gobble, gobble, bloggle, bloggle

trish, caden and myself would like to wish everyone a happy thanksgiving.


2008 is a year in which we have a lot to be thankful for, and a year we cant wait to end.

we appreciate all the love and support we've received from everyone this year, it has made all we have gone through more barrett-able.

trish is continuing to do great. dr. jeffrey removed her drains on monday, and she is healing up quite nicely and feeling better with each day.

things are good around here.


enjoy your thanksgiving,

trish, caden & oak (and bella)

the final pathology report...

one of trish's drains kinda sprang a leak this morning, so we headed over to our favorite surgical oncologist this afternoon for her to take a look.

ended up being a non issue. dr. jeffrey cleaned out some clotting in the tube, put some new bandages on trish, and she is good to go until monday morning, when dr. jeffrey will remove the drains for good.

before dr. jeffrey took a gander at trish's drains, she handed me a sheet of paper, it was trish's final pathology report.

dr. jeffrey asked me to read it aloud to trish, and this is what i read...

No residual carcinoma is seen in the right mastectomy specimen. No tumor is seen in eighteen total lymph nodes (0/18); however, several lymph nodes demonstrate scarring and infiltration by foamy histiocytes suggesting possible involvement prior to therapy.

the english version:
------------------------
the breast tissue and 18 lymph nodes removed from trish WERE NOT CANCEROUS anymore... not even possible micro-metastasis the pet-ct, mri, mammogram & ultrasound may have missed.

several lymph nodes appeared to possibly have been cancerous in the past, but the chemo, herceptin & trish's determination kicked cancer's ass.

without the mastectomy, lymph node dissections and subsequent biopsies, we would not know with 100% certainty if the cancer truly was gone or not.

now we know.

it brings tears to my eyes as i type:

Trish is in complete pathological remission

it shall be celebration ale tonight...





p.s.

trish is out & about spending money everyday, so i guess that means she is feeling great.. :)

do you mish your dish?

we really, really appreciate all those that have dropped of dinners over the past 7 months, but ill be the first to admit we have been horrible at returning dishes.

with the holidays around the corner, im sure you would love to be reunited with you long lost dish.

send me an email and let me know what we have of yours, and ill track it down and get it back to you.

thanks

oakbarrett@gmail.com

first post-op follow up...

dr. jeffrey wanted trish to come in yesterday afternoon, so she could take a look at how things are going. so we pointed the car towards the cancer center yesterday, and trish, ria and myself arrived about 10 minutes later..


it didn't take long for dr. jeffrey to see how well trish is doing. in fact, i think she was able to tell just by the glow of trish's face.

after a quick look, dr. jeffrey was thrilled with trish's progress, and thought she was doing really great.

the bandages are clean, the stitches are good, trish is healing well and the drains should be out by monday, possibly even by friday...

she walked trish through some arm exercises she wants her perform, but more importantly she proved to trish that she doesn't need to be scared about moving her arm. dr. jeffrey had trish put her hands behind her back, bend over and swing her arm in a circle, shoulder shrugs, lift her arms up, touch her shoulders, etc... trish was able to do it all without any problems, and im glad dr. jeffrey showed trish she doesn't have to worry about any range of motion, or be concerned with ripping her stitches or drains out.

not all the pathology reports are back yet, but the results so far indicate no presence of cancer cells in the tissue that was removed.

this is good news, but not the final news..
so we will wait until the complete pathology report is back before we get too excited.
we learned early on not to get too high on the good news or low on the bad news.. stay in the middle and it makes the emotional roller coaster easier to handle.


trish is still sore, but thats a given. yesterday she went shopping with her sister, and she continues to do little walks around the neighborhood and around the house. she isn't over doing it, but she is keeping herself moving and keeping herself healing..


she is doing really well, and looks forward to her healing touch session tonight.

the update...

11:30am friday update:
-------------------------------
im typing this update from home, watching trish hang out in the backyard with caden..

yup.. she is home, and doing great.

the vicodins will take care of the soreness she has, but other than that, she feels really good..

walking, talking, eating, smiling and laughing...

you would never know she got out of surgery last night at 7pm.


its a beautiful day in redwood city... sunny, blue skies, 80 degrees & not a cloud in sight...

a fitting day to be even more cancer free-er...







7:45am friday update:
--------------------------------
trish was finally transferred to her room last night around 9:00pm and looked terrific.
she wasn't too groggy from the anesthesia, and aside from being a little sore, she was feeling great.

around 11:00pm we got her out of bed, and took a stroll down the hall. she has good strength, and can move her arm without any problems. didn't have any problems walking, wasn't dizzy, and the anti-nasea medicine they gave her helped ward off any side effects of the anethesia.

trish slept well considering the nurses come in every few hours to take her vitals, but overall it was a really smooth night. she had a pretty good appetite last night and is now looking forward to her breakfast suprise.

dr. jeffrey said she would stop by this morning to check in on trish, and i can only assume that sometime this afternoon she will be discharged.

so everything is good here.. ill post another update later









7:00pm thursday update
---------------------------------
dr. jeffrey just came out with a big smile and gave us the update..

trish is out of surgery and she did great.
no complication, no issues, no suprised, everything went smoothly.

surgery ran a little late cause it started late, and dr. jeffrey took her time.

trish is in recovering now, and will be transported over to the hospital in about an hour, and thats when we will be able to see her.

dr. jeffrey still believes trish will be able to go home tommorrow





5:00pm thursday update:
---------------------

the update is... there is no update..

we haven't heard anything yet


stay tuned






thursday morning update
--------------------------
we arrived at stanford at 11:30am this morning

about noon, trish was brought in for the standard pre-op stuff... gown, iv and most importantly marking the correct breast... right is right in trish's case, but sometimes right is wrong, so you quickly learn to say things like 'correct' and not right..

ria, yvonne, julie, chrissy and myself were all able to spend time with her before she went into the operating room.

about 12:45pm, she was given an anesthesia technique called a parvertebral block, and then brought to the OR.


trish was in really good spirits this morning, and was ready for this.

surgery should have begun around 1pm, and we expect a ~ 3 hour surgery.

she will be in the recovery area for an hour following surgery, and we hope to see her around 5pm after she is transferred to the hospital side of the medical center, and into her private room.

thanks for checking in...
trish really appreciated all the recent comments, cards, phone calls and visits latley. knowing that she has so many people thinking about her is really helping her get through this...

the cancer center's wireless network is currently down, so my access to the blog is limited, but ill try and keep it updated.. i have not heard from any doc or nurse in the past 2.5 hours, and dont expect to hear from anyone until she comes out of surgery..


thanks

this morning, right before we left for the hospital

surgery info...

we just found out the time for tommorrow's surgery...


check in: 11:10am
surgery: 1:10pm


surgery will be in the ambulatory surgery center located on the third floor of the cancer center, right above the ITA...


trish will be staying the night in the actual "stanford hospital" and not the cancer center, and will hopefully be home friday.

ITA, oh how we have missed thee

ahhh... our old friend
the infusion treatment area... the ITA


6 months of coming here every week, sometimes several times a week, and you really get used to it... you get to know the nurses, they get to know you..

now when we only have to swing by about once a month, its nice... but odd.
i still dont think we are use to it, but its great when the nurses stop into trish's suite to say hi and congratulate her on the news, cause they haven't seen her in a while.

nurse chris got trish going on her premeds a little before 10:00am, and she is getting her 3 week dose of herceptin right now, and that should be finished up around noon.
trish is in benadryl-la-la-land, and taking a little nap to get caught up on the sleep caden robbed her of last night.

although we haven't been upstairs to the ITA lately, we have made plenty trips to the cancer center these past few weeks..
yesterday we were back in good old Clinic F on the first floor to visit with trish's surgeon, dr. stefanie jeffrey, to go over the pre-op plan for this thursday's surgery.

as mentioned before, trish is gonna go with a single mastectomy, and remove the leve1 1 & level 2 lymph nodes. we feel this is the best bet for trish, it will allow her to heal the quicker and get on with radiation. a double at this time would mean more recovery, longer surgery, more nights in the hospital, etc...

so lefty gets to hang around for a few more months.


dr. jeffrey is currently doing a research study on identifying cancer cells and their genes in the blood, and asked if trish would like to contribute her blood to the study... trish was more than happy to do so..
while i cant explain all the specifics of the study, i can tell you when dr. jeffrey called last night, she told trish she did not find any cancer cells in her blood!!! :)


after we left the cancer center, we headed home to pick up caden and bring him to the pediatrician.. the little guy got himself his first ear infection... he has been a little grumpy, and (lack of) sleeping over the last couple nights has been an adventure.

anyhow... caden is taking his meds... mommy is taking her meds... and daddy is looking foward to that cold sierra nevada sitting in the fridge..


after the herceptin is done today, we have a 1:30pm meeting with the anesthesiologist to go over whatever it is that anesthesiologists go over with you before surgery.



anyhoooo... trish has been feeling really, really great.
her energy is coming back, her hair is coming back, her eyebrows are coming back... but the smile has always been there.

she is physically and mentally ready for surgery, and slowly but surely we are getting back to normal around here..

dr. jeffrey believes trish will be able to go home friday, so it will be a short stay (in a private room) at the hospital.
trish's out of town support staff will be rolling into town this weekend..
her sister, yvonne, will be flying in from holland..
college roommates, ginger, is flying up from LA and riley is driving down from sacramento.

trish will be in great hands..




thanks for checking in..

the plan going forward...

so we heard from trish's surgical oncologist, dr. stephanie jeffrey, last night.

as you know, dr. jeffrey, dr. carlson and dr. horst met yesterday to discuss trish's situation. since monday, the doctors have pooled their resources and discussed trish's case with other oncologists at major cancer centers around the united states.

the feedback was unanimous...

based on trish's diagnosis, age and the fact that she has the little guy at home, all the oncologists concurred they all want what is best for her long term health.

what is best is what we have know all along...
a mastectomy of her right side and removal of the first and second level lymph nodes.


trish has surgery scheduled for next thursday, a week from today. she will have a single mastectomy at that time, as well as lymph nodes removed.

5 weeks of radiation will follow a month or so later after she has had time to heal.

the reconstruction process will be begin after she has recovered from radiation.

the first step of reconstruction will be to remove her left breast, and place tissue expanders in both the right and left sides at that time.

several months later, there will be another surgery for artificial implants.


our emotions have been bounced around like ping pong balls lately, but in the end, this doesn't differ from what we had already prepared ourselves for had surgery been this past tuesday.

dr. jeffrey didn't give us any false hope, and i applaud her for thinking outside the box, and questioning "the norm".

it helps reinforce the decision we had already made, when trish's doctors take the time to think about her specific situation, and discuss it with other oncologists at other institutions to formulate plan tailored to her needs, and not come up with a plan "just because that is the way its always been done" .

although we may have wished for a different plan,
this does not change the fact that TRISH IS CANCER FREE.

surgery... postponed.

well today was interesting to say the least.


when we met with dr. jeffrey this afternoon, she questioned why she is being asked to remove the breast of a women who shows no signs of cancer in her body.

this kinda through us for a loop, cause we thought we would be discussing a double mastectomy, and how many lymph nodes would need to be removed...

but rather the day was spent discussing different approaches to trish's (possible) surgery.

as you may recall, the first time we met with dr. jeffrey, she commented that trish might not even need her surgical services because she felt nothing of concern in terms of cancer in her breast and lymph nodes.

she then ordered the pet-ct, mri, mammogram and ultrasound to see exactly how trish's body had responded to the chemo & herceptin.

with the test results coming back a couple weeks agao, we now know trish's body shows no signs of cancer. dr. jeffrey wonders if surgery is needed, and if just radiation would be sufficient.

another thought is to do a sentinel lymph node biopsy to see if there is any trace of residual cancer cells the chemo didn't kill & the tests/scans did not detect;
if there is... continue as planned with the double & lymphnodes
if there isn't... continue with just radiation


this afternoon, dr. jeffrey spoke with dr. carlson, who disagrees, and suggests a single mastectomy and a removing Level 1 & Level 2 lymph nodes.

there are enough questions in the air right now, that trish and i decided to postpone the surgery until we know a little more.

next thursday, ten days from now, is when surgery is rescheduled for, but at this time we dont know WHAT exactly that surgery may entail.


i think its a good thing that doctors are butting heads at this point. dr. jeffrey said if there was any sign of cancer that chemo didn't rectify, she would surely operate. but with trish, there is no cancer...

this goes against "traditional" approaches, as with most folks, you kinda get the chemo, radiation, surgery... that "standard" cancer trifecta.


but it does make ya think for a bit... if there is no cancer, do you need surgery?
if dr. jeffrey didn't know trish was a breast cancer survivor, and based on all her scans and tests, would a mastectomy still be a viable option?

talk about food for thought... it really gets your head spinning.


ultimately, the choice is still up to trish, but we are gonna take the next 10 days to gather some info and decide then...


it may very well be the same exact choice that we planned on taking tomorrow morning.


to help with the choice, dr. jeffrey is consulting with several colleagues tomorrow, including one a doctor at MD Anderson to gather more information of similar situations.
additionally, dr. carlson, dr. jeffrey and dr. kathleen horst, a radiation oncologist at stanford, will sit down on wednesday to discuss trish's surgery face to face.



enough questions were raised today to take a pause for thought...


we are gonna discuss it over the coming week, and re-make a tough decision.
what we do know is that we will not do anything that jeopardizes trish's health. we aren't looking for her to be a guinea pig, we have come too far for that.. but we are open to hearing different approaches, and possibly even more "current" thoughts...


as for the days other events...
our morning meeting for dr. rockson's lymphedema study went quick... no wait, and 15 minutes of measurements, and trish was done..
the radioactive dye and scan was canceled for now.



anyhow... we appreciate all those good thoughts and prayers, we just wont need them tomorrow morning..

thanks for checking in..


its now time to relax and have a frosty sierra nevada (or six)

the beginning of a hectic week...

tommorrow morning is trish's surgery for her double mastectomy.

we have decided the best course of treatment for trish is to remove both, and have tissue expanders placed AFTER radiation. this will result in one additional surgery for the tissue expanders a month or so after radiation, but we feel it will give the best results in terms of radiation effectiveness.

priority #1 is trish's long term health.

so tommorrow, we will be checking in for pre-op at 6am, with surgery beginning around 7am and scheduled for 3 hours. the doc said expect two nights in the hospital, but she might go home after 1 night, depending on how she is doing..



today we have our hands full.


at 11:00am, we have a meeting at the cancer center for a research study on lymphedema that trish will be a part of. lymphedema is a possible side affect when lymph nodes are removed. today is basically a meeting to get trish's pre-surgery baseline.


at 12:00pm, we are meeting with dr. jeffery to go over the plan for tomorrow morning's surgery.


at 2:00pm, trish is scheduled to get pumped full of some radioactive stuff


at 4:00pm, trish will have a scan done to get some pictures of her lymph node system, thus the need for the radioactive juice two hours earlier..


so... we are leaving home shortly to head to palo alto. ill try and leave some updates a little bit later..