The Echocardiogram and Other Stuff

Another visit to Trident Medical Center under my belt, and another great person in their radiology department.

An echocardiogram is an ultrasound of the heart. The purpose of this test was to have a baseline, we’ll do more periodically to see if the chemo effects on my heart.

So for the echocardiogram, I only had to put the gown up top. She put the little wand over my heart, then below my heart. I had three wires attached to leads on my chest. It took about twenty minutes total. Easy peasy.

It was neat to see the pumping of my heart on the screen, hear the whoosh whoosh, and see the valves flapping. Cool stuff. I guess everything was OK, the tech said she wouldn’t let me leave if it wasn’t, but she couldn’t really say anything specific – wasn’t allowed. Which is fine, I get it. I’m sure my oncologist will tell me all about it.

In other news, chemo starts Monday!

Originally, the port placement was supposed to be Monday, but that would put off the chemo, and they’d rather do the opposite and get the chemo started ASAP.

I’m a little nervous, mostly because I’m imagine it burning through my veins or something equally as devilish. I know it won’t, but whatever. I can think what I want to think.

I believe I mentioned that the first dose will be a loading dose, so it will be a little longer than subsequent treatments. I’ll probably be there from 8:30am until 4:30pm. I have a bag I’ll be loading up with goodies to keep me (and Brad) occupied and comfortable, like a blanket and snacks. Gotta have the snacks! I’ll probably throw in a deck of cards, Phase 10, Trivial Pursuit, Monopoly. Hey, we have ALL day, we can definitely play some Monopoly!

I’ll share about the chemo on Monday or Tuesday!

Flashback: The Mammogram and Ultrasound

I had the mammogram and the first ultrasound done during the same appointment, so I’ll talk about them together. They actually took place the morning of the biopsy, even though I already posted about the biopsy. So I’m a little out of order, but we’re almost up to date so it’s all good!

When I arrived for the mammogram, I filled out the paperwork and somewhere along the way was told that mammograms weren’t as bad as they used to be and as their made out to be. I thought, “OK, cool. I wasn’t really looking forward to my boobs being smashed like a panini.”


It was TOTALLY like a panini press.

I have to give the tech credit, because she handled it—me, ha—like a pro. I don’t know that I could do that…manipulate someone else’s boobs into assorted contraptions. She was really great.

The left side wasn’t so bad. It wasn’t comfortable, but it wasn’t terrible. The right side, where JP resides, eh. Remember I mentioned the tenderness? Well, as much as JP didn’t like me being all grabby-grabby with him, he liked the panini boob press even less. He was irritated, which meant I was irritated.

So the mammogram was a lot of awkward positioning, hands, and squishing.

After that, I went for the ultrasound. Less awkward positioning, more hands, and some gel. At least it was warm.

On a different note, the facility was nice. It’s called The Breast Care Center and it was all about the ta-tas, which, I think, made it a more relaxing experience. Something about being around a bunch of female patients when having boob stuff done was better than when I had to get the MRI in a mixed gender environment.

Girl power.

Flashback: The Specialist, Another Ultrasound, and The Biopsy

Caution: Image at bottom of post. Kind of gnarly looking. No nudity, I have some modesty. (Not much left though!)


But let me back up.

“Concerning” is the term that was used to describe the images from the mammogram and ultrasound when I went to see my original doctor after the mammogram. I was immediately referred out to a specialist, a breast surgeon, who my doc/NP (Nurse J, I will call her going forward) highly recommended. I was able to be seen right away, which was amazing in and of itself considering it was a Friday and it’s damn near impossible to do anything on a Friday around Charleston.

Dr. JB (not to be confused with JP) is as fantastic as I was made to believe, and for that I am so incredibly grateful, and her office staff is wonderful. She’s so positive and she makes me feel positive, too, even though I am still not sure I truly know how I’m supposed to feel about all this.

So she did an ultrasound, and for the first time, I met JP. Stupid little black shadow that he is. He is sort of shaped like a boomerang, though not as slim, more like an elongated kidney shape? Maybe? I don’t freaking know. He’s there, let’s leave it at that.

Next up…biopsy…it seriously all happened that quickly. I was numbed up and biopsied. It only hurt a little bit, that’s the honest truth…a pinch when they injected the numbing agent…it was more the vibrations of what I knew was going on that was unnerving. Also some loud little snaps as they snatched up pieces of JP — I assume that’s what the snapping sound was. I didn’t ask. I was trying not to freak out at the needle in my boob.

So the biopsy was complete and I left Dr. JB’s with a slightly bleeding boob and lots of words of encouragement. She’s a wonderful person. She said all the right things and really didn’t give me the opportunity to feel discouraged. She told me I was going to get through this, that there was lots of support out there for me, and everything would be all right.

I believed her, still do. It’s hard not to.




This is a couple days after the biopsy. Lots of bruising and tenderness. You can see the small slash from where they went in.

The Oncologist and Treatment Plan

I met the oncologist yesterday; Dr. YB. He is wonderful. When he went over everything, he drew pictures and diagrams and dumbed everything down so I could understand the whats, hows, and whys of everything, which was refreshing because, while I know my diagnosis, I don’t really know what any of that means. So it was cool to get a visual on that.

Here’s the nitty gritty details:

Invasive Ductal Carcinoma
Estrogen positive (99%)
Progesterone positive (5%)
HER2/NEU positive (3+)

Don’t ask me to reiterate what all the doctor said…I have the visual in my head and can see and understand it, but I can’t translate it as well as he did. Haha. That information up there is how they determine the treatment, which is chemo and hormone therapy.

So scan and lab results…JP is measuring at 2.8 x 2.2 x 2.2 centimeters, which puts me at Stage IIA. There is also a suspicious node in my underarm on the right side, measuring approximately 1.1 x 0.9 x 0.8. When I have my port placed, they’re going to check that out, but it’s not going to change much in terms of the treatment if it ends up being concerning. The CT scan and the bone scan both came back clean – so hooray for that. Actually, they say “unremarkable,” which is kind of insulting, but whatever. According to my mom that’s what you want to hear…I still think of myself as pretty remarkable, though.

Now for the treatment. Chemo, obviously. And hormone blockers. And immune boosters. Quite the cocktail I’ll be receiving.

So I’m getting a port, that’ll happy on September 18th. It would probably be happening sooner, but because of Hurricane Irma shutting everything down, scheduling is all out of whack as procedures scheduled on the days offices have decided to close will need to be rescheduled and all that fun stuff. I’ll be under general anesthesia for the placement, it’ll take about an hour. It’s ultrasound guided, and this will be done by Dr. JB. While she’s in there, she’s going to ultrasound the node, and biopsy it if necessary. Again, it won’t change much in terms of the treatment plan as we’re already pretty much going balls to the wall.

I also have to have an echo cardiogram prior to starting chemo so they can get a baseline reading of my heart. Then I’ll have to go every so often to get other readings since some of the chemo drugs can cause interference with the pumping action of the heart, so they’ll monitor that closely. Also, I’ll be having ultrasounds with Dr. JB every 6-7 weeks so we can watch JP shrink!

I’ll be on 3 week cycles for chemo, a total of 6 cycles. So that’s 18 weeks total. All-in-all, the chemo/hormone stuff will last a year, but it’s chemo for the first 18 weeks, then they’ll do surgery to remove whatever is left (which may be nothing), then about 34 weeks of hormones to finish off the year. After all that is finished, I’ll still be looking at about 5 more years of some kind of preventative/maintenance therapy, but it won’t be as frequent. I’ll deal with that in a year.

So there’s herceptin, taxotere, carboplatin, and pertuzumab. I’ve linked to info pages on those drugs because, yeah…I’m not a pharmacist. That’s all administered the first day of the cycle. The very first day I get a “loading dose,” so it’s a little bit more, a little bit longer, but after that my first day of each cycle will be about 6 hours total. Lots of time for me to read, write, nap, or take up knitting. I go back the second day for pegfilgrastim, which will boost my immune system, since the first four drugs will weaken good cells, as well as the bad.

I also have a wad of prescriptions to fill. Pills for nausea (one I must take the tree days after chemo and one I take as needed), an antibiotic (to have on hand in case I have a fever and it’s the middle of the night – I won’t have to wait for it to get called in or the pharmacy to fill it), and a cream that contains lidocaine (which I’ll put over the area of the port to numb the skin about 30 minutes before I go in for chemo so the needle going in won’t hurt.

So as far as physical limitations, eating, working, etc…

I made a big deal of the potential nausea. Dr. YB was like, seriously, that’ll be the least of my worries because of all the anti-nausea meds I’ll have. He said he’d be concerned about the weakened immune system and heart stuff, and I was like…dude, I like to eat. My mom, the doctor, and the medical assistant laughed, but I was totally serious. I like to eat, I don’t want to be nauseated and not able to eat. He said I should be fine. He also said he has chemo patients who do the bridge run (which, if you’re not from the Charleston area, is a very popular 10k race). So physical activity shouldn’t be a problem, though I will have some days where I may feel like dirt and not want to do anything, and that will likely remain pretty routine with my chemo cycles. So that’s good, I like for things to be routine, even if they’re a crappy routine.

So the first day I go in for chemo will be a longer day due to the loading dose, but in general when I have day 1 of each cycle, we’re looking at about 6 hours. So where does my mind go? Yeah…I asked K, the medical assistant, a little bit about that day and she told me I could bring whatever I wanted with me (blanket, tablet, books, but not my dog – I asked). I asked how long I’d be there, she said about 6 hours. I asked if I could eat. Her and my mom laughed. Again, I was totally serious. She said I could bring food and drinks with me, run out and get something, send someone to get something, etc. So I’m all set, as long as I have access to food.

Don’t get me wrong, I know my love for food may dissipate as the treatment goes on, and I will have good days and bad days. I won’t always be Suzy Sunshine, but I’m going to embrace all the good feelings when I can. And when those good feelings include an appetite, I’m going to be ALL OVER IT.

So don’t rain on my parade, or piss in my Cheerios.

The MRI, CT Scan, and Bone Scan


What a cranky ass machine. You’d think with all the advances in modern technology, they’d find a way to make the machine a little quieter. That thing made sounds that should be only heard on train platforms and ambulances. Not quite an air horn/fog horn, but equally as alarming. Thank goodness the tech gave me ear plugs because OMG…if I hadn’t had them, I doubt I’d have hearing. It was like an error message sound on steroids, if that makes any sense at all. Like if the buzzer from the game Taboo was possessed. The occasional vibrations in the machine kind of reminded me of one of those paint mixer things in Home Depot, or an out of control printer. Maybe I’m being a little dramatic, but jeez. It was an interesting experience. I kind of expected that I’d lay down, they’d take some pictures, and voila! I didn’t expect the noise. I’m starting to reconsider the whole avoiding internet research thing so I can prepare for the next two scans.

Let me get back on track and talk about the actual process…I had to lay on a platform, face down, that had openings for where my boobs would go, then it slid inside a closed tunnel, where I rested for about 30 minutes while they got the images. I had my jeans on and a gown up top, and the tech put a blanket on top of me so I was warm. I also had to have a contrasting dye injected, so I had an IV. The tech also gave me an alert thing, kind of like the bubble you squeeze on a blood pressure cuff, to squeeze if I needed anything. I didn’t think a quieter MRI machine would count, so I didn’t use it.

Really, there isn’t much to say about this one. It was loud. I was kind of bored, and I wasn’t in a position I could comfortably nap in, if I could get passed the sound.

After the MRI I had some blood drawn, and then I was done. For now.

CT Scan

So the CT scan was much better than the MRI. For one, it was quick. The registration process took longer than the actual scan, and I was “picked up” right after I got to the waiting room from registration and immediately sent in, then apologized to for having to wait (which I assured them I didn’t have to wait since registration took for-ev-er) because they had an emergency.

I got another IV so they could inject an iodine contrasting dye. I didn’t have to undress or even take off my shoes, I just had to lower my jeans to my thighs and that was that. I was covered with a sheet and that was that.

Similar to the MRI, I had to lay on a platform, this time on my back. The CT scan looked at stuff in my abdominal area (liver, lady parts, etc.) to see if there is cancer in any of those spots. The scanner part of the machine was more like a ring, so it was very open. There wasn’t any noise, just a mechanical voice that told me when to hold my breath. The platform slid in and out of the ring a couple times, then they injected the dye. I was warned that it would feel warm, almost hot, and make me feel like I peed my pants. One of the two techs said it was sort of a warm, wet feeling. He was right, that’s exactly what it was like, like I was lying in pee. Lovely. But it was a quick feeling, over by the time I’d sat up. One more platform slide with the dye and I was done. Maybe 5 minutes total versus the 30 minutes for the MRI.

Bone Scan

Before the CT scan, I had the radioactive whatever injected into my IV. The tech who did the injection carried it in this tiny little metal lunch box looking thing. It was small, but long and narrow, with hazmat decals. I was totally singing “Spider-Jen, Spider-Jen, does whatever a spider can” in my head while I was supposed to be listening. But really, the only relevant information was that I had to come back later for the scan, and walking directions from the emergency entrance rather than the main entrance. (Which I totally didn’t remember and just parked at the main entrance. In my defense, there was NO parking spaces at the emergency entrance so I couldn’t even try to get lost.)

The injection was around 8:30/9:00, and I had to go back at noon for the actual scan. The radioactive stuff needs a few hours to go through my system and I had to drink 30+ ounces of water to help it out. I love water, I drink it every day. Tell me I have to? Ugh…water suddenly becomes my worst enemy.

Sidetrack: Every time someone talked to me (MRI, CT, Bone Scan), they ask me for my name and (almost every time) my birth date. I am seriously considering giving a wrong answer one of these times just to see what happens. But I’d need to make it creative, like Evel Knievel or Peter Parker.

Well, unfortunately no one asked my name when I returned for the bone scan so I was unable to try out one of my cool, new names. Bummer. Maybe another time.

The bone scan lasted about 25 minutes in the Nuclear Medicine room. Hehe, Nuclear Medicine. Sorry. Same sort of deal as the other imaging…lay on a platform, scoot into the machine, etc. This time I only had to remove my glasses…kept my rings on, pants on, shoes on…the whole shebang. (Note: “shebang” did not get the little red squiggly line for a spelling error, that surprised me.) Oh! And they had music on…I heard some Beatles, Journey, and more. Definitely entertaining.

So I laid down, had this velcro wrap thing placed across my ribs, set my arms down by my side on top of that, then the tech wrapped it up and over my arms and velcroed it shut so my arms wouldn’t move. It’s not as complicated as I just made it sound, I swear. And I didn’t feel restrained, there was some give. Then there was a towel wedged between my feet and a giant tourniquet/rubber band placed around my feet (flip-flops and all) to keep them steady. Again, I didn’t feel restrained, just a way to keep my feet upright and steady. (Ugh. And I had an itch on the top of my foot while the machine was scanning…talk about implementing the power of mind over matter!)

A square plate-like thing was lowered to just above my face (I assume it’s what zaps the images), where it stayed for a few minutes, then the platform slid and the thing scanned my shoulders and chest, then down, and down, and down, etc. The last part was moving back up to my head to get a scan of the side of my head, so the square plate thing turned and instead of being on top/bottom, it was right/left. Anyway, that was that! I’m kind of really curious to see the images…especially my squiggly scoliosis spine.

Proud patient moment: I was complimented by the tech on my hydration. (I managed to guzzle one big metal thermal cup of water in the two or so hours I was away, plus another half of one of those tall Arizona iced tea cans.) He said the contrast was great and they should be able to get real good images, comparing it to photocopies that are almost identical to the original, versus ones where the printer is running out of ink. So that’s cool.

And I must give a shout-out to the people in the various radiology departments of the different buildings I’ve visited over the last two weeks at Trident Health System. From the mammogram, to the ultrasound, to the MRI, the CT scan, and the bone scan…these people have been amazing. Extremely professional and friendly. When I arrived in the morning, a volunteer took me and another person from registration back to the radiology waiting room and got lost. No lie. So this nice lady in radiology came out of her office and escorted me and the other lady to the rooms we needed to be in. Super nice! And the techs were also great at doing the IVs, only one shot each time. So yeah, I have nothing but nice things to say about the gray scrub wearing staff at Trident. Kudos.

My doctors’ appointments are today, so I’ll probably post an update on all that tomorrow!