Saturday, January 31, 2009

The lump is invasive ductal cancer, the most common kind of breast cancer. The sentinal lymph node - the first one connected to the lump - was also cancerous, so he went forward with an axillary lymph node dissection. He made an incision over two inches long in my armpit, removes the wad of fat that is in the hollow of the pit which contains many of the lymph nodes. Lymph nodes are glands, small and embedded in that fat. Usually there are 10-15 nodes in it. The pathologist will find as many as he can in that tissue and test them. He also will do a thorough examination of the entire lump to assess the details of the cancer, and test for the clean margins. The surgeon attempted to take the lump out with a margin of healthy tissue surrounding it - if it tests as having clean margins, he's gotten out all the cancer. It's not uncommon to need to go in and re-excise where the lump was to get the clean margins. So he may have to do that. The good news is he won't have to back for the lymph nodes, those are gone and don't grow back.

I'm not going to lie, it hurts. There's a tube coming out of a hole in my pit, it's a drain that drains fluid buildup. I empty it regularly and measure the out put. When the output get's low enough I can have the thing removed - that will be a very good thing. The lumpectomy incision is 2 1/2 inches or so long and it's sore as well. I'm taking pain pills & using bags of frozen peas for ice packs. So two long cuts with stitches, and a hole with a drain in it.

I am very grateful it's my left side, as I am very right handed. Right now my left arm is pretty worthless. My wonderful hubby is waiting on me hand and foot, which I have a hard time with but I'm learning to just surrender to. It is what it is!

I am very thankful that my mother and father in-law were there yesterday waiting with him, it was a big relief for me to know they were there.

My brother and sister in-law came to the clinic, then returned to the house with us last night. I am so grateful for that. What a relief to be with them again. When my brother left last night he said "just let me know if you need anything - blood, kidney or whatever". He and I have always said to each other "you can have anything I have two of or anything I can live without". I am grateful for them.

My doctor..............not digging him much at all. First lesson I learned is - don't be the last surgery of the day. Stephen said the surgery took 3 hours I think? Before I was completely coherant, the surgeon was long gone. I was left with a nurse who was a complete idiot - that was a touch scary. Husband was going to record the doctor when he came out after surgery to explain what he had done, what he'd found. Before my surgery we told him we were going to do that. I reminded the doctor I was very Type A, I wanted details. He marched out, just said the basic's, too quick for it to be recorded. Then he left the building. Nurses didn't know squat. Stephen said he thought they'd removed 2 or 3 lymph nodes. Nurse said she thought my chart said 1 or 2 lymph nodes. I knew the sentinal node was positive for cancer, so I was freaked out that he might not have followed thru with the total axillary node disection, because I knew that HAD to be done, so was I going to have to go thru the pain of another axillary surgery in the near future?? I finally talked to the doctor about 9:30pm last night, he confirmed he had done what I knew had to be done, he removed the "level 1 and 2 lymph nodes". Full dissection. It sucks that no one could tell me that, because last night the arm pit surgical site and the drain were VERY painful, I went 3 hours not knowing what had been done. I was thinking - if it hurts this bad and he only took out a couple of nodes, what the hell is it going to be like when he does the whole thing?? Sucky situation, made my husband feel bad which pisses me off even more!

I'm in the market for an oncologist now. Dr. Surgeon said there are 4 at Baylor that do breast oncology and "they are all very good". I'm thinking it's 2nd opinion time. The treatment is going to go on for quite some time - I need to make sure I'm getting the best care of course, but I also need to be happy and comfortable with my docs - so far not so good. So my future will prolly look like this:

By Tuesday afternoon next week we should have full pathology. How many lymph nodes are involved? Did we get clean margins? And there are a lot of typing they do now, regarding hormones, size, etc. By then I'll have the "numbers" on it, Like stage whatever.

I would assume there's going to be some body scan's to look for spreading.

If my margins were'nt clean, there'll be a re-excision to get them. These days, in most circumstances, they get the exact same survival and reoccurance rates with a lumpectomy and treatment, or mastectomy and treatment. Some women automatically want the mastectomy - they just want the breast tissue to be all gone. I've already told my doctor that if my chances are exactly the same, I'll stick with the lumpectomy. If for some reason it's determined that my chances would increase with mastectomy - I'll have it.

Chemo - here's where I need the oncologist. They are very precise these days in making a chemo cocktail, customizing it for your tumor type. My neighbor said she avoided the worst of the chemo drugs because of some typing of her tumor. It's meant she has had no nausea, she get's tired and she's lost her hair - but none of the violent nausea we all think of when we hear chemo. They decide what recipe and how many rounds of it. My neighbor is having 4, she goes and sits for a day while she gets it, no spending the night. I think there's 3 or 4 weeks between her treatments.

Radiation - you usually end treatment with radiation. It's painless, it's administered quickly. There are a couple of ways to do it - anywhere from a couple of weeks, to 5 days a week for 6 weeks. The area may look a bit sunburned during the treatment, over the course of the treatment you may get fatigued - but that's it. No nausea or tremendous pain from radiation.

After all the treatment, they run a few tests on you, put you on a preventative medication of some type like Tamoxifen - usually for 5 years - then that's that. Bottom line is, they usually cure it these days. One in 7 women will get breast cancer in thier lifetimes- which is astounding! GET THOSE MAMMOGRAMS LADIES! Immediatly! If you have a mammo and they say there's a spot they want to "watch over time" make sure that time is 3 or 6 months - not a full year.

SEND ME YOUR RECOMMENDATIONS for breast docs - surgeon & oncologist. After I have all my pathology next week, I'm going to make the rounds and find a good fit for myself. My neighbor is very happy with her team - at UT Southwestern - so I'll be headed to meet them, I'm sure.

And feel free to email me anytime, about anything. No question is off limits, you won't "bother me". I want to give info out freely, so that anyone that cares about me worries the least amount possible. I'm a fighter, you all know that - I have no intention of letting this take me down.

No comments:

Post a Comment