Bab's Blog

It's just me, in words.

D-Blog Day-A Trip to the Endo November 9, 2011

Filed under: Diabetes — babscampbell @ 10:11 pm
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Today I had my quarterly visit with my Endocrinologist.  I. LOVE. MY. ENDO.

The visit starts off with the usual catching up. . “what’s been going on in your life since the last time?” he asks.  Well, I went into a narrative of my surgeries, my infection, my neuropathy, my radiation treatments. . . he listened, leaned back in his chair and smiled at me, then said,”you are pretty amazing to me.”  What?  Wha?  He continued, “You’ve really been through alot this past year and you’re in good spirits and thriving.  In the medical profession, I see so many people in different situations and coping at different levels.  I just think you’re a really strong, amazing person.”

Wow!  I do hear that from others and I’m happy they see my strength, (which is not my own, btw. .rather from my faith) and my warrior mentality.  He told me that he admires a Buddhist saying. “There are two kinds of problems; those with solutions and those without.  If yours is a problem with a solution, then apply the solution and move on.  If there isn’t one. . move on anyway and stop fretting about it.” That was a Dr. R paraphrase. . but, I like it.  I told him that I definitely have moments when I break down.  My poor husband and mother get to hear most of that.  But, I try to be a positive, upbeat person, so I allow myself to feel the down times, but refuse to wallow in it.  I give myself an hour to really cry, boo-hoo and blame everything under the sun for my situation and then, I need to go clean something.

After all this mutual admiration, he checked my eyes, my neck and lymph nodes and my feet.  Ahhh, my feet.  The last four treatments of chemotherapy left me with peripheral neuropathy. It’s most painful at night, with my feet burning and feeling like someone is stepping on them, but numb on the bottom.  I’ll never figure out how I can be numb and in pain at the same time. . but, there it is.  The pain radiates up into my calves and feels like someone is grinding away at my calf muscles.  I’ve been taking narcotic pain killers, just to be able to fall asleep at night and I end up waking up exactly four hours later, requiring another dose.

He poked around my feet and said, “how did you injure your foot here?”  What?  I haven’t injured my foot.  He continued poking around in front of my left ankle, “Oh, this is definitely an injury of some kind, you have a large swollen area here; looks like you’re building up quite a hematoma.”  Seriously, I have NO recollection of hurting my foot.  I insisted I had no idea that I’d injured my foot recently.  He smiled up, “Aha. . that’s what neuropathy is all about.  That’s why we check for you.  You’re obviously unable to feel your feet correctly and something has happened here.  It looks like a sprain maybe or you banged your foot against something.”  I have no idea. . but, I’m supposed to ice it up at any rate.

So some refilled prescriptions, a different med to help with the nerve pain, some sample insulin to keep in case my pump dies again, some more small talk and admiration and another appointment in 3 months.  Oh, and did I mention? My A1c is 6.3!  Woot!  I expected it to be much higher with all the surgeries and infection.  I head toward the door and he stops me to say. . “if you need anything, you call me, even if it’s not diabetes related.  I don’t offer that to everyone. . just the fighters.”  Thank you Dr. R.  I’ll be back soon enough.

 

Surgery, another stop along the way October 3, 2011

On September 22nd, I entered the lobby of Menorah Medical Center, knowing that this day would change me forever.  We arrived at 8:30am to begin preparation for the surgery, scheduled for noon.   This had been a long morning as I was told to fast from midnight.  I often have low BGs during the night so I was really worried that I would crash overnight and have to cancel the surgery.  The anesthesiologist was very helpful with this and suggested I cut my basal rate by half overnight and keep watching for my BGs to drop.  If  it dropped, I would lower my basal rate a bit and if it started climbing, bolus a correction to get it back down.  It was a bit nerve-wracking but it worked.  Once I was on the table and unconscious, they checked my BG every 30 minutes and corrected as needed.

Once I arrived, I was whisked away to the prep room, leaving my DH waiting in the lobby.  I was hoping he could stay with me, as I always feel much stronger when he’s holding my hand.

First, I changed into the coolest (literally) gown.  It completely wrapped around, was below my knees and had a connection  at the knee that looked like you would hook a vacuum hose to it.  Apparently, a hose DID hook to it and the hose blew either hot or cold air into the gown.  The first climate controlled gown, I’ve ever worn.

Next, they started an I.V. (yuck), drew some blood work, then, took me down to Nuclear Medicine.

 

Note:  I’m explaining this next procedure in detail, because I couldn’t find anyone else’s description online when I searched for it.  I almost cancelled doing it because it scared me to death.  My description is, hopefully, to encourage other women facing this, to proceed with this procedure and not be fearful.

Since my right breast was being removed as a precaution, the surgeon suggested removing the sentinel lymph node and sending it to pathology.  The node could then be examined for microscopic cancer cells.  If cells existed, it would mean that some cancer existed in my right breast and I would have radiation on my right side as well, following surgery.  If no cancer cells exist, they would know that either the chemotherapy did its job, or no cancer had ever been present there.  In order to find which node is the ‘sentinel’ node, they inject radioactive isotopes into four areas, surrounding the areola.  They can then watch on a monitor to see where those isotopes travel through the lymphatic system.  The first lymph nodes identified are the ones they remove.  This procedure is called Sentinel Lymph Node Mapping.

As this was explained to me, all I heard was ‘FOUR INJECTIONS SURROUNDING THE AREOLA’.  I got so obsessed about those words, for 2 weeks, and several times decided I wasn’t up for it.  I couldn’t imagine having this done. . I’ve had enough pain and uncomfortable procedures done. . isn’t there any other way?  PLEASE, PLEASE. . if your surgeon has suggested this procedure, please follow through with it.  My surgeon prescribed EMLA cream to be placed on my breast 1-hour before the procedure.  I used half the tube and made sure it was thoroughly coated.  I then, placed a piece of saran wrap over the area to keep it off my clothes.  If you use gauze or dressings, it’ll be absorbed and won’t work.  I promise you, I felt absolutely NOTHING.  I braced myself as the radiologist came in, closed my eyes, a tear rolled down my cheek as I waited for the expected pain and he said, “ok, all done then.”  I DIDN’T FEEL A THING!

The next step is to massage the area to make the isotopes start moving.  It was actually amazing to watch it on the screen.  What started as a large, bright mass, turned into individual specks of light spreading and then forming straight lines.  The technician came over and made some dots on me with a magic marker to show the surgeon where these lymph nodes were.  During surgery, they use a Geiger Counter to locate the specific lymph nodes and four of mine were removed.

I then returned to the prep room and my DH was able to join me.  The Dr. came in and reassured me that everything was ready and I would be well taken care of.  I would be lying if I said I wasn’t scared out of my wits. . . but, I kept smiling and saying I was ready.  Just before noon, two surgical techs came in and said that they were ready for me.  One added some medication to my I.V. and I started feeling really tired. . . Pastor V. and some men from church came and prayed for me. I hugged and kissed my Mom and my DH and was wheeled away into the surgical suite.

The next thing I knew, I was being told to breathe. . wake up and breathe deep.  For the next few hours, I was in recovery, trying to put a number to my pain.  On a scale of 1-10, how do you rate your pain?   I can’t imagine what a 10 must feel like, I mean really, that’s the worst pain ever, right?  So, I stuck around 7-8. . I mean it hurt pretty badly, but not like. . like. . having your leg cut off while awake, or having your head slowly cut off by a dull blade, that must be what a 10 feels like. I’m nowhere near that.   Eventually, I was brought to a regular room and was greeted by my DH and Mom.

I was surprised I didn’t hurt as badly as I imagined I would.  I refused the pain meds a few times, but the nurses talked me into taking them, explaining that it’s much better to stay “ahead of the pain” rather than letting it take over.  So, I swallowed the pills and slept quite a bit.

I had three drains inserted, two on the left side, one on the right.  These are used to catch all the fluid that accumulates during the healing process and keeps the area from swelling too much.  They’re a minor inconvenience, but, I’ll be SUPER STOKED  to have them removed on Wednesday.

On the left side, I had a modified radical mastectomy with 14 lymph nodes removed, dissected and examined.  On the right side, I had a skin sparing mastectomy with 4 lymph nodes removed, dissected and examined.  We received the pathology report this last week:

I AM CANCER FREE!

The chemo worked!  No tumors were physically visible.  The tumor clip was located with nothing attached to it.  No cells were evident in any of the 18 lymph nodes.  God is good. .

Now, we board the train for some recovery time. . .next station. . radiation therapy.

I, again, want to thank everyone for your kindness and love.  I have received so many beautiful flowers, thoughtful and funny cards, visitors who made me laugh.  Now, I’m being blessed by food deliveries and house work being done for me.  I can’t thank you all enough.  Blessings to you all!

All aboard. . .