Turn the Radio Off!!!

Thursday and Friday were the big follow-up appointment days as I stated before.  We saw Dr. Ahmed, the oncologist, on Thursday.  She and Deb went over the pathology report (which Deb got a copy of on Tuesday) and discussed the genetic testing results (which she gave Deb a copy of) and much of it was med-speak and if it didn’t go over my head, it certainly scraped my scalp.  But I do feel that I caught the gist of it.

First of all, Dr. Ahmed stated that while it was up to the radiological oncologist to confirm, she didn’t feel that radiation would be necessary given all of the pathology results.

Let me just skip ahead at this point and say that we saw the radiation oncologist, Dr. Yao, on Friday and she told Deb something to the effect of “Nice meeting you, but I got nuthin’ for ya.”  No, that wasn’t exactly what she said, but you get the idea.

Let me repeat myself here.  No radiation. 

This is definitely a load off of our minds.  I didn’t want to run the risk of her turning into She-hulk.  That would be bad.  Green isn’t her color.

So going back to Thursday, the other subject of talk with Dr. Ahmed was the remaining course of therapy.  Deb will be going on Tamoxifen for the next 5 to 10 years.  That much is a given.  Everything else is in flux.  The current accepted protocols for chemotherapy and other treatment rely on things like the size of the tumor and whether there are receptors on the cancer cells that respond to estrogen, or progesterone, or HER-2 (Human Epidermal Growth Factor Receptor 2 – yeah, I had to Google that).  Deb’s tumor size was right on the decision line, and she was estrogen receptor and HER-2 positive but progesterone receptor negative, which is apparently out of the ordinary.

It isn’t that the research says to do this or do that for someone of her age with her pathology, it’s that the research doesn’t exist.  Part of this is that it is unusual for a diagnosis like this to be made so early – her tumor size was small because her monitoring was so often that it was detected very early. 

And chemo comes with the risk of some potentially nasty side effects – not just the short-term annoyances of hair loss and weight gain (surprised to hear gain instead of loss – I expected the other way around), but neuropathy and cardiomyopathy (Google those yourselves if you wish).  

Next week are second opinion appointments, and genetic counseling is still to come…and we’re hopeful that then we’ll have a clearer path to making a decision.  But those decisions will still likely be very difficult.  How do you know where to place the cut-off point on the risk/benefit chart?  What is the point of diminishing returns?  Which risks are simply too great?  How many licks does it take to get to the Tootsie-Roll center of a Tootsie-Pop?  (The world may never know.)

Meanwhile, healing from surgery continues.  Fatigue and some pain and soreness remain the biggest nuisances she faces.  And a new torture has been instituted in the form of in-home PT to improve arm range of motion.  At least I can truly sympathize with that.

Drained

I meant to write a post last night, but I was exhausted after a busy day, so ... yeah, sorry about that.

So, the big news right now is that Deb had her first follow-up appointment with her surgeon moved up from Thursday to yesterday.  The reason?  She desperately wanted the surgical drains removed.  I won't go into detail about post-surgical drains for the sake of the possibly squeamish, but they are certainly a nuisance.  Deb was recovering well enough that the drains could come out though, so now they are out (hurrah!).

We also got the pathology report on the removed tissue as well.  The biggest news on that front is that there was no indication that the cancer had moved to the lymph nodes (bigger 'hurrah!' and a sigh of relief).  Every indication is that he was able to get it all.  However, there is still the question of chemotherapy intensity and duration, and whether or not radiation therapy will be included.  Those are things we'll discuss further on Thursday and Friday with the oncologist and the radiation oncologist.

But a brief recap; no more drains (hurrah!), and no lymph node involvement (bigger 'hurrah!').

Other than that, Deb is still making good progress at home, is continuing stepping back the painkiller frequency, and is in pretty good spirits overall.  In fact, she made her first excursion (other than the appointment with the surgeon) yesterday afternoon to the grocery store with her mom.  A brief outing, but hey, baby steps for now, eh?

Moving Right Along

Deb is doing pretty well.  Actually better than the last time she had surgery, so that's a relief.  I think that one factor in that is the fact that she knew a little better what to expect coming out of surgery this time.  Another factor is that she's in better physical condition this time.

I think that she used her recovery last time to kick-start an effort to improve her stamina and conditioning overall, and I must say that it has worked well these last few years.  I think it is also paying off now.

She's still very sore, but she has been making herself get up and walk around the first floor of the house several times each day, and has been trying to increase that amount each day as well.  She's also been able to decrease the frequency of having to take her painkillers a little bit.  She can't do a lot of simple things, like load/unload the dishwasher or get things out of the cabinets that are higher than a certain distance off the floor, but that will come and meanwhile her mom and I are here to handle that sort of thing.

Last night we had a visit from our friends Brie and Randall when they brought dinner over and ate with us.  Deb seemed to hold up pretty well for the couple of hours that they were here.  Another couple of friends had brought dinner to us on Sunday, but they couldn't stay and Deb wasn't quite up to a longer visit yet.  We are also set to have Cris and Anna over for dinner on Friday (I think they're bringing something from Luam's restaurant, so it should be delicious).

As for new information on Deb's recovery process, we won't really know any more until late next week.  She'll see her surgeon and oncologist on Thursday, and she'll have a visit with the radiation oncologist on Friday.  I will definitely post something after we have the news from those about her treatment going forward.

I may post something after the weekend about Deb's initial recovery, or I may not post anything until Friday.  Again, thank you to everyone who has posted replies or FB comments, texted, or sent cards to Deb.  I have been relaying them all along to her and I know that she appreciates them.  Confidentially, I appreciate them too.

Be It Ever So Humble ...

Sorry for the delay, but it's been a little busy around here.  Deb and I got home a little after noon yesterday and started settling her into her recliner.  Greg showed up with Linda (Deb's mom) a little after that. Deb slept for most of the afternoon, and I have to admit that I slept for a couple of hours as well.  I guess I hadn't realized how exhausted I was.

Not much more to report than that Deb is really doing pretty well so far.  She's been up walking around inside the house a bit, she was able to sit at the table for dinner last night and breakfast this morning, and she's generally got a pretty good level of energy at this stage.  Long naps are still de rigeur, but she has been able to have her hair washed by Linda and I helped her take a shower this morning, so I know she feels a lot better about that.  Plus, I know we both got a lot better rest last night than we did the night before in the hospital.

She does feel like she's been on the wrong end of a beating, but that's hardly a surprise.  She's starting to get the bruising to support that assertion as well. I think she was (reasonably) mentally prepared for all that though, so she seems to be taking it all in stride.

There may not be many posts here for the next week or so.  Maybe one every day or two just to note her progress.  I will be posting more around the time of her follow-up doctor's appointments, but I think the first couple of those aren't until around the 27th.

If you've called or texted over the last couple of days, please forgive us if we haven't responded.  There is a pretty big backlog for her to deal with and while her energy level is good, it's a relative statement.  It's good considering that she just had major surgery.  Full recovery is still a long way away, but we'll deal with it one step at a time.

Morning Has Broken

Deb is awake and has eaten breakfast now.  I think she did fine through the night.  The nurse was in and out of the room several times to check in on her, but Deb never seemed to be in any large amount of pain.  There's pain, don't get me wrong, but it is being managed and she's resting again while we wait for the surgeon to come see her and kick off the discharge process (we hope).

I'd like to take a moment to thank our friend Greg.  He came over while I was still waiting in the outer area yesterday once he got off work and came up with me when they assigned Deb to her room.  He stayed around talking with us for a while before heading back home.  But our biggest thanks is for later this morning when he goes to pick up Deb's mom at the airport and either takes her to the house or brings her here to the hospital, depending on how far along the discharge process is at the time.  There's no way I would have been able to break away to go get her.  Also thanks go to Brie for being our backup plan had Greg not been available.

Friends are very important at times like these, so let me go ahead and say thanks as well to everyone who has sent encouragement through comments here or Facebook or by text, even if I haven't been able to respond directly to everyone.  Be assured that I am passing all that along to Deb during her waking moments.

Evening Hours and Into the Night

Deb is resting.  Quite well, actually.  She said she's really really tired. And that she's really surprised by how tired she is.  She's actually said that about a dozen times not remembering that she's said it before.  She just doesn't remember how tired she was after the last two surgeries she went through.

Actually, I think the term shouldn't be 'tired'. It should be 'groggy'. Hey, it takes a while for anesthesia to work its way out of your system.  That, plus the trauma of surgery - yeah, I'm not surprised she's feeling out of it.

Not that she isn't capable of lucidity.  She's been able to converse intelligently with everyone.  She was just talking to the shift nurse about how to deal with her diabetic dog (feeding and medicating).  Will Deb remember it?  Probably not.  Doesn't matter.

I just hope I can get some rest tonight.  When I walked into her room I was reminded of the Monty Python hospital sketch from 'The Meaning of Life'.

"Ah, I see you have the machine that goes 'Ping!'"

And She's Out ...

Though I still can't go back to see her yet.  I did talk to her surgeon a moment ago and he said she did fine through surgery, though she'll have a bit of bruising for a while - but that's normal for this case.  He said she would be in the recovery room for about an hour and then will get moved over to the southwest tower (which I inferred to mean that she will go straight to a room - preferably a private room so I can stay with her).

I think it's a good sign that the actual surgery took less time than they had set aside for it.  Four hours versus five or more is encouraging.  I just wish I didn't have to wait another hour to get to see her, but that's how it is, I guess.

I probably won't post again until after I get a chance to talk to her a bit, maybe not even tonight (unless we have a repeat of The Potato Soup Caper).

And We're Off!

A good bit later than expected, but Deb was finally taken into surgery at around 1:15 PM and had to leave me standing outside. So yes, a little more than two hours later than we'd been told.  Why so late?  I'm glad you asked!

Following a late night of trying to get everything in order at home, we got up early this morning, took our showers, I got a little bite to eat (sorry Deb) and we headed out to Swedish hospital on First Hill.  Deb got checked in and they took us back to a pre-op area where Deb got to change into lovely hospital clothes (at least the pants matched the robe) before the sent us up to Nuclear Medicine.  That they let me go too was a happy surprise.

The whole point to going to Nuclear Medicine was to inject Deb with a radioactive dye (technetium 99 if you are interested) in the hope of being able to locate the sentinel lymph nodes for later biopsy during the surgical procedure. They injected Deb on both sides and then told her to spend the next half hour moving her arms around to help the dye make its way to the nodes.  After that 30 minutes they put her into a detector (that looks suspiciously like an MRI or CT machine) for a series of 5-minute images.  Of course they couldn't see anything.

They stood Deb back up and told her go through another 15 minutes of movement. So I led her through some light calisthenics before they put her back in the machine.  They could see a node on one side (the left) but not the side she'd previously had done.  Back up, more movement. I don't think she really minded since this is the last chance at exercise she'll have for a while.  Back in the machine, more imaging, and maybe a ghost of a spot on the right.  They would have carried on longer with more exercise/imaging cycles, but the surgeon called up and said something to the effect of "Hey, where's my patient?"  Done with that, then.

We returned briefly to the first pre-op area and were taken immediately downstairs to the surgical area.  I got to stay with Deb while they put in her IV, the surgeon came and discussed again his plan, and the anesthesiologist came in to give Deb an initial couple of medications (not the sleepy stuff yet).

And then they took her away and kicked me out.  Not that I wasn't expecting that.  I doubt the surgeon wants me in the OR with them, and frankly I don't want to be back there either.

So that was about 1:15 as I stated before.  It is now 2:00 and I've been typing this on my iPad while trying to eat a bite of lunch.  I apologize for any grammar or spelling errors.  I'll come back and edit that later if it's too bad.

There it is.  The adventure has begun in earnest once again.

Pre-Surgery Night Out

So, this post is not about cancer.  Or about surgery.  Or chemo/radiation/whatever.  It isn't.

Deb and I are Seattle Sounders FC season ticket holders.

Yes, I have a point to make with that - I'm getting to it.

As you attend games, and buy merchandise and food at the games, you got a certain number of points in your account that you could use to either get certain promotional items or bid for things being auctioned off (though I think they are changing how that all works this year).  Late last season I had a large number of points to use and they were auctioning off a game-day experience package (yes, I won the auction).  Part of that package was for four tickets in the club section (we took our friend Greg and my friend Tom).  And the Sounders won the game! Hurrah!

No, I'm still getting to the point.  Here it comes.

Another part of the package was a voucher for a free night at the Hyatt at Olive 8 (at the corner of Olive Street and 8th Avenue - how creative...) and a dining credit at their on-site restaurant, Urbane. Fortunately, they didn't require that we take the free night on the night of the game.  The voucher was good for a calendar year.

We used it last night.  That, by the way, was the point.

We know that Deb has a long period of recovery ahead of her.  We know that she's not going to feel up to going places and doing things for a while.  But she needed to have one last pre-surgery fun day. So yesterday around 1:00 PM we checked into the Hyatt and then went over to a place over on 4th called Lola that she's been wanting to take me for lunch.  They have excellent salmon kebabs.

We then went to Pioneer Square to one of the smallest National Parks, sort of.  The Klondike Gold Rush National Historical Park is actually comprised of sites in the states of Alaska and Washington.  The Washington part is in Seattle and isn't much more than a few thousand square feet in a historical building (the former Cadillac Hotel).  Deb has been wanting to go find it ever since she heard about it a few years ago, so now we've done that.

Another place Deb's been wanting to go for some time is the Chihuly Garden and Glass in Seattle Center.  Some of the things they've got on display are astounding in their dimension and complexity.

We also got to watch a couple of glassworkers put on a display of some of the types of glassblowing projects they do.

We went back to the Hyatt and went to dinner at Urbane.  Following that we went back to the room and crashed out for the most part.

This morning we got up and worked out at the hotel gym (wow - very nice ... better than any hotel gym I've been in).  Probably Deb's last workout for a good while.  That was followed by getting cleaned up and walking down to Pike Place Market for breakfast at The Crumpet Shop, one of our favorites that we rarely get to go to anymore (though the owner still recognizes us every time we see him).  Following that we bought a few things at the market and went back to check out of the hotel.

On the way home we stopped off at our church to see the pastor for a moment.  She had a prayer shawl for Deb that one of the church groups had made for her (very nice - she'll be able to wrap up in it while she's recovering on the sofa or recliner).

So, while this post didn't really have anything to do with her cancer or surgery, it was all about getting her into a good mental space ahead of Friday.  24 hours of pleasantness.  Maybe that's something she can look back on while she's down and out over the next while.  Something she can look forward to doing again after all this cancer stuff is behind us.

Counting Down

Friday is surgery day for Deb.  I can't say I'm excited to have her undergo surgery, but I am looking forward to getting the cancer removed as soon as possible.  She will be reporting to surgery at 9 AM (0900 in my preferred way of referring to time) and probably be put into a room where she can get changed, get the IV line put in, have a last-minute consultation with the surgeon and the anesthesiologist (or CRNA), and get comfortable in the hospital bed - but I hope that I will be able to stay with her through this time.  I'm going by our previous experience with surgeries on all that.  They could surprise me with some other process, but I do want to be with her back there for as long as possible.

We expect that they will probably take her back into a pre-op area sometime between 1000 and 1030, where they will start to give her the nice little injection through the IV that makes you not really care what else is going on.  This, of course, is later followed by another injection and the encouragement to count out loud backwards from 10.  I'm not aware of ever making it past "5" myself.  A question for all of you readers who've spent time in surgical suites - does anyone ever actually make it to "zero"?  Just wondering.

So, one other doctor visit to report.  Last Friday we saw a radiology oncologist.  She and Deb discussed her case at length, but I think that the general consensus is that Deb may not need radiation therapy following surgery et al, but that it is still a possibility depending on the post-surgical pathology results.

So now we're just spending time doing what we can to get ready for the next several months.  Deb did go ahead and get her hair cut shorter in anticipation of chemotherapy (she says it's her 'transitional haircut'), but she threatened me with great bodily harm if I actually post the picture of her that I snuck in while we were at the coffee shop afterward.  I think I might do well to take that threat seriously.  She makes the same threat for any picture that I sneak of her.

A Chance to Cut is a Chance to Cure

The title of this post is one of the sayings that Deb has been using all the way from the beginning back in 2009.  I think it has something to do with the mindset of the common surgeon, even the ones that only operate on animals as Deb did.  Yeah, OK, fine.  I've been cut on a few times myself, so I can't say much on that.

Deb's next date with a scalpel, and not being on the handle end of it, will be on February 12th (which is a Friday for those keeping score at home).  I will be posting quite often around then, especially since most of the reason for this blog is to keep interested parties informed about what's going on without my having to make a bunch of phone calls.  The surgery time will be around 11am PT (just assume that any times that I mention will be in Pacific Time from here on out), though they will take her back for some other stuff before that.  I'll explain reasons for that in a later post.  They may well take her and shoo me away to the waiting room (AKA the Pit of Agony and Worry and Gnashing of Teeth) as early as 9am.  Maybe not until 10am.  I guess I won't know for certain until February 12th.

The current thinking is that she will spend the first night in the hospital (which is good because they have better, quicker painkillers there that go straight into your arm - we don't keep an IV pump at home).  Deb's mom, Linda, is due in sometime on Saturday morning so, depending on when they say they'll discharge Deb, I'll either go get her at the airport or ask a friend to do it for me.  Linda will be around for at least two weeks, which makes me feel a lot better about being able to care for Deb.

That's all for now. As usual, more to follow.

F*#&ing Cancer ...

(... And Inhale) Some Detail ...

So my last post was not very informative other than to say “What?!?  Cancer, why won’t you leave us alone!!!”

Sadly, cancer doesn’t listen.  If it was in some sort of conscious form I would send Liam Neeson after it with his ‘particular set of skills’ (vis-a-vis the “Taken” movies).

So, more detail.  Deb has been having a two-pronged screening approach ever since her original cancer diagnosis/surgery/reconstruction back in 2009.  Because there’s an implant on the right side and because of her history with cancer, she has a mammogram and then later an MRI to monitor her.  These have been scheduled six months apart ever since we moved to Seattle in September of 2009.  Her most recent MRI was in mid-December.

We got word back that they wanted to do an ultrasound-guided biopsy on the right side.  It was originally scheduled for December 31^st, but for some reason they only did the ultrasound part to see if they could actually locate it.  Something about not taking a sample on the afternoon before a long weekend because of the possibility of complications with the biopsy procedure (though those chances are relatively low).

It was another week and a half before they actually took the sample.  Two days later we were at a surgeon’s office going over the results.  Yep.  Cancer rears its ugly head again.  But not the same kind as last time, so we really shouldn’t think of it as a recurrence, just a new tumor (that is fortunately pretty small).  The original surgery had removed all of that cancer, but there was a little bit of breast tissue remaining.  Just enough of it, I guess.

But wait, I didn’t mention …  At the time of the MRI they looked at a little spot on the left side that hadn’t been changing much over the years but that might have been getting bigger.  Deb went back for an MRI-guided biopsy on the left side.  Why didn’t they do both at once?  Because one was an ultrasound (which requires a certain piece of equipment) and the other was an MRI (which requires a totally different piece of equipment).  This was mostly because the spot on the left was so small that they couldn't locate it with the ultrasound.

There were other doctor visits in the meantime though.  We saw the oncologist here that Deb talked to seven years ago.  We also went to see a reconstructive surgeon to discuss possible approaches and time-lines for that.

Regardless, two days after the second biopsy we were back in the first surgeon’s office to discuss the results.  Not cancer, but the cells weren't completely normal on the left.  Deb had already decided that she isn’t going to fool around with this any longer and is going to go with a double mastectomy, so that result helps to confirm that decision.

That’s enough for now.  Next time I’ll mention what will likely happen this time after the surgery.  And maybe call cancer by a few bad names (might not be suitable for small children).

(Sigh...)

Ready for Round 2?




We weren't.




Not that we've been given a choice.

More to follow...