Today I met with Dr. U, a hematologist/medical oncologist. The meeting was sort of... meh. Dr. U was fine. I didn't LOVE her, but then again, how much can/should you love an oncologist?! LOL. I realized when I was walking up the stairs to the appointment that the building was not a happy place in general. The entire building is a Cancer Center, so you have to figure no one going in or coming out is ecstatic. Dr. U was pretty much all business - definitely no warm fuzzies - but I guess that goes with the territory.
Anyway, the appointment was not super informative, as Dr. U said her recommendation would depend on how the surgery went, as well as the final pathology report from surgery. She said the report usually takes two weeks, but that she wouldn't recommend starting any sort of treatment until at least 2-3 weeks after surgery, and probably more like 4-5, because you need to give your body time to heal. So... she counseled us against taking our family vacation in July, because it's very likely that I'll be starting a treatment right around that time. If it's radiation, that's not something that can be easily done on the road, because it is every day single day, Monday through Friday, for six fucking weeks. If it's chemotherapy, I'll basically feel like crap and won't feel like traveling. So that pretty much sucks. And of course we have paid for everything already. So that sucks even more. Overall, everything pretty much sucks right now. I know, I know, cry me a fucking river, right? Feeling pissy over replacing two weeks on the beach with chemotherapy is such a first world problem.
Then we talked in very general terms about what some of the possibilities are. Basically since I'm opting to not have a mastectomy, some sort of follow-up will be necessary, whether it is radiation or chemo. If the sentinel lymph node biopsy that will be done during surgery comes back negative, meaning the lymph nodes are free of cancer, radiation combined with some sort of hormone therapy will be the likely recommendation. Depressingly enough, this is the best case scenario. If the lymph nodes are cancerous, some sort of chemotherapy will be necessary, and the exact type would depend on the pathology of the tumor.
As far as hormone therapy, Dr. U mentioned that tamoxifen, which is an estrogen blocker, was sort of 'old school' and would not necessarily be her first choice for me, given that I am only 40, and there is significant risk of the cancer coming back in my lifetime. She said for younger women, it's often more effective to just shut down the ovaries altogether, either through drugs or just taking them out. Either way it is basically a forced premature menopause. I'm not sure how I feel about this. It's a lot to digest. I am, however, thankful that I am done having kids, because I can only imagine what this would be like for a woman who still wanted to have children. As if the cancer isn't enough to deal with, having to consider your future fertility adds a whole new dimension of stress. I remember when I was pregnant with my daughter, we lived in a very sketchy place, and most of the other women in my birthing class were, like, half my age. The only other woman who was 'older' and actually had a husband said she had had ovarian cancer. Needless to say, she and her husband were THRILLED to finally be having a baby.
And speaking of taking out parts... Dr. U discussed the results of the PET scan with me and said that the spot on my rib didn't show up on the scan, which is good, although she did mention that sometimes small spots wouldn't show up, even if they are cancerous. (Like I said, there weren't a lot of warm fuzzies going on. LOL.) However, she said my uterus was of concern and that I would need to have a pelvic ultrasound sometime soon. W. T. F. ? She did say that body parts could appear bright for any number of reasons on a PET scan, so it could be nothing, but that we would definitely need to get to the bottom of it. In the end, we agreed that I would see her in three weeks and we would schedule the ultrasound at that point. Because that is JUST what I need right about now, another body part to worry about! OMFG!
The one thing I was really surprised about was the timeline for everything. I guess I was naïve in thinking that I would have most of the treatments done by the end of the summer. But geez, it's not as if I have experience to draw on. Either route will most definitely drag on into the fall, which is a good thing to know now. Dr. U said that although there were fewer side effects from radiation therapy, it was very time-consuming and would probably also make me feel tired. It's not just the fatigue from the radiation itself, but also the fatigue from the amount of time it takes, and the stress from the amount of time it takes. And it goes without saying that chemotherapy would make me feel like ass. (It gives me the heebie jeebies that there is a wig clinic right next to the doctor's office.) She said that teaching through this might be easier than a regular 8-5 job, because at least there's some flexibility, but that I should probably consider trying to get a reduced load or ask for some accommodations or... something. Wait. Haven't we been here before? God the past year has sucked.
After the appointment, I went up to work to pick up the exams from the final my colleague gave for me this morning. We talked for about an hour then I went home, picked up my daughter from school, and then crashed into a deep, deep sleep. Needless to say, I have not been sleeping or eating well. The only good thing about all of this is that I finally lost those five pounds I've been wanting to lose. LOL. What can I say, take the small victories whenever you can.
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