Tag Archive | Dr. Engel

2014 in Review

2014 was a pretty big year for me. Not quite as big as 2013, but quite a bit still happened in my cancer journey. Therefore, I think it’s worth a look back on the year to see what changes occurred.

I started the year recovering from my mastectomy and going through radiation. While radiation wasn’t as hard as chemo, I really didn’t appreciate breaking out in hives at the end of the treatment.

Hives from the radiation treatment

Hives from the radiation treatment

With hindsight being 20/20, I’m wishing now that I didn’t decide to try reconstruction after my mastectomy. It was a pretty close decision, and now it’s looking like I went through all the pain of expansion and living with the expander (never did get anything close to comfortable with it) without the benefit of an implant at the end. It’s not a big deal living without a right breast. When I’m just going to be home, I don’t even wear a bra much.

I did finish up all my active treatments – radiation and Herceptin were the treatments in the beginning of the year. Now I access the port only to flush it.

No more of this!

No more of this!

My hair is still changing as it comes in. It’s much curlier now than it was at the beginning of the year. I think I’m going to keep it short for a while, especially now that I can go four months or so in between hair cuts. Getting a hair cut every two months gets expensive, even at the cheap place I go!

My hair at the beginning of the year

My hair at the beginning of the year

My hair at the end of the year - so curly!

My hair at the end of the year – so curly!

Things to look forward to this year: not as many doctor’s appointments, since I’m not in active treatment. I’ll have another MuGA scan and a mammogram, but I’m not sure what else in terms of tests. I’m down to every six months with Dr. Engel, and I something similar for the oncologist.

My big goal is to get my port out. I’ve finally gotten used to it and hardly ever notice it anymore (it only took about 15 months), but I still will be happier with it out. If nothing else, it will open up my bathing suit and mastectomy bra options.

Let’s see what the year brings, shall we?

 

Another Checkup

Monday I was scheduled for another check-up with the breast surgeon’s office. Good, I could tie that appointment to my trip to the Cancer Center for my port flush. Too bad the office called early Monday morning to reschedule. The PA I was seeing wouldn’t be in the office Monday morning. Bummer. I still needed that port flush ASAP (since it had been a week too long already), so guess I couldn’t tag team the appointments.

I rescheduled for Thursday at 11am. It would break up a school day (the other advantage for the Monday appointment), but at least it was close to lunch and perhaps wouldn’t screw up the schooling too much that day. The check-up was quick and easy, although we had a bit more to talk about than usual. She commented on the circle of pink on my expander. I explained about overdoing the yard work, pulling a muscle and the significant pain associated with that event. She commented I might have torn a muscle, and what we were seeing was a hematoma. Just keep an eye on it and call Dr. Kang’s office if it got worse. It continues to get fainter, so I’m not too worried (although it better be all healed by October 10th. I don’t want anything to mess with that surgery date!!).

The other topic of conversation was a cough I seemed to have picked up. For a couple of days, I could hardly talk because every time I tried, I started coughing. Again, the PA was a little concerned because it’s always possible the cancer has moved to lungs. If it doesn’t go away in a reasonable amount of time, I should get a chest X-ray “just in case.” Of course, now I’m all paranoid about recurrence, when I’m sure it’s just allergies. It’s prime allergy season (StatsGuy lets me know every morning), and I’ve had this cough-when-talking phenomenon happen before. Hey, at least I already have orders for a chest X-ray before my surgery so I could get one without having to see a doctor first. I scheduled an EKG before the surgery (one, because I’ve never had one, and might as well add to the tests I’ve taken, and two, less radiation, which I’m all about with all the testing I get.), but I could always change my mind.

The coughing does seem to be getting better. Lots of raw honey from my mother and trying to rest and heal as much as possible.

Checkup with Dr. Engel’s office

Last week I had two doctor’s appointments – one with Dr. Li and one with Dr. Engel. The appointment with Dr. Li wasn’t originally on the schedule and in fact, I had to remind Dr. Li why he was talking to me when he came into the room. Dr. Engel’s appointment, on the other hand, was a routine check-up. I actually met with his nurse, Carol. After waiting for an hour and a half (she got stuck lancing an infected cyst or similar such procedure), she finally showed up in the room. I was really glad I had a good book to read.

During my appointment, Carol did her routine checks of my chest and breasts. I had to sit and put each arm on her shoulder, and then lay down with my arm over my head. I get to go every six months for three years, yearly until five years, and then I can switch to my gynecologist or family care provider to do my checks after that point. I asked what she was checking for, and she said they were just looking for irregularities.

I also asked about a knot in my back, just below the point of my shoulder-blade, to see if it was related to the surgery. She indicated it was likely related to the surgery, since it’s at the edge of the nerve that goes through your armpit and down to your fingers. I have to stretch that nerve on a regular basis. It seems to tighten up and make a line running from my pinky towards my elbow tingle. It all seems to be related, which is good because it means it’s not likely to be cancer causing the pain.

Breast surgeon check-up

I met with Dr. Engel’s nurse today, just for a check-up. The incision is healing nicely, but my arm is still sore. It hurts under my armpit, although I can’t tell if it’s because of damage to the nerve that serves that part of my arm, or if it’s just still healing. The other part that is still sore is the muscles in my chest. Everything hurts worst first thing in the morning, but as long as I keep moving it’s not too bad. I can probably stop wearing the Ace bandage, but my other choice is a sports bra. Sadly, I can’t wear one because the straps go over my port. I’m still trying to figure out what to wear instead.

We also discussed future visits. I’ll need to see the surgeon every six months for the next three years, with a mammogram on the still existing breast every year. After three years, assuming nothing changes, it goes down to yearly visits. My favorite – doctor’s visits.

Christmas presents from my surgeons

I had an appointment with Dr. Kang this afternoon. I was hoping he’d take out a drain today, although I was worried that neither of the drains was extremely low (one producing 40ccs in 24 hours, the other producing 30ccs). Even so, he was satisfied I didn’t need both drains in and took one of them out. Now I only have one of my special baby egg sacs I need to carry around with me. (I feel like they are egg sacs from parasitizing wasps that I’ve been tricked into caring for – it’s the biologist in me, what can I say).

Luckily, I had read somewhere that it’s a good idea to take your pains meds an hour or so before the doctor’s visit where he’s going to take out the drains. I probably would have done it just for the car ride into the doctor’s office, since the bumps aren’t very pleasant to my sore muscles. Getting the drain out was not at all pleasant. First, he snipped the stitches holding the tube in my body, which I could totally feel and leaned toward the pain side of feeling. Then, he pulled the drain out, which didn’t hurt but felt completely disgusting as I felt the tubing move through the incision. Finally, he put a big band-aid over the incision site (after mopping up a few drips of the fluid the drain had been collecting). It’ll take a day or so for the incision to close up.

Couple of things I learned from the plastic surgeon. I need to be careful with moving my arm over my head while the drains are in place. I should be wearing my Ace bandage tighter, so it squishes the fluid out of my body. (Bonus, it won’t slip when it’s tighter.) Finally, the drain that is left may increase in the volume it collects as it is now doing the work of both drains, so not to be alarmed about the increase.

Since Dr. Kang’s visit didn’t take very long, and I had genetics paperwork to take to my breast surgeon’s office, we walked over to Dr. Engel’s office. I hand delivered the paperwork to Dr. Engel’s scheduler this time. Last time, I just gave them to the nurses at the front desk, and they got lost. This is about 10 pages of paperwork on family history that requires I call my mother to fill out properly, so I didn’t want to have to do it a third time. Since we were there, we asked if the pathology report had come through yet. Dr. Engel called us back to his office and gave us the down and dirty results – NO CANCER seen in the breast tissue OR the lymph nodes!!!!! Needless to say, we’re a bit excited! I still need to do radiation, just to be on the safe side, but only about 10% of the time does chemo remove cancer to the point they can’t even find microscopic evidence. Glad to be special in the good way for a change!!!

So, all in all, two great presents from my surgeons. Merry Christmas, everyone!

Surgery day

Dr. Engel performed a modified radical mastectomy, taking some of the lymph nodes under my arm as well. He was able to get all the tissue he needed, and none of the lymph nodes were obviously abnormal. I’ll have the results from the pathologist early next week to see what it looks like under the microscope. Dr. Kang worked next, putting in an expander. Because of the amount of skin Dr. Engel had to remove, Dr. Kang was only able to put 50 ccs of fluid in the expander, while the breast tissue removed was just under 200 ccs.

My collection of bracelets

My collection of bracelets

Before I went into surgery, I got a collection of identifying bracelets. The red allergy bracelet refers to the reaction I had to steri-strips when I had my biopsy. The white bracelet is my personal identification bracelet. It even had a QR code on the front the nurse would scan any time she gave me medicine. The pink bracelet says “Do not use this extremity” since I shouldn’t use my right arm for blood pressure or giving blood ever again. The yellow fall risk bracelet is because I’m getting full anesthesia and the first time I get up afterward surgery, the nurse needs to accompany me to make sure I’m stable on my feet.

My gown pattern - not too bad this time.

My gown pattern – not too bad this time.

I had an IV put in my left hand. The anesthesiologist who was did it remarked on how small my veins were. It probably didn’t help that it had been almost 12 hours since I had anything to drink. Unfortunately, he put it so close to my wrist that any time I bent my hand back, it would hurt. That made it really tricky getting out of my hospital bed since I couldn’t push with either arm comfortably. I also found out my airway is classed as a one out of four – who knew I had such a high quality airway! It’s just one of the many fun facts I’ve learned by talking to the techs, nurses, and anyone else I come into contact while I’m being treated.

When I woke up after surgery, I had an Ace bandage wrapped tightly around my chest, and two drains snaking their way out of the bandage. Every once in a while, a nurse would want to look at the incision, which was always a bit tricky because she would just stretch the bandage a bit more to look under it. The bandage was so tight to my chest, it would hurt a bit to check under it.

My pain levels weren’t too bad. It certainly didn’t hurt much to lay in bed. Getting up was probably the hardest thing I had to do since I couldn’t push my torso upright with either arm. I didn’t realize at first that I had to ask for more pain meds, so I probably let the pain build a bit more than I should have before asking for another dose, but I paid more attention after the first time. I find the pain feels mostly like I pulled a muscle, or a set of muscles. Every once in a while, I’ll get a spike of pain if I move the wrong way and activate muscles across my chest, but it usually isn’t too bad.

The worst thing about being in a hospital is the lack of sleep. A nurse came in every two hours to check my vitals. She skipped the 2am time slot, but my IV drip ran out at 3am, so I got less than three hours of continuous sleep. At least the pain meds kept me sleepy so I had no problem going right back to sleep. Even so, I looked forward to a good night’s sleep in my own house.

Pre-surgery

My mastectomy was Tuesday morning, and there’s lots to say about it, so I’ll put up a couple of posts about it. Long story short, it went well and I don’t hurt too bad today (the next day). If you want all the details (I’ll spare you the gory details, I promise), keep reading.

I met with Dr. Kang the night before the surgery so he could mark up my breast to assist him in reconstruction. By the time he was done, it looked like he’d drawn a target on my breast in black Sharpie.

Sharpie lines on my chest.

Sharpie lines on my chest. You can also see my port on the upper right of my chest. The shadow on the left is just marker smear.

Dr. Kang marked the inframammary fold as well as the extent of breast tissue on the inner and outer margins, and a line right down the middle of my chest.

The night before surgery, I knew I wouldn’t be sleeping all that well so I stayed up late wrapping Christmas presents. I didn’t get quite all of them done, but I put a sizable dent in the pile. The other advantage of staying up was I could eat and drink up until midnight. I had a snack about 11:30 and kept drinking water right up through midnight. I felt a little like a gremlin with the number of times I was reminded not to eat or drink after midnight.

I had to be at the Women’s Hospital by 8am for my surgery. We were a little late, which didn’t really matter since I didn’t head down to pre-op until 11am. I was quite impressed with the size of the room – it is bigger than some hotel rooms the family has stayed in with a fold-out couch, a recliner, and a table and chairs.

The impressive room

The impressive room – there’s a flat-screen TV on the opposite wall

The bathroom even had a shower - not that I could use it.

The bathroom even had a shower – not that I could use it.

Too bad the hospital didn’t exist when I was giving birth to my kids. There was even an awesome view of Presque Isle Bay out the window.

The frozen waterfront

The frozen waterfront

Sadly, it was too cloudy to see a sunset, not that I would necessarily have remembered it after surgery and all the good drugs they gave me. I’ll provide the details of post-surgery in the next post. This one is long enough, and the lack of sleep is catching up with me.