" /> The Merits of the Case: May 2007 Archives

« April 2007 | Main | June 2007 »

May 31, 2007

The Early Bird Catches the Worm Cancer

I saw my surgeon today to get the results of the lymph node biopsy, and it’s all (mostly) good news. The lymph nodes were completely clear of cancer. In addition, the thyroid biopsy also came back clear. I have to follow up with the thyroid issue later to make sure everything is really okay, but it is not cancer.

In my elation at the receipt of such great news, I asked my surgeon hopefully if the combination of all the testing results changed his opinion that there was a 90% chance that I will have to have chemotherapy. He said his opinion had changed, but that now he thinks there is a 100% chance that any oncologist will recommend chemo for me based on my age and the type of cancer. The only question, he said, is which chemo treatment will be right for me. And there might be more surgery in my future if I end up needing a port for a particular chemotherapy medicine.

I have an appointment with one oncologist next Thursday and I have a call into a prominent oncologist at Rush-Presbyterian in Chicago to make an appointment for a second opinion. Once I meet with them I should have a Plan For Treatment, and then I will feel like I can really be on my way past all of this.

I am lucky, you know. I caught this early and I did something about it immediately and that is why the news is so good today. If I had waited to see what happened or if the tumor had been deeper within my breast, I might not have found it. I had not had a mammogram in three years. I was planning to get one this year, but it wasn’t on the calendar and you know how that goes. Maybe I would have postponed it longer because I was busy with school or work or the kids’ activities. It was a fluke and pure accident that I found the lump when I did and the way I did. Please don’t let the same thing happen to you. Do your self-exams* ** and schedule your mammograms. (And get used to hearing me say that, because it’s my new mantra!)

* Click here for a link to an online video from the Susan G. Komen foundation about how and when to do a self-exam.
** Click here for an article from breastcancer.org about how to do breast self-exams.

May 27, 2007

Surgery Redux

If I never had to have surgery again, it would be too soon. I am tired of it already. I am tired of the recuperation time and of the pain and of not being able to do the things I would normally do.

As I mentioned in my update post on Friday, the surgery went well. When I first arrived at the hospital, my surgeon injected radioactive fluid in four different spots in my breast around the area where the lump had been. The fluid was allowed to work its way into my system for about 10 minutes, and then a radiologist took several pictures of my chest area from different angles. For some reason I think that some dye was also eventually injected into the area, maybe during surgery, but I don’t remember for sure.

This time the incision was made under my left arm just below my armpit. The pictures allowed the surgeon to see which lymph nodes might have been affected by the cancer and to remove only those nodes. This is called sentinel lymph node surgery. I understand that this is relatively new technology, and that before the use of this method a surgeon would remove all the lymph nodes to be certain that he or she had gotten all the cancer. My surgeon took 4-6 nodes, which will be tested for cancer. I should have those results in a week. While I was out, he also did a needle biopsy on the lump they discovered in my thyroid last week.

Prior to this last surgery, they told me that it would be a bit more invasive than the lumpectomy and they were right. I feel like it took me longer after this surgery to feel something other than “bad” and I am still in some pain today. However, I have refused to take any more pain medication other than Advil because I hate feeling that out of it. I have too many things to get done to feel like Paula Abdul! Despite my good intentions, though, it’s been slow going today since I don’t have much use of my left arm. I’m not supposed to lift anything with it and it hurts. I can’t type with it because my hand and arm get numb so I am typing this one-handed (which takes forever!). I’ll be very happy when I can get back to feeling relatively normal.

And now we just settle in for a long wait. I will see my surgeon at the end of this week to check my post-surgical progress and hopefully he will have the results of the lymph node and thyroid tests by then. I have an appointment with an oncologist scheduled for next week after which I hope to have a treatment plan. From there, I hope, it will be onward and upward and as far away from breast cancer as possible.

May 25, 2007

I'm heading to the hospital this morning for lymph node surgery. I'll update as soon as I can.

UPDATE: Surgery went well and I'm back at home. Details later.

May 24, 2007

Meals on Wheels

Many of you who live locally have offered to prepare meals for our family during this time. Quite a few of you brought us meals after my first surgery and it was definitely wonderful to be able to feed my family a good dinner on those days when food preparation was the last thing on my mind. One day during that week we ended up with seven (7!) meals being delivered on one day! Luckily I was able to freeze several of them so we could spread them out over a few days.

In order to prevent the same thing from happening, one of my friends, Cynthia, has offered to coordinate future meals if we need them. I have mentioned to several of you that I don’t foresee needing meals again unless and until I’m going through chemotherapy and having a rough time.

If you would like to help out by preparing a meal sometime in the future during that time, you can contact Cynthia via e-mail here. Her e-mail address is also posted as a link over in the right hand column.

It’s difficult for me to post this. But we appreciate your kindness and generosity. Thank you.

The Language of Cancer

I have always loved languages. My favorite subject in school was English and when I got to college I majored in Russian and French. (I also took an ill-fated Italian class at 8:00 a.m. one semester, in which I mostly spoke French because my poor tired mind could only fall back on what was most familiar when faced with Italian grammar and pronunciations that early in the morning.) Languages and grammar make sense to me, and I am lucky enough to have the ability to pick up new languages easily. When I got to law school I discovered that a large part of what I was learning was based on yet another language containing such vocabulary as “equitable servitudes” and “subject matter jurisdiction” and “de novo”. One language that I never planned to learn, however, was the language of cancer.

Being diagnosed with cancer is the equivalent of a crash course in medical terminology. Suddenly I’m throwing around terms like “histologic grade” and “alopecia” and “hormone receptors” as if they are just another slang term. To be on such familiar terms with these words goes beyond what we all pick up during our weekly viewing of ER and enters the realm of too much information. I don’t want to know what “lymphedema” means, and I don’t want to include the definition of “in situ” in my new store of Latin terms.

But I don’t have a choice if I want to understand what’s going on. In between my reading of Evidence chapters these days, I can be found sitting at my computer reading up on chemotherapy treatments and the long-term prognoses of other breast cancer survivors. Sometimes I think that all the medical information is going to take up all the room that is supposed to be reserved for legal information. Hopefully I can find the room for both.

I am on the train on my way to my second Evidence class period as I write this, and I find myself looking forward to my time in class just as much as I suspected I might. Only one other student in my class (and the professor) knows that I have breast cancer, so when I’m there I don’t have to be “okay” or reassure anyone that I am feeling fine. My classmates don’t expect me to be feeling any other way right now. It’s as close as I can come right now to a mini-vacation from thinking about breast cancer.

Thank You

I just want to take a moment to say thank you to all of you who are reading this. Your outpouring of love, friendship and support has been incredible and unlike anything I have experienced before. I am humbled by the depth of your care and concern and have no idea how to thank you for it. Please know, however, that your support has been the reason that I have been able to make it through these past couple of weeks with some semblance of strength and with the will to keep moving forward aggressively. It seems that in my darkest moments one of you calls or writes, and your words allow me to focus forward again rather than backward. I have heard from old friends and new from around the country and around the world, from classmates and family and internet friends and neighbors, and each contact renews my conviction that there is a lot of good in this world. I am blessed to have you all in my life, and I think about that every single day these days.

May 19, 2007

Glitch in the Comments

There seems to be a glitch in the comment function right now. I'm working on it (and if anyone has any ideas of how I can get it fixed, I'd appreciate them! I'm using MT and I think I have the comments set up properly...but maybe not). In the meantime, there's a link to my e-mail address over on the right.

UPDATE: With many, many thanks to the imbroglio, my own personal computer technician savior, comments are now working!

May 18, 2007

Good News Today!

Today I spent most of the day at the hospital going through scans to determine whether the cancer has spread to the rest of my body. Rather than having to wait the standard 2-3 days for the results, however, my wonderful doctor called me with the results just a few hours later. The news is good: the breast cancer has not metastasized, so the rest of my body is cancer free. However, the doctor told me that the scan did turn up a lump on my thyroid. It is unrelated to the breast cancer, but a concern nonetheless. He is going to exam my thyroid next week before the lymph node surgery and possibly biopsy the lump while I am out. I can’t wait for that.

When I arrived at the hospital today they immediately started an IV and then served me the first of three luscious barium cocktails. I spent a lot of time trying to convince myself that it tasted just like a tropical drink and that if I just pretended I was on vacation somewhere and that the glass contained rum, I’d be fine. Each serving was 16 oz of fruity goodness, and I had 40 minutes to drink each one. As I sipped I read Evidence and tried to concentrate on objections and hearsay exceptions. It didn’t work very well. In the middle of the first drink, the bone scan technician called me into another room and injected a radioactive fluid into my IV which had to run through my body for three hours prior to the bone scan. Then it was back to the waiting room to keep drinking.

I wasn’t the only one being treated to tropical drinks in the waiting room. I was most amused by a guy sitting a couple of seats over from me who looked like he was about 20 years old or so. At one point when the nurse/waitress brought him his third round, he asked her if he could play the PSP that he had been eyeing at the children’s table set up in the corner of the room. She said he could and he immediately became engrossed in a game. So engrossed, in fact, that he forgot to drink his barium. I started on my third drink before he had finished even a couple of sips of his. He finally remembered it, but only drank about 1/3 before the technician came to get him. I laughed to myself as she scolded him for not drinking all of it and when she made him take “one big last drink.”

My surgeon, who I like more and more every day, came into the waiting room while I was choking down my drinks to check up and see how I was doing. He also gave me his cell phone number so I could call him for the results later in the afternoon. When I eventually called him later in the day he didn’t have the results, but got them and called me back 20 minutes later.

When I finally finished the barium cocktails, I waited for a very uncomfortable 20 minutes until the CT technician came and got me. Once in the CT scan room, she had me lie down on a narrow table and she inserted two tubes into my IV. (I was thrilled that I was able to keep my regular clothes on since it was cold in the room.) Then she left the room and the scan began. The narrow table that I was on slid in and out of the tunnel while the machine told me when to hold my breath and when to breathe. I was very happy that the machine was more like a giant inner tube than a big long tube like I expected.

After a couple of couple of preliminary images, the technician came back in the room and started the IV drips. One was saline and the other was dye. I could feel the dye as it quickly tracked through my body. It felt warm, but also caused a strange feeling, as if I were very tired. It caused a metallic taste to rise up my throat and into my mouth, and was altogether pretty uncomfortable. Once again the table slid in and out of the machine which told me when to hold my breath and when to breathe, and a few minutes later it was over. The entire thing took maybe 20 minutes.

I had an hour before the bone scan was to begin, and so on the advice of the CT technician I went to the cafeteria and had a bowl of soup even though I was not hungry. I returned to the imaging center and then the bone scan technician called my name and led me to a different room. I lay down on yet another narrow table and she kindly covered me with a warmed blanket. (She also told me that I felt so cold because of the barium.) The table slid forward into the machine (which was also not a big long tube, but more similar to a giant square inner tube) and then a plate was lowered down until it was about half an inch from my face. Then very, very slowly the machine moved from my head to my feet. The entire thing took maybe another 20 minutes, and then I was out of there.

It’s good to be able to check things off the treatment list. Next up…surgery

May 17, 2007

Diagnosis

I saw the surgeon today and the news was exactly what I thought it would be. I have breast cancer. He removed everything that was there, including some additional tissue around the tumor and some of my muscle. The margins are all clear, which is good. The tumor was 1.8 cm, which isn’t small, but it isn’t big. Even though I expected this news, it doesn’t make it any easier to hear. I am relieved to know, though, and to be able to begin to fight.

Tomorrow I will spend the day at the hospital going through a series of scans of my body to find out if the cancer has spread. A week from tomorrow I will return to the hospital for yet another surgery to remove any infected lymph nodes. After that, I will meet with a couple of oncologists so that we can determine what my treatment plan will be. The surgeon suggested that since I am young there is a 90% chance that the oncologists will recommend chemotherapy. Radiation is another possible treatment, and I can elect to have a mastectomy if I want to. I have decided not to pursue a mastectomy at this time since there isn’t any more cancer in my breast. However, if later genetic testing reveals that I am genetically predisposed to breast cancer I may decide to do that.

I am still processing all of this, I think, and maybe I am in a little bit of shock right now. It has all happened so very, very quickly. I would never have predicted two months ago that I would be facing something like this.

I sent an e-mail out to family and friends today to let them know what was going on. The response I have received has been absolutely overwhelming. I can see that this support is the thing that is going to get me through all of this. I don’t know if I could do it without knowing that all of these people are behind me. They have been amazing. I know that many of you are reading this now, and I wish that I could convey to you all how much your words of kindness and compassion and love have meant to me. That sense of peace I was talking about yesterday? I think that this is where it comes from.

May 15, 2007

Surgery

Yesterday morning I had a lumpectomy, and now am waiting for the pathology report to come back. Following the surgery, the surgeon told me that he wanted me to make an appointment to see him in his office to go over the pathology report with me rather than calling me on the phone. That, combined with the fact that he took more tissue than he originally planned, has me convinced that whatever he found is bad, as in cancer bad. I won’t know anything until Thursday morning, however, so for now I’m just playing a waiting game.

In the meantime, I received the first assignment for the Evidence class I’m scheduled to take this summer. The class begins on Monday and the assignment is lengthy enough to keep me busy between now and then. The idea of a law school casebook reading assignment is surprisingly comforting to me. I never thought I’d say that briefing cases and reading procedural rules could be comforting, but I think it is because it is familiar and I know how to do that. I haven’t quite figured out how to have cancer yet.