St Croix River Road Ramblings

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Sunday, March 10, 2013

Surgery Monday

Update 8:00 Am Tuesday   Other than needing some sleep, things appear to be going fine.   The bleeding stopped; she is feeling OK and says she will sleep all morning to catch up.  Still is likely to come home this evening. In a day or two we will get the results from the pathology lab to find out if there was any remaining cancer in the breast and lymph tissues. The surgeon and initial lab report said none--but a more careful look is being done.
   I have been trying to understand the problem with her swollen left arm and hand--which we thought at first was due to an injection of MRI contrast fluid that missed the vein--but appears to be something else.   Then we thought that it was lymphedema--problem with the lymph system draining fluids in the arm and hand.  However it has not been responding to lymphedema treatment very well.  
    Blood tests showing some extra antibodies seem to say that what is happening is a localized scleroderma--an autoimmune disease where your immune system makes antibodies that attack your own tissue (yes--that is what I have with Myasthenia Gravis)  except Margo's is attacking just some of the arm tissue.   If that is the case, she too may end up taking prednisone or something similar to improve the arm and hand.   That  treatment will come after cancer treatment is finished.  In the meantime she has her hand and arm tightly wrapped all of the time to try to keep the internal pressure in the arm/hand from swelling the skin too much.  Scleroderma, like most autoimmune diseases, has no cure, just treatment.   However, that seems to work for many folks. 
   It appears that the chemo or the cancer or maybe the MRI contrast fluid may have activated Margo's immune system to produce the antibodies that are causing the problem (if this is really what is wrong).  Our immune system is always on the lookout for new challenges to our health--and mostly does a great job of identifying the bug and creating new antibodies to get rid of it--however, there are times when it starts production of a new antibody that is self-destructive.  
    Scientists have identified about 100 autoimmune disease and think there are at least another 40 that are likely.  About 25 million Americans suffer from them.  Many have only been identified in the last few decades.   Treatment is quite standard--take something to lower the immune system overall. 

   As they say, when it rains it pours!

Update 1:30 AM Tuesday
At 1:30 Margo was out of surgery.  The blood was drained and no blood vessel was bleeding, so everything appears to be OK.   The surgeon said that if Margo feels OK, she still may go home late Tuesday.  The surgeon said that part of the reason for sending folks home from the hospital soon is that patients in hospitals are exposed to more infection risks than at home.  It appears that everything is OK and this was a minor problem--but needed to be checked out.  

Update 11 pm Margo went back to surgery.  She had two drain tubes left in to allow blood and fluids to drain out.  They were still draining blood this evening and a little swelling was occurring in the area of the surgery--what the doctor said was a hematoma.  The surgery is to drain the blood and see if there is a blood vessel that needs closing.  Margo was alert and doing OK otherwise.  In about 2 hours we should see her back from surgery.  

Update:  1:40 Margo is done with surgery and in her room, alert and looking fine.  The surgeon said things went well--and that it appears that the chemo had gotten rid of the cancer.  Tissues are being sent to pathology to check for cancer cells.  Everything seems to have gone as planned with no problems.   Probably will go home tomorrow evening. 

Update 11:10 AM  operation is mostly over and at the "stitching up" level.  So likely 1:30 to room Methodist 6th floor room 6-415.  Expecting a call from the surgeon with the "results" soon. 

Update: 9:25 AM Monday.  We drove into Rochester through the 5 inches of new snow and got to Methodist Hospital for checkin at 5:30.  Spent an hour in preparations before giving Margo a hug and sending her off to surgery prep at about 7:00am and then Scott and I had breakfast at Pannekoeken across the street.  At 8:20 she went to the surgery room and at 9:06 surgery began.   
 There is a big TV screen with each patient listed and the status, just like an airport flight schedule.   Surgery is to last 1.5-2 hours, with 2 hours in recovery and then to 6th floor to a room.   Probably an overnight stay and released late Tuesday. 
  I have my laptop to take advantage of the free WiFi here.  Margo has been handling the whole cancer process quite well.
 Margo reports for surgery Monday 5:45 to Methodist Hospital, Mayo Clinic in Rochester MN.  She will have the left breast and nearby lymph nodes removed. She should be back in her room by about noon.  I will update the blog when she is back.
    Margo has been doing some winter plantings!

Geranium seedlings   -- very tiny seeds growing plants
about 1 out of 5 seeds sprouted--purchased at Menards

We forced spring bulbs --Nov - Feb in the refrigerator
potted Feb 1, and blooming now.  About a dozen pots
shared with our neighbors and relatives

Yellow pear tomato plants 

The basement photo darkroom is now Margo's plant starting area

A mix of ice snow and water after Saturday's rain and warm temps