surgery jitters and more drugs

The woman before me in exercise class this morning was tall and thin. She used the high step and kept up well with the instructor, so she was easy for me to follow as well. When I looked at her in the mirror, though, I noticed that she had very high (and large and round) breasts. She wore a low top, and at times her breasts looked like they were going to jump out!

My gosh. Why do women do this? And yet here I am, 2 days away from “doing it”! I called my plastic surgeon’s office this afternoon and spoke to Leah again. I won’t end up like this, will I? I mean, I’m almost 60 years old, and breasts like that would make me look like a freak. Leah assured me that Dr. L knew what I was expecting from the reconstruction surgery, and that I would not end up with such exaggerated breasts.

Last minute jitters, I guess. I am nervous about the surgery – more about the anesthesia than everything else, though.

I saw my oncologist today and complained to her about the femara. The hot flashes are so pronounced through the night that I don’t get a lot of sleep, and end up very tired most of the time. Along with my bones and joints aching more, I’m pretty cranky. She suggested an antidepressant – Effixor – says that it will relieve much of the night sweating and help me to sleep better.

I’ve never taken an anti-depressant before. Even though I have my moments of feeling “down”, I’ve never considered myself to be clinically depressed. And I’m hesitant to take yet another drug to cover the side effects of a drug.

Anyway, we’ll see. I’m going to get through this next surgery, with all the pain pills and antibiotics that go with it, before I consider taking another drug.

the basketball on my chest (the "expander")

I just had the 3rd injection of saline into my “expander”. I call it the basketball on my chest. According to Dr. L, there is now 380 cc’s of saline in there. He wants over 400, so that means another injection next week.

It’s not that it “hurts”, but it is quite weird, especially for a couple of days after the injection. I always feel a little shaky after I leave the office. Like my body is just a bit shocked. This week I came home and just laid down. It definitely feels “full” and tight (and big!).

I am starting to get anxious to just get this done, even though it means another surgery. Dr. L says that after the last injection, I will need to wait at least 3-4 weeks so that the stretched tissue can settle down before he can put in the implant. And he says that lifting and matching my native breast will be the challenge for him. I told him that he needed to be like God, and make them beautiful.

And then there is the complication that chemotherapy would bring to this whole schedule. But I’m not thinking about that now …

still in the woods

Just when I thought I was out of the woods, home free, exercising, getting my life back together …

The pathologies from my mastectomy looked pretty good to me. Small tumors, clean nodes, clear margins. Even Dr. Rimmer said that I had come out on the good side of the numbers, with a 9mm tumor which is 1 mm shy of the size at which they would recommend chemo.

It seems that there are other factors. Like HER2/neu.

HER2 is a protein that promotes the growth of cancer cells. One of every four breast cancers over-produce this protein, which means that the cancer is more aggressive. They think that breast cancers that test positive for HER2/neu are more likely to recur.

I had 2 primary cancers in the breast that was removed. Both were relatively small. The DCIS was more extensive (2.5 cm) but showed small places (1mm) where it was getting out of the duct and becoming invasive (micro-invasion). Both cancer sites tested positive for HER2. The invasive site was less positive (rated 2.something), the DCIS site was more positive (rated 9 something). I don’t have a copy of the report.

If it were not for the HER2 distinction of my cancers, I would definitely not benefit from chemotherapy. As it stands now, it’s unclear whether or not I should be given the drug, Herceptin, which, according to Dr. Bertand, my oncologist, is given with (or as) chemo-therapy. (I still don’t really understand cytotoxic therapy, I’ve been avoiding the topic).

But there is this test - the Oncotype DX assay. It can predict the likelihood of breast cancer recurrence in women with newly diagnosed, early stage invasive breast cancer. That’s me. Oncotype DX also assesses the benefit from chemotherapy.

The test is also very expensive. Like thousands of dollars. Evidently it analyzes the genetic makeup of the cells. Dr. Bertrand says that the results are a good guide to whether or not chemotherapy should be prescribed for people like me. She says that it will help us to decide.

I’m not sure if my insurance will cover it. I have told Dr. Bertrand that if my insurance does not cover it, I am not inclined to pay for it myself. I would rather take my chances and NOT have chemo.

Somehow, I still don’t feel like I have cancer! I feel more like a number on a chart. Maybe all of this radical treatment (mastectomy, chemotherapy) would be easier if I had BIG cancer tumors, or if my lymph nodes were infected with cancer cells and I knew I was in trouble.

Anyway, we’ll see. The test takes 10 days. Dr. Bertrand is going to order it. I have another appointment with her in 2 weeks.

2 weeks post surgery and still in a funk (and a drain!)

In about 2 months time, I went from getting a suspect mammogram to a mastectomy and the beginnings of reconstruction. A part of my body was cut off. One of the drains is still in, 2 weeks after the surgery. I have taken so much antibiotic that I smell like sulfur.

I have worn the same clothes for 2 weeks. A woman from the breast cancer support group thought to give me a “mastectomy camisole”. This is the only piece of clothing that I feel secure in. There is a pocket for the drain. It is soft and gently hugs my skin. I wash it about every other day, and then put it right back on. It is like a comfort blanket.

I take a shower every day, but I don’t enjoy it. My drain hangs, precipitously, at my side. If it dangles, the irritation and soreness gets worse. Once the tubing got hung on the doorknob – real pain. And I have to sort of look at the still mangled looking area where my right breast used to be.

I hope the drain will be removed tomorrow. They tell me I have to have 2 days of under 30 cc’s of drainage. Yesterday there was 28 cc’s. But it looks like I’m draining more today – this morning there was 18 already. I’m trying to stay still, do nothing, anything to stop the drainage and get the damn thing out.

I am uncomfortable with the “aggressiveness” with which my cancer has been treated. My cancer sites were small and early stage. But because there were 2 separate sites, mastectomy seemed to be the only option they would give me. My pathology report, as far as I understand now, looks good. The margins were clean. The invasive cancer was only 9 mm at its widest – 1 mm short of warranting the chemotherapy where you lose your hair. I have yet to meet with the oncologist. I’m in no hurry. I expect that she will want to put me on the estrogen-blocking drug, and I’m not keen on the idea. My cancer cells were only 10% responsive to estrogen, which they say is low. I've heard that the estrogen-blocking drug causes weight gain, sleeplessness, and aching bones. Just what I need.

Basically, I want my life back, and I want to have more say in what happens to me. I want the drain out!

At this point, I’m not even sure I want reconstruction – a silicon breast and more surgery. Yet the expander was put in. I didn’t have enough time to consider all of this.

I wish that more women defiantly wore their breast cancer instead of opting for fake “boobs”. I wish that I felt more comfortable walking around with just 1 breast, and not feeling like I have to “cover it up”. I actually like the feel of the no-breast side of me now. There is no need for a bra, it feels a little free-ing.