Saturday, October 20, 2012

Practice surgery

Yesterday we spent the afternoon in Portland getting a chest port placed to make the rest of the chemo safer to administer.  For clarification, it is not a shunt and has nothing exposed on the outside. There will be a small bump on my skin and it is all underneath my skin, so I can do my normal activities, which is a relief since I will have it for about a year.  I will be getting Herceptin eleven more times after the chemo is done, every three weeks, and will get it through the port.  Luckily, Herceptin is not a chemo drug but more of a biologic type agent so it will not make me sick or prevent me from growing hair after the four months if chemo.  The lame (all relative) news is I cannot go in the pool for two weeks while the surgical site heals.

I love my surgeon. She is brilliant, highly competent, and has amazing social skills (I know some surgeon types lack those).  Also, in chatting, we found out she is also going to the Springsteen concert, and The Book of Mormon!  This says nothing about her qualifications, but it made us so happy nonetheless.  She's One Of Us!  If anyone is curious about her, her name is Jennifer Garreau at Legacy Health Center in Portland.  (Mothers, I know you may want to google her if you haven't already!)

Dr. Garreau also called the procedure a little practice surgery.  Also, we got some clarification on the lymph node question.  That is, I have been asked by concerned friends and family why I am not having a sentinel node biopsy during my surgery.  I had a needle biopsy that found cancer in a lymph node, and the MRI showed three positive lymph nodes.  If a sentinel node biopsy is done, all the information they would have would be about the sentinel node and there is no way of knowing whether there is cancer in others even if the sentinel node shows none at that time (because at this point there is) until they are removed and examined. It is definitely possible that the chemo may clear out all the cancer prior to surgery, but that is not a guarantee.  To do a double mastectomy and leave potentially cancerous lymph nodes in me is not a good idea.  The standard of care in my case is to do the axillary dissection (removal of lymph nodes, in my case, two of the three clusters of them under the right arm).  Dr. Garreau told Jon that my physical fitness and level of activity will help me not to have arm problems, and I am definitely a person who will do all of the recommended follow up, physical therapy, and whatever else to prevent or minimize problems with my right arm.  So that is the definitive word on the lymph node question.
This weekend I am supposed to take it easy, and can probably go for a run by Monday.  I have been thinking about the time period of the beginning of my rheumatoid arthritis for some reason.  2006 and part of 2007, about a year and a half, were pretty hellish.  So far, physically at least, I am concluding that that experience was a whole lot worse than this one.  It was incredibly, incredibly painful, debillitating, and was accompanied by depression that was physiologically caused by my immune response.  I feared during that time that the state I was in was the state I might be in for the rest of my life, which would possibly involve me ending up in a wheelchair.  Luckily my medications panned out and I have been living almost symptom free for the last five years. This current crisis is more of a challenge mentally (and may certainly become moreso physically as time goes on), much more, as the cancer word is involved and with it some pretty scary questions about what the future holds. It is also a condition with outward manifestations (particularly the baldness) that advertise to the world what I am going through, which is also much more of a challenge.
Anyway, that is just some rambling, as this is what my brain does now: ramble.  Happily, my cousin is coming over today, which will be pretty great.


  1. Again, an incredibly helpful update.

    You are an amazing writer!

  2. Very good piece, Laura. So pleased you are writing--

    Sue Skinner