Sunday, October 12, 2008

Two Weeks Down and Four to Go

So far this radiation therapy gig is going well. The drive takes longer than the treatment and then I am off to work or to do some shopping before heading back home to catch up on a few chores. I haven't noticed any side effects, no burning or low energy. I am told that I won't be seeing that until 3 to 4 weeks into the treatment session. I have been applying aloe vera 99% twice a day and hoping that is enough.

I have heard all sorts of different responses from people - no tiredness and very little burning, others have said they were soooooo tired towards the end, some had burning and were feeling pretty sensitive, others just had flakiness. So I am hoping for the best outcome for myself. I did notice during chemotherapy that when they had told me that I would very likely feel verrrrryyy tired that evening, I went home and felt verrryyy tired. The next morning I had gotten up and felt great and decided most of it was due to suggestion. So this time I will be keeping that in mind and am determined NOT to get verrrrryyyyy tired.

Overall things are doing well, hair on the head is slowly growing back, mostly dark brown (oh, that was what my original color was!) along with a good mixture of gray (sigh). It seems to be slow, but it has grown probably a 1/2 inch now. I am hoping that in 2 months or less I will be able to remove the wig and unveil my new head of hair (newly dyed and hopefully somewhat styled).

I have been feeling fairly energetic, but unfortunately have been gaining more weight back. I am up to 117 lbs. now. The brain is still operating a little slow and memory is still a little vague, but things seem to be slowly coming back and concentration isn't as difficult. So overall doing well and looking forward to the end of this last treatment phase. Yah!!!

Thursday, September 25, 2008

New Shopping Experience

I decided it was time to graduate from stuffing a sock in the bra to using an actual breast prosthesis, so I got on-line. Gee! Something new to shop for! And good heavens! How many different things you need to consider - size, nipple or no nipple, color, tear drop shape or round shape, silicone or fabric, full weight or light weight. I had no idea there was so much involved. I should just have my daughter help me out. She has been running around stuffing balls of rolled up toilet paper under her shirt and displaying a C cup! Oh boy. I am just not ready for that yet. Back to shopping.

I finally picked a fabric prosthesis as they advertised they were sooo much more comfortable. However, I have already realized that I won't be able to swim with it, so that means getting another prosthetic for that purpose. Gee, a fashion statement. A boob for regular wear, for swimming and probably need one special for when I work out. How about for that night out on the town?

The good news is that my hair is growing back! Everywhere! Sob. I am going to have to shave my underarms and legs pretty soon. I had my brows waxed just the other day to give them some shape. I am able to wear mascara once again even though my lashes are still pretty stubby. I have eyes! And I have short stubble on my head! The kids and Paul like to rub my head as they walk by. Make a wish!

Radiation treatments will be starting this Monday. I am supposed to go in every day except for weekends to get zapped, for a total of 6 1/2 weeks. I have heard that everyone seems to have a different response to this treatment. Aloe Vera 100% lotion is recommended to be used during this time and hopefully the area will not get too sunburned and painful. Some people have said that they didn't have too much trouble, the lotion helped, and others found that they still got sunburned towards the end and it was quite painful. I may have purchased my prosthetic a little too soon as it might just aggravate the area even more.

And then there is the tiredness that you start having about halfway through the 6 1/2 weeks. This is due to the fact that the radiation treatment is destroying cells, both good and bad. The cancer cells can't replicate their DNA and make new cells, but our good cells can. So it is understandable that one would be getting pretty tired if their body is constantly having to rebuild for this length of time.

These next 6 1/2 weeks are supposed to be the final stage of treatment to fighting the cancer. It is supposed to be the easiest compared to the chemotherapy and surgery. Okay, I'm ready. Bring it on!

Tuesday, September 9, 2008

Sigh of relief

I went in to have the preliminary work done to prepare for radiation treatment. They informed me that they would be utilizing the CT scanner and would be inducing dye along with it. I said, funny, I just had that done on Friday. This was after I had undressed, put on one of those lovely hospital gowns and was lying on their table by the CT scanner. One of the techs came back to say that as I had just had the CT scan with dye just a few days ago, that they needed to have a blood test first to make sure that the creatinine was at a normal level. So off the table I went, got dressed and went to have the blood work done. The appointment was then rescheduled for Thursday, in two more days. I was informed to make sure that I had no more CT scans in the meantime. Hmmmmm. Since this office had scheduled both of these CT scans, I had to bite my tongue. Good thing they don't offer CT scans with dye in alleyways as I am obviously addicted and don't know whether I could hold myself back for the next 2 days! Okay, be nice, Shelley!

So off I went to do some quick grocery shopping and then head home, disappointed that I hadn't heard the results of the CT scan performed on Friday. While at the grocery store I received a call from Dr. Warner, the radiologist. She was at a different location today, but wanted to let me know that she was sorry for the scheduling problem we had with the CT scans. What a pleasant surprise for her to call me so quickly. I asked her when the radiation treatments might actually begin and she thought that September 22nd was a probable start date.

Dr. Warner then told me that she had gotten the results of the CT scan and that the nodules on my lungs had remained stable and so were most likely scar tissue and not metastatic cancer from the breast tumor!!! Whew! So far the cancer has remained contained in the breast and lymph nodes, and the radiation treatment should kill off any last remaining cancer cells.

Unfortunately this good news is shadowed by bad news of a friend who has just been diagnosed with esophageal cancer. I am hoping that her treatment will be as successful as mine appears to be. It is amazing how quickly the thoughts of fear and denial jumped up when I heard her news. I know exactly what she is going through and can only hope the best for her.

Thursday, September 4, 2008

To radiate or not radiate

I met with the radiologist, Dr. Warner, yesterday. She was very informative and went over everything that I had been through. She had the pathology report which she went over with us to make sure that we understood the findings. While I had been diagnosed with invasive ductal carcinoma, no invasive cancer was found in the breast tissue from the mastectomy, only non-invasive ductal carcinoma. And that cancer had been removed with clean margins around it, showing that they had gotten all of it. So the chemotherapy did its job and killed the invasive cancer tumor.

Now the only worries that we have are the lymph nodes, one of which did show cancer and could have been in other lymph nodes that weren't removed. There were only 3 lymph nodes removed (one positive for cancer, one 'dead' due to the chemotherapy, which had probably been cancerous, and one normal lymph node). Dr. Warner said that they like to see more removed, around 10 lymph nodes so that they have a better idea of whether there was spreading of the cancer or not. She felt it was in my best interest to receive radiation therapy in two sections to cover the lymph nodes along the arm pit area and up above the clavicle where there are more lymph nodes, as well as the lymph nodes along the sternum. One of these lymph nodes along the sternum had shown uptake of sugar on the PET/CT scan that I had received back in March which could possibly mean cancer as well. The radiation destroys the DNA of cells, but while our normal cells can remake the DNA and repair itself, cancer cells cannot repair their DNA so they are destroyed.

The only confusing part to me is the numbers for 'survival'. The radiologist was saying that by receiving this radiation therapy I would be increasing my chances of not having the cancer return by another 10%. Okay, that isn't that big of a number to me. But the way she was saying it, she made it sound like a significant amount. Also by receiving the radiation therapy my right lung will be affected in a couple of areas with some scarring that could give me some trouble in the future, but she said this was a very small percentage. If I wanted to become a marathon runner after all of this, the scarring would not prevent me from doing so. My thyroid might also be affected and there is a chance that I might have to take some medication in the future for a hypo-thyroid problem. And there is also the chance of some rib fractures the first 1-3 years after the treatment, but also a small percentage.

I was told that I could receive reconstruction surgery on my breast, but as I am receiving radiation therapy which tightens the skin and 'sunburns it', they recommend waiting about a year before having this surgery performed.

Tomorrow, Friday, I will be receiving a CT scan with dye to the chest to see if the small nodules in the lungs have changed or not. I believe there had been about 5 nodules found in my lungs before chemotherapy had been started. They felt that at least 4 of them were due to scarring from infection, dust, etc, but they weren't sure about the 5th one. They had said that if any of these disappear after chemotherapy then there was a good chance that the cancer had metastasized to the lungs. Next week, on Tuesday, I go in to see the radiologist to begin the preliminary preparations for radiaton treatment which will probably start within a couple of weeks. I should hear the results of the CT scan at that time.

Wednesday, August 20, 2008

Healing well

After a short week I had the drains removed which was a big plus. Not only did my choice in wardrobe increase, but I also had the bandages removed and was able to finally move from sponge baths to a real shower! I was doing well and was even able to wear a bra (stuffed with a sock) without any problem as I still am fairly numb along the incision.

Just this Monday I started noticing a little more pain around the armpit area. I had a long day as I had went to the office and then afterwards had dinner with Paul and the group he works with. Even though I did nothing strenuous I noticed at the end of the day that I was somewhat swollen.

I didn't sleep well that night. It was uncomfortable lying in pretty much any position. I started thinking about what one of my sisters-in-law had said (yes, the one who had asked about the nipple) - that if you had the drains pulled too soon infection could begin. So then I had that going through my head. Then I realized that I might even be getting lymphedema as I had some lymph nodes removed and if there was a backup of lymph fluid hanging out at the armpit, my arm should be swelling up and turning red at any moment!!!! I was up in the middle of the night googling lymphedema and infections due to mastectomies. I was able to finally get some sleep but decided that I should stay home from work the next day and take it easy.

The swelling didn't get worse and didn't get better, however, this morning it seemed like the swelling was just a little worse. I already had an appointment scheduled with my surgeon in the afternoon so waited to find out what she thought.

My surgeon thought I was healing great and that yes, there was some swelling but no big deal, she would just draw out some of the fluid, that it was pretty normal. Whew! She drew out about 40 cc's which looked gi-normous in a tube! However, on looking at a measuring cup it was about a quarter cup. She said that I may need to have some more fluid drawn out at the beginning of the week, and maybe not, but that it was perfectly normal with the healing. So no lymphedema is starting and no infection, so no antibiotics are required. I think I may sleep better tonight.

Now I am supposed to start a prescription of tamoxifen which could be for 2 years before I start something else, or it could be for 5 years and then 5 years of something else. Who knows. They are still trying to come up with the best formula and 10 year test results are coming in by the end of this year as well as others that are still ongoing. It is supposed to kick start menopause in case the menopause I have entered is only temporary from the chemotherapy. I have been holding off taking the tamoxifen because of different reasons, but it looks like I have run out of reasons ( no antibiotics to interfere) and should get started. Say hello to hot flashes and night sweats! Woo hoo!

Thursday, August 14, 2008

Where's my nipple?!

My sister-in-law said she had some questions that a friend of hers had asked. When they did the mastectomy, did they take the nipple? I told her that I hadn't had the bandage taken off yet, but I was pretty sure that they had taken the nipple. Then she asked if reconstruction was performed, do they give you a nipple then? I told her I hadn't investigated that but I assumed they were just rebuilding the form and not the nipple.

I went home and told Paul about this. He almost got ballistic. No nipple?! I want my nipple!!! How dare they take the nipple without telling us!!! Too funny. This obviously bothered him quite a bit and he went on Google to do a little searching. He informed me later that yes indeed, they had taken my nipple, but if we had reconstruction surgery they could rebuild the breast with a nipple if wanted. (How come I feel like the 6 Million Dollar Man - we can rebuild him!)

I saw my oncologist Wednesday morning and he said that due to the pathology findings from the surgery he felt that I should probably have radiation therapy to be on the safe side. That won't be started until about a month after the surgery to make sure that everything is healed. I will be going in 5 days a week for a shot of radiation for 6 weeks. My surgeon called me later in the day to give me more specific details on the pathology findings. She said that the tumor had been removed and the margins were clean. One of the lymph nodes was positive for cancer, but another lymph node was shriveled, obviously killed by the chemotherapy. She was very happy with the surgery and that we had gotten most if not all of the cancer. Yeah!

They don't recommend breast reconstruction surgery until after radiation treatment, and it can be somewhat difficult after that as the skin loses its elasticity. However, I am assuming that it regains a lot of elasticity after recovering from the radiation treatment. At this time I am not sure whether I will be getting reconstruction surgery or not. I am not fond of surgeries (who is?) but I will see how I do with a prosthetic and decide what will be best for me as I will have some time before making a decision. However, if I do have reconstructive surgery, I obviously need a nipple for my husband! :)

Sunday, August 10, 2008

Hospital inmate on the loose

Went into the hospital on 8/08/08 to be admitted for the mastectomy. The surgery was delayed 1 1/2 hours due to a delay with a patient scheduled before me. They wheeled me into the surgery room at 2:30 p.m. The anesthesiologist announced that he was going to put some 'margarita music' on for me as I was going to be getting a 'margarita cocktail. They must have done something with my IV behind me because that is the last I remembered until I surfaced in the private room they took me to later. I was informed that I didn't get to the room until 6 p.m. and then afterwards the nurse had to nudge me a little to wake me up as I was lying there trying to catch flies. Sigh. I suppose I probably had drool rolling down my face, too.

I was fighting the anesthesia and kept dozing off and then coming back to talk to the family before dozing off on them again. The family decided to leave after a while when they had determined that I was okay, but I obviously wasn't going to be very communicative.

The surgeon stopped in the following morning to let me know that she had gotten the one tumor, that we had just biopsied earlier this week, but the original tumor (that I had thought was a rib head out of alignment) was totally gone - which she thought was freaky. I thought was great as something was obviously working - probably the vitamin D. :) However, she felt that she might not have gotten all of the cancer in the lymph node area and would probably recommend the radiation treatment afterwards. We will know more on that when the pathology report comes back later this week.

I had to deal with a little nausea through the day, but by dinner time I was able to hold my meal down and my stomach was very happy to have some solid food after almost 48 hours! As I was doing better I was able to go home that evening and was able to get a lot more rest without any nurses waking me up to take vital signs. And the first thing I had Paul do this morning was make me some coffee!

I'm feeling fairly pain free unless I move my right arm too far in any direction. I am supposed to do some stretches with my arm, but I figure I should play it fairly easy until my drains slow down a little.

All the best wishes, healing energy and support was much appreciated, and definitely helpful. During times like these you realize what great friends and family you really have.