Lumpectomy

My bad…I just realized this post was still a draft and never went live. Whoops! Insert this around January 24, mmmkay? Thanks!

Howdy! Everything went great yesterday, but it was a long day and I was pretty loopy last night.

Here’s the rundown:

Arrived at hospital around 9:00am. Let’s face it, it was downtown at the tail end of rush hour, I wasn’t getting there at 9:00 on the dot. I had to hit snooze for the appropriate amount of time, shower, pick up my prescriptions…you know the drill.

After admitting, I went to the waiting room and went to my pre-op room pretty quickly. Did the whole vitals and IV thing.

Then I went to nuclear medicine for the contrast dye injection, which highlighted the lymph nodes the cancer could spread to, the ones associated with the ducts. That was easy and painless. This time while in nuclear medicine, I was singing “Radioactive” by Imagine Dragons in my head.

From there I went down to the Breast Center for the wire locator. The wire locator was literally a wire (two actually since I had an area of calcification that Dr B wanted to go ahead and take care of as well) inserted into my boob via needles. They were sticking out the side after insertion, it was quite weird. They were super thin and bendy though, sort of like a stiff fishing line, if that makes sense. This process stung a little bit, but it still didn’t hurt exactly. And for both this and the dye injection, I had a local anesthetic – Lidocaine. Oh, and this was mammogram guided, so I had another mammogram! Yay…

After that, I returned to my pre-op room. I took a while downstairs, spent a few minutes here and there waiting, so once I got upstairs I had people waiting on me for the next stuff.

Dr H (plastic surgeon) was there, and he marked me up for the reconstructive stuff. In addition to the nipple preservation (which is the reason I am having a lumpectomy and then a mastectomy in two separate procedures, for anyone who was wondering and hasn’t asked or who I didn’t have an answer for at the time), he shifted things around on the right side (reconstruction) and did a reduction on the left to match the right.

Then came the anesthesiologist. My favorite people. I just think the whole concept of general anesthesia is so cool. They’re like magicians…now you see me, now you don’t! Anyway, I got a nerve block for this procedure. He said it’s something they do with major breast surgeries that works a little bit better than general anesthesia alone. So he gave me a little bit of a sedative, Brad said his goodbyes, and they inserted the lines for the nerve block, one on each side of my back/spine. I had to sit up and sort of lean forward with my head on the table how you would for a seated massage. Also painless.

Then Dr JB came in and talked to me for a few minutes about the lumpectomy. Then I was rolled down to the OR, I moved from the stretcher to the operating table, I remember saying something about not having been awake in the operating room before, then it was lights out.

So I woke up groggy and my mouth and throat were super dry. I felt a little nausea, but that could have been due to the dryness from having the breathing tube. They did give me a good dosage of nausea meds through my IV (and morphine) before they removed it, just in case. I felt the meds coming in the IV, it was weird but didn’t hurt. I drank some cranberry juice and felt pretty good after a few minutes. I still have the nerve block, though not as high a dosage. I’ve got these two pouches that each have a bocci ball side rubber belly thing with meds. They give a slow drip of meds to the nerve block to keep things numb and keep me comfy. I increased the right side last night before bed since that side stings a bit. I got my discharge instruction, then I got dressed, and we were discharged. This was around 5:45 I think.

Traffic was a mess going home. Rush hour from downtown, up 61 through West Ashley is never fun. But we eventually made it to my parents’ house where we spent the night so I’d have adult supervision today to ease Brad’s nerves.

I hadn’t eaten since dinner time the night before, so I had half a Publix sub when I got to the ‘rents. I wasn’t sure I’d be able to eat (ha-ha), but I needed to get something inside so I could take the pain medicine. I took baby bites and was able to eat the sandwich over about an hour. I did take some Zofran, just in case, but no nausea.

I slept in the recliner last night because I figured it was the easiest way to stay on my back. Even if I fall asleep on my back, sometimes I end up on my side. Aside from Daisy waking me up to pee at 4:15, I slept well.

Woke up feeling some sting on the right side still, and took another pain pill with breakfast. Hopefully that’ll knock that out.

Overall I feel great. I wasn’t sure what to expect as far as pain goes, and I’m sure the nerve block has something to do with it, but I feel good and that makes me happy. I’m having no trouble with movement, aside from a little soreness in my right underarm area, but I feel like I’ll be back to being (semi-) independence soon! I can’t lift anything for 4 weeks (ugh), but everything else should be good to go in no time.

I’m just finishing breakfast and the pain pill, Nucynta, should be kicking in soon, so I’m going to hit the recliner again!

Adios!

Post-Op

I had my first post-op appointment with Dr JB and Dr H today. It went pretty well. They’re happy I have been comfortable and taking minimal pains medication, and everything looks good as far as the incision sites.

Unfortunately the margins weren’t perfect and there’s still a little bit of cancer left, like two or three cells. It’s nothing terrible and nothing should have to change as far as treatment goes. It means I will definitely have to have a mastectomy on the right side, but since I was planning on doing a bilateral mastectomy anyway, that doesn’t affect anything. Dr JB said that since I still have several cycles of Herceptin left, I should be fine as far as the oncology side goes, meaning I shouldn’t need to have more chemo. But I have an appointment with Dr YB this afternoon so I’ll talk to him more about that.

My lymph nodes came back clear, yay, so no radiation! That makes me super happy.

So I’ll update more later if Dr YB says something different regarding treatment, but for now everything still looks good and we’re on target for the mastectomy and reconstruction surgery in about three months.

😁👍🏻

Surgery

I’ve decided what I want to do in terms of surgery, and I’m opting for the bilateral mastectomy.

Unfortunately, nothing will eliminate the risk of recurrence, or new cancer, so I’m going with what reduces the risks the most.

This is a two part thing.

First is the lumpectomy, which is scheduled for Tuesday, January 23rd. During the lumpectomy, whatever is left of the lump (not much according to ultrasounds and feeling around) will be removed and any of the lymph nodes connected to the breast (I forget the technical terms, but it’s the ones that connect to the ducts) will also be removed. So at some point before the surgery, they inject a dye to see which nodes “light up” and remove those. Dr. JB will do the lumpectomy. The same day, while I’m still knocked out, Dr. H will also do some cosmetic work to preserve my nipples in preparation for the reconstruction, as well as balance things out so I’m not uneven and lumpy for the next several months.

Part two of the process is the actual mastectomy and reconstruction. Dr. JB will do the mastectomy, and Dr. H will do the reconstruction. The reconstruction will use belly fat, and I described all that in a previous post so I won’t go through it all again. But this will take place three months after the lumpectomy, per insurance guidelines…so some time in May.

The recovery for the lumpectomy is about two weeks, give or take. There will be drains (yay, vomit) for some of that time. So I’m pretty much out of commission as far as filling in shifts for work and anything else physical for the rest of February.

I’m hoping for smooth sailing! I’m totally over all the yucky parts of this disease, so I don’t particularly care to deal with any more of it!

In other news, my former supervisor at my last admin job, K, is sending us some meals over so we don’t have to worry about food for a little while following the surgery. It’ll be nice to have one less thing to think about and have to do! People have been amazing and supportive, and we appreciate it so much.

Good news!!

Sorry for the radio silence over the last week or so. I haven’t had anything new to report since the bronchitis. I’ve just been laying low, getting well, and enjoying my good days.

I had my ultrasound with Dr. JB today, as well as my consult with the plastic surgeon, Dr. H.

First we did the surgical consult and talked about the lumpectomy, mastectomy and reconstruction stuff. Now remember, I’m not a medical professional and may not use the correct terminology here, but hopefully you’ll get the gist of it.

The lumpectomy would take place about 2-3 weeks after my last chemo treatment (Jan 8). Recovery would be about a week, I believe it’s an outpatient procedure.

About 3 months after that is when the mastectomy and reconstruction would take place. This would involve about a 5 day hospital stay and about 6 weeks of recovery. As I mentioned in a previous post, they can use belly fat (which would be my choice over artificial implants), which would essentially add a tummy-tuck to the procedure. Using belly fat eliminates the need to return to the plastic surgeon in a few years to have the implants/spacers replaced. Dr. H talked about what he’d do, and that includes transplanting arteries to keep the fat tissue alive when they move it to the breast. They also transplant a piece of skin attached to the fat, sort of a lemon shape, that will stay on the outside of the breast and be monitored to make sure the tissue stays alive. I guess if that skin dies, it’s an indication that the tissue has died as well. After a certain amount of time (I don’t remember what he said), they’ll remove that skin from the outside. Please see my horrible drawing below, which is sort of like Dr. H’s drawing at the appointment today. That’s what it would look like when the skin is there, after they remove the skin, it would just be a line-like scar in that same place.

So, the options are still just the lumpectomy, lumpectomy and a single mastectomy, or lumpectomy and a double mastectomy. The lumpectomy alone leaves me with the highest risk of new cancer in either breast, and recurrence of the existing cancer in the right breast. Single mastectomy reduces the risk of new cancer in that breast, but doesn’t eliminate it, and does nothing to reduce the risk in the other breast. Double mastectomy reduces the risk of new cancer in both breasts significantly, but also doesn’t eliminate it entirely.

So, regardless of what I choose to do, there’s still going to be risk. It’s likely I will face this again in the future, but we’re talking many many years into the future when it’s possible there’s some new and (hopefully) less evasive treatment.

So after the surgery talk was over, we did the ultrasound.

And…drumroll please…

There was nothing there!! The cancer is gone!

Yes, we can still feel JP, but he’s not showing up on the ultrasound, which means he’s blending with the other we can also feel that he’s much smaller than he was in the beginning. He was very apparent on the first ultrasound, so this is great news!

I still have three rounds of chemo left, the next one being Monday after my little break for Thanksgiving. Why more chemo if the cancer is gone? Because it will grow back. So before they do the lumpectomy, they want to shrink everything as much as they can so they can get the best margins.

Lots of information today, lots for me to think about. But today we’re celebrating that I kicked cancer’s ass. 😉

Echo and Ultrasound Update 

I had another echocardiogram and ultrasound yesterday. It was my six week follow up for each.

Echo was good. Heart was squeezing just fine and there was no extra fluid. The tech was great, as usual, and they had a new bed in there. It was comfy. Process was the same as the last. My blood pressure was randomly low, but it seemed to be a fluke. 

Ultrasound was great! JP was barely detectable, and that’s just after two treatments! 

I met with Dr JB’s Physician’s Assistant (PA), M. We talked a little about surgery options. I will still need to have some kind of surgery after the chemo is complete because, while the mass may shrink to nothingness, some tissue will still be left and it can grow back. So, at the very least, they need to remove the remnants through a lumpectomy.

If I have a lumpectomy, it’s still highly likely that the cancer will return, so I’ll need to be monitored through frequent mammograms and MRIs…pretty much forever. 

Another option is mastectomy, which is the full removal of the breast tissue, single or double. With single, the other side will still have to be watched. Double, the chances of recurrence are drastically reduced. Also, with mastectomy comes reconstruction, which can/would be done at the same time, and can be done using belly fat rather than implant materials. 

There would also be some node removal, somewhere in there. I’ll have more info on that at my next appointment in November, when I meet with Dr JB and the plastic surgeon for a consult. 

Some of this will depend on what the genetic testing says, too, so I’m not in a hurry to make a decision. I need more facts. But honestly, I’m leaning towards whatever will significantly reduce my future cancer risk, because I would love to not have to go through chemo again. That would be great! That’s sort of my guiding light at this point.

Anyway, I’m still hanging out in bed. I’ve been up for a while, reducing my phone battery to 55% from all the playing I’ve been doing for the last few hours. I feel good, it’s been a great week! Of course I’ve still had some moderate diarrhea, but at least it wasn’t like the lava of last week (thank you, liquid Pepto!). 

My new favorite gif, by the way…

If you haven’t seen bridesmaids, it’s worth it for Melissa McCarthy. 

Anyway, I’m just getting myself hyped up to clean and make some sliders for the football game today. 

Go Cocks!

Have an awesome weekend!

Hello darkness my old friend…

Let me start by saying I’m using that lyric in reference to the original song, not the remake. Mmmkay?

So yeah, it’s that part of the cycle again.

I feel cruddy. My body is sore, my throat is a little sore and tight, my head hurts, I’m tired, etc. Waa waa waa. I don’t want to read or write, so I’m just laying in my bed and occasionally listening to books on tape. I’m bored, but don’t really have enough strength or brain power to do anything productive, which sucks because there’s a lot I could be doing for school and around the house. I finally reconciled my bank account yesterday after about a week, that was fun. I hate falling behind.

I’m hungry, and so far I’ve been able to eat. I get nauseated, but that’s what the Zofran is for. I learned what I could tolerate last cycle, so we stocked up this time. I had Campbell’s chicken and dumpling soup yesterday, the kind in the plastic microwaveable bowl, and it was wonderful. Today I had oatmeal, this time the fruit and cream variety, not the plain cardboard type. It was good. Then I had macaroni and cheese for lunch – a Kraft microwaveable bowl. Not all the healthiest of selections, I know, but I’m managing with what I can. I had a sandwich yesterday with meat, veggies and avocados, so my system seems to be allowing some variety, I just don’t always have the umf to make it fresh. I can also tolerate water better this time around, more so than the Crystal Light that was my saving grace last time. It’s so weird how things flip and flop like that.

Things that are particularly annoying: sounds. Phone ringing, door bell, text tones, dog barking, etc. It’s making me quite irritable, which I’m sure is just pleasant given all my charming characteristics as of late.

Brad has been a real trooper. He’s always been super tolerant of me, but he should get an award after this, even though he’d deny deserving it. “Can you get me this?” “Never mind, not this, that.” “I realize you worked all week and weekend, but I want popsicles.” “I left my puzzle book in the other room.” “Has Daisy been outside?” “I want a popsicle, but a good flavor.” His personal assistant job description does include criteria about mind reading, FYI. And he does it all without whining about it AND giving me compliments, which I’m not so sure I’d manage if the roles were reversed. I’m tired from doing nothing, so I’m sure he’s exhausted.

So kudos to the cancer spouses, caregivers, parents, children, siblings, etc. Your job is hard, too. Really hard.

What else is new? Well, the diarrhea is back. That started around 1:00am last night and continued every couple hours throughout the night. It stopped around 11:00am, I think. Then happened once again since, but it at least seems to have slowed down. I’m taking in fluids and took Pepto, so hopefully we’re on the upside of that, though after last cycle it’s anybody’s guess. I’m doing my best to stay horizontal and not jostle anything.

I mentioned nausea…that’s been pretty persistent, and I wonder if it’s because I’m eating more and trying to be a little more active? The medicine helps, so I can’t complain, but it’s definitely more present this cycle than last.

My tastes haven’t completely become shot just yet, and I’ve been able to taste what I eat, but I do have that horrible taste in my mouth. Yuck. I need some peppermints, the red and white ones, you know? Those seem to help. (*cough*Brad*cough*) The blue and green ones are too close to mouthwash right now, and my gag reflex is ready!

Daisy has had enough of my boring self. She keeps looking at me and sighing these big huffy sighs. Like, “Come on, ma. Get up. Watch me roll on the floor. Watch me chew my foot. Watch me scratch.” She’s just not used to me being home and doesn’t know what to do with herself, or me.

Whoa is her.

But anyway, I’m on the flip side! I should be feeling pretty good by the weekend, so I’m looking forward.

Tomorrow I have labs, so we’ll see how I’m doing, and maybe if I’m feeling like garbage I’ll get some fluids while I’m there. Next Friday, the 27th, I have my six week echocardiogram to see how my heart is doing with all the poison. Then, after that, I’ll have an ultrasound of JP to see what’s happening there.

I think I’m going to crawl out of bed and get a popsicle. 🙃

Second Chemo Cycle

So this was a tad bit different than the first. Of course, I had the port, so it was easy access. It was much cooler having everything go through my chest than my arm, I could flail all I wanted and no tubes were disrupted…not that I flailed. Who me??

Started with vitals and blood. Everything was good. Everything is doing its job. Score! I talked with the doc and he was pleased with everything. Asked me about the mass, and I admitted it was less apparent than it had been in the beginning. He said, “Yeah! And that’s only after one round.”

So yeah, JP is less apparent. He’s still there. But he’s not as firm and close to the surface as he was, at least he doesn’t feel that way. It’s so hard to tell through all the fluffy tissue, but there’s absolutely a change.

Also, there was a lady there getting chemo today. She was across the room so we didn’t chat, but I overheard her saying that this was her last round, and on her last ultrasound the doctor couldn’t even find the mass! I don’t know what type of cancer she has (or had?!), but how awesome is that? That’s exactly what I want to happen. It would be an epically awesome Christmas present. My next ultrasound is scheduled for October 27th, the same day as my next echocardiogram. Then my next chemo cycle will be that following Monday. 

Back to today. I was there from about 8:30 until 2:00. It was much shorter since there wasn’t a loading dose and they shorten the administration of some of the drugs since I showed tolerance to them the last time. Maybe tolerance isn’t the right word, maybe it’s durability? Ha! I don’t know, but basically I didn’t have any reactions or immediate side effects, so instead of administering the dose over an hour, they did thirty minutes or forty-five. That was nice!

This was post-Benadryl, so I was pretty loopy, but remembered I needed a pic!

To access the port, they clean the area with alcohol, then there’s a little scrub brush with some cleaner, it kind of looks like one or those sponges on the end of a tube that you fill with soap to clean inside glasses? Anyway, they do that. Now, approximately thirty minutes before my appointment, I put some lidocaine cream on the site to numb it a little bit. Yeah…I still felt the initial prick. I mean, it’s a needle going through some decently thick skin, into the port. It stung a teensy bit. I have a decent pain tolerance though, I think it comes from having a nurse mother who wouldn’t cut us any slack unless we were severely bleeding or broken, like, say…we swing into a table and break our collar bone, fall off a ladder, slam a finger shutting a window, or slice the tip of a finger off in a meat slicer. Not that any of those things have ever happened before, they’re just very specific examples. *ahem* Growing up, just about everything could be treated with ice, bacitracin, or gargling salt water. However, if I watch the insertion of a needle into my skin, it’s probably game over. I’ll probably face plant. Same with a tube filling with my blood. Yep, I’d rather not!! 

So all in all, that part was pretty easy. I thought I’d feel differently during the chemo since the port goes to my jugular, which goes directly to my heart, but nada. I might have felt tired from the Benadryl quicker, like almost instantly, but that’s about it. Oh, and the metallic taste from the saline flush, that was pretty instant, too. But nothing adverse, nothing strong. 

I was solo today. My dad dropped me off in the AM and both ‘rents picked me up in the afternoon because Brad had to work. My sister-in-law, Michele, brought me lunch! She was seriously the hero of the day…because food…and my dad did give me a mini bag of Chips Ahoy and peanut M&Ms. I ate the cookies for a morning snack. Yummy. I occupied myself well and the time seriously flew by! I read for a little bit, a fun book by R.S. Grey, The Foxe and the Hound. I did some crossword puzzles, and decided I need more puzzle books! Chemo really effs with your head, so I’ve read that games and stuff that engage your mind and keep you thinking are good for you. I play the heck out of Sporcle trivia on my phone, too. I tried to write a little, but by the time I started, I had about twenty minutes before the Benadryl drip started and it was pretty much game over for my attention span. So I shut down my computer, and resumed my crossword puzzles. It doesn’t sound like a lot, but it was enough to occupy me from beginning to end! I probably spaced out a bit, too. Not gonna lie. Ha.


So here’s an interesting side effect/reaction I had. It goes to show just how toxic the chemo can be. It popped up right before my port surgery last week. If you remember from an earlier image, a little to the upper right of the scab on my arm in that image is where my first chemo went in. That stuff is rough on veins, kind of makes more sense why they want to use stronger veins to administer it. So the reaction doesn’t hurt and there’s no numbness or bad feelings.  It itched a little, but I’m not sure if it actually itched or if I was psychosomatically inclined to itch it because it was there. I don’t even know if that makes sense on paper, but it does in my head. And the scab was a little blister. So they checked it today and it’ll heal and fade, and I obviously shouldn’t use that vein for anything in the meantime to give it time to recover. 

And because I couldn’t not share this pic. Why is my dog so weird? It’s like she can’t gather the strength to hold her head up, so she’s resting on her nose. Either that or something smells really good inside the couch. Somehow, I think it’s the former and not the latter. 

So that was my day! Missed two sessions today, and fortunately class was canceled so I didn’t have to miss that, too. But I’ll be working tomorrow, and I’ll do my Neulasta shot at 3:30, missing only one session.

Oh! And if anyone knows of any good, reputable, work from home gigs that are on the freelance side, let me know! Due to treatment and getting sick, I am missing some work (I’m an independent contractor all around, no work = no money!), so I’d love to pick something up to try to make up some of the difference in income, but I’d need to have some flexibility. I have signed up with UpWork, just haven’t checked in routinely enough to snag any good gigs, but I will. 

Until next time! Maybe I’ll show off my wigs and more hats. 😉😘

Flashback: The Specialist, Another Ultrasound, and The Biopsy

Caution: Image at bottom of post. Kind of gnarly looking. No nudity, I have some modesty. (Not much left though!)

Ouch.

But let me back up.

“Concerning” is the term that was used to describe the images from the mammogram and ultrasound when I went to see my original doctor after the mammogram. I was immediately referred out to a specialist, a breast surgeon, who my doc/NP (Nurse J, I will call her going forward) highly recommended. I was able to be seen right away, which was amazing in and of itself considering it was a Friday and it’s damn near impossible to do anything on a Friday around Charleston.

Dr. JB (not to be confused with JP) is as fantastic as I was made to believe, and for that I am so incredibly grateful, and her office staff is wonderful. She’s so positive and she makes me feel positive, too, even though I am still not sure I truly know how I’m supposed to feel about all this.

So she did an ultrasound, and for the first time, I met JP. Stupid little black shadow that he is. He is sort of shaped like a boomerang, though not as slim, more like an elongated kidney shape? Maybe? I don’t freaking know. He’s there, let’s leave it at that.

Next up…biopsy…it seriously all happened that quickly. I was numbed up and biopsied. It only hurt a little bit, that’s the honest truth…a pinch when they injected the numbing agent…it was more the vibrations of what I knew was going on that was unnerving. Also some loud little snaps as they snatched up pieces of JP — I assume that’s what the snapping sound was. I didn’t ask. I was trying not to freak out at the needle in my boob.

So the biopsy was complete and I left Dr. JB’s with a slightly bleeding boob and lots of words of encouragement. She’s a wonderful person. She said all the right things and really didn’t give me the opportunity to feel discouraged. She told me I was going to get through this, that there was lots of support out there for me, and everything would be all right.

I believed her, still do. It’s hard not to.

 

 

 

FullSizeRender
This is a couple days after the biopsy. Lots of bruising and tenderness. You can see the small slash from where they went in.

Flashback: The Lump, a.k.a. Jean-Paul, a.k.a. JP

During a (not-at-all-routine) self-examination, I found a lump. This was in July. It felt about the size of a pin ball, was hard, seemed round, definitely out of place in the otherwise soft tissue. I went to the internet, as I often do when I want to learn more, and searched for breast lumps. I found a list of possibilities: cancer, cysts, etc. I read that sometimes lumps came and went with your cycle, and I was approaching mine, so I decided to wait and see if it went away after my period.

No such luck, so I called my doctor.

I had to wait a little bit for an appointment, mostly because I didn’t want to take off work and I had a day off coming up. I worried about the stupid lump a little bit here and there. I knew it was possible it was bad news, but I was damn proud I’d found it.

So I went to the doctor (I see a nurse practitioner at the practice who is wonderful, Nurse J) and she did the exam and said, “Yep, that’s definitely something.” She referred me for a mammogram and ultrasound, which I schedule for the following Friday, and that was that.

Insert me feeling pretty bummed right about here. I guess I had naively thought that she’d feel it and have something more definitive to say. Totally unrealistic, I know. She’s not Superman, she doesn’t have x-ray vision – though I’d argue that Nurse J is some kind of superhero.

At this point, only two people knew about JP: my husband, Brad (who even left work to be with me at this appointment that I was in and out of before he even arrived at the practice) and my boss (I felt I needed to tell her just in case it was bad news and I needed to go off the grid), but that’s it, because why worry people over something that could be nothing? So Brad is still worried and I’m still all chill about it because I still don’t feel like I have enough of a reason to be anxious.

Meanwhile, I haven’t stopped feeling myself up since I found the lump to see if it has shrunk, changed shape, etc. Which of course I couldn’t tell. The only thing I managed to do was irritate JP and make him sore. Not like a steady pain or anything, just a tenderness when touched. So don’t touch it, right? Wrong? When you have a lump, you’re going to touch it. Over and over and over again…to make sure it’s real, see if it’s magically disappeared, moved, etc.

So next up on the agenda was the mammogram (I can’t even with this scan…it deserves its own post), ultrasound, and possibly a biopsy, which I’ll cover in another flashback post.