Things are moving right along!  My surgery is scheduled for August 12.  I’ll have the surgery which was originally planned for in January, which is a lumpectomy (aka segmental mastectomy) and a lift on both breasts.  While the plastic surgeon is doing the lift, Dr. White will also remove a lipoma (fatty, non-cancerous mass) on my left breast.  That lipoma is probably the reason I didn’t think much of any growth I felt on my right breast during self-exams, so thank goodness for annual mammograms.

I’ve already received the surgery instructions, and I was sent a microbial soap with which to shower on the morning of my surgery.  I think it’s the same soap that surgeons use to scrub before a surgery.  Prior to the surgery, I have a needle localization procedure done, and then Nuclear Medicine will inject a dye to help identify the lymph nodes.  The paperwork currently states that Dr. Ching  will remove the sentinel node and possible removal of axillary nodes.  I thought that because I had chemo first, that Dr. Ching was going to remove more than the sentinel node for sure, so I’m cautiously optimistic that perhaps fewer lymph nodes will be removed than I thought.  The more nodes she removes, the higher the risk of lymphedema.  The lymphatic system is the body’s garbage removal system, and removing nodes can cause a blockage, resulting in swelling, or lympedema.

Prior to August 12, I’ll need blood work (surprise, surprise) and an EKG.  I’ve had both, so no sweat.  I’ve had 5 surgeries – all orthopedic in nature – so I know that when I hit 40, an EKG was required.

This is the first update in a while – things have been very busy.  We went live with the new database system on July 15, a 2 year project to convert from the previous database.  There is the inevitable shakeout from a system change, but all in all, the conversion went fairly smoothly.  In the meantime, I have been preparing for a conference of which I am the chair.  I leave tomorrow morning at 6 am for Boston and return late on the 8th.  We are moving my mom to a residential care facility that weekend (thank you Ted for helping on Saturday), I go to work for 2 days, and then my surgery is on Wednesday and I’m off work for 7 weeks (6 weeks leave, 1 week vacation). After that, though, the second big hurdle in my treatment is complete, and I will admit to a bit of excitement about the progress.

Yesterday I had chemo.  Yes, chemo.  While I am done with Taxol, or what I’m calling “general” chemo, I still have targeted chemotherapy.  Dr. Priya wanted me to take full advantage of getting approved for Perjeta and gave me a 4th dose yesterday, and I also received Herceptin, which I will need to receive until probably May at this point.  I also received magnesium, but only 1 gram – my magnesium level is finally climbing back up. It was actually really great to see all the chemo nurses – I’ve gotten to know almost all of them and they are wonderful.

Targeted chemotherapy is not immuosuppressive, which means, theoretically, that my blood counts should be on the rise back to normal.  Indeed, my hemoglobin was 11.4 without the help of a blood transfusion, and all other counts are heading to normal  (in case you’re curious, both Perjeta and Herceptin are monoclonal antibodies.  Each targets a particular part of the HER2 cancer and blocks the HER2 receptors.)  The nature of targeted chemotherapy allows for me to get chemo just 12 days before surgery.

Of course, I had to have some last minute excitement…my left ankle has been swelling the last few days.  A few weeks ago, both ankles were swelling, but after a week of sleeping with my legs elevated the swelling went away.  Because the swelling was only in one ankle, I had an ultrasound to rule out a blood clot (aka DVT, or Deep Vein Thrombosis).  Typically swelling resulting from chemo would be in both ankles, hence the concern.  The ultrasound was negative for a DVT, though, so I guess I’m having yet another unusual reaction to the Taxene family of chemotherapy.  There is a little concern because I’m flying tomorrow, but I’ll wear the ever sexy compression stockings and continue to sleep with my legs elevated.  The good thing is this morning the ankle is almost back to normal.  We’ll see how it is after a day of activity today.

I am excited for my trip!  I am transporting a 13 week old Siamese kitten to her mom with me, and then I get to spend a week with 6 fabulous colleagues.  We have almost 100 participant registered – a 50% increase over last year – and we will be in one of my favorite cities.  I am doing a visit with one of the vendors we use, which will be really fun, and then I get to geek out with like-minded folks.  This conference is my favorite: while it’s not an insignificant amount of work and energy, it is also the most fulfilling because you really get to know the participants.  You’re with them for 5 days, working with them on team projects, and seeing the same folks in sessions.  There’s time to socialize and get to know each other in that way, too.  It’s the first time (for me) this conference is in a more urban surrounding, so I’m curious how/if that changes the nature of the conference.

I probably won’t post again until after surgery, and since my arm movements are restricted for a couple of weeks, it may be awhile!  I’ll take all positive thoughts (and prayers, if you’re inclined) that everything goes well!