Same old, same old

Sorry for the long gap between posts. It seems that this chemotherapy thing has become rather routine and I keep thinking that there isn't much to write about. I had treatment number 3 on Monday and the after effects have been similar to last time. I felt really zonked out Monday by the time we got home - thanks to Mary for being my chemo-buddy this time! Tuesday I felt pretty good but then had to go get the Neulasta shot, and so Wednesday was another achey, sleepy day. The big difference this time is that I stayed sleepy on Thursday, which is the first sign that this is starting to wear me down. Luckily I only have one more treatment with the AC (Adriomycin/Cytoxin), and my Doctor assures me that this is the hard part and the Taxol, which I do four times after the AC, will be easier. She better be right!

Tuesday I went back to Fargo to meet with the Plastic Surgeon and also for a second opinion with another Radiation Oncologist. The Plastic Surgeon was really cool. Her focus was so different from the other Docs - she wanted to know about my hobbies and activities: what do I do with my body, so she could advise me on how the different surgical options would impact my life. It was so nice to have a Doctor focusing on the real me, not just the cancer in me. I found out that not only am I not fat enough to build a boob out of my belly, but also that moving body parts around would have some other consequences that I hadn't thought about, such as difficulty reaching and stretching, and possible hernia. They can also move upper/back shoulder muscle and fat around, which often leaves you with a weak arm and shoulder. Neither of those sounds to great to me, so I guess I'll hold off on packing on the pounds for now. If it does come to mastectomy it's looking like I'll be an implant gal.

I left the Surgeon and headed over to the Radiation Oncologist. I liked this guy better than the first Radiation Doc. He seemed to be a little more restrained in his attitude, both about the radiation and about my supplements. He's not going to support me taking them during radiation, but he cheerfully acknowledged that I can do whatever I want and it doesn't affect his willingness to treat me. He was also fighting a cold and kept coughing and hacking during our meeting. I reminded him at one point that I wasn't supposed to be around sick people, which did get a rather sheepish response. At any rate, I felt more comfortable with this Doctor than the first one, and there will be some radiation therapy after the surgery since there are lymph nodes under my collar bone that will need to be treated for sure. I'm definitely not looking forward to that part since it requires daily treatment (Monday through Friday) in Fargo for about 7 weeks. At least the weather should be better by then - unless the spring floods close all the bridges - that's a possibility!

I hope you all have a Merry Christmas this year! We'll be having ham and kapusta and watching A Christmas Story (in between the never-ending football games)!

Difficult patient

When I was little I noticed a pattern in my life. The things that I worried about and obsessed over never seemed to happen but then I would get blindsided by some totally unanticipated event that would rock my little world. Rather than draw the logical conclusion that worrying obsessively about the future is a waste of time and energy, I drew the logical (?) conclusion that worrying over these things and plotting out the worst case scenarios was the best way to ward off disasters. This trait stayed with me well into my adult life, and served me well is some ways - my bosses always liked my ability to thoroughly plan field trips and the like. But eventually I realized that it is not a great way to live and it really doesn't work all that well when you break it down. Bad things still happen and spending the good times worrying about what might happen is really not a great plan. So I learned how to lighten up and go with the flow more, letting go of my worries.

It is tempting to fall back into those old habits now (but I'm not going to). I was prepared for the worst at the ultrasound yesterday. I was ready to face the tactless radiologist, I was ready for more bad news from the results. I wasn't even anxious going in there, because there was nothing they could tell me that is worse than what I've already been told.

And the visit was just about as pleasant as it could be. The ultrasound technician was a warm, honest, open woman who I liked right away. The radiologist (yet another different one) was the same way. They looked and looked for the spots that the MRI showed and couldn't find anything they would have wanted to biopsy, even if I had been willing to do the biopsy. The down side is (there always seems to be a downside in my stories doesn't there?) that my breasts are incredibly dense, even after two cycles of chemo, which should be putting me into menopause and loosening the tissue up. Finding the spots on me is like looking for snowballs in a blizzard, which was my metaphor, to which the Doctor exclaimed "that's EXACTLY what its like." They said I was a very difficult patient, which I've been kind of waiting to hear from somebody, but I didn't expect that they would mean physically!

At the end of the visit the Doctor took the time to show me the MRI pictures and the PET/CAT scans, which I have been wanting to see. All in all it was a good afternoon that didn't really help me much with the decisions that I have to make about surgery. But I'm going to set those worries aside for today. I feel good, the temperatures are supposed to warm up to a balmy 18, and I'm going to work this morning and ski this afternoon.

Into the Cold

I just stopped by to look at my own blog and realized that I left you all with a post from the bad day, so I had better update this thing because I'm feeling much better since then. I was feeling pretty good by Friday and took advantage of the not too cold afternoon to take the dogs out to the ski trail. I met my goal of skiing down the flatter part of the trail without overdoing it and getting all worn out and sweaty, which is what I usually do. Since walking is getting more difficult due to the snow we've had, I need to master the art of skiing without working too hard. Unfortunately the forecast is for some nasty cold the next few days.

After that nice, stress-reducing exercise, I returned home only to get a call from the Surgeon with the MRI results. Even though I had gotten a briefing from the other Doctor on Monday, today's version was more troubling. MRI's are notorious for finding all kinds of things that turn out to be nothing, but let's face it - every test they have done on me so far has found things to be worse than expected, so I'm starting to get very stressed out by the idea of more tests. And the Surgeon wants to do more tests. The MRI found four or five more suspicious areas on the left side and so he wants to do another ultrasound to check all of those out. If they still look suspicious on ultrasound, then he wants to pick the worst looking area(s) and do another biopsy. The goal of all this would be to find whether the rest of the breast is in fact clear of cancer, in which case a lumpectomy would still be an option. On top of that, I asked him about genetic testing, which some of my research indicated might be a good idea given my age, even in the absence of any family history, and he agreed that I am a candidate and referred me to the genetic counseling center. So if I have the cancer genes, then mastectomy would make more sense and I could skip the second biopsy, or if I just want to choose a mastectomy then I could skip the biopsy, but if I want to try to save my breast, then I will more than likely be stuck getting another biopsy. And the chances are I will have to make the biopsy call long before I have any results from genetic testing. The worst, most stressful part about all of this is that I am constantly having to make decisions before having all of the information that I should have. There are times when having a scientific mind is more of a curse than a blessing. At any rate, the upcoming week will likely be filled with more tests and more trips to Fargo - and I will of course, keep you posted on the gory details.

Just to end on a bright note, I feel great and I'm looking forward to the second week of the chemo cycle, secure in the knowledge that I can expect to feel pretty good. And we're going to the John Berry Christmas concert tonight, which should be a great show.

The day after the day after

That's the bad day: the day after the day after. First of all, they give me some serious drugs before the infusion to prevent nausea and side effects. Those drugs last for between 24 and 48 hours. Second, the Neulasta shot that I have 24 hours after the treatment makes me ache and feel crummy for about a day. So it all converges on Wednesday - the good drugs wear off, the bad drugs are still there, which all adds up to a crummy day. On the bright side though, it was just crummy, not full out crappy. The anti-nausea pills work well, so I haven't been getting sick, and let's face it - one bad day every two weeks is so much better than I had feared this experience would be - I'll take it.

For those who were intrigued by John's comment about the straw bale garden, I have added a picture of my first one. I didn't invent this, I just read an article and decided to give it a try since our soil at the time was basically gravel. You take bales of straw, add some compost accelerator (nitrogen) and keep moist for a couple of weeks, put some dirt or finished compost on top and plant your garden. It is productive, as John said - although I think he has taken it to the next level!

Round Two

Had the second round of chemo yesterday and also had my first real "hat day." Despite seeming pretty solid at night, a bunch more hair came out in the morning and it's looking pretty ratty now, so hats or the wig will be in order for the next few months. I think I have decided not to clip off what's left because it occurred to me that little crew-cut pieces of hair will be way more itchy and annoying as they fall out than big pieces that I can catch and throw away.

For once we had a Monday without snow and the trip to Fargo was easy. My friend Carol came along, which was wonderful. It's nice for me to have the company during the infusion, which takes a few hours, and I think it is nice for my friends to see Roger Maris and get a taste of how great the staff is there. We all feel better about things at the end of the day.

Everything went smoothly again. I'm supposed to be getting Adriomycin, which is one of the chemo drugs that has been in the news lately due to a nationwide shortage. For my first treatment they substituted a related drug because there was no Adriomycin to be had, but yesterday they had the right stuff so I got that. Of course, I've been wondering if things will be different for me this time around with a different drug, and I would say it was a little worse last night than the first time. It seemed like my whole system shut down for awhile - lunch didn't really digest well, I kept drinking fluids in but hardly anything was coming out, and I had quite a headache after I got home and through the evening. But during the night things straightened out and I actually got more sleep than after the first treatment. So far this morning I feel ok. Next step is the white blood cell shot today after lunch, which was what made me feel kind of achey and lousy for a day last time, so I'm planning to take it easy tomorrow.

Down the Drain

I'm getting ready for my visit with the Oncologist and second chemo treatment tomorrow, with another list of questions for the Doc and another great friend lined up for driving and company (yay Carol!)

I started to find hair falling out last night and this morning had quite a surreal shower experience as handful after handful of hair got caught in my fingers. I was wondering if I would ever get out of the shower, because I really didn't want to be covered with hair, but it just wasn't letting up for the longest time. Well, finally the pace slowed down, I got myself dried off, the mirror defogged and I surveyed the damage. Not too bad. It's looking a little thin, but not patchy or mangey looking, so the clippers will stay in the closet for at least one more day. Most of the hair that's left seems inclined to stay rooted. I don't know if that means I have a reprieve of a day or a week before becoming bald, but I'll take it. I like that I get to ease into this rather than having it ALL fall out at once.

Thanks for the birthday wishes and all the great hats. I certainly won't be forgetting this birthday anytime soon!

Not what I expected

Of course, what HAS been what I expected lately? Add MRI's and Vailum to that list. The MRI would have been fine either way (meaning with or without drugs), because it turns out that for a breast MRI you have to lay on your stomach with your face in massage table-type cradle and your arms stretched out like superman. Also your breasts dangle through a hole in the table - do they think this stuff up for men? When was the last time you guys went and put your testicles in a vice to get x-rayed, just in case there might be some cancer there? But I digress. Since my face was in the cradle, there was no way to see or notice in any way what a small tube you are being pushed into, hence no problem with claustrophobia. They didn't offer any music, just the ear-muff style ear protection, and it was still loud. So I lay there, being calm, breathing slowly, but not too deeply, thinking that it was all going pretty well. After about 5 minutes the noise stopped and the technician's voice came through the headphones "you moved a little bit that time, try a little less breathing". WTF? Less breathing... great. So I switched to very shallow breaths, pressing my chest down so it wouldn't move much. Soon it started getting hot, then my shoulder started to cramp up, and it pretty much just got more miserable until it was finally over, about a half hour later. If the Valium was helping, then I guess it would have been really miserable without it.

So what about the Valium? I was expecting kind of a warm fuzzy feeling, like all is right with the world. I was kind of looking forward to that. But I couldn't even notice that I had taken it until after breakfast when I started feel sleepy, despite just finishing two cups of coffee. I felt just slightly dazed, sleepy, and totally unmotivated for the rest of the day. What it reminded me of more than anything was the feeling I used to get when I lived in Canada and had winter depression. Thank god for the stir-crazy dogs who made me take them for a walk this afternoon. After a brisk walk in the cold I snapped out of the haze and felt normal again - so it least it wasn't like the real winter depression that lasts until April.