Ellen update 07/30/06 (aka Way Too Much Information)

Hi! I am recuperating calmly and gently from surgery last Friday morning. I am doing pretty well physically and emotionally. Here is what is going on.

I spent most of Thursday as a prisoner of Albany Medical Center for “pre-surgical procedures” and the filling out of yet another detailed health history form, etc. etc. I had the fun company of my doula friend Dorian in the morning, spent lunchtime reading in the park, and returned to the hospital in the afternoon. My mom flew in and found me there at 2:00, and we got to leave at 4:00. We went home, went for a short walk, and went out for a delicious sushi dinner! Friday morning we reported to the hospital again and Eric met us there (having driven down from Lake George and left the kids with the rest of our clan). The surgery went fine and we got to leave for home at around 5:00 p.m. I sat on the porch soaking up our beautiful view of the hills from 6 to 8, which was wonderful.

What was done Friday:
–removal of 3 “sentinel” lymph nodes under the left arm (the ones that are first in line to drain lymph from the area of the breast where the tumor was)
–removal of 3 other nodes that kind of “rode along” with the ones the surgeon was extracting, so she took out a total of 6
–removal of the tumor itself (lumpectomy)
–insertion of a “port” under the skin below my right collarbone so that chemotherapy can be administered easily without ruining my arm veins

What was learned:
–the sentinel nodes were sent off to the lab during the surgery and examined to see if they had cancer cells in them or not. One node had a small cluster of about 10 cancer cells. The surgeon and oncologist conferred and decided that this was not enough to warrant removal of most of the other lymph nodes (though generally if a sentinel node is positive for cancer then all the nodes are removed and all are checked for cancer). The surgeon had mentioned that sometimes it goes like this (a few cells, not enough to trigger the complete operation on the lymph nodes). Historical note: when I went through this in 1995, the usefulness of checking just the sentinel nodes had not yet been proven and so the standard was to take out most of the nodes (a much more damaging operation). So that’s what I had done then, and it was way more extensive and hard to recover from than this. Whew!

–the tumors were a pair of connected tumors, a little larger in total than 2 cm. but basically what the surgeon said she expected to find.

What is yet to be learned:
–characteristics of the cancer itself (hormone-receptor status, aggressiveness, etc.), which will be reported next week by the lab
–status of the other (non-sentinel) lymph nodes (but they should be clear)
–whether the surgeon got “clean margins” (in other words, cut out all of the cancerous tissue)–if not, she’ll do another operation to fix that

What we already know:
–I will be having chemo most likely without Adriamycin (can’t have that twice in one’s life–bad for your heart) starting most likely in August
–I will have to do without my hair again for a few months starting in September
–the chemo will be every 3 weeks for a so-far-unspecified number of weeks, and will be followed by radiation therapy

What’s next:
–an appointment Wednesday with the oncologist, maybe to discuss chemotherapy choices if the lab report is done
–a bone scan and CT scan just to rule out metastases (spread of cancer to other parts of the body), probably week after next
–possibly a second-opinion visit with another oncologist during the third week of August, if I decide to do that
–a followup appointment with the surgeon in 2 weeks
–a haircut!

Thanks for your good thoughts!