Oncology Appointment

The technical term for what was contained in my pathology report, according to my oncologist, is:

"Your breast was a mess."

I guess I'll need to get my medical dictionary out for that one.

He said he'd never seen anybody with my pathology who didn't have lymph node or vascular invasion before, and that I'd gotten very, very lucky. "Somebody is looking out for you, that's for sure."

No dictionary needed for that one. I really should go play the lottery.

My chemo regimen is going to be grueling. It's TCH: Taxotere, Carboplatin and Herceptin. I'll have six rounds, every three weeks, of Taxotere and Carboplatin. Every week for an entire year, I go in for Herceptin. Then, I'm semi-free; I'll take Tamoxifen every day for five years. That though, is a pill I can take at home.

Wow. I'll be treating this cancer for seven years.

Dr. Blair gave me the choice of starting before Thanksgiving or after. I chose after - my stepdaughter is coming to cook for us, and I don't want to be in bed - I want to eat turkey with my family. So, my first chemo infusion is December 2nd, first herceptin is December 9th, 2nd herceptin is December 16, and the 2nd chemo is December 23rd.

(Note to self: start shopping now and forget the after thanksgiving deals.)

(Note to family: it may be a meager gift year. Consider my continued breathing as your main gift.)

I'll lose my hair about ten days after my first infusion, so warm hats for Christmas is a gift idea I never would have suggested before. :)

During chemo, I'll be taking a steroid to prevent fluid retention, and compazine and ativan for nausea, and possibly neulasta to get my white count up. Any other side effects that pop up will be dealt with at the time.

My main concern, which I brought up but wasn't really addressed to my satisfaction, is what happens if I get migraines because of these medications? If it happens in the infusion room, they'll give me demerol. But, if it's something that happens after, I got the distinct impression that I'm on my own.

I don't think I can possibly get across to these medical professionals how much these migraines have affected my life. The only ones who understand it are neurologists.

Maybe I can get a neurologist to treat me for the side effects of chemotherapy?

I can live with nerve pain. I can life with fatigue. I can live with bone pain. I can live with nausea, diarrhea, bloating. I can live with hair loss. What I can't live with is migraines -- not a year's worth.

How to describe it to somebody who hasn't had one? It'd be like giving birth every day of your life. And, not an easy childbirth either. For you men, it'd be like having somebody kick you in the balls every hour - forever.

Let's just hope that I'm not one of the people who get week-long headaches from herceptin. Maybe I shouldn't get ahead of myself. Maybe my cancer luck will hold.

Because of my focus on migraines, I completely forgot to ask Dr. Blair about getting a port. I think having a port surgically implanted is pretty standard for people who have to have a year of infusions. I'd rather not - it's ugly and leaves a scar that you can't hide, but I have small veins and since mastectomy they can only use one arm for sticks. An IV in one small-veined arm every week for a year might be a challenge.

I guess this will ruin my chances of ever being an IV drug user too.

Darn. Cancer takes away so much.


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Oncology Appointment #1

So, there I am, sitting in the examination room, after doing my time in the waiting room watching cheerful, hairless people come and go. I was surprised that I was, by far, the youngest person in the room.

Anyway, here is the picture on the wall in exam room #8, where I was placed. You can click to enlarge.


 

Do you see what that is?  It's a cat, holding a hand mirror out, brushing his hair. Or fur; whatever. 

As I sat there, waiting for the doctor who will eventually administer toxic poisons to my body that are designed to kill all fast-growing cells - like, um, hair  - I wondered about the logic of putting that picture in an oncology exam room.  

What is it trying to tell me?  

Is this a mid-chemo cat, brushing his hair while it's coming out in big chucks that we can't see?  The eyes do look quite demonic and distressed. Is he soon to be an ugly, skinny, sickly hairless cat that will have to wear a full body do-rag with big earrings?

Or, is this supposed to demonstrate what happens after the chemo?  Is it telling me, never fear, cats and woman both grow their hair back after chemo and pretty soon, I'll be looking in a mirror, brushing my fur too?

Is it an evil joke, torturing us cancer patients with the knowledge that even a cat can brush its hair, and we can't? Ha ha!!

The fact that it's a pussy cat - is that a subtle hint about the places I'll lose my hair?

I couldn't figure it out, so I stopped staring at it, and I picked up a wig catalog until the doctor came in. (Some of those wigs looked like they could have been made from cat fur - maybe that was the message? A promotional poster from the cat hair wig company?)

The doc, by the way, was wearing a tie with old Chevys and big American flags on it.  I am now pretty sure he picked that picture out himself.  

I liked the guy a lot and found him personable and intelligent in a geeky way, which is my style. But unfortunately, he had nothing to tell me.  He said he can't make any recommendations until after I have surgery and he doesn't usually see patients until then.    I told him I had a strong desire for lumpectomy over mastectomy and could the cancer be shrunk down before surgery to accomplish that goal? He said yes, but he also seemed to think a lumpectomy wasn't likely given my cancer soup, but "I'm not a surgeon.."  He said my large breasts would be good for lumpectomy as smaller breasts have worst cosmetic results but unfortunately, my thinness would work against me if I have mastectomy - no DIEP reconstruction for me as there is no extra skin or fat anywhere on me.  I'd have to get those big, fake, plastic, hollywood boobs I always thought looked ridiculous.

Anyway, it was kind of a wasted appointment but it was nice to meet him, and he made another appointment for November 10.  He figures I'll be a month out of surgery by then, but if it comes earlier, I can always reschedule.

Tomorrow, the MRI.  

I hope at the MRI place there are no pictures of cats with their nipples in machines.