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 was very emotional. 

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

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.

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.  

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.  

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.

Getting close

One left.  At long last, I only have one hard chemo and its recovery to go.  This will be my ninth chemotherapy for this cancer, 15th chemotherapy lifetime, and it will occur on August 22nd.  Can you hear the trumpets and fanfare?  I almost can.

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                                                               11111111111111

In the meantime, I have plenty of resting and strength-building to do.  Good thing it's been pretty much the most awesome midwestern summer in recent memory.  I just love being outdoors with my kids, family, and friends.  I do a lot of walking around the neighborhood with various of these comrades.  It's good for strength-building, among other things.

Tomorrow my dad is driving me to my other Cancer Center for appointments with Dr. Medical Oncologist (the Her2 cancer expert) and Dr. Pulmonary Oncologist.  I am looking forward to the trip for the following reasons:  1) it'll be awesome to spend a day with my dad, 2) we're going to try a new Indian restaurant for lunch, 3) I'm hopeful I'll finally learn what further treatments are in store for me after my last taxotere on August 22nd.  

It was just Dr. O and me at my usual appointment with her this past Friday.  After the exam, I told her I was excited for my appointments tomorrow.  It's true, I am.  Knowledge is power.  I'm ready to come up with a plan and execute it.  Her response, however, was discomfiting.  She chuckled, saying she's glad I'm excited about the appointments because she's nervous.  Nervous?!?!  Why would she be nervous?  It turns out that the treatment path forward is unclear to her as well.  To be clear, she has ideas (more than I have!), but there's no protocol for precisely what to do with my and my cancer(s).  I suppose she's nervous about what further treatments these other experts will suggest.  Or perhaps she's worried about whether or not any of the plans will work for me.  Who knows.  Clearly she knows more about what could happen to me than I do.  All I know is that I am a helluva long way from deathly ill, and I seem to be moving in the right direction (chemotherapy side-effects notwithstanding), so I'm not going to worry about those things yet.  

At the end of this conversation I said well, at least I can count on a mastectomy in my not-so-distant future.  Here's where she threw me curveball.  At the breast cancer conference she attends every year, new research was presented showing that patients with metastatic disease (that's me and my lungs) do WORSE when the primary cancer (that's my breast cancer) is surgically removed.  To say this another way, patients with metastatic disease do BETTER when the site of the primary cancer is kept in place.  Can you believe it?  No one yet knows the mechanism for how this counter-intuitive phenomenon can be, but it just might mean that I'll continue to be lopsided rather than breastless.  Cool!  

I suppose, then, it becomes important to have confidence with the conclusion of metastatic disease.  Boy am I glad that I'm seeing a pulmonary oncologist tomorrow.  I have my PET scan disks in my bag. 

In the meantime...Just keep healing, just keep healing, healing, healing, healing.

My krumping heart

My heart is full of peace and love
It rarely pounds in anguish,
Regardless of the circumstance,
It does not seem to languish.

My heart is good.  My heart is strong.
I can depend upon it.
But the medicine.  It does me in!
The 'roids wreak havoc on it.

And my heart goes

bump
bump
bump
up a-
gainst
my
chest
wall,
each
ventri-
cle
strugg'ling
to
out-
do,
krump
krump
krump
to the
beat
of the
'roid
song,
keep
me
awake
'til the
break
of
dawn.