Flat-Chested

   It's almost been two weeks since my surgery, and I'm feeling a lot better. I haven't needed any painkillers the past few days (even for the chest pain!). The surgery went well and I got out of the hospital Wednesday afternoon. There was some strange swelling on the left side, so I saw the doctor Friday to get it checked out, but they said it was just the tubing inside from the drain (gross). I saw the doctor again Wednesday to get the two drains taken out. Everything's kind of numb in my chest area, and I didn't have those terrible shooting pains from the lymph node surgery this time, so the drains were much easier to manage, but I was still glad to have them out. I ditched the uncomfortable hospital/surgical bra as soon as I could and I've been wearing the As Seen On TV Genie Bra because they had an extra-small that actually fits. It's almost just as hard to find bras now. I'm somewhere between the little girls and the juniors, but most of them come built-in pockets with padding. Our society's obsession with big boobs and oversexualization of pre-teens are working in my favor. Walmart even has $5 "water pads" next to the Buty Pant butt-enhancing panties. While I opted to skip the padded underwear, those cheap bra pads are good enough to make me look a little less like a flat-chested twelve year old.
   I saw Dr. K today for a follow-up. She ripped the steri-strips off both sides, but thankfully I couldn't really feel it. That swelling never really went away, so she just sucked it out with a syringe. Again, happily still numb! It's definitely flatter now, but I forgot to ask about the other swollen part at the top. Hopefully that's not just leftover skin... Everything else looks really good, completely flat and the incisions are very thin, even though each one goes from the middle of my chest up into my armpit. I think she did a great job.
   She gave me a copy of the pathology report, and said everything was fine with the surgery. The chemo obviously worked because the tumor went down from 2 cm to 0.6 cm. When I got home and looked over the report, I realized I don't know what any of it means, but Wikipedia's super helpful. Overall, I had a grade of 1 which is the lowest (and best). Tubular differentiation had a score of 3, which isn't good, but nuclear pleomorphism was only 1 and mitotic count was only 1. Nothing was found on the left side, except that fibroadenoma. While Kyle jokingly said it was a waste of a good boob, I feel better knowing I have almost no breast tissue left to form new cancer cells. Plus, they're a pair anyway; I'd rather be flat-chested on both sides than lopsided.
   Dr. K also went over some massages for my arm when I asked for a new referral for a lymphedema physical therapist. I mentioned the arm pain to the oncologist a few months ago, and they said it was lymphedema, which is why I thought it was a lymphedema... And my right hand is noticeably swollen compared to my left. She said lymphedema doesn't hurt though, it's just the swelling. She thinks it's just the muscles in my arm and I must've overused or underused that arm after the first surgery. She said to keep it elevated above my heart whenever I have a chance, and showed me the massages for both the lymphedema and for my muscle aches. If I'm still having issues in two weeks and want to see a physical therapist, she said to call. Otherwise, I'll see her in six weeks to make sure everything's doing okay. She also asked when I wanted to get the port out, but considering this is my THIRD one now, I'm going to hold onto it for as long as possible. Once I'm done with treatments with the oncologist, it'll need to be flushed every three months to keep it functional. She said they could take it right out in their office instead of dealing with all the hospital stuff. Very different from the last two ports...
   I have an appointment with Dr. B from radiation oncology tomorrow for another consultation. My chest pain finally went away (after seven weeks), but I really don't want to get radiation if it's going to aggravate it in the future. I guess we'll see what she says tomorrow.
   As for the official weight for my boobs: the right one was 439 grams and the left was 427 grams. Less than a pound each! I was expecting heavier.

Yay I Can Shower Again!

   Finally got my drain taken out today. Dr. K ripped all the tape off from my other bandages first, so I barely noticed when she pulled the drain out of my side. The hole will "leak" a little for a few days, but should heal up fine. She showed me some exercises to do to keep my arm and shoulder flexible. (I also pointed out my double jointed elbows, and she told me to let the genetics counselor know.) I'm scheduled to see Dr. K again August 25th to make sure my exercises or working or else I'll go see a physical therapist. I'm also penciled in for January 10th or 17th for the bilateral mastectomy, which means I have to get in touch with the plastic surgeon before then to find out about reconstruction. Dr. K said the results of the lymph node surgery showed that 3 of the 10 she removed were cancerous. Good thing they're gone.
   Now I'm going to go take my first shower in 9 days. Goodbye armpit odors!

Update post-shower:
   I don't know what was scarier: seeing the four inch incision under my arm for the first time, or the small forest that has taken root in my armpit. Omg.

First Bone Marrow Biopsy Awake

   I had my bone marrow biopsy this morning. Awake. They gave me Ativan first though which made the room start spinning. I was much more exposed for this one than the previous ones, but they gave me a sheet to cover up my butt. Dr. C started poking my back bone to show where he was going to do it, and that was probably the most painful part of it all. He numbed my back and the medication hurt going in, but that was it. Watching Kyle's face as he watched him do the procedure was the worst part. Dr. C was having trouble getting into my "21-year-old bones" and was cranking away with a needle back there. Luckily I couldn't feel any of it, I was just trying to not get pushed off the table. It hurt for like a second when he sucked out the marrow. And my leg started to hurt when he broke off part of the bone for the biopsy. But that went away after a few seconds, and they were done. They showed us the two capsules of marrow fluids and the pieces of bone they got. Ouch.
   Then I passed out for a few hours. (Why didn't they wait until the Ativan knocked me out first?) Now my back is sore like usual. I'm looking forward to getting the drain out tomorrow so I can shower (8 days). Aunt Janie and Grandma came up to visit, so hopefully I can go in earlier to have the doctor remove it. And Aunt Janie bought me a fancy blender so we can make smoothies now, since the chemo's probably going to wipe out my appetite.
   Dr. C didn't have any updates for me, the lymph node tests aren't back yet. My heart's fine, as I heard yesterday. The genetics counselor wants to see me again next week to get more tests done.
   My arm pain's getting better, but now it just feels like I'm getting punched in the armpit, repeatedly. The vicodin acts like speed when I'm trying to fall asleep, so I've just been taking extra strength Tylenol. My right arm also won't bend out as far anymore, which might be a good thing, since the double jointedness in my elbows creeps everyone out so much. Everything else is just itchy, itchy, itchy, including the back of my arm, which is numb so I can't scratch it.

Chemo Info Session

   We saw the oncologist today. I'm starting chemo August 8th. Since my cancer is lymph node positive, Dr. C said they have to use an aggressive treatment, since the cancer cells have shown they can spread to other parts of the body. I'm getting a bone scan next Friday to make sure it hasn't gotten into my bones (they already checked my lungs with a chest xray and my liver from bloodwork). I'm also getting a heart test done Tuesday to make sure my heart muscle can handle all the crap they're about to pump into it. And to add to all the fun, he wants a bone marrow biopsy to see how robust my bone marrow is after all my aplastic anemia treatments. Unfortunately, I have to be conscious for it since they don't have the proper equipment nearby for anesthesia. They said they'll give me something to sedate me and I really hope it's something good.
   The chemo's going to be in two phases. The first one is Adriamycin and Cytoxan by IV once every 2 weeks for a total of four treatments. The day after each treatment I'm supposed to get an "antidote" (yea they're definitely poisoning me) of Neulasta which will stimulate my white blood cells so I'll be well enough in two weeks for the next round. The problem is I've had shots from the aplastic anemia treatment (Neupogen) that did the same thing and gave me really bad bone pain. Since the Neulasta is given once and lasts two weeks, Dr. C suggested I get the shots individually instead so at least if my bones start hurting, we can stop it right away. We just have to see if the insurance will cover it.
   Phase II is Taxol by IV once a week for 12 weeks. Dr. C says this drug is much easier to tolerate than the first two, but will still keep my hair from growing (I'll be bald about 2 1/2 weeks after the A/C treatment in Phase I). I'll also start Herceptin at the same time, by IV once a week for 12 weeks. After those twelve weeks, I'll get it every 3 weeks for 9 months. Since the cancer is HER 2 positive (15-25% of breast cancers are), the Herceptin works as an antibody (?).
   Once I'm done with the poison sessions, I'll start Tamoxifen, a small pill once a day for 5 years. Since my cancer's estrogen-receptor positive and progesterone-receptor positive (66% of breast cancers), the anti-estrogen is supposed to help stop feeding it hormones, but it could put me at risk for premature menopause (at 21? Seriously...?). I will also have my surgery after the chemo, with the choice of a bilateral mastectomy (take them both off) or lumpectomy (just take out what's left of the tumor). Dr. C did say that by keeping my breasts, I would have a slightly higher chance of either the original cancer coming back as a local recurrence or a new breast cancer showing up, since breast tissue would still remain. Considering my luck already, I really think it'd be better to have the bilateral mastectomy. At least I'd get new boobs out of this mess. And maybe I could avoid having my left lymph nodes ripped out because the right side still really hurts.  Either way, I still need radiation after surgery because my lymph nodes were positive. That'll be for 5 1/2 weeks Monday through Friday.
   I'm still getting the drain taken out next Thursday. A nurse came by yesterday and today to check it and the dressing. She said everything looks good, no swelling or bruising surprisingly. I'm too creeped out to look. The stuff coming out is starting to turn yellow, which is good. Only six more days til I can shower! Eww..

Day After Surgery

   They doped me up on a bunch of pain killers last night but it didn't help me sleep at all. When I finally fell asleep around 6, the nurses came in to wake up the old lady next to me, who was wearing a hearing aid. Dr. K's assistant, Donna, came in pretty early to check on me and get my discharge paperwork ready. She told me they did the axillary lymph node dissection because when they checked the sentinel node, they couldn't get clear results whether it was cancerous or not. I asked if that was normal, but she said that it rarely happens (go figure). She said it was just kind of a grey area of what to do and they discussed it with the oncologist during surgery, so they just decided to take everything out that was there. I'm getting the drain out next Thursday and a nurse is coming out to my house tomorrow to check on me again.
   I got home around 1 after fighting with a missing date on my controlled substance prescription (thanks Doc...), but we went to the grocery store and I was feeling fine. I'm supposed to be taking Vicodin every 3 hours. It's making me incredibly nauseous, but it stops the sudden sharp/burning/stabbing pains in the back of my arm. I spent most of the day knocked out on our fancy new reclining couch (very good idea Kyle), while Mommy yelled at the little brats screaming their heads off in our front yard. Maybe I'll go throw up on them next time... But for now, I think the milk of magnesia is finally kicking in! Yes!

First Surgery Today

Surgery was scheduled for 10 AM this morning, so Mommy and I got to spend 3 hours waiting in an ice box. Dr. K put a fancy new port in on my left side, with a new scar since the old one's been cut open too many times already. I requested she sew it on extra tight so it doesn't come loose like the last one. No problems so far, it's only a little sore.
She also did the biopsy on the mysterious lump the MRI found in the left breast and got the results right away. If it had been cancerous, she would've done a sentinel biospy on that side too. Luckily it wasn't!
The right side wasn't so lucky apparently and Dr. K ended up taking out more than the sentinel node. I now have a really gross/bloody drain coming out of that side and a very painful armpit. A nurse just emptied it and measured 20 mL. She said it's better that the stuff comes out, otherwise it could cause an infection. I'm also on antibiotics just in case (and Vicodin mmm).
The doctor's going to talk to me in the morning to go over everything she did and what I need to do now. I have an appointment to discuss chemo this Friday, but I also have a dentist appointment next week which I need to get done before they screw over my immune system (I actually go to the dentist unlike some members of my family...). So I don't know when chemo starts yet, but will keep posted.
Now I get to spend the night in the hospital next to Miss Virginia and her pee pads. Oh and my own pee is blue for the next 24 to 48 hours.