Serenity for Surgery

Surgery. The word seems to terrify a lot of people but I’m fascinated, kind of like River Tam reading Shepherd Book’s book. I tried to get them to agree to take pictures during the procedure but haven’t had any luck with that so far. I asked if I could stay awake and watch but that is apparently not an option either. They tell me there are a mix of privacy, lawsuit, and infection concerns plus they don’t want to distract the surgeon. Sigh. I bet Dr. Simon Tam would take pics during surgery if I asked… at least if I looked like Kaylee or Inara.

Friday I am having a lumpectomy, also known as breast conservation surgery. From a clinical perspective they are simply removing what is estimated to be a 1.3cm tumor and 1-2 lymph nodes through a small incision (maybe two incisions) that is expected to heal with little scarring. I expect Dr. Szentes to have the mad piloting skills of Wash and the brash, confident command of Captain Mal as he operates. Or even better, the mechanical skills of Kaylee. It’s outpatient surgery and I will go home within a few hours of the end of surgery. In about 3-5 days I get pathology results back to confirm that they got the entire tumor and that it doesn’t appear to have spread like Jayne on a drunken spree with Vera. Given the early detection, low grade, and small size of the tumor they are pretty confident it hasn’t spread. The bigger concern is whether I get another in the future. My mom had breast cancer twice and the second one killed her. However, treatment in the 1990s when she got sick and treatment and screening now are very different. they will prescribe Tamoxifen and I may take other steps to reduce my estrogen exposure. No matter how my BRCA results turn out (genetic testing is due back around September 13) I will be on an every 6 months screening schedule, alternating MRIs and mammograms, for the foreseeable future. With that level of “enhanced screening” my survival rate from breast cancer is actually higher than the general population, certainly higher than if I ran into a bunch of Reavers. So ladies (and high risk men!) don’t put off your mammograms and get to know your own boobs!

Everyone else seems more concerned about this surgery than I am. I look at it as an inconvenience that will make me uncomfortable for a few days. I’m grateful they caught the cancer early, it’s non-aggressive, and I have a clear, relatively easy treatment plan. The advances they’ve made in surgery (they take only a small margin around the tumor in most non-aggressive cases) and radiation (very targeted and much less troublesome than chemo) are remarkable. I’ve asked a ton of questions and explored all sorts of options such as new types of genetic testing on tumors (EXON 7 testing for example is too new and unproven and other genetic markers in the tumor would prove the same thing) and bio-preserving my tumor for research (Boise has a bio research facility and it looks likely I will be able to participate). I am very lucky to have a nurse navigator assigned by St. Luke’s to help answer all my questions, track down providers, and help me through any sort of concerns I have. She’s very no-nonsense like Zoe and helpful like Shepherd Book.

In the meantime I am enjoying my birthday (it’s today but I had a fun costume party at my house Sunday night with many great friends) and my vacation (tubing the Boise River, multiple movies, friends visiting from Phoenix, walking the greenbelt, great food and wine). I wish I could visit Jaynestown too but that will have to wait a few hundred years. I’ll take a couple of days off after the surgery; more to make sure I’m relaxed and caught up on personal things than because I expect to truly need it for recovery. It will be about a month or so before I start radiation, then we’ll be on to the enhanced screening and I’ll continue to get on with my life. This surgery and the cancer is just a small bump in the road and I’m looking forward to moving on past it so I can live long and prosper. The future is looking Shiny because no power in the ‘verse can stop me! And I definitely aim to misbehave because you can’t take the sky from me!