All I want for Christmas is My Two Front . . .

Boobs!

What does this mean, you ask? Well, good news from my oncologist, Dr. K.: there is nothing going on with the rib bone. He said the radiologist said that the bone looked okay. Cool.

I then asked if he'd talked to Dr. H, the plastic surgeon, about the timing for reconstruction. He said they had talked and Dr. H was inclined to wait until spring break in March in order to give the wound more time to heal. But then I told Dr. K that the International Arctic Science Committee asked me to co-chair a session related to Indigenous Cultures - Past to Future for the Arctic Science Summit Week in Bergen, Norway over spring break. I'd like to go to that so March would be out and my chair would prefer that I try to schedule a surgery around winter term teaching, which means scheduling it for maybe the second week of December. Dr. K was fine with that and he said I'd just have to convince Dr. H that that was okay.

So, yep, it looks like I might be getting what I want for Christmas!!

Update - An Appointment with Dr. K.

Dr. K's office called me yesterday - he asked that I come in and talk to him about what to do about the rib bone and we made an appointment for next Wednesday. Options, as I understand them based on the talks with Dr. H, Dr. M., and my wound care nurse, are:

1) Do a CT scan or a chest x-ray to see what, if anything, is going on with the bone. Is it infected? Or is there some necrosis?

2) In the meantime, continue monitoring the open wound for healing.

3) If the healing plateaus and/or the bone is infected, then surgery is indicated in order to either take out the bone and/or to cover the bone with some soft tissue from my lat.

4) Another option is to undergo hyperbaric oxygen treatments. Apparently, you sit in a chamber that is 100% oxygen for about 20-30 minutes, daily, for four weeks. It apparently does wonders in terms of healing wounds and my rad onc, Dr. M, said that people come out of the chamber feeling really refreshed.

5) Or, we may opt for surgery anyway in order to get some soft tissue over the bone to protect it. If I do surgery, I may have to go off of Xeloda and perhaps Tykerb and then I run the risk of the cancer growing again. Which then argues for what is the lesser of two evils, right?

Hmm . . . Still Pondering That Conversation

Today, I had a check-up with my oncologist. It started out fairly well - every time I see him, they ask me to fill out a form about any medical issues/side effects I may be having. I sat there and thought, hmm, I don't really have any, other than the healing wound and lymphedema. (Got a f#*@in' bee sting yesterday that's sorta making my knee stiff - it's right below my knee - and I want to scratch it!) I've been getting hot flashes, but not too badly. My sleep has been really good this past week or so - I've been sleeping at least 3-hour stretches the past few nights. I have energy. I just have a bit of pain where the lymphedema is, but it's intermittent. So, I wrote on the form, "Hey! It's nice to just have 'normal' problems!" The nurse and my onc chuckled at that.

He looked at the wound and the area that was radiated and he didn't see any signs of cancer and neither did he feel any lumps. Cool.

Then, we looked at my CT scan. I asked him what he meant by some spots being somewhat bigger and how that was related to the healing process. He said that the body is trying to seal off and contain these small colonies of cancer cells that are in my bone marrow, so it takes calcium out of the serum - the circulatory system- and surrounds it with a layer of calcium. Sometimes, cancer pokes out of the calcium shell and starts growing. It didn't look like that was happening in my body as he just saw the calcium spots. So, when a spot does get bigger, sometimes it means that the body is adding another calcium layer on top of what's there.

Zometa makes my bones themselves stronger. By making it stronger, it makes it harder for cancer to lodge in the bone itself. He likened it to a worm going through sandstone versus a worm trying to make a hole in granite. Zometa makes my bones more like granite. Cool. I have no cancer on the bone itself and we want to keep it that way.

I wondered if, in the healing, the body was leaching calcium out of my bones and that made them weaker and he said that that wasn't the case. It's taking calcium out of the serum in the bone marrow. Both cancer and cancer treatments can make bones weaker. But Zometa will take care of that.

I asked about whether or not those calcium deposits (now surrounding dead tumors- at least that's what I think) in my marrow would ever disappear. In his opinion, he feels that they are likely to never go away. Sometimes, the body dissolves those calcium deposits. But not very often.

Bummer. I'd hoped that those buggers would go away. I will continue with my visualization to get rid of them.

I then asked about when someone is considered to be in remission. He said that there are different definitions of remission. The first is when there is no progression of disease, that a plateau of sorts has been reached so that there are no new spots and whatever spots there are aren't getting bigger. That's where I'm at. The second definition is when all the tests show "no evidence of disease". He doesn't feel that I will ever be in that category.

Hmm. Guess I'll have to prove him wrong.

Then, on my way out, I asked about reconstruction surgery. His reply was, "not in your lifetime". (What? That was a surprise to me.) He just didn't think the skin and tissue there would ever be able to handle a surgery like that. At least, that's what I gathered. I told him that my plastic surgeon thought that he could do reconstruction. So, my oncologist said that he'd defer to the surgeon on this one. At the very least, we'd have to be sure that there was no disease left there in the skin before considering surgery.

Okay. That calls for another consultation with the surgeon. I will wait until this wound heals and then schedule that appointment. And give the whole area a few months to be sure that nothing returns in the skin.

Hmm. Guess I'll have to prove my oncologist wrong, again.

Overall, he did say that he was pleased that we'd achieved stable. He seems satisfied with that. But, I'm going for NED. And, reconstruction. Never say never, right?