May 07 2010

Cancer Chronicles : Vigil Week (bare bones version)

Published by at 2:49 pm under falling down,health,me vs. cancer = I win

(continued from this entry)

This is a hard week to write about. Hard to think about, too. This is the week I was literally dying, incrementally and tangibly. We’ll probably revisit this time once or thrice before we’re done.  For now, just the facts, ma’am.

We meet with the surgeon in charge of my surgery, a brisk but competent-seeming guy (Dr. Uecher – gotta check spelling on that one) who is willing to be asked and answer our many questions.  He does his duty in describing the options that are normally explored with malignant breast lumps, but agrees with our assessment that in our particular case, it is surgery first and ask questions later given the nature and size of the swollen left breast. We also receive the official diagnosis of breast cancer (invasive ductal carcinoma) in this visit, and report to the doc that the lump the first specialist originally palpated in the right breast hadn’t been further examined by anyone since, and I’d noticed in the last week it had started to hurt similarly to the other breast pain.  He looks irritated at this and gets a sonogram machine brought in so he can scan the right breast and get pictures of that.  (So far we haven’t managed to get our hands on a copy the ultrasound pictures, but we think we will soon.)

After the scan, he announces that he’s concerned about this lump too, so we agree that they both should come out.  He tells me that I will be scheduled for a modified radical mastectomy on the left side, as it is so swollen and we know so little about it that they plan to take as much of the affected breast tissue as is needed — up to all of it — as well as the nipple, all of the lymph nodes feeding to that area, and enough surrounding tissue to test clean.  I ask if they are going to have to take the muscle, and he tells me honestly that he doesn’t know.  They can’t tell how far into the chest wall the tumor extends, based on the pictures, and given the size he isn’t all that confident that they won’t have to cut deep.  They inform me what I already know from research, that if they have to remove some or all of the muscle I will have permanent crippling effects on arm mobility.  On the right side the lump is much smaller, and he feels confident he can get away with a lumpectomy (which he calls a partial mastectomy for precision’s sake) and possibly only one lymph node removed on that side.  They leave the room to consult and find out when my surgery can be scheduled.

They return shortly and tell us that it is scheduled for Wednesday March 24, only 6 days away.  The speed of the surgery scheduling is directly related to their concern about the tumors, especially the left one.  They decide that I can’t safely be drained further before the surgery, so I have to deal with feeling myself slowly inflate again over the coming week.  They describe how it will go: after surgery prep, they’ll first remove the sentinel node for the right breast (the main one that drains the breast) and flash-biopsy it to see if the cancer on the right side has spread to the lymph node.  They’ll get the results of this back while still in surgery, so if it tests clean they won’t remove any more lymph nodes from that side. While they are testing that they will get to work on the left breast, removing all of the stated areas, then finish up by removing the lump on the right side.  They will flash-biopsy the surrounding tissue after removing the tumors and cut more tissue away on any questionable areas until the slides show clean non-cancerous cells, then remove a tiny bit more of the clean layer to try and minimize the chance of cancer returning.  I’ll have side drains installed, possibly on both sides, to deal with the excess fluid production.  They estimate only an overnight hospital stay, assuming no complications.

They ask if we want them to go ahead and install the catheter port for the permanent site for needle sticks in my chest that they have to put in chemotherapy patients.  I say we want to get through the surgery and learn more about what the heck is actually going on before we make a firm decision about chemotherapy, and they agree the port cath can be done as a separate day surgery if or when it’s needed.

We enter a very trying wait, pre-surgery.  Externally, I make sure the important things get done that need to before I’m put under – last will and testament, medical power of attorney, durable power of attorney, last wishes reminded to the people who needed to know them.   Friends ask what they can do to help and all I can ask for is “shared time”; the people are the only thing still keeping me here at this point, because internally this week, the lights are going out one by one.  I can actually feel myself dying, feel the cancer growing (it did increase in size from the first scans to the surgery), feel my connections to everything I care about life and the loved ones around me becoming harder and harder to hold and touch.  My color melts away from my face and I am a ghost still walking and breathing.

Four days before the surgery I had a sharp internal downward turn, and spent most of the day asleep trying to get enough energy to fight for just a few more days.  The last few days pre-surgery, our house was never empty as a stream of friends and family came to share their time and their love and their energy with me in what had to be a scary time for all involved.  I got calmer and calmer even as I grew more distant from life and the world.  The last three days, I could tell that it was only my strength of will COMBINED with the physical presence of all our guests that allowed me to make it through to surgery day still breathing.

I am 32 years old.

And that’s a good place to pause the accounting, in quiet thanks for all of you who made it possible for me to have enough extra energy to keep up the fight.  Next time, we’ll learn about surgery and the absolute worst area of the hospital — the Recovery Room.

(to be continued)

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