The first (s)mile

August 1, 2010 at 7:19 am (Uncategorized)

I like my surgeon. I got the feeling her sincerity about ‘my’ cancer was something practiced… a bit of necessary niceness that the breast nurses coached her in before getting down to tin tacks. Here is an example of the kinds of things she says:

When she told me I’d have to take an anti-hormone medication for five years I asked, “Will that send me into an early menopause?” She replied, deadpan, “You’re five minutes off turning 49”. Another time, I asked her if I should be feeling really tired (because I have been) and she replied blandly, “You’ve got cancer”. I imagined a thought bubble extending the statement with “You idiot”.

I don’t mean she’s not nice, but she’s the kind who would never have come up with the word ‘journey’. She’s more likely to say ‘treatment plan’. Speaking of which here it is:

Treatment Plan 1 (hit the link to see the document she constructed during our first consultation)

For those of you who find it difficult to read maps, I’ll translate into a six point plan (or itinerary):

  1. I’ll have two procedures on the same day. One is a lumpectomy and one is a lymphocintogram (yes, I did consider typing lymphojacintagram)
  2. The lymphocintogram entails the injection of blue dye into my breast which will make its way to the lymph nodes under my arm
  3. After a few hours I’ll go into surgery and have the lump (actually there are two, but one is so inconsequential it’s hardly worth mentioning) removed along with a margin of surrounding tissue
  4. At the same time two sentinel lymph nodes will be removed and examined. If there is any activity, i.e., if there are signs of the cancer having travelled there as part of its own merry ‘journey’ around my body, the surgeon will conduct an axillary clearance. This means she’ll take out the remaining lymph nodes from under my arm. (We would prefer this not to happen).
  5. If the cancer has been slow out of the blocks, having spent too much time languishing in my breast tissue and not enough time hitting the road, I’ll be stitched up, sent back to the post op ward and given a stale sandwich to eat.
  6. After a week there will be a final analysis of the surrounding tissue margin and lymph nodes. If there is any activity in the margins, the surgeon will remove more breast tissue and if there is any activity in the lymph nodes, she’ll take take them all out. The odds are these: in one in ten cases there is activity in the margins and in 30 per cent of cases they go back and take out the rest of the nodes.

The result of the surgery will determine the rest of the treatment. No activity in the margins or lymph nodes means it’s likely there will be no chemo, just radiotherapy. If I have to have chemo, I want it known now that I will not be wearing a turban and I’m not sure about scarves. Lee has a blonde bob wig that she might consider lending me and I’m also tossing up the idea of sporting a well polished dome in public… if my guts, probably heaving towards a ceramic bowl, haven’t left me completely.

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