Friday, November 2, 2007

No easy victory

What a long day!

We arrived at the hospital promptly at noon. Interviews were taken, noting all the proper information. Blood was drawn and four needles were inserted in the breast to inject a radioactive dye. I left during that procedure. The nurses were pleasant, professional and competent. Dr. Compagnoni arrived about 2:45pm and outlined what would happen in surgery. She thought somewhere between an hour and a half and two hours in surgery and about an hour in recovery would be sufficient.

They took Deb promptly at 3pm, and I started to read the book I brought, Playing for Pizza. Time passed and Deb's parents arrived to keep me company a bit after four. The receptionist advised that Deb was still in surgery, and that it had started at 3:45.

So we became a little concerned at six pm without any real word on the delay. Finally at about 7:10 Dr. Compagnoni met with us. She told us that the frozen section of the sentinel lymph node tested in surgery indicated the presence of some disease. Three other lymph nodes were removed and would be tested by the pathologist. The delay in the start of surgery was because a breathing tube was necessary and it took some time to get it in place.

If all four tissue samples had disease (cancer), then she and the oncologist, Dr. Weyburn, would have to decide what further treatment would be necessary. Perhaps more chemo or radiation. Or both! It will seem like an eternity until Wednesday.

Sentinel Lymph Node Dissection
One of the most talked about new surgical techniques in breast cancer is sentinel
lymph node dissection. This is an alternative to standard axillary lymph node dissection, and many women believe that it can spare them more invasive surgery and side effects. However, the sentinel node procedure is not appropriate for everyone. Recent research shows that even after the sentinel node procedure, more surgery may be necessary. It has its own limitations and drawbacks, and must be done by a surgeon who has significant experience with the technique.
The dictionary defines "sentinel" as a guard, watchdog, or protector. Likewise, the sentinal lymph node is the first node "standing guard" for your breast. In sentinel lymph node dissection, the surgeon looks for the very first lymph node that filters fluid draining away from the area of the breast that contained the breast cancer. If cancer cells are breaking away from the tumor and traveling away from your breast via the lymph system, the sentinel lymph node is more likely than other lymph nodes to contain cancer.
The idea behind sentinel node dissection is this: Instead of removing ten or more lymph nodes and analyzing all of them to look for cancer, remove only the one node that is most likely to have it. If this node is clean, chances are the other nodes have not been affected. In reality, the surgeon usually removes a cluster of two or three nodes—the sentinel node and those closest to it.
Strategic removal of just one or a few key underarm nodes can accurately assess overall lymph node status in women who have relatively small breast cancers (no more than two centimeters) and who have lymph nodes that don't feel abnormal before surgery. Studies have shown that after almost five years, women who had just the sentinel node removed were as likely to be alive and free of cancer as women who had more lymph nodes removed. Longer follow-up will help us better understand the long-term pros and cons of sentinel lymph node dissection



Wednesday, the drain will be removed and she can take a shower. The stitches will dissolve automatically. We will have the results of the pathologist's findings.

We got to see her about 8:30pm. Deb was pale, cold to the touch and got sick after a couple of bites of jello.

Her mom and dad stayed for a few minutes more as I left to come home.

Deb is in room 746. I don't know now if she will be home tomorrow or not. It depends on how she feels.

This isn't necessarily bad news, as we will know more on Wednesday. There is a good chance, according to Dr. Compagnoni, that the other three samples will not have evidence of cancer.

So we thank God that Deb made it through surgery.


Please say a prayer for our friend John Beebe. John is in the hospital with the diagnosis still to come, but artery blockage is mentioned.

I updated this at 3am the first time. Now it's 8:47 am and Virginia at the nursing station just told me Deb is eating breakfast and feeling much better this morning. Woopee!!



Dan



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