I managed to get a post to publish in Times font, after ages of trying. Blogspot then cheerfully eradicated two days' posts. I am frustrated with this. Hopefully someone read them this morning before that happened.
Today is radiation day 14.
Yesterday I bought two "un-bras" in case of unpleasant skin "sunburn" as we get closer to "the boost."
To review, I scrolled back to the day I met Dr. Sands, the radiation oncologist. She said the plan is three weeks and one day, followed by four days focusing radiation directly on the known trouble area. She doesn't call the four days The Boost, but everyone else seems to.
Radiation brain fog is just attributed to sleepiness, but I didn't feel sleepy when I drove to the cancer center a day early for today's treatment. They are closed on Sunday.
Can't resist looking ahead and researching Tamoxifen versus the aromatase blockers. One patient has told me that several women she knows have had to switch back to Tamoxifen to avoid bad side effects.
The printed information reprinted from medical journals is frequently confusing me. Or maybe confusing everyone?
In a couple of weeks I will try to meet the medical oncologist (in this case, the pill doctor). Then at the end of the month, another appointment with my surgeon.
Monday, January 6, 2014
Sunday, January 5, 2014
LUMPECTOMY - THE SEQUEL . . . Stories old and new
If I've told part of this before, please forgive me. The "dancing doctor's" brave video has opened Pandora's box of medical memories and things to be thankful for.
In the 70s, in a then-small California city, my doctor got the idea that there might or might not be a lump in my right breast. The next thing I remember is sitting in a hard chair in the middle of a large, chilly room, naked from the waist up. The surgeon was in the room with me; so were a number of male medical students or interns or whoever. If there was a female nurse around, I don't remember her at all.
I was fairly miserable during the long time it took for almost everyone to palpate my breast and discuss my plight, if there even was a plight. All that poking and puzzling; no findings.
Although I don't know the standard of care for breast diagnosis in the 70s, the surgeon decided on a combination surgical biopsy and possible mammography method that I now understand had been developed at the beginning of the century at Mayo Clinic.
In this approach, the patient was put under sedation. The suspicious area was excised and sent to pathology for frozen section -i.e. slicing it up paper thin. If the pathologists found malignancy, the breast and possibly near-by lymph nodes were removed. Finally the patient would wake to find out if she still had her breast.
I must have put myself into a sort of pre-surgery denial fog. My husband, who later became my ex-husband, made a brief, awkward attempt to talk about outcomes. I was not at all clear on how much to tell my little, grade-school age daughters, and still don't remember what I did tell them.
Finally, I put on my red blouse and was driven off to the hospital. I should probably inject here that I didn't really like the surgeon. In those days, women made remarks like "He's not much for bedside manner, but he's good." Later, he became a client of mine, and we still did not become friends.
When I finally woke, I believe for some reason one of my in-laws was in the room--is that possible? (We were not huggy in-laws.) A nurse stuck her head in, said "benign," and vanished. Someone asked me what I wanted to eat. There was no sign of the surgeon. By the time my green beans arrived, I was still too groggy eat them, and went back to sleep instead of enjoying the fact that my husband was in the room.
After so many hours under the anesthesia of the day, I was a little dopey for a while. Even weeks later I would suddenly get tired when we went for a walk. Were there pain pills? How long did I stay in the hospital? There must have been pain, since the nipple had been removed for the exploration. The good news is that the scar has been almost unnoticeable.
Just a very few years ago, one of my daughters told me she and her sister had been sure I would die in the hospital. I wonder if anyone tried to comfort them when I wasn't around.
The good news: I have a surgeon I like, who is as kind and caring as the best family doctor, and who also did a great job removing the affected area for analysis. I am different now than in the 70s; I would not have let him do the procedure if I hadn't trusted and liked him.
And lumpectomy let me avoid, as many women can now, the long and dangerous surgery to remove a whole breast.
In the 70s, in a then-small California city, my doctor got the idea that there might or might not be a lump in my right breast. The next thing I remember is sitting in a hard chair in the middle of a large, chilly room, naked from the waist up. The surgeon was in the room with me; so were a number of male medical students or interns or whoever. If there was a female nurse around, I don't remember her at all.
I was fairly miserable during the long time it took for almost everyone to palpate my breast and discuss my plight, if there even was a plight. All that poking and puzzling; no findings.
Although I don't know the standard of care for breast diagnosis in the 70s, the surgeon decided on a combination surgical biopsy and possible mammography method that I now understand had been developed at the beginning of the century at Mayo Clinic.
In this approach, the patient was put under sedation. The suspicious area was excised and sent to pathology for frozen section -i.e. slicing it up paper thin. If the pathologists found malignancy, the breast and possibly near-by lymph nodes were removed. Finally the patient would wake to find out if she still had her breast.
I must have put myself into a sort of pre-surgery denial fog. My husband, who later became my ex-husband, made a brief, awkward attempt to talk about outcomes. I was not at all clear on how much to tell my little, grade-school age daughters, and still don't remember what I did tell them.
Finally, I put on my red blouse and was driven off to the hospital. I should probably inject here that I didn't really like the surgeon. In those days, women made remarks like "He's not much for bedside manner, but he's good." Later, he became a client of mine, and we still did not become friends.
When I finally woke, I believe for some reason one of my in-laws was in the room--is that possible? (We were not huggy in-laws.) A nurse stuck her head in, said "benign," and vanished. Someone asked me what I wanted to eat. There was no sign of the surgeon. By the time my green beans arrived, I was still too groggy eat them, and went back to sleep instead of enjoying the fact that my husband was in the room.
After so many hours under the anesthesia of the day, I was a little dopey for a while. Even weeks later I would suddenly get tired when we went for a walk. Were there pain pills? How long did I stay in the hospital? There must have been pain, since the nipple had been removed for the exploration. The good news is that the scar has been almost unnoticeable.
Just a very few years ago, one of my daughters told me she and her sister had been sure I would die in the hospital. I wonder if anyone tried to comfort them when I wasn't around.
***
Through the multi-step DCIS diagnosis, the old scar on that nipple wore a cute little sticker like a wreath, to keep it from looking like a problem on film.The good news: I have a surgeon I like, who is as kind and caring as the best family doctor, and who also did a great job removing the affected area for analysis. I am different now than in the 70s; I would not have let him do the procedure if I hadn't trusted and liked him.
And lumpectomy let me avoid, as many women can now, the long and dangerous surgery to remove a whole breast.
Saturday, January 4, 2014
LUMPECTOMY - THE SEQUEL . . . What those X-rays are for
A specialist privately answered my question about the reason for a weekly X-ray before my radiation treatment: the breast is not always the same size, especially if it swelled after surgery or during treatment, and is no longer swollen, or for various other reasons. {I've noticed week-to-week size changes myself through the years by the way a bra fits} These X-rays, called port films, let the radiologist decide if the marks on us are still located at the exact spot that needs radiation. If the marks are no longer accurate, they can be replaced.
This comforted and reassured me. for two reasons: she mentioned that the amount of radiation in the films is very small. And, the fact they take them makes it clear that the radiation really is aimed as accurately as I've been told. This protects other areas as much as possible, including my lungs.
This comforted and reassured me. for two reasons: she mentioned that the amount of radiation in the films is very small. And, the fact they take them makes it clear that the radiation really is aimed as accurately as I've been told. This protects other areas as much as possible, including my lungs.
Friday, January 3, 2014
LUMPECTOMY - THE SEQUEL . . . Famous decisions--the other side of the story
I've read plenty about a surgeon and a film superstar and their double mastectomies. I know the surgeon had been diagnosed with breast cancer; we've all heard the superstar's reason. I don't mean to downplay what they've gone through, but I also knew they could expect world-class care. Now I read that their stories have started a clamor for voluntary double mastectomies.
I was thinking tonite (Thursday) about the dangers of what they have gone through, as well as the benefits.
And I have often thought before about why lumpectomy is simply called "breast preservation" or similar names. To me, lumpectomy, when it's the standard of care, is the way to avoid an incredible amount of danger of infection, not to mention pain, dangers of major surgery, and lengthy, difficult convalescence. I've shuddered at the stories: frantic daughters of mastectomy patients tracking down nurses, and insisting, "Give Mom her shot. Now!" I'm glad I've been spared for now from being that suffering mom.
I had nothing to say with any authority about this question, so took a break, went to KevinMD, and lucked into an article by
I clicked The Crab Diaries, and found her cautions on that very subject - possible reasons not to choose a double mastectomy and when or why not. She is a wonderful storyteller and you may want to read.that January 2 post, Primum non Nocere..
My suspicions are confirmed, and there are even more reasons to think very, very carefully about voluntary double mastectomy for yourself or someone you love.
I was thinking tonite (Thursday) about the dangers of what they have gone through, as well as the benefits.
And I have often thought before about why lumpectomy is simply called "breast preservation" or similar names. To me, lumpectomy, when it's the standard of care, is the way to avoid an incredible amount of danger of infection, not to mention pain, dangers of major surgery, and lengthy, difficult convalescence. I've shuddered at the stories: frantic daughters of mastectomy patients tracking down nurses, and insisting, "Give Mom her shot. Now!" I'm glad I've been spared for now from being that suffering mom.
I had nothing to say with any authority about this question, so took a break, went to KevinMD, and lucked into an article by
Miranda Fielding is a radiation oncologist who blogs at The Crab Diaries.
I clicked The Crab Diaries, and found her cautions on that very subject - possible reasons not to choose a double mastectomy and when or why not. She is a wonderful storyteller and you may want to read.that January 2 post, Primum non Nocere..
My suspicions are confirmed, and there are even more reasons to think very, very carefully about voluntary double mastectomy for yourself or someone you love.
Thursday, January 2, 2014
LUMPECTOMY - THE SEQUEL . . . Day 12 and brain fog
I really have been making a lot of mistakes since the diagnosis. Some of them with time-consuming results.
What is really important for me now is: thinking back to before the diagnosis and even before the callback for additional mammogram films. Some of my mistakes that seem big actually started before the latest mammograms. So, the confusion is not from DCIS. For instance, an email gift wasn't received because I've always had the wrong email address in my contacts list.
Also, I told a friend (who also has DCIS) that I feel a little depressed some days. She reminded me that this disease, and anything that starts with the word cancer, is stressful and can be overwhelming. Add this to moving twice in two years - once to a different state- and overwhelm is practically a given.
I also need to remember the old joke, "After a certain age, mood swings don't count as exercise."
She talked with me awhile, and her diagnosis was that I'm having a "Human Attack." She advised being nice to myself.
Also, I went into the building the other day for my radiation appointment, and in the lobby was a man a lot younger than I am, in a wheelchair, accompanied by his family. And while in the reception room, I heard someone say to a patient, "So you'll go to chemo after radiation today?" I need to be grateful every day that chemo is not on my To Do list. And be kind to people who may be doing both.
What do you do when a depression elbows its way into your day?
PS Breast Cancer Action SF is having a survey on what members think the group should tackle for the new 5-Year plan.
What is really important for me now is: thinking back to before the diagnosis and even before the callback for additional mammogram films. Some of my mistakes that seem big actually started before the latest mammograms. So, the confusion is not from DCIS. For instance, an email gift wasn't received because I've always had the wrong email address in my contacts list.
Also, I told a friend (who also has DCIS) that I feel a little depressed some days. She reminded me that this disease, and anything that starts with the word cancer, is stressful and can be overwhelming. Add this to moving twice in two years - once to a different state- and overwhelm is practically a given.
I also need to remember the old joke, "After a certain age, mood swings don't count as exercise."
She talked with me awhile, and her diagnosis was that I'm having a "Human Attack." She advised being nice to myself.
Also, I went into the building the other day for my radiation appointment, and in the lobby was a man a lot younger than I am, in a wheelchair, accompanied by his family. And while in the reception room, I heard someone say to a patient, "So you'll go to chemo after radiation today?" I need to be grateful every day that chemo is not on my To Do list. And be kind to people who may be doing both.
What do you do when a depression elbows its way into your day?
PS Breast Cancer Action SF is having a survey on what members think the group should tackle for the new 5-Year plan.
Wednesday, January 1, 2014
LUMPECTOMY - THE SEQUEL . . . Day 11, skin and questions
Monday, was the halfway point of the 20 treatments/4 weeks, and I didn't even notice.
Today, woke with the worst headache in a long time; but last night and today had energy for organiziing and exercises. The breast is pink but so far doesn't look sunburnt. Once in a while it hurts inside for a few minutes - I wonder if this cold spell could have something to do with it?
Secret thoughts: Maybe having Christmas and New Year's off from treatment is a benefit. Daring to wonder if a day off in the middle of each week could be beneficial? Not daring to ask anyone.
Yesterday, Tuesday, they took an X-ray before the treatment. They've done this before and told me they do it periodically. Of course my first thought was: More juice going into me. More rays. I need to ask what they learn from the X-rays.
Energy? Fatigue? I'm not sure how much of going back to sleep in the mornings is the holiday season and many changes in routine, or the radiation, or laziness. . .
I wish more health and healing for all of us this year - inside and out!
Today, woke with the worst headache in a long time; but last night and today had energy for organiziing and exercises. The breast is pink but so far doesn't look sunburnt. Once in a while it hurts inside for a few minutes - I wonder if this cold spell could have something to do with it?
Secret thoughts: Maybe having Christmas and New Year's off from treatment is a benefit. Daring to wonder if a day off in the middle of each week could be beneficial? Not daring to ask anyone.
Yesterday, Tuesday, they took an X-ray before the treatment. They've done this before and told me they do it periodically. Of course my first thought was: More juice going into me. More rays. I need to ask what they learn from the X-rays.
Energy? Fatigue? I'm not sure how much of going back to sleep in the mornings is the holiday season and many changes in routine, or the radiation, or laziness. . .
I wish more health and healing for all of us this year - inside and out!
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