Today was our almost two week post operative visit with the surgeon at MSKCC. This time we only had to venture to Basking Ridge, NJ and not wonderful NYC.
Besides checking on Sue’s healing, which by the way is doing very well, we were also to learn the results of the pathology of the lumpectomy. The purpose of the lumpectomy is to remove the tumor and enough tissue around it so that they have what is called clear margins. Clear margins are enough tissue surrounding the cancerous tumor that indicates to the surgeon they “got all of it”.
Clear Butterfly
The results: CLEAR is a bit of an understatement as NO CANCEROUS CELLS AT ALL were found in any of the tissue removed. My first question of course was “Did you remove the right area?”. After giving me a look you would expect, she assured us she did. Obviously very good news.
Future:
Four (4) more weeks of healing and then seven (7) weeks of radiation therapy. Don’t know much of the details yet about radiation, the surgeon told Sue to be prepared to come home afterward and sleep as fatigue is the most common side effect.
So I owe all you good people a wrap-up of the events of the past week and where we need to go. I’ll get a bit more verbose in this posting than those of this past week as I have a bit more energy and a real keyboard and screen to work with.
Tuesday February 5th was a preoperative testing day, the day started at 9:15AM and ended just after 4:00PM
Faith made her presence known and kept Sue company during preoperative testing.
EKG, Blood work, Chest X-Ray and exam with a nurse practitioner
Breast radiology-seed localization – Simply put they use a radioactive seed that the surgeon can then detect at the time of surgery with a special instrument to ensure they are removing the area of interest based on previous imaging of the cancer.
Nuclear medicine-nuclear mapping – After injection with a radioactive dye they map out the sentinel node and lymphatic system from the breast outwards.
Wednesday February 6th was surgery day. We were first cast (approximately 7:30AM) and told to report to MSKCC at 5:45AM. We were staying only a few blocks away and a quick 5 minute cab ride got us there by 5:35 (before staff arrived). We were not the first in line waiting though (second).
Everything went rather smooth, checking in, prepping for surgery. The hardest part was when they tried, unsuccessfully, to start an IV. Sue’s veins in her arms are very sore and scarred from the chemotherapy drugs that went through them. After two attempts the nurses stopped and deferred to anesthesia who were able to get it first shot in the OR.
We warned them that Sue was not very tolerant to any opioid pain killers, not allergic, but not a friend either. After each of her three C-Sections they injected a drug called duramorph a long lasting morphine pain killer. It lasts about 24 hours and basically caused Sue to vomit for the 24 hours after the c-section no matter what type of anti-emetic medications she was given. Makes for some lovely after birth stories for me and the kids.
They did not use any opioids during the entire procedure and I’m happy to report Sue kept everything where it belonged.
Before passing out she also informed the surgeon that if they went longer than expected to please let me know because I would “panic” if it went too long without news. So as I sat in the waiting room, they called other families up to the concierge desk to get updates on their family members and be brought back to recovery. At the two hour mark (about an hour plus beyond what they predicted) the surgeon still in full scrubs, booties, hat and mask comes out to speak with me. No one else so far has received this treatment so I’m ready for the “here we go again”. She apologized for taking so long and said they were done about 20 minutes after starting. They were waiting on the frozen section biopsies of the sentinal lymph nodes they removed. They had removed three lymph nodes and wanted to make sure all three moving away from the tumor site were all cancer free. They were, it just takes 20-30 minutes to complete the examination. I was able to see Sue in recovery about 30 minutes later.
When I went back into recovery she was just awakening from the anesthesia and being the typical “good nurse patient”. One complaint we do have about MSKCC is we did get the feeling of being rushed out of the same day floor after the procedure. Sue was barely awake when they were giving her instructions and her prescriptions to go home with (a nice service). When we were finally ready to leave they asked if we needed a wheelchair or would be walking out. Based on her inability to stand on her own yet (drug effect) we opted for the wheelchair. I got her in it and pushed her out to the lobby asking directions along the way. No help in the lobby either, just left the wheelchair there and told the unresponsive security folks that we were done with it. Another quick cab ride on the upper east side at noon (helped wake Sue up some more) and we were back at the hotel. Sue slept for the rest of the afternoon.
Pain has been tolerable, initially some low dose hydrocodone and advil along with ice took care of it. Now just advil and ice.
What’s Next
We have a followup appointment with the surgeon Dr. Deborah Capko on February 18th. She will have the final pathology reports by then and we should know if all of the margins are clear. If so the surgery was a success. If not Sue will need to heal and then undergo a full mastectomy. The chance of failure (unclear margins) is about 25% so the odds should be in our favor.
Once she is fully healed from the lumpectomy surgery Sue will start a seven (7) week course of radiation therapy. Following that, the next five years will be very diligent follow up and checking for any metastatic disease or local recurrence.
News
Today February 11th 2013 Bob’s Long Valley Pizza, Deli & Bagels will be holding a fundraiser for Sue and the income she will loose while recovering from surgery and radiation. Please stop by and support this local merchant for the West Morris Central School District.
Some have commented here and sent us e-mails about donations. If you want you can send anything you wish into the school. You can also use the page I had setup for Faith on her blog http://www.faithsfolly.com/donate
I just spoke with the surgeon. Surgery went well no complications or surprises. They took three lymph nodes and did immediate frozen section pathology on them. They were all clean.
I should be able to get into recovery in about 45 minutes to see her.
Good evening everyone. A quick update as I am on the iPad and need a real keyboard.
All pre operative testing went well today. An interesting experience hopping from building to building and the upper east side certainly isn’t Washington heights. I would still pick country livin over the city any day.
Sue is first case tomorrow, approximately 7:30am, we need to report to the hospital at 5:45am. Good thing we are only a few blocks away.
