Week In Review: A Bit of Necrosis and the Oncologist

Our beautiful girls.

This was a week of some ups and downs.  My downs are usually short-lived, but man do I hit the floor at at times.  It's a good thing Tom is so very even-keeled.  It balances us out.  

The week started with a revisional President's Day day surgery procedure.  Unfortunately, some of the skin didn't "take," mainly along the incisions.  From what I've read, this happens approximately 10% of the time.  Our plastic surgeon, Dr. K, and a woman who's doing a fellowship at the U of MN in plastic surgery worked on each side of me simultaneously so it was over in a matter of 20-minutes or so.  In answer to all of your questions about whether I was nervous about having a newly minted plastic surgeon working on me.  Just a bit, but you gotta start somewhere, right?  

My incisions look so much better and less purple.  I think I'm going to have some wicked scars on my chest. Whenever I think of scars, I think of my good friends who loves scars because she thinks they make people look more interesting and they always have a story.  True.  I split my forehead open last May and ended up with a Harry Potter-like line in the middle of it. I just added that to the circular chicken pock scar on my forehead and the dog-bite scar on my cheek.  The line on my forehead has faded nicely, but it still serves as a reminder to me that beauty is in the eye of the beholder.  And if you don't find my scars beautiful, feel free to lie to me; I'm okay with that. 

On Thursday night, the night before we went to see the oncologist for the first time, we got the news that one of the mom's of a girl in Lark's class who had been treated for ovarian cancer in the past year and a half, is going in for surgery tomorrow to have cancer on her brain removed.  It really threw me for a loop.  It's funny how when I hear about cancer in friends I always think, "It's just not fair." And it pisses me off.  Ironically I don't feel that way about my bout with cancer.  The first thing I thought is, "What is this supposed to teach me?"  I still feel that way about our situation, but f- cancer for all of the other beautiful people who are effected by it.  Back to the mom from Lark's school, please send her and her family prayers for a good outcome and recovery.

I woke up on Friday with a heavy heart and allowed it fuel my mood for the day.  Our oncologist appointment was at 1pm.  When we walked into a large waiting room, I was struck by how many people there were waiting for appointments and also at how bleak it looked in there.  It was all florescent lighting, no natural light and decor that probably hadn't been updated since the 80's.  While we were waiting, Tom told me he could tell  I was sad by the way I was walking.  Darn it.  I wish I wasn't so transparent.   

We were eventually led back to an examine room where my someone took my vitals, we met with the oncologist's nurse, who was nice enough, and then the oncologist.  I don't know why I'm always surprised when we end up in a examine room.  I always picture in my head taking to a specialist, like an oncologist, across a desk.  I have no idea where that comes from.  Back to the meeting...the oncologist listened to my lungs and then examined my chest.  She said something like, "How long ago did you have your surgery?  Two weeks ago?  I would have expected you to be further along.  Are you a slow healer?"  I responded that I normally heal quickly and sited my recent head-wound as an example.  

Tom reminded her that I had just had some necrosis removed on both sides.  To which she responded something like, "Huh?  You're not a smoker.  I'd expect necrosis in a smoker."  Maybe that was her inner voice just coming out.  In any case, that's NOT what you want to hear when you're already in a bad mood and maybe just want some reassurance.  

Rather than tell the whole story as this is getting long, I'll just bullet point our takeaways:

• My prognosis hasn't changed and is still great!  One can lose sight of that when layering on additional information, such as looking at an actuarial table that gives me my 10-year chance of survival (90%).  
• Chemo therapy is still on the table.  I didn't realize that as I was under the impression from our surgeon that it would be hormone therapy only.  It's possible that I just heard what I wanted to hear.  The tumor will be tested to determine the chances that breast cancer will return (it usually comes back somewhere in ones core) and if I would benefit from chemotherapy to help prevent recurrence.  The test is the only one in the market and is called the Oncotype DX.  In two weeks we'll find out my recurrence score from 0-100.  0-18 is a low risk for recurrence so no chemo (50% of samples) and a score greater than 31 is considered high risk and there's a statistical benefit for chemo.  18 - 31 is the murky middle where you need to make a judgement call.  We'll get the results in 2-weeks.
• If chemo is in order, it will be Taxotere  Cytoxan.  We'll cross that bridge on knowing the details of it if we need to, but she did mention that it's a given that you'll lose your hair.  Here's to hoping that's that worst side effect. I read in another young woman's blog who underwent this therapy that her hair actually grew back thicker.  I've always wished that my baby fine hair has some more volume.  Be careful what you wish for. 
• I'm being tested for the breast cancer gene, or BRCA1 and BRCA2.  Having a secondary relative who's been diagnosed with cancer (one of my mom's sisters), my Norwegian heritage and my early age of diagnosis make me a candidate for this testing.  Only 5 - 10% of the population tests positively for these genes.  If you test positive, you have an increased risk of not only breast cancer, but other cancers such as ovarian cancer. Many women opt to have their ovaries removed to prevent that from happening.  Clearly it would also be important information to have for our family.  
• We want an oncologist who thinks about cancer as treating the entire family.  Certainly there's just one of who's physically effected, but we're all on this ride together and it matters that we have two children and the fact that this is Tom's second go around.  This oncologist gave a great cancer tutorial - it was like a good salesman going through their pitch - but she barely acknowledged Tom and seemed sort of removed from the situation.  I could detail some more gaffs on her part, but I'm going to spare you.  Suffice it to say we're going to look for a new oncologist.  

Back to the present.  I'm happy to say that my dauber is up again - at a 3.5 out of 5.  I am, however, getting a little stir crazy.  My energy level is back to where it was before surgery so I have to resist the urge to do to much.  Taking it easy is NOT my forte.  Fortunately, we have Sue, our mother in-law (i.e., Tom's late-wife's mom) here with us for the week to help me maintain my sanity. Thank you, Sue! 

I have another appointment tomorrow with the plastic surgeon where I think (and hope) I'll get the remaining drain out.  

Good thoughts,

Lisa