A quick review of today's dr. visit

In no particular order, here's what happened today:

I asked if my general malaise, which has been present since before I found the lump, is in any way connected to this cancer. The answer: Quite possibly, some people report 'not feeling well' as the first sign that something was amiss.

I asked when and through whom the oncologist participates. This answer was more vague: It depends on the surgeon. Since Dr. Shaw and I had already discussed the fact that I'd be moving my care to the East Bay, she knew there'd be a different surgeon on the case. Some surgeons like to complete their part of the process before bringing in an oncologist, others do it differently.

Of course the final results of all the tests on the tumor will drive the process, but it's important for me to advocate for myself and, perhaps, be a squeaky wheel to have all my care coordinated.

Particularly, Dr. Shaw said that the test for estrogen/progesterone receptors would show if I'd be likely to benefit from beginning Tamoxifen. The Her2New test would suggest, if it's a positive result, that Herceptin might be in order here.

Although the tumor was only 1-1/2 cm. long, she said it was "poorly differentiated which means it is very aggressive." Her words. And that it might be appropriate, again depending on the results of the testing that's being done now, to have Neo-Adjuvant chemotherapy, which is used before testing is even complete, or Adjuvant chemotherapy, used 'just in case.'

Dr. Shaw told me that her plan for me, just for my information at this point, would be to operate again (after I'm completely healed from the lumpectomy, and the recovery is going smoothly), to remove more breast tissue to get clear margins, and to do a sentinal node biopsy. This biopsy will determined if there is any reason to believe that cancer cells may have spread. If the sentinel node biopsy is negative then I'd just be facing radiation and the possibility of chemo.

But it is up to Dr. O'Neal to give me her opinion, and I'll be getting all my medical ducks in a row before I see her -- I'm planning to coordinate with the lab in SF to assure that my biopsy results go to the correct doctor, I will be talking to an oncologist-friend in Kaiser SSF who might help me sort this out, and I have my films with me.

I'm exhausted, it's been a long day, and I'll write more tomorrow about Heshy's birthday and the ships outside the Golden Gate.

Oh, ending on a very positive note - I've got clearance to exercise my tuchus off. Yoga, walking, the whole thing. Yippee!