Top o' the morning!

We went on our first walk this morning since my lumpectomy.  This is one of my favorite yards, but the  photo really doesn't do it justice.  It's a combination of tropicals and natives and this is its best year yet!

Cancer update:

I met the oncologist, Dr. Hellerstedt yesterday.  I really liked her.   I found out this morning that she was my friend Corie's mother's oncologist. Corie had e-mailed me the day after I had gotten the recommendation from a friend, singing the praises of her mom's oncologist,  how she had saved her mom's life,  and that I should at least meet with her,  but didn't mention her name.  Tiny, tiny world.  I feel like the goddess of healing has smiled upon me!  Thank you, Kati and thank you, Corie!

My cancer was classified as Stage 2A due to the size and the positive test for HER2 sensitivity. This type of cancer is fairly aggressive (grade 3) which explains how it got this big relatively quickly (3.2cm).

So here's the treatment plan. 3 months of chemo cocktails every three weeks including the "red devil," Adriamycin.  After that Taxol for another 3 months along with Herceptin that blocks the HER2 receptors. The Herceptin continues for 6 months after that's done. The first three months are will be the hardest, the 2nd and 3rd phases of treatment will be a lot easier to handle.  That which doesn't kill me... http://www.chemocare.com/faq/act_chemotherapy.asp

Beth said I'm likely to have 1-4 rough days after each treatment during the first phase. Chemo lasts three-four hours.

Next week they're doing every test under the sun:  echocardiogram, CT scan, brain MRI, full bonescan. This is to establish my baseline measurements of health so they can monitor me throughout the treatment and post-treatment for signs of problems or recurrence. Chemo starts on Tuesday,  August 3rd.  

Oh, Dr. Hellerstedt also gave me a prescription for a cranial prosthesis, i.e. a wig!  Isn't that hilarious?  So, I have always wanted a wig and now

I get one and insurance will pay for most of it!  Whee!  Wig shopping

anyone?  Although as hot as it is in September, I will probably be rocking the bald head until it cools off. 

Went for my first walk since the lumpectomy this morning and I feel pretty good. I'm going to see if I can do some light chores like laundry folding and a little pick up around the house, too. Then we're going to go out to dinner with some friends tonight, too. Life is actually pretty damn good, in spite of this foolish cancer! 

This is Ida Skeen and me.  Ida was my nanny when we lived in Port Arthur.   Because both of my parents worked and Ida, my mom's friend Judy's mother, needed employment, Ida came to live with us during the week where she looked after the house and me.  Mostly she looked after me.  We loved each other very much.  When my dad took a job in San Benito (down in the Rio Grande Valley), Ida moved with us.  Sadly, she missed her own family and grandkids so much that she only stayed with us for a year, then moved back to Bridge City.  I missed her terribly and when we would go to visit family in Orange, we always made a trip to Bridge City to see Ida and her big, affectionate family.  They became very dear friends and I loved spending time at their rambling old country house.  There was a screened sleeping porch and lots of big old comfy furniture for curling up in and reading.  The back yard was huge, with enormous trees, a badminton net, and a big vegetable garden.  Ida's grandsons,  Ricky and Butch, who were a few years older, would actually play with me sans complaints! 


I was thinking about Ida today because when I looked at this picture this morning,  I realized how beautifully it depicts love.  I'm feeling a lot of love right now for Morgan and our family and friends, and I know how healing that is.  


My lumpectomy was yesterday.  Three lymph nodes were also removed.   Some hopeful news is that the sentinal node (http://www.webmd.com/breast-cancer/guide/sentinel-node-biopsy) does not appear to be cancerous.  If no cancer is found there, chances are that there will be no cancer in the other two that were removed.  And if it's not there, then it's safe to say that it's not in the lymph system.  Cancer is happiest in the place it originates.  The next place it wants to go is someplace neutral--the lymph nodes.  It will usually move to another organ only after going to the lymph system.  So now we have to wait for the pathology report to make sure the edges of the mass that was removed are cancer free (known as "clear margins") and I'll meet with my oncologist.    If the margins are clear, then I'll move on to radiation.  If not, more surgery.   There's a lot of time spent not knowing with cancer.  I've been getting friendlier with that frame of mind.   It's teaching me to live, if not in the moment, at least in the day!  


The surgery recovery period is going to be longer than I'd anticipated.  I'll be able to move around this week, but I can't lift anything heavier than 5 pounds, can't drive for 2 or 3 weeks, and have to wait until my surgeon authorizes it to begin exercising.  I've cut my pain med dosage in half and that seems to be fine.  Yes!  
I'm going to stop typing now because that seems to be making the affected arm sore.  

Life goes on

Tomorrow I have the lumpectomy--such an ugly word.   Morg and I met with Dr. Martinez on Friday.  The procedure is pretty straight-forward (http://surgery.about.com/od/proceduresaz/ss/Lumpectomy.htm).

It's the side effects I worry about, like lymphedema (http://www.networkofstrength.org/information/treatment/sideeffects/lymphedema.php).  Ew.  We should have the pathology report by Thursday, then we can proceed with radiation and chemo.  Morgan is taking the week off to care for me, but I'm hoping that recovery from a lumpectomy doesn't take that long.  

Last night we had a scrumptious dinner at Laura and Greg's house: grilled wild salmon and eggplant, roasted potatoes, broccoli, and cauliflower, a delicious fennel and apple salad, followed by a desert of dream bars (http://bakinandeggs.com/2009/10/22/dream-bars-angel-bars/)

topped with vanilla gelato.  As you can imagine, it was a happily sated group. 

This morning my friend, Elena, brought us two (!!) lovely homemade veggie pot pies. Yum! That's dinner for several nights this week.  Thank you, Elena!  Then we wandered over to the Hope Farmer's Market on the east side.  (11-3 Sundays) I loved it--nice and shady and very low-key. You can still sleep in a bit on Sunday, have coffee and a leisurely breakfast before venturing out.  If you haven't yet, you should check it out. 

Morgan hung shade cloth over our garden.  Maybe that means we can have a viable garden for the rest of the month! 

Life dishes out a few lemons

I've been postponing this post for a few days now.  I knew I wanted to share this news, yet after finding out only a week ago today that I have breast cancer,  I'm already getting weary of talking about it.  So it looks like, at least for a while, this blog,  like my life,  is going to be headed in a new direction.  


History:
June 17:  After coming home from a fun day spent with Laura on her birthday and a lovely dinner with Lauren, I discover a lump in my left breast.


June 21:  Schedule appointment with the nurse practitioner, Nancy Loomis,  in Dr. Reich's office.


June 25:  After the exam, Nurse Loomis sends me off with a referral for a mammogram and  some encouraging words, "feels like a cyst."


June 28:  The results of the mammogram lead to a sonogram and a short visit with the radiologist who says that there are, "areas of concern" in the images.  I'm to schedule an appointment with the breast surgeon for a biopsy.


July 4th weekend:  Worked on the chicken coop and in the garden, went to Natural Gardener, ran some errands, had Laura and Greg for dinner on the 4th, and had a great weekend despite the looming "areas of concern."


July 6:  My second biopsy--I had one 3 years ago when a routine mammogram revealed some suspicious looking calcifications, all benign--with Dr. Kelly Martinez.  I like Dr. Martinez very much.  Stephanie Reich, my awesome gynecologist, referred me to her.  She's competent, kind, and a straight-shooter.  I trust her.  They give you a local for these things, but they hurt, dammit.  I'm to go back in tomorrow for the pathology report.


July 7:  After I'm escorted into the examining room, I notice that the pathology report is up on the computer screen.  I look.  I see these words, "positive" and  "invasive ductal carcinoma."  It's like a gut punch.  I turn pages rapidly in the "Simple Living" magazine I've carried into the examining room,  my eyes passing over images of  fresh, sunlit rooms, refusing to think, yet turning the phrase, "invasive ductal carcinoma" over and over in my mind.  It seems like an eternity, probably more like 5 minutes, before Dr. Martinez comes into the room.  "I have some bad news," she begins.  Then she repeats the terrifying phrase, "invasive ductal carcinoma."  It's real.  I have cancer.  Invasive means that the cancer has left the duct where it originated and moved into the breast tissue.  It's a little over 1 centimeter.   She says that I'm "an excellent candidate" for a lumpectomy, which must be followed by radiation and chemotherapy.   (We won't know if the cancer has moved into the lymph nodes until the lumpectomy.)  Or, I could have a mastectomy with no radiation, just chemo, but the recovery takes longer and there's no difference in the survival/recovery stats.  She talks to me for several minutes about types of radiation therapy, but really I take very little in.  I'm still stuck on "invasive ductal carcinoma."  As I leave the office, she recommends a couple of books (Dr. Susan Love's Breast Book, the bible of breast care http://www.amazon.com/Dr-Susan-Loves-Breast-Book/dp/0738209732/ref=sr_1_1?ie=UTF8&s=books&qid=1279111996&sr=8-1) gives me a reassuring pat and says, "you'll do just fine."  I'm actually able to take that in.   I'm to schedule an MRI and make an appointment with the radiological oncologist, Dr. Timothy Dziuk, who specializes in a relatively new form of radiation treatment:  mammosite brachytherapy, which I'll talk about later.  I'm numb, but grateful for my husband, friends, and therapist!  I will kick cancer's ass.


July 8:  I schedule the MRI and my appointment with Dr. Dziuk (pronounced "juke," like the box).  I am even more determined to stay positive and kick cancer's ass!   I begin to tell a few of my closest friends. 


July 9:  The MRI.  I requested a sedative because I was afraid being enclosed in a confined space for 45 minutes would make me twitchy, at the least.  The MRI tech, Rusty, was warm, friendly, and laughed at my jokes--which equals "awesome" in my book.  My blood pressure was super high and Rusty said that was par for the course.  He advised me to check it daily for a week and if it continued to be high to make an appointment with my doctor.  In case you don't know, here's what the numbers in blood pressure mean:

• The higher (systolic) number represents the pressure while the heart contracts to pump blood to the body. 
• The lower (diastolic) number represents the pressure when the heart relaxes between beats.

The systolic pressure is always stated first. For example: 118/76 (118 over 76); systolic = 118, diastolic = 76.Blood pressure below 120 over 80 mmHg (millimeters of mercury) is considered optimal for adults. A systolic pressure of 120 to 139 mmHg or a diastolic pressure of 80 to 89 mmHg is considered "prehypertension" and needs to be watched carefully. A blood pressure reading of 140 over 90 or higher is considered elevated (high). 
The MRI was fine, the Xanax had kicked in, and I found the super weird, noisy MRI sounds to be really interesting.

July 10-11:  Another lovely weekend: gardening, doing chores, running errands with Morgan, going to the library and checking out a bunch of books on cancer, a book of Wallace Stevens poetry, and East of Eden, so Lauren and I can read it in tandem--although mostly I'm reading the cancer books, which are fascinating.  I am actually in great spirits.  I will be kicking some ass soon. 

July 13:  
Met the radiation oncologist today,  and really liked him.  A lot.  He explained the mammocite procedure in detail. http://breastcancer.about.com/od/radiationtherapy/a/mammosite-brachytherapy.htm  He has more experience performing mammocite brachytherapy than anyone in the area. When I left his office I felt more informed and reassured that I was on the right path.


   I'm scheduled for the lumpectomy on Monday.   I'm not sure what time yet.  My pre-op appointment is tomorrow and I'll find out then.   They'll also be removing the sentinal lymph node (the closest one to the breast mass) and will be able to tell, while I'm on the table, if it's positive for cancer, although they won't know for sure until the pathology report comes back if it's negative.  If it's positive they'll remove more lymph nodes for testing.  If, as both the surgeon and the radiation oncologist now think (and the MRI seems to indicate), the cancer has not gone elsewhere then I'll start the radiation treatments around mid-week.  I'll be going to those every day (I think twice a day) for a week and then I'll be through with radiation therapy.  

I have a pre-op appointment on Thursday morning and I'll get all the info then about what time the surgery is scheduled, etc.   Apparently the kind of cancer I have is positive for a protein called HER-2 (human epidermal growth factor receptor 2) which promotes growth of cancer cells.  HER-2 cancers tend to be more aggressive than other types of breast cancers.  There's a drug called Herceptin that specifically targets and kills HER-2 cells while reducing the risk of the recurrence of cancer.  It's my understanding that I'll be taking this while I'm on chemo and I'll be on chemo for about a year.  Herceptin has some pretty scary side effects, but supposedly the doctors moniter the Herceptin patient closely for adverse effects.    It just gets more real every day.   I still plan to kick some cancer ass.

Morgan is setting up a support network website for me that will include progress reports and information, things we'll need help with if and when the going gets rough (like grocery shopping, light housework, and meals, errands, etc.) so friends who've asked how they can help out can sign on for whatever they feel like doing in a particular week.   This seemed like a handy thing to have and it's just so like Morgan to want me to have a "Lynell Kicks Cancer" website. Don't imagine I'll really need this before I start chemo, but it will keep the man busy.  He's pretty adorable. 

A couple of our kind and generous friends, who are professionals in the fields of acupuncture and Chinese herbal medicine, have offered free acupuncture and herbal prescriptions (all I have to do is pay for the herbs!) to help offset the effects of radiation and chemo.  I'm really thrilled, since I was thinking about going for acupuncture for help with side effects.  People have just been amazing these last couple of weeks.  We have so many amazing, generous, loving friends.  If you're reading this, I love you all.  And that means YOU!  

July 14:  So this brings us up to date.   I am determined to be present, be real, take good care of myself,  stay positive, retain my sense of humor, and kick cancer's ass!  Today, I'm going to do some grocery shopping, some housework, and do some reading--maybe something that's not about cancer!