Sunday, December 30, 2007

I Am Legend

I went to see I Am Legend with some girlfriends tonight. I knew nothing about the movie beforehand so I was blindsided during the first five minutes when Emma Thompson's character announced that she found a cure for cancer. Next thing you know Will Smith's character is the last man standing in New York, which has been taken over by these zombie/vampire creatures that were exposed to the supposed cancer cure.

The movie was intense but entertaining. I screamed a few times and thought of leaving more than once. Had there not been the cancer connection I'm sure I would have enjoyed it more. Next time I'm going with a comedy.

Friday, December 28, 2007

A Friend's Cancer: Good for your Health?

This is funny:


A Friend's Cancer: Good For Your Health?

Gulp!

It's scheduled! I just got a call from the hospital asking me to come in for pre-admission testing. I asked if that means that the surgery is scheduled and the woman said I am all set for Monday January 21st.

Breathe, breathe, breathe!

Thursday, December 27, 2007

Just kinda odd

Last night when Dr. S called I was sitting on the couch next to Matt. Two feet to my left is my darling husband and in my right hand another man was on the phone telling me I had very large breasts.

I think I've talked about and pointed to my breasts to more people in this last month than my entire lifetime. Every time someone asks how things are going or I talk to friends about things, their eyes always glance down to my breasts.

I sat across the desk from my boss and while I explained things to him I noticed I was grabbing myself in the area of the spots. What in the world??

This is bizarre.

Two bits of good news

1) The scheduling secretary called this afternoon to say that she's still working on the date. She doesn't have anything yet but will call me as soon as she finds out. While it would be nice to have the date now, I wasn't expecting to hear from her today. It's nice to know that she's working on it.

2) My niece R has agreed to come out and help me after the surgery! This is a huge relief. My mother will also be coming but I was afraid that Cha would be too much of a handful for her. (She's too much of a handful for me!) It will be nice to be surrounded by family.

Call from the plastic surgeon

Dr. S called me last night. He had a consult with Dr. K and said he had some concerns. He said they work very well together and he trusts him, but he's afraid of getting 'burned'. I was confused as to what he was talking about so he explained it to me.

He says he's been burned in the past with women who get the DIEP flap and then have to endure radiation, which destroys the new breasts. He could spend 8 hours of surgery and create two perfect breasts (his work of art!) only to see them ruined by radiation. That leaves unhappy, upset patients.

Dr. K told him that there was a near zero chance that I would need radiation but it's a difficult call since my breasts are so big and we don't know what we might find. They might test the tissue after the mastectomy and find it's loaded with all sorts of invasive cancer. Dr. K doesn't think that will happen, but it is a possibility.

Dr. S said he could always insert tissue expanders following the mastectomy and once the pathology results come back clean (or after I complete radiation, if needed) then he can perform the DIEP flap. That will mean two major surgeries and two recovery periods, which doesn't appeal to me. There's also the chance that insurance will view it as an elective procedure, which means it's all out of pocket for me.

He said it was my choice and he certainly wouldn't have offered to perform the DIEP flap if he didn't think it was possible. He wanted me to know ahead of time that there is a risk that I may need radiation and what it would mean. I appreciate him being upfront about it. I understand that if I end up needing radiation I will have what will appear to be a botched boob job and it will not be the surgeon's fault.

So, we're going ahead with the DIEP flap. I have my fingers crossed that the pathology report shows no advanced cancer so no further treatment is necessary. The scheduling secretary is currently working on lining up the date and I should hear from her in the next couple of days. I'm thinking I'll know something on Tuesday but secretly hoping she'll call tomorrow.

Wednesday, December 26, 2007

Very Merry Christmas

Christmas was magical! Here are a few pictures.









Saturday, December 22, 2007

Interesting email exchange

I have been reading various breast cancer bulletin boards and came across a woman who had the DIEP flap procedure. I sent her a note asking if she wouldn't mind sharing her experience. She got back to me very quickly and was incredibly helpful. She sent me her phone number and said I could contact her anytime. I recognized the number as a Simi Valley exchange (my home town) and asked her about it. She lives not too far from the house I grew up in. Kinda neat.

I asked her specifically if she'd had a c-section because I am curious how the two recoveries compare. This is her response, which I find hopeful! I was up and walking around the second day after my c-section and didn't find it too uncomfortable, so this should be a breeze!

As for a c-section, no I have not had one. My friend who had a double mastectomy and DIEP has had a c-section. She said this was a better recovery. They do not cut the muscle so you have abdominal strength. One thing though is you can not pick anything heavy up for about 6 weeks. That could be hard with a little one. The pain pump was inserted I suppose at the end of the surgery and stapled to my abdomon. I was pretty freaked out when the Dr. went to remove it. You do not have any feeling in the abdomon after the surgery so it is not painful to remove, it just looked like it would be. The pump was great though and really alleviated the pain. I had it for I think 4 days. I would ask your surgeon for one. My friend did not have one and she was uncomfortable without it.

I had the second half of the reconstruction 4 months later and that was an outpatient proceedure. He reduced my breast a little and fixed the dog ears on the end of my stomach incision. I had my nipple done 2 months later. I watched him construct my nipple without any anesthesia because I have no feeling in that breast. He also fixed my belly button at the same time. I thought the whole proceedure was very interesting. The whole cancer process is amazing. My oncologist said that if you every have to have BC, now is the time because there have been so many advanced in just the last 5 years.

I hope I have helped ease some of your anxiety. Call or email me if you need to talk to someone. I'll be more than happy to help answer any questions you have.

The online support for breast cancer (or any cancer actually) is wonderful. There are many people out there who want to share their stories and help however they can. It's heartwarming.

View My Claims

I've been calling the insurance company and checking out my claims online every other day. I don't want to inadvertently mess up and find myself out of network with a hefty out of pocket expense.

I checked my claims this morning and so far this whole journey has cost the insurance company $13,095. I've only had to pay four $10 co-pays for office visits. I'm so thankful that I have such great insurance. It will be curious to see what the costs are when all is said and done. I guessed $75k and Matt said it would be well over $100k.

Friday, December 21, 2007

$8 - For the both of us!

Update: After 24 hours I decided I hated this phone. Maybe I'll upgrade it for my birthday.

What a great deal! We decided to change cell carriers and went shopping for a new plan. Consumer Reports rated Verizon #1 in the Philly area, and my employer offers a great discount plan, so that's what we chose.

I scoped out the deals on the employee online ordering site, and sent Matt to the Verizon store to select his favorites. He fell for the MOTOKRZR K1M which seems a little girly but has lots of fun options.

We ordered two (black for him red for me) and also got the music kit which allows us to transfer music from the computer to the phone. With the employee discount we got both phones for a grand total of $8. Bargain! The plan is cheaper than our old one too, so it was a smart move.

The phone came in today and Matt's in love.

Here's my phone. Aint it pretty?

Thursday, December 20, 2007

Chat with the plastic surgeon

It's 9:30 and I just got off the phone with Dr. S, the plastic surgeon. He told me yesterday that he'd call back today to see how I felt about things. I told him that I would like to try the DIEP flap procedure but had a couple questions.

Yesterday he mentioned that there is a chance that the tissue is not viable due to a number of reasons. I asked him at what point will he know that it's not viable, and what are the options. He said he won't know until the time of surgery or shortly thereafter. The tissue could 'die on the table' which will make it unusable. Also, my prior c-section could have caused significant damage or the tissue could die after the surgery which would require removal.

If the tissue dies on the table or they cannot match up the arteries or whatever, he will insert tissue expanders into my breast at the time of surgery, which gives me the opportunity to insert implants at a later date. If the tissue dies during the recovery period we'll have to schedule another surgery.

He also said that the DIEP flap wasn't a given. He had to get approval from Dr. K. I asked him what events would cause Dr. K to nix the procedure. He said they generally won't do it if there's a chance of chemo. I believe Dr. K mentioned that there really wasn't any chance that I would need chemo, but Dr. S needs to hear that himself. He also said that my mastectomy would be more difficult than most because I have especially large breasts, so the surgery will last longer than 'normal'. Dr. K might feel it's too risky to have both surgeries going on at once, or have the surgeries going on so long.

Dr. S is going to call Dr. K tomorrow. He is usually in the Monday cancer board meeting, but was unable to participate in last Monday's session where they discussed my case. It would have been so much easier if he had been, so he'd already be up to date. (Oh well!)

Dr. S mentioned that there have been several cases where he and Dr. K have disagreed with a patient and refused to do the requested surgery. They will not do something they don't believe in 100%. He said he feels like I am the ideal candidate for the DIEP flap and wouldn't have recommended it if I weren't, but Dr. K has to agree. Oh and he also said something curious. He said that he is in this business to help cancer patients. He said it really bothers him when people demand the flap procedure, just to get the free tummy tuck. He said that the cancer is the number one priority and the aesthetics come second. I gotta respect him for that, but I'm happy he wasn't at dinner with Jaime and I tonight when I was giddy talking about my new bikini body!

Anyway, if I don't do this, then I'm honestly not sure what I'm going to do about the implants. I'm wondering if I want to bother with them. That will be a much longer decision, I think.

She's 'fine'

There's a doctor at Cha's ped office that I really don't like (neither does she). He's very matter of fact and never talks to her, which makes her scared of him. Unfortunately that's who we saw today.

He looked at her cheeks and I explained what's going around at daycare. He simply said that she had a cold and there was nothing to be done. He did look at her ears and say they were clear. I asked about a throat culture and he said she had no symptoms so he wasn't going to do it.

I'm happy that's she's healthy, I just wish wish he had taken a culture to make sure there isn't something that's going to pop up Saturday afternoon after the office is closed and spoil her Christmas.

Are we living in the 1800s??

When I dropped Cha off at daycare this morning her teachers said that Scarlet Fever is running around the school. Scarlet Fever? How crazy is that?! They said it's starting with the rosy cheeks, followed by vomiting and diarrhea. It's a strep/Scarlet fever mix so antibiotics should be an easy fix. I have to pick Cha up shortly and take her to the doctor for a rapid test. I'm hoping it passes her by. I don't want her sick for Christmas.

I had lunch with Kristin and Baby Carly today. I haven't been out in the real world forever. It was nice to sit and chat and I felt so much better afterwards. I miss my friends.

I called to confirm a surgery time but the office is closed. I left a message and should hear back from them tomorrow. I've got January 21st on the brain and Dr. K said it should be free, so I'm hoping that's the day. I submitted the request for medical leave for work this afternoon. The plastic surgeon said recovery would be 6-8 weeks, so I put it for the full 8 weeks. It has to be approved but I highly doubt they would have a problem with it. The benefit covers 100% of salary for 63 days, which will make things easy. One of the perks of working for a mammoth company.

I had a meeting with my boss today too. I gave him the update and filled him in on my schedule. He has been so wonderful and understanding. At the end of the meeting he handed over three envelopes from my co-workers. They sent a gift basket earlier last week but the envelopes were over the top. They included gift certificates to a spa and a very nice restaurant and an envelope filled with something green. I am touched beyond belief.

Wednesday, December 19, 2007

I'm going for it

Okay, that was a super quick meeting with the plastic surgeon. Fortunately the office is only a mile from here and altho he was technically off work, he agreed to stay and meet with me. He works with the breast surgeon quite often and he says they work well together.

I had done so much research before meeting with him so I didn't have a lot of questions. He said there are two options that are best for me, one being the implant and the other DIEP, which is taking fat from my belly and moving it to the breast.

Like I stated earlier, I would think about the belly one only if it didn't mean a longer recovery. Well, I guess that was a lie! He said I'm a perfect candidate for DIEP (I'll try not to translate that into him calling me fat) but it is a longer surgery and a longer recovery. He said I would be significantly smaller both in the chest and stomach and that sounds too good to pass up! I gotta get something out of this cancer crap, right?

The surgery will be 7-8 hours and the recovery is 6-8 weeks. Some of his patients go back to work after 4 weeks, but he prefers people stay out at least 6. If I go the implant route I could be back to work in 3 weeks. So, it's not a huge difference.

I'm going for it.

Make Mine a Double

I met with Dr. K today. Matt couldn't take off work, so I went on my own.

He told me that the cancer board had a meeting on Monday and discussed my case. They all recommended the best option would be a bilateral mastectomy, regardless of what the genetic testing has to say. At the time of the mastectomy they would also do a sentinel node biopsy to make sure the cancer hasn't moved to the lymph nodes.

I feel comfortable with this since, as I've said all along, I do not want to deal with this every six months for the next 35 years. Yes, there is a slight chance that the cancer could come back but it is much less likely than if I just had a lumpectomy and radiation. I mentioned to Dr. K at one of our first talks that a double mastectomy was something I was not afraid of. This is not something that he, or anyone else, talked me into. This is my own choice and like I said, I am comfortable with it.

The next step is meeting with a plastic surgeon. I have an appt with one in about an hour. I'm still unsure of what I want to do in regards to reconstruction with or without an implant. That's not something I need to decide right now and I'm very interested to see what the plastic surgeon has to say. One thing I do need to decide now is when. Dr. K said any Monday in January is fine with him. He said we could also push it back to February, but he'd rather not go any farther than that. Honestly, I would probably go insane if I had to wait too much longer.

I'll update when I get back from meeting with the plastic surgeon.

Tuesday, December 18, 2007

She's screaming for me

Matt has been trying to put Cha to bed for nearly a half hour. She's upstairs in her room screaming for me. I kissed her goodnight, but I know she wants me to lay down with her. Matt and I switch back and forth putting her to bed and I'm sorry to say he's been doing it more often than I have recently. I'm just kinda depressed after today's appt so Matt is taking over tonight.

Altho I know what it means if the genetic test comes back positive, it's taken a while to process my feelings. The nurse told me that along with the double mastectomy, the doctors would most likely recommend removal of my ovaries and fallopian tubes (well, my one remaining tube). That means no more babies. Cha will be my one and only. I love her dearly and she is truly my miracle baby, but I wanted one more. I figured it wouldn't happen with the treatment and all, and the fact that I am already 40. But I had hope.

The Lexapro is kicking in. I'm just feeling blah as opposed to bawling my eyes out and kicking the cats. I'm still crying but it's not like it was before. I know that if I weren't taking something I'd be an angry mess. Tonight Matt spilled the litter box down the stairs. He was on his way outside to clean it, so it was nice and stinky. Three weeks ago I would have barked at him. Tonight I shrugged it off. He did mention that he could tell the pills were working. Lucky him.

It's been 22 minutes and the screaming has stopped. If I wasn't afraid of waking her and getting stuck on the floor for the rest of the night, I'd sneak into her room and snuggle her. I am so lucky to be her mom.


Woo Hoo! Free Parking!

One of the very few perks of being a cancer patient, I'm sure.

I met with a nurse to discuss the genetic test this morning. Her office is at the cancer center which was a tough building to walk into. I felt so out of place almost like I was invading people's privacy. When I first walked in there was an older gentleman being wheeled out on a hospital bed. He didn't look well. There were several other cancer patients coming in and out for their chemo treatments. Yep, there's no room for denial in the lobby at the cancer center.

The education session went well but honestly I didn't learn anything new. I've been a research hound recently and had already read much of what was presented. I gave my vial of blood which will be overnighted to a lab in Utah tonight. They will start working on it tomorrow and I should have the results in a couple of weeks. The nurse will give me a call when she gets them and I'll go back in and talk with her and another doctor.

She put me in a chemo treatment room to take my blood. There were patients on either side of me chatting with family and friends. I was surprised that the mood was so upbeat, given what was going on.

Tomorrow afternoon Matt and I are meeting with Dr. K. I think it will be good for Matt to have the chance to ask questions and get information from the horse's mouth. It's not easy being in his shoes.

My Wish List

Other than the obvious (a happy & healthy family, to be cancer-free, a billion dollars, a candidate who shares my beliefs, and an extra 5 hours in a day) here is my Christmas list.....

The whole house to be painted
All the pictures hung on the wall
The basement and bathroom finished
A brand new Forester w/nice leather seats and a moon roof
Weekly maid service for a year
A week long cruise to somewhere warm w/Matt and Cha to just relax and have fun

Then there's the list I gave Matt...

A new set of drinking glasses
The new Sue Grafton Book
A new faucet for the kitchen sink

I think I'm pretty easy to please.

Overcompensate much?

Yes, I know I've gone overboard. This is Cha's first real Christmas and I want to make it special. Especially since I have these overly dramatic fears that I might not get another with her.

She knows about Christmas trees and Santa and the reindeer. We've been reading the story of Jesus' birthday at night before bed and I think she gets it. It's so cool to see her react to all the decorations around town or at the stores. She hasn't visited Santa yet, but I'm hoping to get her there this weekend. (She calls Santa 'Grandpa' and really, who could blame her. Have you seen a picture of my dad?? )


I had planned on getting her just a few things from Santa but I just can't stop myself. The basement is filled with toys waiting to be wrapped. There's a toy medical kit, shopping cart, dozens or puzzles and books, a baby doll with a stroller, crib and bouncy. There's also a toddler laptop. I can't wait to see her expression when she wakes up Christmas morning. It's going to be the best day ever!

Monday, December 17, 2007

Second Opinions

I am very happy with my current doctors and have confidence in their abilities. There may come a time when we receive all the information that I decide to seek a second opinion, but as of right now I'm not going to do it.

For those of you who are questioning my judgment or feel that I just don't know what I'm doing please have faith.

A little info about the doctors:

Dr. M is my family doctor. She did her residency at UPenn and I've been seeing her for close to two years. She knows my medical history and performed a physical on me in February 2006. She's been keeping tabs on my elevated blood pressure and my weight and has been cautioning me about diabetes (my tests have always been good, but not great). She also sent me for the mammogram that found the original calcifications last year. I realize that she'll have very little to do with my treatment, but it feels nice to have her in my corner.

Dr. K is the breast surgeon. I met with him after the radiologist recommended that there were areas in my breast that required a biopsy. He went to UPenn, did residency at Hospital of the U. of Pennsylvania (HUP) and worked at HUP and Memorial Sloan-Kettering Cancer in NY. I've done a bit of research on him and haven't turned up any skeletons so far.

I will be receiving treatment at The Cancer Center of Paoli Hospital. A bit about Paoli:

At the Cancer Center of Paoli Hospital, we offer the best of all worlds in cancer care -- board certified oncology specialists, the most innovative technology, a full range of sophisticated services -- all in a convenient and comfortable setting. As a Fox Chase Cancer Center Partner, our patients have access to the latest research and cutting-edge treatments. The Cancer Center of Paoli Hospital is accredited by the American College of Surgeons as a Community Hospital Comprehensive Cancer Program.

The Cancer Center of Paoli Hospital brings Chester County and Philadelphia's western suburbs a full spectrum of cancer services from screenings, early detection and cancer prevention studies, to advanced treatment for patients diagnosed with breast, prostate, lung, colorectal and gynecologic cancers, as well as melanoma, leukemia, lymphoma, and multiple myeloma.

I understand that I am new to the world of cancer and there is so much that I do not know. However, at the moment I am comfortable with the care I am receiving. I have lots of questions and have been searching for answers.

Just like a pregnant woman doesn't want to hear horror labor stories, cancer patients don't like hearing how things can go wrong. That's not to say that I'm going to put my head in the sand, but I think I'm on the right track as of today.


Saturday, December 15, 2007

Bad morning

I woke up extra early this morning with super dry mouth. That's one of the effects of Lexapro and even tho I've been dealing with it for nine days, this morning was especially bad.

I tried to get back to sleep but couldn't turn my brain off. I kept obsessing over what's ahead. If there were any way to snap my fingers and make the next 6 months go away I would. I don't want to have another biopsy. I don't want to have surgery. I don't want to have radiation. I don't want to think about these things anymore. I want it to be summer where Matt and I can relax and toast to the fact that the past is behind us.

I'm sad and depressed and really want these meds to kick in. It's the holidays and I need to finish my shopping and make sure Cha has a magical Christmas. I just wish I could find the energy to get out of my PJs.

Sorry to be a downer. I didn't want to hide it.

Friday, December 14, 2007

I really like this doctor

Dr. K called me back at 4:30 today. He already had the MRI results in hand and suggested we go over the results and then cover any of my questions.

The same radiologist who performed my biopsy also read the MRI. It's good that he was already familiar with my case. The MRI showed more of what they were assuming to be cancer in the right breast. We knew there was an area of concern before they did the initial biopsy and they only sampled a small area. So, it's not surprising if the other area is cancerous as well.

Unfortunately they found more of the same in the left breast which they would need to sample. And this is where I butted in with my questions. I asked if we could hold off on the biopsy until we get the results of the genetic test. If they come back positive for the gene I would want the double mastectomy and wondered if we were even need to biopsy the left breast.

He says the left breast will need to be biopsy'd regardless. They need to know if 1) it is indeed cancerous and 2) if it's further along than what is in the right breast and if they'll need to test the lymph nodes.

I explained what a hard time I had with both the MRI and the initial biopsy and certainly didn't think I could handle an MRI guided biopsy. He said he understood and promised to send me in with a Xanax in each hand. He said we might even be able to get away with an ultrasound guided biopsy which is 'the easiest'.

I mentioned that I understood that the cancer is in very early stages, but wondered if it would still be considered early 8 weeks from now. He said there's no question regarding the right breast, but didn't know what they were dealing with in the left breast. So, it looks like I have another biopsy in the very near future.

He'll be speaking to the radiologist on Monday to discuss which route is most preferred. Since I have the genetic test on Tuesday, Dr. K suggested we get together Wednesday to discuss things.

Despite the bad news regarding the left breast, I was actually in a pretty good mood when I got off the phone. Dr. K answered all my questions, listened to my concerns, offered suggestions and talked to me like a person. Several times he mentioned that he would make the same suggestions to his wife. The staging process that he is suggesting is up to date with all the newest studies I have read online, which makes me feel like I'm in good hands. I also like that I feel like we're actually doing something.

Friday babbling

I'm waiting for a call from Dr. K. I left a message with his office this morning asking if I could speak to him for a couple of minutes. He probably won't call until after hours, but I'll be waiting.

I haven't spoken to him in over a week and I know there's really nothing to say but I just have a few questions for him. I want to confirm the diagnosis. When we last spoke I was in shock and was only listening with one ear. I want to make sure I heard him right. I also want confirmation that I'll be okay to wait 7 or 8 weeks to start treatment. I know it's early, but I want to make sure it will still be considered early in 8 weeks. I know I'm just being paranoid but I'll feel better after I talk to him.

I went back to work this week and it was tough. I'm not comfortable with everyone talking about the cancer all the time. I am very grateful that people are concerned and want to be supportive, but I am a private person and I like to cry to myself. Every time someone would walk up to my desk and ask about it I felt like bawling. Besides, right now there's not really much to say. I also get the stinking suspicion that some people just want to see me breakdown. They ask questions about how the doctor told me and how I reacted. I just don't feel like answering a lot of questions right now.

That's why I hope none of you mind the blog. It's really so much easier for me. I appreciate the calls and the emails but I find myself saying the same things over and over and I'm tired of crying. Charlotte started seeing monsters recently and I'm afraid it's because she can sense that I'm upset. Eek, I can't wait for the meds to really kick in.

Thursday, December 13, 2007

Today's MRI

I had my bilateral breast MRI this afternoon. I thought I was being smart by scheduling it during the day when Cha was in daycare, but I'm learning that nothing is going to be that easy. Thanks to a mini ice-storm her school closed early and I was stuck trying to find someone to watch her. There was lots of last minute stress and running around which I think led to me freaking out in the MRI tube.

I thought I was doing fine until they started rolling me in the tube. I immediately got hit with a wave of anxiety and felt very closed in. I wasn't sure how I was going to breathe and felt like the whole thing would cave in on me. It's similar to how I feel when I drive thru tunnels.

I realized that there was no getting out of the test so I fought my hardest to calm down and breathe. I tried to think of happy thoughts but that only lasted so long. The noise was so loud that I decided to just go with it and keep myself occupied by counting the pounding chugs from the machine. The technician kept announcing how much longer and the time for each round of test. I learned that there were 130 beeps for the 3 minute tests and counting down made things easier.

The longest part was when they shot the dye into my arm. I don't think I would have noticed had the tech not warned me and cautioned that that was the most important part of the whole test and that I had to remain perfectly still. The minute she said that I had an uncontrollable urge to cough and scratch my nose. That was a tough five minutes.

I was out of the robe and walking out the door in just over an hour. I am guessing I'll hear back from Dr. K by Monday. I am planning to give him a call Monday afternoon if I don't hear from him first.

I read this article before this test this morning. Based on those results I am expecting the surgeon to come back and say there are many other areas of concern and perhaps suggest another biopsy. Since breast MRIs have a high level of false positives, I'm not going to worry until the gene tests come back. Right now I'm feeling like I'll be facing a double mastectomy regardless, so the MRI results are a moot point.

Great article about the gene test

It's interesting how many people I've spoken to who have not heard about the gene testing. BFF Kristin from Iowa sent me this article:

Test tells which cancer patients can skip chemo

SAN ANTONIO - Thousands of breast cancer patients each year could be spared chemotherapy or get gentler versions of it without harming their odds of beating the disease, new research suggests.

One study found that certain women did better — were less likely to die or have a relapse — if given a less harsh drug than Adriamycin, a mainstay of treatment for decades.

Another study found that a gene test can help predict whether some women need chemo at all — even among those whose cancer has spread to their lymph nodes, which typically brings full treatment now.

The gene test in particular "will start changing practice nearly immediately," said Dr. Peter Ravdin of the University of Texas M.D. Anderson Cancer Center in Houston. "The results are compelling that this test ... helps select patients who will most benefit from chemotherapy."


There are so many new tests and treatments now and I am feeling so confident about my doctors. I know it's going to be a long wait to get the results, but I'm pleased that my doctors are pushing for the genetic testing.

Wednesday, December 12, 2007

'I want My Tebby Bear'


Ugh, I blew it today. Cha LOVES her Tebby Bear. She became attached when we took away her binky and now she carries it with her everywhere.

Recently she's taken to bringing it to school with her. As hard as I try to force her to either leave him at home or in the car, I just don't have the time or patience in the morning to fight with her (it was hard enough to get rid of the bink). Her teachers let her carry it around for a little while and then tuck it in her cubby where we pick it up on the way home.

Well, today was the day her class pictures came in. I was in the lobby with the other moms looking at the other pictures and staring at the beautiful shots of my little Cha. These are the first good pictures she has ever taken. Super happy day!

She was outside on the playground so after I purchased the pictures I went out to pick her up and take her to the car. She was in a great mood and babbling about all of her friends. She just moved up to a new class and she loves her teachers and classmates. I was having such a great time listening to her that I totally forgot about Tebby. And Cha was so excited that she didn't remember him either.

Here it is many hours later and Tebby is (hopefully) still in her cubby. Do you think Cha will be comforted by one of the dozens of other teddy bears she has in her room? Nope, no such luck. Putting her to bed tonight was a nightmare. She kept crying 'I want my Tebby Bear!" over and over and I am kicking myself. She's finally asleep but I know it's only a matter of time when she wakes up and notices that he's not there.

3-4 weeks?? Ugh!

I finally got a hold of the woman for the genetic testing. She's been out on vacation and returned to the office today. I will be meeting with her next Tuesday the 18th for an 'education session' and draw the blood. I asked her how long it will take to get the results and she said usually 3 to 4 weeks.

That puts us at mid-January before we get the results, then the surgeon has to review them and then we decide what action to take. I'm stunned at how long this process takes.

I'm holding at my original estimate that we won't even start treatment until the end of February.

Tuesday, December 11, 2007

I miss work

I am home again from work today. I was looking forward to going back yesterday but Cha woke up feeling bad. She had a fever, her nose was runny, and she looked miserable. I made the mistake of waking her up at 6:30 am to get her dressed and ready for school.

I managed to get half way to work when I noticed how awful she looked so I turned around and brought her home. She slept quite a bit but was super whiny when she was awake. It made for a loooong day.

This morning she woke up happy but I am feeling miserable. I could barely get out of bed and dreaded getting Cha dressed and ready for school. It's a 25 minute drive in bumper-to-bumper traffic, but the thought of keeping her home with me again was more than I could take. I need a hot shower and a nice long nap, which is impossible with a toddler running around.

I miss work though. I'll be going in tomorrow, but leaving early for the MRI.

Question from the peanut gallery

Question: Can you explain the genetic testing you have to have done?

There is a mutated gene found to cause breast cancer (BRCA1). People who have this mutated gene have an 80-85% chance of getting breast cancer in their lifetime.

I have several suspicious spots in my breasts (other than the two known cancer sites). If the genetic testing comes back showing that I have this gene, odds are that those suspicious spots will turn cancerous. It will make sense to take care of them at the same time as a preventative measure (double mastectomy). If I do not have the gene, treatment will most likely be a lumpectomy followed by radiation of the two known cancer sites and regular mammograms to make sure the other spots don't turn funky.

Here's an article I read yesterday which explains how things go bad. Mutated Gene

Monday, December 10, 2007

Oh Christmas Tree



Last week Matt picked up a Christmas tree after work. Charlotte and I were going to trim it the next day but I just couldn't get in the mood. It seemed like too much work and I didn't feel like fighting with the kitties over how to keep the tree upright.

Late that following day I had an idea. I wanted to shine a light on the elephant in the room and acknowledge that yes, this is the year of fighting Cancer. So I decided to Go Pink. I went out and bought pink ornaments and ribbons and am still searching for pink lights and a tree topper. It may be ugly as hell, but it's fitting.

Here's Cha Cha Bear helping me pose the kitties. How she gets them to sit still is a mystery.

Sunday, December 9, 2007

Missy Love

I spoke to cousin Missy tonight. She battled cancer (Hodgkins?) when she was 23 and was very kind to give me the scoop on chemo and radiation. She also shared stories of other women who have survived breast cancer.

One of my biggest fears has been taking care of myself and Charlotte while I endure radiation. I have many wonderful friends who have offered to help, but the reality of getting up in the morning and taking care of a child after a day of treatment seems overwhelming.

Missy helped me to see that if I have a mastectomy there won't be any radiation. It will be gone and I'll 'just' be dealing with the emotions of losing my breasts and the pain of healing. It won't be the weekly sickness for 3-6-9 months or whatever. That is hopeful.

She also pointed out that I can survive radiation. People will be there to help and I will not be alone. Matthew is a wonderful father and has the ability to do it all himself if he needs to. I am hoping that my mom will be able to come visit when the time comes.

I get these moments of extreme worry but talking to others who have been there helps tremendously.

Thanks Missy Love!

Lexapro

I took my first pill on Thursday the 6th at 2:00 in the afternoon. I felt nothing the first day. I heard it would make me very thirsty so I drank lots of water as a preventative measure. I thought it would be interesting to track the side effects and what it does for me.

Friday the 7th - I took it again at 2:00 and by 5:00 I felt like someone had poured buckets of warm mud on top of my head. My head felt so heavy and I was tired. I could barely keep my eyes open. I was also super thirsty!

Saturday the 8th - A friend suggested taking the pills at night so the side effects would hit me while I slept. Smart move! I was still tired, but not as much. It also made me very very and thirsty and my tongue felt like it weighed a ton. I took a short walk and noticed that I was more aware of my body than I had been in a while. I could feel my toes as I walked and the way my clothes felt against my skin. I wonder if the depression has dulled my senses. It hit me at 7:00 that I hadn't eaten since breakfast when I had coffee and half a scone. I wasn't the least bit hungry and hadn't even thought of food all day.

Monday the 10th - Still feeling super tired. I think my sinus infection is back, which might explain things. I'm expecting to feel better any minute now (right?)

Wednesday the 12th - Not as tired today but I've still got my cold. I'm back at work and thinking clearly. That's a good sign!

Thursday the 20th - Two weeks to the day, just like CC said, I am skipping with joy! Little things just aren't bothering me anymore. I still feel emotions and get happy and sad, but the sadness isn't extreme. I feel like things roll off my back easily.

Sunday the 30th - I'm thinking about calling my doctor to up the dosage. Since I got the call about the surgery being scheduled I have been so anxious and on edge. At this point I think I need something stronger.

Friday, December 7, 2007

Thanks Auntie!

I spoke to Auntie Ca tonight. She battled breast cancer back in 1998 at the age of 50. She found a cancerous lump and opted for a mastectomy. No radiation was needed and she's been healthy ever since. She mentioned her MIL who had a double mastectomy and implants. She had trouble with infection and pain and regrets ever getting the implants.

We spoke about positive thinking, making changes in your life and the power of prayer. It was a wonderful call and I wish I were there to hug her in person.

Hope

Hope begins in the dark, the stubborn hope that if you just show up and try to do the right thing, the dawn will come. You wait and watch and work: You don't give up. ~ Anne Lamott

Thursday, December 6, 2007

Day Two

I had a rough night last night. The doctor called with the news at 5:00 and by 6:00 my body was in shock. I started vomiting uncontrollably, was shaking like a leaf and freezing cold. I didn't sleep much at all both because I was getting sick and I couldn't turn my brain off. I really wish my mother was here so she could clean up the vomit that I spewed all over the walls and floor My body is ticked right now, that's for sure.

I am much better today. I called to make an appt for the genetic testing but the woman is out of the office for the rest of the week. The surgeon's office called me at 9:00 to see how I was doing and remind me what I needed to do. Very nice on their part, altho I already had my list. The nurse did provide a couple of phone numbers for me and I was so happy to talk to her. I really like this doctor already.

I've got an MRI scheduled for next Thursday. When the surgeon gets the results we'll sit down and talk. From the chicken scratches I made while I was talking to him, and what I have looked up online I believe it's ductal carcinoma in situ which is usually treated with a lumpectomy and radiation. Altho, with patients who are high risk like myself, it will probably be a mastectomy. He mentioned the spots in the other breast, which we never discussed before so I'm thinking he's going to suggest a double mastectomy. At the moment I'm okay with that. Actually, I am smiling at the possibility of being a nice firm C cup by summer, subsidized by UnitedHealthcare. Does that make me a bad person?

I had to call the insurance company to make sure everything is covered and thankfully it is. I was afraid the genetic testing would be out of pocket.

And finally, I had an appt with my family doctor yesterday and that was incredible. I really like this woman as she's caring but doesn't hold anything back. She had already received a copy of the test results and knew what was going on. She talked about some of her other patients and how they successfully beat it. She also said something that will probably stick with me forever. She said I will learn so much in the next twelve months and will come out the other side a much better person. She said cancer could be the best thing that ever happened to you. As strange as that sounds, I really felt it to be true. She put me on 5 mg of Lexapro, so we'll see what happens.

The hard part is not knowing. I think in a couple of weeks after we have all the information and we take some action I'm going to feel much better about things. The rate things have been going, I don't expect to even start treatment until the end of February.

Wednesday, December 5, 2007

C'mon, I said Please!

Famous last words....Please God do not make me turn this into a Cancer Blog.

Maybe I should have said Pretty Please.

I guess the good news is that we caught it very very early. The bad news it that there are two other 'suspicious' spots (his words) in the other breast that they want to take a look at.

He wants me to schedule an appt with the geneticist (sp??) to get the testing done. Then I have to get an MRI and then we decide what to do. He said if there wasn't the family history they would just cut out the whole thing and be done with it, but there's the fear that more could pop up or whatever.

Merry f-ing Christmas, huh?

Monday, December 3, 2007

my biopsy

I had a stereotactic breast biopsy this morning. It was actually harder than I thought it would be. There wasn't too much pain but the mental aspect of it was tough. They took samples from two areas which meant two needles. They also planted titaniam clips in each spot as a marker.

They gave me the option to break between the first sample and the second but I said I wanted to get it over with ASAP. It took almost a half hour to position me correctly on the table and I didn't want to do that again. At one point I got very lightheaded and almost vomited but I'm certain it's because I was thinking about things too much. They stopped for a minute to check my bp and put a cold compress on my face and neck. They asked if I was too hot or too cold and I said no but I heard the nurse mention that I was pale and sweating.

When it was over I had to go into another room for another mammogram. They must have taken a dozen x-rays of my boob while I was on the table to follow every step. The nurse showed me the pic of the newest mammogram. I could see the clips and the voided space where the doc took the sample. Man, he took a lot! I got a chance to look at the two sample jars when they were bandaging me and it was pretty grody. The nurse pointed out a hematoma and warned that I'm going to have a mighty bruise by tonight.

My arm is sore and while I know some people could run off and go to work the same day, I'm just not going to do it. I am way too drained. They told me not to lift anything heavy or raise my arm over my head. It's going to be a challenge getting Cha in and out of her carseat when I pick her up at daycare today.

The results should come back by tomorrow night, but it might be as late as Wednesday.

Please God, do not make me turn this into a Cancer blog.

Saturday, December 1, 2007

late night ramblings


Cha woke up screaming this morning at 2:09 am. She usually sleeps very well in her toddler bed but we have a baby gate on her door for the times she wakes up and wants to sneak into our room. We used to allow it until we realized that when she climbed into bed with us she spent all night using us as a jungle gym so we're trying to break her of the habit. Tonight I think one of the kittens climbed over the gate and woke her up.

She was standing at the gate screaming for me so I picked her up and immediately sat in the rocker with her on my lap. I calmly asked her what was wrong and she said she wanted to sleep in mommy's bed. I told her no, that she slept in her own bed but we could rock a little while. I leaned my head back and closed my eyes while she spent the next ten minutes repeating 'sleep in mommy's bed' over and over and over. She eventually slowed down so I was hoping that she'd go to sleep but then she switched to a chorus of 'mommy wake up' again and again.

I finally picked her up and put her in her bed. She cried for a minute so I sang to her a bit until she calmed down. She sat upright in her bed and told me to sleep on the floor. I laid down and grabbed a stuffed rabbit for a pillow. She mellowed out but I knew I was stuck there for the next half hour until I was positive she was asleep. If I waited 25 minutes and tried to get up she'd cry and the whole thing would start over.

So, I laid there quietly not able to sleep. To keep my sanity I think back on all the wonderful Cha stories to remind myself that the good far outweighs the bad. Tonight I thought of the trip to the Good Will we made this afternoon.

She is such a sweet, social little girl. She talks to everyone and is always singing or chatting to herself (wonder where she gets that??). We go to the Good Will a couple times a month and I always let her play with the toys and pick out a bear. (It's only 97 cents and it helps keep the peace.) Today she found a stuffed dog which she carried around the store while I shopped. She talked to him and showed him all the different trinkets. I'm lucky that she's never had the need to touch everything. She can stand in an aisle of breakables and just look.

We got in line to check out and Cha took the dog over to a table of Christmas items that was next to the cashier. She played there while I stood in line. All the other shoppers commented on what a sweet, well behaved little girl she was. The cashier was an older, heavyset woman who we've seen a dozen times. She's never pleasant and barely tolerates the customers. There were several people in front of me so she was especially grumpy by the time I reached the front of the line. She bagged my items and I told Cha that it was time to go home.

She continued to play for a couple more seconds as I started to walk to the door. I asked her to come and she said 'Wait a minute'. Then she walked up to the cashier, waved and said 'Bye Bye. Thank You'. and walked away. The cashier smiled and said 'Take me with you!'

So that's the happy story that kept me from losing my mind at 3:30 in the morning. Every day I think about how happy Cha is, and my daily goal is not to mess her up!