Positive Energy Needed

Please keep these people in your heart today, Linda K's sister - she had surgery on Tuesday and needs to heal well to continue the journey. Elle starts chemo tomorrow and I am sure she is scared. Kathy W. moving through the process of early breast cancer. Tracy B. lost her gallbladder and is worried she becoming hooked on the 3 vicodin she has taken for pain. My brother-in-law Phil.

I am back on the Toradol for my Lupus and starting to feel better already. I am trying to walk everyday.

I still have a tiny opening present where the SAVI device came out. No drainage.

Genetics came back negative for the BRCA1 and BRCA2 gene mutations. BRCA1 and BRCA2 stand for Breast Cancer Susceptibility gene 1 and 2. These are human genes that help supress tumors when they are normal. If the genes have changed or mutated they can increase the chances that breast or ovarian cancer will develop. Mutations are also linked with other types of cancers as well. In my case, this means my ovaries stay put.

I am not in menopause- I could have told them that because there are days I still feel those hormones pumping! This means I am not eligible for the alternative to Tamoxifin or any research studies which would get me other alternatives. I will write more about these drugs in a future post.

Still waiting for my vitamin D level to see how the mega doses that I have been taking helped and becoming a freak about taking anti-oxidants.

Radiation Helpful Hints - Updated 07-20-2009

Please feel free to add these hints if you have ideas from having radiation or from other types experiences. I would love to have a really comprehensive list for people to peruse.

Bring an IPod or an MP3 Player: Listening to your own music is so soothing and keeps your mind off the machine noises. For days when you do not feel as well try uplifting, classical or light tunes. Some days when you feel the fire - rock and roll is just the thing.

Reading material or puzzles are indispensable. I like to read series starting at the beginning and work my way through so I always have something to pick up and go with.

Try to look happy when checking in and leaving. Most of those waiting in the lobby are at the beginning of the journey and we need to show them that we can do it and so can they.

Plan a treat. If you are having brachytherapy you may want to schedule to have your hair professionally washed and styled - no showers for the duration of partial breast radiation. Try a pedicure, a facial, or a new dessert.

Thanks to other readers for these tips:

Finding a good lotion to use on the breast afterwards is important to keep the skin from becoming leathery. Lots of readers mention this and these lotions were suggested by them. (You might try to get a sample or small size first. )

*Dove Cream Oil Intensive Body Lotion
*Lubriderm Sensitive Skin Therapy Lotion
*Lubriderm Shea & Cocoa Butter Lotion
*Bliss Naked Body Butter
*Avon Naturals - comes in several flavors but the reader preferred Cucumber Melon or Vanilla.
*Several readers raved about Aquaphor and others hated it.

Other tips included:

Tell your friends, "It’s okay to ask me how I’m doing. Just don’t ask every day. "

Ask if you can participate in any research studies.

How I met Iridium -192: A Savi Story

Radiation is used to kill any stray cancer cells left over after surgery. The traditional whole breast radiation delivers radiation to the whole breast using a machine called a Linear Accelerator. It is outside of the breast .
Breast Brachytherapy is the application of radiation near where the cancer cells were taken out. It is delivered through a device that is placed inside the breast and the radiation is deliver through small small catheters that look like straws. The device was placed in my breast by my surgeon about two weeks after surgery. Part of the device is inside and part sticks out.


My device is called a SAVI. You can see it where it comes out the skin near the bottom of my breast.













This is the CAT scan image of the device inside of me. You can see the device on the left and shadows of my ribs in the middle portion of the image.

The machine that delivers the radiation for brachytherapy is called a High Dose Rate Remote Afterloader or HDR. It has tubes called catheters that hook up to the tubes on the SAVI device and the HDR sends little seeds of Iridium-192 through the device stopping the seeds every 5 mm for a very short time.

HDR Machine as seen by me while hooked up.







Me as seen by the HDR machine while hooked up.








The radiation treatment itself took about 15 minutes but I had a CAT scan to check the placement of the machine before each treatment and the doctor and the physicist checked the device and the HDR before each treatment. I had 5 days of twice daily treatments.

Jenn was one of my radiation therapists. She went to school in Wisconsin at the University of Wisconsin in Lacrosse, I believe and she and her husband are looking for a house.




This is the CAT Scan machine.






I have now completed my radiation and meet for a second time with the oncologist on the 29th.

Thanks Dr. Kuske for helping me with all the radiation lingo and description!

www.armyofwomen.org

I am finished with my radiation, have a terrible headache, and can't wait to get to Redondo, hopefully later in the week. Corey has been more than patient with me this week, Courtney & Ali have kept my spirits up and so have the army of women friends who I have known for years and new friends I have met in the past few months as I have been treated for cancer.

My heart is with my cousin Wendy as she undergoes continuing chemotherapy for breast cancer. Wendy and I are the cousins who are the same age and we were diagnosed with breast cancer within months of each other!

Please send out special energy to my new friend Pam P. Pam has two more radiation treatments to go and then a break before chemotherapy. She is so pretty and calm and I felt such great strength from her as we passed twice daily to receive our treatments!

The army of women site listed recruits healthy women with no history of breast cancer, breast cancer survivors and those at high risk for breast cancer to register through the site to become potential clinical trial participants. Check it out! You may be help even if you do not have breast cancer!

All about Friday.

Friday morning we arrived for surgery at Banner Good Samaritan at 8:30am. My husband, Corey, and my younger daughter, Ali, accompanied me. I checked in and the three of us sat around in the lobby of the same day surgery department until around 10:15. The long wait was a little annoying. During the wait a woman with no hair who said her surgeon was Dr O'Neill was called in to be prepped and I felt a little tearful for her.

A lot of time in the waiting room allows for family bonding and contemplation of the events to come!

At 10:15 someone came over from the Breast Center and got me so the guide wire could be placed. Corey and Ali transferred to the Breast Center waiting room and I went back into the center. Dr. Nino placed the guide using the same technique as my first biopsy. This involves laying on a sling face down with your breast hanging through a hole and then paddles similar to the mammogram paddles are placed on either side of the breast to secure it. An xray is taken and then when they see the clip they can tell from the markings on the paddles where it is within the breast.

I was worried about them marking the correct clip because by now I have several in each breast now but Dr. Nino showed me that each clip has a different letter on it. He then cleaned and numbed the area and placed the guide wire in a matter of minutes. A follow up film showed that he hit the right spot on the first time and I was done. The procedure is relatively painless, the numbing stings quite a bit but the sensation only lasts about 5 - 10 seconds.

We then went back to the same day surgery waiting room until after 12:30pm when they finally called me in to prep me for surgery. Corey and Ali stayed in the waiting room. By now they were beginning to make a few friends with other family members waiting. In between visiting with their new friends, our older daughter, Courtney, and my sister, Faith, would call to see what was going on. All of this activity kept them very busy. The two of them came back into the pre-op area after I was in my lavender gown and had my IV started. The pre-op nurse, Kim was not only a Stephanie Plum fan but also excellent at starting IV's.

Kim started my IV but did not mention if she prefers Joe or Ranger for Stephanie Plum.

Corey and Ali took some more pictures to pass the time.

At a little after 2 pm, Dr. O'Neill came back and we met the anesthesiologist, Dr. Brennan Watkins.

Dr. O'Neill and myself. I think she is the best breast surgeon in Arizona and I am glad she is on my team!

Shortly after that I had some Versed through my IV and went back in the surgical suite, I did not wake up until after 5 pm. Dr. O'Neill checked on me twice in post op and made sure I knew that the sentinel node was clear, the other nodes were enlarged but we had decided not to touch them if the sentinel node was clear and will follow them later.

The area removed was a little larger than a golf ball and then she shaved a bit more tissue all around the site. Although my whole breast is very, very bruised, the pain is quite tolerable. The lymph node site is a second incision & stings more than the breast incision. Sometimes I getting shooting pains into my collar bone but the prescription pain medication, Toradol and Tylenol taken in between works pretty well. My lymph node site is continually leaking a clear fluid which I guess is lymph fluid but the site on the breast itself is clean and dry.

On Wednesday, I follow up with Dr. O'Neill and she will let me know if the margins of the surgical area were cancer free. If they do have any cancer cells, I will need a second surgery next week but I feel pretty optimistic that this phase is done!

One Month Anniversary

Today is my one month anniversary of knowing that I have cancer. Yesterday, I chose a new team member, my radiation oncologist. His name is Dr. Robert Kuske and I liked him. He is one of the innovators of partial breast radiation which I am planning on having unless something new pops during surgery on Friday.

Dr. Kuske's gut feeling is that my cancer is still in situ which means it has not invaded the surrounding cells and remains inside the milk duct. This has been the question that has plagued the doctors since I was diagnosed. Some indicators seemed to show that in my case the cancer had invaded other cells - when this happens it is called invasive cancer. Each indicator has turned out to be negative in my case. The last test will be the nearest axillary lymph nodes to the cancer sites which will be tested during surgery and I should have final results of that next Wednesday.

If I have invasive cancer then I need to have more extensive chemotherapy along with the radiation and medications to block the estrogen and progesterone. If the cancer remains in situ then I will have radiation and medications to block the estrogen and progesterone only.

Trivia: in situ is from the Latin term which means in it's place.

Breast Cancer Primer

People keep asking me about these terms so I thought as a health educator, I would describe them. I will add to them over time. Any errors in these definitions are my own except for the one Shirley defined. You can see the Primer by scrolling down to and looking on the right side of the screen.