Met with Dr. H yesterday about the next round of surgery. She says it is a very straightforward laproscopic procedure, so the recovery time (pain and movement-wise) should be quite short. She did warn that, particularly with everything else I have been through, I will probably need a good month to recover from the surgical fatigue. More - ahem - exciting will be the instant onset of full-blown menopause. I got a taste of it while on chemotherapy, but the surgery will bring on the real deal. I am not looking forward to it by any means, but it has got to be better than chemo.
Dr. H will coordinate with Dr. B to make sure there isn't anything else she needs to do while we're in there, then get the procedure scheduled for the next few weeks. In some ways, I feel like a car. "Hey, Cooter, ya wanna throw in a new valve cover gasket while you're in there? Save me the price of the labor in 20,000 miles..."
So, to sum up: outpatient surgery, fully anesthetized, laproscopic, month of recovery.
Friday, February 29, 2008
Wednesday, February 27, 2008
From Treatment to Prevention
The appointment went well. The team at Dr. B's office oohed and aahed over my new hair, and were - of course - thrilled to see Zack. I even got to see my chemo-buddy, which was an extra treat. Dr. B says my radiation burns don't look fabulous, but are within the bounds of normal so not to worry.
Surgery:
No major surprises, just some tweaks. The surgery to remove my ovaries needs to happen ASAP, rather than in May as I'd planned. So, we're trying to get it scheduled for the week after we return from vacation. On the positive side, Dr. H can probably do the surgery. Zack is excited to meet her, as he credits her with saving my life. By working her personal contacts, Dr. H bustled me into the offices of Dr. S and Dr. B within a few days of my visit with her. Without her direct intervention, that process could easily have taken a month. A month, it turns out, I didn't have.
Drugs:
I start Tamoxifen tomorrow. I'll take it until the surgery, then switch to an aromatase inhibitor. I also start calcium & vitamin D supplements, since both early menopause and the AIs tend to increase bone loss. So, osteoporosis is the newest item on the list of things to worry about. I figure this gives me all the justification I need to eat Cabot's cheese by the brick and drink lattes all morning. There's calcium in butter, right?
Monitoring:
I'll have checkups every three months to check for any possible cancer recurrence. Any new tumors would be most likely to grow in my bones, liver, chest wall, or lymph nodes. Although the evidence is mixed on their utility, Dr. B and I decided to go ahead and test for blood borne tumor markers. The problem is, the tumor markers often spike without the doctors being able to find an actual tumor anywhere. However, a tumor marker spike does throw up a red flag, and in the best case scenario this could give Dr. B a three month head start finding for a new cancer. Based on the incredible growth rate of the first cancer, Dr. B wants every time advantage she can get, as long as I am willing to live with the potential for unnecessary anxiety that false positive results could bring. (we are.)
Other than that, Dr. B wants to do symptom-triggered scans, rather than have me do CTs every three months. She feels that I will pay close enough attention to know when something feels strange, and she'll do careful checks whenever I see her. She'll use regular bloodwork to check up on liver function and my other organs.
Summary:
We're living in a coin toss world. Think tails!
Surgery:
No major surprises, just some tweaks. The surgery to remove my ovaries needs to happen ASAP, rather than in May as I'd planned. So, we're trying to get it scheduled for the week after we return from vacation. On the positive side, Dr. H can probably do the surgery. Zack is excited to meet her, as he credits her with saving my life. By working her personal contacts, Dr. H bustled me into the offices of Dr. S and Dr. B within a few days of my visit with her. Without her direct intervention, that process could easily have taken a month. A month, it turns out, I didn't have.
Drugs:
I start Tamoxifen tomorrow. I'll take it until the surgery, then switch to an aromatase inhibitor. I also start calcium & vitamin D supplements, since both early menopause and the AIs tend to increase bone loss. So, osteoporosis is the newest item on the list of things to worry about. I figure this gives me all the justification I need to eat Cabot's cheese by the brick and drink lattes all morning. There's calcium in butter, right?
Monitoring:
I'll have checkups every three months to check for any possible cancer recurrence. Any new tumors would be most likely to grow in my bones, liver, chest wall, or lymph nodes. Although the evidence is mixed on their utility, Dr. B and I decided to go ahead and test for blood borne tumor markers. The problem is, the tumor markers often spike without the doctors being able to find an actual tumor anywhere. However, a tumor marker spike does throw up a red flag, and in the best case scenario this could give Dr. B a three month head start finding for a new cancer. Based on the incredible growth rate of the first cancer, Dr. B wants every time advantage she can get, as long as I am willing to live with the potential for unnecessary anxiety that false positive results could bring. (we are.)
Other than that, Dr. B wants to do symptom-triggered scans, rather than have me do CTs every three months. She feels that I will pay close enough attention to know when something feels strange, and she'll do careful checks whenever I see her. She'll use regular bloodwork to check up on liver function and my other organs.
Summary:
We're living in a coin toss world. Think tails!
Nerves and News
So, we leave in a few minutes for my post-radiation "so now what" appointment with my oncologist (the much praised Dr B). Before I came down, I found myself dithering about lipstick, and what to wear. I even tried to brush my hair. (For the record, half an inch is still too short to brush...or even to do that brush it all forward and make the front stand up hairstyle that has been popular among my students. The male ones.) I caught myself doing my nervous routine and laughed. Do I think my prognosis will be better if I look better? That I can somehow get out of the next steps if I just look healthy enough? Ah well, we all need these reminders that human logic doesn't always correspond to cold logic.
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