Pyogenic Granuloma Surgery

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Pyoge…what?

Yeah, that’s exactly what I thought when my podiatrist told me. It’s a benign tumor of sorts, where blood vessels connect together and cause swelling as well as other problems. Women are more prone, and people on chemotherapy are also more prone to these issues.

Chemo…the culprit!

I have been struggling with my toes, toenails, and fingernails ever since I started receiving chemotherapy in 2013. I’ve already had surgery once to my left big toe to deal with severe ingrown toenails; but, I wasn’t actually expecting another surgical procedure.

I scheduled this appointment a few weeks ago, after waiting to see if they would get better. It never did. I won’t go into all the gross details because you can google it and see as many hideous pictures as your heart desires. Consider yourself forewarned!

Two toes bandaged in the picture were problematic. I couldn’t get the bleeding to stop on most occasions, or it would take a long time to stop. My toes are very swollen. The infection appeared to be taking over my left foot, and it was hurting to walk. So my primary doctor gave me an antibiotic (Reflex) last week. That was a good move, apparently, as these things can get out of hand very quickly.

I’m happy to say, it felt much better within a couple of days. The swelling in my foot went down and the pain went away. Praise God!

I need my feet, and my toes. I have enough trouble with balance as it is. I think I’ll keep them.

đŸ€ŁđŸ€Ș😜đŸ€Ș😜😂

The surgery entailed numbing the toes, scraping out the tumor, and cauterizing the blood vessels. It’s all done in-office, and my appointment was over within an hour. I really like this podiatrist. He explains everything in detail, and has a good bedside manner as well. His staff are very friendly as well.

I learned something else today. Medicare covers a routine exam by the podiatrist every 10 weeks. Why? Because it helps prevent these kinds of things from happening. I will be on Medicate starting next year. At least, that is what I’m told since it will be 24 months since I was approved for SSDI.

Apparently, they learned from me too. I do love the fact I can still teach. I may not be teaching doctoral learners or counselors at the university as a faculty, but I am constantly educating people about metastatic breast cancer, stage 4, and what that means in terms of my treatment.

Public Service Announcement: If you have diabetes or neuropathy, you need to go more frequently to get your toenails clipped. Insurance covers this as well, because foot problems can result in very serious issues if left unchecked.


À la prochaine…Until next time…

Seven Years Ago Today…

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Seven years ago today, on 12/12/12, my family doctor sat me in her office and uttered those four words I will never forget: “You have breast cancer.” Four words that changed my life forever. I didn’t have the slightest clue exactly what it would look like, or how long it would affect me. I knew it was bad, but once you have the diagnosis you just press on with the treatment. That’s when I started this blog. That’s when all my friends started making a daily commitment to pray for me. That’s when my husband became a caregiver. That’s when my daughter was a freshman in high school and my son was an ROTC cadet in college. That’s when I met all the oncologists, surgeons, specialists, nurses and others on the team who would become my closest allies for the rest of my life.

Seven years have flown by in some ways, and dragged on in other ways. As I look back I am somewhat thankful I didn’t have a clue. In some ways naĂŻvety is like comfort food. The less you know, the less you have to worry. I took it one step at a time, and continue to do so. Here’s what I do know…fighting cancer is a LOT of work. Don’t be naĂŻve in thinking it will be easy. If you know someone who has been diagnosed with this dreadful disease, understand they are dealing with a lot. They may not even know all the ins and outs of the fight. I put together a brief recap of the past seven years. I don’t know, maybe it’s the seven-year itch. I thought it might be helpful to read the context.

12/12/12 – Diagnosed with breast cancer. Staged by the end of the year. Stage 3B Triple Positive Invasive Ductal Carcinoma. Cancer was in the right breast (9 cm) and several lymph notes. Treatment would begin next year, then surgery, followed by more treatment.

2013 – Port was surgically installed in January. Six months of chemotherapy (yeah, I lost my hair).  Radical, modified right mastectomy in July. Followed by thirty-three days of radiation. Finish out the year with infusions of Herceptin. I was deemed “cancer free.” They removed my port at the end of the year.

2014 – The Year of Reconstruction (several surgeries over several months to complete). Only God can make a real boob, but my plastic surgeon holds a close second. My hair was growing back. My mom passed away from melanoma while I was recovering from my DIEP Flap. It was a really hard year.

2015 – Back to life. Cancer is behind us, and we can move on. A few follow-up visits and I will be home free.  I was only inconvenienced by taking a pill every day (Tamoxifen) to decrease chance of reoccurrence, a bit of neuropathy, and some hot flashes, but I felt it was worth it. Life seemed to be getting back to “normal” again.

My oncologist moved to another facility and I was seeing the PA until they filled the slot. By the end of the year, I started noticing some pain under my left ribcage. PA said it must be muscular, since the pain would come and go. She didn’t do any X-rays or other scans at that time. Hmmm…

2016 – We moved houses this year, and while we were in between homes we figured if we were going to live in a hotel while waiting for our house to close, we might as well live in a hotel on the beach…the Gold Coast beach that is! We took a trip to Australia to see our friends and once again enjoy our “second home.” That was a nice reprieve.

I was noticeably sleeping a lot. Of course, we had just been on a long flight overseas, and we did move into a new house. One tends to overlook these things under such circumstances. I also continued to have pain on the left side off and on. In October, I went to my GYN for my annual check-up and she said, “Let’s do an X-Ray,” which discovered a mass on my ribcage. It was pressing against the lung, so they conducted a lung biopsy at MD Anderson a few days before Christmas. I remember the scheduler trying to talk me into waiting “in case something goes wrong,” but I insisted on getting it done. I got a new oncologist, and I really like him. I told him he could never leave as long as I live (which I hope is a very long time).

Diagnosed Stage 4 MBC (Metastatic Breast Cancer) just before Christmas. Future tests showed metastasis in several locations: 7 cm mass on ribs, lesions in spine, skull, liver, lungs. This time, we are here for “treatment,” and it will never be for a “cure.” While the oncologist was reluctant to answer the time question, the PA gave me 6-18 months. But God is not a God of the human calendar!

2017 – Port was surgically installed so we could start the year with another round of chemotherapy infusions (yes, I lost my hair…again), Herceptin and Perjeta for HER2+ every three weeks for life, as well as a different little daily pill for the hormone receptor (Anastrozole). By the end of the year, or shortly thereafter, all the spots in my bones, liver, and lungs have gone away. My body is stable. We will continue on maintenance biotherapy (infusions of Herceptin and Perjeta) every three weeks to keep it that way.

In addition to the treatment and staging scans, I have CT scans, bone scans, and an echocardiogram every three months. I also have a monthly shot to strengthen my bones (Xgeva). This was later switched to a 15-minute infusion of Zometa, which I only have to do every three months and they can align with my other infusions. They also take blood every time I walk into the building, probably gallons by now. Doctor visits align with all the scans.

Lymphedema seems to be getting worse since starting the new chemo treatment. My right arm is about three times the size of my left arm. I wear a compression sleeve 24/7.

One of the side effects they do not always tell you about is cataracts. Well, I ended up getting cataract surgery in both eyes in July of this year as well. The good news is, I can see 20/20! I just need to wear readers to see up close. New lenses were definitely worth the inconvenience.

2018 – Continue with maintenance meds. Toward the middle of the year, I started feeling dizzy. By December, I was unable to walk a straight line. My body was still stable, but the brain and body are treated independently as it pertains to cancer. MRI of the brain showed two lesions–brain metastasis in the cerebellum–enough to cause dizziness, but small enough to treat with targeted radiation (Gamma Knife). They added a neurosurgeon to my team of experts.

2019 – We rang in the new year with a big ol’ zap to the brain. MRI guided radiation (Gamma Knife) took place at the MD Anderson downtown location. There were three little spots; not just two. They zapped all three spots, and we all felt good about the prognosis. We took a picture of me just after they installed the “crown,” but I never showed it to anyone. I looked like Frankenstein.

In addition to all the maintenance medicine, doctor’s visits, and body scans, I added another radiation specialist and MRI of the brain every three months as well. The remainder of the year showed a decrease, then a disappearance of all three lesions. In addition, my body remained stable, so my oncologist started scanning my body every 4-5 months instead of every three. (I still have to get echos every 3 months.)

MD Anderson opened a new building in The Woodlands this year. When it is completely up and running, they will be infusing more patients than the main campus downtown. Yeah, let that one sink in for a few!

And that brings us to today! It is December 12th, 2019, exactly seven years since my first diagnosis. I am much more knowledgeable, much more clued-in, and after all of this, all I can say is “whew!” I recall the various hairstyles, short hair, long hair, no hair. I now have shoulder length hair.  As I wrote each phrase of this journey I recalled how many hours and weeks it took to accomplish these tasks; it seems so simple as I read it, but it was quite complex. I am so glad that much in the past! Now I can focus on staying healthy and staying stable. I am praising God for giving me the strength to make it through the past seven years.

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I continue to work full-time as a university professor. I teach doctoral learners online, with some travel to meet my learners face-to-face. Providentially, I stepped down from my role as faculty chair (I had 50+ faculty reporting to me from 2012-2016). This happened just three or four months before I was diagnosed with Stage 4 MBC. God knew!  My faculty schedule is more flexible, and I can work around my medical schedule.

Every quarter I look forward to the end of the term. And now, I am happy to see the end of another year. I enjoy my job, but it’s getting harder and harder to balance the demands of a busy job with my treatment and doctors and scans and etc. Tomorrow is the last day of my university’s academic term, and I will finish grading all of my classes within the next few days. It’s that time of year when I am so thankful to be finished! Then, I can relax and enjoy the holidays and the rest of the year.

Aside, over the past few months my left eye has been red, swollen, and inflamed. I have been to the optometrist multiple times, and he has tried multiple rounds of eye drops to no avail. He is referring me to an eye specialist to rule out metastasis.  One thing I know is this: when you have MBC, they always want to rule out cancer if there is an ongoing issue. I’ll see him after Christmas, but my prayer warriors are already on it.

2020 – I don’t know what the future holds, but I choose to live each day to the fullest. I do know we have some big plans for the next year. God is starting a new ministry in us, and we know He is not finished with me yet. 🙂 More on that next year!

Á la prochaine…until next time!

Gamma Knife

Today was a big day. Our drive downtown was fairly uneventful. The traffic was lighter than usual; I imagine many folks are taking off work for the Christmas holiday weekend, and school is out for the winter break.  We valeted the car and got to my appointment about 30 minutes early. This is my first visit to the brain and spine center, but we have been to the main building before. If you have never been downtown Houston to the MDAnderson center, it is like a city all of its own. I remember the first visit here six years ago, when I was going through all the initial staging. I saw a sign to the aquarium, and I thought they had an actual aquarium here. Turns out, that is the name of one of their cafes. (Egg on face.) But, in my defense, it IS a very large place.

As we sat in the waiting room playing games on our iPads and listening to Property Brothers in the background, I asked Tim if he had any questions. He quipped, “will it kill much of the brain? Or better yet, will it restore any of the brain?” Yep, that’s my hubby.

All joking aside, we spent the whole day learning about this next phase of my cancer journey, the Gamma Knife procedure, and what it entails. I did break down and cry at one point as it is a bit overwhelming. But, thankfully, the wave of emotion didn’t last long. The nurse (Tina) was really sweet as she talked about the process and handed me a tissue.

So much for the “one and done” approach we had naively imagined. I should know better. Nothing is quick and easy when you get involved with cancer treatment at MDAnderson, or anywhere for that matter. The main campus is known for even longer waits. Today was no exception. After a thirty minute wait (an hour really, but we were 30 minutes early), Tina escorted us into a room she “stole,” because the others which belonged to my doctor were full. She took my vitals, described the Gamma Knife process, and discussed possible date options.  She also informed us of a YouTube video explaining everything MDA does with this treatment. We really liked her.  She was down-to-earth and truthful about the wait times as well.

Next, we were visited by the Physicians Assistant.  She was also very sweet and knowledgeable. Another explanation and some tests of strength and balance. Tim is my levity as he likened my walk across the room to the DUI test.  Not that I would know…fortunately.

Thirdly, we were visited by our very tall radiation oncologist, Dr. McGovern, who will follow me through all of the Gamma Knife procedures, now and later if needed.  Most likely there will be more; of course, no one is willing to predict the future. She explained how Gamma Knife actually works. It’s quite interesting, actually. The machine has 192 Cobalt beams that intersect at the exact location of the lesion. By itself, each beam is relatively harmless. But when they intersect, they send a combined large dose of radiation for what I consider an explosion into the lesion which “nukes” them. The table on which I will lay moves me into position so the beams intersect at the exact right location.  In this respect, a head frame is imperative (more on that in a minute). The frame prevents me from moving my head even a mm to zap the wrong spot in the brain. Each lesion takes about 15 minutes, so the entire procedure will be about an hour. This is just an estimate until we get the final MRI the day before the procedure.

In addition to a new radiation oncologist, I now have my very own neurosurgeon. “Is there any specialist I have not seen?” I wondered. Apparently, this is also required when you get the Gamma Knife.  I was fortunate Dr. Ferguson was available to see me today, so I don’t have to come back another day.  Initially they said 3:00, but we came back after lunch and I got a call saying to come on up. That was a real blessing! Lunch, by the way was delicious. We had crepes at Sweet Paris downtown.

Dr. Ferguson is the exact opposite in stature to Dr. McGovern. I believe she said she is West Indian; Tim missed that part of the conversation as he left the room to go find his Diet Pepsi which he left in the waiting room (and I’m the one with brain issues LOL). Funny thing is, he couldn’t remember which room I was in, so he opened the wrong door. Another doctor had to help him out. He opened our office room door and said this gentleman was looking for a good-looking wife, and since I was the best looking in the hallway would I take him. Yeah, I guess so.

Anyway, I digressed.

Dr. Ferguson asked if I wanted to see the pictures from my latest scan, and of course we said yes. The spots are very tiny, but I could see them as well.  To do this very precise procedure, one has to wear an aluminum frame, which I mentioned earlier. From hereon, I will dub it my “bedazzling crown.” I may not be a monarch, but I sense this crown will represent victory and triumph, (as it does for the royals), and represents power over this awful disease. Wearing it will enable me to feel victorious. I say it is bedazzling because I prefer to feel like I will be wearing something beautiful over a medical devise, for one. Also, when I think of the radiation beams attacking the lesions, I imagine a big firework display going off inside my head. THAT is bedazzling.

One responsibility of the neurosurgeon is to attach the crown to my head. Basically, they screw it in place. Do you want to hear more? I didn’t…feel free to stop reading. She is also now connected to me in the event I ever need brain surgery. Wow. I know some people who have had brain surgery, but I never thought I would think of that for me.

History.  All five professionals seen today took note of my history.  It’s amazing how they can summarize six years of treatment in a manner of minutes. Since 2012… Chemotherapy, mastectomy, radiation therapy, continued Herceptin through year one, reconstruction, and Tamoxifen until the MBC reoccurrence in 2016. 2017 started with more chemotherapy, Herceptin and Perjecta every three weeks for maintenance, with daily doses of Arimadex and a shot of Xgeva every month.

In January of this year we discovered two tiny spots in the brain. My medical oncologist sent me for an MRI after Tim astutely noticed I was unbalanced and a bit more fatigued.  These have been watched regularly, with no growth until the last scan. They are apparently growing at a snail’s pace, yet now there are three.

Treatment.  Mostly what we heard today was good news. It’s easier to treat these lesions when they are small, and there is a less than 5% chance of brain damage to the surrounding areas, much less than treating larger lesions. I also learned that the MRI scans I have been receiving take larger slices than the MRI they will do at MDAnderson. The day before my procedure, I will go in for another MRI, bloodwork, and training by the nurse. They will access my port so I don’t have to get an IV. The thinner slices on the MRI will uncover any other possible lesions, which will all be treated at the same time with the Gamma Knife.

The day of the treatment sounds like an exhausting day. While many people choose to work the day after, I am hoping to get this done over the break. Then I can rest before going back to work. I have to fast after midnight, and arrive early in the morning.  They will install my crown, do another MRI, and wait for my treatment time. I’m sure I’m missing some steps, but one thing I remember is that I will sit around and wait with my crown attached to my head until it is my turn for the Gamma Knife. They do three per day, so I could be first, second, or third. There is no specific time frame. They will bring me food, but otherwise I will sit and wait. During the treatment I can listen to music. Afterward, they will watch me for an hour and then I can go home.  We are hoping for an appointment on January 2nd, which means all the pre-treatment will be done on December 31st, since they are closed on New Year’s Day. Looks like we will get to see fireworks two days in a row.

We learned a lot — more than I was bargaining for.  We are on information overload once again.  It was a bit daunting. However, regardless of how we may feel at times, I know it’s going to be okay. God is on my side, and He is watching over me through this whole process.  This song by the Piano Guys always gives me a pick-me-up.

A la prochaine…until next time.

 

Helga

Helga

Lucinda West

My Story

The name Helga means holy or blessed, and in a way, I was blessed to slip into a cancellation slot with the physical therapist while I was already in the building. Her time is in high demand and we were having trouble synchronizing our schedules. That’s not why I call her Helga. I did not feel blessed by the time she finished with me. Helga is the wife of Hagar the Horrible in the once popular cartoon strips. Helga is the founder of the Hufflepuff house in the Harry Potter series. Helga is the name I assign to women who inflict pain instead of pleasure.

Continue reading “Helga”