It's B-Day . . .

It's 12:30 and I'm due at Good Sam at 11 am.  I'm a little nervous.  Wish me luck.  A lot of it.  Will write again when I've been de-lumpified.  

It's been a while . . .

. . . because I've been traveling while trying to find out what's going on at the same time.  Now I'm back, and have a better idea of the plan.  Here's the latest:  My lumpectomy is on Tuesday, the 28th.  I head over to Good Sam at 11 am, where they'll put me in the Short Stay Unit, make me put on silly hospital clothes, run a bunch of tests and do some things to prep me for the surgeon.  The two biggies are an injection and a guide wire.  First, they will give me an injection that's a mix of a blue dye and a radioactive material.  The radioactive material and dye will go into my lymph system so they can find what are called the sentinel nodes--more about that later.  Second, they'll insert a guide wire into the side of my breast.  This won't be too bad, as they can get me numb pretty easily.  When they did the biopsy, they left a speck of metal where they were taking samples; that makes it easy to find the area again if the biopsy is positive.  So, using ultrasound to find the speck, they will insert a wire right to speck.  The wire will guide the surgeon so she doesn't have to dig around.  

At about 3 PM they'll take me to the operating room, knock me out, and Dr. Johnson will do the lumpectomy.  While I'm on the table, she will do three things.  First, she'll take out the tumor itself.  Second, she'll perform a sentinel node biopsy.  According to WebMD, "Sentinel node biopsy is a . . . way of pinpointing the first few lymph nodes into which a tumor drains (called the "sentinel" node). This helps doctors remove only those nodes of the lymphatic system most likely to contain cancer cells. The sentinel nodes are the first place that cancer is likely to spread.  In breast cancer, the sentinel node is usually . . .under the arm. . .  If the sentinel node is positive there may be other positive lymph nodes upstream. If it is negative, it is highly likely that all of the upstream nodes are negative."

The dye and radioactive material injected earlier go into the lymph system along the same route that the cancer cells would go (if they've spread), and highlight the sentinel nodes.  Dr. J  will be able to just remove the one or two sentinels and send them to the lab--while I'm still on the table--to see if she needs to take more nodes or not.  Given the kind of cancer I have, and how new it is, it is highly unlikely that it's spread.  

Third, after Dr. J is done taking things out, she'll put a balloon in where the tumor was, with a tube leading to the outside.  Then they'll patch me up, move me to Recovery where they'll monitor me as I come out of the anesthetic, and listen to me beg for ice chips.  At that point I will have been without any water for 9 or 10 hours.  Once I'm stable, they'll move me to the oncology unit on the 6th floor where I'll spend the night.  

Wednesday morning they'll do a scan of my left boob to make sure the balloon is positioned right for the radiation treatment, and then they'll send me home.  

I have Thursday off ;-).  

Friday at 7 am I take some meds for anxiety and pain, and at 8 am I go to the radiation oncology area at Good Sam.  This is a little ookey--and the reason for the anxiety and pain meds.  Dr. Lee, my radiation oncologist, will take out the balloon Dr. Johnson put in my breast and insert another one.  The one Dr. J put in was just a placeholder; the one Dr. L will insert is designed for the radiation treatments.  It's a balloon (that will be filled with saline) and an inner tube that's like a straw with one end sealed.  The inner tube is dry and is where they insert a wire with radioactive "seeds."  Then I'll have my first radiation treatment: a machine inserts the wire with the seeds and, 20 minutes later, takes it out.  I go home, and at 2 PM go back for another treatment.  Then I get the weekend off.  Most people don't have any side effects from this type of radiation because it is so localized and the treatment time is so brief.  It is a good idea for me to make sure I get plenty of rest and good food during the treatment--but that would be a good idea for the recovery from the surgery too, so . . . 

Monday (we're now at May 4) I go for radiation treatments at 8 AM and 2 PM, and do the same Tuesday, Wednesday, and Thursday.  At the second appointment Thursday, they take the balloon out and I'm done with radiation.  

While all of this has been going on, my tumor has been shipped of to a lab that analyzes the DNA and advises my oncologist, Dr. Orwoll, what my chemotherapy should be--which drugs, how often, how much.  We should get the results from the lab at about the same time that the radiation therapy finishes up.  No idea what the chemo will be, or what the side effects will be--but I'll keep you posted!

Final bit of news on the medical front:  Dr. Orwoll ran a truckload of tests on me, and one of them was a Vitamin D level.  Turns out my level is about one-quarter of what it should be!  Vitamin D deficiency may be related to a host of conditions, from MS to diabetes, cancer to thinning hair.  One of the clear links is osteoporosis: you need D to process calcium, and if your D is low . . .so next time you see your doc, ask for a Vitamin D level.