well, crap

I definitely have an infection going on. There is a spot in my incision (the axillary dissection site) that is red and infected and my entire breast is warm and pink and swollen. I have a call into Dr. Calhoun's nurse and I'm just waiting to hear back from her.

So this has been my morning so far:

-I got up at 5:00 and decided there is definitely something going on with my breast
-I took a shower
-I called the paging operator at 5:45. Now, both Dr. Calhoun and her nurse have informed me that Dr. Calhoun takes her own calls. I was instructed to call the paging operator and ask for her and she would be paged. However, when I called the paging operator this morning, I was told that she is not on call for herself and that Dr. Someone else is on call for her and he would be calling me back. Some resident, I assume. I explained that Dr. Calhoun told me that she takes her own calls, but the operator said no. Now, I wasn't going to have an argument with the paging operator. What pisses me off is the fact that it's 8:45 now and no one has called me back. I will be having a pointed discussion with Dr. Calhoun today when I see her, that's for sure.
-I cleaned the cat box and in the process, stepped in some cat puke and tracked it all around the kitchen before I realized what was going on. Luckily I wear Crocs slippers, so cleaning them was easy, but I was highly annoyed at the cats, not only for the puke, but they keep peeing outside the cat box and I'm changing the pad twice a day (I use puppy training pads all around the cat box).
-I got to work at 7:15 and my co-worker and friend who is also an RN took a look at my breast and agreed that I definitely have something going on
-I headed downstairs one floor for my first PT appointment at 7:30. My physical therapist is really wonderful and I'm very happy with her. She exclusively works with breast and gynecological cancer patients. We talked about my history and what the future plan is, but we did not do any therapy today. She also examined my breast and placed her own call to Dr. Calhoun's nurse.

Now, I am just waiting for the return phone call to find out what time they want me over there. Oddly enough, I feel much better today than I did yesterday. I did check my temperature last night and it was up a little bit at 98.9. I normall run low, about 97.7 or 97.8, so it's a little high for me. I don't feel that warm today though. I am starting to have some sharp pains in the axilla area, so I think this infection is starting to spread a bit.

That's it for now. More updates later.

Several days later

This is just a list of what is currently happening:
Ok, I am definitely tired of wearing the velcro "sports" bra contraption they put me in after surgery. Not that I am going to take it off, but it's starting to really annoy me.

After a bolt of lightening went through the back of my arm last night, I remembered what Dr. Calhoun said about "electric shocks" going down my arm post-surgery. She didn't say how big they would be and that they hurt!

I'm also starting to get achy down the back of my right arm, yet somehow I am also numb. The numbness is weird, because it makes things feel strange and I was worried for a minute that my upper arm is starting to swell up. I don't think that is happening, or if it is, it could be drainage from surgery.

As far as the drain, the fluid is getting less and less and it's turning lighter in color. Almost to the "chardonnay" stage. Dr. Calhoun went over the colors of the fluid in terms of wine. ha! This morning the drainage was under 50 cc for the first time. I am pretty sure it will get down to the magic number of 30 cc before my appointment next week.

My throat is still sore from the breathing tube and I'm still phlegmy at times.

Today will be my first venture out of the house. My niece turns 3 next week and today is her birthday party.

My mom, bless her, is putting in a garden out back. I wasn't going to deal with the garden until next year, but she is determined to plant some veggies! It's been weeded, raked, mostly leveled and the rows are done.

post-surgery update

My surgery went really well. The unfortunate thing is that the sentinel lymph node did show cancer, so they had to do a lymph node dissection and I had to stay over night in the hospital. I'm home now and feeling pretty good. Hopefully the full pathology results will be back on Monday or Tuesday. My surgeon will call me when she gets them.

For now, I'm just taking it easy and hanging out with my mom.

Surgery tomorrow

I haven't updated for awhile.. I think I've been trying to avoid all that is going on.. I reached a point a couple weeks ago where I didn't want to deal with it anymore, and why should I? Then I realized that is probably a very normal reaction to dealing with cancer and I'm sure I'll feel it again down the road.

My surgery is tomorrow and I'm definitely feeling a little anxious. I haven't been sleeping well the last several weeks, and although I have been seeing some of my friends and family lately, I'm feeling very isolated. I'm just really tired. I want to go to sleep and wake-up and have this all be over. If only that were possible!

I have to say that I am very grateful to everyone who is praying and thinking good thoughts for me. Knowing that you are there helps me to face the next challenge. As far as surgery, I am confident in my doctors of course, and I know things will be fine. But for today, I wish I could just stay in bed and hide away from the world. I'm leaving work early this afternoon and have to go over to the medical center for the lymph node mapping. Tomorrow morning I have to go get the guide wires put in, so the surgery itself won't be until later in the morning or even early afternoon. At least I get to go home tomorrow and not have to spend the night.

It seems like there is a lot of things I have to do tonight.. stupid stuff like bring the fans in from the garage because it's going to get hot, and put the garbage in the bin because garbage day is Thursday, but I need to get it all ready to go for someone to take it out on Wednesday. I also need to find some CDs I want to listen to during surgery and convert them to mp3s and put them on my iPod. They said I could listen to music in the operating room. I'm also trying to decide if I want them to use some healing statements. I kind of do, but I feel a little silly asking them to do it. Both my surgeon and the anesthesiologist have told me that they have done it before and if I want that, they are happy to do it.

I wanted to eat lightly today, but I didn't get around to making sure that I had anything light in the house. I've decided for lunch I will have a tuna sub at Subway and soup for dinner.

I also have to remember to take my work laptop home so that I can do some work later this week or weekend to make up for the 2 days I took off last week and for any extra time I might need off next week. The bummer about this being a new job is that I don't have much sick/vacation time built up.. only 18 hours.

Last week I ended up taking off Thursday because I could not sleep the night before. I was literally wide awake the entire night. Around 5 am I sent an email to my boss saying I wasn't coming in because I had appointment in Olympia later in the day and I needed to get some sleep so I could drive.

Friday was my pre-op appointment. I was going to work at the beginning and end of the day, but it just wasn't worth it for 2-3 hours. I still spent the entire day in Seattle. The meeting at SCCA went fine. It was nice to sit down with my surgeon and talk about how the surgery will go and be able to ask questions. It was in a very relaxed atmosphere. When I went over to the hospital to meet with anesthesia, that was completely different. You are just 1 person in a long line of people coming in that day. I felt like I was being processed. I was able to connect with the anesthesiologist resident when I told him about my experience at the simulation center a couple weeks ago. So, that was something. The nurse though.. it was completely ridiculous. On a positive note, when I went over for the chest x-ray, it took about 10 minutes.. in and out. So that was good.

I'm going to wear my "hey cancer" t-shirt tomorrow as my form of protest against having cancer. Maybe that will brighten someone's day.

Surgery

I spoke to Dr. Calhoun for about 30 minutes last night. In reviewing all of my films with the radiologist, they both think I can move forward to the surgery. The radiologist at SCCA does not see this mysterious "3rd area" in the same way as the radiologist in Olympia. In fact, he recommends no more diagnostic testing and doesn't believe this area is of any concern. As disconcerting as this sounds, I have to believe that the guy who looks at cancer in MRIs all day vs. the guy who looks at the kitchen sink in MRIs all day knows what he is talking about. That being said, I will be very closely monitored over the coming years that if this area does start to look suspicious, we will catch it very early. I talked with Dr. Calhoun at length about it and I have faith in her assessment.

My surgery will be on May 14. Two guidewires will be placed under mammogram before surgery, and if for some reason it doesn't look like the area of microcalcifications will be amenable to excision at the same time as the cancer, then a biopsy will be taken of it. However, my surgeon feels that both will line up as they do in the films and will be excised at the same time.

Since my surgery is on a Wednesday, I may be able to go back to work on the following Monday. I'm going to be prepared to do some work from home, just in case.

Although it seems like a long time out, May 14th works very well for me. I have some appointments the week before that I'd rather not reschedule. Also, waiting until May means I'll get at least 2 days paid time off (1 sick day and 1 vacation day) that I will have accrued in April, but can't use until May. Plus Dr. Calhoun will be gone all next week at a conference, so her surgery schedule is booked this week and the first full week of May. So, it all works out.

I am feeling very confident about things, but it is 2:15 in the morning and I haven't gone to sleep yet. I'm hoping that after a cup of lavender and chamomile tea, I will be able to squeeze in 3 hours of sleep. I may be back to the sleeping pills for a day or two until my mind stops with the constant thinking about things.

A treatment decision

After talking to surgeons in Olympia and Seattle at Swedish and SCCA, I've decided to go with SCCA for my care. I met with 3 doctors yesterday, the surgeon, radiation oncologist and medical oncologist. Although I didn't think it mattered, I like the fact that they are all women. My surgeon, Dr. Calhoun, is wonderful so far. She is very easy to talk to and has a great personality. I was also really glad to talk with the oncologists, since I haven't had the opportunity to do so yet. We are not sure yet that chemo is in my future.. a lot will depend on the sentinel node biopsy.

The next step is to get another MRI at SCCA next week. They want to evaluate the third area and determine if it really needs to be removed. Also, since my first MRI was such a mix-up, I actually feel better about getting a second one. This time though, I'm going for the Xanax!

It was a very long day. I checked in at 11:30 and we did not leave until 5:30. I've received a ton of literature over the past 2 days. Plus, my step-mom ordered a bunch of books for me that my regular doctor had recommended. I'm not sure when I'll have time to read it all, but it will give me something to do when I'm recovering from surgery.

Now that I've made this decision, I'm anxious to get the surgery over with. I feel like I've almost forgotten that I have cancer over the past few weeks while I've been busy moving and starting my new job. Unfortunately, that doesn't make it go away. I'm ready to move forward with my treatment and get into the process of healing.

Decision time

I see two surgeons at the end of this week, Pat Dawson at Swedish and Kris Calhoun at SCCA. I've heard good things about both of them from various people. I'll make a decision on Friday as far as who I'm going to go with.

The appointment at SCCA will be very interesting.. it'll be almost a full day on Friday, and I'll be meeting with the surgical oncologist and radiation oncologist, as well as the surgeon.

Sometime on Friday I hope to have a surgery date set.

First visit with the surgeon

I was surprised by how open the surgeon was. He talked about the different options, but is inclined to start with breast conserving surgery, which works for me. However, before that determination can be made, he wants me to get an MRI of both breasts just to make sure there aren't any hidden lumps that weren't seen on mammogram. Since I have two areas of concern, the tumor and the micro calcs, if any others show up then I'm most likely in for a mastectomy.

The lumpectomy surgery would consist of taking out both areas in one large excision and also doing a sentinel node biopsy to see if there is any cancer spread to the lymph nodes. During the surgery, the pathologist will be able to determine if the node is positive or negative. If it's positive, they will take out about 1/3 of the lymph nodes.. basically all the nodes in the axilla. Although the surgery would be under a general anesthetic, I would go home the same day.

Since I plan to see another surgeon for a 2nd opinion, we didn't make any definite plans for the MRI.

Oh, and he said it is normal for the tumor to feel larger and closer to the skin. The biopsy caused the tissues to swell. At least I'm not imagining things!

I have breast cancer

That's not a very nice thing is it? But, it's a part of my life now...

This has been a very crazy, busy week since finding out about my diagnosis on Monday. Between family, friends, doctors, and women I don't even know, I don’t think I’ve ever talked on the phone so much in my life as I have the past 3 days. I'm grateful for the attention though. There is nothing worse than being diagnosed with a terrible disease and then never getting a call or email.

The pathology report from the biopsy has some encouraging news in that the estrogen and progesterone receptors are positive. This means I can be treated with anti-neoplastic drugs such as tamoxifen.

Today, I have my first visit with a surgeon in Olympia. I have received some excellent advice and support at work and I feel that I am prepared to discuss the different options including lumpectomy vs. mastectomy, radiation and chemo options.

Ok, so this is weird. Before I had my first mammogram, I did not feel any lumps. My doctor had done a breast exam the week before and she did not feel any lumps. During the week between “abnormal mammogram” and “biopsy” I felt around looking for a lump. I finally found it after the ultrasound was done and realized where the radiologist was looking. I mean, I had to kind of dig for it. Now that I’ve had the biopsy done, this lump is so completely obvious on the underside of my breast, I don’t know how it could have been missed. I’m wondering if the trauma to the tissues associated with the biopsy somehow made it stand out more. Or, now that it’s become the object of so much attention, it’s just more obvious. I don’t know. Another question to ask today.

I made a 3-ring binder to organize this phase in my life. Lots of tabs with names like, "diagnostic reports" "pathology reports" "healing retreats" "correspondence" "other women with breast CA" "surgeon notes" It goes on..but it's a good resource for me to make sure I have all the information I need.

One of the challenges I'm facing is where I should get treatment. I'm currently living in Olympia, about to move to Tacoma, and start a new job in Seattle. So, hmmm... do I get treatment where I live or where I work? Do I get some treatment in Seattle and some in Tacoma or Olympia? I don't know right now. I'm seeing one surgeon in Olympia and one in Seattle, so I'm just going to go with the person who makes me feel the most comfortable.