Dr. appt stats

Dr. Wahl (my oncologist)

The new information was basically about anti-nausea medication, the need to explore radiation as an option, long term hormone medication and then the long term post-cancer maintenance plan. I've provide the details below, for those interested in specifics.

Dr. Harrington (my surgeon)

Dr. Harrington suspected I might be secretly working out, thereby increasing my fluid output. I promised her that all I've done is go and fetch the newspaper from the driveway. I'm supposed to try not to use my arms so much.

Shoot!! I was enjoying the challenge of reaching the upper shelves in the kitchen.

BUT...she said I could drive! Apparently the restriction is really about pain killers. Since I'm not on them, I'm a free bird!

She took my stitches out-- now I'm walking around the house feeling my chest is suddenly going to peel back ((SPROING)) like an overextended window shade ((phwapphwapphwapphwapphwapphwapphwap))

But I get to keep the drainage tubes until I make that magic 30 ml 24 hour total. She said to make an appointment for two weeks -- and then call when I made the magic number in either tube.

Having Dr. H nag me about my drainage feels a bit like my mother threatening me with a visit to the gynocologist if I 'didn't get my period by age 15'.

My mother's threat worked.

Dr. Harrington said that at the breast center conference discussion of my case that morning (I was DISCUSSED ...How THRILLING!! ...I'm so SPECIAL!) there was some debate about whether I should consider radiation therapy or not. Apparently the usual scenario with stage 2b breast cancer is to not do it. But they were discussing some long term study results that showed a significantly higher long term survival rate for estrogen positive cancers diagnosed in young women like myself when those women had radiation therapy.

Here's the downside. The lymphedema risks increase significantly with radiation therapy, and my risk is pretty high already.

Have I written about lymphedema yet? Lymphedema is when your arm swells up with lymphatic fluid. Once it happens, it's difficult to reverse. It's nasty -- but not fatal.

I like this website best for their information. I'm linking you directly to their prevention page.

http://www.lymphnet.org/lymphedemaFAQs/riskReduction/riskReduction.htm

Anywhoo -- Dr. Wahl will have Dr. Preston (the radiation doctor...radiologist??...)'s office call me and schedule a consultation. I have until February to decide what to do.

So... Dr. Wahl.

You know how stupid you can act when you're in shock and you think everyone else knows how this works better than you do? Well, I was stupid. I called Dr. Wahl's office and asked them for an appt on the same day as my post-op appt with Dr. Harrington. That part is fine.

But Dr. Wahl's receptionist asked me what time my appt with Dr. Harrington was. When I said 3:45, she said she could get me in at 3:20 to see Dr. Wahl.

"Are you sure that will work?" I inquire vaguely.

"You just need a 20 minute appointment, right?"

"I think so."

"So we're good."

Of course, Dr. Wahl had a newly diagnosed patient come in and need some time. Ack! The stress! What idiot WOULDN'T think there might be some delay with a Dr. dealing with so many life and death emotional choices each day!??

I had a NIGHTMARE about this the night before. I dreamnt another Dr. (unkown mousy male generic doctor) kept me too long and made me late for Dr. Wahl. When I finally got to her office, she was all dressed up in her winter coat (??) ready to go home to her little boys.

So, the nurse weighs me (I've lost 12 lbs! 4 through diet and exercise, 4 via mastectomy and 4 just hanging out and trying to be healthy post-surgery.) and takes my vitals.

Then, while Francois and I are waiting in the examining room, I call Dr. Harrington's office to find out if she's running late.

She's not. So we inform the nurse why we have to go...and we skip out on Dr. Wahl!! I felt so bad!!

AND she made time for us when we returned. A lot of time. I was ready to just give her my hoped for chemo dates and run, but she had a whole lesson plan prepared!

So unprepared was I that I was scribbling notes on the back of the little blue appointment note she had given me. I hadn't bothered to get out my calendar or my cancer notebook.

OK. This is Dr. Wahl, mind you. If you are tired of reading this blog entry now, you might as well go take a nap before continuing. This woman packs a lot of information into a small time/space continuum.

Ready?

Anti-Nausea

With the chemo, intravaneously, she'll give me Aloxi, which she called an anti-nausea medication -- but which is also a serotonin inhibitor (read ANTI-DEPRESSANT!) -- and decadron, a steriod. The steriod will make me a bit anxious and hyper.

So, uh, Friday nights, I'll be MANIC.

I'm used to manic.

I can handle manic.

Sounds FUN!

PLUS -- she's prescribed two other anti-nausea medications that I can take as I need, Zofran and Compazine.

Zofran is another serotonin inhibitor. I don't know much about Compazine. I'll have to look it up.

And, I'm not supposed to throw up at all. She doesn't think I need to be nauseous at all.

THAT is the best news ever.

And -- I was just reading online that a patient's anxiety levels impact nausea a great deal. Patients who are very anxious experience worse nausea.

I'm thinking my outlook is pretty good.

Apparently, they want to keep your estrogen levels even lower than post-menopausal levels. I'll be on Tamoxifen until I'm clinically proven to be permanently in menopause. Then I'll switch to another drug. I might be on drugs ten years or more -- even if they 'suppress' my ovaries.

I love that verb.

(Could you supress the barking dog down the street? He's keeping me awake at night!!)

They have this very cool thing going where they invite new patients in for an orientation to chemo room before your first chemo session. The nurses teach you the ins, outs and practical tricks.

So my nurses teaching session is scheduled for 2pm on Thursday, October 9th. My first chemo is from 11:50 - 3:30 pm on Friday, October 17th.