In The Beginning

Hi Family and Friends,
 
As you know, I was diagnosed in early March with an aggressive form of breast cancer. It is called IDC/ILC.  That stands for Invasive Ductal Carcinoma and Invasive Lobular Carcinoma. Some doctors call it infiltrating instead of invasive but they both mean the same thing.

I feel like I am finally starting on the road to recovery because we have a date for surgery! My surgery will be Monday, April 14 at 8:30 am. I have chosen to have a lumpectomy. Both surgeons (first and second opinion) said a lumpectomy would be OK because they believe the area involved is small.

Lumpectomies are now done on an outpatient basis but I will be staying in the hospital overnight because I am also having the right half of my thyroid removed. The right side of my thyroid has a ping pong ball sized nodule on it and it is interfering with my breathing, swallowing, and comfort.  I will be monitored after surgery for calcium imbalances caused by the parathyroids (they control calcium in our body).  If they get bothered, bumped, or nicked during surgery, it causes problems which need medical attention. Two different surgeons will be operating on me...NOT at the same time though!!!

The first part of the lumpectomy is finding the Sentinel lymph nodes and removing them.  They are tested right there in the operating room to see if cancer cells are in the removed lymph nodes.  If no cancer cells are found, then we will know that my cancer has not metastasized (spread) to any other parts of my body. If they find cancer cells in the nodes, then they may remove between 23 to 40 more nodes in an attempt to remove more of the cancer. That is a more involved surgery so I am very much hoping for the Sentinel node to be clear, allowing me to not have the more extensive surgery.  After the surgeon knows what he is dealing with (lymph node involvement or not), he will do the lumpectomy.

I am HER2+ which is the aggressive part of this disease. Because I am HER2+, I will need to receive a drug called Herceptin every 3 weeks for one year. Some people do well with this drug while others have a variety of difficult complications. I will have a port put in my chest sometime around the end of April to make the infusions easier and to save my veins.  

At the same time as I receive the Herceptin, I will also need to have 30 or more sessions of radiation to kill off any nasty breast cancer cells that may have escaped the surgeons. Radiation is daily, Monday through Friday, for at least 6 to 7 weeks. I need all those cancer cells killed because this kind of cancer is aggressive and likes to come back in the lungs, liver, bones, and brain.  Because of that, I will be closely monitored for several years.

After surgery, the removed tissue is sent away to be analyzed for size of cancer, margins of the cancer, shape of cells, and many other things. When the pathology report comes back, the care team will decide if I need chemo or not. Right now, the opinions of the surgeon and the oncologist are mixed...one says yes while the other one says maybe.

On April 24, I go back to my oncologist to find out the results from the pathology report.  That's when I will find out if I have to have chemo or not, when the Herceptin will begin, and when the radiation treatments begin.

So the long and short of it is...WAIT for surgery and then WAIT to heal and then WAIT for the path report and then WAIT for the follow up visit.  I think you catch my drift...

I was planning to retire at the end of this school year.  Now, I believe I may be done teaching for the year...actually for the rest of my career... after surgery. Often the Herceptin makes you very achy, tired, and feeling nauseated like you have the flu.  The radiation also makes you very fatigued.  It sounds like naps will be in order.  Can you imagine that!!??!! The queen of late nights and little sleep will be napping!  Ha! How ironic!

The other ironic fact is that we are trying to plan my school retirement party around surgery, chemo (?), Herceptin and radiation treatments. Who would have thought that 6 weeks ago when the date was chosen for my party that we'd be worrying about those things???!!???!!!

Sleep has been evasive.  I usually sleep from about 1:00am to 4:30am and then toss and turn without falling back asleep until the alarm rings at 6:30. Yup, I am tired...

Some of you have asked what to pray for.  My prayers are for:

1. NO lymph node involvement which would mean the cancer is contained to my breast.
2. CLEAR margins around the removed tissue (if margins are not clear, I would need more surgery about a week after my original surgery to get more of the cancerous tissue out).
3. Two SKILLFUL surgeons along with others who are assisting them.
4. NO CANCER in my thyroid.

The list could go on but I don't want to be a "prayer hog".

Sorry this got so long. It is hard to summarize so much in a few words.

Thanks for being on this venture with me!

Verna