one year later...

My next chemo treatment will be this Friday, December 15th, 2006. Almost to the day one year ago I had my first chemo treatment. When Dr. Lee told me the treatment of my cancer would be very aggressive I didn't imagine I'd still be doing this after an entire year. Just thinking about it makes me feel exhausted. I honestly don't know how I've managed to come this far. All I know is that I've had a lot of help along the way and for that I am very grateful. I just had another CT scan today; hopefully it will show that the cancer is completely gone. Then I might be finally able to stop this marathon of chemo treatments.

Thankful

Going into the next round of treatment I'm a bit worried about how I'm going to handle Thanksgiving. Between going to Peter's family gathering, and then attending my family gathering on Sunday I just don't have a good feeling about this. Whenever I'm not in my own home my recovery from treatment is much harder. I think it's because I'm just not comfortable in other surroundings and I get easily overwhelmed by large groups. So Thanksgiving this year is going to suck, but I have something to be thankful for…life, (and not feeling nauseated around the turkey).

Oh, My Poor Heart!

I've hit another snag treatment wise. My heart is not taking Herceptin well. It was a risk when I started treatment. The susceptibility of my heart (due to sickness as a baby) was one of the major reasons why we chose Taxotere over Avastin. Now that my heart is struggling we'll be watching that very closely. If it gets too bad I'll have to stop Herceptin for a time until my heart can recover.

What happened was I was rushing from the bus stop to the hospital for an appointment with Dr. Lee. It's a long walk and I was late so I was moving as fast as my tired ass self could go. I was out of breath, flushed, and hot but to me it seemed perfectly normal considering I hadn't moved that fast for that long in quite awhile. Dr. Lee and his nurse, Peggy, were taking my heart rate every 5 minutes. It was not going down. I was fine to the naked eye but my heart was definatly not fine. I was sent to the ER to get me hooked up to heart monitors. Everyone was rushing around me like it was a code or something. It might have been now that I think about it.

I got a lot of questions from different people and none of them like my answers. How do I feel? Fine. Is my heart racing? No. Am I out of breath? No. There were a lot of concerned looks and murmurs then they all left the room like a flock of birds squaking at one another. I was bored so I got out the crossword puzzle book I carried for bus rides and started working away. Occasionally the monitors I was hooked with would go off and the birds would all come back. Fluttering around and asking questions. Are you sure you feel okay? Yes....should I be?

The answer was no. I should definately not be working on a crossword puzzle in the ER while hooked up to heart montiors that keep beeping in alarm. Okay, I said, now I don't feel well.

I was in Ventricular Tachicardia, V-Tach. My heart was beating fast and irratically. I should have noticed. I should have felt light headed, out of breath, and I definately should have noticed that my heart was beating way too fast and way too hard. I didn't, which means I have a-symptomatic V-Tach and that is a very bad thing because my body should be trying to warn me that I might be dying.

I spent the night in the hospital and met a lovely cardiologist, Dr. Hall. She's my height and has a warm smile. I had an ultrasound of my heart. The tech said I had a pretty heart. She explained that most of the hearts she looked at were damaged and didn't light up the screen so much. My heart lit up the screen so much she had to turn the light down. Dr. Hall came in with her diagnosis. My heart was weak from the chemo and Herceptin. It was having to work overtime to pump the blood out of it.

The medication they gave me keeps my heart fairly consistant when I'm at rest, but any exercise can cause my heart to beat even harder, so hard that it might stop. The only way to be sure that doesn't happen is not to exercise. Not a good thing for my ass that's for sure. Nothing more than a casual walk for me if I want my heart to be "Zen-like." That's what Dr. Hall told me I needed to be.

We also learned that my original heart capacity was likely at the extreme end of normal. I probably had a heart capacity closer to Lance Armstrong than the average person. It's all speculation, but I should have had symptoms long before now unless my heart was pretty strong to begin with. For a woman who had life-threatening heart problems as a baby this was remarkable to hear.

Asymmetry

It's been so long since I've written, but I'm finally feeling like myself again. Actually, I'm feeling rather asymmetrical in my chest, but other than that I feel fine. It took me quite awhile to recover from the surgery. I'm apparently allergic to most pain medications so I was experiencing a great deal of pain and not sleeping well. On top of that I had chemo a week after surgery so that slowed the healing process. But now I'm doing okay. I'm even working full time again, and that makes me really tired, but I'm kind of used to being tired. My birthday is in a few days. I'll be 28. I'll be almost old enough for the breast cancer diagnosis to be a little less unusual. Normally at this time of year I'd be treating myself to an expensive haircut and highlights, but all I'll get this year is another buzz cut from Peter. I might sound a little depressed, but I don't really feel that sad. I know I'll be around next year, and I'm already planning what to do with my hair. Luckily I don't have to have any treatments this weekend, so I can enjoy celebrating my birthday without feeling crappy.

Addendum: After the biopsy of the tumor from my breast the doctors determined that the reason the tumor stopped responding is because it was an entirely different tumor. It is possible it was there all along, but surrounded by the other tumor so it didn't show up on the scans. It might even be the first tumor and the other tumor was just a morph of the first. This is explains why there was still positive change in the lymph nodes and liver. It is also really good news because it means that the tumor in the liver should continue to respond to the present treatment.

Ill news is an ill guest.

I hate bad news, so I've put off sending out this email for as long as possible. My last MRI showed an increase in the size of the tumor in my breast. Basically it's no longer responding to treatment. To prevent it from spreading again Dr. Lee and I have decided to go ahead with a mastectomy of the left breast. The surgery is scheduled for Friday September 8th; I'll spend one night in the hospital, and will be taking 2 weeks off work to recoup. The strange thing is that it appears as though the tumor in the liver and lymph nodes is still responding to the chemo. It's atypical, but not much about my case has been typical. Until the scans show otherwise, I'm going to keep having treatment every 4 weeks as usual with the mini-treatment at the half way point. Hope is not all lost, but this is certainly a set-back. It's hard to look at the removal of my breast as a positive, but I think in the long run it will turn out to be the best decision. Now if only the liver will continue to respond to the chemo I'll still be progressing towards remission.

The Break Up

I had to have an MRI of my chest because Dr. Lee couldn't quite tell what was happening with the tumor in the breast. The result of the MRI is good news! The MRI could not pick up any visible spots on my liver, nor could it detect any cancer in the lymph nodes. Best of all, it seems that the tumor in the breast is breaking up into smaller pieces. Dr. Lee described it like a meteor hitting the earth's atmosphere and breaking into smaller meteorites. Nice huh?

Every bit of good news must be coupled with not so good news. My body is unable to handle 3 week treatments any more. After 7 months of poison killing my blood as soon as my body can make it I'm just not able to rebound well enough to make the 3 week treatment possible. However, since the treatments are going so well, Dr. Lee doesn't think that it would do too much harm to just push them out to every 4 weeks. It'll give my body time to recover and hopefully I'll be able to be consistent.

When it rains, it just rains.

The results of my CT scan were very good. Of the many cancerous spots on my liver, only two remain and they're quite small. Woohoo for my liver! Herceptin is indeed a wondrous drug if it can get these kinds of results. Even if my heart is a little taxed by the medicine it's great to see my liver looking practically normal. However, the results of my CT scan were also…questionable. That is, the doctors cannot quite figure out what is going on in my breast, and I will need to have an MRI so they can have a more in-depth look at it. Hopefully the results of the MRI will be available this Friday when I'm back at the doctor's office for Round 9 of treatment.

Treatment update, well life update really...

I'm so busy at work that I haven't had time for posting. Gasp! We've hired a part-time assistant to help me out a bit, so I'm spending much of my free time training her. Anyway, I've no news to report on the treatment front other than things went as expected. Actually, let me amend that...things in Dr. Lee's office have not been right the last couple of treatments. There's always a long wait and sometimes it seems that the right hand doesn't know what the left hand is doing. It is irksome to say the least, but I really like and respect Dr. Lee.

5mm Spots

The results of my last CT scan are in and the news is still very good. All of the small tumor spots on my liver are reduced to 5mm or less (some were as high as 10mm). The mass in my breast is still visible, but not to the naked eye. Woo hoo! The last round of treatment went off without a hitch, and all of my blood counts were within normal range. After weeks of resistance I finally agreed to try Priolosec for my acid reflux and the recovery is going much better. Serves me right for being stubborn.

My Doctor Skips

It's been one week and I'm recovering from treatment quite well actually. I'm starting to get into a rhythm with this thing. Since I know how my body reacts I can preempt some of the more unpleasant aspects of chemo. Of course, I still need a great deal of nursing in the days immediately following treatment and I am very lucky to have so many people eager to lend a hand. The treatments themselves are very dull and only tolerable because of the people who take me to them and keep me company. However, two interesting things did happen this time around: it snowed and Dr. Lee skipped. I know neither of these events are truly newsworthy, but they did make me smile and that's really all that matters. I don't recall why Dr. Lee skipped out of the room, but I think perhaps he was just possessed by a fit of whimsy. His ability to find some humor in an otherwise bleak and depressing environment is one of the reasons I like him so well. That's how I've tried to deal with the cancer...with as much humor as possible.

At last good news!

The results of my follow-up CT scan were very good. The change in the size of the breast mass is amazing. There is also some noticeable change in the liver but not nearly as dramatic. Maybe I should post pictures. Then again maybe not. The pictures are kind of creepy, but seeing the results of these horrible treatments is reassuring. I feel like celebrating. It might be premature of me to celebrate but I need to celebrate something in order to keep a positive outlook. All the more reason for the Seahawks to win the Superbowl.

My Hair is Gone

When my hair started falling out I was dismayed. It meant I couldn't hide my condition from the world anymore. I was particularily concerned with how all the patients at work would respond to seeing me suddenly bald. It was going to cause a great deal of concern and interest, and I wasn't sure I could handle it. I tried cutting it short to begin with, but that didn't last long. It was thinning so badly, and I kept finding my hair everywhere. I lost about 1/3 of my hair when I was in highschool due to a medication I was taking for my seizures and it was extremely upsetting then. My hair thinned, but it was never as dramatic as it has been this time around. Back then I kept it in a pony tail and put on a hat (I even had special permission to wear my hat in class). Despite my reservations, once I had made the decision that my hair had to go I felt at peace. So one night I asked Peter to shave it all off. I only cried a little, but I honestly don't know why because I didn't feel upset that it was gone. Now I'm all buzzed and I've got some great scarves to wear at work and when I go out. I get stares, particularily because I'm so young, and lots of people ask lots of questions that I didn't expect them to ask. I'm going to have to get used to it I guess, especially at work. Norton enforces his company policy of "no such thing as a bad day" with an iron fist. Even before my diagnosis I'd been reprimanded for not being cheerful enough. He also has a policy of making our patients feel so welcome that they think of us as friends. So not only do I have to be cheerful despite what I'm going through, the patients that do in fact think we're "friends" don't hesitate to ask what I feel are rather personal questions. Dr. Norton didn't ask me to keep the truth from the patients, but I know he was relieved when I told him that I wouldn't let them know how serious it was. It would be just too difficult to try to remain upbeat and cheerful while explaining how dire my health really is. So I tell them that it was caught early and my doctors expected me to go into complete remission.

My First Chemotherapy

I wasn't prepared for it. Nothing I read, nothing they told me, nothing could prepare me for the terrifying process of a chemotherapy infusion. I brought my sister-in-law and husband for moral support, but it was not enough. The treatment room was full of people and there wasn't enough room for them to be close to me. They sat a few feet away trying to talk about other things and stay positive. I couldn't even hear them. When they went to get something to eat I cried. Big silent tears that I couldn't contain despite my best efforts. Treatment took all day because they had to go slow the first time. Other than being physically and emotionally exhausted, I had no side-effects to the drugs. I wasn't prepared for that either.

The side-effects did come, only later. Some the next day, some the day after. Each day it seemed like there was something new. None of them good. After five days I was about 85% recovered, so I went back to work.