A medical update following an afternoon at UAMS

With three weeks since my last and hopefully final chemotherapy, today I was scheduled for more lab work and a visit with Dr. Makhoul, my last visit with him before surgery. 

I just love this man!  The minute he walks into the examination room, his smile is over-the-top contagious.  When was the last time you spent 90 minutes with your physician to review your medical prognosis?  And we even leave his office with two large charts with drawings by the good doctor, feeling much like I’ve attended one of his classes at the Medical School.  Fortunately for me, Tim was with me and always seems to know the right questions to ask.  Heck, I didn’t even know that women produce both estrogen and progesterone, making it difficult ask an intelligent question when we got to this chapter. 

The new information we left with today:

• It is not likely that I am cancer free, and I said this in my news last week.  Last week’s truth was that the MRI could not detect any cancer in my breast or lymph node system.  However, today I learn that the likelihood of being completely cancer-free is only about 20 to 25%.  Oh well, it felt good for a while.  What Dr. Makhoul did say is that there will likely be residual tumors, and hopefully they will be very small in size. In his words, if there are any residual tumors that are less than 2 cm, this will not be a problem.  If surgery finds any residual tumors larger than 2 cm – well, this could be a problem that we’ll deal with at that time.  I’m betting on the more optimistic outcome. 
• Pathology reports from the surgery could take as long as a week to ten days.  And Dr. Makhoul will not be able to determine follow-up treatment until the pathology reports come back and my medical team meets to review.  I must be patient. 
• Today I began taking my new ORAL chemotherapy treatment – one pill each day for the next five years.  My new partner in the cancer fight is a little white tablet called Arimidex, a chemotherapy used to treat breast cancer in postmenopausal women.  Lucky for me I’ve had a hysterectomy and am able to take this very effective chemo pill, which provides a little bit higher rate for survival than some of the other drugs.  The down side is always the potential side effects – hot flashes, joint pain, nausea and vomiting, bone loss, weakness and fatigue, possible swelling/lymphedema, and an increased likelihood for osteoporosis.  Dr. Makhoul said that many of these side effects subside after three to four months, and most can be treated with some other drug.  Just what I need – more drugs. 
• And finally,  about my persistent leg pains . . . it seems that chemotherapy is no longer in my body, but there has likely been some chemo damage to my muscles, which is why I still have these pains.  Dr. Makhoul seemed optimistic that this was not a permanent problem, that it would eventually go away.  How long - nobody knows as each patient has their own timeline.  In the meantime, he has prescribed a muscle relaxer for me to take each night to help relieve the pain.  Yes, more drugs. 

WOW!  Today was sure filled with lots of new information – some good news, some not-so-good news.  But I’ll take residual tumors and chemo side effects any day of the week over large cancer sheets in my body.  No doubt.    

While in the infusion center having my lab work done, it was impossible to not notice a man about my age who was crying and vomiting off and on the entire duration of his chemo treatment.  I asked the nurse what was wrong.  She explained that some people are just not able to tolerate chemotherapy drugs as well as others.  I certainly felt lucky that my body was able to suck in all of this magic elixir, and I felt terribly sorry for this disheartened cancer patient who has more struggles ahead.  

My surgery is T-minus thirteen days and counting.  I’m already getting ready to get this next part of the journey moving forward and behind me.