Monday, November 29, 2010

Plastic Surgeon

We saw the Plastic Surgeon at Huntsman last Tuesday.  Sorry it has taken me so long to write about it.  There are lots of details for those who are interested.  Let's just say that it wasn't what we were expecting when we went up there!

We met with Dr. Agarwol's assistant first.  She took one look at Morgan and asked her if she was going to have chemo....it was great, she couldn't even tell Morgan was 2/3rds through and wearing a wig!!  Once she found out that Morgan was having radiation after her January surgery, she said "well, radiation complicates reconstruction." (What is that supposed to mean?....not a good start to the meeting!!)

The (latest) plan is that Morgan will have a new PET Scan after chemo to see if everything responded the way it was supposed to.  Followed by a lumpectomy on January 14th.  That will take out the margins around the original tumor and include a sentinal node biopsy.  This is when they inject a type of radioactive dye in the breast to see where the fluids drain out first...under the armpit or into the nodes under the breast bone.  Usually 95% of the fluid goes out the armpit (which is why it is strange her inner nodes lit up and her armpit nodes did not.)  They may take out a node or two in the armpit while she is in there.  This will be an in and out procedure and two weeks later she can begin the six weeks of radiation.  She shouldn't have too many (if any) side affects of the radiation and her spring months will be as normal for her as possible.  Then in May, she will undergo a bi-lateral mastectomy followed by reconstruction a couple months later.  We need to make a decision on what kind of reconstruction to do, so that is why we had this meeting.

I thought it would be as simple as tissue expanders followed by implants...but that isn't one of our options.  They want to use Morgan's own tissue which would have its own blood supply...as they said "radiation plus implant is ALWAYS problematic."

1st option: Take fat and skin out of Morgan's stomach to fill in her radiated breast.  This would include needing to remove a blood vessel and reattach it to a blood vessel in her chest.  The Dr. checked and she doesn't have enough "fat" for a tummy tuck so this option is not available.

2nd option:  Same as above, except use fat and skin from her upper rear end.  This is an 8 hour surgery and would have to be done twice a couple months apart. 

3rd option:  Use the Latissimus muscle from Morgan's back.  It would stay attached to its own blood supply which would make it less complicated.  They would just wrap it around the front from the back.  (weird, I know....I hadn't heard of this before either!) It is called Latissimus Dorsi Flap if you want to learn more.

As for now, all of us (the doctors, parents, etc.) are going to meet at Huntsman on Wednesday for a final meeting before the surgery...to work out all the details.  There is SO much to this entire process!!! When you add up all the doctors, all the visits, all of the tests, every procedure, and all of the insurance and financal issues......it's like a full time job!

Many of you ask how Morgan is doing...she is handling all of this as well as can be expected.  She has felt weak and very tired....like it is all catching up with her.  I am amazed at her every day, sometimes I forget she is sick at all.  Only two more chemo treatments, tomorrow and the tuesday before Christmas.  Dr. Beck told us it would be like pregnancy and the last part would seem a lot slower than the beginning!

Don't forget to wear your pink tomorrow!!!  Thanks for all of your support...

P.S. I hear the fun run will be on December 11th now....more details are coming!!!

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