When I spoke to the nurse practitioner today (and I should note that she specializes in breast cancer), I asked if that meant that I'd get to keep those lymph nodes. The answer is no. As with the breast tissue, the goal with chemo is to get rid of it, but then you still get surgery just in case there's anything still in there that might come back later to cause problems again. I'm fine with this. Aggressive treatment is what I want. I don't want to do this again.
So given that I'll be losing some lymph nodes, I asked about lymphedema (the lymph system is how your body drains fluids, specifically lymph, from various parts of the body. In the case of the axillary nodes, they handle fluid from the arm. In this case, it's possible that I might deal with some swelling and fluid retention in my right arm). Apparently, this is more of an issue if you get more than 6 nodes removed. So what they'll do is inject a liquid that will cause potentially problematic nodes to "light up" (I do not have additional information on this but I'm assuming it's like the many other scans, like how in an MRI or a CT scan, they use contrast to "see" places that might be bad) and then all nodes affected will be removed, and then they'll check the nodes they removed to see if they are cancerous or if they're just lymph nodes. This is all to say that the NP thought I would probably not run into problems, but if I did, my occupational therapist is actually one of the lymphedema OTs, so, in the NP's words, "You're right where you need to be."
I have a meeting with my surgeon in a couple of weeks to talk about what that will entail, what to expect, etc, and I'm looking forward to it. I like information. More information, for me, is always better.
I want to briefly mention that on Monday, when I had my PT and OT appointments, I asked my occupational therapist if she could give me more detail on the differences between PT and OT, and what I learned was that in this particular practice, she and the PT I've been working with work very closely together and specialize in breast cancer patient care. So while in a different practice there might be more space between those two roles, in this case, there's a lot of overlap. The easiest way to explain it is that the OT is concerned with what you need to be able to do to live your normal life, and the PT is concerned with making sure that you have the strength, balance, and flexibility to do those things. For me, in this moment, they are both preparing me for surgery and the time after surgery, and then eventually, the rest of my life. They both keep up on the latest research about how their disciplines can impact outcomes for cancer patients, and they also keep up on how other facets of care intersect with the body. The OT asked about the icing for taxol, and I explained that the nurses at the infusion center had already said they were going to ice me. She was really happy about this, because I guess they didn't used to push it, it was more up to the patient because it's not exactly pleasant, but it has a lot of data to back up its efficacy.
I'm really impressed with the people who are working with me, the level of knowledge they have about where the research is on breast cancer and all of the things surrounding it, and I always feel like I am being seen as a person first and a patient second. I appreciate that I get deep dives on people's specialties, and then overviews of how all of my care works together. It's really, really nice. I'm very lucky. I don't think I could ask for better care or better providers, and I really do think I'm right where I need to be.
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