Wednesday, September 10, 2014

Elation

I did it!  Huzzah!

Wait a minute, that's not nearly enough exclamation marks for the hbomb.

Huzzah!!!!!!!!!!!!!!!!!!!!

Let me start out by deeply and publicly expressing my gratitude to my friend M, whose last message to me before surgery was to remember my revised pain scale. Thank you, M, mother-of-triplets. I love you. (I revised my pain scale after my first mastectomy. That is when I learned 1) my previous notion of intolerable pain doesn't exist for other people; that is, I have a bit of a pain tolerance. Combine this with my aversion to drugs, and the result is me estimating my pain at a 2 or a 3 on a 10-point scale. After a mastectomy.  So vowed to revise my pain scale (there's a blog post on that, but I can't insert the link here on my phone.))  My revised pain scale allowed me to recognize my pain as a 5-6, which elicited the perfect drugs. They reduce the pain down to a 2 (a real 2) and don't send my brain out to lunch. Perfection!

Also, I'm simply not in as much pain as I was with the previous mastectomy. I am not experiencing nerve pain, and this was the Worst last time. 

Finally, I have discovered a new pain medication that is going to make my sister rich and famous. He is baby Calvin, and when he smiles the mastectomy is erased. He's leaving soon, so hopefully the only ache he leaves behind is mild and in my heart. 

The surgery went well!  Dr. Surgical oncogist said that the sentinel (first) lymph node was NEGATIVE for cancer. A thousand huzzahs!!! She was nonetheless conservative and removed the sentinel node, a second node, and an inch of fatty tissue around them.  My armpit is the most sore of my wounds. 

I have nothing to report about the mastectomy yet. It will be a week before we know the pathology. 

The port was placed successfully. Huzzah! It is another purple power port, which is the same model as my previous port. Prior to surgery, a resident doctor freaked me out to the point of tears by saying that the vascular doctors would be placing my port on the left side.  But my mastectomy was on the right today!!!  She had all sorts of reasons that made clinical, theoretical sense, so I explained my real-life, empirical reasons: the skin on the left is very tight and is scarred from full chest wall radiation, up until yesterday I had a blood clot in the left jugular that May or may not be fully resolved, and my right side was already undergoing surgery. She conceded slightly, writing on the consent form "left or right" and agreeing to let the vascular surgeon make the call during the operation. Ah!  That's a bit nerve-wracking!  In the recovery room, the very first thing I said was, where's my port?  I am thrilled to report that it is tucked into its former home on the right. When I later saw Dr. Surgical Oncologist, she apologized for the apparent confusion, because she always intended for the port to go on the right. The information simply didn't trickle down to all of the folks interacting with me (seemingly dozens).

I'm spent, with nothing left in me to read and revise. Hopefully this has been sufficiently coherent and error-free.

I am humbled by and grateful for your support.  <3 and (>'')>

Monday, September 8, 2014

Cellular torture

My daughters have a small indoor tent made out of a material that is a strange hybrid of fabric and paper.  Dora the Explorer images are printed on each of the four sides.  They've had it for several years, set up in the toy room by the window as a special reading nook.  On Labor Day weekend I wasn't feeling tip top, but despite my lack of energy I wanted to do small things to make the weekend special.  One thing I thought to do was take the Dora tent outside.  Not to be bothered by collapsing the thing, I picked up the tent by the peak, which unfortunately elicited a ripping sound.  I awkwardly maneuvered the torn tent down the stairs, at which point Azalea pointed out a large tear down the back of the tent, reaching up to the ridgeline from the back door.  I reached for some masking tape, intending to fix the tent just enough to perform this final outdoor activity before depositing it in the trash.  With tape in hand I pinched the new seam, which readily flaked off a chunk of the paper-like fabric between my fingers.  I chose a different ripped location and grabbed again, liberating another hunk of the tent into my palm.  The fabric must have weakened over time, perhaps because of sun exposure at the window.  Before my small ones could throw a fit over their disintegrating play house, I embraced the tent, tear and all, and tossed it into the yard.

My brain on taxotere is the fabric of the Dora tent.  Weak, fragmented, and orange.  Each morning I toss myself into life and hope for the best.  

Fortunately I am feeling a little better every day, and I will continue to get better in the absence of further cellular torture by chemotherapy.  At night I send my healing thoughts to my brain, taping up the pieces of my mind.  This week I have caught myself making some coherent thoughts, so I thought I'd attempt this blog post.

Tomorrow we make the drive to the other town for my pre-mastectomy procedures.  At 2pm I am having vascular pictures taken.  These are for the doctor who is going to be placing my port.  I used to have a port, but I had it removed after being cancer-free for almost 3 years.  Dr. Oncologist chose not to re-install my port for the current cancer treatment for numerous reasons.  However, now that I am looking to be infused with Herceptin and Pertuzumab every three weeks for the rest of my life, I asked if I could get another port.  I figured I could get it installed at the same time as my mastectomy.  All of doctors on my team thought that this was an excellent idea.  My port will be placed in exactly the same location as my old one:  chest wall, center-right side, just below the collarbone.  A doctor whom I have not met yet will come into the operating room after my mastectomy and hook me up.  

At 3pm tomorrow I will be injected with a radioactive tracer.  This will be injected into the breast cancer.  On Wednesday the doctors will be able to follow the trail of radioactivity to see which lymph nodes to remove.  This procedure is called sentinel lymph node dissection.  I didn't have this before because it is not recommended in cases of inflammatory breast cancer.  It is recommended for ductal carcinoma in situ, which is my current diagnosis.

My surgery is scheduled for 7 am on Wednesday.  I am to report to the hospital at 6am.  My husband, parents, sister, and mascot (Calvin the Cure) will be there.  I will stay in the hospital for a night or two.  

On my previous mastectomy eve, my college friends booked a room for Ian and I at a fancy, contemporary hotel.  I decided to do the same this time, for luck or something like it.  I'm not superstitious.  It just seems like an appropriate night to be a tiny bit spoiled.

I am grateful to not have any downtime between my last chemotherapy and this surgery.  It's true that the surgery will keep my healing energies busy, and that my healing energies could use a break.  However, I feel that it will be easier to maintain my healing routine than to be teased by a break from healing only to be plunged back into the fray at a later date.  Besides, I don't want the cancer to think that I've gotten complacent.  Kick it to the curb!

48 hours from now my cancer will find itself excised from its happy Heather bath.  It will be slapped onto a lab technician's benchtop, fixed in formalin, set in paraffin wax, and sliced into thin preparations for a pathologist to scrutinize under a hot, microscopic spotlight.  I am not a vindictive person, but after all of the pain that cancer has caused me, I delight in the cellular torture that is about to be inflicted on it.      

Friday, August 22, 2014

Last hard chemo!

It was a party in chemo room 7 today. Non-alcoholic champagne, treats, and excellent company. 

Elation!

Are you sure there was no alcohol in the bubbly? Or is that the Benadryl kicking in?

On the way out I got to ring the end-of-chemo bell all the way out through the waiting room, hugging nurses the entire way.  S took a short video (it's uploading to YouTube now, so I'll update with the link when it's done).  It was very emotional. 

What a beautiful way to end the hard chemos!  I can't wait to get through this next week! Huzzah!   

Thursday, August 21, 2014

I've still got this

Alright.  I've finally got my hbomb back.  Sorry if I scared any of you, but thank you for all of the extra support I've received.  Some of your words and gestures were deeply touching, such as the books from Nebraska, the email from Wisconsin, and the bead delivery.  I love you all.  I'm sure that they are the direct cause of my improved mood.

A few other things have helped me to feel better.  1) Last night I escaped from my life by going to the cinema.  I haven't been to see a non-animated movie in an age.  My friend S was my buddy, and I inadvertently tested her friendship by dragging her to a Woody Allen movie.  I'm so out of the pop culture loop that I didn't know it was written by Woody Allen!  I just saw that there was a Colin Firth movie playing (I love Colin Firth) and I hastily dragged us to it without doing further research.  This is pure neglect on my part, considering the various modern technologies I could have employed to spare us from this tragedy.  In all seriousness, Colin Firth was excellent and the story was unique, so we just rolled our eyes at the pretentious scenes while we happily munched on our popcorn.

2)  This afternoon I hosted an ice cream social at work.  An undergraduate student who has worked in the lab all summer is returning to her institution next week, so someone suggested an ice cream party to celebrate.  I brought the ice cream and everyone brought a topping to share.  The result:  a lovely half-hour with my awesome co-workers eating the fanciest sundaes imaginable.  Sure we had hot fudge and strawberries, but would you believe that someone made homemade candied ginger?  And homemade cinnamon toast croutons?  I don't think any of us stopped at one sundae.  You'd be in a better mood, too, if you had sundaes like these.

3)  I took my daughters to the pool tonight.  I put my hat on Eleanor so that I could stand under the waterfall and let the water massage my shoulders.  I tried to get her to hold my sunglasses, too, but she couldn't get them to stay on her face and so she moved to set them down...in the water.  I decided it was best to hold them outside the waterfall myself.  Also, watching my girls hold hands as they ascended the steps to the waterslide was pure bliss.  

I've rapidly progressed to the point where I'm so ready to be rid of this toxic breast it's not even funny.  I don't know how I can possibly wait until September 10th.  Oh yea, I suppose I'll be busy recovering from tomorrow because...

...IT'S MY LAST HARD CHEMOTHERAPY!  Woo hoo!  I'm oddly excited, like almost as excited as I feel before a trip or a show or something.  I've already got the coffee pot filled with water and decaf grounds, set to brew at 7:02.  My intentional choice of the odd time of 7:02 makes me even happier.

I'm pretty sure that I had more things to say, but my friend F just sent me this awesome mix via Spotify.  Now I'm distracted by these fantastic tracks.  Here's one for you.

Tuesday, August 19, 2014

It's scheduled

Wednesday, September 10th, is the date for my second mastectomy.  I wasn't expecting to feel relieved by having this scheduled, so it comes as no surprise that I am not exactly jubilant today.  

On the plus side, that fantastic Indian restaurant my dad and I tried to hit up last time was indeed open today.  Lunch was amazing.  Huzzah for being able to taste and digest my food!

If you'll recall, Dr. Medical Oncologist was going to present my case to her institution's Tumor Board.  As luck would have it, Dr. Surgical Oncologist was present at that Tumor Board meeting and so had already spent a lot of time pondering my case before my appointment today.  She chuckled at what a lucky girl I am because all four surgical oncologists in her department were present at the meeting.  Apparently this is a rare occurrence.  This is lucky because they all weighed in, and Dr. Surgical Oncologist was able to present me with the consensus today.

Consensus:  My case falls in a medical "gray area", and the surgical oncologists will support whichever decision I make.

Well, at least we can all agree on the ambiguity of the way forward.  Huzzah for a consensus?  Bleh.

Since my diagnosis in February I have thought that the breast has to go.  This was muddled by new data brought to my attention in recent weeks, but given the "gray area" I fall back on my need for the breast to go.  Mastectomy for me.

Decision made!  And it is the right one!

At the time of mastectomy we will also do a sentinel lymph node biopsy to determine which one(s) to remove.

I thought that getting some of these things nailed down might provide a bit of relief from the turmoil, but so far it hasn't.  I'm just so tired of all of this.  I'm just so tired.  
 
Home stretch.  Home stretch home stretch home stretch.

I've got to get out of this funk so that I can enjoy the special day that is Friday--my ninth and final hard chemo.  15th lifetime.  That's pretty fantastic!  My dad and my friend S will be joining me.  We're going to have croissants and coffee.  It's going to be lovely.

It's all going to be lovely.  

Monday, August 18, 2014

Disoriented

My head, or my heart, or both, have been in increasing turmoil since my appointment with Dr. Medical Oncologist last week.  I think it is because, for arguably the first time in my entire cancer experience, the path forward is conflicted.  My treasured oncologist, Dr. Oncologist, thinks I should keep my breast (and thus my primary cancer, which certain science suggests will control my secondary cancer), while my Her2 expert, Dr. Medical Oncologist, thinks I should remove my breast (and thus remove the potential for future breast cancer, which we have learned I am prone to develop).  Neither oncologist is highly confident in their position.  They both suggested that I get the opinion of a surgeon, so tomorrow I will see Dr. Surgical Oncologist for her opinion.      

I have been barrelling through this cancer treatment on the notion that I will beat this breast cancer.  That is what I do.  I beat breast cancers.  However, the current oncological conflict has greatly reduced my confidence in my ability to fight cancer.  The two paths have transformed into a "damned if I do, damned if I don't" mentality: remove the breast, but feed the lung cancer! Or keep the breast, but develop another breast cancer in a year!  This negativity has been coursing through my veins, soaking my weak and defenseless brain day and night.         

The inner turmoil has been manifested as extra fatigue, distractedness, and unsettled guts.  At my sister's delightful baby shower on Saturday, I found myself thinking well, this could be my last baby shower.  I felt not sadness but bitterness, mostly about having to contend with these thoughts during what should have been an enjoyable family event.  Who needs these thoughts?  Also, any baby shower could be anyone's last baby shower.  Why has my own mortality, after so many months of much weaker days than these, come to the forefront this week? 

Today my children inadvertently kicked me while I'm down, as it were.  They were playing an imaginary game after school today.  One of them was the mom, and the other was the kid, and I wasn't paying that much attention to their play as I worked on the dishes.  All of a sudden one of them said, "...and then the mom died...".  I tuned in fast.  They argued for a bit about whether or not the mom actually needed to die, and one argument included the fact that she had to die in order for one of the players to turn back into a baby.  I was relieved that it was an abstract mom dying abstractly and not a real-ish mom dying of, say, cancer.  In the end the pretend mom did not die, the winning argument being that one of them could simply turn into the baby without the death of any pretend beings, and so I did not interrupt the game for a heart-to-heart on Moms and Death and the role Cancer could play in that.      

Is no corner of this life safe from my cancer life?  My eyes have been watering all month.  I thought it was allergies, but perhaps I have been quietly weeping, watering my soul garden.

I went to another restorative energy session today.  It was really lovely.  I told her about my turmoil.  She had so many snippets of wisdom, most of which were placed somewhere inside of me such that I can't recall them but they are still in there, guiding and supporting me.  One that I still remembered by the time I returned to my car, which is relevant because then I could dictate it to my iPhone and release my feeble brain from the responsibility of remembering, is to trust my center.  When I am feeling centered, do I think I should have a mastectomy or not?  Perhaps I should ask myself this question every day for a few days, listening to my body and detecting any fear in my inner voice.  I don't want the decision to come from a fearful place.  

I take this to be similar to a "gut feeling".  I can usually trust my gut feeling.  Today my gut feeling is to go for the mastectomy.  However, today I am also bitter and unsettled, as discussed above, so perhaps today's not a good day to query my guts.     

She also gave me a metaphor for the two paths forward.  She suggested that the oncologists are recommending that I travel to a National Park.  One oncologist wants me to go to Yosemite, and the other to the Grand Canyon.  It turns out that I haven't been to either park (perfect for the metaphor!), but neither would be the wrong choice (true statement!).  

This is what I need to start thinking about my cancer treatment options.  Neither is the wrong choice. That is so hard for me to say.  If I only had more data I'm sure that one of them would clearly be the wrong choice.  I desperately need more data.  Nope, there I go again, start over.  Neither choice is the wrong choice.  Whatever choice I make is the right choice.  Neither choice is the wrong choice  

I have strength.

I am strength.

I have peace.

I am peace.

And I have the ability to rest.  Let's go rest before tomorrow's data collection.  

Monday, August 11, 2014

Progress

Oh my.  I sat down to write an interesting and informative post about my appointments today, but I am overcome by fatigue and a touch of nausea.  Perhaps I will have energy for a more interesting post tomorrow.  The short update is as follows:

-Dr. Pulmonary Oncologist says that my lung nodules are few and tiny.  Even he won't biopsy them now.  He's impressed with how they've responded to treatment.

-Dr. Medical Oncologist thinks that the best course of action for me is indeed a mastectomy.  This is because it seems important to eliminate the potential for new breast cancers to sprout, more important than the risk of metastatic cancer getting worse.  She also thinks that I should remain on herceptin and pertuzumab (the anti-Her2 therapies) indefinitely.  Aka, for the rest of my life.  This will suppress the metastatic cancers and prevent new cancers from developing.  None of these recommendations were scientifically obvious, however, and so she plans to take my case to her institution's Tumor Board this week to get the opinion of her colleagues.  She'll let me know if her recommendations change after that. 

-The Indian restaurant is closed on Mondays.  Drat!  Instead, we found a Vietnamese restaurant with equally good reviews.  The food was delicious.   

-My dad is the best.