Cancer treatment didn't kill me

This will be brief because I am so, so tired.  No better way to keep myself brief than a numbered list.

1.  Sinuses.  Dr. Oncologist was on the same fence that I was on in yesterday's post about my inconclusive symptoms, so she sent me to Dr. Ear Nose and Throat.  His opinion was that my sinuses are not acute enough for surgery and we haven't tried everything in his non-surgical arsenal.  The antibiotics will be ceased and I am to shoot some steroids (Nasonex) up my nose every day, in addition to maintaining the sinus washes.  The goal of the 'roids is to open things up and let the sinuses drain on their own.  I predict another sinus UFO in my future.  I am very happy about this outcome.  I did not want surgery.  

2.  Heart.  I had an echo (ultrasound) of my heart today, and I suppose you could call it routine.  Dr. Oncologist wanted to check on my heart after chemotherapy, but she had to wait for all of my surgical and radiological wounds to heal.  My heart is in excellent condition.  This is outstanding news.  This in addition to all of the other ways I'm healing causes me to tentatively conclude that cancer treatment did not kill me.  This may not be news to you, but I am glad to finally have enough evidence to believe it for myself.  

3.  Lung (left).  What I don't think I have told you yet is that I am experiencing some shortness of breath in my left lung.  I biked to work last Friday and got a little unnerved when I couldn't catch my breath upon arrival.  Also, I run out of air even when I talk too much (as I did on Monday when training a new person in the lab).  Dr. Radiological Oncologist warned me that this decreased lung capacity may occur between 1 and 4 months after radiation.   This is because a sliver of my lung was in the radiation field and could not be avoided.  He said that this lung tightness usually resolves itself with time (although I am unclear if this is because the rest of my lung compensates or if the wounded lung heals).  Regardless, in light of my ongoing sinus woes Dr. Oncologist wanted a chest x-ray to rule out a lung infection.  I do not have these results yet.  Again, the left lung tightness is to be expected, and there is probably nothing more wrong with me.  Maybe I should sharpen my former tuba-playing skillz and exercise the lung with some John Philip Sousa.  

(Stars and Stripes Forever, performed by NY philharmonic.  Happy Independence Day, everyone!)

4.  In summary, it was a very busy day.  I was at the clinic for 6 hours and went from Echo to blood draw to Dr. O to chemotherapy to Dr. ENT to chest x-ray.  Whew.  No wonder I'm exhausted.  

5.  Now I am looking ahead to my first vacation since cancer started!  Woo-hoo!  This weekend I am driving the girls to scenic Columbia, MO, to visit my dear friend Martha and her triplets.  Should be epic in terms of cuteness and messiness.  Ian will not be joining us because I surprised him with a plane ticket to Seattle to visit my larger-than-life brother.  Tee-hee!  He deserves a vacation even more than I do.  Safe travels and safe celebrating to all of you!             

40 hours

I did it.  I worked my first 40-(plus!) hour week last week (see the above screenshot of my timesheet...yes, I have to fill out a timesheet <sigh>).  I didn't have any appointments or therapies, and no new problems arose that compelled me to call one of my many doctors.  And so I did it.  My greatest accomplishment?  Getting a draft, albeit extremely rough, of a manuscript to my boss and co-authors at 4:30 on Friday.  This manuscript needs to get done before I can do two others that are in my queue, and some of my collaborators are following this blog.  Therefore I'd appreciate it, cancer and associated ailments, if you'd get out of my way.  Thankyouverymuch.  

Indeed, apparently I've been working TOO much.  The timekeeper person in DC called me and asked if I wanted to give back all of the sick leave hours that people donated to me and I haven't yet used.  I said I still have chemo every third Wed. and am concerned that I won't have enough leave on my own to cover that through October, and also I might be needing sinus surgery soon.  She said oh, you'll have to fill out another application for people to donate sick leave, because the other sick leave is for CANCER and not sinus surgery.  I sputtered but, um, yea, I wouldn't have the sinus issues if I never had CANCER.  It's all RELATED.  She said she'd have to talk to her supervisor, and I'm to call her on Thursday, presumably after I know more about the possibility of sinus surgery.  I was cursing my big mouth.  It never crossed my mind that anyone would not relate said sinus surgery to cancer.  I should have said that the sinus INFECTION was caused by cancer treatment.  But I just jumped straight to surgery, because that is all that matters to ME.

This brings us to the topic of sinus surgery.  Here's where I'm at:  tonight I took the last antibiotic of a 3-week course, and this was nearly in tandem with the previous 3-week course of a different antibiotic.  I've been shooting yet another antibiotic up my sinuses for over a week now, again for the second time.  I was taking Claritin for weeks to dry things up, but I quit on Sunday because I hate it so much and things seem to have been dry for quite some time.  Now on to the symptoms:  I have always been able to breath through my nose and have never been congested in spite of four sinus infections since December.  (Perhaps mine could be dubbed Rubber Sinuses?  I smell [pun intended] a new superpower for the next X-men movie!)  I have had some drainage, but I currently have no drainage, and only once did a glob of green goo drain out of one side with a sinus wash.  I have had some sinus pressure, but I currently have no pressure (interestingly, the sinus pressure presented only WITH the Claritin and went away when I quit taking the Claritin).  I have also had some dizziness and upper tooth pain, both of which can be associated with a sinus infection, and those are both resolved.  I do, however, have dimmed hearing in my right ear, and my voice is "nasally".  I am therefore somewhere between healthy sinuses and a sinus infection.  

Any predictions?  When I see Dr. Oncologist tomorrow for Herceptin chemotherapy, will she recommend sinus surgery or not?  Will she first call for a CT scan?  Your guess is as good as mine.  Interestingly, I am no longer vehemently against sinus surgery if it improves the prognosis against future sinus infections.  I am sooooo tired of being on so many drugs, specifically antibiotics.  My microbiota needs a chance to recover (and it will recover to a stable and slightly different community, according to Les Dethlefsen and David Relman's data on the effect of ciprofloxacin on the human gut microbiota).

I'll end with a random shout-out to my awesome sister, Holly.  We love you and your Precious little dog, too!

Woman (with two kids and cancer) in Science

The New York Times recently ran an article in which they interviewed four female scientists at the top of their fields.  These women are role models for women everywhere, in every field, regardless of aspirations.

I was eager to listen to the full interview that is available with the article.  I have always benefited from learning the milieu of ways that other women have progressed in science.  Taking time off to have kids, hiring some help at home, and choosing (not settling) to teach are just some of the ways that women strike a harmonious balance between Science and Life.  And so it was with great disappointment that I heard three of the four women interviewed say that they would not recommend a scientific career to their daughters.

What?

They say it has been hard, perhaps too hard, and that they have become hardened.  They have made too many sacrifices for too little pay-off.  I really am in no position to judge, but it seems to me that so much unhappiness should amount to a career change.      

Everyone has struggles.  Right now my struggles happen to be fighting cancer and being a fantastic mom while trying to build my scientific career.  It's hard, and I could do without the cancer, but I love it.  Yea, it's a lot of work, but the best things in life often result from Work.  No other field would allow me to be as creative, innovative, and challenged as I am in science.  In no other field could I isolate DNA, take photographs, and read (scientific) stories all in one day.  I am a microbial explorer, and it's awesome.    

I don't profess to be at the top of my field, or even in the middle of it.  Also, I recognize that I am fortunate in ways that are particularly essential to building a scientific career:  supportive spouse, family, boss, mentors, and work environment.  Perhaps these top-of-the-field women struggled with some of the individuals in their would-be support network, thus souring their perspective.  Maybe getting to the top is harder than simply chugging along in the pile.  I wouldn't know.  Their experience is theirs, and I suppose that painting a falsely rosy picture never helped anyone.  I guess I just would have preferred to hear a more positive perspective from the top, because I guarantee there are some happy-at-the-top women out there.

Azalea and Eleanor, you can be whatever you want to be when you grow up.  I'll love and support you no matter what.  But for the record, science rocks.  

Fluffy

Don't tell Dr. Oncologist, but this sinus infection is not going away.  I am halfway through a three-week course of a new antibiotic.  I have been diligent about washing my sinuses every night.  And on Friday, I resumed taking generic Claritin D, to dry things out.  But my sinuses are slowly building in pressure where they should be dissipating, and draining where they should be drying.  Drat.  Bilateral drat.  

Oooo I hate taking Claritin D, generic or not.  When combined with the antibiotic and antifungal drugs that I am also taking to combat said sinus infection, it makes my head fluffy.  This is probably the result of the drug cocktail created in my system, because each discrete pill claims that it could cause drowsiness.  Overall I wouldn't describe my primary side-effect as drowsy, but that is certainly playing a role.  I would define a new side-effect called fluffiness.  They should put that on the bottle:  "may cause fluffiness of the mind".   I can initiate thoughts, but I have trouble finishing them.  My attention span is a fraction of what it should be.  The worst part is that I'm sufficiently coherent to recognize this failure to close my own gaps in my own thoughts, and it is exceedingly frustrating.  I am channeling patience from elsewhere, as mine is wearing thin.  

After this is over I think I'll burn my pill box, with my bras.  Except for my nice bras.  Someone really should adopt them.   

Speaking of fluffy things and adopting things, our neighbor offered us a kitten.  A white kitten.  It is probably very cute and fluffy.  This is the closest we have come to getting a cat, but I think we're going to remain pet-free for awhile longer.  Cats are a practical pet in terms of their independence, but the whole pooping-in-the-house thing doesn't do much for Ian or me.  The plan is to hold out and get a dog in a few years.  We shall see.  I do enjoy a good cat cuddle once in awhile.  

You know what else is fluffy?  A certain pillow on a certain bed, just upstairs from where I am right now.  I think I should go check it out.  

I really ought to quit doing blog posts so late in my day.  I'm sure the multifaceted drowsiness is affecting the quality.                       

Check that box

This weekend I had to be reminded about celebrating my cancer victory.  I know, can you believe it?  The H-bomb was oblivious to possibly the best reason in her history for a mega-celebration.  No, it is not because the 7 mm lung node is bothering me.  It's not, and I'm pretty sure I hacked it up last Thursday anyway.  I think celebrating my lack of cancer did not occur to me because I have eagerly moved on with my life.

With the cancer diagnosis came an intense need to beat it, and during chemotherapy that turned into the present tense of "beating it".  I continued to work on beating cancer through surgery and radiation, right up through last week's PET scan results.  And I will always work on beating my cancer.  I am keenly aware of the possibility that my beaten cancer is temporary.  It is relatively likely (I seem to recall reading that there's a 40% chance of recurrence for inflammatory breast cancer) to come back at some point, so this reservation will be in my mind during any cancer-free celebration.  I shouldn't let an uncertain future inhibit my celebrations, though.  I have enough mojo for daily celebrations, to be sure.  Perhaps ignoring the potential for recurrence has catapulted me past the celebratory phase of beating cancer and straight into my attempts to return life to normal.  

I've realized a better reason for why my celebratory sensations have been lacking:  beating cancer is accomplishing a goal that I never should have had.  I didn't aspire to get cancer so that I could beat it.  In fact, I didn't aspire to get cancer at all.  I tend to set positive, output-oriented goals, and my larger ones have included marriage, getting a PhD, and having (two beautiful) children.  Beating cancer is to eliminate a negative thing, which in a way is a double-negative, and this type of goal is very unlike me.

I think that my aversion to negativity is the primary reason that I haven't been inclined to celebrate beating cancer, trumping even latent fears of recurrence.  I think that all along I've expected myself to rush through and accomplish this goal, to beat cancer senseless, to get it out of the way of my numerous positive goals.  Even on those cold winter days, filled with fear and fatigue, I longed to return my focus to my real goals.  Beating cancer was just a distasteful, temporary goal, given to me by someone else.  Now I feel that I've dumped it off of my desk and can get on with my real jobs.

Check that box.

Speaking of positive goals, I have a sewing project that desperately needs some attention, as I am hours away from my self-set deadline (tomorrow).  I'll get to it after I finish this post and tidy the kitchen.

Did you say that I fought cancer recently?  Huh, that's amazing, because I can hardly recall...are you sure it was me?  

Predicted victories

Perhaps all of the campers should evacuate Camp Allen, what with all of the wildfires springing from our camp.  Wildfires of gossip, that is.  Can't a girl take a nap before writing a blog post anymore?  :)

Indeed it is as Holly commented:  Dr. Oncologist is not concerned about the 7mm lung nodule, and her preferred course of action is to "watch it".  She said it is too small to biopsy, too dim to think it's cancer, and therefore too insignificant to worry about it yet.  Huzzah, huzzah!  Also, she was positively beaming with the news that the T9 vertebral body in my spine is no longer glowing; it doesn't matter why, and we'll never know anyway.  The morning took a slight downturn when she told me that if I have one more sinus infection she's going to send me to Dr. Ear Nose and Throat to drain my sinuses.  This involves spelunking in my sinuses and poking holes to make more drainage routes.  Ugh!  That sounds positively awful, and I'm not convinced that that's necessary.  Even if my sinuses were riddled with holes, couldn't an infection still set up shop up there?  The problem is my po-dunk immune system, right?  We shall see.

In the meantime, it's time for Operation:  Sinus Storm.  I am upping the antibiotic anti and switching to avelox (a fluoroquinolone) instead of augmentin.  I am taking claritin to dry out the sinuses and flushing them every night with a saline solution to.  After the eradication of the current sinus infection, I will adopt a daily prophylactic sinus wash regimen and wear a face mask the next time the kid(s) are sick.  My goal is to prevent the need for sinus surgery.  Oh, yea, and to reclaim my health at last.  I will be victorious!  

As alluded to, I already took one nap on this easy-chemo day.  That herceptin, I tell you what, I can hardly keep my eyes open on the walk home from the clinic.  I must have extra Her2 receptors on my brain because the herceptin seems to thicken and settle right in the center of my head.  Fortunately it will be largely cleared up by tomorrow and gone by Friday for sure.

I have been receiving herceptin every third Wednesday since March, but not once have I made it between herceptin appointments without having some other appointment or ailment.  I think June is my time to shine.  I'm feeling it.  I am going to work 40 hours next week, and I am not going to get sick before my next herceptin treatment.  I will be victorious!    

Fail

The results of PET scans are definitely pass/fail.  There's no middle ground for this sort of thing.  No room for B-pluses or C minuses.  You're either good (pass) or you've got something fishy going on that needs to be watched, biopsied, or removed (fail).  

Dr. Oncologist was out of the office today, so substitute Dr. Oncologist called to give me what he thought were the time-sensitive PET scan results.  Sub Dr. O called to tell me that I have a sinus infection.  I said thanks, I'm already treating that.  He said great and was about to hang up when I interjected, "How about my spine?  I'm really nervous about my spine."  He began to orally skim through the highlights of my PET scan results, starting with a normal-looking spine.  Just as I was letting out the largest sigh of relief these former tuba-playing lungs could hold, he mentioned a 7 mm node on one of my lungs.  "Tiny" and "bright" and "7 millimeters" are the only details I remember.  He said that it could be an infection related to my epic sinus infection, and that it's small regardless of what it is.  He said that my normal Dr. Oncologist will discuss it with me on Wednesday.

Logic tells me not to worry, because there is a very good chance that whatever it is is related to my sinus wars, or my recent surgeries, or my recent radiation therapy.  My goal is to have that worry under control by tomorrow, and this post is, as always, therapeutic.  This morning didn't I say something about Living, and happiness, and no need to worry?  Time to go re-enact some Ring Around the Rosy.

Fail.  

Living

This was supposed to post automatically at 7am this morning...sorry for the delay.

I have a PET scan at 9am this morning.  It is important because on my last PET scan three months ago, my T9 vertebral body (a bone in my spine) showed increased metabolic activity.  I had a biopsy taken from this bone, and although no cancer was found, they did find "atypical" cells.  This was good news because it wasn't cancer, but bad news because it wasn't nothing.  The conclusion from this exercise was to repeat the scan in 3 months.  That is today.

I suppose I am a bit worried about these results, but not as much as I could be.  You see, I have been doing so very much Living lately that I don't expect the results to wreck my life.  I think have learned how to live with the threat of continued cancer, or at least to ignore it.  There's nothing I can do about it, anyway.  And besides, Living is way more fun than worrying, especially when done on your husband's amazing patio...

And when playing with remarkable children...

And let's not forget the joy that is camping...

Sometimes the best part of Living is simply Ring Around the Rosy.

My other degree is in Cancer

I'm really sorry I didn't post yesterday.  I had to work late last night.  Thank you, Hilary, for posting in the comments section the results of last Friday's skin biopsy:  eczema.  Yet another weird thing that has popped up in conjunction with my cancer treatment, but at least it's totally manageable.  I've never had eczema before, and the dermatologist said it usually occurs in the winter or with a change in detergent, for example.  I haven't changed anything and clearly it's not winter, so naturally I suspect something related to the April 4th needle-localized biopsy in that area.  Perhaps the surgical glue?  Who knows.  I got a prescription for an ointment that should calm things down.  It's a rare day that eczema is good news, but I'll take it.

When it rains, it pours, because I have another sinus infection.  No joke.  The kids had some piddly virus last week, and I of course caught it this past weekend.  It started with a sore throat, so I did a salt-water gargle Monday night to nip it in the bud.  And it was nipped!  The sore throat was gone the next day.  But things never 100% cleared up.  Gradually over the course of the week I've felt my sinuses get a bit stuffy.  That was no big deal, but when my teeth hurt upon bending over to lift someone out of the stroller tonight, my heart sank.  Achy upper teeth is the hallmark of a sinus infection.  Here's where I gave myself an honorary degree in Cancer:  I prepared and performed a sinus wash; I took one free-sample antibiotic that Dr. Ear Nose and Throat gave me last month and told me to keep; I took a claritin D; and I took an anti-fungal (prophylactically).  Boo-ya!  I'll call Dr. Oncologist in the morning to get a full course of antibiotics, and hopefully she'll give me a bye on a head CT scan.  I am indeed a professional patient.    

Did I tell you that I asked Dr. Oncologist about why I get sick every time I even look at my kids (aka I complained)?  I asked her how long it will take for my immune system to start performing as well as it used to.  I feel so much better and my hair has gotten so thick that it just seems like my immune system should be doing well, too.  Not so.  Her response:  TWO YEARS.  Yep.  And I'm only 3 months out from my last hard chemo.  I'm going to have to start a sinus infection tally (I think I'm on number 4, if not 5).

The worst part about this sinus infection is that it's physically dragging me down.  I can feel the fatigue quietly drifting in, like a fog creeping over Lake Wingra and enveloping unsuspecting picnicers.  I was doing so, so good for an entire week, and now here we go again.  I might not be able to protect my energy, but I won't let the fog get a hold of my spirit!

Speaking of preserving energy...time for bed.

Updated poke tally (I had a blood draw on Wednesday to check for tumor markers.  I'll get the results on chemo day (next Wednesday)):

port  32

right arm 12

tummy  6

left arm  6

right breast 2++

left breast  1+

superior vena cava 1

T9 vertebral body