Pre-Op Meeting 2-18-09

WOW. We sure got a bunch of info today, which was really scary and helpful all at the same time. As I sit here scrolling through my 6 pages of handwritten notes, the first thing that stood out to me was a really neat thing Mom’s Doctor told us about. Do any of you have XM radio? Evidently there is a special channel dedicated to supporting life saving cancer research at the City of Hope. It’s called ‘The Pink Channel’ and Mom’s Doctor, Lisa Kruper speaks on the station every once in a while. Is that cool or what? Mom’s Doctor and her Physicians Assistant Kirsten both totally rock. I said today after leaving their office that I LOVED the both of them, and I mean that in every sense of the word. I could totally see them as people I would be close with outside of Mom’s treatment. I love them. I love how smart they both are, how personable they both are, how compassionate they are, understanding, caring, and how not once - even when my Dad tells random stories – NOT ONCE have they made us feel like their time is too valuable to spend talking with us. :) (love you, Dad! heehee) :)

For our first major question, we still don’t have an answer. We still don’t have a time for her surgery. They said it is most likely the second on Dr Kruper’s schedule which will most likely be 10:00am. The nurse will call Mom with all of the final details the day before her surgery.

Our appointment today was mainly to discuss the pre-op and post-op ‘need-to-know’ info. Doctor Kruper was very happy that Mom decided on the double mastectomy and realized this would be the best choice after seeing how much tissue was involved. Mom shared her feelings about the meeting with her plastic surgeon, and how she was less than happy with his bedside manner, but that not once has she considered having anyone else do her surgery. She can tell he is a perfectionist and wants him to be in charge of her reconstruction. Doctor Kruper also confirmed that the mastectomy will allow Mom to not have chemo and radiation, which Mom has stood firmly against. Thankfully, there is no need for those treatments with her type of cancer, removed with a mastectomy. The one thing that Dr Kruper says is still not ‘off the table’ is whether or not Mom needs to take Tamoxifen for the next 5 years. Mom has also been very clear about not wanting to take that cancer-prevention drug either, but Dr Kruper says that she would rather Mom meet with one other Oncologist before that decision is made. The great thing about Tamoxifen is that it reduces the risk of any new or recurring cancer by 50%...which is a HUGE number, but it comes with a several side affects that don’t sound all that fun (stroke, blood clots, uterine cancer, cataracts…). The more I read about the side affects, the more I understand her hesitation.

Another thing Mom wasn’t that thrilled about today was that in addition to the mastectomies, Dr Kruper will also remove 2 nodes (Sentinel Lymph Node Biopsy) from her right armpit with a small incision to test the nodes, JUST to make sure that the cancer we’re dealing with is still DCIS (the non-invasive type). The Doctor says she’s almost certain there won’t be a problem, but would really rather be 100% positive. Dr Kruper assured Mom that the node removal with be the least of her worries with the surgery, and that she will most likely be much more focused on the pain and swelling due to the mastectomies.

The great thing we learned from today is that Mom’s recovery won’t be quite as long as I had anticipated. They say within 3 weeks she should really start feeling closer to herself again. She obviously won’t be able to resume all normal ranch work at that point, but she will be able to get back to many normal daily activities.

Another great opportunity was presented to Mom today, and was one that she met very happily. She was offered the chance to be in a clinical trial to help in earlier detection of breast cancer as well as the hope for a cure someday. Basically, they will collect all of Mom’s medical data, some blood samples and all of the leftover tissue from pathology once her surgery is over. The pathology dept will take all of the tissue removed during the mastectomy and freeze/slice the whole thing for numerous tests and preserve it in Mom’s files…it’s a really interesting process! Then, the clinical trial will take whatever is left for their studies. Mom had to sign consent forms and be witnessed by someone else. My Dad witnessed and signed the papers with her. Each time she is treated at the hospital they will collect data and continue this study for the next 5 years, if I’m not mistaken. It’s totally anonymous and she can back-out at anytime if she chooses, but I can’t imagine that she would. They think that if they figure out how different receptors in the blood work that they can pinpoint why women get this and what might trigger it. Isn’t that amazing? This is all being paid for by the City of Hope. They are truly brilliant people.

The next person we met with was Nurse Jeanie (great name, huh!). She went through many of the post-op questions we had. Nurse Jeanie has been with the City of Hope for 37 years and trains nurses and was also a surgical nurse there for many years. She actually retired for a bit back home to the Philippines, but decided that she’d like to come back again…which we’re thankful for. She went through all of the standard surgical preparations (like no food or water after midnight) and had Mom sign some consent forms. She also instructed us on how to take care of Mom’s incision tubes for the week following the surgery. I took a few pictures because it was interesting. She also said that they would hook us up with a nursing agency to take great care of her for the first few days she’s home by coming to the house and checking up on her. She let us know about what we should expect, what’s normal, what’s abnormal and what to do if we feel something isn’t right.

The other thing they focused on today is making sure that she’s not TOO cowboy tuff. They want her to make sure and take the pain meds if she needs them, and not try to just tough it out (which she’s known for). They said that her pain level being low will help her in the healing process, so she’s not too tense. They said there will absolutely be discomfort, but pain is what they are hoping to control.

My (sort of) favorite quote for the day today was from Mom. In between appointments she leaned over and said, “The sooner I can get off this property, the better for me.” And boy howdy I should have believed her. I was sending a text to Chad after we got out of the last appointment, and she made a beeline for the car. She didn’t even say a word! She just took off. I didn’t even know what happened and I was standing there by myself. LOL I had to call my Dad and figure out where everyone went. I think she was glad the day was over.
:)