Post Op with Dr. K

The drains came out today!

As I suspected, two of them were definitely ready to come out. But the third was borderline. It was putting out about 50 cc's of fluid each day. At first, Dr. K wanted to leave it in. But since we live in North County, it would be more difficult for us to get back down in a few days to have the last one removed. She gave me the option and I chose to have her take the third out.

The drains basically help my body remove fluid buildup around the wounds on the inside as they heal. There is a give and take with having one or more in longer. The longer they are in, the more the risk of infection. Frankly, it is gross to have a tube coming out of your body. But if my body isn't ready to have them out, fluid may build up internally. The remedy is to have it drained with a large needle. Gulp. That sounds gross too, doesn't it? Dr. K said they would numb the area before inserting the big needle. Then I thought back to the biopsy. That needle prick wasn't too bad. And it isn't a given that the fluid will build up. Each day that goes by, the chances decrease. Dr. K advised me to put the immediate post-surgical camisole back on and put it on tight to compress the chest to help any fluid disperse. If it did build up, she said it would be very obvious--like a breast growing. So we'll keep an eye on that for the next few days.

As far as having the drains taken out, it was not a big deal. I took 2 pain pills before we went down. My usual is just 1, except at bedtime. So I was a bit lightheaded. She had me lay down and I said a little prayer. She snipped around the sutures and it was out before I knew it. I didn't feel a thing. Then she told Eric that the tubes had been at least 6 inches inside of my body. Yikes! I'm glad I didn't know that before.

She said the scars on my chest were healing quite nicely too. My next appointment with Dr. K is in 6 months, unless something goes wrong. I'll miss her. She was a great surgeon. Anyone in San Diego with Kaiser insurance that needs surgery should request her. (Contact me and I'll give you her full name!)

She is basically handing my case off to Dr. P, the oncologist. I got a copy of my pathology report on the way out. I was trying to decipher it when I got home and comparing it to some books I have on cancer. Although Dr. K (on the fly) said it was a stage 2b, I think it is actually a stage 3a. I'm not positive, and frankly, it doesn't make a big difference what the label is.

The juicy parts of the final pathologic diagnosis:

On the left: Invasive ductal carcinoma. Histologic grade: 3 of 3 (tubules 3, mitoses 3, nuclei 2)

Invasive tumor size: 3.5 cm.

Ductal carcinoma in situ: Present

Type and pattern: Cribriform and solid with necrosis

Grade: Intermediate

Lobular carcinoma in situ: Not identified

Lymphatic vascular invasion: Present

Nipple involved: No

Multiple simultaneous invasive carcinomas: No

Associated findings: Metastatic carcinoma present in five of fifteen left axillary lymph nodes (Largest lymph node metastasis 2.5 cm; carcinoma outside of confines of node capsule focally)

TNM: T2N2a

It's the T2N2a that makes me think it is grade 3 and not 2. The T2 refers to the tumor size (between 2-5 cm), and the N2 refers to the lymph node involvement (N2 means involved nodes are fixed to one another).

We'll find out for sure about staging next week from Dr. P. But again, it doesn't really matter that much. It is what it is. God is in control regardless of the stage. He'll see me through.

My prayer requests:

• That fluid does not build up in my body now that the drains are out.
• That I'm able to get a physical therapy appointment before August 17th. Dr. K referred me to PT to learn how to avoid a swelling of the arm (lymphedema). The soonest appointment they have right now is the 17th of August.
• That I continue to heal and be able to start some exercise to get into condition for chemotherapy.
• An ongoing request is for my family. It is hard on them to have me out of commission. Pray that they be strengthened and given extra doses of grace and mercy towards one another.

Bless you all!