Post Surgery, Staging, and Chemotherapy

2014-02-25 20.01.03

February 5th was my first post-op appointment with the surgeon, who, along the way, has proven to be the rock star amongst surgeons in my area.  Everyone, from the primary care physician who referred me to her, to all the other doctors, technicians, nurses, therapists, and on and on, had the same rave reviews. I was, indeed, in the best hands.  I heard, over and over again, that she is the first doctor they would choose if they had to go through this.  I mentioned this and thanked her.  In her modesty, she pointed out that the team surrounding her is what makes her so successful.  Anyway, thank you, Dr. Tjoe and your fabulous team.

The appointment went well.  I am feeling strong and healing well.  We reviewed all the usual stuff – medical history, allergies, current medications, vitals, etc.  Although, I’m not sure why we still do this.  After 25 or so appointments in the last month, I’d say it should all be current and up to date by now.  It’s rather like re-introducing yourself repeatedly to a dear, old friend.  I considered changing it up, just to see if anyone was actually paying attention, but decided against it.

Anyway, we then reviewed the pathology report, clarifying some details that I didn’t pick up in the phone discussion.  I now know that my breast cancer is a stage 3A.  Staging is far more complicated than I ever imagined, only determined post surgery with the facts from the pathology report.  It is based on the primary tumor size, lymph node involvement, and whether the cancer has metastasized, or spread, to any other organs.  T (tumor) N (Node) M (metastasis) scores determine the stage of the cancer.  My tumor was a scale-busting 9.5 cm, there were 5 cancerous lymph nodes, and, thankfully, no sign of cancer elsewhere in my body, based on the numerous tests and scans which I underwent prior to surgery.  The end result – my breast cancer is a T3N2M0, or Stage 3A.

With this information in hand, I strolled down the hall, clad in my stylist hospital gown, to meet with the medical oncologist to discuss the next step on this journey.  Once again, reviewing my  history, allergies, current medication, vitals, etc.  Really.  It is all conveniently and electronically on hand in each exam room, so I find it redundant in that unnecessary sort of way.  I have always dotted Is and crossed Ts, so I suppose I appreciate the thoroughness of it all.  Yet, I digress.

Originally, I was told I would recover for a month after surgery before starting chemotherapy.  Apparently, my strong attitude and healthy body made them decide that my recovery is far enough along and they want to start chemotherapy next week, just over two weeks after surgery.   Wow!  I’m not entirely sure I was ready for that.  I had thoughts of a short pre-chemo road trip, pre-chemo margaritas out with some friends, and pre-chemo fun with the kids.  Pre-chemo running away from home even crossed my mind, but friends suggested that it might be a poor choice….

So, Chemotherapy.

But first, a couple more tests just to be sure my body actually is ready as opposed to my strong-will simply putting on a front that it’s ready.  Next week’s visits include an EKG, to make sure my heart is stronger than my head (some might argue that I am strong-headed, stubborn, or, as I now intend to call it, thanks to Dr. Tjoe’s suggestion, full of grit and determination), blood work, physical therapy and a first saline injection into the tissue expander.  The regiment my oncologist wants to go with is called TAC.  It is a combination of three chemotherapy drugs.  If I clear the hurdle of this next round of tests, I will have my first round of chemo on Wednesday.  It will involve a 4 hour visit, with the drugs dripping into the convenient and creepy “port” which I now have protruding just under my left collarbone.  I’ve affectionately called it my “port into another world”, but I’m not convinced I’m going to be a fan of this other world made possible by my “port”.  The following day I return for a shot, whose intended purpose is to minimize the side effects of the chemo.  I wonder if a shot of tequila might also do the trick…