The one with more information

Hey kids.

Yesterday (Wednesday) was the day of the doctors.   I just wish it was Doctors Who #9, #10, and #11 and my clinic was the TARDIS.

I saw my endocrinologist, Vanessa, in the morning.  We’ve been working on the craziness that has been my blood sugars and finally, for the last week or so, my sugars have stayed between 120 and 170.   This is high for most people but this is closer to our target of 120 – 150 for me.  There is a blood test called the HgB-A1c that measures your average blood glucose over a period of three months.   The A1c that we are aiming for is at maximum a 7 but really 6-6.5.  At one point I was up at a 10.  Two weeks ago I was at 8.5.  Basically, my diabetes is out of control.  It is because Tamoxifen raises glucose and so I started a brand new medication and things are stabilizing.  I was also able to cut in half another diabetes medication because the new one is working so well.  So Hurrah!  But I still have work to do.

I asked Vanessa about the cancer surgery and she said that with an 8.5 A1c, I was at huge risk for infection.  I knew that but was glad to hear it come out of her mouth.

In the afternoon, mom and I drove out to LA and the USC Norris Cancer Center.   When I emailed my oncologist (Dr. T)  last week about the possibility of not having surgery, he emailed me back within 10 minutes and had the breast center schedule a dual appointment with himself and my surgeon (Dr. M).   He was available first and basically told me that I was responding to the Tamoxifen and that that medicine would continue to actively work on my tumor for another year or so.  After that, it loses its effectiveness because it’s not meant to cure cancer.   It can last as a medicine to shrink tumors for about a year and a half but after that it’s supposed to be used as a preventative medication for another 5-8 years.   So, medication only is not a long term solution.  At this point, Dr. M came in and we talked about surgery and her comments were that she was concerned that I can’t have the medication for the white cells but that she has operated on people whose white count was lower who are still around.

They both are really positive about being able to minimize risk of infection and bleeding out from surgery, by giving me platelets and blood and pre-op, during-op and post-op antibiotics.

There are two issues:

1.  Dr. M said in no uncertain terms that she will not do surgery with my A1c at an 8.5.  It has to be under 7 and optimally 6.5 or lower.  I’m getting it retested at the end of February to see if it has gone down.   She is also going to talk to my endo, Vanessa, regarding my case.   She is also going to find me an endo at USC, not to change from Vanessa, but to have someone at USC that is familiar with my case to call if something happens with my blood sugars during surgery.

2.  My overall life expectancy.   I’ve never had this talk with my doctors because I’ve just always had the belief that when it is your time, it’s your time.  Cancer, old age, car accident – no one knows.  So I just leave that to God and go about my daily life.   Now I have to have this conversation now with my hematologist (Dr. O).

What Dr. T told me about my cancer prognosis was:

If I don’t have surgery – I’m looking at probably 5 years.

If I do have surgery – I’m looking at 10+ years

My decision/choices:

If my anemia prognosis (pretending the cancer doesn’t exist) is 5 years or less:   most likely no surgery

If my anemia prognosis is 5+ years:  Definite surgery because I’m sticking around as long as possible.

I still am not ready to have chats with friends about this because it’s too new and I’m pretty emotional.  It’s harder than I thought to ask and hear when your doctors think you might die but right now the conversation is necessary.   So far I have done really well with all the health crap I have to deal with so I’m praying that my hematologist is going to return a verdict of 5+ years but I have to be prepared to hear the other.  I may still go for the surgery as, quite frankly, I’m a stubborn bitch and a crappy prognosis can just fuck off.

After talking with my docs yesterday, I’m more comfortable with the surgery.  Since I can have another year on the medication, it’s not like I have to have it right away.  If it happens, I would probably do it during the summer when more of my family are on summer vacation.

Ugh!  It’s been an emotionally packed week.  I’m also low on blood and am getting two units tomorrow. La-La La-La, Life goes on.

I did get some GREAT news yesterday!!!  Both Dr. T and Dr. M examined me and they kept taking turns feeling around my armpit/lymph nodes and there was some measuring at one point.  It was to the point where I was wondering what the hell was going on! Last time they had examined me there had been one or two lymph nodes that were suspicious and my tumor was 3.5″.   Yesterday, they couldn’t feel any suspicious lymph nodes and they estimate that my tumor is now 2.5″!!!!!

A cool aspect of this good news is that if they don’t find any suspicious lymph nodes, I won’t have to have that part of the surgery just the breast removal.   The lymph node removal is the risky aspect of this surgery.  People say that the mastectomy part is not bad at all – up and around in a week or so.  So it ended up being awesome that we couldn’t do surgery in December!

People, always remember that “Rejection is God’s Protection.”  If it feels that everything is going wrong, it just means that you’re either being protected from something worse or being prepared for something better.

I think this post was heavy enough even though I tried to end on positive news item.  I will keep you posted on how things are going.

Go back to your regularly scheduled lives.

Schedule a mammogram or feel yourself up.

Have Faith and FIGHT ON!!!

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10 Comments on “The one with more information”

  1. kkofron says:

    I love the great news!! I also love that you are a stubborn bitch lol!

    Like

  2. Lori says:

    ” I may still go for the surgery as, quite frankly, I’m a stubborn bitch and a crappy prognosis can just fuck off.”

    That is one of the many reasons I love you.

    “People, always remember that “Rejection is God’s Protection.” If it feels that everything is going wrong, it just means that you’re either being protected from something worse or being prepared for something better.”

    That s another. 🙂

    It sounds like you totally have your head screwed on right about all of this even though it’s like, THE hardest thing that anyone would ever have to deal with. AND that you are under the most excellent care avail (duh, you ARE at USC after all 😉 Both very good things.

    And those Mysteriously Disappearing Suspicious Lymph Modes (MDSLM’s) and the Incredible Shrinking Tumor (IST) is THE best news of all!!! Here’s to the IST continuing to wither away.

    Love, love, love you!

    xoxo

    Like

  3. elizabeth lamar says:

    Pam, Your news has so many positives, and I am soooo glad. Your last comment leaves me http://www.flickr.com/photos/antiochian/10451731255/in/set-72157636940400903laughing. Your sense of humor AND how you express it is priceless. (How the http showed up in the middle of my few lines?? And, magically, it may not appear when you receive it.) YouTube: be sure to watch How dogs and cats train their young to go down stairs.

    Like

  4. Barbara DiCarlo says:

    Pam you surely have taken in a lot of information.Just know I am thinking and praying your decision will come easy for you. You are a strong woman with many friends to help you through this journey to good health! Take care and God Bless you. Ciao, Barbara

    Like

  5. Diana Keim says:

    Pam, I love your spirit and I love your outlook. YOU HAVE GOT THIS. And you have plenty of peeps that will be there for whatever you need. I’m also of the “when it’s my time, it’s my time” mindset, but I’m also “give it all you’ve got” and the “crappy prognosis can fuck off!” type. You have friends and love all around!!!

    Love you!!

    Like


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