Diagnosis

Three Appointments in One Day

Thursday, May 19, 2016

Appointment #1: Laser Dermatology

This was a big day for me, with three different appointments scheduled, including one unrelated to cancer.  Prior to “catching  cancer,” I had recently decided to deal with a few minor lingering health issues.  One of them was attempt #47 (exaggerating, but not a lot!) to eradicate the painful Plantar wart that took up residence on the ball of my left foot when I was about 14 years old, and has refused to budge ever since.  So, on Thursday morning, my day started with my monthly visit to the laser dermatologist who has been mounting a valiant campaign against it.  I’ve been visiting him monthly for the last year-and-a-half.  It’s a persistent little bugger!

Let me tell you, getting your foot lasered to remove a wart hurts like a sonofabitch.  Apparently after three pulses, the temperature at the site is well over 200°F.  The doc has told me stories of having brought police officers and war veterans to tears.  I don’t know how it compares to waterboarding, but it definitely should be outlawed by the Geneva convention.  The saving grace is that it’s over with very quickly, and the lingering pain is minimal.

Last month, my appointment for the laser procedure happened to be on the same day as my biopsy.  At the radiologist, as they were prepping me for inserting the needle, everyone was very careful about warning me that the initial “sting” of the needle might hurt a bit, etc.  As the needle went in, I thought, “That was it??  Oh, you have no idea!!!”

Appointment #2: Breast MRI

Shortly after my monthly foot torture session, I checked in for the breast MRI.  The other minor health issue I’ve been dealing with lately is my lower back, for which I recently had an MRI done.  The back MRI session was surprisingly relaxing; the technician let me select a genre of music (I chose classic rock — I figured “indie folk” would be too open to interpretation), then I laid comfortably on my back with a pillow under my knees, snuggled into a warm blanket, and rested, meditated, and listened to music for 20 minutes. When I came out of the machine, all sleepy-eyed and relaxed, the technician quipped that he could “sell time in that thing in the mornings”!

Yeah.  The breast MRI was not like that at all.

After stripping down and removing all metal, I donned the standard-issue hospital gown that is clearly not designed to be open in front.  Next, I looked away while a clumsy technician stabbed me a couple of times until finally finding a vein for an IV, which would be used to inject a cold dye into my bloodstream (blood feeds the cancer, so the flowing blood brings you straight to the cancer).  Once in the MRI room, I had to lay on my stomach with my boobies dangling down into two holes on the bed, my arms over my head (told you there was a theme there!), and my face in one of those massage table holders.  They admonished me repeatedly throughout the procedure to stay as still as possible, which is very hard to do when your face starts to ache from padding that felt fine for the first few minutes but now feels oppressive; and when your arms are over your head, becoming painfully numb.  At least there was classic rock playing again, so there’s that.

Appointment #3: Dr. Cancer

My final appointment of the day was in the afternoon, with the Hematologist Oncologist, Dr. Cancer*.  My understanding is that my oncologist is the one who’ll stick with me for the long haul.  Once the surgery is done, and any other treatment is done, I’ll have regular visits with Dr. Cancer for at least several years.

Given the time of day that the appointment was scheduled, I was not expecting Tad to be able to join me.  So I was happily surprised when he showed up, just in time, in the waiting room.  What a sweetie!

Once in the exam room, Dr. Cancer’s intern examined me first, interrogating me at length about my lifestyle, family history, etc.; then she gave me a physical exam (SO MANY PEOPLE want to feel me up these days!!), including … my ankles.  WTF?  (Apparently swollen ankles tells them… something.  I do not have swollen ankles.)

Then Dr. Cancer herself arrived.  Earlier that afternoon, the wonderful Dr. Zap had actually called me and left me a voicemail with preliminary results from the MRI, which I thought was super nice of him.  Dr. Cancer had also reviewed the MRI already.  So Cancer Talk Version 3 had evolved to include those results.

First of all, Lefty is clear – no cancer there!  But Righty does not look good; even us lay people could see it very clearly on the MRI image: looks like a bunch of fireflies in a jar (see below). Dr. Cancer explained that this means the cancer is “multi-centric.”  Multiple tumors in the same breast quadrant is “multi-focal”; and across multiple quadrants – as mine is – is “multi-centric.”

This does not change the diagnosis; the cancer stage is based on the size of the largest tumor, which in my case is 1.8cm, so that still counts as Stage 1.

What it does change is the treatment plan.  Because there were so many lumps, across two breast quadrants, a lumpectomy procedure was no longer an option.

This means: full mastectomy of the right breast.

On the upside, it probably also means no radiation; but that would need to be determined at the time of surgery.  I learned a bit more about what’ll happen at the surgery, but I’ll save that info for my next posting when I write about my visit with the general surgeon.

And not to be a ridiculous optimist: but it also means we’re back to PROJECT PERKY!!! (Hey, silver linings!!!)

MRI-annotated
MRI.  Yes, I covered the nipples with smiley faces.  You’re welcome.

 

 

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