Get In Line!

The Friday before Christmas, I had a routine mammogram. It contained a "vague area" in the location of my sentenal lymph biopsy from 2008. I was under the hairdryer at my stylist when a call came through from radiology. I called them straight back, and I was told that they thought it was actually the oncologist trying to locate me. That's the moment when I knew I was in trouble. He called me back the next day and told me that there was new cancer in my arm pit of the same type I had before. He tried to contact my surgeon but they were out of the office for the holiday. Blake and I had plane tickets for New Hampshire, leaving Christmas morning. The doctor said we could go ahead and go to New Hampshire, but I would be contacted Monday morning, the 28th to make an appointment for surgery. That appointment was made on Monday for Thursday, January 7th. A PET/CAT scan was also ordered for Tuesday, with results hopefully available for surgery. My surgeon wanted to meet with us after I checked into surgery on Thursday, but before beginning. He said that in the panel that had met that morning, my case had been presented and there was disagreement about the nature of my new cancer. All but two (of about 50 people) felt that a full mastectomy was essential to my ongoing chances to survive. The other two said that if the cancer was isolated to my lymph nodes (as was originally diagnosed by the radiologist who reviewed my ultrasound the week before) that I had a right to choose between the two surgeries. He sent us back for consultation to my oncologist who was also at the panel discussion and we got his opinion first-hand. He told us that they had all reminded each other that I was a person, not a case, and had the right to be informed, even though it made them look sort of bad in their efforts to get things done as soon as possible. He sent us back to the surgeon who, in the meantime, had discussed further with the radiologist. Radiology's initial job was just to identify "tumor, no tumor, and to designated a location. Looking deeper, he agreed that the pictures were 'vague" and gave a couple of scenarios. Both of those men agreed with each other, that the only situation that would even be worth considering preserving my breast would be if the cancer were absolutely contained to the lymph nodes (not spread to lymphatics--small veins that bathe the breast tissue with fluid and filter away debris.) The image didn't support that possibility, but they thought I needed a chance to know that and choose my own procedure. The surgeon had also contacted a plastic surgeon to discuss what options I had if I chose mastectomy. We were sent to him for consultation. He reviewed my pictures, evaluated my tissue condition and made some recommendations that involved stage one reconstruction if I did have the more involved surgery. He was optimistic about the condition of my tissue, even though radiation has caused some damage to nerves and skin. The surgeon also gave us the option of having the vague area removed and biopsied before going forward, but that such a choice wouldn't really protect me if that cancer involved any breast tissue or lymphatics. That decision came down to "is it a wasted step, wasting time?" and everyone's opinion was "yes" (except those two who were speaking out in behalf of my right to choose.) After agonizing for a day, I finally made the decision that Blake and everyone else was ready to make Tuesday. I needed a mastectomy/lymph dissection/stage one reconstruction surgery. Now that was scheduled for Tuesday afternoon. I had to get my head around the reasons why I was so reluctant to accept the obvious. I was finally able to understand that I felt like I was giving up--I'd worked hard and the fact that I didn't need a mastectomy at the end of chemo was a wonderful surprise. Now, to be faced with losing the breast anyway made me feel like a failure, like I'd failed to "take care" of the gift I was given last year. I was hesitant to give up the offered biopsy, even though almost everyone thought it would be a wasted step. I know! Distorted thinking, but that's how I was feeling. As soon as I was able to see my situation not as failing, but rather as "round two" in the war against cancer in my case, I was comfortable to decide that mastectomy was the only path that made any sense. It wasn't about image, or obsession with keeping my breast at all! Surgery Tuesday went well. I can't have any more chemo or radiation, so the next step is to heal and prepare for stage two reconstruction in 4-6 months. I'll be out of school until I go off track on the 22nd. Then I'll have three more weeks to recover before returning to my small abandoned Kindersmurflings. I've had some nausea for which I finally got medication. Now pain meds and antibiotics will stay down! Loads of people survive mastectomy and have years of quality life left. I'm hoping to be one of those. And what about the dangerous herniated disc, star of the pre-Christmas search for more drama in my life? Neurology said, "Nothing to rave about under the circumstances--it'll just have to get in line!"