Post surgery follow-up

Friday, May 24, 2019. Steve and I drove down for my post surgery appointments with both Dr. Rugo (10a) and surgeon Dr. Ewing (noon). It was an easy drive, most likely due to the Memorial Day weekend and folks taking Friday off to make a long weekend a bit longer.

Our appointment with Dr. Rugo was to go over the results of the surgical pathology report. I had been upset with Dr. Rugo all the days prior, because during surgery she had texted Dr. Ewing instructing her not to remove my port. She failed talk to me about that decision, so I was super disappointed when they informed me about it in recovery. The one thing I was really looking forward to was for the “alien” to be gone. Grrrrrr.

As it turned out, her decision was sound.

Dr. Rugo and Steve and I went over the preliminary pathology report. It confirmed that the surgery did get everything and there was no cancer in any of the skeletal tissue. Yes! So technically I’m cancer free.

Just prior to surgery I was injected with nuclear medicine near the site of my original surgery from 19 years ago to see what lymph nodes it would travel to. Those nodes were then identified during surgery and removed. In addition to the lymph node between my pectoral muscles and the node under my arm, Ewing took 3 additional nodes. Of the five lymph nodes that were biopsied, 3 had cancer cells, two of which were pretty significant. As a result, Rugo strongly recommended more chemo and gave me four options to consider, along with the possibility of focal radiation. Her top choice was AC (Adriamycin and Cytoxin) to be infused every other week over the course of two months; second choice was Adriamycin alone–less toxic, same regimen; third was Xeloda, a less toxic oral chemo taken daily for two weeks and then off for one week for 8 cycles (6 months); and fourth was Epirubicin, a weekly infusion, although we didn’t discuss how many cycles. All of these treatments are more toxic than the Taxol/Carboplatin cocktail I was getting. The purpose would be to kill any scout cells sent out into my body by cancer-infected nodes before they were surgically removed.

There is a fifth option, and that is to do nothing. But statistically my chances of being around 5 years from now drops considerably from the 90% survival rate of triple negative cancer patients who received chemo after surgery.

Let’s be honest. Triple negative cancer is a bitch to get rid of.

Sunday, May 26, 2019. This is not an easy decision to make. As I envision what I think my decision should be on an intellectual level, I struggle with the authentic truth of my situation. Like before, I have been fiercely adamant about NOT doing any additional chemotherapy, no matter what. I really hate chemo, and after being off of it for over five weeks, I am finally starting to feel good. My hair is coming back. Not so much for my eyelashes and eyebrows, but I know it will happen. I can taste food again. My nose isn’t so drippy. My sensitivity to light is back to normal. My stomach and bowels aren’t bothering me at all. I’ve been able to have caffeine, and it’s been such a treat. To spend the majority of my summer chemo sick and sacrifice all this post-chemo progress is impossible to imagine, little lone do.

I am conflicted and sad. I honestly don’t know what decision I will ultimately make. I want to be true to my intellectual truth, but I also want to be here five years from now to keep telling and living my story.

You can’t be brave if you’ve only had wonderful things happen to you. —Mary Tyler Moore