Finished Sculpture, 2 weeks left of radiation

new port-a-cath sculpture

This week I am continuing the countdown to the end of chemo (8 days) and the start of the second annual Labor Day Weekend Artist's Studio Tour in Yakima (9 days, but different ones). The studio tour, sponsored by Pamela Searcy's Artebella Gallery, will be at my home studio, as well as 5 other studios/houses and Oak Hollow Gallery, on September 3, 4, and 5. Saturday and Sunday the tour runs 10-4, Monday 10-12. Tickets are $10 per person and can be purchased at my studio on the day of the tour or ahead of time.

detail of another new(ish) port-a-cath sculpture

Since I last posted, a week ago, I've fired and unloaded two kilns. A low-fire kiln with cone 04 glazed sculpture and a cone 6 kiln with mostly plates and mugs (images coming soon). It feels like a got a lot done, but the hard work was glazing, not loading and firing. Yesterday I took photos of all the pieces and started preparing posts about the new work.

new-ish port-a-cath sculpture

I've been feeling an increased amount of fatigue from radiation. I've also been feeling foggy, like I can't think or remember as well as usual. I think this is also from the treatments. The result has been that I can do repetitive tasks like glazing and photographing, but I've got less stamina and motivation. I also feel like my writing or planning is not as sharp as usual.

the other side of the yellow one I was working on in April

Though I have 8 days of radiation left, I've got only three of the whole breast and lymph node radiation. Next Tuesday we start on the 5 day "boost" of radiation to the tumor bed. Yesterday the radiation techs drew on me for a while after my radiation treatment. This simulation or planning appointment was to get images and make plans for how and where the boost will be delivered. I am mostly looking forward to them laying off the upper chest and armpit area.

I finished building this one back in February!

My radiation appointment went long yesterday because of both reasonable and unreasonable issues. When I first got there, I was informed it would take an extra 6-10 minutes; apparently the ambulance was late bringing someone from the hospital for their appointment. Then they delayed again to recalibrate the machine (or something). Finally I had my radiation about 15-20 minutes late, followed by the extra time for planning/drawing on me.

another view of the same one  

As I was walking out of the radiation room, dizzy from fatigue or from holding my hands above my head for so long, the nurse who usually brings me to my doctor check in on Thursdays seemed to be motioning for me to get on the scale. Since it wasn't Thursday, I walked past her. She followed me to the changing room and informed me that it was "doctor day." I reminded her that "doctor day" for me is Thursday, so she checked with someone and then confirmed that it was my doctor day regardless.

and another view

I asked if they'd moved my appointment to coincide with the planning thing, since my doctor just came into the radiation room to approve the drawings on my breast. The nurse didn't seem to know, but she took my weight and walked me to an exam room where she took my temperature, blood pressure, and pulse, and explained that everyone doing radiation needed to see the doctor every 5 days. I allowed as how Thursday was less than five days ago, but she didn't seem impressed. This is my 6th week of radiation and I've had doctors meetings on Thursdays for the past 4 weeks, but what do I know?

poster for the Studio Tour

Next she asked after my young kids. I corrected her, realizing that she had no idea who I was, but still unsure whether that was because she was confused or because she thought I was someone else. She took paper notes on my vitals and the answers to the usual questions (are you in pain? fatigue? have you had a fall?), then asked for my full name and birth date. Then she stared at the screen, hmmmed a bit, repeated my full name and informed me that I was right: it was not "doctor day" for me. I'm glad they ask my name before radiation. I'm curious how that many clues (I told her radiation was running late, I told her I didn't have a doctor's meeting, I told her why, etc), didn't trigger her to confirm my identity sooner. As to why I didn't tell her my name right away, I don't know if that's the fatigue or I was convinced by her confidence.

postcard for the studio tour

Hopefully that's the last interesting thing to happen during radiation this year. If you are in the Yakima area, I hope to see you at my studio on Labor Day weekend. If I can find the energy and motivation, I'll post more on the new work before that day.
 

Yakima Artists’ Studio Tour

The Artist's Tour poster for this year

 

Next month is the second annual Labor Day Weekend Artist's Studio Tour in Yakima. The event features 7 studios and over 30 artists at those studios. The Tour is only $10 per person and that one ticket gets you into all 7 studios anytime during the three day weekend. At the studios you can talk to artists, see their workspacee, see their work, and buy art. Some artists may even be demonstrating during the tour.

work on display in my studio for last year's tour

This is not the Tour of Arists Homes and Studios that Larson Gallery used to run in Spring. This event features working artists and their studios only (no art collections or whole homes) and also features lots of artwork you can buy and take home for your own collection. This show is sponsored by Pamela Searcy's Artebella Gallery and Pamela has done a great job of taking care of all the advertising (I was happy not to have to think much about that this year).

postcard for this year's tour

My studio was in the tour last year and I enjoyed having people visit the studio. For me, it's a nice way to show off my studio (newly remodeled in Winter 2020) and talk to art lovers about art. I enjoy doing shows, but I don't enjoy standing in the sun or transporting my work to a different location. With this tour, I can stay inside (or in the shade in my lawn) and people come to me.

works in progress for this year's tour

The past year since last year's tour has been a bit of a rollercoater (she says, downplaying the drama). I found a lump in late September, was diagnosed with agressive breast cancer in November, and have finished 20 weeks of chemo and several surgeries, plus ongoing occupational and physical therapy to prevent lymphedema and bring back full-range of motion after the surgery. By Labor Day weekend, I will have finished 32 of my 33 radiation treatments.

A piece I finished earlier this year (and showed at Larson Gallery for the student show)

Despite all that, I have spent some time in the studio. I've built quite a bit of new work that integrates port-a-caths into the design and I've even got some thrown work in progress (bowls, plates, and cancer-y mugs) from earlier in the year. I've probably only finished one sculpture since the last tour, but I have work in the kiln today and I'm hoping that my energy holds out (through at least another week or two of radiation) so that I can finish the rest before the tour.

port-a-cath bulb in progress earlier this year

Last year it was just me and my daughter (and her friends) at my house for the Tour. This year I've asked my friends Monika Lemmon and Chris Otten to also show at my house. 

Lithosphere by Monika Lemmon (you can't have this one because I own it), see more at her website

Monika is a painter and also works in painting and sculpture. She from Yakima, though she spent some time teaching out of state, and you may have seen her work at Larson Gallery, Boxx Gallery, Yakima Maker's Space/Collab Coffee or The Seasons. She has work in the Larson Gallery collection at Yakima Valley College. I used to eat lunch in a room with one of her paintings at YVC and now some of it is found in Chris Otten's office and in the new Larson Gallery.

Photograph by Chris Otten, from his Endless Horizons series, see more at his website

Chris Otten is a photographer and photography instructor at Yakima Valley College. Chris taught photography in Florida and Colorado before moving to Yakima. At YVC he teaches digital photography, digital design, and photography history classes for YVC, and this past year he was the only full-time art faculty still working after the rest of us full-timers left the state or went on medical leave. Around here, you may have seen his work at Larson Gallery, Sarah Spurgeon Gallery, or Terrain Gallery in Spokane.

Alison and her friends at last year's tour, find their work on Instagram at Dezignosaur 

Last year my daughter and her friends sold their handmade polymer clay, felted, and beaded jewelry during the tour. The plan is for them to do so again this year, though they are much busier with school stuff this year than they were in the lead-up to the 2021 show.

heart-a-cath mugs waiting for glaze

I will be right at the end of my radiation treatment when this tour takes place, so I've already let Chris and Monika know that they may have to take on the hard jobs. I've been told that I might be fatigued and I might be hurting like I hae a really bad sunburn. As of my checkup today (2 weeks in), I have some fatigue but my skin is holding up fairly well so far), but it sounds like these things are cumulative. I figure that if I'm too tired or sore, I can rest and give over more of my studio space to Monika and Chris.

postcard back, this year's tour

I'm still hoping that I'll be feeling good (or reasonably good) throughout the month and these treatments. I've got a kiln ready to unload today and I'm hoping I can get two batches of work fired before the tour. I've got sculptures in progress and some functional work that I'd like to fire to a higher temperature.

port-a-cath sculpture in progress

Besides my unknowns this year, I think this year's tour should be a strong one. We've got more artists exhibiting at various studios and hopefully folks enjoyed their experience last year and are inviting more folks to come see the studios this year. The goal is to make this an annual show and I know that I'm looking forward to doing it again next year when I'm hopefully feeling 100% in the lead up to the tour.

trifold ad for this year's tour

If you wish to buy tickets, you can buy them ahead of time from me, Chris, or Monika, or other artists. You can also simply show up at the studio that weekend and buy your ticket then. For folks who are thinking about coming on the tour, we have trifolds and postcards that I can get you. Once you buy your ticket(s), you get a nice booklet featuring artists statements and bios, photos, artist listings, and a map of participating studios. 

new abstract bulb in progress

 

I hope to see you on Labor Day weekend at my studio. Let me know if you'd like to buy tickets ahead of time, put up a poster, or if you have questions about the tour. 

First week of Radiation, plus a setback in PT

I have now completed the first full week + two days of my radiation therapy. Last Wednesday (earlier than I had expected it could happen), I had kind of a practice run, and then real radiation treatments on Thursday and Friday. This week I've had five more treatments. I have radiation daily, M-F, through the start of September. I've got six and a half weeks total, or 33 treatments. The radiation is targeting the whole breast as well as the lymph nodes in my armpit and those near my collarbone on the left side. The last week of treatments will be a boost to the area where they removed the tumor lump from my breast. 

some bulbs I've nearly finished, underglazed and now waiting for glaze

Why my treatment has to be so long

I had some trouble, and apparently keep having a bit of trouble, understanding why the treatment has to last so long. I'd read about accelerated whole breast radiation (or hypofractionated radiation therapy for breast cancer) and couldn't understand why "new guidelines" from 2018 for speeding up treatment wouldn't apply to me.  I asked my doctor last week why my treatment couldn't be sped up. She explained that my treatment couldn't be accellerated because I'd already had chemotherapy, which pacified me for a week until I started to write this post and fell down the same rabbit hole, again, when I saw the bullet list from the BreastCancer.org article that says "The decision to offer hypofractionated whole-breast irradiation should not depend on...previous chemotherapy." I reread the PubMed article (I've read a whole lot more medical research reports this year than ever before in my life!) and did, eventually figure out that my issue is the combination of lymph nodes and previous chemo. 

a detail of the underglazing process of a sculpture I'm working on

Not only is there a lot of dense information out there, and not only does breast cancer have a lot of complications and variables (hormone status, HERS2 status, nodes, size, and grade), but when I read about it, I'm not an unbiased reader. Especially in this case, I wanted to find that my treatment could be done more quickly, so I had trouble finding or understanding why it couldn't.

the sculpture with the orange underglaze layer partly removed

As my doctor originally, said, and as I finally accepted (twice), because I've already had chemotherapy, a systemic treatment that impacts the whole body, not just the breast, the increased dose of accelerated radiation risks causing scar tissue to my lymph nodes. If the cancer had never been in the lymph nodes and I'd had chemo, I could have tolerated the increased dose of radiation to just the breast that is delivered in the accelerated approach. The unspoken part of this, too, is that my lymph system is already working at a deficit because I'm missing 15 or 16 nodes (because they were removed).

the orange underglaze removed, ready for glaze

Radiation & preparation

Wednesday's practice was longer than the actual treatments, as they were checking that everything worked right, I think. The pillow thing ("cradle") they made for my arms was apparently unusually wide, as they had to kind of break off part of it to get the machine to fit on the right side. (When I walked into the room for the practice, one of the radiation techs who hadn't met me before said she was surprised I was so small given the size of the cradle). They also changed the position of my right arm from what it had been during the planning CT scan. That means that my right arm doesn't go into the molded position of the pillow. It also means that every few days, when a new person is working in the radiation room, they will tell me that my arm is in the wrong spot. I suspect it may contribute to the feeling of loosing blood flow to the fingers of my right hand.

bulbs in the kiln with the first underglaze layer or waiting for their first bisque firing

The radiation itself is pretty quick. I walk into Northstar, tell the person at the front desk (who usually already knows my name) that I don't have COVID symptoms, then walk directly into the changing area and grab a gown. The gowns are sized for people who are much taller and much larger than I am. It's unfortunate, because with how warm it has been, I don't really want extra fabric on my body, luckily they let me leave my shorts on, so I can just leave the gown wide open in back for a pleasant breeze.

I thought the gown was big on me, but then a smaller woman walked in and hers just about dragged on the floor!

Depending how early I get there, I wait next to the changing rooms for anywere from 1-10 minutes (though, honestly, the first day was the longest wait and usually if I show up early, they get me in early). Then a radiation tech comes to take me back to one of two radiation rooms. Since they make me take off my watch when I change, I'm not sure exactly how long the whole process takes, but I timed the process from watch off to watch on again after I get dressed and that was 12 minutes. In the radiation room, I lay down on the bed thing, get my arms and head positioned in the pillow depressions and the techs running the machine put a lift under my knees and a foam foot holder in place (presumably to keep me still and in the same position each time). Usually the knee holder is slightly sideways--I assume this so that I don't get too comfortable.

The cradle thing that positions my arms looks more like the "inferior vaccum bag form" on the right, though it isn't blue. Image from Smither's Medical Products.

Next they check the tattoo(s) on my side to make sure I'm positioned right. They've only adjusted me twice, which worried me at first, since it seemed too easy.  They position me using a couple of laser lines. I can see myself in the reflective glaze in the ceiling and also in the reflective part of the radiation machine. From above, the lasers form a green + across my chest and left arm and up the side of my body. They cross near my shoulder. From the side view of the reflective glass in the machine, the one laser line follows the countour of the breast being treated.

This diagram form the Mayo Clinic shows what's happening in the machine, and also gives a pretty good approximation of how I'm positioned

After checking my position based on the tattoo on my side, they have me take a breath and hold it so they can check the tattoo near my shoulder. They rub the bottom of a block thing (to warm it up, I think) that looks like an alarm clock and put it on middle just below my breasts. This block somehow tells them if I've taken and held my breath correctly. Someone says "twelve point nine" and part of the radiation machine whirrs itself over to my right side where it almost touches my elbow. This is the part where they needed to hack away part of the pillow during the practice session last Wednesday.

This picture is similar to what I experience, and shows the round part tilted to the side. I found the image on RadiationInfo.org

Every day except for the second Thursday, the sequence has been the same. They say that we are ready to start and the techs exit the room. Then someone on the intercom tells me to take a breath and hold it. The machine whirrs a bit, then stops and the tech tells me to breath. Both the bed and the other parts of the machine can move. When we start, the biggest part of the machine, a round white part roughly two and a half feet wide is looming over me at about a 45 degree angle, nearly touching my elbow and the cradle. This has a ten inch piece of glass (that I can see my body and the laser reflected in) with metal teeth things behind it. The teeth are long metal pieces with pointed ends that can open and close all together or separately. I looked it up, and this is called a collimator. As I had guessed based on watching it in action, it is used to control the shape (and size) of the radiation beam.

The collimators on the machines I use look a lot newer and more friendly than this picture from the cyclotron at University of Washington (image from Wikipedia)

Next the metal teeth-looking parts of the machine close most of the way. The teeth are behind glass and can all move together or move independently. That part of the machine starts on my right, very close to my body and face. The first breath hold is in that position and lasts about 10 seconds. Next the teeth move, then the collimator moves to be directly above me. The short breath hold is followed by two long breath holds each lasting about 20-25 seconds (as measured by my highly inconsistent counting methods). The collimator moves to my left and I don't know what it does over there because I'm required to look to the right the whole time and my reflective surface doesn't extend that far. I have another short breath hold with the machine on that side. Then it's all over, but I have to wait for the techs to lower the bed thing which has raised up while I've been prone.

How I'm handling it

After the first few times, I was worried, actually, that it was so easy. They've only corrected my breathing once (told me to let a bit of air out) and they've only adjusted my position twice. It felt too unlikely that I got myself into the exact right position on the first time every day. But I've now met with my radiation oncologist twice (last Friday and this Thursday) and she said that I was doing great with my breath hold (yes, I was complemented by a professional on my ability to breathe). 

a batch of bulbs after the first underglaze layer was fired in place, waiting for the second

Thursday I was mildly alarmed that the order of the machine's movements and the timing of my long and short breath holds was different. The technicians explained that at the end of each week they'd do something a bit different. I didn't understand it, but I was mostly just checking for them to say "oh no! we gave you somebody else's radiation today" or something, so I was happy when that didn't happen. 

the first layer of underglaze on a port-a-cath bulb

So far I don't appear to be having a skin reaction to the radiation. Everything I've read or been told by folks who've done radiation makes me think my best shot at avoiding a painful skin reaction and/or the fatigue that many people complain about is to apply lotion to the area every day, wear loose clothing that doesn't rub or constrict the area, drink plenty of water, and exercise. The nurse and doctor both said that they can't really predict if I'll have a bad reaction, but suggested those same things to try to prevent it. Apparently being on the smaller side is a potential advantage, as more breast tissue can mean a worse reaction. On the other hand, it sounds like pale and/or sensitive skin might also mean a worse reaction, so I'll just have to wait and see. Women who've had radiation say that the reaction is worse the longer the treatment goes, and mine is longer than most I've heard of.

the first layer of underglaze on the low areas of a bulb

I'm presenting all this calmly now, but last week I was nearly in tears from how worried and generally stressed out I was about starting radiation. I was disappointed that the 5-6 weeks of radiation predicted in December had become 6.5 weeks. I hadn't realized how much I was counting on more time between radiation and the start of the Fall quarter at YVC. Northstar got me in faster than I thought they'd be able to last time I posted, but the extra surgery and the recovery time after surgery extended the timeline beyond what I'd been hoping back in December or April. 

As it stands, I will be finishing radiation on September 6 (my previous estimate ws that September 7 was the earliest time possible, and I'd forgotten about the holiday). Convocation for faculty and staff at YVC starts the next week (with students returning the week after). I'm doing everything in my power to set myself up to be not fatigued (exercise) and not in pain (lotion and hydration) in the last weeks of radiation and the time right after, but I've had some setbacks on the exercise side of things. The last weeks of radiation and the weeks right after are when others tell me they had the hardest time. Worrying won't help, and I can't change the weather, so I'm trying to keep my focus on what I can do today.

interior view of my studio during the 2021 Tour of Artists' Studios

Tour of Artists' Studios over Labor Day weekend

With the assumption that I'd probably be done with radiation by then, I agreed (months ago) to have my studio on the Yakima Artists' Studio Tour over Labor Day weekend. I did this last year and I like the idea of the tour coming to my house, rather than having to bring myself somewhere else. My colleagues and friends, Chris Otten (photography instructor at YVC) and Monika Lemmon (painter, mixed media artist, and soon to be drawing instructor at YVC) will also be at my house and I've told them if I feel bad they're in charge of all the hard stuff.

sign from last year's Tour

If you would like to visit me on Labor Day, my studio will be open Saturday and Sunday from 10-4 and Monday from 10-12. Tickets are $10 each and you can purchase them from me ahead of time or when you get to the studio. You can also buy them from other artists and locations, but I make more money if you buy them from me. I am hoping to have some of my new port-a-cath mugs and bulbs and sculpture done before the show (and some bowls, too, if I really get motivated), but my studio time has been unpredictable this year and this summer.

port-a-cath and heart-a-cath mugs waiting for glaze

Physical Therapy & a little set back

I also started Physical Therapy (PT) this week, in addition to continuing my Occupational Therapy (OT). The OT (at the lymphedema clinic) is mostly focused on increasing my range of motion and preparing me for how to prevent lymphedema, as well as how to recognize the symptoms of lymphedema. I've learned and have been doing some exercises to increase range of motion in the left arm (after they cut into it and removed a bunch of lymph nodes). I've also learned and have been practicing lymphatic drain massage, which is intended to "prime" the lymphatic system and help drain lymphatic fluid away from the arm and the side of the body where the surgery was and the radiation continues to be. Radiation is (hopefully) the most taxing thing that's going to happen to the weakened lymph system on that side.

the cats know it is too hot 

The PT is also focused on increasing range of motion, as well as increasing strength. The exercises she has me doing involve a bit more of my body, with the idea that other muscles in the back, trunk and shoulder support the arm. My physical therapist also talked with me about how to adjust my position so that I don't get backaches while typing on the comptuer for a long time. My goal is to get back to regular exercise and weight lifting, but this week I had to readjust my ideas of how fast that might happen. 

My PT had me take a picture of myself at my desk. Here's what I'm doing wrong: feet aren't flat on the ground, upper arms should be parallel to my body, forearms should be supported, computer screen should be lower, back should be supported

I have radiation every day and was scheduled for OT and PT on Tuesday, but OT called and said that those three things in one day were too much, especially in combination with the high temperatures this week (highs have been 107-110 this week). So I did PT and no OT that day. PT Tuesday was mostly first-day kinds of stuff, like getting my history and checking my range of motion and posture. At this point, the history of my medical experience this year takes some time to relate. We also did a few exercises and she gave me some homework stretches.

We don't have AC or insulation upstairs, so the cats intentionally choose the hottest spots in the house

That night, Tuesday, I walked down to Davis at the end of Alison's band practice with the idea that I'd walk home with her. It was 9pm, but still 91 degrees out. I only walked two blocks, but they were late getting ou. Basically I was out in 91 degrees, no sun, for 10 minutes, including a casual walk (downhill) and standing around. But the heat bothered me so much that after 5 minutes of waiting, I started back home. My OT had told me to watch out for being outside in very hot weather for too long. I think she said above 103 for 15 minutes. This wasn't that, but I still got scared. My husband happened to be driving home right then, so he actually picked up up a block from home and drove me home!

melty warm stretches

My OT said that I could do up to 20 minutes of exercise every other day, but I needed to keep it low impact and I couldn't use weights. So Wednesday morning, following her instructions, I did a (modified) 20 minute indoor cardio workout video which seemed fairly mild compared to what I used to do. It didn't seem like a strain, but by the end of the day Wedesnday, the side of my chest under my arm had swelled a bit. It isn't clear whether the swelling was from the heat or the exercise (or the radiation), but when I saw her on Thursday, my PT suggested I reduce my activity to just 10 minutes every other day. 

Alison trying to train the cat to do indoor exercise, too

It feels very strange to do so little, especially as I've been advised that I should be exercising during radiation to ward off the fatigue. This week, there really isn't anytime when I can walk outside, let alone run (or jog). Last week I was avoiding walking between 10am and 5pm, but this week even getting up at 7am or walking after 9pm didn't work, since it never gets cool enough during that time. Maybe I could walk in the middle of the night, but I'm not sure that's a great choice in my neighborhood. Instead I've been driving to Target or Lowe's to walk inside.

the weather on Tuesday night at 9pm (91 degrees), and forecast for the week (108 on Wednesday, 110 on Thursday and Friday)

I went back for a second PT appointment on Thursday and we did more than on Tuesday, though my idea of what I "should" be able to do by now and My PT's idea of what I actually "should" be doing right now to ease myself back into my previous routine are not perfectly simpatico. She started me on an exercise machine that was a bit like a recumbent bike. There was a place for my feet and bars for my hands, though she didn't want me to use my feet. The wildest thing, to me, was that she turned the seat 90 degrees to the side, then had me sit, then turned it back to front-facing before I began. She had me gently use my arms to pump back and forth for about 2 minutes, then she turned the seat to the side again before I got up. Meanwhile, I'm thinking that last time I was on a similar machine, I did 20 minutes of intense rowing! Of course, that was way back before Covid when I used to go to the Y (without a mask).

I feel like I've been assigned the cat-level of exercise

After the rowing, we did a variety of arm exercises, while my PT corrected my positioning. I tend to arch my back backwards to get my arm up higher and I tend to lift the left shoulder. She says this is normal in folks who've had a surgery like this, as we instinctually do that to protect the shoulder. The challenge is to work against that instinct, while increasing strength and range of motion.

Another sculpture I'm hoping to have finished for the Labor Day Tour

Of course the other challenge is to be patient with the process. I still have some swelling today (three days after I first noticed it), though I've been avoiding the heat and continuing to do the lymphatic massage. It doesn't appear to be worse, but I think I'll feel better once I see my OT on Tuesday. I anticipate that I'll be gently scolded for overdoing it, but I'm hoping she'll also be able to give me a sense of how concerned I should be and if there's anything else I can do to make it reduce. The PT, on Tuesday and Thursday was very good at helping me understand better the parameters of what I am and am not allowed to do, which I appreciate very much, even if it is annoying to have these restrictions.

Surgery & Waiting on the “Tumor Board”

Surgery & Recovery

I'm feeling a bit sore, as if someone punched me under the arm, maybe with something sharp. I had my surgery Monday. Maybe I should call it surgeries, since there really were three different cuts. They took out my port, took out my tumor, and took out three lymph nodes. 

In the week before the surgery, I did a bunch of glazing and loaded a kiln

The lymph nodes/armpit area is the part that hurts. The port area (I'm calling it my portside, even though portside on a boat is apparently the left, not the rigth) is barely even sore when I touch it. I figure that was both the most supercial (as in not deep) of the procedures and they were removing something that wasn't supposed to be there in the first place and hadn't been there long.

I was hoping to get some stuff done in the studio before I wasn't able to work in the studio for a while

The lumpectomy removed the tumor from relatively deeper in my body, but that one doesn't hurt constantly, just when I touch it or something brushes against it. The cut for the sentinel node biopsy is in an awkward place, at roughly the place where my arm folds over my body. I would say it is more on my body than in my armpit, but the bruise covers more space. This one hurts or feels uncomfortable more or less constantly depending on my pain medication.

I'm glad I did so much then, because I haven't felt able to do nearly so much this week

Sean and I were at UW Medical Center Northwest all day Monday. We arrived when and where we were instructed to at 7am, but they really didn't do anything with us until nearly 8am. The only interesting thing that happened was that another man came in, apologized for not having a mask, then took one but didn't put it on and proceeded to check in without it.  A short while later, he and an employee were sitting behind me and Sean and she informed him that the multiple phone calls he missed and messages he ignored were telling him that he had COVID and couldn't come in today. Upon hearing this, Sean and I stood as one and skeddled over to the far side of the room. 

I did a bit of experimenting with glazed and unglazed sections of these port-a-cath bulbs

A few minutes before 8, a chatty woman took us from the surgery waiting area all the way through the medical center to the breast imaging area. Along the way she gave us a guided tour with far too much information, including three different explanations of where the cafeteria is and how to get there. She also pointed out the childbirth center "in case [we] need that later."

I also finished a sculpture I had started during chemo

I needed to go to the breast imaging center because they needed to put a wire locator into the tumor using the mammography machine. They had a fancy chair I sat in that pushed up against the mammography machine. Then the three women doing the procedure manipulated me into the awkward position required and they used the computer to set up a grid thing to orient the needle. 

I'm not actually supposed to be lifting, so my folks (who are visiting from out of state) helped me unload the kiln when I got back from surgery (the next day)

They first numbed the area with a couple of shots, then told me that I shouldn't feel any pain, just pressure, during the procedure. They were wrong, because it hurt quite a bit, so they added more novacaine. Of course, by then my body's panic response had set in. They were able to place the wire, but immediatley after, from my secured position, I tried to remove my cap and needed help because I was suddenly hot and the world was turning grey or black around the edges.

I took some pictures of many of the bulbs, but I am still consdering adding some glaze (the shiny stuff) to some or all of these bulbs

Here's where they broke into a well choreographed maneuver. They rolled the chair back and tipped it into a bed. The lady who had been holding my hand (and took my hat) during the procedure, held my feet up above her shoulders. Another lady fanned me with a clipboard and the third got me wet washcloths for my forehead and chest and for my neck once they started to ease me back to vertical. 

I also have these heart-port-a-cath bulbs, and more heart mugs ready to be loaded sometime

Unfortunately they still needed to finish getting the wire in the right place and taking more pictures. We did that and then they let me rest in the bed-converted chair for a second time. They helped me get dressed and asked if I wanted a wheelchair to return to the surgery waiting room. I said that I was fine without (after all, I had a similar experience during and after the mammogram that immediately followed the original biopsy in November. 

The pieces in the kiln included some newly built work getting bisqued and some pieces with just the first coat of underglaze

They decided to call for a wheelchair anyway, but I was saved from actually having to use it by the fact that the chatty lady didn't listen when they requested a wheelchair. We walked all the long way back up the stairs, over the sky bridge and through the hospital with our chatty host, but I just held onto Sean and ignored everything she said.

I also had pieces with the second coat of underglaze

We were in the surgery waiting room again by a little after 9. My surgery check-in was at 11 or 11:30, but they wouldn't let us leave. We did go for a little walk outside, and I was glad I brought a book, even if I did pretty much hate the book by the end of the day (not necessarily the book's fault). I had forgotten my phone and my kindle charger in Yakima the night before. I was actually starting to worry that forgetting those things, plus having to switch hotel rooms the night before, plus the fact that construction at the medical center meant our directions weren't quite right, plus the fact that we had such a long wait time all were bad signs leading up to surgery. Sean thought all those things going wrong would mean that the surgery would be error free.

I hope to get back to these as my arm starts to feel better

They finally took me back to the surgery prep area a bit early, I think. It felt like we'd already been waiting for eons. They didn't let Sean come until after the IV was in, which was annoying since he could have distracted me. I told her I was bad with needles, but since I was already lying down it was probably fine. While I carefully stared at the other wall, she started by telling me how thick my skin is (which I've never heard before). Once she had the needle in, she said "oh no!" which is basically the best thing someone can say to someone who has a fear of needles. She then explained that she had "blown a vein" or something like that.  I wanted to tell her that all she was allowed to say was "everything is going great" and maybe "I'm just going to do another litttle IV thing that's totally normal procedure and you don't need to worry at all."  Instead I started at the other wall and wimpered. 

My arm after I took off the cotton ball after surgery

She eventually did get an IV in, then told me to hold onto the cotton ball thing for what seemed a long time. Then Sean was allowed to come back and we got to hang out in pre-surgery for 2 or 3 hours. The neat thing was that they had this heater that had a hose that hooked up to my blanket so that my lower half was in a blow up tent of warmness. The warm air feature feels particularly good when they take away all your clothes and replace your cloth hat with a mesh hairnet (even though I'm nearly bald still), but it feels considerably less nice when they've been steam cooking your legs for several hours while you wait, motionless for surgery.  Eventually Sean shut it off for me.

the bulbs are meant to hang on the wall, but I haven't gotten the energy for wall photos yet

The surgery was scheduled to start at 12:30, but actually started about 2:30. The previous surgery had run late and until they were ready they had bascially no timeline for when it might start. I was hooked up to an IV and hanging out in my hospital bed. Sean was entertaining me. Around 12:15, our anaesthesiologist came in and informed us that she had no lab work. I have serious questions about why she'd notice this 15 minutes before surgery, but they were, with some fuss, able to get the last pre-chemo labs sent over from Yakima. 

Right now the photos are just based on how they will sit on the table

Once the surgeon was done, she came in, apologized and answered our questions. Then I got wheeled in to surgery. Our four questions were: Can we drive home tonight (because they originally wanted us to stay until Tuesday, but our hotel wasn't great). She allowed us to drive home. I asked for my port (after the surgery I wanted to take it home). She said no. I said "pretty please" she said no. Then I described my art project and she said she'd check. I woke up to find my port in a specimen cup with my things near my bed. We also asked about the possibility of another surgery (answer to follow).

My hard-won port in a specimen cup

From my perspective, the surgery was quick. My brain woke up in recovery a little while before my eyes would stay open. I woke up in pain, but the nurse next to me immediatley asked if I was in pain and gave me some painkiller which quickly made me feel better. It felt like I spent maybe 20-30 minutes in the in-between zone of waking up. Then it felt like I spent a full hour fully conscious and just waiting for a spot to open up in the second recovery area. 

The port is much simpler and a bit smaller than I realized

From Sean's perspective, they told him I was done with surgery about 4:30, told him it would take an hour or an hour and a half for me to wake up, then didn't talk to him again until 7, when they wheeled me into the second recovery area. When he came into the second recovery area, he was feeling pretty worried that something had gone wrong. He was also anxious to leave, as was I. 

I can see that my port is pictured on this brochure, but the one I made for these bulbs is based on the more visually interesting one below it.

By the time we did leave, it was 7:31. We'd been at the hospital for 12 hours and about 45 minutes. 

I also am some ways off on the size, as you can see when comparing this port and this mold

Surgery Results, Pathology, and the Tumor Board

We were told that the pathology results would be ready in 3-5 days and that we'd hear from the surgeon with those results in 5-7 days. There were two parts of the surgery whose results would only be deterimined by the pathologist after the fact. The tumor needed "clean margins" meaning that they got all the cancer out. If they didn't get it all out, they'd need to do a second surgery to get what they missed. The sentinel nodes they removed would also be tested for cancer and if they found cancer, they would need to take out more nodes with a second surgery. 

 

I do plan to make a sprig mold of the real port, but again, I'm waiting until I have more stamina

Tuesday morning I read the surgery notes in MyChart online. They indicated that they got out the clip (marker from the biopsy) in the tumor, but didn't find the marker in a lymph node. This is the same marker they couldn't find in ultrasound in February. 

During chemo I made these bulbs by impressing my plastic infusion bracelets into the wet clay. I've got so many infusion bracelets it seems like they should be useful for something 

On Thursday the pathology report showed up my MyChart. When I first read it, I focused on the fact that they had found cancer in two of the three sentinel nodes they removed. They had clear margins on the tumor, but cancer in two of the nodes. Based on my understanding from the doctor, this meant that I would need the second surgery.  

But I keep coming back to my (apparently inaccurate) port-a-cath bulbs

However, after spending some time feeling disappointed, I reread it (and discussed it with my Dad) and we realized that the nodes were negative for macrometastases and micrometastases, while two had "isolated tumor cells."  Not sure what this meant, we searched the internet and determined that it either meant a second surgery or not.

I started doing more underglaze this week, but basically exhausted myself in a much shorter time frame than expected

This morning I got a call from the surgeon and she explained the pathology report. (I was very happy she decided to call this week and not wait until next.)  The surgeon explained a bit more about the lump. They removed the original tumor, but also found DCIS (Ductal Carcinoma in Situ) which is basically pre-cancer material. They removed 23 mm of this DCIS with clean margins as well as 12mm of the tumor. I don't understand if these were connected or not.

After wearing myself out, I decided to step back and worry about finishing these later

The nodes are a "bigger question mark" according to the surgeon. She was going to ask the pathologist if she had found the clip (the marker from the biopsy) in any of the three nodes, because she couldn't find it during the surgery. 

The upshot is I've got sculpture and bulbs and mugs all waiting for me, but I'm not ready yet

But the bigger issue is that these isolated tumor cells are in a grey area. If we hadn't already done chemo, these isolated tumor cells wouldn't be a bit deal and the chemo would clean them up. But, since we already did the chemo, she's a bit concerned that they didn't go away with that neoadjudavent chemo. She is going to present my case to the tumor board next Friday. The pathologist will show slides, they'll have an answer on the clip, and they'll look for evidence of chemo working on the tumor cells. The radiation oncologist will also give her opinion as to whether radiation will be able to get rid of any isolated tumor cells in other nodes.

My folks are visiting and they and my husband are all helping me remember not to overdo it.

I'm glad that my surgeon called to help me understand, but we're essentially back to waiting for an answer until Friday. I was scared for a minute that my surgeon was going to say that I got to decide. That sounds like a lot of pressure and I'm glad the experts are going to discuss and come to concensus together.

Instead we're going for walks and I'm avoiding lifting and reaching

If they determine that I don't need the surgery, I will move on to radiation. Now we see why radiation is still so important after 20 weeks of chemo and surgery!!  Next Thursday I have a check-up at SCCA to see how I'm healing after surgery. They radiation starts anywhere from 3-12 weeks after surgery, but presumably after I'm able to lift my arm without pain.

And I'm sure I'll feel better fairly soon and be able to finish my stuff

If they determine I do need a second surgery, that will be an axillary lymph node dissection taking out 10-40 lymph nodes. This comes with a fairly high (30%) risk of lymphedema, so they also recommend a plastic surgeon reroute my lymph system at the same time. This would mean one more surgery (2-4 weeks after the first one) that will take about 3 hours. There will be more significant recovery time and that probably pushes the radiation back a bit later in the summer.

In the meantime, at least I can keep sharing in-progress photos