Numbers, numbers, numbers

October 2, 2015

It’s not clear that ductal carcinoma in situ (DCIS) can develop into invasive ductal carcinoma (IDC). There are a lot of opinions out there.

Doctors think that only a tiny portion of DCIS will at some point involve IDC, maybe 10%-15% according to my surgeon. I am one of those women. There is a lot of research going on, so those percentages will change with every new breakthrough, which is good, because understanding DCIS could very well be a key to something big for breast cancer research. I hope so for all the other women who may be going down a version of my path at some point in their lives. But I’m not a doctor or medical researcher. I’m just one woman trying to understand her own cancer.

The numbers just keep piling up inside my brain. I can usually make sense of things by way of numbers. So I start to think and calculate based on 100 women. These are all ballpark numbers. Like I said, I’m not a doctor or researcher, but I want to try to wrap my brain around it, and this is what I came up with.

100 women
12% – will develop some form of breast cancer. That’s 12 women.
80% – of the 12 women diagnosed with breast cancer will have invasive cancer. That’s 10 women.
10% – of the women with invasive breast cancer will find some cancer in their lymph nodes. That’s 1 woman, named Leah.

One woman in 100. Looks like I am in an elite group. I have hit every goddamn bad statistic so far.

I keep wanting this to stop; at DCIS, at lumpectomy, at mastectomy, at invasive, at lymph node. And it hasn’t. The one thing I’m left with is Can I not have to get chemo, please? Can I just get a break here? We won’t have an answer for at least 2 more weeks. We’re still waiting for pathology reports, I need to have a post-op meeting with my surgeon, then we move on to the oncologist. Cancer is my co-pilot.

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Macabre drainage

October 1, 2015

I am extremely visual and tactile. I was that kid who touched every thing when I shouldn’t. I still am that kid. I can look at something and quickly see how it operates and how I can re-create it. These qualities are great for fostering creativity, but when they apply to my body after surgery, it’s horrible.

It’s nightmarish and unnerving to see two plastic drainage tubes coming out of me. One is in my armpit, the other is in the incision in my chest. The tubes are inserted at the bottom of my rib cage and go up about 8 inches. They drain into bulbs that I empty and measure a few times a day. One side effect of my surgery is some swelling due to fluid build up, even with the drains. With five of my lymph nodes gone, it takes longer for my body to re-absorb the fluid. I also have to “milk” the tubes, by squeezing and pulling on them so any debris is flushed into the bulbs. It’s amazing how quickly I went from nauseated and repulsed to fascinated and curious. What is this stuff? Why is it changing? Where does it normally go? What is the debris? Do I event want to know what the debris is?

Because fluid is building up, I have to massage it toward my drains, which I can feel under the skin with my fingers. But I am completely numb on my left side starting in my armpit and going down to the bottom of my ribcage. It’s like when you get novocaine at the dentist, that feeling that your face is HUGE. Who doesn’t hate that feeling? It’s creepy. It takes all I have to massage that area, and puts me into a mini panic. I can’t feel it, but I know I’m doing it. Am I doing it hard enough? Then I encounter the hard bump that is a drain under my skin, and I pace back and forth. Pacing is my attempt to self-sooth.

Sometime next week the drains will be removed. When I asked the nurse how it’s done, she said in a cheery voice, “Oh, it ‘s just a quick 1-2-3.” Suuuuure it is. I am not looking forward to that appointment.

This all reminds me of some terrible horror movie. How the hell did I land this role?

Balance and strength

September 29, 2015

The hardest thing to do right now is putting on my left sock.  Putting on a sock, a simple little thing that I won’t take for granted after this. Other things that are quite difficult: getting in and out of the car, driving over bumpy patches of road, getting in and out of bed, opening a bottle of ibuprofen, picking something up that’s on the floor, putting my shoes on, tying my shoes, particularly my left shoe.

My left arm was in rough shape since the surgery removed five lymph nodes along with my left breast. I couldn’t raise my arm over my shoulder two days ago. If you don’t exercise your arm after an axillary lymph node dissection, you’re kind of screwed. Your remaining lymph nodes can stop draining properly, causing the arm to swell and a significant loss of range of motion. I need my lymph nodes to be doing their jobs right now more than ever, so I’m doing the exercises religiously. The simple task of walking my hand up and down the wall until I can feel my underarm pull a little gets easier by the day. The exercises are basically waking up the remaining lymph nodes, and don’t seem to affect the actual incision at all.

Full recovery after lymph node removal takes four to six weeks. I now shouldn’t get blood drawn or blood pressure taken from my left arm because I have less drainage creating an elevated risk of swelling. The lymph nodes send out fluid to help heal an injury and with fewer places to drain it, it can result in inflammation and swelling. Squeezing my fist above my heart over and over helps pump fluid out of the lymph nodes. You can feel all sorts of things happening during the exercises, including warm tingles mixed with slight discomfort.

Balance is my best friend right now. When you can’t use one side of your body, there is an amplifying domino effect that reverbs through the rest of your body and you need to figure out how to compensate for it. Yoga is your friend in times like these. Really it should be your friend all the time because sooner or later we will all break down physically so knowing how to balance now while you’re healthy is key. I’m not talking about the yoga people do and exclaim, “I can do man push-ups!” “Look at my beefy arms, woo!” It’s not a competition; it’s a practice in awareness of your body.

A few years ago Amelia pointed out the importance of the squat as we age. “Because dammit, we will not be the people who can’t get the hell off off the toilet when we’re old,” she says. A wise woman. I can’t use the left side of my body very well right now and suddenly I’m asking my thighs do a lot more than they used to do four days ago. Picking something up? I can’t just bend at the waist now. I have to do a deep squat to the ground and then back up. And I have to do it correctly, with my back as straight as possible. Day two I had some serious thigh burn, but my body has already adjusted and my thighs feel fine today. (You know what that means? “Squats! Yeah, look at my beefy quads, woo!”)

Getting in and out of bed? Now that is a production. I can’t really use my back because it’s pretty impossible to isolate my right side while telling my left side not to work, so it’s all stomach, all core. But we adapt. We get good at things relatively quickly. This is our new normal, Amelia and I keep saying.

The best worst case scenario

September 25, 2015

This morning when I was finally out of my drug fog I was able to get a glimpse of my modified self under the bandage and two sentences kept quietly coming out of my mouth over and over; “Oh, my god,” and “This is real.”

Amelia is going through the same thing I am right now, feeling everything that I am, plus layers and layers of her own emotions. She is the Taskmaster, the Nurse, the Therapist, The Advocate. She is my voice of reason.

Cancer is putting both of our lives on hold. The amount of space cancer takes up is almost as large as Amelia and I put together. It’s big. But not bigger than the two of us.

When I saw Amelia after surgery, she didn’t have to say it. I knew cancer was in a lymph node. I knew it all along. So instead of the road ending with “just” a mastectomy we will go down another road. The road of finding out what feeds the cancer so we can find out how to destroy the cancer. That will dictate what type of treatment I will need, if any at all. My sense is that I will need treatment. So far, every worst case scenario has turned into our best case scenario, so I’ll take microinvasive cancer in one lymph node at this point. I will take Stage 1.

In my head I think, Isn’t giving up by left breast enough? Can’t the road end there? I’m going through the why and what the fuck phase. Right now I can’t even wrap my mind around my chest, where my left breast used to be just yesterday and what it looks like now. I do not look forward to taking the bandage off in two days and seeing what’s there.

Surgery update

September 24, 2016

By Amelia Sauter

Hi. It’s Amelia. I’m writing this from Leah’s hospital room where the nurses made me up a comfy bed so I can spend the night. Leah is sleeping quietly. We arrived around 10:30am today and after starting an IV they scooted Leah to the nuclear imaging department to put radioactive dye in her to highlight the sentinel lymph nodes, that is, the guardian lymph nodes that stand between the breast and the lymph pathways into the armpit.

The surgery itself was a relatively short part of a long day, only about 2 1/2 hours. My mom came to be with me while I waited, and we spent most of our time in the “healing garden” outside where I watched the bumble bees landing in the flowers as we talked.

It wasn’t until the surgeon called me after surgery that it occurred to me that we might get something other than good news, even though I knew that was a significant possibility. He immediately started talking about the lymph nodes – the same place the diagnostic doctor started three weeks ago. We took five lymph nodes out, he said. Four were fine. The other has a tiny amount of cancer cells.

I think he offered some reassurances about how a tiny amount is different from a larger amount, but these weren’t the words I wanted to hear. I wanted to hear “Everything went great and the lymph nodes are clear!” The surgery itself went great: a successful tidy mastectomy and a level 1 lymph node dissection with no complications and no damage to the muscle tissue. But all I could think was, I am going to have to tell Leah that she has cancer in her lymph nodes.

Yes, I’m the one who told her an hour and a half later after they wheeled her bed into her room. I’m sure she already knew when she saw my face. The cancer face. We’ve gotten to know that face so well these past few weeks.

Leah says she felt the whole time that the cancer was invasive, and that this is the good news she’s been waiting for, that it’s only in one node and it’s only a tiny amount. She keeps saying it. This is my good news.