Zack and I are returned from our very rejuvenating vacation in New York. We're still digesting all of our NYC faves (pizza, Chinese, bagels, pretzels, pastrami, and, of course, a black and white cookie). We saw theater, movies, and museums - we are so full of culture we could be yogurt. Our very favorite moment: during the curtain call for Patrick Stewart in Macbeth (just as fantastic as it sounds), a guy to our left yelled "Bravo, Captain Picard!" Yay, trekkies!
So, here we are now at the watershed moment. Tomorrow will either be the first day of the pure prevention phase of my recovery, or it will be the first day of treatment for a new kind of cancer. I'm daunted by both options. On the one hand, I've gotten so used to being a full time patient that it will be strange to start making other sorts of plans. Sortof like being a Chicagoan in February - intrigued by the idea of spring, but skeptical that it could ever really happen. On the other hand, holy crap. Chemo, again. Radiation, again. Bucket day, again. Bald, again.
The craziest part, though, is that whichever way tomorrow goes, I know we can make it. We've got each other, our families, our friends, and a great medical team.
Zack will bring a computer tomorrow, and plans to post once I am out of surgery. If all goes well, I'll be home tomorrow night. For tonight, Zack and I are going out to dinner and celebrating. A little Italian, a little vino, a little fantasizing about the summer...nothing of consequence. Hey, we're still on vacation!
Sunday, March 16, 2008
Thursday, March 6, 2008
Left Field
Met with Dr W today (gynecological oncologist). Very sweet gentleman. He referred to my demographic as "ladies". Going into the appointment, Zack and I most wanted to understand a) what the heck is going on, b) what piece of the procedure moved from a laparoscopic surgery to an open surgery and c) is that piece of the procedure worth the additional recovery time and muscle damage.
Turns out, the only part of the procedure that cannot be done laparoscopically would be removing the omentum (a fatty layer over the colon). The omentum tends to be a common site for ovarian cancer to spread. Zack and I decided that since I would only need to have the omentum removed IF they discover ovarian cancer, we could put off that procedure. So we are back to a laparoscopic, day surgery. Drs H & W will remove my ovaries, fallopian tubes, and uterus, and do a series of washes of the peritoneum. Pathologists will then test the organs and the collected fluid for cancerous cells.
Here's where we veer into left field. Our entire assumption of why we are doing this surgery was - well, not off base, exactly, but missing a key component. Up to now, we thought we were doing the oophorectomy to remove the major source of estrogen in order to keep from feeding any colonists from the breast cancer. That remains true. In addition, though, my BRCA2 mutation carries an almost 50% risk of ovarian cancer, and a small risk of peritoneal cancer. So, what Dr W will REALLY be looking for next week is a brand new primary cancer. And, unfortunately, the chemotherapy agents effective against breast cancer don't usually work against ovarian cancer, so it could have been lurking for a while. Given my history, if they find anything even remotely funky, we'll be right back to the beginning. Scans, chemo, radiation, and surgeries.
Strangely, we aren't despairing over this news. I think we are so excited about being able to negotiate back to laparoscopic surgery that we haven't quite processed the other piece. It was definitely an "informed patient" moment. We also are living in such a left field world right now that new, bizarre risks feel pretty inevitable. Right now, the surgery is tentatively scheduled for Monday, March 17 (the day after we return from our vacation in New York).
Turns out, the only part of the procedure that cannot be done laparoscopically would be removing the omentum (a fatty layer over the colon). The omentum tends to be a common site for ovarian cancer to spread. Zack and I decided that since I would only need to have the omentum removed IF they discover ovarian cancer, we could put off that procedure. So we are back to a laparoscopic, day surgery. Drs H & W will remove my ovaries, fallopian tubes, and uterus, and do a series of washes of the peritoneum. Pathologists will then test the organs and the collected fluid for cancerous cells.
Here's where we veer into left field. Our entire assumption of why we are doing this surgery was - well, not off base, exactly, but missing a key component. Up to now, we thought we were doing the oophorectomy to remove the major source of estrogen in order to keep from feeding any colonists from the breast cancer. That remains true. In addition, though, my BRCA2 mutation carries an almost 50% risk of ovarian cancer, and a small risk of peritoneal cancer. So, what Dr W will REALLY be looking for next week is a brand new primary cancer. And, unfortunately, the chemotherapy agents effective against breast cancer don't usually work against ovarian cancer, so it could have been lurking for a while. Given my history, if they find anything even remotely funky, we'll be right back to the beginning. Scans, chemo, radiation, and surgeries.
Strangely, we aren't despairing over this news. I think we are so excited about being able to negotiate back to laparoscopic surgery that we haven't quite processed the other piece. It was definitely an "informed patient" moment. We also are living in such a left field world right now that new, bizarre risks feel pretty inevitable. Right now, the surgery is tentatively scheduled for Monday, March 17 (the day after we return from our vacation in New York).
Tuesday, March 4, 2008
Another Day, Another New Wrinkle
So, I got a call from Dr. H today. She's been conferring with a gynecological oncologist (Dr. W) about my case. Turns out, in people with my particular combination of genetics and aggressive cancer, a slightly more complicated surgery is necessary. I'll get more details on Thursday, when I meet with Dr. W. (The advantage to being an 'extremely high risk' case is that docs find time for you.) What we know now, though, is that the surgery will have to be abdominal instead of laproscopic and that my uterus is on the chopping block along with my ovaries.
I'm pretty unhappy about the whole thing. I'd rather not have an abdominal incision - recovery is much harder, and, well, to be honest, I'd rather not gain any more big scars. Not that I intend on showing up in a bikini anytime soon, but still. I'm also disappointed that yet another of my organs has turned into a dangerous sleeper agent that must be removed for my safety. And the timing, frankly, sucks. I'd intended this to be a time of healing and celebrating. Instead, I'm feeling sucker punched.
More details Thursday.
I'm pretty unhappy about the whole thing. I'd rather not have an abdominal incision - recovery is much harder, and, well, to be honest, I'd rather not gain any more big scars. Not that I intend on showing up in a bikini anytime soon, but still. I'm also disappointed that yet another of my organs has turned into a dangerous sleeper agent that must be removed for my safety. And the timing, frankly, sucks. I'd intended this to be a time of healing and celebrating. Instead, I'm feeling sucker punched.
More details Thursday.
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