Thursday, December 17, 2009

In the clear

Today was the day I had my first mammo and sono since the initial one back in January/February of this year that eventually led to my cancer diagnosis. Apparently I was supposed to have this done six months after the initial mammo, but nobody told me that. It wasn't until my oncologist mentioned something about this during my last visit with him in October, that it dawned on me that something had fallen by the wayside. Several pestering calls and reminders later, I finally got set up with orders for a diagnostic mammo and sono, and roughly four weeks later, with an appointment.
Thus I went today to have my one remaining boob squished. At first everything went swimmingly. I got there at 1 p.m., a full half hour before the actual appointment, as requested by the diagnostic imaging center. They took care of me promptly, told me to walk on back, change, and have a seat. And only a few minutes later, at 1:15 -- i.e. a full fifteen minutes before my actual appointment date, they called me in for my squishing session. Yikes, it hurts to have your boob squished during the unfavorable part of your cycle (i.e. essentially from ovulation onwards), especially when you tend to develop plenty of cysts as I do. Anyway, the pain passes pretty quickly, thankfully, and I was able to lift my right arm as requested, despite the still fresh scar from the chemo port removal.
They told me to go back to the overcrowded waiting room to await word from the radiologist that everything in my pictures looks good. So I waited, and waited, and waited. Clearly, the doctors were nowhere near as fast as the technicians. After about an hour or so, they told me that the mammo looked good and that all I needed to do was wait for the sono. So I waited, and waited, and waited, and waited, ... and waited some more. Apparently, the sono was backed up quite a bit. This was starting to be a problem for me, since I had not yet had a chance to grab any lunch as I rushed to my appointment straight from work (thanks again to 2l for bailing me out early by taking on the remainder of my supervision duties!). At least they wheeled in the goodie cart with pretzels and cookies after a while, so I snacked a bit. But the wait in the crowded room was just getting far longer than I had bargained for. After what seemed like an eternity, I finally got called for the sono.
Of course the scan itself took another half eternity, as my breast apparently produces a cacophony of cysts, all of which need to be painstakingly compared to my previous scan. After the technician was done, I once again had to wait for the doctor to review the technician's findings. This time I was at least laying down on an exam table -- albeit only clad in an examination gown, my boob smeared with transducer gel, and scantily covered with towels.
After a little eternity, the doctor came in and introduced herself. Turns out it was the radiologist who did  my initial ultrasound-guided biopsy in my left breast that produced the specimen the pathology lab judged benign! She said that was strange, and that she hardly remembered my case when reading her old report... What an odd thing to tell me. I answered back that it was a strange thing and wondered how it could have happened -- given that the cancerous component was fairly big: 3.1 centimeters in its largest dimension! It seems that she should have been able to get a sampling of that, when guided by ultrasounds, at least. All she replied was that she didn't know how that could have happened, but that they pretty much knew from the mammo and sono that it had to be cancer.
In all fairness, they did encourage me to see a surgeon after the pathology came back benign. However, based upon this benign pathology report, the surgeon recommended that we observe the lesion for a few months and see whether it grows or shrinks. Given how fast this thing was growing, waiting a few months would have been a very bad idea. On the Bloom Richardson scale of how aggressively a cancer has invaded healthy tissue, I got the high score of three. This thing had grown to well over an inch in a few short months. So really, waiting would have been a very bad idea ...
You'd think that given these circumstances the radiologist, after reading these reports, would have offered some words of apology for missing the cancer. But you'd be wrong, of course. Nothing. Not a single word of regret from her. Nada. Niente. Zilch. Well, merry Christmas to you, too, lady! I'm just lucky that I'm still alive and can celebrate this holiday season. Had I relied on your handiwork for my diagnosis ...
Anyway, after spending about four hours at the diagnostic imaging center I finally got a clean bill of health for my lone remaining natural boob. Looks like I'm in the clear this holiday season!

Friday, December 11, 2009


This morning DH and I ventured out to the Ambulatory Surgery Center before the crack of dawn. My surgery was scheduled to take place at 8 a.m., which meant we had to be there by 7 a.m., which meant we had to leave by 6:30 a.m. So we were up by 5:30 a.m., braving the freezing temperatures on a dark winter morning. We got there right on schedule and I was called in after a short wait. 

Unfortunately, I did not get my favorite sleep man as requested. Instead, my anesthesiologist was a short Russian woman, who was very nice. It took her two tries to find a usable vein, but then I could get my "pina colada" so I could sleep through the hour and a half it took my two surgeons to free me of the chemo port, and swap out my tissue expander for the final silicone implant. Yipee, I got an early Christmas present this year!

DH and I left the Ambulatory Surgery Center by 10:30 and were home a little after 11 a.m. Everything went quickly and smoothly, entirely without unpleasant surprises. The anti-nausea drugs did their job so well that I felt good enough to have potato salad for lunch (DH made it with the mayonnaise I made the day before -- not to worry, I used a pasteurized egg in the shell we found in a rural midwestern grocery store during a recent trip). For dinner I had hankerings for Thai food, so DH procured some Tam Ka Gai and a red fisherman's curry. Spicy, but YUM!

The post-surgical pain is also manageable. It's almost 9 p.m. right now, and I've only had two percoset all day. Oddly, though, the side where the butcher removed my chemo port hurts more than the side where my boob man took out the tissue expander and inserted a 450 ml silicone implant! I bet that once again, the boob man's incision is equal in length or shorter than the one the butcher used to insert/remove my chemo port... Well, I suppose the pain difference may stem from more than the incision length, as the mastectomy removed the main nerves in that area. But anyway, implant exchanges like this don't seem to be a big deal. This is encouraging, as implants do not last forever and will need to be replaced in 15 years or so at the latest. 

Thus I am feeling pretty good. I took a nice long nap this afternoon to catch up on the sleep I missed this morning. As you can see above, my appetite is good. I am glad to be rid of the chemo port and to finally have my silicone foob, not the hard "turtleshell" tissue expander.

I haven't seen the results yet, as I am securely locked into one of those awful post-surgical bras, but I gently poked the side of my new silicone foob. I was very happy to find that it feels considerably softer and more natural than the saline-filled tissue expander. Supposedly, since this is a regular round implant, whereas the tissue expander was more anatomically shaped, this implant will also have less upper quadrant fullness. This means it should look more like my natural right, not-so-youthful-any-more boob. Apparently it will take two months or so for the implant to drop down and settle into its final position. As a consequence, it will be at least two to three months before I can contemplate the final step towards reconstruction, i.e. nipple reconstruction and possibly a lift on the right side (with a small implant if needed to achieve symmetry in the upper quadrant). 

But that is all next year. For right now, I'm just glad to have conquered another step on the long road to reconstruction. I won't have to go to work on Monday, so that I can have sufficient time to recuperate from the surgery. Come Tuesday I plan to be back in the fray, though, as the pre-holiday time is always entirely crazy at work. So I'd better get my strength back fast!