Surgery #4 and Updated Staging

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When I got this tattoo a little over a year ago, I had no idea how special it would be to me on days like this! Messages of love from my parents, sister, and grandmothers, always with me!

This last week has been absolutely crazy. Just 8 days ago I left the downtown hospital feeling so completely overwhelmed and like treatment would never begin.

Now, here I sit with a port surgically implanted into my chest, ready to begin treatment on MONDAY. My head is spinning, but I’m so incredibly grateful.

Let’s back up and cover 4 major updates from this last week.


 

1. Mitotic Rate

While at the hospital in Indy, that oncologist told me about my “mitotic rate.” Mitotic rate is something measured in cancer, basically counting how many cells are currently in mitosis. Simply put, it is how fast and aggressively the tumor is growing and spreading.

Early on in my research, I read a little about mitotic rates and how it is something I should know. At each doctor’s appointment, it was on my list of questions to ask. “What is my mitotic rate?” However, I always got talking to the doctors about other issues, and I never got around to asking. Besides, I wouldn’t have really understood what they told me anyway.

Here’s what I know now. There are three main categories of mitotic rate. Low is 0-1. Medium is 2-3. High is 4 and above. The higher the mitotic rate, the more aggressive the cancer.

Mine was a shocking 10 (Yes, TEN). This means in every square millimeter, 10 cells were in the process of mitosis…growing, splitting, spreading, you get the idea.  This is considered very aggressive.

As I processed this information in the days following the appointment, I became overwhelmed with how grateful I am that I went in to the doctor when I did. At that kind of growth rate, every day that I would have waited would have made a big difference. As I have said before, if you have any kind of spot that concerns you, go get it checked out. Don’t wait.


 

2. Satellite Metastasis

To be fair to the doctor downtown, I have to say that he worked very hard to get a hold of me in the days after my appointment. Apparently he reviewed my case again, and he saw something in my pathology report that he hadn’t noticed before. He called me several times when I was unable to answer the phone. Finally, we connected on Wednesday evening.

He shared with me that I had what is called a satellite metastasis. Cells from my original tumor broke off, traveled less than 2cm away from that tumor (using my lymph system as a highway), and settled in to create their own tumor. At the time that this area of skin was removed (back in September), it was still microscopic, and it was completely removed along with that skin. I just didn’t know it was there!

He took his suspicions to a group of oncologists and pathologists that discuss cases, and the group agreed that I did indeed have a microscopic satellite metastasis.

So what does this mean? Honestly, not a whole lot. Since it has already been removed, there is nothing more we do about it. And since we already knew that my lymph system was involved (I already had a metastasis in one lymph node), it is not all that shocking to have a satellite. It’s not good by any means, but it doesn’t change how we treat it. It does, however, make the percentages slightly higher as far as my chances of the cancer returning.

It also means that I am now considered Stage 3C (rather than 3B). There are no other letters… This is as high as we go before hitting Stage 4, something that we definitely do not want. Stage 4 would mean metastasis in distant organs. Right now there is absolutely no sign of this, which is fantastic.


 

3. Port Surgery!

Yesterday I met with a surgeon at Community Hospital Anderson to discuss implanting a port. I was shocked when he told me they were going to slip me into the schedule for today — the very next day! Apparently Dr. Reddy had called and explained the importance of me getting started on treatment next week (more on that next!), and they agreed to getting my port done as quickly as possible.

I’m so grateful they were able to make that happen! I am well aware this took some extra work on the part of the hospital and all of its employees (coordinating operating rooms, staff, the surgeon, etc.), and once again I’m blown away by Community and its wonderful care for patients.

Right now my port is covered with gauze that can’t come off for 2 days, so below are some pics from my friend Google!

 

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This is what the port looks like before it is placed.

 

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The port is placed just below the skin. The tubing connects with the closest artery, and all they have to do is insert a needle into the port to administer my treatments!
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This is not me (as I said, mine is covered in dressings right now), but my port should be like this when I take the gauze off. An incision, some steri-strips, and a bump.

I was only under light sedation, and I woke up as soon as they stopped administering the anesthesia. I was still in the operating room at this point, but they were all done with my procedure. I don’t remember any of it (thank goodness), and it was not painful. There is some pressure when I move my arm or stand up after sitting, but it is easily manageable with just Tylenol and Advil. They gave me a prescription for narcotics, but I’m not planning to fill it. It seems unnecessary at this point.

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It has become a tradition to send my family and coworkers a hospital selfie. Here was today’s! Feeling way more “with it” than after the other surgeries!

After returning to my hospital room, some ladies wheeled in a portable x-ray machine and took a picture of my chest. This way they could ensure that my port was properly placed.

After this, my dear friend Erinn Bridgman came to pick me up. I am SO regretting that we did not take a hospital selfie. What were we thinking?

I am home now, and my Tylenol and Advil regimen, plus an occasional icepack, are doing the trick. I’m slightly uncomfortable, but it’s not terrible!


 

4. Treatment starts MONDAY!

So, my treatments start Monday, and it’s hard to wrap my head around that. I found this out yesterday afternoon, and the rest of the day was a frenzy of making sure all of my work responsibilities would be taken care of during this last week of the semester before Christmas Break.

I know I have mentioned them before, but I am so incredibly grateful for this group of ladies:

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Martin Hall staff 2015-16!

They have been stepping up throughout this semester, and they continue to amaze me with their great attitudes and servant hearts. And, they are ridiculous, which is good for my heart and soul 🙂

And a special shout out to my Assistant (to the) Resident Director, Karissa!

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This is on Karissa’s door, and it makes me laugh every time I pass it. I love being the Michael to her Dwight!

Karissa is taking on a bunch of the responsibilities that are usually mine at the end of the semester. On top of her classes and everything else she is involved in, this is a huge deal. So thankful for you, Karissa!

Anyway, back to my treatments! I will begin on Monday. I will have about an hour with my Navigator (oncology nurse). She will explain what I can expect and how to take care of myself between treatments. After that, we will begin my first infusion. My Navigator (Michelle) has already called me to talk through several things, and I love her already. We are going to be spending quite a bit of time together over the next month, so this is a good thing!

The reason it was so imperative for me to begin next week is because Christmas is just around the corner! I will have a break from my daily infusions every weekend, and I will also have Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day off. That means next week is my only opportunity to have a full week of treatment before the holidays! Dr. Reddy wanted me to get a full 5 days in before the choppiness of those holidays. I’m grateful he advocated on my behalf with the surgery center, and I’m glad they gave in to his requests! According to the nurse, this was unusual. Once again I feel so taken care of and like these people really care about what is best for me.


Thank you for walking this journey with me! Your constant support, prayer, and encouragement is getting me through. I love you all!

6 thoughts on “Surgery #4 and Updated Staging

  1. Maggie, I am so glad that you were able to get the port put in so quickly so that you can start treatment on Monday. You are so amazing and brave and very gracious to keep all of us up to date on what is happening. I am praying for you!

  2. Good job, Maggie! Now get the show on the road!
    FYI: there will probably be LOTS of information thrown at you on Monday. When I started to get overwhelmed that day, I just turned it over to my husband to listen and I relaxed as much as possible. He needed a job to keep his mind busy and I needed to breathe deeply and carry on. It worked for us.
    Best wishes, dear!

  3. I’ll be thinking of you tomorrow and the rest of the week and future treatments. My prayers are with you and you have the best attitude, that will help you so much! Thank you for sharing so we can keep you in our thoughts and prayers, step by step! Tish

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