Monday Recision

I'm scheduled for the recision surgery on Monday, September 17, which is easy for me to remember, as it's my parents' anniversary. (Happy Anniversary, Mom & Dad!) ;-)

I'll check in at the hospital at 9:30 and surgery is scheduled for 11:30. Assuming everything goes well (and remember, we have no nasty lymph nodes to deal with this time around), I should be done by 3 p.m. and then home around 4 or 5 p.m.

Meanwhile, the MUGA this morning was pretty boring. Frank and I showed up at Alta Bates hospital, where we checked in at Nuclear Medicine. I got shot up with some radioactive isotopes and then waited for about 15 minutes for them to circulate through my bloodstream. Then I was put on a narrow bed and had 3 leads put on me for the heart rate monitor. I had to put my left arm up over my head and the kindly nurse, Mark, strapped my right arm around me, so I'd stay nice and still. He positioned the circular scanning device over me and it slowly moved around my heart for 20+ minutes.

Frank asked if he could talk to me and Mark said, "yes, just don't make her laugh." So, at one point, Frank starts to tell me how he's going to prepare the Smithfield ham he just acquired.

Frank: I'm going to cook it the Alton Brown way.
Karen: And what way would that be?
Frank: Well, you braise it in Mr. Pibb.
Karen: Mr. Pibb?
Frank: Yeah, and sweet pickle juice.
Karen: You're not supposed to make me laugh, remember?
Frank: That wasn't supposed to be funny.
Karen: Sweet pickle juice?
Frank: Oh, okay. ......Iraq.

You gotta love him.

2B or not 2B?

Frank and I saw Dr. Kuan today, to go over the pathology report and to discuss chemotherapy. What a long appointment.

First, the details. The CT scan showed the breast lump and the rather large lymph node in my armpit, but that's it. So, yay, we get a zero on the M(etastisis) for the TNM staging for breast cancer. We told Dr. Kuan that Dr. Broderick had said I was staged at 3A (67% survival rate) and she looked confused. She said, no, a T(umor)2 and N(odes)1 meant a 2B. She looked through the pathology report and we talked about lymph nodes that are "matted," which can move a stage 2B to a 3A, but she said the pathology report showed no indication of this, so we're going to take that 2B with no further argument, thank you very much. All in all, given the TNM "score" combined with the fact that the tumor was "high grade" (i.e. aggressive), gives me a 75% survival rate. (But as my oncologist friend, Carla, reminds us, "these statistics refer to large numbers of people, not to individuals.")

After clarifying those details, Dr. Kuan let me know that the cancer center is doing a clinical test on Taxol infusions. If I sign up for the test, my chemotherapy would consist of 4 bi-weekly infusions of Doxorubicin (Adriamycin) and cyclophosphamide [abbreviated AC], and then either 12 weekly infusions or 6 bi-weekly infusions of paclitaxel (Taxol). The benefit of taking part in a clinical trial, of course, is that you have even more doctors watching your condition. So, despite the fact that weekly infusions would be a drag from the perspective of getting on with life, we are considering it.

We got to meet the nurse for Dr. Kuan's practice, Lisa Mune, who showed us how the "port" works for the chemo infusions. You can go here for an image of where the port goes. This port, which is surgically inserted under the skin, enables the nurses to give me my chemo meds and to draw blood without having to find a vein every other week. We're hoping that Dr. Broderick can put in the port when he's doing the recision to get more of the margins (still no word on when that will occur, yet).

But, if you look at the image, you'll note that meds go right into the vena cava, which leads right to the heart. So, to make sure my heart can handle all this (the Adriamycin, the "A" part of the AC, is hard on the heart) I'm having a heart scan (MUGA) on Thursday morning.

Whew. What a day.

On a positive note--I went camping this past weekend with the moms and daughters in Maggie's girl scout troop. There were four girls and four moms in Marin and it was lovely. I came home on Sunday utterly exhausted. But I'm figuring I won't be doing much of that kind of thing for at least the next six to nine months, and I wanted the Maggie time.