After Having Surgery

The past three days have begun the treatment of my cancer and have provided more information. Dr. A. planned to do a lumpectomy and sentinel node biposy. Those procedures were successfully performed on Thursday, September 15, 2005. I arrived at the hospital at approx. 6:45 am and was soon in the same-day surgery area getting prepared. I took my knitting with me and kept at it until the nurses began to put the IV in the back of my hand. I was scheduled for surgery at 8:30 but Dr. A. was late in arriving and she came in to see me right about 8:30. The anethesiologist, Dr. H., was already there. We again reviewed the plan, I signed my consent, Dr. H. added something to the IV line and away we went, down the hall to the OR. Within a couple of minutes of arriving in the room I was out, unconscious, and the next thing I remember is waking up coughing and coughing. Apparently, a bit of mucos or spit went down my windpipe as they took out the breathing tube and I was coughing to rid my throat of the tickle. Or, I suppose this to be the reason. Anyway, they asked me to slide over to the gurney, which I did and then I again must have gone to sleep. Next, I was in recovery and a very nice nurse was taking care of me. I became more and more alert and after a time was wheeled back to the same-day surgery unit. Soon, Craig and my friend, Laura, came in to be with me. I began drinking liquids (ginger ale) and to combat a bit of nausea, I asked for saltine crackers. Getting fluids and a couple of crackers inside me helped me to clear up even more. Dr. A. came in to check on me and gave me the good news. By 2 pm we were on the way home.

The margin of tissue she took out with the tumor appeared to be cancer free. She took out 3 lymph nodes and they also appeared to be cancer free. These tissues - tumor, margins, and lymph nodes - will be throughly examined in the pathology lab over the next few days and she will call me with the results. There is a chance that cancer cells will be discovered outside the immediate vicinity of the tumor, so until we get the results nothing is certain. Actually, I know that in life, there is never 100% certainty. Still, these results sound pretty good to me. After healing from this surgery, the next steps will involve radiation of the breast and possibly the armpit, along with possible chemotherapy. These decisions will be made after receiving the pathology information.

I want to be optomistic. I believe I have to be positive about myself and my treatment in order to get and stay well. But, of course, in the back of my mind is the reality that there is more to come and some of it may not be so great. All in all, so far, this has been a physically minor event. I am sore from the surgery, but have never experienced excruciating pain. The pain pills were great but I only needed them until Friday and have not had one since Friday night. Since Saturday morning I have only used acetominophen for discomfort. I wouldn't even call it pain, really. There is some discomfort on moving my arm, but it is really minor compared to other pains I have had, especially recent mouth pain from an abcessed tooth and another broken tooth. I have needed more sleep and have been tired, but certainly not debilitated. So far, the worst has been the anxiety prior to diagnosis - the fear of the unknown. I am grateful and feel extremely blessed by the course of events so far.

In fact, in some way I feel a bit undeserving of the kindness, generosity, gifts, and services received from co-workers, friends, church family members, and relatives. I have received so much and feel like maybe I should have suffered more to deserve it. Thinking about this clearly I realize I do deserve kindness because people care about me. I do not have to suffer for it. We human beings are at our best when offering kindness and service to each other and I am gratified to know that so many people in my life have this impulse toward me. It is encouraging and inspiring to know that so many people are concerned and care about my well being. I am greatly blessed.

I know Heavenly Father has blessed me in this experience. I have felt the love of many people, I have been fortunate in the circumstances of this illness (even though I hardly have felt ill at all). I have been blessed with wonderful resources (employment, insurance, health care, the institution, etc.), amazing doctors and medical personnel, and with peace of mind and spirit. Prayer has been a comfort, blessings by the priesthood have been effective, and the scriptires have given me inspiration. I am a very blessed woman. It is humbling and encouraging at the same time. I know Heavenly Father has blessed me. He cares about me and his caring has been expressed by so many of the people around me. These are enough wonderful things for many, many days.

Changes

After the doctor appointment on Wednesday, Craig and I went out to celebrate our 14th wedding anniversary. Ironic that we would be discussing surgery and cancer on this day. Really brings home the "for better or worse" part of the contract.

While we were eating, the restaurant manager came by to see if we were satisfied. I spoke up and told him it was our anniversary and asked if he could do anything to help us celebrate. He offered free dessert and I accepted. We enjoyed a cookie-icecream-topping concoction.

Craig looked at me and said, "Where did that come from? You usually don't do anything like that."

I said, "It's the cancer." I've used that response previously to explain a burst of cleaning and organizing at my desk at work just after getting the diagnosis. It is a little wicked to use that explanation. People are shocked and don't quite know how to respond. But, the truth is getting a cancer diagnosis is very motivating to me and I am changing inside and out.

I'm finding that I want to change through this experience. I said to someone else, "What's the use of having cancer if I don't come out different on the other side?" Some changes may only be temporary, like baldness if chemotherapy kills off my hair cells for a time, and others may be, hopefully will be, permanent and eternal.

How do I want to change for the better?
I want to have more wisdom, compassion, faith, and love.
I want to have a more direct connection with the spirit of the Lord and my Heavenly Father.
I want to have one of my great weaknesses, neglect of my body and health, transformed into a great strength, motivation and committment to caring for the miraculous body Heavenly Father gave me.
I want to have strengthened relationships with loved ones of all kinds - family, friends, co-workers, care givers, and other people who are also taking this same journey.
I want to eliminate whatever is unncessary, unfulfilling, unworthy, useless, and unloving from my life.

This is just a very small list. I have so many other ambitions. I feel this period of my life could be a great time of transformation. But, it could also be a flame-out. I am confident that I can be transformed. I told a dear friend that I know I can do anything I set my mind to do. I have seen myself accomplish great things from time to time. Much to the frustration of Craig, sometimes those accomplishments have come with anguish and turmoil at the last possible moment. I haven't been well-organized and planful in many areas. But, along with being confident I am also optimistic. I believe in myself. I believe there is something in me that I cannot even imagine at this time. We shall see. In some ways I am eager to see where this all leads me.

I'm having the experience of a piece of a song run through my head right now. I'll have to ask Craig what it is. The phrase is "cha-cha-changes. . . . " Isn't that from some Beatles song? Now I want to add to my long list of things to do - find songs & music that express and embody the spirit of change, transformation and hope that I feel. I need to start collecting inspirational music. That would be an interesting collection - the music of change.

A date for surgery

Dr. A. 's assistant called me. I am scheduled for surgery in one week, Thursday, September 15. I wrote about the details in my previous blog, earlier this morning.

A Plan For Treatment

Yesterday I met with the surgeon, Dr. A., who will begin the treatment of my breast cancer. I also consulted with her nurse practitioner, MG. The treatment will begin with surgery. It will happen in the next couple of weeks. I will get a call later today to give me a schedule. Fortunately, Dr. A. thinks I am a good cadidate for a lumpectomy. This is a breast sparing surgery. She will remove the lump and a margin of healthy tissue around it. At the same time she will also examine the lymph nodes that drain the breast area using a technique called sentinel node biopsy. Using a radioactive substance she will track the drainage pattern from my breast and take out the first lymph node in that pathway. It will be quickly examined while I am still asleep. Ideally, no cancer will be found. If there are cancer cells in the lymph node then a section of tissue, mostly fatty tissue, will be taken from under my arm. Contained in that tissue will be the majority of the clump of lymph nodes that drain the breast and arm. The breast lump, surrounding marginal tissue, and any lymph nodes will all carefully examined by pathologists. Results take about 5 or 6 business days.

Lumpectomy alone will allow me to go home the same day and will probably not take a long time for recovery. Taking the lymph nodes, if necessary, will be more extensive surgery and will be at least an overnight stay in the hospital. The resulting recovery will be longer and more difficult. I may need help from visiting nurses to care for drains that would have to be placed.

Sometime following surgery I will have radiation to destroy any possible remaining cancer cells in the breast. Lumpectomy and radiation are the alternatives to masectomy. This combination of treatment has the best chance of reducing the risk of re-occurance of cancer in this breast in the future. Of course, I realize that no treatment can guarantee a 100% cancer free life. Then after surgery I will be in the care of a radiation oncologist and a medical oncologist. They will help me make further treatment plans.

If no cancer is found in the lymph nodes, I may not have to take chemotherapy. On the other hand, I may need chemotherapy. The findings from pathology will give information that will guide me and the doctors in that decision. Surgery and radiation are the treatments for the local occurance of cancer in my breast. Chemotherapy would be treatment for my whole body to eliminate any possible breast cancer that may decide settle in some other location. I may also go on to have hormonal treatment for a period of time in the future to guard against further breast cancer. Again, as good as treatment is at this time in history, nothing guarantees never ever facing cancer again.

So, a plan is outlined, although some of the details are still fuzzy. Further information, which will come from the surgery and pathology studies, will bring the situation into greater focus.

It is difficult to wait for these developments. I do not feel greatly anxious - more like medium anxious. I am having trouble sleeping through the night. I tell myself it is to be expected after the "slap in the face" of hearing the breast cancer diagnosis. I am also limiting myself to small amounts research per day. I am fortunate to have great resources at the medical school library (just down the hall and accessible through my computer at work). There are some days when I want to read and read. But, it gets overwhelming. Other days I am content to rest, knit, read for pleasure, and live my life. I have a great desire to experience change through this journey. I want to be different in many areas. I find that I am questioning what I eat, how I spend time, how I relate to the world, relationships, values, priorities, etc., etc. I have begun a graduate course in the meaning of my life, with additional studies in biology, pathology, cancer treatment, nutrition, etc. I was always a very good student. Hope I get an A+ in this course of study.