Mastectomy Procedure

The plastic surgeon explained this procedure rather nicely and I thought it's a good idea to post about it as a lot of people (I think) have no idea what it entails. So here goes...

The operation will take about 2,5 to 3 hours. It takes Jenny, my surgeon, about an hour to remove the tissue from one breast. As she then starts with the second breast, the plastic surgeon will take the silicone implant and "insert" it behind a muscle in the first breast. Before this though, they apparently weigh all the tissue that Jenny has removed, just to double check that the silicone implant he has chosen (according to measurements of my breast of course) is the correct size. It take him about 40 minutes per breast.

Because of my family history with cancer, Jenny said that my RHS breast and nipple must be removed. I have had a few months to get used to this idea and have decided to also have the LHS removed. Apparently there is an 80% change of the cancer also appearing on the LHS. That is just way too high to take a risk.

Sentinel Node Biopsy
I have also opted for a sentinel node biopsy on the LHS. I had one on the RHS during my lumpectomy. This is when they check your main node to the lymph system in you arm. If there is any sign of cancer in the main node, it will be removed to prevent it from spreading the cancer to the rest of the system. Even after chemo there is less than 1% chance of cancer... To check the nodes, however, I need to go to a specialist on Tuesday morning, before the op, who will perform a lymphoscintigraphy, where a low-activity radioactive substance is injected into the LHS breast area. I then go into a scanning machine (like a CT scan) where scintigraphic imaging is usually started within 5 minutes of injection and the node appears from 5 min to 1 hour. This fluid enables Jenny to see where exactly the nodes are. Please note, this is a very summarised version of the whole process.


Post op
I am hoping to be out of the hospital by Thursday but it could be Friday, not sure yet. There will be a drain on both sides that will be removed about 10 days after the op. I am not sure yet about bandage removal etc but will know more next week. After about 2 weeks I will also go and see my oncolgist, Irene, and will hopefully start Tamoxifan.


For now, I am looking forward to getting the op out of the way. I have taken February off at work so I will have lots of time to heal and relax.

Operation confirmed

After seeing Jenny last Monday, we booked a date for my mastectomy. It's this coming Tuesday, the 1st of February. We basically discussed the op and she had a look at my breasts and also the lumpectomy scar (which has healed very well by the way).

There are 3 options for reconstructing the breasts after a mastectomy:

1. Breast Implants (silicone)
2. Tram Flap Reconstruction (uses tissue from the stomach area)
3. Latissimus Dorsi Muscle Flap Reconstruction (uses tissue from the back area)

I have opted for the breast implants. Jenny works closely with a selected few plastic surgeons who specialises in any one of these 3 reconstruction procedures. I then had to go see the surgeon who she "uses" when a patient wants implants. A very nice guy, has worked with her for 15 years. He explained the process and I also saw and handled a silicone "breast" – when you close your eyes and feel the implant with your one hand, and then use your other hand to feel your breast, it's really very much alike...

The next step

I am seeing my surgeon today. We are supposed to discuss the next step. As far as I am aware, I need to have my RHS breast removed. However, Dr Edge recommended to have a bilateral mastectomy, as preventative measure, because I have a family history and also because I am still quite young. So from day 1 I have "prepared" myself for this mentally. All of a sudden though it is nearer that time and I am feeling quite anxious and scared. I guess this is normal.

When I saw my oncologist for the last time, she still said I am going onto radiation now. Until I told her about my decision to have a bilateral mastectomy, in which case I do not need to have radiation treatment. I then realized that I have decided to take this path but have never really confirmed it with anyone. So today I am doing just that with Jenny.

And then about 2 weeks after my op, I will go back to Irene and discuss the pill, Tamoxifan, that I need to take for the next 5 years. I am not completely sure when I will start this as Irene said there is a risk of blood clots if you start taking the pills too soon after the mastectomy.

Chemo is finished!!!

My final chemo session was last Monday, 3 January 2011. I can't believe how quick the 4 and a half months went, its insane! 

I must say, I have been blessed in general with having few side-effects and almost never getting very sick. I have had a sore stomach for weeks now, up and down. This could be for various reasons. It's rather irritating and of course I get paranoid but I try not to. The only other issue is my hair. I think it's going to take much longer than I anticipated for it to grow back. It has stared slowly, very thin fluff-like hair. You can almost only really see it if I stand against the light. Otherwise I pretty much look just bald.

Blogging

I have been so bad with this blog, I know. It's been a busy couple of months since I last posted.  The end of the year is normally very social and all about seeing friends and catching up before everyone goes off to a holiday or family affairs. This is indeed what happened last year. I found myself awing up very early, often, wanting to get up and write something but I end up making mental notes rather and then never actually posting at all. Besides, I am not very good at writing. I thought perhaps it would work better for me if I post some pics as well, just to make it interesting. I will see…

Chemo 2 of 9

Monday 15 November 2010

The treatment on the actual day wasn't as bad as last week. By "bad" I mean I didn't feel so completely out of control, intoxicated... I was still drowsy and a bit sleepy but nothing hectic. But that is just a bit of what I actually do remember from Monday ;-) (at home we call my short-term memory issue, chemo brain). This time they got a vein on the 2nd try but I didn't mind so much because it was my favourite nurse and she really is very careful and kind. 

Earlier, while waiting for Irene, I met a new patient. She was chatting to Colette, a woman I have met a couple of weeks ago. So I joined in. The new patient is an ICU nurse and she has been working in Afghanistan for a while. But when she was diagnosed with BC she packed up and headed back to South Africa. Her case is similar to mine. As for Colette, she was just so happy on Monday. It was her last day of Taxol! She said that she never wants to go through chemo again, ever. She already had a mastectomy before she started chemo, and will now proceed with radiation treatment. It is quite a thing, this radiation. She will be going in every weekday for 6 weeks. That's rather hectic. But unfortunately, her BC is also genetic and her mum and sisters all had to battle with it. I do hope she does well with her new treatment, she is lovely. And she was saying that she cannot wait to ride her motorbike again. Her husband bought her a BMW 650, not too shabby. I suggested she start in the new year, making it a definite goal for 2011. She agreed but said she feels like starting now already – the only thing is she might forget to do something essential, like put down her feet when she stops!

No other news really. I have had a spot of flu since the weekend and I am becoming increasingly irritated with the symptoms. But I hope it clears by the end of the week!

Chemo 1 of 9 (2nd cycle)

Monday, 8 November 2010

The diagnosis:

Breast cancer, stage II

The chemo plan so far:

1 Monday, every 3 weeks, for 8 weeks

Drug: FEC (as discussed in a previous blog)

TOTAL = 3 sessions

LAST SESSION = 18 October 2010

The NEW chemo plan:

Every Monday for 9 weeks

Drug: Taxol* (generic name Paclitaxel)

TOTAL = 9 sessions

LAST SESSION = 10 January 2011

So my day started with a quick black coffee and some Pronutro. Cath dropped me off at 8:45 and I went to "check in" at the hospital, got my blood taken and waited for Irene, my oncologist.

We discussed again the recommended Taxol drug I will be receiving from now on and the possible side-effects*, obviously. This is apparently not as hectic as the FEC. The main reason why they change my chemo drugs halfway during my 18 week cycle is to avoid longterm effects such as the toxicity (which causes the very sore veins and arms and makes your veins actually feel solid!). And the Taxol is a much "easier" drug with regards to these effects.

* Taxol: possible side-effects

• numbness and tingling of the hands and feet (Peripheral neuropathy)
• restlessness
• heart palpitations
• heartburn

The only downside is that there can be an allergic reaction. This they can establish by taking your blood pressure during treatment. But they only took my BP afterward the chemo session and it was 115 over 66, fairly normal, thank goodness! 

I first received the normal saline solution, to "open up" the veins. Luckily the nurse found a lovely vein without struggling, it wasn’t sore or anything, nothing like the last attemp 3 weeks ago. Then there are 3 bags of drugs including antiacids and cortisone. I can't now remember the third one.

After this the Taxol followed. It is a huge bottle (probably 1,5 litres) of clear fluid (no more FEC red devil!), administered through a drip, as previously. There is no pill form of Taxol. Just a while after starting the Taxol I felt very dizzy and disorientated and when I went to the loo the nurse had to help me a bit. I then started feeling very sleepy and dozed off a couple of times. I am just glad Cath brought me in and fetched me again as I can’t remember much although I did drive myself to hospital the previous time. During all of this, my best friend popped in twice, first to bring me a magazine, and the second time to see how I am doing. I remember vaguely talking to her, or should I say mumbling slurringly.

But from next Monday they half the dose of Taxol. So I think it will be much better then. I only finished well after 2 o'clock. Hopefully next week a bit earlier.

*Taxol: some info

• Taxol is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Taxol is classified as a "plant alkaloid," a "taxane" and an "antimicrotubule agent."
• Taxol is used for the treatment of breast, ovarian, lung, bladder, prostate, melanoma, esophageal, as well as other types of solid tumor cancers.

I woke up this morning at 6 o'clock feeling well. I slept most of the afternoon yesterday after chemo. And i had a good might's rest. It's now 9 and I am still fine. I have a few admin things to attend to today and then work tomorrow.

I will try and post more often, there are very specific things I want to mention like my diet, medical aid and so on. After my last post I felt quite ashamed for moaning and bitching like I did. I realised soon after that that there are so many things I must be grateful for. I have the most amazing friends supporting me, praying for me and sending me good thoughts and love...I thank you all!