31 March 2011

Time for something else to panic about!

Now that I can shower every morning for as long as I want, I can also go to work. Just going outside is amazingly pleasurable after being stuck on the couch for three weeks. Seeing other people, well, I certainly won't be complaining about that added bonus.

The only problem? I'm still stuck in sports bras for 24 hours a day. They make my back itchy, which is particularly not useful when I can't even scratch the normally accessible areas. And while I am absolutely ecstatic to have the damn drain out, the superfluous hole is taking its sweet time to heal. The area under the steri-strips is constantly begging for a good scratching. But Matt won't let me because then it'll never heal. Stupid epidermis.

Now for the news you all have been waiting for - test results! From the initial biopsy, I already knew that the tumor was positive for estrogen and progesterone receptors. This is good in that the tumor likes hormones, so denying it hormones is akin to starving it. Then came all the imaging, which determined the cancer to be an in situ ductal carcinoma with left axillary lymph node involvement. After the surgery, which provided a much better look at the stupid thing, the initial report found cancer cells in only one lymph node out of the twenty-two removed. That's the best possible result when they know at least one lymph node has been affected. Now, here's where it gets interesting.

There are two tests run for HER2, a protein associated with faster growth. One checks for extra copies of the gene that creates the protein, the other checks for the proteins themselves. The initial report had one positive test and one negative test. Since that is only very contradictory, the pathology department decided to run both tests again themselves, as well as to send it out to a third-party lab for independent confirmation.

Waiting for test results under the best of circumstances can be nerve-racking. These results would only determine how many weeks and the type of chemotherapy to which I will be subjected. Negative means twelve weeks and I'm done with chemo and radiation before the wedding. Positive means, well, I can't finish before the wedding date. Nothing big.

Dr. Oncologist expected the results by Wednesday, approximately a week after she explained the situation. I went berserk until she finally called after 8:00PM on Wednesday. The official report was not ready yet. However, a nurse friend took a look at the handwritten and unsigned lab report on the pathologist's desk. Negative! Huzzah! But I shouldn't celebrate until the official report comes back with results from the other lab. Me? Celebrate early? I would never.

Okay, some more waiting. But at least I had the answer, even if it was handwritten and unsigned. Or at least until I got another call from Dr. Oncologist, that is. Apparently a certain nurse was in trouble for misinterpreting handwritten and unsigned lab reports on the pathologist's desk. The actual results were... heterogeneous! Not only am I ridiculously young for breast cancer, I have the ridiculously uncommon version!

Some poor lab tech actually had to sit there and examine each cell in the tested sample. He determined that 42.5% of the cells are HER2 positive, while the remaining 57.5% are negative. Well, fuck.

HER2 positive is good in that there are well-known courses of treatment. Somehow that didn't make me feel any better about the 18 weeks of chemo in my near future. For those of you without a calendar, that takes me through mid-July. Even with an aggressive schedule, it would be physically impossible to finish radiation before our wedding date. Excuse me while I go cry some more.

But wait! Apparently radiation is the least important step in treatment. It can be delayed for six weeks without additional risk! And since nearly two months is more than the necessary three to six weeks to recover from chemo, I'll be fine come mid-September! THE WEDDING IS OFFICIALLY ON!

25 March 2011

Step two is official over!

If step one in cancer treatment is to irradiate the patient by every means possible, step two is to remove all the offending cells. In my case, this consisted of the tumor in my left boob and an icecream scoop worth of lymph nodes in my left armpit. Then, instead of giving it to me take to the bomb range, the tumor is cut into cross sections, placed on slides, and further tormented by a trained pathologist. Though my method of examination is more satisfying, the pathologist's report is more useful.

Meanwhile, after a night in the hospital with loyal Matt by my side, I was left with two incisions and a drain dangling from my inside my armpit. Both incisions were closed with dissolving stitches and steri-strips, while the superfluous drain hole merely had a drain sewn into it. Normally, the steri-strips, which are basically strips of medical-grade packing tape, come off on their own. However, due to a certain drain, I wasn't allowed to shower, bathe, or look at a picture of a pool. Without water or normal activity, the steri-strips stayed attached as I became stinky.

In case the lack of proper hygiene wasn't bad enough, the drain was annoying and painful. And that doesn't even take into account having to constantly measure and dispose of that which was draining out of me. When asked how I was feeling, I came up with quite a few colorful descriptions to impress the proper level of horror upon unsuspecting individuals. But that is no longer the case as, after seventeen days of pure agony, the drain was removed this morning!

After snipping the stitches holding the evil tube in place, she yoinked it out. I would like to point out that I did not scream at all during the procedure; I patiently held it in until the surgeon's underling finished yoinking. She also removed the steri-strips, allowing the world a first look at the damage. My underarm is still a bit swollen (thank you stupid drain), so I can't guess as to the final result there. The dumb boob is looking fairly decent, though slightly misshapen. While definitely not its original shape, it is certainly within the natural epsilon.

If I was excited going into the hospital, then I must have been skipping on my way out. Or at least as close to skipping as I could get without causing any boob bouncing. Not only was the dreadful drain but a distant memory, a proper shower with soap and everything was in the near future!

That shower was pure bliss. At least, it was pure bliss until the hot water heater stopped providing deliciously hot water. Then, after drying off, I put on my first clean bra in forever. My skin in the bra coverage area will require some more time to completely recover, but I don't care. I'm clean!

24 March 2011

The horrible drain is being removed tomorrow morning!

Anybody who has been within reasonable proximity of me post-surgery has heard me complain quite loudly about the bane of my existence, the drain. And it is being removed tomorrow morning! I have never wanted to go to the hospital so badly in my entire life.

Hooray!

Bald is stupid

Since the onset of doom, I've been fixated on the impending loss of my hair. I <3 my hair. It's long, thick, and the perfect shade of red-brown. Whenever I get it trimmed, half the salon stops by with felicitations. Though I usually pull it back at work, wearing it down always bring admirations from my adoring public. Speaking of adoring, a certain fiance has a tendency to worship my copper tresses.

Now I'm facing the complete loss of all my hair. While not having to shave my legs is by no mean unwelcome, I'm mortified at the idea of being bald. I've asked every doctor if there is any chance of my hair not falling out due to chemotherapy. There are some courses which have lower incidences of depilation, but the odds of one of them being appropriate have approached zero.

My first thought was to have a wig made out of my own hair. It's way past long enough, and there is a more than adequate supply. With this is mind, I went to a custom wigmaker to find out more about it. For a mere $2400, he'll turn your hair into a wig made to the individual characteristics of your own head! If you bring in a prescription from a doctor, he'll do it tax-free as it becomes a medical supply! Compared to the cost of everything else cancer related, that's a drop in the bucket. A barely covered by insurance drop. Perhaps I should think about it?

There are benefits to synthetic wigs, namely cost and ease of care. Human hair wigs, however, look much better and, with proper care, last much longer. Custom wigs, not surprisingly, look the best. As of now, I'm planning on getting a custom my hair wig, because I know that it is the only way I will be truly happy, or at least not completely miserable, with the lack of hair situation. I will also be getting a couple of much cheaper synthetic wigs to cover me during the three weeks it takes to make the wig.

Even with the custom wig, which is certainly the best option in a crappy situation, I don't want to lose my hair. Perhaps I can just cover my scalp with a layer of super glue before the first round of chemo?

23 March 2011

Who wants gory cancer details?

I do! But the doctor hasn't called back with the final test results. If only it was a useless test, but no, it had to be way totally important. Since I don't know the verdict, I can't accurately answer questions, so you'll just have to wait another day or two. Or three if the lab wants to see my head explode.

In the mean time, what do you think the first thing doctors do as soon they suspect cancer? Why expose you to every type of medical imaging radiation available! I can only assume this is to create a tumor on the off chance that none previously existed. At this point I've been put through, in no particular order, multiple ultrasounds, multiple mammograms, a chest X-ray, a breast MRI, a full-body bone scan, a PET scan, and two CT scans.

Until disaster struck, I had no idea that ultrasounds were done with anything but that little supermarket scanner things. I was much happier that way, as the alternative is an eight inch wand. They cover it with a rubber prophylactic and a gallon of jelly, then shove it your special parts. Don't worry, it's just as uncomfortable as it sounds.

The MRI was just bizarre. There's a body size pillow with two boob-sized holes in a reasonably appropriate anatomical position. Assuming your boobs are two feet apart. It was a rather weird feeling to me lying down on my stomach with my boobs dangling.

A full-body bone scan requires two! appointments. The first involves a nurse and a prefilled glass syringe in a thin metal sheath. While the sheath was a bit unusual, the lead box labeled "CAUTION: RADIOACTIVE" was a bit more worrisome. Except the liquid was clear! Who puts clear liquid in a lead box? Everyone knows it's supposed to be bright green! How else could it properly irradiate?

Now, someone make the phone ring!

The second appointment was a mere three hour later, at which point I found myself in a large machine that claimed to detect gamma rays. The best part? I was allowed to keep my clothes on! The second best part? Once my head was scanned, I enjoyed a lively debate with the technician. As opposed to lying dead still in an unnatural position for a half-hour.

For the bone scan, the metal sheath was removed prior to injection. For the PET scan, the needle remained encased in three centimeters of what was presumably lead. That didn't prevent me from ascertaining that this liquid was also clear! I had no choice but to assume that the lack of color meant I could safely ignore the warnings about avoiding pregnant women and young children.

The doctors have also taken about twelve liters of urine and seven thousand twenty-eight liters of blood. It's better to take blood from the arm farthest from the dumb boob, so my right arm is covered in track marks. When the nurse took blood last time, he actually had to exert effort to find an unperforated area . But on the plus side, I'm getting used to the prickling sensation!

20 March 2011

It's ALIIIIIIIVVVVVVVE! Useless.

If you're me, the first course of action is to name the tumor intent on ruining your life. The second is to call your mother with this important update.

"I named the tumor Buffy Junior."

"Why?"

Hysterical laughter erupted from both my dad and myself.

Around five minutes later, my dad regained enough control to query, "What did you name your tumor?"

"Uh, I don't remember?"

"Seriously, mom? BUFFY! You even had it printed on a t-shirt!"

"Oh yeah. Residual chemo brain."

Great. Something else to look forward to.

Around the same time, I started visiting every doctor in the known universe. Assuming that the known universe consisted of St. Johns Hospital and its environs. The good news was that I found some very good doctors. The bad news is that I found Dr. DoucheNozzle along the way.

My new-found set of doctors assured me that I would survive this Stage 1 mess. Except for the surgeon Dr. DoucheNozzle, who was too busy with the pole up his ass to show any compassion. Needless to say, I found a different surgeon. But, for those of you interested, here's the story of Dr. DoucheNozzle.

First let me say that Matt has been absolutely amazing, which includes chauffeuring me to any and all doctor appointment. In other words, he was there the entire time and witnessed every one of these atrocities.

The appointment started off normal enough, with the doctor on one side of his desk and Matt and I on the other. He was going through my medical history, asking questions. Then the phone rang. He not only answered it, but started discussing another patient right in front of us. HIPAA anyone? Strike one.

"Who diagnosed you with OCD?" A perfectly valid question. Except his tone of voice was accusatory. I replied that I'd been seeing various psychologists since high school, though I wasn't official diagnosed until college. "Uh huh." Clearly he didn't believe me, despite the prescription medication I indicated on the 8019 page form his secretary had faxed* to me the day before. Strike two.

Examination time! This time I was given the top half of a gown, which is also know as a shirt in the non-medical community. Despite having handed me the "gown" himself, Dr. DoucheNozzle practically tore the thing off of me as soon as he was in the room. Admittedly, I wasn't a big fan of the useless paper thing which would just get in the way of the examination. Ball one?

After jiggling and poking to his heart's content, the doctor asked me to lie down for further jiggling and poking. He may have used more clinical terms. I guess my boobs weren't enough for him, because, without any warning or explanation, he unzipped my pants and continued poking! If Matt wasn't in the room, I probably would have screamed. Strikes three through eighty-seven.

When I explained what happened to the doctors that recommended him, they were very surprised. When I told my dad, he got angry. And you wouldn't like him when he's angry. Problem solved.

* Don't get cancer without a home fax machine. Every doctor has a completely different medical history form that you need to spend hours filling out before your appointment. And not one has heard of email.

17 March 2011

Fun with cancer! And other miserable happenings!

I have breast cancer. No, really. I am 100% completely serious.

After the official diagnosis, I spent the first two weeks avoiding telling people during the occasional moment I wasn't at the doctor. During this time, I discovered that a) ignoring cancer doesn't make it go away and b) my mom is perfectly willing to nag me into telling people. Some people I've told myself, others have already heard second hand. Some people I haven't told at all because there are only so many times that I can relay my story. And so we come to my public announcement.

I'll start at the very beginning, back in The World Isn't Ending Land. My mom had breast cancer, so in late December, when I discovered a lump in my left breast, heretofore referred to as "the dumb boob," I was a bit worried. Mom said I should check with the doctor, just in case. With everything else going on, I didn't get there until late January, at which point my gynecologist said that it was most likely fibrous tissue. However, she sent me for an ultrasound, just in case.

A little over a week later, I found myself topless and gooey, with an ultrasound technician examining me. She confirmed that there was definitely something there, then left to get the radiologist. The radiologist did some image reading, some examining, and some poking. At this point I started worrying, but the panic didn't set in until she left the exam room to call my doctor for permission to do a mammogram and biopsy.

The mammogram came first and was merely uncomfortable. The core biopsy, well, that hurt like hell. Even the anesthetic injection was incredibly unpleasant. After that, the lymph node biopsy seemed like a gentle massage.

What was supposed to have been a half hour imagining appointment turned into a 3.5 hour marathon in the part of the building without cell reception. Let's just say that more than one person was wondering what happened to me. But I survived! And somehow I managed to drive home, an act made even more miraculous by the fact that my car is a stick shift. Not to mention the icepack taped to the dumb boob. Per doctor's orders, I immediately flopped down on the couch and only got up for icepack-related activities.

The imaging and poking was done on a Wednesday. Someone in pathology was busy twiddling thumbs as my doctor called on Friday to say that she hadn't heard the results yet. Clearly someone was whipped into shape over the weekend, enabling my doctor to call early Monday morning with a Valentines Day present: cancer! Yay!

And then everything sucked.

07 March 2011

Warning: Horrible Pun Ahead

I was in The Gap with my mom and Zero, when I came across an unprotected pricing gun. It was just lying there on the table! No one guarding it! Ergo, it was totally NOT my fault when I picked it up and started making tags. The end result?



Do these come in blue with lapels?

It's barely legible, but the tag reads "0.00". In other words, it's a Zero Price Tag!