Before I discuss my pathology report I have to discuss some stuff with you all. Some of you have commented this blog reads like an episodic series. You will call me right after reading and say things like “That was intense!” or, “So?! Do you have one or two drains?!!” just to find out what happened next, which I promptly replied, “Huh? What? No, you’re going to have to wait to read the next posting!” Just so we all know the timelines, I posted the The Drain five days – 5, after my surgery and gave you all a reply to it three days after the posting it. In between, The Drain and June 8,th 2011, I slipped in, The night before, (in hopes of satiating you for bit before I was ready to blog again) I was still drugged up and fatigued and y’all needed to cut me some slack! You know who you are. I know, I make you worry, a little on edge wondering what’s next, whenever I don’t put out this blog fast enough.
Well, guess what? This is exactly what having cancer is like!
Waiting for my pathology report made me a little anxious. My first appointment with Dr. C, after surgery, is cancelled, which sets my mind spinning, for all the possible reasons, why it would be postponed for another week. Even though I am told her office has not received the report yet, my tensions revert back to the day Dr. C cancelled my first surgery date when we all thought I was going in for a lumpectomy. I try not to focus too much on all the negative reasons why the report will not be produced on time because I’m constantly reminded to stay positive. Fuck that! Where’s my effing report?!!
My physiotherapist, Tania is the one who tells me there is a shortage of pathologists in the city. It makes sense to me when summer is here, people go on vacation and work speed decreases with the rise of temperatures. And so, I am a little relieved based on this reason, my pathology report takes 3 weeks and not the regular 2 weeks to complete. I was supposed to be doing these exercises to increase the range of stretching in my arm. I tried once, on the floor with a broom pole in my hands, to try lifting the pole above and over my head. I fell asleep on the floor for an hour and decided to try again when I had more strength. In Tania’s workout room, at WCH, I attempt the exercises for the second time, in my life, after I have lied to her that I am regularly exercising. I have to say, the removal of the drain has helped my range, and probably the fact I only had a 3 lymph nodes removed, instead of all 20-30 of the Axillary lymph nodes, helped too. By the time I saw Tania, my range had increased ten-fold from the first time I attempted those exercises. The area around my armpit still feels tight but I was able to manage swimming a couple of strokes this afternoon! So, please don’t call me or text me to chide me for not doing my exercises.
The week after physio, Dr. C confirms Tania’s answer to the late pathology report. There is still missing information, however. Dr. C draws the curtain for privacy between her examining me and Marni sitting by the door taking notes. Notes such as, asking Dr. B how many more expansion sessions will I need. After two expansions, my reconstructed breast seems almost more than half the volume to being the same size as my other breast. I ask Dr. C if she thinks it’s a bit high compared to my real breast. She tells me the same as Dr. B, to not worry about this for now because it is just an expander to stretch the skin until it’s ready for the implant, which is months away. Aside from my scrutinizing, Dr. C confirms the scar is healing well. I cover up, we open up the curtain for Marni to join our discussion. We find out the receptor information is not in, which is something I was highly anticipating to know. Without the receptor information I’m unable to google what I have to look forward to, in terms of chemotherapy type treatments and whether I will be looking at using pre-menopausal drugs for the next 5 years. There are 3 types of receptors which thrive on breast cancer cells, progestogen, estrogen, and her2/neu (Human Epidermal growth factor Receptor 2). Not knowing this info thwarts any preparation I can do for myself on the computer which, to some of you, might be a good thing not knowing because it prevents me from getting all worked up about, what side effects, these treatments will have on me. I hate not know what’s coming around the chemo corner. Dr. C continues to tells me all the cancer in my breast was removed with very good margins for all, except perhaps for one of the tumours. Most of the cancer cleared with 3 mm margins or more and the other, they cleared with only a 1 mm margin. Even though Dr. C assures there was no more tissue to remove, because it was in the duct, it was also right next to skin. She truly believes no radiation will be needed but she is sending me to a radiation oncologist to be on the safe side. A meeting with a medical oncologist is also being set up because my tumour was a stage 2, high-grade (cells were growing quickly), meaning they will likely recommend chemotherapy so the cancer cells do not show up again down the road.
Good news from a surgical pov – all the cancer is gone! is one of the last notes Marni wrote in my little black notebook. I will follow up with Dr. Cil in another 6 months and we will meet again in 2012 to check cancer has not invaded the other breast. Marni is extremely pleased with the meeting and feels confident I am in the clear. I’m glad one of us is staying positive because the other one is scared shitless with all the not knowing and trying her best not to think about it too much.
Marni asked me over lunch what I thought about the pathology report. I’m honest with her and tell her I didn’t like the sound of the 1 mm margin, I didn’t like the idea of having to meet with a radiation oncologist, and I didn’t like not knowing the cell receptor info. Everything about my breast cancer diagnosis, which sounded good, always backfired in the end. I went in for a lump we all believed to be non-malignant I ended up having 4 long needles pierced into my breast to reveal a cancerous tumour. It was originally supposed to be a lumpectomy, in the end they removed my breast. I wanted a “natural” breast reconstruction, I had to agree on inserting a tissue expander for my future breast implant. I cannot set myself up for disappointment again. I cannot be as hopeful as Marni, my family, and friends. I have to remain neutral or mentally prepare myself that radiation is still looming over me, which means it could damage the skin and muscle around my tissue expander which means the third surgery procedure, to remove skin from my back to replace the skin on my developing breast, may still happen. Cancer makes it extremely difficult for my psyche to stay positive.
Ed the other day, facebook chatted with me asking if I was feeling positive, my honest response was, “no, I’m never positive that’s why i leave (being positive) to my support system.” Marni reasoned, Dr. C truly believes radiation is not necessary, she just has to make sure by sending me to a radiation oncologist. In all honesty, I know Marni is right about Dr. C and I know sending me to a radiation oncologist is just a back up for Dr. C’s prognosis of, no radiation therapy.
I never have definite answers to share with you all, as you can read for yourself. The answers are beyond my control which, lucky for you, makes for excellent episodic reading material! It kind of guarantees you will be back next week to find out what happens. But in the interim, know I’m not keeping things from you or making you wait for my next post, on purpose.
Don’t worry, I will write soon enough. It’s just, sometimes not thinking about what happens next, I am able to enjoy the little normalcy I once took for granted.
So, be patient with my blog and please tune in next time for whatever comes my way.