Wednesday, March 22, 2006

"LEFT" means "left"

DeAnna and I are back from outpatient surgery... After some chicken noodle soup and a toasted english muffin with butter, she's now curled up on the couch, doing just fine. She was a trooper (anyone out there surprised?).

Let me rewind a bit and give you a quick rundown of the afternoon: noon arrival at Grant hospital, free valet parking, quick check in at the front desk. We were directed upstairs to the Abulatory Surgery waiting room where we met a VERY pleasant nurse who really knew her stuff.

Grant has a fantastic system for family and friends: she handed me a pager they would use to notify me when D was done that would work anywhere in the hospital AND the public library across the street (BONUS!). In the waiting room, they also have a computerized patient status system mounted to the wall. In short, DeAnna was a assigned a patient number and I could use to check where she was in the process simply by finding her number in the appropriate column on the monitor (ie waiting to be checked in, surgery, recovery, etc)- think ariport arrival/departure monitors- BRILLIANT!

We barely had time to take off our coats and have a seat in the waiting area before a volunteer came to whisk DeAnna away to get her prepped and ready to go.

About a half an hour later, I was permitted to go back to the prepping area with her. There, I found her all gowned-up, covered in warm blankets and in good spirits. (They had also marked the word "LEFT" right below her collar bone on her left side, in case they forgot where they were supposed to go once they had her sedated and could no longer ask HER, I suppose. Where's my camera when I need it?!?) We were able to sit and giggle together for about a half an hour before they whisked her away a final time to surgery.

Couple of hours later, I was paged, informed by the friendly nurse that she was out of surgery and doing well. She pointed me to a small private room where I met with Dr.Liang, her surgeon, to get the official scoop.

The results are as follows: the port went in easily. No problems there. As planned, Dr.Liang also performed the excisional biopsy, removing a hardened lump from DeAnna's breast, as well as a bit of surrounding tissue. She had a pathologist waiting right there to do an on-the-spot test of the tissue. Much to Dr.Liang's surprise, it came up negative. Benign. No cancer found.

Hm. Crap.

So where does DeAnna proceed from here? Dr.Liang is... well... stumped! She is still recommending following through with the chemo, treating this as occult breast cancer; attack this stuff wherever it's setting up shop. DeAnna still has to tough it out through a few more tests (the painless ones, at least- another MRI and ultrasound) to make ABSOLUTELY sure they're not missing anything before they get started with the chemo. So the plan has not changed, post-surgery.

Worst case scenario is that DeAnna has a mastectomy some where in her future. But one thing at a time: more tests, chemo (bye bye eyebrows!), surgical removal of the offending lymph nodes.

WHEW.

DeAnna says "hi" from the couch, by the way :) She just informed me that "the only thing that hurts is my boob!" Yeah, that's going in the blog, too :)

Tuesday, March 21, 2006

Needles, schmeedles

Saw the doc after all of those tests. I have to admit that I spent the weekend not very happy. OK, yeah, that sounds odd. But I wasn’t happy to have been through a round of tests and then have to sit tight for an entire weekend. It’s not even that I had to deal with the worst-case-scenario running through my head. Rather it was just the not being able to do anything (again). But Monday came, and I was in to find out where things stood...

She was incredibly positive. The tests all came back really great. The CT scan was clean. The MRI showed some things, but hey, we knew there might be something. She checked out a few of the areas with her portable ultrasound right there in the office. The only spot that still worried her was the area around where the calcifications were found on the MRI. The bone scan was also clean—and that was a huge relief. OK, back to the great unknown, but at least the worst-case-scenario was NOT happening. For now, the assumption still had to be that the primary location was something in the breast tissue. I questioned the doc on several things, but my biggest concern was determining the primary location. She was confident that it it’s NOT lymphoma (of any kind); the cancer cells from the lymph node biopsy showed adenocarcinoma cells. These cancer cells do not originate in the lymph nodes.

Stereotactic biopsy… So I’m not sure I can explain a lot of this in words. In fact, they gave me a diagram showing how it works. I again wound up on my belly on a table, with the area in question poking through a hole in said table. Underneath that table was a unit, similar to a mammogram press, complete with xray. Here is where it gets dicey to explain the details. Let’s just say that after 5 or 6 tries at getting the position correct, I was finally told to hold still. This, of course, with my left girl in a press and my body contorted. I had to breathe very carefully to ensure that inhalations didn’t reposition me such that I’d have to go through the set-up over again. Here I stayed, for some 30 minutes. During that 30 minutes my boob was numbed, stuck, and plucked. After all was said and done, they had 12 tissue samples, some of which in fact had the calcifications that were seen on the mammogram. I left the office bruised, stunned, numb, and sore. I can say compared to that, a mammogram is nothing.

The call I received from the doc concerning the results of this biopsy—DCIS, or ductal carcinoma in-situ. Simply stated, these cells are precancerous cells that haven’t moved anywhere. This of course adds to the confusion—I have cancer cells in my armpit that came from somewhere. I did some of my own research as well, and it does seem that these cells CAN become invasive and move. It’s highly likely that there is a small area that is invasive (and moved on to my lymph node). Have I mentioned that I like my doc? We have spent a few conversations over the phone—a nice thing that doesn’t require me to keep going in for consults in her office. Over the course of these conversations, we have laid out a plan for the situation—chemo followed by surgery. OK, it’s not exactly that cut and dry, but close.

So tomorrow (Wednesday), I’m headed in for out-patient surgery to get the port put in place. This port will help with the administration of chemo drugs. It gives a semi-permanent, direct line to a vein. The stick at each chemo treatment will be into a receptor on the port that then travels into the vein. Saves the arms and keeps me from looking like a heroin addict. Along with the port placement, the doc has decided to do part of the other surgery—she’s going to remove a piece of breast tissue where the other biopsies have come from (called an excisional biopsy; it will be about the size of a quarter). It is likely that the cancerous area is small enough that they have just missed it with all of the needle pokes. As nice as it would have been to just go straight to this (to avoid all of the needles), it is encouraging that whatever is in there isn’t large enough to hit directly with a needle stick. Strangely, I am hoping for a positive test result on that biopsy. The mystery will be solved, and I’ll be ready to start getting the chemo treatments. Have I mentioned that I like my new hair cut?

Standardized Test Practice

Tests, tests, and more tests. It’s been over a week since I had these tests, but I realized something about that today. It least was a time when I felt like I was DOING something towards dealing/treating/whatever. The last week or so, I’ve been playing the waiting game. There is kind of a plan of attack, but it’s about getting all the ducks in a row to get it started.

The tests…the CT scan was first. It was scheduled for 9am, but I had to be there at 7:30am. If you have ever had a scheduled CT scan, you probably know why. You get 2 bottles of something-barium-with-berry-flavor-something or other. It was, well, not as filling as I thought it should be. If I had the equivalent of that in the form of a chocolate milkshake (from Coldstone made with cake batter ice cream), I would have been STUFFED. But within an hour (they give you an hour and a half), I had this stuff downed. Patty and I played a game…OK, it wasn’t really that fun of a game, but she gave me a time deadline to drink part of the cup’s worth. It worked until the receptionist was confused about what test I was there for and yelled at me to STOP DRINKING. After a minor consultation (wherein the receptionist bitched and moaned about how Maurine had failed to cancel something else), I was back to drinking and on track for the 9am scan.

And no CT scan is complete without an injection. Wow, I can’t remember what this injection was, but I do remember it was NOT the radioactive injection (that comes later). Apparently it was some other contrast agent—all running through me making me HOT from the inside out. The tech warned me about that, with the little note that the warmth would travel EVERYWHERE, wherein it would make me feel as though I had wet my pants. “You won’t,” she declared. Whew. I hadn’t brought a change of clothes. Once in the unit and after watching the thing spin loudly and having to hold my breath on the command of a computer-generated voice, it was over. OK, that was easy enough. By the way, that something-barium-with-berry-flavor-something really didn’t taste like anything, so if you ever need to drink it, don’t be afraid.

MRI…BREAST MRI…um, instead of lying on my back in the MRI tube (which I thought was going to happen, so I took a little Xanex to help me through that—no need for panic here!), I had to lay down face first, with my girls appropriately placed in 2 squared areas. Um, they ain’t square. And there was PLENTY of room there. My face was placed in a cradle similar to that on a massage table, and holy cow, there was a mirror down there. With the mirror in place, I could just look OUT of the tube, without having any perspective as to how tight that tube was. Nice—although a little TV or something would have been better. I was hooked up again to receive another injection of something or other (I think this time it was gallium). When it was injected, little syringes (that I could see thanks to that little mirror—see, a TV would have been better) started to move down, slowly pushing that gallium in. It kind of reminded me of some movie where there was an execution scene. OK, perhaps that was the Xanex talking. Despite the fact that I was given no music and the ear plugs were barely in place, I managed through the knocking and pinging of the MRI.

After a night’s slumber aided by the presence of Xanex in my system (not to mention barium and several other contrast dyes), I headed in again for another 7:30am check-in time for a bone scan. In terms of my effort, this was by far the easiest. Checked in, got injected with radioactivity (for those of you keeping count, that’s injection #3, technium-99), and headed to the cafeteria. Apparently it takes up to 3 hours for the radioactivity to stick where it’s supposed to—basically bones (anything with a lot of calcium). Bone scans are GREAT at detecting lots of things about bones—including hairline fractions and the like. Very sensitive, so if anything abnormal was on my bones, it would find it. Patty and I hung out at the hospital—cafeteria, gift shop, lobby—then headed back for the scan. The scan itself was nothing. This scanner was just a moving table with “readers” above and below me—not a tube, like the MRI. It took a mere 15 minutes to drag my body through the reader so the computer could pick up the radioactivity that stuck to my bones. The excess was supposed to leave via my bladder, but apparently I hadn’t quite emptied it. I thought I had, but as I said, the scanner is a wee bit sensitive…

Sunday, March 19, 2006

Friends and family beyond belief

I still have not completed the story as to how I have gotten to this short hair. Yes, I know everyone knows WHY I now have the short hair, but there is more...those blasted tests. But before I head into that, I wanted to say that I feel so INCREDIBLY FORTUNATE for all of the people that I have around me. Friends have been sending messages that have stopped me in my tracks. Wow, I miss so many people that have previously touched my life. And it is so great to hear from them again--if even for this reason.

And my family--you guys ROCK. I feel you around me all of the time (as I do my friends), even though you are not physically here.

Thanks everyone. I feel really blessed.