Forward

I'm done.  I'm done with the painful, sickening treatments for the second time.  I've fought breast cancer twice, and for the time being I've won.  Again.

I think it will be a few more days before the full magnitude of these statements sink in.  I'm done!!!

The appointment today was perfect.  Dr. Surgical Oncologist snipped my stitches and pulled out my J-P drains.  Whew!  It wasn't quite as ticklish as last time.  I think it was due to the fact that the drains were shorter--she said that she trims the length of the drain tubes based on how many lymph nodes she removes.  Since I only lost two lymph nodes, the drains were relatively short, perhaps about 6-8 inches each.  I had gotten so accustomed to having the drains in that all day I've been having to re-learn how to live without them.  No, I don't have to clutch my elbow to my side and lift slightly to relieve the pressure on the stitches.  No, I don't have to make sure I'm not slamming them in the car door.  No, I don't have to avoid laying on them while I'm sleeping.  Oh!  Sleep!  It will be so sweet tonight!

She also gave me the results of the Tumor Board's discussion.  Based on the favorable pathology results, the consensus is that I do not need radiation for either my lymph nodes or my lungs.  Huzzah!  They do still recommend that I remain on Herceptin + Pertuzumab "indefinitely".  That's fine with me.  I'm so lucky that there is something to help control my disease.

I still have so much recovery ahead of me, but I'm thrilled to know that it won't be undone for awhile.  For the first time in months my recovery will be exclusively forward.  No backward steps due to do further treatments.  Just forward.    

24 hours

Twenty twenty twenty four hours to go
I'm gonna be elated
Nothin to do
Nowhere to go
I'm gonna be elated
Just put me in my dad's car
Take me to the main
Hurry hurry hurry
Before I go insane
I can't control my itches
I can't control my drains
Oh oh oh oh oh oh

Almost perfect news, and 100 miles to nowhere

Dr. Surgical Oncologist's office called with what she described as "good news" and "almost perfect news" regarding the pathology of my breast cancer.  The good news is that six months of chemotherapy worked as it should; a little bit of ductal carcinoma in situ (DCIS) remained in the breast tissue, but it was no longer invasive.  This means that it wasn't trying to grow out from its location.  The other way that I took this as good news is that the remaining DCIS seems to support my decision to get a mastectomy.  No doctor has said that, but my gut is taking this at further evidence of its trustworthiness.

The almost perfect news is that the pathology confirmed that there was no cancer in my lymph nodes.  The reason this is not fully perfect is that they did find a few cancer cells in the duct on the way to the lymph nodes.  I have no idea what this means.  Was my cancer spitting off cancer cells until the moment it was cut out of me?  Or had these cells split off from the cancer long ago and decided to hang out in this bodily hallway?  But it doesn't matter because the lymph nodes were clear, which is the most important result.

I'll see Dr. Surgical Oncologist on Tuesday when I get my drains removed, and I'll get clarification on the significance of all of the pathology then.  Also, the surgical team is/was to present my case to the Tumor Board (again) today, so it will be interesting to hear what everyone at the institution thinks about my case.  I have my fingers crossed for no plot twists, such as radiation.  I'm ready to close the case, at least for now.

My recovery is continuing in a positive direction.  The only major development is that I have a hot, itchy rash that covers my chest wall surrounding the surgical sites.  I'm not terribly surprised to have a rash, since rashes have been one of the main sidebars of my chemotherapy this time around.  But I am terribly uncomfortable.  I have been taking all sorts of allergy medicines to try to control the rash:  benadryl, zyrtec, zantac, allegra.  The only thing that has been moderately effective is an anti-inflammatory ointment, but it is not a cure.  It prevents the rash from bubbling and oozing (yay!), but it allows it to maintain a hot and itchy state (boo!).  My second tool for getting relief is ice.  I ice the chest wall all day long.

Additional relief came this week in the form of some amazing news.  Two of my dear friends are organizing and riding 100 miles to nowhere, on their bicycles, around my block.  They are doing this on Oct. 18th to raise awareness of inflammatory breast cancer and to raise funds for my daughters.  To read more about their event and to find out how to participate or donate, please check out "Steven's" blog here, or "Norman's" blog here.

The kindnesses, generosity, and support continue to amaze me and fill me with gratitude.  Can't wait to hug you, Steven and Norman.          

Tick tock

As I lay on the operating table with the nurses and technicians bustling around me, I couldn't help but marvel at all of the resources being spent on helping me live.  I thanked them all for their efforts.  Then a nurse put the gas mask over my mouth and told me to breath deeply.  I instinctively started in on my mantra, "I have strength, I am strength.  I have peace, I am peace.  I have strength, I am...".

Now that I am six days post-op, and I find myself impatient to get on with living.  After months of chemotherapy and now a major surgery, most of the gears of my life have necessarily ground to a halt.  I am so excited to wind them up again.  I feel like a shiny pinball has rolled into position, and I'm amassing the energy to pull the spring and play the game.

Amassing the energy takes so much effort, though.  My thoughts remain cloudy, perhaps yet from anesthesia, painkillers, chemotherapy, or all of the above.  I am not in half as much pain as I was after my first mastectomy, but the wound is nonetheless stressful and exhausting.  I cannot yet look at my new wound without getting nauseated (although everyone who has looked tells me "it looks good"--it is still a bit too purple and gruesome for my tastes).  Taking a shower is my most dreaded activity, because of the effort to both hold the drainage tubes and to not look at my wound.

Ah yes, the drainage tubes.  Did you know that their official name are J-P drainage tubes, or Jackson-Pratt drains?  You must be one egotistical person to name these disgusting things after yourself.  They collect fluid that ranges in color from red to golden yellow, and occasionally clumpy stringy bits of me collect with the fluid.  They utter terrible, juicy sounds when being emptied.  They are a pair of plastic testicles pinned to the inside of my shirt, flapping against my stomach when I walk and occasionally peeking out from under their hiding place.  They are so, so gross.  I get them removed one week from today.  I'm almost halfway done with them, not that I'm counting down or anything.          
My mom has been a wonderful asset this week.  She is a nurse who is on a short leave-of-absence to be here with me.  She is a lifesaver, doing all of the things I either can't do (such as walk the girls to school) or don't care to do (such as empty my Jackson-Pratts).  I appreciate you, mom.

In addition to getting on with my own living, I am anxious to start paying back all of the kindnesses that have been shown to me throughout this cancer ordeal.  I fear that my debts to the universe are getting quite large.  Hopefully I will have ample time to pay them back.

ps  I finally fixed the YouTube glitch and got the movie of my last chemo to upload.  It's now linked properly in my Last Hard Chemo post.

Elation

Updated to add a link to my revised pain scale.

I did it!  Huzzah!

Wait a minute, that's not nearly enough exclamation marks for the hbomb.

Huzzah!!!!!!!!!!!!!!!!!!!!

Let me start out by deeply and publicly expressing my gratitude to my friend M, whose last message to me before surgery was to remember my revised pain scale. Thank you, M, mother-of-triplets. I love you. (I revised my pain scale after my first mastectomy. That is when I learned 1) my previous notion of intolerable pain doesn't exist for other people; that is, I have a bit of a pain tolerance. Combine this with my aversion to drugs, and the result is me estimating my pain at a 2 or a 3 on a 10-point scale. After a mastectomy.  So vowed to revise my pain scale.)  My revised pain scale allowed me to recognize my pain as a 5-6, which elicited the perfect drugs. They reduce the pain down to a 2 (a real 2) and don't send my brain out to lunch. Perfection!

Also, I'm simply not in as much pain as I was with the previous mastectomy. I am not experiencing nerve pain, and this was the Worst last time. 

Finally, I have discovered a new pain medication that is going to make my sister rich and famous. He is baby Calvin, and when he smiles the mastectomy is erased. He's leaving soon, so hopefully the only ache he leaves behind is mild and in my heart. 

The surgery went well!  Dr. Surgical oncogist said that the sentinel (first) lymph node was NEGATIVE for cancer. A thousand huzzahs!!! She was nonetheless conservative and removed the sentinel node, a second node, and an inch of fatty tissue around them.  My armpit is the most sore of my wounds. 

I have nothing to report about the mastectomy yet. It will be a week before we know the pathology. 

The port was placed successfully. Huzzah! It is another purple power port, which is the same model as my previous port. Prior to surgery, a resident doctor freaked me out to the point of tears by saying that the vascular doctors would be placing my port on the left side.  But my mastectomy was on the right today!!!  She had all sorts of reasons that made clinical, theoretical sense, so I explained my real-life, empirical reasons: the skin on the left is very tight and is scarred from full chest wall radiation, up until yesterday I had a blood clot in the left jugular that May or may not be fully resolved, and my right side was already undergoing surgery. She conceded slightly, writing on the consent form "left or right" and agreeing to let the vascular surgeon make the call during the operation. Ah!  That's a bit nerve-wracking!  In the recovery room, the very first thing I said was, where's my port?  I am thrilled to report that it is tucked into its former home on the right. When I later saw Dr. Surgical Oncologist, she apologized for the apparent confusion, because she always intended for the port to go on the right. The information simply didn't trickle down to all of the folks interacting with me (seemingly dozens).

I'm spent, with nothing left in me to read and revise. Hopefully this has been sufficiently coherent and error-free.

I am humbled by and grateful for your support.  <3 and (>'')>

Cellular torture

My daughters have a small indoor tent made out of a material that is a strange hybrid of fabric and paper.  Dora the Explorer images are printed on each of the four sides.  They've had it for several years, set up in the toy room by the window as a special reading nook.  On Labor Day weekend I wasn't feeling tip top, but despite my lack of energy I wanted to do small things to make the weekend special.  One thing I thought to do was take the Dora tent outside.  Not to be bothered by collapsing the thing, I picked up the tent by the peak, which unfortunately elicited a ripping sound.  I awkwardly maneuvered the torn tent down the stairs, at which point Azalea pointed out a large tear down the back of the tent, reaching up to the ridgeline from the back door.  I reached for some masking tape, intending to fix the tent just enough to perform this final outdoor activity before depositing it in the trash.  With tape in hand I pinched the new seam, which readily flaked off a chunk of the paper-like fabric between my fingers.  I chose a different ripped location and grabbed again, liberating another hunk of the tent into my palm.  The fabric must have weakened over time, perhaps because of sun exposure at the window.  Before my small ones could throw a fit over their disintegrating play house, I embraced the tent, tear and all, and tossed it into the yard.

My brain on taxotere is the fabric of the Dora tent.  Weak, fragmented, and orange.  Each morning I toss myself into life and hope for the best.  

Fortunately I am feeling a little better every day, and I will continue to get better in the absence of further cellular torture by chemotherapy.  At night I send my healing thoughts to my brain, taping up the pieces of my mind.  This week I have caught myself making some coherent thoughts, so I thought I'd attempt this blog post.

Tomorrow we make the drive to the other town for my pre-mastectomy procedures.  At 2pm I am having vascular pictures taken.  These are for the doctor who is going to be placing my port.  I used to have a port, but I had it removed after being cancer-free for almost 3 years.  Dr. Oncologist chose not to re-install my port for the current cancer treatment for numerous reasons.  However, now that I am looking to be infused with Herceptin and Pertuzumab every three weeks for the rest of my life, I asked if I could get another port.  I figured I could get it installed at the same time as my mastectomy.  All of doctors on my team thought that this was an excellent idea.  My port will be placed in exactly the same location as my old one:  chest wall, center-right side, just below the collarbone.  A doctor whom I have not met yet will come into the operating room after my mastectomy and hook me up.

At 3pm tomorrow I will be injected with a radioactive tracer.  This will be injected into the breast cancer.  On Wednesday the doctors will be able to follow the trail of radioactivity to see which lymph nodes to remove.  This procedure is called sentinel lymph node dissection.  I didn't have this before because it is not recommended in cases of inflammatory breast cancer.  It is recommended for ductal carcinoma in situ, which is my current diagnosis.

My surgery is scheduled for 7 am on Wednesday.  I am to report to the hospital at 6am.  My husband, parents, sister, and mascot (Calvin the Cure) will be there.  I will stay in the hospital for a night or two.

On my previous mastectomy eve, my college friends booked a room for Ian and I at a fancy, contemporary hotel.  I decided to do the same this time, for luck or something like it.  I'm not superstitious.  It just seems like an appropriate night to be a tiny bit spoiled.

I am grateful to not have any downtime between my last chemotherapy and this surgery.  It's true that the surgery will keep my healing energies busy, and that my healing energies could use a break.  However, I feel that it will be easier to maintain my healing routine than to be teased by a break from healing only to be plunged back into the fray at a later date.  Besides, I don't want the cancer to think that I've gotten complacent.  Kick it to the curb!

48 hours from now my cancer will find itself excised from its happy Heather bath.  It will be slapped onto a lab technician's benchtop, fixed in formalin, set in paraffin wax, and sliced into thin preparations for a pathologist to scrutinize under a hot, microscopic spotlight.  I am not a vindictive person, but after all of the pain that cancer has caused me, I delight in the cellular torture that is about to be inflicted on it.