Becoming Radiant!

I'm happy to report that there's not much to report other than that I've had 7 of 20 radiation treatments, and so far everything is super easy with no side effects.

Here's a picture of "the machine."

The appendages on the big silver ring rotate around while I'm lying on the "comfy" (not!) black plastic bed. On top is the one that delivers the radiation in short bursts with an accompanying beep - it takes less than 2 minutes. It rotates to one side and then about 180 degrees the other direction to zap me from both sides.

I don't know what the protuberance on the right does, and the one on the left (and the bottom one?) are X-ray imaging devices. I'll have to ask a few more questions.

So that's it! Have a great 4th of July weekend :-)

Having a "Rad" Birthday!

This year I'm celebrating my birthday by starting four weeks of radiation treatments. I've been saying I'm "celebrating life" that way. Some clever friends wished me a "rad" birthday, and others assured me that I'll be looking radiant. Ha!

Today's session was just a bit longer than it will usually be but even at that, it was quite short. Essentially I lie down on my back on a lovely hard plastic "bed" and stay still while a machine beeps and radiates. They had to do a couple of other extra things today but I think the treatment itself was only 4 minutes - super short!

Whatever side effects I might get are cumulative - possibles include some redness, some fatigue, etc. I'm "planning" on having minimal side effects - we'll see how that works out :-)

A memorable birthday indeed. THANKS so much to all who have sent birthday greetings my way. Warms my heart and makes me smile!!

All tatted up!

Got my first-ever tattoos today - but nothing fancy. Just little dots so the radiologists can always position me correctly for my upcoming radiation treatments.

Everything has been healing up WAY better than after the first surgery, so we're finally ready for this last phase. Today was a CT scan (they want to make sure where all my vital organs are so they don't hit those!), plus the tattoos and scheduling the first treatment, which will be on my birthday, June 21. A memorable B-day to be sure! Then I'll have a total of 20 treatments, on weekdays, so I'll be done in mid-July - which makes it possible for me to go on my annual Kenya mission trip with Kizimani - woo hoo! I've been thinking that I would probably be able to go, but wanted this final assurance before I started raising funds and booking my ticket.

Got to start celebrating my birthday tonight with some dear friends with a picnic up in the Rose Garden - perfect! Every bush was bursting with flowers and the smell was heavenly.

Forward ho!

Back from our weekend at Wild Canyon Games, and I was able to go "all out." I was tired at the end, but then we always are :-)

A quick update on what my medical oncologist said just before I headed over to Central Oregon for the Games. He agreed that though he's not a surgeon, it didn't seem to make a lot of sense to do surgery when there was nothing specific to aim for. He confirmed that radiation should take care of any cancer cells we can't see.

Next step - meet with Dr. P, the radiologist, on June 6 for a CT scan and simulation. I'll know more about what all that involves when I do it, and then we can start scheduling radiation treatments. I'm thinking June will be "radiation month" this year.

Clearing up some confusion

We met with the surgeon today - partly as a followup to last week's surgery, but also as an opportunity to get some clarity on what the tumor board said, and why what I was hearing from the nurse navigator seemed so different.

Everything is healing up much better than last time - hooray! Plus she had taken just a little bit of skin around the incision both for better healing and to have pathology done on it - and there was no trace of cancer - not that we were expecting any but it's good to check. She said it's ok to resume normal activities, and I should be able to start radiation in another 3 weeks.

We now feel like we understand much more what the tumor board was saying. For one thing, they had no conversation about the dratted spots, because they couldn't see them on the most recent MRI. We'll call that good news :-)

What Dr. D told us was that there are a couple of governing bodies in the area of breast cancer treatment which look at thousands of cases to come up with recommendations and "standards of care." Post surgery, you always want to hear that there were clear margins - that they got all of the tumor and just a little more besides. Over the years, the standard of what a margin is has changed. It used to be 5mm, then 2mm, then 1mm. Now it is "no ink." The tumor and surrounding tissue is rolled in a special ink so that the outer edges can be seen under a microscope. If the tumor doesn't touch the ink, you're "clear." The margin for the tumor was 2mm; the margin for the DCIS was .5mm (DCIS is not cancer but sometimes is pre-cancer. It was around the tumor and that's why she took out more than we might have originally thought - she knew it was "not quite right.")

So the debate was essentially between the docs who said, "Yep, that's right." and the ones saying, "I'd be happier with a bigger margin." Given that it was obvious she was going to have to go in and clean out the hematoma anyway, there were a lot of people saying, "Since you're going in anyway, take out more in the tumor area as a diagnostic procedure." But others were saying, "The reason we do radiation after lumpectomies is to deal with what we can't see. We're not seeing anything on the images, so the radiation will handle it just fine."

Part of my confusion and fear was that when Dr. D last told me about the tumor board findings, it was all new and surprising info. So when I called the nurse navigator to get some clarification, she was reporting to me the fact that a lot of docs were supporting the "since you're going in anyway" scenario.  But Dr. D was reading those docs as saying, "Well, we don't know for sure, but new and bigger margins are a way we could be sure." They weren't saying it as a "have to."

So I'm breathing easier. I'll meet with my oncologist on Thursday as (hopefully!) an extra confirmation that I can continue on with the plan we'd developed for radiation along with other tests and meds. I won't be able to post on the blog right after that because I'll be heading to Wild Canyon Games for the weekend, so I won't have time or, more crucially, internet access!

I know this is long already but I just have to add this in. A few years back, I had two friends going through kidney surgeries. The first one had been given an adorable "plush" kidney - a little pillow shaped like a kidney, so I got one for my second friend, Rick. When he heard of my diagnosis, guess what he ordered for me?

He actually ordered it months ago from an Etsy site, and the apologetic letter that came with it was hysterical. She said she was sorry for the delay in about as many ways as it's possible to apologize. So our new catch phrase in that group is, "I'm so sorry. I can't apologize enough for how sorry I am..."

Surgery #2

It was strange to be walking back into the Short Stay unit almost a month after my previous surgery. We had the same escort who took us back there, which added to the deja vu.

As promised, everything happened speedily. Here I am modeling the lovely paper hospital gown:

I like the purple color. But of course one friend noted the "bear paw" logo and wondered if Jon had bought me to a veterinary hospital. Another thing that's pretty jazzy about this ensemble is there are "pockets" built in which can be connected to an air hose that pumps in hot air (or cold air I guess, if that's what you want) and I made use of that after surgery. Mmmmm - toasty warm!

I'm also modeling a "bracelet" that keeps track of where I am in the hospital, just in case they lost track of me. I guess that's reassuring.

Both the surgeon and anesthesiologist came in and chatted with us beforehand. This time the anesthetic was what you get for a colonoscopy so there was no tube stuck down my throat and you come out of it more quickly and easily. They woke me up while I was still in the surgery (AFTER the procedure was done, thankfully!) and they didn't even have to take me to the recovery room. The woman who "drove" my wheelchair to the entrance when I was discharged commented a couple of times about how early I was getting out, as did the woman checking me out of Short Stay. Overachiever, that's me!

So back to "recovery mode." I just snoozed and watched TV yesterday, plus one business phone call. Today I took my time getting started on the day, then took my laptop out on the deck to catchup on email and a few things. It was a perfect spring day in Portland - mid 70s, clear blue sky, birds singing and swooping through the yard. Overall, I feel good - just occasional little aches.

I have to admit I was pretty shaken over the weekend. Going back in for surgery felt like a step backwards, and having the tumor board be split on their recommendation muddied the waters that have been relatively clear for me lately. Then my nurse navigator (my usual "go to" with any questions and a helper in setting next steps) was saying things about the tumor board which seemed different from what the surgeon told me, which was unsettling to say the least. I'm still sort of unnerved by that, but next week I'll be seeing both my surgeon and my oncologist, armed with a list of questions, as always!

A byway on the detour...

One appointment with the surgeon - two big pieces of info to absorb.

Her first words to us were, "Well, you split the tumor board." When you're looking for clarity, that's pretty much the opposite of what you want to hear. I was (naively!) hoping that all the tumor board members would be in agreement. But on the other hand, it does affirm that it was a good move for her to take my case to that smart group of cancer professionals.

Basically, it's impossible to say for sure, based on the imaging (mammograms, ultrasounds and MRIs) that there is anything cancerous that can be surgically removed. So essentially one half of the group said, "Radiation is our tool to get rid of what we can't see, there are excellent success rates from that, so that's the course of action we recommend." The other half said, "You could go back in for diagnostic surgery to be sure." 

As I told the surgeon, my philosophy about is, "less is more." She agreed that there is such a thing as too much surgery. She also said it's good to think about for awhile - would I regret not doing the diagnostic surgery if cancer did recur? And she encouraged me to get a second opinion if I wanted. Jon and I are thinking it would be good to talk with our medical oncologist about it - see what his take is on it.

So that's one thing. The other is a hematoma, which is basically a collection of blood cells at the surgical site. It had seemed weird to me that the bruising and swelling hadn't changed for so long, and we had an appointment with her last week to see what was going on. She looked at it, said it was a hematoma, hopefully it would go down on its own and we'd look at it again in about a week (today). But after hearing about the dramatic "bloodletting" on Tuesday, and after checking it today, she scheduled me to come in early on Monday morning (moving all her other surgeries a half hour later) to just clean all that out and stitch me up again. It would eventually dissipate on its own, but would take a long time, and we need to get radiation treatments started. Also, she can't just aspirate it because though there are some "liquid" cells, there's some that are sort of jellied - blech!

So this isn't wildly scary - just not the norm (I'm special!) Dr. D explained how she always makes sure the site is "dry" before she starts stitching, by cauterizing all the incoming vessels, so it's hard to say why I have these blood cells that don't want to move along.

Whew! I'm sorta down about all this but I feel perfectly healthy in all other respects. You know what to do, prayer warriors! Thanks, thanks and ever thanks!