I am a post surgery sloth

I am recovering from surgery. It is very slow. Or, rather I  am very slow. Moving slow (the heat doesn’t help this at all). Typing is actually quite difficult for me (it hurts some what, and the accuracy, well forget it. So I try to type a message here and there but I end up having to retype, back space etc. and it takes so long and it hurts so there you are, I don’t do it much at all. But, here it has been several days and no post from me. So here goes. I will correct my typos, but, don’t expect perfection.

So, everything is slow. But, I am doing my best to get back to my normal self. I just don’t have any energy and I an very impatient (apparently). I saw one of my surgeons today, she told me – of course you’re tired, you’ve been through a lot and it takes longer to recover from surgery if you have it after chemotherapy. I did know this going in, but I guess I didn’t fully appreciate what “expect to take longer to recover” from surgery really meant.

So here is my my update (lots of details are coming, stop reading at any point if it becomes just too much detail).

Pain – still having it, but it is lessening some for certain. Although I expect (but hope I am wrong) there will be more pain this Thursday as my reconstruction surgeon will potentially “expand” my breasts (my “new” breasts). This is done with saline injected into what they call an expander and voila – more boob is present. The expanders (one on each side) were placed during surgery. On Thursday my reconstruction surgeon may expand me. This was already done during surgery – once the expanders were placed, my reconstruction surgeon expanded the expanders with saline. So when I came out of surgery I already had a chest, pretty unbelievable. But, she could only expand a little bit and wants to do this process slowly so as to cause less stress (and pain, I hope) to my skin. I hear the process usually only takes a few weeks to do. But, in my case, because I had chemotherapy prior to surgery, she wants to be extra cautious and allow my skin ample time to heal. Therefore, I will see her weekly until she reaches the size that she wants (or, I guess that I want).

What’s next after “expansion” reconstruction wise: These are called “expanders”, not implants. I will get breast implants in the future. But, first expanders are used to expand your muscle and skin (especially if you have to have radiation as radiation can cause your skin to shrink – isn’t that lovely). Well, if you expand prior to getting radiation treatment, then you can still have breast implants of a size that you want and not be limited by skin shrinking from radiation treatment. At a later date a procedure is done called an exchange procedure. This is where the expander is exchanged for a breast implant. So, I have a little ways to go. But, in the meantime, visually no one will be able to tell the difference between how the expander looks or how the implants look. So, that is a pretty nice thing that they are now able to do.

So, I am mixed about my meeting with my reconstruction surgeon on Thursday – it will be great to be able to proceed with the “expansion” and make progress that way. But, it will cause some pain. But, maybe it won’t be so bad, at least that is what I am hoping. In any case, it will be one step closer to being done.

Pathology Report

My pathology report came back about four days after surgery. The results were not what I had hoped. (I had hoped for what is called a “complete response” to the chemotherapy – meaning that when they performed the surgery the surgeons would simply be removing dead cancer). However, there was still cancer left in my breast and in my lymph nodes. But, it does appear that the chemotherapy did kill a lot of the cancer (shrunk it). It is so hard to know though as MRIs are only as accurate as they can be and really the only way to know what you have going on is for pathology of all of the tissue.

Because I ask a ton of questions I had asked the specialist up at UCLA what if I don’t have a complete response to the chemo (most don’t by the way) and she said, “Don’t worry about it, you’ll be on Herceptin”. She did say that depending upon the pathology report, she might decide to keep me on the Herceptin a little longer (it just would depend upon how much cancer was left after chemotherapy. So I am looking forward to seeing her. I faxed my pathology report to her today and expect to speak with her soon about the results. 

Good news about the pathology report (excellent, excellent new actually) is that they re-ran two tests that confirm my HER2+ status. Both tests reconfirmed that my tumor was (as it is gone, out of my body – yeah!!!) HER2+.  But, not only did both tests confirm this, there are levels of being positive and there are two different ways of being HER2+. To keep this whole explanation short (I am tire and so are my fingers) the point of it is that I am high (3 out of a potential 3). Herceptin tends to work best the higher your positivity is – so being the highest is a good thing. The other test confirmed that I have something else that will also improve the likely successfulness of Herceptin with my cancer.

So, the recap of the above, pathology confirmed that at surgery there was still cancer remaining, the active cancer was removed – so it is now gone and I tested well for Herceptin likely being a very successful continued therapy for me. But, I will know more about this when I speak with the specialist up at UCLA. (As established in my prior posts, I do not have a lot of confidence in my current oncologist and have been seeing a breast cancer surgical oncologist up at UCLA. I will ultimately switch to her, but have to time that right.

Meeting with Oncologist NOT looking forward to meeting with my current oncologist. He is the guy who doesn’t read my file/chart etc. and is simply not invested in my care. I spend my meetings with him correcting him and catching him up on what has been going on, what treatment I have had so far etc. (since he can’t seem to take the time to actually read my file, i have to to update him every time. I find this pretty discouraging. Plus, he doesn’t even remember basic information about my cancer and even confuses me in the meeting with other patients who have other types of cancers. I usually leave my meetings with him pretty down for the aforementioned reasons and for others not worth repeating here. So say please say some prayers for me that tomorrow’s meeting is not somehow a positive one.

Appointment with Specialist at UCLA

As I mentioned above, I faxed my pathology report up to the specialist at UCLA. (Actually, someone faxed it for me, that’s how slow, tired and weak I am these days – it is temporary though). I am quite anxious to hear what she has to say about it and how she thinks we should proceed. I trust her and can’t wait to have here as my regular oncologist.

Okay, here are some pictures and then I am off to bed. Please keep sending messages, either here, via email or on facebook (yes, I went “public”, at least in a limited way). I love the messages and need them. Until I am better, my replies will have to be here as I am just not up to writing too much. Thank you for your prayers, please keep the prayers coming my way! The following pictures were taken four days before surgery at a family gathering for my Dad’s 80th birthday.