So a girl walks into a doctor’s appointment….

Today I had an appointment with the cancer side of things – my surgeon and oncologist.   I always see them together which is very helpful as we always have productive conversations.   This was just a followup – so I expected nothing.

And of course, I ended up overwhelmed.  Yes, there were tears.

The last appointment I had resulted in our deciding that we were working towards a left-side mastectomy, I was going to work on getting my HgBA1c down to the 6’s and I was going to have a C-Spine MRI to see what the heck was going on with the pain and tingling in my arm.

This afternoon, the doctors (and a medical student) came in and tag teamed me.  Apparently they had been talking and because my A1c has plateaued at 7, the mastectomy is ruled out.  There is just too much room for horrible infections/bacteria to show up.   But, they think that a lumpectomy would be reasonable (less surface area under the skin that could get infected AND they think that radiation might work.  And what about scheduling my lumpectomy for late May?



This doesn’t sound too overwhelming but this is what it looked like in the exam room (between the moments when the two doctors were feeling me up):



Then one of them was getting busy with my lymph nodes and felt something “odd”.   So the other one reached in and also felt something “odd”.  Next thing I know I’m being walked around the halls to get an ultrasound.  So I’m laying there and I have an audience of the radiologist, his assistant, my surgeon and her medical student.  He finds the spot they think is odd but he thinks it’s fine but what about this other odd place?

So I went to my happy place for the rest of the ultrasound.

When I got back to my exam room, everyone was standing in the hall.  I was told to get dressed and that they would be right in.  So I did and they did.  With much different information.

This is the newest plan:

1.  The Tamoxifen is most potent at shrinking tumors between the 9th and 12th month.  I am currently in month 8.   So no surgery of any kind until the end of summer when I’m closer to month 12.

2. They are going to get in a room with my hematologist and the tumor board and go over my case again with all the new data.  The tumor board will look at everything and the suggested treatments and make recommendations.

3.  I am getting a second opinion/new set of eyes on my whole case from the head of surgical oncology at USC.  (more appointments)

4. I am getting a second opinion on my diabetes treatments from the head of the USC diabetes center. (more appointments)

5. I have to focus on proper nutrition and getting my A1c down still.

The super fun part is that my surgeon is super conservative and thinks surgery is too risky but will consider the lumpectomy and likes the idea of radiation.  My hematologist wants me to have the mastectomy and isn’t concerned with infection but wants nothing to do with radiation.  The oncologist is somewhere in between where he thinks the combination of the lumpectomy & radiation are fine but leans against surgery.

So the deal with radiation is that normally they blast you straight down with radiation and in my case, it could destroy the remaining stem cells I have in my bone marrow that keep my platelets intact.   With Breast Cancer, they don’t blast you straight down, they blast you from an angle so the radiation hits just the tumor and doesn’t hit your main bone marrow holding bones.   My oncologist is also a board certified Hematologist so I’m thinking he would know if he was putting me at risk.

If I had to choose one of the treatments today, I would go for the radiation.

One positive thing about getting a lumpectomy is that I can do it under a local anesthesia instead of general anesthesia.  They would just shoot my breast up with local anesthetics and then give me a sedative to make me feel sleepy.  You know that I would be asking all kinds of  questions and stuff during surgery. I know I would want a selfie with my tumor!

Anyway, that was my life between 3:30 and 5.

Luckily, just before I went in, I had a meeting with this little girl:


Her name is Lucy and she was so sweeeeet!   You can see the other therapy dog, Prince, behind me.  I met him last time.

I just realized that my whole face is one color despite the makeup I’m wearing.  Transfusion on Friday folks!


(P.S.  I just realized that I made my doctors sound like Ogres.  They aren’t.  They are truly awesome.)



7 Comments on “So a girl walks into a doctor’s appointment….”

  1. You are such a brave woman!!!


  2. Lori says:

    1. I LOVE that photo of you, you look so beautiful. And Lucy is such a cutie.

    2. There’s such a thing as a tumor board?

    3. I am SO grateful to God right now for the brilliant Trojan doctors who are so clearly, deeply, and heartfully invested in your care. I’m going to have to hug every one of them personally after you’re all cured up.

    4. I think it’s great that there are so many options available to approach this. I have every confidence the right choices will be made.

    5. You’re awesome.

    Keep the updates coming, I think of you often and chat with God about you always.

    Love you,
    Lori Ann Lewis Day Lewis

    P.S. FIGHT ON!


  3. Karen Stember says:

    I think you have become a med student Pam. You are so knowledgable about all that is being thrown at you…and you seem to understand it all so well. You sound like you are in good hands….pun intended 🙂 Hang in there and hope you get more puppy love.
    xo Karen Stember


    • Pam says:

      “good hands” LOL! It’s almost to the point where I just throw off my shirt and bra every time I walk into a doctor’s office 🙂



  4. elizabeth lamar says:

    Wow, Pam, your title Pam Fights On is so apt. Yes, the photo of you and the puppy show love., so needed in your med visits. The lumpectomy sounds like the best solution all around. And radiation a good way to go. Somehow I feel that this is really going to go well with this new plan. Stay strong. You are my epitome of strength. Love you, Elizabeth


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