Today I had an appointment with a surgical oncologist in at the University of Iowa hospitals and clinics. She specializes in breast surgery and is quite wonderful. I brought files totaling the size of a dictionary, and she and her resident carefully went over everything. Without hesitation the most aggressive surgery was decided: left mastectomy with full lymph node resection. I thought that the most aggressive surgery plan would include the right breast, or at least lymph node mapping on the right, but she disagreed. There is no evidence from the PET or MRI scans that there is anything wrong with the right breast. She said that she'd prefer to focus my healing energy on the diseased breast, or the region remaining after the removal of the diseased breast, and this seems like sound logic to me. Since reconstruction of my left breast is not possible in conjunction with the mastectomy (because it's inflammatory cancer, because I might need a skin graft as it is [lots of affected skin has got to go], because I still need to do radiation), I can always opt for mastectomy + reconstruction of the right breast at the potential future date of reconstruction of the left breast. This is fine with me. Emotionally, I could have handled loosing both breasts at this time, but keeping the right one won't increase my nervousness about metastatic disease. T9 has pushed that emotional limit already. And what is "at this time?" Monday, March 7th. I will be in the hospital at least one night. I will spare other gorey details at this time. I'm sure they will all be revealed in due course, unless I am suddenly overcome with modesty.
So what of the T9 vertebral biopsy? Still up in the air. I received a call from the nurse at 3pm with yet another question from the radiologist. We'll talk with Dr. Oncologist at chemotherapy tomorrow and come up with a new plan for that biopsy--before or after the mastectomy? Here in town or in Iowa City? I am happy to report that I am no longer loosing sleep over it. What will be will be. In the meantime, I have diverted some of my healing powers from the left breast to T9, and Uncle Rod's famous lentil soup will help strengthen those healing powers. So delicious!!!
I probably haven't answered all of your questions, but I am SOOO done thinking about this crap for the day. Just ask questions in the comments and I'll answer them in the next post. Time to go jump on the bed, brush my teeth with princess toothpaste, and read Hand Hand Fingers Thumb before I fall asleep. Now.