The Not-Great News Chapter
Before I get to the final pathology from the lumpectomy/lymph node removal surgery, I have a quick update on the post-surgical healing process. Also, for those of you who find my parenthetical inserts and asides annoying, you'll just have to put up with a whole lot of them this time around.
I've been pretty sore at the incision site under my arm where the surgeon removed 2 sentinel lymph nodes last week. The incision also has been a bit weepy, so I went to see her on Tuesday morning, 2 days prior to the follow-up visit yesterday. She examined me and said everything was healing fine and what I'm seeing is serum leaking. It's typical, and I should expect swelling. She also said to use warm compresses. So I did, and I the swelling arrived a day later.
When she looked at it yesterday, prior to delivering the results, she said that I have a seroma, which is fluid in the area of the surgical site. It should resolve itself within 3 weeks. But, if it gets larger, she'll take a needle to it and drain it.
She also warned me that sometimes these things can drain at a very rapid pace, and to not be frightened if it starts "streaming" (Niagra Falls! Slowly I turn...). She recommended that I keep a pad at the incision site.
For many years (this is about to become TMI for a lot of you), I've used reusable, soft cotton, organic pads for my monthly cycle. The actual reason I joined FB ages ago was to get a discount on Lunapads. The secret is out!
Since all bets are off now as far as predicting the timing of my post-progesterone cycle (see previous entries for that bit), I've resumed carrying and using Natracare and Seventh Generation disposables. All the above to say, the soft cotton reusable pads are what I've been tucking halfway into my sports bras to deal with the seroma leakage slightly above where the bra fabric sits under my arm. They are exactly the right size and shape for the job.
Just an aside about sports bras. My favorite sports bra company, Moving Comfort, was absorbed by Brooks a number of years ago. They stopped manufacturing the best one for me (the Fiona model -- wireless, very adjustable, and supportive for larger chested people like me). I've tried scores of other bras by other manufacturers, but have been unsuccessful in finding a good fit (especially with adjustable straps because I'm short) and support.
Prior to the surgery, I scoured ebay and other sites to see if anyone had the Fiona (or similar models such as Juno or Maia) in a slightly larger size to accommodate the swelling that would come from the surgery. I bought the only two available. I've been pretty much living in them (wearing one, washing the other) for the past week.
OK, we're now up to the tough part. Deep breaths, folks.
After the exam, the surgeon took me into a consultation room and asked my nurse to retrieve my dear friend Marilyn from the waiting room. I knew it wasn't going to be good because otherwise, she would have told me right at the start. So, I took a deep breath and sat down. Before Marilyn got there, the doc told me that one of the two lymph nodes had cancer. Which means that it's moved beyond the breast. But she wanted to walk me through the whole final pathology when Marilyn arrived.
Of course, I felt upset by the news, but I held it together so that I could be as present as possible and take notes when needed. The surgeon explained to us that the surgical margins were negative, which means that the entire tumor is out of the breast, so that part is done. But now we have to treat my body systemically to ensure that I don't die of this because it showed up elsewhere.
She told me that I'd meet next with a medical oncologist who would send my lymph tissue to be Oncotype tested. It's a genomic test that determines if early stage breast cancers need chemo (if recurrence elsewhere in the body is likely) or just the estrogen inhibitor pill. Radiation therapy will likely occur no matter what, but if I need chemo, the chemicals will come first. Speaking of stages, because I am positive for metastatic carcinoma in one of the lymph nodes, I'm now Stage 2.
Once the doc orders the test, it will take 2 weeks to get the results. But the test needs pre-approval by the insurance company because it costs (get ready) $4000. Yep. But, I've got to do it. For more information on this test, here's a good link: https://www.breastcancer.org/.../testing/types/oncotype_dx.
About the medical oncologist I'll be seeing on Tuesday (Marilyn will accompany me again), he did his fellowship at Sloan Kettering and is double-board certified in oncology and hematology. He's also the chief of medical oncology and hematology at St. Peter's. So, I'll be in good hands.
After Marilyn and I returned to my house, we took a walk around the neighborhood because I needed to move my physical self and get some fresh air and sun on my skin before I began the great communication effort. I also needed to meditate on how to talk to folks about all of this while still just beginning to wrap my mind around it myself.
Marilyn and I talked at length about self-care and cancer. Sometimes it's challenging because it involves making decisions that other people might not like or approve of, but it's not about them, it's about ME. I must put myself first, which can be tough because I'm typically very responsive to others.
I've also got to make all efforts to keep my stress levels as low as possible, so if that means that I don't respond to every text or call from folks who "need" me to communicate with them, that's OK. They will get used to it.
After some time and a few tears, I spoke with family, and texted and called my closest network of friends and spiritual family members. I am overwhelmed with gratitude for all the love, prayers, and support I've received.
I'm still wrapping my head around all of this. My plan for the weekend is to give myself a big break, rest, and practice as much self-care as possible. What does my version of self-care look like? Among other things, recovery meetings and taking walks in my favorite places (and, of course, sharing the photos with you all), perhaps with a friend. Harvesting the arugula and some of the now-massive blue oyster mushroom crop to grill. Perhaps making my favorite walnut-lentil pate from the now-defunct Angelica Kitchen (So delicious but takes hours to make. The special ingredient is umeboshi vinegar.).
I will be very gentle with myself for a while because this is big. I feel 20 different ways all at once. Coming to terms with this news will take time and many long phone calls with my close network, some of whom have experienced cancer, including breast cancer. It's a different conversation entirely with people who have been through it (not just adjacent to it), and I'm grateful when they share their experience with me. It's a club that sucks to join, but its members are AWESOME.
I haven't mentioned yet that it's a good idea to get a mammogram, so there it is. Go get screened.
No comments:
Post a Comment