The Unexpected.

My 6 month oncology follow up was two weeks ago.  As I mentioned in my last post, there was no reason to believe that there would be anything to really report about.  Because my oncologist follows the “only scan on symptoms” protocol, I was not worried.  I have been feeling pretty great. 

The thing about the  ”cancer vortex’ is you never truly know what comes next. 

My appointment started off as usual. The nurse took my blood; I filled out my self evaluation sheet and waited some more in the overly crowded medical oncology office where the majority of patients are over 60. 

Dr W was extremely busy – more than usual, but she really gave me her full attention.  She was even more compassionate than I have ever remembered.  We talked about a lot of things- My treatment choices; side effects; my fibroid issues, babies after cancer and my overall well-being. 

Things did not start to get weird until the physical exam. 

Dr W: What is going on over here?  I do not remember this breast being so discolored?! 

Me: Well, it sort of started a few months ago but it does seem to have gotten worse. I assumed it was the norm and it was probably a side effect from radiation, no?

Dr W: I am sure it is nothing but I want you to get an MRI.  Oh and I am calling Dr M (radiation oncologist) over to have him take a look. 

I did not panic; I thought for sure she was just being overly cautious.  I had not seen Dr M since February 2011 (a month after my last radiation treatment) but he seemed to remember me enough to know what he was looking at. 

Dr M: Well, it could just be the implant and some lymphatic blockage but the only way to tell is a skin biopsy.  An MRI is not going to tell us what is going on with the skin. 

Me:  Is this something I can do with my plastic surgeon?  Wait…you are worried it could be skin metastasis? 

Dr M: No, not really but a biopsy is really the only way to know for sure.  Call you plastic surgeon and see what she thinks about a biopsy and the discoloring.

 

Both doctors agreed and they think this is nothing but now the words have been said, documented and I am stuck with following along with all the annoying and scary tests that would follow. 

I was able to schedule an appointment with my plastic surgeon for the following day.  Dr DP would know right away if she could/would biopsy the skin.   

As Dr DP looked me over she asked  me some questions, ran her finger down my radiated skin and then when she touched this one specific spot – I jumped up!   It is a spot that we have been ‘watching’ because the skin was really thin after my exchange surgery due to radiation damage.  I had thought it looked a little worse but this confirmed it. 

At this point, I was now standing up while she began sizing me up and grabbing my waist and my back trying to figure out what she had to work with.  I have been trying pretty hard to lose some of the extra tummy and toning up so she didn't really find much. 

The bottom line is my implant is failing.  This is in the side that was radiated 33 times.  The skin is just too damaged.  The implant is actually starting to show through the skin! That was why I had a lot of sensitivity to the touch.  Here I thought I was just getting my nerve sensation back.

 

The concern is that if we do not take this implant out now and look at alternate reconstruction options, this could end up being considered an emergency surgery and my options just went from 2 to none.

 

The other issue and the whole reason I went to see her is the skin that is turning color.  She brought my breast surgeon in to discuss and have her take a look.  The discoloration concerned her as well but mostly because they both think it is another issue with the implant and the constant tightening and tugging I have going on.  It is contracting and according to the photo evidence, rising higher by the month.  Of course that is causing me great pain but I just thought this was the way it was and I never really complained that much about it.  I just sort of accepted it as the new normal post radiation/reconstruction.

 

We knew there was a chance of this happening if I decided to go the implant route after radiation.  Some plastic surgeons won’t even touch radiated skin with an implant since it is very common for radiated skin to fail.  We took our 50/50 odds and went for it.  We were all  hopeful and thought I was in the clear for a while.  I did not think it would happen this quickly if at all.  It was just a year ago that I had my implants put in.  

The sadness, fear and overall frustration has really taken over on this. 

I had a biopsy last week.  It had to be in the OR since they could not risk my implant getting exposed and infection setting in.  That would add insult to injury.  I am grateful to report that my biopsy is benign and the skin sample is normal.  Dodged a bullet on this one!   

  

The new reconstruction options are very limited.  Everyone will have an opinion but there really is no great option for me. Either way, I am having surgery on November 27.   Instead of starting my bike race training for the 2013 season, I will be getting my ass kicked by another major surgery.  

I will share more about the type of surgery in another post.  It is just too exhausting to explain right now.  It has been consuming my mind and my extra time doing research.  

It can always be worse but for me, this is a big setback that I had not planned on.  It is not cancer this time (Thank GOD) but it is because of the cancer treatments that I have to go through this again.  

The good news is we were spared during the most recent storms that tore through the north east coast.  It is really bad for a lot of people and my heart hurts to see all the devastation.    

I was still able to get up to Maine for my nephews 2^nd birthday and it was a nice distraction from ALL the craziness around us and within my head. 

Happy Birthday J!  

Waiting for his birthday dinner!  

The cake- A handmade log truck.  So fitting for Maine and he is obsessed with trucks!  

Hope all my east coast blogger friends are safe and warm. 

S.M.