Fat Pads, Radiation Tattoos, and an Oozing Incision

Oops, I can't believe it's been a whole month since an update.
   I had another MUGA heart scan the day after my radiation appointment, and everything's okay, so I've been getting the Herceptin every three weeks as planned (only seven more months!).
   I had another radiation appointment for the planning stuff. They gave me three tiny tattoos, one on each side of my chest and one in the front on the right side. These are to make sure I'm lined up correctly everyday when I get treatment. She had to redo the tattoos three times to make sure they were visible enough (which was fine with me because I want to make sure they're radiating the right spot!). It just felt like she was digging holes in my skin. And then I bled all over my shirt.
   I go back for another prep appointment Friday, May 18th, before I start the treatments. My appointment time is 11:30 everyday and it should only take about 15 minutes each time. I'll see Dr. B once a week for bloodwork and a checkup to make sure my skin hasn't fallen off I guess. I tried to fill my prescription for the cream that's supposed to help, but the clinic pharmacy could barely read the handwriting. I saw three pharmacists in the back on their smartphones trying to figure out what "Prutect" was while we waited for 30 minutes. They thought it was over-the-counter and had no clue what it was for, even after I told them. We finally just left and one of them ended up calling me to say they had to order it and it'd be a few days (this was 2 weeks ago?). This is why I go to CVS and just pay the copay, at least they get you in and out in 15 minutes!
   I also went to visit Dr. K. Twice. Without an appointment. I noticed the left side near my armpit looks swollen, so I called and she told me to come in. She did an ultrasound to make sure there's no fluid and said it's just fat. Normally, breast tissue weighs down the fat in that area so we don't notice it, but since I'm so little, it looks more obvious. She said she can thin it out when I get my port taken out, and she'll fix up the old port scar. She'll have to do it as outpatient surgery, but I wasn't looking forward to having the port taken out in the office while awake anyway.
   I must have missed her, so I went to see her again a few weeks later. The right incision was starting to ooze near my armpit. She looked at it and said it wasn't infected, but that the bandages I was using were tearing up my skin. So she gave me some waterproof ones that I can change less often. But it's STILL oozing. Dr. C looked at it today and said it's not infected, and that an infection would be very obvious. So he stocked me up with some more bandages, and I just need to wait it out. He explained how the incision is very taunt in that area and how every time I move my arm, it's putting more pressure on it. So it's basically the incision trying to split open. He did mention that they might not start radiation on schedule if I'm still oozing. So hopefully it'll start healing properly so I can get all this crap over with. It's really hard to NOT use my right arm so with my luck this is going to take a while. I was reaching up for something earlier and suddenly felt shooting pains all down my arm. Gotta love lymph node dissections...
   I finally went to the dentist for a checkup and cleaning (unlike certain other members of my family!). I found a new dentist in Mt. Holly and they were much better than the last one. Nobody sprayed my face with water this time. I had two cavities, one of them was next to the bonding from my fake tooth. I didn't realize that could happen. But the dentist was great and smoothed down both sides for me so it'll be less likely to develop more cavities. They do the Maryland bridges too so when these pop off, I have somewhere to go to fix them.
   Besides that, I've been feeling fine. My energy level has definitely improved, even though radiation is going to make me tired again. But I'm done with classes and college! Graduation is May 12th, and it seems like EVERYONE in my family is going. But afterward, I get to relax a little and spend my summer applying/praying for jobs.

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.

Skipped Herceptin

   Now that I only have regular appointments every three weeks, I'm probably going to be lazy and update a lot less. I had a MUGA scan last week, but Dr. C called the next day to tell me the number was lower than he wanted, so I didn't get the Herceptin today. It was only 52, and my first two were 65 and 55. He said it's still normal, but I'm at a certain threshold where they want to wait and see if it gets better before giving me any more Herceptin. I have another MUGA scan scheduled for April 4th and see the doctor again April 11th.  I asked for a copy of my counts as I was leaving and apparently they still had me in the system as male. My hemoglobin was 8.7, my platelets went down to 112, but my white counts are good. Hopefully that won't mess up my surgery date next Tuesday. I'm also supposed to start the Tamoxifen when I get home from the hospital. The hot flashes stopped a few weeks ago thankfully, but this medication will probably start them up again. And I'm supposed to be on it for the next five years. Oh what fun. Besides the typical menopausal symptoms, it also has rare side effects of blood clots and uterine cancer (just can't win).

   My chest still hurts (four weeks now?). He said it's a good thing that it hurts when I push on my ribs because it sounds like a cartilage issue and not something to order a bone scan for. He even said it sounded like costochondritis, which I thought I had told him before? But either way, at least he's familiar with it. I realized I've been dealing with this on and off for almost seven years now. The only thing I can do for it is pop ibuprofen and slap a heating pad on my chest. I just hope it gets better before surgery next week.

   I saw Dr. K for a pre-op appointment last Thursday for the list of questions I've been making. She said the surgery might make my chest pain worse because it'll feel tight, but that it's fine to keep taking the ibuprofen, as long as I don't drink anything the night before surgery. And yes that crazy thing in my chest IS a power port, that's all they use apparently. I was supposed to get a booklet and a card when I was in the hospital, but she's going to try to get me another one. I should only be in the hospital for one night and the surgery should take less than three hours. I asked her not to leave any extra skin, and she said it'll be completely flat with the scars slanted with the way the muscles underneath naturally stretch. I'll have drains again, but I won't have that terrible nerve pain since they're not messing with any more lymph nodes. She said I could drive once the drains are out and I'm not drugged up on painkillers. 

   I tried to make an appointment with the radiation oncologist, but they told me to call back after my surgery. Dr. K said they can start radiation two to four weeks after surgery, but that seems too soon and I don't see how my skin would have time to heal before then? We're going to SC for a week in May so they're going to have to work around that anyway. I'm more concerned about what the heck radiation is going to do to my chest in the long run, especially with this ongoing chest pain and my swollen arm. The radiation oncologist was unsure at first whether to do it or not (September and October entries). Maybe whatever they find during surgery will influence it. Either way I'm screwed.

Done!

...with chemo at least.
   No Taxol #12 this week. The numbness has stayed about the same, but he kept asking if I was having pains in my fingers, as if that was going to determine whether or not I had the last treatment. Then again, for the last 6 weeks, he kept asking if I was still able to button buttons and tie shoelaces without problems (two completely avoidable tasks) as if THAT would determine whether to continue treatments. He did acknowledge the issues I've been having typing on my phone or a keyboard for the past few weeks (much more important!).
   Thankfully, he let me stop so I'm officially done with chemo! And I'm two weeks out from the last treatment, so I've been feeling much better. I even got on my exercise bike last night, since my legs were already sore (thanks to a combination of six months of not moving, some leftover Taxol side effects, and those flu-like symptoms associated with Herceptin). But after about 20 minutes, my feet went numb. So I'm really glad we didn't push those last two Taxols. Hopefully all this numbness and tingling will start to go away, along with these other crappy side effects. My skin's started cracking and peeling because it's so dry. I'm still waiting for my constantly runny/bloody nose to get better. The hair on my head's definitely grown out at least an inch, but it's mostly on the top and in the back. My forehead looks huge now because most of the hair in the front has thinned or fallen out. I still haven't shaved my armpits or my legs in weeks, which is nice and all, but my eyebrows are disappearing too, so I could use some hair growth. My chest pain mostly went away last week, but in the last few days, my shoulder starting hurting again, but this time on the left side. I've been popping ibuprofen and that seems to help.
   The nurses printed off a copy of my blood counts (since I actually remembered this time), and they're slowly going back up. My hemoglobin was 9.7 and platelets went up to 127 (almost normal). But then I noticed the "Gender" on the printout says "Male". I know I don't have as many female hormones running through my body anymore and I'm about to get my boobs cut off, but seriously? They fixed it right away, but I wonder how long it's been like that and if it's affected anything...
   I also called Dr. K's office last week to reschedule my surgery. It's now for Tuesday, March 20, and I have a pre-op appointment in two weeks for any last-minute questions. I really don't think it'll be that bad, since they aren't ripping out any lymph nodes this time, and especially in comparison to six months of chemo hell (most of which is a blur thankfully). I'm just ready to be done with all this.
   I'm still getting the Herceptin, but now it's every three weeks, so my next appointment isn't for a while. My next MUGA heart scan is scheduled for February 6th. Speaking of never-ending appointments, we had to reschedule the one for the dogs, but Zeus hasn't been chewing on his feet lately, and instead has been getting into the trash and tearing everything up to occupy himself. Guess that's a trade-off?
   And Skye's still fat.

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.

Not So Boring Update

   I got Taxol #5 today. I'm supposed to have 7 left, but since my fingers are getting worse, I might not be able to finish all 12 treatments. If they're still worse next week, Dr. C says we're going to stop the Taxol altogether and switch the Herceptin to every 3 weeks instead of weekly. This would also bump up my potential surgery date to February instead of the end of March. I have an appointment with the surgeon January 19th, but they might call me if something sooner opens up. AND this would mean I could potentially finish radiation before  graduation (May 12th) instead of trying to schedule around it. I really wouldn't mind finishing chemo "early" because it generally makes me feel like crap, but I also need to make sure I do as much as I can this time to prevent this from happening again. Dr. C says it's about balance, and the numbness in my fingers might never get better so we don't want it to get any worse. So we'll see what happens next week.

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.

Day After Chemo: I'm Still Alive!

   Today was aggravating. I've been feeling a little nauseous, my ears were ringing last night (Dr. C said it might be from the steroids , and most of the stuff I eat tastes like crap. I spent most of the morning calling Financial Aid at CofC trying not to yell at dumb people. Someone from Disability Services ended up walking my forms over to their office to make sure they had everything in order. I have to call back Financial Aid tomorrow since no one picked up when I tried to call back later. Dr. C called this morning too, to check up on me. He said if I haven't gotten sick and vomited already that I probably won't at all. Oh good.
    Kyle and I went grocery shopping when he got off work, and that was exhausting. I did order some new glasses online really cheap though. Walmart wanted over $120 just to replace my lenses in old frames, but I used Goggles4u and got two pairs of glasses for $55 total. One pair's even tinted and both pairs have fancy coatings on the lenses. There are a bunch of coupons online too if anyone's looking for new glasses. Hopefully nothing will go wrong with them.
    Kyle was supposed to give me my first Neupogen shot today, which we picked up from the pharmacy earlier. Unfortunately, I didn't think to check them there, so when I pulled them out at 9:00, it turns out we only have vials of medication. The nurse told us we'd be getting prefilled syringes, with safety caps. I called the doctor's office and gave the nurse my number to have the on-call doctor call me back. A few minutes later, I had a voicemail on my phone, but it hadn't rung at all. The doctor said he'd called about 3 or 4 times, and that if was urgent, patients usually pick up their phone. Uhhh.. Thanks T-Mobile for my in-home dead zone. Gotta get that taken care of. I called back the nurse and gave her Kyle's number. The doctor says I should be fine for tonight, but to call first thing in the morning to see about getting some syringes.
   I also just added a wishlist to the blog if anyone noticed. I really want a brand-new memory foam mattress before my next surgery because the one we have now is murderous on my new wounds. Christmas would be good timing, hint hint.

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.