Surgery logistics

I just had my mri and physical. The mri did not show any improvement in the tumor or surrounding enhancements since round 3 of chemo. Very disappointing. Chemo round 4 and 6 had a reduced dose of Taxotere and round 5 was delayed a week. I stopped fasting after round 3. And, I generally felt miserable the whole time. A lot of pain and suffering for no discernible improvement. My oncologist says it could be scar tissue, but I do not believe her. The whole point of an mri is to differentiate between cancerous and noncancerous tissue based on altered metabolic rate. If it still looks like cancer, it probably is. The mass is definitely still palpable although smaller. I really wanted a complete pathological response because the survival and disease free recurrence rates are so much better. I am pretty angry actually, but what can you do?

Physically I am doing much better. My platelets are still a bit low at 134, but close enough. BP 123/76, HR 69, Ox 99%. 10# fatter than before chemo. I still have a lot of congestion but they didn't seem to care. I told my oncologist about my back outside ankle hurting before I restarted exercise. I asked her if I should be worried about rupturing my Achilles, and she said she had never had that happen to a patient. She never had an ovarian hyperstimulation patient either before me, so I am not comforted by that response. My peripheral neuropathy is still pretty bad too. Also rather than let me have Herceptin only today or Monday,  she pushed it back again to next Friday. Now I will not be finished until after July 4 as I had hoped. July 9. Again, NOT happy. Between repeated delays, scheduling and computer errors, and a lack of returned phone calls, I am losing patience. Everytime I showed up for the horrible cocktail, my insurance paid them $30k. You would think that counts for something. I miss my old chemo nurse, but I am really starting to understand why she left.

The pre op physical nurse had very little information about what to expect after, although she was lovely during our visit. I walked in to the surgeon's office to ask the surgical coordinator my post surgery questions. She was getting ready to call me anyway because my surgery time got moved up. I also visited the radiation oncology office just to be sure the schedule was set.

Here it is:

Wednesday, November 19:
5:30 AM Wash skin at home with Hibacleanse for surgery prep
6:00 AM Leave home
7:00 AM Arrival and check in
8:00 AM Lymphatic Mapping Procedure aka injecting the breast ducts through the nipple with radioactive dye to see where it travels and therefore how many lymph nodes to take out during surgery
9:00 AM Wire Localization Procedure aka using radiology imaging to guide a needle into the center of the tumor so that the surgeon can make sure she takes enough out around the outside of the needle post to achieve clear margins. It is a surgical guide post.
10:00 AM Lumpectomy aka wide area excision, with sentinel lymph node biopsy (60-75m)
11:00-15AM Estimated time out of the OR, recovery begins (1h min req, est 1.5-2h) I have to be able to eat and drink a little without throwing up, use the restroom and have stable vitals before they let me go home.
12-1:15 PM Estimated time out of recovery and release to go home Get me outta there!

Friday November 21
3:00 PM Herceptin chemo infusion Round 1/12

Monday November 24
9:15 AM Surgery Follow up and Pathology report expected

Tuesday December 2
9:00 AM Radiation Simulation and Mapping

Monday December 8
TBD 6 weeks of radiation every week day, round 1/30

Each step has its own set of horrors, but it also gets me closer to done. There is no alternate route. There is only getting through. So bring it on. Let's crush this.