Fred's Dead Baby!

For those of you  have seen the movie Pulp Fiction, you might recall the line Bruce Willis said to his girlfriend, Zed's dead baby!  And I'm happy to report that Fred is dead too. The surgery yesterday went beautifully.  At least that's what I hear, because quite frankly I don't remember much.  But the best news is the surgeon  removed 4 lymph nodes and they were all negative for cancer!  Which means the likelihood of needing chemo is very minimal.  There is some additional information that will be gathered from the pathology of the tumor itself to make the ultimate determination, which we hope to find out on Wednesday.  I am very hopeful that chemo will not be needed.

We got to the hospital yesterday at 10 am and my surgeon's scheduling nurse Diane, who is a total sweetheart, met us to give us some updated paperwork.  You see, originally my surgery was scheduled for Friday the 8th, but had to be pushed up a day due to a scheduling conflict in the OR.  She helped us get admitted and the walked us up to the area where they do the nuclear med injection and stayed with us through that.  The nuclear med injection is a small amount of a radioactive tracer to help the surgeon locate my lymph nodes during the surgery.  The nuclear med injection technician, a very charming man named Viet, told me in somewhat broken English the lymphatic system is tied directly to a persons happiness and good feeling.  He told me that these situations should be seen as opportunities for good health and happiness.  He made me laugh and I found his words of wisdom very comforting.  A doctor came in and did the actual injection, which was painless.  I then laid under a scanning device (the same device they use for bone scans apparently) to ensure the injection did whatever it was supposed to do.  Within 15 minutes Viet and Diane were walking us down to the surgery prep area.  We said our goodbyes and I went into to get prepared for the procedure.

The main nurse, Jennifer, tucked me into a heated bed to get started on surgery prep.  She had a student nurse with her who asked me if I minded if she put in my IV.  I have to say I was a little hesitant, but I  agreed.  Another student nurse came in to watch and I swear these 2 girls totally reminded me of characters from Grey's Anatomy.  For those of you familiar with Grey's, the other student who was watching was Christina Yang and she was telling the girl putting my IV in what do do.  They were talking about what areas of the hospital that they got to work in and they were trying to rally for as many procedures as the nurses would let them do. It was very comical.  The girl doing my IV was a little nervous and asked the head nurse and the other student lots of questions and reminded me of one of the newer Grey's characters, April.  Christina Yang was saying, "use that vein"!  Which student nurse Gina did as suggested by her fellow student and she did a great job on my IV. 

After all my prepping was done, Brad got to come in and keep me company for the next hour and half or so.  My dad also stopped by for a quick visit.  About 15 minutes prior to surgery starting, the surgeon, Dr. K, came in and asked if I had any last questions.  Then she asked me to confirm which breast she would be operating on.  I indicated my left and she whipped out a sterile (one time use) sharpie type marker and wrote the word "yes" on the upper chest area of my left side.  Phew!  Good to know we were all on the same page.  Brad asked to have the marker and after she left, he drew a little smiley face on my leg.  The OR nurse and anesthesiologist came in next to do the final prep.  Brad kissed me goodbye and wished me luck and the nurse wheeled me away for surgery.

The inner corridors of the hospital are absolutely freezing.  And the surgery room is even more cold.  Luckily they have these cool heat blowers for the beds.  I don't know how they work under such frigid conditions.  I climbed from my bed onto the surgery table and they started to get me ready.  The lights are very bright above and within just a few minutes of being on the table I was out.  The anesthesiologist put a mask over my face and told me to breathe in and out deeply and I would be sleeping within 10 seconds.  I guess I wasn't breathing deeply enough because  I was thinking it's been more than 10 seconds.  They reminded me to breath deeply and I remember taking about 4 deep breaths....

Next thing I know some lady was talking to me.  A nurse, in the recovery room.  She was talking but I really don't know what she was saying.  Needless to say, I was quite disoriented.  I was already wearing the snazzy recovery bra they give you, but I don't remember how it got on me.  I get to wear this bra 24/7 for at least a couple of weeks--good times!  More talking, a sip of apple juice and a sip of water and she asked me how I was feeling.  I told her I felt a little nauseous and she came back with something that she put into my IV.  Then she was getting out my clothes to get dressed.  Next thing I was loaded into a wheel chair and whisked out to Brad and the waiting car.  I think I could of used a little more time to get my bearings, but it all worked out just fine.  The car ride home seemed to go quick.  I ambled up the stairs at home and crawled into bed for a nap.  The kitties came to visit me, mostly because I think I smelled funny from the anesthesia.  But they were cute and took a nap next to me.

After my nap, I was feeling pretty good.  Though most of the evening I had an anesthesia hangover headache.  I only had mild soreness from the surgery and took extra strength tylenol (though I have stronger stuff on standby).  I watched a little TV and slowly started to eat and drink again.  Saltine crackers with cheese and then some chicken and wild rice soup...all courtesy of slave, I mean helper Brad.  I had a good night's sleep and woke up today feeling really good all things considered.  It's just like the doctor said, I would feel better than I would think I would.  In fact Brad and I went to breakfast this morning at the Original Pancake House.  I am moving a little slow, and my appetite isn't in full swing yet, but it was nice to get out. 

From what I can tell Dr. K did a beautiful job on the surgery.  She said I'm an excellent candidate for the partial/localized radiation (which you can read more about from my first blog post).  After surgery was over she gave Brad a detailed update while I was in recovery...most of which I mentioned above.

We go back and see Dr. K on Wednesday, October 13th.  She will check on my healing progress and hopefully have the final pathology results.  And lastly we will discuss next steps.  If all goes according to plan I am hoping to be able to start the partial/localized radiation treatment the following Monday, October 18th.

Thank you to everyone for all the good wishes, phone calls, emails and cards.  I really appreciate the wonderful friends and family in my life.  And I want to give special thanks to Brad who has been with me every step of the way, from every doctor's appointment to playing caretaker.  In fact as I write this he's in the kitchen busily making my lunch.  I love you honey! 

Thanks again everyone!  I am well on my way to a speedy recovery. 

'Twas the Night Before Surgery

The eve of surgery has finally arrived!  I'm excited and anxious to get it over.  I had a little scare on Tuesday morning...I woke up to my voice being completely shot.  I could barely get out any coherent words.  I didn't have any congestion so I wasn't sure what was going on.  All I could think about is what if the doctor won't let me move forward with the surgery.  I called the doctor's office and they assured me I would be ok to move forward on Thursday.  Unless I was running a fever or got progressively worse, the show would still go on.  So I took it easy most of the day from work to prevent further aggravation.  I even made a quick trip to urgent care for a second opinion and they too reassured me I would still be ok for the big day.  My instructions were to simply get rest and drink a lot of fluids. 

Today I woke up to a slightly improved voice....though I sounded much like a 13 year boy going through puberty.  I was able to tie up things at work and get some things taken care of around the house.  I'm eating and drinking as much as I can now because in just about 2 hours I can't have anything else to eat or drink prior to the surgery tomorrow afternoon.  Brad took me to dinner tonight to my favorite restaurant in Long Beach.  Open Sesame serves the most delicious Lebanese food and I completely stuffed myself in anticipation of my upcoming fast.  I'm not sure how the whole not drinking thing is going to work with my throat being somewhat agitated.  Brad will be assigned to keeping me distracted. 

I go to the hospital at 10 am to receive a nuclear med injection....it allows the surgeon to locate my lymph nodes for the procedure.  Surgery is scheduled to start at 1:15 and I will have general anesthesia.  The procedure should take approximately 1.5 hours and then I will hang out in the recovery room for another 1.5 to 2 hours and then home.  The doctor will be able to share some preliminary information on the surgery that day.  But we won't get the full pathology results until next Wednesday.

So wish me luck!  I hope to be reporting back on how things went sometime over the weekend.

The Story

Many of you may not know that I was diagnosed with breast cancer on September 3rd. Nearly one month later, after a lot of research, doctors appointments and soul searching I am moving forward with a lumpectomy on Thursday, October 7th. If all goes according to plan the lumpectomy will be followed by partial/localized radiation.

I have a  2.7 cm lump in my left breast (as measured on MRI) that is currently classified as stage one ductal invasive carcinoma, estrogen and progesterone receptive and HER2 negative. It's a low grade, slow growing cancer. It's growth is fueled by hormones. I'm told these are all "good" things in the world of breast cancer.

Unlike many other health conditions where the doctors tell you what type of treatment you need, I was presented with choices. Choices are good. But choices make decision making hard.

I was presented with the options of lumpectomy with radiation or bi-lateral mastectomy (removal of both breasts followed by breast reconstruction). Through all the anticipation of hearing if my second biopsy was cancer (the first one was inconclusive), I didn't think mastectomy would be on the table for some reason. But I guess these two options are standard choices offered to women in my situation. I'm told I'm lucky to have to these choices, because if my cancer was more aggressive, or I was positive for the breast cancer, BRCA gene test, or if I was above a stage 2, lumpectomy may not even be an option. Though mastectomy seems quite radical, there are very valid reasons to choose this option. Age, reducing the risk of recurrence and the benefit of avoiding radiation are the biggest factors. Apparently it's not typical for a woman my age, 36, to have breast cancer. It's most common in women 50 and older.  So I have a longer span of time in which another breast cancer could occur. 

Two mammograms, 3 ultra sounds, 2 core biopsies, 2 genetic tests, an MRI, 5 doctors and 9 doctor's appointments later I finally concluded that lumpectomy was the right choice for me. Throughout the research process Brad and I learned all about radiation (partial and full), plastic surgery, and medical oncology (the overall treatment plan pre and post surgery). Though I won't get into all the details here, there a countless variables to be considered. Ultimately the mastectomy option seemed too extreme for me personally. So I am taking it one step at a time and going forward with the less aggressive approach.

What is the next step? Surgery on October 7th to remove the lump.  During the surgery they also test my lymph nodes to see if the cancer has spread (my MRI showed no signs of the cancer spreading but they still test because the MRI doesn't always pick up small groups cells). Surgery will be followed up by a doctor's appointment on October 13th where we will learn the results of the pathology of the tumor, additional details on the lymph nodes, if I am a candidate for partial radiation and next steps.

You're probably wondering why the name of this Blog is The Fight Against Fred....Gloria vs Fred.  We named the tumor.  Well actually Brad named it.  Fred sounds a little better than saying "my tumor"....because every time I hear or see the word "tumor" I hear it in my head as "too-mah" in an Arnold Schwartzenegger voice.  Fred is our way of bringing some humor into the tumor situation.  Our official position on Fred is that he as a speed bump in our lives rather than a road block.  And I fully intend to kick Fred's butt along with any of his friends!  So Fred....your days are numbered.

I know this is a lot of information, especially for those of you who Brad or I haven't the opportunity to call and talk to personally. So I'll take a moment to answer some frequently asked questions.

FAQ's:

How was the tumor detected? My doctor felt a lump during my annual gynecology exam. So ladies, do your self breast exams....because had I done mine I would have felt this lump long before it was discovered.
Does breast cancer run in your family?  I have an aunt who had breast cancer and was treated with lumpectomy, radiation and chemo and never had another recurrence.  However, my cancer is not genetically related. 
How long does the surgery take? 1.5 hours and I get to go home the same day.
What does the surgery consist of? Removing the tumor and doing a full pathology. The surgery also involves removing some of the nearby lymph nodes to see if the cancer has spread (my MRI showed no signs of cancer in the lymph nodes, but they still have to check anyway).
How long is the recovery from surgery? About a week and involves pain that can typically be managed by over the counter tylenol. Brad technically gets to be my slave for the week. ;) I'm told I will feel like I can do more than I should. So it sounds like I'll be watching a lot of TV and reading trying to avoid overdoing it and boredom.
Why is radiation needed? Once the lump is removed during the surgery radiation is necessary to kill any stray cancer cells that may have broken off from the tumor.

What is partial or localized radiation? It's a procedure where a balloon is inflated inside the breast where the tumor previously resided. The balloon is attached to a tube that is outside the breast and a series of cables hooks up to administer radiation to just the impacted area. The treatment is administered 2 times per day for 5 consecutive days. Side effect is fatigue.

What is full radiation? This radiates the entire breast and is done once a day 5 days a week (M-F) for 7 weeks. Side effects are a sunburn effect on the skin and fatigue.

Will chemotherapy be needed? Possibly. It depends on the results of lymph nodes. If the cancer has spread, then chemo will be required.

What long term treatment is involved? I will be taking a hormone reducing drug called Tamoxifen for 5 years to help reduce the risk of recurrence. There is a genetic test to ensure I am receptive to the Tamoxifen therapy and I took the test and am receptive.
Where can you get more information about cancer? http://www.breastcancer.org/ or American Cancer Society

The past month has been a whirlwind of activity as you can imagine and we have not had the opportunity to personally reach out all our friends and family members. But Brad and I will plan to provide updates via this blog as way of keeping everyone in the loop on how things are going. If you have any questions don't hesitate to reach out to us.  Or you can leave a comment here on the blog and we will respond.  We appreciate the love and support from all our friends and family.  Thank you!

Gloria and Brad