photo: san francisco, november 2011

Earlier this week, I hit the 6-weeks post-op milestone. It’s been a trip.

It started with a few heady morphine-filled days in the hospital where every few hours a nurse or a medical student or a resident or members of the surgical teams came by to check on me, take my vitals, give me medications, replace my IV bags, or confirm that the transplanted tissue was still thriving. I knew my surgery had gone well when one of the medical students that came through on rounds looked at my wounds and said with considerable awe in his voice “That is a beautiful closure.”

The surgeons had done their work, and now I needed to fulfil my part of the bargain to heal.

I am so happy to say that my abdomen incision has healed well. I have come to know some ladies who have had their incisions open up – some even at the 6-week mark – leaving them with a longer and much more complicated recovery. I have a few stitches that are stubbornly refusing to dissolve in my breast incisions which has led to the formation of a few thick, and deep scabs that are now seeping some fluids. Fun. Hoping this plays out well.

Then there is the nerve pain. It’s out of this world. Initially, my abdomen incision felt like it was on fire, like I was being continually burned. A little bit like how a tattoo feels going on, come to think of it. But, imagine that the tattoo artist never lifts her needle. Turns out the spot that hurt the most (and still does from time to time) is where my plastic surgeon found a “nice, big vein” that he used for the reconstruction.

I also have nerve pain in my reconstructed breast and along the upper part of my chest leading into my cleavage. This is apparently where the blood supply is, and where that “nice, big vein” from my belly went. This pain is also unrelenting. I have some medications to help with the nerve pain, but am now seeing the end of the bottle on the horizon. I am already growing concerned about having to do without. It’s the same medication that is prescribed for Shingles. So, yes – it’s a lot of pain to handle.

As part of my rehab, I have arm stretches to do. Plenty of them. It seems that after a mastectomy, a DIEP-flap reconstruction, and a lymph node extraction that for the first two weeks your arms don’t move much at all. Nor should they. No moving your arms above your shoulder. Ha! Even if I had wanted to, I couldn’t have without tears.

But now, even with fairly diligent rehab, I am discovering I might have something called lymphedema. This is a fun group of symptoms to unpack. In a rather large nutshell, your arm can swell leading to permanent loss of range of motion. Obviously, no one wants this. I am on a wait-list to be seen at the Survivorship Clinic at Princess Margaret for a definitive diagnosis. In the meantime, I am seeing my chiropractor, who also seems to be a miracle-worker, and she is rehabbing me. Next, I will be looking for lymphatic drainage – as I read that that can help a great deal, especially in the early stages.

There are days I feel pretty good. I go for long walks, I help with dinner, I play with the cat, I manage a few light chores and put in a full day of work from home. And then there are days that I can’t even move. A shower exhausts me to the point of tears. My nerve pain fires up. I’m on a seemingly endless emotional and physical rollercoaster. Very much like our collective Covid-19 experience, in my opinion.

Then there is the pathology on the tissue that was removed. After waiting a few weeks for the results and then a few weeks more for additional results (this is a common theme) my report came back saying that not only did I have a 8.6 cm mass of DCIS, but I also had 7 macro invasions and 4 micro invasions of IDC. Another fun acronym. IDC = Invasive Ductal Carcinoma.

This means the cancer broke out of the milk ducts and was spreading in the breast tissue. The largest invasion was 1.1cm. Not too large, all things considered – but there were a large number of invasions over all.

Duck. Duckity-duck-duck-duck. Duck me.

Long story short, my cancer is IDC, Stage 1, Grade 3 ER/PR (+) HER2(-). The great news is that the lymph nodes came back clear of cancer. Silver linings.

Let me know if you want more details; because, I have them. Cancer patients undergo a crash course in cancer education. It’s similar to what happens when you watch the Olympics. You know what I mean. It’s when you find yourself going from being mildly-interested in a sport, to becoming an animated armchair commentator that seemingly knows all the nuances of that sport; all within the space of a single afternoon.

Cancer is like that.

Cancer turns you from someone who is idly sitting on the sidelines – possibly cheering others onward – to someone who is in the throes of the most competitive event in the world.

To compete in this sport, or to out-dance cancer, we need to know what Stage 1, Grade 3, ER/PR(+), HER2(-) IDC means in terms of treatment plans. Well, because nothing with cancer is simple, I find myself waiting for an Oncotype test that should tell us more. I have a follow-up with my medical oncologist on December 14th. Until then, we continue to rest, and recover, and rehab, and look for those silver linings.