August 31, 2010 - New Side Effects

Up until now, after only one chemo treatment, we thought we had this thing figured out (well, not really, but …).  Having only had a day and a half of shin splints and fatigue, then full energy and appetite, I kind of thought I’d pretty much remain symptom free until the next treatment.  Then last night I got a little surprise.

Yesterday had been another good day.  I had some good orders and got a lot done at the shop, came home to a crockpot pot roast for dinner, and watched the news as usual.  Al went out in the heat to mow the lawn and, after cleaning up the kitchen, I lay down to read Dragon Tattoo upstairs on the bed.  After a few pages, a kind of heaviness settled over me, and I folded up the book and lay my head down to “rest my eyes.”  When I heard Al come back into the house, I really had no intention of moving.  I felt like I could just go down for the night at 8:00 PM.  But he talked me into a recorded episode of Rubicon, after which we decided to retire.

I believe I fell asleep right away, but around midnight I woke up to some pretty intense achiness in my lower back.  It reminded me of the tension I get in my lower back when I’ve been reading lying on my stomach propped up by my elbows (which is how I was reading 5 hours previously), and then turn over to lie on my back.  (I usually have to curl up in a ball for a few minutes to relieve the ache that causes my lower back.)  That’s kind of how it felt, but more intense. 

I got up to use the restroom, and when I returned to bed, I realized that the pain was both in my lower back and in my sternum, and it seemed to pulse with my heartbeat.  I tried to change positions and do some distracted breathing (you learn a lot of techniques that carry into other areas of life when you go through childbirth), but nothing seemed to alter the pain.  I knew the new ibuprofen we just bought was in a bag at the shop, and the Tylenol was downstairs – further than I wanted to go.

Finally, at 12:30 I got up to take a couple of the old (expired) ibuprofen that was in the master bathroom cabinet (I know it should have been thrown out years ago, but I hate to waste).  I didn’t know if it would work or not, but I must have fallen back to sleep, because I recall waking up briefly at 1:30 AM and realizing my back no longer hurt.  And it didn’t hurt since – until a few minutes ago.  After I’ve posted this, I’ll be taking one of those NEW ibuprofen.

A couple other things I’ve noticed recently, to which I don’t know what else to attribute them:

• I have a couple of small sores in the corners of my mouth, which I first noticed on Sunday afternoon, so that if I open my mouth too wide they split and hurt a little.
• My ankles, which used to click when I walked upstairs, now positively rattle like a sack of small bones.  I sometimes wonder if they’re even still attached to each other.
• I've been having very lucid dreams lately, such that when I have to get up in the middle of the night, I seem to float right back into them when I go back to sleep, and I remember them for quite some time after I wake up in the morning.  This is very strange for someone who would otherwise swear that I HAVE NO DREAMS.  

Well that’s where we are today.  Life is so interesting – just when you start getting complacent, you get something else to work on.

August 29, 2010

Nothing much to report.  I'm feeling good again.  I've had a symptom-free weekend, have enjoyed anything I wanted to eat (which still hasn't been very much; I've lost a couple of pounds), and have had energy to cheer on both Twins and Vikings, although not into the wee hours of the night (bedtime seems to need to be around 9 or 9:30 PM).

I'm expecting I will continue to feel good at least until after my next treatment, which will be on Wednesday, September 8 (due to Monday being Labor Day).  That means I'm expecting to still feel great during my daughter's birthday visit (Sept. 2-6; actually she'll leave the day before her birthday, which is the 7th).

I don't have enough experience with chemo and my body's reaction to it to say difinitively how things will continue to go, but I'm expecting I'll be feeling a little low during the Friday and Saturday of Steamboat Days.  Bummer.  I may not have the appetite for funnel cakes, cheese curds and cotton candy.

But this evening we are going to Crofut Winery for wine tasting (very moderatly for me) and dinner with our neighbors.  It's something we have never done, and I'm looking forward to the adventure.  Our garden club is supposed to be meeting there tomorrow; I'd like to see them all, but not sure I'll want to go two evenings in a row.  But we'll see!

August 27, 2010 - AM

I think it's going to be a good day today -- not that the past couple days have been awful!  It's just that I feel like I have some energy again this morning!

Although I had some nice business at the shop, I was VERY tired all day yesterday.  Dragged myself out of the rocker to the front when the doorbell rang.  My friend, Bonny, came in with her grandson; bought a couple of miniature garden plants and told me she's finally gotten some job offers, which is FABULOUS! My friend, Shannon, came in to check on me and offered to buy me lunch (I had to turn him down, as I'm not eating a lot lately).  We had a nice talk, though.  Two separate customers came in and announced they had seen our ad in the Savvy.MN magazine.  YAY!!!  One of them went immediately to the Trick or Treat kids that were featured in our ad, and bought a couple, so that made me feel great.  Gave out some jam/relish samples and sold a couple of jars.

But still, I was dragging.  Tried to read my Deathly Hallows, but kept closing my eyes after a couple of pages.  When I got home at 5:15, I immediately got into bed to take a quick nap.  Al heated up some leftovers, and I had a tasty but small dinner.  We turned on the Twins game, which the previous night had put me to sleep in my chair.  But I was actually able to keep up with it, and even do a little cheering of the boys.  Then I had a bowl of cantaloupe and grapes (thanks, Connie; they're still great), which tasted REALLY good and refreshing.  Before I knew it I was asking Al to put a little more in my bowl.  :)

Still went to bed at 8:30 PM, but I actually felt like I had a conscious choice about it.

This morning I got up at 7 AM, to get ready for day 2 of the Treasure Trek.  I don't expect any customers to come in until close to 11:00, but you don't want to not be here in case someone starts on the east end of the route instead of the west end.  Shin spints are gone.  I feel like I've got a chance of having a pretty good day today.  Hopefully, the worst is over for this first round of chemo.  We'll find out how cumulative the effects are.

AUGUST 26, 2010 - AM

I was so tired last night, I couldn't even think about posting.  Thankfully, it wasn't busy in the shop yesterday (although I hate to say that).  I spent most of the afternoon in grandma's rocker waiting for 5:00 PM.  As soon as I got home, I went up to lie down.  While I was resting, Connie brought over some wonderful comfort food.  It smelled SO GOOD!  But I couldn't eat a lot; not sure why.  Taste buds are still working, and no nausea.  It tasted marvelous, but I just felt full after a small amount.  Kept dozing off during the Twins game, and finally went up to bed at 8:00 PM.

I think I slept quite well, although I'm drinking so much liquid I had to get up a couple of times.  But fell right back to sleep.  It felt so good to sleep with the windows open, and that cool breeze blowing in.

Got up early this morning (6:30 AM) to bake a quick coffee cake to bring to the shop.  I signed up to participate in this year's Treasure Trek this weekend, without realizing that during the chemo I might not want to get here to open at 8 AM the next three days.  Despite a good night's sleep, I'm still moving pretty slowly today.  Shin splints are still bothering me, although not enough to take ibuprofen.  My metabolism just feels real low today.  But no real painful or uncomfortable side effects; just fatique.

I'm torn between wanting no one to come in to the shop today and wanting the business.

August 25, 2010 - Mid-Day

Much more tired today than yesterday.  Got up at 6:45 AM and made a small pot of coffee.  At 8:00 I walked the .7 mile circle once with my neighbors, Bev & Connie.  I only did one lap because toward the end my shins were feeling kind of sore.  I guess that could be from the injection yesterday, although I thought they said I'd feel it mostly in my neck, shoulders, arms and upper back.

Took a nice, luxurious hot bath, had a small breakfast, and headed to the shop.  But I've been moving very slowly here today.  Not much energy, but a lot to do.  The Treasure Trek starts tomorrow at 8:00 AM and I had to finish up the yellow signs and get my fairy garden plants out on a table.  I also put all of my breast cancer related paperwork together in one binder.  It contains all of the explanations and side effects of the treatments, support resources I've been accumulating from various sources, and my bills and EOBs as I get them.

Thank God we have health insurance through Al's work!  So far the gross charges for the biopsy and surgery alone total $18,656.63, of which our portion will be only about 5% of that, although we haven't gotten all the bills yet.  Linda, my chemo technician, was telling me that the chemo treatments, depending on their make-up, can cost from $4,000-10,000 EACH! And I'll be having eight of them!  It will be interesting to see the statements as they come.

Maybe this is a good time for a little chemo lesson.  Cancer is characterized by rapid-cell division -- out of control cell replication without any checks or balances.  This rapid cell division happens in cycles from a resting phase, through an active growing phase, and then to mitosis (division).

Chemotherapy kills cancer cells by halting cell division; if the cancer cells are unable to divide, they die.  Some chemotherapy drugs affect cells only when they are dividing, and are called cell-cycle specific.  Other drugs affect cells when they are at rest, and are called cell-cycle non-specific. The chemotherapy schedule is set based on the type of cells, rate at which they divide, and the time at which a given drug is likely to be most effective.

The two drugs I'm taking now are Adriamycin (the red Kool-Aid) and Cytoxan.  Adriamycin acts during multiple phases of the cell cycle and is considered cell-cycle specific.  Cytoxan (which is actually a derivative of mustard gas) is most active in the resting phase of the cell, so is considered cell-cycle non-specific.

Unfortunately, chemotherapy does not know the difference between cancer cells and normal cells -- it only knows that it is to kill all cells that are rapidly dividing.  There are other, normal cells in the body that also rapidly divide, such as cells in the mouth, stomach and bowel, hair follicles, and blood cells.  This is why most of the side effects of chemo drugs are mouth sores, nausea or diarrhea, hair loss and low blood counts.  Once chemo stops, these other normal cells will grow back and healthy.

The most troubling side effect is the low blood counts, particularly low white cells.  Once chemotherapy starts, the bone marrow stops producing new blood cells.  If a patient gets any infections, the white cells in reserve can get used up and no more are produced, unless chemo is stopped for a time to allow the blood cells to build up again.  This retards the effectiveness of the chemo treatment.  This is why, 24 hours after a chemo treatment is complete, a cancer patient gets an injection of Neulasta, a drug that stimulates growth of blood cells.

So ... that's the cancer treatment lesson of the day.  Now I'm going to go sit in grandma's rocker for awhile and try to get through the day.

Agusut 24, 2010 - PM

All in all, I think I had a very good day today.  Got a little tired in the early afternoon, and kind of felt like you do when you're on the verge of getting a cold.  But other than that, I feel suprisingly ... normal.  Oh, other than the brain muddleness.  But that could be advancing years, too.

Closed the shop at 3:30 and went to Waconia for my Neulasta injection.  (I had planned to write more here about the injection, it's purpose, etc. but frankly, I'm way too tired tonight.)  Got home around 5:30 (after another side trip to Target).  While Al mowed the lawn, I attemped to advance in my Deathly Hallows book, but I was overcome by a heavy tiredness.  Couldn't really sleep, but couldn't do much of anything else, either.

Bonny showed up with a fabulous meal about the time Al finished the lawn (perfect timing).  We ate (I had about a half an appetite), watched the news and an episode of Rubicon (which I may not have picked up all the details on), and now at 9:00 PM I can hardly wait to hit the bed.

Just took another anti-nausea pill (they said to stay ahead of it, rather than behind it) and an ibuprofen (in case the aches from the injection wake me up), and I'm turning in.  So nice to have one of those nights where we can leave the windows open all night.  I may not hear the coyotes tonight; hopefully I'll be too sound asleep.  G'Night.

August 24, 2010 -- AM

Still feeling good.  Despite how tired I was last night, I had trouble falling asleep.  They said that might happen, as one of the anti-nausea drugs they gave me is a steroid, and can make people feel hyped up.  Adding to that, I didn't exactly have a bland meal last night so, not wanting to be awoken by nausea, I took the optional "take one" of that same drug before going to bed.  After lying in bed for a half hour and still feeling "tired but wired" I took a half of a Simply Sleep (the PM only part of Tylenol PM).  I guess it worked.  I slept.

I feel well enough right now to go to the shop today (with Al, of course; he took the day off).  We do have a floral pick-up this morning for an anniversary (I made it up before I left for the day yesterday, not knowing how I'd feel today).  We'll be leaving early (3:45?) to get to Waconia for my injection (more about that later).

I'm getting ready to brew a pot of coffee and coax Al into walking around the circle with me (.7 of a mile) to get my system moving (constipation can be a side effect of the drugs).  We bought a loaf of bread and a dozen eggs last night while at Target -- let's assume they know about the egg scare, and that these eggs are safe.  That's all I would need!

Back again later!

August 23, 2010

My first chemo treatment ended 3 hours ago.  I left the lab feeling no different than when I went in.  But a sleeping Leviathan lurks in my veins.  It could be stirring.  I'm starting to feel a little tired.

We got to the clinic at 2:15 PM.  Dr. Blumenreich had to check my "infection" first.  Actually, it turns out it's not an infection at all.  It's a breast lymphedema, which is not real common apparently.  Lymphedema typically occurs in the arm on the side where lymph nodes (usually all of them) have been removed.  With the nodes gone, there's nowhere for the lymph (part of our everyday body function) to be drained and get filtered.  Sometimes the arm swells with the retained fluid.  In my case, only 3 nodes were removed, but these were the sentinel nodes -- the ones that lymph from the breast traveled to first.  With those nodes gone, as well as the vessels leading to them, my breast had trouble draining fluid that resulted from the surgery.  So, the slight swelling and redness that was originally attributed to infection is just that lymphedema.  I finished the course of antibiotic that I started anyway, and have been applying heat packs to the area for the past few days.  It's better than it was a week ago, but it's not totally back to normal.  But Dr. B felt it would not be worsened by the chemo, so we went ahead.

The chemo lab is a brightly lit room with about 8 recliners (complete with heat and massage options) lined up against the windowed wall.  I took my place on one end, with Al on a chair next to me.  First my technician, Linda, took some blood samples, to check that my levels (particularly white blood cell count) were normal; they were.  Then (after signing all the consent forms) she started the "preventatives" drip.  These are two anti-nausea drugs (Aloxi and Decadron) that are combined with saline and fed through the veins. The Aloxi lasts about a day; the Decadron for 2-3 days.  They must have worked, because I have had no nausea at all yet.

Once those drips were completed, Linda (the blonde on the right in the photo) manually fed two vials of liquid that looked like cherry Kool-Aid gradually into my IV tube.  This was Adriamycin, a rather nasty vesicant that does good things for cancer victims.  The technician must introduce this drug because if any of it inadvertently escapes the vein, it can cause extensive skin damage and blistering.  (She did a fine job.)

When those vials were empty, she attached the second chemo drug, Cytoxan.  This took a little over an hour to complete.  During this whole process, I was able to sleep, talk, walk around (I didn't), or read (got a few pages of Deathly Hallows read; I'll get more reading done next time, now that I know the drill).  The drugs are fairly cool (room temperature) compared to the body's temperature, so at one point I asked Al to get a blanket out of the warming machine and drape it over my bear legs and feet.  Eventually, I also pulled it up over my arms.  This felt surprisingly good, considering my post-menopausal body is always on a low simmer.

When we were done, about 4:45 PM (the exam at the front end set us behind a little), we walked around the grounds a little. The hospital has a couple of nice gardens with waterfalls, and we took them in.  Then we headed to Target, where we needed to pick up two prescriptions for anti-nausea drugs to take at home, as needed.  NOTE TO SELF:  Try to avoid going to Target pharmacy between the hours of 5:00 - 6:30 PM.  They were very busy, and I was told "20 minutes" three times before we finally got the prescription.

As a treat, since I still was feeling fine, we stopped at It's Just Perfect in Chaska for a couple of malts.  They were very good (especially the whipped cream on top), but I'm glad I just got a small one.  When we got home, we were just starting to figure out what Al would eat (I wasn't really very hungry, having had a rather large lunch, ginger ale during the chemo treatment, and the malt), when the doorbell rang and there was my darling neighbor, Sarah, delivering a meal from her mom, Tracy!  And it was perfect!  Not too heavy, and wonderfully tasty.  (I understand my tastebuds are going to start to rebel in the next few days, and everything is going to taste different to me.  I may not be able to stomach old favorites, and things I don't like now may taste wonderful.)

So, now I wait for the onslaught.  There is a long list of side effects, but different people seem to suffer from different ones at different intensities.  So we'll learn in the next two weeks what my body's proclivities are.  I have a lot of reading to do.  I requested a copy of my blood workup, so I'll watch what happens to my white cells every week throughout this process.  Some people don't really want to know all that's going on with them during chemo, preferring to leave all the details to the professionals.  But I'm an analytical type, so I am interested in the details.  To me, more information leads to more understanding.  But that's me.

Yes, I'm feeling ... different.  A kind of "heaviness" is starting to settle in.  I think I could sleep.  But the Twins are only in the top of the 5th, so I might have to go check in on them for awhile.

I'll report in again tomorrow, maybe early in the day, but for sure after my Neulasta injection.  Another cancer victim, who provided me with a whole list of chemo tips, said her worst day was alwasy the day after the injection.  We'll have to see.

August 21, 2010

This morning I had 90% of my hair cut off -- just so the shock of losing it in the next month or so won't be so severe.  I haven't had hair this short since I was 11 years old!  As a kid, my mom gave up trying to comb my long hair without me putting up a fight, so early on she brought me in to get a "pixie" haircut.  That was my look until I turned 12 or so, and I've had long (-ish) hair ever since.

Poor Sheri (my stylist).  She cut, and cut, and cut ... then had to sweep the floor mid-way through, because she was slipping on piles of hair on the floor.  It's hard to imagine that it's likely to come back in even thicker than it is now.   But I think Sheri did a great job!   (Thanks, Sheri!)

 Although -- I did want her to make me look like Emma Watson, and I don't think we quite got there.  I'd need to shed about 75 pounds and 35 years to have a shot at her new look.  But Emma wears it well!

August 18, 2010

Well, we now know what we have ahead of us. Let’s just say I’ll be glad when winter is over!

We had a great consultation with my oncologist, Dr. Martin Blumenreich (old photo, left; add a few years and more facial hair and you have the current Dr. B) in Waconia. He reminds me of Lenny (for those of you who know my dear old friend who used to work in the workshop of our building, and moved with the Treasure Chest folks to Shakopee last spring), except that he has a German accent. He was very thorough and clear about what my situation is, how they plan to treat it, what the risks are, what the side effects are, and what they can do to try to mitigate those risks and side effects. While we had some questions going into the consultation, we had none left when he was finished.

The first thing we’re addressing is that I have a mild infection at the breast incision site. Not serious; nothing a week’s worth of amoxicillin won’t cure.

I’ll be starting chemotherapy on Monday, August 23. The chemo treatment involves going in every two weeks for a 2-hour intravenous treatment. Each chemo treatment is followed 24 hours later by an injection. That’s because the chemo not only kills cancer cells, but it has other effects as well, including causing my bones to cease production of white blood cells. For this reason, infections are a risk during chemotherapy. While there is a storehouse of white cells now, these can get used up during the process, and no more get produced until the treatment regimen is over. The injection somehow helps in the production of white cells. (I think I got that right.)

Anyway, this first round of chemo will involve two drugs, and the bi-weekly 2-hour treatments will last for 8 weeks. According to Dr. B, this will be the roughest part of my ongoing treatment. Side effects are fatigue, nausea, loss or change in taste or appetite, etc. for one day, three days, a week – we don’t know yet; everyone is different. Roughly three to four weeks into the treatment, I’ll lose my hair – all of it, eyelashes, eyebrows, everything. We’re debating about scarves, a wig or au naturale (my husband is not in favor of the latter). We have the treatments scheduled for every other Monday at 2:30 pm. I picked Mondays because they’re usually the slowest day of the week at the shop, and this way I’ll at least get to be at the shop until 2:00 that day before having to go in. Whether I’ll be up to coming to the shop the next day remains to be seen. Some of this is still a mystery.

After that will be another 8 weeks of chemo using a third drug only. Apparently this one will be easier for my body to handle, but I thought he said these would be 4-hour treatments (can’t remember everything). Then after that will be six weeks of daily radiation and anti-estrogen hormone therapy. These daily appointments will take 10 minutes – 9 of which will be positioning the machinery for a 1 minute zap. So all of this should be completed by mid-January, giving me a month to get ready for Valentine’s Day!!

I may need some of my friends to help from time to time. Some are already volunteering for driving duty. Al will be with me for the first chemo treatment, but after that it really doesn’t make sense for him to take off work to sit and watch me read or work on the laptop or whatever for a couple of hours. So I thought if I could get a ride to the lab, he could pick me up on his way home from work. Also, I may be too tired 24 hours later to drive myself in for my injection. Then there’s the issue of the shop. I still haven’t decided what to do about that. I may just close for half days from time to time. I know many of you offered to take a “training course” on my POS system so you could help ring up sales, but honestly, business is EXTREMELY slow during the week. And by the weekend, when it’s busier, I should be fine to come in. Meals on treatment day would be extremely welcome – at least for Al. I don’t know exactly what will taste good to me; the doctor said I might find myself loathing old favorites and craving things I otherwise wouldn’t touch. But I don’t see myself cooking that night.

Here’s the kicker that I learned. When my hair starts to grow back, it’s possible it will be a different texture (more straight or more curly), or even a different color (darker, lighter, or maybe gray!), but it’s likely it will be thicker than it was before! THICKER!! How is that possible! I have so much hair right now, when I get it cut Sheri has to thin it by, like, 30% just so I can dry it in a reasonable amount of time.

As it stands right now, my first couple of treatments are as follows:

•  Monday, August 23 Chemo 2:30-4:30 PM
• Tuesday, August 24 Injection 4:15 PM
• Wednesday, Sept 8* Chemo, Dr. appt 11:30 AM–2:30 PM
• Thursday, Sept 9* Injection 2:30 PM
• Monday, Sept 20 Chemo 2:30-4:30 PM
• Tuesday, Sept 21 Injection 4:15 PM

 *This is because Monday is Labor Day, so that week will get screwed up a little. Otherwise, the Monday/Tuesday schedule should continue all the way to the end of November with the possible exception that, if I heard correctly, starting in mid-October, the treatments might have to start at 12:30.

Anyway, that’s where we stand right now. Maybe next week I’ll be able to give everyone a first-hand education on what chemo feels like and what I’m doing to handle it. I know my kids feel bad about my having to go through with this. And, of course, if it were my choice, I’d pass on this adventure. But, as I learned long ago, I’m not in control anyway - of anything, except my attitude. So we’ll go through this as best we can. Ever since I found out this news, I have never felt, “Woe is me. Why did this have to happen to me?” Instead, I feel as though there is some reason I was chosen to do this. God intended for me to go through this trial. And some good will come from it – maybe for me, maybe for someone else. But this is the task I’ve been selected to carry out.

“God, help me to remember that nothing is going to happen to me today that, together, You and I can’t handle.”

August 11, 2010

I sincerely apologize for my silence these past couple of weeks. I stirred everyone up with my initial news, and then neglected to keep everyone suitably informed thereafter. I’ve been tired, busy and involved with company, so now I’d like to catch everyone up.

I have recovered nicely from the surgery. My two incisions (one under my left breast where the tumor was removed and the other under my left arm where the three lymph nodes were removed) have been healing well (we were given WAY to many Vicodin to take home; I think I only used 7 pills total, including one to get me through the Twins game at Target Field 3 days after surgery).

I had a follow-up appointment with my surgeon last Thursday (August 4) to go over all of the findings. They were pretty much what we had already heard, with a few minor edits. She (Dr. Amy Whitson, my outstanding surgeon) removed a 9 cm lump from the lower part of my left breast, somewhat recessed into the chest cavity (she had described it to my husband as the size of a baseball, but I think a baseball is bigger than 9 cm). Of this, 3 cm was the diameter of the actual cancer tumor (they had told me 2 cm earlier), the balance was additional tissue. To be classified as Stage IIA cancer, the tumor must have been 2 cm or less, so this pushed me into the Stage IIB category (not that that’s a big deal).

When the pathologist examined the nearest lymph node, he was puzzled by the fact that the cancer cells in it were microscopic and scattered. Generally when a cancer spreads, it begins replicating immediately, and so they find one or more clumps, which they measure to further define the situation. N0 means the metastasis is < .02 cm. Because these cells were scattered, they had to estimate the combined size, which originally they said was in that range. However, they revised it to .03 cm, so that put me at N1mi (for microscopic). The only difference these numbers make is that they confirm that they will add chemo to my treatment; they might have anyway if I had been Stage IIA N0, but for sure if it’s Stage IIB N1 chemo is recommended.

The pathologist also sent his findings to both Mayo and Methodist, to get additional opinions on whether they should go back in and take any more lymph nodes out. The unanimous decision was that this was unnecessary. They feel that with radiation, chemo and hormone therapy, if there are any more scattered cells left in me (presumably in lower quantities than what they found in the nearest lymph node), they will be destroyed by the treatment anyway. Saves me from getting cut open again.

My next appointment will be my initial consultation with Dr. Blumenreich, the physical oncologist and hematologist. He will lay out my treatment schedule, and discuss all the pros and cons of the treatment options. A couple weeks later I’ll be introduced to Dr. Sperduto, who is the radiation oncologist. So I still don’t know what order these treatments will come in, nor their frequency, duration, intensity or timetable. We won’t know until we start whether they produce the normal side effects, or if my body has a different reaction to them. I don’t know how sick, tired, or anything else I’ll be, so I don’t know how this will affect my energy level or work load. It’s another adventure.

On a more positive note, my son and daughter, who both live in Southern CA, came to see me this weekend. I see my daughter (age 30) quite regularly, but this was her first visit since my diagnosis. She left to go back on Monday. I had not seen my son (age 25) in a year and a half, so it was awesome to have him here. I have missed him incredibly. He left this morning. It was a great, fun weekend – maybe one of the best we’ve had together in 5 years.

I will try to be better about my updates, now that I’ve hooked you all into this melodrama of mine. I’ll let you all know what I learn about my ongoing treatment. Your prayers are felt; thank you! And thank you to those of you who offered help and cooked us meals in that week following surgery. Your acts of kindness have made a world of difference!

Love you all!

July 27, 2010

I just woke up from an afternoon nap. I'm home, feel OK (after a Vicodin an hour ago), and looking forward to dinner.

Just for an update:

I went in at 7:45 AM today. They admitted me, then sent me to radiology where they inserted a wire (not unlike a #22 floral wire) to locate the mass for the surgeon, and they injected a radioactive dye into the breast. Then I sat with Al in the waiting room for a little over an hour (re-reading Harry Potter and the Goblet of Fire) to allow the dye to travel. This was to set up the "sentinel lymph node biopsy." Once I went into surgery, the first thing the surgeon did was trace the route of the dye to the lymph nodes with a scope. She removed the first three lymph nodes that "lit up" and brought them to pathology for examination. The first two nodes they examined (which were actually the two furthest from the lump) were clear of cancer cells. The hoped for outcome was that all of the nodes would be clear. Then it would be labeled Stage 1, which requires radiation treatmet follow-up. Stage 2 means the cancer has traveled, and they add chemo to the follow-up treatment.

When they examined the node that had been closest to the lump, they did find some microscopic cells - no clusters, just some isolated cells. Technically, that sent it to the Stage 2 definition, but only just. (They're calling it Stage 2 N0.) But because of the minute amounts of cells found, the surgeon feels (and the oncologists will weigh in later) that radiation only is still called for. She took only the tumor with an extra 1 cm of breast tissue all the way around it (the size of a baseball?), and did not remove any more lymph nodes. If, by chance, the pathologist (who continued to examine that nearest node), finds any more cancer, or the oncologist feels they did not take enough, they can always go back in (in a week) and take more, but the surgeon does not think that is going to be the case.

They should have a final pathology report by the end of the day tomorrow, or early Thursday. I will talk to the surgeon again then. And she told me if either of my children want to talk to her and ask her questions, they'd be free to call her.

So, I woke up in recovery and have the anesthesiologist to thank that I did not get nauseated -- not when I moved from the table to a recliner, and not when I took my first walk to the rest room. (I've had three previous out-patient surgeries of various types involving general anesthesia, and this is the first time I have not had to deal with the urps.) I was even fine on my not-so-easy ride home from the hospital. As a matter of fact, on the way home Al asked me if I thought I could eat a DQ cone. I answered to the affirmative and was treated to a large chocolate cone which never felt better -- partly because I hadn't eaten since last night, my throat was parched from the insertion tube, and it was 93 degrees out!!

They told me to eat light and bland tonight. But hell with that. We have BBQ ribs, grilled turkey and pasta salad (thank you, Linda), and all of that sounds extremely good to me right now. Al is heating it up and I intend to enjoy my dinner and the anticipated thumping of the Royals by the Twins.

Al took tomorrow off, and will go with me to the shop tomorrow. I don't anticipate having to do much, but I just love to be there. I'm sure I'll be fine.

Thank you,everyone, for all of your prayers and good wishes. Pray for no more cells in that lymph node. I'll be in touch.

July 22, 2010

What a surreal 48 hours this has been.

I received a call from one of the nurses in radiology yesterday afternoon, saying she would help me to get an initial consultation scheduled with one of the three surgeons available at Ridgeview at the earliest possible time. Shortly thereafter she called back to say the soonest I could get in would be some time on Monday (July 26). She said she would put a binder in the mail to me that has the most up-to-date reading material on breast cancers, surgical and treatment options, etc. so I could study up on my situation before the appointment. Fine.

An hour later, the hospital called to say they had a cancellation for this morning with a different doctor, and would I like to take that time slot, rather than wait until Monday. I was happy to do so. After a lengthy interview (the surgeon still hadn’t gotten the final pathology report yet) and exam, we talked about treatment options. I feel very comfortable with this surgeon, Dr. Amy Whitson (photo, left). She talks professionally, listens and answers all my questions. As expected, she thought a lumpectomy was appropriate. Radiation will be involved in follow-up treatment, but whether or not chemo will be needed will depend on whether, during surgery, they find that any spread has been found in the lymph nodes. Physical exam showed no swelling in any of the lymph nodes, but you never know.

Scheduling? Believe it or not, I could have had the surgery TOMORROW! No kidding. But I elected to delay a couple of days (which won’t make any difference in outcome), and scheduled it for Tuesday (July 27). I felt I needed a couple of days to catch up with this runaway cart – they don’t have the pathology report yet, I don’t have my reading material yet, and I just don’t want this to go so fast that something gets missed. I’m fine with Tuesday —as long as I can still go to the Twins game next Friday!  I still think it’s amazing that I can be having surgery only a week after my initial doctor’s appointment, 10 days after the initial discovery of the lump.

Of course, there always needs to be a pre-op physical, which I’m going to be having in a couple of hours. I was able to get in to my doctor yet today. So … this train is moving!

I want to thank everyone for their very supportive emails and hugs (Bob, you almost brought me to tears this morning). You’ve all been incredible. I’ve had offers of prayers and food, offers to help man the shop during appointments, offers to accompany me to appointments if Al can’t – even offers to help weed the garden (Barb, you have no idea what you're volunteering for!). You guys have no idea how much your friendship and generosity mean to me. If, in the week or two after surgery, a couple of you want to drop in from time to time to see if I need a nap, I’d welcome your company. Other than that, I guess I don’t even know enough now to know what I might need. But I now know I have no shortage of good friends, and for that I am grateful.

July 21, 2010

On Saturday night (July 17), my husband discovered a lump on my left breast. (He says, "God made boobs appealing to men so women will get regular breast exams, because women won’t do them."  And he’s right; I haven’t been doing self exams. And, worse, with all that getting the flower shop up and running has entailed over the past two years, I skipped my mammo last year, so it's been two years.

If Al hadn't been in my life, and if his mother hadn't died of breast cancer 45 years ago, I may have waited to act on this.  I mean, there's no history of breast cancer, or any cancer for that matter, in our family.  I've always been extremely health, as was my mother.  I'm 57, and have never had a serious health problem.  My first thought was, "It couldn't be."  Thinking it must be just cartiledge or something, I checked for a match on the other side.  Nope.  So, knowing how troubling this must be for my husband, my plan was to get in to the doctor, have him rule out any problem, and thus put my Al's mind at ease.

So, I called my clinic on the next business day (Monday, July 19) and was able to get an appointment for yesterday (Tuesday, July 20). I went from an exam at my doctor’s office, directly to Ridgeview Medical Center in Waconia for a mammogram, followed by an ultrasound in the room next door, followed by a biopsy – all in about 3 hours. The radiologist promised to call by mid-day today with the results, which he did.

So the bad news is that it IS breast cancer. BUT the good news is …

• We found it relatively early, and it’s not real big. At the hospital yesterday, the radiologist (Dr. Gross) guessed that the mass was about 1” in diameter. He now says it’s more like ¾,” and it’s surrounded by some scar tissue and fibrosis, so the actual cancer is even somewhat smaller than that.
• On a scale of 1-3, Dr. Gross has graded it a 2, based on looking at the nucleus and measuring the activity of cell replication. It’s not an extremely quickly spreading type (3), but it’s also not just sitting there (1).
• He’s going to inform my regular doctor, and also have a surgical nurse from Ridgeview Medical Center (where all the diagnostics were done yesterday) call me later today to discuss the next steps, so I guess I’ll know more later.
• He says he does not consider it an emergency. If I were to tell him I have vacation plans booked for 3 weeks from now, and I’d like to take care of it after that, he said that would be fine. But because I don’t, and nothing in my life is more important right now than getting this behind me, there’s no point in delaying.
• He’ll let the surgeons lay out the plan, but based on his experience, he believes it will involve a lumpectomy followed by radiation, and we’ll be looking at this thing in the rear view mirror in the not too distant future.

I’m fine, and extremely optimistic. Surprisingly, Al seems to be fine, too, considering that the traum of losing his mother to breast cancer when he was 10 years old was the greatest trauma of his life, so I think he’s being a trooper with this news. Medical advances being what they are, even in the last 12 months, I think we’ll get through this just fine. But prayers are always welcome.

So, ladies, do your breast self-exams!