Wednesday, August 1, 2018


I'm recovering.

The day of surgery is a bit of a blur now.  We checked in early in the morning, and I changed into a gown and waited to meet the various doctors and nurses who would be involved in the surgery.  Whitney, my PA, had to draw on me; we joked about her drawing some cute doodles, but it turns out they get in trouble if they do that.  Too bad, because it would lighten the mood a bit.  My IV hurt, but I don't remember anything after they started to wheel me back toward the surgery room.  I remember saying goodbye to Jamie, but that's the last thing until I woke up in recovery.  Recovery is a blur, as well.  They kept asking me if I felt any pain, which I thought was ridiculous, so I think I answered, "It hurts" every time.  I don't remember the ride to my room, either, though I remember when we entered, because it looked a lot like the rooms I gave birth in.  (Same hospital.)

I spent just over 24 hours in the hospital, including pre-op prep time.  After surgery they kept compression wraps on my legs and I had nurses coming in to check my vitals and drains often.  Jamie got a decent night's sleep, but I didn't.

Recovery at home has been difficult, though made a lot easier by my Mom, who has been here for a week and a half so far, with another few days to go.  She has done all of the cooking and cleaning, chauffeuring the kids, reaching anything I can't reach, helping me with the drains, getting dressed, adjusting pillows, anything needed.  Jamie and the kids have been fantastic, also.  I'm not able to lift my arms above my shoulders, and they make sure I don't need to.  Jamie has helped me shower and get dressed, has emptied my drains... not what he expected, I'm sure, when we promised, "For better or for worse, in sickness and in health."  Cancer is a true test of love.

I've had less of an adjustment looking at my Bride of Frankenstein chest than I thought I would.  I have a long horizontal scar on either side of my chest, nearly meeting in the middle and wrapping partly around my sides under my arms.  The incisions/scars are covered with dermabond still, and are pinched and shiny and will be so for quite a while.  I still have some swelling in my chest and under my arms.  My entire chest and upper arms are sore/tingly/painful/numb/tight all at once, and it's extremely uncomfortable . I've been using tramadol for pain control and am down to 1-2 per day.  Dr. Miggins says the numbness will stay the rest of my life, but I'm hoping the other (painful) sensations subside.  My range of motion is still limited, though I've done my exercises religiously, so she's going to send me to physical therapy early.  (She usually waits until all drains are out.  My first 2 drains came out at day 5, but my 3rd one is still in.)  I have cording/scar tissue in my chest and under my arms, and without physical therapy I may not be ready for radiation on time.

We got the pathology back.  I had a great response to chemotherapy with regards to the cancer in my breast, with less than 5% of the tumor remaining in any of the cells.  There was some residual DCIS (ductal carcinoma in situ), also, but chemo generally doesn't work on that, anyway.  12 lymph nodes were removed, and 5 had cancer present.  The size of the largest was 9mm, and there was also an "extranodal extension" (reaching out of the cancer) of less than 1mm.  (So it didn't get very far out of the lymph nodes.)  So the lymph nodes didn't respond as well to the chemo, but ER/PR positive cancer like mine doesn't respond as well to chemo in the first place, anyway, so that's not surprising.  The plan was always radiation for me based on my initial diagnosis, so the surgical pathology doesn't change anything.

So - next steps:

I should be notified about physical therapy soon.  I'll be going 2-4 times a week until they don't think I need it anymore.  That will help me get my range of motion back, and it's important to get my full range of motion back before starting radiation.  After radiation it's much harder to regain anything further.

I have 1 drain still in place - the one under my arm, where the lymph nodes were.  (The 2 from my chest cavity have been removed.)  When it starts draining less than 30ml a day for 2 consecutive days, I'll go in to have it removed by Dr. Miggins's nurse, April.  My physical therapy will ramp up in intensity after that.  After that drain removal appointment, I won't go back to see my Surgeon until my follow-up appointment in 4 months.

I see my MedOnc (her replacement, actually) next week on Thursday.  We'll go over the pathology and discuss next steps.  Dr. Miggins thinks it's highly unlikely I'll need any further chemotherapy, so we should be talking about hormone therapy.  That would most likely start after radiation and either be a daily pill for 10 years, or a daily pill and monthly injection for 10 years.  Both options help to prevent recurrence and are available to me since my cancer is hormone positive.

I see Dr. Arzu, my Radiation Oncologist, on August 14th.  We'll discuss radiation and set up the placement appointment.  Radiation will start when school starts, at the end of August/beginning of September, as long as I'm able to physically get into the position needed by then.  Radiation will be every weekday for 6 weeks.

So for now I'll continue to empty my drain twice a day, do my exercises, and try to stop losing weight.

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