A Few Days Later

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…(Sorry this is late today, but my new granddaughter was born on Thursday and we just moved the newly expanded family home this afternoon!)

A few days ago, my wife and I took off a day from work to visit doctors.

It’s been almost a year since the initial diagnosis, so this is sort of a “1 year check up” as well as the “6-month since the end of chemo” (http://breastcancerreaper.blogspot.com/2011/09/end-to-chemotherapy.html)  check up.

The morning session was with at the cancer treatment center with the doctor who performed the biopsy and gave us the news. While he’s very efficient, he’s not…our friend, so to speak. He’s a busy doctor and has many patients to see. However, my wife went armed with a list having heard from her former doctor that when people come with dozens of questions, they effectively “snow” the doctor. So she had a brief list: hand, eyes, legs, armpits.

The hand question was deferred and the doctor determined that it was NOT related to the leg issue. In fact, in discussing it, he noted that the symptoms my wife was experiencing: hand pain, thigh pain and armpit pain didn’t present in the way that the drug she will be taking for the next five years usually presented as side effects. See the drug, anastrazole (http://breastcancerreaper.blogspot.com/2011/12/next-five-years-anastrazole-whats-it-do.html) will give you joint pain, but it’s a general joint pain and effects every joint in your body (oh, joy…) and isn’t specific to the hand or even the muscles of the thigh.

It was something else.

When the blood work came back, it was clear to them that the liver numbers were good, a previous bone density scan had turned up no suspicious spots, and a lung x-ray hadn’t shown any spots. Unfortunately, there isn’t any real way to “scan” the brain – but there’ weren’t any symptoms that come with brain cancer.

We left the cancer clinic somewhat relieved but now wondering how to deal with the muscle pain. Of course, the doctor had suggested “exercise” while at the same time giving no hint whatsoever as to the KINDS of exercise or frequency or how to overcome a loathing of exercise…(read my next post for a continuing discussion of THIS subject!)

We stopped at Sears to look at exercise equipment and looked specifically at Elliptical Trainers because my wife had heard good things about them.

SHEESH! $$$$$$ We’ll see what happens with this.

At any rate, I bailed on the next appointment which was the dentist. Prior to chemotherapy, the cancer center had recommended a thorough cleaning of teeth and a checkup, which my wife did. It was time for her to go now that her body had gotten rid of the last traces of chemo drugs. She was concerned that because her gums hurt, they had been damaged by the chemo. She was thrilled instead to find out that while the pain WAS chemo-related, it was called DRY MOUTH. The dentist quickly supplied a mouthwash and toothpaste that would care for that problem! Her teeth were in great shape and she came home to rest before the last appointment of the day.

Regular clinic: on Thanksgiving Day in 2011, she had jammed her hand against the wall; specifically, her pinky and the finger next to it. There had been no swelling or bruising so she figured that ice and rest would take care of it, though we watched for lymphedema because the injury was to her right hand, and that was the arm where they’d had to remove a cluster of lymph nodes.

Recently, she developed something called “trigger finger”. The clinic doctor explained that an injury to the hand caused the swelling of the tendon that connected the finger to the wrist. That same tendon has to pass through a narrow opening at the base of the finger and when it was swollen, it would get stuck in the opening thereby “freezing” the finger. He recommended a shot of cortisone and an aluminum splint for the finger, immobilizing it for at least four days.

We’ve reach day 4 today and the finger, when my wife has tried to move it, it barely moveable. Hopefully that is from being splinted and the stiffness will disappear as she continues to work it.

So there you go, the One Year/Six Month Report. You'll notice that we never got to the "armpit" question. *sigh*

Even so, all seems well; as I said, it seems to be All Quiet On The Western Front and I pray continuously that it remains so. That being said, I’m pretty sure there’s STILL lots to talk about because guys NEED to talk about breast cancer – everything from the shock waves of the initial diagnosis through learning to live with it.

Later.

Image: http://c3018002.r2.cf0.rackcdn.com/14128-0400px.png

An Update On Man Cancer: Translating the Doctors

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…(Sorry this is late today, but my new granddaughter was born on Thursday and we just moved the newly expanded family home this afternoon!)

My old friend who had a radical orchiectomy (http://breastcancerreaper.blogspot.com/2011/12/man-cancer-and-orchiectomy.html) faces a second operation next week. The procedure is a real mouthful so to speak because it doesn’t have a “common name”. He will be undergoing a retroperitoneal lymph node dissection or an RPLND – which really doesn’t do anything to make it easier to remember, because the letters might make up the word “ResPLeNDent”, but that’s not helpful and I doubt very much that it’s particularly descriptive of how my old friend will feel AFTER the procedure.

Not even Wikipedia has a simple explanation, so as I am wont to do, let’s see about translating the doctors:

Retro (= behind) peritoneal (= a sack that lines the area below the lungs and above the bladder that holds the kidneys, liver, parts of the large and small colon, most of the pancreas and the stomach) is surgery that tries to get at and remove abdominal lymph nodes.

The nodes are outside of the sack that holds all the abdominal organs and lie against the INSIDE part of the spine. Lymph nodes are usually found at “bending points” like knees, ankles, arms, elbows, etc. Humans bend at the waist as well and a node in the abdomen pumps lymph through the body just as the others do. But it is close to the testicles and the nodes are the first to be attacked by cancer cells if they metastasize from there. Testicular cancer spreads in a well-known pattern, and these nodes are a primary landing site during spread of the disease.

 Doctors need to remove the nodes in order to treat testicular cancer, as well as help establish its exact stage and type. This has been done in the past by surgery so invasive that it required cutting a man open from the bottom of the sternum (middle of the rib cage) to below the belly button! There are dangers in this as well that I prefer not to go into.

But several doctors do the same surgery laparoscopically and while some surgeons consider it “less effective” others, it is less painful, runs fewer risks and joins the ranks of laparoscopic surgeries for repairing knees, shoulders, hernias and prostrates. It’s more expensive and detractors point out that not “all hospitals” have the capability of doing this, but it is far less incapacitating than the invasive older surgery.

Once the nodes are removed, an oncologist can examine the tissue to determine the extent of spread of the cancer. If no malignant tissue is found, the cancer may be more accurately considered as a stage I cancer, limited to the testicle and the orchiectomy may either be considered the “final solution” or they can follow it with chemotherapy or possibly radiation therapy. The low mortality and relapse rate with this procedure, as compared with the alternative, which is observation is the main reason my old friend has considered this as an alternative to the invasive surgery.

If you have testicular cancer – and any of us with testicles are susceptible. Warning signs are NOT LIMITED TO but may include: a lump or mass in either testicle, any enlargement or swelling of a testicle, a collection of fluid in the scrotum, a dull ache in the lower abdomen, back, or in the groin, a feeling of heaviness in the scrotum, discomfort or pain in a testicle or in the scrotum, enlargement or tenderness of the breasts. If you’re worried, go to your doctor! If you’re wondering, try the link below.

Resources: http://en.wikipedia.org/wiki/Retroperitoneal_lymph_node_dissection

http://www.tc-cancer.com/treatment/rplnd.html   http://www.tc-cancer.com/index.html

Image: http://www.biologyreference.com/photos/lymphatic-system-3892.jpg

Coming Up On One Year -- All About Me...

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

If you clicked on this to get information or find wisdom, you should click the return arrow and go back to your search. All you’re going to get here today are musings.

On March 18, 2011 Liz found out for sure that she had breast cancer. I detail the initial roller coaster in my first post (http://breastcancerreaper.blogspot.com/search/label/Introductions).

It’s now nearly a year later and shortly, we’re going to return to the hospital where it all started and talk with the breast cancer doctor who worked with Liz from the beginning.

My feelings run in ripples I feel in my muscles as I flash back and forth between the past and present. The biopsy day makes me shudder and my breathing catches in my throat.

The day of the mastectomy makes me feel numb as I can’t remember much except that I was surrounded by people who loved me – I wasn’t up to returning the love that day. I DO remember walking around the hospital in the cold with my sister. I remember walking around the hospital with Kathy. I remember Abbas coming to be with Mary. Other than those peculiar memories – and the bagels my sister brought. And the warm, grizzled redheaded embrace of my best male friend, Jon. See…it all comes in waves.

The choked conversations with my family after the biopsy.

The unholy terror of our first time at chemotherapy and the shock of the nurse dressed in goggles, mask, gloves, and gown injecting the red devil into Liz’ bloodstream to slaughter the invading cancer cells (http://breastcancerreaper.blogspot.com/2011/10/adriamycin-whats-it-do.html) and my thought of: “If it’s so dangerous you have to suit up like you’re going into an infectious disease ward, then what are you doing injecting into the heart of a cancer patient?!!!!!”

The repeat visits and watching Liz go from positive and chatting to lethargic and nearly unconscious were frightening. If I didn’t believe it was the effect of the drug trashing cancer cells, I would have refused to take her to the hospital again.

Ever.

For anything.

Then there was the guilt. Every one of the Neulasta shots (http://breastcancerreaper.blogspot.com/2011/11/neulasta-whats-it-do.html) cost $12,000. WHAT? How could I justify that? What were we doing to the poor? Shouldn’t I be doing something MORE to make the price come down? How could I explain this to the students I work with every day – some of whom are homeless? Can you put a price tag on a human life? What’s wrong with me? I shouldn’t even be THINKING about the price tag – but here I was, thinking about it! What kind of man am I to question this? It’s my WIFE of 25 years, for God’s sake!

But there I was, wondering about it. Struggling with it. Calling myself a douchebag.

So now it’s a year later and we’re going to go see the doctor again at the Breast Cancer Center. What’s he going to say? What’s next? Where do we go from here? Will life ever get back to normal?

*sigh*

See – no wisdom here. No hopeful pronouncements here. Only tentative thoughts of the future. Only breath holding. Only a closing of the eyes and a pretending to forget. Only a running of my hand through the baby-soft hair on Liz’ head. Only a sitting so close you can’t slip a hand between our thighs; only seated on opposite sides of the room, doing our own computer work and feeling guilty because I should be sitting so close you can’t slip a hand between our thighs because time is ALWAYS short, even for the granddaughter we’re waiting patiently for.

Maybe one thought, as trite as it sounds, as Disneyesque as it appears above: keep moving forward...

That’s what I’ll do.

Image: http://marc.digitalcitymechanics.com/wp-content/uploads/2007/04/moveforward.jpg

Lymphedema -- Another "For-the-Rest-of-Your-Life" Thing...

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Once the surgery was over and the “main” healing begun, we talked with my wife’s cancer care team and they introduced us to lymphedema.

First of all, “What is lymphedema?”

Let’s begin with an overview of the body system affected by this. Lymph is a clear fluid that lies in between the cells of the body. It’s there to feed the cells and to carry away waste. It comes from the blood itself and (to put it as simply as possible), “leaks” out of the tiny vessels that carry blood. It leave the red blood cells behind and if it were not cleared out, it would cause a massive amount of swelling.

Another system of vessels call the lymphatic system, “vaccuums up” that lymph and carries it back to the heart.

HOWEVER, where the circulatory system as the heart to push the blood around, the lymphatic system HAS NO HEART!

The only way to lymph can move around is by you and I moving. The movement of our muscles presses the lymph into the collection spots called the lymph nodes. These nodes are a gathered at very specific points in our bodies – the places where we move the most, the joints. Behind the knees, in the groin, the elbows, the armpits, the neck is where you’ll find large clusters of nodes. In addition you can find nodes in the lungs, underneath the chest muscles, along the spine as well as numerous other places in the body.

These nodes not only collect lymph to pass it back to the heart, they are also places where white blood cells made in the bone marrow, thymus, spleen and tonsils are gathered to be redistributed through the bloodstream to fight disease in the body.

The nodes are vital in moving the lymph fluid around and when some are removed during a mastectomy, the ease with which lymph can be moved is weakened. Even though there are still nodes under the muscles and in places besides the nodes – and so removal doesn’t instantly STOP the movement of lymph – it does reduce how much lymph can be moved around.

You probably already know that white blood cells fight disease. They also fight infections as well. When you get a cut or have surgery, white blood cells are moved by the body through the blood stream to the wound and often times leave the bloodstream to fight the infection. Once the infection is past, the white blood cells need to be transported back to the heart to go back into the bloodstream again.

When nodes are removed through surgery (or other damage or illness), the process takes much longer to “clear out” the white blood cells and the other extra fluid that the wound or damage caused. Because blood never stops flowing at its regular rate, fluid is still NORMALLY leaking out between cells. When you add the normal fluid leakage to the extra fluid and white blood cells from an infection, you get too much fluid in one place. This is called lymphedema (lymph of course, is what we’ve been talking about here; “edema” is a Greek word that means “to swell”).

The second question is: “What can I do about it?”

Lymphedema is treated by pushing the extra fluid back to where it belongs by helping the muscles and lymph nodes that are missing. Often this involves using massage as well as a compression garment: “The most common treatments for lymphedema are a combination of manual compression lymphatic massage, compression garments or bandaging.” Regular exercise is also helpful (see last week’s article on exercise: http://breastcancerreaper.blogspot.com/2012/01/10-exercise-hints-for-cancer-folk-and.html for some pointers!)

This is very straightforward, does not appear in any of the reading I did to be something to PANIC about…it does however require an awareness of what’s happening in your body and how to deal with it!

Image: http://s2.hubimg.com/u/3967945_f260.jpg