Monday, November 29, 2010

Again

I went to NYC AGAIN today. I think this is this last of the seroma. Please pray and keep your fingers crossed for me. Today was the easiest trip into the city. Now that I have my drains out I can finally use mass transportation into NY. No traffic, just trains and ample time to finish one book and start another. It was a nice conclusion to the seroma saga.

I go back to Sloan on Wednesday. I am meeting with their oncologists for a second opinion for my chemotherapy. I will be meeting with one of their Radiation Oncologists soon sometime in the future. I just want to make sure all people are recommending the same thing. If I went with my first surgical opinion, we would have missed my lymph nodes and all of that DCIS floating in my L breast. I thank God everyday for my onocologist at Virtua and team at Sloan for IDing these things in my tests prior to surgery and recommending the mastectomy. I know I should see all options in front of me for this next leg of my 5 leg journey of treatment (yes, its that long).

My 5 Stages of Treatment
1. Bilateral Mastectomy with Immediate Reconstruction - 11/11/10 Done
2. Chemotherapy - Start 12/15/10 (lasts 5 months and will finish aprox at the end of April 2011)
3. Radiation to L chest wall and axilla - Start May 2011 End June 2011 and/or Start June 2011 End July 2011 (depends on Step 2 of Reconstruction)
4. Step Two of Reconstruction - May 2011 and/or December 2011 (depends on Radiation)
5. 5 years of Ovarian Suppression and Tamoxifen - May 2011

All in all one year from this point I will either have all of this behind me or I will be coming out of one of my last surgeries for a good amount of time. :-)

I meant to put something witty and funny in here today. I thought of it sitting in the waiting room at Sloan, but it passed my mind. Lately I have been pretty forgetful and spastic. I am getting Chemo brain even before the treatment starts lol.

Wednesday, November 24, 2010

Celebrate

After three long days in NYC.... drains out, seroma gone and/or significantly smaller. Moving onto my second fill and finalizing my chemotherapy treatment decisions. Have a Happy Thanksgiving. Now its time to take that real shower

Tuesday, November 23, 2010

NYC times Three

I have been to NYC twice this week and will be driving up a third time tomorrow. I wish I could live closer or drive myself, but I am lucky to have very supportive friends and family to tow me back to and from Sloan.

On Monday I saw my Plastic Surgeon for my f/u to check on my drains, drain the reoccurring seroma, and to take off my bandages. Good news: Bandages are off and the seroma was drained. Bad news: Only one of the drains came out. That means I get to wait a few more days until I can take a real shower with shaving and shampoo in tow.

I also saw my Oncologist in NJ on Monday. We discussed my pathology report. My cancer was IDC (Invasive Ductal Carcinoma), Stage 2b, Grade 3, Estrogen + (95%), Progesterone + (10%), and Her2-. The primary tumor in my left breast was 2.5cm with two smaller tumors (0.1cm) within the ducts. The lymph channels in my left breast were filled with calcifications (small pieces of cancer) and the ducts were fill with DCIS. I am glad I got the mastectomy otherwise I would have had so much cancer left in the left breast beyond the original lump. My surgeon removed 21 lymph nodes from my left side, 3 were positive for cancer (2 were within my breast and 1 was under my armpit). They found 0 signs of cancer on my right breast, but its gone and neither it nor my evil tumor ridden left breast can hurt me.

It looks like I will be doing chemotherapy. My oncologist is leaning towards using Adriamycin, Cytoxan, Taxol/Taxotere. I will be starting December 15, but I will not know the combination or frequency of treatment until I consult with the oncologist at Sloan on December 1. At that point, I will have a clearer idea of how long chemo will be. I also will be having radiation, I am truly not excited about this at all. I have read so much how it damages skin and your implants...bla bla bla. I have seen nothing good from it. It just seems very very old school, but apparently its "recommended" from my oncologist in NJ and my surgeons at Sloan. My onclogist is sending me for some more testing - Echocardiogram to get a baseline of my heart before chemo and a pelvic ultrasound due to my aunt being a survivor of ovarian cancer to also get a baseline. After I am done with Chemo and radiation, I will be on Tamoxifen and Lupron to shut off my ovaries and decrease my production of estrogen, due to my tumor's high estrogen receptivity.

Today I met with my oncological surgeon at Sloan, we also reviewed my pathology. 0 signs of tumors or cancer beyond my breast. She also drained the seroma some more...ewww. I was referred to a Medical Oncologist, Dr. Goldfarb, at Sloan for a consultation about the type of chemo Sloan would recommend based on my pathology. Sloan will be sending their recommendations to my oncologist in NJ and I will resume treatment in NJ. By next Wednesday I should have a clearer picture about things to come.

Tomorrow, I get to go back to NYC. My last drain is coming out, the last of the seroma is going away, and I am going to celebrate having my first shower in 13 days and getting to shave my legs in warm water. YAY

Sunday, November 21, 2010

Seroma!!!!

I got the seroma drained on Friday and it went away for 24hours. It came back, it was painful and it sucked. I kept going on my walks hoping blood flow will help with the fluid retention, but alas it didn't work.
What did help was that my increased blood flow dislodged a clot in my drain, which was the culprit of this stupid stupid seroma. Gross, but kinda happy it was just that. Now my back and armpit are starting to feel like normal. This is incredibly painful to release all of this backed up lymph fluid through my body.

I also hoping I could get my drains out tomorrow, but it is looking very bleak if the drains are still filling. I still have to go to NYC tomorrow to make sure the drains are working etc etc. I also might have to move my oncologist appointment tomorrow, because Sloan hasn't sent over my pathology yet. I hate waiting, I am the most impatient person on earth. I just want to get the ball rolling with treatment ASAP!

For all of you who say you wish you could wear sweatpants everyday, take it back. I am sick of wearing hoodies and yoga pants everyday (a life I dreamed of temporarily when I was working). I would like to have an option as to what to wear. There are only so many VS yoga pants + hoodie + fuzzy sock outfits I can create. All I want to wear some nice jeans and a pullover sweater or even a shirt that doesn't zip or button up. It would also be nice to take a real shower and not a half-shower. I just hope I do not have to be this unkempt on Thanksgiving. It's starting to get embarrassing going out into public like this...Blegh

Friday, November 19, 2010

All Good Things Come to Those Who Wait

My drain removal got pushed back to today because they were still outputting a lot of fluid. I was a little frustrated because I truly want these out. I am craving a real shower. I am also looking forward to getting out of lounge gear and looking less homeless and unshowered.


Its a good thing that I had to wait until today, because yesterday I had my first negative side-effect from surgery. You hear about all these risks associated with surgery that only a FEW people get. I got to be the lucky few. I developed a seroma under my left armpit due to the removal of my axillary lymph nodes. This happens to less than 20% of people, which I was told "wouldn't be a worry." It has become a worry. My arm pit looks like someone cut a tennis ball in half and glued it to the inside. My physican is going to aspirate it with a needle today (insert sarcasm) What Fun! I just hope that it goes away and I have my arm pit back. I do not even care if they wait until Monday to remove my drains. I just want to put down my arm, it is really starting to get painful.


For all of you google geeks like me whom want to know "What is a seroma?":

seroma is a pocket of clear serous fluid that sometimes develops in the body after surgery. When small blood vessels are ruptured, blood plasma can seep out; inflammation caused by dying injured cells also contributes to the fluid.
Seromas are different from hematomas, which contain red blood cells, and form abscesses, which contain pus and result from an infection.

In my case, my seroma (you know kinda like the song My Sharona) is filled with lymphatic fluid. The drains are kinda working its way out of me, but trust me that won't do the job. Wish me luck with getting another needle put into me today. Usually I would be frightened, but now needles nor blood do bother me. Maybe I shouldn't have given up on that whole doctor thing...people are right you eventually get used to needles and blood the more you are exposed to it.

Monday, November 15, 2010

Surgery...a few days late

I am sorry I have been a bad blogger. I have been mentally "out of it" since I came out from surgery on Thursday. The anesthesia and pain took a big hit on me and blogging was seriously the last thing on my mind at that time.

On Thursday, I went with my family and friends in tow to Sloan for my surgery. I got to wait 2hours until my appointment, I was a nervous wreck. It also didn't help that the admitting nurse kept trying to stab me in my hand for the IV, but my hand has 0 veins and can never take IV. I kept trying to explain that but alas, no one listens to me. My surgeon even explained this twice to two different nurses and they didn't listen to her...when does a nurse not follow a physician's orders?

I went into surgery. It was strange and very hi-tech. All I remember is a nurse and my doctor holding my hand. I woke up hours later in a room with my family around me. I honestly could not remember much, but the anesthesia apparently made me very giddy and outgoing and in 0 pain.

Hours later I came to, they removed all cancer. I woke up with the same size chest, which was a little disappointing because I have been living in an allusion that I was always a C cup, when I am really a big A. LOL

I also found out that they had to remove my left axillary lymph nodes (right under my armpit) even tho my prior testing did not show any signs of cancer in that area.  It is still unclear if they were cancerous or not. I should know when I get my pathology report back next week. My left armpit has 0 sensation and it feels like it doesn't exist, but I know its there. When they went in for surgery they saw suspicious signs of cancer in at least 2 nodes, they removed "fatty pocket of nodes" which also took away some of my sensations in that area.

I am 100% sure I am going to need chemo therapy. They are so far recommending "Dose dense" chemo either TCH or TAC. I am not too sure when that will start, but I should know more details once the path returns. I will be meeting with my oncologist on Nov 22 and have my postoperative appointment with my surgeon on Nov 23. I should know more details about pathology, prognosis, and further treatment.

The days after surgery were hard and taxing, but I tried my best to keep moving. I slept a lot and I moved as much as I could. I started a small walking regimen yesterday, I am up to 45min now. This is all I can do until I get my drains out. Sadly, I still have drains in me now, which seem to be producing less and less post-surgical fluid. That is a good thing, which means I am recovering 1 week faster than expected and will be getting my drains out this coming Wednesday Nov 17.

So far I am spending a lot of time relaxing, recovering, and itching to resume normal activities.

Tuesday, November 9, 2010

Disorganization

One thing I hate the most in this world is disorganization. Following that comes last minute surprises. That could be due to my "OCD" like behaviors, but it also could be due to the fact that I really cannot tolerate many more surprises after the cancer diagnosis.

Today at 5pm I had a wonderful (insert sarcasm) surprise... I have a 1pm appointment at Sloan. What? I never made that appointment. Apparently I have a doppleganger running around making cancer appointments for me. Or just by happen-chance the idiot who registered my appointments forgot to tell me about this one important pre-surgery appointment. Strange how she was the only one who knew...

Anyways, I thought that tomorrow would be my last day at work, but surprise today was... I can't even remember what I needed to do before I left. O well. Good thing I met with HR and finalized my disability...how strange some things work out.

How dare this disorganized secretary make a cancer person, nonetheless a cancer person with OCD, have to face a change in plans less than 24hrs before her appointment. Truly its blasphemy. I am definitely glad that my support staff, as I work in the medical/psych field, is much more organized and competent and cause my patients 0 stress.

Off I go to Sloan for the second time this week. I wonder what adventures lay ahead...

Wednesday, November 3, 2010

No More Testing

Finally, finally done with all the testing before surgery. I felt like a human lab rat ... definitely not the ideal situation for using my paid-time-off from work. I would rather be on vacation or at least doing something fun in NYC. Instead, I got to see all the wonders of Sloan Kettering Hospital in NYC. I got to wait in many waiting rooms, steal many free candies, drink some odd crystal-light drink pre-PET scan, and eat the same pretzels/graham crackers that they seem to serve in every waiting room through out the hospital. Good news is that I am done with anymore testing for now.

I first went to a biopsy of my axillary lymph nodes (which is under your armpit). Surprisingly that wasn't painful and I got the bonus of having my left arm numbed for 1 hour post procedure. I also got to have a PET Scan. I always heard about these things in neuropsychology classes, but yesterday I actually got to have one done to myself. It was strange to say the least. I drank some fluid, which tastes like Crystal Light, and was injected with radioactive material. I was highly radioactive, kinda like Radioactive Man from the Simpsons, but much cuter. I fell asleep through the whole procedure, it was a nice nap. The last step was pre-surgical testing, which was not worth the 2.5 hour wait. All I got done was a blood-test and an EKG...I think that was the least exciting part of my day. Considering I have been to the doctor almost 100 times over the last year, I have had enough blood drawn and EKGs done for an "average" persons lifetime.

Next steps are:
1.  Finishing up some paperwork for SSD and also getting more financial paperwork filled out by my physicians. I am hoping I can nab a little financial assistance from organizations to help with copays and transportation costs. Keep your fingers crossed for me!

2. Finalizing plastics and meeting with my plastic surgeon at Sloan next Monday. This would be almost any 20-something year old's dream. If it were under any other circumstances, it would be mine too jk. But seriously at least this will make this whole process a little less psychologically traumatizing for me.

3. Figuring out what Sloan and Virtua both will recommend for my hematology treatments. I think I will have to figure this out next Monday or on surgery next Thursday.

4. Getting a wig. This is truly going to be strange, but I have my hairdresser, whom went through this not too long ago helping me out with a few wigs. Thanks Michelle!

5. Getting all my loose ends tied up with help of Kyle's handy dandy to-do list (btw Ky put this stuff on that list too!!!)

Okay off to get some of this stuff done..

Monday, November 1, 2010

Sleep!!!

I slept 10 hours yesterday...I could have slept longer. It was very nice.

Tomorrow, I have some more testing in NYC. I get to have another biopsy...fun, looking forward to that (insert sarcasm). I also get to become a lab rat AKA pet scan, chest xray, EKG, and bloodwork to get me ready for surgery next week. I hope I get some good food at the end of all of this.