Preliminary Pathology Results

  I received a call from my surgeon last night with my preliminary pathology results. Here they are:

• 3 sentinel lymph nodes were removed from my left axilla (armpit) and all three were negative for signs of cancer ✅
• The entire tumor was removed along with margins which were negative, meaning no residual cancer cells from that specific tumor were left inside me ✅
• There was residual cancer found inside the tumor that was removed which means I did not have the pathologic complete response (pCR) I had hoped for ❌

 Next steps:

• Healing from surgery
• Attending upcoming appointments with various surgeons and oncologists
• Determining my adjuvant (post-surgery) treatment which will likely have a further component of chemotherapy (not just targeted therapy) but that is yet to be determined
• Return to work
• Targeted radiation therapy
• Oral (pills by mouth) therapies for 5-10 years
• Live my life

Healing

  I am focusing on healing. It’s killing me to do nothing, but with instructions to not lift my arms over my shoulders for 14 days and no lifting anything more than 5 pounds for 4-6 weeks, I just sit here despite wanting to do all the things. 

 I’ve written about Juven before when I used it to mediate my chemo side effects, but I’m using it for my wound healing now. 

 I have weekly follow ups with my plastic surgeon and a 2 week follow up with my surgeon who performed the lumpectomy and sentinel node biopsy. I will visit my medical oncologist in 2 weeks and my radiation oncologist in 1ish weeks to determine next steps based on pathology results. 

 

Post-Op Day 1

 

 Although I felt like I was hit by a truck yesterday, I’m already feeling quite a bit better today. I appreciate all the well wishes. I’ll be following my post-op instructions to a tee, not that any of you are surprised by that. 

Surgery Day!

7:30 am - Check-in

8:30 am - Nuclear medicine for sentinel lymph node mapping

The day of your lymphatic mapping procedure

During your mapping procedure, you will lie in a reclining chair for about 20 minutes. A healthcare provider will give you an injection (shot) of a radioactive liquid called Tc-99m.

They will inject a small amount of the radioactive liquid under your skin near the site of the tumor. This may be the area around your breast, axilla (armpit), or thigh, depending on the kind of cancer you have. You can feel stinging or burning during the injection.

After the injection, you will massage (gently rub) the area of the injection site for 10 minutes. This will help the radioactive liquid travel in your lymphatic fluid to your sentinel lymph node(s).

Then, a technologist will measure the radioactivity from the radioactive liquid that was injected in your body. This will show which lymph node(s) absorbed the radioactive liquid and how much of the liquid was absorbed. The lymph node(s) that absorb the most radioactive liquid are the sentinel lymph node(s).

11:30 am - Surgery start time

4:30 pm - Approximate end time

But most importantly, I will have the support of my family and friends.

  Tomorrow’s the day. Thank you all for your continued support. 

Empathy

 

 I believe I’ve posted about this before, but when I find myself experiencing similar situations as my patients, I use that experience to better care for them in the future. I liked the quote above for that reason. We all can try to imagine what it is like to be a patient in a certain scenario, but until we live it, we truly can’t. I hope to bring further understanding and empathy to my work, when I am fortunate enough to return. 

Some days are for conquering.

 

 I've been trying to practice what I preach recently, and have used a few tools to keep me on the right path. 

 Next Tuesday, I will undergo Oncoplastic Lumpectomy. I feel very fortunate to be able to have tissue conserving surgery, as many women have to opt for a single or double mastectomy, which is even more life changing. While I'll still have significant treatment to go, this will be another hurdle I can say I have overcome as I continue through my recovery.

  

Good vibes.

 

 Thank you to everyone sending good vibes. It is officially one week until my surgery. I reflect on these last months and realize, through chemo, it was really just focusing on getting through each cycle and keeping on schedule. After chemo was complete, the next stage hit like a ton of bricks. Now what? I wait for surgery. So here I am, waiting, knowing that in only one week, yet another chapter of my reality with cancer will be done. 

Water you.

 Sometimes we need to slow down and assess what really matters.

Yellow

 

 Not everyone knows how colors influence us. Yellow is important to me right now.

 The Psychology of Color Yellow

 The vibrant hue of yellow has remarkable effects on the human psyche, eliciting a broad spectrum of emotions and behaviors. Yellow is mentally activating, psychologically stimulating higher cognition, creativity, and feelings of optimism. However, in excess, it can also overstimulate, resulting in anxiety, impulsiveness, and emotional fragility. Yellow sharpens analytic thinking and decision-making by muting subjective emotions, but this lack of empathy can become extreme logic at the expense of compassion.

 The Yellow or Solar Plexus Chakra

 Yellow Chakra, sometimes called Solar Plexus Chakra or Manipura, is the third from the bottom chakra, located in the abdominal area, a few inches just above the navel. The yellow chakra is the center of our own identity, which is sometimes referred to in psychology as our ‘Ego.’

 The yellow chakra serves as the basis for personal strength and power. It stresses self-esteem, confidence, and the will to follow your real path and create the life you want.

 It provides the body with food and energy and keeps it alive throughout the transformation process. Fire is the important spark that assists in fueling the change process.

 The yellow chakra is in charge of the following aspects of your life:

• Strength
• Transformation
• Personal Power
• Determination
• Courage
• Self-Esteem
• Confidence
• Motivation
• Decision Making
• Collaboration
• Digestion
• Metabolism

Keeping Perspective

 

 This is a great article about keeping perspective. The highlights are:

1. Nothing in life has any inherent meaning; it only has the meaning you assign to it. Shakespeare once said, “There is nothing good or bad, but thinking makes it so.”
2. We become what we think about. By the law of cause and effect, what we think about in our lives, we bring about in our lives.
3. Conformity is the killer of creativity and individuality. There is nobody on the planet that is quite like you. There is also nobody who has ever lived, nor anybody who will ever live, that will be exactly like you. You are literally one-of-a-kind. You are unique.
4. A sense of gratitude can immediately increase your quality of life. Thinking about and being grateful for the things you have increases joy, happiness, and overall outlook on life.
5. Most people regret the things they didn’t do, not the things they did do. Your life is singular and finite. Take chances and enjoy life. You only live once. Make this one-time experience great, fun, exciting, and full of joy and happiness.
6. Focus on the things you can control, and do not focus on the things you cannot control. Allowing things that you cannot control to upset you will set you up for frustration and decrease your quality of life. There is absolutely no point in getting upset about things such as the weather, traffic, and other people.

Magseed and Let it go

  On Tuesday, instead of having a Faxitron Seed placed, we have chosen to upgrade our options at Mat-Su so I got what is called a Magseed. It is used to mark and find the impalpable (unable to be felt by touch alone) tumor (YAY!) so they can remove the right tissue and conserve the good tissue.

 

 There will also be sentinel lymph node mapping on the day of my surgery called a lymphoscintigraphy (don't worry, I have a hard time pronouncing it as well). It involves injecting a radioactive tracer to help identify my sentinel node(s) for removal for biopsy. 🤞that it has not progressed into my lymph nodes.

 While I've made it through so much so far, there is still much to be done. I am thankful for the continued excellence of my physicians and can't wait for this next step to be completed.

Herceptin and Perjeta are a go!

  My labs were great again today and it let me get my last Herceptin and Perjeta infusion before my surgery. This helps to prevent any growth between now and June 25th. Once we find out pathology results, we determine our next steps and what types of infusion I may need. One step closer.