Norm's meeting with Dr. Carr, the surgeon

Norm and I had an appointment with Dr. Carr this past Friday at 4:00 pm. When we arrived, there was no on else in the office except for his secretary. He gave her instructions to turn off the lights and that he would lock up. 

Norm and I sat with him until just after 5:00 while he answered every question we had. He showed me all me results - Invasive ductal carcinoma. Definition: invasive Ductal Carcinoma (IDC): a cancer that begins in the milk duct but grows into the normal breast tissue around it. My chest x-rays came back fine and my blood work is fine, with the exception of an elevated white blood cell count. I told him that this was the same result I received when I had blood work done because of my ankle. Dr. Carr explained that this could be because I am fighting a cold or another infection. I don't have a cold, so what's going on? 

On Thursday, I had met with Dr. Malone, an orthopedic specialist about my foot. His opinion is that I could have had a stress fracture in one area of the foot, but that now it looks a swelling and possible infection of the synovial membrane in my ankle (which apparently is not the same as arthritis). He is recommending cortisone shots, of which I am leery. I asked Dr. Carr's opinion on this, expecting a brief "yes, he's a good guy, you should do what he says, or "no, cortisone will affect you other treatments so stay away from that" , but that's not what I got. Dr. Carr, at 4:30 on a Friday afternoon, he pulled up all my previous doctor reports on his computer, including my bone scan and the CT scan. He explained what each of them meant, what he thought of my foot, all the while saying that he himself is no expert, trust Dr. Malone for he has very good reputation. I spent more time in his office talking about my foot with Dr. Carr than I did with the orthopedic doctor, and that's not even why we were there. I asked him if he thought that my breast cancer has spread to my foot. He laughed and said that he has never heard of a breast cancer metastasis in the foot. He said it's possible, but he's never seen it. OK - I had to ask. 

The rest of the time we were in the office we did talk about the cancer. He explained what would happen on Friday with the surgery, how the treatments would work, how I will feel, where I will have to go, and when I will be done. 

Friday the 21st, I have to be at the hospital at 7:00 am. I will get sent to the nuclear medicine department for an injection of radioactive dye that will track which lymph nodes are acting as the drainage for my right breast. Then I will get prepped for surgery, which will begin about 11:00 am. They will take out the lump, some surrounding tissue, and a few lymph nodes (sentinel node biopsy) to see if the cancer has spread to the lymph nodes and/or the surrounding tissue. The actual procedure will take about 40 minutes, and once I wake up and everything checks out, I can go home the same day. 

The tumour, tissue, and the lymph nodes will be examined, and from that I will get an accurate diagnosis of the stage of my cancer. I will then be referred to the BC Cancer Centre in Victoria for a consultation with an oncologist. Dr. Carr recommends that my treatment will include a 6 month course of chemotherapy (which can by administered in Nanaimo) followed by a one month course of radiation. The radiation will be the tough one, since it will be given daily for 4 weeks in Victoria. My first round of chemo will likely begin just after Christmas, and last through June. I don't know if I would a break before beginning radiation. The first couple rounds of chemo should make me feel too badly at all. I should have the results of the lumpectomy in 7 - 10 days. This will tell me whether or not I will need further surgery (mastectomy). 

I still feel pretty confident that things will turn out OK, although I do have moments when I panic about the possibilities. Thanks to everybody who has called and emailed. It's been great reconnecting with people I don't see everyday.