Allergies after cancer treatment

This spring I have had two bouts of an interesting phenotype.  Each bout was the same:  I would awaken one morning with swollen, itchy hands and feet; the itchiness would travel toward but never reach my torso; the itchiness would come and go for several days before finally subsiding.  I assumed that this was an allergic reaction to some undetermined allergen, but since I had no prior allergies I thought I'd do a bit of internet research.

Naturally, Google came up with all sorts of horrible things that could cause swollen, itchy hands and feet.  One of them included various blood cancers, which I know could be a side effect of my chemotherapy.  I therefore called Dr. Oncologist.  She assured me that my recent bloodwork (February    2013) looked fantastic.  She also assured me that this was neither a normal thing nor something that I should tolerate, and she referred me to an allergist.

Dr. Allergist was the most amusing doctor I have ever had.  He had numerous anecdotes and jokes, and I laughed even though I was probably the millionth patient to hear them.  Interestingly, he virtually ignored my swollen appendages.  Instead he focused on the breathing-related answers that I put on the intake questionnaire.   

Breathing issues, you might ask?  Ever since radiation therapy I have had a few breathing-related issues.  For example, I awake every morning with a deep cough.  It ebbs and flows in its severity, so I never thought much about it.  Also, I occasionally have a hard time catching my breath.  Sometimes it  happens during exertion so I chock it up to being out of shape and having permanent lung damage.  But sometimes it happens during rest, such as when reading aloud to the girls.  Also, it is inconsistent.  I often go weeks and weeks being totally fine, then have a spell of hard breathing.  I had discussed all of this with Dr. Oncologist, and she said that she'd order a chest x-ray if it was continuing at my next visit.    

Enter Dr. Allergist.  My breathing issues were unintentionally aired to Dr. Allergist because he had a lengthy questionnaire to be filled out for the first appointment.  Many of the questions pertained to breathing.  Apparently many of my answers to the breathing questions were out of the ordinary, and he focused most of the visit on my breathing issues rather than my itchy appendage issues.

I was tested for reactivity to numerous allergens and we discovered that I am allergic to cats, dogs, mold, and tree pollen.  These discoveries explain everything entirely.  My breathing problems were most severe during the drought last August (mold spores in the air!) and now (springtime is tree pollen time!), and each episode of itchy hands and feet correlate with cuddling my dad's new kittens (I'll miss you, kitties!).

Additionally, I was diagnosed with mild asthma.  This is actually an unfair diagnosis because it is merely the word to define the manifestation of the allergic response.  I have allergies, and they cause an asthma condition.  Presumably if I control the allergies, I will control the asthma.

The result of all of this is that I have two different inhalers and an allergy medicine.  This was a lot to acquire at one time, but I am getting the hang of figuring out how frequently I need to use the stuff.  I hate taking any allergy pill (they all mess with my head in one way or another), but if I take a certain one at night it's not so bad.  And I shouldn't have to take it all the time.  Just in the spring, or whenever my symptoms are bad.

Dr. Allergy did not think that any of these new things are a result of my cancer treatments.  I agree with him that folks can develop allergies at any time in their lives, and that a person's allergies can change at any time in their lives.  But I will note that cancer treatment, including indirect treatments of side-effects via numerous antibiotic therapies, altered my formerly healthy gut bacterial community.  And I will also note that changes in the gut bacterial community influence the immune response in the lungs, and that asthma is one such immune response in the lungs.  My gut microbiota underwent catastrophic changes that are likely still affecting my overall health, including these new allergy and asthma diagnoses.  I am but one patient in an uncontrolled, heavily biased study, so these comments are simply comments and not to be taken as facts.  

On a happy note, Dr. Allergy did sign me up for a chest X-ray, and my lungs look glorious.  No signs of  cancer or anything else unusual.  That gave me a sigh of relief.  No inhaler can cure the chest tightness that comes from the fear of cancer recurrence or metastasis.  That single x-ray film obliterated my fear and gave the inhaler a chance to succeed.  With clean lungs on my mind and a week of asthma treatment under my belt, I can finally take that deep breath that's been eluding me for so long.          

Two years since mastectomy

Not sure what the flow of this post is going to be like.  I'm a little bit rusty.  

Every morning I wake up and smile at my loved ones.  I am having a ridiculously good time living (despite these prolonged winter conditions--Mother Nature missed the memo that tomorrow is the first day of Spring!)  It blows my mind to think about where I was two years ago at this time--bald and emptying drainage tubes multiple times daily.  I was revising my pain scale so that I could get more appropriate pain management.  And check out this post from March 2011 that truly exemplifies my optimistic personality.  I was experiencing the worst kinds of pain and having unidentified objects fall out of my body, but I somehow managed to crack jokes and be upbeat.  

When you talk about it in terms of attitude, not much has changed.  I am the same in these most important ways.  I am grateful for that.

Physical recovery has been such a long process.  The fatigue lingered with me for such a long time.  I can retrospectively estimate that it wasn't until January 2012 before I had sufficient vigor to participate in all of my old hobbies.  I often wonder if I continue to gain more energy, or if I have reached my peak.  I'll reflect again in a few more years to determine if the increasing trend is continuous or plateaus at some point.  

This is not nor will ever be a food blog, but today I am going to celebrate my recovery with pictures of a pie.  Not just any pie, but a key lime pie.  My college friends and I would bake this pie in the wee hours of the morning when normal college students were ordering pizza.  I used to make this pie all the time.  I had not made this pie since before cancer.  My evidence for this is that my stash of sweetened condensed milk, purchased and stored exclusively for the purposes of this pie, expired in 2011.  

Last week, I made my key lime pie.

sweetened condensed milk is gradually added to egg yolks.  Then add lime juice, water, and food coloring (if desired, and it's always desired when you live with preschoolers.)

Making this pie caused me to reflect on all of my key lime pie memories:  pie on Iowa Avenue, pie on Bracken Place, pie on Spaight Street.  And now, pie on B_____ St.  

have a special little helper squeeze the lime juice.  makes all the difference.

pour the filling into a crust that you've prepared (I like a graham cracker crust for my key lime pie). Bake until halfway done, then top with meringue.

look at that pie!  and the clever foreshadowing of the green pie pan, suggestive of the filling! I could totally start a food blog!

except that I forgot to take a picture of the sliced pie until it looked like this. I could never start a food blog!

I've decided that I'm glad I don't have a cancer+key lime pie memory.  Cancer was, you know, that stuff that happened to me a couple of years ago.  Unlike cancer, key lime pie has staying power in my life.   Hopefully my cancer is over forever.  Hopefully you can expect a lot more key lime pie posts (figuratively speaking, that is).    

Seattle

December was a big month for my family, in more ways than the usual holiday-related stuff.  This is because my husband graduated with his Bachelors of Science degree from a big local University!  I am so proud of him!  After high school he served in the US Marine Corps for four years, then started his degree program, then paused it to stay home with our young children for two years (one of those years being my cancer year), then returned to school in fall 2011.  Isn't he just plain amazing?  I completely agree.  

I thought we should do something major to celebrate his major achievement, so we took a trip to Seattle to visit my brother.  It was a 4-day, 5-night trip, and oh man was it wonderful.  We rented a house while we were there (www.vrbo.com, it's the best!), and Eleanor still calls it our other house and asks when we are going to stay there again.  Below are a few highlights of our trip.

You should know that although we took nearly 300 pictures on the trip, they were mostly of silly faces or the floor.  That is because the kids have discovered their inner photographer and enjoy taking gobs of pictures with our digital camera.  It ended up being a great diversion while waiting on transportation (airplanes, ferries, etc.).  Needless to say Ian and I ended up feeling like we did a good job getting the camera out, but rarely did we capture the true moments of our memories.

airport silly face

airport silly face, with my brother making a cameo in the background.  He wasn't on the same flight as us, but we were flying the same day (he had come back for a visit, and we planned the trip to be travelling to Seattle in parallel with him.)

airport silly face.  Our local airport has these great kiddie tables for us to hunker down and color at. 

airport handsome face

Our rental house was only 3 blocks from the beach, so we walked there despite the rain and chill.  We midwesterners love an ocean beach regardless of the weather!

The rental house had gorgeous landscaping, including a wooden outdoor fish tank with 5 goldfish in it.  We loved to watch the fish, and indeed to count them every time we visited to ensure that none were missing.  It seemed unlikely that their 24/7 open-air tank would go unnoticed by neighborhood kitties, but indeed, the fishies were always accounted for on our watch.  Seattle truly is heaven on earth, at least for outdoor fishies!

The rental house also had an outdoor hot tub.  We got in it every day, and sometimes at night, too (as shown here).

We went to the Seattle Aquarium.  I highly recommend it.  The kids loved it, and although I haven't been to many aquaria for comparisons I thought it was very well done.  

Here's my brother and the girls behind a giant tube of circulating jellyfish.

The aquarium provided so many creative angles for fish-watching!

This is us outside of the aquarium, and it's the only picture of all of us from the whole trip. You can see that Eleanor is ready for a nap after her big morning out!

We decided not to go in the space needle, but what a beautiful day to be photographed WITH the space needle.

We also went to the science museum.  It was amazing!  We could have spent an entire day there but had to leave due to naptime pressure.  There is a large butterfly house, and the butterflies loved Ian.  He had one on his shoulder for a long time.  Can you see it in the picture?  

We spent a day riding ferries and exploring an island.  Ferry time = silly face time!

Now THAT's a silly face.

The last ferry took us back into Seattle after sunset.  It was so beautiful watching the lights of the city get closer and closer.  Impossible to get a good picture with the wind and the rain and the motion of the boat, but a glowing Ferris wheel makes any picture tolerable. 

We also rode the Ferris wheel, hosted a barbecue, hiked to a lighthouse, built sandcastles with our mittens on, got seafood and the most delicious raspberries at the Market, drank fresh-roasted coffee, baked cookies, and walked to a romantic Italian restaurant for a date.  It was such a wonderful trip.  

Thank you so much, brother, for hosting this remarkable vacation for my little family.  You are a wonderful host and operate just at our speed!  Let's do it again soon.  <3 

Congratulations, Ian, on your gigantic achievement.  I am so proud of you for everywhere you've been and I'm so excited for everywhere you're going.  <3  

Lights for ourselves

I had a series of excellent doctor appointments in the week leading up to Thanksgiving.  Dr. Oncologist said that everything looks and sounds good.  She is sending me to get an echo cardiogram of my heart, just to see how it's doing.  I haven't had one since June 2011, so it's time to give my heart a full check-up and see how it has recovered from chemotherapy and radiation.  That is scheduled for December 28.  I still have to see Dr. O every three months, probably for the next year.  But that's okay.  I enjoy catching up with her.

My appointment with Dr. Surgical Oncologist was also excellent.  My mammogram showed no change from the previous mammogram, meaning that the area of abnormality is almost certainly scar tissue and is remaining stable.  Also, my mastectomy site has healed very well and remains recurrence-free.  Dr. S.O. has loosened my leash, saying she doesn't need to see me or have me get a mammogram of me for a whole year!  Huzzah!

With both of these great appointments behind me, I was poised to have the greatest Thanksgiving ever.  And  I did.  I spent tons of time with my wonderful family, including an extended family sleepover at my dad's place.  This might not be everyone's idea of a good time, but I assure you, it was.  I have some FUN people in my family, and mixing fun people with Catch Phrase, Just Dance 4 on the Wii, and a hot tub yields a very good time.  

My little family then continued our tradition of getting a Christmas tree on the weekend after Thanksgiving.  Below is our tradition in photos.        

It was nearly dark at 4:30 when we struck out to find the perfect tree.

Our journey led us, as usual, to our neighborhood grocery store, Fareway.  "This is the one, dad."

We waited patiently for Ian to strap the tree in the wagon. 

Everyone took a turn pulling the tree home.  

We put the tree in a new spot this year in our den/toy room.  Ian put the lights on it and us girls took charge of hanging ornaments.  

This is the look on the girls' faces when Ian first plugged in the finished tree.  Azalea's face:  pure joy.  Eleanor's face: what's going on?  Behind us note that we also decorated the sh!t out of our dining room.  All illumination in the photo is coming from Christmas lights.  

This is the view of our dining room plus den/toy room from outside.   You can see the tree in the back.  Also note that we failed to remove our Halloween decorations before applying the Christmas decorations.  That is a witch on a broom flying on the picture window.  

Our Christmas tree 2012, complete with the first present underneath.

We decided to put up more lights inside our house than outside because, well, we wanted to enjoy them ourselves.  We have eaten dinner by Christmas light almost every night since we put them up.  It's quite lovely.  I recommend putting up up some lights for yourself this year.  You deserve it.    

I'm a flattie, and proud of it

I have previously written about my choice not to reconstruct after my mastectomy.  I continue to be interested in this choice, and my interest is rooted in the fact that there must be hoards of other women out there who choose not to reconstruct.  They seem to be hard to find and I rarely encounter them in person, but now some have been found electronically thanks to some recent online publications!  

My friend S. and I have continued to research the variables that lead to and outcomes of the choice to be flat-chested after a mastectomy.  Recently she interviewed me for articles on the websites Flyover Feminism    and Mothering.com to align with IBC awareness week.  Great job, S., and thank you for your efforts to raise the awareness of this important issue!  

One of the articles received a comment from Melly with a link to another article.  It's a great article.  But even greater are the comments.  Check out all of the positive feedback from other women who have chosen not to reconstruct.  Of particular interest are the occasional insights into spousal support.  Considering that women often feel pressured to reconstruct in order to remain attractive to their spouse, I think that some of the feedback here is particularly informative.  

Happy reading!

Calm and smiling

I had a great day today.  I established a new collaboration that I hope will yield very interesting results.  I taught a student a new protocol.  I reviewed a manuscript that was actually quite good.  I attended a cartwheel recital right here in my own living room.  I had a good laugh while winning (and losing) at Twister with some young people who might not always know their left and right, but yes they can stretch all the way from red to green.

What made today truly remarkable was the absence of something.  Based on the schedule I have maintained for the past two years, today should have been PET scan day.  I should have fasted for 4 hours, rested for 1 hour while radioactive glucose did some reconnaissance in my body, and held my arms above my head in the cylindrical scanner.  However, since my past two scans have yielded no signs of cancer, my oncologist has released me from prophylactic PET scans.  !  !  !

The best part of PET scan freedom is PET scan RESULTS freedom.  Ordinarily I would be too nervous to sleep on the night before PET scan results.  But tonight I feel calm, relaxed, healthy, and normal.

This reminds me to say that I am continuing to gain control of the anxiety that has been plaguing my heart since my last PET scan in August.  I don't think I've experienced a heart flutter since before my birthday three weeks ago.  A few things to attribute this success to:  huzzah for breathing, yoga, and knitting!  And no, I don't have to live every day like it is my last!  (Whoever came up with that saying clearly didn't have a life-threatening illness.  Seriously.  Talk about piling on the anxiety in a situation that truly doesn't need it!)      

I do indeed  have an appointment with Dr. Oncologist tomorrow to check on my blood (white blood cell counts, magnesium, etc.).  I will continue to see her every three months, but I'll report back if tomorrow my leash gets loosened.  My understanding is that as a person who had IBC I will remain on high alert until 2 years after my last treatment, and my last treatment was a year ago (November 8th or so).   FYI I  have a mammogram and surgical follow-up with Dr. Surgical Oncologist on Tuesday.  I love my visits to Dr. Surgical Oncologist because I get a day to myself in the car and I take myself out to lunch.  Fun times!

Speaking of my last treatment, the clock to calculate cancer survivorship starts 1 year after the patient's last treatment.  I just passed the one year mark cancer-free!  Happy one year survivorversary to me!!!   

I'm grateful for the good times.  So good.

32

In terms of birthday excitement, not much has changed since I was a kid.  I still suggest desired presents months in advance.  I still like to be excited by the potential presents lurking in the house prior to my birthday.  I intentionally avert my eyes when I open the closet door, just in case a present is peeking out from behind the coats.  How old am I going to be, anyway?  That's right, 32.  Well, I am currently baking my own treats to bring to school work tomorrow, and only big kids grown ups can do that.  So there.

It is also an exciting birthday because, well, it marks another year that I have survived on this earth.  One never know which year will be the last, but since facing a breast cancer diagnosis four days before my thirtieth birthday, making it to 32 seems monumental.  I had a terribly aggressive cancer that has a high chance of recurrence (less than 50% 5-year survival rate, with the highest chance of recurrence in the first 1-2 years!!!!).  Knowing these statistics made it hard at times to visualize my 32 birthday.

But what is a 32nd birthday, anyway, compared to something like high school prom.  Prom is often a one-time event, in addition to being an important event at an age in which you are perhaps just beginning to have diverse important events.  Youth brings further significance to milestones.  So at some point during treatment I quit trying to visualize my 32nd birthday and instead started visualizing myself helping my youngest daughter prepare for her high school prom.  Surviving until your 32nd birthday is a lot less stressful when you set your goals for somewhere around your 46th.  And I am in no way capable of picturing myself at 46, so I have the distinct pleasure of assuming my continued existence until then.

IBC statistics, come and get me.    

My transition from concern that I'd make it to 32 to the assumption that I'd still be here doesn't make the birthday any less special.  What it does is allows me to enjoy a normal birthday like I always have.

The girls each got to choose and wrap a present for me.  The gifts are perched on the buffet, awaiting tomorrow with more patience than I have.  Ian said he took them to a craft store and that they wanted to buy me everything, including an entire row of fuzzy fabric bolts arranged by ROYGBIV.  It will be so cute to see what they chose in the end, but I actually don't need any presents at all.  I already have everything I need.