Thursday, September 14, 2017

5112 Medical update - eyes and mammo

September 14, 2017

I had the second treatment with the macular specialist for my right eye yesterday.

Before I saw the doctor, the technician did the usual "read the chart" thing, and did a scan of the back of my eyeball.  I did better with the chart than I did last month, and my scan results were spectacular!  The doctor was impressed.  He said they don't usually see results like this until nearly a year into treatment.  His excitement was palpable.

It's nice to get some good news.   And again, I felt nothing when he did the shot into the eye.

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I think I forgot to mention it, but I finally got another mammogram a week or so ago.  I  had a followup visit with the radiation oncologist and he asked when I'd had my last mammo, and I said it was over a year ago, before the diagnosis, and I'd been asking when I'd get the next, and everyone just shrugged, and I was getting concerned, so he wrote me the prescription for a diagnostic scan right then and there.  (A diagnostic mammogram is different from a regular mammo - it's done with a radiologist looking at it in real time, as it's happening, so if there's anything questionable they can reshoot or zoom in right then, and you get the results immediately.)  I am all clear.  I was concerned about all the scar tissue in the right breast, and the underside of that breast where there's some hard scar tissue is very sensitive to pressure, but she said no problem, they could see clear through it.

Another way the diagnostic mammo is different from a regular is that the diagnostic mammogram is much more, uh, I don't know the word to use.  It's much tighter, and they cram more of the material in, like you're being eaten by the machine.  I still have the chemo port implant in my chest, about 1.5 inches below my collar bone.  The technician crammed so much of my chest into the machine that the port was actually squished between the plates.   Remember, I'm in my 70s, and that breast is a DD, so the breast is pretty far down these days. So to squish up to less than an inch from the collar bone is pretty durn impressive.  In my entire life, that's the first time a mammo hurt - that port is hard!

My left breast is a DD.  Now that the mutilated right has settled down, I estimate it to be about a C.  I like the C  much better!  When I wear the right bra that raises up and cinches down the left, and clothing that skims rather than clings, you can barely see a difference.  (Yes, there is a difference, but it's not immediately obvious.)  However, because of the tenderness in the scar tissue, I prefer to do without a bra as much as possible, and then the difference is glaring. The unfettered left is MUCH lower, and it, uh, swings, whereas the right is high and tight.  Sigh.  By the time I'd be medically approved for surgery to reduce the left to match, I'll be too old to care anymore.

Anyway, clear,  both breasts.  Not much, but I'll take it.

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Oh, something I don't understand.  The chemo doctor said that if I get a tumor in the left breast, or another in the right, it is not considered a a recurrence of the original cancer (not metastatic), but brand new cancer with likely different characteristics.  If bits of the original tumor has traveled at all, it would go to the lungs, brain, liver, kidneys, bone, etc. etc. etc.  Not the other breast.

I don't understand why it doesn't ever metastasize to the other breast (his implication).  Doesn't make sense to me.  If I were a wandering breast tumor cell, that's where I'd go....
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5 comments:

the queen said...

It does make sense that a breast cancer cell would go to the other greats, but I guess that would only happen if it was content to not grow or change. And isn't that what they do?

the queen said...

Greats? I meant breast.

~~Silk said...

Cells that break loose from a tumor can travel in the lymph system or through blood vessels to a new location, where they can set up camp and start to grow again, making new tumors. Breast cancer often spreads to the lungs, because that's where blood goes first. Those tumors are not lung cancer - it's breast cancer metastasized to the lungs. Cancer cells are never "content to not grow or change". They will grow if they manage to find a nice new home and can avoid the immune system, and they do sometimes change (but even in their original manifestation they often change. The more they change from their original design, the more virulent they are.) So if blood travels from one breast tumor to the other breast (eventually, through normal circulation), then it seems reasonable that the same cancer can reappear in the other breast.

KJL said...

Insurance will cover plastic surgery to repair the treated breast or reduce the larger breast or both. These surgeries should only be done by a plastic surgeon with experience in radiated tissue and you must wait 6 months after the radiation before they can do anything to the treated breast. You can have size C, or even smaller, on both sides, if you want :-).

In the meantime, insurance also pays for special "mastectomy" bras and a custom small prosthesis to even you out - You get 4 to 6 bras per year and a new prosthesis every 2 years unless your weight changes, up or down, by 20 pounds or more. Your doctor need to sign a prescription by there's a standard format we all use - my boutique has them pre-printed.

Look for a shop that specializes in mastectomy bras and make sure they fit you - don't try this online.

Kris

~~Silk said...

Kris - Thanks for the information about what I can expect from insurance. I'd love to get the left reduced, not so much for appearance (I really don't much care) but I think it would help my lower back to get rid of that bowling ball hanging around my neck. On the other hand, I'm not sure I want to go through an unnecessary surgery right now, not for a long while, if ever. I'm tired of doctors and pain and messiness. Plus, I will be 73 next month, and even though I heal quickly and easily from trauma, especially if it has been explained to me exactly what's happening so my mind can help too, it seems like everyone wants to treat me like they're afraid I'll keel over at the slighest touch. (Perhaps my tiny stature has something to do with that. Dresden doll and all that.)

My PCP has mentioned a mastectomy care shop he seems to think highly of. His sister had breast cancer.