Tuesday, October 6, 2009

The next step

So the next step was the Cancer Clinic at my local hospital. It's pretty neat; they have a group that meets early Wednesday mornings and goes over all the new cancer patients (without names, of course). As a group, the surgeons, oncologists, radiologist, etc., discuss your prognosis and decide the best course of action. Then the cancer patient comes in during the day and meets with each of their doctors. They each tell you the same cancer treatment plan, emphasizing their specialty.

First came our Surgeon, Dr. C. We were warned that he wasn't friendly, but other than not making much eye contact, he was informative, and nice enough that I'll trust him with my chest. ;) I don't think he is usually first, but gave us the full run-down. He said I would get chemo therapy first, then he would perform a mastectomy and also remove my lymph node (Lymphectomy?? Not to be confused with Nymphectomy hehehehehe). Then they may opt for more chemo therapy or just go straight to radiation. He also explained he would insert a Porta Cath. This is like a semi-permanent IV hook-up, but it is a port placed beneath the skin in the upper chest (just below the collar bone), with a tube running into veins that feed into the heart. This is the thing that made me shudder the most. If you have ever watched Star Trek the Next Generation, it made me think of a Borg. Luckily, it will be beneath the skin, so no one who doesn't know it is there will notice it, I can even go swimming! But still, it will be in there, and I'll be able to feel it (shivers!).

Then he left and in came our Radiation Doctor. I can't remember her name. She won't get me until the tail end, so it won't really matter until then anyways. She did suggest having a plastic surgeon coordinate with my surgeon so that when I have the mastectomy, they can place tissue expanders. They don't recommend doing the breast reconstruction or implants before having radiation, but the tissue expanders will be okay and set the way for regular sized boobies later on. Halfway through her visit, Dr GG came in to listen to what the doctors had to say, and for moral support. He had been in at least part of the early morning meeting.

Third was our Oncologist, Dr H. He was very friendly. He walked in and said "I know everything about your case, and we know just what to do." He explained what exact kind of breast cancer I have: Invasive Ductal Carcinoma. So the cancer cells started in a duct, overflowed from the duct, and traveled to the lymph node in my armpit. (Road trip!) This is a fairly aggressive form of cancer, but responds well to chemotherapy and the plan that they outlined. He said we were still waiting on a test to see what kind of receptors the cancer cells have. They can have Estrogen, Progesterone and/or HER2 receptors or none of those (known as triple negative). The first two I know what they are, the last I don't. They want you to have something be positive, because then they can give you medicine to block those receptors. Interesting, huh?! He said we would also do a full body scan, called a PET/CT scan, to see if the cancer had spread to anywhere else in my body. He talked about different chemo therapy options. The one that is most aggressive to my type of cancer can damage your heart, so I would have a Muga scan to determine the amount of blood flowing out of my left ventricle. More specifically, the valve between my ventricle and the artery there.

When Dr H left, Dr GG talked with us a bit about what had been said and went back to his clinic. What a nice guy!

After he left the geneticist came in and asked a bunch of family medical history questions. The interesting thing is, the only other person in my family that has had breast cancer was my dad's aunt. And since my dad is an only child, if this is an inherited genetic predisposition, it may not have shown up in his family until now.

Since my mom and both of her parents have many siblings, and only 3 out of all those and their children got breast cancer (two of whom got it from eating eggs laid by chickens eating irradiated grain), it is not likely it came from her side of the family. Anyways, she gave me a kit to take to the lab to test my blood for the genes that make me predisposed for breast cancer. She said if this comes back positive, I will have to have a double mastectomy. In theory this is okay with me because then I could get them lifted and filled to match. But, that’s also double the pain, so either way will have its benefits.

Then we talked to the office Nurse, Wanda. She is great. Nice, informative, informal, friendly. Good things when you are dealing with stressed out cancer patients all the time.

Then down to the lab to get blood drawn, and then over to set up the porta cath surgery and follow up appointment. Then home we go.

Now this took from about 9 am to 1 pm. We have great neighbors, and the one I had told about my diagnosis had this day off from work. So she watched the little kids when we left, and the bigger kids walked home to her house. She kept them while we went out to lunch to talk things over. I couldn't ask for a better friend. Of course I have a lot of friends like that, and I am sure I will be taking advantage of them for quite a while. hee hee hee


  1. I've always wanted a Borg for a friend. Do you think you will start talking as a collective? Know we are thinking of you often!

  2. Ooooh, the borgs that look the most normal are always the worst! Did you ever read The Host?!? (I know those were aliens, not borgs, but you see where I'm going..)
    What a nice guy Dr. GG is. I will never be irritated ever again when my GP is running late for no apparent reason, cause there is probably really good reason.

    You are in my thoughts and prayers constantly!