All systems GO!

I went in for my pre-chemo lab work and oncology visit.  Everything looks good.  My blood counts are excellent, even for a non-cancer patient. Thank you Jesus!  I mentioned my "female" issues and we agreed to let chemo take its course and see what happens.  It often will stop women's cycles.  There are drugs they could give me to stop them, but I'd rather avoid more medication if I can.  He said chemo can interfere with ovulation, so basically I get to live with every day as a suprise in that department.  Lovely!  If I was worried about my red blood cell count because of the periods, he said I could take an iron supplement, but my blood counts really didn't warrant that.  Spinach works, folks!  Food is medicine!

I have a new side effect.  It looks like I am in the process of losing a toe nail.  Fortunately, it is not the big toe.  It is the second nail on the left foot.  About a week ago, it started hurting. I thought maybe I had an ingrown nail. I gave myself a gentle pedicure over the weekend and trimmed it.  It wasn't ingrown, but still was irritating.  This morning, I took the polish of that nail and it was turning black.  Apparently, this is a possible side effect of taxotere.  It may fall off, but Dr. P said that would happen when another nail grows underneath to replace it. That is good news.  But it all is a bit ghoulish.

So all systems are a go for tomorrows chemotherapy round.  Round number three.  When I was coming out of the pharmacy with my next batch of Cipro, I ran into the chemo nurse.  I told her, "We have a date tomorrow!"  The chemo appointments themselves really aren't that bad.  At least they haven't been for me so far.

My afternoon was more interesting.  I went to the Women's Health Boutique to get my prostheses. It is funny because you basically get to pick what size you want to be.  I was a B cup before, so we started there.  She measured me and went and got several bras in a 36B.  I tried a couple on, and they just looked HUGE!  Maybe it was because "my" B's were saggier, but these just made me feel conspicuous.  I had brought a form fitting sweater to try on as well to see how it looked.  So we switched to 36A.  Ah.  That looked much better. Kaiser pays for 3 bras each year, and a set of foobs every 2 years.  The foobs have a 2 year warranty, so they only pay for them when the warranty runs out.  Sounds like a car, doesn't it?

Frankly, I've become accustomed to being flat.  Having something up there again feels pretty strange. Maybe its because they don't have any sensation.  I realized I've developed the habit of crossing my arms over my chest.  Now when I do that, I bump into these "things."  It is also kind of strange because you are just standing there nude from the top up and the lady is coming in and putting the bras on and off of you.  It's not that big of a deal...I've lost a lot of any shyness around professionals when it comes to my chest.  Childbirth does it for down below, now this!

The prosthetic "foobies" just slip into the bra.  You fold it up a bit like a taco and slip it in the bra itself.  Then when you put on your bra, you are putting on your breasts as well!  It gives me a new angle each morning getting ready.  Do I want to have a breast-look, or not?  I don't think I'll work out in them, although I could.  They are even waterproof!  Salt water or pool water.  All you have to do is take them into the shower and wash them off.  Wild.  They do have weight and feel of real flesh. I'll weigh them tomorrow and see how much they weigh.

The kids are a little weirded out by the new additions.  I gave Isabelle a hug after school and she stepped back with a quizzical look on her face. She isn't that keen on them at this point. Olivier is going to be weirded out on the whole thing because, well, he is in middle school.  Once again, Jean-Marc is the only one who didn't notice. He even leaned back on them while I was reading him a goodnight story tonight and didn't flinch a bit. 

Praise Report! 
I had asked for prayer about the timing working out for Isabelle's student council speech?  Well the school moved the speech time to 2 p.m.  They didn't really, because my mom got there at 2 p.m. and Isabelle was in the middle of her speech. But because of the bizarre rain storm we had today, they moved it inside to the cafeteria, so the kids had to do the speeches twice to accommodate the number of students.  I got out of the appointment right at 2 p.m. and raced over to the school.  Typical of San Diego, a little rain and people forget how to drive.  So traffic on the 78 freeway was a little slow.  Stress!  I got there as soon as I can, and literally ran to the cafeteria.  I got there with a couple minutes to spare!  I was so happy to be able to be there.  She had been so nervous this morning.  And furthermore...she won!  Here is her speech if you're interested:

Prayer Requests:

• That I get a good night's sleep tonight.  I'm going to take the sleeping pill because I'm on the steroid now which kind of amps you up.  But still, anxiety could trump that. 
• That this third round of chemo go smoothly.  That I don't get sick while there.  That I tolerate it well and that it does what it is supposed to do.  
• That we have a smooth weekend.  Eric leaves on a business trip on Sunday. My plan is to lay low and take it easy this weekend.  I don't want to be tired out from the weekend on Monday when the crazy school and activity schedule starts up again.
• That the kids who did not win one of the 4 coveted officer spots aren't too disappointed.  Its hard to put yourself out there and fall short in front of everyone.  We've been there too.  

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!

Meeting Dr. P

I had my long awaited oncology consultation yesterday.

Eric went with me. Him being in the drug discovery field and knowing many researchers (including cancer specialists) has been a great blessing. He had several pages of notes on research that he had done to get ready for the meeting. I just wanted it to start. As I waited, I played with an app on my iPhone called "Bible Shaker." You choose a category, push a button, and then an appropriate verse pops up. So I chose the topic "Fear" and started pushing the button. There was one really cool one and for the life of me right now I can't find it or remember exactly what it said. But it did say "You will not die." Thank you Lord.

The door opened and Dr. P came in and sat down. He was a quiet man who sat hunched over on the stool and looked at us over the top of his glasses. As we had our conversation, he reminded me of some of the scientists that I've met that have worked with Eric in the past. Quiet, but smart.

Had the results from this week's MRI (an answer to prayer). The MRI showed 3 tumors on the left breast that were fairly close together. That explains the strange feel that it has--it seemed huge. Now I know that it is 3, not one big one. There was a suspicious area at 6 o'clock as well, which may or may not be cancerous. If I was interested in trying to save the breast, it would need to be biopsied. If it was cancerous, a lumpectomy would not be an option. I had already decided that a mastectomy would probably be the way to go, and this sealed it. I don't want to have another biopsy and wait another week for results.

We discussed whether to do chemo first or surgery first. Chemo first would tell us if my cancer was responsive to chemo--apparently not all are. When they do surgery first, they remove the known cancer and then blast you with chemo to kill any cancer cells that may be wandering in the system. They don't know for sure that they are, its kind of a prophylactic measure. If it was responsive to chemo, the tumors should shrink. Frankly, knowing that there was something suspicious in there that we couldn't even feel yet makes me want to just move ahead with surgery STAT.

I brought up the question of a bilateral mastectomy. He did not think it was necessary. There is no evidence of cancer on the right side and I've had the best diagnostic tests done. With my history, I will be monitored very closely for the rest of my life. If cancer does develop, it will be caught early...hopefully stage 0. But still. I want to fight this right now once and for all. Do it right the first time. Knock it out with overwhelming force. He said the chances of it moving to the right after treatment were like 1 in 20. He thoughout t hose were small odds. I don't know. It seems pretty high to me. There is also the question of symmetry. I'll be given a prosthetic breast to wear during treatment and until I do reconstruction. (If I do reconstruction). I wonder if I'll be lopsided if I only have a single? The wig lady earlier this week regretted not having both taken off for that exact reason. Any thoughts you fellow pink ribbon clubbers have out there would be welcome. I was awake for part of the night pondering this question.

There is also going to be the option of participating in a clinical trial. If I choose to participate, I would have to do the chemo down at Zion rather than in San Marcos. They would randomly assign me to one of three groups. Each group gets a different chemo cocktail. I want my experience to help others, but I'm not sure about the trial. I also want to be treated with what is known to work. There's time to decide.

He also did a breast exam. He checked the lymph nodes in my neck. All clear. Whew. He checked the left side and felt the tumors we already knew about.

Througout the exam, Eric was quizzing him on various drugs and trials. As he helped me sit up after the breast exam, they started chatting about Eric's line of work, various uses for drugs on different types of cancer. I'm standing there in a hospital gown, just wanting to get dressed, and these to science guys are yakking! It was funny in a way. They could definitely communicate on a different level that I could.

Is Dr. P "the one?" I suppose so. I'm not really that particular about his personality as long as he is a good doctor and knows what he is doing. On a personal level, he got warmer as we went through the meeting. I get a sense that he really knows his drugs. Eric quizzed him pretty good. He made me feel like I had a good prognosis, even though he won't know the extent of the cancer until after surgery. He referred to women with "much more advanced" breast cancer. Funny how knowing there are others out there worse off than you can be a comfort.

It looks like I'll start chemo in early August. I should have the surgery within 2 weeks. I'll find out more specifically on Monday. That is an area for prayer. I want this cancer cut out as soon as possible. 2 weeks will be an eternity. I also ask for more clarity as I decide between a bilateral or single mastectomy. Thank you all, once again for being prayer warriors on my behalf. It is working!