Tag: heart

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Oncologist Appointment & 2nd Biopsy Results

My husband and I went to see my oncologist on Tuesday to get the biopsy results on my rib. He told us that the results were positive, that there are several cells of cancer located on my rib, and that the mass as a whole is 2.9cm and is located about 1 inch from my spine. I do not have bone cancer; the cancer is not inside my rib. I had absolutely no idea that it was there until a “spot” showed up both on the nuclear bone scan and the PET scan, hence getting the biopsy last week. The cancer cells are similar to the cancer I had before, so it is the same type, breast cancer, so I am diagnosed with Stage 4 Metastatic Breast Cancer. It is metastatic breast cancer because my originating cancer was breast cancer, and it has now spread from the breast to another part of my body.

Once the biopsy results were in, my oncologist and my radiation oncologist spoke and determined that putting me through radiation would not only be challenging to treat but also a waste of time. It is difficult to treat me because I have cancer in two very different areas of my body, my neck, and back. They decided it would be a waste of time because they are convinced that I most likely have cancer elsewhere in my body that is too small to show up in scans. So they decided that we should treat my entire body instead of just the areas where we know I have cancer. Surgery is not an option because there is no point in opening me up when I most likely have cancer elsewhere. Plus, surgery in both areas is quite risky due to major blood vessels, arteries, and the spot on my rib being so close to my spine. So with all of those facts in place, I will be starting medication on Monday.

Stage 4 cancer has no cure. As odd as it sounds, I am lucky that we are dealing with breast cancer because there are many drug choices for treatment, and the medical world is always coming out with new and improved drugs. Why is that? Because breast cancer is the leading cancer in the US, with over 2.26 million cases per year, followed very closely by lung cancer at 2.21 million cases per year. Stage 4 breast cancer ads constantly barrage us on TV, and that is why. Not all stage 4 metastatic breast cancer meds are chemotherapy drugs, but I will be on a chemotherapy drug called iBrance. No, I will not lose my hair while on iBrance, even though it is chemotherapy which I am very thankful for. What is sad about iBrance is that it is $18,000 a month; no one can afford that, so thankfully, there is an aid to apply for to get it free for a year. I will also have a new inhibitor in an injection called Faslodex. These two medications are often paired together with favorable results in killing cancer, keeping it from coming back, and extending life.

It is hoped that iBrance being chemotherapy will kill the cancer in my body, and Faslodex with replace the current inhibitor that I am taking, which is Anastrozole because it didn’t work. The Anastrozole might have kept my cancer from spreading and growing more, but it did not keep cancer from coming back by lowering the estrogen in my system, which is its primary job. I have estrogen-driven breast cancer, so I have to take an inhibitor. I took Anastrozole for two years out of 10 before my cancer returned. My treatment plan is as follows…I will be taking iBrance for 21 days, and then I will stop taking it for seven days, then that cycle will repeat. On Monday, I will start my Faslodex injections, with the first three injections being one injection every two weeks and then once a month after that. In about three months, I will have a PET scan to see if there is any change in the size of my tumors. If the medications are working, my tumors should be smaller; if there is no change, my medication will most likely be changed. If my tumors are persistent, I may have to undergo infusion chemotherapy again, but we will try to avoid that. I don’t have any details about how long I will be on the medications, but I suspect it will be at the very least until having a clear PET scan; but I will find out for sure when I see my oncologist on Monday.

I will post again when I have more information about the length of my treatment and how my first injection appointment went. Take care, everyone!

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CT Guided Biopsy

A few days ago, I had a CT Guided Biopsy of my 8th rib on the left side, on my back. Everything went well; I am in a little bit of pain, but nothing that Tylenol can’t help. The doctor instructed me to rest for the rest of the day on Thursday, remove my bandage on Friday, and resume my normal activities.

After finishing my paperwork in the hospital registration office, I went to the lab to have my blood drawn for a few panels; among a few other things, they had to check my kidney function before doing the CT, and after that, I went to radiology to wait to be taken to the pre-op area.

Once my nurse was done prepping me for my procedure, my anesthesiologist came to get me and take me to the CT room. He explained that he would only give me enough medication to make me relaxed and a little sleepy but not entirely out. He said that if I did get sleepy not fight it and let myself fall asleep. I did fall asleep for some of the procedure, but I don’t think it was for very long because the process only took about 30 minutes.

When I walked into the CT room, they had me lay on my stomach on the CT table. I was shocked to find out that the lesion is actually on my 8th rib on the left side of my back, not in the front, and it is very close to my spine, so that has me a bit concerned. The rib that I fractured some 18 years ago, that I was thinking was what was showing up in my scans, was a few ribs down from where the lesion is located, so it has nothing to do with the lesion at all. So with that said, I don’t know what to expect when I meet with my oncologist next Tuesday to get my biopsy results.

I have had many people ask me what I think of all of this, how I am feeling, and what my gut is telling me. I can’t help but see the similarities to the first time I went through cancer three years ago. With every appointment, things get worse and worse, more scans, more biopsies, etc. As before, I want to know what type of cancer I have to fight against, and I want to get started on whatever treatment plan my doctors and I agree on as soon as possible so I can get this over with and move on.

I am feeling OK so far. Even if the lesion on my rib is positive for cancer, it appears to be localized like the tumors in my neck, so it is not as aggressive as it was in 2019, and because of that, I have been feeling much better physically this time around so far. Mentally I am up and down; the stress is unreal because this is the moment as a cancer survivor that I have been fearful of, having to deal with recurrence.

Lastly, what is my gut telling me? I will be shocked if the lesion on my rib is negative for cancer. After reading the PET scan report and looking up a few medical terms that I had not seen before, I immediately thought that it would be a bad result once the biopsy results came in. I, of course, hope that I am wrong, and in a few days, I will know for sure.

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Radiation Oncologist Appointment

A few days ago, I had an appointment with my radiation oncologist. I hadn’t seen her in over two years, so it was nice to see her, but I wish it had been under different circumstances. After we caught up on where we had been, I was finally able to show her the pictures from our vow renewal ceremony, so that was nice, and what we had been doing; we discussed my cancer.

Unfortunately, since the CT of my neck came back clear, she has to wait for the results from my PET scan. She needs to see the exact size and location of the tumor to figure out if she can treat me or not. If there is even the slightest part of the tumor in my previous treatment area, she can’t put me through radiation. I didn’t know that you couldn’t radiate the same area more than once, so we must have clear images to compare from 2019/2020 to today. My PET scan is tomorrow, Friday, and I am going back to my oncologist next Tuesday for the results.

So after my initial appointment, my doctor asked if I could come back in an hour to do some plotting with the tech. I didn’t need to be anywhere, so I said I could come back, no problem. When I came back, they took me to the CT room, measured a few coordinates, and went ahead and marked me with stickers in case I could have radiation soon. When I laid down on the table, my doctor came over and felt where the tumor was, and she said, ” it seems like it is very superficial; that might be why the CT scan didn’t see it.” I hadn’t thought of that being the reason for the clear CT, but it makes sense.

Next, they had me put both arms over my head, which is the position I will have to be in for the radiation treatments. It has been almost three years since my first surgery in April 2019, and it still hurts to have my arms up over my head for any length of time. I have gained a lot of mobility back since that first surgery but not 100%. Because of the pain I am in when in that position, they will make molds for me to rest my arms in so the pain and pressure will be decreased, making me more comfortable. When I put my arms up, my doctor felt the tumor again and said it had dropped slightly in location, taking it closer to the area where I had radiation before; this is not good if I want radiation to be the primary treatment to get rid of the tumor.

So, now we are waiting for my PET scan and the results. What will happen if I can’t have radiation? I am guessing that I will have to have surgery to remove the tumor, but after that, I am not sure. I will be asking my oncologist about that when I see him on Tuesday next week.

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Ultrasound-Guided Biopsy: **WARNING: SENSITIVE MATERIAL**

So here we are again, another biopsy, just shy of a few weeks from three years ago when my surgeon did my first biopsy and diagnosed me with breast cancer.

This time I was only in pain when my surgeon gave me the shot of lidocaine. He kept asking me if I was OK because the needle was in for a little bit as he moved it around at different angles to numb the area around the mass. I was facing away from him so he couldn’t see my face for a reaction, so I appreciated him asking me how I was doing multiple times, as it was just another example of what a kind and caring doctor he is.

I had to lay on my right side so he could easily get to the mass because it was at an odd angle on my neck. Since I was lying on my side, I was able to watch the ultrasound monitor and see him put each needle in the mass, collect a sample, then pull the needle back out. As he put each sample into a small container with a tiny amount of saline, his assistant closed each container; there were three in total. He said that the mass is about 1 centimeter, so I hopefully caught it early enough.

All in all, everything went fine. I should have the results back at the latest on Tuesday. I couldn’t help but notice that my surgeon told me that he was taking the samples over to the lab personally, right away. Yes, that did concern me a little, his urgency, and that only made my gut feeling about all of this feel more valid. He also told me that he spoke with my oncologist and that if my results are positive, my oncologist will order the PET scan asap.

Minor bruising today, along with a small hematoma. I am very, very sore, but you would be too if you had four needles poked in you!

My gut feeling is based on these events, are they coincidences? This mass is very much like the first one three years ago in many ways. It feels the same and looks the same on the ultrasound, and there is something else, each time I have had pain in another part of my body before finding a mass. I first had pain in my neck, shoulder, and shoulder blade a few weeks before finding my tumor. I thought I had slept funny, but as the days went by, the pain did not go away. This time, around Thanksgiving, I had terrible pain on the outside of my ear, going up the side of my head to the top of my head. As I said in a previous post, my oncologist ordered an MRI of my head, but it was clear, so we had no explanation for my pain. I was in agony until about two weeks ago when the pain suddenly stopped, and I now have found another mass.

I will update as soon as I have the results…prayers! 💕

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My 5th Surgery: Revision of My Reconstruction Surgery **WARNING: GRAPHIC PHOTOS**

In a previous blog post, I wrote about my follow-up appointment with my surgeon on February 22nd. During that appointment, we agreed it was time to remove the lump under my left arm that has been bothering me for over a year. We scheduled my surgery, and I started to prepare for it. By prepare, I mean following the pre-op instructions that I am given, such as making sure I stop taking certain medications a few days before surgery.

My surgery was on Thursday, March 4th, at 9:00 am at the surgery center. This time I had to go to a hospital-associated clinic and get a rapid Covid test the day before surgery. I didn’t have to pay for the test, so that was a relief because I still do not have medical insurance, and I will have to pay the surgery center fee, my surgeon, and the anesthesiologist directly out of my pocket.

Just like my surgery in April 2020, my husband had to drop me off at the front door of the building. He wasn’t allowed to go up to the surgery center with me and sit with me until I went into surgery due to Covid, but he can come to see me once I am awake in post-op. Once my surgery was over, my surgeon called my husband and let him know that everything went well and that the post-op nurse would call him once I was awake.

I went through all of the pre-op steps with my nurses, such as changing my clothes, getting an EKG, checking my blood sugar, hooking up my catheter, signing paperwork, etc… My surgeon came by to take a look at the area he was removing and to mark a few spots as a guide for himself. He asked me if I had any questions; I didn’t as I am sadly getting used to this process, so he said he would see me soon and left. A few minutes later, my anesthesiologist stopped by to check on me and ask me a few questions. He grabbed a stool and sat right beside me, facing me, as he spoke with me. Little details like what he did just to talk with me is why I prefer to have my surgeries at the surgery center versus the hospital. At the surgery center, I do not doubt that I am getting the best care, one on one, which reassures me that I am being cared for by people who love what they do and want only the best for their patients.

Before I went to the OR for my surgery, I went to the restroom one last time. I know it probably sounds silly, but I always worry that I will pee during surgery accidentally, so I make sure to take care of that just in case. I have never asked anyone if it is even possible to do that, but I guess it is a superstition of mine as I have done it right before all of my now five surgeries. Anyway, when I came out of the restroom, I had two nurses waiting for me, and one of them said, “We are going to walk you straight to the operating room from here.” I laughed and said, “What, I don’t get a ride this time?” They explained that since I was already up and mobile from my bed, I may as well walk directly into the OR. It is a short distance as well, so why not walk in? I told them that I like walking into the OR better because I don’t have to perform the awkward maneuver of moving from my bed to the OR table.

This surgery was much shorter than my previous surgeries, being only about 30 minutes long. The last thing I remember is one of the anesthesiologists; I had two of them this time because one of them was shadowing, commenting on the smell of the mask he put over my mouth and nose; we agreed that it smelled like a new plastic beach ball, and then I was asleep. By the way, I have never had anyone ask me to count backward as I am falling asleep; almost all of the anesthesiologists I have had have told me to think of somewhere else I would rather be at that particular moment.

Everything went well with my surgery, and before I knew it, literally…hahaha, one of my post-op nurses was welcoming me back and asking if I wanted something to drink and what kind of crackers I wanted. When I had surgery at the hospital, they never gave me a choice; I had water and saltines, but the surgery center is different and better in so many ways, including giving me a choice of what I wanted. I sipped my water and ate a peanut butter cracker as I woke up a bit more and waited for my husband to arrive. As usual, I was nauseous, so the nurse gave me some medicine in my IV. I did have the anti-nausea patch behind my ear, but it wasn’t working; it rarely works on me for some reason; I am not sure why.

I will update you about my recovery in a few days and how my follow-up appointment went with my surgeon, which is scheduled for Wednesday afternoon.

Prepped for surgery!
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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.

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