Tuesday, March 2, 2010

Some infection

I guess I felt it coming, but chose to ignore it. Lizzie visited with me for a week, and it was great having company!! We took her to the airport Friday night, and Saturday, I just didn't feel good. I put it aside as just being exhausted after having a house guest and over-doing.

Then Sunday, when I changed out of my nightshirt, I noticed the inside was all yucky. There had been a drop or two of leakage from under the bandage for a couple days, but I assumed that was normal. It stopped. It had started 'leaking' again a couple days back, and I chose to ignore it. Later Sunday, I notice it was starting to smell a bit yucky too. I recognized the smell, but chose to assume it was just old dried blood.

And I was getting pretty cranky anyway - the drains were making me crazy! They wiggle and wobble and hurt and are incredibly uncomfortable and I couldn't sleep from the irritation and discomfort. Bitch, bitch, bitch.

Thank goodness for the last couple days of the Olympics to distract me.

Then yesterday, when I took my shower, a little chunk of the bandage washed loose, and took with it a big glob of really nasty looking stuff. Because of the angle, I really couldn't get a look at it then. I flushed it and washed it and flushed it again.

When I took a look at it in the mirror, I just wanted to cry. The wound is open - hasn't even started to heal up in the area that's leaking - about an inch long opening in the incision. Did the normal bathroom things and looked at it again. This time there was ugly pus looking shit oozing out of the opening.

That did it - I finally had to admit that perhaps things were not all hunky-dory. I didn't feel good, wasn't hungry (not like me at all), didn't even want chocolate (absolutely unheard of!!). I dug out my thermometer to see if there was anything to the heat I had been feeling for a couple days - 94.3! That's even low for me, so I guess it's time to replace that old thermometer.

I called Mac for an opinion, but he wasn't around. Looked at it again and decided to call the doc - she said 'come in RIGHT NOW' - so I tried Mac again, because he's threatened to take my car keys away if I even think about driving yet, but again he wasn't available. So I hopped in the car and took off. Thankfully driving wasn't too bad, as long as I kept my right hand on the stick shift and not on the steering wheel!

Dr. K looked at it and said it wasn't as bad as it could be. Poked around in it for a bit, prescribed a heavy antibiotic and said we'd see how it looks in another week. She said she might have to debride the site when I see her next week. Dead skin. That area didn't get it's blood flow back soon enough and died. Said that happens sometimes in a big-breasted woman - skin ends up pulled way too tight to try to cover the area. Lucky me. And I know how nasty a debriding can be, but she says she can do it, if she has to, in the office, probably. Made my day.

She then said she'd like to leave the drains in for another week - I told her I'd planned to beg her to take them out, and she said OK! Yeah! Said it would hurt a bit.

A bit? Turns out I'm not as numb still as I thought. She said 'take a deep breath and blow it out hard' - 'OK do it again and I'll pull it out' - OMG, it felt like she took a red-hot branding iron to me! I yelped - so glad the Silver Fox wasn't there to see that I'm actually human! He thinks I'm tough! Thankfully, by the time I caught my breath and the splash of tears cleared, the pain was gone. Except there was one more to take out and I had to go thru it again. I won't yelp this time!!! Wrong! Damn - next time, put me to sleep!!!!!!! And of course, after the fact, it felt like I'd been kicked in the side with an Army boot! But the damned things are gone and I feel a thousand percent better!

I asked about the pathology report. Not as good as I had hoped.
  • the largest tumor was 3.5 cm - about the size of a golf ball - there was no mention of the second tumor, and apparently the suspected third near the nipple was not there.
  • it was histoligical grade III/III, poorly differentiated. This means the cancer cells do not look or behave like healthy cells. They are described as 'high-grade tumors' and are generally the most aggressive in behavior. They spread and grow quickly. (Not good!)
  • appears they got most of it - the margins were negative. And the closest margin was the posterior margin (back towards the chest wall) at 2.5 cm, or a little more than an inch from the chest wall. The chest wall is defined as including the ribs, intercostal muscles, and serratus anterior muscle but not pectoral muscle. Dr. K was pleased at that number.
  • in the fat pad of lymph nodes that was removed from my arm pit (politely called the 'axillary tail' in the report), two of the 10 nodes were positive for metastatic carcinoma - but we already knew that. The biggest one was 1.7 cm, about 3/4 of an inch, which is fairly large.
  • TNM cancer stage - T2, pN1a, MX. Huh? People keep asking me what stage the cancer is in. This gobbledy-gook apparently gets into that question. The 'T2' means the tumor is more than 2 cm in size, but less than 5 cm in its greatest dimension. 'pN1a' means it has 'micro-metastasized' to the axillary lymph nodes (none larger than .2 cm). And the 'MX' means that the presence of distant metastasis cannot be assessed. So - I still have no idea what 'stage' cancer this is, and I didn't think to ask. Where was the Fox when I needed him to help me think??
  • Tumor markers - the estrogen receptor (determined by the 'any or none' method) tested positive. The way I read the linked page, this means the chemo therapy will be positively drawn to the bad guys. The progesterone receptor tested negative, which means the cancer is not 'driven' by the hormone progesterone. In this case, a test is needed to test for the HER2+ protein, and since I already know I'm HER2+, it is already dictated that I would require the specialized chemo treatment for that fast growing cancer indicator. These receptor tests help determine how hormone therapy might work to stop the cancer from growing. Hormone therapy is treatment that adds, blocks, or removes hormones. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormonal therapy, and hormone treatment.
  • Ki67 proliferation index - this is the one that's scary. My test shows elevated, at 30% with anything about 15% considered elevated. This indicates an aggressive tumor and a poor prognosis, with the risk of recurrence being higher than average. SHIT!! so to speak. That means I should start chemo ASAP, but I can't do that until this ugly gash across my chest actually heals up, because chemo destroys the healing process.
So, here I sit, with an oozing wound in my chest (at least the drains are gone), with a 'poor prognosis'. Cheery. But I'm reading a phenomenal book, sent by a girlfriend who knows me well, "The Art of Racing in the Rain", 'written' by a wonderful dog about his life. I'm about half way thru it, and I cry about his stories, some fun and some sad, on almost every page. So I have an outlet for my tears, for this situation I'm in, that I won't allow anyone else to witness! Not even my incredible friends who love me!

A couple other interesting little facts gleaned from the path report - the 'specimen' (my boob) measured 9"x8-3/4"x4-1/2". The slab of skin was 9" long by 7" wide, and the little fucker weighed just over 5 pounds (not my recommendation of a good way to lose weight). Other than the tumors, the rest of the 'specimen' shows firm to rubbery fibrofatty tissue (my delightful fibrocystic disease) with a few blue dome cysts' measuring up to about a quarter inch in size. And all this time, some men thought breasts were beautiful!

Please think get-well thoughts for me!!

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