Getting more active

I started taking walks in our neighborhood about 6 days after the surgery, 40+ minutes, once or twice a day. Getting some exercise did me a world of good; it was wonderful to be moving again. But I was still feeling fatigued in the late afternoon and would lie down for a few hours, maybe napping, usually just listening to a podcast.

A week after that, I remembered that there is a nice metropark just 15-20 minutes drive from where we live now. The weather was perfect: clear blue skies and unseasonably cool temperatures in the upper 60's.

It. Was. Glorious!

I chose a 2.5 mile loop trail. I encountered a number of runners, mostly women, wearing their cute running outfits. There I was, in my button-down cotton blouse from the thrift store, purchased to wear while I'm recovering and not allowed to lift my arms over my head, and my hiking shorts that are a size too big because I've lost weight since I bought them, and I didn't care! I was all, I had breast surgery two weeks ago, and here I am hiking on a real trail in the woods, motherfuckers!

By the time I finished I was grinning ear to ear.

I walked there every day last week, with the exception of one day off for recovery. I pulled out my hiking boots, and started extending the length of my walks: 3 miles,  3.5 miles. I had forgotten just how much I love hiking. I love the solitude, and the exercise. And I love the sounds: wind rustling the leaves, my boots striking the ground, water sloshing in my water bottle.

Maybe it's the exercise, or all the sun I've been getting, or maybe it's just the healing process, but I no longer find myself tired in the afternoons. I'm able to get a few things done around the house. I have shopped for a cooked my breakfasts and lunches.

I was afraid I would be bored on disability, far from it.

One day last week, I made homemade deodorant, following a recipe I found online.








The following day, I hemmed a couple of pants. Not quite as interesting as making deodorant, but useful.

Disability is starting to feel more like a vacation. I'm not ready for it to end!

Good news, plus book tips

Earlier this week, I had an appointment with my surgeon to get my pathology report. She was running over an hour late. My husband, Rob, started a new job this week, so I wasn't sure if he was going to be able to go with me. I really wanted someone there in case it was bad news. At the last minute, he was able to get leave to take a couple of hours off work. Unfortunately, because the doctor was running so late, he spent most of those hours waiting.

Finally, we got to see the nurse practitioner. She was smiling when she entered the examination room.  That's a good sign, I thought.

And it was! It was all good news! The surgeon was able to remove all the cancer.  The area of invasive cancer was 4mm, quite small. (Any tumor less than 20 mm is considered Stage 1). There was some associated non-invasive carcinoma (DCIS), which was also entirely removed. She also removed 3 sentinel lymph nodes, all of which tested negative for cancer, meaning it hasn't spread.

I am so relieved! All of this means that I won't have to have any additional surgery or chemotherapy. I made a "Score!" gesture with each new good piece of news. Yeah, totally did not play it cool, there.

The NP left after a brief visit. Rob also had to leave then and get back to work. I didn't have to wait much longer after that before the doctor appeared.

My surgeon went over the pathology results in a bit more detail, and gave me a copy to keep. She also examined my bruised left breast, which she called a hematoma.  By this point, the discoloration is concentrated around the incision, and there is a palpable goose-egg of a lump underneath. I am to treat it with warm compresses, 20-30 minutes, three times a day.

She also ripped off the steri-strips that were protecting the incisions. Ouch! I was not ready for that!

Overall, it was a lot of waiting for a short visit with the doctor and NP. They were so rushed that I wasn't able to get all my questions answered. At least I did get an answer to my major question, could I use deodorant yet? (I wasn't allowed to use any creams or deodorant after the surgery until the incisions healed up). Yes, was the answer, and thank goodness, because my B.O. was starting to get on my nerves!

I left feeling relieved, and grateful, but also like something was missing. The visit focused on the mental aspect of healing -- giving me the pathology results -- and a little on the physical. But what about the rest of me? My doctor told me my job now is to heal, but how, I wondered? I had hoped to get some exercises to do, just some simple guidance, but no such luck. I didn't even have a chance to ask for any. I left feeling cast adrift.

What I do know is that the radiation treatments will start once I'm completely healed, in about 6-8 weeks. I have an appointment to see the radiation oncologist in three weeks, and another visit with the surgeon the week after that.

Other than that, I guess I can look for guidance in the books I have picked up. Here are the ones that have been most helpful.

The Mayo Clinic Breast Cancer Book, Edited by Lynn C. Hartmann, M.D. and Charles L. Loprinzi, M.D.
Man, this book is good! It's a comprehensive guide to understanding types of breast cancer, various treatments, and decision points, like deciding whether a lumpectomy or a mastectomy is right for you. I cannot recommend this book highly enough.

Life Over Cancer by Keith Block, M.D.
I love Life Over Cancer for its clear, easy to read nutritional support for undergoing different therapies, as well as tips on nutrition to prevent cancer recurrence. LOC has more than that, but that's what I use it for. Right now I'm following the suggestions for recovering from surgery (eat plenty of protein and whole grains, in addition to lots of veggies).

Crazy Sexy Cancer Tips by Kris Carr
This book is specifically for women with cancer (not necessarily breast cancer). It's fun, and inspiring, and a little irreverent. This was a great read right after my diagnosis, as I was coming to terms with having cancer. It also gives some pretty interesting diet tips for combating cancer, which I followed after my diagnosis and before surgery (basic premise: no dairy, no sugar, lots of raw greens. Carr advocates a vegan diet, but I do eat fish because I feel healthier when I do).

And now I can add The Breast Cancer Survivor's Fitness Plan by Carolyn M. Kaelin, M.D., M.P.H.
I got this one used, online. It has a program of stretches and strengthening exercises for progressively recovering from breast cancer surgery. It contains tailored workouts based on whether you had a lumpectomy or a mastectomy, and whether you had any lymph nodes removed. This looks like the guidance I was seeking. :-)

Healing

art by Jenia Maslova, http://jeniamaslova.prosite.com/

For the most part my healing has been going really well -- better than I expected, actually. My pain level is pretty low, and gets better every day. The first couple of days were the worst, of course, but even then the pain was manageable by icing frequently during the day. I had been warned that I could have some numbness along the underside of my arm as a result of nerves being stretched or cut during the surgery. I didn't experience any numbness, but I did have a weird neuralgia along the underside of both arms down to the wrist (along the median nerve) that I would call "creepy" or "itchy".  Not painful, but unpleasant. That only lasted a couple of days, though.

I do find I tire easily, and need to rest for an hour or two in the afternoon. My energy is going toward healing.

And then there's my poor left breast.

As instructed by the home-care instructions, three days after the surgery, I -- with my husband's help -- gingerly removed the bandages covering the incisions. Everything looked fine. The incisions remained covered by steri-strips that should fall off by themselves in a week or so. I took a very awkward shower that avoided either lifting my arms over my head or letting the shower spray hit the incisions directly. Very thankful for my husband as a shower buddy!

After the shower I switched to a different bra because I didn't want to put a dirty one back on after showering. I picked a new bra that I'd bought just before the surgery but had never worn. Then I accompanied my husband grocery shopping -- I swear I didn't pick up anything, just pointed out what I wanted -- because my mind was foggy and pointing seemed easier than making a list.

The bra must not have been supportive enough, because when I took it off the side of my breast was an ugly dark purple-red. It didn't hurt internally, but it was tender to the touch, probably because it was so swollen.

I had no any signs of infection that I could tell, and I had no fever or much pain, so I wasn't too worried about it. However, I did notice during the next couple of days that the bruising seemed to get worse after I took a walk or went shopping. I decided to call the nurse practitioner just to be sure it wasn't anything to worry about. She says it is normal to have bruising at one incision site and not the others, depending on whether the cut was made near a blood vessel. So it doesn't sound like anything to be too concerned about. (Though I do wish I had been given some warning ahead of time that I might have some bruising).

Since walking made it worse, I decided it was prudent to stay off my feet for a couple of days.  The bruise definitely began fading and healing.  This photo is from three days after the bruise appeared. You can see the steri-strips over the incision site.

I am getting to know which bras* provide the best fit and support. And I found it is vitally important to wear my most cushioning, supportive shoes. The yellow is still there today, but the red has all but faded now.

*I have been instructed to wear a high-impact sports bra, with a front or back closure, for the first couple of weeks after surgery, 24/7. I bought two to wear as I recovered from the biopsies, and three more prior to surgery, in different brands and sizes (I lost weight in the months after the biopsies and the lumpectomy).

Post-surgery

I am home and recovering from surgery! I was at the hospital Thursday from 7am to about 4pm. The surgery itself lasted about 2 hours. I haven't spoken to my doctor yet, but she did find my husband in the waiting room. She told him the surgery went well. She is fairly sure she was able to remove all of the cancer, but we won't know that for sure until the pathology report comes back from the lab. My doctor also told him that the lymph nodes were okay, which is a great relief to me, because it means the cancer hasn't spread to other parts of my body. Again, we will get confirmation of that from the pathology report.

She also removed a non-cancerous lump containing "atypical cells" on my left side which will also be tested to get more information about it.

I have a follow-up appointment with my doctor scheduled for July 24th, a week and a half from now. By then, she should be able to give me the pathology lab results.

I was in the pre-op prep room for quite a while before the surgery, so I had time to ask the anesthesiologist what I was going to be given. First I would get a relaxant and an amnesiac drug via IV to put me out. Then I would get a tube down my throat for the gas. (That gave me a sore throat for about a day.)

I got a small dose in the IV before I was wheeled to the OR. I was only in the OR a for what felt like 5-10 minutes before the anesthesiologist said, "This is it." I started saying my relaxing mantra--"Humme Hum Brahm Hum"--but I didn't even make it to the last Hum!

The next thing I knew someone was waking me from a dream where I was at a party, telling a friend that I'd had "A lumpectomy, both sides." (I'm sure now that I was actually responding to a nurse's question). The nurse called my name to wake me up and asked me if I felt any pain. I was being wheeled down the hallway to the post-anesthesia care unit. I think I was out for about 5 hours.

I was pretty dizzy coming out of the anesthesia. I was given an anti-nausea drug, which kept me from throwing up, but the dizziness had to wear off on its own. I sipped water and snacked on crackers and banana until I finally began feeling myself around 6pm and ate a normal dinner. I was wide awake by 8. And 10. And 12.

To try and get sleepy, I finally took some of the Percoset I'd been given for pain, but I was afraid of taking too much and getting dizzy and nauseated again. So I took an 8th of a tablet at a time until I'd eventually taken half a tab, which finally put me out around 3am. Yay insomnia!

I took another half tab last night at 10pm. I slept all night, but woke up parched and with a crazy headache. I downed three or four glasses of water and the headache subsided. The bottle says the dose lasts about 6 hours, but honestly, it's been 20 hours since I took it, and my brain is still foggy and loopy. No one ever needs to worry about me getting hooked on opiates. I'll stick with wine, thanks.

Finally....a surgery date!

Earlier this week I got a date for my surgery. June 11. Two weeks from today. Two weeks is good. Just enough time. Enough time to delegate all my work and get the house ready for my recovery period. Just enough time to get mentally and spiritually prepared.

Two weeks is not enough for me to really freak out too much, either.

Two weeks is just enough.

Pre-surgery visit

I had a visit with my surgeon's nurse practitioner today, basically a pre-surgical intake visit. I got bloodwork, an EKG, and a chest x-ray to make sure I'm in good enough health for the general anesthesia.  I also got educated about how to prepare for the surgery, what to expect the day of surgery, and aftercare.

I confirmed that I will have a lumpectomy on the right breast. I will also have a biopsy done on one of the lymph nodes of the right breast, to see whether the cancer has spread to the lymph nodes. I will also have a non-malignant (but possibly pre-cancerous) lump in the left breast removed. I will end up with three incisions: two on the right and one on the left.

What I did NOT get was the thing I was most anxious to have, the thing I've been telling everyone I would get today: a date for the surgery.

Instead, I will get a call when they have a date for me.

The waiting game is hard. As the impending surgery draws closer, my desire for a hard date grows stronger. The date is my deadline. It's my crap-I-need-to-delegate-my-workload-before-I-leave date. It's my is-the-house-ready-for-post-surgery? and am-I-mentally-prepared? deadline. I feel a great need to know this date, and how much time is left before it arrives.

"Begin to relax with, lean in to, whatever your experience may be. Drop the storyline and simply pause, look out and breathe." Pema Chodron

This is a place for good Buddhist practice. Can I sit with uncertainty? Can I, as Pema says, drop the storyline and relax into the experience? So far, the answer has been not so much, as far as the waiting game is concerned. I will have to work on that.

I am, however, doing extremely well with my needle phobia. I got two vials drawn with no pain and very little fear!  (Well, okay, I did kind of collapse into a little puddle of  relief when it was done. But I got through the actual experience just fine!).

Actually, the most difficult thing about today was discussing the disability paperwork with the nurse practitioner. I dutifully relayed the instructions I had been given by my HR person as to getting them filled out so that the State approves the leave with the least amount of hassle. The NP was incredulous about such stringent requirements and sort of argued with me a little. Finally she laughed and admitted that in the end she'll probably forget my instructions and fill them out the way she usually does. But at least I've done my due diligence!

Adding insult to injury

In preparation for surgery, I have been instructed to stop taking some of the supplements that I take. Some may cause extra bleeding, like Vitamin E and Omega-3 capsules. And some may interfere with the general anesthesia. One of these is St. John's Wort. St. John's Wort is a mild anti-depressant, of the SSRI type. I take it in the winter to help alleviate Seasonal Affective Disorder, aka Winter Blues.

Granted, it's nearly summer now, and I should be letting it go for the year. But REALLY???? I'm going through a major life change, here...I have CANCER, fercrissakes, and I'm supposed to give up my antidepressant?!?

*sigh*

But I'm game. And it's not going as bad as it could be. I have been stepping down gradually over the past 4 weeks. From 3 capsules to 2, then 1, then half a gelcap (open top of gelcap, sprinkle out half the powder), then a quarter gelcap. Each time I step down I have a couple of days of random weepiness and crankiness, then a couple of days of low, but gradually improving, mood. By the fifth day I am feeling back to normal. Day six is a happy day. Then it starts all over again.

I took my last quarter gelcap two days ago. That's it. No more St. John's Wort. This last time, having already gone through four cycles of sad days, and knowing there was one more coming? That took some inner fortitude. Yesterday was not great. Today I am feeling better. Knowing this will end and I will feel normal by Thursday is very good. I spent a lot of my younger years depressed, and the feelings I am having now are oh so familiar. I do not miss those days.

I have a meditation planned for this afternoon, and that will help. And I will see if I can get out for a walk in the sun in a bit. Also very therapeutic. But if you were at the party I attended last night, and I seemed down? Now you know why. Sorry about that. :-)