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Welcome to the DebiLyn Smith blog site. If you like what you read here, check out her website at www.debilynsmith.com

Saturday, September 25, 2010

Part 7 Another Week of Cancer 101 (older blog)


Today it has been 12 days since the second surgery: the widening of the first lumpectomy and the axillary lymph node removal. I have parked myself on the couch as the leather feels nice and cool on my recovering skin and I am able to elevate my right arm while I watch yet another episode of the LOST series I rented. There's a ridiculous stack of DVD's three feet high on the floor and I have a feeling I am going to get though them all. The mobility of my right arm does improve steadily every day. I can now lift that elbow as high as my chin, use it to brush my teeth, spread mayo on sandwiches...that kind of thing. But it tires quickly and I'm back to the movies. I wake up every morning with aching breasts. I can barely touch them, they are so sore, so tender and I know I have to get up to eat something before I can take the Torodol anti-inflammatory which will take the discomfort away. I saw Dr. E on Thursday. After admiring his handi-work, which he says he usually does not do and I believe him, he replaces the bandages with fresh ones and cleared the tubing in my drain. It can come out next week. That means another few days of catching it on the kitchen cupboard knobs and doorknobs. It doesn't really hurt in any way, just is a bother more than anything and is disgusting to have to empty, especially at first with the blood clots in it. The only part that really ruins things is the amount of liquid now sloshing around inside my breast. With half of it hollowed out, it's like a water bed inside and every step gets it rocking. I grip it with one hand and squeeze to stop this but it doesn't help. It's too far inside, so...it's back to the couch. I made it to the gym on Friday and tried pedalling on an out- front stationary bike. That worked well. Thirty minutes on that plus some weights with my legs and I was back to the couch. It's all good. My morale lifts with my new momentum, yet I still feel anxious about the next pathology reports that hopefully come on Tuesday, the 2 week mark since the nodes were sent. If there's any more cancer it may mean more surgery plus radiation in that arm, and they say I do NOT want to go there. Okay. I'm convinced. I do NOT want to go there. I think, actually, that I might just want to go back to that couch. There's still three more LOST seasons to watch.

Monday, September 20, 2010

Part 6 Deja Vu Surgery Cancer 101

August 13, 2010 was a beautiful sunny Fall day. It was because of this fact that I ragged my husband's butt most of the way between Houston and Smithers. We were leaving late and it was so important to me to get in a four hour hike straight up ANY mountain before succumbing to more surgery the next day. I couldn't go backwards before going as far forward as I could push myself first. Just a taste of a major hike. WHAT! We have to stop for gas? How will I make it to Dr. E's office by 3 PM?
Long story short. I didn't. I did make it back down to the vehicle from Terrace's butt burning Sleeping Beauty by 3 PM to phone Dr. E's office. I am on my way. No one minded and indeed I think it was Fate because once in his office waiting room, in walks a good friend. She's here to see about a lumpectomy, which ends up being scheduled for the following week. She will need the dye and the wire and her lump was also 9mm. Wasn't she lucky? I had to hold my tongue and wish it to be so for her.I mean that with all of my heart. BUT, what fun to run into her and her husband. Dr. E has a student shadowing him and when I asked if while in surgery he could biopsy the instigating left breast and have that sample analyzed properly, he insisted on an examination. The student got to practise feeling for a lump, which even I had to say he was doing it all wrong. Ha!
The second surgery required no invasive, painful wire or nuclear medicine. A perkier, well rested anesthetist was at my side and before I knew it, the room was spinning barely after transferring me to the surgery table. I don't remember waking up in post-op but I did wake up to my own morphine pump this time, which I used right off the bat.
With the pain under control, I was fed a liquid dinner. Friends showed up with Chai tea, a chocolate sundae, flowers and fresh fruit. Perfect. A sleeping pill put me down for the night even though, yes, more babies.
The tube jutting out of my side is so revolting I almost threw up the first time I have to look at it. It looks like a rubber hand grenade and it collects clots and fluid that leave my insides and travel down a skinny tube to the collecting bulb below. It will end up flushed down the toilet.
I have special surgical band aids on both breasts that stretch the skin tightly together, sealing the incisions firmly before protecting them against any outside bacteria. My right nipple now points severly right and I look oddly disfigured. I wonder where that student was when that band-aid was applied?
Am I starting to finally see some humour in all of this?
Today is Day 6 of Post-op and I still have 10 movies I rented left to watch. The best place in my world is flat out on our couch. The straight back gives me an arm rest so that my operated arm can sit away from my body. The drain hangs down by my side. I try to get up and walk every day, do some chores, but rest in between. I have to do something to wear off the indulgences I imbibe in everyday now.
Thank goodness I thought to get my long hair whacked off last week. I didn't want to cut it but I can now wash it myself using the one arm. My sister sent me a one handed book holder that I am greatly enjoying (as well as a web cam so we can Skype, a book I wanted to read, cards and our family Treasure...a soft cuddly bear named Homer, who sat by our Mother's side as she passed away).
Morale improves daily. Thanks everyone for the constant support.

Part 5 Getting The Next News Cancer 101

And yet another surgeon I have never met before enters the room. Dr. F will deliver the news which is all good because I don't know him. It will be easier to hold a firm dislike and grudge against the person that can so easily kick the wind out of your sails. The lump was removed with a clear margin, but only a 500 macron margin on one side, which is not the best. Also, a tiny bit of cancer was found in one of the 7 lymph nodes removed. He also mentioned the "C" word (Chemo) which Barry said, "he means future drugs." Barry was thinking Tomoxifin. Dr. F was thinking Chemo. Okay, so at this point I am unsure of what this all means. So I spend the next few hours making up cute scenarios. Just a wee bit of cancer probably means radiation of that node area. Right? Maybe they'll take more out, right? Or maybe , probably I can skip more surgery because it's such a wee bit, a small tumor and I'm so lucky. You said that, or someone said that, who said that? Someone said that. I'm lucky. None of this should be happening anyway.
Then I meet with my friend Dr. V. It was right to the point. Possible full mastectomy. The surgeon will probably recommend going for that clear margin. And Chemo. Once in the lymph nodes, you go for Chemo.
I started to cry at this, but kept on talking as I pulled Kleenex from the box. "But it was only a bit..." and the usual arguments only I could come up with. Arguing with cancer specialists. Does that make sense to anyone else? Is this how I was supposed to learn this lesson in life, the hard way again? Make it so that my arguments would eventually sound ridiculous, even to me?
I left smiling and telling my friend I would see her on the weekend for a jog. I had to hold the breast firmly with my arm or hand as I ran, but I could still run.
It wasn't until I got to the vehicle that the reality hit home and thankfully I have a BF up the road from the clinic. I fell apart in her driveway, great racking sobs mostly from the fear of it all. I had skipped over every Chemo section in all the literature. That wouldn't apply to me. I just had a BIT of cancer. It was just the positively worst news. Or so I thought at the time.
The hardest part through most of this has been the waiting in between. Now we had to wait for an Oncologist to tell us the next plan of action. We picked having a Kelowna oncologist, which means doing Radiation out of that centre.
That plan came through the first of September. More surgery. Dr. E phoned and wanted me back to Terrace for more breast tissue and more lymph nodes. This time I would have a drain attached to my side for 2 weeks to remove the fluid from my lymphatic system. The good news? The breast could still be saved.
Forgive me if I no longer jump for joy at anything a Dr. tells me anymore. To tell the truth I was all psyched to head straight to Chemo and blast any cancer cells still in my body the heck out of there. In fact, take both breasts off and reconstruct a higher, firmer set, then send me to Chemo where I will find the most amazing, life-altering wig and become the most exquisite cancer-free creature, indeed. What do you mean more surgery? I am finally healing. I am just starting back to jogging twice a week, and I did laps this week at the pool. How can I possibly go backwards again? Especially when it is all too fresh in my head. It hurt. Remember??

Part 4 Post Op #1

My eyes are closed but I am talking. It doesn't REALLY surprise anyone. I am coming out of the anesthetic and mumbling on about my mother and the left versus right breast dilemma. Funny, after the scope procedure last month, I came to talking about picking Morel mushrooms.
I'm rolled into a room with 4 beds, which I will fortunately (I think) have all to myself overnight. I'm now on Demerol but it isn't cutting through the pain and I squirm the 25 minutes for it to kick in, but it's not enough. The nurse calls Dr. E and gets me a prescrip for Torodol, an anti-inflammatory and together the meds manage to sooth me. Barry arrives with a Chai Tea latte, such a treat to go with my first meal of soup, salad and sherbet. It's after dinner already. What a long day. My throat is raw, they say from a tube that was in it. My left arm is hooked up to an IV bag and my right arm is too sore to move very far. That is from the sentinel lymph node removal. The wire is no longer sticking out of my breast. I had been so scared someone would accidentally rip it out. I can't see any incisions as everything is neatly covered in clear bandages with small white gauze strips in the middle of them.
MP Nathan Cullen's newborn twin boys keep myself and the nurses up most the night. Add that my IV stand beeping when its battery runs low and the bed across the room sounding off because...what? It was lonely? Not a lot of sleep, so am anxious to go home. I am cleared by Dr. E by 11 am and so homeward bound we go.
The hardest, sorest part is the underneath of my right arm rubbing anywhere close to the trunk of my body. The nerves beneath are positively on fire. I have to keep my arm away from my body at all times.
Fast forward another week to my first inspection with Dr. E. Everything is healing nicely. We leave for our train/ferry trip to the Queen Charlotte Islands a few days later. Some hiking, walking, fine noshing at little eclectic eateries for five days. It helps take my mind off what might lie ahead.
We return to messages on the machine from the hospital. The pathology report is in and a surgeon will see me tomorrow in Smithers to give me the results. They are not at ALL what we'd hoped for.

Part 3 Discovering Cancer 101

I can't convey the weight of attending your mother's ash spreading after being freshly diagnosed with breast cancer. Determined to keep this news from my children until after the occassion was over and everyone was safely back at their homes and into their own routines, I nevertheless spilled the beans to my sister who after one look at me said, "What?" There must have been that "deer caught in the head light " look on my face. My brother and his wife caught on as well.
Breaking news of this magnitude is never easy. You can't tell how the reciprocant will react. My daughter took it the worst, which is to be expected. I know she didn't think of it at the time, but this will now affect her life as well, how she is handled by the medical profession with maternal cancer looming behind her. My step daughter put on a brave face- she lost her mother to lung cancer in 2000. My son and step son are men. Keep them posted. Cheer up. You'll be fine. That's what I thought too. This would be over as soon as you can say "heal from surgery." Right? My son's girlfriend's mother went through this. Diagnosed, surgery, radiation, living day-to-day until hopefully the golden prize of the five year "clear" mark. We would have a scar party when we finally got the chance to meet.
On August 9, 2010 my husband and myself travelled to Terrace and booked into a hotel. We were to see Dr. E this day before surgery to sign the consent form and to go over any last details. I had a page of questions. How many nights in hospital? Can I prearrange no fat meals? Are there private rooms (yes, at $160 extra). How big will the scars be? Does the hospital have hair dryers? "You won't need to wash your hair," he tells me. He may know a lot about surgery, but really, what could this man know about a woman's hair? (In the end, I never had a shower. It was the furthest thing from my mind after surgery. I know, it's a recurring lesson I need to learn!)
At 6:20 am without usual adornment of make-up and jewellery, I walked into the Emergency area of the Terrace hospital. Upstairs in the Nuclear Medicine dept my right breast was injected at 4 quadrants with blue dye. I was taken to surgery where I was braceletted, weighed (149 pounds)and asked about false teeth (prove it) and diseases. Back to Nuclear Science for x-rays of the right breast to see where the dye went to. I carry the hard copy of the images by hand back to the surgery holding area.
Next I'm off to ultrasound to have a wire inserted with the use of ultrasound. This is so the surgeon can find the exact spot where the tumor lies to extricate it. Oh, oh. Dr. Pain again. I tell her this is her chance to atone for that painful biopsy. With my permission, a student was allowed to attend. With breast tissue as dense as mine, Dr. Pain, after three attempts, had the tech hold the breast in two hands while she again attempted to drive the wire deep into the breast to the tumor site. With alligator tears rolling, toes clenched and curled and all breathing stopped, the student was told to leave the room. This was getting ugly. "I suppose failure is not an option," grumbled Dr. Pain under her breath. With surgery pending within the hour, I guessed not as well. Again, then again she tried until searing pain pierced something inside of me, was drawn backward, then pushed through again. It was in place. I had to ask them to leave me for a minute to get myself back in place. But all that did was unleash everything I had kept pent up for the past month. The Why Me, the WTF,had my mother been in this much pain, what was ahead of me, more of this torture or not. It all came out in torrents. The tech helped me to mop up and personally rolled me down the hall toward surgery, where two nurses came looking for me.
Once behind the surgical area doors, I was questioned again by nurses (Alice) and a grumpy anesthetist who had been on call and up all night. He wondered about the strokes in 2002 and I told him they now figure they were a result of taking ritalin for my ADD. And who diagnosed the ADD? I couldn't remember,I have ADD remember? This made the nurse laugh and I was out a split second after. I went to sleep feeling like a silly old woman. (How can these morons be trusted with their own bodies!)My husband later reminded me it was not one but two separate diagnosis from psychiatrists that recommended the Ritalin.
We'll wake up together in the next Blog sequence!

Sunday, September 19, 2010

Part 2 Discovering Breast Cancer 101

After my mother passed of pancreatic cancer April 4, 2009, I decided it was time to make sure my own health was in line. I was 49 and it was suggested a colonoscopy be performed when one turns 50, especially when colon cancer runs in my paternal lineage as it does. So I saw my regular GP for a referral to a surgeon. (That's a whole other story in itself because it turns out my regular GP had started sharing his practise with his brother-in-law, someone who made my jaw drop and my BP rise the first time I saw him. We're talking underwear model, Ladies. Although a short-lived joy as he is always away, I consider it my the best perk in this entire bizarre saga to date) That scope was performed on May 25, by the same surgeon,that had sent me for a breast MRI in Vancouver. He had the results and the mass on the left breast was normal looking BUT there was something suspicious looking in the right breast that they felt should be pursued.
I remember the conversation quite clearly because I was so frustrated. I had gone all the way to Vanc and back to finally get answers on the left breast and the surgeon wanted to discuss nothing but the right breast.
It was then that I was referred to another surgeon, for what reason is not exactly clear ( my argumentativeness??). I was to call the new fellow's office and make an appointment.
On June 2, I waited in this next surgeon's temporary office in Smithers. He is from Terrace and had spent his Wednesday morning in surgery in Terrace before hopping in his vehicle, backpack in hand and travelling to Smithers to see more patients.
A bit behind, Dr. E barrelled into the examining room where I sat draped in a gown. I remember wondering why yet another person had to inspect my breasts? Wasn't the MRI a "Be All to End All?" And another man at that. Little did I know that at the hands of Dr. E I would end up flashing another eight people in the next few months whenever he examined me. All quite innocently as the Dr. faced me the entire time, oblivious of the open door or open curtain behind him. It got to be a running joke. Before meeting Dr. E I had been somewhat shy about baring the breast even with my girlfriend,, Dr. V. I'm writing this 16 weeks later and I tell you I could flash a pair of Saints and not care anymore. Besides, they're little traitors, the pair of them. (the breasts not the Saints)
I think the Torodol has finally kicked in. I seem to be spinning my wheels here.
Back on track. Dr. E wants me to travel to Terrace, 3 hrs from Houston, to get yet another opinion using an ultrasound with the new radiologist Dr. B. I call her Dr. Pain. Although it was never scheduled, Dr. B and the ultra sound tech decided they could also biopsy the growth seeing as I was there. Barry and I were floored that there was even a question of not biopsying that day? Isn't this what we had travelled so far for, not just a consult?
The biopsy is done with a big, thick, evil "needle-gun." It looks like a knitting needle with a very sharp end- one of those long sweater needles, not the smaller sock type. This is stuffed into a gun apparatus. The breast is supposedly frozen, mine repeatedly to no avail, and the knitting needle inserted repeatedly into the tumor and surrounding tissue, taking a "bite" out of the tissue before being withdrawn and then re-inserted. The samples are collected into a pill bottle filled with liquid. They resemble tiny polywogs, only white ones with red streaks on them. They took 4 easy samples, but it is the fifth one I will never forget. Mid sentence of saying, "I'm fine. I hardly feel a thing..." I clenched my teeth, the breath left my body and my knees tried to draw into my chest. It felt like my heart had been bitten by a shark and if I could have I am sure I would have screamed. I'm thinking THAT was the one sample that probably was the cancerous one?
It's a good thing a biopsy was done right away because two days later, as Barry and I left for Invermere to spread my Mother's ashes, we heard that the biopsy returned positive for cancer. Blow me down and knock me over with a feather. I got the news while visiting wonderful, dear friends of ours in Kamloops. It was with a large glass of premium wine in hand and a BBQ'd lamb meal before us that I called my girlfriend, who said, "I'm so sorry." Not able to take the seriousness, I was cracking jokes within seconds and my laughter had everyone in the house sure the news was good. It took awhile to sink in. I'm still not sure it has completely although I can tell you there have been a few days I take this all far too morbidly. I think the biggest realization came when a BF sent me flowers. What? Am I sick? This must be pretty bad. I better take this a little more seriously, I thought.
We all know how healthy I am. There's the shocker.I have never been in better shape. I eat so many vegis, fruit and organic meats.I pump iron and vitamins. Why is this happening to me? And why can't I reach my mother on the phone to tell her all about it?
When the "why me" voice subsided a bit, the WTF voice began. This was all because of an insistent non-cancerous growth in my left breast. A tiny 9mm growth (the size of your baby fingernail) which was never seen on any of the mammo's or ultrasounds in Smithers was only detected out of Dr. V's and my own persistence to get to the bottom of something else entirely. What if I had never gone for that MRI?
And that's not the least of the trouble this little cancerous mass would cause!

Part One Discovering Breast Cancer 101

It was a dark and stormy night. Sometimes it feels as if it should have started this way, this whole nightmarish roller coaster ride I am on, but it didn't. Rather it was a two year long journey of my Dr/friend Sandi and myself monitoring a suspicious formation in my left breast, a "lump" I discovered using self examination over two years ago, so around February 2008. Yearly mammograms usually resulted in further testing using ultrasound, but because of the density of my breasts nothing has ever been found. The lump feels like a hard pea with a long tail. It worsens in size as my menses approach and hurts to the touch the nearer my period comes. This is a good sign, I am told by a surgeon who examined the lump and said, "I hope you haven't been losing sleep over this?" Meaning it neither felt irregular or suspicious or cancerous in any way to him. Not satisfied with that answer, my Dr/friend suggests we have two choices. Either have it removed or fly to Vancouver to have a breast MRI. This cannot be done in PG or anywhere else up North, yet. So, the surgeon agreed to requisition me for the procedure and sent the necessary forms to the Lions Gate Hospital. On May 2, I flew to Van by myself,getting a special HawkAir medical rate which gave me an open ticket. I was under the impression from my surgeon that the "people" at this hospital would get to the bottom of this. That they were very good at what they did and if they felt there was an issue to deal with, that they would deal with it there and then. Looking back, I think the surgeon meant if there was a big cancerous mass or other reason to say OMG, that yes, they would then admit me and do what they must to save my life.
But that's not what happened. After overnighting in North Van, I walked, dragging my suitcase, up and down hills for 50 minutes to get to the hospital. It was sunny but chilly, especially with the perspiration rolling down my back. The exercise felt wonderful, especially before sitting in a waiting room with a surgical gown on for 30 minutes, before being subjected to what could only be labelled a mild form of torture. For a breast MRI, a patient lies on their abdomen, arms stretched overhead on a table that has two holes cut out into which you place your breasts. Headphones cover your ears so you can listen to a station not quite on the country or rock station but in some hideous nether land in between. An "escape ball" is placed into one palm. It's in case you can't take it and need to come out, you squeeze and they bring you out, ruining whatever test they are in the middle of. You are now pushed backward into the MRI machine, back in, very deep into the bowels of the machine. It's like a giant cigar tube and you're rolled to the very bottom of it. PLEASE do not put the lid on while I'm in here!! The entire time of all the tests will take 45 minutes. MINUTES that make you wonder if the clock ran out of batteries somewhere along the arduous way?
Claustrophobia is a strange sensation. I never felt it for the brain MRI I had in 2002. Little mirrors were attached so that I could see out very well from inside the long cigar tube and my abdomen was free to catch full breaths so that I could regulate my breathing. Not so with the breast MRI. You cannot breathe. And trying to do so would fetch a sharp, "Don't Move!" from the techs, even in between the nerve wracking loud Boops, Bangs and Bings that the machine makes.It's like a stick and tin can band straight from hell.
I reminded myself fervently that Barry had paid lots of money for me to endure this privilege, that if I could only lie still, then we would have the answers to what we have sought for two long years. My mother had recently succumbed to a very painful wrestling match with pancreatic cancer, passing away April 4, 2009. It was at the forefront of every thought still. If this was cancer, I wanted it dealt with now.
After the test was finished, I was told to wait while they checked the results were legible. When I was told I was free to go, I questioned the tech about when I would see the results and was disheartened to hear it would take two weeks more. She felt bad I had been under the impression something might have been done that day. As I said, this would have only happened had the techs seen something alarmingly wrong.
So, I boarded to plane to fly home more than a little crushed, with another waiting sentence. But what the heck. It had already been two years. What was another few weeks?
And like myself, you will have to wait for the results. This blog is long enough.

Sunday, September 12, 2010

Travelling A New Road

I've been getting the gears from all sides for failing to blog. Sorry about that, but things in my life have taken an abrupt side road, which may take a serious chunk out of the year for me. On May 2, 2010 I flew to Vancouver for a breast MRI, recommended by Dr. G (first by my friend and "specialty female doctor" Dr. Sandi V.). A suspicious mass was biopsied in Terrace and on July 22 we got the news that it was cancerous. A lumpectomy and lymph node surgery on August 10 removed the small growth but found a slight infiltration of cancerous cells in one of the nodes.
Also, although a clear margin around the cancerous mass was achieved, the width of the margin was not to the oncologist's satisfaction. Think of a fried egg- there wasn't enough egg white taken from around the yolk, so...now I am on my way back to Terrace for a second surgery on September 14. My surgeon, Dr. E feels he can still save my right breast even though taking more from it. (It's worrisome because another friend went through this and her breast collapsed after the follow-up surgery. She now faces breast re-construction. I can't begin to imagine how she feels about this!) Dr. E will also be removing more lymph nodes, this time to check for any more cancer. The samples will be sent to a pathologist and then the results to the surgeon and an oncologist in Kelowna. The oncologist will then tell us the next plan of attack on this surprising twist of fate.
That's the facts. Now for the rest of it.
I do believe everything happens to us for a reason, which I am churning over in my mind as an idea for the next line of books. A series of fictional Chicken Soup For The Soul re-incarnation or "lesson learned and how" books. To help people believe in their purpose, whether they know what it is or not. I believe you make out of life what you put into it but some people stagnate and don't seem motivated to do anything other than survive. Maybe that is all their trip on earth was meant to accomplish this time? If nothing else, this line of thinking sure takes the stress out of worrying that you might not have time left to do what it is you hadn't figured out yet. It also helps your mind set if indeed you are not destined to carry on any further.
I believe I still have a long future ahead of me. But I am not going to bet the farm anymore. Maybe this was a wake-up call for me to get on with what I was supposed to be writing about all along. The past two books were very therapeutic in another way. Now I think it is time to get serious. AFTER I get down this new path. I still have a very long way to go. I have been told I will be getting chemo next followed by radiation treatments. Just something else to write about.
If I have the energy, I will try to keep posting about what having breast cancer is like. I knew absolutely NOTHING about it. So, stay tuned if you want to know more.