Tuesday, July 19, 2016

Healthy as a Horse - NOT!

I’ve always been healthy as a horse – with the exception of arthritis in my knees.  I had a second knee replacement in January and decided since I had my deductible and out-of-pocket medical all paid, I might as well get all of the wellness checks I’ve been putting off for literally years done.  So, I actually got a general practitioner to call my own (I’d always just popped in the doc-in-the-box urgent care places if I needed anything) and got the ball rolling.

First visit with my doctor, he did a pap smear (wasn’t planned, but he had time and it was one of those things I hadn’t had done for, oh about 10 years, so I said what the heck, go for it).  He suggested I make an appointment to have blood work done, and put in referrals for a mammogram (it had been about 12 years since I had my last mammogram) and a colonoscopy, and I went on my merry way.

Had the mammogram.  Results showed some abnormalities and indicated a need for a diagnostic mammogram.  I was assured that this happens frequently and most often shows nothing.  Went in for the diagnostic mammogram and then was shuffled into another room for an ultrasound.  Ultrasound tech fetched the doctor, who did some more ultrasounding.  Then told me I needed to have a biopsy in each breast because there were four spots (two in each breast) that were concerning.  But assured me that 80% of the time, those spots turn out to be benign and I shouldn’t worry.  I cried in the car, but otherwise tried to do the whole alternating stiff upper lip with joking around thing when I returned to work. 

Had the biopsy, followed by another mammogram (to make sure the little metal doohickeys they put in my breasts were, in fact, in the correct locations). 

Got the dreaded call on May 25 that I did, in fact, have breast cancer.  Only 1 of the 4 spots that had been biopsied were cancerous, though, so I did have that going for me.  And the cancer was mucinous carcinoma, which is apparently the kind you want if you have to have breast cancer.  It is, according to the doc who did the biopsy, slow growing and very treatable.  Got a referral to a surgeon.

Met the surgeon, who also assured me I had hit the breast cancer lottery as it was totally curable.  I think my surgeon doesn’t know how to handle people who deal with these kinds of problems with joking around.  He gave me some rather interesting looks – probably due to my lack of gravity about the whole thing.  But, really, if I’m not laughing about this, I’m crying – right?  He very seriously told me that because my cancer was in “the upper, inner quadrant” there might be a possibility that a scar would show if I was wearing an evening gown (snort!) or a bathing suit.  Now, folks, I’m not a young, thin gal and vanity about my boobs is about as far from my mind as can be imagined.  I was all, “No problem, just get it out of there!”  So we scheduled a surgery date for June 20th.

First, because they were very small and could not be felt by hand, I had to have wires inserted into my breast to assist the surgeon in locating the lumps (while there was only one definitive cancerous lump, the second lump in that breast had a strange shape, so we decided to vamoose it also).  From there, I was taken to the nuclear medicine department to have blue radioactive dye injected into my breast so that the sentinel lymph nodes could be determined and later removed to be tested for cancer.  (Funny note:  I peed BRIGHT blue for a full day following surgery.)  Then a bunch of waiting time – why I had to be at the hospital at 7:30 for a 1:20 surgery is beyond me!  But I was finally wheeled back to the operating room and put under general anesthesia. 

Who woulda thunk that this was an outpatient procedure?  I was bandaged up, given lots of instructions and sent on my merry way.  I had a prescription for Norco and took one pill before I went to bed, but the rest of my week of recovery was done on Tylenol alone.  It was really more discomfort than pain.  Had to wear a sports bra and sleep in the darned thing.  The scars were rather shocking looking at first, but now that the stitches are out and they’re healing well, it’s not so bad.  And infinitely preferable to cancer, of course.

Met with my radiation oncologist last week, who informed me that radiation is good.  Hmmm, I had already planned to have it as both the biopsy doctor and my surgeon had indicated that would be the next step.  I was hoping that appointment was more of a doing whatever had to be done to get the ball rolling step and less of a convincing me of the correct ball step.  But whatever!  My radiologist is a very nice guy and it was good to meet him.  Tomorrow, I’ll be having what’s called a “CT simulation” after which, according to the information sheet I was given, the “Radiation Oncologist, along with the physics and dosimetry staff will devise a treatment plan, make your blocks and calculate your treatment fields.”  They’ll also give me tiny little permanent tattoos to help direct the radiation at the same spot every time.  Fun times!  At least I’ll only have to have radiation therapy for 4 weeks (15 minutes a day, 5 days a week - the nurse said I’ll be spending more time changing into a gown and then back into my clothes than actually having the treatment).  I was originally told 4 to 6 weeks, so it was nice to hear that the shorter time frame would work for me.  The radiologist reiterated that the kind of cancer I had (past tense, since it was removed!) is eminently curable.  The radiation is simply to reduce the chances of a recurrence from 30% to about 5%. 

Have an appointment to meet with a medical oncologist in August.  Suspect I’ll be told I need no chemotherapy (which is what all of the doctors I’ve seen have thought – but the Med Onc is the definitive one).  Pretty sure he’ll recommend hormone therapy.  Which I am seriously thinking about not having.  The list of possible side effects is long and obnoxious and if I only have a 5% chance of a recurrence after radiation, I’m not sure I want the potential for blood clots, for instance, to reduce it any further.  When I mentioned that to my Rad Onc doctor, he looked pretty surprised.  As did my surgeon.  We’ll see …

Non-medical side effects?  Well, I actually feel a lot of guilt that this whole process has been relatively easy.  I know a woman who is in her mid-30s, has a young son, and will die of her breast cancer since it was a much more aggressive type and she was Stage IV when she was diagnosed.  Why am I, who have raised my kids, going to make it and she isn’t?  And why has my treatment been so easy, when she has gone through hell with hers?  Another thing I feel guilty about is the amount of time I have had to take off work – and that is going to continue to happen until treatment is done.  That’s on top of the 4 weeks I took off in January when I had my knee replacement. 

Modesty?  I’ve pretty much lost mine.  I ran through the list of folks who have handled my breasts since the end of April, and I believe at least 12 different people have done so.  Tomorrow, I’ll be adding to the list.  At this point, if a stranger on the street wanted to see my right breast, I’d probably whip up my top since any modesty I had is nonexistent any more.  Obviously, I wouldn’t really whip up my top, but I no longer think anything of it when someone I’ve just met is feeling me up.  I have to laugh when I compare how I felt when my general practitioner did a manual breast exam along with my pap smear (really embarrassed) to how I felt last week when my radiation oncologist checked the breast (no big deal).  A world of difference.

And throughout this whole procedure, I’ve had to keep my husband updated because he had to take a job across the country right before my first mammogram.  I think it’s been harder on him than it has on me since he can’t even be here with me. 

Perhaps I'll actually update this blog again before another 4 years have passed!