Second Surgery Results - On September 30, the second surgery was completed. The pathology report arrived a week later and it indicated the cancer was still not contained within the material removed. Since the spread was in all directions, a point is reached where there is little breast left to keep. That is why the guidelines at this juncture call for a mastectomy. But guidelines are by their very nature somewhat behind leading-edge understanding. So Doering spoke with local doctors about her case and with doctors at Memorial Sloan Kettering in New York, an institution frequently considered as the premier cancer research facility in the world.

The people at MSK did offer an option they have been exploring. It involved reversing the normally recommended procedure. Instead of a mastectomy followed by chemotherapy to perform a "mop-up," chemo would be started immediately. Since these types of cancers are so responsive to chemo, the treatment may clear the breast. If so, the breast would be saved.

If that proved not to be the case, then a mastectomy would be called for.

So now there was an option available and we appreciated Doering searching for one without our even prompting him to do so.

I was pretty sure I knew what Gloria would choose and a story from her 1997 experience illustrates how her mind works.

When Gloria was in the hospital in Topeka, Dr. Shapiro was the "shrink" who checked on her state of mind. One day when I arrived, she seemed a bit cranky - not a typical mood for her. It seems that Dr, Shapiro had just left and had suggested some medications might make her feel less depressed. Since I was at the hospital from about 10 a.m. through 9 p.m., I saw most of Gloria's day. Depressed was never a word I would have chosen to describe her.

She turned toward me and said something to the effect that she was largely paralyzed, couldn't get home to see her girls, reading was difficult because of some lack of eye-muscle control, she was being fed through a tube and so on. Then she looked at me and said, "Don't you think it would be completely reasonable to be a bit depressed?" We both laughed.

Gloria has a wonderfully rich emotional side to her, but it is always moderated by her logical side. She had recently mentioned how pleased she had been as a youngster when puberty finally arrived. But her tone of voice said, "That was then; this is now!"

So I wasn't surprised when she said, "I'm ready to be done with this." She had made peace with the mastectomy.

But there would be dealing with being "lopsided," not wanting reconstructive surgery, and needing to have mammograms for her left breast, knowing that with increasing age, a third cancer was not out of the question. So I was only a little bit surprised when she declared she had settled on a bilateral mastectomy even before our recent visit. I had personally thought it was the best choice. Doering was also good with it.

With the under-arm lymph node being positive, there were two options: (A) radiate them or (B) do nothing. The former may lead to lymph fluid buildup - edema - in the arm for which little can be done. Plan B involves hoping the chemo treatments will address the situation. Plan B it is! Doering agreed.

Going Forward - Surgery has been scheduled for this coming Tuesday, October 14 at around noon. Because this procedure is more extensive than the previous two, she will spend the night in the hospital, mainly so the staff can watch for any bleeding. The skin over the top of each breast is separated from the breast and then placed over the area where the breast was removed. She’ll have a drain on each side for a week or so.

Trip Cancellation - Most of our friends and relatives know we were scheduled to leave for England on the 14th - next Tuesday. My cousin Kris was to meet us in Chicago and then we would later fly to Malta from England with the Fron Choir for their week of performances on the island.

But the surgery means our participation has been cancelled. Kris is going solo a week later, meeting up with friend Jan and granddaughter Courtney, who will be expected to give us a full report. Kris will return a week earlier than originally planned, which still includes the entire Malta affair.

At the very time we two had been scheduled to fly out of Manhattan next Tuesday, Gloria will be recovering from having had a bilateral mastectomy a bit earlier in the afternoon. Her prognosis is the same as it was after the first surgery - which is excellent.

The Port - I mentioned earlier that Doering will be putting in a port, which he did. As mentioned, they have a varity of names, but Gloria describes it as the "alien insect in her chest."