It’s OK to tell me to get over myself

Happy Sunday. It’s another one of those hot and humid days and I’ve been content to sit in the house and write marketing copy (I’ve jut been promoted and won’t have to spend too many more Sundays writing copy!) It’s time to take a break.

For some reason I’ve been thinking a lot lately about what I deserve, namely all the attention from lots of wonderful people, near and far, who write, call, or visit and tell me they care about me. It’s such a boost to my spirit and it wraps around me and helps hold me together on tough days,

Sometimes it makes me wonder what I did to deserve all the love and attention (did I already go into this once before? It’s hard to remember.) I wonder if wondering, and talking about wondering, is just another way of calling attention to myself. I don’t know the answer—-it’s just the question of the day.

Reminds me of a line from a James Taylor song, "The Secret of Life"
"Nobody knows how we got to the top of the hill
Since we’re on our way down, we might as well enjoy the ride.”

Maybe I just need to get over myself. After all, it is a lovely ride--if you're lucky.

Read More......

The “C” Word

That’s “C” for chemotherapy.

Preliminary tests from the August 6 surgery showed no evidence of DCIS in the tissue taken, and showed the two lymph nodes to be negative. However, new technology allows an additional series of tests on the nodes, and one showed a tiny cluster of tumor cells. The best course of action is to order up a short cycle of chemotherapy (perhaps 2 to 3 weeks in length), called “adjuvant” chemo. So that’s what we’re going to do.

(I love it when my doc says “we.” It’s “me” this is happening to, not “we.” It’s all about me.)

Adjuvant chemo is given to fight the RISK of a future cancer, not to fight existing disease. The assumption is that the cancer in my breast is gone (proven by two rounds of excisions with clear margins each time.

Adjuvant chemo isn’t like the chemo given to people who are actively fighting cancer, trying to shrink known tumors, trying to survive their cancer. Dr. Nath says adjuvant chemo isn’t a “throwing-up-losing-your-hair” kind of treatment (we’ll see, won’t we…?)

Remember that microinvasion discovered during the first surgery? Because of it, Dr. Nath wanted to do the sentinel node biopsy during the August 6 surgery (and I’m so glad he did). Initial reports were negative (which he reported to me in the days after surgery), but that new technology proved otherwise.

Five years ago this would not have been found. Even today, without the sentinel node biopsy, it wouldn’t have been found. Who knows what it might have turned into down the road? Maybe nothing. Maybe something.

The assumption is that with the radiation and drug therapy already planned, this would not have survived to grow into something terrible. But why take the chance? Enter adjuvant chemo. The current plan is to do radiation as planned, then chemo, then the planned drug therapy.

Dr. Nath likens it to finding a dandelion in the yard. You pull it out, root and all, and then throw down some dandelion killer on the grass. You don’t get any more dandelions.

But why not? Maybe pulling out the weed, root and all, solved the problem. But you can’t be sure. Maybe throwing down the weed killer did the trick. My adjuvant chemo will be my weed killer.

So that’s where it all stands at the moment. I see Dr. Nath in a month, and before that time I need to see both the radiologist and oncologist again.

My sister-in-law is a mammography technologist with 25+ years in the field. When I called her tonight she admitted she’s pleased I’m going to have a course of chemo. She reasons that I’m young and that my medical team should throw everything they can at this and reduce all of the risks. Hearing her say that makes even more sense of everything Dr. Nath said today.

We have a plan, but plans change. I’m learning to be better about being flexible. Plus there’s more waiting. I’m getting good at it.

Once again, thanks for hanging in. If you have a question, post a comment and I’ll be able to reply. If you know someone in a similar struggle, send them the blog or give me their name, I’ll be happy to call and be a hand-holder. I have all of you doing that for me, it’s a small way to pass along the love and support.

Read More......

Turning "one of those days" into something better

I haven’t had an “I’m feeling sorry for myself” day in a while, to today was it. I felt myself sliding in that direction and try to stop. I pull up all the images that usually remind me of how lucky I am, but none of them worked today. I needed to have a good cry, and did.

Today was about feeling unattractive and discardable (I don’t care if that’s not a real word, it’s my blog). When I get like this Dave is sweet to remind me that I’m one of his best girls and after a while, that helps get me over the moment. He gives me every indication that he’s rock steady through all of this. If he’s not, he hides it well. Some days I feel like I take terrible advantage of him and PJ, particularly when I’m having one of those days and want noting more than to indulge myself in my own misery.

Eventually today turned into a chance to look ahead and make plans. I’m itchy to plan a party and celebrate my good fortune, but it’s going to be a little longer before I can really move on it. I need a schedule for radiation treatments to know when they’ll be completed. The location I want for such a fest is the Hartshorne House in Wakefield, and it isn’t available after then end of October. I’m not sure I want to wait until the spring. I’ll be able to take a closer look at that after my appointment with Dr. Nath on Wednesday.

I’m also pondering what I can do to get involved in breast cancer community service. It seems like the right thing to do, it will be a matter of finding the right outlet. Some efforts are done by many (three-days walks and the like) and are fiscally successful. That's terrific, but I'd rather find something little-known and try to give that a boost. So I'm looking. Do you have any ideas?

I’ve been so pleased with the care I’m receiving from the teams at Winchester Hospital. PJ found that the hospital sponsors ‘A Caring Place,’ a resource for wigs, prosthetics, and head coverings for cancer patients. It’s open on a by-appointment basis, and is in the same location as Dr. Nath’s office. The best thing is that they offer gift certificates, and I wonder if I can mount an effort to purchase certificates that could be turned over to people in the community who might not have the means to buy the items they need. That will yield an immediate result--help for someone who needs it right now.

We went to a party today for Shelley Sgrulloni, a belated gradation party before she heads off to college (cling peaches... stay with me, this will cycle back to make sense). There were a number of people there from church and I had long talks with a few, including Ginny Hipple. Once again, the concern and kindness are wonderful reminders of the friendship I’ve found at WUMC and of how good it feels to go on Sundays and be part of the congregation. I should go more often.

Anyway, Ginny told me that there is talk about starting up the church cancer support group once again (it became inactive as the need fell away). I offered my support (ha! support for a support group!), and offered myself as a resource or sounding board for anyone in a similar situation.

Plenty to think about, plenty of reasons to feel positive. Maybe having a bad day sparks a better ending.

Read More......

Pearls of Wisdom

I don’t really have any. I went back to work this week, and the days crawled by. People kept telling me that I didn’t looked like I’d had such a significant surgery. That’s the beauty (or curse) of breast surgery—no one can see the bandages or the scars.

It’s taking more time than I thought it would to feel better. This time around it’s a different kind of recovery process. The last time the incision was small but there was a lot of bruising. This time there are two incisions (one 2 ¾” long, the other is covered by gauze padding and I can’t see it, which is probably a good thing). There is more need to protect from further injury this time.

Over the last 48 hours I’ve had a lot of sudden and sharp pains throughout my breast. Some of those pains take the breath out of me for a moment. I’m told this is normal following a surgery, it’s reaction of nerves that were cut.

I haven’t had any luck shopping for a new fleet of bras. I’m trying to get through this phase with current inventory. Part of the problem is the way the cup of a bra is cut. Because of the incision made to take lymph nodes, I need a more generous cup on the side up and toward the underarm. The bras I currently own (except the two I can wear) fall across that incision and are impossible to wear unless I stand perfectly still. And that’s not an option!

So, on we go, waiting for my August 22 appointment with Dr. Nath. Until then it’s one day at a time. Thanks for hanging in with me.

Read More......

Now what?

For the first time in 50 days (since my DCIS diagnosis), we’re in “cancer free” thinking mode. Even so, I am one of those who believe that it’s never really gone. I don’t think that’s being a pessimist, it’s being a realist.

But what the hell, let’s go with the assumption that it’s gone.

Someone asked, “What’s next?” I’ll spend the next few weeks healing. (If you don’t want to know the details of scars and incision sizes, stop reading and go to the bottom of the page under the ############ line.)

I can’t see the incision from the lumpectomy surgery. It’s hidden under a piece of gauze that measures 1 ½ inches by 4 ¼ inches that runs along the right side of my breast (as I look down at it). The nipple and areola are covered and I assume the areola is cut. In the last surgery he cut around the areola.

Dr. Nath talked to Dave and me in the pre-op area on Monday. Dr. Nath indicated he’d make a crescent-shaped incision and go in, then finish by drawing the two sides together and stitching it closed. Makes sense, as he said he took a lot of tissue. As he talked he drew on my breast with a pen and Dave’s expression when from “hhhhmmmm, interesting...” to mild horror. I couldn’t see what he was drawing (being prone), it was more for Dave’s benefit than mine.

But I clearly remember thinking, “I hope you’re going to wash that off before you cut me. The ink can’t be healthy in an open wound…”

The second incision (for the lymph node removal) is about 2 ¾ long and on the back edge of my breast (10:00 as you look at me). It’s not quite under the arm; I could shave my underarm and wear deodorant without affecting the bandaging. I can see this incision under layers of steri-strips.

Both wounds are covered by a see-through bandage; it’s like sticky Saran wrap, so I can shower without getting the wounds wet. All of the bandaging will remain in place until Dr. Nath removes it.

###################

(Welcome back!)

I see Dr. Nath on August 22, at which time he’ll have final pathology reports, check my bandages and perhaps remove them, depending on how the healing goes. Last time the bandaging remained in place for about a month and since this round was more extensive it will probably be at least that long (or he’ll remove, examine, and re-bandage).

Next stop on the DCIS Sally is Radiation, which will begin in about six weeks (Dr. Nath’s call).

So that’s where we stand. Won’t be much to report until the 22nd. Hang in with me, I’ll keep you in the loop.

Thanks for the cards, the calls, and the prayers. I have two beautiful bouquets of flowers and a basket of the most amazing cookies. I’d invite you to come by for one but I’m not sure there will be any left by the time you get here!

Read More......

Dr. Nath just called...

..and for the moment, all is well.

There is no residual DCIS in the specimen he took Monday.

The preliminary report on the two lymph nodes shows them both negative; immunostains (?) are still underway, but he expects those will be negative as well.

There is one focus point in the specimen still being studied, but whatever it is they are looking at is fully contained.

Don’t you agree that it’s all great news?

Read More......

Bras as tax deducations

It’s inevitable that I’m going to have to go bra shopping. And since it will be a matter of my health, I wonder if we can slide the receipts through as medical deductions on the 2007 taxes. We’ll have to ask Mike The Tax Man.

I can see that my days of shopping for bras at Wal-Mart and Target are over (I can hear the ladies screaming!) For the moment I’m OK with current inventory. Actually—I only have one that is comfortable. The others are under-wire or sport-style, and both styles are off limits. The underwires hit my incisions and the sports do little more than crush tender tissue. Both those styles have also been ruled inappropriate by the radiologist during the radiology cycle.

I’m living in a bra these days. Whether awake or asleep, it’s a critical part of my recovery. My injured and recovering breast is subject to unnecessary movement and injury if unprotected. That means when sleeping as well, to protect it from injury when, for instance, rolling over. Bandaging alone doesn’t provide enough to support its weight (I’m not bragging about size; size doesn’t matter when it comes to recovering from breast surgery). So cupped it must be, which means her sister must be cupped as well. You can’t harness one and not the other.

I never put a lot of thought into my bra inventory. Their cost can be staggering, and the chain store varieties do the same job as those purchased in pricy mall stores.

( PJ bought me a Victoria’s Secret bra once. It was without question the most comfortable bra I’d ever worn, and I swore I’d never let another brand touch my skin. That didn’t last long. I still love it but in a few months it won’t fit.)

For now I can probably get by going to Wal-Mart to see if they have another (or two) of the style I’m presently wearing. I’ll only need it for a few months so it’s the smart way to go.

Months from now, when the swelling goes down and the radiology effects have eased, I’ll have to do my bra shopping at specialty stores such as Lady Grace. Those folks know just what we breast surgery girls need to be comfortable (we’re all girls, no matter our ages). I’ll join that special Sisterhood of the Asymmetrical and be proud to do so. It beats the hell out of the alternative.

I’ll save all the receipts for Mike.

Read More......

Glad yesterday is over

Well, kids, yesterday is history and I couldn’t be happier. It was an easier day than I thought it would be, but even at it's best, it was crappy.

Bottom line is that the surgery went well. Dr. Nath removed more breast tissue than he thought he’d have to and wasn’t very happy with what he had to do to put me back together. He says he’s a perfectionist but thinks he’s left me with a scar. I couldn't care less. It’s my battle wound, I’ll wear it with pride.

Dr. Nath called this morning to talk me through everything again. Apparently he and I had a conversation yesterday in the recovery room after surgery—I remember absolutely nothing. He said he removed additional breast tissue (beyond just clearing margins) and took two lymph nodes, both of which were negative on a quick pathology report. That’s great news. Of course we’ll have to wait for complete pathology, which should come some time later this week.

The day itself was an adventure and filled with some familiar faces.

Dave and I started the day with a 10:30 check-in and my day surgery nurse, Judi, was the same one I had on June 14. She is one of those eternally cheery people and just perfect at her job. I was once again very comfortable in her care.

The sentinel node biopsy was a very easy procedure. It involved four injections of lidocaine (as an anesthetic) followed by four injections of a radioactive agent that Dr. Nath used to follow the blood flow path from the breast tissue into the lymph system. The diagnostic radiologist who administered the injections was the same gentleman who performed the stereotactic biopsy (I still don’t know his name, I’ll have to ask Dr. Nath).

(During the actual surgery, Dr. Nath dropped a blue dye into the surgical site and the dye took a similar path from the site into the lymph system. The dye and radioactive agent had the same role, to guide him to the sentinel node, the first one in the path out of the breast. He followed the dye and used a Geiger counter to find the right nodes and removed two.)

The radiology work was followed by a trip to the nuclear medicine department for a few images to be sure the radioactive agent was moving through my system.

Then we waited for an operating room to become available. My 1:20 procedure began at about 3 p.m. As he did on June 14, Dave sat with me in the surgery staging area and slipped out before the anesthesiologist pushed what she called my “happy cocktail” into my IV tube. A few minutes later we were in the operating room and everything that happened from that point on was done without my active involvement.

I woke in the recovery room in terrible pain. The nurse offered to push some morphine into my line and followed with a second dose. Once I hit the clouds she let Dave and PJ in to see me. Perhaps that was a mistake. I could tell from the look on PJ’s face that she was upset at the sight of me, and Dave looked a little freaked as well.

I moved back to day surgery and sat there for a while before Dave brought me home. We were here by 8:15.

Highlights of the Day:
• PJ’s and Dave’s smiling faces
• Kind, cheerful health care professionals at every step along the way (a few with great senses of humor)
• Saltine crackers and ginger ale following surgery—nothing in the world would have tasted better at that moment
• Dave’s $3 roast beef sandwich and complimentary soda in the hospital cafeteria
• Ice packs and the pillow the day surgery nurse let me take home
• Turquoise-colored urine, thanks to the blue dye
• Vicodin and morphine on the same day

It’s over, at least for the moment. We’ll await final pathology and hope not to have to go through this again. But if we do…

Next step: A follow up with Dr. Nath on August 22. At that time he’ll schedule me into radiology (says it will start about 6 weeks post-surgery, mid-September-ish).

Read More......

Waiting

I’m in waiting mode again, this time it’s waiting to go to the hospital for surgery. For some reason I’m focusing on what I need to bring with me. They say I should not bring any personal items but it’s not possible to leave everything behind.

First there’s my wedding ring. I’m not going without it. Last time they made me take it off and I gave it to Dave to hold. Maybe this time I’ll pretend I can’t get it off my finger and I’ll ask them to tape it onto my hand.

Then there is a pair of reading glasses. You might recall the six-hour delay the last time I was scheduled for surgery. I can’t possibly read the weeks-old editions of magazines I’d never pick up with the first place (“Golf Digest” seems a popular waiting room staple along with standard “Prevention’).

And of course, I’ll need my insurance card. They have all my information in the computer but someone will insist on seeing it any way. I shouldn’t fuss at this; I make a career in healthcare publishing and I know the challenges providers face getting paid what they deserve. My card will make it a little easier for them, and hopefully for me as well.

Wait… I’ve got a bill here for $2,298 for the July 3 MRI. Seems my insurance company is denying coverage.

Ah, something to distract me until it’s time to leave.

Read More......

The 43rd day

The work week is over and there are three days to go until the next significant moment in this sally.


My colleagues are a wonderful bunch, loaded with hugs, handshakes, cards, well-wishes, and words of encouragement. Kim and Julie cheerfully took projects off my schedule for me (and I pledge here in print that I'll return the favors). I promised I'll climb into e-mail come Tuesday (home e-mail not work e-mail) and send a "Hello! I'm here!" message (and a "Saved By The Bell" update for Wendy). Let's see if I can follow through on that promise.

That's all for the moment. More soon.

Read More......