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Survival.

3/18/2010

6 Comments

 
Hello Friends.  Sorry it's taken me awhile to get back to this blog.  I could say I've been laying around, invalided, wounded, healing, sleeping -- but the truth is I've just been busy!  I did lay around for a week or so, and then I went to New York, met with a new doctor, flew to St. Louis, worked a weekend, flew to St. Paul, loaded-in and opened, flew to New York, and here we are.  I figured I could wait two weeks after surgery to do a post -- more than that is just shameful!  

So, the Good News: all of my pathology reports came back CLEAN!!  No cancer in any of the lymph nodes, no remaining active cancer in the mass they removed from the breast.  There was some residual DCIS (ductal carcinoma in situ, which is basically pre-cancer) in the tumor mass, but all of the "margins" of the tumor were clean -- so they didn't have to go back in and remove more tissue (thank God).  

So, here's how it all went down:

Pre-Surgery: I flew in to Raleigh late Tuesday night, met up with Jane, who had come down to help take care of me post-op, and went to bed.  We (me, Jane, Mom) arrived at the hospital at the crack of dawn on Wednesday, tired and anxious, and hungry (no food allowed).  I went over to Radiology and had some blue dye injected into the tumor in my breast, which then traveled to the lymph nodes, then images were taken to help my doc find the lymph nodes during surgery.  This stung quite a bit, but wasn't awful.  Next I went over to Mammography and spent 45 minutes in a mammogram machine while doctors stuck two wire needles into my breast on either side of the tumor, to "mark" the boundaries.  This was about as fun as it sounds.  The doctors and nurse (three women, one of whom was pretty pregnant and shorter than I am, so she was constantly up on her tippy-toes to see over the mammogram, and bumping her belly into my knees) were great and very kind and the nurse kept asking me "How you doin', sug?"  I replied about seven times "Fine."  Now, both the question and the response are relative.  She meant "Are you hanging in there, lady?"  And I meant "About as well as can be expected with my breast in a vice and this lady stabbing wires into it."  Every time they'd get a wire in, they'd all run behind this big wall and take a mammogram image.  That makes a patient feel very safe, when the doctor runs away from the danger you're in.  I thought it was pretty funny that they all ran for the hills every three minutes and left me there, half-naked, with my breast clamped inside this machine they were running from.  I giggled a lot when they'd scamper.  They didn't see the irony.  Anyway, it all went smoothly except the doctor ended up having to put three wires in because one of them wasn't at the correct depth.  Lucky me.  When they finished my chest looked pretty fascinating, kinda of like those fetal pigs you dissect in Biology, with all those little pins holding its skin down.  I wanted to take a photo but they wouldn't let me wander into the waiting room to get my camera. 

Surgery: Finally they led me into pre-op and made me put on the backless gown and scratchy footy socks and lay down in the bed.  Then the nurse handed me this bright red hairnet thing, saying I had to wear it because it was a signal to the nurses that I hadn't seen the anesthesiologist yet and therefore wasn't ready to go into surgery.  I assured her I'd scream bloody murder if they tried to take me to surgery before I was anesthetized.  She made me wear the damn thing anyway, but every time she left the room I pulled it off and tried to hide it in the bedclothes.  The nurse explained some stuff to me, and then said she was going to start an IV.  I could tell I was getting nervous when she came at me with a little needle filled with liquid and I yanked my hand away saying "Whoa, whoa, what's that?"  She explained that it was lidocaine, to numb the skin before inserting the IV.  "Oh.  Okay."  So she numbed me up, and then took three tries to get the IV in, which I didn't mind because I DIDN'T FEEL ANYTHING.  Apparently the lidocaine works so well that even when the nurse has to stick you twice and then dig around under your skin to get the IV in, you don't feel it!  So, my question is, WHERE HAS THIS BEEN ALL MY LIFE?!  Why don't they use this stuff in the chemo ward??  Why the hell didn't Kitty Cat Nurse come equipped with a vial of lidocaine?!  I shared my sentiments with the nurse, who giggled.  

The anesthesiologist came in and talked to me for a long time about some scary stuff like nerve blocks and sedation and intubation (which they'd only do if absolutely necessary), and then she put a big "X" in marker on the back of my shoulder so she'd know which side to do the nerve block on.  Again, not so reassuring.  After that my surgeon came in and said hello, asked me some questions, answered some questions, and said she'd see me in the waiting room.  You know you're having surgery in the South when your doctor is wearing a double strand of pearls with her scrubs.  

Finally they went and got Mom and Jane and Lisa, let them come and say goodbye, and that was it (Mom said goodbye twice).  After my mom disappeared around the corner, two nurses and the anesthesiologist descended on me, and I actually surprised myself by getting really scared...for about three minutes, until I was unconscious.  All these images of scalpels and nausea and cutting and wires and boob-less-ness were flying around in my head and I could hear the pulse beep start to speed up.  The nurse had me turn and sit on the edge of the bed, and then started to shoot some fluids into my IV, saying "These are some pre-sedation meds.  They work pretty fast, so we'll get the oxygen mask so that-------"  And that was it.  End of Surgery.  I woke up in the recovery room about three hours later.

Post-Surgery: I woke up, groggy, and immediately started peppering the nurse with half-conscious questions about how it went and whether they got it all and if it went okay and how was it and did it go okay?  Back to sleep for a bit.  Awake in my hospital room, with family in attendance.  Surgeon came in, said it went very well, but took a bit longer than they thought.  I felt pretty good, all things considered.  Very sleepy, but not unable to carry on a conversation with my visitors; sore and stiff, but mostly numb and so not minding so much.  The worst part was that the anti-nausea patch they stuck behind my ear gave me terrible dry mouth, so I was croaking like a bullfrog and gulping and constantly sipping water (to no avail) and coughing.  (By the way, that patch came with all sorts of dire warnings not to touch it under any circumstances, because if I touched it and then touched anywhere else on my body, that body part would immediately become numb and slack.  Apparently they've had women touch their faces and then think they were having a stroke!  And I must NOT under any circumstances shower while wearing it, or the water would flow over it and down my body and slowly turn me into Quasimodo.  I got so freaked out about touching the damn thing that eventually I just covered it with a BandAid.)  I couldn't really use my right arm at all, so any sort of adjustment in bed was pretty much hopeless without a team of at least two people to hoist me up and out.  And of course, with all of the IV fluids and the water, I had to pee about every twenty minutes, which went like this: realize I have to pee, buzz for nurse, wait, nurse comes in and unplugs IV, I take five minutes to push back covers and wiggle to the edge of the bed, slowly get up and totter to the bathroom with help, pee bright blue because of the dye they injected earlier (neato!), totter back to bed, take ten minutes getting back on bed, scooting back into bed, adjusting covers, adjusting pillows and ice packs for my arm, buzz for nurse, wait, nurse comes in and re-attaches IV tube, doze for ten minutes….realize I have to pee.  Repeat process.  

The rest of the night was pretty uneventful.  Jane stayed the night and slept very well on a lovely vinyl Lay-Z-Boy.  I did eventually have to call for more pain meds, and more ice-water, and more graham crackers (which were the only edible thing in the hospital cafeteria).  And every hour or so some nurse would come in and cheerfully wake us up, poke me, listen to my heart, peer down my gown, adjust my IV, take my blood pressure, drain the drainage tube, and leave (and then five minutes later I'd have to pee and buzz her again).  But we did actually manage to get a few hours of sleep, which was nice.  The steady flow of drugs helped (both of us!), I'm sure.  

I've neglected to mention up to this point this fascinating aspects of recovery: I had a hole in my side with a tube in it.  This tube helped drain the excess fluid buildup from the lymph node removal in the week after surgery.  Soo, three times a day we (aka Jane) had to empty the drain, measure the fluid, and then when I got below 30 cc's in a day, I could have it taken out!  Lucky for me I made it under 30 cc's in a week or so, so it was able to come out before I had to go up to NYC to meet my radiation oncologist.  So for a week I walked around with a tube in my side and a bag of my own bodily fluids clipped to my shirt.  Sexy.    

Recovery: As I've said, I actually felt pretty good Thursday afternoon when I got released from the hospital.  This state went up and down a lot over the next weeks, but I started off on a good foot.  Jane and I actually went out for a nice coffee and breakfast pastry (everyone deserves a treat after a night in the hospital).  Then I came home and slept, then visited with Jenn and Hudson (who was kept at a safe distance from the tempting tube dangling from my side), ate dinner cooked by Lisa, and went back to sleep for many many hours!  This is basically how the week progressed -- sleep a lot, wake up, take a walk, drink a chai, eat some food cooked by someone else, nap, wake up, watch a movie, go to sleep for many many hours.  In between this was much taking of drugs, icing of armpit, fluffing of pillows, and hilarious attempts to shower/bathe without getting the upper right quadrant of my body wet.  I did have one horrible day about four days after surgery in which the combination of heavy antibiotics and heavy narcotics caught up with me, and I puked all day.  That was no fun.  Through it all, Jane was an exemplary nurse, never shying away from drainage tubes or wound tending or whiny requests for more water or more pillows or more air conditioning or more ice cream!  Mom also did her fair share of nursing, shopping, fetching, erranding, and caretaking.  Between the two of them and Lisa and Jenn, I was one well cared-for puppy.  

I also received an INCREDIBLE number of bouquets, packages, letters, cards, e-mails, texts, and phone calls from all of you wonderful people -- thank you so much for them.  They really make being a sicky much more fun.  

Okay, my arm hurts from all this typing (not really, but that's going to be a great excuse for awhile), so I'll leave it for now.  More soon about the meeting with my new radiation oncologist, upcoming treatments, and how cancer kicks you when you're down, just when you thought you were up again.  


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Waiting around before surgery with Lisa (stylish as ever)
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Pre-Surgery (note red hairnet unworn on the bed)
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Post-Surgery (note unedible hospital food on the tray)
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Jenn visits, we pose
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Please note the caption at the bottom of this menu. Enough said.
6 Comments

Surgery

3/3/2010

10 Comments

 
As I type this I am sitting in a bathrobe and sweatpants (stylish as ever) in the Duke hospital waiting room, preparing for surgery today.  I arrived at 7am, came over to the hospital, and had radioactive dye injected into my breast (really comfy) near the tumor, which will travel the lymph-drainage pathways into the appropriate lymph nodes -- these will then light up like christmas lights, so that the surgeon will be able to see which ones to take out.  
I'm waiting to have some more images taken of the lymph nodes around 9:30am, after which I'll go back over to the Ambulatory Surgery Center and have thin wires inserted on either side of the tumor "boundaries," after which I'll (eventually) go night-night and have surgery.  

Surgery should take around 3 hours.  They'll go into the breast and cut out the tumor with a margin of healthy tissue around it.  They'll also remove a number of lymph nodes under my arm -- how many will depend on how many "stain" positive, but Dr. Wilke is anticipating removing several.  During surgery I'll be unconscious but not intubated (no breathing tube).  I'll be in recovery for another hour or so, and then will spend tonight at the hospital.  If all goes well, Dr. Wilke will check in on me early tomorrow morning, and they'll send me home.  I'll come out with a drainage tube to remove fluid from the lymph area, which will have to be removed in 10ish days.  I'll have some physical therapy to do in order to reduce my risk of developing lymphedema (swelling of the arm because of the removal of the lymph nodes), but should be able to return to a fairly normal routine in a couple of weeks (no bull-riding for awhile). 
The pathologists will test the "margins" around the tumor to make sure that they are clear -- that there isn't any cancer that could still be lurking in the breast tissue.  If all comes back clean, I'm all good.  If there's a bit of cancer somewhere, they'll have to go back in and remove it.  But I'm sure that won't happen!    
Thanks to everyone for your thoughts, prayers, emails, phone calls, text messages, and goody baskets.  More when it's over!
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10 Comments
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    "I have heard there are troubles of more than one kind.  Some come from ahead and some come from behind.  But I've bought a big bat.  I'm all ready you see.  Now my troubles are going to have troubles with me!"
    -Dr. Seuss

    The Battle

    Present: The battle has been won!  
    (The fallout continues...)

    Past: Stage III "Invasive Ductal Carcinoma", or IDC, of the right breast and lymph nodes.

    The Strategy

    Present: In the midst of hormone therapy: daily doses of Tamoxifen, and monthly shots-in-the-ass of Lupron.

    Past: Four months of aggressive chemotherapy, followed by hormone therapy, a lumpectomy and lymph node removal, six weeks of radiation, and a year of Herceptin.

    The Plan of Attack

    May 2010 - May 2015 Daily Tamoxifen pills, monthly Lupron shots

    The Allies

    Young Survival Coalition

    Army of Women

    Tilly

    Hudson

    F*ck Cancer  Great site with cancer-related gifts and hilarious logos

    Breast Cancer General Info

    American Cancer Society

    Crazy Sexy Cancer - one woman's journey through cancer and recovery
    The Breast Cancer Site

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