Thursday, November 29, 2012

Na na na na na na na na na na na na na na na na... BATMAN!

Session #1 of physical therapy in done! One down, seven more to go. With the exception of one of the stretches feeling an awful lot like a brazilian jiu-jitsu paintbrush, I'd say it all went pretty well. And now I've got a handy-dandy sheet of exercises to work on at home in between my PT sessions.

Oh! And in addition to the axillary web syndrome, I learned that I also have a winged scapula. Also common in mastectomies with axillary node dissection.

So my should blade doesn't look nearly as bad as the guy's in this video, but the video is still pretty educational. And if you're not educated by it, then you'll at least be entertained by the narrator. His accent is fantastic!
And that is why I'm now adding Batman to my list of super-hero powers. Spider-Man... Batman... what's next? If I have to have radiation, can I add The Hulk to the list?

Monday, November 26, 2012

I like the Christmas Jesus best

Treating cancer is a little bit like saving money by buying stuff ('cause it was on sale). Sure, you get rid of the cancer. But in the process, you break a bunch of other stuff that wasn't broken before.

Today I met with a physical therapist for a lymphedema evaluation and to discuss the now limited range of motion in my left arm. Lymphedema is a common result of axillary dissection, and the rate of suffering from it significantly increases once you've had greater than 7 axillary lymph nodes removed. Because I'm now lacking 21 of mine it's a good idea to a get a baseline evaluation - even though I'm not experiencing any symptoms. The eval was helpful in that it also goes over ways to prevent developing symptoms. That includes wearing a compression sleeve when flying (I hope they come in different colors!) and avoiding repetitive motion. The PT's best example of this was scrubbing the bath tub, so I'm gonna say I'm off bathroom cleaning duty for a while

Impact on range of motion is also a pretty common side effect from a mastectomy and axillary dissection. So where my left arm used to move 180 degrees like it's supposed to, now it's closer to 120 degrees (lifting to the side) and 150 degrees (lifting to the front). To what do I owe this pleasure? Oh, just a little something called lymphatic cording. Which means I've got 4 weeks of physical therapy to look forward to. 

UPDATE: I just found that the other name for lymphatic cording is Axillary Web Syndrome. Here's a pretty good link explaining it. Also, I'm adding Spider-Man to my list superhero powers.

Now right here is where I was going to whine and complain about that. But decided instead to share this with you. Moxie as little baby Jesus. Enjoy!

So maybe that's not actually Moxie, but a very convincing likeness courtesy of a Christmas card I found at World Market.


Wednesday, November 21, 2012

What's new...

...since my last post? Let's see...

I got my fourth and final drain removed last Thursday! 

As a recap for those of you playing along home; post-op I came home with two surgical drains on each side. Both right side drains were removed on Day 10. One left side drain was removed on Day 17, and the other on Day 24. In case you were wondering, they kinda look a little something like this...
Should we talk about how much fun it is to shower and wear normal clothes with these hanging from you for over three weeks? No? Alright then... moving on!

After the last drain was removed, my tissue expanders received their second saline injection. Another 40 cc's on each side, putting each at right around 305 cc's. There's probably some very advanced math that converts expander cc's to bra size, but I have no idea what that formula is. I do, however, know that my regular, pre-mastectomy bras fit pretty well now. They're just really uncomfortable because the expanders don't move. At all. 

That means that I've got another week or two to let the expanders settle and relax ('cause no one likes an uptight tissue expander) before their next injection. Dr. M explained that once the right size is reached, he gives one additional injection - a 10% overfill - to allow the final implant a little extra room. So I may only have one more injection in my future. Woohoo! 

After the final injection, how long I have the tissue expanders in before they are exchanged for the final implants will depend on radiation (more on that in a minute). Here are the two possible scenarios...

Scenario #1: The radiation oncologist (Dr. G) gives me her blessing that the remaining tissue and nodes don't need radiation. Dr. M gives the tissue expanders a final injection in a week or two. And I can schedule the exchange surgery (exchanging the tissue expanders for the final implants) for 4 to 6 weeks after the last injection. 

Scenario #2: Dr. G does recommend I receive radiation in addition to the neo-adjuvant chemotherapy and bilateral mastectomy I've already received. Radiation would begin in roughly two weeks (they like to allow for 4 to 6 weeks post-op recovery). I would receive treatment five days a weeks for six weeks. Then... I would have an additional 6 months of recovery - allowing my skin to heal - before the exchange surgery. 

Now, to radiate or not to radiate? That is still being discussed and decided. According to Dr. G, here are the reasons to radiate...

1) My age. Because I'm young, my risk is high for the old cancer to come back or a new one to show up.
2) My cancer cells had a "high growth factor". Meaning they liked to move fast. 
3) I had positive lymph nodes. Again, the cancer cells were on the move before we stopped them in their tracks. 

And the reasons not to radiate...

1) My age. The radiation can cause damage to my heart and lungs. Which is bad in general, but worse if I plan to use them for the next 60 years. 
2) My cancer cells were triple positive (estrogen, progesterone, and Her2) and responded really well to treatment. Which is a good indicator that I'll have a lot of success continuing Herceptin and adding Tamoxifen. Meaning those two drugs are likely enough to keep me in the clear for the next 5 years. 

So that's the latest. Happy Thanksgiving to all! Try not to mow anyone down in your Black Friday shopping-induced excitement. 

Sunday, November 11, 2012

Hello...hello...is this thing on?

Yup, still here. Cleverly disguised as a really lazy blogger. So tomorrow will be the three week anniversary of my surgery and Tuesday will be my first day back to work in as much time. What's new since my last post? Well...

I got to watch Marissa compete in a regional cheer competition. There may be some bias here, but holy crap is she amazing. #soproud

We had dinner with Alyssa and Chris. And made brilliant election predictions. Then I slept through all of the election night coverage. #surpriseme

In an attempt to keep me from going completely stir crazy, Mom took me to see Cloud Atlas. Which I highly encourage everyone go see. Mostly because I have no idea what it was about and need all of you to explain it to me. #whatthehelljusthappened

Rob took me back to Dr. M's for my first saline injection. Which looks a little something like this...
This graphic is slightly inaccurate, in that my tissue expanders are beneath my pecs - stretching muscle. But...we forgot to take pictures at the appointment and this is the best one Google images had to offer. 
...Dr. M injected 40 cc's on each side and has got me scheduled to come back this Thursday for another 40-50 cc's. I was hoping to get rid of both my remaining surgical drains this week, but #2 has still been producing too much fluid. So at almost 3 weeks post-op, I've still got one very annoying drain left. #fingerscrossedthatitcomesoutthisweek

I got to visit - and shop - with Grandma yesterday where her community hosted a holiday bazaar. Also where I got loads of compliments on my haircut. #lovestylishlittleoldladies

And today I made Rob drive almost two hours to look at a bunch of really old rocks. #thatmanmustreallyloveme
Click HERE for our entire album of really old rocks!
Oh, almost forgot! And I received this in the mail...
...I'm gonna give you a minute for this irony of this to sink in. #areyoufrigginkiddingme

Thursday, November 1, 2012

Warning! mildly graphic content below...

...but it's really not that bad, so don't be such a sissy. But first...

 Major accomplishments of the day!

1. Upgrading from yoga pants and tennis shoes to jeans and ballet flats.

2. Getting 2 of my 4 surgical drains removed. 

3. Having the steri-strips removed from my incisions. 

4. Getting a clear pathology report!

Today was 10 days post-op (and 7 weeks since last chemo - but who's counting), which meant ALL the docs wanted to see me. Dr. B was first up and went over the pathology of everything she removed during surgery. Long story short, chemo kicked some major cancer ass! 

Dr. B (surgical oncologist) removed 21 left axillary lymph nodes and their biopsy came back cancer-free. The invasive ductal carcinoma - which was a 3x3x2 cm tumor just a mere six months ago - gone. The only thing the chemo hadn't sent running and screaming was the ductal carcinoma in situ. There was still a 2.2 cm tumor hanging out in the evil twin. But not anymore, thanks to surgery. And the good twin? All pathology was clear there, too. Mad props to Dr. B!

Now, to radiate or not to radiate? That is the question. Which will be answered by Dr. G, the radiation oncologist. Stay tuned

Next stop was Dr. F (medical oncologist), who remains super psyched about how well the chemo kicked major cancer ass. Her recommendation? Stay the course with Herceptin (8 infusions down, only 9 more to go) and hold off on Tamoxifen until the jury has decided on radiation, or not. Also, go for another echo at the beginning of year.Three snaps in a Z formation for Dr. F!
Last stop was Dr. M (reconstructive surgeon), who was super impressed with how well/quickly my incisions are healing. I attribute that to the fact that I am now part vampire... or Wolverine... or something.
This is the right side (good twin) where two of my drains were removed today. Looking suspiciously like vampire bites.
And this is the "before" photo. As in before the drains came out. See? Not that bad.
Hopefully the two left side (evil twin) drains will be ready to come out by Monday or Tuesday. Then I'll be back in Dr. M's office next Thursday for my first tissue expander fill. He left both 450 cc expanders about half full at the time of surgery. Starting next week, I'll go in once or twice a week for the expanders to gradually be injected with saline. Kinda like getting your braces adjusted... but different. Anyway, slowly filling the expanders gets my muscles ready for the implants that will eventually replace them. The expanders, that is, not my muscles. They're staying just where they are, if only a lot more limber. So tissue expanders are kinda like really intense yoga for your pec muscles. 
I have no idea what's going on here, but tissue expanders look way less painful than this.