No chemo for you!

     Last Thursday brought my BIG appointment....oncology. This was my first time meeting my hematologist/oncologist, and I must say I am smitten. He explained everything thoroughly and didn't even break a sweat with my barrage of questions. So, here are the details........
     They consider me cancer free. Even though there was vascular invasion in my tumor, the first place you would see the cancer cells travel to is the sentinel nodes, of which I had three removed and all were cancer free. The margins surrounding my tumor were clean, meaning the entire tumor was removed during the mastectomy. What I really wanted to know was 'my number.' That number was my Oncotype DX score. This test looks a a piece of my tumor and can predict my rate of recurrence. It measures a group of breast cancer genes in the sample to see how active they are. The result of the test is reported as a number between 0 and 100, known as the Recurrence Score^® result. A lower score means the cancer has a lower chance of returning, and a higher score means that there is a higher chance of the cancer returning. From what I have read, a score below 17 results in chemotherapy not being used. My Oncotype was 7! Obviously this was amazing news, but I wasn't quick to celebrate. I had to ask a whole lot of questions before I felt comfortable with this decision. So, chemo is a no go, but I do need hormone therapy to further reduce my risk of recurrence. Dr. Smartypants said that with a double mastectomy, I reduced my cancer recurrence chance to 30%, with additional hormonal therapy that risk drops to 15%. By the was-my left breast was completely benign-sorry lefty, but it had to be done.
     So, this Thursday brings menopause. Normally, an estrogen receptor positive breast cancer would be treated with Tamoxifen for 5-10 years as hormonal therapy to further reduce recurrence risk. Well, Tamoxifen also has a chance to cause blood clots. Seeing as I had a DVT post-op, Tamoxifen is not a treatment option for me. So, I need to get a monthly injection of Lupron to shut down my ovaries(where most estrogen is made) and take an aromatase inhibitor, Arimidex, to further eliminate estrogen in my body. This will be for the next 5-10 years. This isn't too bad a gig, seeing as a major study just came out this year finding that ovarian suppression + aromatase inhibitor had greater risk reduction than Tamoxifen alone. Of course these medications come with a lot of side effects, but I will try them and see. Earlier today I had a baseline bone density scan, and my bone health will be monitored every two years going forward.
     Last Thursday I also had my last drain removed. I felt lost for a day or two, but quickly forgot about him. Now I will go to the plastic surgeon for weekly fills of my tissue expanders and if all goes according to plan, momma may have a new rack for Christmas!

Summer fun

      I haven't blogged in a bit, I have been too busy having summer fun! I made a conscious decision that my child's summer wouldn't suffer because of my cancer. Of course, we have limitations on this one.  I can't go in the water, I can't carry the beach supplies, I tire fairly easily, car rides make my skin crawl and induce muscle spasms. The toughest parts of my day are going to sleep and waking up. It seems close to impossible to get comfortable in bed with surgical pain and tissue expander pain...even with muscle relaxers and pain meds. Then, waking up after sleeping on my back all night is very painful. It seems to be mostly sternal pain. Crushing, stabbing, tearing sternal pain. Sleeping in my amazing recliner seems to help quite a bit. But, during the day I fair pretty well, other than some occasional muscle spasms. 
     This week brings 2 big appointments-oncology and plastic surgery and they both happen on Thursday. I see plastics every week, so that is nothing new.....but this week I should get rid of my final drain. It will be very odd to not have to worry about hiding my drain. Then, next week I can begin fills of my tissue expanders! That brings us a few steps closer to having boobs...or 'foobs' (fake boobs) as I call them! If every person who wanted implants had to go through tissue expanders, there would be a whole lot less silicone in this world. They are hard and they hurt and there is nothing fun about them! The oncology appointment should bring a chemo decision. I am truly hoping I don't need to have it, but only time will tell. This decision is based on a test called Oncotype DX. It looks at your tumor, it's markers and your age, etc. It creates a numerical score of 0-100. Anything below 17 means you will not benefit from chemo (the risks outweigh the benefits), above and you will. I have no worry or anxiety about this appointment because the chemo decision seems pretty cut and dry. My oncologist is also a hematologist, so he will manage my blood thinner as well. So, until then we will enjoy sunshine, ice cream and Del's frozen lemonade! We can also begin to count the days until my sister visits from Texas-yeehaw!
      

The changing tide

     Wow, what a difference a couple of days make. The days of feeling great with total pain control have escaped me. Wednesday night I was too uncomfortable to get much sleep.  My leg ached and my drains felt like they were on fire. Earlier in the day, I felt well enough to wash my own hair. Maybe that is what caused all the pain? Wednesday also brought my follow up appointment with my breast surgeon. As I already knew, my incisions all look great. Was my full pathology report in? Yes! My margins were good and my sentinel lymph nodes were clear. That was wonderful news. Then, the surgeon stated that the pathology report shown vascular invasion. Oh, not cool. So those pesky cancer cells not only invaded the tissue of my breast, but the blood vessels too. So, those cells hit the vascular highway in my body and could be setting up shop anywhere. Chemo will most likely be in my future.  Next Thursday I will meet an oncologist and find out the results of tumor board and hopefully come up with a plan.
     Thursday brought my plastic surgery follow up.  The ride there was very uncomfortable, every bump and turn surged pain through my body.  As the doctor pointed out, my pain would be better controlled if I actually took my pain meds!  Well, I don't like being sleepy all day from hard core drugs. I am much happier taking my Tylenol and muscle relaxers.  I was also able to get 2 drains removed, which was a bit exciting.  If all goes well, I will return next week for the last 2 drains to be removed. Then, depending on my oncology appointment I may be able to start fills of the tissue expanders. So, overall everything is headed in the right direction.  It is just a bit tough as the first week I had full control of my pain and was even going all day without pain meds.  We will see what the future holds.....

Surgery and recovery

     So, it has been one week since my surgery. The night before my surgery, I actually slept pretty well.  Surgery morning was pretty uneventful, mostly just waiting in pre-op holding.  I met my anesthesiologist and my only request was that he didn't kill me. He laughed at this request. I didn't. I was wheeled into the OR and the doctors agreed that Coldplay was going to be the first music of my 6 plus hour surgery journey. Next thing I knew, I was waking up and my first question was, "were my nodes clean?" YES! The preliminary findings were that my three sentinel nodes were free from cancer. Hallelujah, that was a huge relief! I am well aware that this could change upon final pathology, but for now, that is a small victory.
     Next thing I remember was being in my hospital room, asking for my husband. I don't remember much of our visit as a Morphine pump is a pretty amazing thing! I sent my husband home to get some sleep. My throat was so sore, I was convinced Mr. Anesthesia made minced meat of it and the ice chips really weren't cutting it.  Thankfully, I packed some Ricola throat drops which helped. I couldn't get the pain under control. The Morphine pump was my only pain relief, but unless you are awake to hit the button, the pain is getting way ahead of you.  I tried to scoot my butt back in the bed and it was so painful and I had no strength to move.  Thankfully they left my foley catheter in, so I didn't have to drag myself to the bathroom.  I lay in my hospital bed in horrible pain not moving because it only made the pain worse. By 3am I had a terrible headache. Luckily my nurse offered me some crackers, juice and Ibuprofen. Shortly, I felt human again!  I watched a little tv, dozed off and made phone calls!
     The morning brought the end of my pain pump and catheter.  I knew I needed to get up and moving, but really didn't want to.  The most amazing thing happened that morning....they brought me coffee! Coffee and a blueberry muffin-it was pure heaven to me! After that, I was free to get up and move around as I wanted.
     The next day I was discharged home.  The recliner that I bought is just perfect for sleeping in. On Friday, I got up and went for a pretty long walk with my husband and dog. I couldn't believe how mobile I was. Friday was also the day that my right foot was painful and swollen. Saturday brought some increased pain. By Sunday morning, I knew I was in trouble.  My foot and calf were so painful and swollen that I could barely walk.  Despite the Lovenox injections in the hospital, the leg compression machine and lots of walking, I had developed a DVT.  Because I was a fresh post-op, the hospital wanted to keep me overnight.  This was difficult. I had gone all day without pain medication. I had almost zero surgical pain and almost full range of motion in my arms.  I had a pity party for myself that night, alone in my hospital room.  I just wanted to be home in my ridiculously comfortable recliner with my family. How can a tiny little blood clot cause all of this debilitating pain?  After one night, I was released home on oral blood thinners.
     So, here I sit one week post op marveling at how good I feel (except the right leg). I can completely take care of myself. I can brush my own hair, dress myself, brush my own teeth. I can lay in my daughter's bed and read to her. Things I never thought I would be able to accomplish this early. Tomorrow is my follow-up with my breast surgeon. I am hoping that my final pathology is back and we can weight my chemo options. Thursday brings my plastic surgery follow up and hopefully I will get 2 drains removed. Moving forward, day by day!

It's go time!

     So, tomorrow is my big surgery. Today I had to go have an injection in my right breast of some radioactive liquid to map out my sentinel node(s). I had heard it was quite painful and asked the radiologist. He gave me a very 'medical' explanation about injecting right near the nipple which has a lot of nerve endings. So, yes it will be painful. I have to admit, it was not bad. A couple of deep breathes and it was done. Then you wait around for 20 mins and go get some x-ray like pictures taken. Done. Time for ice cream!  Yes, Hubby and I ate ice cream for dinner.
     Prior to this fun of 4 injections in my nipple, I had to do one of the most difficult things I have ever done....hand peanut over to my mom.  My mother lives almost 2.5 hours from me, so we met in the middle for some quick lunch (I didn't feel much like eating) and load up Z's 2+ suitcases! She was fine until I strapped her into her car seat and she started to get upset. "Why do you have to go? Why can't you come with me? Why did you get breast cancer?"  Wow! That was tough, but smiles, hugs and nose blowing got her through it. I got a text a little while later that she was very busy playing with her cousins.
     I am ready and waiting to get this done and move on. I will see you all on the other side!
xo

Sadness. or is it sinus pressure?

     So, I am feeling sad today. I don't know why, but I do. Is it that I am closing in on surgery? Is it that my baby girl is finishing preschool? Is it that I had such a good time with my husband and daughter last night having a photo shoot by a dear friend, that today is a let down?  Is it that I miss my parents and feel bad because their 'baby' is having to deal with cancer? Is it that my friend Bonnie is such an amazing person that she calls me every couple of days to check in and I have yet to do anything meaningful for her?  Maybe it's just this terrible sinus pressure I get when I sleep with my windows open. Yes, it's definitely the sinus pressure.

To be continued...

     So, I have been meaning to blog....really, I have. But somehow life just keeps getting in the way. In 19 days I am having surgery and want to get about 5 million things done prior to that. I've never been one to sit and relax, so why would preparing for cancer surgery be any different?  For some reason, cleaning all of my windows inside and out needs to be done before I have surgery. Why? I don't know.      
     Every day I run around start to finish trying to get a few things done in between dentist appointments, preschool pick up and drop off, grocery shopping, dinner prep, evening clean up of the house, bedtime routine for a 4 year old.  That last one is a doozy! Peanut not getting into bed until 9 leaves momma no time for herself, and it's wearing on me. I am trying to enjoy the moments of non-stress, like visiting the sheep and cows down the road, lunch with friends today, watering the plants for 10 minutes-alone! Like most moms, I get so busy taking care of the others around me that I forget to take care of myself. Next week I will make it to the beach, even if just for an hour, to sit alone and do nothing.......maybe!