Month: January 2021

Still Mortal

Posted on by Chantal

Weird. I expected to turn when the sun went down last night, but it didn’t happen. I’m still not a vampire. Maybe it will happen at sunset tonight. In any case …

There’s very little in terms of pain today, and I was able to work normally. I can swallow food and drink no problem. I am being careful not to use my right arm much, but that’s just because I want to give the areas a chance to heal as opposed to any actual pain. The only time I feel pain is when I sit up after lying down, cough, sneeze, or laugh too hard. All I have been taking is Advil every 6 hours, and CBD.

It’s a little bit creepy, but I can feel the tubing under my skin going up to my jugular vein. It doesn’t hurt, but it’s weird. I’m sure the port will also feel really strange once the bandages are off and the swelling comes down. I was told by a friend yesterday who has dealt with cancer and having a port to make sure that I always bring a scarf or something to pad a seatbelt if I have to be the passenger in a car. I hinted at that in yesterday’s blog post, but I didn’t quite explain where that came from.

If you want to learn more about how ports are used, here is a decent YouTube video.

Vampire Encounter?

Posted on by Chantal
Vampire Bite

I thought all I was going in for today was my port. However, I ended up with this instead. I know I dozed off once or twice during the procedure due to the drugs they gave me, but I’m pretty sure this is an actual vampire bite. There should only be one neck incision for a port insertion. ?

This procedure was somewhat painful at the start. The doctor had to stick freezing needles into my neck (ow!) and chest (meh) which wasn’t what I would call pleasant. I could also feel something being fished through my neck. The nurse injected fentanyl into my IV probably about 5 times during the procedure, which really helped block the pain. They also gave me a sedative so I would be in a state of ‘conscious sedation’. During the whole procedure, I was able to do things like take a deep breath and respond to questions no problem.

Everything that would affect my cognitive abilities wore off very quickly after the procedure, so that’s great. Of course, I was nervous about having fentanyl for a procedure because we all hear about fentanyl overdoses in drug addicts, but it’s measured and completely safe in a hospital setting.

Now that this is done, my chemo can be administered via the port just under the skin on my chest instead of through the veins on my hand, which aren’t big enough. Depending on the chemo I’m getting, trained staff might be able to use the port to do bloodwork too. They can even do enhanced CT scans using the port because it can handle 300 psi for the imaging dye. Fancy.

My port is the smallest one shown at the top of the image.

In terms of pain, it hurts a bit when I laugh, cough, or swallow. I’m sure it will be like that for a couple of days. After that, I shouldn’t feel a thing, except if I am in the passenger seat of a car and I forget to pad the seatbelt!

I also did my COVID-19 test today, which should really just be a formality. Next up, I visit with the Oncologist on Tuesday and do (more) bloodwork before my first chemo on Thursday. Shit’s gettin’ real, as the kids say.

It’s only Wednesday, and I have been at the hospital three out of the last four days. I’m glad I have a break until Tuesday.

Bone Scan, ECG

Posted on by Chantal

I had to get up at 05:45 today to make it to the hospital by 06:45. Yuck. I have a bone scan, ECG, and bloodwork to do.

When I went into the nuclear medicine area to get even more radioactive substances injected into my body, I heard one of the staff grumbling about Mondays. I laughed to myself because obviously today is Tuesday! Right? It dawned on me that I just feel that way because I was here yesterday. Oops.

I’m supposed to drink a lot of water to flush the radioactive tracer out of my kidneys, so I went to Tim Hortons to get some tea. Their coffee is too disgusting to smell, let alone drink. The folks in Nuclear Imaging let me hide out in an area alone so I could drink my tea.

When I got to the Cardio-Pulmonary Department, the receptionist was venting about her husband’s ex, and how the ex never picks the kid up on Sundays because she drinks too much. The other receptionist said she shouldn’t be dragging the kid into it, which was fun to hear them debate. ?

The ECG was interesting to watch. There was a student doing the procedure on me, so I asked her a few questions to make sure she actually knew what she was doing. (hah)

Other than that, the bone scan was pretty boring. I had to get strapped into place on a bed so I wouldn’t move my hands or feet, then the scanner moved me through over a 17-minute period. After that, the scanner went around my torso, which took probably 25 minutes or so. I fell asleep a few times since I had to get up so early, so yeah. This procedure is not scary or painful at all.

After that, I had to get bloodwork done at the cancer centre by swiping my patient card at the kiosk for the first time. I guess it’s official now. Everything in the bloodwork looks great, and my hemoglobin is almost at the maximum of the range. That’s crazy, since it was less than half of what the minimum should be 10 years ago.

Once my bloodwork was done, I heard someone saying an anglicized version of my middle name. Since the name is very uncommon around these parts, I asked the phlebotomist if maybe someone mixed something up and is calling me. Sure enough, a woman walked in and said that it was her name, and because they don’t use accents, nobody ever knows how to say it. I laughed and told her that’s my middle name, complete with the accents. I also thought to myself, that I am really glad my parents didn’t reverse my middle and first names. People screw my name up enough as is.

Surgical Consultation

Posted on by Chantal

I met with my surgeon today. I can see why everyone loves him. He is extremely good with people, which probably isn’t the norm for surgeons. Or at least, that’s what I learned from Grey’s Anatomy on TV. ?

The surgeon explained the risks and benefits of the surgery, which was pretty straight forward since I have done so much reading and research in the past week. I know that the tumour has to be removed via process called a lumpectomy. From there, they have to make sure that there is healthy tissue all around the removed tumour, which is what they call negative margins. This is determined by sending the tumour off to a lab, where they look at it under a microscope to make sure that there are no cancerous cells around the removed tumour. At the same time, they will analyze the tumour to find out if it is estrogen or progesterone positive, HER2 positive, a combination of the three, all three (triple positive), or none of the above (triple negative).

Of the tumour types, I am most worried about a triple negative breast cancer. That type of cancer does not respond to targeted therapies like trastuzamab or estrogen blockers. The only things it responds to is chemo and radiation. And if the chemo is not effective, what do you do? HER2 is a fast growing and aggressive type of tumour, but there is a drug called trastuzumab (Herceptin) that beats the crap out of it. However, you also need chemo almost 100% of the time if you have that type of tumour. I get the feeling that a HER2 positive tumour used to be especially dangerous, but isn’t quite bad these days as long as it’s caught early enough.

The surgeon plans to remove the tumour and perform a sentinel node biopsy. In this case, the word biopsy is a bit misleading. Usually, when a biopsy is performed, a sample of tissue is taken. In a sentinel node biopsy, large amounts of radioactive dye is injected into the breast. At that point, your body needs to figure out how to drain the extra fluid out, which is where lymph nodes come into play. The idea is that the first lymph nodes that take on the radioactive dye are the same ones that drain fluid from breast tissue. So, they identify those lymph nodes and remove them to analyze them for cancer.

The reason surgeons do this now is because someone figured out that there is no need to perform an axiliary node dissection to remove all lymph nodes. If the sentinel nodes are healthy, there is no reason to believe the cancer would have spread anywhere else. As a result, the other lymph nodes can be left alone. That spares people the complications of an axiliary node dissection which is 30-40%. Some of the complications are numbness in the arm, lymphedema (swelling in the arm), or weakness. Yuck.

Radiation Oncologist

Posted on by Chantal

I had an appointment with my radiation oncologist today. He explained how the treatment works in full detail, including side effects during the treatment, along with short-term and long-term effects.

Fatigue and burns to the skin are pretty much guaranteed during the treatment, and so is some damage to the lung on the affected side. The lung damage due to scar tissue is supposed to be minimal to the point where I shouldn’t notice it at all.

After the treatment, scar tissue in the treated area is also a concern. Lastly, in 30 – 40 years, I could get cancer from the radiation, such as leukemia, or even another breast cancer occurrence. It doesn’t sound wonderful, but it reduces the chance of this breast cancer coming back from 25% to 5%. So yeah, I’ll take that.

We talked about the game plan of doing chemotherapy first, followed by radiation, and further surgery to remove the first two levels of lymph nodes. I know my surgeon wanted to do the lymph node surgery first, but I thought it made more sense to do the chemo and radiation first, so that the lymph nodes have the best possible chance at being free of cancer when they are removed. That way, I can breathe easy, despite the lung damage from radiation!