Five Weeks Left of Chemo

   Taxol #6 was last week. For some reason, my fingers suddenly stopped feeling all tingly, and the numbness seemed to have leveled off, so I might end up doing all/most of the Taxol treatments after all. My platelets were pretty low last week though, around 60, so Dr. C was a little worried about that.
   I met with the breast surgeon for a pre-op appointment last Wednesday. All she wanted me to do was sign a paper basically. She went over all my options again. I told her the plastic surgeon said I couldn't get an implant on the right side since I'll be doing radiation, but she says that's not true. Okay? ...But the plastic surgeon she referred me to, who shares her office, refuses to do it. She also said that moving the fat alone from my stomach into boobs wouldn't work because you need the blood supply provided by a muscle. Otherwise you just have "dead fat" hanging there. Good mental image. Either way, I told her I don't like the ideas of sacrificing muscles for boobs, having foreign objects in my chest for the rest of my life, or, more importantly, extra and unnecessary surgeries at this point. She pointed out that having a mastectomy on the left side could be considered "unnecessary". Except let's remember that my breast tissue is potentially deadly and leaving any of it attached to my body does not seem like a good idea. And that's really the best argument she could come up with to try to convince me to get immediate reconstruction? I can personally live with my decision (and will probably live longer because of it), it's the rest of the society that seems to have a problem with me going boobless. As of now, my surgery's scheduled for April 10th if everything goes according to plan (ha).
   I had Taxol #7 yesterday. My platelets and hemoglobin are looking better. Dr. C said he can't even feel the tumor at this point, just some "thickening" from the biopsy. He asked if the breast surgeon examined me and was surprised she didn't. So I took the opportunity to ask him if my ribs would be sticking out once my boobs are gone. Apparently they won't because they leave the muscle intact in today's modified radical mastectomy. Good to know. Kind of wish the surgeon had gone over some of this, except I was at a blank when she asked if I had any questions.
   My mom came up to visit last week and cleaned the house for us (thanks Mommy!), even though she might have been trying to kill the dogs by using toxic chemicals to scrub the floors. I almost killed them myself earlier when they escaped out the front door, which was the fault of the HVAC guys who just stood there like idiots with the door wide open as the dogs took off. Luckily Kyle came home for lunch right as Zeus was taking a dump in the neighbor's yard and snatched him up mid-poop. When the guys were leaving, I asked what we could do to make the downstairs warmer, and they gave me another stupid look and asked if I'd gotten a letter from housing saying when the maintenance guys were coming. I thought THEY were the maintenance guys! I have no clue who these men were that I let into my house and the real maintenance people never even showed up. And I'm pretty sure the heat's broken now because the house is freezing.
   Very frustrating day. And to top it off, the numbness/tingling in my fingers seems to be coming back, making it painful and irritating to do schoolwork. And the new hair that's been growing on my head since I finished the Cytoxan is starting to fall out. It's about an inch long all over, so this is pretty depressing. I should've seen this coming though since my eyebrows are still pretty sparse and I mysteriously haven't needed to shave my armpits for weeks. Thankfully only five more weeks of chemo.

Plastic Surgeon

   I saw a plastic surgeon yesterday (now conveniently located at Dr. K's office). All these older women were there waiting, so excited about having their new boobs installed. It kind of creeped me out. And I've kind of already decided to not have reconstruction done the same time as my mastectomy, especially since I'm only two months into chemo and I have another four to go. I don't want to deal with anything "extra" by the time I get to surgery. Not to mention the five weeks of radiation to follow. But I figured it wouldn't hurt to see the plastic surgeon to see what my options are.
   Since we're planning to do radiation, he said I'm not a candidate for an implant, at least not on the right side. I don't really like the idea of having a foreign object in my body for the rest of my life anyway, especially if it can cause extra complications. The tissue on that side won't heal very well after radiation, so it can't be expanded for an implant. He then squeezed the fat on my stomach (awesome), but said even though there's "some" fat there (thanks), it wouldn't be enough to do both boobs. So they start salvaging other parts of your body. In my case, he said he could use tissue from my back. Four large incisions in three different areas of my body all at once?? No thanks! Plus they'd be taking muscle from my back too. I can't really see the justification of sacrificing (any) muscle on my body for a boob. I'm already so weak from the chemo and the lymphedema in my dominant arm, I'd rather not make it any worse in the long run. Plus I googled some pictures of the stomach scar (pretty sure it's the DIEP flap procedure he was talking about), and it does not look like a fun recovery time.
   I mentioned that if I did get reconstruction, I wouldn't want the same size. Whenever I say that, people always seem to assume I want bigger boobs for some reason. I'm five feet tall, I'd like, for the first time in my life, to have boobs that are appropriately sized for my body. So smaller. Much smaller. It's a nightmare finding bras to fit, and that 32 band size? Pretty sure it should be a 30 but they don't make those. I don't think the doctor took me seriously though, because he kept saying "for the same size" when he was mentioning all the parts he'd have to scrape together from the rest of me.
   He said insurance should cover reconstruction, no matter when I have it done, so that shouldn't be an issue. However, for the best looking results, I should do it the same time as the mastectomy. After another four months of chemo, I can't imagine I'm going to feel well enough to change my mind about it. Plus there's that more important question of why get reconstruction at all? Maybe so clothes fit a little better, or so people don't mistake me for a 10-year-old year girl, or worse, a 10-year-old boy. My husband said he just wants me alive either way. Plus, I'd never be able to feel them. The numbness in my arm still feels weird, and the mastectomy scars should be numb too, I don't want extra tissue hanging off me that I can't even feel. Why pretend to make it seem normal?
    He also kept mentioning how important it is to get back to a good "quality of life". Maybe I'm just a little dazed from chemo brain, but the way he kept saying it made it seem like I would never have a decent quality of life if I didn't get new boobs. If anything, not having extra, unnecessary surgery right now will give me a better quality of life, considering I'll be able to return to normal activities much sooner. I asked if I could just wait until my stomach inevitably gets fatter and THEN have them rip it out to make new boobs. He said that's fine, but geez, he kept trying to emphasize how much better they'll look if I do it right away. Boobs have never been that important to me. If anything, they've caused me a lot of extra stress in my short lifetime and now I'd like for them and any semblance of them to go away for a while.

Final Round of Adriamycin! Mmm... Back to Nausea...

    I saw the radiation oncologist again Friday to find out what she wants to do. She said she talked with 3 other radiation oncologists and they all agreed that I should get radiation, but Dr. B herself is still kind of hesitant. Here's a link to the study she was looking at trying to determine what'd be best in my case. She ran through a bunch of numbers and statistics that made me wish I hadn't slept through that statistics class freshmen year, but overall, she said considering my age and the SLIGHT improvement they've seen in patients with the small number of positive nodes and size of the tumor, that we should plan on going ahead with it. I told her they're testing me for the p53 gene and we'll get the results in 3 weeks, which might affect her decision. I'll meet with her again after chemo is over to figure out all the details.
    I finally got that last round of the Adriamycin yesterday. My hemoglobin went up to 9.4 and my platelets were 96. My blood pressure's still pretty low. Dr. C is out for the week, so I saw his assistant Phyllis again. I asked her about the pain in my right hand and arm, and she looked at it and noticed it's starting to swell. Yay for lymphedema. Here's a link for some info on it. She said she'd send me to a physical therapist specializing in lymphedema treatment "when [I'm] ready"? I guess she meant when I'm not getting my ass kicked so much by all this chemo. When I went back today for my Neulasta shot, I ran into her again and asked if I could get a referral sooner since I'm going to be flying across the country in a month. I'll need a compression sleeve before I go on that trip since it's such a long flight.
   I also asked her about possibly rescheduling one of my upcoming chemo sessions so I can go down to SC to visit friends and family October 28th through November 5th. She said to come in for my next appointment as usual and we'll see how my counts are doing. (Knowing me, they'll be low anyway.) And then plan on getting chemo November 7th regardless since I'm going out of town the week before and that week itself. Tight schedule... But it's good to know they'll try to work with me on it. I'll probably be miserable during my Portland trip thanks to chemo.
   Since I'd gone in so late in the day, I guess Phyllis had some free time to chat. She said the fatigue I'm experiencing so much lately probably isn't going to get much better since I'm going into month THREE of chemo and won't be done til FEBRUARY. I also told her I'm thinking about skipping reconstruction altogether or at least delaying it since I'm definitely going to be wiped out by the time I have my mastectomy surgery. She said that's probably a good idea since I'm going to have radiation, and that radiated skin doesn't heal as well as normal skin. So much fun stuff going on...
   On to ACTUAL fun stuff: my mom suggested a birthday party since I'm going to be home for my birthday. But most of my friends are still in Charleston, so we're going to try to have the party down there October 29th. I'm looking into renting a house or something and having my mom cook dinner. It'd be nice to have a post-chemo/pre-mastectomy party too in February or March. Lots of time left to plan for that one though.

Change of Plans

   We went for round two of chemo today, but my platelets were only at 91. Dr. C said the one study shows that it's most effective to give the A/C chemo combination every 2 weeks, but that there were two other arms that it followed. One was just to do the combo every 3 weeks, though slightly less effective. And the other was to split the A and the C parts, and do them separately every 2 weeks, which is more effective than the three weeks schedule. So we're going to try that, since we kind of don't have many other options. I had my second round of (only) the Adriamycin today (along with anti-nausea meds and steroids). This'll just prolong my chemo, and estimated surgery date, but the side effects should decrease. I'm still starting to feel nauseous though, and my legs hurt, and I'm tired, and that really gross taste in my mouth is coming back. But other than that I'm fine. I'm going in tomorrow to get the single Neulasta shot instead of the 10 individual shots. And then we're going to hopefully do the 3rd round of the Adriamycin two weeks from now.
 
Updates from last week that I missed:

• We had an earthquake Tuesday. The house shook and scared the crap out of me, but there wasn't any serious damage.
• Hurricane Irene hit Saturday night/Sunday morning. The power went out around 2 AM and didn't come back on until today around 2 PM. It was terrible.
• The in-laws are visiting in two weeks and bringing Kyle's super fat dogs. 
• I had a post-surgery follow-up with Dr. K Thursday. Everything looks fine, and I made appointments with radiation oncology to see if I need radiation after chemo and with their new in-house plastic surgeon, Dr. P, to find out about getting new boobs later. 
• Kyle and I shaved each other's heads Thursday night. My hair started coming out in clumps Tuesday and was getting EVERYWHERE, so we kind of needed to do it. Walmart finally brought out winter hats though so I stocked up, because my head feels cold all the time now. But it's nice and round (thanks Mommy!), and I keep thinking of that episode of Roseanne where Jackie's rolling the baby to keep his head from getting a flat spot.

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.