Friday, April 25, 2014

My Cancer Report Card…The Results Are In

The amazing group at Fort Thomas 
Women's Wellness Center unofficially
crowned me "Ms. Fort Thomas!" I 
absolutely love and adore Dr. Heidi
Murley, Bev, Linda and Nancy. 
Bev and Linda sure know how to make a lady feel special!


PATHOLOGY RESULTS
This past week, I finally had the chance to discuss my pathology report with my oncologists following last month's double mastectomy. The pathology report is the equivalent of getting your cancer report card. It shows you how your cancer is doing after hitting it with chemo and surgery. I had a very good response to the chemotherapy and the tumors shrank significantly. Dr. Flora used the terms "near cure" and "better than expected." If this was my starting point, I would have been considered a stage 1. There were three areas left that were found to still be cancerous, but they were much much smaller than what I started with…2 mm down from 4 cm. Dr. Heidi Murley was happy about the margins surrounding the remaining cancerous sites. She said she is confident they got all the cancer in the area. 

While I am relieved that the cancer responded well, I have to admit I'm a bit uneasy that we didn't knock it out of the park. We didn't achieve the much coveted "pathologic complete response" or pCR (which means the cancer is completely annihilated by neoadjuvant chemotherapy). Those who achieve pCR have a much better prognosis than those who do not achieve it. If you know me well, you know that I have a strong competitive side. While I've been able to curb that competitive spirit with age, I still do have certain expectations when I do choose to fully commit to a competition or battle, like I have in fighting this cancer. I choose my battles and competitions carefully and throw my all into the ring when it's my turn. So, from a competitor's standpoint, my pathology results feel a bit like winning runner-up or honorable mention…or salutatorian (you know that one stings a bit for this former valedictorian, ha!). It's a position I'm not completely comfortable with so it is difficult for me to be overwhelmingly excited even though I know asking for a pCR is more than I should have expected.

I asked Dr. Flora the question I have been afraid to ask until now. I've alluded to it at past visits, but the response was always vague no matter to whom I imposed the question. How do we know the cancer didn't spread through my lymph system beyond the nodes under my arm and take up residence somewhere else? His answer was simply "statistics." I've been on the slim side of statistics too many times to gain much comfort from that. At this point, they do not recommend body scans or any other proactive work ups. They wait to see if symptoms should present themselves in the future and hope it is caught in time during routine office exams. This is where I have to learn to let go and take the leap of faith that we are doing everything that can be done and the treatments will work. Just acknowledging those feelings and insecurities allows me to push past the fear and move forward for the rest of the battle. I'm sure the fear of recurrence must be felt by nearly all cancer patients, so I know I am not alone in feeling this way.

So that's where I stand now, and I am extremely thankful for how well the chemotherapy reduced the cancer and for the amazing care I've had and continue to experience. As you can see from the pictures associated with this post, my team of doctors and nurses are making this an experience full of warm memories and lots of laughs, too! For every difficult instance or tough news, I, in turn, have a fun and wonderful memory associated with it and that is quite a gift!

ATTENTION SLATER FAMILY
Cousin Jeanne Beckwith Elberfeld recently tested for that pesky CHEK2 gene that I tested positive for. As much as I wish it weren't true, she also tested positive for this same gene mutation. The CHEK2 mutation appears to run in the Slater side of the family. We are awaiting results of my dad's CHEK2 test as well and will let you know when I hear something. If you want more information about the CHEK2 gene, I listed some sources in a previous post. What it comes down to is a need for diligence in screening to catch any cancers early. The mutation makes it easy for the cancer to proliferate quickly as the gene to suppress growth and hasten death of unwanted cells is compromised. Jeanne, thank you so much for undergoing this genetic testing and for sharing your results for the sake of our family. May our children be armed with better information that with allow them to be proactive and hopefully spare them from this terrible disease. 

RANDOM REMARKS
I will find out next week when I am able to begin radiation therapy. That should happen within the next two weeks. I am ready for this next big step which is also the last big step. I will continue to receive Herceptin treatments every three weeks through October, but I can totally handle that. It's not a mass kill chemo like two of the other medicines I was taking. Instead, it works to block the HER2 receptors on any cancer that may have been left behind or that spread beyond the localized lymph nodes. Side effects are minimal. 

In the meantime, I am excited to report that my hair is sprouting right along with the fresh spring grasses! I can see repopulation progress every day so I am now able to look forward to going hatless as some point in my near future!

Oh, and check out my dear friend Krista Krallman's appearance in a feature story about The St. Elizabeth's Breast Center. A cancer survivor with incredible strength, she continues to inspire me daily: https://www.dropbox.com/s/0chhhxueqwkhf55/Healthy_Neighbors_Spring_2014_FINAL.pdf

Tuesday, April 22, 2014

Why My Mom Became a Stripper

With encouragement like this from my kids,
how can I do anything but my best to recover!
It’s been awhile since I wrote my last blog post immediately after my double mastectomy…well, there’s a reason for that. What a bugger it’s been in between then and now! When I last wrote, I was still embraced by a comfortable fog of quality pain killers. Then I went home and had to start the real recovery process. It wasn’t all bad, but it certainly wasn’t all good and definitely not something I’d care to repeat anytime soon. I’d never had a mastectomy (obviously!) so I didn’t really know what all was involved with it. The doctors and nurses can tell you about it to prepare you as best they can, but until you are actually called on to live it, it’s difficult to truly comprehend what your body must do to recover.

At the end of the surgery, Dr. Vashi installed four drain lines around the entire area and then he sewed me up. The drains allow for the exiting of all the extra fluid caused by the trauma of having your ta tas chopped off and your lymph nodes removed. The long flexible tubes come out of your body on your sides, two on each side, just straight out of your skin…it’s pretty creepy. They drain into four containers that look like flexible grenades and those are always with you to empty as needed. To keep everything flowing and avoid blockages, you have to “strip” the lines three times a day. This is how my mom became a stripper! She helped me with this task until I gained enough range of motion to do it for myself. After a week, the doctor removed one line on each side. After the second week when the lines were supposed to come out, I still had too much fluid. The doctor faced the decision of whether to keep the lines in and risk infection from having those things hanging out of my body too long, or to pull them and see what happens with all that fluid. He chose to pull them. I was so happy to get rid of those awful things…that was until my upper body started filling up with fluid! This was the worst part of the whole recovery process because it was terribly uncomfortable. I was so full that I felt like I could burst at any time. I actually wished I had those gawdawful drain lines back. Time does heal, though, and since then my body has slowly but surely absorbed much of the excess fluid and boy does that feel good. Much can be said for time and patience.

So here I am doing much better and doing much of what I was able to do before. The expanders I will have in place until the end of summer are rigid and unforgiving because they sit under the chest muscles and have to coax those muscles and the skin to stretch to accept the permanent implants. You can only imagine what that feels like. I’m constantly aware of the rocks I’m smuggling up top...significantly higher than where the natural ones liked to rest! You know, I prefer my margaritas top shelf and on the rocks, but not necessarily my boobs!