Final pathology report and doctors' follow-up visits today/herceptin

Hi everyone :-)
I felt pretty good this morning and not quite as fatigued, though the mornings tend to be fine and then I crash out around 2-3pm and I'm toast after that for the rest of the day, so whatever is important to do I have to do in the morning.
Final pathology report...
I received the written version of the report today and it was amazing to read. We already had been told last Friday that the left side was totally clear and that the lymph nodes removed in the right side were also clear, but I was curious of the details of the axillary dissection on the right as well as the small foci of cancer that was in the right breast tissue that was removed. So...out of 50 lymph nodes that they removed (that's a lot of lymph nodes) NONE were cancerous. Its just absolutely amazing and a miracle that there was no evidence of cancer there. Out of the right breast, the tumor that was there before chemo was 2.2 cm and it had been more or less obliterated into some tiny little pieces. One was 2mm and the other 5mm. so the chemo really worked!!!!Praise God!!! Im so glad for Dr. Luke Dreisbach and his team at Desert hematology/oncology, they are so wonderful and helpful anyway and it's wonderful that they have been an instrumental part of this great news!! - God arranges everything. He is the Lord of the heavens and the earth and everything in them and while it's totally possible that my situation could have been a lot worse, I would still praise Him anyway becuase He is wonderful and has helped me along this journed. So....as far as I know NO RADIATION wahoo!!! I did leave a message for Dr. Khanna who is the radiation oncologist that I saw in order to see if she had a different opinion, but I don't think so :-) Wahoo!!!
Doctor's visits.....
Okay, the first visit was to Dr. Silverstein's office so that he could check the progress of the healing from his perspective. He was happy with how things are progressing. I brought a copy of the blood count report I had from the blood draw yesterday showing how anemic I was and showed it to the nurse. She concurred that it was low and that something was to be done about it but wasn't sure how that was going to happen since I didn't have an oncologist there. So, after talking about it for a bit and how I had wanted to have my herceptin infusion there, etc., she mentioned another drug besides the procrit called aranesp. It's a longer acting version of procrit in that it lasts two weeks rather than just one week. I had never heard of this before since my oncologist had never given this to me prior. Anyway, since I was pretty anemic and would have to go through this whole thing next week, we thought that the aranesp might do the trick, it was just a matter of the insurance approval, and she didn't seem to hopeful about that....so we waited for a while....and so I was a little late to Dr. Sherman's appointment but it was so cool, she came back with the aranesp shot ready to shoot me with it in my leg. I was so excited!! Thank you for praying about this for me! Hopefully this will help my body recover from the red cell depletion still caused by my last chemo and compounded by losing some blood in surgery (only about 200 cc).
I asked him how long it would take before I could get on an airplane, drive, etc. and he said to really wait about a month or six weeks before that.

On to Dr. Sherman's office....
We arrived and Hillary, his physician assistant checked out my dressings, re-gauzed a few things and then she "milked" (encouraged the fluid movement from the surgical site down to the drain bulb) both of my drains in a manner far better than I could ever do. She said everything looked really good. We talked about a few things, like:
When do the drains come out? That will happen when the fluid accumulated is <20-30 cc in 24 hours. Right now I'm averaging about 20 every 8 hours, so it might take another week before they come out.
Should I do some kind of physical therapy to help the process along? Not yet. After the drains come out then I can do some things to help restore the range of motion in both arms. At the moment my left is better than my right, but that's mainly due to the lymph node dissection (they remove the pocket of tissue in your armpit basically) under my right arm
How long will the expansion process take? I can have my first saline "fill-up" around November 8th and then I'll have to go about once a week for additional fills until each of the expanders have reached the point that my skin has room for and that feels right. At that point, I'll swap it out in another surgery for an implant. That surgery isn't as difficult however, and although I'll be under for a few hours, I'll be able to go home later the same day. So, at this point, we're looking at some point around mid-January for that. There will be subsequent surgeries for nipple reconstruction and tatooing for color if that's a choice I make as well.
Will I have some of the feeling return? No. Generally not. All of the nerves have been cut and the tissue removed. So that makes sense that all I can feel is the pulling of the chest muscles underneath and the discomfort and pain at times that goes with it. that part will follow through the expansion process.
Saline or silicon? Right, everyone wants to know about this, dont they? I was able to look at and feel samples in the office and, frankly the silicone seems to be a good choice. Sometimes the saline ones have a rippling effect due to the way that they're made towards the top of them and some women who don't have a lot of tissue towards their collar bone area, this is more pronounced in, and silicone doesn't tend to do that as much. So, I"ll get to see when I have the silicone ones expanded and we'll go from there.
Well, those were the extent of my questions at this point, so I started to re-think the whole timeline that I had set up for staying out here to recover
Because Dr. Silverstein said that it would take about a month for me to be able to drive, and that in combination with the fact that I'll be having weekly "fill ups" at the office, I thought it might be wise to think about staying out here another week until I get my clearance to drive. That way, I'll stay for my second fill up and then be able to drive myself home rather than having to have someone come out week three to get me, and my car..and then drive back week four for the fill up and then be able to drive home. So, I asked my aunt and uncle about it and they said it would be fine. I definitely don't want to wear out my welcome here but I do think it would be just more efficient and better to wait for a more functional clearance from the doctor before I go back home. That means that I will still be out here until around November 15th or so. I pick up my house messages and do have my cell phone so that would be fine. I definitely feel more comfortable waiting until I am cleared to drive before leaving becuase it makes everything else easier.

Herceptin...
Because it had been so difficult to get the infusion of this done at USC I'm going to wait until I come back to the desert to do it. Dr. Luke said it would probably be okay if I waited until then so I'm going to do that. That way I can concentrate on just healing form the surgery while i"m here.

Whew. That was a lot that transpired in just a few hours this morning and it was so thrilling that when we got outside I did a Gene Kelly and jumpec up and clicked my heels together as my sister and I walked back to the car. Great day!

God is so good and I just want everyone to know that none of this would be possible without knowing HIm and knowing that He orchestrates everything to show who He is. Jesus loves to show who He is all the time in our lives, and it's so exhilirating to be a part of it. I just marvel at how he puts timelines together in everyone's different lives and somehow weaves it together in some kind of multi-dimensional tapestry that has a beautiful design showing it was Jesus all along. Wow. God is so good and you have all been amazing partners with me along this journey. Even though I still have more to go, I'm so grateful.

Love to you all!!!
Shalom,
Julie