Saturday, April 22, 2017

20 Days of Radiation

Back in December I was diagnosed with DCIS non-invasive breast cancer.  I blogged about the first portion of my diagnosis & treatment HERE.

The last phase of treatment is radiation.  I met with the radiation oncologist the same week I met with the medical oncologist.  I wasn't nearly as resistant to radiation therapy as I was the hormone therapy.  I met with the radiation oncologist on Thursday, March 16th.  Dr. Hayne, although nice, wasn't as open to discussion to radiation as an option like Dr. Ari was. Of course I could have declined treatment but it wasn't like the discussion Dr Ari & I had. It was more to the point, how many days, what to expect, what you can & can't do, etc and I was OK with that. When you look at the DCIS trial data below radiation therapy seems to be the big hammer when it comes to reoccurrence.  
B24 Trials
My treatment plan was 15 days of radiation plus an extra 5 days to the tumor bed. This was due to the inferior margin.  I was scheduled to come back the following Monday (March 20th) to get scanned so the planner can create the radiation profiles. They also marked me with body paint & stickers. On March 22nd, I went back for a dry run of sorts so the techs can make sure the profiles were accurate so we would be ready to start for real the following day.

Day 1 of radiation was on Thursday March 23rd.  I picked the end of the day since it worked better with my work schedule.  Plus afterwards I could just go home & rest which would be needed about 2 weeks into treatment. Below is the table & equipment.  Every Tuesday was a quick visit with the nurse & doctor to make sure all was OK.  Every 5 days the techs took an x-ray while on the table to make sure the position was still good.  The treatment takes about 5 minutes total of which about 1 minute is of actual radiation. Most of the time is spent aligning you on the table using the body markings.  Treatment is daily, Monday through Friday, for 20 days. 

Radiation Table
Day 1 Post Treatment Arbo Walk with Steve
I was told the main side affects would be fatigue & possible sun burn on the treated area.  It seemed crazy that only a minute of zapping would cause fatigue but about 10 days in I really started feeling it.  Especially as the week went on.

Quarter Horse Relay Marathon - 3 days after I started radiation
Another issue I had was a really tight, painful upper back.  I think it was partially from the surgery & partially from the treatment.  It was so sore that ibuprofen wouldn't touch it. When I got home after my last treatment of the second week I massaged some Tiger Balm into my upper back.  That actually took the edge off.  I used it all weekend & by Monday it was feeling much better. Unfortunately after Monday's treatment it was sore again. I didn't use the Tiger Balm on Monday since I didn't want it to interfere with the treatment.  On Tuesday I saw the doctor & explained what was going on.  She didn't have an issue using the Tiger Balm on my back but didn't want me using it on my armpit since that was part of the treatment area.  Apparently I wasn't the first patient that day to complain about a sore back. They discussed looking at the table ergonomics the next day to see if adjustments could be made.

One nice benefit is the massages at the Wellness Center next to the radiation treatment.  I had a massage scheduled for Wednesday after my 5th treatment.  Since they are in the hospital they are trained to work with cancer patients.  The prior weekend the masseuse had gone to a craniosacral training seminar.  It was unlike any 'massage' I have ever had.  It was amazing! My back felt so much better after I left and it never got really bad again after this session.

Around Day 7 you could start the notice the redness on the treatment site. The area was swollen & tender.  The doctor said this would be expected until after the treatment is over.

Baptist Health - Lexington, KY
About 10 days in I started to feel the fatigue.  It wasn't awful but it would hit me suddenly. I would take a 30 minute nap & feel OK after that.  As the treatments went on the fatigue got progressively worse.  Never so bad I couldn't get up but definitely more tired than normal.  Also, as the week went on the likelihood of needing a nap increased.

The first 15 days was treating the full breast, the final 5 days was called a tumor boost.  The radiation was focused at the tumor site.  On day 15 after my treatment they set me up for the last 5 days.  There was an attachment that was used & the angle was different.  The setup took about 15- 20 minutes but each actual treatment is only about 30 seconds.  Getting me lined up on the bed took more time than the actual treatment.

Tumor Boost
After day 16 & 19 treatment I got another massage.  Since the last session went so well we agreed to do the same treatment again for both sessions.  It was the correct call.  My upper back is feeling normal again after these sessions.  It is really amazing. It is the most relaxing massage I have ever had & I leave feeling so much better.  My upper back is no longer in any pain.  Yay!

My friend Ruth joined me for my last treatment.  She was also there for my first dry run day.  We followed up the last treatment with a walk around the Arboretum.

After my last treatment

Yes, they gave me a radiation diploma :-)

Post treatment & walk celebration beer!
Overall, the 20 sessions were not bad.  I do have some general soreness, fatigue & itchy skin but that will pass.  I am really grateful that the cancer was caught early & chemotherapy was not needed.

What's next?  

I have a follow up in 3 weeks with the radiation doctor then I go into monitoring stage.  My next screening MRI is in late summer.  Hopefully I can avoid the embarrassing passing out episode from my first MRI.

We head to Washington state for an overdue vacation in May.  Lots of hiking & exploring to be done!

I signed up for the LIVESTRONG program at our local Y to jumpstart the rebuilding process. It starts the first of June & goes for 12 weeks.

I am hoping I can build up enough endurance to bike the GAP trail this summer.

Cancer, even a stage 0, puts things in perspective. Life is short. Choose to be happy. Plan the vacation. Call that friend. Tell someone you love them. Don't dwell on the past. Plan for the future but live in the present.

Lastly, I am so appreciative of all the love & support I was given during this process. Thank you, thank you, thank you. You never know what someone is going through so sending them love, prayers & positive energy goes a long way, even when they seem to be AOK on the outside.

Love & peace to you all!

'Pink tulips for your last week of treatment - Jennifer'






Saturday, April 8, 2017

Two Week Food Intolerance Test

I don't remember how I came across this website, I suspect it was on Facebook but it intrigued me.  I had packed on an extra 5 pounds this past winter, was feeling really blah & oh, had this little cancer diagnosis I was still processing.  I needed something to kick start my metabolism & originally planned to start the Sunday after the Quarter Horse.  I decided to pull it in a few weeks for a couple of reasons.  One was I already dialing the intensity down thanks to my lumpectomy & two, I wanted to be off the sugar & carbs prior to starting radiation.

I started the two week test on Sunday March 5th.  The test seemed really straight forward.  The Yes food list was short.  Lots of veggies, high quality meats & full fat dairy.  I estimated the hardest thing for me was going to be giving up the sugar in my coffee & all the fruits for two weeks.  I knew I could reintroduce fruits after two weeks but the daily sugar is gone forever.

I was already pretty good with Sunday meal prep so that didn't change too much.  I added a lot more meat to my meals - bacon, beef, pork, chicken.  Before I started the test I created a two week meal plan & grocery list. This helped significantly with the food prep & meals especially during the week when time is short.

Breakfast consisted of some kind of egg dish.  I started fancy with frittatas & souffles but  after a few days ended up eating an omelette every day.  Initially it was really hard for me to eat so much food shortly after waking up.  Before the test I was drinking a green smoothie loaded with fruit on the way to work. I figured out if I brought the omelette to work & ate it when I arrived it was much easier. My daily omelette consisted of 2 eggs, a splash of heavy cream, spinach, sautéed onions, peppers, bacon & cheese.  I drank coffee with heavy cream but no sugar.

Omelete
Lunch was either a cabbage or spinach salad.  I would add carrots, sweet peppers, feta and/or blue cheese, toasted almond slivers & some form of meat - bacon/chicken/tuna.  The salad dressing was homemade - olive oil, balsamic, salt & pepper.

Cabbage Salad

Spinach Salad
Dinner was various meat - pork, chicken, fish, beef & veggies.  My favorite was an alfredo recipe that I altered to use 'yes' foods. I used heavy cream in place of the half & half & creme fraiche instead of the cream cheese.  I used my spiralizer for the zuchinni noodles.  I think I could eat this every day - it's that good.

For snacks I ate almonds, macadamia or pistachio nuts and string cheese.  I didn't keep track of calories at all.  I just ate to my hunger level.  The first few days I was really missing fruits.  I felt sluggish for the better part of the first week.  Day 5 & 6 I had a wicked headache.  By the second week I was not craving any foods & had high energy levels.  My legs still felt dead which was really noticeable climbing the 2 flights of stairs at work.

I took before measurements & weight and re-took them at week 1 & 2.  In two weeks I lost 6.2 pounds & just over 7 inches.

Here are the notes I took right after the 2 week test ended:

Pros:

- No cravings. Not stress eating or feeling peckish. This was a huge problem for me.
- Sleeping better, not waking up groggy. Another problem area.
- Garmin says I am getting over 1 hour more of deep sleep every night
- If I wake up in middle of night I fall back asleep right away. Prior to test I would toss & turn most of the night.
- Lost 6.2 pounds --> haven't been below 140 in at least 2 years.
- Lost a total of 7.25 inches across belly, hips & thighs

Cons:

- Legs are dead on long runs. Even when changing intervals to 4 min walk / 1 min run. Legs really feel dead around 6 miles. Although, this test is supposed to occur in the off-season so long runs/races won't yield good results.
- Yesterday's 10 miler was a 4.8 of 5 effort. Even though I only ran 20% of the time.
- Weird taste in mouth. Ketones? Not sure what that this but read in the Q&A this may be the cause. This does make me brush my teeth more frequently so my dentist will be pleased.

Other Items of Note:

- If you are not used to food prep this will be a LOT of work. Also, our grocery bill went up but for me, my eating out bill went to virtually zero.
- Withdrawals will be dependent on how you are eating before the test. I ate veggies every day & limited my bread intake so it wasn't awful. I did have some nasty headaches on days 5&6 & I really missed fruit. I was also eating at least 5 servings of fruit everyday.

The past few weeks has been spent re-introducing 1 food serving per day. The order goes like this:

1Legumes
2Low-glycemic fruits (berries, grapefruit, prunes)
3Medium-glycemic fruits (apple, orange, pear, strawberries)
4Gluten-free grains (whole oats, brown rice)
5Grains with gluten, if not intolerant
61 teaspoon of organic honey with coffee or tea (excluding agave, or any other kind of sugary substance)

So far, fruits are OK but beans & sprouted bread is not.  A few hours after eating them my belly will feel bloated & I confirm this by my waist measurement.  Both cases my belly measurement was 2 inches greater.  Most days I notice a 1/4 to 1/2 inch difference between AM & PM measurements.  For the first week I was taking my belly measurement every morning & evening to see how the daily food affected me.  Now I am not so religious.  I am only measuring if I think something had a negative affect.  I can see how some folks could get obsessive over this.  That certainly wasn't my intent.

I am back drinking my green smoothie most mornings with modifications. Now my smoothie contains coconut cream or milk, spinach, carrots, a scoop of almond butter & 1 serving of fruit - either banana, blueberries or strawberries.

Green Smoothie Before

Green Smoothie After
My current favorite post test recipe is banana muffins.  Coconut flour is my new best friend.  These are surprisingly good.  The recipe makes a dozen & can be frozen.  These have been my mid afternoon snack.

Coconut Banana Muffins
I also made slow cooked steel cut oatmeal.  I used to make this recipe all the time.  The only modification I made was omit the brown sugar.

Slow Cooked Steel Cut Oatmeal
It's been 5 weeks now since I started the test.  I am down a net 5 pounds & my measurements are down 11.25 inches. Note that I actually gained back a pound but continued to lose inches over the following 3 weeks when compared to the post 2 week measurements. Personally, I really liked the test.  My husband on the other hand has not.  He isn't a fan of eating salads everyday. He also had terrible sugar/carb withdrawals, much worse than I had.  Now that he is re-introducing foods he is more aware of how foods affect him.  I think we are both glad we did the test but we certainly had vastly different experiences.   

Fitness wise, I still have the intensity dialed down due the cancer treatment. I am planning to do the MAF 180 test next since I already backed down my running to walking.  The timing for me to do these tests have been good.  This is something I have wanted to do for a long time but never had the proper motivation.  That is one good thing about this cancer diagnosis!  I am not sure I would have been motivated to do the 2 week test otherwise.

Happy, healthy eating everyone...


Sunday, April 2, 2017

Nevertheless We Persist

Back in January Ruth, Audrey & I volunteered for the Urban Mountain Challenge which earned us a free entry to a future RaceRise event.  We picked a new spring race, The Quarter Horse Marathon Relay and recruited our running buddy Mary to be our 4th runner.

About our team name - Nevertheless We Persist.  Around the same time we were trying to come up with a team name, Mitch McConnell said the now infamous quote "Senator Warren was giving a lengthy speech. She had appeared to violate the rule. She was warned. She was given an explanation. Nevertheless, she persisted"  I never felt connected to the Nasty Women campaign but the Nevertheless She Persisted soooo resonated with me for so many reasons.  We decided to name our team with this slogan in mind - Nevertheless We Persist. 

Mary, Me, Audrey, Ruth
The event was held at Spindletop Hall on March 25th.  Packet pick up was the evening prior & we were able to pick our tent location.  Thankfully, the weather was going to be beautiful.  We arrived around 8AM on Saturday to get everything set up.  The race started at 9AM.  The first runner runs 3.5 miles then each team member will run 1 lap (approximately 1.5 miles) before handing off the baton to their next teammate.  There is a total of 16 legs.  I had no idea how long it would take us to finish.  None of us knew how we would feel running a 1.5 every 45-60 minutes.  It was a unique race to say the least. 

Audrey was our runner #1 & got to run the extra couple of miles.  Mary was runner #2, followed by Ruth & myself bringing up the rear.  



And Audrey is off...

Everyone was running faster than we each thought we would.  The 1.5 mile lap kind of messed with everyone.  It's only 1.5 miles so everyone went out hard.  I originally was going to do a 1 min run/4 min walk but immediately threw that out.  I switched back to 4 min run / 1 min walk.  We all pushed ourselves on this race.

Ruth handing off to me

Finishing Lap #1

The first & second laps were good, the third lap I started to feel it & by the last lap my legs were dead.  The temperature warmed up into 70's by mid day which we all felt.  I averaged just under a 11 minute mile for the 6 miles.  Overall the team finished in 4 hours 42 minutes.  

I wasn't sure how to eat for this race and to complicate things I was still doing the food sensitivity test.  Before the race I ate an omelet.  After my first lap I ate one of my banana muffins, after my second lap I drank a green smoothie and after my third lap I ate some dry roasted almonds.  Overall my belly was fine but the third & fourth laps my legs were feeling it thanks to this test.  My heart rate was really high and the run was a 5.0 effort.  

At the end of the day, the race was so much fun.  It certainly helped that the weather was perfect.  I really liked the laid back atmosphere & hanging out between runs.  

Audrey, Mary, Me & Ruth

Nevertheless, We Persist!





Thursday, March 30, 2017

Perfect 10 Miler at Mt. Brilliant

Before I was diagnosed with DCIS breast cancer I had signed up for the Perfect 10 Miler on March 18th.  I had run the 10K last year & it was a beautiful course.  I wanted to maintain my higher run base throughout the winter & thought this would be a great race to keep me training.

My original plan was to start ramping up around the first of February & maybe even add a spring half marathon to the schedule.  Well, then 12/21 came along & plans changed.  I only had a basic idea what my treatment plan would be but no idea how quick or slow I would move through the process.  I decided to start my ramp up on the last Saturday of the year, 12/31. I put together the below plan & was able to stick to it with the exception of the week post surgery.


WeekTuesThuFriSat SunTotal
12/24/201633Rest5Rest11
12/31/201633Rest5Rest11
1/7/201733Rest6Rest12
1/14/201733Rest7Rest13
1/21/201733Rest3Rest9
1/28/201733Rest7Rest13
2/4/201743Rest8Rest15
2/11/201744Rest9Rest17
2/18/201744RestSurgeryRest8
2/25/20171.5 (Was 4)4Rest5.3 (was 9)Rest4
3/4/201743Rest8Rest15
3/11/20173Walk 2Rest10Rest13

After the surgery I did switch to a longer walk interval.  Pre-surgery short runs were on a 4 min run / 1 min walk interval & long runs were a 3 min run / 2 min walk interval.  The week after the surgery I walked the entire distance.  2 weeks post surgery I did a 4 min walk / 1 min run interval.  I had to use an ace bandage to keep the girls from bouncing. For my last long run I did a 4 min walk / 1 min run for 8 miles again with the ace bandage.  I felt pretty good until 6 miles then my legs were dead.   I believe that was a side effect of doing the 2 week food test.  The 2 week test will eventually get it's own blog post.  I originally planned to start the test after the Quarter Horse but decided to start it sooner.  I wanted to be done prior to starting radiation & since I had already reduced my run volume I didn't think it would hurt too bad. 

A March running event is always a toss up weather wise.  It could be cold/snowy, wet/windy, sunny/warm or any other combination. The morning started promising.  It was partly sunny in the low 40's.  My plan was to continue the 4 min walk / 1 min run for as long as I could. The first part of the race is on Huffman Mill Pike but the last 7 miles are within the horse farm.  The back half of the course is hilly & of course the wind picked up for the last 3 miles.  Thankfully there was no rain but man the wind was brutal.  I was also grateful that Audrey & I did the entire race together. 

After one last hill to climb I crossed the finish line 3 weeks post lumpectomy surgery.  FU cancer!




Sunday, March 26, 2017

DCIS Non-Invasive Cancer - My Story

I started getting mammograms when I turned 40.  I had several in the following 2 years due to calcifications they wanted to monitor.  When I switched to annual exams I managed to skip 3 years.  Part of it was time flies by & part of me felt that mammograms would always find suspicious areas that would require me to return for follow up mammograms & ultrasounds which would end up being nothing.  So when I was called back in November for a follow up mammogram I didn't think too much about it.

The Diagnosis:

I had my routine screening mammogram on November 17th.  They called me back for a 3D mammogram on December 8th & told me that I had 2 spots that needed biopsied.  Well, that was different but I still wasn't worried.  Honestly, I was more concerned about getting the biopsy before the end of the year since I had already met my deductible.  Yeah, seriously, I thought that. I have a high deductible plan and knew a double biopsy would not be cheap.

They were able to get me in on December 19th before we left for my birthday trip to Chicago.  If you have never had one, a stereotactic biopsy is not a pleasant experience.  You lay face down on a table & you are raised up like your car at the mechanic.  Unfortunately, there is not a hole for your face in the table like at the chiropractor.  You have to turn your head to one side which for a couple minutes isn't a big deal but after 20 minutes is pretty miserable.  There is a hole for your breast to hang through the table.  The doctor will give a local anesthetic prior to starting.  They use imagining equipment to pinpoint the location to get the sample.  Each biopsy took about 20-30 minutes.

I didn't think they would have the results back until after the holiday but they called me on December 21st.  We flew into Chicago that morning & had just checked into the hotel.  The nurse was quick & to the point.  She told me the 9 o'clock location was non-cancer but the 6 o'clock location was DCIS non-invasive breast cancer.  Uh, yeah, heart drops into stomach.  Really did not expect that at all.  The nurse was great & spent time on the phone with me explaining exactly what DCIS was & what the next steps were.  She explained that this was a Stage 0 cancer & that it would be OK to not immediately jump into action.  Her suggestion to me was ask around for doctor suggestions & to call back after Christmas to get a surgery consult scheduled.

That afternoon I texted & emailed several friends for surgeon recommendations.  My plan was to get some recommendations & research them when we returned home.  I gave myself that day to process the information.  The next day was my birthday & I really wanted to forget the diagnosis for a few days.

When we got home from Chicago on Christmas Eve I had this pamphlet waiting for me.  I originally told Steve I would wait until after Christmas to read up on DCIS.  Well, that went out the window when I saw this pamphlet.  So yeah, I spent Christmas Eve on the couch reading up on DCIS. Fun times!


Surgical Consult:

I polled 8 of my local friends to see if they had any suggestions on surgeons.  Luckily most of them did. Several of them are either currently in healthcare or have relatives that are.  So it boiled down to two doctors at Lexington Surgeons.  The two doctors were Dr. Rogers & Dr. AJ.  I gave the nurse the two doctors & told her whoever had first availability I would meet with.  I ended up with an appointment with Dr. Rogers.

The surgical consult was on January 16th.  It started with a breast exam followed with a conference room meeting.  It was Dr. Rogers, a nurse navigator, my husband & myself.  The entire visit was about 90 minutes.  The doctor did a thorough job explaining the typical treatment process for DCIS non-invasive breast cancer.  Since there is so much research on breast cancer the treatment conversation was very straight forward. He reviewed the biopsy results with me.  My hormone receptor status was estrogen & progesterone positive which meant that I would be a candidate for hormone therapy after surgery.  My next steps were to meet with a genetic counselor & get a breast MRI.  After we had these results we would confirm if the lumpectomy was the correct route to take.

The nurse navigator took all the notes for me.  She sent us home with all sorts of reading material & various support therapies.  She also arranged getting the genetic counselor & MRI appointments scheduled and eventually the surgery.

Big Book on Breast Cancer
Just some of the brochures they sent me home with


Genetic Counselor:

The counselor meeting was the next morning, January 17th. We went over my family history of cancers which did include colon & breast cancer.  She explained that about 10% of breast cancers were genetic but the majority were not.  I decided to have the testing done regardless.  They drew blood work to send out for the test.  The results took about 3 weeks to get back.  In my case it was good news, I did not have the genetic marker for breast cancer.  If I did, the conversation around lumpectomy vs mastectomy would be more difficult.

Breast MRI with Contrast:

This one was entertaining to say the least. Well, I can say that now.  When the nurse first took me back she noticed I had surgery in 2001 to remove my left kidney.  Her reaction went something like this, 'hmmm, contrast is processed through the kidneys, we typically don't do kidney function tests unless you are over 50.  You are 46...' I jumped in & told her I just had creatinine tests in October and all was well.  That satisfied her but planted the seed in my head.

Moving on, now I am have my IV installed by another nurse when the first nurse is explaining what to expect.  She tells me that if I need to pull out of the tube for any reason I will have to come back & re-do the test.  This got me thinking to the last MRI when I had a panic attack & had to be pulled out of the tube.  Uh-oh I thought.  About that time the second nurse doing my IV tells me to stop making a fist.  Instead, without realizing it I start pumping my fist.  Oops, that makes blood leak out everywhere.  Oh Em Gee, the blood.  I tell the nurses I am feeling dizzy.  The next thing I know I am waking up, going where the hell am I??  Oh yeah, I am at the imaging clinic about to have a breast MRI because I have cancer.  Shit.

This was my lowest point in all of the treatment to date.  The nurses were great.  They got me cleaned up, changed my gown & gave me some sprite to drink. They told me I was their first fainter. Yay me! After a few minutes I was ok enough to get the damn test over with.

For a breast MRI you lie face down, face & boobs in a hole.  Much more comfy than the biopsy table.  They do some mirror tricks so you are looking at the main room instead of a dark hole.  This was super helpful for me.  At the beginning of the 3rd or 4th scan I started to feel the panic rise up but thankfully was able to quell it with some deep breathing & focus.  The rest of the scan was uneventful.

I went to work for a couple of hours afterward but ended up heading home after lunch to sleep it off.  Like I said, this was the lowest point of all my treatment.

They called me with the results the next day.  They found nothing new on the left breast but found a spot on the right.  They sent me for an ultrasound but they couldn't see anything of concern.  I do get to go back for another MRI in 6 months. This probably would have been the case either way.

With the Genetic testing, MRI & ultrasound results all back I was now able to get the lumpectomy surgery scheduled.

Lumpectomy vs Mastectomy:

When I was first diagnosed there was a part of me that felt I should just have the mastectomy and be done with it. That would eliminate future mammograms, worry & headaches.  At the end of the day the data just didn't warrant such a radical surgery & although I am not a very vain person it was hard to wrap my head around.  The lumpectomy surgery was a very easy decision to make.

Lumpectomy Surgery: 

Since this was a stage 0 & no lymph nodes were to be removed the surgery was outpatient. I scheduled first available which ended up being a Friday, February 24th.  Surgery prep was no big deal, no eating or drinking after midnight.  The first stop on the morning of surgery was the breast center.  Since the tumor couldn't be felt they placed a localized wire to help guide the surgeon.  This was inserted using the same technology as the biopsy.  It took about 30 minutes to get everything in place & yes, you leave with about a foot of small gauge wire taped to your breast.

I am not sure if all breast centers are like this but this one has a gowned waiting room for all the ladies to hang out waiting for their appointment.  You have no idea what people are in for.  Some are there for initial screening mammograms, some are call backs, some for biopsies & some, like myself, are waiting for a lumpectomy.  So while I was waiting, two women starting talking about the wire localization procedure I was about to have.  They went on & on about what a horrible doctor they had & how she didn't use any local which caused them horrible pain.  It wasn't just a quick discussion, they went on for at least 20 minutes.  I finally asked them to stop because they were wearing me out.  I told them I was about to have the same procedure & their response was 'oh, I am sure you will have a different doctor'.  I just shook my head & turned away appalled at their behavior.

When the tech called me back I told her what was going on.  I wanted someone to be aware that someone was really bad mouthing one of their doctors.  Maybe the story was true but the bitching was so excessive I had a hard time believing it.  Some people just love to dramatize things.

Once I had the wire in place the tech walked me over to the outpatient surgery.  We got to outpatient around 10:30AM.  I was called back to pre-op around 11AM where they got me all hooked up to IVs, heart rate monitor, etc.  Steve was able to come back & hang out until they took me in for surgery around noon.  Once in the surgery room things moved fast.  They get you on the surgical table, lay your arms out, hook up all the monitors & tell you to think of really nice thoughts.  The next thing you know, the post op nurse is waking you up in the recovery room.  Crazy.  The surgery took about 30 minutes. That post anesthesia grogginess is funny. I remember asking the nurse 3 times if I had stitches but could never remember the answer.  I was in recovery for about an hour before they had Steve get the car.  They wheeled me out & we were home by 2PM.

When we got home I made chicken noodle soup & barely finished eating it before climbing into bed to sleep it off.  They gave me a couple doses of pain meds before I left the hospital so the pain was minimal.  Later that evening I took another pain pill but that was the last one I needed.  I spent the weekend chilling at home.  I went back to work on Monday.  Still pretty tired but not in much pain.

The incision is about 3 inches & no stitches.  Glue & heavy duty tape was used to close the site.  The tape stayed on for 2 weeks before I finally peeled it off.  It probably would have stayed on another week if I didn't peel it off.

I had the follow up with the surgeon a week later.  He looked at the incision & reviewed the pathology results.  They got all of the tumor but on one side they had what was called inferior margin.  Not too concerning but depending on what the Radiation Oncologist said they may recommend another surgery.  Next steps were to get my Medical Oncology & Radiation Oncology appointments scheduled.

Medical Oncologist (aka major turning point in treatment process):

Lexington Surgeons arranged both my Medical oncologist & Radiation oncologist appointments.  First up was the Medical oncologist.  Baptist has several medical oncologists but my appointment was with Dr. Ari.  This was the appointment I was most apprehensive about because the discussion would be around hormone therapy.  Since my cancer was strongly estrogen positive I was assuming they would recommend hormone therapy.  I had absolutely no interest in taking hormone pills for the next 5-10 years.  I am going to get to menopause sooner or later.  I would prefer it to be later & not pre-maturely force the issue.

Dr. Ari was amazing.  He really took the time to explain his thoughts on DCIS, the treatment options & the typical treatment paths. He sketched it all out to help the conversation. He explained his view on DCIS non-invasive cancer.  He had a hard time calling it a cancer since it had a 99% survival rate.  His point being that people can get to awful-lizing the situation.  Being told you have cancer can mess with your head, even when it is a stage 0 cancer.

Dr. Ari's Sketch
He reviewed the Tamoxifen clinical trial results with me & explained what they meant.  At the end he told me I could take it or not.  For a higher stage cancer patient he would have strongly recommended it but for a Stage 0 he said he would support my decision either way.  He even said the thing I had been thinking, 'you will be watched like a hawk with MRIs & mammograms every 6 months'.  I didn't want to deal with the side affects to slightly improve my odds of reoccurrence.  Looking at the data again as I write this post, I am even more convinced I made the correct decision since I am doing radiation (radio therapy).  Looking at this chart, there really isn't much of a difference between RT & Tam+RT.

B24 Trials
I really thought the doctor would say to take the hormone therapy, monitor the side affects and deal with them accordingly. This would also mean lots of medical oncologist appointments over the next several years. I was so happy to find out this was going to be a one & done session! It really turned things around in my head.  This wasn't going to be a long, drawn out process with a constant reminder (daily pills/side effects) of this diagnosis.

Next step is Radiation Oncology which I am going to break out into a separate post.

Since this is really a fitness blog I have to post at least one race picture.  I did the The Perfect 10 Miler at Mt Brilliant 3 weeks post lumpectomy.  I will save the details for another post but here is me crossing the finish line:

The Perfect 10 Miler Finish.
Read the radiation post HERE


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