So much has happened since my first surgery one month ago today. I had a follow-up with Dr. Moore today to see how I was healing and chat about my next chapter - chemo. I guess it's a good thing that all the doctors communicate, because Dr. Moore was right on top of where I am, my next steps (Dana Farber), my decision on treatment option (type of chemo), and my 'start date' (6/11).
We had a good conversation (felt like an exit interview). We discussed the pros and cons of the decisions already made and how I could be regretting a decision if I had decided not to go the chemo route based on a one in four chance of recurrence. If the cancer had decided to metastasize in my liver or lung, dealing with the cancer at that point would be so much more intense.
Clearly the biggest fear I have is the unknown. For most undergoing chemo, there are certain side effects that are a given, but all the other side effects are based on the individual. To me, it feels like roulette. You don't know until the wheel stops what happens next. That's my anxious fear.
So I asked Dr. Moore, what was next. He said, "I'll see you in 6 months." He did add that he might see me earlier if I need a reservoir. Come again? Reservoir?
He said it's not uncommon to place a reservoir near my clavicle so the chemotherapy drugs can be injected and moved into my blood stream quicker without damaging the veins. I said, "Does it require a surgery?". He said, "Yes, it's an outpatient procedure." He did say that I may not need it also. [Why am I thinking that I will?] He said when it's done, he just removes it. [Visions of the drain enter my head.] I guess we'll have to wait and see.
I had asked the doctor if I could return to work. After asking what I specifically did for work, he said yes, I could. I asked him to send an OK to return to work letter to HR. He shook my hand and said he would have it done immediately.
I scheduled my follow up (November 30th) and provided the fax number for HR.
So, after one month, I'm back to work - for a little while at least. I have two medical appointments next week and chemo starts on 6/11. From that point it's unknown how I will be and what I can do.
Work ends for me on 6/30.
More to come.
Wednesday, May 27, 2015
Tuesday, May 26, 2015
Preparations
It's kind of scary that I know my way around the Holy Family Hospital campus so well that I no longer need to ask for directions.
I visited the lab today for my blood test. I suppose before my body is polluted with all that badness, there needs to be some baseline measurement recorded to determine the 'before'. I'm certain along the way there will be more blood letting for comparison.
I was in and out in a flash. I didn't even feel the 'pinch' when the needle was inserted into my vein. Either I'm getting used to it or the phlebotomist was doing a phenomenal job.
As soon as I got home I noticed a Massachusetts Health number display on my caller ID. Answering, it happened to be Dr. Mehta's office scheduling my chemo date. Although I have yet to decide which poisons to take and my Dana Farber consult is scheduled for next week, I did receive my Holy Family date - June 11th.
Counting out 12 weeks, I come to September 3rd. Not sure if that's the end or the last dose. I can never recall my wanting the summer to be over - but I do. I want this to be far behind me.
More to come.
I visited the lab today for my blood test. I suppose before my body is polluted with all that badness, there needs to be some baseline measurement recorded to determine the 'before'. I'm certain along the way there will be more blood letting for comparison.
I was in and out in a flash. I didn't even feel the 'pinch' when the needle was inserted into my vein. Either I'm getting used to it or the phlebotomist was doing a phenomenal job.
As soon as I got home I noticed a Massachusetts Health number display on my caller ID. Answering, it happened to be Dr. Mehta's office scheduling my chemo date. Although I have yet to decide which poisons to take and my Dana Farber consult is scheduled for next week, I did receive my Holy Family date - June 11th.
Counting out 12 weeks, I come to September 3rd. Not sure if that's the end or the last dose. I can never recall my wanting the summer to be over - but I do. I want this to be far behind me.
More to come.
Thursday, May 21, 2015
Pack up the hats and hooters - it's crying time again
Back in the day I'm sure we've all experienced something like this:
In grammar school (it seemed that) too much homework was always being assigned. Some of those assignments were long-term: book report; science project; art project; term paper. Throughout the quarterly grading period, teachers would remind the class about these ongoing assignments. If you were really lucky, one of these may have been forgotten by the teacher. So the moral decision was: should I still do it, or chance it and not do it?
I always did it anyway and this has served me well throughout my life. However, there were many times when the assignment was never asked to be turned in. Some classmates (you know who you are) would laugh and say I was a loser for doing the work when I didn't have to, but I innately saw the bigger picture and found that completion held intangible rewards and one never knew when "out of the blue", the assignment would be requested for submission. You never know.
Riding on my cancer-free high since yesterday, I was hopeful for a short, sweet follow-up with Dr. Mehta. I arrived early wanting to give myself enough time to find their temporary quarters resulting from the construction of the new wing to reflect their Dana Farber affiliation. I was greeted and quickly seen by a professional who took my vitals. After, I was told that the doctor would see me shortly. 50 minutes later, Dr. Mehta arrived and extended an apologetic handshake. He recapped on what transpired since my last visit (pre-surgeries) and validated that the last surgery confirmed that all the cancer was indeed gone. YAY!
Turning the page in my medical file, his demeanor changed as he mentioned that test he talked about when we were discussing the pathology of the biopsy. [Now I was feeling like that forgotten assignment from school was being requested just before my receiving my diploma.] Oh yes, that panel test for other types of cancer I'd be prone to? Pausing as he pulled the report, "Yes, the OncotypeDX."
Basically, using 21 genes in the tumor tissue, a recurrence score would be determined based on comparative date of 650-700 patients who had the exact criteria (as I). My score was 35. Which he said was very high. He then showed be a few X/Y axis graphs.
The first graft demonstrates a prognosis: 10-year risk of distant recurrence after 5 years of Tamoxifen only. (This is what I expected as my treatment plan post cancer removal). Based on my recurrence score and 10 year risk of recurrence and curve of clinical results, I had a 24% chance of cancer returning. Dr. Mehta was quick to point out that my cancer is gone from the breast, but there could be cells that have traveled though-out my body. Based on the type of cancer I had, and based on the clinical data, there's a 24% chance of having the cancer metastasize in the lungs, liver, bones or other large organ. [For joy.]
"Those are fairly high risks", he said. "So what can we do about bringing that number down?" He said, "Chemo and Tamoxifen". He then showed me that next graph.
The second graph demonstrates a prediction of chemotherapy benefit after 5 years of Tamoxifen. Based on my recurrence score, 10 year risk of recurrence and curve of clinical results, I had a 7% chance of cancer returning. Clearly those numbers look better, but with chemo. What can I expect?
Dr. Mehta said that chemo has come a long way since some of the traditional approaches. He began to explain his recommendation and approach.
At the highest level, the regimen would be over a twelve week span. Four times (every three weeks) I would be given the chemo intravenously along with the tamoxifen (which was a given anyway). The side effects (for most choosing this approach) include: hair loss, nausea, low white cell count, fatigue, risk of infection(s), loss of appetite, weight loss and/or gain, constipation, frequent urination and neuropathy. I stopped him there. Having a family history of neuropathic maladies, I was most concerned with what this meant. [Not discounting any of the preceding side affects.]
Lawyers are all to familiar with 'it depends'. Apparently they haven't cornered the market on that expression because Dr. Mehta said, "It depends on the individual - case by case". The discussion left me thinking that this would affect my fine motor skills (being a musician). Although he wasn't emphatic, I got the sense that this could be the deal breaker. He said that in some people the neuropathy dissipates after the treatment, others up to a year, and others never. He did start to talk about the alternative to this, the traditional approach, but he said that there is a high risk of heart damage, early and latent and a small risk of developing leukemia. [Bring up the violin soundtrack.]
Here I am at the cross roads again, needing to make a decision. So, what if I do nothing, I ask?
Dr. Mehta said that chemo usually starts about four weeks after surgery. Since my first surgery was April 27th, he thinks the chemo should start early June. My doing nothing there is that risk that a rogue cell could begin to metastasize by attaching to an organ that has a big supply of blood. He said he would have no problems with a second opinion. I had mentioned that I had previously had consultation with Dr Overmeyer at Dana Farber, which he said that Beth is his 'go to person'. He even offered to have his staff schedule the appointment for me. [At this writing it's scheduled for 6/3 and 6/4 back with Dr. Mehta.]
I asked about my reconstruction surgery and Triple A. He said that he had had a long conversation with Dr. Kansal (at St Elizabeth's - Triple A consult) and that can wait. The reconstruction will need to wait because of the infection risk. At this point it's gather information, make a decision on chemo (type) based on research and consultation, do the chemo, wait until I'm able to have reconstruction (October/November) deal with Triple A (see how it's progressing if at all) and take the appropriate action.
So the 'cancer-free' celebration was glorious - for a day at least. Hats and hooters, champagne and caviar will keep until New Years Eve. In the interim it's a very tough road ahead that I have to travel.
More to come.
In grammar school (it seemed that) too much homework was always being assigned. Some of those assignments were long-term: book report; science project; art project; term paper. Throughout the quarterly grading period, teachers would remind the class about these ongoing assignments. If you were really lucky, one of these may have been forgotten by the teacher. So the moral decision was: should I still do it, or chance it and not do it?
I always did it anyway and this has served me well throughout my life. However, there were many times when the assignment was never asked to be turned in. Some classmates (you know who you are) would laugh and say I was a loser for doing the work when I didn't have to, but I innately saw the bigger picture and found that completion held intangible rewards and one never knew when "out of the blue", the assignment would be requested for submission. You never know.
Riding on my cancer-free high since yesterday, I was hopeful for a short, sweet follow-up with Dr. Mehta. I arrived early wanting to give myself enough time to find their temporary quarters resulting from the construction of the new wing to reflect their Dana Farber affiliation. I was greeted and quickly seen by a professional who took my vitals. After, I was told that the doctor would see me shortly. 50 minutes later, Dr. Mehta arrived and extended an apologetic handshake. He recapped on what transpired since my last visit (pre-surgeries) and validated that the last surgery confirmed that all the cancer was indeed gone. YAY!
Turning the page in my medical file, his demeanor changed as he mentioned that test he talked about when we were discussing the pathology of the biopsy. [Now I was feeling like that forgotten assignment from school was being requested just before my receiving my diploma.] Oh yes, that panel test for other types of cancer I'd be prone to? Pausing as he pulled the report, "Yes, the OncotypeDX."
Basically, using 21 genes in the tumor tissue, a recurrence score would be determined based on comparative date of 650-700 patients who had the exact criteria (as I). My score was 35. Which he said was very high. He then showed be a few X/Y axis graphs.
The first graft demonstrates a prognosis: 10-year risk of distant recurrence after 5 years of Tamoxifen only. (This is what I expected as my treatment plan post cancer removal). Based on my recurrence score and 10 year risk of recurrence and curve of clinical results, I had a 24% chance of cancer returning. Dr. Mehta was quick to point out that my cancer is gone from the breast, but there could be cells that have traveled though-out my body. Based on the type of cancer I had, and based on the clinical data, there's a 24% chance of having the cancer metastasize in the lungs, liver, bones or other large organ. [For joy.]
"Those are fairly high risks", he said. "So what can we do about bringing that number down?" He said, "Chemo and Tamoxifen". He then showed me that next graph.
The second graph demonstrates a prediction of chemotherapy benefit after 5 years of Tamoxifen. Based on my recurrence score, 10 year risk of recurrence and curve of clinical results, I had a 7% chance of cancer returning. Clearly those numbers look better, but with chemo. What can I expect?
Dr. Mehta said that chemo has come a long way since some of the traditional approaches. He began to explain his recommendation and approach.
At the highest level, the regimen would be over a twelve week span. Four times (every three weeks) I would be given the chemo intravenously along with the tamoxifen (which was a given anyway). The side effects (for most choosing this approach) include: hair loss, nausea, low white cell count, fatigue, risk of infection(s), loss of appetite, weight loss and/or gain, constipation, frequent urination and neuropathy. I stopped him there. Having a family history of neuropathic maladies, I was most concerned with what this meant. [Not discounting any of the preceding side affects.]
Lawyers are all to familiar with 'it depends'. Apparently they haven't cornered the market on that expression because Dr. Mehta said, "It depends on the individual - case by case". The discussion left me thinking that this would affect my fine motor skills (being a musician). Although he wasn't emphatic, I got the sense that this could be the deal breaker. He said that in some people the neuropathy dissipates after the treatment, others up to a year, and others never. He did start to talk about the alternative to this, the traditional approach, but he said that there is a high risk of heart damage, early and latent and a small risk of developing leukemia. [Bring up the violin soundtrack.]
Here I am at the cross roads again, needing to make a decision. So, what if I do nothing, I ask?
Dr. Mehta said that chemo usually starts about four weeks after surgery. Since my first surgery was April 27th, he thinks the chemo should start early June. My doing nothing there is that risk that a rogue cell could begin to metastasize by attaching to an organ that has a big supply of blood. He said he would have no problems with a second opinion. I had mentioned that I had previously had consultation with Dr Overmeyer at Dana Farber, which he said that Beth is his 'go to person'. He even offered to have his staff schedule the appointment for me. [At this writing it's scheduled for 6/3 and 6/4 back with Dr. Mehta.]
I asked about my reconstruction surgery and Triple A. He said that he had had a long conversation with Dr. Kansal (at St Elizabeth's - Triple A consult) and that can wait. The reconstruction will need to wait because of the infection risk. At this point it's gather information, make a decision on chemo (type) based on research and consultation, do the chemo, wait until I'm able to have reconstruction (October/November) deal with Triple A (see how it's progressing if at all) and take the appropriate action.
So the 'cancer-free' celebration was glorious - for a day at least. Hats and hooters, champagne and caviar will keep until New Years Eve. In the interim it's a very tough road ahead that I have to travel.
More to come.
Wednesday, May 20, 2015
A major milestone reached
I had a follow-up visit with Dr. Chatson today to see how I was healing since the drains were removed. Yesterday, I was able to take a shower for the first time since last week's second surgery. I had removed the bandages and saw the aftermath of the trauma. I was shocked to see so much bruising. I literally looked like I had been run over. Really ugly. But of course I took some pictures to document the progress. [Not for the squeamish.]
It was quite busy in his office today. The last few times I was the only one there, but it was like an airline terminal. After waiting the obligatory 45 minutes, I was called into the examining room where my vitals were taken and recorded. "They will be with you shortly", I was told. [They?]
About 15 minutes later, one of the nurses came in and looked at the surgical area and asked how things were going. I had mentioned the bruising and she said she noticed it the other day at the hospital. [She was the one wearing the mask.] She also said that it hadn't gotten any worse, which is a good thing. She said the doctor would be in shortly then quickly turned back to share the pathology results for the tissue removed last Tuesday. No residual cancer found in all tissue removed! Apparently some muscle tissue was also removed during the procedure which explains some of the soreness if/when I attempt to lift my arm. But the news of the day - I successfully beat this cancer.
Dr. Chatson arrived and looked at the area and exclaimed that it was healing nicely. He said that scar tissue starts off tight but loosens over time. Before the next phase of reconstruction I am going to need about four months of healing. He spoke the next four months aloud (as if counting) and said, "So we'll start in September." However, he wants to see me in a month. He said that I should 'take it easy' for another week.
It was a good news day - for a change.
It was quite busy in his office today. The last few times I was the only one there, but it was like an airline terminal. After waiting the obligatory 45 minutes, I was called into the examining room where my vitals were taken and recorded. "They will be with you shortly", I was told. [They?]
About 15 minutes later, one of the nurses came in and looked at the surgical area and asked how things were going. I had mentioned the bruising and she said she noticed it the other day at the hospital. [She was the one wearing the mask.] She also said that it hadn't gotten any worse, which is a good thing. She said the doctor would be in shortly then quickly turned back to share the pathology results for the tissue removed last Tuesday. No residual cancer found in all tissue removed! Apparently some muscle tissue was also removed during the procedure which explains some of the soreness if/when I attempt to lift my arm. But the news of the day - I successfully beat this cancer.
Dr. Chatson arrived and looked at the area and exclaimed that it was healing nicely. He said that scar tissue starts off tight but loosens over time. Before the next phase of reconstruction I am going to need about four months of healing. He spoke the next four months aloud (as if counting) and said, "So we'll start in September." However, he wants to see me in a month. He said that I should 'take it easy' for another week.
It was a good news day - for a change.
Monday, May 18, 2015
Sans Drains
Since Friday's hemoglobin homecoming, I had been closely monitoring the output of drain number one. It had been steadily producing a little less than 10 CC/day but not the color I had hoped. Drain number two now had output with a tinge of yellow. But the active drain looked 'fresh' [if you know what I mean].
On Sunday all I could imagine was being admitted on Monday. I'm sure the anxiety increased my heart rate which in turn netted red crude. Although the output was well below 5 CC/day, the color looked ominous.
I woke up 15 minutes before the alarm on Monday. Breaking from my 'low light' routine, I entered the bathroom and hit the light switch. The output was at trace levels, but the color was still wrong (to me).
It is what it is.
I arrived at Holy Family and because it was a last minute, unofficial appointment with Dr. Chatson, hardly anyone knew the reason for my presence. Thankfully someone knew and I was asked to wait. About a half hour later, Christine called me into the Surgical Day Care Unit and directed me to an unassigned bay. Dr Chatson probably just arrived and was still in his civilian clothes. I was told to remove my shirt and a nurse (wearing a mask) asked me to sit on the bed. Dr. Chatson went off to look for gloves.
On his return he had asked for a brief synopsis of the Friday drama while looking and pressing the surgery area. Thankfully I had remembered to bring my drain output ledger and there was only a few bubbles in the hose leading to drain one. He said that he would take them (the drains) out.
After some discomfort, the drains came out and the nurse 'gauzed me up' and said no shower until tomorrow. Dr. Chatson discarded the drains and said he wanted to see me Wednesday. He asked that I 'take it easy' and don't do too much activity. So, I resigned myself to more binge watching on Netflix and accepted the fact that the grass won't get done anytime soon. [My neighbor hates me anyway.]
I left Surgical Day Care in search of coffee thinking to myself - Free at last. Free at last.
I really really hate the drain(s).
On Sunday all I could imagine was being admitted on Monday. I'm sure the anxiety increased my heart rate which in turn netted red crude. Although the output was well below 5 CC/day, the color looked ominous.
I woke up 15 minutes before the alarm on Monday. Breaking from my 'low light' routine, I entered the bathroom and hit the light switch. The output was at trace levels, but the color was still wrong (to me).
It is what it is.
I arrived at Holy Family and because it was a last minute, unofficial appointment with Dr. Chatson, hardly anyone knew the reason for my presence. Thankfully someone knew and I was asked to wait. About a half hour later, Christine called me into the Surgical Day Care Unit and directed me to an unassigned bay. Dr Chatson probably just arrived and was still in his civilian clothes. I was told to remove my shirt and a nurse (wearing a mask) asked me to sit on the bed. Dr. Chatson went off to look for gloves.
On his return he had asked for a brief synopsis of the Friday drama while looking and pressing the surgery area. Thankfully I had remembered to bring my drain output ledger and there was only a few bubbles in the hose leading to drain one. He said that he would take them (the drains) out.
After some discomfort, the drains came out and the nurse 'gauzed me up' and said no shower until tomorrow. Dr. Chatson discarded the drains and said he wanted to see me Wednesday. He asked that I 'take it easy' and don't do too much activity. So, I resigned myself to more binge watching on Netflix and accepted the fact that the grass won't get done anytime soon. [My neighbor hates me anyway.]
I left Surgical Day Care in search of coffee thinking to myself - Free at last. Free at last.
I really really hate the drain(s).
Friday, May 15, 2015
Thar she blows
Since my release, I've been religiously recording the output of my two drains with the hopes of their removal today. One drain had produced little output, but the other performed as expected. After looking at the results, I was one call away from visiting Dr. Chatson's office for the removal of the drains.
Just before the office opened today (prior to my calling), drain number 1 decided to increase production. So much so that I had to empty the bulb three times in an hour. This was quite concerning [not to mention very Dexter-esque].
I called the office and was told to come in for an evaluation. Dr. Chatson was out of state but the PA [who had assisted in the past] would change the dressing and evaluate the condition and consult with Dr. Chatson via phone.
Arriving at the office I was quickly seen and upon examination it appeared that the output was fresh blood. Shelley left the room to consult Dr. Chatson. Upon returning she asked if I had anything to eat today. I had coffee and a muffin. She told me to abstain from eating/drinking anything and head over to Holy Family where I may have emergency surgery. Dr. Moore was already at the hospital performing surgeries today, so he wanted to evaluate the condition and make the determination to operate now or do nothing.
Arriving at the Breast Cancer Care Unit, I met Nurse Brenda who brought me into an examination room where I was readied for Dr. Moore. Dr. Moore arrived, looked at the surgical area, pressed some areas that were swollen and asked a few questions about pain level and other symptoms (I was not having). By this time the output had slowed to 'normal'. He said he would call Dr. Chatson and discuss the next steps.
A few moments later, The doctor arrived and said that Dr. Chatson agrees to 'do nothing', but I would be scheduled for surgery Monday. At that time, Dr. Chatson would make the determination if surgery would be warranted. However, if the output continues at the current rate (or less) over the weekend, then no surgery would be required.
So I'll have these drains over the weekend. It was scary for a bit.
Just before the office opened today (prior to my calling), drain number 1 decided to increase production. So much so that I had to empty the bulb three times in an hour. This was quite concerning [not to mention very Dexter-esque].
I called the office and was told to come in for an evaluation. Dr. Chatson was out of state but the PA [who had assisted in the past] would change the dressing and evaluate the condition and consult with Dr. Chatson via phone.
Arriving at the office I was quickly seen and upon examination it appeared that the output was fresh blood. Shelley left the room to consult Dr. Chatson. Upon returning she asked if I had anything to eat today. I had coffee and a muffin. She told me to abstain from eating/drinking anything and head over to Holy Family where I may have emergency surgery. Dr. Moore was already at the hospital performing surgeries today, so he wanted to evaluate the condition and make the determination to operate now or do nothing.
Arriving at the Breast Cancer Care Unit, I met Nurse Brenda who brought me into an examination room where I was readied for Dr. Moore. Dr. Moore arrived, looked at the surgical area, pressed some areas that were swollen and asked a few questions about pain level and other symptoms (I was not having). By this time the output had slowed to 'normal'. He said he would call Dr. Chatson and discuss the next steps.
A few moments later, The doctor arrived and said that Dr. Chatson agrees to 'do nothing', but I would be scheduled for surgery Monday. At that time, Dr. Chatson would make the determination if surgery would be warranted. However, if the output continues at the current rate (or less) over the weekend, then no surgery would be required.
So I'll have these drains over the weekend. It was scary for a bit.
Thursday, May 14, 2015
Coming to
It was around 4:30PM when I regained consciousness. I was in pain, very similar to the last time. A nurse asked if I needed pain meds, to which I nodded yes. About a half hour later she asked if I needed more. Yes, I did.
The meds kicked in and I was comfortably numb, but regaining consciousness and awareness of my surroundings. It was very quiet. I took a peek and saw that I now had two drains. Really?
The nurse asked if I could eat some crackers and have some liquid and if I was nauseous. I could eat some crackers have ginger-ale. And no [thankfully] I was not nauseous.
Dr. Moore arrived and spoke to me, but I'm vague on what was said. I did hear the word 'successful' but I heard something like he had to take more 'skin' that anticipated. He said there would be more con-caving, but the restoration procedure will take care of that. I had no expectations that things would look perfect at this point. He did say he had to have two drains and to see him in two weeks. I mentioned that my FMLA paperwork would need to be updated. He asked that I have it sent for his completion. [Kim in HR followed up for me and faxed it to Dr. Moore's office. Thanks Kim.]
Not too long after, I was moved to Surgical Day Care where I was able to dress and was briefed on the post op instructions. My ride arrived and I was wheeled out into sunshine. Apparently there was just a thunderstorm. Arriving home, I was still groggy and resigned myself to the TV. I dozed off and on. Got up to empty the drain, record the output take a pain pill and went to bed. I had a different kind of pain this time. It appears that my muscles around my abdomen and back where sore, possible from those uncomfortable beds. My chest felt tight, but the surgical area seemed to be calming down.
I slept OK, but not great. I was prescribed an antibiotic that I've taken (and will continue to) but I've only needed one pain pill.
Now the healing - again. Yup no showers too.
The meds kicked in and I was comfortably numb, but regaining consciousness and awareness of my surroundings. It was very quiet. I took a peek and saw that I now had two drains. Really?
The nurse asked if I could eat some crackers and have some liquid and if I was nauseous. I could eat some crackers have ginger-ale. And no [thankfully] I was not nauseous.
Dr. Moore arrived and spoke to me, but I'm vague on what was said. I did hear the word 'successful' but I heard something like he had to take more 'skin' that anticipated. He said there would be more con-caving, but the restoration procedure will take care of that. I had no expectations that things would look perfect at this point. He did say he had to have two drains and to see him in two weeks. I mentioned that my FMLA paperwork would need to be updated. He asked that I have it sent for his completion. [Kim in HR followed up for me and faxed it to Dr. Moore's office. Thanks Kim.]
Not too long after, I was moved to Surgical Day Care where I was able to dress and was briefed on the post op instructions. My ride arrived and I was wheeled out into sunshine. Apparently there was just a thunderstorm. Arriving home, I was still groggy and resigned myself to the TV. I dozed off and on. Got up to empty the drain, record the output take a pain pill and went to bed. I had a different kind of pain this time. It appears that my muscles around my abdomen and back where sore, possible from those uncomfortable beds. My chest felt tight, but the surgical area seemed to be calming down.
I slept OK, but not great. I was prescribed an antibiotic that I've taken (and will continue to) but I've only needed one pain pill.
Now the healing - again. Yup no showers too.
Where everybody knows your name
Tuesday arrived and as I walked into Holy Family there was no need to ask where I was supposed to go. Surgical Day Care was quite busy. I was early so maybe the first round of patients hadn't all been called yet. I checked in with Carmen who found my file right away and didn't question my co-payment that I processed online, although I was ready with proof. There were no questionnaires to complete, but two authorizations (one to bill, the other to have the surgery performed - in that order). I was directed to the waiting area where I watched some mindless TV talk show then was greeted by my guardian for the day, Nurse Carol.
We walked the walk until we reached the not too pearly gates of Surgical Day Care. It was hopping. Lot's of activity. We walked looking for a bay and stopped midway so Carol could find a 'tall bed'. It seemed that all the tall Paul's were booked for today so she had to snag one from some remote location. She said weren't you just here as she wheeled the bed into bay 17. "Yes, about two weeks ago", I said. "So you know the drill." I was told to undress all the way like I was going into the shower. [How could she know that I don't shower with my clothes on?]
Stripped and now wearing a johnnie, Carol returned and started asking the obligatory questions: name; date of birth; reason for today's procedure; which side; etc. Lot's of shuffling of paperwork as a book was being assembled in a three ring binder. Nurse Mary stopped by to talk about allergies and my experience with nausea following anesthesia. I was told that I would be given a patch behind my ear and to remove it the next day taking extra precaution to fold it on itself as to not get any medication on my skin. If I got it in my eye, it would dilate. I mentioned that I did not have that last time. She said that it was a Dr Chatson special, but she would check.
Carol came back and placed a number of items on the bed as she was going to prepare my IV. As she sat down, she loudly said, "Christine, do you want to do this?". Christine said, "yes, in a minute." Carol hesitantly said, "I'll try it". I laughed out loud and said "I'll TRY it? She immediately sensed my hesitancy and said, "You better do this Christine".
Christine was a pro. She was done in flash.
Dr. Moore arrived and drew on me with his green sharpie as he described what the procedure would entail. He though it should be quick and it sounded like some of the reconstruction was also going to be done. He talked of correcting a defect. I recall that when Dr. Chatson was examining me last week he pointed out two areas that needed some rework. I can only assume that they were both talking about the same thing. I asked if I was going to have a drain again and he said most likely. [It is what it is.] Dr. Moore said he'd be seeing me shortly, then left.
Reminiscent of Hitchcock's Rear Window, I watched all the happenings and could overhear certain conversations close by. One guy had mastoid surgery and was being briefed on post op care, while another guy was coming in to have something (a lump) removed from his neck. A few beds away, someone was really in pain and moaned endlessly. My bed was not comfortable and even without my caffeine intake for the day, I couldn't even doze, although I did try. Even if I could, I had a parade of nursed stop by and ask the obligatory questions as the completed another page for the binder. Nurse Tammy dropped by and asked why I didn't have my patch on. Soon after Nurse Mary said that we weren't using the patch and Tammy said she would 'check it in". [I'll have to remember when checking the bill to see if this was charged to the insurance company]
Dr. Chatson stopped by and asked if Dr. Moore had visited and reassured me that he would be there assist. He smiled and said he'd see me shortly.
Around 3PM, the masses gathered and prepared my 'tall bed' for departure to the operating room. The all too familiar ride was quick where I met with Nurse Margaret again. She said good luck and I said Thank you Margaret. She exclaimed, "He remembered my name'. The other nurses there asked if what I did for work had anything to do with remembering people. I said I had a good memory and am good with peoples names and faces as I named both nurses and others that had waited on me this visit. Nurse Karen said that she could only remember people if they had a name tag. I said that a face is a name tag and that's how I remember. Of course, while I was being wheeled in I was introduced to Tony who had a surgical mask on. I won't be picking him out of a line up.
Scooting over to the operating table was quickly prepped and before I knew it the IV was turned on and things began to sound tinny. "Breathe deeply, please". I felt myself drift away.
We walked the walk until we reached the not too pearly gates of Surgical Day Care. It was hopping. Lot's of activity. We walked looking for a bay and stopped midway so Carol could find a 'tall bed'. It seemed that all the tall Paul's were booked for today so she had to snag one from some remote location. She said weren't you just here as she wheeled the bed into bay 17. "Yes, about two weeks ago", I said. "So you know the drill." I was told to undress all the way like I was going into the shower. [How could she know that I don't shower with my clothes on?]
Stripped and now wearing a johnnie, Carol returned and started asking the obligatory questions: name; date of birth; reason for today's procedure; which side; etc. Lot's of shuffling of paperwork as a book was being assembled in a three ring binder. Nurse Mary stopped by to talk about allergies and my experience with nausea following anesthesia. I was told that I would be given a patch behind my ear and to remove it the next day taking extra precaution to fold it on itself as to not get any medication on my skin. If I got it in my eye, it would dilate. I mentioned that I did not have that last time. She said that it was a Dr Chatson special, but she would check.
Carol came back and placed a number of items on the bed as she was going to prepare my IV. As she sat down, she loudly said, "Christine, do you want to do this?". Christine said, "yes, in a minute." Carol hesitantly said, "I'll try it". I laughed out loud and said "I'll TRY it? She immediately sensed my hesitancy and said, "You better do this Christine".
Christine was a pro. She was done in flash.
Dr. Moore arrived and drew on me with his green sharpie as he described what the procedure would entail. He though it should be quick and it sounded like some of the reconstruction was also going to be done. He talked of correcting a defect. I recall that when Dr. Chatson was examining me last week he pointed out two areas that needed some rework. I can only assume that they were both talking about the same thing. I asked if I was going to have a drain again and he said most likely. [It is what it is.] Dr. Moore said he'd be seeing me shortly, then left.
Reminiscent of Hitchcock's Rear Window, I watched all the happenings and could overhear certain conversations close by. One guy had mastoid surgery and was being briefed on post op care, while another guy was coming in to have something (a lump) removed from his neck. A few beds away, someone was really in pain and moaned endlessly. My bed was not comfortable and even without my caffeine intake for the day, I couldn't even doze, although I did try. Even if I could, I had a parade of nursed stop by and ask the obligatory questions as the completed another page for the binder. Nurse Tammy dropped by and asked why I didn't have my patch on. Soon after Nurse Mary said that we weren't using the patch and Tammy said she would 'check it in". [I'll have to remember when checking the bill to see if this was charged to the insurance company]
Dr. Chatson stopped by and asked if Dr. Moore had visited and reassured me that he would be there assist. He smiled and said he'd see me shortly.
Around 3PM, the masses gathered and prepared my 'tall bed' for departure to the operating room. The all too familiar ride was quick where I met with Nurse Margaret again. She said good luck and I said Thank you Margaret. She exclaimed, "He remembered my name'. The other nurses there asked if what I did for work had anything to do with remembering people. I said I had a good memory and am good with peoples names and faces as I named both nurses and others that had waited on me this visit. Nurse Karen said that she could only remember people if they had a name tag. I said that a face is a name tag and that's how I remember. Of course, while I was being wheeled in I was introduced to Tony who had a surgical mask on. I won't be picking him out of a line up.
Scooting over to the operating table was quickly prepped and before I knew it the IV was turned on and things began to sound tinny. "Breathe deeply, please". I felt myself drift away.
Wednesday, May 6, 2015
Tuesday is confirmed
Technology can be a wonderful thing. I've always been an early adopter and continue to promote technologies as efficiencies.
During my last stay in the hospital, a technology advocate stopped by to coax me into establishing an account within the Steward Health Care Patient Portal. It was probably their easiest pitch of the day because I had already created a profile and began poking around. Nice little tool.
I had some spare time today so went in and noticed a secure messaging service. In lieu of calling the doctor's office today, I composed a missive asking if the oncologist and radiation oncologist were in agreement with the approach proposed by Drs. Moore and Chatson. Earlier today I had the drain removed by Dr. Chatson and he mentioned that he would see me Tuesday. In my mind it was a tentative until we heard from Mehta and Goff and I may have (unintentionally) planted that idea with Chatson. I didn't want to gum up the works so I confessed this in the secure correspondance.
Conveniently I received an email that I had an email in the portal. I logged in and got a confirmation about Tuesday.
As it stands, I begin fasting Monday at midnight, arrive at Holy Family Surgical Daycare at 1PM, and have the surgery at 3PM. I was told that the operating room was booked for an hour and a half, but it shouldn't take that long. [I was told. Not sure of the anesthesia recovery time frame.]
Earlier today, Dr. Chatson had pointed out (on my - in the mirror) what was going to happen and what he the results he expected. He did say he was going to give me a script for an antibiotic and would call it in today. He wanted me to take it following the surgery. [Forgot to ask why, but will ask Dr. Moore when I see him on Monday]
At this point I can't shower until Thursday. I was told the hole for the drain will close up tonight. I took a very long walk today and was feeling pretty good without that awful drain.
I'm looking forward to enjoying the weather for the next few days since I have not been given clearance to return to work.
I'll take the good with the bad.
During my last stay in the hospital, a technology advocate stopped by to coax me into establishing an account within the Steward Health Care Patient Portal. It was probably their easiest pitch of the day because I had already created a profile and began poking around. Nice little tool.
I had some spare time today so went in and noticed a secure messaging service. In lieu of calling the doctor's office today, I composed a missive asking if the oncologist and radiation oncologist were in agreement with the approach proposed by Drs. Moore and Chatson. Earlier today I had the drain removed by Dr. Chatson and he mentioned that he would see me Tuesday. In my mind it was a tentative until we heard from Mehta and Goff and I may have (unintentionally) planted that idea with Chatson. I didn't want to gum up the works so I confessed this in the secure correspondance.
Conveniently I received an email that I had an email in the portal. I logged in and got a confirmation about Tuesday.
As it stands, I begin fasting Monday at midnight, arrive at Holy Family Surgical Daycare at 1PM, and have the surgery at 3PM. I was told that the operating room was booked for an hour and a half, but it shouldn't take that long. [I was told. Not sure of the anesthesia recovery time frame.]
Earlier today, Dr. Chatson had pointed out (on my - in the mirror) what was going to happen and what he the results he expected. He did say he was going to give me a script for an antibiotic and would call it in today. He wanted me to take it following the surgery. [Forgot to ask why, but will ask Dr. Moore when I see him on Monday]
At this point I can't shower until Thursday. I was told the hole for the drain will close up tonight. I took a very long walk today and was feeling pretty good without that awful drain.
I'm looking forward to enjoying the weather for the next few days since I have not been given clearance to return to work.
I'll take the good with the bad.
Tuesday, May 5, 2015
Placeholder for the cutting room
Received a call form Dr. Moore's office. Scheduled for the next round on May 12th. No over-night anticipated.
Fun begins with fasting Monday at midnight with check-in at 1PM. Knives are on the table at 3. Anticipate an hour and a half, then go home.
More to come as this might change if Drs. Mehta and Goff disagree with this approach.
Fun begins with fasting Monday at midnight with check-in at 1PM. Knives are on the table at 3. Anticipate an hour and a half, then go home.
More to come as this might change if Drs. Mehta and Goff disagree with this approach.
I should really play the lottery
Only a small percentage of men get breast cancer. Only a small percentage of post operative pathology result require additional surgery. BINGO!
Received a call from Dr. Moore today who wanted to 'chat' about my pathology results. Like the sword of Damocles, this had been over my head since being told that the removed tissue undergoes an initial pathology then a subsequent (full blown) pathology.
The good news is the lymph nodes are OK. The bad news is that I'll need another surgery to take 'a little more' tissue near the 'foot' [not my feet]. The way it was explained, the 'edge' of the cancer was a millimeter from the tissue remaining. Because it's so close, for certainty, a subsequent surgery was recommended to take more tissue. The other option was radiation which I have strong feelings against.
Dr. Moore told me that he had consulted with Dr. Chatson and both were in agreement with this approach. However, Dr. Moore said that he would reach out to Drs. Mehta and Goff to get their concurrence. They may disagree. If they do and I am convinced of their reasoning, then this surgery won't happen and I would be forced to go the radiation route.
The way I see it [at this moment], the surgical site is still 'fresh'. The tissue hasn't healed enough to warrant new cuts so a revisit should be less invasive. The proposed approach will be targeted to the 'foot' area and not the lymph nodes. So I anticipate a similar (and hopefully lesser) degree of pain/discomfort and extended healing period (with my favorite-but hopefully fresh drain).
Dr. Moore said that he would schedule the surgery once he aligns with Dr. Chatson's availability. Dr. Moore's office will be in contact with a date. If Drs. Mehta and Goff have differing opinions, then the date will be canceled. I asked when he thought this might take place, and he said next week or the week after. Personally I hope this is sooner than later.
More to come. Off to by a lottery ticket on this cinco de Mayo.
Received a call from Dr. Moore today who wanted to 'chat' about my pathology results. Like the sword of Damocles, this had been over my head since being told that the removed tissue undergoes an initial pathology then a subsequent (full blown) pathology.
The good news is the lymph nodes are OK. The bad news is that I'll need another surgery to take 'a little more' tissue near the 'foot' [not my feet]. The way it was explained, the 'edge' of the cancer was a millimeter from the tissue remaining. Because it's so close, for certainty, a subsequent surgery was recommended to take more tissue. The other option was radiation which I have strong feelings against.
Dr. Moore told me that he had consulted with Dr. Chatson and both were in agreement with this approach. However, Dr. Moore said that he would reach out to Drs. Mehta and Goff to get their concurrence. They may disagree. If they do and I am convinced of their reasoning, then this surgery won't happen and I would be forced to go the radiation route.
The way I see it [at this moment], the surgical site is still 'fresh'. The tissue hasn't healed enough to warrant new cuts so a revisit should be less invasive. The proposed approach will be targeted to the 'foot' area and not the lymph nodes. So I anticipate a similar (and hopefully lesser) degree of pain/discomfort and extended healing period (with my favorite-but hopefully fresh drain).
Dr. Moore said that he would schedule the surgery once he aligns with Dr. Chatson's availability. Dr. Moore's office will be in contact with a date. If Drs. Mehta and Goff have differing opinions, then the date will be canceled. I asked when he thought this might take place, and he said next week or the week after. Personally I hope this is sooner than later.
More to come. Off to by a lottery ticket on this cinco de Mayo.
Monday, May 4, 2015
The simple pleasures
It's a gorgeous day. It's hard to believe that two months ago we had close to eight feet of snow on the ground. Reminders can still be seen here and there where crews piled that unwanted stuff out of the way and now a blanket of dirt keeps it insulated from the warming sun's rays. Given the expected warm weather, one can only wager on how long that stuff will be here - Memorial Day? July 4th? We'll see.
I was hopeful today that the drain would be removed, but I guess my wound has more to offer in lines of output. I feel so gross not having a nice, hot, long shower in more than a week. Eeewwwww!
Oh the simple pleasures in life are so missed when we can no longer enjoy them. Sponge baths for a few more days it seems.
May the Fourth be with you!
Saturday, May 2, 2015
Weekend update
As directed, I called into Dr. Chatson's office to report my 'output' from the drain. Unfortunately, the output was still too much for the drain to be removed. What that means to me: I still can't bathe; the drain area where it's into my body is still sensitive; I'll still need to record the output through the weekend; I'll be 'enjoying' the warmer weather feeling dirty and restricted in motion with spurts of uncomfortable and sometimes aching pain; I won't be returning to work Monday. That's what healing is all about. However, all this has been manageable and I've not had to take the pain pills.
During my discharge, there was mention about the need for mobility to reduce the risk of blood clots. I was told to take aspirin for blood thinning and walk. So, I've been walking about a mile a day. When at work, I can average 3 miles per day traipsing up and down three floors, but a steady walk of one mile through various gradations should be beneficial. [No clots please.]
Now I wait for Monday and hopefully the removal of the drain. I'm hoping to hear when I can return to work seeing I've been scolded by HR because I've been logging in from time to time.
Through this, everyone has been wonderfully supportive. This outpouring brings me great comfort and gratitude for caring friends and family.
During my discharge, there was mention about the need for mobility to reduce the risk of blood clots. I was told to take aspirin for blood thinning and walk. So, I've been walking about a mile a day. When at work, I can average 3 miles per day traipsing up and down three floors, but a steady walk of one mile through various gradations should be beneficial. [No clots please.]
Now I wait for Monday and hopefully the removal of the drain. I'm hoping to hear when I can return to work seeing I've been scolded by HR because I've been logging in from time to time.
Through this, everyone has been wonderfully supportive. This outpouring brings me great comfort and gratitude for caring friends and family.
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