Part Forty-Four: Complete Response

            Today (November 22) is another landmark day, a pre-Thanksgiving Tuesday I will celebrate for years to come.  It is the day I received the two best words a breast cancer patient can receive from her surgeon:  complete response.

            Complete response means that the pathology report from last week’s lumpectomy and sentinel node biopsy was negative.  In other words, I am cancer-free!  All that remains is radiation.

“Wait a minute,” you say.  “Why do radiation when you are cancer-free?”  That has been my question for months.  I was sure that if I was declared cancer-free I would never consent to radiation.  Today, I asked Dr. Smith what would happen if I did not do radiation.  She knelt down beside me and said, “Without radiation, the risk for cancer recurrence in your breast is thirty percent.  With radiation, the risk for recurrence is fifteen percent.  Why stop treatment now when you have all the hardest parts behind you?”  Her facts, the solemnity of her tone, and the look of compassion and concern on her face sealed the subject for me.  Besides being a highly skilled surgeon, she is an incredibly compassionate woman who is invested in the well-being of her patients.  She wants the best for me, and she has the knowledge and experience that give her words great weight.

            Thus, I am saying yes instead of no.  

Part Forty-Three: From Worst to Best

            I was prepared for the worst.

            And only now do I realize why:  Because of being so sick all summer from the “red devil” chemotherapy.  Because of the pneumonia that landed me in ICU over Labor Day Weekend.  Because of the peripheral neuropathy from the Taxol.  It’s been a rough road.

            I was supposed to be rejoicing over the death and disappearance of my tumor.  And I was, except that I was having such a hard time with the neuropathy.  And then the week before surgery, I was struggling emotionally with the information about lymphedema and physically with severe joint pain from being off my anti-inflammatory medication. 

            I read up on lumpectomy recovery and also remembered recovering from my dislocated shoulder in 2004.  I was prepared to be helpless and in lots of pain.  Thankfully, oh so thankfully, that is not what happened.

            But let me go back to the day of surgery for a moment.  My daughter drove me to Hillcrest, and we settled in to wait in the pre-op area.  The pale purple disposable hospital gown and dark purple slipper-socks cheered me (I mean, who doesn’t like purple?).  The IV insertion in the back of my left hand was surprisingly painless.  The nurses were very nice.  My surgeon, Dr. LaNette Smith, came to check on me and to ask if I had any questions.  Naturally, I could not think of a single one.  Then she surprised me by asking, “Would you like me to pray with you?”  She and Dana and I joined hands, and Dr. Smith prayed.  How her presence and prayer comforted me!

            After some more waiting, a nurse escorted me into the surgery room.  The anesthesiologist put a mask over my nose, and I expectantly waited to get sleepy.  I didn’t.  I was sure to keep my eyes open as a signal that I was awake, and then the next thing I remembered was waking up in the recovery room. 

            The surgery was both brief and successful.  The only difficulty was getting me intubated, but my throat doesn’t even hurt.  Dr. Smith took out the tissue where the tumor had been as well as a single lymph node.  The most uncomfortable part after surgery was how tight the binder was. 

            Recovery this week has been a bit of a lark.  I am more comfortable, physically speaking, than I have been in weeks.  My arthritic joints are rejoicing with the return of Celebrex.  The discomfort from the incisions is well managed by Tylenol #3.  I’m hanging out at my house with daily visits from church choir members and Bible Study Fellowship friends who signed up to check in on me when my daughter could not.  (I’m not yet ready to face the probability of a grandchild bumping into my sore spots.) 

            Next week I hope to receive the pathology report at my post-op appointment.  Naturally, I’m hoping for the best. 

            

Part Forty-Two: No Matter What

            I meant to blog last week.  Really, I did.  But I felt so bogged down by American politics that I didn’t.  I spent lots of time reading news articles, trolling Facebook, and using fact-checking websites.  The mudslinging on social media and in the press depressed me.  Silently disagreeing with my family and many friends--and, evidently, most of Oklahoma--about the presidential race depressed me more.  I stood with Christian leaders such as Max Lucado concerning their opposition to Donald.  I voted for Hillary.

            But America has made her decision now, and it is time to move on.  Today I am especially grateful that my lumpectomy is this month instead of in January.  If president-elect Trump does what he has promised concerning the Affordable Care Act, I won’t be able to afford insurance for 2017.  It seems ironic that a presidential election could well be the deciding factor concerning whether I receive radiation treatments in the new year or not.

            But let’s stop thinking about presidents and policies.  I’d like to go back to my little world of triple negative breast cancer, wildly successful chemotherapy, and next week’s surgery.  Last week the peripheral neuropathy began to lift a little.  It’s not 24/7 anymore.  I get breaks from it for minutes or hours at a time now.  That is a very big blessing.

            On Monday, I followed doctor’s orders to stop taking Celebrex, which is an anti-inflammatory medication that keeps much of my arthritis and fibromyalgia pain at bay.  Let’s just say that my joints and my muscles are complaining loudly every minute of the day.

            On Monday, I also had my pre-op appointment followed by a lymphedema specialist appointment, both at Hillcrest where my outpatient surgery will be.  I came away with a plastic hospital bag filled with copies of completed forms, pamphlets, pages of information, and pre-surgery cleaning wipes.

            Not having had much experience with surgery, I had no idea how extensive a pre-op would be:  filling out forms, answering questions about my medical history, listening to the nurse’s pre-surgery instructions, having an appointment made for December with a sleep specialist because I am high risk for sleep apnea, and having an EKG and a chest X-ray. 

            Then Alice (my neighbor who provided transportation) and I had just enough time to eat lunch in the hospital cafeteria. (It was far better than the food I ate as a patient back in September.)  From there, we went over to the third floor of the Women’s Center where I met with the lymphedema specialist.  That’s where my education really began.

            I learned that the rest of my life will be spent in prevention of and/or dealing with lymphedema.  My right arm has been the favored one for many years due to ulnar neuropathy, tendinitis, and the lingering results of a shoulder dislocation.  I get to favor my arm even more now, protecting it from cuts, scratches, bug bites, and heavy lifting.  No more heavy purses dangling from my right shoulder.  No more blood pressure cuffs or blood draws from my right arm.  Careful surveillance of the right upper quadrant of my body for any swelling, and immediate reporting of such to my breast surgeon.  I learned that stage one lymphedema is when swelling is short-lived, and that is where you want to stop it with appropriate treatments.  You see, lymphedema is progressive, and once you go past stage one there is no return.  At stage two (continual swelling), you must wear a compression sleeve pretty much all the time.  Thus, it is important to prevent lymphedema from ever progressing.  The best thing, of course, is to try your hardest to prevent the lymphedema from ever beginning.

            So please forgive me if I am a little overwhelmed right now.  I’m trying to do a few things around the house to prepare for recovery from surgery, and at the rate I can work, they will not all get done.  I’m in constant pain now with the prospect of post-op pain to follow.  At least the post-op pain will be in different places: the incisions in my breast and armpit.  And I’m wondering how much medical stuff I can cram into December while I still have 100% coverage.

            Last night’s Bible Study Fellowship lesson was from John 6.  The feeding of the five thousand reminded me of Jesus’ compassion and generosity.  I could relate to the raging storm on the Sea of Galilee, the disciples in the boat struggling with the waves, and their terror when they saw Jesus walking toward them on the water.  I’ve been in the storm of cancer for almost six months now, for the most part sustained by “the peace that passes understanding,” but sometimes stricken with terror.  “Don’t be afraid,” said Jesus to his disciples.  “Don’t be afraid,” he says to me.  I don’t want to be afraid.  I want to trust him completely all the time, no matter what.