After the OperationThings in our lives have just become a tad more interesting. Close to the end of 1999, my annual check-up was scheduled, during which my regular mammogram was also scheduled. Lo and behold....a small mass was noted, and it was suggested that I have a biopsy performed.When the biopsy results came back they showed a Ductal Carcinoma In Situ (commonly known as DCIS).
This means that
1) I have a cancer
2) it is non-invasive, at this time and therefore non-life-threatening.
I wish all women over the age of 25 were able to consider having an annual mammogram simply because the lump found in my breast was not palpable (meaning it could not be felt during a routine breast exam). Only because of the mammogram was this lump discovered. The sad thing is, that not every country has easy access to mammograms for women. It amazes me, though, to find out that, even here, some women are most reluctant to have them done as part of their annual checkup..(assuming they care enough about themselves and their loved ones to have the check up done!!).
Fortunately, in Canada at this time, we have an excellent Health Care system and therefore, do not have to rely on private insurers for medical coverage. In cases of cancer, I was informed by the Plastic Surgeon, even a non-invasive type, there is an 'urgent' flag put up. This means that Cancer cases take priority over most everything when surgical facilities are needed.
Cancer, in any form, has no age bias. It doesn't care how old you are to form in a breast. It is an insidious disease, and can hide so well that only certain methods are able to detect it. Of course, having every woman over the age of 25 have an annual mammogram is a bit of a pipe dream in this world where everything we need is so expensive. However, regardless of cancer history, or lack of it, in a family should have their Doctor's encouragement to have the simple (though) uncomfortable test that could save their lives.
Suddenly my life wasn't quite as settled as I thought....now there were decisions to be made that were not going to be easy at all. I do not enjoy making decisions......at all!
I visited the Surgeon who had performed my Biopsy and who, in turn, referred me to the Tom Baker Cancer Clinic here in Calgary. There I met a very soft spoken Doctor, I think he was the Oncologist, a Dr Craigshead. He gave me a thorough breast exam and then explained to me what he had found, after the initial biopsy. Originally, Dr Martin, my surgeon, had said that the cancer was about 2cm large. Not too big in the scheme of things really, however, Dr Craigshead had found it to be closer to 5cm in size. This size difference would make quite a difference in any decision I had to make
I had two choices really. The first being another biopsy, or lumpectomy followed by radiation therapy. This would be followed by another mammogram to make sure nothing else was left. If anything suspicious was found, then another lumpectomy followed by radiation therapy would be scheduled. Hopefully, this treatment would completely rid me of all sign of cancer. There is a pretty good survival rate for this type of treatment for DCIS, but my concern was, that the radiation would have certain side effects (not as drastic as those with chemotherapy) one being that I would probably suffer extreme fatigue. Then the worst case scenario would be possible occurrance of DCIS in the other breast, or more cancer and a recommended mastectomy. The second choice was a complete mastecomy (precluding any possibility of recurrance of the cancer) and eventual reconstruction of the breast. At this point I was under the impression that reconstruction would have to wait until the site of the mastectomy was completely healed.
So, the first decision was made after much discussion with my incredible husband and supportive family members and friends. I would have a mastectomy performed to remove the complete left breast. I informed Dr Martin of my decision and he sprung this question on me "would you like immediate reconstruction?". My response was "Can I?". You see, in my ignorance it hadn't occurred to me that this would be possible. My answer was definitely Yes.Now, another decision had to be made. What type of reconstruction was available and what would be best for my situation. Ugh...I do not enjoy making decisions. Especially decisions that ultimately affect my physical and psychological future.
Immediately I began to perform web searches for DCIS. What luck, I found one site developed by a remarkable woman named Patricia Murray. http://inform.acor.org/diseases/breast/recon/pmurray/artbc.html . I recommend her site for it's integrity, wit and honesty. Her pictures aren't bad either!!!
Patricia's was the first site with photographs that I could identify with. She is built similarly to myself and the photos and text were totally informative. The whole site takes the viewer from before, during and after the mastectomy and reconstruction (using implants).
At this point I needed to see a site where another form of reconstruction was illustrated and described. The formal medical sites are all rather informative, however I did not find any with pictures with which I could identify. Drawings and old photos (in other words not current ) just do not do not help me understand the process and it's end result.
This time I discovered Nancy Delaney http://www.idsi.net/~delaney/owr.htm . Nancy had chosen to have reconstruction using the TRAM method. Simply put, this method takes muscle and flesh from one part of the body, and uses it to replace the missing breast. Nancy's site is as well done as Patricia's with photographs and text also showing aspects of the operation and process.
After informing Dr Martin of this decision he arranged an appointment for me with Dr Haugrud, a plastic surgeon, who will perform the process. He also told me something of great interest, the reconstruction is covered by Alberta Health Care because it is not considered merely for cosmetic reasons. That certainly was a relief to hear. I am sure it is information that most Canadian women, in my situation, are not aware of either.
Dr Haugrud explained both processes in more detail for me, as well as showing photos of women who had been through both procedures. I saw and felt the saline implants for one type of reconstruction, and had the TRAM procedure explained in complete detail. After discussing it with David, I decided on the TRAM.
Dr Haugrud has now asked me to refrain from taking any painkiller or anti-inflammatory which could make it difficult for my blood to clot properly during the operation. He prescribed iron tablet (ferrous glucomate) to build up my blood so that it will be possible to donate two pints of blood for use in case of an emergency. This will take a couple of weeks, then once the blood has been taken and both Dr Martin and Dr Haugrud have corresponding time available (they are estimating at least 5 hours needed for both operations) the operation will be scheduled.
Today's date is January 23rd, 2000 and that is all my news up until now....I will write more as soon as it becomes available
In the meantime here are some URL's for Canadian Cancer Sites.....full of information, reassurance and support lists.
I found these sites with the help of my l favourite search engine....Mamma.com. By simply asking 'mamma' to look for canadian cancer sites, or canadian breast cancer sites I found all of the above sites. Wherever you live, in whatever country, simply put in the specific words you need and mamma will find it.
Well, we have 'action'. This morning (January 24) Dr Haugrud's office called and informed me that my surgery (or as I like to refer it as....lift off!) is scheduled for February 18th. I will be called by the hospital shortly to let me know when the first unit of blood will be extracted; then the second unit will be scheduled.
The Canadian Blood Services called and I have two appointments to give blood. One on Feb 2, and the other on Feb 9, at 8:55 a.m. on both days. Any one who knows me well understands my concern about this......Oh, no, not about the giving of the blood.......it is in the morning, well before noon, almost before the birds are up.....and, I do not 'do' mornings with either grace or dignity!!!!!! Seriously though, my conversation with the blood services nurse was quite interesting. If , during, my operation I do not require a transfusion, then the blood will be deep sixed, trashed, thrown away. When I asked why, the answer made sense....in a way....because not enough is known about the actual source of cancers it is not wise to risk giving the blood to any one else.
It then occurred to me to ask about my donor card. I am a great believer in organ donation, it is something that makes sense, however, since my blood cannot be given to any one else...would the having of cancer (in any form) make it impossible to donate organs (after I am gone, of course!!!) The nurse suggested that I make note of this on the donor card, and I would suggest any one with similar questions check with the health authorities in their own area.
UPThere is another appointment coming up, on Valentine's day, it is at the Pre-Op Assessment Clinic at the Rockyview Hospital. Oh, it is in the morning again, however it is a little better than 8:55 a.m....not much though. The appointment is at 10:30 a.m. I was able to barter it up to 10:30 from around 8:30 but it is still before noon. At first I was told that the appointment could be done over the phone, but then 'they' changed their minds and want to see me in person. It is morning for gosh sakes.....it must be a test!!!! If this keeps up I shall be one very grumpy mastectomy patient by the time the operation date comes around. Thank goodness they make me take my dentures out.....then I can't bite anybody!!!! The funniest thing about this last appointment is, the questions I shall be required to answer are the same questions that have been answered at each doctor who is involved in this whole thing!!
For Example:
| Have I had operations in the past, including dental? When, What and Where. |
| How about any problems with anaesthetic? |
| A list of medications, prescribed, over the counter and herbal etc. What, How Many, How Often. |
| Do I smoke? (No by the way) |
| Did I ever smoke? (unfortunately yes) When and How Many. |
| When did I stop. (six, almost seven, years ago). |
| Do I have Allergies? |
| Have I had a Respiratory Infection in the past three weeks (I think it is three weeks). |
| Have I had Malaria? |
And the list goes on. I suppose it is necessary, but I really think they are all comparing notes to see if I can remember what I answered on the previous sheet!!!! (just kidding)
UPWell, I gave my blood. Anyone who hasn't, like myself, ever given blood before..be prepared for some 'interesting' questions, other than the regular health related ones that is. I found some of them amusing...but that is me! All my answers were negative so I am now 'officially' a boring person!!!! Just kidding of course. After giving the blood, which didn't take long at all, I got really very tired. More tired than I realized. David was waiting for me in the 'snack area' but I did not even want a snack. Remember now, this was an early a.m. appointment for me and all that was in my mind was...."Take me home so I can go back to the warm, cozy comfort of my bed". So, off we went. After getting in the house I stumbled to the bedroom, disrobed, crawled under the covers and remember nothing until about 2pm. Being that tired is really not pleasant because you are not awake long enough to be aware of the luxury of going back to bed! Oh, well, at least I know what to expect when the next 'unit' of blood is taken!
UP
UPToday, Valentine's day, and where was I? Getting pre-processed, in the Pre-Operative Assessment Clinic at the Rockyview Hospital. Romantic don't you think? NOT! There I filled out another form answering the same questions about the same things.....medication, past operations, any allergies...etc. etc. etc. It is safe to say that this could be done with my eyes closed!!!
In all honesty though, the nurse who worked with me today gave me more information about this operation than has been given in a while. First, although the op will take between 5-6 hours, I will be out of commission for about 8 hours all told. This gives me time to wake up properly before I get taken to my room.
After
the operation it looks as if I shall be in hospital for anywhere from
5 - 7 days. Then, and here is the worst thing imaginable, once I get
out.......I will not be allowed to do housework!!!!!! 
As to using my left arm, that, it seems will not be viable for a while.
Because there will be a sample removed from the lymp nodes (just to
be sure there is no cancer there) I will be limited in what my left
arm can do. Now, here is the frustrating part of this.....two years
ago I fell and smashed my elbow, the surgeon who rebuilt it left a
loo, but small, piece of bone in (he said it would't be a problem.....and
it wasn't ....for him). This piece of bone has been moving around
causing problems in the use of my hand and arm. Why am I mentioning
this? Simply because I am also primarily left handed!!! Thank goodness
I was educated in England at a time when one was discouraged from
using the left hand ( a sharp slap with a wooden ruler could be a
deterrent!) So, I am able to use my right hand for some things....but
not the important things. So, other than my 'front end job' making
things tricky, my left arm will be out of commission for a while too.
Damn it!!!!
On
the bright side......I
will be alive!
UPWell, just one more day to go....it is the 16th today....tomorrow I will be pretty busy, making sure everything is ready to go. Suitcase packed, pretty housecoat.....slippers, books, magazines.... Tetris game-boy!!!! So, if anyone would like to email me....Just click here . I will answer all when 'they' let me type again...or before, if I know my pushy nature!!!!
Always
Remember
....."If You Hide From The Rain.....You Will Never See A Rainbow..."