Wednesday, May 4, 2011

Back on the roller coaster

I'm all dressed and ready for work, except I don't want to go in yet. Good thing Wednesday morning is my office/paperwork time, so I'm not expected there at a certain hour.

I'm tired of this. It has been a long two months and I've had such a wide swing of emotions that I'm surprised I'm still considered sane. I remember the other day when my breast was squished between two mammograph plates and the radiologist was injecting it with lidocaine, and I thought, I don't want to play anymore. It hurts, it's humiliating, and it's scary. And if I was able to forget about this disease for periods of time before, now I am constantly reminded due to the ache at the surgery site.

I'm waiting for the other shoe to drop. It's a little disconcerting to have your surgeon say (right before your operation!) that you will have a 10% chance of needing a double mastectomy depending on what the biopsy and genetic testing shows. I didn't sign up  for this! I am tired of all of the appointments, of all the uncertainty, of the sympathetic faces from friends and family. I just want to be normal again. Me and my tennis elbow (which, by the way is feeling so good I may not need surgery on that after all). My little 40-year-old aches and pains. Not cancer. No, I didn't ask for that.

On the other hand, I am also looking at this experience through the eyes of a scientist and of a health care consumer. I am amazed at what doctors can do these days, but equally amazed at their limitations. It's a world of statistics and probability and no good answers. We make choices in our care based on probability and risk aversion, and what may be right for one patient won't help another, but often times there is no way of knowing who will be helped by what. One of my most vivid memories of watching the mini-series "John Adams" was when his daughter was diagnosed with breast cancer and had a mastectomy (the only available treatment at that time, well, other than maybe leeches). This was done with NO ANESTHESIA. How barbaric! But it was the best that could be done at the time. Think of how far medicine has come since then! But think of where we'll be in another 200 years. They'll look back at us and wonder why doctors kept lopping off breasts when there's now (in 2200) a pill to prevent all forms of breast cancer. Or not. Maybe we'll never figure it out.

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OK, it's been a few hours since I wrote that post and since then I received a phone call from the surgeon. It seems like the surgical pathology doesn't match the initial pathology. The initial path report (which was read by 2 pathologists) showed DCIS. The surgical report shows only atypia (which is possibly a precursor to cancer, but not cancer itself.) She is sending all of the samples to a breast pathologist at the Mayo clinic for verification. If it turns out to be atypical cells only, then I obviously would not need radiation. Good news, right? Yeah, I think. To be honest, I am very conflicted about that. Like I've been through so much and have steeled myself for the worst only to find out the diagnosis was wrong. And I've broadcast my story to the world and I have received so much support and now I don't have cancer after all. Actually, I don't know anything yet - the results won't be back for a day or two.

I am kind of in the medical field, so I get that it is more of an art than a science. I don't expect things to run perfectly, and I think that my medical team has only my best interests in mind. But, jeez, how many appointments have I had over this? How many sleepless nights? How many invasive procedures? I'm not angry, just a little anxious and also confused as to why I am not jumping up and down with joy right now. I guess that time will come. I guess I really should just wait for the Mayo report. Oh, good. More waiting. I do that so well.

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