Three Months Down...

And the last of my medical news came in today: the chest x-rays were clear. No metastasis in my rib. So far, so good. Only nineteen years and nine months to go :)!

Yet More Human Maintenance (with a Nod to Rafia)

The past couple of weeks have again been very busy with medical stuff. On Friday a week ago (9/17), I had my first posttreatment bone and CT scans done. I arrived at the hospital at 8:30 when they asked me to, and even though I'm 47 and have not menstruated since November 2009 (because of my treatment pushing me into an early menopause), they felt they had to give me a pregnancy test. So that took about an hour, after a half hour to get registered. At 10, they gave me the shot with the radioactive stuff for the bone scan, which had to be in my body for two hours before they could do the scan. So sat and waited. Again. I got the bone scan, which takes about 45 minutes and goes from head to toe and is actually pretty relaxing. Around 1 -- and remember, I had to fast for all this, so I've had NOTHING to eat, just some water -- the radiology guy handed me over to the CT guy, who gave me about 1.5 liters of water that he put something in (I thought he said steroids?), and he told me I had to drink it all down and wait an hour and a half before I could have the CT scan because all this stuff had to reach my lower intestines. So I sat and waited. Again. And went to the bathroom. A lot. I had the CT scan, which took only about 5 minutes and was finally out of there at around 3:30, feeling rather ill from lack of food and whatever was in that water. I came home, had a quick snack, and laid down for a bit before having some lovely soup that Kyle made for dinner.

On Monday, I saw my primary care physician for my yearly exam/checkup. Here's what she had to say:

1. My bloodwork looked really good. Cholesterol, liver and kidney function, counts -- all were great. Except my thyroid numbers. Evidently, it's not uncommon for women going through menopause to lose thyroid function to some extent. My numbers were very low. So now I'm on something called Armour. Hopefully, it will help my thyroid function and increase my metabolism, giving me more energy and helping me to lose weight.
2. To prevent recurrence of my cancer, I need to eat 7-9 servings of fruits and veggies a day. That's like four cups. I'm supposed to stay away from bananas, guava, mangos, and a couple of others because they have too much sugar. Really good for me are the following (all must be organic): any kind of berries, cruciferous veggies, greens, apples, citrus fruit, something called broccosprouts (which I have yet to find), and others. Also good are pumpkin seeds and other nuts and grains. I need to limit my intake of refined sugars and red meat. So basically, it's a sensible diet. I'm enjoying it so far.
3. To reduce inflammation of my mucous membranes in certain parts of my body, and to stabilize my hormones a bit, I'll be getting a vaginal cream with minute traces of estradiol and testosterone. I know. Seems weird, but I'm told it works. I was supposed to do this saliva test that costs $150 and that takes A LOT of saliva as a baseline test for my hormone levels. See below for my decision on that.
4. Also to help prevent recurrence of my cancer, she put me on a fish oil supplement and doubled my intake of vitamin D (to 2000 IU per day).

Just this past Friday, I saw Dr. Krekow for the first time in three months. I actually became more than a bit annoyed, much as I like her, since she kept me waiting almost an hour and a half. And I had a morning appointment! Grrrr. I just sat there and watched the minutes tick away and got more and more steamed. I mean, this is my vacation time I'm using now since I'm out of sick time again! Anyway, once she finally arrived we had a nice chat. Here's what she had to say:

1. My chances of a complete cure (i.e., the cancer NEVER returns) are 60%-75%. I thought I remembered her saying that from the very beginning, but I wasn't sure, so I asked her again.
2. That said, every year that goes by with no cancer means the likelihood of it coming back decreases.
3. With the "personality" of the type of cancer I have, she will not say that I'm "cured" at five years, or even ten years. She's seen this type come back as late as 15-18 years after initial diagnosis, so she said she would not use the word "cure" until after 20 years. That means I will not be able to breathe easily and forget this nightmare until/if I reach 67.
4. She said that my numbers look really good, and that I look very healthy. She also thought that I'm healing quite well from the implant surgery.
5. My bone and CT scans looked great overall except for one very small spot on my fourth rib on the left side, basically directly under my mastectomy incision, where the rib joins the sternum. She said that the spot is probably some inflammation from radiation (I also have some areas of my left lung that are inflamed), but she ordered a series of chest x-rays just to rule out the very slight chance that it's metastasis, which I had done on Friday afternoon. I should have results from those tomorrow or Tuesday.
6. I asked her about the saliva test and whether it would be all that much more accurate than blood levels. I really didn't want to do it because (a) it's very expensive and (be) it would be a huge pain in the butt to spit in this vial for about an hour to give them enough saliva for the test. Dr. Krekow said that blood levels would be accurate, so she ordered those tests.
7. I will stay on Tamoxifen for probably another two years and then switch to Femara. It is more effective at reducing the chance of recurrence, but I cannot take it until my ovaries are completely shut down.

That's about it for now. Everything at work is going well, just very busy with the beginning of the semester. We've had one of our best friends, Mike Larson, visiting since Friday night and have had a blast with him as we always do. He will head out on Tuesday to the deep south of Texas to visit his grandma for half a week. I hope all is well with you. Peace, Jody

New Tatas -- Ta Dah!

The past month or more has been a bit of a whirlwind. As you may recall, I saw my plastic surgeon, Dr. Heistein, about halfway through radiation. He was amazed at how well my skin was doing, so we went ahead and scheduled the surgery to remove the tissue expander on my left side and put in permanent implants on both sides. I also had made an appointment with my oncologist for my first posttreatment checkup, and she wanted me to have a mammogram, bone scan, and CT scan before that checkup. So one day around mid August I'm chatting with my friend Gretchen about all this, and she pointed out that I might want to get the mammogram on my right side before I get the implant. I can't believe I hadn't thought about that! Thank the FSM that Gretchen is a very smart woman, obviously a better planner than me! I called my oncologist's office and asked The Good Nurse Sue if I should have the mammogram before my implant surgery, and the answer was a vehement YES.

So now I'm under a time crunch to get the mammogram. The earliest I could schedule it was exactly a week before my surgery: mammogram, August 18, surgery, August 25. I go in for the mammogram, a diagnostic one, and the radiologist calls me in and says first that everything looks fine. Whew. Then he says that there's this one tiny area of calcification that's questionable, deep in my breast, close to the chest wall. The only reason he's hesitating over it is because the same area in last year's image is not as clear, so he can't tell for sure whether it was there then. He recommends follow-up at six months. Now I had it in my head at the time that I was going to be getting a breast MRI later, along with the CT scan, etc. So I called my oncologist and spoke to her P.A., Lisa, who checked my chart and said that no, Dr. Krekow had not put down that she wanted me to have a breast MRI. Even if she did, Lisa said that it wouldn't give us any more info than the mammogram did for a calcification. And even then, I CAN'T have an MRI because I have a tissue expander with a metal valve! In talking with her about all this and about the fact that I was scheduled to get my implants in less than a week, she posited that I might want to go ahead and get a biopsy. My mood at this point is getting more and more bleak. I called the mammogram place, Solis, and told them that I needed to schedule a biopsy and my oncologist would fax the order over soon. They said the earliest they could get me in was Monday, August 23, that it would take that long to get clearance for the biopsy from my insurance company. Tick-tock.

I called Dr. Heistein's office and explained the situation to them. One of his nurses said she would relay all the information to him and have him call me. At this point, I'm kind of leaning toward not having the biopsy because it doesn't seem like I'm going to get results from it before my surgery has to be done. It's now around 5 p.m., and Dr. Heistein calls. He told me that it was up to me as to whether to do the biopsy, but he also said that if I were a member of his family, he'd advise going ahead, just for the peace of mind. "Because," he says, "the chances of your actually having something bad there are minuscule." I point out to him that we may not get results by COB Tuesday when we need them since my surgery is scheduled for 7 a.m. on Wednesday. He says he'll call Solis to see if he can get my biopsy scheduled earlier.

The next morning (Thursday, 8/19), I'm getting ready for work and my phone rings. It's Solis, asking if I can come in that afternoon at 1 p.m. for my biopsy! Yay! Somehow when a doctor calls and says it's got to be done sooner, all other problems and complexities melt away. So I show up that afternoon and have the joy of having another stereotactic biopsy done, explained and described fully in a previous post, so I won't go into the details again, except to say that when I arrived, the tech was very doubtful that they could get the exact sample they wanted to get because the area was so small and so deep. She said if they couldn't get it, I'd have to have surgery to have a biopsy. My mood gets bleaker still, even though I didn't think it possible. After 45 minutes of extreme discomfort for me, however, the tech and the radiologist seem to think that they have a sample with the calcifications. The tech goes to take an X-ray of it, and returns triumphant. They place a marker in me, bandage me up, and take a couple of mammograms to be sure all looks good. It's over and I go home for the rest of the day. I am happy that it's done and I don't have to fret about facing it all weekend as I would have if I had had to wait to get it done on Monday. I still have to await results, but I've gotten pretty good at putting that out of my mind and being patient.

I get a call from Solis Monday morning while I'm teaching a class. I actually forgot about the call until about an hour after the class (my caller ID didn't ID the call, just gave me a number I didn't know). So I check my messages call them back immediately. O frabjous day! Callooh! Callay! It's benign! I can have my surgery as scheduled on Wednesday!

After all this tension and angst, I was almost giddy walking into the hospital on Wednesday morning. Well, I would have been giddy had it not been 5:30 in the morning. So mostly, I was bleary-eyed. But I was also somewhat giddy and excited and joyful that I was going to get rid of the damned tissue expander and get my implants! In other words, my mood could not have been more opposite of what it was last September 2nd when I had my mastectomy. Surgery started on time (7 a.m.), I was in recovery by 8:45, waking up by 9-ish, and leaving around 10. The pain was kind of bad but not horrible; it stayed that way most of Wednesday. I couldn't lie on either side, and I'm not comfortable sleeping on my back, but I did. Kyle and I both slept most of the day, in fact.

The next day, I felt a lot better and was able to lie on my sides, gingerly. By Friday, I was able to stop taking pain meds, and by Saturday, I just had some lingering soreness and achiness, but mostly I was just really, really tired. I worked from home most of this week except for Tuesday when the library had several big academic-year kick-off events planned that I needed to be there for. I went in and worked a full day today as well.

Thanks once again to Kyle for taking care of me, cooking for me, and helping me. And thanks to my coworkers for filling in for me without complaint. Peace, Jody.