Tuesday, March 15, 2011

A Day in the life of a lab rat..

is exhausting.

After not sleeping well Sunday night, I woke up at the early hour of 7:30 to prepare for my day. I knew that I had 4 separate appointments, in the matter of 6 hours, in 3 different locations around the City.

Mom and I headed over to the Outpatient Center for my first appointment at 9:00. It was my pre-surgery testing. As I sat there waiting to be called I could only think one thing---I am too young to be here.

Then I get called back to begin my testing. I am surrounded by the Jersey Shore want-to-be cast. These girls are tan...TAN...and obnoxious. I considered pulling my hair out... Or attempting to jump out the 7th floor window. Instead I decided to cover my ears and hope the appointment would fly by...Just my luck, the want-to-be-Snookie's let me wait an additional fifteen minutes so they could continue  discussing Jersey Shore. Let me tell you...I had a headache by the time I left. (I would typically not judge; however, it was a tad bit ridiculous.)

The testing itself was OK. My EKG was perfect, blood pressure was fine, blood work easy. The nurse practitioner did not know a lot of the answers to the questions I had so that was pretty frustrating. I think she still had her mind on Jersey Shore...

Testing finished, I headed on over to the radiology building. More radiation, woo hoo! Dr. Glenda wanted to determine what the "spot" on my liver was that showed its little face on the last CT. I had the nicest technician. He made sure I was warm, comfortable, helped me get my arms over my head, and treated me like a human being---quite the opposite of the girls at Pre-Surgery Testing.

As I was leaving I thanked him for being so nice to me. He said, "No. Thank you for being so nice. Where are you from?" "Virginia." He explained that he knew I was too friendly to be from New York. Look, Ma & Dad, proof you raised me with manners!

Time to head to our next appointment at the actual hospital. Let me tell you---that is one HUGE place. Obviously lost, the security guard helped us find where we needed to be. I met with Dr. Glenda's nurse to discuss the upcoming surgery, the drains I will have in, the recovery time. She really took her time explaining it all to us--which both Mom and I needed.

Next, off to meet the Head & Neck surgeon who will be assisting Dr. Glenda in the surgery next week. There is no other way to describe him and his nurse other than as being outstanding. Since I am the type of patient who needs warm-and-fuzzy, they pass with flying colors. The nurse, Jill, was out-stand-ing. She escorted us into the room, and said, "I am going to tell you what I know about you, OK?" And she did.

She listed mymedical history...which is really becoming too involved for my liking...however, I was relieved to know she already knew everything. This is another pro of Memorial Sloan Kettering--the doctors actually talk to one another! She had various emails between Dr. Glenda and the Head & Neck surgeon as proof I have been discussed quite thoroughly. After talking with Jill for a good twenty minutes, she left us to wait for Dr. Adorable (ask me his real name...it makes me giggle.)

We waited.

and waited.

and waited.

Around 4:15--my appointment was at 2:45--Dr. Adorable walks in full of apologizes. Knowing how things happen in the medical field, and because I have never had to wait long for any appointment at Sloan Kettering, I did not mind one bit. 5 minutes into meeting him, I knew I was in good hands.

He is so nice.

He gets major points of course for complimenting me on my "poise," said I am fantastic, and that it is obvious both Mom and I have educated ourselves.

Cha-Ching--brownie points.

Back to the medical part--While examining my neck, Dr. Adorable continued to focus on one particular lymph node located on the left side of my neck, directly under my jaw line. I asked, "Is that supposed to hurt when you press on it like that?" He answered, "Well, there is a lymph node there." He examined me some more then says, "I feel like I got left out of the party..." And ordered a CAT scan of my neck. Of course I am now curious if he ordered that scan just to get a better picture of my neck prior to operating, or if he suspects something is wrong on the left side. The left side of my neck was negative for Melanoma; however, I am still paranoid.

I joked with Dr. Adorable about my mini breakdowns over every swollen lymph node. He laughed at my attempt of joking away a serious matter, then told me to try to relax...Not every swollen lymph node screams cancer.

Let's discuss the surgery: we all know it is a serious procedure because there are a lot of important nerves and muscles in our neck. Dr. Adorable said he plans to use the same incision site as Dr. Pink, but he will have to extend the incision about an inch forward and an inch backwards. It will kind of wrap around my neck. (Bummer.)

Here is the other (superficial) bummer: because Dr. Adorable will remove fat along with lymph nodes, there will be a noticeable difference in my neck. In other words it will appear to sink in a little. He did say that it almost always returns to normal in about six months.

I suppose I should begin my supply of light weight scarves for the summer, huh?

I know my appearance should be the last thing on my mind, I know that, but I have to admit I am a tad bit concerned about it. Is that wrong?

After meeting with Dr. Adorable, I feel one hundred percent positive I am making the right decision about having the surgery. As both surgeons keep telling me, I am young. Minus Melanoma, I am otherwise healthy. I can handle the surgery. Dr. Adorable said that if I was an 80 year old patient, he would have to scratch his head about operating. With me, he fully believes it is the best option.

We managed to get the CAT scan of my neck scheduled for 6:40 that evening so Mom and I headed down to the cafeteria to waste some time. There I am, facebooking on my iPad when Dr. Glenda calls to give me the official results of the MRI of my liver. Realizing we are still in the hospital, she tells us to head on up to her office. We did. She is such an awesome doctor...Mom and I agree, both surgeons make you feel like they are your friends, like you are not chart number 500232. She had the second opinion pathology report from my original surgery
back in January 2011. I am going to post the info then try to spell it out for you:

Sloan Kettering found my original tumor to be Melanoma.
Histologic Type: Superficial Spreading
Breslow thickness: 1.0 mm
Ulceration: Not identified (this is good news)
Mitotic index: 3/mm2
Clark level: IV
Surgical Margins: Not involved
Infiltrating lymphocytes: Non-brisk
Regression: Not identified.

Skin, left upper back, wide excision--no residual melanoma seen. (good thing!)

Lymph nodes--

Right suparclavicular sentinel node: consistent with micrometastaic melanoma.

Left suparclavicular sentinel node--2 benign lymph nodes, negative for melanoma (woo hoo!)

Right axillary sentinel node--after much debate, "the findings favor altogether a capsular nodal nevus." AKA---NO MELANOMA! (this was huge news since I orginally thought it was positive.)

Left axillary sentinel node-- Consistent with micrometastic melanoma. The largest aggregate measures 1.5 mm. 2 of the lymph nodes are involed."

What does all of that mean?

Basically nothing new...I am still Stage III A. It just shows that Melanoma is quite aggressive...which is another reason why I am doing the surgery to remove ALL of the lymph nodes in my right neck, left armpit.

The MRI of my liver: "Hypervascular segment 7 hepatic lesion; probably represents focal nodular hyperplasia. No evidence of metastatic disease." That is what we prayed for...NO METS!

Having Dr. Glenda spell out the pathology report and the MRI report made me feel a lot better. She even drew me pictures to fully explain things---no rushing me out of there. (I really am THAT patient who asks 102121 questions, but this is my life...I try my hardest not to be annoying.)

Said goodbye to Dr. Glenda and headed downstairs for yet another CAT Scan. Boy, I am going to glow when all of this is over. While the nurse put the IV in me, I came across the first patient I have seen who is right around my own age. He looked a lot worse than I do...I had to fight the urge to hug him. I hope he is lucky enough to have the support I have. Let's send me good juju, OK?

Alright---I made this post super long and I apologize. I just wanted to update everyone on yesterday. My day as a lab rat left me with very little bruising--oddly enough--YAY for nurses who know how to put in IV's!

This lab rat left New York this morning...back home at my parents, resting up before the big surgery. It is hard to believe I only have one week of being fully(ish) independent. I know the surgery is going to be a tough one--but--as someone commented on my facebook, I am one tough mamma jamma!

...and really...I have the best doctors on my side...that helps.


Tina Sullivan said...

Here is something that a friend of mine sent me that has gotten me through a lot. Hope it can help you with any future mini break downs :)

Remember - You are just as likely to get the same aches and pains and off days as anyone else. Just because you have cancer does not mean that everything that happens to you is caused by cancer. Do check with your doctor about any symptom that is worrying you. It is likely that it will not be caused by your cancer. And if it is, the sooner you get treatment the better

Anonymous said...

I just had surgery with Dr. Aryian. Who was Dr. Adorable?