Friday, October 27, 2023

I got 99 problams but a (fake) boob ain't one (or two)

I have all kinds of things to tell you about my new boobs, but first I'd like to share two kinds of good news.

The definitive good news is that I had an appointment with Tammy, the NP I adore in plastic surgery. She pronounced me well healed, and said I could go back to normal life, including sleeping on my side and exercise. But really, to listen to my body.

I said, "Downward dog is OK?"

"Yes. Listen to your body."

"And headstands? Like, not today, but yes?"

"LISTEN TO YOUR BODY."

Nick said he'd encourage me to do this thing that everyone thinks I am not inclined to do.

I was going to go to yoga this morning, but I slept right through it. Look at me listening to my body and not the alarm!

After plastics, we minced on over to medical oncology. Actually, we did the opposite of mince. Because walking those hospital halls, I was reminded that Nick is a clompy walker.

"Are you always this clompy?"

"I'm not clompy."

"You're clomping."

I notice because I used to be a heavy heel strike walker. I still am if I'm not paying attention. 

Anyway, first we met with this very handsome fellow—and by fellow I mean like person doing a fellowship and just some guy. I mean, he was wearing a mask, but so maybe he has a weird mouth or bizarre choices in facial hair, but all other data points indicate handsomeness. And he was wearing this cute wool vest over his button down shirt.

Which reminds me—when we met with the radiation oncologist, one of her fellows was in normal clothes and Nick was all, "Where's your coat?"

And he said, "What?"

And Nick was like, "You know, your doctor coat!"

Nick was just teasing but the guy got a little flustered.

Although maybe he's new to breast surgery and women sitting around with boobs out?

Honestly, the oncology department was the first one that left me clothed the entire time. Now I walk into an exam room and reach to pull off my top.

It's like getting drunk in my 20s.

Anyway, I'd like to mention that all my doctors except my plastic surgeon are women. I quite love this fact.

I definitely wanted a female surgeon. There's a recent study indicating that they have better outcomes. This surprises me zero percent.

But good lord let me get to the point.

Nick and I both really liked the oncologist. She explained things so well and was patient with questions.

And here's what she said. 

First, she didn't feel like she could legitimately argue with insurance for the CT and bone scans, because my risk is so low. She doesn't see a need for them.

Also, with invasive lobular cancer, which is my kind, they do a special stain on the lymph node. The normal stain showed nothing, and then they do this extra special step.

(Who wants to be a normie?)

They didn't used to have this stain, just the regular one. And then this stain was developed, and they started using it for everyone, which led to overtreatment in some cases.

I do know from friends who had cancer decades ago that treatment used to be much more brutal. For example, they used to take out 20 ore more lymph nodes as a matter of course. Which led to lymphedema and I don't know what else.

They now treat more cautiously because they don't want to fuck you up for life if they don't have to.

Please understand that this is not verbatim, just my interpretation.

And the doctor said that the tumor board (with olives and prosciutto!) has representatives from every cancer specialty. These are the big brains at the top of their fields. This is what they do for a living. And none of them believe I'm high risk.

So.

The oncologist said that she is as certain as she can be without Oncotype results that I will not need chemotherapy. 

She explained that Oncotype has data on outcomes from all of these women with different kinds of breast cancer, and they use the genetics of your specific tumor and do fancy statistical analyses (again paraphrasing, and please know I failed probability and statistics--only class I've ever failed, and depression of course figured into it but also a severe cognitive inability to make letters stand for equations and also a lack of interest in how many red marbles there would be in a barrel of a million colored marbles).

Essecntially, for me what matters is after their analyses, they give you a number from 1-100. And a number under 25 means that for me, chemotherapy does not increase survivability.

It's weird to think in those terms. But chemo has all kinds of downsides that maybe aren't so worth it if going through it isn't likely to make you live longer.

The number for radiation is 18. I asked her why and she said it's just different analyses.

So sincerely and truly praying that my number is under 18.

I relayed this conversation to a dear friend of mine who had a different kind of cancer, and he said, and I quote, "The fact that she spoke about it at all is very encouraging news regarding chemo. Doctors find it uncomfortable confirming even the previous day's weather."

What I can tell you for certain is that it's been 80 degrees and delightful in DC lately. I mean, delightful in a global apocalyptic kind of way.

More on boobs soon. They're so weird.

2 comments:

  1. Thanks for updating, and a cautious yay! Olivia

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    Replies
    1. Thank you, Olivia! Hugs, LJ

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