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As promised, I have more details on surgery and will be sharing them today. Surgery is scheduled for 11/3 (election day). When I let my oncologist know, he was like GREAT, I look forward to celebrating two amazing outcomes that night. I'm glad he is optimistic! My first thought was that Chris was going to die of a heart attack while I was at the hospital between stress about me and stress about the election. I know he is going to be watching all the live coverage and yelling at the TV and generally raising his blood pressure. Who knows, though, maybe it will be a good distraction for him. For me, it will be weird to sort of miss that moment with the rest of the world, but maybe good for me, too.
Since chemo, I have been BUSY with pre-surgery appointments. Because the cancer showed up on the skin, my surgeon had me come in this past Monday (10/12) so she could take skin samples and have them biopsied before surgery to ensure she was getting clean margins. She took four skin samples, gave me four sets of stitches, and from those initial samples, 3 were cancer-free. The one at the top of my chest (closest to the tumor, as well as my heart and lungs, eek!) was not. So I went back yesterday and had two more samples taken, two more sets of stiches, and those were both clean so she now has the line for the surgery, which is reassuring and amazing news! Also, how super smart to take the samples before surgery???? Usually they just do the surgery and do their best for clean margins, but if we had done that, I would have had to go back under for a second surgery because the original line of incision would not have been clean. I am so grateful to have such smart people on my care team, who are also really collaborative and open to learning and trying new things. I think it will result in overall better outcomes for me.
I've also had two consults with my plastic surgeon and a follow-up with the radiologist, so that we are all on the same page about the surgery. Here is what will happen:
1. The Oncology Surgeon (Dr. Mitchell) will remove the skin, implant, and tissue leftover from my original surgery in 2014, as well as all the lymphnodes in the left armpit. Her job is to get out all the cancer.
2. The Plastic Surgeon (Dr. Soares) will be doing three different things, and his part of the surgery will take longer.
- First, while Dr. Mitchell is working on the left side, he'll work on the right side, remove my implant and replace it with a small over-muscle tissue expander so that the radiologist doesn't hit my skin on the right hand side when I do radiation in December.
- Second, he will be attempting a procedure that helps to overcome the risk of lymphedema that might result from all my lymphnodes being removed from my armpit. He'll be looking for a vein in my arm that can be re-routed to connect to the lymphatic system to pick up the drainage being impacted by the removed lymphnodes. There is an actual medical name for this - I don't know it - and I may not even be describing it well, but it's effective in 85% of cases, so I am hopeful. This will help me continue to maintain as much mobility and activity throoughout the rest of my hopefully long life as possible.
- Last, he'll close me up and things get a little tricky. Dr. Mitchell will be trying to take as much skin as necessary to get the cancer out, but also not too much so that my skin can be sewn together to close me back up. If they are able to do that, then Dr. Soares will just close me up like he would any surgical incision. There is a 50% chance he'll be able to do that. If there isn't enough skin to close me up, then he will be performing a lat flap, meaning creating an incision around my side and taking my lat muscle and stretching it over the chest in order to provide skin to close the opening. There is a 50% chance that will be necessary. If that is the procedure needed, word on the street is that I will premanently lose about 15-20% strength on my left side and may not be able to perform certain activities (push-ups, rowing, climbing...) which will be sad, so I am hopeful he can just close me up without the extra step...but I also want all the cancer out for good this time, so I am fine either way and will deal with whatever it does to my long-term mobility.
- Next week, we are going to Pismo for 5 days for a change of scenery since we have taken ZERO vacations in 2020 and have diligently been sheltering in damn place since mid-March due to Covid. I can't remember if I shared here, but we thought I would have the whole month of October off and thought about traveling through several states and hitting up several National Parks on a one-month road tour. Then, I had the liver issue with the second stage of chemo, and chemo got delayed a week, so we stopped feeling confident about scheduling anything. Toward the end of chemo, we had reduced it to a 3-week trip to Utah to see their five National Parks, but then my surgeon mentioned pre-op appointments, and I have monthly shots of Lupron to shut down my ovaries and needed to be here on 10/27 for that, and they thought I might be able to have surgery in October, and Covid cases started spiking in Utah, so a long out-of-state trip stopped feeling realistic. Last week, we ended up booking the one house still available that looked nice in Pismo which was available for the five days remaining in October which we had free. I booked a private kayak tour since it might be my last time kayaking. We'll go see the monarchs, and hopefully have s'mores on the beach, and just feel normal for a few days. So, I'm excited for five days - which are of course not as amazing as a month-long road trip - but better than nothing!
- Peloton Outdoor Power Walks: When our hiking trails shut down because of high fire risk, and we'd hd bd air quality for days as well, I just stopped walking at all and it sucked. My sisters have been talking up Peloton for months, so I downloaded the app and have been doing these guided 45 minute power walks and I totally love them. I feel super self conscious about doing the dorky power walk arm swing, but the instructors tell me I have to, and so I do. The first few have made my butt sore, and I think it's been a good add to my workout regiment, especially since there have been several days when I can't do my normal workouts becuse of stitches and things. (I am going to REALLY STRUGGLE to not workout after surgery! Eek!)
- My surgery "success" guided visualization: The cancer therapist I work with who gave me the great visualization for my scans, created a visualization for my surgery so I am listening to that every day and visulizing a great outcome~!
- The idea of becoming a Breast Cancer Advocate. I reached back out to the postpartum breast cancer specialist who I had the consult with (Dr. Borges) and asked her what needs their might be for a former recruiter with program management skills and a 16 year old MPH...and she suggested I look into getting the education and training to be a breast cancer advocate, and is looking for someone to join her team part-time. A breast cancer advocate is the voice of the patient in advocting for funding, research, legislation related to breast cancer. I think it sounds perfect so I plan to look into the courses necessary to do this. And, it's the kind of job you can work around your regular job, so we'll see if this helps me put all the pieces together of post-cancer 2.0 for my life. I can't imagine what that feels or looks like yet.
- I am back to reading and exploring new shows - let me know if you have recommendations for either. I am going to need things to fill my time after surgery!
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