On Monday Scotty and I went to see the surgeon to receive the pathology from the ALND (axillary lymph node dissection) surgery. Originally the PET scan showed that there appeared to be more than one node involved, however, the pathology came back showing only one. We obviously had questions.

First, and most important, did they get all the tumors out or was there more in there that they some how missed?! After further discussion with the surgeon, and him actually calling and talking with the doctor that had done the dissection, we think the reason the imaging showed more than one node with cancer was because of two reasons. The lymph node biopsied had a metal medical marker clip put inside it. This procedure left an indentation on the node and also removed a chunk to be sent off to confirm that it was cancer. All of that was done prior to the PET scan so it made that node appear to be split in half or more like tightly bundled grapes. The second reason could have been simply a false negative on the PET scan. Bottom line is that all the nodes in the region that had the cancer node were removed.

Second, we wanted to know how many nodes were removed. There was a total of 16 nodes taken out. Each ALND is different because all of us have a different number of lymph nodes. I was told that if you are heavier you tend have more nodes and if you are thinner you have less. This means there is no magic or correct number of nodes that should be removed because it varies based on each individual. And again only one of these nodes came back as having cancer in it.

Overall the pathology report was great news. Not having any additional physical tumors growing is what we wanted and not having any microscopic cells inside any others is pretty amazing.

During that visit I was also able to have my drain removed because it was well under the 30ml threshold. Let me tell you that this surgery was not as painful as the bilateral mastectomy but the drain is 500 times more painful. I’m not sure if it was because of where it was located, the amount of “digging” done on the inside of my body causing bruising, or if I am suddenly becoming a wuss, but holy heaven above did I want that thing out. One other difference from the drains after mastectomy versus ALND was that the incision where the drain is placed takes much longer to close up and heal. With the mastectomy drains I had to wait about 24 hours before I could shower and remove bandages. Today is Thursday and the incision is still not fully scabbed over allowing me to shower.

My mom took this picture about a week after my surgery so I could see where the incision was and how long it was. The puckered looking line is where they opened me up to get out all the nodes and below you can see the bandage, that is where the drain was. The stitches are on the inside and then it is glued together (the puckered skin). Plastic surgeons like to use glue to close instead of stitches to decrease the visible scars after. I guess I got lucky and my surgeon does this. I didn’t know that prior to surgery. In the grand scheme of things this body of mine is no prize. It wasn’t ever a grand showcase but God gave me it and I have tried to treat it like the temple it should be. I have accepted that whenever the end comes for me this body will probably be riddled with more scars than perfection and beauty which I am fine with. Each scar is a visible representation of me fighting to live, and living is all I care about.

Above is a picture I took this morning after I cleaned the drain incision and before I re-bandaged it. Since I did chemo my skin hates all bandages and medical tape. The red surrounding the area is just the irritation from that. You can see bruising and I don’t know why that is there, my guess is from all the digging and pulling during the surgery.

This week I also started doing the physical therapy exercises to prevent lymphadema and to help me regain my mobility back. It is depressing. I am in a full body sweat attempting to do these. Today I also went for a walk. Also depressing because I am slow. No offense to anyone out there but I feel like an 80 year old woman. Mentally I am very frustrated with part. I had just gained back almost full mobility after the mastectomies and was able exercise with 15 pound weights. It has taken a year to get back to that point. Now here I am back where I started. UGH.

Tomorrow I am meeting with my regular oncologist to finalize the treatment plan. Once I am done with that appointment I will post an update.