Friday, June 10th - Meeting with the Oncologist

I love my oncologist!  Kind of a funny statement, I know, but she truly is a gem.  Her name is Dr. Tiffany Svahn and her office is in Pleasant Hill, over near the Sun Valley Mall.  I had heard wonderful things about her from several of her patients, so when I found out she was the oncologist I would be working with I was very pleased.  Lucky for me, all the things they had told me about her were true.  She is a very caring, compassionate doctor and is a specialist in treating breast cancer.  And yes, she is younger than me. :)

Dr. Svahn confirmed the two pieces of good news we got yesterday - one one lymph node was affected with cancer, and the cancer inside the breast was estrogen receptive.  Yes, these are both good things but unfortunately it means the game is TOTALLY changed.  That one, stinkin', diseased, cancerous lymp node they found beneath my armpit essentially changes EVERYTHING.  Yes, to look on the bright side, I am happy that it is only ONE cancerous lymp node, but its presence changes everything.

Because it was only one lymp node found, she suggested not having a PET scan.  Usually patients with 4 lymph nodes affected or more are advised to have the PET scan.  I am fine with that.  But now the game changes from having Stage 0 cancer to having Stage 2 cancer (again from that one stupid lymp node).  That's a big jump.

Next step in my treatment - Chemo.  I am bummed, because chemo was my ultimate fear with all this (honestly, even moreso than having the bilateral mastectomy surgery).  Mainly because my kids will surely be affected by seeing me with no hair, but unfortunately I have no choice in the matter.  I'm just gonna have to rock a stylish wig, I guess!  It's fairly ironic because my hair now is the longest it has ever been.  Oh well.  I will have 16 treatments of chemo over five months.  My treatment will start probably July 1st and I will have a chemo treatment every two weeks (for the first two months), and then I believe every week for the next three months.  I'm trying to schedule the appointments so that I can still do our annual summer vacation in Tahoe...surely, I am not going to miss THAT due to cancer!  The hardest part over the five months will be the first two months; that's when the most powerful drugs are administered (the chemo is called dose-dense chemo).  So that means that my July and August will not be my happiest of times!  But my September, October, and November should be better.

Chemo essentially involves sitting in an office hooked up to a port (in my skin) where they administer the medication over 2 or 3 hours.  Dr. Svahn said I will probably feel fine the day it is administered, but the two or three or four days following I will be extremely tired and maybe nauseated.  She said they do try to give you a drug cocktail to help alleviate these symptoms, but to expect a rough road.  She suggested shaving my head/hair before it starts falling out on its own (she said that can somehow be LESS disturbing to women rather than losing it in chunks...not sure how that could be?!).  Yuck!  I'm gonna have to get some cool bandanas and rock that look for awhile, I suppose.

The survival rate after my bilateral mastectomy and chemo treatments will be 87%...I'll take it.  That number will possibly go up if I also choose to utilize hormone therapy (see my paragraph about Tamoxifen below).

So that all being said, next week will be busy with appointments for me.  I have a huge "to do" list.  First stop early in the week will be Dr. Wotowick's office to have my drain tubes removed...woo hoo!  This could not happen soon enough, believe you me.  These damn tubes are extremely uncomfortable and I cannot wait to have them gone.  Next, I have to schedule an appointment with Dr. E to have a port put in my chest area for the chemo...evidently it is an outpatient procedure and not a big deal (yay, for once, something is not a big deal!).  How refreshing.  Thirdly, I have to visit John Muir for a chest x-ray, some blood work, and an Ekkogram (to check my heart).  These are all tests that are required before you start chemo.

And all this will go on even during the reconstruction of my new boobies!  I am going to be one busy lady for the next few months.  During the chemo, Dr. Wowo will continue to "do his thing" creating my new girls.  This means weekly visits to his office so that he can add saline each time to my temporary implants (allowing the skin to expand gently each time).  I will have a later surger in the Fall to have the permanent impants put in and I'm still sticking to my goal of having them looking picture perfect by Christmas.

OK, so even after ALL THIS chemo and reconstruction is over, I will probably be put on a 5-year regime of a drug called Tamoxifen.  It is usually prescribed to woman like me (pre-menopausal) to keep the cancer away.  A crazy side affect is that it might send me into menopause early - yuck; but there are proven benefits to taking it so I will obviously comply.  I feel like I will cross this bridge once I get there...I realize there is a great deal to accomplish in my treatment before I start taking Tamoxifen.  Too much to think about now to worry about it.

That's all for now, folks.