14
Sep
08

September 14, 2008

Well, I’ve been negligent (yet again!) in keeping up on posting – between vacation, work, and medical-related appointments, I will claim lack of time as the culprit.

As I mentioned in the previous post, we had a lovely relaxing vacation down at the cabin, and arrived home late in the afternoon on Labor Day.

I jumped right back into the fray on Tuesday, when Brian and I met with the oncologist.  He told us that nobody really has a “normal” treatment plan for a recurrence like mine, basically because a recurrence like mine is anything but normal.  However, pending the results from pathology on the tumor, his plan would be to treat as follows: less than 0.5cm mass, no chemo; 0.5 – 1.0cm mass, we’d talk about whether chemo would be beneficial or not; greater than 1.0cm mass, definitely chemo.  As the words are leaving his lips, his assistant knocks, and passes the path report in.  The doctor looks at it, and says “Oh. 1.3cm.  That’s bigger than one of the original masses, isn’t it?”  The end result is that I will be having chemo; the only decision was whether or not I would do chemo or radiation first.  He knew I would be meeting with the surgeon later that week, and said that she would discuss the rest of the path report with me.

The next two days started very early, because I had dental appointments both mornings at 8 – I’m in the process of getting my braces into the “retainer” stage, with a little additional work on one of the front teeth.  I will be *so* glad when I’m done with them!

The meeting with the surgeon started out with her coming into the exam room, commenting that I had been “the hot topic of conversation at the breast conference” that morning – in case you’re wondering, that isn’t a good thing.  Basically, a lot of surgeons, oncologists, radiological oncologists, and related medical personnel get together and discuss each case they have.  The consensus was that this recurrence needs to be treated very aggressively, since it is very aggressive itself.  So I said, “So I will be having radiation *and* chemo, then, right?”  She said “Yes,” but then went on to ruin my day by telling me that because the margins were so narrow on the lumpectomy, that she wanted to go back in and take some more tissue.  The big problem was that she felt like that meant removing the implant because there wasn’t enough skin/muscle to take out enough otherwise.  While I was there, she called my plastic surgeon, who is in the same office complex, and he had her send me down so he could take a look.

He sounded much more hopeful that it could be done without removing the implant (which would actually be a remove/reinstall, using a somewhat smaller implant) – basically he gave me a 50% chance that it could be done that way.

So the end result was that we scheduled the surgery for the 12th with both of them there, with a couple smaller implants just in case.  I went into it not knowing how I would come out.  7:30 Friday morning came way too early, but the surgery schedule was on time, so they took me in right at 9:30.  I spoke to the surgeons and the anesthesiologist beforehand, and asked if they could start me out with the twilight sedation, since that’s all the surgeon would need if she was able to do the excision without removing the implant; with the caveat that if the implant did need removal, *then* I would be given the general.  Everyone agreed, and I was pleased to wake up in the operating room at 10:30 with the final dressing being applied to the incision – it gave me a bit of a start to see the plastic surgeon working on me, but it turned out that the surgeon asked him to deal with the closure because there was some concern about the blood supply in the area being interrupted from all the scar tissue, and she felt that he was more experienced with that kind of situation.

An hour in recovery, and a short ride home (via DQ for a Heath Bar Blizzard and some french fries!), and I spent the rest of the day relaxing in our backyard under the elm, lying in one of our new zero-gravity chaise lounges – what a lovely day, sunny, warm, and firmly C-cupped still ;-}

I’ve spent the weekend taking it easy, including a lot of naps (some short, some long), and doing some reading, a little bit of knitting, and a lot of talking on the phone.  I’m going back to work tomorrow, although I don’t know if I’ll be up for a full day or not.  There’s not a good place to lie down at work if I need to, although I could try lying under my table – I should take one of our camping air-mattresses in…

I’ll meet with the surgeon again on Thursday, and expect to find out then if there was any additional cancer found in the excised tissue; and what the next step is.  If they did find any cancer, I don’t know what will happen next – otherwise, it is going to be radiation starting in two or three weeks; that usually runs 5-1/2 or 6 weeks; then I’ll have chemo for somewhere between 4 and 8 sessions.  The radiation is first because all the doctors are sure it hasn’t spread, but it was very aggressive locally; thus they want to do the local attack first.

Anyway, even after the 3-1/2 hour nap I took this afternoon, I’m ready for bed already.  I’ll post the results from the surgeon’s meeting later this week.

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