Remember that big ol' party you threw for all your friends and neighbors as soon as you read about the ruby slippers working their magic for clear lymph nodes? Well we are unfortunately all the victims of premature party-ation. Further path analysis revealed a little bitty 1mm tumor in one of the sentinel lymph nodes.

A great big hurrah for the development of cytokeratin immunostains, right? Without which I would have gone blithely on my way....

In the meantime, going back to work has been really good for me. This weekend I hope to get a good walk on every day, since I won't be spending all day at the office. I'm sure the return to walking will be therapeutic as well.

Healing is going great. Hand strength and coordination, well okay I'm still a spaz, but I was never that graceful to begin with.

I have a bottle of Dom Perignon in the wine chiller (thanx Nancy L) that I have clearly labeled REMISSION for the future!

Lots of good news and a little bad news, my friends.

Good news: Path report confirms lymph nodes all clear! The tumor at its largest point was 1 centimeter. Yay! Current diagnosis is stage 1b. Happiness now, and living happily ever after. Who would think that something the size of an almond is going to require so much accommodation this year.

Bad news: the margins, not clear. There is a 1 millimeter clear margin and apparently the standard of care is 5 mm. We are talking a difference of less than the length of my little fingernail here, but I'm going to have to have another surgery. Dr. Korey's office called Friday and offered me a surgery date of May 7, and I said "no". In a more eloquent fashion, I hope.

I'm in no rush. The big bad tumor is gone, right? And on Wed Dr. K had given me the green light to take a few days off from work and from being a Patient. I booked a getaway ASAP. In mid-May I get to get out of town and enjoy life for a few days. As long as I don't lift a suitcase.

I have an appointment with a plastic surgeon 4/30, the oncologist 5/3, Dr. K 5/4, and MD Anderson 5/6. In the meantime, I'm doing one of the things I do best: gather and analyze information. Then I can make a decision about the best course of action for me based on fact and expert opinion.

My sister left this AM amid much wailing, gnashing of teeth, rending of garments, and tearing of hair on my part. Ok, the wailing is exaggerated and I am certainly not giving up one precious hair out of this head until absolutely necessary. I cannot begin to enumerate the ways, large and small, in which she supported me this week. It is all about keeping things in perspective.

Overall, I think I'm doing great. Judy took my bandages off this AM as per Dr. K's orders. I have mostly passed on pain pills in favor of Tylenol for a few days now. The numbness seems to be getting a little better. I am able to lift a small glass of water off the table with my right hand, a superhuman feat which I demonstrated to the approbation of friends recently. Although I wouldn't bet on getting said glass as far as my lips.

Mega-thanx to the crew at Sarah's house last night. When I arrived there and found the front door wrapped in pink with the humongous breast cancer ribbon. I doubled over in laughter. I know that, and everything that followed was a team effort. My friends and family will always be a way bigger part of my life than this transient encounter with cancer.

Your unstinting positive energy is doing a fine job of winning out. CLEAR LYMPH NODES! I am so happy. The frozen sections of the sentinel node are clear, which makes it a 95 percent chance that the cancer hasn't spread. They took sections from three axillary lymph nodes which are being biopsied in a lab so they can make it 100 percent sure. Because the SLN was clear I didn't have to go home with a tube for drainage, which would have been very demoralizing.

MARGINS: Won't know if the margins are clear until the pathology lab processes the tumor. If the margins are clear then I can avoid another surgery. If the margins are not clear then here we go again. I should have that info middle of next week.

When we got home from the hospital at about 5:30 I tried to eat some avocado, and I slept, and I got up and tried to eat again but I literally could not keep my eyes open. I mean, I was falling asleep in mid-chew.

Today I am much better. I have two incisions. The one on my breast is no big deal. The one under my armpit is a royal BITCH. And there is numbness and weakness in my right hand. Like I can't hold a glass or a comb or a toothbrush. Silver lining is I get to practice being ambidextrous, Just got back from a post-op with Dr. K and he thinks the numbness will go away, that its from the positioning of my arm during surgery. I got a prescrip for antibiotics too.

I rescheduled my appointment at MD Anderson for May 6 so I will have path lab reports to bring with me. Now I can just hang out and heal and get waited on like Princess Nephratata.

I can't thank you enough for the cards and calls and everything else you have done to make my life easier and to show me that you care. Keep up the Clean Margins mantra, and I will keep CHARGING down the road to recovery.

RUBY SLIPPERS, Ya'll.

The pre-op, since some of you have asked, was just an interview for medical history by a nurse, and then getting stuck, again, for some blood tests.

My sister Judy drove down from Atlanta yesterday and will stay as long as needed, or until she can go home with a really good tan, whichever comes first. Bjorn will also be off work Tuesday and Wednesday.

My orders for tomorrow include nothing to eat or drink after midnight, then in the morning at home there is some strange ritual involving ointments and saran wrap that would be kind of kinky under other circumstances, arrive at the hospital by 6:30, wire localization at 8, radioactive injections at 9, scan to make sure radioactive injections are doing what they are supposed to be doing at 10, and surgery at 11:15.

Now I have my own Doctors Orders for you, Ladies and Gentleman of the Blog. Tomorrow morning when you get up, those of you who have ruby slippers (and you know who you are), put them on and click your heels together while you say "clear margins, clear lymph nodes, clear margins, clear lymph nodes".

If you don't have ruby slippers, well that's just sad and it's a situation you really should go out and remediate. In the meantime you can compensate for that by saying "clear margins, clear lymph nodes, clear margins, clear lymph nodes" but you have to say it much louder and with FEELING.

Thanx to all of you who have been checking in with me.

Tuesday I had a contrast MRI at CCH. That was definitely a weird experience to collect. Then I went upstairs to the oncologist's office and got stuck in the other arm to draw blood for the BRCA analysis test. Since my grandmother had breast cancer and my sister had ovarian last year(past tense: goodbye and good riddance to the OC) genetic testing is important. The results of the BRCA will take a few weeks.

Dr. K called this AM to tell me my MRI shows no other suspicious spots. Yay! We are go for launch on Tuesday 4/20.

MOST importantly, he answered my burning question about getting out of town for a few days post-op and pre-chemo/radiation with a resounding YES. Another yay. For once this year a doc is saying all the things I want to hear.

Got a pre-op at CCH scheduled for this AM before work. That makes four medical appointments so far this week. That's more than I usually have in a whole year. The pre-op coordinator told me to bring a list of my medications. That's easy enough: NONE. I keep telling these people I'm healthy as a horse, and they keep telling me I have cancer.

Second opinion appointment regarding treatment protocol scheduled at MD Anderson 4/22.

Other than that, just keeping up with work and life. MacKays have this idiosyncratic trait: before leaving for vacation the house has to be in order. Magnify that times ten, apparently, for pre-surgery. This not sleeping thing has some advantages in terms of getting stuff done. There's always a silver lining.

Met with Dr. Levine yesterday. He was very patient with me. I took copious notes on everything he said, and then at my request he went over the massive and detailed amount of information again, and again if I asked. Dang. If anyone out there comes across my 40 missing IQ points, please put them in an envelop and send them, overnight express.

Bottom line is that the limited prognostic indicators in the path report are favorable. Dr. L is going to have tissue samples from my tumor sent to a company called Genomic Health. They then analyze the tumor on a molecular level and provide him with a report that predicts response to chemo, survival rates, chances of recurrence, etc, and is intrinsic, along with a few other variables, in treatment planning post-surgery.

He is leaning toward chemo for three to six months followed by radiation for 8 weeks. Lucky for me, I know someone who has a closet full of "cranial prosthetics". I have a follow up appt with him 5/3 to go over tissue test results and plan a treatment protocol.

It was a great weekend. Walked every day. Paddled in the Thousand Islands both days, very dreamlike, serene. Got to spend some unexpected and treasured time with friends both Saturday and Sunday. Cancer is bad, but life is good.

I have a feeling that there's going to be lots of information to disseminate in the coming months and while I adore phone calls and emails and especially cards, it occured to me that in addition to this it might be helpful if I have a place to post updates you can check on when you don't have time to call or email.

I have invasive carcinoma in my right breast, probably lobular in origin. Found TFL (the freaking lump) late in January. Waited a month for it to go away. Saw the OBGYN, got diagnostic mammogram and ultrasound. The radiology report said that there was a 95 to 100 percent chance that I have cancer. Had an ultrasound guided core needle biopsy 4/5. It went quite well and kudos to Dr. Gordon and the staff at the Women's Diagnostic Center at Cape Canaveral Hospital for a job well done. The results confirm the cancer.

Today I saw my surgeon, Dr. Korey. I have much faith in him. He patiently presented all my options and the pros and cons associated with each. At my request he scheduled an MRI for 4/13. Surgery is scheduled for 4/20 at CCH. Leaning toward a lumpectomy with sentinel lymph node biopsy. Axillary lymph node dissection will be done at that time if necessary.

I have an appointment with Dr. Richard Levine, an oncologist at the Space Coast Cancer Care Centers 4/12, and I'm planning to get a second opinion at MD Anderson in Orlando.

I feel fine! Still walking, kayaking, eating, working, in good spirits, all the usual stuff. Okay, maybe not sleeping so well. I'm soaking up positive energy like a sponge, so send some my way.