Posts
Recovery, continued
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.
Friday, November 30, 2007
Post Op. MUCH BETTER!!! 11.30.2007
I wake up, I don't know to what stimulus. It's shortly after 12 noon. Hi, I'm Steve, You're in recovery. (Cool. Awake. And mostly alert. System check -- nausea, nope, pain, yeah, some, maybe a 4 or 5. Definitely not as intense as last Friday. The iv site is still annoying. Hm. Warm. So far, so good. Let's check the dressing--yup, bulky dressing like before, and the 4 x 4 gauzes are placed over the entire breast, off to the outer side of the breast, and another few overlap into the axilla. I see the drain has been removed, yay, and wonder if the steri strip was removed from the axillary incision. Can't tell. There is white perforated tape over the whole shabang. Wait--tape over everything? I look for the nipple area to see if it got taped. Nope, whew, my poor nipple, it got spared this time. The corner of the gauze is protecting it, and the tape is on the skin.) Steve watches me, I tell him I had to check this dressing. I don't know if he looked before, but he looks now and sees that all is well. I must say the dressing feels good, supportive? maybe. He pushes Toredol 30 mg. The sequential compression stockings are doing their thing. They squeeze kinda tight, I was surprised. Last week, the stockings had been removed by the time I regained memory. Steve offers me ice chips, water, or pop. I ask about fresh coffee :) But he wisely offers me cola. 1215, BP cuff inflates. 123/76 or something good like that, pulse high 60's. Good. Steve documents the vitals, asks about pain. We have the discussion about pain control options, and he ends up calling one of the Docs for something other than Dilaudid to push. I think he takes the legs things off, too.
While he's gone, I see that Jan (my recovery nurse from last week, is across the room with a patient. She's finishing up his recovery and discharges him, taking his cart, I assume, to one of the cubicles labeled Patient and a number. Then I see her approaching my cart. Hi, she says, smiling, and takes my hand. She says that they don't often see patients again, and saw that I was back. She asks how I'm doing, and why I had a re-excision. I tell her that it's good news, about the margins being clear, and the only positive lymph node of the 19 total removed was the sentinal node. That Dr. Sanchez wanted a larger area of clear margin. Wow, she says. That is good news. She's smiling and stroking my hand. She tells me that she has been praying for me all week. WOW I feel my eyes well, and don't know how to tell her how powerful that was for me. I tell her thank you with all the sincerety and love I can muster. Thank you, God, for Jan in this world.
Steve comes back with Morphine 2 mg, and shoves it in, kinda fast, I thought, over a few seconds, as I could feel a slight sensation as it went in the vein. Ok. He has also brought me a diet cola over ice. I sip on it and find I'm able to tolerate it. Mmm. Jan moves on. 1230, BP. I twist my head around and see that I'm stable, (Thank you God) and that I'm not nauseated. (thank you again) In fact, I think I'm feeling pretty good. Steve comes at my iv port with another syringe. What's that?? Another 2 of Morphine, he says. Oh, you think I need it? I ask. (I don't know, I've never done this before. And I'm not sure if I need it or not.) I ask, If I have that, do you need to keep me another time interval?? He says no, as far as he's concerned, I'm ready to leave now. Ok. He pushes that Morphine, I sip my soda (through a straw) and he goes to call report. I check in with myself: no nausea, and yes, most of the rest of that discomfort has gone. I'm glad he gave me that other 2 mg.
I see Steve calling report, and hear a few words drift over: he's speaking to Alicia, who took care of me last week, I hear my name, the procedure, there's a dressing, and ice over the incision. There is?? I don't remember seeing an ice pack. I look, I don't find one. He hangs up, comes over, and tells me he's called report to Alicia, who remembers taking care of me last week. I tell him that Alicia was very patient with me when I wasn't doing very well. He smiles and says she's one of the good ones. I also tell him I don't have ice on the incision--he looks down at my chest, recovers quickly, and says,"sure you do" as he lifts the glass with cola out of my armpit. Good save, Steve. He scurries off, fills an icepack and brings it right back. "There" he says, and helps place it under the blankets. I will say I'm glad to have that ice again. He unwraps the blood pressure cuff, removes the sat monitor, and we're on our way back to Same Day Surgery, cubicle Patient 19. Steve tells Alicia that he's sent me over with my chart and an application for employment. Thank you, Steve, for taking such good care of me. Will you hire an LPN with 26 years experience, and give me 4 weeks paid vacation, at or above the wages to which I've become accustomed?? He laughs. Me, too.
While he's gone, I see that Jan (my recovery nurse from last week, is across the room with a patient. She's finishing up his recovery and discharges him, taking his cart, I assume, to one of the cubicles labeled Patient and a number. Then I see her approaching my cart. Hi, she says, smiling, and takes my hand. She says that they don't often see patients again, and saw that I was back. She asks how I'm doing, and why I had a re-excision. I tell her that it's good news, about the margins being clear, and the only positive lymph node of the 19 total removed was the sentinal node. That Dr. Sanchez wanted a larger area of clear margin. Wow, she says. That is good news. She's smiling and stroking my hand. She tells me that she has been praying for me all week. WOW I feel my eyes well, and don't know how to tell her how powerful that was for me. I tell her thank you with all the sincerety and love I can muster. Thank you, God, for Jan in this world.
Steve comes back with Morphine 2 mg, and shoves it in, kinda fast, I thought, over a few seconds, as I could feel a slight sensation as it went in the vein. Ok. He has also brought me a diet cola over ice. I sip on it and find I'm able to tolerate it. Mmm. Jan moves on. 1230, BP. I twist my head around and see that I'm stable, (Thank you God) and that I'm not nauseated. (thank you again) In fact, I think I'm feeling pretty good. Steve comes at my iv port with another syringe. What's that?? Another 2 of Morphine, he says. Oh, you think I need it? I ask. (I don't know, I've never done this before. And I'm not sure if I need it or not.) I ask, If I have that, do you need to keep me another time interval?? He says no, as far as he's concerned, I'm ready to leave now. Ok. He pushes that Morphine, I sip my soda (through a straw) and he goes to call report. I check in with myself: no nausea, and yes, most of the rest of that discomfort has gone. I'm glad he gave me that other 2 mg.
I see Steve calling report, and hear a few words drift over: he's speaking to Alicia, who took care of me last week, I hear my name, the procedure, there's a dressing, and ice over the incision. There is?? I don't remember seeing an ice pack. I look, I don't find one. He hangs up, comes over, and tells me he's called report to Alicia, who remembers taking care of me last week. I tell him that Alicia was very patient with me when I wasn't doing very well. He smiles and says she's one of the good ones. I also tell him I don't have ice on the incision--he looks down at my chest, recovers quickly, and says,"sure you do" as he lifts the glass with cola out of my armpit. Good save, Steve. He scurries off, fills an icepack and brings it right back. "There" he says, and helps place it under the blankets. I will say I'm glad to have that ice again. He unwraps the blood pressure cuff, removes the sat monitor, and we're on our way back to Same Day Surgery, cubicle Patient 19. Steve tells Alicia that he's sent me over with my chart and an application for employment. Thank you, Steve, for taking such good care of me. Will you hire an LPN with 26 years experience, and give me 4 weeks paid vacation, at or above the wages to which I've become accustomed?? He laughs. Me, too.
Pre Op, Again 11.30.2007
Dan and I started out at 0830, checking in at the admitting desk, then waiting.... to be called to be registered. The nice lady called us in, sign here, here, here,... copied the insurance card (that was a first), then we were off to Same Day Surgery. 0910.
At the desk, a couple of the same people were there as last Friday. One of the familiar faces showed us to Patient 4 cubicle, and "someone will be right with you." Connie came in and got the processes started. I verified my name, birthday, everything's spelled correctly,.... and got my bracelet. I signed the consent for the Re-Excision of the Left Breast Lumpectomy. Connie was very nice, and helped me feel more at ease. Daniel, too.
My BP was better than last week -- 123/67 as compared to a diastolic of 99. Ya think because I didn't have the pre-op breast invasions?? Daniel's, however, was 160/100. No Kidding. He did some breathing and brought it down to 146/96. Somewhat better, we'll go with that.
Connie strings up the iv, and I tell her I have poopy veins. She says, yeah, I was watching while the BP cuff was inflating. We'll let anesthesia put it in. ok. She finishes up her nurse paperwork stuff, marks above the left breast with a surgical skin marker, leaving the marker for Dr. Sanchez to initial the site, also. She goes out to find the lab results from last week. When she comes in, I ask her what my Hgb was. 14.1. No Kidding!! I don't know if my hemoglobin has ever been that high. Anyway, the crit was 36 something, platelets 236 or something. All good. Time to urinate.
I go over to the bathroom with my giant patient gown trying to fall off, and me trying to hold it on, as well as hold onto the drain bulb, because that tubing pulls pretty good when it's not supported. Of course, a couple of the snaps are non-functional, adding to the design concept. I pee ok, wash up, and get back on the cart. Connie comes in with warm blankets (whoa, Connie, thanks, that feels really good) and the trick is to support my swollen, pendulous breast, drain tube, and bulb, with some level of comfort. Jim and Polly have arrived.
Finally, the surgical team drifts in. Dr. Bez is the anesthesiologist, and he does his little interview thing. He has kind eyes and a warm smile, and is about mid 40's. He tells me the CRNA is Denny Herm (sp?), and that Denny is very fond of telling that he has more experience in anesthesia than the Dr. We discuss the fentanyl issue of last week, and choose to do Toradol instead, as well as other meds intra op. He says he'll take very good care of me, and keep me comfortable. I trust that he will.
Dr. Sanchez comes in, greets us, and initials the surgical site. She and Dr. Bez discuss the fentanyl concern, and we all are in agreement that we'll do something different, and if I need more pain control post op, they are a phone call away. Thank you for your concerns, Drs.. Karen Little comes in, who will be the circulator. She and Dr. Sanchez talk business about the case to follow being cancelled, notify the patient scheduled next, and get things in motion to move up that case, blah, blah. Dr. Sanchez has been writing in the chart, addresses my family members about what to expect at their post op discussion, and drifts away. Dr. Bez gets a page and goes away. Karen goes away. I go over to the bathroom again before the iv start. nervous, anxious. I am experienced now with my billowing gown and Dan wraps it twice around me. And in the bathroom I have to unwrap, hold the bulb, get the panties.... use your imagination. I giggled at my situation, and did get everything taken care of. Back to Patient 4.
Connie walks by, peeks in to see we are on track. Denny CRNA comes in, pulls up a chair beside me, and looks for a vein. You know the procedure. Karen drifts back in, tears tape, and Denny gets the iv started in the back of my right hand. Ouch. It's the achy vein syndrome. It's running well, so I don't complain. Things are moving along, with personnel moving in and out. Dr. Bez comes back and sees that Denny is here and has started the iv. It's very obvious they are not only good co-workers, but good friends, as well. (Sometimes I miss my job and the comraderie.....) Indeed, they tease each other about the gray in their beards, I knew him when.... I ask to decline the versed, and they oblige. Why? they ask. I don't like the not knowing, but I also wanted to see their OR. They chuckled, and gave me a verbal tour of their new suites when we got in there, after hugs and kisses and see-ya-laters to my family. Seems they've been about 2 months in their new ORs, and were pleased to show Room 7 to a fellow nurse. Someone is changing out the warm blankets with fresh ones. Oh Yeah this is good. Thank you. I think her name was Millie or something, she's a Scrub Tech, and speaks with an (hispanic, central american) accent. I'm liking this team. I do tell them we have prayed for the OR team this morning, and trust that they will take good care of me. They get quiet for a moment, and a couple of them say thank you. Denny makes some kind of comment about not needing it right now, he's been good, or that he really needs it right now, or something like that.
Karen put the O2 mask over my face, both she and Denny explaining that they are "pre-oxygenating" me. Somebody (I think it's Karen) is adjusting the arm boards and asking about the comfort of my shoulder, etc. Denny tells me he's pushing the propofal, and my arm will probably burn. Ok, I've felt burn this last couple of weeks. Holy DoDah! Burn?!! Ache!! Ow!! My arm feels like it is falling off. I mean, oh-my-gosh, maybe I should have had some versed before he pushed the propofal..... Not just the vein, and I couldn't really identify the vein, but the whole arm, from the inside out, up to the shoulder. Ok, I say, yup, it burns, whoa, that's amazing, and I feel the drug moving through the shoulder and into my heart, then centrally diffusing, (Yes, I did, I was trying to pay attention so I could tell you...). I consciously snorted big whiffs of oxygen, and said I was going to go to sleep. I felt hands on my head going to tip me back, but, I'm not asleep yet, so I open my eyes. I smelled something, must have been added to the O's, and indeed, I went out.
At the desk, a couple of the same people were there as last Friday. One of the familiar faces showed us to Patient 4 cubicle, and "someone will be right with you." Connie came in and got the processes started. I verified my name, birthday, everything's spelled correctly,.... and got my bracelet. I signed the consent for the Re-Excision of the Left Breast Lumpectomy. Connie was very nice, and helped me feel more at ease. Daniel, too.
My BP was better than last week -- 123/67 as compared to a diastolic of 99. Ya think because I didn't have the pre-op breast invasions?? Daniel's, however, was 160/100. No Kidding. He did some breathing and brought it down to 146/96. Somewhat better, we'll go with that.
Connie strings up the iv, and I tell her I have poopy veins. She says, yeah, I was watching while the BP cuff was inflating. We'll let anesthesia put it in. ok. She finishes up her nurse paperwork stuff, marks above the left breast with a surgical skin marker, leaving the marker for Dr. Sanchez to initial the site, also. She goes out to find the lab results from last week. When she comes in, I ask her what my Hgb was. 14.1. No Kidding!! I don't know if my hemoglobin has ever been that high. Anyway, the crit was 36 something, platelets 236 or something. All good. Time to urinate.
I go over to the bathroom with my giant patient gown trying to fall off, and me trying to hold it on, as well as hold onto the drain bulb, because that tubing pulls pretty good when it's not supported. Of course, a couple of the snaps are non-functional, adding to the design concept. I pee ok, wash up, and get back on the cart. Connie comes in with warm blankets (whoa, Connie, thanks, that feels really good) and the trick is to support my swollen, pendulous breast, drain tube, and bulb, with some level of comfort. Jim and Polly have arrived.
Finally, the surgical team drifts in. Dr. Bez is the anesthesiologist, and he does his little interview thing. He has kind eyes and a warm smile, and is about mid 40's. He tells me the CRNA is Denny Herm (sp?), and that Denny is very fond of telling that he has more experience in anesthesia than the Dr. We discuss the fentanyl issue of last week, and choose to do Toradol instead, as well as other meds intra op. He says he'll take very good care of me, and keep me comfortable. I trust that he will.
Dr. Sanchez comes in, greets us, and initials the surgical site. She and Dr. Bez discuss the fentanyl concern, and we all are in agreement that we'll do something different, and if I need more pain control post op, they are a phone call away. Thank you for your concerns, Drs.. Karen Little comes in, who will be the circulator. She and Dr. Sanchez talk business about the case to follow being cancelled, notify the patient scheduled next, and get things in motion to move up that case, blah, blah. Dr. Sanchez has been writing in the chart, addresses my family members about what to expect at their post op discussion, and drifts away. Dr. Bez gets a page and goes away. Karen goes away. I go over to the bathroom again before the iv start. nervous, anxious. I am experienced now with my billowing gown and Dan wraps it twice around me. And in the bathroom I have to unwrap, hold the bulb, get the panties.... use your imagination. I giggled at my situation, and did get everything taken care of. Back to Patient 4.
Connie walks by, peeks in to see we are on track. Denny CRNA comes in, pulls up a chair beside me, and looks for a vein. You know the procedure. Karen drifts back in, tears tape, and Denny gets the iv started in the back of my right hand. Ouch. It's the achy vein syndrome. It's running well, so I don't complain. Things are moving along, with personnel moving in and out. Dr. Bez comes back and sees that Denny is here and has started the iv. It's very obvious they are not only good co-workers, but good friends, as well. (Sometimes I miss my job and the comraderie.....) Indeed, they tease each other about the gray in their beards, I knew him when.... I ask to decline the versed, and they oblige. Why? they ask. I don't like the not knowing, but I also wanted to see their OR. They chuckled, and gave me a verbal tour of their new suites when we got in there, after hugs and kisses and see-ya-laters to my family. Seems they've been about 2 months in their new ORs, and were pleased to show Room 7 to a fellow nurse. Someone is changing out the warm blankets with fresh ones. Oh Yeah this is good. Thank you. I think her name was Millie or something, she's a Scrub Tech, and speaks with an (hispanic, central american) accent. I'm liking this team. I do tell them we have prayed for the OR team this morning, and trust that they will take good care of me. They get quiet for a moment, and a couple of them say thank you. Denny makes some kind of comment about not needing it right now, he's been good, or that he really needs it right now, or something like that.
Karen put the O2 mask over my face, both she and Denny explaining that they are "pre-oxygenating" me. Somebody (I think it's Karen) is adjusting the arm boards and asking about the comfort of my shoulder, etc. Denny tells me he's pushing the propofal, and my arm will probably burn. Ok, I've felt burn this last couple of weeks. Holy DoDah! Burn?!! Ache!! Ow!! My arm feels like it is falling off. I mean, oh-my-gosh, maybe I should have had some versed before he pushed the propofal..... Not just the vein, and I couldn't really identify the vein, but the whole arm, from the inside out, up to the shoulder. Ok, I say, yup, it burns, whoa, that's amazing, and I feel the drug moving through the shoulder and into my heart, then centrally diffusing, (Yes, I did, I was trying to pay attention so I could tell you...). I consciously snorted big whiffs of oxygen, and said I was going to go to sleep. I felt hands on my head going to tip me back, but, I'm not asleep yet, so I open my eyes. I smelled something, must have been added to the O's, and indeed, I went out.
Surgery, Again 11.30.2007
And we're off, hopefully for an easy surgery today. I'm anxious, but not as anxious as the initial procedure. Keep praying, please. Right now I don't feel so strong.
I'll try to write again this evening. Love to all.
I'll try to write again this evening. Love to all.
Thursday, November 29, 2007
Pathology 11.29.2007
Dan and I saw Dr. Sanchez this morning, and she reviewed the pathology with us.
The good news:
The tumor was removed in it's entirety, and the margins are clear.
The sentinal node was positive for cancer cells, which we knew and was why she went on to do an axillary dissection.
The axillary nodes, 18 in all, were ALL CLEAR!!!
Woo Hoo!! Praise The Lord!!
HOWEVER--
The margin for the ductal cell carcinoma was only 1.1 mm, and the margin for the infiltrating/invasive cell carcinoma was only 2.2 mm. I had to get out the measurer to see the sizes. It's not much. Dr. wants to re-excise the margins of the defect (take more healthy tissue from around where the tumor was removed), to get appproximately 3 cm of healthy tissue. Her description was that the milk ducts are like tree branches going from the nipple (trunk) through to the back of the breast (branches). Because the amount of clear ductal tissue was so small, she wants to take more tissue to make sure those pesky ductal cancer cells haven't taken up residence further out in the branches.
So, I am scheduled for a Re-excision of Left Lumpectomy, tomorrow, Friday, at 11:15.
For those who may be interested, here are the specifics of the pathology.
Sentinal node specimen=1.8 x 1.5 x 1 cm
-Metastatic ductal carcinoma
Left breast lumpectomy=1.5 x 1 x 1.5 cm
-Ductal carcinoma in situ (DCIS), grade 2
-Closest margin to DCIS is 1.1 mm. (lateral)
-Infiltrating ductal carcinoma, grade II, 1.4 cm in greatest dimension
-Closest margin for infiltrating carcinoma is 2.2 mm (posterior)
-Lymphatic invasion
-Previous hormonal studies-estrogen and progesterone receptors are positive; Her-2-neu is
2+, but negative by FISH
-Pathologic staging - pT1c N1 Mx
Axillary contents left=7 x 5 x 1.5 cm
-Eighteen lymph nodes negative for metastic carcinoma
-Including specimen A, one of nineteen lymph nodes is positive for metastatic carcinoma
So, that's that. Surgery, tomorrow, 11:15. Again.
Thanks for checking in on me/us, and thanks ahead of time for all the prayer activity and positive energies being sent our way.
The good news:
The tumor was removed in it's entirety, and the margins are clear.
The sentinal node was positive for cancer cells, which we knew and was why she went on to do an axillary dissection.
The axillary nodes, 18 in all, were ALL CLEAR!!!
Woo Hoo!! Praise The Lord!!
HOWEVER--
The margin for the ductal cell carcinoma was only 1.1 mm, and the margin for the infiltrating/invasive cell carcinoma was only 2.2 mm. I had to get out the measurer to see the sizes. It's not much. Dr. wants to re-excise the margins of the defect (take more healthy tissue from around where the tumor was removed), to get appproximately 3 cm of healthy tissue. Her description was that the milk ducts are like tree branches going from the nipple (trunk) through to the back of the breast (branches). Because the amount of clear ductal tissue was so small, she wants to take more tissue to make sure those pesky ductal cancer cells haven't taken up residence further out in the branches.
So, I am scheduled for a Re-excision of Left Lumpectomy, tomorrow, Friday, at 11:15.
For those who may be interested, here are the specifics of the pathology.
Sentinal node specimen=1.8 x 1.5 x 1 cm
-Metastatic ductal carcinoma
Left breast lumpectomy=1.5 x 1 x 1.5 cm
-Ductal carcinoma in situ (DCIS), grade 2
-Closest margin to DCIS is 1.1 mm. (lateral)
-Infiltrating ductal carcinoma, grade II, 1.4 cm in greatest dimension
-Closest margin for infiltrating carcinoma is 2.2 mm (posterior)
-Lymphatic invasion
-Previous hormonal studies-estrogen and progesterone receptors are positive; Her-2-neu is
2+, but negative by FISH
-Pathologic staging - pT1c N1 Mx
Axillary contents left=7 x 5 x 1.5 cm
-Eighteen lymph nodes negative for metastic carcinoma
-Including specimen A, one of nineteen lymph nodes is positive for metastatic carcinoma
So, that's that. Surgery, tomorrow, 11:15. Again.
Thanks for checking in on me/us, and thanks ahead of time for all the prayer activity and positive energies being sent our way.
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