Yesterday they said there was going to be a blizzard. Yeah, there was some snow, and yeah, it was a little breezy. Blizzard? Not here. Just a good old fashioned spring storm. It stuck around long enough today to slowly melt into the soil, giving our trees and perennials a good soaking, just like they needed. It was cool most of the day, until the sun started to peep out early afternoon. By the time I ran my errands, I didn't even need a jacket. I just wore a long sleeved shirt with the cuffs rolled up. Spring is funny that way. I enjoy it.
I met the physical therapist for the first time today. She and I really clicked. It's almost a shame that I'll only have a few visits with her. I could always use another cool friend, and she would be someone worth knowing. She didn't actually say that she specialized in breast cancer patients, but she knew all of the doctors very well, had her office decorated with BC posters, and had cabinets full of samples things she recommended patients use, like specialty pillows, compression tank tops, and what not. We spoke at length about my situation, and not once did I feel rushed or judged. She gave me space and time to turn things over in my head and to form all the questions that came up. We covered the matrix of possibilities of how my lupus could affect the process. Turns out it either could be significant, or it could have no bearing at all.
My physical therapist sits on the tumor board at my local hospital. If I haven't discussed this already (surely I have?) or if you have not encountered such a thing yet, the surgeons, oncologists, and other medical professionals who will be treating a cancer patient get together and discuss each individual case ahead of surgery, chemotherapy, or other treatment. No one doctor is acting alone, in a wilderness, without input from peers who also keep up on the latest insight on cancer treatment. They brainstorm the best path toward customized care. The PT looked on the schedule, and saw that my case is first on the agenda for next Tuesday. After all of our conversation today about the potential risks of radiation on a person with lupus, she assured me that it would be covered on Tuesday. She said it could be that the radiation would just make me a little sensitive, like I have a bad sunburn. It could cause inflammation and swelling. Or it could be a horrible mistake. The radiation oncologist would have access to the most current medical practices, and they would offer that advice.
We talked about the three different treatment options for radiation. The "fast track" they initially suggested is the twice daily for five days, targeted attack. It is preferred for most cancers like mine, for the precise application of radiation and the limited total dose. (Assuming that it doesn't make my lupus flare like a 4th of July finale.) It could also be spread out to four and six week treatments, that end up being sixteen or twenty-four total treatments (so that whole $30 copay per dose is even worse with those options). Or if lupus and radiation seriously Do Not Mix, then my options get scarier. I could have a complete mastectomy and reconstruction done simultaneously. This means a hospital stay, if I'm not mistaken, and a whole lot more pain, drains, and trauma to my upper body. My initial visit with the surgeon didn't really cover this last option, so I'm hoping it means that she has experience enough with cases like mine that she trusts it won't be necessary.
The PT and I also covered lymph node biopsies and how my life will be different from here on out. I'm going to be restricted forever from having blood pressure cuffs on my left arm, and IVs, and blood draws, and for that matter, any sort of punctures. No flu shots, allergy shots, nothing on that side, unless it is absolutely unavoidable. Even the minute trauma of having a vaccination puncture on the arm can cause enough inflammation to overwhelm the lymphatic system when it's down by a couple or three nodes. Inflammation is already enough of a pain in the neck for me. I'll not choose to challenge the fates on this topic.
I had a long talk with someone who knows where I'm at with learning to accept this new twist in my life, having gone through cancer also. He said he was in denial for a long time too, and said eventually he progressed through the anger stage, the "why me?" stage. I said on those rare occasions when I escape denial, it's less "why me" and more "oh, of course, this too!" and "like I didn't already have enough!" I'm trying hard to be positive about all this, but sometimes what I think is sangfroid is just avoidance. I have less than two weeks to come to terms about it. I'm sort of afraid of what will happen on the day it really hits home.
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