Pathology Report

After surgery, my doctors sent my tumor and breasts to a lab to be analyzed. I got the results yesterday. Here are some details from the report:

--80% of my tumor was dead tissue! This is great, considering how large the tumor had gotten (9.7 cm, or about 4 inches).

--Out of the 15 nodes they took out of my right arm, only one was positive for cancer and that was only microscopic.

--My left breast and left sentinel node were completely clear

--The cancer had spread into my chest wall, so that is the bad news. But, I was already slated for radiation, so that will take care of that.

My oncologist was very happy with this report. I will be meeting with my surgeon tomorrow (Wednesday) and the radiation oncologist on Thursday. The three of them will discuss the situation and come up with a recommended plan of action. I'll see my oncologist next week and then as soon as I'm healed from the surgery, I'll go onto the next step.

I am so relieved that this was good news. I really needed it this time. I've had too much bad news for awhile.

Bilateral Mastectomy

I was diagnosed with breast cancer on April 13, 2011 and it has been a crazy, hectic ride since then. A lot of women with breast cancer have surgery very soon after diagnosis. In fact, my first cancer-specific appointment was with a breast surgeon. In my case, we decided that chemotherapy first was appropriate, so I was sent to a medical oncologist. After my course of chemo, we waited for 3 weeks for my body to heal before surgery.

I checked in to the hospital at 5:30 am the morning of my surgery (August 16th). I was anxious and was told my the nurse not to take my anti-anxiety medication that morning because the anesthesiologist did not want me to. (I told the anesthesiologist this and she said that I should have taken my anti-anxiety medication and said that she would look into why I was told not to take it). Anyway, I checked in, accompanied by my father-in-law (Tom) and my good friend Sandy. The receptionists where a bit on the slow side and the nurse came out to get me before I was fully checked in. After the paperwork was filled out, I was taken back to the pre-pre-surgery room. I could have one visitor with me at a time so Sandy sat with me and Tom sat in a little waiting room right next to us. I answered a bunch of questions about medications and why I was there and then changed into the fabulously unfashionable hospital garb. Tom came in for awhile too and we basically waited.

Eventually they took me back to the pre-surgery area and Sandy came with me, while Tom went back to main waiting room in the hospital lobby. The waiting in the pre-op area was the worst, but Sandy tried to keep me at ease with humor and she mostly succeeded. It was hard to be there without Gessner sitting beside me, but I really tried not to think about that. The anesthesiologist came to chat with me and ask some questions and answer any of mine. The only thing I asked is how my eyes might get injured (it was a warning on the anesthesia consent form) and I'm pretty sure she had never gotten that question before. (The answer was that if your eyes opened for any reason something could get in them, so they usually use tape to keep them shut). She was very nice and encouraging. My breast surgeon also came over and chatted briefly as did one of the nurses who would be in the OR.

I was in the OR at 7:30 am and they got me on the table and the next thing I know I was wake up in recovery.

I actually don't remember a lot about the hours after recovery, but that means they gave me the appropriate drugs :)

What a difference a year can make

This summer has been difficult for me. Not just because of the cancer (though that has definitely been a challenge), but also because I keep thinking about what we were doing this time last year. I think of last summer as the beginning of the end. Of course, at the time I didn't think that it was the end, I thought that it was just a bump in the always bumpy CF road.

In July we went to Colorado to visit Gessner's family. He was too sick to go and I tried to convince him to postpone the trip, but he insisted. He said that he wanted to make sure to see his grandmother in case something were to happen to her. It makes me wonder if he knew or felt something, but I don't think that he did. I think that if he did he would have done more "wrapping things up." Anyway...we went to Colorado and had a good visit with his family, including celebrating our niece's birthday.

(Gess and Hannah posing with tutus and tiaras)

But, Gess's health did not do well and he ended up in the hospital. It was scary to be in a hospital in a smaller city, with doctors that have no clue about CF. Gessner's oxygen saturation levels were way too low. He had to wear oxygen 24/7 while we were there. (Gess wearing 02)

After we got back to Seattle, Gess continued to use o2 much more frequently than he had before. It wasn't quite 24/7, but he needed frequently. He stopped working, which was HUGE for him. Gessner loved to work and worked way more than I wanted him to. I think that part of it was to prove that he could do it in spite of CF and to prove all of those people who said that he wouldn't live to be an adult wrong. And man did he prove that! He was an amazing man and did so much in his short life.

The reason for him taking time off from work was because he started the lung transplant evaluation process, which requires a lot of tests and appointments. I was actually a bit surprised when he decided that he wanted a lung transplant. He always said that he didn't know if he would want one or not, but I always felt that he wouldn't want to go through it. I'm not sure why, it was just a gut feeling. But, when the time came, he didn't want to live like he was living with the increased limitations, so transplant was his only option for going back to a more "normal" life. His lungs were not bad enough for a lung transplant under normal circumstances, but he had liver involvement too, so it changed the landscape a bit.

As we went through the transplant process I started to have hope that he would get better and I certainly didn't think that in a few short months he would be gone. I keep going over and over those months in my mind and looking for something that I could have done differently. What if I didn't let him go to Colorado? Would that have made a difference? Was I nice enough to him and supportive enough? Did I give him enough of myself? Did I make him happy? I know that there was nothing that I could do, but I can't stop these thoughts. Or the flashbacks and nightmares. I wish that I could.

In less than a week...

In less than a week I will have no breasts. I just can't quite wrap my head around this. I know that it is necessary--I want this cancer out of my body now--but I am scared of the after effects. I have done pretty well without having hair for the last couple of months, but now we are talking about body parts. And body parts that are viewed as "essential" parts of being female. I know that I will still be a woman without my breasts and that I will eventually have reconstruction, but I am not sure how I am going to deal with the emotional upheaval that is sure to follow.

I feel so broken right now. I am 33 years old and am a widow, a cancer patient, have no hair, will be permanent disfigured after my surgery on Tuesday, no career. In sum, I'm damaged goods.

Getting out of here!

I am being discharged from the hospital today--yay! I am so happy to be going home. I have been here from 3 days and that was long enough for me. I can't imagine the long stays that my CF friends have to do--but I guess you do what you have to.

I am still pretty anemic, so my oncologist gave me the option of staying for another day and getting a blood transfusion. He also said that we could take a look at my labs in a few days and then do a transfusion on an outpatient basis at that point. I decided to take the outpatient route. He said that the main issue I might have is being tired. And then because I have surgery coming up, I want to make sure that everything is okay for that. I am going to call my surgeon and discuss the issue and then get a transfusion next week if necessary. In the meantime, I guess I'll have a steak and spinach for dinner :)

Surgery is only 12 days away and I'm feeling a bit anxious about that. It is going to be so strange to wake up with no breasts. But I am ready to get this tumor out of me. I'm sure I'll have more rambling thoughts about this in the future.

Hospital

I am currently admitted in the hospital. This is my first "real" hospital stay--the only other one being a one night recovery stay after my emergency gall bladder removal. I also spent countless nights as a "visitor" in the hospital, but it is quite a different experience when you are the person in the bed.

Chemotherapy--particularly the regimen I am on--can wipe out a body's white blood cells. Part of the job of WBC is to help the body fight off infection. In order to help boost WBC, I get a shot of neulesta to help my body rebuild its WBC. With the first 3 doses of AC, this was sufficient. For the fourth and final dose, apparently not.

On Sunday I started to feel pretty crappy, so I just hung out at home and took it easy. On Monday morning I had to go to see my oncologist and I started to feel increasingly sick during the drive from home to the clinic. By the time I got there I felt awful. Apparently I looked awful too because the IV nurse suggested leaving my port accessed in case the oncologist wanted to order fluids (normally I would have been deaccessed immediately because I wasn't getting treatment). I vomited twice before I was able to see the doctor, again, not a good sign. By the time I got back to see the oncologist, his face said it all and I knew before he opened his mouth that I would not be going home. My WBC were too low--near zero--and he was afraid that I had an infection. I had a fever and also had lost 6 pounds in 6 days (which would normally be cause for celebration for me, but I wasn't trying and didn't even know).

Before I knew it, I was wheeled into room 801 and put in a fashion-deficient gown. It hit me that the last time I had been in a hospital room was 9 months ago when Gessner died. Even though this was a different hospital, I couldn't stop the tears and I spent my first few minutes of my admission crying. The nurse came in and I felt compelled to explain. He was very understanding and sympathetic, which I appreciated. I pulled myself together and answered all of the questions and let the nurses get me settled in. They started IV fluids and the doctor ordered IV antibiotics. They took me down for a chest xray and drew blood for blood cultures. These are all of the same tests and procedures that Gess went through when he was admitted--although much more efficiently and competently here.

My first night in was okay--I slept intermittently and had some weird dreams, but it wasn't too bad. The first full day was mind-numbingly boring, but I didn't feel much like doing anything and couldn't even muster the energy to waste hours on the internet. I did start to get restless and found myself arranging and picking up in the hospital room. Gessner used to do this with some regularity and I really never understood his need and seemingly intense drive to do this. But now I completely understand it. At some point after sitting in the bed doing nothing you just have to get up and do something productive--anything productive, even if that means restacking reading materials and folding your socks.

All of these little reminders of Gessner and flashes of his mannerisms and routines make me feel like he is here with me. There have been times when I have been pretty angry that he is not here to go through this with me and times when the same thought makes me very, very sad. But when I have these glimpses of him I find some comfort in feeling that he IS here with me or that all of the years of hospital stays with him readied me for specifically for this. It makes me feel a little less lonely and a little less afraid.