally the room opened up and they took me in there. I had a regular mammogram, just so I could remember how much it hurt. Then they set up for the real procedure and locked me into the modern day torture device. The technicain was really nice and was trying to make it as painless as possible but it is just a painful procedure. The technican was working wtih the doctor to find the exact location of the clip, this meant that after the mammogram I had to remain under compression for the 90 seconds that it takes for the mammgoram film to develop, for the technican and doctors to look at the film, align the machine, swab me with some sort of antibacterial and then for the doctor to insert a needle and take another mammogram "picture" to make sure that he inserted it in the right place, then insert the wire through the needle, and do some other things, then finally let me go. I was allowed to sit during this time, but I dont remember the final things the doctor did, probably because I was in survival mode to deal with the pain. Oh and I forgot to metion, at some point they did insert some pain meds, but it still hurt.
After all that was done they put me in the wheelchair in the hallway again and called for transport. I guess the transport guy was pretty unhappy cause he was giving the technican attitude when she called and when he picked me up he never said anything to me. As soon as I got back to my preop cubicle there were several doctors and nurses waiting for me and I had to pee. They let me pee but my preop nurse barged in to help me flush and carry my IV.
Then I had a "meeting" in my cubicle with all the doctors . . .the curtain was drawn and the anesthesiologist, general surgon, plastic surgeon and nurse were all in there. It was a party. They were all trying to do their part as quickly as possible to get me in surgery as I think it was already an hour past my scheduled time. The anesthesiologist asked about prior reactions to the aneshesia and if I had any loose teeth. She also mentioned that I may wake up with a sore or dry throat from the tubes. I mentioend that chemo has made my throat dry and she replied then probably you will wake up with a sore throat. She is also pregnant so my only question/comment for her was to please not go into labor during my surgery, ha ha. Then the General Surgeon Initaled my right shoulder area . . . dont want to get those messed up, but since I now had a wire sticking out of that one I thougth it was a low likelihiood that she would get it mixed up. But I am glad that is their policy. Then the Plastic Surgeon went to work marking me up with her marker. She looked at the shape of my breasts and then was looking where the nipple would look best and then looked at each breast differently and tried to think about how the right one would look/change after radiation. She seems like an extremely detail oriented person and I like that in a plastic surgeon.
Then after the docs asked a few more questions, called my hubby in to give me one last kiss they gave me the "happy juice" and yes, that is exactly what they called it (same with my SNB). She inserted something in my IV and it hurt . . .maybe cause my veins are so battered and abused or maybe there was a little clot there. I dont remember anything after that, ha ha.
Then I started waking up. I heard voices but dont remember opening my eyes. I heard a male voice asking me if I was in pain. I had to stop and think about it and yes, I was in pain. I tried to fall back asleep but he was telling me not to fall asleep. When you are coming out of anesthesia you are incredibly obedient, he could have asked me to stand on my head and count backwards from 10 and I would have done it. But really I wanted to fall back asleep. He asked how bad my pain was and I said 5 . .. he asked if I wanted pain meds and I said yes. He then gave me a pill, a little water and made me take a bite of a cracker. Then I fell back asleep. I remember waking up later and I could hear people talking and I think it was my hubby and my Dad. I dont really remember too much as I was coming to but I do know that they were pumping air into my paper gown. I started to wake up but was still groggy. I asked for water cause my throat hurt really badly and felt really dry. I was still in a daze and had all of these people around me - nurses, my hubby, my Dad, hubby's Mom, overload for someone just waking up. I snuck a peak at myself and saw there was this bra on me but that was prettymuch all I saw. The nurse then did some tests and said I could leave when I was ready. I wanted to go home, but I didnt get ready just yet. I dont know how long it was, but I waited a little while then got dressed and ready to go. I wasnt really in any pain but looking back I think I was a little too drowsy to leave. I had a bunch of people help me and of course I got the wheelchair ride to the car. My Dad even gave me some pretty flowers as we were leaving.
The car ride was uneventful and I managed to walk up the three flights of stairs to my place without any trouble. Once home I started to feel hungry. I knew it had been a long time since I ate so I asked for some really easy to digest foods like chicken broth, apple, rice and black beans. They all went down ok but I was getting tired. I also started to have some pain. Since the pain meds normally make me sleepy and I wanted to stay ahead of the pain I took a pain pill then went to the bed. I was playing on my phone for a little bit then decided to close my eyes. Every time I closed my eyes I got dizzy. WTH?? The room would spin like I had too much alcohol, um, I mean so I have heard happens when you have too much alcohol. At this time I also realized I had not peed since surgery and it had been several hours. I had the urge a couple of times but wasnt able to do it. I was starting to get worried.
Despite being tired I couldnt sleep so I went to the living room to watch some tv/play on the computer. Then it hit me. My stomach didnt feel well. I walked to the bathroom. Then I had a feeling I havent felt in years, like I was really going to throw up. Unfortunately the bathroom has a mirror along the wall of the toilet so I could see myself. I did not look good. I gave myself a pep talk that I would not throw up. Then I threw up everything I had eaten while trying to not move my chest too much which is prettymuch impossible. And I missed, not a lot but when we are talking about vomiting missing even a little bit is too much. My stomach felt better though and surprisingly enough my drymouth feeling started to go away. I also went pee afterwards so that was one less thing to worry about.
I watched tv for awhile then went to sleep on my wedge pillow and had an uneventful night. Till I woke up the next morning and I couldnt talk cause my throat hurt so bad. My throat hurt worse than my breasts. My throat was sore from the tubes during surgery. I wanst really hungry but wanted to drink a lot. I had some water, "juice" from black beans and tea. Nothing really helped. Later a nurse told me to suck on ice chips to help with the swelling and then a nurse at my first post op appointment suggested I get Sucrets of Cepacol. We went to CVS right after the visit and got the strongest Cepacol lozenges and they did help tremendously I also ate a couple of popsicles I had left over from my Taxol days too.
All in all I dont feel that bad and surprisingly enough I dont really have any pain. I have the annoying feeling like I am wearing an underwire bra that is digging in, but no real pain more of an inconvenience. And I am happy with the decision to do the oncoplastic reduction cause they are the same size. Now I just need to find out if my margins were clear. I have follow ups with my general surgeon, plastic surgeon and Oncologist this week. If my margins are clear I will then meet with the Radiation doctor to talk about radiation that is required for all lumpectomies to get the same survival as a mastectomy.
Wow, I wrote a book!
I changed my mind several times and I really did give some thought to having a mastectomy, and even asked my doctor about a nipple sparing mastectomy but she is not comfortable with nipple sparing mastectomies and wont do them so my only choice to save my nipple/areola was to have a lumpectomy. The advantage to doing neoadjuvant chemo is that you can actually feel the tumor getting smaller as you have more chemo. I will say that was an added benefit that I didnt really think about when I made the decision. After talking with several women who had surgery first and were wondering if the chemo was really working, I realized this benefit.
I noticed the tumor was shrinking a few weeks after my first chemo and it continued to shrink while I was on AC chemo. I even got to the point where I didn't really feel it anymore. I did stop feeling my breast after awhile. Then I started having these weird pains, mostly when I woke up and was sleeping on my cancer side. I had similar pains during the first few weeks of chemo and I thought they were the tumor shrinking, but really I have no idea what it was. A few weeks after I declared I could barely feel it I did start to notice other weird differences in my cancer breast compared to my "good" breast. I tried not to freak out about this, with some success, mostly because I stopped feeling it. But there was something else there, and it seemed to move or be a little different each time I felt it. During my first ultrasound I was told I had fat necrosis, or dead fat cells in my breast, likely from when I hit my breast as I was hurriedly going out a door. But there was still something there and whatever it was would be removed during surgery. This also meant that there was a high likelihood I would have a dimple or divot in my breast. My doctors offered me an option - Oncoplastic reduction or basically a lumpectomy with a breast reduction to make them match. After much deliberation I decided to go for this, even thought it meant I was going to cut the good one.
I have never been into big breasts . . . in fact in the past I have wished to have smaller ones but never would have had a reduction unless I was already having surgery on them and thought I would later regret that the they were no longer a similar size. I also only had one shot at this . . . cause with a lumpectomy you have to have radiation to get the same survival rate as a mastectomy and radiated tissue does not heal the same. My plastic surgeon will not do reconstruction on radiated tissue, so it was either now or never. I took the proactive approach and decided to go for it because I thought that later on down the line I would regret that I didnt do it when I had the chance. There is a risk that I will have to have a mastectomy if they dont get clean margins of the tissue surrounding the tumor. This was not a decision that was taken lightly and I worry that I made the right decision.
Prior to starting chemo, they inserted a titanium clip into the tumor so that after chemo has shrunk the tumor to almost nothing that she can still find it and know what tissue to remove. I am a little sketchy on the details of the surgery, but I do know that I had to get a wire inserted into my breast to help with the surgery. That was fun - NOT but I'll go into details later.
I was told to arrive for my surgery at 6:30am . . . the night before and again the morning of surgery I had to wash my chest area with a special soap that was in these scrub thingies. When I looked closer I realized it was the same soap that doctors use to scrub their hands prior to surgery. So that morning I got up and washed again with that soap, which kindof seems redundant cause I just did it hours before, but I'll do anything to prevent infection.
When I showed up they called me back in right away (unlike my SNB where I had to wait), had me get into the lovely paper gown, gripper socks and hairnet. The nurse didnt call it a hairnet, she called it my "party hat" which since I dont really have hair I appreciated that :-). They also started my IV on my battered left hand while noting how beautiful my right hand veins looked. I noted how different things were than when I was there for my SNB in that I am more comfortable with people poking and prodding me and I even knew that my hand was the best place to start an IV Then she allowed my hubby and his Mom to come back and be with me. At 8am I had an appointment in the Ultrasound/Mammogram area. Someone promptly came and took me downstairs to that appointment where I waited in the hallway. This is the same area where I had my inital ultrasound and mammogram so while they left me sitting there to think, not fun.
The ultrasound technican then came and got me and got me ready to do the ultrasound and insert the wire. She then scanned my breast several times and couldnt see the tumor at all so she had to order a mammogram assisted wire insertion. I had a general amoutn of fear at this point . . . but the technican just explained that the wire had to be inserted under mammogram compression and now I was scared. Really scared. And she got me in the wheelchair and put me outside the door to wait for the mammogram room to be available. Oh boy, more time to freak out about my surgery and that I will soon be under mammogram compression for like 10 minutes or so. For those of you lucky enough to never have a mammogram, take your breast and put it between two 2x4 pieces of wood and then clamp them down. Sounds like fun, right? If you have breasts and didnt wince at that analogy then you probably didnt really think about it. Finally the room opened up and they took me in there. I had a regular mammogram, just so I could remember how much it hurt. Then they set up for the real procedure and locked me into the modern day torture device. The technicain was really nice and was trying to make it as painless as possible but it is just a painful procedure. The technican was working wtih the doctor to find the exact location of the clip, this meant that after the mammogram I had to remain under compression for the 90 seconds that it takes for the mammgoram film to develop, for the technican and doctors to look at the film, align the machine, swab me with some sort of antibacterial and then for the doctor to insert a needle and take another mammogram "picture" to make sure that he inserted it in the right place, then insert the wire through the needle, and do some other things, then finally let me go. I was allowed to sit during this time, but I dont remember the final things the doctor did, probably because I was in survival mode to deal with the pain. Oh and I forgot to metion, at some point they did insert some pain meds, but it still hurt.
After all that was done they put me in the wheelchair in the hallway again and called for transport. I guess the transport guy was pretty unhappy cause he was giving the technican attitude when she called and when he picked me up he never said anything to me. As soon as I got back to my preop cubicle there were several doctors and nurses waiting for me and I had to pee. They let me pee but my preop nurse barged in to help me flush and carry my IV.
Then I had a "meeting" in my cubicle with all the doctors . . .the curtain was drawn and the anesthesiologist, general surgon, plastic surgeon and nurse were all in there. It was a party. They were all trying to do their part as quickly as possible to get me in surgery as I think it was already an hour past my scheduled time. The anesthesiologist asked about prior reactions to the aneshesia and if I had any loose teeth. She also mentioned that I may wake up with a sore or dry throat from the tubes. I mentioend that chemo has made my throat dry and she replied then probably you will wake up with a sore throat. She is also pregnant so my only question/comment for her was to please not go into labor during my surgery, ha ha. Then the General Surgeon Initaled my right shoulder area . . . dont want to get those messed up, but since I now had a wire sticking out of that one I thougth it was a low likelihiood that she would get it mixed up. But I am glad that is their policy. Then the Plastic Surgeon went to work marking me up with her marker. She looked at the shape of my breasts and then was looking where the nipple would look best and then looked at each breast differently and tried to think about how the right one would look/change after radiation. She seems like an extremely detail oriented person and I like that in a plastic surgeon.
Then after the docs asked a few more questions, called my hubby in to give me one last kiss they gave me the "happy juice" and yes, that is exactly what they called it (same with my SNB). She inserted something in my IV and it hurt . . .maybe cause my veins are so battered and abused or maybe there was a little clot there. I dont remember anything after that, ha ha.
Then I started waking up. I heard voices but dont remember opening my eyes. I heard a male voice asking me if I was in pain. I had to stop and think about it and yes, I was in pain. I tried to fall back asleep but he was telling me not to fall asleep. When you are coming out of anesthesia you are incredibly obedient, he could have asked me to stand on my head and count backwards from 10 and I would have done it. But really I wanted to fall back asleep. He asked how bad my pain was and I said 5 . .. he asked if I wanted pain meds and I said yes. He then gave me a pill, a little water and made me take a bite of a cracker. Then I fell back asleep. I remember waking up later and I could hear people talking and I think it was my hubby and my Dad. I dont really remember too much as I was coming to but I do know that they were pumping air into my paper gown. I started to wake up but was still groggy. I asked for water cause my throat hurt really badly and felt really dry. I was still in a daze and had all of these people around me - nurses, my hubby, my Dad, hubby's Mom, overload for someone just waking up. I snuck a peak at myself and saw there was this bra on me but that was prettymuch all I saw. The nurse then did some tests and said I could leave when I was ready. I wanted to go home, but I didnt get ready just yet. I dont know how long it was, but I waited a little while then got dressed and ready to go. I wasnt really in any pain but looking back I think I was a little too drowsy to leave. I had a bunch of people help me and of course I got the wheelchair ride to the car. My Dad even gave me some pretty flowers as we were leaving.
The car ride was uneventful and I managed to walk up the three flights of stairs to my place without any trouble. Once home I started to feel hungry. I knew it had been a long time since I ate so I asked for some really easy to digest foods like chicken broth, apple, rice and black beans. They all went down ok but I was getting tired. I also started to have some pain. Since the pain meds normally make me sleepy and I wanted to stay ahead of the pain I took a pain pill then went to the bed. I was playing on my phone for a little bit then decided to close my eyes. Every time I closed my eyes I got dizzy. WTH?? The room would spin like I had too much alcohol, um, I mean so I have heard happens when you have too much alcohol. At this time I also realized I had not peed since surgery and it had been several hours. I had the urge a couple of times but wasnt able to do it. I was starting to get worried.
Despite being tired I couldnt sleep so I went to the living room to watch some tv/play on the computer. Then it hit me. My stomach didnt feel well. I walked to the bathroom. Then I had a feeling I havent felt in years, like I was really going to throw up. Unfortunately the bathroom has a mirror along the wall of the toilet so I could see myself. I did not look good. I gave myself a pep talk that I would not throw up. Then I threw up everything I had eaten while trying to not move my chest too much which is prettymuch impossible. And I missed, not a lot but when we are talking about vomiting missing even a little bit is too much. My stomach felt better though and surprisingly enough my drymouth feeling started to go away. I also went pee afterwards so that was one less thing to worry about.
I watched tv for awhile then went to sleep on my wedge pillow and had an uneventful night. Till I woke up the next morning and I couldnt talk cause my throat hurt so bad. My throat hurt worse than my breasts. My throat was sore from the tubes during surgery. I wanst really hungry but wanted to drink a lot. I had some water, "juice" from black beans and tea. Nothing really helped. Later a nurse told me to suck on ice chips to help with the swelling and then a nurse at my first post op appointment suggested I get Sucrets of Cepacol. We went to CVS right after the visit and got the strongest Cepacol lozenges and they did help tremendously I also ate a couple of popsicles I had left over from my Taxol days too.
All in all I dont feel that bad and surprisingly enough I dont really have any pain. I have the annoying feeling like I am wearing an underwire bra that is digging in, but no real pain more of an inconvenience. And I am happy with the decision to do the oncoplastic reduction cause they are the same size. Now I just need to find out if my margins were clear. I have follow ups with my general surgeon, plastic surgeon and Oncologist this week. If my margins are clear I will then meet with the Radiation doctor to talk about radiation that is required for all lumpectomies to get the same survival as a mastectomy.
Wow, I wrote a book!
Tuesday, November 27, 2012
What's next? Surgery . . . Lumpectomy
I am very thankful to be done with chemo although I have a new motto "I can do anything, I've been through chemo". Even though it has made me tougher I still wish I didn't have to go through it.
I am now in the recovery phase . .. chemo really beats up a lot of different cells in your body and the steroids and chemo do a number on your white blood cells. I kindof feel like an old lady, especially when I get up from the couch very slowly and I can feel my muscles tightened up. And I have fatigue too . . . I feel lazy and when I do get up and do something I get tired way easier than normal.
Since I have no eyelashes or eyebrows and I do not normally wear makeup I decided to take advantage of a class offered by the American Cancer Society called Look Good, Feel Better. It is a class for people before, during or after chemo. Several of my online friends who have had cancer have been to them and learned some useful tips. They are offered at several hospitals and due to the timing I chose to go to one in Fullerton because it was the next available one. This was the same week that I finished chemo. Things were going great and I was on time and almost there when I was exiting the freeway and turning left to go back over the freeway . . . when a 20 year old kid ran the red light and hit my car. I was not having a particularly good day up to that point, but it instantly got worse. It was a relatively slow speed accident and after a second or two I still hadn't really processed the whole situation so I did what I do when I don't know what to do . . . I bawled my eyes out. So many things were running through my head like Really Universe?? Have I not been through enough already?? I just finished chemo so now I get broadsided? I felt very weak and vulnerable and lost at that moment. Before I really processed everything there were a couple of guys at my window asking me if I was hurt or needed medical assistance One called the police too. They seemed a little lost and I found it hard to find the words to reply to them . . .all I could do was cry. And cry and cry. I couldn't help it. The more I tried not to cry, the more I cried. So I just let it all out and cried for a few minutes more. One of the guys that came to help asked me if I could move my car and I just cried. I don't think I ever answered him. After a few more minutes I did move my car out of the way. And then I just sat in my car and cried. I finally composed myself and got out of the car and the cops came and we exchanged info and everything. My car wouldn't run though so the cop called AAA. Long story short I got my car towed and eventually made it home. And I am ok. But my car, not so much. It was later determined to be a total loss :-( So on top of all this I also have to get a new vehicle. A distraction from thinking about chemo and surgery.
On to Surgery. When I initially found out that I had cancer I looked at my options and having a mastectomy scared me. If you want to have nightmares google mastectomy and look at the pictures. I dont know why, but the pictures of women with no nipples just doesn't seem right. So I really wanted a lumpectomy, if possible. My tumor was 3cm which is rather large for a lumpectomy. And of course on the day the doctors saw it, it seemed larger. Sometimes after the biopsy things can appear different. And at the end of that day when all the doctors were examining me, it did seem to go back to the size I remember it being although my oncologist still insists that it was 5cm. So that is why I chose to have chemo first . . . to shrink it to the point where I could have a lumpectomy.
When I first started getting chemo I was really excited to feel the lump shrinking. If anyone is trying to decide between neo-adjuvant chemo (chemo before surgery) and adjuvant chemo (chemo after surgery) I highly recommend getting chemo first because it is nice to know that the chemo is working and the lump is getting smaller. I was feeling it regularly and it took longer than I would have preferred for it to get smaller, but it did get smaller. But there has always been something still there. I was told at the time of my ultrasound and biopsy that I had fat necrosis which is dead fat due to trauma. I am hoping whatever I am still feeling in there is fat necrosis . . .it does feel different and is in a different location. That breast does feel a little different too. And I have been having some pains, but it could be scarring from the biopsy or something like that (I hope).
So because there is still something there and the doctor has to take a fair amount to make sure and get clear margins (make sure that they remove all the cancer) I was referred to a plastic surgeon. The only real option for reconstruction is what they call an oncoplastic reduction. Basically a breast reduction for symmetry. The surgeon and plastic surgeon both feel that there may be a divot or dimple left after they remove what they need to remove. I am not particularly vain and have questioned if this is overkill. But then if I am lopsided it will be a daily reminder of cancer. I have asked my doctor about a mastectomy and about a nipple sparing or areola sparing mastectomy but feel that the lumpectomy is the right decision. How confident am I in that decision? Not very. Well, I guess confident enough to schedule the surgery but not confident enough to know without a doubt this is the right decision. I feel a little vain . . . and if the cancer comes back I will not be eligible to do tissue expanders and implants because if you do a lumpectomy you have to do radiation to get the same survival benefit as a mastectomy. But I try not to think about the cancer coming back.
Surgery is one week from today, December 4th.
I have had to make a lot of tough decisions lately . . . what surgery to have . . . and what car to get.
I am now in the recovery phase . .. chemo really beats up a lot of different cells in your body and the steroids and chemo do a number on your white blood cells. I kindof feel like an old lady, especially when I get up from the couch very slowly and I can feel my muscles tightened up. And I have fatigue too . . . I feel lazy and when I do get up and do something I get tired way easier than normal.
Since I have no eyelashes or eyebrows and I do not normally wear makeup I decided to take advantage of a class offered by the American Cancer Society called Look Good, Feel Better. It is a class for people before, during or after chemo. Several of my online friends who have had cancer have been to them and learned some useful tips. They are offered at several hospitals and due to the timing I chose to go to one in Fullerton because it was the next available one. This was the same week that I finished chemo. Things were going great and I was on time and almost there when I was exiting the freeway and turning left to go back over the freeway . . . when a 20 year old kid ran the red light and hit my car. I was not having a particularly good day up to that point, but it instantly got worse. It was a relatively slow speed accident and after a second or two I still hadn't really processed the whole situation so I did what I do when I don't know what to do . . . I bawled my eyes out. So many things were running through my head like Really Universe?? Have I not been through enough already?? I just finished chemo so now I get broadsided? I felt very weak and vulnerable and lost at that moment. Before I really processed everything there were a couple of guys at my window asking me if I was hurt or needed medical assistance One called the police too. They seemed a little lost and I found it hard to find the words to reply to them . . .all I could do was cry. And cry and cry. I couldn't help it. The more I tried not to cry, the more I cried. So I just let it all out and cried for a few minutes more. One of the guys that came to help asked me if I could move my car and I just cried. I don't think I ever answered him. After a few more minutes I did move my car out of the way. And then I just sat in my car and cried. I finally composed myself and got out of the car and the cops came and we exchanged info and everything. My car wouldn't run though so the cop called AAA. Long story short I got my car towed and eventually made it home. And I am ok. But my car, not so much. It was later determined to be a total loss :-( So on top of all this I also have to get a new vehicle. A distraction from thinking about chemo and surgery.
On to Surgery. When I initially found out that I had cancer I looked at my options and having a mastectomy scared me. If you want to have nightmares google mastectomy and look at the pictures. I dont know why, but the pictures of women with no nipples just doesn't seem right. So I really wanted a lumpectomy, if possible. My tumor was 3cm which is rather large for a lumpectomy. And of course on the day the doctors saw it, it seemed larger. Sometimes after the biopsy things can appear different. And at the end of that day when all the doctors were examining me, it did seem to go back to the size I remember it being although my oncologist still insists that it was 5cm. So that is why I chose to have chemo first . . . to shrink it to the point where I could have a lumpectomy.
When I first started getting chemo I was really excited to feel the lump shrinking. If anyone is trying to decide between neo-adjuvant chemo (chemo before surgery) and adjuvant chemo (chemo after surgery) I highly recommend getting chemo first because it is nice to know that the chemo is working and the lump is getting smaller. I was feeling it regularly and it took longer than I would have preferred for it to get smaller, but it did get smaller. But there has always been something still there. I was told at the time of my ultrasound and biopsy that I had fat necrosis which is dead fat due to trauma. I am hoping whatever I am still feeling in there is fat necrosis . . .it does feel different and is in a different location. That breast does feel a little different too. And I have been having some pains, but it could be scarring from the biopsy or something like that (I hope).
So because there is still something there and the doctor has to take a fair amount to make sure and get clear margins (make sure that they remove all the cancer) I was referred to a plastic surgeon. The only real option for reconstruction is what they call an oncoplastic reduction. Basically a breast reduction for symmetry. The surgeon and plastic surgeon both feel that there may be a divot or dimple left after they remove what they need to remove. I am not particularly vain and have questioned if this is overkill. But then if I am lopsided it will be a daily reminder of cancer. I have asked my doctor about a mastectomy and about a nipple sparing or areola sparing mastectomy but feel that the lumpectomy is the right decision. How confident am I in that decision? Not very. Well, I guess confident enough to schedule the surgery but not confident enough to know without a doubt this is the right decision. I feel a little vain . . . and if the cancer comes back I will not be eligible to do tissue expanders and implants because if you do a lumpectomy you have to do radiation to get the same survival benefit as a mastectomy. But I try not to think about the cancer coming back.
Surgery is one week from today, December 4th.
I have had to make a lot of tough decisions lately . . . what surgery to have . . . and what car to get.
Monday, November 12, 2012
Last Chemo - Finally Done with this part of Treatment
My last chemo was on 11/7/12, wohooo!!!! It was pretty uneventful (yay!). It hurt a little when Julie got the IV started, but I wasn't complaining cause nothing was going to stop me from getting the last chemo!!! They rang the bell for me too . . . and I went and rang the bell too :-) For those of you that don't know, ringing the bell is a tradition at most cancer centers as a way to celebrate being done with chemo. Those of us going through chemo are easily amused and ringing a bell has much significance as a way to celebrate moving on. I hate this picture, but here is a picture of me ringing the bell.
Well, later the next day my face got a little red and looking back my face was red in the picture of me ringing the bell. I also had a really bad headache. I think it was a mild allergic reaction to the chemo. It took some zyrtec and it improved but later that evening it happened again and cause zyrtec is supposed to only be once every 24 hours I couldn't take another one. When I noticed my face and chest getting flushed I was also starving so I postponed calling the docs until I ate something. After eating I got into a fight with DH and it seemed to go away. I think the endorphins from the fight helped with that. But it figures it would be just my luck that I have another allergic reaction . . . oh, and looking back I did have a headache about the same time after the last one too :-/. But none of that matters now cause I am done with chemo, woohooo!!!
Of course when I say I am done with chemo that really means I am done with getting chemo injections. Chemo is the gift that keeps on giving. I had the allergic reaction and still have other side effects. Neuropathy (tingling of my fingers and feet), yucky taste in my mouth where food doesn't taste right, very low white blood cell count, fatigue, getting tired easily, chunks of blood when I blow my nose, heartburn, the 15 pounds I gained during treatment . . . oh joy. The neuropahy is the one that worries me the most. I have been having it off and on after most of my Taxol treatments but the weird thing is that I would notice it would show up a few days after chemo, then after the next chemo it would get better. I mentioned this to my oncologist and she seemed surprised. I suggested that it may be the decadron (steroid that is given to prevent allergic reaction) and she thought it may be masking it somehow. Well since I don't have any more chemos I wonder how the neuropathy will be cause the week I had off when I was sick it didn't get better. And the lack of fingernails and the dryness makes my fingernails pretty sensitive. But I am done with chemo so I wont complain.
Well, later the next day my face got a little red and looking back my face was red in the picture of me ringing the bell. I also had a really bad headache. I think it was a mild allergic reaction to the chemo. It took some zyrtec and it improved but later that evening it happened again and cause zyrtec is supposed to only be once every 24 hours I couldn't take another one. When I noticed my face and chest getting flushed I was also starving so I postponed calling the docs until I ate something. After eating I got into a fight with DH and it seemed to go away. I think the endorphins from the fight helped with that. But it figures it would be just my luck that I have another allergic reaction . . . oh, and looking back I did have a headache about the same time after the last one too :-/. But none of that matters now cause I am done with chemo, woohooo!!!
Of course when I say I am done with chemo that really means I am done with getting chemo injections. Chemo is the gift that keeps on giving. I had the allergic reaction and still have other side effects. Neuropathy (tingling of my fingers and feet), yucky taste in my mouth where food doesn't taste right, very low white blood cell count, fatigue, getting tired easily, chunks of blood when I blow my nose, heartburn, the 15 pounds I gained during treatment . . . oh joy. The neuropahy is the one that worries me the most. I have been having it off and on after most of my Taxol treatments but the weird thing is that I would notice it would show up a few days after chemo, then after the next chemo it would get better. I mentioned this to my oncologist and she seemed surprised. I suggested that it may be the decadron (steroid that is given to prevent allergic reaction) and she thought it may be masking it somehow. Well since I don't have any more chemos I wonder how the neuropathy will be cause the week I had off when I was sick it didn't get better. And the lack of fingernails and the dryness makes my fingernails pretty sensitive. But I am done with chemo so I wont complain.
Monday, October 29, 2012
Weekly Taxol Number 7 - 3rd Time is a Charm
How many times does it take to get an IV started? Three. Yep, 3 . . . and the first two hurt really badly! I had this nurse, Christy, for my final AC and I had no issues with that IV. I suspect my veins are protesting the weekly prodding, but they have not been poked for two weeks since I missed chemo last week. She started on the side of my wrist, just below my thumb. I have had the best luck with IV's on the back of my hand but she saw all the scars and thought my wrist might be better. I did notice on my week off from chemo that the back of my hand was swollen so I didnt protest when she went for my wrist. Things were going OK and I didnt really suspect there would be an issue. There is always some pain when an IV is started and by this point I know what is a "normal" amount of pain and too much. She started the IV and then it felt like the needle was stinging and while I think she was only just barely in, it felt like the needle was 4 inches long. It was stinging so badly that I was wincing/whining and sitting straight up and on the edge of my seat and I'm sure that my face told the story of how much pain I was in. She decided to try another spot. I wasnt thrilled at the thought of being poked again, but it did hurt really bad and I couldnt stand it . She then tried the vein on my forearm. I told her before I had got bruising and my vein had leaked there (after my third AC and first couple of Taxol's). She said she was good at getting the vein there so I gave her the go ahead. Again, it hurt really badly, probably moreso than the wrist, but I think the forearm is a painful area for an IV in the first place. She decided to have another nurse try cause she didnt want to hurt me again. I reaffirmed that she had done it successfully before and I didnt really think it was her fault. A few days later I had a bad bruise on my forearm (again). All nurses are officially banned from using that vein.
She got me a heating pad and a warm towel to wrap my arm in - I guess warming the vein is a trick for making them pop out and be easier to get. I also drank a bottle of water cause being well hydrated helps. In hindsight I maybe should have drank more water that morning. I did drink a lot, but the bottle I had did go down really easily so maybe I needed it. Or maybe my veins were protesting cause they had a week off and wanted to have more time to recuperate.
I dont know if I mentioned it here, but all of my IV's have been on my left arm. My tumor is on my right side and the Sentinel Node Biopsy (SNB) I had was on the right side. If you have lymph nodes removed you are at risk for lymphadema, a condition where they lymphatic fluid does not drain properly. Once you have it, it is a lifelong condition and you need to wear compression garments, etc. My surgeon told me that I am not really at risk cause I only had 3 nodes removed, but better safe than sorrry. I have noticed that my left arm (non-SNB) has been swollen off and on though this and if that happened on my SNB side I would be worried that it is lymphadema. Well, I dont want to risk it so I started out having all blood draws, blood pressure and chemo infusions on my non-SNB side. About halfway though the weekly Taxol's I talked with my surgeon who said I am not at risk for lymphadema. I did my own research and there is a risk, although much smaller than if I had had all lymph nodes removed (which was standard practice for years and many women still have all nodes removed today). I decided that I would allow blood draws on my non-SNB side to give my poor left arm a break. It is still very battered and abused but I think it will hold out for the 2 more chemo's I have left.
Anyway, the other nurse did get the IV started in the back of my hand. I dont know what she did but somehow she managed to get blood all over my hand. But at least the IV was in with the "normal" amount of pain.
The rest of the infusion went without issue although I did notice that my mood had changed. You know how after you cry, you have that kindof exhausted, emotionally spent feeling. Yeah, I had that. I went home and parked it on the couch after that, even though I really wanted to go to Costco - something I have been able to do after previous chemo infusions. I didnt feel bad, just unmotivated to do anything.
Two more chemos to go. Anticipated PFC (Post Final Chemo, although there is another more colorful version) date is 11/7/12.
I will have my lumpectomy about 3 weeks to a month after that. I have met with the surgeon and Plastic Surgeon. Usually lumpectomies do not have any reconstruction, but the PS mentioned that I may have a dimple or divot. She said that she can do what is called an oncoplastic reduction, basically a breast reduction after removing the cancer. I am still mulling over if that is what I want. It is a longer surgery, I would have both of them reduced to match, and if I were ever to get pregnant there is a chance that my "good" breast will not function either. I cant decide if I would really care if there was a divot/dimple there. I will have a giant scar and it will look the same with a bra on so I dont know if it is that important or not. Oh and if I do have the reduction I need to have it done before radiation cause after radiation the skin does not heal as well and my doc wont do it. So much to think about. I dont have a surgery date yet, but I need to find out soon.
She got me a heating pad and a warm towel to wrap my arm in - I guess warming the vein is a trick for making them pop out and be easier to get. I also drank a bottle of water cause being well hydrated helps. In hindsight I maybe should have drank more water that morning. I did drink a lot, but the bottle I had did go down really easily so maybe I needed it. Or maybe my veins were protesting cause they had a week off and wanted to have more time to recuperate.
I dont know if I mentioned it here, but all of my IV's have been on my left arm. My tumor is on my right side and the Sentinel Node Biopsy (SNB) I had was on the right side. If you have lymph nodes removed you are at risk for lymphadema, a condition where they lymphatic fluid does not drain properly. Once you have it, it is a lifelong condition and you need to wear compression garments, etc. My surgeon told me that I am not really at risk cause I only had 3 nodes removed, but better safe than sorrry. I have noticed that my left arm (non-SNB) has been swollen off and on though this and if that happened on my SNB side I would be worried that it is lymphadema. Well, I dont want to risk it so I started out having all blood draws, blood pressure and chemo infusions on my non-SNB side. About halfway though the weekly Taxol's I talked with my surgeon who said I am not at risk for lymphadema. I did my own research and there is a risk, although much smaller than if I had had all lymph nodes removed (which was standard practice for years and many women still have all nodes removed today). I decided that I would allow blood draws on my non-SNB side to give my poor left arm a break. It is still very battered and abused but I think it will hold out for the 2 more chemo's I have left.
Anyway, the other nurse did get the IV started in the back of my hand. I dont know what she did but somehow she managed to get blood all over my hand. But at least the IV was in with the "normal" amount of pain.
The rest of the infusion went without issue although I did notice that my mood had changed. You know how after you cry, you have that kindof exhausted, emotionally spent feeling. Yeah, I had that. I went home and parked it on the couch after that, even though I really wanted to go to Costco - something I have been able to do after previous chemo infusions. I didnt feel bad, just unmotivated to do anything.
Two more chemos to go. Anticipated PFC (Post Final Chemo, although there is another more colorful version) date is 11/7/12.
I will have my lumpectomy about 3 weeks to a month after that. I have met with the surgeon and Plastic Surgeon. Usually lumpectomies do not have any reconstruction, but the PS mentioned that I may have a dimple or divot. She said that she can do what is called an oncoplastic reduction, basically a breast reduction after removing the cancer. I am still mulling over if that is what I want. It is a longer surgery, I would have both of them reduced to match, and if I were ever to get pregnant there is a chance that my "good" breast will not function either. I cant decide if I would really care if there was a divot/dimple there. I will have a giant scar and it will look the same with a bra on so I dont know if it is that important or not. Oh and if I do have the reduction I need to have it done before radiation cause after radiation the skin does not heal as well and my doc wont do it. So much to think about. I dont have a surgery date yet, but I need to find out soon.
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