Yesterday was my last scheduled chemotherapy – taxol. We went to the tree before my first appointment and took the requisite pictures. I had some fun with it.

Towards the end of my treatment, the chemo nurses sang the chemo song: http://vimeo.com/110530951

A tear or two did drop from my eyes as they were singing and congratulating me. For the last four treatments, I had been anticipating the moment I finally got to say “this is my last chemo”. The problem is, I don’t feel like the chemo is done. Let’s start with the fact that this may have been my last infusion, but I still have to go through the side effects from the last infusion – so I still have a difficult week ahead of me before I start to recover from the chemo. But also, my treatment isn’t done. I don’t know what the results of the pathology will show. So, for now the chemo is done, but I just don’t know that it is really done. So instead of ‘hey now, the chemo is done’ … it feels more like ‘for now, the chemo is done’ …

From the treatment perspective, focus is now shifting to surgery. It seems each time I see the surgeons things change a little. I wanted to know from my breast surgeon, where the incisions were going to be and what I could expect when I wake up from the first surgery. The thing is, they do the incisions on the first surgery based upon the second surgery – so they can use the same incision points. Fortunately, Thursday is the day that plastics are at the women’s center, so my breast surgeon brought in my plastic surgeon and the two of them discussed and decided where the best place would be for the incisions. The my surgeon drew on (in ballpoint pen) where the incision will be.

We then talked about pain management. Prior to surgery I will see nuclear medicine to have an isotope injected to help identify the sentinel node(s) for the sentinel node biopsy. In my case, this will involve approximately 4 needles in each breast, each feeling like a bee sting. Then, I’ll go to mammography center where they will use a mammogram machine and place wires that the surgeons will use to identify where two of the tumors are (current plan is to only remove L1 and R1 – one tumor on each breast). Typically, a local anesthetic is used for wire placement (although it still not pleasant with the mammogram machine squeezing – which is extra not fun when you have port). They don’t usually use any anesthesia for the nuclear injections. Of course, in most cases, women are only doing this with one breast. My surgeon happens to be connected to the head person for pain management in anesthesia (the regional director). Given all the pre-surgery procedures, I’ve been referred to him to have paravertebral nerve blocks prior to the visit to nuclear medicine for the injections. This will mean (in theory) I won’t feel anything around the breast area.

All my pre-op appointments are scheduled in the morning. Surgery is scheduled for 1:30pm and has been booked for three hours. Then I go to recovery for at least 2 hours (while I wake up). I’m booked for an overnight in the hospital. I’m happy to be in the hospital overnight, as that is when all the surgery related pain meds will wear off – so I’ll have ready access to doctors if needed to help with pain management. We will leave the hospital with written prescriptions for pain meds (actually, I’ll probably send Scott over to the Stanford pharmacy to get the filled – so we will leave with the drugs in hand).

I continue to be impressed with the little bits of special treatment I’m getting. I’m definitely a squeaky wheel – in that I booked the extra appointment to see my surgeon because I didn’t know where she was placing the incisions – and I wanted to know. I’m so glad we had the appointment, as I have a much clearer picture of how things will work on the day of surgery, and being a special case for pain management will also mean my personal experience will be a little less painful.