Being Thankful

My hair started falling out yesterday.

It's been a full week since I've had any real side effects from the chemo. I tend to get tired around 3pm (pretty reliably) and occasionally still get nauseous first thing in the morning and headaches in the afternoons. But I've been eating real food (YAY!) and feeling generally like myself. I even ran 3 miles this morning (although at a super slow pace).

So the hair thing was a little bit of a shock. But it's right about when they said it would happen - between 14-21 days - and I'm 15 days out today. 

I've been trying to tuck my hair into hats and get used to seeing myself with no hair. It's weird though. I may just avoid mirrors for a few months.

Otherwise, I've received a few good pieces of news in the last week. A visit to Dr. M (my oncologist) last week revealed that the tumor appears to have shrunk a little in response to the chemo. I say appears because the first time she measured it was relatively soon after my biopsy and things might have been swollen. So measuring now may not be comparing apples to apples. But at least it hasn't gotten bigger. This is good news.

I also went in on Thursday for an MRI guided biopsy of the lesion in my right breast. Anything smaller that 6mm can't be seen with an ultrasound or a mammogram, so doing a biopsy of this spot required going back into the MRI machine and toughing it through one of the most uncomfortable procedures I've had to date.

Imagine laying on your stomach face down so you can't see anything with your sternum propped up on a hard piece of plastic (no padding) while holding your arms up above your head. 

Now do that for about 35 minutes while they wheel you in and out of an MRI (and by the way you can't even move a little bit or they may end up sticking the needle into you in the wrong place), numb up your whole boob and then stick a needle into you.

I imagined it was a yoga pose and practiced deep breathing. "Get comfortable with being uncomfortable".

The news came back good, though. No cancer on the right side. 

*Phew*

So tomorrow is chemo day #2. Because I'm trying to get to Thursday as my treatment days, we went a little longer between treatments this time than we normally will. I go on Wednesday this week because who really wants to spend Thanksgiving in the chemo clinic? Not me. But after this, we will be on Thursdays. I guess I should be thankful that I got a few extra days of feeling normal before descending back into the toxic fog.

Last time I had no idea what to expect, so I had nothing really to fear. This time I know what's coming, and although I think I'll be able to fend off the headaches this time, the chemo has a cumulative effect. Which means that side effects get worse each time......so again, I have no idea what to expect. 

I am dreading the visual nausea I get from looking at food (Good thing Thanksgiving is the day after treatment!), but have stocked up on the staples I know I can eat. I also happen to be on furlough from work this week and next week, so at least I can just lay around and do nothing guilt free.

I must say, though, that going through this process during the holiday season is giving me a whole new perspective on being thankful for what we have and on appreciating this simple things in life. I hope my dilemma may help you all appreciate those things a little more, too. 

Mostly though, I have developed a whole new appreciation for the immense amounts of love I have in my life and for the amazing people that I am blessed to know. I have been overwhelmed by the amount of support, love, and humor that has come my way. Emails, texts, videos, cards, gifts, care packages, flowers, and visits. It's humbling. And it is truly what keeps me going. Thank you to each and every one of you that has spent time thinking about me. It means more than I can ever say or ever repay.

I am constantly being asked, "What do you need?" and "What can I do?".

I have what I need. You all.

You are doing what I need you to do. You are being supportive. You are making me laugh. You are keeping my brain distracted from all the poison that is being pumped into me. 

You are reminding me that no matter what happens in this world - love is the answer. 

Love heals. Love conquers all. Love wins.

Be thankful for the love you have in your life. More than ever, I know I am.

And now, I am going to have a Thanksgiving cocktail because I can.

I suggest you have one, too.

Cocktail pairing: a nice glass of Murphy's Law Riesling. Cheers!

Feeling Human

Day 5 of chemotherapy.

I feel like a human today.

A very hungry human.

A very hungry human that cannot eat anything because everything she looks at makes her nauseous.

*sigh*

Chemo has been an interesting adventure so far. Mostly because a) I hate being sick, b) I hate being dependent on others, and c) I hate not being in control.

So I guess I should get over that.

So here's how it went:

The chemo clinic is set up to be a nice, comfy place to get toxins pumped into your body. I got to pick a recliner, and then the nurse inserted the catheter into my port which delivers the IV meds directly into my subclavian artery.

The first two bags they hooked up were anti-nausea drugs. They each took about 20 minutes. There is a chance that these drugs can cause headache, as well as a host of other side effects just as bad as the cancer drugs. But I guess its worth it to decrease the nausea.

The third drug the nurse pushed directly into the IV line. This was the first cancer drug - Adriamycin. The cancer drugs kill the fast growing cells in your body. These cells include cancer, hair, and cells like those in your mouth that are replaced quickly. So, since this drug has the possibility of causing mouth sores, I was provided with a popsicle - a green one - to suck on while the drug was being administered. I guess cold stops the cells from absorbing anything new, so with ice in my mouth the mouth cells are less likely to take in the poison. And I got a popsicle.

The fourth drug, Cytoxan, is the other cancer drug. This one took about an hour to drip during which I beat my husband at a nice game of Travel Scrabble (ha ha!).

And then I was done. Easy, huh?

I actually felt pretty good when I was done. No big deal. So we went to Costco and proceeded to buy lots of easy to fix food so that Bryan can feed himself when I'm sick and/or fatigued.

On the way home, things started going down hill.

By the time we got home I had a raging headache, chills, and a stomach that was trying to be anywhere except where a stomach should be.

Prior to my chemo session, I was provided with a whole protocol of what to do in case of nausea, so I started through the list as quickly as I could. First pill - Compazine  - didn't work. Thirty VERY long minutes later, I tried the second - Ativan. Ativan is an anti-anxiety drug, but it is also a known reliever of chemotherapy-caused nausea. So not only does it make your stomach feel better, but it makes you feel less stressed about your stomach feeling better. It also "may cause drowsiness" which is medical speak for "It will make you pass the hell out".  Which I promptly did. I woke up 6 hours later to no nausea, a slight headache, and a slightly worried husband. And then I went to bed.

Day 2 I felt fine. I went to work. I talked to people. I laughed. Ha ha ha. I actually ate dinner. This chemo isn't so bad!

Day 3 I woke up with a slight headache. I did a few chores around the house. I walked 3 miles on my new treadmill (thanks, husband!). And then the chemo beast reared its ugly head. Like the flip of a switch, I felt like crap. I took an Ativan for the nausea that had just moved in, laid down on the couch, and promptly passed out. Five hours later I woke up to the worst headache I have ever experienced. Every piece of food I looked at made me want to throw up. I tried Tylenol to no avail. I proceeded to lay and whimper on the couch. And then I went to bed just to stop feeling what I was feeling. Blah.

The headache woke me up on Day 4. It alternated between my ears, the top of my head, my temples, and my sinuses. No let up, no relief. I felt like my head was being stabbed repeatedly. I still couldn't look at food, so I ate a dry piece of white toast to keep my stomach from turning. Yum.

Day 4 was also the day for my plastic surgery consult. Lucky me. So not only did I feel like shit, but I got to go talk about the best way to chop off and replace my breasts. The doctor did not endear himself to me when he walked into the exam room and said, "So how can I help you today?"

Really??

He asked a few more stupid questions that I took as flippant and then I repaid him by bursting into tears. Take that!

He excused himself to bring himself up to speed on my case (i.e. actually look at my MRI) and then came back in apologetic and serious and regained my confidence by actually showing that he knew what he was doing. Based on my case, he recommended double mastectomy with a bilateral LD flap procedure. This was basically what I was expecting, so it wasn't too much of a shock. Even though right now I only have a confirmed tumor in my left breast, the right one has an undetermined spot that doesn't show up on mammograms. So how do you track that one? Go in every 6 months and have an MRI? No. Apparently, you just get rid of the breast so you don't have to worry about it and get two matching replacements.

The replacement surgery has lots of options to it, but because I will probably have to have radiation therapy afterwards, it is to my advantage to have a procedure that reuses some of my own tissue. Long story short, they take a large piece of the latissimus dorsi muscle from your back, slide it to the front of your body, and use it help remodel your new breast. Big scars everywhere. Decreased strength in your back for the rest of your life. Not a boob job. I won't go into more detail, but you get the idea.

This is where you have the conversation with yourself about self image and the value of normality. I've had it with myself. It doesn't make any sense.

So all of this occurred while my head was throbbing and I felt like I wanted to die. Perfect.

The one good part of the day was discovering that McDonald's Mango Pineapple smoothies are actually something that taste great and don't make me want to vomit.

After all this fun, I went home, placed a call to the chemo nurses begging for help with my headache, and went to sleep.

The next 8 hours were a blur of trying not to move so as to not get sick and not make my head throb any more then possible. I even tried putting ice packs on my head. Oh....and I was starving but couldn't eat anything.

The nurses eventually called me back and told me to try......wait for it......Ibuprofen. Really? But it worked. I woke up from my next nap with no headache. Hallelujah!

So that brings us to today. Day 5. Me feeling like a human being. I can move my eyes without suffering. I'm not nauseous. I still can't think about food without feeling a little sick, though. So far, I've been able to handle white toast, ginger ale, canteloupe, and, surprisingly, pumpkin spice muffins from Costco. Baby steps, I guess.

I'm hoping this will continue through the next week or so. I've got a check up with my oncologist on Monday to see how I'm handling things. (Hah!) I don't have another chemo session until the day before Thanksgiving which, if it follows the pattern, may mean that I'll feel ok for the holiday.

At least I know more about what to expect now. So I guess I'll work with it and just keep trying to feel human. Definitely something I've come to appreciate more lately. Funny how it takes things like this to remind us of the simple things. You're welcome. :)

There is no way in hell I can even think about having a cocktail right now.
But you should definitely have one for me.

The Scar Project

This finally put words to some of the things I that have been going through my head.

I will be fine.

But I will never be the same.





More images from the The Scar Project:

Peacocks and Aliens

I have a little alien in my chest.

Yesterday was port day! Yay! You may be asking yourself, "What the heck is a port?" I had no idea until just recently. Here is what it looks like:

Just like there's a little alien in there waiting to burst out! Very weird. The port serves as a receptor for the IV of chemo drugs that they'll be putting into me every other week. There is no permanent opening (which is how I thought it worked), so they'll punch through every time. Again, very weird. The catheter attached to it goes straight until one of my arteries so there is no lag time to start killing baddies. So it's lump vs. lump. May the best lump win.

Oh, and did I mention that gave me a free pair of sweet socks with the little grippy dots on the bottom? They're blue. Free stuff rocks.

Chemo starts Monday at 11 so Bryan and I went and did our "chemo teach" the other day. We watched a 45 minute video (complete with a Powerpoint Notes handout) and then went through all the details with Nurse Amy. Long story short, the next 8 weeks are really going to suck, and then the following 12 weeks will suck less. The first combo of drugs will cause nausea, hair loss, constipation, fatigue, and a host of other fun side effects. Eating, apparently, will also be a challenge because the chemo makes everything taste different. I was told not to eat anything I like during the first week of each round because I will quickly not like it anymore. Also, no fatty or fried food. Less sugar. Cocktails, though, are allowed on a limited basis. Thank god.

The second drug, which I start in January, doesn't cause nausea. Big step forward there. But because it is administered every week instead of every other week, the fatigue could be the biggest hurdle. It's cumulative, so as I move on, it will wear on me more and more.....especially in the evenings. Luckily for me, one of the best ways to combat fatigue is to exercise. I say luckily because I was afraid I was going to lose all of my fitness during this ordeal. I will probably lose a lot of it, but it's nice to know I'm allowed to push myself a little and that it will actually make me feel better. My wonderful husband has oked the purchase of a cheap treadmill to put in our spare room so I can work out easily at home. Party bonus; it has also inspired him to clean all his stuff out of the spare room. SCORE!

So because my hair will start falling out a week after I start chemo, I decided to cut some of it off. I read that it is less traumatic that way. And that thinning hair is less noticeable when your hair is short. So off it went.

It may be less traumatic to watch short hair fall out, but getting to that point was pretty traumatic in itself. The poor girl at Aveda that got my case didn't know what she was getting herself into. She was pretty new and I asked her to dye my hair blue and cut it all off (it's very short in the back). And on top of that my hair is super thick and pretty wavy.

The poor baby started out by messing up on the blue. The dark blue dye she put in my hair caught onto the blonde highlights I already had and turned them aqua. So I ended up with multi-color hair that looked a bit like a peacock. I actually really like it now, but she was distraught that she had messed up. She called over everyone she could find and tries several different methods of scrubbing my hair to try to get the aqua out. I admit that I cried a little. But then an enlightening thing happened.....

3 hours into my hair appointment I was watching this poor distraught hairdresser beat herself up over messing up the cancer lady's hair and I found myself saying, "Don't worry about it.....it's just hair." And I realized it was true. It's just hair. It's going to fall out. And I'm going to deal with it. And it will come back. I will probably cry when it falls out. But it will be ok.

It will all be ok.

I definitely needed a cocktail after the hair adventure.
I think you should have one, too.

Cocktail pairing: Boulder Beer Shake (because chocolate and beer are a perfect pairing for mental trauma. Yummmm......)

Winner Winner Chicken Dinner

Well, the results are back!

(Drum roll please......)

I still have cancer.

And....wait for it.....it's worse than we thought! TA DA!!

I really should just stop having tests done.

Ok, so it's not quite as dramatic as that. It could be a lot worse. But I have been upgraded from Stage II to Stage III. Why is that, you ask? Well, for the answer we go to the results of our friend, the MRI.

I got the MRI to confirm  the state of the second lesion that was found by the folks at the Breast Diagnostic Center. (This second lesion, by the way, was totally missed by the folks at the Estes Park Medical Center. Note to self.) However, the MRI confirmed that there actually is no second lesion. It's just one big-ass lesion that you can't see in its entirely on an ultrasound. So.....the lesion is now bigger than 5 cm all together which puts in into the Stage III zone. Yay!

The PET scan turned up a few little goodies, too: a "questionable" spot in my right breast (to be biopsied at a date to be determined soon) and a possible spot in one of the lymph nodes under my breast bone (which should be taken care of by the chemo).

So what does all this mean? Nothing new, really. It just confirms what I was already thinking was going to have to happen.

The PET scan indicated that the lesions are fairly metabolically active, so they should respond to the chemo. There is a chance that the chemo will shrink the main lesion, but probably not enough to have a lumpectomy since the damn thing is now too big to be a space station. The lesion is in two different quadrants of the breast, so that's the magic pathway to a mastectomy. Because there is a possible spot in the right breast, we'll have to wait for the biopsy to see if I'm the grand prize winner of a double mastectomy. Winner winner, chicken dinner.

Just a few more mighty things for me to wrap my head around. They've been coming at me pretty steadily lately. Stage III drops the 5 year relative survival rate from 93% to 72%. Up to this point, I've pretty much been ignoring the survival rate. 72% is still pretty good, but does get me thinking about life just a little bit more. The sunrise this morning, by the way, was fantastic.

All  of this also makes the idea of double mastectomy and double reconstruction all that much more real. I'm not afraid of surgery, but this will be a big surgery. I guess a lot of women with breast cancer opt for the double M just for the symmetry of reconstruction. I'll have to think more about that.

So this week is turning out to be a very full week. I have a echocardiogram on Monday. This is meant to get a baseline read on my heart health since there is a very small chance that the chemo can cause heart problems. Monday, though, is also my hair cut day. I'm headed to the hair salon to get my hair chopped shorter to as to prepare for the Great Fall Out. There will probably be some hair dye administered, too. Just sayin....

Tuesday will probably end up being port day. They'll need to put a port in for easy administering of the chemo. I don't think this is a very big deal, but it's something to do.

Wednesday is "Chemo Teach" day where they tell me about all the wonderful procedures and side effects of the chemotherapy. I've been doing a little research on my own, and the Doctor M has enlightened me a little, too. One of the fun decisions Bryan and I got to make the other night was whether or not we wanted to have children. Because that's an easy one to answer, right? Chemo will probably cause infertility and early menopause, so  if we want kids we'll have to do some egg harvesting (all these terms are just awesome, huh?). Bryan and I have never really been on the baby train, but it does get a little harder when you realize you don't have the option to change your mind later on.

Chemo will probably start at the end of the week. And there on....

So I'll be in chemo for the next 6 months or so. Which also means that the training schedule for work that I was hoping to invigorate this winter will also have to wait. I've had my personal work goals on the back burner for the last year or so while I babysat the Rocky Mountain National Park Centennial Celebration. Since I won't be able to travel to help out with trainings at other NPS sites, I won't really be able to move forward with my professional goals for probably another year. But apparently I'm  not supposed to worry about that. I have cancer. Why should my professional life that I've been working to build for the last 15 years be important to me? (Please note the sarcasm in my virtual voice).

But life is about impermanence. Things are never what we plan. Enjoy the day. It was a beautiful sunrise.

I think I need a cocktail later (maybe a beer for the Broncos game).
I think you should have one, too.

P.S. Hanging out with men who have been drinking beer for 4 hours at a Beer Fest and listening to them try to make me feel better about having breast cancer is possibly the funniest thing (and sweet in a very funny way, too) I have ever heard. Nuff said.