Ready to start chemo

Mary Jo’s oncologist, Dr Gall presented Mary Jo’s case to the breast cancer group on Tuesday morning. It was the groups consensus that an additional surgery to attempt to get clear margins on the cancerous left breast tissues that still remained would only delay the more therapeutic methods of chemo, Herceptin and radiation treatments.

Mary Jo and I met with Dr Luong, her plastic surgeon yesterday at 9:15am for a follow up visit. Dr Luong was prepared to do the first of several additional fills as part of the reconstruction process but decided against doing so since it the procedure could be delayed (less pain) until Mary Jo has completed her chemo cycles. After consultation, Dr Luong suggested two small 50cc fill appointments two weeks prior to the first radiation therapy appointment. Following our appointment with the plastic surgeon, Mary Jo was admitted to Fairview Ridges Hospital at 11:00 to have a purple "power port" surgically installed. This is a small triangular shaped device that is placed under the skin and over the area above the heart. It will be used when IV drugs (chemo) are given or blood needs to be drawn for tests. Special IV needles are inserted directly into this “port” devise so that the it is not necessary for the patient to get “stuck” with a needle in a vein every week. Very convenient and lees painful.

Mary Jo is planning to start her first chemo treatment on Monday in Dr Galls office. She will likely be receiving T-C-H. Taxoter, Cytoxin and Herceptin. Mary Jo's chemo will be 6 cycles, one every three weeks for 18 weeks with Herceptin given every week for 18 weeks and then given once every three weeks for the remaining 34 weeks, 52 weeks total.

After the completion of the 6 chemo cycles, Mary Jo will have the radiation therapy to both breasts and right side lymph node areas. We expect that treatment to be a daily treatments for 30-36 days.

After radiation therapy is completed, Mary Jo will be scheduled to have a complete hysterectomy performed. The final reconstruction breast surgeries will follow after Mary Jo is strong enough to endure the two additional plastic surgeries to complete the breast reconstruction.

Plans seem to change as quickly as I send the news to you so everything is tentative. Please keep her in your prayers.

Post Op consultation

Mary Jo looks great and is feeling almost pain free just two weeks after her surgeries. She is in good spirits and pretty much back to herself today. Huge improvements in the past week. That's the good news.

Mary Jo and I met with Dr Gall (her Oncologist) yesterday for her post op consultation in Dr Gall's office. Dr Gall reviewed and explained from an Oncologists perspective, the findings of the pathology report from the double mastectomy and axillary node dissection operations. There were a few new surprises discovered and Mary Jo's exact treatment plan will be determined later today after Dr Gall presents Mary Jo's case to the hospitals breast cancer group of surgeons, pathologists, plastic surgeons and oncologists that meet weekly to review new discoveries, techniques and case studies. Her case is not the norm because of her age, family history and genetic mutations she carries.

What's new and not so good....
We were told that based on pathology, Mary Jo is now at least a stage IIIa cancer patient. This is a more advanced stage of breast cancer than the stage IIb we had assumed.
We were also told that the left breast tissue that was removed only as a precaution, which turned out to contain a 9mm tumor (Invasive Ductile Carcinoma) does not have clear margins. That means that they did NOT get all the cancer. We wanted to hear "clear margins" or negative margin. She still has cancerous tissue in the left breast which may require an addition surgery to make Mary Jo surgically clear of cancer before she starts chemo and radiation. The later is necessary because she had excessive lymph node involvement with 7 of 22 lymph node testing positive for cancer.

We learned from the path report that the tumor now tests positive for the HER2 gene which is a more aggressive type of breast cancer. The pre op needle biopsy on the tumor previously indicated that the tumor was HER2 negative.

Mary Jo is planning to start her first chemo treatment on Monday. She will be receiving T-C-H. Taxoter, Cytoxin and Herceptin. Mary Jo's chemo will be 6 cycles, one every three weeks for 18 weeks with Herceptin given every week for 18 weeks and then given once every three weeks for the remaining 34 weeks, 52 weeks total. She will have the hysterectomy performed 3 to 4 weeks after the last chemo treatment. The final reconstruction surgeries will be sometime after that.

Mary Jo is scheduled to meet with Dr Luong, her plastic surgeon tomorrow, Wednesday at 9:15am and then she will be admitted to Fairview Ridges Hospital at 11:00 to have a "power port" surgically installed. This is a device that is placed under the skin and used when even IV drugs (chemo) are given or blood needs to be drawn for tests.

These plans could all change today if the breast cancer group, lead by Dr Gall feel it is imperative that they surgically remove additional tissue on the left side, all the way to clear margins. If this is the case, Mary Jo would have an additional surgery and need some time to heal prior to starting the chemotherapy, a dangerous delay.

I will keep you all posted as to the doctors final decision as soon as we hear.


We could really use your prayers today.

No more Oxy

Mary Jo is improving everyday. Her spirits are much better since she has the Oxoycodone out of her system. We have a doctor appointment with her Oncologist, Dr. Gall at 2:30pm today. I expect he will be able to read the pathology report and suggest Mary Jo's treatment plan or chemo and possibly radiation. Will see.

inproving

She is doing a little better today. I just took her for a walk around the lake.

Not so good day

Everything is relatively fine. Mary Jo is having ok days and bad days. Today is a bad day for us. She is not in severe pain any more but the negative side effects of Oxycodone are really messing with her emotions and that may be worse than raw pain. She just can't talk to anyone today. She woke up crying this morning and went to sleep tonight crying. Not a good day but thanks for caring. We'll be ok. Mary Jo and I are just going to take this one day at a time.

Drains come out

Mary Jo is doing pretty good today. We had an appointment with her plastic surgeon, Dr. Luong this morning and Mary Jo was able to get her temporary "JP drains" removed. JP Drains are three foot long tubes on both Mary Jo's right and left sides, coming out of incisions in her chest and connected to small suction bottles that collect excess fluids from the breast surgery. We meet with the oncologist next Monday and again with the plastic surgeon. She continues to improve day by day. Getting the drains out should make things so much more comfortable for Mary Jo.

Going Home Tomorrow

Mary Jo is expecting to be released from the hospital tomorrow (Saturday). MJ rested well today as her doctors seem to have gotten her pain reasonably managed as of this message.

Mary Jo's surgeon visited a short time ago and briefed us on the pathology reports from the double mastectomy and the auxiliary lymph node dissection procedure that he performed Wednesday. The results were a bit of an unpleasant surprise to all of us. Pathology reported that the tumor size in the right breast was in fact a little larger than detected from the various CT, PET, Ultrasound and Mammogram imaging procedures. We expected the tumor in the right breast to be 1.7 cm and in turned out to be a 2.2 cm Invasive Lobular Carcinoma, ILC tumor. The lymph node dissection procedure removed 22 lymph nodes under Mary Jo's right arm, of the 22 removed, 7 tested positive for cancer. We had hoped, best case that this number would have been only the 1 known node. The bigger surprise came from the left breast report. The pathology report showed that the removed breast tissue tested positive for Invasive Ductile Carcinoma, or IDC which is a different type of invasive breast cancer. Mary Jo's left breast had a 9 mm invasive tumor growing that was undetected by all the modern imaging procedures. Mary Jo's Sentinel Node from the left under arm was removed and tested, fortunately that result was negative.

We still feel very blessed that Mary Jo detected this cancer in the relatively early stages. It is so much better to be dealing with this now than blissfully ignorant and dealing with something very different in the near feature. The surgeon, Dr Maurer placed Mary Jo as a stage 2B. The definitive staging number will come from Mary Jo's oncologist, Dr. Gall when we meet with him next week.

Thank you again for all your support through your thoughts and prayers. We feel very blessed to have all the support we continue to receive. I will try to update everyone as soon as I know more.

Not ready to go home

Mary Jo is at Fairview Ridges in Burnsville, room #504. She was very hopeful yesterday that she would be going home today but last night, she was sooooooooo uncomfortable that she may be here another day. We will have to see how today goes.

Over doing it

I just wanted to send a short update this morning to give you a heads up on how Mary Jo is feeling today. She had improved dramatically from Wednesday (surgery) night to Thursday afternoon. This rapid turnaround may have given her a false sense of her actual condition. She was very much back to herself near midday yesterday, talking and joking with the nurses and all the friends that stopped by to see her. We were expecting to be going home from the hospital today since she had meet nearly all the requirements for a discharge on Thursday. I want to thank all of you for lifting her spirits with yours calls, emails, text messages, cards, flowers, candy, gifts and visits to see her. Unfortunately, Mary Jo just being Mary Jo, may have overdone the party hosting a bit for her actual state. She had a pretty tough night last night pain wise. The doctors are hopeful that after messaging the meds and dosages a bit, her pain will be manageable soon. She will be going home today at this point (though that could change). Her doctor just changed Mary Jo's discharge to Saturday. The hospital staff is telling her to just try to get as much rest today as possible. If you would like to see her, it might be best to wait until she gets home and her pain management has improved. I will let you all know when she is released from the hospital and can tolerate more activity. She was disappointed to be told no guests, but apparently that is what is best for here healing at the moment. Please keep her in your prayers.

post op details

Mary Jo was admitted at Fairview Ridges Hospital yesterday at 1:00 pm. She was prepped for the double mastectomy and auxiliary lymph node removal procedures. Her double mastectomy surgery started at 3:30 and concluded at about 5:09pm. Dr. Maurer, Mary Jo's surgeon briefed us after the procedures and gave us the good news that everything went well and as expected. A Pathologist will now test the tissues that were removed a give her doctors the detailed results in the next several days. Mary Jo's reconstructive plastic surgeon then took over after Dr. Maurer and installed the temporary expanders in the breast capsules and closed the surgery site. She concluded her procedures at 5:57 and came into the family waiting room to brief us. Dr. Luoong spoke positive and said Mary Jo did well and was now in the recovery area. She said we could expect her to remain in recovery for about an hour or soon before being transferred to a private room, where she is now.

Mary Jo is in good spirits this morning. Her pain is controlled and much better than last night. If you would like to call or visit Mary Jo, the direct room phone number is 952-460-4504 and she is in room 504. She is feeling well enough for visitors now but you may want to call the room first (or you can email me or call my cell at 952-210-5243, please limit the text messages)

We want to thank all of you who have been praying for Mary Jo. (keep it up because its working great) Mary doctors tell us that in order for her to be released from the hospital, she needs to have the pain managed by oral meds so she will likely be here for a few days.

post op update

The surgery went well and mj is resting in room 504.

scheduling issue

Mary Jo is feeling good and has a positive attitude. She has been diagnosed and had all the pre op tests that the doctors planned to give her. We had expected to be in surgery this week but a scheduling conflict with her plastic surgeon and her other surgeon is creating the only hold up now. September 1st is the first date that works for both doctors and we think that is unacceptable. We should know more in a few days.

somes good news and a plan

Good news, the pathology report from last Wednesday's biopsy procedure of the "suspect" lymph nodes near Mary Jo's lungs is complete. Her oncologist and thoracic surgeon both called yesterday to confirm that the biopsied lymph nodes tested are NOT malignant. The doctors noted that there is some type of metabolic activity going on there but it is not of concern to her cancer treatment at this time.
The next step in Mary Jo's care is to schedule the double mastectomy and reconstruction surgery as soon as possible. We assume that she will be admitted into the hospital by early next week. After Mary Jo recovers from initial surgery she will undergo chemotherapy treatments, then more reconstruction surgery and finally a complete hysterectomy surgery. A long road ahead but she is in great spirits and she is a strong girl. We can't express enough how much all your prayers and support have meant to us. We are truly blessed to be surrounded by so many good people.