Wednesday, July 29, 2009

2 down/6 to go .... And Dish Sat & Sun at 9

Had my second chemo today- in all respects it went more smoothly this time. Everything went well in infusion, no seeing stars afterwards, no incoherent conversations :), could work productively afterwards, good appetite, no nausea, didn't crash for my 3 1/2 hr nap 'til 6:30 or so.

I was a bit worried about getting this chemo round since my blood work was all over the map - but I guess the right things were close enough(?). In any case, I got it. I'll learn more next week at my follow up appt.

Today was the first day that I have started to become "follicilarly challenged" so I cooked up a plan to visit my hairstylist on Friday. We are going to make the switchover - "out with the old and in with the new". It turns out she's happy to adjust my "cranial prosthetics" to better fit my face and look.

Here's to a good appetite in the next few days - Bon Appetit!

Dish Plans - As of now, I plan to walk the Dish both Sat and Sun (8/1 and 8/2) this weekend.


Monday, July 27, 2009

Yeah, yeah... I know....




....It's been more than a week since my last post! But what a chaotic week.....

So last weekend I did walk the Dish both Sat and Sun mornings! Yay for the exercise and thanks to my Dish buddies: Pat, Robin and Sue! It goes so much more quickly when girls spend the whole time talking about... um...whatever it is girls talk about. Coulda been the exercise, coulda been the chemo, ... but I did go to bed at 7 both nights!

The neulasta shot didn't make me feel like a truck hit me on friday ( which is good) .... but it did make me tired and it did result in some wicked headaches sun thru wed - Now I know and I'll be more prepared next cycle! I'll also be prepared for waves of what I will call "chemo-rage" - or highly exaggerated emotional swings during the headache phase. I sent an embarrassing "red-lettered" email at work during that time that made me stop and think about the interplay between my treatment and my work. I think just being aware of how the chemicals make me feel is a good start toward preventing that type of thing from happening next cycle. I also got to experience the frustration of trying to find something to eat during the "mouth-sore" phase. It lasted about 5 days in total and took me by surprise. Again, now that I know.... I can be a bit more prepared.

I did get my kitchen cabinets modified to make room for a new, larger ( ie normal sized) refrigerator. Now if I could only get a delivery date for the new fridge :) Turns out the model that I want was written up in consumer reports as a best buy so it is on backorder with no promise date. Oh well, at least I know that CR likes it! This project took several days out of the week and required me to empty out many of the cabinets in order to run some plumbing. Great opportunity to prioritize and add to the goodwill pile growing in my garage!

My food posse continued to provide a wonderul selection of delicious healthy foods! Melanie provided a huge container of healthy greens cooked in coconut milk, quinoa with currants/scallions and marinated cukes. And Angus cooked up a healthy mixed vegetable sauce over forbidden (black) rice. Ken and Sue surprised me with a (still warm) batch of split pea soup. And my first organic box delivery appeared. To top it off, my garden is spewing out beans, cukes, tomatoes and peaches! I am eating well!

And it was a fun social week:




  • Sandy's wine potluck last sunday - at that point I could taste and spit. What a great variety of wines and great food and company.


  • This past Saturday we celebrated Lori's birthday at the beach! The sound of the ocean is as healing a sound as I can imagine. Makes me think that I need to get to the beach as much as I can during this treatment adventure.


  • Sunday - "Last Hair Standing" BBQ! I couldn't resist. I just had to have a last minute BBQ to celebrate the last weekend of my natural hair. (Apologies to those on FB that didn't receive the invite - my intention was that all local FB friends were invited but I heard that some folks did not get the invite - sorry about that)


  • What a great party! I had such a great time - it feeds me to have that much fun with and support from friends. Everyone cooked up the most healthy, delicious food! I have never eaten so well! And though I couldn't even taste wine this time, I had such fun watching you all!! I think I get a contact intoxication just from being in the midst of the wine merriment!


It was a big week! Today and tomorrow I'm eating all I can eat while I have a good appetite!



Wed 7/29 is the next chemo treatment - the 2nd out of 8. In theory I will lose my locks shortly after the 2nd treatment. Next up - fun wigs!



[ My chemo treatment is 16 weeks - 8 chemo infusions, every other Wed starting July 15. First 4 are AC, last 4 are Taxol]




Thursday, July 16, 2009

Day 2 Report - and Dish hikes this weekend

So Day 1 was a bit rocky but Day 2 has been much better. I'll be at the Dish 9am both Sat and Sunday this weekend (July 18th, 19th)

Day 1 started out pretty good - they told me that the chemo would be 5 hours ( pretty standard) but it was only 3 hours. That's because one of the drugs Adriamycin ( referred to informally as the Red Devil - it is bright red) is pushed by the nurse into the vein rather than dripped. So it takes a much shorter time. The regimen starts with an oral anti nausea pill then in the drip some saline, steroids and another anti-nausea med just to get you started. Then comes the Red Devil push and then finishes with a Cytoxin drip. This is the AC part of the AC-Taxol. The first four treatments will be AC.

I drove home safely but once I got home I kept getting hit with waves of dizziness, spaciness, queasiness and then drowsiness. I took a full 2 hour nap in the late afternoon and then got the waves again. I had a pretty incoherent phone call with a friend! I'm thinking that Day 1 will be an "alone day" - not quite fit for company!

Day 2 has been much better. Anti-nausea pills have kicked in and while I don't have a giant appetite, I can certainly feel hunger and can eat most healthy things today. Fish seems to still be off limits - something about the smell - which is a bummer because I love fish!

I went to work and worked a good chunk of the day.

Two appts:
First an aspiration - down to 30cc's so I'm hopeful my lymph is figuring out a new route back.
Second, I had a Neulasta shot to beef up my neutrophils (WBC) to keep from getting immunosuppressed. I have heard that Day 3 is the peak nausea plus the peak pain from the neulasta doing it's job and inciting the bone marrow to crank up the neutrophil production. That means bone pain on Day 3. But if bone pain means great neutrophil counts then bring it on! I'll report back on that :)

And today I had 2 visits from members of my food posse - Thanks!!!!:


  • Melanie brought her famous carrot/ginger/miso soup plus Thai green curry of yams and summer squash and Kale ( my favorite anti-cancer food) plus gifts from our shared CSA box.
  • Melissa and Angus cooked a vegetarian pasta with Ezekiel complete protein pasta a beautiful salad with Angus' special dressing, and peach/banana homemade frozen yogurt. It was yummy.

A very good Day!

Wednesday, July 15, 2009

Down the rabbit hole....

Wed July 15

"In another moment down went Alice after [the rabbit], never once considering how in the world she was to get out again. The rabbit-hole went straight on like a tunnel for some way, and then dipped suddenly down, so suddenly that Alice had not a moment to think about stopping herself before she found herself falling down what seemed to be a very deep well." Lewis Carroll


That is kind of how it feels. Today is the first day of chemo - 16 weeks of dose dense AC-Taxol - administered every 2 weeks.....the first of three legs in this treatment journey. I don't usually condone violence but I am looking forward to having the chemo kill cancer cells! I really would like them out of my body!


Thanks to all of you who have offered support! I can drive to and from chemo and appointments and should be able to work through it as well. So, I still don't know what else I will need during chemo but I will keep you all posted.

In general, though, I can always use food and company :)... and Dish-walking buddies on the weekends. (I'm supposed to walk/exercise as much as I can during chemo)





Tuesday, July 14, 2009

Exaspirated - tired of being aspirated

Sun July 12
This past week I invented a new word - Exaspirated. I am exasperated by all these aspirations!

Oy, my lymph hasn't figured out where to go yet since a number of nodes have disappeared and this poor, confused lymph collects in a pool under my arm. I got aspirated twice last week and am due for another one tomorrow. We are talking 70cc's and 85 cc's respectively. In my calibration world that is somewhere around a tenth of a bottle of wine sitting in my armpit.

I had a talk with my lymph today and gently told it that I understand that it is lost and I'm sure that it feels confused and sad but that it will feel better once it finds a new way back into the collective lymph system with all the other lymph. I'll feel better too!

Except for the aspirations, not a big medical week. I worked almost an entire week in the office last week and it felt great - I often forget completely that I am sick when I am in the office. And that is a GOOD thing.

Ran lots of errands this week including looking for a new refrigerator - turns out the one that has all the features I want is out of stock everywhere I look. Silver lining is that a new crop of refrigerators is coming out in Aug, many with the features I want. So soon I should be able to get a new full sized refrigerator! ( Those of you who have been to my house might remember that I have an "apartment' sized fridge and now I really need to upgrade)

Gearing up to start chemo on the 15th.

Surgery...Qtr end close and a 4 day weekend!

July 5
I feel like my life went through the eye of a needle this week!

First the good news - CT scan normal! The second test ( of 2) to rule out stage 4.
So, I am stage 3 ( T3,N2).

Surgery- Had the excisional lymph node biopsy Monday. It was kind of a bigger deal than I had been led to believe. After 3 days, I developed an extreme allergy to the tape adhesive so we removed that and replaced with dry bandages and paper tape- which means that I can't shower. And it really hurts... I've got a big pocket of lymph built up which will be aspirated tomorrow. It's the first surgery I've had where the pain increases over time ( due to the fluid buildup). Frustrating!

Pathology - well even if the news is bad, it's good to be conclusive and the pathology on my lymph nodes was just that. The nodes are completely " involved" so all nodes will be removed during surgery, there will be radiation to the node sites and it's good that we are starting with chemo. The only story right now is that we need to prevent the "animals that have escaped the cages" from creating homes in other locations. Surgery is incidental.

Work - Yup it's quarter close starting this week and I'm off galavanting around getting surgery and taking vicadin! Luckily, my work has been extremely supportive and my manager hired a contractor to help me out during this difficult time. She has been great - smart, learns fast and has already made process improvements. She even stuck around late on Wed so we could post all our journals. Hope she will stick around to cover me during surgery!

Chemo training: Yup it took an hour for me to get chemo training! There are other prescription meds to buy and to schedule, OTC meds to buy for side effects from the anti-nausea meds, instructions, a calendar, phone numbers, symptoms that must be reported immediately, symptoms that we just have to get through, what not to eat during chemo, etc. All this on my day off from work!

4 Day weekend. Even though I got chemo training on one of my days off, I sure needed that 4 day weekend! Tried to sleep in, visited with friends, went to parties, and just exhaled. It has been a whirlwind and I just needed the earth to stop spinning around me. At least I don't have any major med appts next week and can focus on work and quarter close and getting ready for chemo which now starts on July 15th.

A bump in the road .... and a 2nd opinion

June 26 - A BIG week with a bump in the road and other detours

First of all, I "passed" the MUGA and my bone scan was normal! - yay!
But, then the ultrasound results were confusing and the MRI showed an "area of concern" of almost 8cm as well as a much more dismal view of the axillary nodes. Not what I was hoping.

Outside of that it was like the path disappeared for a while..... then re-appeared but at a distance.

On Monday I did have the node ultrasound but the results were very confusing to the team. Several of the nodes did look "involved" ( ie cancerous) but the pesky 2.5 cm node appeared normal ( which we all knew to be preposterous). So, after a presentation to the tumor board, the team decided that the safest solution was to perform an excisional ( ie surgical) biopsy on several of the nodes and get a clear pre-chemo pathology report on the level of "involvement". This would also aid in staging the disease, ensure that during breast surgery the safest/most appropriate number of lymph nodes would be removed and that the appropriate radiation treatment would be recommended.

I was disappointed to learn that the chemo would be delayed by 2 weeks because of this decision but I do understand the importance of getting accurate pathology data on the nodes. The surgery is scheduled for this Mon June 29.

Another development was that the Stanford tumor board called back this week and so I scrambled to get the biopsy slides, charts and a cd of all the mammogram, ultrasounds, and MRI to Stanford. Don't get me wrong - I am very happy with my team at PAMF, I just thought that it would be a good idea to get a 2nd opinion and also to get into the Stanford system in case things got, um, "more interesting". I'm reallly happy that I got a second opinion from such an excellent team and that this team came up with the same exact diagnosis and treatment plan as my current PAMF team. I was especially happy to hear that my oncologist had worked under the head Stanford oncologist and that his reviews of her were glowing.I'll sleep better knowing that I got a second opinion, that it matched my plan and that my current team is validated.

I'm scheduled for surgery Monday and will stick with the PAMF team at this point and am looking forward to getting treatment underway!



Meetting the Team - Choosing a path -scheduling tests

June 19 - Meeting the Team

The team:
Dr Runi - surgeon, Dr Colocci - Oncologist, Dr. Bates Plastic Surgeon, plus an array of support folks- social worker, geneticist, financial "counselor", nutritional counselor, and of course, the indispensable nurses that do all the prep work.

This week was all about meeting the team and settling on a path. We started on the path of surgery first, then went back and forth a bit, but ultimately settled on a path of chemo first, then surgery, with chemo starting July 2. I was really happy to be starting treatment as soon as possible! It turns out the "area of concern" with multiple masses was measured by my team doctors at 6-7cm rather than the 4 ish cm measured by the first ultrasound. That ( combined with the palpable lymph nodes) means that the cancer cells have likely entered the lymph system and are circulating throughout the body. This means that I am at least stage 3 with more tests needed to rule out stage 4.

Or, as I have been thinking about it, " the animals have left their cages" and we need to round 'em all up and move 'em out. Chemo is the tool for that task and the earlier the better. I will have 16 weeks, dose-dense AC -taxol with treatments every 2 weeks. According to the oncolologist, I can drive to/from the chemo and should be able to work for the most part throughout the treatment. I'm happy to keep working - its the only place I forget that I'm sick!

Lots of tests scheduled:
  • MUGA - Apparently one of the chemo drugs can sometimes create heart issues so I need to pass this test in order to be able to take the chemo and it will form a baseline for future evaluation of the effects of chemo
  • Ultrasound of the lymph nodes - a further look at the axillary nodes to see if they are "involved",especially that pesky 2.5cm node
  • Bone scan - one of the tests to rule out stage 4
  • Breast MRI with contrast - further look at the breast masses
  • CT scan with contrast - the other test to rule out stage 4

With the change in direction this week my head is spinning! I have to re-organize my life for the chemo now.

I am so looking forward to a hike with friends tomorrow morning at Rancho SanAntonio. Everything I read says that exercise is a good thing for beating cancer. I also have a fun weekend planned with amusic party on Sat night and on sunday: brunch with friends, drinks with a friend and some more music in town. Looking forward to exercise, parties and time with friends!!

The telling

June 14 - The telling

How do you tell people this news? Who do you tell? When do you tell?

I tried telling my brother ( my only living family member) and his landline was disconnected and his cell doesn't work in his house. Ironically I could get on his FB wall and kept posting "call me" which he kept responding to with smart aleck remarks. After 2 days of this he did finally call and ... possibly felt a bit ashamed after I told him the news.

Work - I told my 3 bosses because I will need to take time off for diagnosis and surgery and treatment. I think I will tell the rest of work folks that I have a medical issue and am still ironing out the treatment plan. Which is true! I haven't even seen the surgeon.

Over the weekend I ended up telling a whole lot of people - because I ended up seeing a whole lot of people. Went to the RandC at happy hour time and ordered an iced tea. Time seemed to stop as the bartender looked at me like I was a Martian - " No really, I want an iced tea..... not drinking for a while" That drew even more stares and confusion. I just decided to blurt it out..... "I was just diagnosed with breast cancer and I'm not drinking for a while" "Oh....I see.... that'll be $2" In the silver lining dept my bar tabs ought to go down drastically! So, then the cat was out of the bag and suddenly everyone that I knew at the bar was in shock and then full support mode with hugs and sobs all around. These are the people I see almost every day so it was terrific to feel this network of support.

Then, ironically, I was hosting my wine tasting group on Saturday and rather than make up a story about why I wasn't drinking at my own house at the winetasting party, I again took almost everyone aside and told them the news. The cat is really out of the bag now!

There are a number of people that I feel I need to tell ... before they find out from someone else or when I post the blog address on FB. THis week will be very hard as I try to contact them all by phone.