Appointment With My Oncologist & A Big Milestone

When I had my appointment with my oncologist on August 5th, I was hoping that my red blood cell count would finally be in the normal range, but it isn’t quite there yet. I wasn’t too surprised as I have been tired lately and not feeling the greatest. At this point, nothing but time will help, so I am trying to be patient.

I am still having a lot of issues with my memory. It seems like only my short-term memory is being affected, but it is starting to drive me crazy. My oncologist asked me if I am still “fuzzy,” and I said that yes, I am still having issues. So, I am taking a week off Anastrozole to see if it helps clear my head or not.

The good news is that I have reached my first significant milestone! On May 23rd, one day after our 17th wedding anniversary, I made it to my second anniversary of being cancer-free! I am incredibly grateful that I have made it through the first two years, and I am hopeful that I will continue to stay healthy and cancer-free until my next milestone in another three years, at five years.

Once I have my next appointment in December, I will finally be on a different schedule with my oncologist. I will switch from seeing him every three or four months to every six months. I am making progress, and it feels good!

My 5th Surgery: Follow-up Appointment with My Surgeon **WARNING: GRAPHIC SURGERY PHOTOS**

Yesterday, I had my first follow-up appointment with my surgeon. Once the tech was done with my blood pressure check and updating my information, she removed my bandage. She apologized at one point because she was pulling on the bandage a little harder because the gauze was sticking to it. I assured her that she wasn’t hurting me because I was still numb under my arm from my first surgery almost two years ago. I asked her how the incision looked, and she said that everything looked good. She then told me that my surgeon would be in soon to see me and left the room.

A few minutes later, my surgeon walked in. I turned to look at him and noticed that he had a winter coat on. I had been sitting there with half of my paper top on burning up because the heat was on. I laughed and said, “You do know that it is 73 degrees outside, right?”; He smiled and said that for some reason, he is always cold when he is in the office.

I have a ton of steri-strips, about 30, and my incision is about 9 inches long. This is my most extended scar so far, but because of how my surgeon combines internal stitches with steri-strips for healing, my scar will be minimal, and it will become less noticeable with time. The scar on my chest’s right side from the first reconstruction surgery is barely noticeable 17 months later, so I am sure this scar will be the same.

I know it looks gnarly, but I am not in much pain at all.

Once we were done talking about this recent surgery, he said that this should be my last surgery. He is confident that I will be fine from here on out and that I will not require any further surgeries. The only way I would need surgery in the future would be if I develop Capsular Contracture. We are both aware from previous conversations that I could develop that particular complication because I went through many radiation treatments and I have implants. I will need to stay mindful of any changes that I am noticing and let him know. The only way to fix Capsular Contracture is to go back into surgery and have my breast implants replaced, so hopefully, I will never have to deal with that.

I asked him if I can start walking on my treadmill. I told him that I had finally fought off the fatigue plaguing me for over a year and that I was getting back to working out again before this last surgery. He said, “so you are itching to get back on,” to which I replied, “yes, I have been since the day of my surgery!” He said that I could walk on my treadmill, but I can’t swing my arms; I need to keep them at my sides, and I can’t do anything too strenuous. I need to keep resting and healing over the next two weeks, and then I should be released from any restrictions once the steri-strips are removed during my next appointment. I told him that my goal is to lose another 20 lbs or so, and he said that it would be ideal for me to do that as it is essential to keep my body mass low considering the type of cancer I had. Estrogen-fed breast cancer thrives when a patient’s BMI is too high, and mine is too high because I am about 20 lbs overweight. So the best thing I can do for myself to keep from having a recurrence of my cancer is to continue exercising, watch my portions, and what I am eating to get to an ideal weight and BMI.

To end my appointment, I thanked him for doing this last surgery. I let him know that I could feel the difference later on, on the day of my surgery, that the area was gone, my chest looks much better, and that I felt much better. I said, “First, you saved my life, and now you are helping me improve my life. I will never be able to thank you enough.” He looked down and away from me when I said that to him, with an almost bashful look. His reaction at first surprised me, but then it didn’t because his genuine reaction reminded me of why I am so grateful that he is my doctor and how lucky I am that he has been by my side from the beginning. He does not have a big ego like some surgeons; he is passionate about his work, humble and caring, and it shows.

My 5th Surgery: Recovery **WARNING: GRAPHIC SURGERY PHOTOS**

When my husband arrived at the post-op area, I asked him to see if I had any drains coming from the surgery site. I was pretty sure that I didn’t have any, but I wanted to know for sure. I completely understand the need for them, but drains are the worst! I have had two surgeries where I had drains; both of the surgeries required two drains, and they make recovering from surgery that much more challenging. They have to be emptied twice a day, and it seems like they are always in the way of anything I might be trying to do. Plus, for me anyway, there is a constant feeling of the drains pulling on my skin; it is a weird, uncomfortable, and sometimes painful sensation.

Once I was dressed and ready to leave the surgery center, my husband and I stopped by the pharmacy to pick up my medication. This time around, my surgeon did not prescribe an antibiotic, only Oxycodone for pain and Promethazine for nausea. I called my Dad while hubby was in the pharmacy, and I don’t remember much of the conversation other than him telling me that I sounded out of it, and I was, but I didn’t think I was that bad, or I wouldn’t have called myself. When hubby got back to the car with my medication, I wasn’t sure if I wanted to eat yet, so we decided to go home and get something later once I was a little more coherent.

After we got home and I was feeling a little more awake, I went to the bathroom to look at my bandages. I was surprised to see one long bandage and nothing else. Wow!! Is my incision that long? I have a bruise peeking out from about the middle of the bottom of the bandage, but the pain is minimal, as I am still numb under my arm from my first surgery back in April 2019.

My recovery has been up and down over the last few days, which I know is normal after any surgery. The first two days after surgery are usually the hardest, and then it usually gets more manageable. I slept a lot the first few days, a real sign that my body is working hard to heal from the recent trauma of surgery. I had a ton of muscle spasms in my back during the first few days after surgery, and I am still having them now, but they have eased off quite a bit. I am assuming that they are because my incision is not isolated to my chest this time. I have also had a lot of nausea almost every evening after dinner. My husband says that I have had nausea after every surgery, but I don’t remember having it after more than a few days. I have an excellent nausea med to take that works pretty fast, but still, I would like it to go away sooner rather than later. Yesterday I felt good, and I was hoping it would carry into today, but it didn’t. Today I have been feeling tired and just off; I really don’t have a good way to describe it.

I am starting to itch under my bandage, which I know is a good sign that I am healing, but I am also starting to have pain in a few spots. The pain is not so bad that I have to take anything more than Extra Strength Tylenol, which is good because I stopped taking the Oxycodone every six hours, a few days after surgery. I try to stop taking Oxycodone as soon as possible because it scares me. I am only taking it once a day now, usually before bed, and I hope to stop taking it very soon.

I also have the bottom part of my bandage lifting away from my skin, so I know my surgeon will remove it tomorrow during my follow-up appointment, and hopefully, he will not replace it. My husband took a peek under my bandage before he pushed it back down onto my skin, and he said that I have a lot of steri-strips and some stitches along my incision. If the bandage isn’t replaced, I will finally be able to take a shower, and that will definitely help me feel better. The last shower I took was last Thursday morning, right before I went to the surgery center. I can’t get my bandage wet, but I can use a washcloth and soap, so I have been doing that, but it isn’t the same as taking a nice hot shower. Today I couldn’t stand my dirty hair any longer, so my husband washed my hair in the kitchen sink. He has never washed my hair before, not once in the almost 21 years we have been together, but, at least during my breast cancer journey, this is the first time I have had enough hair to get dirty every few days since I started having surgeries in April 2019.

I will update again soon with pictures once my bandage is off and with the details of my follow-up appointment with my surgeon.

Three Month Follow-up with My Oncologist

As I said in my previous blog post, I have had some struggles recently. I have been trying to write about what has been going on, but it has been challenging to put it into words. I am still not prepared, but there may never be a good time, so I may as well start to talk about it.

I had a check-up with my oncologist back on the 7th of January. I didn’t write about my appointment right away because it was an unusual appointment, not my usual, “Yes, I am doing fine on my medication. My sleep is improving, as I am averaging just one night a week, where I am still awake at 5 or 6 am, instead of several nights a week. I am still fighting fatigue…blah, blah, blah…”

My bloodwork has improved to where all of my levels are normal except for my red blood cell count, it’s still low, and unfortunately, it may be my regular reading from now on. It’s not terribly low at all, 4.18, where 4.20 to 5.40 is a normal range. But being even slightly low, I can feel it, so hearing that I might not ever be in the normal range makes me terribly sad as I hate feeling this way. I asked if there is anything I can do, that some cancer patients say that they take iron to fight the fatigue. My PA said that I could take iron, but she cautioned me that it could upset my stomach, so I should take it only every other day to start if I decide to try it. She also said that she had heard that there is a liquid version that might be easier to take, but she hasn’t seen it, so she wasn’t even sure where I could get it. I am on the fence about taking iron, so for now, I am not doing it.

My PA explained that one of the essential readings they are looking at when I come every three months is my Hgb or hemoglobin. Low hemoglobin levels usually indicate that a person has anemia. There are several kinds of anemia: Iron-deficiency anemia is the most common type. This form of anemia occurs when a person does not have enough iron in their body, and it cannot make the hemoglobin it needs. High Hgb is known as polycythemia. This means you have too many red blood cells. Polycythemia vera is a cancer of the blood in which your bone marrow overproduces red blood cells. With polycythemia, a blood test also shows a high red blood cell count and high hematocrit. So low or high Hgb would be bad for me, it would mean I am either anemic, which was also a concern during my chemo treatments, or I have cancer in my blood. My Hgb is a little low, only one point from the lowest acceptable level, but nothing to worry about for now.

Now for the tough part…for most of my appointment, I cried a lot. It was hard to talk about, even with my PA, whom I adore. I kept looking away from her while I was talking and crying; I was embarrassed. Why was I crying? It was a lot of things, but mainly the fact that I have had an overwhelming feeling of guilt recently. Why do I feel guilty? As it is, it’s hard being a cancer survivor, and for me, it is tough because I have always had a great deal of empathy for people, but now it includes other cancer patients. Recently quite a few people I know, through various ways, are dealing with having a cancer recurrence. I feel guilty because I am still doing well; I am OK for the most part. They are experiencing my greatest fear, and I am feeling guilty because it isn’t me. It is also a reminder that my breast cancer was incredibly aggressive, and it could return at any time.

It is easy for most to say, “don’t live in fear, don’t worry about it,” but honestly, someone who says that to me clearly doesn’t understand how horrifying it is to go from barely needing to see a doctor to countless scans, blood draws, chemotherapy, radiation and four surgeries in a matter of fourteen months. All three of my doctors, my cancer treatments, everything I went through saved my life without a doubt, but it also damaged me in every way. I don’t know if I will ever be myself again, many cancer patients tell me that I won’t be, but I am doing everything I can to defy that future.

At the end of February, I will reach the second anniversary of my first appointment with my surgeon when I was diagnosed with breast cancer. In many ways, I can’t believe that it has been that long already, and in other ways, it feels like it has been a lifetime.

Thank you for being here; it helps to know that people care enough to read my blog, that the information I am sharing helps other cancer patients and their caregivers, and it helps me in more ways than I can say.

Fatigue & Depression

I have been going through quite a bit of fatigue and depression lately. I am still experiencing fatigue almost every day, so when I do have a burst of energy, I make sure to take advantage of it. On days when my entire body is hurting, I try to remind myself that I had my 4th surgery not that long ago, so I don’t need to be so hard on myself when I just want to rest. Resting has become another problem in the form of not being able to sleep properly. It is not out of the realm of possibility for me to be awake until 2 or 3 in the morning, sometimes even later, at least a few nights a week. I realize that fatigue is linked directly with depression, so I am beginning to understand how everything I have been dealing with within the last few months is all part of the same problem.

Not all of my depression is linked to breast cancer, but most of it is. I was talking to a breast cancer patient the other day, and she was asking me how long it has been since I had finished each portion of my treatment. I hadn’t thought about the timing of everything in a while, so as I was answering her questions, I was surprised that time has passed much quicker than I thought. It has been 11 months since my last chemo treatment, 7 months since my last radiation treatment, and 4 months since my previous reconstruction surgery; at times, it feels like a lifetime ago, but when I am having a bad day, it all seems like it happened yesterday. Even with all of that time passing so quickly, my body and mind are still healing. I have been experiencing what I thought were some of the side effects that I had at the end of chemo again, but chemo ended almost a year ago, so I am beginning to realize that some of them are symptoms of depression, as described below. Luckily, we are going on vacation soon, and the timing couldn’t be more perfect. I need a break; I need time away from everything that has been hurting my heart and soul lately, and I need to get my mind and body back on track, and I will!

Depression may be a side effect of breast cancer and fatigue is often a symptom of depression. Some people may have a tendency to depression, which treatment can make worse. At the same time, fatigue itself can lead to depression. Not knowing why you feel drained week after week, and not knowing that this abnormal feeling is normal for many people going through treatment, can make you depressed.

Treatment for breast cancer may leave you feeling sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

If you’re abruptly going through menopause 10 years earlier than you naturally would, with a quick lowering of hormone levels, you may experience feelings similar to postpartum depression.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don’t allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. You may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can lead to fatigue and depression.

How can you tell the difference between fatigue, sadness, and clinical depression? The symptoms of clinical depression include:

  • an inability to cope
  • an overwhelming feeling of helplessness and hopelessness
  • inertia
  • an inability to concentrate
  • memory problems
  • panic attacks
  • loss of pleasure in what used to make you happy
  • lack of interest in sex or food
  • sleep problems

If you think you’re depressed, talk to your doctor. If your doctor doesn’t have experience treating depression, ask for the name of an accredited psychotherapist. Together you can sort out if what you’re feeling is depression or extreme fatigue. Therapy can help you feel supported and allow you to talk about what’s bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better. An accredited psychotherapist with experience treating depression can help.

Follow-up with My Surgeon

On Wednesday, I went to see my surgeon to go over the results of my mammogram and to have him take a look at my breast implants and surgery site from my surgery that was just about four months ago. When he came into the exam room, he said that yes, I have some small cysts in my right breast, but that he is 0% concerned about them. I asked him if the cysts could turn into cancer, and he said no, they wouldn’t as they are benign. I asked him if anything needs to be done about the cysts, and he said that we do not need to do anything concerning them; they will most likely go away with time. He said that he is very pleased with the images from my mammogram and ultrasound and that everything is clear and looks great! {He explained to me when he ordered the mammogram that we had to wait for at least six months after finishing my radiation treatments to do it, or the images would be cloudy, so that is why I had to wait so long.}

Next, he took a look at how I have healed from my last surgery and how my breast implants are settling in. Everything is looking good so far, but my chest has not finished settling into place, meaning that the area under my left breast, in particular, has not dropped down and rounded out, it is still somewhat flat. It takes time for the internal part of the chest to heal and for the implant to get into place, so there is nothing to be alarmed about; my body just needs more time.

We do have to watch for a complication from my breast implants. It is called Capsular Contracture, and it is a breast augmentation complication that develops when internal scar tissue forms a tight or constricting capsule around a breast implant, contracting it until it becomes misshapen and hard. When my surgeon put my breast implants in, he added donor tissue to help prevent this complication from happening, but that doesn’t mean that it won’t happen anyway. He said that if it does happen, I will need to gauge my level of pain, watch for distortion, let him know that I have a problem, and that I am in pain that I can’t bear. He explained that some patients would have a severe case of Capsular Contracture and have very little pain, while others would have a milder case and have horrible pain. He said that if the pain is too much for me, I need to tell him to fix it, meaning I will need to go into surgery and have my implants removed. Whether or not I would need to have a new set of implants put in or have them left out is hard to say; it just depends on the circumstances. Being the excellent surgeon that he is, he told me that this could happen when we were discussing the option of breast implants. I told him that it was worth the risk to me as I was feeling very out of proportion after my first reconstruction surgery. I wanted to feel like me again and not the stranger staring back at me in the mirror.

The reason why we were even discussing this horrible complication on Wednesday was that he pointed out that the implant in my left breast is much firmer than the implant in my right breast during my exam. The firmness is caused by the 25 radiation treatments that were part of the breast cancer treatment performed on my left breast. So, it is already firm, and I need to watch it and check to make sure that I don’t have any harder areas that could indicate a problem is developing.

Unless I notice anything in the meantime, I will not go back to follow-up with him until six months from now. I have fewer appointments with my oncologist and surgeon these days, a real sign that I am healing and adjusting to life after breast cancer. ๐Ÿ’•