Tatts & Cats

Fabulous. Love the New Doctor. Very astute, very confident, very well regarded, very fantastic sense of humor. I have to wonder how I am getting so lucky with the doctor selections. I mean I have a billion now, and I know my husband's being on staff helps, but my odds must be thinning.

So, I'll be having the last vestiges of cancer in my chest blasted by radiation every day (Monday thru Friday) for around 5.5 weeks. I'm sure you've heard of the usual set of possible side effects. Skin irritation and scar tissue accumulation (thickening & hardening) can occur. These things, if they happen, will only change my cosmetic results. I'm not too worried now though because
a) my mother had a fantastic experience with radiation and
b) I've seen my plastic surgeon's smile. I know I'm already on a good path there.

First up in the process is a meeting next Wednesday wherein I'll have a ct scan of the area and get a few tattoos to make sure my positioning is the same every time. The contest begins to see who can come up with the best design to turn these tattoos into when I'm done. Sorry Dad. For those of you who don't know, I've got a fairly large tattoo on my back, so I'm not worried about the pain I'll endure on Wednesday. It'll be a snap. And the ct scan will be without contrast, which means no IV in my arm. Hooray for that.

I also saw Dr. L today and had a little more fluid put into my expanders, which means I've got a case of the ouches. It's not as bad as the last time, though. I have to say I'll miss visiting his office while I'm having radiation. I'll pop in on them to have Dr. L check out my skin a ways into my course. But I love his staff. Luckily, the staff at the oncology pavilion I'll be spending so much time at seem equally lovely. Better yet, I'll be able to sneak a peek at my husband during his workday.

Okay, a Medium Post

I have a lot to say about how cancer has and hasn't changed things, bits and pieces of ideas that have been coming together in my head. But those thoughts are going to have to steep a little longer. I've got to run out soon to grab some last minute treats to incorporate into a little surprise for Mark tonight. He deserves, well, everything good. Things that will take a lifetime to give. For tonight, since I've been feeling so much better lately, despite a sore throat, a small amount of fun is in order.

So, before I get going, where are we? My chest is healing nicely. I've stopped whimpering when I change and have to look at myself. I'm stronger and totally recovered from my last expansion. In fact, I'm able to drive now and Mark and I took an inaugural cruise around the neighborhood on Sunday. We have no plans yet for radiation, but we're meeting Dr. W tomorrow to get that started & scheduled. I'm looking forward to learning about the process. Friday then I'll stop in on Dr. L, my plastic surgeon, to make sure my chest is ready, in his opinion, for radiation. That visit could include a pat on the back, some removal of fluid, or a small bit of expansion. We also realized that the tissue expanders have to be in for at least three months. So, barring any serious side-effects, radiation may not slow anything down at all.

We still haven't decided if I'm going to take Tamoxifen yet. One thing at a time and all that. But I am going to go visit a new primary MD. Ha! You thought I had a million doctors already! Dr. R has been recommended by a lot of folks and should be a better fit for me. You may know that my last primary refused to order a mammogram for me, so I need someone new at any rate. I'll post a little index of docs on the left so that you can read these posts with a tiny bit less confusion. And I promise I'll try not to see any more doctors with last names beginning in S.

Uptime

Hi Kids. Sorry there hasn't been a new post in a while. Our computer had to go in for an emergency procedure but is back with us and happy to be of service. I'll fill you all in with a big post tomorrow. For tonight, just know we're both fine and haven't been avoiding the blog on purpose.

Managing

I can't believe it's already Thursday. Lucky, I guess, because the start of the NCAA tournament is pretty much the most fun we've managed this week. Mostly I've managed my pain from the last tissue expansion in my chest with varying results. And Mark is out for a sec managing our taxes. So we're really exciting folks, as you can see. We did manage to schedule a consult with the Radiation Specialist I'll be seeing, Dr. W. That will take place next week. But I do have something yummy to share.

Although I am still gratefully accepting 3 meals a week from my wonderful book club friends (which have consisted of some very nutritious, delicious, and creative meals), I am periodically trying to peek into the kitchen to see what I can handle. Last week, that turned out to be the best Brussels Sprouts I've ever eaten. I usually munch brussels sprouts with more duty than joy, so this was remarkable.



1/2 lb. Brussels sprouts
6-8 oil-packed sun dried tomatoes
2 tbsp butter
salt, pepper, and nutmeg, to taste

Bring a medium pot of salted water to a boil. Trim Brussels sprouts ends and cut in half, lengthwise, discarding tough outer leaves. Add sprouts to boiling water and cook, 4 minutes. Dice sun dried tomatoes and add butter to a skillet over medium high heat. Drain sprouts and add to skillet, moving sprouts frequently. Add sun dried tomatoes when the sprouts begin to look golden. Continue to sautée, adding salt, pepper, and nutmeg to taste, until sprouts are just caramelized.

Onward

So, we've gotten Plastic Surgeon Dr. L in the loop about radiation, and he still wants to go ahead with my expansion that we scheduled for today. The procedure was a little uncomfortable last time, but I'm actually thrilled because this is the final expansion and will involve a little less fluid. It also makes sense to cross this off the list now since I don't even have a meeting to start the process of radiation scheduled and should have plenty of time to settle down and heal in between everything. And it always feels good to cross these big steps off the list. It really feels like progress. So just because I'm feeling brave, here's me, post-op, pre-expansion #1.



While I get ready for that visit, poor Mark is at the DMV trying to update his driver's license. We're planning a few much-needed fun days, including the kickoff of March Madness, so we'll have some happy posts to share soon. For now, take a look at some of the fabulous gifts and cards you've sent me. I love them all.

We Heart Dr. S

General surgeon Dr. S so generously made time for us Friday on a non-clinic day to talk about my sketchy surgical pathology results. To re-cap, the pathologist found DCIS up to the very edge of one of the outer pieces of tissue that was removed from my chest. Dr. S finally got together with him to talk a little more about that finding. Unfortunately it's still sketchy, but I still have a fantastic likelihood of getting rid of this and living to annoy Mark for a really long time.

The DCIS on the edge was small, a few millimeters and impossible to see. Also, my Plastic Surgeon Dr. L, took out some more skin after they sent off the pathology to make my chest close prettily, so it may have even be removed by him. We can't tell or otherwise find it though, because all the healing that's going on would obscure any tiny cancer in any kind of imaging we tried. So, Radiation seems our most likely next step. Dr. S thinks that may even be overkill, but we can't just sit around and let cancer get comfy on my chest again. Most people tolerate radiation treatments very well. But they can complicate reconstruction, so we have to talk to Dr. L before we go further with the reconstruction and radiation therapy.

It was wonderful seeing Dr. S's confidence and lack of apprehension about all of this, and that he's made himself so available to us is wonderful. We're so glad we picked him, he's just been fantastic. And really this is not bad news. It's still not chemotherapy. So I don't know why, but I'm just getting sick of all of this. I know I can still do it, but it's really not fun being the Patient and I'd love to be done. I think part of it is feeling so much better from surgery. I'm really anxious to get back to my life, and another delay is not greatly welcome. I yearn to be a healthy, boring person. But with Mark home again next week, we'll try to add some fun to all the medicine going on around here. I promise we'll share.

Present

Looks like my quiet week at home has translated to a pretty quiet blog. I'm sorry if that's left any of you feeling out of the loop. Yesterday I spent my first day at home alone, with no appointments, plans or visitors. It was great to not think about the clock and just be lazy. Plus, Mark got home quite early. When he called to say he was on his way, he asked if I could cue up the ipod so that we could have a little dance right when he walked in the door. It was perfect and something I think we'll be repeating.

Today my mom joined me again. I must be doing a lot of healing because I was sleeping like a rock when she called at 10. So groggy me and mom watched some Northanger Abbey and Pride and Prejudice. I was feeling so fantastic, pain med free, that I made the lunch. Well. I heated the soup that lovely L.E. brought us but I did make the grilled cheese sandwiches. Speaking of cheese, I was deciding what to put between those pieces of sourdough and I realized we have TEN different kinds of cheese in the fridge. Yeah. Oh! sorry, S.S. just brought over some smoked gouda, make that eleven. Don't ever let me tell you we're not living the good life.

Tomorrow we'll pop in on General Surgeon Dr. S and hope that he and the pathologist have had some productive conversations. It's been odd not thinking about cancer much this week. It's not really over yet, but it's not time to do anything. How do you just sit back and relax with your cancer? It's not welcome. Focusing on healing has been helpful. Watching my limitations since surgery fall away day by day have been uplifting and empowering. And thinking of the rest as preparation for the next step, whatever that is. I'm going to attack whatever I can, rip to shreds whatever needs killing, when I'm ready. Tonight, listen to the mockingbird and smell the pink jasmine. Tomorrow, fight for my life.

I Want WHAT???

Monday night I started to feel some swelling in my chest. I woke up on Tuesday and it was worse. I knew exactly what I wanted and needed. My plastic surgeon Dr. L and a big thick needle. Yes, things just keep getting stranger. A few months ago, I never would have contemplated plastic surgery. Now, I'm on a happy first name basis with everyone in the office and I actually want to be there and be poked with a giant needle.

The swelling was due to an accumulation of fluid; the same stuff that my drains were collecting before. When I had my first tissue expander session, Dr. L took about 100 mls of fluid off of my right breast before he did the expansion. That I needed to come back was normal - things are definitely slowing down, and should be helped by wearing tighter undergarments. Luckily, Dr. L. got me in at 1:15 on Tuesday and I felt better as soon as that extra 130 mls came off. Even better, poor Dr. L got to see a patient that wanted to be in his office. Every time I'd seen him so far was a completely new, bizarre, and sometimes upsetting experience. I always tried to be brave, but I think my nerves were wearing on his. I'm much happier to be on better terms with someone who is doing so much good for me.

I felt so fantastic afterwards that I went to lunch with my mom, stopped by the house, and then went back out with her to try and find the aforementioned undergarments. With success! I had a nice nap after our outing and my dad arrived for an old-fashioned family taco night. Mark worked late, but even still got to come home to a happy and comfortable wife. This morning I woke up stiff, but haven't needed anything more than Advil. Hooray Giant Needles.

It looks like the rest of this week will continue to be about recovery. We have a meeting with Dr. S the general surgeon to try to figure out the margin issue. But still no word from Oncologist Dr. S. on Tamoxifen, radiation, or anything else. Again, we have plenty of time to decide. The next inflation of my tissue expanders will be on Tuesday. I'll post before then.

Thank you all for your cards & comments, they always lift my spirits.

Quiet

Mark's gone back to work today for the first time since my surgery. It's so hard to believe that was two weeks ago already, but we're so thankful that his work team was so great about letting him be home with me. I think we'll have to take our adjusting slowly today, though.

It was so strange getting up in such a quiet home this morning. Mark had gathered all my regular morning stuff in concert with my limitations.
Milk for coffee and cereal poured out into a smaller container so that I can lift it.
Cereal bowl and cereal taken down from their high shelves so that I can reach them.
Laptop brought out into the living room so that I can type comfortably.
He even found my favorite barrette and made sure I'd see it.

And now what to do. Mom's just arrived with embroidery hoops, a book on making earrings, and mini binoculars, and there are a million thank-you notes to write. Maybe it won't be such a quiet day after all.

This is NOT Like Getting Braces Tightened

I spent a lot of last week trying to prepare myself for the next step in my breast reconstruction; the gradual inflation of the tissue expanders that are already in my chest. My actual skin is mostly numb and they use lidocaine at the injection site, so their assertion that I wouldn't really feel pain, just pressure and tightness, was pretty reasonable sounding. And because it's done in a series of quick visits, it made me think of getting my braces tightened once a month.
vs.

Now, this isn't the same kind of expander that I'm sporting and what makes it different is actually very cool. Instead of a port extending out to the skin, mine has a magnet that encircles the area designed to receive the injection of saline. In order to find this area, Dr. L whips out his glorified stud-finder and marks where the magnets line up. But that's pretty much where the fun ends. I got 100 mls. of fluid per breast on Thursday, all stretching out the area behind my pectoralis major. It didn't hurt going in, but it was very odd as the expander shifted and re-settled. By the time we were in the car I felt like I was walking around with a mammogram setup attached to me. That graduated to the feeling of bowling balls being sutured to my chest wall. Since then it's been quite painful on and off until today (cross fingers). My next appointment, the week after next, shouldn't hurt as much since I'll be getting less fluid. Also, that might do it for the expansion. Assuming I'm not undergoing some interfering cancer treatment, I could have my final implants in as soon as I'm healed.

We did hear from Oncologist Dr. S last night after he met with a group to talk about my treatment plan. Unfortunately, all of that is still up in the air. There just aren't very many women my age who have had what I have, so the published protocols are extremely lacking. He's going to speak with two more Oncologists who we all greatly admire and will hopefully aid in the decision-making. We also still do not have a hard answer on those margins that were not clear. The good thing is though, that we've made huge progress towards getting me cancer-free and none of these issues have to be resolved in a hurry.

Happy Spam

Four years ago tonight was our first date, which I actually didn't know was a date until about halfway through when Mark held my hand at the Waterfront.



Here's us on our first anniversary (AKA Spamalamaversary, AKA Spamalama, AKA Spam), taking in Stomp at the civic center. Tonight will be a landmark Spam in a different way. Me being on the road to health, the most important gift, will mean a much quieter night than some we've had. But I know that today, even though I can't really put it into words, I am so much more grateful and in awe of this relationship we've been given a chance at. It's seen us through some nasty stuff, has brought us days of bliss I couldn't have imagined, and it gets better every minute.

Enough With The Tinterhooks

I'm sorry I'm posting so late today - I know I told you to stay tuned for Wednesday news. Actually, Surgeon Dr. S surprised us yesterday with the pathology we were waiting for, but we wanted to go over everything with Oncologist Dr. S before we got too excited. That's right, excited.

The report showed that none of my lymph nodes were involved at all. Also, my left breast was absolutely clear. The cancer in my right breast was not one large tumor, but many small DCISs with normal tissue interspersed and spread over several different ducts. This fact makes it much more understandable that nobody was ever able to feel a mass. Also, none of these cancer sites showed any evidence of invasion into other areas. This, along with my clean PET scan, is all fantastic news.

There are still a few things to sort out, however. One is that there was a vague mention in the path report that one of the surgical margins wasn't clear. What that means is that there may have been cancer right up to the edge of where my breast tissue was removed. We need more information from the pathologist on this, but Surgeon Dr. S is confident that he removed all the breast tissue he could, and since the DCIS didn't invade into other types of tissue, he's not worried. Hopefully we'll clear this up soon.

The other issue is whether or not to follow up with a course of Tamoxifen, which is an orally delivered drug that's taken for 5 years. Tamoxifen works against cancers that react to the estrogen in your body, so it's not always a worthwhile treatment. But, pathologists don't test for this characteristic when there is no invasive cancer present. So on Friday, Oncologist Dr. S will present my case to a team of peers in order to try and tease this issue out. Tamoxifen is usually pretty well tolerated and it's definitely better than dealing with chemotherapy, but it causes some side-effects that I'm not happy to take on. Mainly, infertility and all the fun of menopause. Needless to say, I'll welcome all of the professional input that Dr. S can gather on that decision and I'm really happy he's taking that route.

Really, notwithstanding those two issues, we're happy kids who feel like we've dodged a big old bullet. And tomorrow we're back to work with reconstruction. I'll be having the tissue expanders in my chest filled with a little more saline to increase the space they're making. This will be the first of several of these procedures, so I'm curious about how it will go. Plastics Dr. L thinks we may be finished with the reconstruction sooner than he'd anticipated. Fine by me!

Adjustments

One of the crazy things about this slow life we're living right now is how quickly things change. Words like "fine," "normal," and "ok," mean completely different things than they did just weeks ago. Apparently "Potato Day" needs redefining too, because somehow I overdid it yesterday. This has happened once already and is bound to happen again, no matter how careful and gentle I am with myself. The day after surgery I was so happy to feel energized. I got a bit of a rush every time it was easier to get out of bed and there were several groups of people stopping by. Around 6 o'clock, though, I completely hit a wall. I couldn't get my pain under control and had no energy. I felt like I was backsliding. Already! Nooo!! And then I realized that I'd been awake and active since 5:30 a.m. Right. Maybe I could have taken a nap? Anyway, we blew the whistle at the Jessie factory for the day and I was back on track and improving, with breaks, the next day. I can't decide what I shouldn't have done yesterday but it was probably the combination of three things that did me in. Opening our sliding glass door to the balcony, carrying a folding chair out there with me, and getting dressed on my own, in non-pajamas. Oh well, I say, all of those things contributed to my high spirits yesterday and so what if I took a nap just hours after getting up this morning. What else do I have to do? In light of that, and because everyone who stops by says, "oh my gosh, you're up!" I thought it would be fun to compile a little list of things I can and cannot do.

Things I Can Do On My Own:
1. Get out of bed - I don't have abs of steel yet so this is a big success when it happens, which is most of the time now
2. Scratch my head
3. Carry things about as heavy as a pint of water & ice
4. Kiss people
5. Brush my teeth - thank you, SoniCare

Things I Cannot Do On My Own:
1. Move pillows and blankets around to my satisfaction
2. Scratch my back - in that one spot right between my shoulder blades where I'm so itchy
3. Carry things about as heavy as a laptop
4. Hug people - I hate this
5. Shampoo my hair - although Mark has promised to help me with this tonight and I'm very excited.

Tomorrow we're off to see the General Surgeon, Dr. S of the kindly mustache. He's just going to take a peek at me and make sure every thing's to his satisfaction, which I'm sure it will be. My skin looks great and there's hardly any bruising on me at all. Wednesday, we meet with my Oncologist, another Dr. S, to discuss final pathology reports on the tissue that was removed in surgery. Although it is fantastic news that the frozen section biopsy was negative for cancer in my lymph nodes, there are still a few answers we need to plan my future. Big prayers, please, that this information will indicate that no further treatment is necessary.

Potato Day

Mark's first day of his week off is always potato day. On potato day we don't do chores, we don't make appointments or big plans, we often don't leave the house 'till noon. We usually have a big breakfast, stay in or jammies until we can't stand it, and generally do a lot of giggling. Today is not the first day of anything, but it feels like my potato day. Everything's sort of settled in here. I had my first shower yesterday, so that milestone is over. The sun is out, I'm down to mostly Tylenol for pain control, and I'm keeping my thoughts light. I feel healthy.

Next week we'll get final pathology reports, so for the time being my only tasks are baby steps towards normal. I need a weekend off from the emotional homework. Last night my brother and littlest nephew came down and made me laugh just as much as I can handle. I even got the hiccups for a few mercifully brief minutes. Best of all, my nephew granted my secret wish by wearing his little league uniform. Tonight my parents and maybe our friend, P, will stop by for an early dinner. Comfort food, I'm sure, topped off with the butter cupcakes and chocolate fudge frosting that were left on our doorstep this morning my S & J.

Monday I'll get back into my fight and explain a little more about my recovery process. If there's anything in particular you're wondering about, go ahead and leave a question in the comments. Until then, have a peaceful Sunday.