Jacki

Since I've had 3 scheduled blocks of time with Jacki, you'd think there would be at least one post about her, here. And you'd be right. To think that.

I have no reason, no excuse, as to why there has not yet been a post entitled 'Jacki' and perhaps even a 'Jacki II',  and 'Jacki the 3rd'. I'm just getting around to it now, even though I met Jacki TWO months ago. That makes me even more behind, if you're keeping track, as I am.

I met Jacki on my second visit to my surgeon's office. With diagnosis confirmed, on the morning of April 19th, Marc and I met first with the surgeon. She provided us with the pathology report of the tumour, all good from her perspective, laid out the  surgical options, which were lumpectomy or mastectomy -- no greater success with one than the other, discussed the medical and radiation dynamics of the treatment, and then told us we'd next be meeting with Jacki. (In looking back over previous posts, I realize that I didn't really dedicate a post to this appointment. I think it's an important missing bit of information that I should make sure I add at some point, both for myself and anyone else following along. The appointment wasn't as rushed as I might have made it sound -- just want to stay on the Jacki track)

While Marc was comfortable talking to the surgeon about the options she was presenting -- I mean after all, its science -- he didn't fare as well with Jacki.

I'm guessing Jacki's a nurse, nurse practitioner, I'm not sure. I feel that by asking I'm questioning their ability and qualifications, when in fact I'm just being nosy! Jacki's job that day was to educate me about lymphedema and its risks and prevention. With the sentinel node biopsy, the lymphatic system would be disrupted and possibly not function properly if I didn't take added precautions with my left arm and hand. No more vein puncture or blood pressure. Care in not overloading that side, with both weight and/or activity, not easy as I'm left handed. And an overall increased awareness of my hand and arm. Staying on top of any changes.

Lymphedema is an unusual accumulation of lymph fluid in the tissues of the arms or legs of a patient due to a malfunction of, or injury to, the lymphatic system. Jacki explained how we would measure my 'normal' prior to surgery, using some fabulous new technology, and I would be monitored for the 2-3 years following surgery, when my risk would be greatest.

She gave me a brochure to add to my beginning-to-bulge folder of cancer stuff. For education purposes, and perhaps as motivation to stay on top of it, there were photographs of the various stages of lymphedema. That was a little too much for Marc. When I looked at him, he had turned a greyer shade of grey. I patted him on his leg and assured him I'd get us through this. And we both laughed! Cuz watching loved ones in pain and suffering isn't easy, and that's the toughest part for Marc in all of this. I know he helps in other ways. We all have our strengths and weaknesses. And I'm lucky enough to have a variety of supportive family and friends, with a variety of strengths to offer. I'm covered in so many ways.

Back to Jacki. Jacki's very matter of fact, planning her role in all of this, for the next 3 or so years of my future. Its was very reassuring, way back there at the beginning, to hear her talk that way.

Jacki's relaxed, easy going. You never feel rushed with her. She likes to talk. And, since I also like to talk, I also noticed that she's good listener. She encourages questions and takes the time to cover anything you want to know. Her voice is both distinctive and relaxing. Familiar and soothing. You feel like she gives you as much time as you need. And like all of those amazing women at the breast centre, you feel better and so much more confident after spending time with her.

That was important at the beginning. Still is, but even more important then. So I looked forward to my appointment a few days later, to do the baseline reading for monitoring my lymphatic system. (I am SO not the science person and I apologize to those who are, those in health care and especially those I'm writing about! This is for me and those who dare to read it. And those who know me are generally aware of my limitations when it comes to science. But if anyone would like to support my posts with accurate information, links, that sort of thing, feel free!)

I had to remove my shoes and all jewelry. That wedding band is always difficult to remove, but it had to go too. I had to lay still for several minutes, with things hooked up to various parts (can't even remember which parts) and think of something that would always make me happy, and thus, stress free. I chose to think about tucking Gaby into her bed. When she was younger, I would always lay down with her. As she gets older, I don't lay down with her as often, or for as long, anymore. Mostly because she tends to take a LONG time to get ready for bed. I'm amazed at how we can always get to soccer games and practices on time, but bedtime is ALWAYS late. Late or not, a few minutes laying down with Gaby at the end of the day is always a peaceful time. And often very entertaining!

Once the test was complete, we spent quite a while chatting. Again. She spoke of keeping an upbeat and positive attitude and atmosphere during whatever treatments I was facing. A big proponent of aromatherary, as am I, she suggested orange, lavender, and something else I can't recall and will have to ask about again. For energy. We use alot of lavender around here, for relaxing. Candles, oils, pillow sprays and lotions. I've also used eucalyptus for energy. 

She's a wealth of information and open to sharing it. When I call my surgeon's office I always hope she'll answer. Not that the other people who might answer aren't kind and helpful, because they are. Jacki's just that something extra special.

I had my third official appointment with Jacki last week, for my BRCA testing. Genetic testing for the breast cancer gene.  In her official capacity, she had to explain the test and all of the ins and outs associated with it, including the health insurance aspect. Of course. The fact that the company doing the test might be calling to discuss what might or might not be covered by insurance. (that's another post -- insurance companies being a PITA when you're fighting to get better. That really sucks!) The implications of the results.

Then the fun part. We got to hit the head together, where I swirled scope around my mouth, three times, for fifteen seconds each time and with specific instructions as to how and where in my mouth I was swishing. After the fifteen seconds I would spit into a vial (not unlike a pee cup!) making sure I got that last bit of residue. Now Jacki's done this before and told me that she knew from experience not to look into the mirror or make eye contact.  Apparently someone did this and spit all over the mirror. I could see that happening! So I didn't look at Jacki or myself during the process. And we got through it.

There have been a lot of surprises, a lot of pleasant surprises, and  a lot more laughs than I would ever have expected in this battle. And a long growing list of amazing people to share this with. Add Jacki to that list.

Richard

Ever since I walked out the door after spending about an hour with Richard, I've wanted to write about him here. This reinforces the thought that I should write fresh. Oh I went on and on about him in my head as I was driving home, but here it is, almost 4 weeks later and I'm finally dedicating that post to yet another amazing human being I've had the good fortune of encountering since this battle to defeat cancer began.

Richard's name on his card has some fancy initials after his name. LPT. Licenced Physical Therapist. Makes sense. CCT. That one's tougher. Something to do with cancer? Maybe. But even a google search couldn't definitively clear this up. It's obviously nothing to do with Cobb Country or combat control. I'll have to inquire further.

But nothing on his card could have prepared me for the uplifting hour I spent with Richard.

I don't consider myself a negative person and don't feel I need others to buoy me, to maintain a positive outlook. Glass half full kind of girl, that's what I am. But I have to tell you, encountering similar minded folks during this battle is not only refreshing, but essential. You can't think any other way when waging a battle against cancer. And if you're lucky enough to have a health care professional like Richard on your team, you won't.

Upon leaving my appointment with him, he had asked me to call my surgeon's office, to let them know I had been seen by him. It was their referral that led me there. Dialing at a red light, I reached Jacki at my surgeon's office. (she deserves a post of her own as well, and has gotten one, in my head, many times!) I was glad to reach Jacki cuz I just knew she would get it. She would understand my elation. After offering the obligatory confirmation of my consult, I had to let her know how appreciative I was.

She wasn't surprised. More shrink than PT, Richard spent more time getting into my head. While his job is to make sure I keep my body on the right physical track during my course of treatment, he's obviously aware of the power of the right mindset and dug to make sure it was there.

I like to think he didn't have to dig too deep to find someone ready to fight, ready to tackle this cancer head on. I know that my resolve to win this fight has been greatly strengthened by the love and support of my family and friends. Here in PA and far far away.

Richard did what he was supposed to do: made sure I had a compression sleeve for flying to Winnipeg the next week. Though as he explained to me, the sleeve probably wasn't necessary as flying wouldn't cause lymphedema. But as it was requested, he would provide it and instruct me on its use.

He gave me a thorough lesson on the lymphatic system  and the cause of lymphedema. Germs. The lymphatic system fights germs. When altered by the removal of lymph nodes which in my case was three, it may not function as normal.The more nodes removed, the greater the impact. Richard wasn't the first health care professional to tell me that my risk of developing lymphedema is slim to none based on the minimal number of nodes removed.

I was advised on how to wash my hands and arms three times a day, like a surgeon. I was given a sample of a topical antibiotic and advised to carry it with me and apply it to any cuts, hangnails and even mosquito bites that appear on my left arm.

We went over the precautions I should be taking with my left arm, and I received pages of literature on the subject of lymphedema.

I was also advised to think about how I was planning to live the next 45 or 50 years of my life, because that was my future. Defeating the cancer and continuing on. Probably not his exact words. Like I said, it's been almost a month since I was there. But it wasn't an 'if' I beat the cancer. It was all about doing what I had to do to get it done.

We talked about our upcoming trip to Winnipeg for Pier and Nate's wedding and why I hadn't told Marc's side of the family. And when I was planning to tell them. I said I wanted to tell them before we left Winnipeg but after the wedding, which left a small window. He asked why. I said I wanted to be able to tell them in person, and by them, I mean Pier, Manon and Nathan.  And I wanted to get a hug. Another hug. The hug that knew. If that makes any sense. Whether or not they felt the same way as I think I would, I believe I would like to have another opportunity to hug someone after knowing that. Rather than seeing them, hugging them, having them go away, then receiving the news of their diagnosis. Again, just me.

I really don't know if I've done Richard justice here. I feel that I haven't. But more than painting a picture for others reading this, I just wanted, in this case, to record a memory for myself. I spent an amazing hour with this person, walked out feeling even more positive and upbeat, and am grateful for all of it.

I don't have to look hard to find a silver lining in my cancer chapter. Here's another one. Thanks Richard.