And now for some Science!

Today we went in to see the surgeon's Nurse Practitioner. We were also supposed to see the surgeon, but our 11:30 AM appointment didn't happen until 1:10 PM, by which time the surgeon was already slicing and dicing over at the hospital.

The NP did check out the embroidery, and is very pleased with how fast I'm healing. She then reviewed the pathology report with me in detail, and gave me my very own copy. It's a little weird reading about the various shavings and slicing, but whatever.

Did you know that the scientific name for the type of cancer I had is the same as the name for a pimple? Neither did I! That name is comedo. On your face, a blackhead is an "open comedo" and a whitehead is a "closed comedo". In the breast, a comedo is a center of dead cells surrounded by a hungrily expanding and wildly proliferating set of cancerous cells. If they are at the surface, comedo cancers can be "squeezed". Yes, just like your momma told you not to do. (It doesn't make them go away, though.)

They are also a lot more aggressive than other sorts of cancers. Mine was very, very different from normal breast tissue, and was really growing very fast (lots of nuclei). So glad that Lump is gone!

The NP said not to worry about the little bits in the lymph vessels. If there's anything at all (and chances are good that there isn't) left behind by the surgery, the radiation and chemo will clear it. But it makes it even more clear as to why I need all this heavy-duty poison medicine.

(And they not only didn't have my medication list right, they didn't have the new medications the oncologist ordered on the list. I got a bit upset. The NP had the right list, thank goodness! and promised to make sure whateveritis is fixed before the 12th. If they don't get it right, I will refuse treatment, because I have to be sure that the people mixing the chemo know what else I'm taking. In fact, I may call the oncologist's office the week prior, just to be sure.)

Now then:

• The chemo is AC (Adriamycin/Cytoxin). The A keeps cells from making or repairing DNA. It really is a poison; fortunately, since cancer cells are madly dividing, it hits them harder than the more leisurely normal cells. The C keeps cancer cells from replicating. So, they can't reproduce and they can't repair themselves and they die. Hopefully, before anything else important dies, like my heart muscle or all my T cells.
• I will be getting Neulasta the day after surgery. This will help my blood recover its ability to fight infection sooner, so I can go through the speeded-up regimen.
• The backbone of the anti-nausea regimen is three drugs: emend, aloxi, and decadron, mostly administered with the chemo. I will also have compazine and ativan as needed, and Zofran if the nausea lasts more than three days. I have been instructed to take an ativan before coming in for my first treatment.

(This last bullet is mostly for my Uncle Bob, an expert on nausea in all its aspects, who instructed me to ask the doctor for medication to take before having the first treatment. Seems that if you take an anti-nausea medication before treatment, thus keeping you from having anticipatory nausea, you may not have much trouble from nausea at all.)

Today's extended wait was enlivened by a lady who moved from commenting on my knitting to a broad-ranging conversation that included a dig at immigrants! I jumped on that one tout de suite, but in a nice way, bringing in my great-grandparents, grandparents, and parents. She was relieved, I think, that I left her a graceful way to backtrack. Normally, I would be less polite, but the lady had to have a surprise mastectomy just a couple of weeks ago, so why point out that her doctor and mine rejoices in the last name of "Zabrinski-Calvillo"?