Seroma Madness:

 

It has been 7 months since my mastectomy and the seroma continues to drain. The good news is that after 25 radiation treatments, the malignant cells in the drain fluid are gone. Radiation apparently destroyed the source of the cancer cells. My breast surgeon had no idea what to do next. Her approach seemed to be a combination of wishful thinking and time heals all wounds philosophy. I took the initiative and discussed my case with the Director of the Virginia Mason Hyperbaric Center. Breathing pure oxygen at 2.4 atmospheres has been shown to build new circulation pathways and is used primarily for radiation damaged tissue. It is also being studied for lymphedema treatment in the U.K. If the oxygen could heal my breast tissue damaged by the radiation of 15 years ago plus my most recent radiation treatments, then the seroma might heal. The doctor gave it a 75% chance of success.

 

Hyperbaric oxygen treatment is a major commitment. Forty treatments each lasting two hours takes over your life. Each morning, I drive to the hospital, change into surgical scrubs (you are not allowed to wear your own clothing) and enter a large chamber along with 7 other patients. The chamber is first pressurized to the equivalent of 45 feet of water (2.4 atmospheres) with air. A clear plastic bubble is placed over your head and the oxygen is pumped in. It is relatively comfortable. You sit in a lazy boy style chair and read or sleep. I have finished 31 of the 40 treatments. Unfortunately, I am not responding as expected. The volume of drain fluid soared from 20 to 30 cc/day after the radiation to 60 plus cc/day. I have heard a lot of “maybes” from the medical staff. Maybe the new capillaries are weeping. Maybe there is another micro tumor that is pumping out fluid so fast that the seroma can’t heal. Maybe, maybe, maybe.

Once again, it was up to me to find a new solution to the problem. I consulted a well known breast surgeon at a major cancer center here in Seattle and she suggested using a sclerosing agent. Sclerosing agents are used to rough up the inner surfaces of the seroma to build scar tissue and seal off the drainage. She injected a solution of doxycycline and lidocaine through my drain tube. The tube was then capped for four hours to keep the solution in contact with the seroma. It was mildly uncomfortable. A first the drainage volume increased, but in the past few days, it has gone down to around 40 cc/day. I see her next week for a second treatment. If the second treatment doesn’t finish the job then I will need to find yet another surgeon. I prefer to believe that there is light at the end of the tunnel. I just hope that it isn’t a freight train.

 

In spite of the seroma craziness, I have had some good news. I started Tamoxifen over a month ago and have had no side effects other than some very mild hot flashes. My hair is growing back. My sexual response is once again normal and my aches and pains are no worse than they were before I had cancer. Only the seroma and the drain darken my otherwise normal life. My old drain finally became so painful from being in for so long, that my doctor sent me to an intervention radiologist who put in a different kind of drain using an x-ray machine to guide its placement. He also created a system using an ostomy bag that does not require a suction bulb or collection bag around my waist. I sometimes forget the drain is there and I can sleep through the night. With luck, there will be more good news to come. To be continued….