Monday, December 31, 2007
The skies cleared to a beautiful blue, and I'm going to go outside and exercise... right after I look at this web site. Then Jeremy called from Afghanistan, and we had a nice visit. He calls with a headset on his computer, a "voice over internet" call, which is a no-charge thing for him. Or me. Isn't technology great??!! Next thing I know, it's after 2 o'clock, and I have run out of time to go outdoors. And it has gotten cloudy. O well. After working 2 days it's nice to recoup a bit.
Daniel goes out to run errands, comes back with sandwiches, we eat, and I go to Jackson. Mom was sleeping when I got there, and I had to wake her. She doesn't like that too well, and makes noises for a time afterward. The aides come in to get her up, and I let them, instead of offering to help. I feed mom her dinner, sit with her until our turn in the bathroom, then get her ready for bed. They come back to help get off the pot and over to bed, then I tuck her in and leave to come home.
I had a bite to eat, chatted with Daniel, he went off to bed, and I wrote here after looking at wig sites on the web again.
May each of you have a Blessed New Year, with peace and love oozing all around you, to protect you from life's prickleys. The wisdom and strength to deal with challenges, and courage to keep reaching for it when you don't.
Happy New Year, my friends. Thank you all for reading.
Sunday, December 30, 2007
My breast was sore intermittently, and for a period of time this afternoon hurt pretty good. I didn't take anything for it, though; I was able just to massage it a little for a little bit of comfort. The heating pad would have felt really good. Ah, well, we do what we need to do....
I can say that there was a level of comfort among my co-workers and myself regarding my health status. Everyone was aware of what was going on, how I'm doing, and what happens next. I sensed/perceived that they were all OK with it, and every once in a while a question came up, or an idea , or an "I wonder why..." Some I could answer, some I couldn't.
Thank you all for reading. For your support, which makes my upcoming chemotherapy treatments just a bit easier to go into. And my concern about my job just a bit less worrisome. For the hugs, which I know go both ways.
God has blessed us all.
Saturday, December 29, 2007
It was a pretty good day. I'll be glad when I won't have to make the comment that my breast is still sore, and the area under my arm annoyingly full. I have it wrapped with the ace wrap, and it feels like it is chafing under the arm. When I look at the area of supposed irritation, nothing looks amiss. Ok--I'll just keep on keeping on.
I'm off--Thanks for reading.
Friday, December 28, 2007
I also noticed when I was out, that my breast didn't seem to be as bothersome, movement-wise. After I showered, I checked it out in the mirror. It does seem to be another little tiny bit of a smidgen smaller, maybe. Still full under the arm, though not as full as it was a couple weeks ago. I'm not real keen on the way that incision looks, though, and will continue to keep an eye on it. The incision on the breast is kind of dimpling. Ideally it will smooth out as the breast heals. It's definitely smaller and different shaped than the other. Does it really matter??--After all, the cancer's gone....
Daniel and Kristen left to take her over to Detroit Metro about 1:30. As soon as they left, I put the sheets in the laundry, vacuumed, cleaned the kitchen, changed laundry over, had a bite to eat, re-made the bed, then headed to Jackson. The snow had changed to rain south of Mason, and by the time I got to Jackson I had seen 5 vehicles off the road. Mom was quiet, I fed her and got her tucked into bed, then headed back home. It was 35 degrees, roads were wet, and the greatest annoyance was the road spray from other vehicles.
I put together scalloped potatoes and ham, put it in the oven, emptied the dishwasher, had another bite to eat, wrote here, and now it's off to bed. Saturday and Sunday are work days.
Thank you for reading, and commenting. It's great to know you're out there.
Thursday, December 27, 2007
I also told her that we had decided on a treatment plan-- the Cytoxin and Taxotere, for a 12 week course, then the radiation for 6 weeks. She reassured me that "the ladies" do very well with that, and I shouldn't have any problems...
The rest of the day I have planned to get groceries before going to Jackson.
Peace out. Kathy
Wednesday, December 26, 2007
I showered, and did the breast inspection. Not much different, maybe just a bit smaller. That incision on the areola is indented/puckered, and the spot between the incision and nipple is still a different color and very sore and tender. The underarm incision looks about like yesterday, but maybe the fullness is just a bit less. And it seems more moveable, though it fills back up. Overall, I see a little improvement today. And I feel good.
I called a couple of wig shops to check on hours and pricing, as our BCBS doesn't cover a hair prosthetic. Fortunately, though, the cancer insurance does, so that will be reimbursed. I think all is moving along well, and I'm happy for the break in appointments.
Thank you for reading--hope you are enjoying this holiday season.
Tuesday, December 25, 2007
I slept well, woke up with sinus pressure and swelling on the right side of my face around my eye. Eww. I wandered around the house, made a fresh pot of coffee and sipped the warm fluid. That felt good. I eventually started feeling better, and removed the ace wrap to have a look...
Whoa!! The swelling has gone down quite a lot in the breast, and it looks, um, different. Like I've had a breast reduction, on the top half. The bottom half is still full and a little firm, but I think there's fluid caught in there. The incision on the breast is still tender and sore, but firm immediately around it, and kind of puckering. I hope that smoothes out. The underarm is full, but maybe not as much. That incision is like indented, maybe like an "innie" belly button. I hope that one smoothes out, too. The swelling above the wound creates a fold at the incision line, and the sensation is bothersome, even though it's still mostly numb.
And then, comparing it to the other breast. Definitely not symmetrical. Hm. Left nipple looking out, right one like a lazy eyelid. And the left one is about an inch higher than the other. This could be an interesting bra-fitting issue. Ah, well, it's not done healing, I'll try to be patient and watch the process, and not worry (too much) about the long term outcome. I go shower, and massage the fluid around, which helps some. The reality is that I can't massage it all day. I do try to move the fluid frequently, though, and keep it compressed with the ace wrap. The ace wrap is a comfort measure, too. I try to leave the wrap off for a couple of hours after bathing to let things rest and see what happens, and I find myself supporting the breast with my hand, and it does seem to be uncomfortable just hanging there. It's ok if I'm able to rest my elbow on the arm of the sofa, with the heating pad over my shoulder and tucked into the armpit. I noticed, too, in the shower, that the numbness down the underside of the upper arm is still there, but maybe not as intense. That will be wonderful to have resolved.
Our afternoon passed by--I putzed around, prepared and ate food, I went to the nursing home and back, all without incident. It's now time for bed again.
I hope you are having a great Christmas season. Thank you for reading, for sharing yourselves with me and Dan. Your support is nurturing us, giving us courage and strength.
Monday, December 24, 2007
I got over to the nursing home and helped Elaine with her dinner, got her washed up and tucked in, and headed home. My car had very light coat of frozen drizzle, though the ice wiped off of the headlights, and was easily removed from the windshield. I headed out, slowly, and just south of Leslie it had stopped precipitating. Much better driving.
I got home and visited with my wonderful husband, then he went to bed and I didn't. I went to the sofa with the heating pad and the computer. Still sore, and tender on the breast, irritated/annoying under the arm. I have to remember that it's only been 4 weeks. I think that I expect to wake up and be all better. I think I have a big sleep to go through first....
Merry Christmas to all. Keep in mind it's Jesus' birthday, and cause for celebration. Let our hearts be light, and the future of tomorrow be filled with optimism and happiness.
Sunday, December 23, 2007
We got to the nursing home, mom had been fed and they were changing her clothes. They had also curled her hair. I thanked them for getting her ready and doing a nice job. Frank came in and helped get her into the car. Mom hardly made a noise, and was quiet all the way there. Frank scooped her up again and carried her into Jim and Polly's home, placing her in the recliner. Mom stayed awake all afternoon, listening and looking. Jeremy called from Afghanistan, and we had a nice conversation. We had a wonderful meal, I fed mom, then we opened gifts. Lots of hugs and conversations. Time for Frank to scoop Elaine again and get into the car. She wasn't so quiet this time, and made noise most of the way back to the nursing home. Frank got her out of the car, into the wheelchair, and we rolled back to the room. She was still fussy, I rolled her around the facility, but that didn't work, but she quieted after I got her into the bathroom to get ready for bed. With her tucked in and comfortable, Dan and I headed home.
Breon and Nick were making buckeyes for gifts, and left after they were done. Dan went to bed at 9 pm, I stayed up and wrote here. I'm just a bit sore, and every once in a while the wound gets a sharp pain. The heating pad feels good. I'm on my way to bed, too, and up at 0410 to work....
Thank you for reading, for the hugs, for the support. You are, each of you, so very important to me and Dan.
I put the cherry pie together and put that in the oven, then go to shower. Daniel goes out to run some errands, and comes back in a short time later.
After I showered, I called out to Daniel--Come here, please, it's time for breast inspection :)
I stand in front of the full length mirror and put my arm up over my head and look, turning front to side, then front, then side.... Hm. The breast itself is much softer today, and looks to be reducing in size. Hm. Could be a challenge later, though, as I see that the right breast, the unaltered one, is looking a little, shall we say, aged?? when compared to the left. The affected side is blinking straight ahead and off to the left, while the unaffected side is looking just a little more downward, like maybe instead of at the chest, at the bellybutton. The underside of the surgical breast is still firm and full, but not as much as yesterday. Hmm. And the medial side, or side towards the middle, is softer, almost normal. WooHoo! Still quite firm at the top of the areola, though, where the incision is, and directly under the incision, or the inside of the breast, the tissue is still firm and tender where the tumor was removed. And the nipple is really tender. The areola is finally regaining some color, though the area where the dye was injected is still somewhat blanched and discolored. And tender. BUT--overall--better. Breathe.The armpit incision is still an indent in the puffy underarm, although it doesn't appear to be as full, either. I picked at the incision--to the back end was a crusty thing that you know I just had to get off. I wondered if it would drain anything, and I pressed around it, but nothing happened. Oh well. It's not as full, so what's happening to the fluid?? I look some more, Dan presses around to the ribs around the back. It's here, he says. And we giggle at the jiggle in my left (butt)cheek. Overall, better. Praise the Lord it's not going down into my arm and hand.
I put the lights and ornaments on the Christmas tree, Dan puts the lights on the balcony railing, and we wrap gifts. There. Pretty much ready for Christmas. I have a bite to eat, then leave for the afternoon. Hair appointment, nursing home, then I come home, change clothes, freshen up, then off to Flint for the 58th Sander Christmas Sing... Fa la la la la la...
Even though we arrived about 9:00, we were in time to sing several songs. What a beautiful thing, the love and community of this family event. Thanks to Etta Mary and Wayne for their energies and efforts. Of course, lots of conversations and hugs and goodies afterwards, and I appreciate hearing other peoples' experiences with cancers and treatments. We were finally able to weave our way out, and got back home shortly after midnight.
Thanks to all for your love and support, hugs and encouragement.
Friday, December 21, 2007
We had a fairly good day today, with a flurry of discharges that lasted a couple of hours in the early afternoon, and the ones laboring hadn't delivered yet. So we ended up staffing down, which was ok. I am saturated with the information Dan and I have been presented with the last couple of days, and at times feel like I want to shut down to be able to process it all. I had an opportunity to Google Taxol vs. Taxotere, and looked through a few of the results. What scary drugs. I have yet to look up the cytoxin. The 12 1/2 hour shift wound to a close, and I clocked out, changed my clothes, and headed over to the nursing home.
Mom was in the geri chair waiting for me, and we had to wait our turn for the bathroom. I got her washed up and tucked in and headed home in the misty fog. It looks like we lost a lot of the snow today.
Daniel was waiting for me, we chatted about our day, and plans for the next few days. While he folded a load of laundry, I took the 3 foot artificial tree from the box and shaped the branches. Wa La!!! Tree's up!! We're ready!!
Thank you for reading, I'll write again.
Thursday, December 20, 2007
I was up, dressed, and fed, and worked on yesterday's entry. Daniel came in, fussing that he couldn't see because of the dilation, and finally closed his eyes and rested.
We left to go over to Ingham Greenlawn where the Radiology Center is. Dan let me out at the door to go in and drop off the request for medical records. I did that, and went back out to the car and we drove around the building to park. Inside, the nice lady Vicky had me sign in, and she asked for my insurance card and the forms I had filled out, and handed me a clipboard with even more forms to sign. She copied the card and handed it back, I went to sit near a window in the sun and fill out the new pile of paperwork. I took that stuff back to Vicky, who thanked me and said she'd tell the RN that we were here, then returned to wait to be called.
And wait. We finally got called back about 2:15. Melissa is an RN who is also certified in radiation as well as chemotherapy. She led us back to an exam room (typical exam room--small, exam table, exam light with a flexible "gooseneck", two chairs, rolling stool, counter with sink, etc.) Melissa told me to leave my coat and purse in the room, and Dan stay there too, while she and I go to where the scales are kept. 142 lb. We go back into the room, she reviews the history stuff I've filled out, and after we've chatted a bit, she checks my blood pressure. 128/66, pulse 88, temp 98.0. Melissa also measured the circumference of my arms. She measured 10 cm from the outer elbow down the forearm and up the upper arm, one arm at a time. The left arm was: Upper-30 cm, Lower-23 1/2 cm. Right arm, Upper-27 1/2 cm, Lower-23 cm. She starts talking about the status of my tumor--receptors positive, etc, and that I've got all the "good" things going for me. She likes Dr Amy Bolmer, and we discussed the treatment options given us. Melissa, being very familiar with the drugs, told us that if there was another tumor of some type in the future, I would not be able to have the Adriamycin again. So her thoughts were to go with just the cytoxin and taxotere; that way the Adriamycin would be out there available if we needed to use it. And it's so harsh. I liked her thinking. She also said that one of the drugs, I think it was the Cytoxin, causes neuropathy (numbness). Permanent. In the hands and feet. What?? I ask her if it resolves over time, she says not usually. She couldn't predict how my body would respond, but that it almost always causes some residual numbness, at least in the fingers and toes. I asked about fingernails and toenails. She nodded her head--the nails lift up off the bed. Eww. They do recover, but it takes a while, like almost a year. And we are doing this on purpose?? Well, I've always had pretty hands, and I've liked them. If they change, I guess I'll be ok with that, at least I'll be alive to remember what they were like. And we have the beautiful hand pictures of our wedding rings, and of Mom's and my hands. Yep, I'm ok with that. The numbness, though, ......not so much.
We had a good discussion: she answered our questions about some things that Amy had said yesterday, and expounded on a lot of things too. She seems to know her stuff. She told us about the radiation treatments--how it's not invasive (no iv's or anything), and the statastics of radiation vs. no radiation. Much better to have radiation. We picked her brain for other concerns and questions, and we were done. She asked me to change into the patient gown, shook our hands again, and left the room.
Dr. DeBiose came in after a few minutes. He was maybe 50-ish, maybe 5'8" tall. Very pleasant, he shook my hand, and I introduced him to Daniel, they shook hands. He launched into a few questions about how we were doing, and what the treatment plan is. He asked me to sit up on the exam table. I told him chemo starts January 9. He told us that the Ingham Radiology Center is unique in that it is affiliated with McLaren Health Systems, Michigan State University, and University of Michigan. He mentioned that Foote Health System has a University of Michigan affiliated radiology program, and he offered if I preferred to go to Jackson for my treatments. I asked if I could have treatments in both places--no, the machines are too sensitive, and if we tried to change the adjustments from one to the other, there is no way to make it precise enough. So, I chose to stay in Lansing.
He said radiation usually starts a couple weeks after the chemo is completed, and mine will be daily, 5 days a week, for 6 weeks. He went on to talk about the risks, what happens, and what to expect. He was summoned at that point by a knock on the door, and excused himself. He came back in after just a few minutes. He started talking again about the process, and asked to examine my breast. He poked and felt, he was focused on the pouch above the axillary wound and talked about lymphedema. Right now this collection of fluid is what I have, but that may change at any time in the future. He said that with all of the factors of my cancer, he will not radiate the armpit. (Yea!!) It will be just the whole of the breast tissue, and he indicated an area larger than the breast that we see. Also, he said he will not include any other lymph, like in the sub-clavicular area (below the collarbone). He feels that there is no need to bother that lymph system any more than what it is. He also looked at the breast, the incision on the breast, the areola, etc. He thought it was healing well, and said when the seroma and hematoma have gone my breast may be a bit mis-shapen. He also said that radiation makes the breast tissue more firm, like fibrous, like it's scar tissue inside. And it will stay, if you will, "perky", where the right one will sag with the passing of time. Hm. Interesting.
And we ask why then don't we do radiation on both breasts? Because each breast is it's own entity, and each breast cancer tumor is its own. Like, the cancer won't migrate to the other breast. So we only treat the affected one. Oh.
He is done telling us all the required stuff, and we've asked all of our questions. He said the office will check with Amy's office to see how I'm doing, and in a couple of months maybe we'll get a CT scan of the breast. If I'm not up to it, we can wait until after the chemo is done and do it then. Then we start the radiation about 2 weeks after the chemo is done, daily for 6 weeks. Wow.
No more questions, he shakes our hands again and shows us out. Dan and I walk back to the car, saying how much we liked both of those professionals. It was 4 o'clock, we had been in there almost 2 hours. I called the nursing home and asked the staff to feed Elaine, as I was hungry myself, and wanted to spend time with Daniel.
We stopped at Flap Jack Shack, ate, got home. Dan put the ace wraps on for me, and I headed to Jackson. Mom was just being brought from the feeder room, and I told her how the visit went. She made the noises she makes when trying to talk, and I talked back to her like I knew what she was saying. I got her washed up and ready for bed, tucked in, and came home. I got home about 9, Daniel was already in bed asleep.
He woke up and held me. That was really nice. He reassured me that we'll get through this, that this time next year we would be almost back to "normal".
Is there a normal...???
Friday is a workday, Saturday is haircut and party in the evening in Flint, and Sunday is our Family Christmas is Concord. I asked Mom if she was looking forward to going to the Christmas party, she nodded her head yes.
Thanks for reading, for supporting us, for praying for us. For the phone calls, emails, and especially the hugs. Your positive energies are easing this difficult road. Love you all. Kathy & Dan
Dan and I were at Dr. Bolmer's office about 2:50. I signed in, and the nice lady asked if I had brought my paperwork with me. Yes, and handed them over. She also wanted my driver's license and insurance card to make copies of. We waited a bit, then were shown to exam room 9. On the way down the hall, we stopped at the scale. Dan held my coat, purse, and envelope with my note paper while Latira, or something (no name badges) asked me to step on the scale. 145 lb. Hm. We went into exam room 9, and she took my blood pressure--110/66, temp 97.1, pulse 88. Good, she says. While the blood pressure cuff is on, she asks if she can take my picture for the chart, reaches into a pouch on the machine's stand, and pulls out a polaroid camera. *Flash* click, there it is. Interesting. I wanted to say something smart, like what are you going to do, take one now then take one later when I'm feeling like *^^$#$%^&*??? She briefly looked through the chart, said something about Dr. coming in, and left.
We were in a typical exam room: cabinet, counter, sink, exam table, and 2 chairs. I thought of my friend (Lucy) who likes to open all the drawers and doors and play with the equipment. I tried to get up but was stuck to my chair. In just a few minutes, Dr came in.
She was maybe late 40's early 50's , shoulder length naturally curly light brown hair, tamed with magnifier glasses on top of her head. She greeted us, and she had a raspy voice like a cold or talking too much today or heavy smokers or screamers might have. Interesting--Dr. Sanchez said this woman had been practicing about 5 years, too, and I expected to see a younger person. Dan reminded me that Sanchez also said Dr. Bolmer had been a nurse before becoming a physician. Oh, I had forgotten that. Anyway, she introduced herself, I stood and shook her hand and introduced Daniel, who also stood and shook her hand. Dr. Amy Bolmer pulled up the rolling stool and sat opposite me, using the exam table for a desk. I had my paper and pen handy, and put it up there, too. She spoke fast--so fast I had to keep focused on what she was saying. I did understand the words, the concepts, etc, but I couldn't drift off and process it to see what I thought about it, so I wrote down key concepts and ideas that I thought would help me and Dan later on.
Amy said the tumor was 1.4 cm, and that the DNA studies on the tumor revealed that it was ER+, PR+, and HER2-NEU negative by FISH. (Estrogen Receptor positive, Progesterone Receptor positive, and the HER stuff--the FISH is the type of study). Grade II, Stage II. Which, she said, is all good. (hm, good) So you'll have chemotherapy and radiation, and follow up hormone therapy for 5 years because you're pre-menopausal. When pre-menopausal women have breast cancer we like to treat it aggressively, which leads us to treatment options. (options??)
We can do Adriamycin and Cytoxin, 4 cycles, then Taxol, 4 cycles, for a total of 16 weeks. She called this a dose dense therapy, and it's pretty harsh on the body. Dan says he remembers her saying that you have treatments every 2 weeks, and she said you feel kind of rough for about 10 days, you might feel better for a few days, then it's time for your next treatment.
The other option is Cytoxin and Taxotere, 3 cycles, for a total of 12 weeks. This combination is less harsh, relatively new (in that the women in the studies are only 3 years out of treatment), but she felt that my factors lend to this option. Also, the treatments are every 3 weeks, and you feel better for about 10 days before the next one.
She said that whichever course we decide, we would start on January 9 and January 10. Radiation treatments will start after the chemotherapy is finished. Oh, that's fast.
She went on to explain that the drugs work by inhibiting cell reproduction, and that hair follicles and bone marrow are cells that reproduce quickly. What that means is that you will lose your hair, and we will follow your blood studies for red blood cells and platelets. Oh. Ok. As she is talking so fast, and I'm trying to keep up with her, she takes her prescription pad out and puts it on the table. And so, she says, I'm going to write you a prescription (pause-writing) for (pause-writing) a cranial (pause-and she looks up at me) hair (pause-writing) prosthesis. She looks up at me, tears the page from the pad, and slides the script over. What!!??? You're writing me a prescription for a WIG!?!?!? You're not kidding --I said that outloud--I realized that I had an expression of incredulous-ness, and I was laughing. Yes, she said, some insurances cover a wig with a prescription. Oh, ok. Do you have a recommendation for a wig shop? Yes, Elegance, in the Frandor shopping center. Ok, when will my hair come out? Usually after the first treatment, in a couple of weeks. Hm--holy doo dah. I'm gonna need a wig. She starts talking again, I need to keep up....
Regardless of which treatment option we choose, she felt there was a GOOD PROGNOSIS. I heard that part ok. And I said, Wait, I'm going to write that right here, in the middle of my paper, where there was a large blank area. She smiled. I think that was about the only time she was quiet and wasn't wiggling all over. I mean that her arms, hands, legs, feet, were always moving. And she called the other patients "the ladies".
We went on to discuss the actual process--IV administration of the chemotherapy one day, the next day back for IV fluids--one or two bags, depending on how you're feeling nausea and vomiting-wise. She said they've found that the second day hydration improves how you tolerate the chemicals. Then you come back in a couple 2 or 3 weeks for your next treatment, whichever course we choose. We talked about other supportive medications, like Zofran, Decadron, Benadryl, Nexium, Neulasta, Procrit--all of which may be used at some point. She did say that with the Adriamycin option they first infuse Zofran, Decadron, and Benadryl, and that with the other option only the Zofran and Decadron, because it's not so harsh. All things to consider.
She also mentioned that because of my status--type and size of tumor, age, pre-menopausal, etc--that genetic studies will be considered. Dan and I asked if they would send a pre-authorization request to BCBS. Those results will impact everyone on my bloodline tree. The genetic studies, hopefully, will be done fairly soon. We will probably hear about that in January.
Dr was done, it had been 1 1/2 hours. She invited Phyllis, one of the nurses, to come in and take us on the tour of the office. There were 10 exam rooms, and 12 IV rooms. Each IV room had a recliner with an iv pole built-in, a wall-mounted tv, 2 side chairs, counter with sink, and a window. She said we were welcome to bring personal music, needlework etc, snacks, 1 or 2 people, etc., whatever we needed to help pass the time and be comfortable. Phyllis looked at my right arm for potential iv sites--she said they looked good. I told her I had poopy veins. She said they use 24 gauge needles and usually remove them each time. But could be left in overnight for hydration the next day, whatever works for you. Ok. And we can place a port at any time. Ok.
We didn't have any other questions, and went to the window to check out and make the appointments for the first treatments, January 9 at 10:00 for whichever chemo course we choose, and January 10 at 10:30 for hydration. The first appointment will be approximately 4 hours. Wow.
I am saturated with all that I have heard. Dan and I leave, we're quiet, and hold hands through the parking lot. We look at each other after we get in the car. Wow, I said. It's real. Yeah, he said. I told him it became real for me when she slid that prescription over for the wig. Yeah, he smiled.
We get home, I chew on some food, and head to Jackson to get Elaine in bed, I also have folding tables and chairs in the van for Jim and Polly to pick up for our family Christmas on Sunday. I do all that, and stop at Meijer on the way home, and find that it' s 11 o'clock when I leave the store. Whoa--I didn't mean to be that late. But I've learned to take the time I need, and evidently I had a hard time staying on track. (you think..???) I got home, chatted with Dan and Breon, had a bite to eat, and tried to write. I was so tired, the keyboard was dyslexic, so I just wrote a brief note to the blog. (this is the alteration of that entry)
Daniel and I have info to chew on, research, and make a decision. Tomorrow, Thursday, we see the radiation oncologist, Dr David DeBiose, at 1:45.
Thank you all for your prayers and energies. Each of you help us maintain. I'll write again.
Tuesday, December 18, 2007
After clocking out, I went in the locker room to change clothes before going over to the nursing home. MaryLynne was there again, and she adjusted the wrap a little. When we did, I was looking at the nipple--it had a whiteish almost waxy creamy substance at the base or in the crease of the nipple on the areola. I was able to remove it just by going over it lightly with my finger, but boy is that areola/nipple tender.
Anxiety crept in several times throughout the day--tomorrow at 3:00 pm is our consultation meeting with Dr. Amy Bolmer, the medication oncologist. We will be discussing The Treatment Plan for chemotherapy. Thursday is the consultation meeting with Dr. David DeBiose, the radiation oncologist. Yes, I'm anxious. Breathe.
I got over to Elaine's, got her washed up and tucked in, and headed home. Dan and I visited a bit, he went to bed, I wrote the blog, and I'm off to bed, too.
Thanks for reading.
Monday, December 17, 2007
I went over to the nursing home and got mom tucked in, then came home. It's cold, about 17 degrees when I came in at 10:15, and will be cooler for the morning drive to Jackson.
I'm tired, and ready for bed. I'll write tomorrow.
Sunday, December 16, 2007
My shoulder is sore. I sit with the heating pad for a while to start with, then after a while I have a look at what's there. After I take the ace wraps off, I see that the redness is better at both incisions, and the shadows on the breast are somewhat better. The breast is still full, about the same as yesterday. Above the underarm incision is still full. When I hold my arm straight out to my side, it just looks full, but if I even put my hand on my hip it forms a bulge there. It also forms a fold that bothers me; I think I wrote that yesterday. I also notice that there is still fullness at the bottom of my ribcage, at the back and side, that's probably lymph fluid. It looks funny, but I'd rather have it there than down my arm and hand, as the handouts and brochures show. Daniel comes in and looks, too; he places his hand over the fullness, which is somewhat larger than his hand covers.
He helps me with the ace wraps. He's really quite good at it, and respects my comfort and what works better. After we're done and taped, my breast and underarm feel much better. And I remember that I wanted to try a picture of the underarm fold, and maybe the rib fullness, too. Sorry. I'll try for new photos another day.
We had breakfast, did some other household chores. It was on my list to go over to the storage unit and get the Christmas stuff. Dan went out and started the van, swept it off, and I went over to pick up the boxes I wanted to bring over. Well, I passed a pickup that had spun out and gotten stuck on the side of the road, and the storage facility was drifted in, at least 3 foot drifts, not plowed, (obviously), and I wasn't going to wade in there and get wet up to my thighs. Back home. I caught the plow guy out front of our building and asked him to plow the parking pad next to the outer garage where the huge snowdrift is. I had to walk over there and show him where it is--it's a new company--but he did, and did a fine job. I put the van back in it's parking place.
By then, football was on, and we watched the game. I took a couple of tylenol for general shoulder and breast discomfort, and ended up napping through the third quarter. I prepared food, and we ate, then it was time to go to Jackson.
The roads were fair, I got there without an incident for me, but someone had gone off the road on the right, down the ditch, flew up in the air, over the fence, and landed upside down. There was a police officer stopped with the lights on, up on the highway, but no other vehicles, and no footprints, so maybe it had just happened?? I sent a prayer with angels.
I fed mom and tucked her in, and came back home. The roads were better, as it had quit snowing about 3pm. We watched more football, then time for bed. I'm still a bit uncomfortable, but hopefully I'll be able to sleep through it.
Monday and Tuesday are workdays, then Medication Oncology, Dr. Bolmer, on Wednesday, and Radiation Oncology, Dr. DeBiosi, on Thursday.
Thanks for reading....
Saturday, December 15, 2007
I was surprised that we slept so long, but it was gloomy this morning, and we tend to sleep longer when it's not so bright in the morning...
We had breakfast, and I sat on the sofa and put the heating pad on. After a while, I decided I'd better go outside and exercise before the snow starts in earnest. I was just a little flaky out, the temp about 28 degrees, and a little wind. I stretched, bundled up, went out. My breast is sore this morning, and the bump above the underarm incision is definitely there. And I wasn't sure I really wanted to go out, but I thought I'd better do it while I can. From what little bit I'm reading, it seems that I may be knocked over a bit, and I want to go into the treatments as strong as I can.
It was cold, but I warmed up ok; I just took it easy. I was feeling good about my slow pace, and noticed I would speed up now and then, and then it wasn't feeling as good. So I'd back off, slow down, consciously controlling my breathing. I thought I was going really slow, and I'd never get done, and had to remind myself that it's just one step at a time, and you'll get there... Sure enough, I did. And I felt ok, too.
After I cooled off, I went in and showered, then inspected myself. Hm. Incisions look much better today, not as pink, and the breast doesn't seem as swollen. It is still swollen, and heavy, but not as much. The area on the areola that has been hurting is still tender, sensitive, sore, and looks to be blanched out as the dye is fading. I wonder why that is. That incision on the breast is firm around it-- scar tissue? swelling? lymph fluid? The area above and on the side where the tumor was removed is softening some, and is tender and sore. The underarm incision--I get closer to the mirror--is still reddened, but less; firm, and sometimes feels picky, prickley, abrasive, abraded. Is that the nerve waking up? Above the incision and forward is the swelling that bothers me the most. It's full, so full it makes like a fold at the incision. Maybe I'll try a photo of that tomorrow, if it's still there. I believe that is the area where the 7 cm x 5 cm x 1 cm slab of tisssue was removed for the collection of the 17 lymph nodes. I look at it more closely--since that skin is numb, the wound is not tender at all. I touch it, then I see that there is something like a small whitehead in the incision line. What's that..?? Hm, I run my fingernail over it, it's something hard. I do it again, and it seems to come out a little. Ok, I'm gonna pick at it now. I end up pulling out something about 1/4 inch long, off white in color, kind of firm, not crispy. I thought it might be waxy feeling or something, but it wasn't. It looked like it might have had a fuzzy or something sticking out of one end of it. Darn, where it that microscope when you want to use it..?? I showed Dan, I think he looked, politely, and wanted me to go back to whatever I was doing. Then I pressed all around it, maybe something else will come out. A small little ooze of thick sticky gray stuff came from the little hole, and nothing more from that. The clear stuff was still coming out of the opening of the incision, but hardly any, and I couldn't encourage anything else to come out, so I left it alone. That incision is firm and slightly reddened--more so than the other, but much less than yesterday. The hole that the drain went in is healing well, just a little pink. The underside of the breast is still a little dusky, off-color. Interesting. Good thing I've got the generic Keflex.
Dan helps me again with the ace wrap, and I finish dressing and get on with my day, which consisted of food prep, food consumption, and computer time. I leave to go to Jackson.
Mom is quiet in her recliner, and watches me move around the room. I help her with dinner, get her ready for and tucked into bed, and leave to go to a Christmas Party. It's snowing pretty good, it's really beautiful with the seasonal decorations in the neighborhoods. I see my friends at the gathering, we hug, smile, chat, and eat, and it's time to leave. I clean the car off, again, and head home. It takes about an hour, the roads are ok if you don't try to go too fast for conditions.
Daniel is still up when I come in, he greets me with smiles and hugs. He's such a wonderful guy. I am truly blessed to have him. He goes off to bed about 11:30, and I write my blog.
And I think that's all I have to write, other than I realized I hadn't had any pain med today. So I took a couple of tylenol just for general principal, because I hadn't had any today. And I'm off to bed.
Friday, December 14, 2007
I sat on the sofa with my arm propped on it's arm, and the heating pad. yo, that feels good. I unlooped the ace wrap from around my neck, and sat there for a while, probably an hour or so, just surfin' the net, kinda veggin'...
The phone rings, it's Sharon from Human Resources at Foote. I had called her and left a message to ask about the info needed to submit to Colonial for the Cancer Policy claims. Her advice was to get the medical records from the hospital relating to the surgeries to include with the Blue Cross Explanation of Benefits. Thanks for the info...
I might be feeling a little better, it's about 1030, and I get up to take care of biologic matters, and I'm hungry too. As I was fixing breakfast and brewing a fresh pot, Dan came home. I finished eating, we chatted, then I go to shower. You know I had to inspect the wounds. Where the most discomfort has been, yesterday and this morning, it's reddened, and still tender and full. There are a couple of quarter-sized spots of drainage on the pad, a darker, almost brownish tan color, different than what I've been seeing. The incision under my arm is kind of puckered, but maybe it's because of the fluid underneath?? And it does look a little wet, like it's oozing slightly. I press a little, and a spot emerges. It still looks like the orange red stuff I saw the other day. ok. In the shower.
The water feels good, and I massage the breast and underarm to try to move the fluid out. I only get a couple of drops, but at least some of it moves. After the shower I leave off the ace wrap and bra to let everything rest. About 3 o'clock I ask Dan to help me rewrap, and we looked at how things are healing. There is still a shadow or discoloration on the bottom or underside of the breast. The breast and nipple are softer, but still very sore and tender. The incision on the breast itself looks scads better. hm--maybe I did need antibiotics. There is redness, however, still on the top of the breast, and the underarm incision definitely is reddened, mostly at the incision and below, maybe to an inch or so. Good call, Doc. Fullness above that incision and into the pit, and forward of that, but not like it was, a lump. Just full, and tender now. Dan also notices that my back appears to be full, over the shoulder blade and the shoulder socket itself. You know, my shoulder was tight and a little sore yesterday, I found myself rubbing it and not using it as much in the afternoon. That fluid has to go somewhere.....
We wrap the 8 inch wide ace wrap around my torso, over the breast (to "lift and support", and to compress also) and around my neck to the back, then under the arm and back to the front, under the left breast. I hold the end of it, and we use the 4 inch wide too, overlapping the ends a bit, then bringing it around the back, under the arm to compress the incision, around the neck, around the back to the front, and taped it to secure it. That feels really good. He helps me with the "everyday" bra (the right breast is dangling in space and feeling left out) and I feel mostly put together. Daniel has prepared a lovely meal of steak and mushrooms and acorn squash and tells me it's ready. Has God been good to me or what...???
I go to Jackson, all is well there, get mom fed, washed up and tucked in, and come home. I have sharp burning pain at the areola where the dye stain is. It seems to ebb, then come on again. The heating pad is my friend, but the pain doesn't stay gone. After a couple hours of this, I finally take a couple tylenol while I try to finish my blog. Daniel has gone to bed, and can you believe it's 11:30 again??
I'll write tomorrow. Thanks for reading.
Thursday, December 13, 2007
Typical morning, I get to the hospital. A couple of different girls are there today, more hugs, smiles, tears. The tears surprise me, but I'm learning to appreciate our vulnerability. The day goes on, fairly well. We're busy, but managable.
By mid afternoon I'm getting pretty tired, and my shoulder's tired, my breast hurts, it feels like it's hugely full of fluid, and I'm ready for a nap. We're getting admissions, and the staff that have been called in arrive. Kelly mostly takes over on half of the patients (I had them all to start, with my RN partners, of course) and I take a couple of tylenol and coast for a minute. (thanks, Kelly) I get a bit of another wind, and finish up the day. Before I leave, Becky brings me a love card with signatures, and a bit of "stuffing." Thanks, you girls, you are, each one of you, the best.
When I get over to the care home mom is in the geri chair, quiet. The one that doesn't stay reclined nor the footrest stay elevated. I asked where the other chairs were, the one that had her name on it, no one knows, and I don't see any other chairs around. I stand mom and she walks, slowly, into the bathroom, but we get there. I finish her, Sandy comes in to help, and we get over to the bed and tucked in.
I left there and got home about 1015. My breast is really full and uncomfortable. There seems to be a lump of fullness where the tumor was. I wonder if that's where the fluid is collecting, and if it's a problem (other than major discomfort). The underarm incision looks wet, you know, like it glistens sometimes. So hopefully the hole is still open.
I am really tired, and it is 11:30 again. I've got to go to bed. Thanks for reading.
Wednesday, December 12, 2007
The new lots west of the hospital were not completed, and as I went on, I could see there were cars in F Lot, where I generally park. So I went in and parked. I didn't see a shuttle coming anywhere near this area, so I pulled my hat on and went across the street.
Into the building, I found I was anxious, and what was the combination to my lock....?? Don't be silly, you've had that lock forever, don't even think about the numbers, it will open. I get up to the floor, turn the corner, and there are the night shift staff. Smiles, hugs, open arms. Wow. I clocked in. We chatted for a few minutes, and I went back to the change room. There's that lock. This way, that way, this way. It didn't open. I laughed at myself. Again, it didn't open. Ok. Slow down, do it again. There. See? No big deal. A couple of other staff members trickled in; hugs, tears. Our fears leak through our vulnerability. We are, each of us, afraid of the unknown, the roulette of disease. Hoping for the best, praying for strength, courage, and the ability to live our best lives for ourselves, for each other.
I went back out to the unit, and greeted, hugged, held you with our first meetings throughout the day. How empowering, the energies we share among us.
My workday itself was busy in the morning right up until noon, when I was finally able to feel "caught up" somewhat and have a bite for lunch. Then back at it. I did pretty good--a couple of tylenol in the morning, and a couple more in the afternoon. That breast feels so full and heavy, it's tender on the inside. I left the ace wrap on today, with the layer over the breast to help with the compression. I'm sure that it helped, for support and for whatever else it's doing with the fluid. There doesn't seem to be an actual collection bulge anywhere, and I strongly wonder "where is that fluid"?
When I got over to the care home, mom wasn't in her room. Oh? Hm. I finally found her in one of the shower rooms, getting bathed, as that's the best way to clean up massive amounts of stool from her mid-back to her knees, including her shoes. The aide, Amanda B., was doing a wonderful job with her and mom wasn't even fussing. They were just about done--I just helped get her bottoms on and transferred mom into the chair then into the bed. She was quiet and tucked in, and I sat with her for about 20 minutes before leaving. Thank you, all you aides, for taking such good care of Elaine, and all the residents.
I'm a bit fatigued this evening, and it feels good just to sit and support my arm on the arm of the sofa to rest it. Tomorrow I am scheduled to work again, so I must get myself tucked in. 0410 comes early.
Tuesday, December 11, 2007
This morning, the pad was still dry. Breast is tender and full, and seems that directly under the axillary incision is firm, and sore. It's a bit reddened, too. After breakfast, we headed over to the office.
We waited, and finally got called back into the exam room, and I changed into a paper gown, open in front. Dr Sanchez came in and listened to why we came in--initially because of the accumulation of fluid, and I told her I popped it yesterday in the shower, and how much fluid came out. She examined that wound pretty closely, and commented on the firmness around and underneath (inside) of the incision. It's also slightly reddened. She also checked the wound on the breast--I told her how tender it is, also the nipple area, and how full it has been. That what we were most concerned of, however, was the discoloration of the underside of the breast. She had me lay back, brought over the bright light, and looked more closely. Poked and touched. Her conclusion was that the filling is stressing that whole area, and she commented on how much tissue she removed. Hm, sounds like she took almost 1/3 of that breast tissue. If not closer to half. Youch.
She wrote a script for Keflex, 500 mg, TID x 7 days. (Three times a day) I had apologized for a maybe unnecessary visit and wasting her time, and she said anytime a nurse comes back in for a check, it's important. I thanked her, and she said it's better to catch something early with antibiotics than wait until it's more obvious.
We thanked her, and ended up all leaving together. She was on her way over to the hospital, and it's her birthday, so she was trying to get finished up. Happy Birthday, Dr., and Thanks again.
Dan and I both felt good that we were validated for our concerns. We dropped off the prescription on the way home, and I'll pick it up on my way out this afternoon.
So, all is ok, and I'm on track to return to work Wednesday and Thursday.
Thanks for reading. Love, Kathy
Monday, December 10, 2007
Kim answered the phone, and I explained what was happening. She said not to be surprised if that pops open again, and lots and lots of fluid comes out. I had to really try to let her talk to me like a patient and for me not to talk to her like I'm a nurse. I told her the underside of the breast was looking shadowed or discolored, and she went on to offer me an appointment for Tuesday at 11:30 am. Perfect, I said, as I repeated 11:30 tomorrow morning. Dan nodded his head, I think we were both relieved to have an appointment. I went in to shower.
The warm water felt really good, but the breast/nipple area is so tight it's tender just to have the water hit it. I lifted my arm some and soaked that incision. The lump was larger, and I had the notion to manipulate the hole in that incision with a fingernail. I can't feel it anyway, that nerve has been cut. So I did, and Whoa, it spurted just like in the office. Lots and lots of that yellow-orange fluid. Streaming out. Not running down my side, streaming, arcing. I was surprised at how long it streamed out. Several seconds, maybe even a minute. I wish I could have measured it, but I was in the shower and the water was running, so I just let the stuff escape. I massaged the areas around the incision, moving the fluid from the edges of the lump toward the drain hole. Did that feel better. I tried to move the lymph fluid in the breast, but that's not as easy to do. I'm not sure I was able to do much with that. But I got that incision opened up, and that's what counted. Much better.
Dan helped me get the ace wrap back on, in a configuration that compresses the area where the fluid collects, and put a peri pad in place. I finished grooming, prepared and ate lunch, and it was time to go to Jackson. My intent was to write before I went down, but time ran out. So, I write later in the evening.
I have had 2 1/2 tylenol, which, unfortunately didn't help much. We'll see what Dr. thinks tomorrow.
Thank you for all the responses to the postings; Renee and Carolynn, Wow, thanks for writing. Renee, who had cancer, and Carolynn, who didn't. We all carry the responsibilities of our breasts. And the men, too. Dr. Sanchez tells me to remind you all to check your chests, especially my sons and brothers, or any male with first line history.
Sunday, December 9, 2007
The peri pad under my arm was full again this morning. Dan helped me straighten/unbunch the ace wrap. That left breast is sure tender around the nipple. Kinda aches. Our day was pretty much uneventful. He did his golf stuff, football was on the tv, I did some correspondence, prepared food for us, then headed down to Jackson. Mom was good, and while I was there, Frank called and invited me to dinner. Ok. See you at Olive Garden when I'm done here. His friend Chris joined us, too.
We had a pleasant dinner, and I headed home. A very fine, freezing drizzle. Enough to keep the defroster on, and the wipers intermittent. The roads seemed ok, and I got home fine. I checked that peripad under my arm--it's full again, so I changed it. My breast is really full, underneath. And seems to be more tender. We looked at it and decided that a phone call to Dr. Sanchez' office would be harmless, answer questions, maybe reassure me that it's all part of the process. Two and a half tylenol and I'm off to bed.
Thanks for reading, and commenting.
Saturday, December 8, 2007
I started running back in the late '70's. Just a couple of miles, almost daily. And, as exercise seems to go with me, I've had periods of months or even years that I hadn't run. In 1998 something happened to the left hip, it wouldn't rotate, and I was off work for 14 weeks. Physical therapy, drugs, rest, accupuncture, massage, accupressure, mind over matter. Eventually the hip free'd up, and although the full range of motion is still not there (I used to be able to sit "lotus"), it works. And I still try to coax the joint to flex. After I regained the use of my hip, I started walking. I went out and enjoyed different routes by the lakes in Michigan Center, distancing 3-5 miles on average. Whenever I had tried to push myself--increase the stride, walk hard, or even jog, it would take 3 days or so for that hip to recover. Bummer. Life changed again, and I am here in Holt. I had been walking here, exploring the neighborhoods and such, and one day last February or so, my new daughter Breon went out with me. She walked with me a little, until she warmed up, the started prancing around like a graceful gazelle. She bounced circles around me, running ahead, coming back, going into cul-de-sacs and joining up, and when we got back to the starting point, she went on and run some more. Shoot. I want to do that.
So, the next time I was out, I gingerly pushed myself, just that little bit more. And I was ok. So, next time, I jogged a few steps. Hm. That felt ok. And so it went, increasing from driveway to driveway, to the crack ahead in the pavement, or to the mailbox with the birds painted on, and so on, until---I had run the entire distance!!
Praise the Lord!! I have been jogging maybe 2-3 times/week since March. And then I had surgery October 23, and haven't been out. Until today. WOW! The sun is out, and even though it's cold (29) it was great. Sure, I was ginger. I went cautiously, but it wasn't hard at all. I put on the sports bra I run in, and the white one I modified, and tucked a peripad under the left arm over the incision. That seemed to work. I did bend my left forearm and supported that breast from the movement, but about halfway around I had figured out (or maybe relaxed) how to not bounce on the stride.
And when I came back to the starting point, the sun was in my face, the sky a soft blue, the snow-diamonds sparkling. I stopped and opened my arms wide, face up to the sky, smiling, and thanked and praised the Lord. Am I blessed or what? I cannot express the humbleness I feel, the thankfulness, how full my heart is.
Back to earth, the peripad this morning was full, though the different configuration of the ace wrap prevented the collection above and forward of the incision. When I changed into the sports bras, the stuff was a constant trickle from the wound. Better out than in, I guess. I'm ok with the drainage. I had mentioned to Daniel that I am glad for the reprieve in appointments; I have until December 19 and 20 to recover and be "normal". (Is that really an option??) I think he agreed with me--this last several weeks has been something.
Thanks, all of you, each of you, for your support and for reading. And commenting. It lets me know you're out there. Love and hugs. Kathy
Friday, December 7, 2007
I dry off, and it's not long before the fluid is dripping again, so I snap a couple of pics to be able to show you, and have included 3 images at the bottom of this entry.
Whew, that's sore. I choose to put on an "everyday" bra, and lay a maxi pad over the wound. The pad is large enough to tuck into the top of the side band and cup, and I think I'll leave it like this and put heat on it this afternoon. When I'm ready to go to Jackson, Dan can re-wrap the ace. We'll see how this works. I did take a couple of tylenol to take the edge off.
Anna, from Dr. Bolmer's office, called this afternoon, and we see her Wednesday, December 19, at 3:00 pm to discuss chemotherapy. Anna said she will put a packet of info in the mail for us.
So, there it is. The yellow is still bruising, and you can see some blue dye just above my index finger. Fullness at the axillary incision. and redness, too. The drain site looks good.
Ouch, that looks sore.
Again, you can see the fullness, both under the arm and in the breast. (My boobs are not that big.)
Thanks for reading. I look forward to your comments.
Thursday, December 6, 2007
My underarm aches, as well as the breast where the tumor was removed, and after a while, like early to mid afternoon, it's time for a couple of tylenol. But that's usually enough to take the edge off. I think I'm pretty lucky, comfort-wise. I've used heat today, too, in the armpit.
I called the Breast Care Center, as I have not heard from Dr. Bolmer's office, the medication oncologist. Char answered the phone, and said that maybe they didn't get the fax, or maybe they are just going to send me a packet in the mail. She said she would check on it, but did not call me back today.
Overall, a good day. Thanks for all your thought, prayers, comments, and emails. I am truly blessed to have each of you in my world.
Wednesday, December 5, 2007
Dan and I went to the Breast Care Center this morning at 0900 to see Dr. Sanchez about the pathology and treatment. We were called back and placed into an exam room. This room had the privacy curtain that pulls over in front of the door, a bookshelf with lots of different brochures about breast cancer, treatment, surgery, radiation, geneology, and other general information about services and providers. A round table with 2 chairs, a white sheet covered exam table, and of course, the adjustable height rolling stool (it's pink), along with the counter, sink, and cabinets. There was a thing for dirty linens, and probably a trash can, too.
The nice lady, whose face I recognized but whose name I had forgotten, (now I remember it's Charlene, the pre-op procedure lady) showed us into the room, and verified that I was there for a post-op visit. She had me change into a patient gown, saying the Dr. would be right with us.
I was changed, and standing near Daniel looking at the various brochures and chatting about the various offerings, when Dr. Sanchez came in.
She stood inside the room and closed the door behind her. She was smiling, and shook both our hands, then was talking and referring to her 5 x 7 legal-type pad that she had notes on. She went on to talk about the meeting this morning, which happens every other Wednesday, with all the team members present. The discussions are about each positive case of breast cancer, where the patients are in the process, and what comes next. Dr went on to tell us about Dr. Amy Bolmer, a medication oncologist, who has been present while my case has been discussed, and who has expressed interest in my case. Dr offered that there are other oncologists available, and if I/we don't "hit it off", it's not a problem to change. She thought our personalities would blend, and Dan and I were nodding our heads in agreement. She also mentioned the radiation oncologist, Dr. David DeBiosi, who was right here across the hall.... I had to interject...
So, Dr, you come in smiling, shake our hands, and go right into a discussion about the oncologists...??? So the pathology is clear?? She smiles-- laughs, actually, and says, oh, yes, the pathology is clear, you are really blessed. I know, I say, I have an incredible support system. We go off on a tangent about blessings, and prayer, and that Dan and I will be married 2 years come January. She is surprised by this, and says that she thought we were long-timers... Nope, I prayed for a good man, and God sent me Daniel. I didn't know that I needed THAT good of a man... She laughs, she tells us that she is learning about prayer, too, and hopes to have babies, with a husband, first. She asks me if I prayed for Daniel, and how long it took? About 4 years, and I told God I thought I was ready for a mate, and that He knows my heart, but if His will was for me to be single, let me be ok with that. She smiled and nodded, knowingly, and directed me to get over onto the exam table.
I did, and raised my arm to show her my third breast; she says Oh, a seroma. (a collection of serous fluid) She turns her back to me to get into the cabinets and get her supplies out. "We'll drain it". I make eye contact with Dan--Yes!--I ask the Dr, "With a syringe?", and she says yes. She tells me she thinks she'll use a local first, I tell her it's numb, I don't think I'll feel it. She cleans the skin with a betadine swab, then brings the needle on a 10 ml syringe over to the table. (I think there's WAY more than 10 ml in there....) She says, Can you feel this sharp? No, I ask her if she's touching the skin. I think she's surprised, and she touches the skin again, You don't feel this?? And she jumps back as the thing bursts open, and a steady stream of clear yellow fluid streams forth from the wound. The stuff runs out for at least 2 minutes, saturating the gown she had wadded up and pushed under my back. Dan's eyes are wide open. I brought my right hand over and massaged up in the armpit, and the stream flowed again. She turned around and grabbed another gown to help absorb the fluid. Boy, did that feel better. Almost as soon as it burst. She and I spent another several minutes massaging around the area and moving the fluid out. She had poked in the center of the incision; I had seen this morning that it had widened there and looked ominous to me. She put a couple of gauze sponges, folded, over the site; I held it while she wrapped my upper chest with a 8 inch wide ace wrap. Whew. Glad that happened. I pull my shirt on.
Ok, back to what comes next. She re-states that I'll be seeing Dr Amy Bolmer for chemotherapy, and Dr David DeBiosi for radiation, and she'll have someone come in to talk about scheduling those appointments. She smiles and hugs me, a nice hug, and said she would "do my port" when that time comes. Ok. She smiles at Dan, he stands, they shake hands. (go ahead, Dan, hug her...)
We wait several minutes and Charlene comes back in, saying she has scheduled an appointment with Radialogy for December 17. Hm, I think that's a work day for me. She said she will walk us over and introduce us, and we can reschedule if need be. Ok, thanks. As for Chemotherapy, she will call them to have them call me, instead of being a go-between. And off we go, out into the hall, through a couple of doors, and magically appear in Radiology.
Charlene introduces us to Vicky, who is the lady at the desk, then takes her leave. Thank you, Charlene. Vicky hands over an envelope that has forms to fill out before the first appointment, then we talk schedule. We are able to make this appointment time for Thursday December 20, 1:45 pm, which is an initial interview type appointment and may take up to 1 1/2 hours. Thank you, Vicky, see you again in a couple of weeks.
We are done there, and head off to Meijer for groceries. I haven't been to the grocery store since before the first surgery. Dan's been doing a good job of it... We do our thing, get home, and after the groceries are put away, I realize my shirt feels damp. Hm. What to do??
I consider this--the amount and consistency of the drainage, location of proposed absorber, comfort necessity of said absorber, and how to secure it in desired location. I look in my stash of "feminine products". Oh yeah, good ol' Always, with wings. Yep. I take a maxi pad (you know they are not very thick), trim the peel away paper instead of pulling it off and leaving the sticky exposed, and ask Dan to come help me please. He looks and says, "what are you doing?" After I explain, he thinks that's a pretty clever idea, and he pulls the ace wrap away from my body. EWW--those sponges are soaked, and he says he can see the stuff draining out. Ok, lay this on here just so, and pull the ace wrap back up over to hold it in place. Ta Da!!! Hey, that might work pretty good! We wash our hands and get our lunch.
A few hours go by, and it's time for me to leave for Jackson. I check the pad--it's saturated. Dan helps me change it, and I head out. I massaged the armpit and side of the breast most of the evening. (mom was wide awake tonight, and made vocal responses when I told her of the Dr visit) I got home around 9:30--that pad was wet and itchy against the incision. But only about half saturated, that surprised me. Dan helped me put another one on about that time. We'll see if it needs changed during the night.
Thank you all for your love and support, and for reading, and commenting. Below is a picture of my Chinese - Binding treatment, with the Always wing flapping over. I see there is a shadow of drainage that happened within the first hour that we were home. Love to all.
Tuesday, December 4, 2007
I called the Lymph Lady, Betty Toll, at the Foote Wellness Center downtown, who treated my arm in April when it was swolled up. (swollen--I just liked the way swolled sounded) I told her I'd had 2 surgeries for breast cancer, and that I have a half a tennis ball under my arm. She was unalarmed, said it was very normal to have swelling after breast surgery (I still haven't seen that in the pre-op literature), told me it might resolve in a week or two, and to use heat or ice, whichever I want to. Ok. Hm. She doesn't think seem to think it's a big deal. Of course, if it doesn't resolve, she'd be happy to see me. Thanks, have a good day. Oh.
So I, almost hesitantly, got out the heating pad. Yes, it did feel good on my shoulder, but it sure made my breast ache. Well, better living through chemistry... 2 extra strength tylenol and 1/2 of a t3, and things were a little more tolerable.
I do think warming things up has lessened the edges of the lump. It's still there, but there also seems to be more fluid surrounding it. It jiggles when I tap it. Dan and I were giggling about it. I think I am very happy that all that fluid has not gone down my arm and into my hand.
Tomorrow, Wednesday, we see Dr. Sanchez about the pathology of Friday's tissue, and to discuss what's next.
I'm off to Jackson to feed Elaine. Thanks for reading, and for commenting. Ta!!!
Monday, December 3, 2007
So, last night I'm getting ready for bed. I had unzipped that bra a couple of hours prior and had ice tucked under my arm trying for comfort and reduced swelling. I pull the nightgown over my head, and as I am checking that underarm (it's numb, you know, so sensation is altered), and I feel a rather large egg or small tennis ball, above the incision from the lymph node dissection incision towards the front. Holy Dogs, Dan, I've got a lump!! He says what?? And we turn the lights on and check it out. Yup. I don't see discoloration or shadowing to indicate that it might be blood, and Dan says Dr. had cautioned him about developing a hematoma, but he thinks Dr. meant in the breast itself. I think it's lymph fluid, as the drain was still collecting approximately 20 ml every 12 hours, and the drain was removed during surgery Friday. It's warm, and feels like pressure. We discuss options--go to ER? Not looking like an emergent event to me--Wait and call the office in the morning?? We decide to sleep on it, and if it changes for the negative during the night we'll re-evaluate and do what needs to be done.
Dan says I slept well during the night, and this morning the lump wasn't much different, maybe a little more firm. As far as discomfort, it's definitely uncomfortable. I did take 2 extra strength tylenol and added 1/2 tab of a t3, and the ice pack.
I called Dr. Sanchez' office and spoke with Kim, who did the scheduling for us last Thursday. I described the lump; her response was un-alarmed and reassured me that sometimes that happens. The fluid will probably absorb, or may find it's was out through one of the incisions. "It may be quite a bit of fluid, so don't be alarmed..." (Yeah, I've seen incisions drain stuff. That can be a real mess...) Use heat or ice as you feel comfortable, and keep your appointment at the Breast Care Center Wednesday. Please call us back if it gets worse, and Dr will be in the office tomorrow, Tuesday, if you need to be seen. OK, thanks. I feel mostly better about collecting lymph fluid, but not liking it none-the-less. I don't remember talking about that as a potential complication; perhaps I wouldn't have been so alarmed when it did develop.
I have added photos below. I tried to keep them small, and placed them at the bottom in case you really don't want to look.
Thanks for reading. The next appointment is Wednesday, when we will find out the pathology of the tissue removed Friday.
Steri strip, blue dye, and the yellow I tried washing off a couple of times before I realized it was bruising, not betadine. The axillary incision is healing nicely, and you can see it's swollen. Under that is the drain insertion site, with bruising beside and below. The red dot at the end of the steri strip is a hemangioma that God gave me.
Pocket of fluid
Different view--also fluid looks to be going down the back posteriorly
Sunday, December 2, 2007
So, If you're interested, here's a front view. I see that it looks full around the side. I know that some of that is dressing....
Spiffy bra, huh?
Side view The incision for the dissection is just above the top of the bra at the side seam, and the drain was about an inch below that, I think. I wonder if that fullness toward the back is fluid??
Image 4 Caution, the bra is off
Quite a dressing
I'm happy the tape's not on the nipple...
Saturday, December 1, 2007
I have my breakfast--egg, english muffin, watermelon, milk, coffee, water. Dan and I don't do much of anything today. He discovered how to use the fax machine without a land line (we have DSL on a "dummy line"), and activated the blue tooth program on a laptop. That took a couple of hours, downloading, babysitting the computer. He gets a call from a golf buddy and leaves to meet him somewhere. I fix myself some food, and then it's time for me to go to Jackson. I am feeling ok to drive, not taking narcotics, and eager to see my mother.
Mom is awake in the recliner, and I talk to her. She picks her head up and vocalizes something--I tell her I did fine, and she nods her head. I feed her her dinner, get her washed up and to bed. The staff were helpful as they know I've had surgery again. When I left, it was the beginning of a winter storm--I scraped my car of about 1/4 inch of snowy ice balls. It precipitated all the way home, and still is at midnight. I made it home safely going 40 mph and taking an hour for a 40 minute drive.
My underarm is aching and is swollen. I suppose it's that fluid that the drain was collecting. Better under the arm than down the arm and into the hand?? I'll have to review the lymphedema literature I have to see if I might be able to facilitate moving that fluid.
Believe it or not, it's midnight again, and I'm going to go to bed.
Thank you all for your love, support, patience as I rattle through some of my writings, and for reading and commenting. Knowing you are out there has been, and is, still, comforting. Hugs to all.
The transporter shows up with a wheelchair, I get transferred in, and off we go. It's so much nicer feeling "normal", with a sliced up breast, a bulky dressing, the drain removed, and just a bit of fog on my brain. Daniel brings the car up and both of them help me into the car. I'm doing much better. I see that it's about 2:30
The sun is out, God is smiling on us. We are at the drugstore, Dan goes in and I stay in the car enjoying the warmth of the sun. He comes out with the drugs, we head home. I get out and wait for Dan to help me up the stairs (there are 14 of them)--I really don't want to end up with a tumble, I've come this far. We get in, he takes my coat and put both of our coats in the closet (!) and helps me get situated. First of all, I'm hungry. I'm feeling really good, and I am able to putz around and take care of things, like the paperwork we ended up with, the mail, I drank some water, and started scrounging around for food. I am fragmented, of course, from the anesthesia, and have difficulty focusing and keeping on track.
After eating and enjoying some fresh coffee, I feel good enough to make a couple of phone calls. The first is to the Breast Care Center, to make my follow up appointment for Wednesday. The girl says she is double booking, with the first appointment at 0900. Ok, I'd rather wait a little at 9:00 than a couple of hours later in the day. The next call was to Human Resources to get the paperwork started for FMLA stuff. What a bunch of hoops--Margie was very informative and helpful, and has put the stuff in the mail for me. There. I think that's about it for my responsibilities for the day.
Then I settle on the sofa with the laptop. Literally, the rest of the day I worked on the blog. I was eager to tell you about my experience, and excited that I had come through anesthesia so well. I did not have anything further for pain until I went to bed at 0100, only the Morphine in the recovery room. I took two extra strength tylenol to go to bed. I did keep the ice pack on, though, as that seems to have the greatest comfort. I didn't really sleep too well, and felt like I was awake most of the night. That's not unusual for me, though, I know that I'll sleep eventually.
Ok, here is the list of meds I had today:
Kefzol 1 gram
Zofran 4 mg
Decadron 4 mg
Toradol 30 mg
Morphine 4 mg
What we remember from last week:
Kefzol 1 gm
Zofran 4 mg
Benadryl 12.5 mg
Dilaudid 0.5 mg
Better Living Through Chemistry
Thank you, God, for taking care of us today.
Friday, November 30, 2007
Steve and Alicia help me off the cart and into the "Lazy-Girl Chair" as Steve called it. Alicia has opened yet another warm blanket into the chair, and I, kind of wobbly-like, with Steve on my right and Alicia on my left, totter over and be seated. I feel like somethin'. She wraps me in a few more warm blankets, Steve raises the footrest, says goodbye and good luck, I thank him again for taking very good care of me, and he's off.
Alicia wraps the blood pressure cuff around my arm again, and the O2 sat monitor is clipped onto my left thumb. The numbers are the same as earlier. She has waiting for me a fresh soda, a pack of saltines, and one of grahams. Hm. That's nice. She busies herself with documentation, I fumble my way through the package to the saltine cracker. That's funny/odd, being clumsy like that. I smile at my awkwardness, knowing it will pass. I nibble on my cracker, and sip my soda, and Alicia asks how I'm doing. Pretty good, I think, Great, compared to last week. Yeah, she agrees, saying I look so much better. Do you need anything more for pain? No, thank you, I'm good for right now, maybe a 2. I ask Alicia for a huge favor. Could you write out a list of the meds that I was given today, pre-, intra-, and post-op?? I had thought of asking for a list last week also, but didn't. Sure, she agrees to do that. Are you ready for your family? Yup, bring 'em in.
A few minutes later Dan, Polly, and Jim file in, all with smiles, but with that hidden look of anxiety, not knowing what they're going to see. Well, let me tell you, the surgical cap is off, and I still have good hair. I'm sitting up, taking nourishment (such as it is), not puking, not painful, and happy to be doing so well. They are too, and the relief shows on each of their faces. Thanks, you guys, for worrying about me. Jim comes up and kisses me, Polly comes up and kisses me. I don't remember her looking at the first dressing, so I show her this one and we check it out together. Daniel comes up and kisses me and checks the dressing. He looks a lot better, too.
Polly and Jim leave after they are convinced I'm doing well. Thanks for coming.
The blood pressure cuff inflates again, Alicia comes in with the anesthesia record to show me. (Whoa, thanks) Vitals are good. She removes the BP cuff and sat monitor. On table time, 1200. Off table time, 1300. Hm. 1 hour, like Dr. said. I scan the format of the form, it's very similar to ours at Foote. So I take my time and read it over. Remember, I'm post op, and the only way I can read is to take my time. I will add the list of meds to the end of this post. I see the iv bag is about a quarter down, is it the second or third bag? Alicia checks, it's the second, and she goes out of our cubicle, telling me to use the call light when I'm ready to get up, that staff need to help me. Ok, I've had 1200 ml iv, most of this 14 oz soda, and I think I might be needing to go. I'm hungry, and she exited like she had something else to do, so I consumed those graham crackers. Isn't it queer, I miss those packaged graham crackers. (Does anybody know where those individually wrapped grahams can be purchased?) Now I gotta pee.
I say this out loud, and Daniel reminds me to use the call light. Ok, like, I know... I press the red button and hear a faint beep in the hallway. (don't miss that noise) I ask Dan to put down the footrest, he reminds me not to get up by myself, Yeah, I know.. and I scooch forward in the chair. It feels good to move myself. I am perched on the edge of the seat, holding the ice pack in place, when someone came in. It was a different someone; she may have told me her name, but I have forgotten. She and Dan help me up and assist me to the bathroom. Much better than last week. They both help me turn around and move the giant gown's fabric (and yes, I did take my slacks off today) get my panties situated, and sat on the pot. She leaves (thank you nice lady) and all goes as is expected. And goes. Finally the bladder is emptied, the paperwork is done, and all fabric gets replaced in its proper places. I go to the sink, wash up, and of course, have to check that dressing. Looks good, no bleeding or drainage noted. I poke at it a little, kind of feels numb on the top of the breast. Hm. Time will show what that's about.
Dan and I return to Patient 19, and I'm walking pretty good and wobbling very little. This is great. Alicia comes in with discharge instructions for Dan, the list of medications, and a prescription for Darvocet. Eww, thanks, but I don't like that medication. She offers to call Dr. Sanchez for a new med, Tylenol #3? Ok, I agree. She leaves and comes back in a bit. She goes over the discharge instructions, and asks if we'd like her to call the script in. Ok, thanks. CVS in Holt. She smiled, that's what I thought I remembered. I need to urinate again, so we get me up and over to the restroom. Still improving, and I can see that Dan is visibly relieved. I go, wash up, and Alicia brings my clothes in. Dan helps me dress, he's so cute putting my slacks and socks and shoes on. We get to the bra; my shoulders are a little stiff and slow to move. Alicia pokes her head in to see how we're doing. We're cautiously getting the shirt on--she makes a comment that he's accustomed to taking my clothes off, not putting them back on. He turns a faint shade of pink. We get back to the Lazy Girl chair, and Alicia calls for transport. She says all the pleasantries, then turns back and hugs me. She holds me just a bit longer than a "I liked taking care of you" hug. As I closed my eyes and recalled this moment, it seems that we breathed several breaths together. What a gift, Alicia, your sharing your vulnerability with my fear.