Dr. David DeBiose, Radiation Oncologist

Daniel's cell phone alarm went off at 0700--he sets his phone when he makes appointments, then forgets about them, and it wasn't written on the calendar. When he got up and looked, it was an eye appointment for a check on his pre-glaucoma condition, at 0800. So he got out early. He called about 10:00, saying he was just leaving, and that the Dr did some further testing after dilating his eyes. Dr said everything was stable, no changes from the previous check 6 months ago, but wants to do a visual field test, and that's scheduled for sometime mid-January.

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