A quick one!

Today’s appointment with my surgeon for follow-up check-up went great. I like it that way. I had a few questions regarding the implanted port, she answered them and all is well. I don’t need to see her again for another three months.

Next appointment is Tuesday, July 5^th, with my regular doctor. Have various questions and concerns. My hot flashes, that started three years ago, are driving me nuts. I thought they were bad before. HA! They have turned into full body hot flashes now. And with the weather being so hot, they are interfering a lot with anything I try to do to cool down a bit.

For “fun”, I added up doctor appointments, tests, and surgery mileage the other day. Since this all began (initial appointment being the mammogram), over the last two months we have driven 876 miles just to accomplish all that has been needed. That doesn’t include the trips for prescriptions and misc. items, so it is actually slightly more than that. Most trips were 42 miles round trip for either a doctor appointment or a test or a surgery. No wonder it seems like we have not been home a lot! Wow, what fun we have been having! What a great vacation that could have been!

Muga Results

On a good note. I received the results of my Muga test. 64%. I am good to go for the chemotherapy they want to do. My first session is still on for July 11^th.

Why can't things be simple? Or at least go as planned?

Went in for the Muga test on Monday to check my heart and make sure it is strong enough to go through the type of chemotherapy I am going to have. This entailed another trip to nuclear medicine. Wonder how a Geiger counter would react around me these days? Heck, if things keep going at this rate, I should be able to pull off a really cool Halloween trick this year by glowing in the dark. No extra accessories needed.

I will know the results of the Muga test later this week. I also stopped by the chemotherapy room so the nurse could check the condition of my veins in my right arm. This was necessary to see if they will be able to withstand eight chemotherapy sessions. As it turns out, they probably won’t. She couldn’t even get a vein to surface. So, she put in a call to my surgeon, Dr. B. to recommend my getting a implanted port put in my chest.

An implanted port is put under the skin, normally on your chest, directly into a vein. It is used for drawing blood and giving medicines such as the chemo directly into the vein. For people like myself, who only have one arm that veins can be used and those veins are not reliable (rolling over, ballooning up, collapsing etc.) it makes the process a lot easier.

Dr. B. had me come in Wednesday to discuss it. She said she could do it Thursday and that it is a simple procedure. Short and sweet……should only take about an hour to do. Light anesthetic to induce “twilight sleep” along with local anesthetic in the area where the port would be placed under my skin. I would be awake but not able to feel anything. The anesthetic is one of those where if asked a question, you tell the truth, the whole truth and nothing but the truth. Oh, boy, guess this wouldn’t be a good time to have Mom drive me! I have no doubt she still has questions she would love to ask after all these years!

The appointment is made. Thursday morning, Ed and I arrived at the designated time, 7:30 a.m.. I check in, we are taken to my room and I put on the stylin’ gown and robe. And there we sit. At 8:45 a.m. the nurse tells us that my surgery has been bumped due to another surgeon needing the room for an emergency surgery. No problem. I feel bad though for the person that has to have the emergency surgery. Don’t know what it is for, but if it is an emergency, it can’t be good.

At 10:00, they come to get me. I’m off to the surgery room. Everything is going well. I told Dr. B that under no circumstances do I want the anesthesiologist that I had last time and I didn’t get him. Thank goodness. This one was like the first one I had that I liked. He asked plenty of questions and listened carefully to my answers.

They put me on the surgery table and the next thing I know I am waking up in recovery. The key words here…. “waking up”. I knew from the way I awoke that I had been knocked out completely. Warning bells started going off in my head. First-off I wasn’t at all happy that I had been put under. Secondly, I was very concerned as to why. After I got back to my room I received a little more explanation. Dr. B stated that she did the incision on my chest, but every time she tried to put the port in I would start coughing. After several attempts, she had them put me under completely, injected local anesthetic in my neck area, did an incision in my neck and put the port there. By the time we left there and got home, it was after 3:00 p.m. So much for short and sweet!

I have some very mixed feelings about this whole thing and the placement of the port in my neck. I don’t know if it is good or bad or indifferent to have it there rather than my chest. It scares me to have it in my neck. Should I be scared? Will it make it through all the chemo that I will need? Will it cause problems or be uncomfortable to have chemo put in through my neck?

I do know that between the two incisions, I and percocet ended up being very good friends for the next 24 hours. It took forever for the local anesthetic to wear off. My throat was extremely sore and tender and again I was sick to my stomach and had major ongoing heartburn from the general anesthetic.

This time, I am afraid my attitude isn’t the best. There have been too many things that have gone wrong, in too short of time here. I just want to get better. I just want to live. I want to be able to have the various procedures that I need done and have them go as expected. I really hate surprises. Having breast cancer is a big enough surprise. I think that surprise in itself should have superceded and wiped out all other surprises. I think I’ll print up a “get out of surprises free” card and carry it around with me everywhere I go to let people know…..no more surprises.

What was that?

Today, was weepy day. Can’t really tell you why. Don’t really know why. All I know is from the time I woke up this morning, my mood was not the greatest. Way too much worrying about things. Way too much reflecting about things. A little bit of anger tossed in here. A little bit of the “why me” thing, tossed in there. A little bit of everything that made one big mess of my emotions today.

To top it all off, Ed and I had to run to Wal Mart to get my blood pressure pills refilled. It was hot out today and over and over again I found myself seeing females everywhere in these wonderful miniature scraps of material called tops with their boobs out there in plain sight just a bouncin’ along without a care in the world.

When we got to Wal Mart I decided to see what type of bras or camisoles I could find that might “work” for me now. This search was brought on after my becoming completely fed up after looking online earlier in the morning. There I found nothing but items that cost $50.00 and up that I can not possibly afford. I was looking for a mastectomy camisole that would be very pretty and easy to wear seeing as how I can not stand bras. I found a really nice one…..at the wonderful price of $64.95 which, of course, is ridiculous.

The search in Wal Mart ended in disaster as well. And, in the course of the search I snapped at Ed, who was trying very hard to be helpful. Now tell me, just how many guys would take on something that risky as to be in the intimate department of a general store to begin with? But here he was, actually working on helping me get through this and helping me find something. Yet I snap at him. I felt really bad about that, and really mad at myself for snapping at him and really mad about not having two boobs any more and really mad that the industry takes advantage of things like this and gouges people on prices for “specialty items” and on and on. I apologized to Ed and then ended up in tears. Then I was embarrassed that I was actually in tears in Wal Mart of all places and that just made it worse. Ed didn’t know what to do at that point except go grab the gallon of milk we still needed and find a way to get out of that store just a soon as possible.

What a mess. Worse part? Upon reflecting on things, I don’t think the boob issue was really the main issue here. Instead I think it was other things such as the issue of my upcoming guarantee of hair loss, due to the chemo, that I am facing with no answers to yet. And the unknown regarding how my body is going to react to chemo. And the unknown of how the heck I am going find an employer willing to hire me while I am going through this at a job that I will actually like. Or otherwise find a way to make an income while going through all this. And trying to pay the bills and not having the means right now to do so. And the neighbor that we are having a major problem with. (That would take a whole new blog to explain that one!) And dealing with so many things all at once. And already getting very tired of all the doctor appointments, yet knowing they have only just begun.

Yep, it was weepy day. Good thing I am not one to have too many of them. Good thing I know that when I wake up in the morning, I will be able look at things a little brighter, just because that is how I am.

A little more Backwards Forward

………backtracking to my mastectomy and lymph node removal: After surgery, the surgeon informed Ed and I that more than just the Sentinel Lymph Nodes were removed due to cancer being found. The exact number removed would be told in the pathology report. She also stated that she removed yet another tumor during the mastectomy. This one, like the first two, was also good sized at 4 centimeters.

Thursday, 6-9-05. I had my first after surgery follow-up appointment. My daughter went with Ed and me, as this was also to be the day I received the pathology reports.

It was a bitter-sweet appointment. First the nurse removed the outer bandage. Then the surgeon removed the rest of the bandages. Having the bandages off felt wonderful! And at least my first look at my chest was one from the angle of looking down. My husband and daughter faced it straight on. They both stated it didn’t look anything like what they thought it would…..and they meant that in a good way. I too, agree. The surgeon did an excellent job of a very clean tight incision. Actually there are two incisions. One were my breast was and one under my left arm pit where the lymph nodes were removed.

After finding that one of the two drains had slowed down in accumulating fluids, the surgeon removed it. That was a bit painful, but a quick relief after it was over. I was really hoping that both could be removed but one was better than none!

The doctor told me that the pathology report wasn’t in yet. So, the waiting still continued. She assured me that when it came in, she would give me a call. She called the next day. The report confirmed that the third tumor was indeed more of the same invasive lobular carcinoma. The final tally on lymph nodes removed; 20. The tally on lymph nodes with cancer; 4. So here again, bitter-sweet.

I am not happy about the total number of lymph nodes removed, but feel some relief that only 4 had cancer. I am already practicing good behavior with my left arm to avoid Lymphedema and any other problems that can arise. I am very much aware this is not a temporary situation, but instead a life-long change. From here on out, I need to make sure that I do everything possible to avoid cuts, scrapes, sunburn, over heating, strain, excessive pushing or pulling, chemicals, etc on/with my left arm and hand. To insure that I remember that no blood pressure can be taken on that side or needles stuck into that arm, I have already purchased an engraved medical ID bracelet. A purchase, that I am sure, will pay for itself at some point in a big way. Plus, I figure, why take the chance of what could happen if I don’t wear one. I tend to be a tad forgetful at times. I can just imagine three years, five years, even ten years, down the road not giving it a thought and having something happen that sets my left arm off right into Lymphedema. That would not be my idea of a good time!

As far as the missing breast goes, now that it is actually gone, I have come to terms with it. For the most part. It does look strange….. no getting around it. It is very helpful that Ed is so accepting. Of course I wanted to see if I could deal with a bra and prosthesis, so I tried wearing a bra a couple of times. Forget it! I absolutely HATE bras and find them incredibly uncomfortable. I realize that by going without, the first time I receive some comment may be a jolt to me, but I will deal with that as I need to. For those fancier times in my life, I will somehow find a way to buy and wear a prosthesis. I will try to get one of those self-sticky by themselves to the chest things. But around my home….. who cares.

Yesterday, I went back in to my surgeon for my second follow-up appointment. At last, the second drain is removed! Freedom! AND, I can now take a shower again! Heaven! Everything is still looking great and healing well. Next appointment with her is three weeks from now.

Today, I saw my oncologist for the first time. He impressed both Ed and me immediately with his extreme knowledge and the way he listened to my answers to his questions. He wrote down every detail. (Either that or he had a very long grocery list he was putting together!) All kidding aside, I do believe he takes his saving lives and giving people every chance at living very seriously. We discussed the order of things to come. First, chemotherapy, then radiation and last but longest (five years worth), hormone treatments. He stated he needs to make sure that my heart can take the type of chemotherapy he wants to administer, so Monday I go back for a heart test, called a muga test. Once it is established that my heart is good, and after I have more fully recovered from surgery, I will begin chemo (about four/five weeks from now). It will be administered once every two weeks over a total of sixteen weeks. Chemo drugs I will be given: Cytoxan, Adriamycin and Taxol. If my heart isn’t up to this type of chemo, then a different type will be administered and will last a total of twenty four weeks. Doesn’t take a rocket scientist to figure out which one I would rather go through. Yep, either one that keeps me alive!

Backwards Forward

I don’t know why I have been unable to write for the last couple of weeks. Oh, I have tried. I have sat down several times since my last entry...... a couple of words would tumble out through the keyboard and then it would just stop. My mind has been so overwhelmed with so many issues that they all just became one great big jangled mess. I would tug on a thought string only to have it snap back up somewhere into the dark masses. Somewhere, where I couldn’t quite pull it out by itself again. So now I am left to try the catch up method. I’ll give it my best. It may be a rather jumbled path, but I will get to the present somehow. Try to stick with me here and we will go there together.

Last entry, Monday May 30. Since then Ed and I worked on/in the house, moving things around, doing the things that needed to be done and trying to get to some type of household normalcy in preparation for my upcoming mastectomy, lymph node removal, recovery, chemo and what-ever-else I will be going through. But you see there were two problems that interfered here: 1) I have been a dedicated packrat for way too many years and 2) what the heck is normalcy? So we did the best we could with the two and three and more of everything we came across, gasp, even threw some things away. And as far as the normalcy goes, well, we are still working on that one. But, I will take time to mention that the cactus we planted outside are doing great. My daughter just keeps shaking her head every time she walks by them, muttering something to the effect of “most Moms plant roses, but no, my Mom plants cactuses. In Wisconsin, no less!”

Monday, June 6th, I went in for my surgery. I had done such a good job of making sure I was mentally prepared for what was to come, that my blood pressure was actually lower than it has been in years.

Prior to surgery day, I had received the initial time that I was to be there to check in for surgery….10:30 in the morning. Several days later, I received a call from the surgeon’s nurse that the time was being changed to 8:30 in the morning. Then, the Friday before surgery, I received one more call from the same nurse saying that time was once more being changed to 9:30. I joked with her on that last phone call and said we could always just come over at around five in the morning and camp out.

Ed and I left home early. Early enough that, when we arrived, we had plenty of time sit on one of the benches in front of the hospital to enjoy the fresh air, pretty skies and greenery all around us. At about 9:15, we walked inside to check in. When we got to the desk, the admitting clerk couldn’t find my records, but she was finally able to check me in regardless. They took us to my room, and after changing into my sexy gown, they did all the weigh-in, temp taking, blood pressure stuff. From there I was wisked away to nuclear medicine to have the radio-active dye put into my system for the sentinel lymph node detection. It was here that the first hint of a problem became apparent. The nurse mentioned that they had been waiting for me for an hour and was glad I had come in after all. She mentioned they thought I wasn’t coming. I, of course, couldn’t understand why she thought this as I wasn’t even supposed to be there until 9:30. She told me that I had been scheduled for 8:30. I explained that the nurse called me on Friday and had changed it from 8:30 to 9:30. The nuclear medicine nurse checked the records and stated no one had changed them to reflect the new time I was given. So……from here it started to all slide………. My surgeon showed up and let me know she was upset that I was late. I explained that I WASN’T late, I was there at the time her nurse told me to be there. She just gave me this odd look and said her nurse must have gotten it confused.

I was then rushed into the pre-surgery room and I started to panic as my husband had no idea what was happening. I wanted to at least see him before I went into surgery. The last he thing he and I were told was that I was going to be coming back to my room before being taken into surgery. The nuclear medicine nurse was very understanding. She found him for me and directed him to the pre-surgery room.

Then the anesthesiologist comes in. HE ISN”T THE ONE I REQUESTED! The one that was part of the reason the surgery was scheduled three weeks from when the surgeon originally thought it should be done. It was scheduled that way to insure the anesthesiologist that I had when the lumpectomy was done would be the same one for the mastectomy. I had very solid reasons for this request. The one I had during my lumpectomy was absolutely excellent. He listened to me and was so very very careful when putting me under. I am extremely sensitive to anesthetic, I do not wake up well and I have had some other reactions as well. How do I know this? Because I have had enough surgeries in my life to have a very good idea of how my body reacts to general anesthetic. My body does not like keeping it’s parts intact! And it must think that growing things for science projects is fun! (I never gave it permission for this by the way. Back to the signing the donor card way too early in life statement!)

Anyway, this anesthesiologist was a whole lot different from the other one. This doctor didn’t want to hear anything I had to say. Instead, he kept cutting me off and telling me I didn’t know what I was talking about. According to him I couldn’t possibly have a problem with general anesthetic. When I explained that several in my family also have this problem, he said that is impossible. I looked over at my husband and the look on his face was unforgettable. He, too, was in shock at how this doctor was treating me. My husband tried to speak to the doctor and he too was cut off from speaking. Then I looked over at our friend who was there also and he too was in shock. At this point I came very close to just saying “NO WAY! No surgery for me. It will just have to be rescheduled.” But I knew doing that certainly wasn’t going to be in my best interest, so I tried hard to just deal with things. Needless to say, I was now so stressed that I am sure my blood pressure was topping off at some ridiculous area bordering on danger zone. THEN……just when I am trying to deal with it and get my mind into some sort of acceptance and reassurance, a male nurse comes over and in his own words “is going to “try” to put an IV in”, He stuck the IV needle into the vein on the top of my right hand so hard that I though he had gone all the way through. As it turned out, he did push it in too far. For the whole time it was in me, if I so much as moved the hand slightly, it kept stopping the flow and the blasted machine would just beep away. One of the other nurses explained, after surgery, that he had hit something or other in the vein and he had used too much force putting it in.

Well, into the surgery room I went. The anesthesiologist knocked me out right away. Probably to shut me up! Wonder what the conversation was after that!

Surgery was fast and furious. After all, the surgeon had already told me that she was now running behind schedule. What was supposed to take 1 1/2 to 2 hours now just took an hour. Wow, the wonders of modern surgery. I know that Chilton’s manuals for labor needed to remove things on cars can sometimes be off a little bit here and there. Does the same thing apply to surgery manuals? But everything came off and out which was the whole purpose, so surgery was successful.

But wait……then came the recovery room. For some strange reason it took them two and a half hours to wake me up! Could it be, I did know what I was talking about after all? The surgeon had told my husband that surgery went well and that I should be back in my room within an hour. As the hour came and went and I still wasn’t back in my room, he asked, several time, where I was. He just kept getting brushed off with, “oh, it shouldn’t be much longer”. We will probably never know what really went on in that recovery room. I do know that my throat was swollen and sorer than ever before from any other surgery that I have ever had. That includes the one that took a whole lot longer when my left kidney was removed. I also had major heartburn and pain in my esophagus for a week afterwards, not to mention intense nausea upon trying to eat for the first time afterwards.

Upon arriving back in my room, my mind set started in on getting out of the hospital just as soon as feasibly possible. Not because of the bad things that had happened, but because I don’t ever want to stay in hospitals any longer than needed. By this time I had enough morphine and demerol in me that I felt pretty good. It doesn’t take much of that stuff to do that to me. As soon as they suggested I try getting up and walking a bit, I was up. As soon as they said I could eat, I did. (Although that first meal was a tough one!) From there on, it was all uphill. The next day, I was out of there! And I felt pretty darn good!

I will take time here to mention that the nurses I had after surgery were really really nice! I felt very lucky to have them. Very professional and yet very personable. It almost made me feel bad that I was saying goodbye to them so soon when I left!

Home. Maybe it isn’t the fanciest place. Or very big. Or very up-to-date. But it felt so good to pull up in the driveway and walk in. Over the last few weeks, home has become my haven. It is my comfort zone. I think I took it somewhat for granted before. Now I look at entirely differently. It is where I raised my kids from babies. It is where my husband and I share our most intimate thoughts and feelings. It is where I can laugh or cry or be scared and no one can interrupt me…..or see me. It is where I can look at my incisions and learn to deal with them. Where I can try on bras and chuckle at the absence of my left breast and how funny a bra looks that way. Before long, it will be where I learn to deal with the loss of my hair from chemo. All in the privacy of my comfort zone. Home.

This and That

I will start out with parts of recent conversations that I either a) am looking at much differently today than I would have in as little time as just over a month ago or b) find interesting in a weird sort of way.

Upon finding out I have cancer, this person responded with, “Wow, you look so healthy.”

Do we have preconceived ideas on what someone with cancer should look like? To me, actually, the scary part is that, not only do I look healthy, but I feel healthy. Oh, there are a couple of minor things that I am now adding together and realizing they may (or may not) have something to do with my having cancer. But in reality? If a doctor had not told me I have cancer, I would never have known. Now THAT is scary. How long could I have gone with cancer in my body and not know it? How long before it would have made me look unhealthy? What are my odds now? What would my odds have been had I not found out when I did?

Another recent conversation with another person…… In a reference to a male worker in a workplace – “He chases after anything with breasts.” Granted, I found this to be a comment that I have heard in various forms over the years. This time when I heard it, I couldn’t help but take note. It was the criteria and the plural; breasts. Once again I found myself mulling over the role a woman’s breasts (yep, there is that plural again) play in our society. Yes, I have always been aware of this, but now it is taking on a much different slant as I my unilateral mastectomy is approaching a week from today.

Where does a one-breasted woman fit in? Do they make one-side bras for those of us daring enough to go without a fake one if we opted out of doing reconstruction of some type? I haven’t checked, but I bet not. How about strapless evening gowns? Now that could be a real challenge. (I think I will pass, thank you. I am very comfortable in jeans!) I never did participate in a wet tee-shirt contest at any time in my life. Just wasn’t my style. Guess I won’t be trying it anytime soon either. I can only imagine the looks and reactions that one would get!

In my quest of finding options to consider, I do know they sell breast forms on eBay. I was looking the other night. As I was reading the descriptions, sizes and prices, my daughter (19) was on her computer next to me, watching me, shaking her head and saying “There is something really wrong with this family!” And of course she immediately instant messaged someone to tell them. Personally, I think it is perfectly normal to look for life’s much needed items on eBay!

Upon checking out breast forms I found they seem to have this unique sizing thing going on. Perhaps it is even more difficult to me as I haven’t worn or bought a bra in many years. I don’t have a clue what size bra would fit right now while I still have two breasts. How the heck do I figure out what size breast form I will need to “match” the breast left after surgery? The end result is supposed to be that I am able to fit both the real and the fake into a bra and have both look “natural”.

Deciding to check things out further, I surfed over to some web sites where selling breast forms are their main business. There, they are listed in sizes ranging from 1 through 17 or so. The bras for them are sized 28AA through 50DD. (Maybe the doctor could just sew some Velcro on my chest while I am in surgery. That would take care of needing a bra.) And then you have different shapes for the forms that need to be figured out, such as triangle, symmetrical, wide base, heart-shaped with tapered edges, underarm extensions, teardrop, modified triangle and more. Then there is the “nipple” thing. Guess what folks, there seems to be a multitude of those out there, too. I think this is so you can attach them to the forms that don’t have them built in to look even more “natural”. If that isn’t enough choices, then there are also various materials used for making the breast forms. Different materials for different purposes. Casual, swimwear, evening, etc. After thinking about it, one that takes on water wouldn’t work out too well for swimming. So I guess it does make some sense.

Prices for all this? Step over cancer unit, because they came close to putting me into a cardiac care unit! They are not in the low-end or even middle price range. It was nothing to see breast forms for $189.00 each on up to $300.00. They certainly know how to take advantage of a woman’s vulnerability! Some of them appeared to be made out of the same type of material and were roughly the same size as toys I remember buying for my kids fifteen years ago. Price for those toys? High end was $9.99 each. Even with inflation, I doubt those toys are $200.00 now. So what gives here? Is it because some insurance companies pay for them? Is it because they know a woman will want to look as good and as normal as possible and will be willing to pay whatever price necessary to do so? Where does that leave women, like myself, that don’t have money and don’t have insurance? Simple enough, but a sad fact. It looks like we do without. Whether we want to or not.

Reconstruction? Now? Later? Ever?

This morning, I had barely opened my eyes, yet my mind began zipping through a multitude of thoughts, questions, and scenarios. This was not a good sign. I am not a morning person. I try to avoid thinking, communication or any other life-form until around 10:00 a.m. or so. This morning it didn’t seem to matter.

Today was the appointment with my plastic surgeon. I wanted to make right decisions based on logic and reliable information. Darn it, that emotional thread kept slipping in. Couldn’t help it. Gonna lose a boob. Funny how, in the midst of knowing I have cancer and knowing I can lose my life, here I was thinking about losing a boob. Logically that was just down right ridiculous. Oh, good, at least I shifted back to logical.

The doctor listened to my concerns, the items I brought forth from the research I have done and my questions. A big concern to me, invasive lobular carcinoma has a tendency to spread to the other breast. Sometimes it will be a while, but it often gets there. What if I have the first breast removed, an implant put in and then I have to have the other breast removed. Kind of stuck then. Either have to have the first implant removed and be left with sagging skin on that side and a tight scare on the other or have a another implant put in on the other side. Then it does become ridiculous. I really feel I would be better off having two breasts removed and no implants. I really don’t want to deal with any of the different flap reconstructions. I want to get on with the chemo and other treatments needed to rid my body of the cancer. I don’t want to take extra time in here for healing from reconstruction.

So…..my decision…..I am going to be lopsided for a while. I have decided against reconstruction of any type at this time. Maybe down the road I will decide I just can not deal with only having one “bump” on my chest. I have the rest of my life to do reconstruction of one type or another and that is just fine with me. Plus, there are breast forms on the market made for women that have had mastectomies that I can check out. Course that means I would most likely need to start wearing a bra. Good grief this is all getting so complicated. I haven’t worn a bra in about twenty years!

Research, Thought Process, Decisions, Decisions, Decisions

Ever since my diagnosis and the setting of the surgery date for my mastectomy, I have been doing a lot of research into invasive lobular carcinoma, various methods of treatments being used for it and also methods of breast reconstruction. The doctor will be doing a modified radical mastectomy of my left breast, which will include the removal of a number of lymph nodes along with my entire left breast. (See http://www.breastbiopsy.com/bioresults_treatmentoptions2.jsp for further descriptions) A biopsy will be done on the lymph nodes to find out if the cancer has spread to them yet. If it has, this is where my needing radiation will come in on top of the chemo they are already scheduling me for. Because the entire breast is being removed, reconstruction methods are limited to a flap reconstruction (of which there are several types) or an implant.

I have been wrestling with several things as I’ve doing my research. The first being the lymph node removal. I have always been a fairly active person. My hands and arms have always been my means of making an income, either within an office setting as an administrative assistant or repairing/fiddling with computers or bartending. Upon reading what the lymph nodes do and finding out the possible hazards involved with lymph node removal, I want to try to keep the possible hazards to a minimum. Some who have a number of lymph nodes removed develop Lymphedema. Lymphedema is a condition, in which a damaged lymphatic system loses its ability to pump or move lymph fluid, thus resulting in lymph build-up. This causes the arms or legs to swell to several times their normal size and is known to be extremely painful and can be disabling. It also presents the potential for massive infections from even the smallest cuts or inflammation of the skin. To avoid Lymphedema and other problems, there are various precautions. Among them would be limiting the lifting of items and repetitive motions. Because my lively-hood and things I enjoy in life involve lifting, this concerns me. Along with becoming a cancer survivor I also need to continue quality of life. Otherwise, what is the point?

After studying methods of lymph node removal, I felt that doing a Sentinel Node Biopsy might be an option. A Sentinel Node Biopsy is a technique to determine the status of the auxiliary lymph nodes first. The tumor site is injected with a radioisotope and/or blue dye. This is tracked into the sentinel node, which is the first lymph node in the body to come in contact with cancer cells as they leave the primary tumor. The sentinel node is then removed. If there is no breast cancer found in the sentinel node, more than likely no further nodes may need to be removed. If breast cancer is found, then it is generally decided that more lymph nodes will need to be removed. By going with a Sentinel Node Biopsy with minimal node removal, it can often save a woman from the possibility getting Lymphedema.

In order to present my thoughts and questions in an organized way and to give my surgeon the opportunity to answer me at a time that was good for her, I wrote everything in a letter to her. I explained to her my concerns on future usage of my left arm and why I have these concerns. I asked her if a Sentinel Node Biopsy would be a possibility for me. And I asked her expertise on the pros and cons of doing this procedure over the one she is planning on doing.

Her response was absolutely fantastic! She called me and we went over it together. She understands my concerns and she agreed that yes, she can and will do the Sentinel Node method first. She did warn me that if the Sentinel Node shows cancer, then she will most definitely remove more lymph nodes. I totally understand and am hoping for the best here. If more need to be removed, well then, that is the way it needs to be. But if there is a way to keep things to a minimum, I want my best shot at that as well.

Another item that has been concerning me is the reconstruction of a breast to “replace” the one I am losing. The original plan was to insert a saline implant at the time of my mastectomy. Upon plenty of research though, I have started to question my having this done. Implants are a man-made material and carry no guarantees as to longevity or compatibility within a person’s body. Look at what happened with the first “round” of implants that hit the market. In the beginning they were hailed as being relatively safe and a fantastic remedy for enhancing a woman’s breasts or for reconstruction after a mastectomy. As time went on and more statistics were compiled, all kinds of problems started emerging. Some of these problems included illness and death. THAT is a big problem! Looking back, they weren’t so safe after all. Now they have come out with new ones that are supposed to be, once again, “safe”. As before though, there has not been enough time yet to really make that a reliable statement.

There are a few other things that bother me regarding reconstruction and the implant idea.
1) Implants can spring leaks. Doesn’t mean they will, but they can. And they have been known to do so.
2) Cancer can come back and the implant can conceal it.
3) It can interfere with radiation treatments.
4) My body could reject it or build up scar tissue trying to get rid of it .
5) I really highly doubt that any medical insurance is going to cover me from here on out. (Let’s see now, previously I have had a hysterectomy, my appendix removed, my left kidney removed and now I have cancer. Nope, really can’t picture any medical insurance company wanting to take on that risk!) With that in mind, if I were to have an implant and it starts leaking or otherwise has a problem, just what am I going to be able to do about it? How would I pay for it? They can only be removed through another surgical procedure.
6) If it does need to be removed, I am left with sagging wrinkled skin in its place. To me this is no substitute for a breast!
7) What do I do if, once I have it, I don’t like it?
And last but not least,
8) No matter what I do, an implant is not a breast!

Regarding reconstruction, I also have to look at the long-term picture. I need to look at it from a realistic standpoint, rather than from the whirling emotional viewpoint I am caught up in right now. Emotionally, I am devastated that I am losing a breast. The reality? There is absolutely NOTHING that is going to put that breast back. To do a tissue flap reconstruction generally means I have to give skin and muscle from somewhere else on my body and place it on my chest. Is that a breast? No. To remove skin and muscle from somewhere else on my body means the potential for problems somewhere else on my body. I am already getting disfigured at one location, why the heck do I want to add more disfiguration somewhere else? All for the sake of concealing the first disfiguration. When they get around to cloning breasts, that look, act and feel like breasts, well, that may be a different story.

I do have to say, as I write this, this is all making so much sense and might even sound logical. Emotionally, I am a wreck. Tomorrow I have an appointment with the plastic surgeon that is scheduled to do my implant. I want to discuss the various aspects with him regarding my reconstruction options. I need his professional input. Plus, with surgery looming over me at only a little over a week away, I have to make up my mind. I will give him and you my final answer tomorrow.

Takes the Cake - Final Chapter

Yep, the boss did it. He has eliminated my job.

Piece of cake. I am sure I am very employable. 53 years old, cancer, major surgery scheduled for June 6th, 4 week recovery from that and then chemo and then radiation or else radiation and then chemo and I have no idea of how long each of these procedures will take. Very employable!

People have a funny way with timing and a funny way of saying thank you for being a dedicated employee after nine years of working for them.