November 20, 2025

I've been going to VCU weekly to visit the plastic surgery office to have the tissue expanders filled. There's nothing fantastic about these appointments, but the needle still hurts. These appointments are pretty quick. They have said the incisions are still healing well. This post-surgical bra is getting really annoying. It's riding up, rubbing one of my drain tube spots and irritating my underarms because it won't stay down. I am going to see if I can find a front closing sports bra at Walmart at some point. I'm afraid to order one online because of the sizing and support needed. I will say the day after I get my fills, my chest is quite tender. I don't remember growing boobs the first time around feeling like this. 😛 They also prescribed me a muscle relaxer to try and help with my back pain. Since having rods and pins put in my back when I was a teen, I can't sleep comfortably on my back. Since I had the mastectomy, the only position I can "lay" in is on my back, at an incline. Lucky me. I'm not having pain from the mastectomy or the fills, but the back pain is what's been keeping me awake most of the night. Hopefully this will help. 

So, today I had my follow-up appointment with my oncologist, Dr. Vachhani. The first thing she asked me was if she could record our visit just for her notes. Doctor-Patient dictation basically. Sure, why not. 

She took a look at my incisions and agreed that things are healing well. She also went over with me the surgical results from pathology and what that meant for further treatment. Because there was still a 5mm piece of the cancer tumor left and because the Rotter's Nodes were highlighted on the first MRI, she's recommending oral chemo for about 6 months. I asked her about what the Roanoke surgeon said and asked if they could've been "angry" since that MRI was done after my first chemo treatment. She said the treatment would not have affected that area. (Remember, the Rotter's Nodes are the interpectoral lymph nodes. Because of their location, they can't biopsy those, unfortunately,) She said if I had been able to tolerate and complete the "Red Devil" chemo treatments and all the cancer was gone at surgery time, then she might have a different recommendation, but here we are. She's just wanting to make sure any and all microscopic cancer cells that may still be floating around get taken care of. The way she words things, the way she speaks, and listens... I really feel like she's looking out for my best interest, all the while saying that it's all up to me in the end. Way better than the Roanoke oncologist. 

This prescription she's recommending will be sent from a specialized pharmacy directly to my house and will need to be signed for. No getting it at the local pharmacy. Capecitabine. Orally, 2 times a day for 2 weeks, then a week off. Oh, and getting back on cycle with the immunotherapy so these will run simultaneously. I'm supposed to start the new drug the same day I restart the immunotherapy, since that's every 3 weeks. That way I'll have a week off from the new drug and they can check my labs before/when they do the immunotherapy. Supposedly the new drug will not make me lose hair, but has a common side effect of severely dry skin on the hands and feet. So much so, they said Vaseline or Aquaphor would be recommended if it happens. My skin gets extra dry in the winter anyway, so I'll just start over moisturizing from the beginning. The other side effects were the basic chemo ones, nausea, diarrhea, fatigue, mouth sores... I didn't have any of those issues with the other chemo drugs so hopefully that will remain my constant. And as with all chemo, low blood cell count too. Reasons for continuing the immunotherapy. Apparently it is more common to have the GI issues since this is taken orally and not injected into the blood stream. I have my meds still so they'll be nearby, just incase. 

The other thing she said was that since not all of the cancer was taken care of by the original chemo plan, she suggests I at least talk to Radiation Oncology to hear their opinion on possible radiation therapy. I agreed to hear what they have to say. Honestly, I really don't know that I'll move forward with that treatment tho. I mean, the known cancer is gone, the Rotter's Nodes were not highlighted on the 2nd MRI, and if I'm going to be taking oral chemo, I don't know that radiation will be necessary.... Seems like it would be putting my body thru a whole lot of extra that may not really be needed. We'll see.

She also brought up a blood test that can be done every 6 months (I think) that would test for my specific cancer to see if it's trying to return, since they know the make-up of my particular cancer. That's how I understood it anyway. Sounds good to me. I know that doesn't rule out other types of cancer, but it would at least be a way to keep tabs on my stupid breast cancer cells. 

The best line from this visit was this: "She has been informed that all her known cancer has been eradicated." 

The only concern I have at this moment is that my short term disability only goes to the 30th of November. I still haven't started PT. Can't raise my arms all the way up, can't lift more than 5 pounds, can't cross my arms.... Ah well.....