The Medical Stuff Update for Thursday

Dear Ones,

Have I mentioned lately how great a medical team I have?

Yesterday we met with Debbie at Dr. Drogula's office, she is the nurse who does the pre-surgical education and makes sure all our boxes are ticked off.  It was another delightful interaction, full of information and details that allow me to understand and relax.

The basics are, Monday is surgery.  I arrive early and will spend the morning doing the prep work, that includes locating the tumor with a guide wire and the prep part of the sentinel node biopsy.  Essentially, between all of that and the IV, it is a morning of poking, and I am allowing that it will not actually be too pokey.

I am scheduled to head into actual surgery at 11:45 and it seems they run the schedule pretty smoothly.  Laura will be there with one of our bestest friends Kat, and Stewart+ will be stopping for a blessing in the morning.   Apparently I will be assigned a number (can I pick?) and there is a board in the waiting room where they can track my progress through the system.  I'm visualizing OTB or the NYSE and that is just odd.  Betting is discouraged.

Surgery, 90 minutes, recovery, 1 hour, home late afternoon.  Laura with me, among other things she has her vet tech degree, so if I act like a cat or dog recovering from general anesthesia, it is all be fine.

Actually, all will be fine I am sure:-)

During the surgery, the tumor, as well as a (hopefully clean) margin of tissue will be removed.  In addition, a second incision and the sentinel lymph nodes will be removed to see if the cancer has spread to them (1-4 nodes.)  This is diagnostic and will help me (with doctor's input) plan the course of my continuing treatment.

I have refused the axillary dissection.  It turns out that offering me the choice is a very new thing, so we don't need to extrapolate what would be going on if I hadn't been offered the choice...  And removing all of the lymph nodes from under my arm feels like too great a risk for me to take for my body and the use of my left arm.

What has been shown is that axillary dissection is equally effective as radiation treatment if we find that there is cancer in the sentinel nodes.  So the expectation is that if I have positive node(s) I will undergo a more extensive round of radiation that will involve my axilla in addition to my breast.

What I know, is that for my body, the tissue fibrosis that the docs expect to see from the radiation is a better long term risk than the scarring, fascial damage and complete removal of my lymph nodes from the axillary dissection.   As a therapist who has worked with plenty of clients who have experienced breast cancer, I realize that this is a different choice.  With either choice, medically, I will always be at risk for lymphedema.  Having worked with it, trust me, I know how serious it can be. 

I feel like having the tissue, connective tissue, fat, lymph nodes - all that would be removed - even if it is seriously damaged and fibrotic from radiation, is better for me.  I can facilitate and allow that area to heal, and even if it were to remain seriously damaged for the rest of my life, it feels better to keep the tissue with me.

And, all of this is still an IF, because the full pathology report will not be out until next Thursday, and that will be when I really know the status of the infiltration into my lymph nodes and how high the risks of it spreading actually are.  With that information, I will make my choices about radiation and other modalities.

What a journey. what a ride.  Keep me and all of mine in your prayers on Monday.
(Sarah will be at camp, send her clear, cool weather and extra riding time.)

Blessings to you all,
~Amelia

PS: if you are local to Annapolis and reading this, the Lighthouse Shelter is in need of staples for the food pantry.  Summer is a time when such things can get overlooked. Here is a list of their immediate needs, because frankly this is a level of need that most of us simply can't imagine and for me, it feels far greater than what I am experiencing right now.