Trip to City of Hope this past Wednesday, 5/31

Hi everyone,
I wanted to share about my appointment at City of Hope this past week to let you know how it's going with surgery options after the chemotherapy is finished.
My mom and I drove to Pasadena on Tuesday night after bible study. By the way, I love the people in my new bible study. Wow.
Anyway, it was great to be with my AniSan and Uncle Ray. Their house has always been a refuge for me, from when I went to college, to my first corporate job, to everything inbetween. They're like a second set of parents to me, for whom I am so so grateful. So, we arrived late that night and I hardly slept.
The next morning it didn't take us very long to get to City of Hope (COH) since it's just east of Pasadena in Duarte. I had to hand over all of my files, reports, mammograms, ultrasounds, cd's of ultrasounds and pet scans, my pathology slides, etc. That made me nervous becuase I wanted to make sure I would actually see them again. My friend Karen told me about the horror of UCLA losing her slides so I was in hyper control mode at that moment.
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The people at COH are great. At first, one of the interns examined me and then Dr. Wagman came in to examine me and talk to me about surgery options. The following link shows how COH approaches treatment and surgery:
http://www.cityofhope.org/BreastCancer/Treatment.htm

The good news was that he saw no problem with doing a lumpectomy with radiation afterwards instead of a mastectomy. Yes!! This is what I wanted. When I initally saw Dr. Shulz here, he seemed to indicate that a mastectomy was probably going to be his plan, though that was before I saw Dr Luke (we'll see what he says at the tumor board now that i have mroe information).
Anyway, This was good news from Dr. Wagman becuase the lumpectomy procedure is more minor than a mastectomy and has the same statistical results in prognosis. Of course, either way, I'll have to have either 30 days or 6 weeks of chemotherapy. He seemed curious about the choice I had made to pursue neo-adjuvant chemotherapy (pre-operative chemo) instead of surgery first, since surgery first seems to generally be the standard practice according to him. He didn't seem to see a difference between neo-adjuvant and adjuvant (post operative chemo). HOwever, I feel realy good about the choice because it has several benefits: 1) The size of the tumors shrink in 80% of the women who do neo-adjuvant chemo so that makes the surgery more minor than it would otherwise be, 2) I'm killing the microscopic oncogenes right away rather than giving them an opportunity to spread while I'm looking at all of the surgical options, 3) A large scale study showed that neo-adjuvant chemo had a statistically significant effect on pre-menopausal women (that's me), 4) The dose dense treatment plan I'm on (just the first part is dose-dense) shortens the overall time in chemo.

In summary, I feel good about the treatment plan that i'm on, though Dr. Wagman questioned the use of tamoxifen down the line since my cancer isn't that estrogen sensitive and the personal cost of tamoxifen might outweigh it's benefit in my case. I'll have time to research and decide on that later, though. I just kind of looked at a timeline and it seems like surgery would happen around the end of November. I have to wait about a month between my last dose of chemo and the surgery according to Wagman. I might go back to Shulz based on what the tumor board says, but at the moment, I feel a lot more comfortable and confident with Dr. Wagman at the moment since he's done this so much. I mean, COH is a national cancer institute and they are doing progressive things there. I like that-to know that the latest options are available for surgery in my case makes me feel good about going there.
After the appointment my mom and I went out to lunch and I ate a LOT. My lunch plus some of hers and a salad and bread, too. Yay. I also bought a dress and a agreat scarf formy head so when I have those "I feel ugly" days, I can just put in on and feel feminine and pretty (okay maybe that's too much information). Mymom and i walked around old town Pasadena and she did some shopping.

When we came back to my aunt and uncle's house my uncle was there waiting for us and he gave me a huge hug and I about lost it. I was so tired and I just fell apart. I went upstairs, cried, and fell asleep and felt better. I think just the emotion of it all probably got to me, not to mention I hadn't slept the night before.

Thursday morning we got up and left to come back to the desert. I was able to take my car in to get some maintenance and then went to bed really early like i have been doing. I tend to poop out in the early evening, probably because I'm getting up so early. Oh well, each day is different.

My mom left today since I'm fairly self-sufficient right now. I'm so glad she was here, even though it was kind of rough at times relating. I guess you just never know what it's going to be like until you're in it, but I'm grateful for her help just cleaning, doing laundry, making smoothies, being there for input. That was great.

I'm looking forward to going to worship tomorrow :-)

Blessings,
Julie