Tuesday, June 8, 2010

told the kids

6/6/10 We told the kids on Sunday that I will be going into the hospital. We explained that mom will have some  female organs removed that she no longer needs since she is not having any more babies. We didn't explain the organs in detail. We didn't mention cancer at this time because we don't know the final outcome. Let's pray the outcome is great news! We also told them a robot will be involved with my operation. We showed them the videos that I posted on my last blog posting. They didn't have any questions. My daughter got upset when I told her that I can't be at the end of her school party since I will be recovering. She later asked me " I thought you were done with your operation". I also explained that grandma Kathy will get them up and ready for school on 6/15/10 the day of my surgery since I have to be at the hospital for 6:30 am We also told them, I might have to spend the night but we won't know until that day.

I have my pre-op exam this Thursday 6/10/10 at the hospital. Take Care :>

Tuesday, June 1, 2010

Tattoo update/misc info

On Thursday May 27, 2010 I saw my plastic surgeon. I went to her for a follow up appointment since I had the tattoo performed. She said everything looked well and glad I had it done. She agreed that it looks better with color and looks normal. The work was great! I will see her in six months for a follow up.

I ran into my breast cancer surgeon in the parking lot before my appointment. She has been cc on all my blood tests and wanted to know what was going on with me. She had asked her nurse to call me to find out if I was okay.(which was going to be this week) She is very thoughtful and I appreciate her to take the time to still follow my medical needs. I gave her all my updates. She asked me to keep her posted after the surgery. I am so happy and pleased with all of my doctors. They really care and sincere with their patients.

I have an appointment on June 10, 2010 at the hospital for a pre-op exam. I will need to have an EKG, chest X-ray, and some blood work before my surgery date. The appointment will take 45 min - 1 hour. I also received my time for surgery. My surgery is schedules for June 15, 2010 at 730 am. I will have to be at the hospital at 6:30 am. I will keep everybody posted as much as I can. Take Care :>

Wednesday, May 26, 2010

appointment with OBGYN Oncologist

Gene and I met the OBGYN Oncologist on Monday May 24, 2010. We liked  his mannerism and knowledge within the field. On Monday and Tuesday he works at Bridgeport Hospital where I will be going and the other days he works at Yale Hospital. He went over everything I mentioned in my previous blog. He talked with my OBGYN for along time about my medical before my appointment. He had most of my medical reports from all my other test and surgery's. I brought all my medical reports and I gave him a copy of my genetic findings report to add to his files. He confirmed  and gave me the options for the surgery. I told him I've decided to remove my uterus, fallopian tubes, and ovaries. He agreed this was a wise decision and since I have kids and I am over 35 years old he didn't have a problem with my decision. He feels that my numbers are increasing for CA-125 within my blood work and there is something affecting it. Its hard to know what is causing this until the surgery. He explained he has had several patients who are young with ovarian cancer and hopes I don't fall under this category. There are several other factors that can also affect my numbers to increase. There was so much information given to us that day but I believe he mentioned around a blood count of 100 is where he has seen patients who had Ovarian cancer. I am at 83 and who knows when my number will go higher but we have scheduled surgery for June 15, 2010 to stop/remove what is causing this change.  I signed some paperwork just in case when he is performing the surgery and my organs look abnormal he will take biopsies from lymph nodes that go into my legs and lymph nodes off my abdominal wall. All my organs (uterus,ovaries,and fallopian tubes) will be sent to the pathologist and we should get the results back within a week. That will be a long week to wait!!! My OBGYN will also be there to help assist through-out the surgery. My surgery will be performed  laparoscopic with help from a robotic machine. The  incisions will be on each side of my belly button but real small which will be hardly seen. The microscope and tools are inserted through this incision and the organs are discarded through the vagina. Its very interesting to watch the following video and read the information. It will only take 3-4 minutes and will explain how the machine helps so I will let you read it instead of trying to explain it all. Continues  below with more information about appointment:

info on robotic machine
http://www.yalegynoncology.com/dvs-system/da-vinci-surgical-system-safety

This site shows you what the robotic looks like:
http://www.yalegynoncology.com/dvs-system/da-vinci-surgical-system-features

Here is a video that shows how the robotic works:
http://www.yalegynoncology.com/dvs-system/procedure-multimedia

I had an  internal exam by the doctor and everything was good from this view. The day before surgery starting at 2:00 PM I will have to drink one bottle of citrate of Magnesia (which I get from the pharmacy,over the counter). This will clear out the bowels. I will have to drink clear liquids only which has no red or orange color. The nurse told me if I get a gaging reflex from the drink then to have a popsicle first to numb my throat. I am not looking forward to this part! He mentioned as a women gets older into her late 50-60's that the vagina naturally drops down. He is going to correct mine which this is called a vaginal suspension since we are preforming this surgery, I guess there are perks to this surgery, ha ha ha.Its like having a lift. There will be no activity for six weeks after. He said if I feel well and the surgery went good, I might be able to go home the same day or might just spend one night. The recovery will be 1-2 weeks without lifting anything. He explained the recovery will be a piece of cake compared to my Breast Cancer recovery. He will also give me pain pills if needed afterwards. He mentioned patients usually only need them 1-3 days afterwards.I don't remember how long the surgery will take. I will be under anesthesia during entire time. I will speak with both OBGYN's before surgery.
My OBGYN left a message today (5/26/10) and said she rearrange her appointments and confirmed she will be at my surgery. I will inform my kids about the surgery when time gets alittle closer. I don't want them to worry. I will have to wait until  after the results are back from the pathologist to know what will be are next step.(lets keep our fingers crossed that it is nothing)

Monday, May 24, 2010

OBGYN and my decesion

I placed a call to my OBGYN on Thursday May 20, 2010 to follow up. I went on with my normal day trying not to think about my blood results. It was 3:00 in the afternoon and I never received a return call back from my OB which is unusual so I called the office again. I was told she was waiting for a call back from another OBGYN Oncologist. In the evening, I went outside with my kids and was only outside for ten minutes and realized I forgot the house phone and my cell phone to take outside. O'boy..... I came inside and my OBGYN had left me a message stating she is going home for the day and to contact her at noon the next day. I called the office right away and they were closed. Lucky for caller ID. I called the number and was surprised a representative picked up the phone and was able to find her before she left to go home. She took her time and explained all the information. Remember my Oncologist had given me two names for OB Oncologist, well she spoke to the second doctor and my Oncologist spoke with the first doctor. I guess that was good so we have four doctors involved with my medical decision.
The first option is not as aggressive. I would have laproscopic surgery and take several biopsies from both of my ovaries, both of my fallopian tubes, and biopsy my uterus. At the end of this procedure I would have a washing to clear out my fluids from cavity. The downside would be if any of the biopsies are positive, I would have to go back to surgery and have that organ removed.
The more aggressive approach would to remove my ovaries, my ffallopian tubes, and uterus. This would be a full hysterectomy. The reason for this procedure is because I have alot of uncertain with my medical. My OBGYN and the OBGYN Oncologist spoke in depth about my medical and they want to give me all the options for me. There is a chance of fallopian tube cancer which is not as common but within this area it is dense and hard to detect cancer from the ultrasounds. I spoke with my OBGYN and I am not planning to have any more children. She explained you only need your uterus to have children. Another concern I might have endometriosis which would require to remove the uterus. I spoke with my doctor for along time and I don't want to live the rest of my life in fear that I might have cancer or what is wrong with me. She explained if I choose the first option that I would need to continue to have ultrasounds and blood work every few months and be monitored the rest of my life. The problem with ovarian cancer is that most of the time there is no signs of this cancer until its in a bad stage before it gives you a sign. I want to be proactive and not let this happen. There are some side effects to remove the ovaries at a early age but I would like to be around for many more years to come so I can out weigh the effects. During this conversation with my doctor I decided that I would like to have a full hysterectomy. She said she would contact the OBGYN Oncologist she spoke with and make an appointment for me to meet him and go over the options and procedure as well. He would be the main surgeon and she would also be there to assist. She spoke highly of this doctor. She works with him alot in the hospital and would trust him to perform surgery on her. After the organs are removed, they would be sent to the pathologist to be examined and help determine what I have that is activating my CA-125. I would probably stay in the hospital one night. This would also be performed laproscopic surgery Here are some of the side effects that may or may not happen:
  • will go into post menopause - may have hot flashes and night sweats
  • if this happens then I will have to go on a low dose of estrogen (hope not because cancer grows on estrogen but women need some estrogen in their body) this is a gray area that I will need to speak with my doctor after the surgery
  • osteoporosis may occur ( again gray area and will discuss with Oncologist about possibility a shot once a year for bone density
  • I will have to get off my Tamoxifen and go onto another medication because now post menopause
  • possible heart disease long term- medical technology will help me here
  • my good cholesterol will go down in numbers so I will have blood test to monitor
  • vaginal dryness - medications/creams can be used if needed
The good outcome I will not have to deal with a monthly menstrual cycle. YEA I have to make some laughter out of all of this. My OBGYN gave me a few dates in June that she is available for surgery but would work around the main surgeon schedule.

Friday May 21, 2010 my OBGYN office called me and scheduled an appointment for Monday May 24 to meet with the OBGYN Oncologist.

Stay tune for more updates... sorry its late and I need to get to bed. There is so much information to absorb and write so I will write some more updates tomorrow. Lets pray the best for me that there is no cancer and if there is that we caught it in time before it spread!
 Ohhh forgot to add that I am healing well with my tattoo nipples/areola and I will be following up with my plastic surgeon this Thursday 5/27/10. I am happy with the results.

Sunday, May 23, 2010

ultrasound/bloodwork results

May 19, 2010 I had my ultra-sound done. The results were good.  All three of my cyst were completely down to a normal size. When a women has completed her menstrual cycle the pockets of fluid should be decreased. As a women gets closer to get her menstrual cycle the next month, these pockets or cyst fill up with progesterone/estrogen fluid. The cyst that I had are normal looking cyst which don't look abnormal. I asked to speak with my OBGYN to get my blood work results but she was off on this day. The nurse said she didn't have the copy and its probably in my OBGYN's office. I text-ed my Oncologist to see if he received my results back from my blood work.
He called me this afternoon. I kinda knew something was up when I received a call from him. Wow the day started off in a positive direction and just like that my day was turned around!  He thought it was great that my cyst went away but the bad news was my blood work has gone up in numbers once again. The CA-125 is now 83 previous 55. I was in shock since my ultrasound was good. He explained that he contacted an OBGYN Oncologist and explained my situation to him. The new doctor recommended that I have biopsy done by laproscopic surgery. My previous history with breast cancer, my BRAC 2 was undetermined and my blood work is increasing is a concern. He asked  that I speak with my OBGYN tomorrow and speak with her about her decision. I text-ed my Oncologist later the same evening to get the names of the OBGYN Oncologist he would refer me too. He gave me the two names and I started my research on the Internet. I trust his opinion for the selection of doctors but I would like to also know as much as I can. I am going to speak with my OBGYN in the morning.

Thursday, May 13, 2010

more test next week

I spoke with my OBGYN last Wednesday May 5, 2010 to review my test since she was on vacation. She was still concern about my CA-125 being elevated even thou the ultra-sound was good. She gave me three options: 1. have another pelvic ultrasound when I get my next menstrual cycle and get my blood withdrawn a few days prior, 2 have laproscopic surgery and remove some cells around my cyst and ovaries and have them tested for any cancer cells. If none present no surgery needed. If one of the ovary has cancer then she would remove it. 3. have both of my ovaries removed. She did inform me the medical data has shown if the ovaries are removed too early in a women's life  (unless their cancer) don't remove them because you have a greater chance to develop heart disease and Osteoporosis.
We agreed on option number 1. She explained if I get my menstrual cycle in the next few weeks then wait until the next month.

May 12, 2010 I spoke with my OBGYN to inform her that I got my menstrual  cycle and it was on a 6 week cycle.She was concern because that is a longer time than normal. This can be due to the medication I am taking. She is worried if my cycles goes another 6 weeks or later that there might be a chance that something is infecting my cells or my cysts are growing and she doesn't want to take any chances. She changed her mind and would like to me come in next week for another pelvic ultra-sound. I have an appointment on Wednesday May 19. I also have to get my blood with drawn prior to the ultra-sound so she can compare the results. I will get my blood work done on Friday or Monday.

I will keep everybody posted as soon as I get the results. Here's another roller coaster ride!!! I am hoping we get the answer soon why my CA-125 (marker for ovarian cancer) has increased. Depending on my blood work and the ultrasound that will determine our next step.

Tuesday, May 11, 2010

Tattoo visit

Gene and I went to Long Island, New York on Wednesday May 5, 2010 to get my nipple/areola tattooed . We had to go to the office where my plastic surgeon works for this particular procedure. It was a bad morning. It should of took us around 80 minutes and it took us forever!!! We left at 9:05 for a 11:15 appointment. The usual morning hectic commute should of been over by this time. The traffic was bumper to bumper all the way out of CT and traffic in New York as well. We barely made it there in time. The building was a beautiful  glass building. I had to go to the anesthetic office which is on a different floor then the plastic surgeons. I had a short consultation with the representative who would be doing my work to review the procedure and my medical information. She took a few pictures and went to get all the supplies ready. She expressed how well I looked. She was impressed with my plastic surgeons work. She said she has seen some bad jobs and my implants were one of the best she has seen. At this time Gene had left and would meet me in about a hour - hour half when I was finished. I had to wait another ten minutes until she returned. I was in a small room and I didn't realize we were waiting for the larger room to be available.

We decided to have a pinkish tone for me since I have light skin. She first outlined my areola area with a pencil that looked like a eyeliner. She examined my breast several times and I was wondering what she was looking at. It turned out that she was examining to see if the nipple area was even and where she had to make adjustments. She noticed that my right side was a little bit higher than my left side. She was good to notice that! I started to think about it for a minute and I forgot that would happened. I had radiation on my right side and the radiation had tighten the skin bringing this side higher. It's a slight difference that I didn't notice and with a person who doesn't have implants  they don't have the same size breast anyways. I forgot and really didn't notice it but she was examining  to make sure the job is perfect. I guess I have moved on from the past and forgot that would happened.She mixed a pink and a brown color together to achieve the color she wanted. She did this step several times to get the color she thought would look best. She would put some color on my skin (breast) to see if it matched.Once she achieved the color, she wiped off the excess and we were ready to start. I was lying down for the procedure. I was thinking to take a volume before the tattoo started to help me be calm but I forgot to bring one with me.
She started on my right side. When she first started it was painful. Oooo I thought I wasn't going to be able to make it through the procedure. She then started to chit chat with me so that helped me to be distracted. The pain did get better. I can describe the pain as a quick needle prick then stop and then again. If you can think of a clock, for some reason it hurt only around the 3:00 and 6:00 area. She said she had heard this from other patients who had this procedure as well. She explained that some of my nerves have developed and that's why I feel it in some areas and where I don't feel it the nerves haven't developed yet. It was tolerable procedure at this point. As she was coloring them in, she was surprised how my skin was responding. She can tell the color was taking right away. The procedure actually puts the needle slightly under the skin to add the color. She was about done with this side and I didn't even feel or know she colored in the nipple. I only felt a slight pressure.

She moved over to the left side. I was a little tense when she was about to begin because I don't like pain and was expecting to feel the needle pricks again. I couldn't believe it! This side was a piece of cake as far as the pain. I only felt a slight  pressure and that was it. I was so happy that the procedure was going to end with a happy experience. She did say for some reason on my left side the nipple wasn't taking the color as well but the areola was okay. She mentioned if I decide to come back in 7-10 years to have them tattoo again since the color does fade over time that I might have a  different experience. The nerves might be fully developed. We will cross that path down the road. She was done and I was able to look into the mirror before she put the gauze over the area. Wow they looked great and different. I was used to them being so light and now the area looks real. She put Bacitracin ointment on both sides and explained this need to be done twice a day for three days then covered it with a gauze. After the three days I apply Aquaphor twice a day up to two weeks total. The final color will take about two weeks to show the actual color that will remain. She also fanned out the color pass the areola area a little bit to help them have the effect as real nipples. She mentioned that I need to follow up for a two week appointment. Since I live so far away my plastic surgeon is in CT once a week for appointments and I will see her instead. She mentioned she would be excited to see how they turned out. I told her maybe my plastic surgeon can show her a picture so she knows how her final art work turned out! She asked me to call her and let her know how I think they turned out after two weeks. She mentioned if I felt I needed them darker or more color to call her and she can add some more. I think they will be good at this point.

The area we were in was beatiful. It was a warm day and I met Gene outside where he was reading a book. There were several restaurants next door so we had a nice lunch together before heading back home. The drive home was good and much better than the way there.

I am sorry for the late posting. It has been so busy on my end. I did speak with my OBGYN so check back soon for more updates. My medical life is keeping me busy at this point.