OT: it really focuses your attention on the important things

[Update below the fold]

My wife has this tongue-in-cheek “theory” on balance in the universe. Comes from being a physics geek I guess (yeah, we are a pair). Maybe I’ll tell the “spherical horse” joke some day again, in public.

Our opening of 2011 was, well, crappy. And thats an understatement.

We lost her father Frank to cancer. He had fought off one form, and 2 years later, it reared its ugly head. I remember packing him into the jeep early October 2010, bringing him to the hospital. He didn’t come home, and he really wanted to.

Saying this sucked doesn’t quite capture the depth, the range … But sucked it did. Affected all of our family profoundly.

Made me start considering mortality. I mean, in an abstract sense, I had before. I knew I would not be around forever. I have specific plans when I am 97, I want to see Halley’s return (yeah, I’m a physics geek) … first time, I was trudging across the NIST (then NBS) campus working on writing code for an experiment that would be famous later. I would really like to make it to at least that. And I would like my wife and daughter along with me.

This year has been bittersweet. I told you the bitter. Well, part of the bitter. The sweet has been familial and company. My daughter continues to grow … starting nearly 12 years ago, as a magnificent and terrifying creature able to fit from my hand to my elbow, now to a young lady with a formidable vocabulary, a ravenous curiosity about the world, and an intense eloquence and creativity. Yeah, all parents think this of their kids. Me too. The company has shattered all our previous records. This makes me happy.

Its the things that intrude upon that. Bitter never leaves. It just hides in the background, waiting for the moment to rear its head.

In a few hours I take my wife of 20 years to the surgeon and oncologist to discuss our options. Prognosis is excellent from all I’ve read up on DCIS, as long as we act quickly and get accurate information.

I’ve seen, first hand, with very dear friends, what can happen if something goes … horribly … horribly … wrong with this.

I know now, many people who’ve gone through this. The level of support has been profound, and we are only +17 days after the diagnosis.

There are things in life you sometimes take for granted. These are things you think will always be there. You act in ways commensurate with this view.

Now place that view under some sort of threat. Yeah, it really focuses your attention on what is important in life.

There is no way in hell I am going let this thing beat us. I have plans for my wife in 51 years. Halley’s comet returning. Gotta know Sir Issac was mostly correct. We are physics geeks after all.

One in eight women will get this type of diagnosis. I was unaware that our genetic code was so buggy as to admit this level of error … I thought the odds were a few orders of magnitude more in our favor.

More as I learn. People I know, like Rich B have already gone through this. As have many others. Maybe one of my close friends will some day write the story of his wife’s experiences … which is heading towards what looks to be a positive ending. The beginning of their experiences … not so much positive. Would make a helluva book, and the story is sufficiently insane as to have people say “I can’t f*cking believe this happened.” But thats not my story to tell, and its up to them to decide if or when to tell it.

I have a sense of the road we are now walking down. I’ll have a better sense of lay of the land in 7 hours or so. My wife’s theory on balance … lets hope that suckitude plus goodness is really a zero sum game.

Update 30-November-2011: A journey of a thousand miles begins with a step. We have just taken two steps. And we are going to keep pushing on, even if my feet are the only ones that are moving.

The sentinel node biopsy and margins are the important things.

Positive margin: in short, they take the removed tissue, and randomly sample slices for evidence of necrosis and calcification. If the locus of these positions is well defined and not near the edges of the sample, the cancer is described as having a “good” margin, and the assumption is that it is self contained. If it goes up to nearly the edge of the samples, then the margin is said to be “positive”, which unfortunately could mean some level of metastasis (spread).

The body is a remarkable mechanism, and it has a great self repair system, and a great self defense system (the immune system). Lymph nodes are part of this defensive structure. More like a filtration system. They trap foreign bodies within them. From there, the body’s immune system attempts to learn how to attack and kill the invaders.

Hey, I am NRD (Not a Real Doctor) … I don’t have an MD. I’ve found that a Ph.D. and 5 bucks will get you a Grande Mocha Latte triple shot at Starbucks. So this is a pedestrian version.

During these learning times, the lymph nodes can get inflamed. When you have a cold, the Doctor (the real ones) might check the lymph nodes in your neck for inflammation. This isn’t a sure fire way to tell if you have a cold, but it in conjunction with other tests could help illuminate what ails you.

When cancer metastasizes, in the simplest pedagogical sense, part of the tumor breaks off, and enters the blood stream. Lymph nodes will collect them. And since the body’s filtration system is so good (really it is … think about all the garbage we feed it, and it still works), the lymph nodes nearest (in the sense of blood flow) the site of the tumor are most likely to catch break away cells.

These nearest nodes are the canaries in the coal mines. They are the proverbial guards on the wall. The next line of defense.

If they have been compromised, we need to know that.

So the next important thing is the sentinel node biopsy or SLNB.

When my wife first saw the October mammogram results, we noted that the calcifications (necroses as we’ve since learned) was wide spread. Notably more than in the April mammogram.

They want to do the SLNB at the same time as the bilateral mastectomy. Aiming for some time in the next 4-6 weeks. We both seem to agree we want the biopsy done a bit sooner. A positive SLNB means more aggressive treatment. It means, in a proverbial sense, we go medieval on the cancers ass. Unfortunately, this tends to beat the crap out of the patient.

More updates when we get more information.

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