Archive for the ‘breast cancer’ Category

Update on Anna’s Post-Surgery Progress

Anna returned home last Wednesday (16 January). She’s feeling pretty good. She complains more about the itching than the pain. Anna did have to return to the hospital on Friday (18 January) because the needle that the doctors had put under her arm to collect the seroma fluid fell out. Seroma is a fluid that collects in the areas where the lymph nodes have been removed. Removal of this fluid is done for the patients comfort.

While at the hospital I also went to see a doctor about the pain I’ve had in my right elbow since July. I’ve been putting it off, because of Anna. The diagnosis is tennis elbow. Recommended treatment: Don’t use your right arm. Easier said than done; however, I’m currently wearing a brace which helps to remind me not to use my right hand/arm as much as I used to. Sadly, the doctor would like me not to use the computer for the next two months. I just smiled and said, “Sure.” Obviously with the all the writing I have to do this winter break, not using the computer is simply not an option.

Anna returned to the hospital this morning to hear the result of the lab analysis of the tissue removed during her surgery. The lab analysis found that five of the lymph nodes that doctors removed had cancer the others did not. So metastasis was fairly wide spread. Reduction on the main tumor because of the initial chemo was extremely significant. (There was a cluster of about nine smaller nodules). Before the initial chemo treatment Anna’s main tumor was nearly 5 cm in diameter. After the initial chemo, it was reduced to 1.2 cm. This bodes well for the effectiveness of her post-surgery chemo. The chemo regiment that her doctors have been using has obviously been quite effective on Anna’s cancer.

Anna’s next chemo session is next Thursday (24 January). Sadly, the hair that has been starting to grow back will once again disappear. She will have another three sessions and then her doctors will again re-assess the situations in terms of blood toxicity. As before, I suspect that Dr. Lee will push her to the edge of her endurance.

Monday, January 21st, 2013

Surgery Update

Anna’s surgery was a success, and here’s how it went:

This morning, I got a text message from the hospital at 7:59 am which informed that Anna had gone into surgery. The actual message said:

노지숙님 수술 시작합니다. 최선을 다하겠습니다.

This roughly translates as:

Roh Jisook’s surgery has started. We will do her well.

If the latter part of the message seems a bit creepy, blame the translator. I’m sure it’s an idiomatic expression and the meaning that it conveys is completely different from what the message seems to suggest in English (or at least I hope so!)

I was already awake and having a cup of coffee when the message arrived. BoA and Noah were still sleeping. I woke them about 30 minutes later after I had showered. I fed them breakfast and then we got ready to go to the hospital.

Around one in the morning, (I guess she couldn’t sleep) Anna sent a long text message that consisted of an itemized list of what she wanted us to bring. BoA and I did our best to find the requested items such as a hot pack, mandarin oranges, and a pillow.

We started off to the hospital around 10 and arrived by 11. Anna told us to go to the surgical theater on the third floor. When we got there we quickly learned that there were 3 surgical theaters on the third floor each with multiple operating rooms. After scouting around we not only located Anna’s surgical theater and her name promptly displayed on a TV screen but we also ran into a couple of Anna’s friends, 젤뚜루다 and 경아.  젤뚜루다 is a women who we originally met in Samcheok on the East Sea;  Samcheok is the place we’ve gone every summer since 2004 but we did not go this summer because of Anna’s breast cancer, so젤뚜루다 came to see Anna.  경아 is someone we have known since 2005 when we used to live at Woobang Apt.

At 12:50 pm I received another text message this one saying that Anna’s surgery was finished. The TV screen was updated a few minutes later. I kind of liked the fact that my phone got a message before the TV was updated.

Anna, however, wasn’t wheeled out of the operating theater for another 45 minutes, because they took her to a recovery area where they could observe her until the  anesthesia wore off.

Then at 1:35 pm Anna was wheeled out and when I asked her how she felt, she smiled and said, “I feel good! It doesn’t even feel like I got surgery!” Her eyes were completely dilated, she wore a big shining smile, her words were also a bit slurred and she giggled. (Anna doesn’t giggle).

I looked at her and I said, “I bet you do. The drugs they got you on would make anything feel wonderful.”

We followed the nurse and the attendant up to Anna’s room on the sixth floor (room 77 for those of you keeping score at home) and stuck around for about an hour. That’s when the nurse kind of shooed us off. We were actually getting ready to leave anyway, because I didn’t want Noah to miss his Taekwondo class. He’s been acting up lately, so I’d like to disrupt his schedule as little as possible while Anna is in the hospital.

Here are a couple of pictures. Anna after the surgery:

 

 

 

 

 

 

 

 

 

 

 

Noah getting ready for Taekwondo:

 

Thursday, January 10th, 2013

Updating the update

Thursday, 6 December, 2012

Since my last post updating Anna’s progress, there have been some significant and positive changes.

First, Anna’s doctor has made a change in her schedule. He examined her on Saturday after Anna had finished her scheduled chemo treatment. This was suppose to be the last chemo treatment before Anna had surgery, but Anna said that during the examination her doctor became excited (sic!).  These are Anna’s words. Personally I can’t imagine her very staid, and even-keeled doctor getting excited, but anyhow… During the examination of her left breast and lymph nodes, he noticed a significant reduction in the size of the cancerous masses.

Anna said he was excited because this change had occurred in the course of the last two week cycle. Up until this examination, Anna had only described his opinion of her progress as being cautiously optimistic.  As we have both read on the internet, chemo doesn’t work for everyone the same way, so there is a bit of craftsmanship to the science involved in the administration of the chemo regimens that doctors prescribe to their patients. But now that Anna’s body seems to be responding very well to the current regiment, the doctor thinks it would be best to extend the current cycle for three more sessions to see if there is further reduction in the masses and more importantly annihilation of any metastasized cells in her body. This will push Anna’s surgery into February rather than the end of December.

Anna also had a chance to talk with her radiologist. It seems that Anna and the radiologist share a connection; that is,  Anna’s mother and the radiologist’s mother were school friends back when they were growing up in Incheon. These kinds of connections are very important in Korean society, and consequently the radiologist took a more detailed and careful look at Anna’s case and gave Anna a call on Tuesday. The radiologist described Anna’s breast cancer as resembling a bunch of grapes, with the largest number of masses in the breast itself and fewer clusters spreading through the lymph nodes from the breast to just under the  left underarm. Neither Anna nor I were aware that her cancer was grape-like, I think both of us envisioned it as one large tumor in the breast and smaller secondary tumor near the underarm.

In other news, the end of the school year is quickly approaching and that means Anna is busy filling out application forms for next semester. These applications are for  Noah so he can enter the lotteries that many of the best  kindergartens in our area use to select incoming students.  Since we have three children and are labeled a “multicultural family” we often have better odds at securing these coveted spots than your average Korean family with a single child.

Anna spent the morning filling out the applications and now it is time to run around to several schools, drop off our applications, the associated paperwork, and the obligatory “here’s my foreigner” that is required when one claims to be a multicultural family.

Korean spouse: “Here’s my foreigner.”
Foreign spouse squeaks, “Hi.”
School official looks foreign spouse over critically to be sure that he/she is really non-Korean.

Really, it’s gonna be the best part of the whole afternoon.

Thursday, December 6th, 2012

End of November Update

Friday, Novenber 30th

Anna is in the hospital for her last Chemo treatment before her surgery. She has now completed two cycles of Chemo. She was supposed to go in yesterday for her treatment, but she wasn’t feeling well, so she gave herself an extra day. She will be released from the hospital either Saturday evening or Sunday morning.

After her release she will have two weeks to recover and then she will do another round of tests to ascertain the effectiveness of current treatments. The following week (December 17-21), is the week her doctor believes he will schedule her for surgery. I’m hoping her surgery happens closer to the 17th rather than the 21st, so that we will be able to have Christmas with her in her hospital room.

In other news, Noah completed her first week at a new Taekwondo school. He seems to be enjoying it. He tried to do Taekwondo this summer, but he just wasn’t ready. Oh, he wanted to do it, but he just couldn’t sit, wait and listen long enough to be able to learn what the sabunim (master) was teaching. He’s doing better now. He’s better able to control his impulses and to listen and follow along.

Noah uses the “school dollars” to buy items at the school store. 17 November, 2012

On Saturday the 17th of November, Noah had an open-house at his daycare. The open-house was organized around  five different situations: school store, school restaurant, performance, robotics workshop, and sports competition. During the performance, Noah and his classmates performed an English song about brushing their teeth.  The costums they had the kids wear are clownishly funny. Sadly, Anna missed this performance because she was again in the hospital receiving Chemo, but BoA and I both shot video.

Here’s the video I took of his performance. (Quality warning – this is a video taken on a smart phone, so don’t be expecting Disney like sound and special affects. However, google/youtube were very kind. They informed me that they had detected some unsteadiness in my video and they could run an anti-shaking logarithm on the video I uploaded. I agreed, so it shouldn’t be too bad, or so we hope.)

BoA has a video of me doing a tug-of-war against some of the other parents. It’s me and two other mothers against a father and these two other mothers. We smoke them, and it kind of funny how serious the women that I’m teamed up with are. They insist that I take off my socks so that I’d have better traction on the linoleum floor. Unfortunately I can’t seem to get the video off BoA’s phone, I keep getting some error message saying that the device is not connected to my computer. I will try to find a micro SD card and save the video to the  card, then transfer it to my computer so I can upload it to youtube.

Grr. I suspect, Andy took all the spare micro SD cards for his Nintendo DS. Don’t worry. I’ll figure something out; just check back for an update.

Friday, November 30th, 2012

End of September through mid-October Update

Anna has completed the first stage in her battle against breast cancer. She has fought through three intensive chemo therapy treatments that have left her weak, nauseous, and eventually sick and feverish from her collapsed immune system.

Not suprisingly, during this cycle of treatment we have had our highs and lows. Especially this past week, Anna has been feeling really good, because she was given an extra week to recover from her chemo while the doctors analyzed her progress. In fact, last Friday, Anna was feeling so good that she opted to take Noah to the park for the day rather than send him to day care. This “mommy time” was definitely something that he needed, because he has on several occasions expressed his concern that he doesn’t think mommy is getting better and has wondered if she is going to die.

Of course, sickness as defined by a four year-old is something that puts you down for a day or two at most and then it’s gone, so he can’t understand why mommy’s been sick for three months and hasn’t gotten better.

We have also had our lows. About a week and a half ago, while Anna was punishing/exterminating a mosquito for daring to drink her blood, she managed to break the middle finger on her left hand. Depending on your point of view (human vs. mosquito) this news will come as either ironic or poetic. Here’s a picture of Anna in her claw like splint.

At the restaurant with Anna and her broken finger.

Yesterday was Anna’s big consultation day. She went to see her doctor to get the low-down regarding her progress in her breast cancer treatment cycle.

The report form Anna’s doctor was mostly positive. He was pleased with the success that the chemo had had on the metastasization in her lymph nodes. The spreading in the lymph system was fairly advanced, but it’s now been reduced to one main area. However, the doctor was somewhat disappointed with the chemo’s affect on the tumor itself. Anna only had a 1 cm reduction in its mass. It’s probably for this reason that Anna’s doctor is recommending a change in the toxic cocktail that will be administered to her on Thursday. (For a list of toxic cocktails or chemotherapy regimens used in treatment of different kinds of cancers see this link).

The regimen that Anna had been receiving included the following products: Adriamycin and Toxitel. The last is a Korean brand name of most likely a doxil/taxol based chemo product, but my inability to understand medical websites in Korean has thwarted my research. They are switching out the Toxitel, so her new treatment will consist of cyclophosphamide, Adriamycin and Fluorouracil (also known as 5FU). This new combination of drugs is most commonly referred to as CAF chemotherapy.

The doctor did raise one point of concern. He said that the PET scan revealed a spot on Anna’s lung. He said that the PET specialist believed that it wasn’t cancer, but was most likely scar tissue from an infection. Anna’s doctor, however, is fairly cautious and drew her attention to the spot because it will be something he will be watching in the coming months.

Wednesday, October 17th, 2012

Anna’s Return

Anna finally made it home on Friday, August 24th. The doctor released her because her fever was gone and her white cell count looked good. She arrived that Friday afternoon with more stuff than she initially brought to the hospital. How that is even possible, I’m not quite sure. I guess humans are simply magnets for stuff.

Not surprisingly, Anna and BoA were running late. Perhaps it was the accumulation of stuff that delayed her or perhaps it was the head shaving because her hair was falling out in clumps. In any case, Anna and BoA arrived much later than I anticipated. This made BoA late for her dentist appointment, and it also made it impossible for me to pick Noah up from his daycare.

Anna was annoyed by this and she snappishly said I should have asked Brandon, whose daughter goes to the same daycare, to pick up Noah up. I let the comment go, because if doctors were pouring a couple of hundred toxic chemicals into me, I’d probably be a little snappish as well.

Justly or unjustly this forced Anna to go to the daycare and pick up Noah while I went with BoA to the dentist. Anna was annoyed at me for not thinking ahead. I found her annoyance a bit off-base since I call her a noon to remind her of the afternoon schedule. If she was annoyed that I hadn’t known she was going to be late even though I reminded her of the afternoon schedule, then I guess I can accept the fact that I am not endowed with the gift of prophecy. Personally I saw Anna having to pick up Noah as karma; that is, the price Anna had to pay for being behind schedule.

Originally written August 25th

BoA’s video of Anna’s shearing

movie

Thursday, September 6th, 2012

What’s going on

Yesterday was my birthday. It was also VJ-Day or as they call it in Korea: “Liberation Day.” To everyone who sent me birthday wishes via facebook and/or email, “Thank you. I really appreciate it. I’m a youthful 29 with 16 years of experience!

This was a photo I took from the ridge above the beach in 2010. We usually stay to the southern part of the beach because the northern end of the beach has a pretty strong rip tide.

This will be the first time since 2004 that we won’t be at the beach for my birthday. We usually go to Yonghwa Beach in Samcheok. Of course, there is a very good reason for this. Anna, my wife, has been diagnosed with breast cancer. We ended up celebrating my birthday in the hospital. We had the cake and the candles, Noah serenande’d me with the Birthday song, but we couldn’t lite the candles because a women next to us was on oxygen.

Anna discovered the lump about month ago. It must have been around the 16th of July. She, of course, showed it to me and I told to get it checked out. So, she went to a local clinic that gives mammograms for free. They confirmed that the lump looked suspicious and urged her to see a specialist at a local hospital. Anna scheduled an appointment at a local hospital and went to see the doctor. He determined that Anna needed a biopsy. Anna had the biopsy on July 23rd and we got the results back on July 30th.

The biopsy confirmed that Anna has an invasive ductal carcinoma, histologic grade 2/3, nuclear grade 2/3 and a metastatic carcinoma in the lymph node in her under arm. The good news is that most breast cancers are invasive ductal carcinomas, so it is treatable. With cancer, however, it is always better to catch it before it metastasizes and this is why Anna had the bone scan and full body PET/CT done. Both of those came back clean.

We went to get a second opinion from an American-trained doctor in Hannam-dong. Hannam-dong is near the UN Village and many of the Ambassadorial residences, so he is well known for handling breast cancer cases among the foreign-service community here in Seoul.

Doctor Lee, the doctor who is well known in the Ambassadorial community, had Anna do additional tests and he determined that Anna has late stage 3 breast cancer. The initial mass is over 5cm and it has metastasized to the lymph system. The spreading of the cancer into the lymph system is fairly advanced, so the doctor recommended that Anna begin chemo immediately.

Although the spread of the cancer is isolated to the lymph system, the doctor wants to treat this aggressively, hence the immediate chemo. There are several benefits to having chemo before surgery. First it may help shrink the tumor so less of the breast needs to be taken, although the doctor will probably recommend that Anna have the whole breast removed, just to be safe. Second it immediately starts the process of dealing with the metastasized cells. With cancer, it’s the spreading that is more serious than the initial tumor.

Anna started her chemo therapy last week. The chemo has really kicked Anna’s butt. It has sapped all her energy and has done quite a number on her stomach. She hasn’t vomited that often, but she has felt pretty nauseous.

Anna will receive six chemo treatments over the next six weeks. After this initial treatment, the doctor will re-assess the situation; however, the most likely outcome will be surgery to remove what remains of the initial cancerous mass sometime in October. After surgery, the doctor will again assess the situation. He will either recommend additional chemo or radiological treatment to clean up whatever cancerous materials remain.

Obviously this second assessment of Anna’s situation is more severe than the initial assessment. The doctor suspects that poor calibration of initial chest MRI and PET/CT scans generated poor data. And it is the data from which a doctor makes his/her diagnosis.

Anna returned to the hospital on the 14th of August for a blood test and the doctor has decided to keep her overnight for observation. Anna was kept for several reason. First her white blood cell count had dropped dramatically, second her nausea was worse than the doctor anticipated and she has lost 4 kg in one week of chemo. We visited Anna yesterday and they were pumping her full of both clear and colored liquids.  It was a veritable rainbow of fluids.

BoA returned from her trip to Thailand, Vietnam, and Cambodia the night Anna returned to the hospital. Anna’s unexpected hospitalization resulted in me being unable to go get BoA at the airport.  I had to stay with Noah. Luckily, because her school group arrived late,  her teachers had planned to stay in a hotel near the airport, so BoA was able to stay with them and then she took public transit  home the next morning.

Our phone conversation must have been pretty shocking.

BoA: “Daddy where are you?”
Me: “I’m at home.”
BoA: “Didn’t you know I was arriving today?”
Me: “Yes, but I thought Anna had Kakoa Talked your teachers.”
BoA: “Why?”
Me: “Mommy is in the hospital and I have to stay with Noah.”
BoA: “Why?”
Me: “Mommy has cancer.”
BoA: <fast and short breathes>
Me: “She’s OK, but the doctor wants to watch her.”
BoA: “Wait. I’ll call back.”

We decided to wait and tell her about Anna’s diagnosis when she got back from her trip, but we hadn’t intended that we would end up telling her over the phone as soon as she stepped off the plane.  She was aware that Anna had a biopsy, because she went with Anna to the hospital that day, but she left before we got the results back.

We’ll be heading back to the hospital again today. Anna probably won’t be released until her white cell count ticks back up enough so that she no longer at risk of infection.

Thursday, August 16th, 2012