Feelling Much Better

Mary Jo is through taking the antibiotics which were prescribed to treat the Bronchitis infection. She is feeling much better today than she did last weekend however the antibiotics themselves produce some pretty serious negative side effects. Mary Jo has her voice back and but continues to experience strong back pain and complains of very stiff tendons in her legs. Sometimes you have to wonder whether the cure is worse than the affliction but we are feeling blessed to have Mary Jo doing much better.

Tomorrow morning we will meet again with the radiation oncologist to begin the first step in the radiation therapy, measuring for the “field angles” and then on Tuesday Mary Jo has her second post chemo Herceptin treatment at Minnesota Oncology. We have been told that the radiation therapy should be a cakewalk regarding the side effects in comparison to the regiment of chemo Mary Jo endured. We are both looking forward to getting this next phase of cancer treatment started and behind us.

Today was pretty exciting as Kevin’s brother Chris, who served in Iraq with the Red Bulls returned home safe and sound. Mary Jo and I were there with all the other family members to see the homecoming ceremony at the Stillwater armory. It was pretty emotional experience and we are so proud of Chris and all the men and women who serve this country in the armed services. It good to have him home.

Kevin's brother Chris returns from Iraq today!

On The Mend

The prescribed antibiotics are starting to kick the Bronchitis and Mary Jo is just starting to feel like she is on the mend. The severity of her symptoms began to subside last night. She was able to talk softly on the phone last night for the first time all week. She will resting at home again today and hopefully she is felling cheerful enough to quietly enjoy Vikings game tonight in front of the TV with me and Opie.

Needs Her Rest

Mary Jo is still trying to recover from a bout with Bronchitis. She is taking a strong antibiotic called Lavaquin 500mg, to help combat the bacterial infection and just about every OTC cold and flu medicine available but her symptoms have barley subsided since Monday.

She is a strong girl. She has endured countless medical procedures, surgeries and six cycles of chemo but this bronchitis has been pretty tough on her. She is miserable. Please don’t try to call her or visit in the next few days as she has completely lost her voice and it is very painful for her to even attempt to speak. She really needs her rest. Her white blood count numbers are very low so she is still extremely sensitive to infections.

Bronchitis Postpones Surgery

Mary Jo was scheduled to have Dr Maurer perform an outpatient surgery to remove a lump from her right arm pit (axillia) at 2:10pm today. We called Dr Maurer’s nurse yesterday afternoon to postpone the surgery. We have not yet had the opportunity to consult with the Lymphedema specialist, but more relevant is the fact that the lump appears to be dissolving on its own and Mary Jo has been experiencing strong cold/flu like symptoms of a sore throat, cough and low grade fever since Saturday evening. I honestly don’t think Dr Maurer would perform a surgery in her condition even if she still wanted to move forward with the surgery. Her symptoms have been so strong and persistent that I called Dr Galls office this morning to inquire about her conditions and the possible need for antibiotics. I spoke with Dr Gall’s nurse and she advised us to get in to see Mary Jo’s primary care doctor for an examination today. Last week, Dr Gall had advised us during Mary Jo’s examination and consultation that Mary Jo’s white blood count numbers were very low. They had taken a hard hit from the six cycle chemo regiment. He also advised that Mary Jo should be cautious around crowds and sick people so that she did not expose herself to possible infections because her immune system was temporarily compromised and would not be able to fight infections well.

Mary Jo was able to get in and be seen by Dr Cross, her primary care doctor this morning for an examination. The diagnosis confirmed that Mary Jo has Bronchitis. She was given Lavaquin 500mg, a prescription antibiotic perscribed to people exposed to Anthrax.   Mary Jo is trying to rest at home this evening. Her throat continues to be very sore tonight and her voice is almost completely gone making it very difficult and painful for her to even try to talk.

We had been pretty confident that we wanted the suspect lump surgically removed but with the postponement of the surgery and the diminishing size of the lump, we are seriously reevaluating the surgery decision and may follow Dr Gall’s advise to not have the additional surgery.

Pre Op Physical

Mary Jo and I met with Dr Cross, Mary Jo’s primary care doctor today this morning. Dr Cross gave Mary Jo the required pre op physical examination prior to the scheduled operation by Dr Maurer to remove the nodule in Mary Jo’s right axillia. Mary Jo appears to be well enough for surgery. She feels good today and keeps get better day by day. Dr Cross ordered blood work to be done as the main concern pre op is her hemoglobin count. She can’t be anemic going into surgery.

We are still not confident with the surgery decision because we get conflicting opinions’ regarding whether to proceed with this elective surgery to remove the nodule and the decision proceed becomes more murky after each health professional we consult with. We are anxious to hear what the lymphedema specialist has to say and that person’s professional opinion will likely carry a lot of weight in Mary Jo’s ultimate surgery decision.

This is the score so far…surgeon Dr Maurer suggests removing the nodule for peace of mind only (and complete pathologic confirmation by examination) but believes the nodule is a fat necrosis and surgery is not medically necessary, oncologist Dr Gall suggests a watch it and leave it alone approach as not to provoke an onset of lymphedema, radiation oncologist Dr McCollow suggests surgical removing the nodule prior to radiation therapy and Mary Jo's general practitioner Dr Cross suggests “get it out, so what if you get lymphedema, peace of mind is critical”.

Click on this link to view photos of lymphedema and you may understand more why this decision is such a struggle for us.

http://www.goldbamboo.com/pictures-t1514.html

               Lymphedema in the arm of a breast cancer patient

January Treatment

Mary Jo and I met with Dr Gall, MJ’s oncologist this morning for the case review and examination. Dr Gall was a bit concerned that Mary Jo was interested in getting the nodule removed. He consulted with Dr Maurer regarding the lab results and he believes the nodule is not a cancer threat; however an additional invasive surgery to remove the nodule could heighten Mary Jo’s likelihood of developing lymphedema. Dr Gall wrote Mary Jo a referral to discuss the matter with a lymphedema specialist.

Mary Jo received her Herceptin treatment after the examination and is feeling better each day. Her blood tests numbers show a decent improvement in her Hemoglobin count (now at 11.8) but her white count is very low. Dr Gall believes the low white count is the expected result of the six cycles of chemo Mary Jo endured. She will have to be careful not to be exposed to sick people this week or she will likely need antibiotics to help her fight infection.

Next Surgery Scheduled

Mary Jo and I met with Dr Maurer on Thursday to review the path report from the fluid removed from the cyst. Dr Maurer had a much better explanation than we had been given by the nurses. Dr Maurer said that non diagnostic means there were no living cells found in the fluid. The cells that were present were degenerated. Dr Maurer went on to say this would be consistent with a condition called fat necrosis (dead fat cells) which patients sometimes get after a surgery when blood flow to tissue was disturbed in surgery. He went on to say that if the nodule or cyst was resolved with aspiration, he believes observation would be all that is necessary but since the nodule was not resolved with aspiration, Mary Jo could consider removal for more complete pathologic evaluation.

Mary Jo has decided after hearing Dr Maurer’s review to move forward and have the nodule removed surgically. The next step is to schedule a pre op physical with her primary doctor next week. Dr Maurer’s team has scheduled surgery for 1:10pm on January 20th. Mary Jo will then be required to rest and heal for 10 days post surgery prior to the start of radiation therapy.

Mary Jo and I are feeling much better after talking with Dr Maurer and we feel that it is best to have the nodule removed so that we can get a complete pathologic evaluation. We feel it is better to know for sure verses just assuming it is a fat necrosis with Mary Jo’s family history and a carrier of the BRCA2 gene.

“Non Diagnostic”

The anxiously awaited lab results from Mary Jo’s biopsy on her suspect lump under her right arm from last week are finally in. Mary Jo’s Nurse Trish, from the Women’s Imaging Center called yesterday and explained the written report results to us. She explained the report said the results from the tissue and fluid samples from the needle aspiration are “non diagnostic” unfortunately meaning we still do not know any more than we did last week. The tissue quality could not confirm or eliminate the presence of cancer but Dr Maurer, MJ’s surgeon and Dr Thiel, the radiologist who performed the procedure both still think that the suspect lump is not consistent with cancer because of its rapid onset among other factors. Mary Jo would just like the lump to be removed. She says it is less painful to the touch since the needle aspiration procedure but the size (bigger than a quarter, smaller than an egg) appears to be about the same.

Today Mary Jo and I had an initial consultation with her newest doctor, Dr Kim McCollow D.O. radiation oncologist from the Ridges Radiation Therapy Center in Burnsville. We met with Dr McCollow for about an hour as she outlined what we should expect as Mary Jo goes through this next phase of her cancer therapy. The big obstacle standing in the way prior to the start of the radiation therapy sessions is this unknown regarding the suspect lump. Mary Jo would like to get the lump removed. Dr McCollow advised us to follow up with Dr Maurer as soon as possible for a consultation regarding a surgery to remove the lump. She explained that Mary Jo is still well within the medical guidelines for starting radiation therapy eight weeks following the last chemotherapy session. If it is determined that surgery is the appropriate action to remove and accurately diagnosis the lump, it will be necessary to delay the first session of radiation for approximately 10 days following a surgery procedure to allow the wound time to heal.

We have scheduled to meet with Dr Maurer in his Burnsville office on Thursday morning to hear his recommendation. At this point, Mary Jo would simply like to have this lump removed surgically but we will wait to hear what Dr Maurer has to say before making the final decision.

2010 a New Year, a fresh start

There is no good news to report on this first day of 2010 regarding the lab results from the recent biopsy , but there is also no BAD news to report, so its a good day.  Happy New Year!

2009 year in review slideshow