Tuesday, December 20, 2016

Six Months

Kim learned of her cancer diagnosis around dinner time on June 19th. Six months later and she's passed through 4 months of chemotherapy, dozens of doctor's visits, and lumpectomy surgery just last week. Her chemotherapy port was also removed during that surgery. Today, December 19th, she's in good spirits and recovering quickly. She's been out for walks, joined us all to see Rogue One, and will return to work tomorrow. Her pain medicine pump came out Saturday evening (by yours truly) and the surgical drain will be removed Thursday morning (by a doctor, whew!). Thursday evening will be the first time in quite a long time that Kim is back to normal. There's some peach fuzz on her scalp. The daylight hours, thankfully, will also be growing longer every day beginning Thursday.

By now I'd bet that all of you know the play-by-play from her surgery last week as so many of you acknowledged well wishes on Facebook as I posted throughout the day. So, for this post I'll just add some detail and let everyone get back to the holiday buzz.

Kim's surgery went as best as we could have hoped for with her doctors reporting successful procedures and her quick recovery from anesthesia.

The real take away from this procedure is that there's never really an easy step. Prior to surgery there's the cleaning of the house, the washing of all the linens and towels, showers for both of us with anti-bacterial soap, all the fasting Kim must do in advance. Next, at the hospital, it's loads of questions, tests, and pre-op procedures. The surgery, for Kim, lasts about 5 minutes. For me, those 4+ hours were spent hanging out with friends nearby because listening to the mainstream news on the TV in the waiting room is mind-numbing. The benefit of this hospital being in town is that there's so much to walk to nearby including snack and treats for both Kim and me.

Perhaps the hardest part of this surgery is that it's not "over" once leaving the hospital. Kim had a pain medicine pump fanny pack attached to her waist with a catheter inserted into her upper left chest. She has a surgical drain exiting her left underarm and a collection tube attached to a special bra. For three days she was bothered by both. Now, it's just the drain. It's unpleasant, uncomfortable, requires regular care, and, of course, requires another visit to finish off. Time, Kim is most eager to have her time back.

Kim's check-in time was 7am for a 9am start. A heavy winter storm hit the city the evening prior so getting up and out early was important. Nothing was keeping Kim from her appointed surgery time.

Please, no more waiting. More than anything, Kim wanted that chemotherapy port out.



Back again in the same pre-op bay as her port surgery. Gotta love those inflatable warming blankets.

Prior to surgery Kim required an ultrasound and trip between buildings. We took the skybridge which was chilly but offered a beautiful view of the quiet, snowy city streets below. Warm blankets are always at the ready.

Ultrasound confirmed location of the tumor and lymph nodes. This doctor was so very nice and quite humorous. Thankfully so, as his job is to give Kim two injections close to the nipple and then insert a very long locating wire into her breast. Damn, Kim is tough. Not a peep from her, just some laughing at his jokes.

Kim was visited by four doctors prior to surgery and each one gave her a thorough, professional, calming talk about what their job would be and the outcome they expected. This is her anesthesiologist. I forgot his name. Sorry, I was nervous.

Each doctor signs their initials at the location of their procedure. Dr Nathalie Johnson is the only doctor authorized to use a symbol, hearts, as her official signature.

Off she goes. 

No one ever wants to see this view of their loved ones.

Though, when it's immediately followed up by this sight, you're filled with great hope. Being married for nearly 20 years there are moments or images that are permanently imprinted and this is one that I will always recall. The image will never fully show that smile or that sense of strength. 

Recovery requires lots of tests, exercises, and such. There's a nurse it at regular intervals to do something and usually just as Kim falls asleep. This is a breathing exercise used post-surgery to fight of pneumonia. Kim had to breath in 10 times with the hopes of getting the indicator to the "500" mark on her first test. By breath 4 she was hitting "3000". The nurse, said, "What do you do? I've never seen a woman do that."

Sunrise after our evening in the hospital. Surprisingly, a restful sleep for both of us.

Kim was so eager for the physical therapist to arrive so she could learn her exercises and get out of the hospital. The therapist came in and I said, "I know you."; she was the star of the PT video we'd watched the night before. She gave Kim a quick talk and then asked her to stand up. Kim got right out of bed. The therapist said, "Oh, you can do that on your own?"

Three days following the surgery Kim's pain medication pump was empty and it was time to remove the catheter. I'd watched the film on how to do this and was ready to go as I knew this was something we could do at home. Now, in the instructional video the catheter is only inserted about an inch or two. This one was inserted from the black mark on the left alllllll the way to the end over on the right. I made Andrew and Jason assist with this. Jason's face wasn't white, it was clear. Kim, as always, didn't say a word.



Friday, December 2, 2016

Ten Years Starts Today

Kim went in for her surgical consultation on Monday of this week. The great news is that the tumor has gone from 3.7 cm to just a bit of 2 cm. Her lymph nodes have also diminished in size though she we be having three of them removed. We went with high hopes that the plan for surgery would be a quick in and out and I'll say that maybe we were flying a bit to high off of the chemotherapy finish.

The surgery will likely be an outpatient procedure on Thursday December 15th though there is a chance Kim may spend the night. It really will depend on what  Dr Johnson discovers during surgery and Kim's comfort level with the drain she'll have in place to manage the lymph node removal healing process. Man, what a bummer. Recovery from the lumpectomy and lymph node removal will have Kim toting a surgical drain for at least a week. There's also a risk of lymphedema, swelling and pain in the arm on the side of the removal. Kim is confident in the surgery process but very worried about long-term effects such as the arm pain. Dr Johnson is as good as it gets and we are confident that the procedure will go well. One benefit to the surgery on that day is the removal of the port in Kim's right chest. It'll be a big day.

Today was the first Thursday in four months that Kim did not return for chemotherapy on the alternating week. She's feeling better and better, her feet don't hurt as much. She also seems to mentally willing her hair and eyelashes to grow more quickly. 

But today is a day to note because it's the first day she's taken a Tamoxifen Citrate tablet. Tamoxifen is used treat breast cancers that test positive for estrogen receptors. It blocks the effects that the hormone estrogen has on cancer cells and lowers the chance that breast cancer will grow. By starting today she'll give the drug a few weeks to work the tumor size down even further. 

She will be taking this drug every day for ten years.

I cannot get my head around that time period. Add to this the possible side effects of hot flashes, nausea, fatigue, headache, and hair thinning and it's a quick end to the sense of joy and optimism we had just a week ago. Sure, we knew four months ago that this drug would be prescribed but it really hit home today standing in the kitchen as she added the tablet to her pile of vitamins and supplements. It feels like another member of the household to me. 

The bright side, right? Kim is strong and healthy and will only become even more so as we go on. To celebrate this fact the family is off to Seattle for the weekend. Art museums are good for each one of us. 

Here's to 2026