I know you’ve been consumed with wanting to know if I had a glass of wine on Thanksgiving. I’m sorry for taking so long to follow up. I hope you haven’t been neglecting important duties in the meantime.
Without further ado, dear Reader, the answer is no. No, I did not.
Cancer gave me all the side effects on Thanksgiving day, including a temperature. As I sat in my chair, wrapped in warm, snuggly blankets trying to calm down my chills, I knew the Pinot Grigio in the fridge would have to wait another day.
Two days later, in fact. Upon which I promptly spit it out. That’s the problem with white wine; it goes bad faster. It just wasn’t in the stars this time.
The worst side effect this week has been the worst stomach ache I’ve experienced. I’ve had it since the start of chemo, but the last two times have been markedly longer. The best way to describe it is Intense, sharp waves of pain. I did get some over the counter suggestions from the doctor’s office today, so I’ll start implementing more pills to my already large daily stash.
Today was a long awaited appointment with my surgeon, Dr. McAuliffe. Like last time, she did an excellent job of explaining things verbally, visually, and by writing them out. She also can no longer feel my tumor! The report from my last scans said that the overall size of the mass was initially 3.5 x 1.5 cm. It has shrunk to 1.3 x 0.8 cm.
She confirmed that breast conservation (vs. mastectomy) is the way to go. There is no change in risk between the two. This method always requires radiation, and with mastectomy, only sometimes.
But why not go with a same day surgery that preserves the breast as opposed to a mastectomy, which has a much more involved recovery, etc?
Dr. McAuliffe said breast conservation (BC) is a great option for me, especially given the genetic results. She said it’s possible the tumor will disappear completely with further chemo. Even if it does, she still needs to go in surgically to sample where it was.
Prior to surgery, I’ll go to radiology and get a marker called a seed. I already have a clip from the biopsy. The seed is also a piece of metal with radioactive iodine that will signal to her so she can find where the tumor was. She will remove any cancer cells and a rim of healthy cells (margin). If no tumor at that point, then it’s all margin. When she removes the tissue, it is x-rayed, and if clean margins, the surgery is done. The removed tissue will be examined more closely after surgery to confirm clean margins. Sometimes, cells extend to the edge of the removed tissue. This requires going back in at another date, called a re-excision. There is a 10% chance that will be needed.
Usually there’s one cut on the breast and one cut under the arm, where she may have to remove lymph nodes. I have always had normal imaging of my underarm lymph nodes, but there’s still a chance there’s cancer there as it’s usually the first place cancer spreads.
During surgery, Dr. McAuliffe will inject a dye, which will go to the sentinel lymph node, and maybe others. She said most people have two nodes that light up (but can have as many as 10). Lighting up with dye means they are upstream from the cancer area and they need to be checked (removed for biopsy). They don’t want to remove more than they need to because of long term side effects
(Like lymphedema, a 5% risk).
Even though it’s outpatient surgery, I’ll need general anesthesia (which I don’t react well to). She explained there’s lots of stuff in the area of the underarm (nerves, vessels, etc) and it can be dangerous if I move, hence the need to knock me out.
So the anesthesia and the restrictions after surgery will be the hardest part, not the surgery itself. Get this – I can’t do any lifting or reaching with my right hand for two weeks after surgery. This includes no repetition, even small movements. Think the mouse and typing – on my keyboard, and phone… Speech recognition may not be an alternative option for me because it always has trouble with my deaf accent.
When will all this be taking place? First I have to finish chemo, and if it gets delayed in any way, I’m to call her office. A week after my last chemo, I have another mammogram and breast ultrasound. A week after, I meet with Dr. McAuliffe again. Four to five weeks after the last chemo will be my surgery, tentatively scheduled for March 28th.
Radiation will begin a month after surgery. Typically it’s daily for 3-6 weeks, but they won’t know my timeline until they get more information from the surgery. So, sadly it looks like I may still be in treatment on my 50th birthday. But the end will be in sight!
