Month: April 2020 (Page 2 of 2)

The biopsy was on Monday afternoon. The nurse called with the pathology results on Wednesday, March 25, at about 1:00 pm. The lymph node was clear. Both tiny masses were found to be invasive ductal carcinoma, abbreviated as IDC. This is a cancer that starts in a milk duct and then gets outside of it. The biggest one is 1.5 cm. IDC is about 75% of all breast cancers and, she told me, they have tons of experience treating it.

She told me that there was additional testing for hormone receptor sites, that would take another few days. But those results would give us more information about what kind of treatment to do.

The next step would be to go to the Multidisciplinary Breast Clinic at the central hospital. I would meet with the surgeon first, and then meet with a bunch of other specialists throughout the day. Because of COVID-19, I would only meet on-site with the general surgeon. The rest of the appointments would be by phone.

They hold the Multidisciplinary Clinic appointments every Thursday. The Mighty Sam asked me if it was more often before COVID-19, but I haven’t remembered to ask. It sounded to me like it was just every Thursday. My appointment would be Thursday, April 2. So I had a week to wait.

Ellen the nurse told me I would be getting a call from a Nurse Navigator who would help me, well, navigate the process. She also told me that I should watch a video on the clinic’s web site about surgery options.

So, that was pretty fucked up. First mammogram. Cancer. I don’t know if it would have helped if the radiologist had told me that it looked like cancer right away.

The Mighty Sam was here when I got the call of course – we were both working from home. He got the gist of the conversation from my side of it, and I gave him a summary. I called my mom and let her know. I took the rest of the day off – I called my boss since obviously this was going to impact my work significantly for quite a while. I can’t remember who else I told. I asked my mom to tell the rest of the fam so I wouldn’t have to. I let Vic and Christi know. My sister called me later.

The Mighty Sam and i watched the breast surgery video. That was probably the only time I did real crying, at least so far. But I also felt like I had a huge cry building up from the whole COVID-19 pandemic. I think it was a combination of both.

I also got a call from a scheduler, who gave me the rundown of everyone I would meet on the 2nd. The initial schedule was as follows:

• General Surgeon
• Social Worker
• Radiation Oncologist
• Medical Oncologist
• Nurse Navigator
• Plastic Surgeon

Later they would add a genetic counselor to the schedule and the order would get switched around a little.

The next day I got a call from Lizzy, the nurse navigator. She introduced herself and her role. That does seem really nice, that they have someone like that just to help you through it.

I had a couple of questions. First, I wanted to know how soon the surgery would be. She said they usually do it within 3 weeks of the initial appointment. However, with COVID-19 things are up in the air.

My other question was about working from home. I really do not want to get sick when I am getting ready to have cancer treatment. I asked if they would be able to recommend working from home and she said they could give me a doctor’s letter to that effect if I need one. She told me that I am not high-risk per se, but that it’s definitely best for me not to get sick. This was when she let me know about the genetic counselor. She thought it was a good idea to do a consult since I am so young (relatively speaking) and because I have an aunt who had breast cancer.

Then, on the Friday of that week, March 27, the nurse called me again with results from the hormone receptor testing. She said the results very good and she wanted to let me know right away: I had positive results for both estrogen receptors and progesterone receptors. This is very good because it means I’m eligible for hormone therapy. I also tested negative for a protein called Her-2-Neu, which is also a good thing.

The next day I woke up with a terrible migraine. I threw up several times and spent all morning and most of the afternoon in bed, writhing in pain. But that’s par for the course after a stressful week, and that week was pretty fucking stressful.

I wasn’t worried about the actual biopsy procedure. I didn’t tell very many people that I was having it – just Sam and my mom, and a few friends. of course at that time I was still hoping it would turn out to be nothing. First mammogram and everything. But also concerned, because two masses and a lymph node.

The Mighty Sam drove me to this appointment. I could have driven myself but it was nice to have the moral support. He did wait in the car though, because they didn’t tell me I could take someone with me.

It was the same drill – stopped at the door to make sure I don’t have any COVID-19 symptoms, then up to the breast imaging center.

You’re supposed to wear comfortable clothes and a sports bra. I stripped them off and put on a hospital gown, ties in front. The people working on me were the ultrasound tech, the doctor, and a PA.

This was an ultrasound-guided core needle biopsy. So they use the ultrasound to see exactly where the mass is, and then they put in a needle tube, and then put the biopsy needle through the tube to grab the tissue sample. Simple.

First they gave me lidocaine shots. I told them that I need extra shots at the dentist and that I burn through it fast. They said they would give me extra. I barely felt the shots and they worked pretty well. It was mostly not uncomfortable at all, except for one twinge when they did the lymph node. The biopsy needle makes a funny sound when it’s deployed, kind of like a cap gun without caps in it.

The same needle tube could be used for the two breast biopsies. When those were done the PA put on direct pressure and then bandaged me up with Steri-Strips and a clear dressing. The lymph node was similar. I didn’t watch any of it.

They also put little titanium clips on each mass during the procedure. After it was done I had to go get a “gentle mammogram” which is where they look to make sure the clips got put on correctly. After that I was totally done and could change back into my clothes. They said results would be back in 3 to 5 business days and someone would call me.

It took a little bit longer than I had expected. The Mighty Sam was very patient!

Post-procedure instructions: Keep the sports bra on for a full 24 hours, even in bed. It’s ok to take the dressings off that night but can leave them on until the next day if they’re not causing skin irritation. Leave the Steri-strips on until they fall off. No lifting things over 5 pounds for 24-48 hours. Take tylenol for pain. It’s ok to take a shower after 24 hours.

I did take Tylenol but I probably would have been able to manage without it. It was sore for the first couple of days, and then just felt like a big healing bruise.

This is the story of how this blog, which was supposed to be about my ADHD diagnosis and treatment, turned into a blog about having breast cancer in the middle of a wordwide pandemic.

It never rains but it pours, right?

I got diagnosed with invasive ductal carcinoma in my right breast on March 23, after a couple of mammograms and a biopsy. I am SO irritated that this diagnosis means I have to say the word BREAST all the time.

I turned 50 last fall, and my HMO kept pestering me to get a mammogram. Fall was really busy and hectic for some reason. Maybe because at the time I had untreated ADHD and had trouble getting even the basics done, and something like a routine screening seemed less important than just running as fast as I could to stay in the same place. I also had that knee injury which was messing with my exercise, which of course didn’t help my self-management. And it was winter, which makes everything more sucky. I did manage to send off a colon stool screening sample, which fortunately came back negative.

I called to schedule the mammogram in January and got it set on February 24. I was a little apprehensive about it – I’ve always heard stories about it being super squishy and super uncomfortable, but it wasn’t bad at all. The tech told me that if the mammogram came back clear I would just get a letter in the mail in about 10 days, but if they found anything or wanted a second look I would get a call within 2 days. She also told me that it is not unusual for first-time mammograms to get called back for a second look, especially for someone with “dense breast tissue” like I have, so I shouldn’t worry if I get a call instead of a letter.

I did get a call and I think it was the very next day. They told me to come back in for a second mammogram and an ultrasound on the right breast only. I told myself it was no big deal, because of what the tech said, and also that there is no BC in my mom’s family and only one case in my dad’s. But I also thought that it seemed weird that they only wanted a second look on the right side. If it was just dense breast tissue and first-time mammogram, wouldn’t they want to look at both?

Here’s a thing I do to cope when I’m waiting for what might be good or bad news: I tell myself to assume that it’s going to be the good-news outcome, because even if it turns out to be the bad news, then I would at least have had a week (or however long it was) without that worry.

I wasn’t able to find a time that worked for my work schedule AND the breast imaging center until March 19, so I made that appointment. Part of the reason that followup took so long was because the Capitol Hill breast imaging center was having new equipment installed so it would be closed for a while, and I had to go to Bellevue.

At this point it’s the last week in February and we haven’t realized how bad COVID-19 was going to get. We still only had one confirmed case in Washington and that guy was getting better. The news about the Kirkland nursing facility would hit the next weekend.

I had planned to take the 19th off for our first-time-ever cleaning service, along with a follow-up appointment with the psychologist who diagnosed me with ADHD to talk about the autism spectrum. The cleaners and the psych appointment were in the morning. The mammogram and ultrasound were scheduled for 2:45 in the afternoon.

It was a weird day. By that time The Mighty Sam and i were both mostly working from home, though I was still going in a couple times per week. So we were home when the cleaners were here. My psych appointment went pretty well though no conclusions were reached, and because of COVID-19 I decided I would follow up with it after it was over. It was super uncomfortable to be in the house with the cleaners, especially because we only have one bathroom and one of them was in it for quite a while, although they did do a fantastic job, and I’m so glad that we at least had ONE cleaning service before the stay-at-home orders became too stringent.

I went to the Bellevue clinic. That was the first time I got stopped at the entrance by screeners who asked if I had a temperature or coughing or other COVID-19 symptoms. I didn’t. I’ve been taking my temperature every day since the beginning of March.

The mammogram was pretty much the same as before, except just on the right side. The ultrasound took a very long time. They looked at both the breast and the lymph nodes on that side.

At the end I got dressed and met with the radiologist. She told me that there were two very small masses, plus a slightly swollen lymph node. She said she wanted biopsies of all three and I would be able to schedule it there, ASAP. She said she was not worried about the lymph node but was concerned about the two masses.

Now I think that they probably knew the two tiny masses were cancer already, based on the shape. I kind of wish they had told me that then, but maybe they aren’t supposed to unduly worry patients before they know for sure. After talking with the radiologist, I met with a case manager person named Amy who talked to me about what the biopsy would entail and also scheduled the appointment. I got a little brochure: “Your Guide to Ultrasound-Guided Core Needle Biopsy.” It didn’t sound too bad, certainly no worse than a nasty dental procedure.

The 19th was a Thursday. My appointment was the following Monday, the 23rd. I physically went in to work on the 20th and I think that is the last day I worked at work instead of at home.