A long day in Chapel Hill...

I don't have my notes in front of me right now, but I do want to update everyone on our day in Chapel Hill.

The doctors initially suggested the same treatment plan that the doctors here in Greensboro said... Mastectomy, followed by chemo and radiation.

The doctors also wanted me to delay reconstruction. But, I expressed my concern that my skin won't stretch after radiation and said I didn't want to take my own skin and tissue from another part of my body to reconstruct... I want a tissue expander put in at the time of the surgery. To me, this means one less surgery and the ability to use an implant. To them, it means a bigger chance of infection and/or longer healing time which would push off chemotherapy.

Lymph Nodes:
Unlike Greensboro, the doctors felt under my arms to see if any of my lymph nodes were swollen. To my dismay, they found a couple. So, with the help of an ultrasound to guide them, they were able to take a small tissue sample with a needle. Unfortunately, the quick preliminary test they did came back positive for cancer. (Ugh! Please pray this hasn't spread past my lymph nodes!!!)

I'm going back tomorrow to start the staging process, ie. whole body scans. The scans BEFORE surgery are important to them. They will be able to see if my cancer "lights up" on the scans. If they do light up now, they will be able to confirm if they got everything after the cancer is surgically removed.

We had creative discussions with the radiologist. She radiates over tissue expanders but was concerned about having two expanders in place after a double mastectomy. We decided that if the plastic surgeon agreed, we could deflate the side not being radiated if better angles are needed. Then, she started to talk about doing chemo first. That way, the healing/risk of infection won't delay chemo. Chemo will treat the entire body and keep the existing tumor from growing... and would probably shrink it. Since we know that the lymph nodes are positive, I actually think this is a great idea.

Studies have shown that reversing the chemo and surgery order do not affect survival rates. Plus, I will have more time to decide what surgery options I should choose. I have to do chemo anyway, so why not do that first? A surgery is forever... I have some peace knowing I will have 5 months to figure out what I should do! The ride home from Chapel Hill was a good one. I didn't feel as drained as I did after my appointments on Monday...

I'll update everyone again tomorrow after my scans. (I'll be out of the office yet again. I guess work will just have to wait. Right now, figuring this out is so much more important!)