Sunday, August 09, 2009

Wrapping up

It was fun, but I'm glad it's (mostly) over. As I expected, my too-pale Irish skin didn't tolerate the radiation well. I'm so glad that I shunned all reading matter relating to treatment (I do love surprises!) I would have been pretty worried had I known in advance that the state of my skin after the twenty-fifth 'zap' was only the beginning. The burn continues for another ten days to two weeks after treatment. I'd already been sent for nursing advice before treatment was complete because my skin was starting to bubble. (Not a technical term, 'bubble' is my own description of early blistering). A few days after my twenty-fifth treatment the radiation department called to ask how I was doing. "I'm miserable!" They suggested I go in to see their nurse again. She took one look and said "Holy moley!" (technical term). She brought in two doctors who looked quite subdued then presented prescriptions for more massive doses of antibiotics. It did look pretty gruesome -- bright red of course, oozing serum, black in some places and one pointy bit burned right off. I got some great pictures but decency prohibits posting them!

She's a lovely nurse, Beverly -- probably ten years younger than I am, but after visiting her a number of times I got to thinking of her as "Mom" for all her tender ministrations. One day a chemo nurse I knew wandered into the nursing station while "Mom" was soaking my burns. Calay, the chemo nurse, came over to have a look and Mom said "Ill tell you, when I first saw it, I GULPED! It was all red, like this (pointing to a still-dark area) and oozing."

The burn got better. The skin texture remains rather like heavy brown paper.

Next up was surgery. I seriously considered passing on that, thinking I'd endured a full year of torture already and now I was going to top it all off with mutilation?! I told "Mom" I might back out on it. She waggled her finger andf said "Now, you're going to have that surgery." I told dear Dr. Karimuddin I might not be showing up for the party and he said that if I didn't he'd keep calling me back to his office until he'd convinced me. "Surgery is still the best chance of effecting a cure."

I'm not really easily led. Had I decided not to proceed, no one would have been able to change my mind. (Actually, my mother considered me a very determined, obstinate person... ) At least I've also got a dollop of common sense and I listen to good advice. So I showed up for the surgery. That was a little different from what I had observed over the years. It strikes me that a mastectomy used to be considered a "big deal". Now it's treated almost as an outpatient procedure. You do your own pre-surgical scrub, once in the evening before surgery and again the morning of surgery. For me, admission was 11 a.m. and surgery about 1 p.m. They kept me overnight and I was dischaged at 9 a.m. the next day.

I was worried about having a general anaesthetic after the awful reaction I'd had to the bronchoscopy drugs (remember, I coughed out the I.V. and they had to replace it at least twice). I think I suffered real brain damage then; my memory was gone for months and suddenly I was an addled old lady. Fortunately the synapses seem to have reconnected, but heading into surgery I was concerned. The anaesthetist came to my bedside to introduce himself. Dr. Fard. A very pleasant, fine looking young man with cafe au lait skin and milk chocolate eyes. And you know what I was thinking? The night before I'd been talking with my daughter on Skype and she'd made a vague comment about anaesthesia. She didn't say much but my mind was back at work and I picked up on what she was thinking. She was thinking about those horror stories we've heard of people who are only half-drugged during surgery, paralyzed so they're helpless, but still able to feel every cut. So, when Dr. Fard introduced himself, I thought "Dr. Fard, I need to remember that name in case I have to kill him." The poor dear man! I'm sure I wouldn't really have killed him! Maybe knee-capped him...

They wheeled me into surgery and introduced three nurses. One of them came over to do the mother role, holding my hand. Dr. Fard put a mouthpiece on my chest. "Take three deep breaths" he said, walking away and peeking back over his right shoulder. If it had been a trick, it wouldn't have worked == he looked too darned shifty! I inhaled once through the mouthpiece, twice, then a third time. Third time, I thought "Whoa!", looked up to the ceiling, thinking "that's powerful stuff!" It was probably quite a laughable scene because looking up to the ceiling obviously was quickly followed by my eyes rolling back in my head as I lost consciousness.

Anyway, I woke up from surgery and one of my first thoughts was "Dr. Fard. brain damage."

Minor glitches: I still have numb fingers and toes, a lingering side-effect from chemo. I've lost two nails from my feet and four more are definitely packing to leave.

They forgot to give me the painkiller prescription that Dr. Karimuddin had left for me, so I used Tylenol and Advil for post-surgical pain. I probably suffered a little more than I should have. (Doesn't matter.)

They told me my dressings would be fine left alone until my post-surgical visit with the doctor. The appointment was delayed and the doctor's office insisted it was still no problem leaving the dressings untouched. It was a problem. Apparently I'd been bound too tightly after surgery and there's some skin damage. I've also got some odd looking little folds. I don't know if they'll eventually disappear. I hope I'm not looking at future corrective surgery. Ah well, I'll worry about that later.

The wound still isn't healed. That's to be expected when surgery follows radiation. When I saw the radiation oncologist he said he wanted me to go back in four months because if I'm not healed by then there are "things we can do". Whoopee. But, never mind, it's all good.

Ten days after surgery I went to see Dr. Karimuddin. The pathology results still weren't back. Peter and I went to Costco then came home for tea. As we were sitting down, the 'phone rang. Peter picked it up and told me "It's Shri, from Dr. Karimuddin's office."

I went over "Hello, Shri".

"Actually, it's Ahmer, Ahmer Karimuddin....I couldn't wait to call you! Can you put your 'phone on speaker? The lab results just came in. They couldn't believe them at first, so they repeated all the tests. They didn't find a single cancer cell! This is the best possible outcome!"

I can't help but feel a little nervous about believing this, but I do. Dr. Bernstein called a couple of days later with the same news and the same 'take' on the report. And Dr. Alexander, the radiation oncologist, came into the examining room saying "I was so happy reading your file! We don't get many like that."

I remember saying to Dr. Bernstein once "I don't believe in illness". She responded, "Well you should, you've had plenty of it!" I don't know, ignorance seems to work for me!