We started the day at the medical center around 10:30 this morning. First, it was my treatment appointment at the infusion center. With my nerves being in a frazzle over the latest developments since the thoracentesis a week ago, my blood pressure was at an all-time high. My husband has been urging me to take my lorazepam, but I usually do well with imagery and meditation and have refused. This morning at the infusion center after I saw my blood pressure spike, I decided I am probably doing a less than optimal job of calming my nerves down. I finally took my husband’s advice and downed half a pill.
After that appointment I went to see my primary care physician, who takes care of everything that falls outside the parameters of the oncology realm. She knows what’s going on with me, and she looks at my other health indicators and keeps me on the right track there. She is both thorough and caring, and she also seems to be able to soothe me because she is a straight arrow with a kind word. She has also been here since my metastasis and in fact was the one who gave me the news on that fateful day 1-28-09, one of those days that are indelibly etched in the memory. She told me today that the lab report shows that the pleural effusions were malignant, so it means that the fluid removed from my lungs carried breast cancer cells. She knew I was meeting with my oncologist directly after that, so she just gave me a little bit of information to help me deal with this news. We discussed the options for the next steps only briefly, sort of like an introduction.
Finally, I finished the day with my oncologist and the social worker who stops by on a regular basis to see patients and whom I had run into that morning in the infusion center. My oncologist has a new nurse, so today was the first time we met even though I have bothered her on the phone a few times already. The room felt cozy with all of us together, and somehow it was comforting to me. My oncologist explained to me that malignant pleural effusions occur not within the lung but in the space between the lung and the pleural cavity. With the large amount of fluid that I had removed (1800 ml) it is expected that the effusions will recur. Removing them with thoracentesis poses a risk that is best not endured with cancer patients, so one of the procedures that pulmonologists do to prevent it is to glue the lining of the lung to the pleural wall (pleurodesis). To do this they use talc that is introduced through a tube into the cavity. It creates an irritation between the two surfaces and causes them to adhere to each other. I will learn the details when I see the pulmonologist on Tuesday.
At this time because the current status of my treatment means it is working for certain aspects of the cancer but not for others, we will be changing my treatment after I undergo the procedure. My oncologist said that she prefers to keep me on Xeloda® until after the procedure, but after that we will look at new options.
I am exhausted with the onslaught of new information, so I fell asleep for two hours when I got home from the medical center. I will avoid thinking about all of the news and will take some lorazepam so I can get a good night’s sleep tonight. It would have been better if the effusions were not malignant, but, honestly, it was not a surprise that they were. It seems to be another one of those crises for stage IV breast cancer.
Here we go again: one step at a time.5 6 7 8 © 2004–2012 Donna Peach. All rights reserved.