An update...Doctors Appointments and Ice Cream Trucks

Ugh...what a long process this all is. In the past 2-3 weeks I have had about 20 appointments with medical people of one kind or another.  Not only for my breast cancer, but also preparation...such as getting my teeth done and my eyes checked.  I have always hated making appointments.  Anyone who knows me knows that I do much better with spontaneity than I do with schedules.  If someone wants to do something with me, it is better to call me at the time to ask,  than it is to say... "What are you doing next Thursday at noon?".  I don't know what's happening tomorrow, much less next week.  Truly...It has been 3 years since I last saw a dentist (but I had no cavities, just had a couple of fillings replaced).  It had even been 2 years since I last saw a doctor at all...even when I had Pneumonia (I'm pretty sure) last February...thank goodness for the antibiotics I had on hand.  ...And let's not even mention the mammogram I should have had earlier. Scheduling so many appointments and making it to them is like a little bit of hell for me, and I have had a hard time getting anything else done.  If dentist and doctor and mammogram trucks came by my house like the ice cream truck does, I am sure I would jump on occasionally...but alas...they do not.

Fortunately, for a little while things have died down now, at least for a week or so.  I have my surgery for lumpectomy scheduled for March 6.  I have changed surgeons.  While I was waiting for other doctor appointments, I decided to check out a different surgeon who does oncoplastic surgery.  Which, if I understand correctly is the "art" of removing the lump with the best cosmetic outcome.  This means I won't need to have 2 surgeons...one for lump removal and one for reconstruction.  She also has newer methods...such as...When they remove the lump they also remove a few "sentinel" lymph nodes to see if there is any cancer spread to them.  If there is, they remove more, even all of them in the area.  The more lymph nodes removed increases the risk of complications such as lymphedema...which is a condition where the lymph fluid does not drain from the arm and causes it to swell.  This is a permanent condition...and well, being right handed, I would really like to keep using my right arm as much as possible.  The previous doctor works that way.   The new doctor says that if they find cancer in the first lymph nodes, they just radiate the remaining ones.  This may still kill the nodes, but decreases the chance of getting lymphedema.

Anyway, I went back and forth on the decision of which surgeon to choose... Older doctor (Harrison) with 35 years experience, or younger doctor (Gunia) with only a few years experience, but information on more current technique. I consulted friends for opinions (Thanks Garth!) and spent a whole lot of time with Dr. Google.  I even scheduled my surgery for February 27 with Dr. Gunia, but then freaked out and got scared and cancelled it and decided to go with Dr. Harrison.  The next day I regretted that decision and called Dr. Gunia's office back and sheepishly asked if I could take that back and reschedule.  They were very nice and understanding...but I don't think I could get away with doing that again without them getting a really annoyed. I dreaded telling Dr. Harrison's office staff that I was going with someone else.  She had been so nice and enthusiastic... and then suddenly her tone was deflated and professional as she wished me well.  It kind of felt like I had just friend-zoned a longtime boyfriend.

Oh well, that's over and now I can relax for a few days. I have a lot I want to get done before my surgery day, but I am beginning to whittle down the list of what I would like to accomplish (a very long list) vs. what really NEEDS to get done so I won't overwhelm myself...which I am prone to doing.  Truly, I would love if the "Lumpectomy Truck" would just drive by and I could hop on and be done with it. The nice thing is that the subject doesn't dominate my thoughts quite so much.  I even find that hours pass and I haven't thought about it...Ron and I even talk about other things....much to his relief I am sure. 

On a brighter note... Tuesday is my Birthday.  I love my birthday...It is my favorite day of the year! It is the only day of the year that I get to do ANYTHING I want.  I'm not quite sure what that will be yet, but it is a blank slate that no one fills but me.  I schedule no lunch dates or other appointments. (especially doctor appointments).  Some years have been very eventful and some just included going to the temple or taking a long, hot bath.  There is nothing I should do...only what I WANT to do on this one fabulous day of the year.  I can hardly wait...I am as giddy as a child waiting for Christmas!!

No Big Deal?? Hmmm... I wish!

I don't think a week has passed by more slowly for me since my days of anticipating Santa Claus.  Waiting for my Friday appointment, the appointment where I would finally meet my surgeon and she would tell me everything I need to know about my treatment options.  I tried to keep myself busy to pass the time, but it was still painfully slow.

Thursday arrived and Carol the patient care coordinator called me.  She and my surgeon are sisters, and she is delightful to talk to.  Always upbeat and positive. She called to remind me of my appointment on Friday...as if I could ever forget.  She told me that they had all the films and information they needed...all I had to do was bring myself and my boobs.  I told her that those were pretty attached to me and I would really like to keep it that way.  I really would...ugh...  The reality is beginning to set in again.  All week I've been able to push the thoughts to the back of my mind, but they are creeping back up to the front again.

Ron and I got to sleep in on Friday.  Although I insisted that I was OK to go to this appointment alone, and suggested that we could just put him on speaker phone when it came time to talk to the surgeon, Ron took off the morning to be with me anyway.  I am really glad he did.  In the elevator on the way up to the office, I suddenly felt like crying again. I haven't felt that way all week, but reality has reared its ugly head and I am feeling nervous again.

Once we got into the office, Carol greeted me again with her upbeat attitude.  We talked, she told me how she had once had BC and now she is a Double D.  She also told me about former patients and how amazing they look after all this.  After losing weight because of the chemotherapy and getting enhancements, she  hardly recognized them.  We talked and joked like we were old-time friends and by the time I had signed in, I was comfortable again.  She made it sound like no big deal.

Soon, I am in the exam room, Dr. Harrison comes in and asks me what the problem is.  Thought flash through my head...  Really??  Did you not see the records and films.  You are a surgeon who specializes in Breast Cancer, and you are asking me why I am here.  So I matter-of-factly state...well, I have breast cancer.  (What a nasty flavor that was to say.)  At that point she begins asking all kinds of questions about my family history... any cancer?  NO!  Well, my grandmother died of lung cancer when she was 47, but she smoked and was exposed to radiation up north during the nuclear testing in Nevada.  So I don't really count that.  Otherwise...I have heard of nothing in my family.  Unfortunately, from here on out, my family will not be able to say the same.  I am feeling a little weak link-ish.

Speaking of weak link...  I have realized that according to Darwin...without modern medical intervention, I would not be considered "fit".  I probably would not have survived choking on a pinion nut when I was five, but if I did, I probably would not have survived my 2nd miscarriage at 29, but if I did, I probably would not survive having breast cancer.  I have always considered myself pretty healthy, but am realizing that it is because of science and medical advances, I am and will continue to be alive.  I sure am grateful for that.

Anyway...back to my surgeon.  After an exam, we go back into her office where she carefully outlines what my surgery day will look like.  It is an all day affair even for a lumpectomy, which I have chosen.  But it is not as simple as that. There will be 3 different kinds of specialists there that day, Dr. Harrison, plus a plastic surgeon and a radiation specialist.  She explains that she will begin the day by injecting radioactive material into the breast and I will wait a couple of hours until it spreads to the lymph nodes.  Then she ill inject a blue dye that will make me pee green (blue + yellow).  After it has had a chance to migrate, they will use a geiger counter to determine which nodes are radioactive.  Those will be removed and immediately be examined by a pathologist to see if there is any cancer in them.  If some have it, more will be removed, if not that part is done.  The two tumors (the large one and the nearby 3mm) will be removed following that procedure.  Then the reconstruction and the radiation will follow.  They will wake me up (I've always hated that part), monitor me for a bit and send me home with care instructions.  I am told I can go back to work in about 2 days...just don't do any heavy lifting.

As I was leaving Dr. Harrison and Carol handed me some brochures for plastic surgeons.  While they were doing so, they tell me their personal experience with each one.  "Oh he is great, he is going to do my eyes", and "Yes, he did my... (fill in the blank)".  Haha!  Nice to know they have personal experience with each of the plastic surgeons.  It is certainly not my area of expertise.  When Ron and I left, we were feeling much more at ease.  In fact,  I started to think that this whole breast cancer thing was exaggerated and I couldn't figure out why everyone made such a big deal about it.  No sweat... surgery, reconstruction, radiation...oh yeah... chemotherapy...and hormone therapy.  In the back of my head was the reality.  As positive as they were, This is NO walk in the park.

By the next day, the fear began to creep up on me again. This is a big deal...in fact, it is life changing.  I have been researching just the hormone therapy, and I really dread it...strangely even more than I do the chemo.  With chemo, it is over in a few uncomfortable if not miserable months, but the hormone therapy lasts for years.  The idea is to suppress my estrogen and progesterone which feeds the majority of breast cancers.  I don't know if you all know this but PMS is caused by a drop in these hormones. These are the hormones that make us feel happy, and nurturing.  The drop is what makes us feel grumpy and out of sorts.  They also serve a number of other purposes and I would prefer to keep them going.  I mean I am aware that my days of having them so plentifully are numbered, but I would prefer to keep them as long as possible and not have them go away just yet.  I am really struggling with this one...as well as the chemo.(Which also will cause what I have heard referred to as "chemopause")  Part of me wants to just take my chances with the removal and radiation.  There are so few statistics that will tell me by how much my chances of recurrence are decreased by taking them.  They say that hormone therapy will reduce my chance of recurrence by 50%.  That sounds great but are they talking a 2% chance being reduced to a 1% chance or a 50% chance being reduced to a 25% chance?  I think I would take my chances on the 2%...but maybe not so much on the 50%.

So I research and am glad for all the science classes I took in the past few years.  I understand better how to read the articles that are actually scientific articles.  They give some information but not enough.  I am trying to get to a point of just taking it as it comes and not worrying about what follows so much.  One thing I am grateful for is that Dr. Harrison eased my concern about needing to hurry (too much). Cancer doesn't spread like I feared.  One or two cells in the lymph nodes remain one or two for a month or two, then they divide into 2-4, then one to two months later they become 4-8 tiny cells.  Cancer doesn't have much of an impact until much more division has happened.   Of course in that time, my current tumor will also double in size.  While it is important that we move on this, I can take my time (relatively).   My sense of alarm is no longer there.  I still have tons I want to get done, but now I have a bit more time.  I want to take a weekend and get away with my wonderful husband who is so kind and patient.  (I can't even begin to tell you enough how much I appreciate him.)  Also, my birthday is this month...on the 24th.  I am excited I will get to enjoy it...once again doing anything I want to do.  Only this time I think I will have a different perspective, because after that we'll get started.