April 23, 2025

Today Nathan and I meet with the local breast surgeon to go over this phase of this stupid cancer. Let me take a step back for a second.

I did read my MRI results the night before and, as mentioned previously, I understand a lot of medical terminology. My MRI results were not happy. 

What does all that mean? Basically, the MRI shows the known jackass that's making my life hell, but it also shows an additional one nearby that could be a secondary jackass, as well as lymph nodes near my chest wall that appear to be pissed off. Two things to note here.... at least I'm already on treatment so steps are being taken to kick ass, and because I'm on treatment COULD be the reason the lymph nodes are pissed. Hard to say at this point. Is it concerning to me, of course. I'd be an idiot for it not to bother me. Why am I not curled up in the corner? GOD'S GOT ME. NATHAN IS WITH ME. I have to think that the God had the delay in MRI arranged so that I would have treatment already started so that when this test result came back, I wouldn't freak out. That's what I'm going with. If I'd gotten the MRI right after the ultra sound and cancer diagnosis, my reaction may have been totally different. 

So, off to today's appointment. Once again, the staff at the facility was nice and friendly. Get checked in and a couple forms filled out. Not a terrible wait time here... just a couple rounds of Cattywampus. Can you tell I really like this game? 😀

The usual vitals, common questions, undress from waist up and put on the gown, opening in front. The doctor (surgeon) comes in and after introductions, we start the discussions. She pulled up my ultra sounds and went over those and what she sees. Nothing new to report here. Then she pulls up my MRI  and we go over that. She proceeds to show us on the screen the areas the report was talking about. She too says the lymph nodes COULD be a result of the treatment but confirms that it's hard to tell at this point. She also goes over the diagnosis and what it means, just as all the doctors before her have done. While at this point it's quite repetitive, I do appreciate the fact that she does this. It's always good to hear a different point of view, different terminology in descriptions, or just hear something that you may not have heard before due to processing information. She also does a minimal exam, locating the lump(s) and her findings. 

She proceeds to go over her thoughts on her portion of this process. Lumpectomy vs Mastectomy. 

A lumpectomy is a surgical procedure where they remove just the tumor. A mastectomy is the removal of the entire breast. 

She felt the 4cm lump previously noted and the additional satellite mass. Based on this, she's of the thinking a lumpectomy won't be an option with the current size of my breasts. She's thinking about 8cm of crap to be removed. This was already my thinking before this appointment. 

She also goes into the various types of mastectomy options.  In a conventional mastectomy, the nipple, areola and some skin are removed. In a Skin-sparing mastectomy, only the nipple and areola are removed. This option leaves a natural skin pouch that makes it easier to have an immediate reconstruction. Nipple-sparing mastectomy preserves the entire skin envelope, the nipple and areola. Going into this diagnosis I've already adopted the thinking that since my boobs are trying to kill me, they can go. They served their purpose when I gave birth to Adrianna. Now they are just there, hanging out. Literally. Gravity is not kind. 

Since the genetic test results are not back yet, she can't recommend a double mastectomy, but knows that I'm ok with that. In my opinion, this would be the best option for making them match at the end of this crap if nothing else.

She explains the plan of attack from her standpoint.... Another MRI at the end of chemo, double mastectomy with lymph node sampling once that is safe (red blood cell damage from chemo), post-op radiation therapy. 

After surgery, recovery time will be hard for me in that I tend to be very independent and don't usually ask for help and this time I will have to. This surgery will leave me with drains placed under the skin to help remove the fluid that accumulates at the site of surgery. I will have to empty the drain bulbs and record the volume and color of the fluid. Sponge baths until these are removed at my follow-up visit. Lovely, huh?