Friday, May 24, 2013
My Saran Wrap boob
Applied the EMLA cream to my boob and have it wrapped in Saran Wrap. This will numb the area. Surgery at 10am, but I have imaging and injections at 7am.
Tuesday, May 21, 2013
May 21, Day 11
I woke up today and immediately realized that my career prospects as a Hooters Girl will be over Friday. Then remembered the joke, "If girls with big boobs work at Hooters, where do girls with one leg work? IHOP."
Sick humor aside, I'm still processing that I will have a mastectomy in just three days. And it comes exactly two weeks after I received my diagnosis. It's been a whirlwind two weeks of appointments, tests, consultations. I'm also trying to come to the realization that in four weeks I'll begin 20 weeks of a brutal round of chemo, followed by radiation and then reconstruction to "look normal". Last night I spent some time looking through the various pamphlets of literature I was given by the nurse coordinator and social worker, and I completed the healthcare Power of Attorney and Living Will paperwork. While 98% of the stuff I did read I already knew, there were a few points I had not considered.
Sick humor aside, I'm still processing that I will have a mastectomy in just three days. And it comes exactly two weeks after I received my diagnosis. It's been a whirlwind two weeks of appointments, tests, consultations. I'm also trying to come to the realization that in four weeks I'll begin 20 weeks of a brutal round of chemo, followed by radiation and then reconstruction to "look normal". Last night I spent some time looking through the various pamphlets of literature I was given by the nurse coordinator and social worker, and I completed the healthcare Power of Attorney and Living Will paperwork. While 98% of the stuff I did read I already knew, there were a few points I had not considered.
Thursday, May 16, 2013
May 16, Day 6
Today was a long day. Both physically and emotionally. I started at the clinic at 7am to get a PET scan. They injected me with the radioactive dye and then let me relax for approximately 45 minutes before taking me into the scanner. The machine first pushed me in and pulled me out quickly for a CT scan, and then it pushed me all the way through, and stopped over my pelvic area for four minutes. After four minutes, it pulled me through another 4 inches and stopped and scanned that area for four minutes. The total scan time was about 25 minutes and was not as bad as I thought it might be. Keeping my eyes closed helped me relax and not freak out; not that I'm claustrophobic, but it was still creepy.
Following the PET scan was a sono and the placement of a titanium marker over the tumor. The sono revealed another cyst in the right breast this time, and a couple of puffy lymph nodes in the left armpit area. So, after the tech conferred with the breast imaging doctor, they decided to aspirate the cyst in the right breast, place the titanium marker over the tumor and biopsy the lymph nodes and place a secondary marker there; from one procedure to three. Apparently I handled it all much better than they expected. Honestly, it wasn't that bad. The worst part was the armpit as it was tender, even after she gave me numbing medicine. I didn't feel any pain per se, but just a lot of tugging and when she popped the biopsy tool the sound it made was slightly disturbing; think 5x worse than getting your ears pierced! Tonight my armpit is quite tender.
Following the procedures I was sent to mammography for a film to show the marker placement. All went well and I was able to call my mom to have lunch with her. She works at Mills and so we went downstairs to grab a lemonade from the fridge, then went outside to sit and chat. It was a lovely day and the lifeflight helicopter went straight overhead! Wish I had my camera on me.
Then I had just over an hour until MRI. So I sat in the library and checked my email, answered some messages, forwarded some phone calls, etc. and then looked at a copy of Water for Elephants; I have wanted to look at that book to see if it was any good for some time, but never taken the time. I'm thrilled to say I will order it on my Nook to read while recovering from surgery. The first chapter sucked me in!
The MRI was a no go, so it was a wait to see the doctor at 4pm. He was running late and we were told it would be more like 4:30, but it was actually after 5 I think by the time he came in the room. He was fantastic. However the news he delivered was not what I was expecting. I knew the tumor was fast growing, but he didn't mince words and told me that it was his recommendation that I have a mastectomy before chemotherapy. His fear is that undergoing neoadjuvant chemotherapy (before surgery) could cause the cancer cells to become resistant to the chemotherapy prior to surgery. He also indicated that I had youth on my side and said that my cancer is bad; the chemotherapy will be difficult and if I were older, I would have a hard time surviving the treatment. Long story short - this is going to be ugly.
Following the PET scan was a sono and the placement of a titanium marker over the tumor. The sono revealed another cyst in the right breast this time, and a couple of puffy lymph nodes in the left armpit area. So, after the tech conferred with the breast imaging doctor, they decided to aspirate the cyst in the right breast, place the titanium marker over the tumor and biopsy the lymph nodes and place a secondary marker there; from one procedure to three. Apparently I handled it all much better than they expected. Honestly, it wasn't that bad. The worst part was the armpit as it was tender, even after she gave me numbing medicine. I didn't feel any pain per se, but just a lot of tugging and when she popped the biopsy tool the sound it made was slightly disturbing; think 5x worse than getting your ears pierced! Tonight my armpit is quite tender.
Following the procedures I was sent to mammography for a film to show the marker placement. All went well and I was able to call my mom to have lunch with her. She works at Mills and so we went downstairs to grab a lemonade from the fridge, then went outside to sit and chat. It was a lovely day and the lifeflight helicopter went straight overhead! Wish I had my camera on me.
Then I had just over an hour until MRI. So I sat in the library and checked my email, answered some messages, forwarded some phone calls, etc. and then looked at a copy of Water for Elephants; I have wanted to look at that book to see if it was any good for some time, but never taken the time. I'm thrilled to say I will order it on my Nook to read while recovering from surgery. The first chapter sucked me in!
The MRI was a no go, so it was a wait to see the doctor at 4pm. He was running late and we were told it would be more like 4:30, but it was actually after 5 I think by the time he came in the room. He was fantastic. However the news he delivered was not what I was expecting. I knew the tumor was fast growing, but he didn't mince words and told me that it was his recommendation that I have a mastectomy before chemotherapy. His fear is that undergoing neoadjuvant chemotherapy (before surgery) could cause the cancer cells to become resistant to the chemotherapy prior to surgery. He also indicated that I had youth on my side and said that my cancer is bad; the chemotherapy will be difficult and if I were older, I would have a hard time surviving the treatment. Long story short - this is going to be ugly.
Wednesday, May 15, 2013
May 15 (Day 5)
Today was an emotional rollercoaster. Meeting with the social worker was uncomfortable and I wanted to be anywhere but in a small room with my mom and her talking about how I feel. I don't do emotions that well. I was fine talking about my clinical diagnosis when she asked; such as how it was discovered, how fast it grew in the last 8 months, the course of action as I know it right now, etc., but I did tear up and feel like I could lose it when the social worker gave me papers on the living will and power of attorney. The thought of no longer being able to make my own decisions and be independent is unacceptable for me to comprehend. I have always been stubborn and seldom asked for help. I'm a "put on your big girl panties and get r' done" kinda gal. A "pull yourself up from your bootstraps" when the going gets tough. We took a tour of the infusion room. I saw the room on a tour when the cancer center was first opened, but it was a large open room without the reclining chairs, IV poles and bald people staring back at me.
Just prior to leaving work for the appointments today, I received a call informing me my surgeon was out sick and couldn't meet with me, but if I wanted to, I could meet with his nurse. I opted to go ahead and keep the two meetings today as I felt bad for rescheduling with the social worker twice, and I figured the surgeon's nurse might be able to answer a question or two I had about the process of surgery and chemo. I grossly underestimated my surgeon's nurse. Not only did she answer my questions, she gave me information I hadn't considered. One of my questions was how soon chemo and/or surgery would take place. She informed me that surgery would likely happen in the next three weeks. Discussing the tumor and it's size, we agreed that I would probably have a mastectomy and not a lumpectomy. I had started to wrap my head around not having a left breast, and having to go through a reconstruction on that side. Tumor Board was held today, a meeting among the oncologists, radiological oncologists, plastics (reconstruction team), and various other medical staff, and my case was the first to be presented. They discussed my care and it's felt that my tumor would respond quite well to chemotherapy and shrink the tumor so that I could have a lumpectomy instead of a mastectomy. The surgical nurse called to inform me of this and I can't describe the emotion I felt at the time; not that I was looking forward to the mastectomy, but when she mentioned a lumpectomy may be a possibility, I was almost disappointed. I think I had tried so hard to accept the mastectomy, that her telling me they would only remove the lump and not the entire breast was a let-down. Probably doesn't make sense to the normal healthy person reading this blog, but hopefully others facing cancer will understand my feeling/reaction.
Tomorrow is going to be grueling with the number of appointments. I start at 7am with a PET scan, then have a marker implanted (which they didn't do when I had the initial biopsy), then a mammogram and ultrasound on both breasts (to be sure the right is healthy), then an MRI and last but not least, an appointment with the surgeon (provided he's not out again sick). Friday will be a meeting with my oncologist and she hopes to have the results from the MRI and mammogram and sonograms. Then I guess we will decide if it's chemo or surgery first.
Just prior to leaving work for the appointments today, I received a call informing me my surgeon was out sick and couldn't meet with me, but if I wanted to, I could meet with his nurse. I opted to go ahead and keep the two meetings today as I felt bad for rescheduling with the social worker twice, and I figured the surgeon's nurse might be able to answer a question or two I had about the process of surgery and chemo. I grossly underestimated my surgeon's nurse. Not only did she answer my questions, she gave me information I hadn't considered. One of my questions was how soon chemo and/or surgery would take place. She informed me that surgery would likely happen in the next three weeks. Discussing the tumor and it's size, we agreed that I would probably have a mastectomy and not a lumpectomy. I had started to wrap my head around not having a left breast, and having to go through a reconstruction on that side. Tumor Board was held today, a meeting among the oncologists, radiological oncologists, plastics (reconstruction team), and various other medical staff, and my case was the first to be presented. They discussed my care and it's felt that my tumor would respond quite well to chemotherapy and shrink the tumor so that I could have a lumpectomy instead of a mastectomy. The surgical nurse called to inform me of this and I can't describe the emotion I felt at the time; not that I was looking forward to the mastectomy, but when she mentioned a lumpectomy may be a possibility, I was almost disappointed. I think I had tried so hard to accept the mastectomy, that her telling me they would only remove the lump and not the entire breast was a let-down. Probably doesn't make sense to the normal healthy person reading this blog, but hopefully others facing cancer will understand my feeling/reaction.
Tomorrow is going to be grueling with the number of appointments. I start at 7am with a PET scan, then have a marker implanted (which they didn't do when I had the initial biopsy), then a mammogram and ultrasound on both breasts (to be sure the right is healthy), then an MRI and last but not least, an appointment with the surgeon (provided he's not out again sick). Friday will be a meeting with my oncologist and she hopes to have the results from the MRI and mammogram and sonograms. Then I guess we will decide if it's chemo or surgery first.
Day 4
Tuesday, March 15, 2013. I'm forwarding my mail to the hospital. Today I had an MRI simulation, a meeting with the genetic counselor and a meeting scheduled with the social worker. I was also scheduled for four more appointments Thursday (starting at 7am and ending at 3pm) in addition to the two I have tomorrow, and the one (so far) I have Friday.
Today's MRI simulation started 40 minutes late, but we got it done and the good news is, I can have an MRI on Thursday. The technicians had to see if I could withstand lying on my stomach for half an hour with my arms above my head. It's not comfortable, and not something I would do on a regular basis, but I'm willing to push myself into a zen-like trance if necessary to get through the discomfort if it means more information toward my overall diagnosis. I'll deal with the slight dizziness from laying with my face down, and the fact that my arms are nearly asleep after being above my head the entire time to get a good result. The genetic counselor was really good. Taking a family history, I have no cancer in my immediate family (mom, dad, siblings), but do have some cancer in my grandparents, their siblings, and their siblings children. Topic of discussion was the BRCA test. After consideration, I decided to start the process. It's a simple blood draw and results can be received in two-three weeks. Let me state now that I did not decide to go through with the BRCA test because Angelina Jolie publicly admitted to having a double mastectomy after her BRCA test identified she carried the BRCA1 gene. However, I think it's fantastic and amazing that she was able to pull off a double mastectomy in February and reconstructive surgery in April without the public knowing - Bravo to the medical community who treated her and kept her secret (regardless of HIPPA as she is a celebrity and they have so little privacy), and the paparazzi who left her the hell alone during her procedure. The meeting with the genetic counselor took so long that we once again had to reschedule the meeting with the social worker. Maybe tomorrow it will actually happen!
Today's MRI simulation started 40 minutes late, but we got it done and the good news is, I can have an MRI on Thursday. The technicians had to see if I could withstand lying on my stomach for half an hour with my arms above my head. It's not comfortable, and not something I would do on a regular basis, but I'm willing to push myself into a zen-like trance if necessary to get through the discomfort if it means more information toward my overall diagnosis. I'll deal with the slight dizziness from laying with my face down, and the fact that my arms are nearly asleep after being above my head the entire time to get a good result. The genetic counselor was really good. Taking a family history, I have no cancer in my immediate family (mom, dad, siblings), but do have some cancer in my grandparents, their siblings, and their siblings children. Topic of discussion was the BRCA test. After consideration, I decided to start the process. It's a simple blood draw and results can be received in two-three weeks. Let me state now that I did not decide to go through with the BRCA test because Angelina Jolie publicly admitted to having a double mastectomy after her BRCA test identified she carried the BRCA1 gene. However, I think it's fantastic and amazing that she was able to pull off a double mastectomy in February and reconstructive surgery in April without the public knowing - Bravo to the medical community who treated her and kept her secret (regardless of HIPPA as she is a celebrity and they have so little privacy), and the paparazzi who left her the hell alone during her procedure. The meeting with the genetic counselor took so long that we once again had to reschedule the meeting with the social worker. Maybe tomorrow it will actually happen!
Day 3
Monday, May 13. Four appointments starting at 2pm. First up was the nurse coordinator who provided me with information about breast cancer, my team of doctors (oncologist, radiation oncologist, and surgeon) and gave me some general reading on support groups and dealing with this diagnosis. Second on the docket, a meeting with my oncologist who I adore. She was incredibly thorough, spoke slowly and calmly while drawing diagrams and writing things down for me to see so that it "clicked". I have a better understanding of the tumor and the treatment and know what to expect which has lifted a giant weight off my shoulders. I feared the unknown. Probably why I spent much of Saturday and Sunday Googling the little information I did have from the pathology report. It came in handy as she asked if I had a friend that was a physicist. Guess I was asking the right questions while demonstrating my newly acquired knowledge as I asked questions about the treatment and what to expect. Third meeting was with the radiation oncologist and confirmation that I would be receiving radiation when the time comes. He informed that if I elect to have a lumpectomy, I receive radiation no questions asked; however, with a mastectomy it's sometimes unnecessary to followup with radiation. However, the size of my tumor and it's aggressive nature has guaranteed that I will receive radiation no matter if I choose to lump it or lop it. The last appointment was supposed to be with the social worker, but it didn't happen as it was already 5pm and I had had enough information for the day; plus, we figured she wanted to go home, so we rescheduled. I ended up going downstairs to the lab to have blood drawn to knock out one more of the many tests I'll have this week.
As I understand, my hormone levels are an aspect of my tumor. Something about Estrogen Receptors (ER) and Progesterone Receptors (PR) and the HER2/neu gene. My HER2/neu was a 2+ which is not negative (0 or 1+), but is not positive (3+). So, it had to be sent for a FISH test. (see below from http://breastcancer.about.com/od/diagnosis/p/her2_diagnosis.htm)
Chemotherapy
Chemotherapy will be necessary and will likely last 5-6 months. Two medications will be given at the start, every other week for 4 cycles; followed by one medication given every week for 12 cycles; radiation will be administered after I have surgery, daily for 33 treatments (approximately 6 weeks). We didn't discuss the side affects in great detail, but I found most of the information on this Mayo Clinic webpage to be accurate to what my doctor and I discussed. http://www.mayoclinic.com/health/chemotherapy-for-breast-cancer/MY01368/DSECTION=what-you-can-expect
Radiation
Radiation will come much later. First, I must navigate the chemotherapy and surgery. As the lump is in my left breast, they worry about exposing the heart and lungs to too much radiation. My doctor seemed pleased that I would be open to laying on my stomach during radiation treatments as they could better target the radiation to the affected area and that position would also allow them to shield the heart much better than if I were on my back. The most common side affect is the breakdown of tissue and redness (similar to a sunburn) that is caused by the radiation.
As I understand, my hormone levels are an aspect of my tumor. Something about Estrogen Receptors (ER) and Progesterone Receptors (PR) and the HER2/neu gene. My HER2/neu was a 2+ which is not negative (0 or 1+), but is not positive (3+). So, it had to be sent for a FISH test. (see below from http://breastcancer.about.com/od/diagnosis/p/her2_diagnosis.htm)
What are the tests for HER2 breast cancer?:
- IHC: ImmunoHistoChemistry - this test measures the production of the HER2 protein by the tumor. The test results are ranked as 0, 1+, 2+, or 3+. If the results are 3+, your cancer is HER2-positive.
- FISH: Fluorescence In Situ Hybridization - this test uses fluorescent probes to look at the number of HER2 gene copies in a tumor cell. If there are more than 2 copies of the HER2 gene, then the cancer is HER2 positive.
Chemotherapy
Chemotherapy will be necessary and will likely last 5-6 months. Two medications will be given at the start, every other week for 4 cycles; followed by one medication given every week for 12 cycles; radiation will be administered after I have surgery, daily for 33 treatments (approximately 6 weeks). We didn't discuss the side affects in great detail, but I found most of the information on this Mayo Clinic webpage to be accurate to what my doctor and I discussed. http://www.mayoclinic.com/health/chemotherapy-for-breast-cancer/MY01368/DSECTION=what-you-can-expect
Radiation
Radiation will come much later. First, I must navigate the chemotherapy and surgery. As the lump is in my left breast, they worry about exposing the heart and lungs to too much radiation. My doctor seemed pleased that I would be open to laying on my stomach during radiation treatments as they could better target the radiation to the affected area and that position would also allow them to shield the heart much better than if I were on my back. The most common side affect is the breakdown of tissue and redness (similar to a sunburn) that is caused by the radiation.
Saturday, May 11, 2013
Day 1
3:22, Friday, May 10, 2013. I was diagnosed with breast cancer. A call from my doctor to tell me the results from my biopsy were "ugly" and "Kiddo, we need to get you into the Mills next week." (Mills is the cancer center in town). Final diagnosis from my left breast ultrasound core biopsy at 10:00 (10:00 is the location of the cyst) was "Invasive high grade mammary carcinoma with extensive necrosis." My knowledge of health and the health field comes from wanting to be a nurse when I was in high school and college (it never happened), to working in the ER for just over 3 years, and remaining very much interested in, and in awe of, medical issues; I love the medical shows on TV. If I had Discovery Health on my cable plan, I might never leave home. I know this is not a good diagnosis. Invasive=potential to, or already has, spread outside the area. Mammary carcinoma=breast cancer. Extensive necrosis=dead tissue - lots of it apparently.
No time to wallow, I was on the stage in Assembly Hall about to start the 3:30 rehearsal with faculty for our convocation ceremony today. After the rehearsal I addressed the "elephant in the tunnel" by telling my boss and co-worker it was cancer. The distraction of work today will make this weekend more bearable.
Happy Mother's Day.
No time to wallow, I was on the stage in Assembly Hall about to start the 3:30 rehearsal with faculty for our convocation ceremony today. After the rehearsal I addressed the "elephant in the tunnel" by telling my boss and co-worker it was cancer. The distraction of work today will make this weekend more bearable.
Happy Mother's Day.
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