And the Waiting Continues

I call it waiting, they call it healing.  Actually it is both.  I felt much better after the last drain was removed and that area is healing now.  I still have swelling and a hard "lump" at the end of my incision that they are watching.  We have to send a photo of it in two weeks to compare to the first one taken.  Hematoma was mentioned but I don’t think that would be hard.  Cording is something they are watching for and I have been doing stretching exercises 3 times a day.  Always something!

We have done a lot of just sitting around worrying about dinner!  It is always the big question of the day.  I declared tonight to be "fend for yourself" wherein anything in the refrigerator is up for grabs.  Fill your plate, microwave it and you will be filled and the refrigerator emptied!  I used this periodically when working with a family of 5!  

We did go to dinner this past week at the outdoor patio Mexican restaurant. Kara and Bill went there and Kristin thought it a good idea to spend Margarita World Day sipping one of theirs.  This created more leftovers!  

Kristin and I went to the nail salon Wednesday and this morning we had a Zoom second opinion meeting with an oncologist available to Kara through an employ benefit from her company.  We had the mastectomy pathology with the recommendation, BMO - endocrine therapy.  We asked what BMO meant since we found a dozen acronyms using these letters.  He said this is the Tumor Board’s recommendation to the Breast Medical Oncologist - prescribe the Arimidex (or similar) and nothing more!!!  He said he agrees with this with the suggestion I get a bone density test and then have Boneva or something similar to protect my bones.  

We were stunned but he said I should never get chemo from anyone for a 1.3 mm tumor following a mastectomy with no lymph node involvement.  We have decided we will go next Thursday to see what she is recommending now that all the pathology is in, my blood clot/Eliquis situation is specifically brought to her attention and see if she has changed her mind.  If so, without documentation to back up her recommendation, we will seek a third opinion.  

Friday evening we went to Olive Garden to use a gift card from my sister Laurie.  It was Kristin’s last evening so it was fitting to use the last gift card.  They also have the $5 Take Home Meal so we bought three for the freezer.    She got off late morning in Saturday and will stop as close to Florida as she can get today.  She went north to 105 to take that to Beaumont and not deal with I-10 out of Houston.  She came in that way too when I-10 was closed in Beaumont and liked the quiet country route.  She arrived home safely on Sunday afternoon.  It was the first we have been alone in over a month.  

Mastectomy Pathology

Post Op Visit.

When my margins came back bad on my lumpectomy I had to choose chancing a second lumpectomy or opt for a mastectomy. There is so much info to go through and you need knowledgeable people to help you understand.

A second lumpectomy could still leave margins necessitating a third surgery. Also, the plastic surgeon said there would not be enough tissue to redo the reconstruction like the first time so my breasts would not be the same size and he knew I was not onboard for messing with my healthy left breast.

Mastectomy would definitely remove any and all cancer. The downside could be regret if there wasn’t anything more there than the small bit at the superior margin that would be removed.

I opted for mastectomy to avoid a possible third surgery and the peace of mind knowing it was all removed.

The outcome is only the small superior margin remained and there was no cancer anywhere else in the breast including two wayward lymph nodes that never made their way to my clavicle area as I developed.  

So … the lumpectomy would have been enough. I would be mismatched and have no definitive (to me) guarantee that there was nothing lingering. But to know there was no other cancer and those two wayward lymph nodes had no cancer was great.

I have a 3/3 appointment with the oncologist to plan for the medical part of beating cancer.  She outlined the protocol then and I guess I will learn if anything has changed in light of all that we have learned.  That 1.3 mm tumor (size of a grain of rice) was the very worst indicator of my type of cancer.  It was actually aspirated in the original biopsy and everything else has been much less toxic.  But whatever she says I need to do, I will do!

The Aftermath

Monday Kara and I went to Canopy, a cancer patient community for all sorts of things. I wanted to ask about when I could be fitted for a prosthesis. What an amazing place! I need to wait 6-8 weeks for a fitting but in the meantime they gave me a lovely bag to hold a shirt with inside pockets for drains to wear home from the hospital, a heart shaped pillow to hold against my incision for comfort, socks, lip balm, knitted knockers! These are hand knitted breast forms soft enough to wear until you get your custom prosthesis. My surgery was scheduled for 3 pm Tuesday with an arrival time of 1 pm. We left in time to check into a hotel suite so Kara could get set up to work while Ted went with me to the hospital. We got checked in and then were told there was an hour and a half delay. Turns out they slipped someone in front of us and we lost are operating room. It was 6 pm before my surgery got started. I don’t recall too much after that. But at 6:30 am Wednesday morning the PA came in and checked me out and proclaimed me fit for discharge! I had them call the hotel and Ted ran Kara over to help me dress and get discharge instructions while he packed up the things at the hotel. True to form it took until 10:30 to get everything in place to leave. We called Ted who drove right over and they were wheeling me out just as he pulled up. I was glad to be home, drains, incision and all.

Another Surgery

We were all counting on good pathology because I had a mammogram, 2 magnified mammograms, an ultrasound, a clip placement, a "scout" to travel to the clip and a soft mammogram to determine the area to be excised.  And in the end, the margins were not clean.  The lymph nodes (4) were all good and that is the very best news.

So back to decisions and odds.  Another lumpectomy would be 90% certain, a mastectomy would be 100% effective (though they will tell you breast cells can remain much like ovary and prostate cancer cells).  I did not want to roll the dice and set myself up for a possible third surgery or the mental weight of "did they really get it all?" so I chose the mastectomy.  Surgery will be 2/8.

In the meantime Kara has been running the ship here at home.  We have been eating well and not doing much of anything but run to doctors.  I visited the dermatologist because two different nurses saw something on my back and said it should be looked at.  Dr. K said I have lots of "stuff" but none of it is in need of coming off except for appearance.  Good!  Then we saw the cardiologist for an EKG, prescription of Lovinox to allow me to forego my Eliquis before surgery and discuss the medicines I will receive during my treatment and their potential to cause heart issues.  She agrees the benefits of Herceptin far outweigh the risks so that is good to know.

We also went to Pappasitos as a guest of my niece who called the restaurant and told them she wanted to host our dinner and gave them her credit card number.  What a tremendous, uplifting thing.  Right now a good margarita helped!

Bill turned 60 on Saturday so the restaurant gifted him a plate of sopapillas for dessert.

And two of our grandchildren sent us strawberries.

Saturday we got haircuts and then Ted went to church and brought Communion home.  Kara’s friends sent money for us to order out for dinner so he and Bill went to Russo’s and brought our dinner home.  After, we played Mexican Train with Bill being victorious.