Mastectomy for Beginners

It's been four months since I had my mastectomy.

At the time I thought I was prepared for it.

I was not.

Looking back on it, the weeks following my surgery were probably some of the darkest of my life....both mentally and physically.

It had been awhile since I had had any kind of major surgery, but I figured that it couldn't be that bad. And I'd heard from many people that the surgery was the least worrisome part of the whole cancer process. So I went into surgery pretty optimistic.

I also went into surgery with the knowledge that I had a great surgeon and a great plastic surgeon. After shopping around for good doctors (a process that was much more stressful that actually having cancer), I ended up with a team out of the University of Colorado Anschutz Hospital in Denver. I was very confident in their abilities which is important when it comes to breast cancer surgery since there are so many different permutations and options for surgery.

Before you go into surgery, you have to know what kind of reconstruction, if any, you intend to have. Not that you can't change your mind later, but it makes things a lot easier if you can combine surgeries and get in any of the prep work necessary done all at one time.

I also had to decide if I was going to have a single mastectomy or a double mastectomy.

All of this seems like it wouldn't be that hard, but it is. There are lots of options. And no one tells you what you "should" do. They only tell you what you "need" to do. There seems to be a trend these days for women to have doubles so they "just don't have to worry about anything anymore." This I guess, is true. However, it also brings twice as much trauma and twice as much loss of sensation.

What I really needed to do was get that big honking tumor out of my boob. After chemo, it seemed like the tumor had shrunk a little. It was still big enough unfortunately that a full mastectomy, not a lumpectomy, was needed. After more tests, though, Dr. K and Dr. A determined that my tumor was far enough back in my chest that I could have a nipple-sparing mastectomy.

In a traditional mastectomy, breast tissue, skin, and nipple are all removed leaving a large scar across the front of your breast. If reconstruction is chosen, skin and/or muscle has to be taken from other places in the body and moved to the chest. Radiation complicates the reconstruction process since it basically cooks the skin and tissue that it irradiates and makes reconstruction much more problematic.

A nipple-sparing mastectomy, though, preserves the breast skin and nipple even though all the breast tissue is removed. The scar I have goes beneath the breast - sort of where an underwire in a bra would go - and isn't really visible once it's healed. I guess this is because my tumor, despite being over 6 cm, was in a good location.

So I lucked out, really. I had been having nightmares about being a Frankenstein's monster and not being able to look at myself in the mirror.

Instead, I woke up after my surgery with the equivalent of a numb, deflated left breast. Not quite as bad as what I had originally imagined, but still not my ideal look. The outside was relatively intact, but all the insides had been taken out. Because I had decided to eventually have reconstruction, my plastic surgeon had placed a plastic tissue expander inside my breast tissue with a small amount of saline inside - so my left side wasn't entirely flat, but it was definitely deflated.

Because I had at least 2 lymph nodes that had shown signs of cancer in my PET scan, I also had about a 2 inch scar under my left armpit where they had removed 17 lymph nodes. Before this whole cancer process, I had never really thought much about what the lymphatic system does. In short, your lymphatic system is essential both both your circulatory and immune systems. It moves body products (like plasma, glucose, proteins, immune system cells, etc.) through your body. It also provides a response to trauma, bacteria, viruses, etc. that invade your body. In short, when you have a swelling response, that is your body sending lymph to the site of a problem. The lymphatic system helps to bring lymph back from the extremities to two major lymph nodes in your neck for it to be cleaned, processed, and sent out again to the rest of your body.

So if you have cancer in your lymph nodes there is a higher chance that you cancer can spread to other parts of your body. Therefore, it's important to get rid of any of them that might have that cancer....as well as those that are a little further down the line that might have microcancer cells that have moved down from the tumor.

Removing lymph nodes brings problems, though, so they don't like to do it if they don't have to. While I was in my surgery, Dr. K did a sentinal node biopsy. Essentially, they find the node that drains directly from the tumor and they biopsy it to see if it has cancer. Mine came up positive, so they did a full axillary lymph node dissection. Thus, 17 nodes gone. Apparently they all come out in one big ball of goop.

Removal of lymph nodes means that your body could potentially have problems draining lymph from the affected area. This is called lymphadema, and it can strike at any time -sometimes years and years after surgery. For me it could cause my left arm to swell up and could be caused by a cut, a bee sting, injury, hot water (hot tub!), or maybe even nothing at all.

So between the removal of the breast tissue and the removal of the lymph nodes, I had a good amount of cutting done in my body that severed a bunch of nerves. At this point, I have no feeling in my left breast, in most of my armpit, and in the back of my upper arm. The feeling is not expected to return. I also couldn't really move my left arm due to all the tissue damage underneath. On the bright side, I no longer sweat from my left armpit, so I'll save a little money on deodorant. :)

After all the cutting, I was in quite a bit of pain for about 4 weeks....especially when I was trying to go from standing to sitting to laying down and back. I also came out of surgery with a pretty bad cough from the intubation they had to do so I could breathe during surgery. This wouldn't have been bad except that when you cough you use all your core muscles which in my case were severely traumatized. The cough was probably the worst physical part of the recovery.

So physically I was dealing with the loss of my breast, disfigurement, pain, loss of movement in my left arm, loss of feeling in part of my body, and the threat of lymphadema. I still had no hair, and felt pretty darn depressed from the weight I had gained from chemo and steroids. Oh, and on top of it all, they put tubes into the surgery site that drain unwanted blood and fluids out of you through suction into gross little grenade shapes bulbs. You have to measure the amount of yucky stuff coming out of you daily until you get to the right amount so the drains can be removed. They hurt, they're gross, and they make it really hard to shower, use the bathroom, or move. It was awesome.

Mentally, I was dealing with all of this PLUS the fact that my lifestyle may have to change for the rest of my life.....AND the fact that I have no way of knowing if this cancer is going to come back in the future and I might have to go through all of this again.

As I said, this was a pretty dark time for me.

I felt the farthest from strong, courageous, brave (and whatever other adjectives people were throwing at me) that I have ever been in my life. I felt defeated. I felt sad. I felt like I had no control over my life. I did not feel like things were going to be "fine" as everyone kept telling me. I did not feel like "I'd forget about all of this once I felt better".

But no one likes a whiner. So, for the most part, I tried to hold myself together.

After about two weeks, I was pretty much back on my feet movement wise. Getting up and down was still hard, and I was on pain killers so I couldn't really drive. I also wasn't very comfortable sleeping. As a side sleeper, having to sleep on my back was very uncomfortable. I couldn't sleep on the hurt side for obvious reasons. And I couldn't sleep on the unhurt side because gravity is a bitch. With limited arm movement, getting dressed is pretty uncomfortable, too. And the drains had to be hidden under bulky clothing because they're gross and no one wants to see that.

But eventually things got a little better. The drains came out (kind of like watching a tape worm being pulled out of someone....those suckers just kept coming!) leaving round little scars. My cough eventually went away (after about 4 weeks), and my core muscles started healing so I could move with less pain.

I went back to work even though I shouldn't have. I wasn't ready. Mentally or physically. Work did provide a little bit of a distraction, but it also made me keenly aware of the physical side of my recovery every step of the way. Having to pretend like everything is ok when you're in pain and have constant reminders in the mirror that you've been disfigured is tough.

Because I had radiation and eventually reconstruction ahead of me, I also started the process of filling up my tissue expander as soon as my incisions were healed. This sucked.

A tissue expander is a temporary implant with a one way valve that can be filled slowly with saline in order to get your breast skin to the proper size. Eventually, the tissue expander is replaced with an implant or with natural body tissue. In a normal body, your breast tissue is on top of your pectoral muscle. However, in order for the body to hold a tissue expander in place, the expander has to be placed under the pectoral muscle. This feels really weird. What this also means is that as the tissue expander is filled your muscle gets stretched. In addition to feeling weird, this is also really painful.

Many women fill their expanders slowly over a few months with about 40 cc's of saline at a time. Because I was at a higher risk of cancer recurrence due to my lymph nodes being involved, I had to get on with my radiation treatments pretty quickly. This meant that I needed to get my expander filled to the right amount as soon as possible. My expander had between 60-80 cc's added every week (sometimes twice a week) for 4 weeks so I could get up to size in time. (Once you start radiation, your skin pretty much gets cooked making it more fragile and tight so it's hard to expand it.)

What this meant was that even as I was recovering from surgery, I was also putting myself through incredibly painful procedures every week. More than once, I found myself sitting in bed crying from the constant pain. The only thing that got me through it was the knowledge that the pain had an end date.

By the time I started radiation I had been through physical therapy so I could get my arm above my head for treatment with minimal pain and my left breast was the size and hardness of a softball. I tried to pretend like I was doing "just fine". Sometimes I was; sometimes I wasn't. I would have been really easy to stay in that dark place. And I'm pretty sure that if I hadn't had such incredible support all around me, I might have stayed there.

Mastectomy is not for beginners. But you don't really have a choice. You have to keep moving forward. So that's what I'm doing.

The Failure of the Pink Campaign

On October 20, 2015, I was diagnosed with Stage 3 breast cancer. There is no breast cancer in my family. I am not genetically predisposed to breast cancer. I hadn't done anything "wrong" to cause my condition.

On May 4, 2016, I had a mastectomy to remove a 6.2 cm cancerous tumor from my left breast. Seventeen lymph nodes were also surgically removed from my left armpit. Two of them were positive for cancer.

Pathology on the tumor and lymph nodes that were removed revealed that the six long months of neoadjuvant (before surgery) chemotherapy I endured did nothing to kill my cancer.

Ahead of me I have weeks of physical therapy to restore range of motion and lymph movement in my left arm. I have 3 more painful sessions of filling a plastic tissue expander under my left pectoral muscle to temporarily re-form my breast while I undergo six weeks of daily radiation treatments. This tissue expander will cause me daily pain and discomfort until I undergo final breast reconstruction sometime next year. It will probably make running intensely uncomfortable, and the missing lymph nodes in my left arm will make it impossible for me to go back to my previous fitness habits. More than a year after my initial diagnosis, I will eventually undergo yet another surgery with a long recovery time to restore natural tissue to my breast.

Meanwhile I will start five years of endocrine therapy that will throw me into menopause and cause painful, stiff joints and possible bone loss. I will also take a year's worth of endocrine superchargers that may cause side effects such as joint pain, nausea, and fatigue.

I accept and even welcome all of this because it means I get to live out a longer life with the people I love. And I try to stay positive about it even though it will mean a pretty drastic change in my lifestyle for awhile.

But, hey, it's ok. At least I got a free boob job out of it, right?

While the Breast Cancer Awareness campaign that has been waged since the early 1990s has made great steps in making breast cancer less taboo to discuss, it hasn't really done much to really inform and educate about what breast cancer really does to the lives it touches. Instead, out of the pink ribbon campaign there seems to have been born some kind of misperception that breast cancer "isn't so bad" because, hey, "at least you get a new, better set of boobs out of it".

There are so many things wrong with this statement I don't even know where to begin.

Most of the many people that have said this to me are coming at it from a good place. They're being funny or ironic or just awkward. So I don't hold it against anyone. I take well-intentioned love in any form.

I have to admit, though, that each of these statements stab straight into my heart and stay with me. It makes me feel like all the mental and physical pain and suffering I've been battling through is being discounted and compared to a superficial, elective procedure that some women do for fun.

I never really know what to say, either. I usually end up just mumbling, "It's not quite that simple."

The accounts of stars battling breast cancer or undergoing prophylactic procedures because they have the BRCA1 and BRCA 2 gene mutations don't really help either. After all, Angelina looks great, right? She bounced right back!

And don't get me wrong - there are many breast cancer survivors that are happy with their implants. They serve the important function of letting these women maintain their self-esteem and self-image and allow they to go on living a outwardly normal life.

Here's the catch: They're not yours. They're forced on you. You lose all sensation. They are a constant reminder of what you've gone through.

For me personally, I liked my boobs. I would never thought of making them "better". They were exactly how I liked them. And, even more, I would never have thought of only have ONE be made "better". How stupid is that? No one would ever do that.

Additionally, I have never wanted to have non-natural pouches of saline or silicone stuffed into my body. After enduring chemotherapy in which toxins of all kinds were dripped continuously into me for six months, the last thing I want now is for more non-natural substances inside me. On top of that, I really don't like having no feeling in most of the left side of my chest.

In fact, all I really want is my old body back.

This cancer fight has been the hardest thing I've ever done. Both mentally and physically I have been ripped apart. But I'm hanging in there. I'll make it through. I will live to tell the tale. And I will be stronger because of it.

I will feel better when I feel like my life is coming back under my own control.

I will feel better when I know for sure that there is no more cancer in my body.

I will feel better when people start seeing me for me again, instead of seeing a sick person.

But I will not feel better because I have "new boobs".

For some reason, the diagnosis of breast cancer now comes with the assumption that treatment includes a double mastectomy and implants. More and more women are, in fact, undergoing double mastectomies even for diagnosis in one breast. But this is not the only option.

There are other options besides implants, but unless you do significant research you probably won't hear about them. In fact, the first plastic surgeon I went to didn't tell me about any options other than the one he thought I should have. If I had listened to him, I WOULD have ended up with a double mastectomy and implants.

Luckily, I was told about an option that uses my own body tissue to replace my missing breast tissue. A "TUG" flap takes tissue from my inner thighs in order to rebuild my breast. Ultimately, I will have a natural looking breast with no implant. It will match, for the most part, my existing breast.

The pink ribbon campaign doesn't share any of this.  And while it does raise awareness for breast cancer and breast cancer patients, it minimizes the reality of the struggle of the disease.

I think the real problem with this campaign is that although the goal was to de-sexualize breasts so that awareness and detection would increase, it has replaced one problem with another.

Now we "save the ta-tas" or "save second base".

And while it's important that women who deal with breast cancer are able to maintain a positive self-image and be provided with opportunities to look as normal as they like after treatment, what they end up with should not be the "prize" for making it through.

So, again, I welcome any love that is sent my way. Thank you for trying to cheer me up. But maybe instead try - "Hey, at least you get to try out some new hairdos!" :)

The Caterpillar and the Butterfly

So the chemo is over. I guess I'm pretty happy that I'm not getting poison pumped into me on a weekly basis anymore. And I'm REALLY happy that the chemo did it's job. But, I've come to realize that even though I'm not getting the weekly drip anymore, it's going to be awhile before I'm feeling back to normal.

So now I'm dealing with the repercussions of 6 months of chemo and trying to be positive about it. I've got three fingernails that are in the process of coming off, my eyelashes are all but gone, and my eyebrows aren't much better. I've got a head full of fuzz (at least it's growing back, I guess) and I'm dealing with about 10 pounds of chemo weight that is driving me absolutely crazy. I know it's all temporary. Everyone tells me it's not a big deal. I guess I'm not supposed to care about what I look like.

It's pretty hard, though, to go out of the house every morning feeling like I look......I don't know......like someone else. Like some other poor sick soul. It's REALLY hard to look in the mirror and not recognize myself. I seriously surprise myself almost every time. It is almost the hardest part of this whole ordeal.

I say almost because I think I've figured out the hardest part really is. I'm actually still wrapping my head around it. I even said it in the first paragraph of this first post - "it's going to be awhile before I'm feeling back to normal". The funny thing is, though, I don't think I'm ever going to feel back to normal. At least, not the normal that I have always known.

Up to this point I've kind of been plowing through everything so I could get back to the way I was before. It wasn't until I met with an oncologist that deals with long term hormone therapy that I realized this cancer crap isn't going away anytime soon. I've got another 10 years of treatment and not feeling like myself to get through.

Realizing this made me cry.

The short term stiff upper lip is easy. For the long term, though, keeping that upper lip from quivering gets a little harder. It kind of wears you down. And all you want is just feel normal again....to not have to deal with any of it.....to recognize yourself in the mirror.

But it's not going to happen. And it's something I just have to get into my thick head. Normal is now NOT having cancer. Normal is scars and new body parts. Normal is no cancer-feeding estrogen in my body. Normal is starting over, finding out what my new body can do, and testing its limits.

Normal is going to take me awhile to get to.

But a friend sent me a card this week that helped. It says, "Just when the caterpillar thought the world was over, it became a butterfly...."

Thanks, Meg. I'm looking forward to my butterfly moment.

Next Steps

The end is near! Six months of chemotherapy is about to come to a close. Thank god.

Once I finish my last chemo treatment on Thursday, I start into a whole new phase of cancer craziness. I'll get about a month off in order for my body to recover and get ready for surgery. It will take a few weeks for my body to stop feeling the effects of the chemotherapy (in fact, it will probably take a lot longer), but I'm hoping to be able to get back to feeling somewhat normal by eating normally again, working out, losing a few of the pounds I've put on by sitting around the house, and not having all my internal organs constantly assaulted by poison.

The last six months have been a never-ending roller coaster ride of physical side effects and mental somersaults. I just never know what the day will bring....how I'll feel or what rabbit hole my thoughts will go down.

I do know that I've learned some pretty big lessons from the last six months:

1) People don't care about your hair. They especially don't care if it's purple....or any other color....or absent. The people who judge you by how you look don't have enough other things to think about. Don't waste your time on them. The way that you let your spirit show to other people will always outshine whatever cut or color or outward appearance you have. This was an especially hard lesson for me to convince myself of because I have such a specific image of myself in my head, but I have received much less attention than I thought I would for either having no hair or having purple hair. I have lost 2/3 of my eyelashes and have a few chunks missing from my eyebrows, and I don't think anyone but me has noticed (or at least people are too nice to say anything). Honestly, losing my hair has made me a little more self-conscious, but it's made me smile more. And I get more comments on that than I ever have gotten on my hair.

2) We can't make it through life alone. There is a reason that human beings evolved in clans. We need our clan to support us, help us, and celebrate with us. My clan has sent so much love and inspired me so much to stay positive and strong that I'm not sure what I would have done otherwise. How do people get through this alone? From cards and brownies to hugs and purple hair to fighting words, I am not battling this cancer alone. I have my clan standing with me.

3) The bad stuff fades pretty quickly. The good stuff stays forever. I know chemo sucked. I know I spent weeks at a time on the couch, and I know I never, ever want to go through it again. But, now that it's over, I don't really think about how bad it was. Maybe it's like giving birth in that way. I've never given birth, but it looks excruciating and yet people do it over and over and over. And they don't think about the pain. They just think about the wonderful little thing they got out of it after the pain. I think about the people who helped me get through it, and I think about all the things I've learned about myself during this process. After all I've been through, I'm even more sure now that I can get through whatever is sent my way. That confidence, and not all the discomfort, is what I will take with me from this experience.

With chemo coming to an end, this part of the ride will be over soon. According to Dr. M, it seems like the Taxol has done what it set out to do. Ultrasound imaging shows that the tumor has shrunk significantly. Dr. M thinks that it's probably totally gone with just the outline of where it was still showing up on the ultrasound. Apparently it's hard to tell. So that's good. But the end of chemo means that surgery is up soon.

Ironically, surgery is scheduled for May the 4th. Star Wars Day. Back when I was diagnosed, BFF and I named the tumor Darth Hideous because it came from the Dark Side. How fitting that Darth should be expunged on Star Wars Day. Gotta love the way life works out some times.

Even with the tumor being gone, the need for surgery hasn't really changed much. They still need to cut out all the tissue that was affected by the cancer. Since I am relatively small boobed (a scientific term), and since the tumor originally took up a pretty large amount of my breast tissue (the size of a lime sized kidney bean), cutting out the tissue that was affected by the cancer means that most of my breast tissue will be taken out. So I'm still looking at a full mastectomy on my left side.

Luckily, the tumor was relatively far back from my breast skin, and now that it's gone it should be possible to do what is called a nipple-sparing mastectomy. This means that the incision they make will be along the bottom of my breast. The skin and nipple will be spared leaving the breast looking relatively normal when everything is done. The scars should be relatively imperceptible once they heal. Because all the internal tissue will be removed, there will be no remaining sensation in my breast, though. One big numb boob. But at least it should look ok. Score one for me.

Along with the mastectomy, I'll also be getting a sentinel node dissection. Because I don't think I can say it any clearer, here is what breastcancer.org has to say about sentinel node dissection:

The dictionary defines "sentinel" as a guard, watchdog, or protector. Likewise, the sentinel lymph node is the first node "standing guard" for your breast. In sentinel lymph node dissection, the surgeon looks for the very first lymph node that filters fluid draining away from the area of the breast that contained the breast cancer. If cancer cells are breaking away from the tumor and traveling away from your breast via the lymph system, the sentinel lymph node is more likely than other lymph nodes to contain cancer.The idea behind sentinel node dissection is this: Instead of removing 10 or more lymph nodes and analyzing all of them to look for cancer, remove only the one node that is most likely to have it. If this node is clean, chances are the other nodes have not been affected. In reality, the surgeon usually removes a cluster of two or three nodes — the sentinel node and those closest to it.Strategic removal of just one or a few key underarm nodes can accurately assess overall lymph node status in women who have relatively small breast cancers (smaller than 5 cm) and who have lymph nodes that don't feel abnormal before surgery. Studies have shown that after almost 5 years, women who had just the sentinel node removed were as likely to be alive and free of cancer as women who had more lymph nodes removed.

This is my issue with breast cancer. It makes it necessary to say things like "after almost 5 years, these women are just as likely to be alive". Really? That seems unnecessarily harsh.

Anyway, my sentinel lymph node appears to still be quite large, but as with the tumor, it's pretty hard to tell from an ultrasound. So the surgeon will take 3 lymph nodes to see if there is still cancer there. She'll do this by injecting a dye near the site of the tumor the day before surgery. During the surgery, she will follow the dye to the first couple lymph nodes. She'll take those out and they'll be assessed by the pathologist while I'm on the surgical table. If there is still cancer there, she will go ahead and do a full axillary node dissection which involves taking out anywhere from 5-30 lymph nodes. Discovering the extent to which the cancer has spread through the lymph nodes will say a lot about how bad this whole thing is. There is always a chance, too, that if just a sentinel node dissection is done, I may need to go back in for further surgery if they find cancer upon looking further at the dissected nodes.

Dr. K (the surgeon) actually wanted to do a full axillary node dissection right away as per the standard of care for my stage and size of tumor, but Dr. M (the oncologist) convinced her to try the smaller surgery first. The less lymph nodes get taken out the better, even if there is a chance that it might mean a second surgery later on if we were wrong.

What's the big deal with lymph nodes? Again, I quote the experts:

There are many good reasons why women want to minimize the number of underarm lymph nodes that are removed. Lymph node surgery can lead to uncomfortable temporary side effects, such as lymph backup in the armpit, called seroma. Other side effects can linger, including mild armpit discomfort and numbness in the armpit and the upper arm. Also, women who have only sentinel lymph node biopsy and not axillary node surgery have a much lower risk of lymphedema. Lymphedema is the build-up of lymph fluid in the soft tissues of the body, most often the arm and hand in people who’ve had breast cancer surgery, but also the breast, underarm, chest, trunk, and back. Besides swelling, lymphedema also can cause arm weakness and numbness, as well as shoulder pain. Finally, the more surgery a woman has in the breast/armpit area, the more potential there is for numbness, heightened sensitivity, and discomfort.

So there you go. Lymph node surgery bad. Let's hope the cancer is gone from the lymph node as well as my boob. I do not want to take the chance with elephantitis of the arm.

The surgery will probably be 4-5 hours depending on how many nodes they end up taking out. I'll be in the hospital for one night (hopefully), and then I'll get to come home and recover. The reading I've done suggests that about 4 weeks is the average recovery time, but I'm not really sure about that. I seem to have bounced back faster on most parts of this process so far, so I'm hoping my recovery will be closer to 2 weeks. But we'll see. There are some pretty uncomfortable times with getting range of motion in the arm back and dealing with really disgusting looking surgery drains. Stay tuned for updates on that fun adventure.

To try to allay my fears, I've been watching a lot of YouTube videos about mastectomies. Not the actual surgery part, but the before and after part. I have to admit that I'm pretty scared about the whole surgery thing. Not because I'm scared of having surgery. I've had lots of surgeries, and I trust my surgeons. But I'm scared of having my body altered permanently and having to learn to deal with it. It will ultimately be fine, I know. But I'm not looking forward to it. And having people tell me that I will be fine doesn't make it any better. For some reason, it ends up feeling like people are telling me it's not a big deal. And I know it is a big deal. At least for me. As strong as I know I am, sometimes you don't look forward to the times when you have to be strong. Sometimes you just want to fold your hands up over your head and whimper.

But the videos have helped. The women in them are honest and brave and show it like it is. And they make it not look so bad. Say what you want to about the tendency of our society to overshare, but there is something to be said for watching a women take off her bandages, show you her scars, and tell you that she's feeling fine about it. Even if she's lying. It helps me face the uncertainty to come by being able to see it.

Surgery is by no means the end of things. After surgery and recovery comes radiation. If chemo is the warm-up and surgery is the main event, radiation is the clean up. The radiation will take care of all the little microscopic bits of cancer that are still floating around, and it will take care of the affected lymph node under my breast bone that had cancer in it, too, that can't be reached by surgery. The radiation will be 5 days a week for six weeks down in Fort Collins. So that sucks. The radiation itself is a 15 minute daily session. The drive will be a little over an hour each way. But if that's what it takes to make sure this stuff doesn't come back then I'll do the drive.

Radiation basically gives you a bad sunburn and makes you tired. Not too bad of side effects. But it also pretty much cooks the skin and tissue of wherever it is aimed. For this reason, I won't be able to have breast reconstruction until after the radiation and after my body has healed from the radiation. That means I end up getting what is called delayed-immediate reconstruction.

After they remove the breast tissue, Dr. A (the plastic surgeon) will put in a place holder. It's actually called a tissue expander, but I like to think of it more as a place holder. The tissue expander is a temporary implant that gets placed behind my pectoral muscle and is filled with saline over 6-8 weeks to fill the space formally known as my boob. This tissue expander holds everything is shape while my body is bombarded and cooked by the radiation. They fill it up a little larger than the size you want to eventually have since the cooking makes the skin contract. (You're loving this, I know.) Apparently, having the place holder in is not very comfortable. I will not be giving out hugs during this time.

Six months after radiation is done, I'll be able to trade out my place holder for a real boob. But that's a another story that I'll go into at another time.

But for now, that's the story of what's coming up next. It doesn't seem to get any easier, but at least I'm not being poisoned anymore. It's a little easier to see the enemy that's coming at you from the front as opposed to the enemy that's coming from inside.

So here we go.

I guess I need a cocktail. Anybody want to celebrate with me?

Cheers!

Myths and Misconceptions of Having Cancer

It's amazing to me how many people get cancer. It's everywhere. And there are lots of stories about people getting cancer. But what I have realized over the last five months is that most people know very little about what cancer is, how it is treated, or how to respond to it. Any why should they? But there are lots of myths and misconceptions that are perpetuated by the media's treatment of cancer...and especially breast cancer. If you want the basics on what causes cancer, this is really nice little cartoon that explains it: http://www.thepharmafist.com/cancer/

But here is my take on some of the misconceptions based on my experiences:

• There is a "right thing" to say to someone with cancer.
• I personally like, "Wow. That sucks." Those words pretty much sum it up. I have also noticed that people who say, "I have no idea what I should say," end up coming up with some of the most heartfelt, moving, empathetic things to say in the end. There is no right thing to say. There are a few really bad things to say that you should try to steer clear of. But just say it with love. Even if it doesn't come out right, the intention will be there. That's what counts.
• There is a reason I got cancer.
• There are many things that can increase your risk of cancer, but it is almost impossible to pinpoint the actual reason I ended up with a 5 cm tumor in my breast. I do not have the BRCA1 or BRCA 2 gene mutation. I do not have breast cancer in my family. I am not obese. I did take birth control. I do drink alcohol. I don't have kids. Many people have these same risk factors and do not get cancer. I do not know why I got cancer. I just did. 
• I do not like being told that everything happens for a reason. Please do not tell me this. I am fully aware that I can pull positive things out of the experience and use it to make myself a stronger person, blah, blah, blah. But I'm also pretty sure I could have reaped those benefits in other ways, too. Perhaps a really hard year at my job might have done it? Maybe a back injury? Oh, wait. I did that. I did not need cancer to help me grow as a person. This did not happen for a reason. It just happened. 
• Going through chemotherapy means that you always feel awful.
• This is a hard one. I usually don't feel great, but I don't always feel bad. I feel like everyone expects me to feel awful all the time. I don't. Granted, I swing between feeling fine and feeling crappy pretty quickly and sometimes several times a day, but sometimes I feel just fine. Sometimes I just feel really tired in the evenings. It often depends on the day of the week and what treatment I am currently undergoing. Right now, for instance, my fingernails are taking the brunt of the treatment. They're brown and bruised. I can't do simple things like pulling up my jeans or opening a can of soda. After I walk on the treadmill, they throb. But other than that, I feel ok. With treatments on Thursdays, I sometimes feel tired. Fridays are my best day due to the steroids I'm getting. Sundays the steroids wear off so I usually feel pretty achy and rundown. Mondays I get the hellish neupogen shots so I feel like I'm coming down with the flu and I get full body aches. Tuesdays I get better except for random waves of achiness. Wednesdays are pretty good. I do feel, though, like people don't want me to say the that I feel ok. On Fridays I've started trying to run again, and people look at me like I'm crazy. "Oh...I wouldn't think you'd be able to do that!" Yes. I can. Last Friday I ran 3 miles at my marathon pace and it felt so good and empowering that I wanted to cry. And then I passed out in my bed by 8:30pm, and woke up with a nose bleed. It all evens out. When I was on my A/C chemo, I did feel awful for a whole week at a time. And then I felt pretty good for a week. Different treatments do different things.
• Finishing chemo means you're done with cancer.
• As I near the end of my chemo treatments, I'm starting to get this one a lot. And it's different for every cancer patient depending on their type, stage, treatment, etc. For me, finishing chemo is a good thing in some ways. My hair will start growing back. Thank the lords! I'll stop feeling general crappy. However, it does mean that I am now moving into the stage of treatment where they are going to cut off body parts. This, in some ways, is harder than chemo because it makes it really real. My body will now show the signs of treatment every day for the rest of my life. Also, chemo is just the first stage of my treatment. Many people do it last, but for me the intent of the chemo was to shrink my tumor, which it did. I now have to go through mastectomy surgery, radiation, and then reconstruction, and the process will not be over until sometime late in 2017. Yup, another whole year of dealing with this. Oh yeah, then there is the 10 years of Tamoxifen pills that I will take to block my estrogen production to try to keep my estrogen positive cancer from coming back. So yes, I'm glad that the chemo is finishing up, but by no means am I almost done.
• Chemotherapy is the hardest part of cancer.
• I am only part way through my cancer treatment, but I'm pretty confident that this is not true. In my opinion, the hardest part of having cancer is the fact that I think about it ALL THE TIME. Every thought process involves or is interrupted by the thought that I have cancer. It's there when I'm working, exercising, and going out with friends. It is very isolating. I guess there are support groups, but I haven't gone to any of them. There are no young people support groups that are convenient for me to get to. I remember reading when I was training for my marathon that even though all I thought about was training for my marathon, no one wanted to hear about my marathon training all the time. The same is true with cancer. I think about it all the time, but I can't talk about it all the time. It is my new normal. It is a distraction when I'm trying to work or talk or think. If life is a dogwalk, cancer is my squirrel. For me, that is the hardest part of having cancer.
• Once you're done with treatments, everything will go back to normal.
• Between the mental trauma, the constant fear that the cancer will come back, the long lasting side effects of chemo, surgery, and radiation, the scars, the numbness and lack of feeling in a newly dissected breast and/or armpit, and the constant reminder that you went through this, I seriously doubt that anyone that goes through this ever feels normal again. They may get used to it. Or they may find a new normal. But things will never just go back to the way they were.
• This brings up another thing that people say to me that make me wonder. Sometimes they say "Oh! You have breast cancer? My grandmother/mother/sister/friend DIED of breast cancer!" Do not say this. Ever. Just don't. I don't need to hear it.
• I have also heard, "My grandmother/mother/sister/friend had breast cancer and now she's doing great!" While this may in fact be true, this does not really help me. It just makes me feel like there is something kinda wrong with me because I do not feel like I will be fine again ever. And while this other person may be fine on the outside and putting on a good show, she is probably not fine all the time on the inside. The mental side of cancer, the body image side of cancer, the personal relationship side of cancer are the sides that I don't think cancer survivors talk about.  There is a lot of pressure to "handle this well"....to "be positive"....to put on a good show. Underneath may be a whole other ball of wax. 
• I do/don't want to talk about it.
• It depends. At the beginning, I couldn't talk about it without crying so I did not want to talk about it. Now, I'm having to make lots of decisions and learn lots of new medical knowledge, so it's nice to get it off my chest. Cancer also makes me feel very isolated, so it can be really nice to share so I don't feel so alone. It depends on the day, too. Just ask....but only if you really want to hear the answer.
• If I want help, I'll ask for it.  
• Nope. Won't happen. I do not like putting other people out and do not like asking them to do things or go out of their way for me. Lots of people say, "Just let me know if there's anything I can do for you." Nope. Again, probably won't happen. I'll do it myself. Unless you make the decision, give me concrete options, or force your help on me. Then I will concede because it actually might be convenient, entertaining, or take my mind off things. But I will not decide for you how you can help me. I'm making way too many other decisions right now...and just trying to make it through the day. In fact, at this point, I feel like I never want to make another decision ever again for the rest of my life. I will accept your help and your company, but I will not ask for it. That's just how I am. It does mean a lot that you offer. Believe me. I have been overwhelmed by the amount of help I have had offered to me. But unless it's something really important, don't expect me to take you up on it. That would require me expending energy....entertaining you or being a hostess or being a gracious gift accepter. I don't have the extra mental energy to do that. I'll probably just lay on the couch and eat tortilla chips by myself and watch long binge sessions of NCIS. 
• Being positive makes everything easier. 
• It is easier to be positive in public. No one wants to ask, "How are you doing?" and hear a long laundry list of ailments. I often have people say, "Wow! You're handling this so well!" To which I often reply, "I don't really have a choice." Right? You either move forward or you stop moving. I'm not really ready to stop moving quite yet. Don't get me wrong. I am generally a positive person. Smiling and being positive actually do make me feel better. But on a daily basis, I am also a sad person, a frustrated person, and an angry person. Sometimes, I'm even a pretty depressed person. It just doesn't do me any good to show people those sides. It just makes them uncomfortable. I am pretty good at reading people, and the last thing I want to do is make them uncomfortable. But it's hard for me to believe that a cancer patient could be positive all the time. It's just really hard. Right now, my life span is being predicted in 5 year increments, I have no hair, and I can't undo my pants without discomfort. However, I have wonderful friends, people love me, and I'm probably not going to die anytime soon, so I find positivity in that. Again, balance is key.
• All cancer is treated the same.
• Again, nope. I've read literally hundreds of accounts of women with breast cancer. I've yet to find a case just like mine. Every case is different. Treatment is different. Reconstruction options are different. Response is different. Personal preferences are different. Choices are different. Mostly because people are different. And there are so many different kinds of cancer out there that when you combine that with the diversity of people, you get lots of different cancer cases. 
• Getting a mastectomy and breast reconstruction is similar to getting a boob job.
• When you get a manicure, do they chop off your fingertips, throw the flesh away, and then stick your new nails onto little blocks of putty that they stick back onto the ends of your fingers? No? Then, no, getting a mastectomy is not like getting a boob job. 
• When you get a mastectomy they are actually cutting a piece of your body off. It is not good. There is no silver lining (except for the getting rid of the cancer part of things). There are amazing ways that they can go about reconstructing the breast, but there are a whole host of things that change during this process. You usually end up with scars, skin grafts, weakness in the area of tissue donation, and lack of sensation in your new breast. If you choose to get implants, they are not placed behind the existing breast tissue as they are in a boob job. They ARE the boob. They look and feel very different. They may rupture. Or, if they don't, they end up looking a little unnatural, especially as you age. If you choose to augment your breast size during the reconstruction process, your chances of complications go up, too.
• You have to ask yourself if you want one or two done. Do you just reconstruct one and live with your breasts looking and aging differently? Or do you have both of them done so they match but you lose feeling in both breasts? Fun decisions.
• If you're like me, you have lymph nodes that have to be removed at the time of mastectomy, too. This may be simple, or, if the cancer has spread, it may involve taking a whole lot of lymph nodes out that affect your lymphatic system in your arm. This can cause lymphedema, or swelling of the arm. Another fun thing to deal with.
• So again, to sum up, getting a mastectomy and breast reconstruction is not like getting a boob job.

So that's what I got. If any of you have said any of the things I mentioned up above, please don't worry. As I mentioned, anything said with love gets a full pardon. i take love in any way, shape, or form. But these are just some of the things that have been going through my head. And maybe they clear up some of the ideas that are floating around out there.

Cocktail anyone? I haven't been having much, but you definitely should. Hoping my taste buds get back to normal soon so I can enjoy a nice riesling again. Have one for me, ok? Cheers!

The Home Stretch

I haven't been writing much lately. Mostly because I just feel like I'm complaining.....and nobody needs to hear that. But I've received a number of questions about how I'm doing lately, so I guess it's not really complaining if I'm just answering a question. So here goes...

Taxol is much better than Adriamycin/Cytoxin. Much. I have 6 more treatments to go and am on track to have March 31 be my last dose. Thank god. I'm mostly just tired of not feeling like myself. It's really hard to concentrate on anything for too long. And forget trying to multitask. I'm tired all the time. I get winded if I walk too fast, and I'm usually in bed before 9 every night - dead to the world. I don't have the nausea and headache that accompanied the AC, but the metal taste is still there most times and I get bouts of stomach cramps for no apparent reason. No one knows why. Apparently this is not a common side effect. But nothing makes it better except not eating - not my favorite alternative.

The weekly Taxol treatments are apparently doing a number on my blood count. Three weeks ago I almost had to skip a treatment because my white blood count was too low. The solution for this conundrum is to make me get Neupogen shots every Monday and Tuesday to boost white blood cell production. This lovely drug - a cousin to the horrible Neulasta that used to auto-inject itself into my arm - is not as bad as the Neulasta, but still makes me feel pretty lousy. Luckily, I don't have to go all the way down to Fort Collins to get it. I just hop into the Estes Park Medical Center and they shoot me up. A great way to start the day. It ends up feeling similar to the Neulasta - body aches, deferred bone pain - but just not as bad. Essentially, I come down with the flu minus the stuffy nose for two days. Because it affects me so much, though, this week we're trying one shot to see if that's enough to keep my blood count up. Hopefully one will be enough. If not, it's back to two a week.

The constant nose blowing has turned into a pretty tortuous dry nose that ends up bleeding randomly at least once a day. It usually bleeds in the morning when I get up - just starts bleeding - from both nostrils. On Saturday I had 6 - count them  - 6 bloody noses throughout the day. Stellar.

The other little side effect that's starting to catch up with me is nail pain. My fingernails hurt. Especially when I try to do anything with them like open a banana. Very strange. Maybe it's because the chemo is killing off the cells that rapidly grow to create your fingernails? Not sure. That's my best guess.

My eyebrows and eyelashes are still hanging in there, but they're starting to fall out slowly. I've got a big gap in my lower right lashes that I've been camouflaging. Not sure how much more I can do about that. I may have to break into the false eyelashes eventually.

And finally, adding insult to injury, the weight gain is finally catching up with me. The decadron (steriods) they give me before each week's treatment is known to pack on the pounds. I'm sure the lack of activity doesn't help either. I try to walk 3 miles on the treadmill as much as I can, but it ends up only being a few times a week. So in addition to having no hair, having gaps in my eyelashes, and constantly having wads of tissue hanging out of my nose, I've also moved up to the next size in my uniform pants. Ouch. Husband is getting tired of me slamming myself for looking so very unattractive, and he tells me that all of these side effects are temporary. It's true. I know. But it doesn't help much. It doesn't matter that nobody else expects me to look attractive when I have cancer. I don't like looking like a cancer patient. I don't like not looking or feeling like myself. So I just try to ignore it as much as I can.

The good news is that in addition to all these lovely little side effects, the Taxol actually seems to be working. At my last exam, Dr. M was really happy that she wasn't able to measure the lump externally anymore. It has apparently changed shape - flattened out. I can still feel it, but it's definitely not as prominent as it once was. This is great news. With 6 more weeks to go, I'm hoping that things will squash down even a bit more. I admit that I do some manual squashing of my own, but I'm doubtful that this is actually effective.

So now that the end of chemo is within reach, it's time to start thinking about next steps.....surgery and radiation.

Dr. M says the tumor has moved back far enough that it seems like I can save enough of my breast to have what is called a "breast/nipple sparing" mastectomy. I know you all wanted to know that. But it's actually a really good thing because it will end up saving me from looking like the Frankenstein Barbie doll if it is, in fact, true.

The frustrating thing about preparing for surgery is that three separate doctors are involved (oncologist, surgeon, and plastic surgeon) and they don't hang out together. You have to see them all separately. The oncologist handles the cancer, the surgeon handles the mastectomy, and the plastic surgeon puts everything back together. So when I come up with my questions, they usually end up not being able to all be answered at the same time. Or they play the "ask your mother/ask your father" game. To make matters worse, right now I'm floating between two different surgeons and two different plastic surgeons depending on which procedure I go with. Nothing is easy.

So really the next steps are to decide on how many of my breasts I would like to keep and in what way I would like to reconstruct the one(s) that I lose.

I checked in with my plastic surgeon last week about my options. This is the same guy who endeared himself to me a couple of months ago when this whole process started out. I thought maybe it had just been a bad appointment because I had just started chemo at the time. Nope. He's as asshole. Don't like him at all. So this, in addition to the option of having a type of reconstruction that doesn't require implants, has inspired me to seek out a different plastic surgeon located in downtown Denver. A new plastic surgeon means a new surgeon, too, since I can't have surgery in one location and plastic surgery in another. So again....I'm waiting to hear back from the new surgeon to see if she'll take me on. Fingers crossed. But more on that in another post.

So that's about how things are going. I'm still working 4 days a week, trying not to look too sick on Mondays and Tuesdays. Trying to get my act together so I'm prepared when I have to take time off for the surgery. I'll be out about 4 weeks for surgery and then I'll be making daily trips down to Fort Collins for radiation. This all makes being present and effective during our busy summer season pretty impossible. Needless to say, I'm rather depressed about it. But I don't have much choice about it either.  I'll do what I can.

I'm also on the home stretch of my Masters Degree in Adult Education and Training that I've been working on for the last year and a half. I started up again about 3 weeks ago. Including the class I'm in now, I've got three classes left to take and I'll hopefully be done sometime around the end of August. All in all the worst timed "enrichment opportunity" I could have taken on. Between the Centennial and the cancer, I've been pretty busy. But at least it takes my mind off things.

So now I'm off to bed. It's almost 8 and the yawning has begun.

I had a cocktail the other day - actually a beer. A wonderful Lugene chocolate stout from the Odell Brewery. I highly recommend them. I barely made it through one bottle, but damn was it good. You should have one, too.

Cheers to you all.

Waiting Room

Having cancer is all about waiting.

Waiting to see the doctor. Waiting to hear about treatment. Waiting to see if it will work. Waiting to see what side effects you'll get. Waiting for tests. Waiting...waiting...waiting.

The last three weeks have been a lot of waiting.

I had my last A/C chemotherapy session on Christmas Eve. It was the worst one and the side effects lasted much longer than all the others, so I'm ecstatic that those are over. My nurse informed me afterwords that Adriamycin is known as the Red Devil (the medicine is red) by lots of patients. She said she doesn't usually tell people that up front, which I can understand. It was better to go into the bad stuff not really knowing what to expect. I fully believe that having a positive attitude going into treatment has helped me feel better about the whole process. If you go in anticipating feeling shitty all the time, it's hard to motivate to do anything.

So on January 7, I started my 12 week regimen of Taxol. Taxol does not have the same side effects as the A/C - no nausea and no Neulasta. Overall, it's much easier to deal with. It does bring my white and red blood cell count down which leads to more fatigue, but I tend to really only feel it in the evenings. After 6 I'm pretty much down for the count. Supposedly I'm more prone to infection, too, but so far I've fared ok through cold and flu season. It also supposedly does and number on your finger and toe nails, so I'm expecting to lose a few toe nails during the process. My poor toes are still recovering from the marathon in October, though, so I'm kind of used to them falling out already.

The surprise side effect has been the stomach cramps. Some people get them, but not many. It doens't make me nauseous, and doesn't seem to be affected by anything I eat. I just have stomach cramps most of the time. Awesome. But I guess it could be worse.

Taxol also causes hair loss, so I'm stuck with being bald for few more months. It really is the worst part of the whole thing. If I still had hair I'd at least be able to fake that things are still normal, but it's a constant reminder when I look in the mirror that I'm sick. And I just don't think I look good bald. But it's given me a whole new perspective on how guys feel when they start losing their hair.

The hair loss so far has been pretty weird. The chemotherapy kills off cells that multiply rapidly, so that's why the hair on my head has fallen out. Apparently, though, hair in other places doesn't multiply or grow quite so quickly. I still have air hair, eyebrows, and hair on my toes. And I still have to shave my legs - granted, not quite as often as before, but I still have to do it. I even have a pretty good, spaced-out fuzz on my head. Not enough to even suggest that I have hair, but enough for me to wonder why the hell that hair isn't falling out. Weird.

My intensive internet research of chat rooms has suggested that Taxol may be the end of my eyelashes and eyebrows. I'm hoping I beat the odds on those or I'm going to REALLY feel like a freak. But thankfully I have wonderful friends who have loaded me up with all the make up I need to recreate my brows and lashes if need be. And then there's YouTube where you can more than enough videos on how to draw on eyebrows. It's fascinating. Look it up.

And speaking of fantastic friends......I can't even begin to express my thankfulness for all the amazing care packages that have come my way. They light up my day and help me keep going. Thank you, thank you, thank you to everyone who has visited, called, sent well wishes, cards, packages, and meals. It really is overwhelming.

A few weeks ago I posted my current medical challenges on Facebook. It took me a long time to decide whether or not I would do it. I finally broke down, though, and put it out there because I knew there were friends who would want to know. I have to send a huge thank you out to all of those friends, too, who expressed their love and support. I now have a constant stream of email and Facebook well wishers, and I've reconnected with friends I haven't really talked to in years. It's been a great reminder of how real friends never really go away.

So where does the waiting come into all of this?

Well, first I waited for the genetic testing that I sent in around Thanksgiving to come back. This blood test would tell me if I carried the BRCA 1 & 2 mutation that leads to a greater risk of breast and ovarian cancer. This is the gene that Angelina Jolie made so popular when she decided to have a double mastectomy before she even had any signs of breast cancer. If I came back as positive for this gene, it would mean a double mastectomy for me for sure and probably a removal of my ovaries, too, just for good measure. Luckily, the test came back negative. No BRCA 1 or 2 in my family. Which is also great news for my 3 nieces. This now means that my surgery options are more plentiful.

Then there was the waiting for the ultrasound. Between A/C and Taxol, I was sent in for an ultrasound to get a better view of how the chemo is affecting Darth (the tumor). Waiting never seems to be so long as when you're laying on a treatment table in a medical gown waiting to hear if the poison you're voluntarily pumping into your body is doing any good. Long story short, the answer is.....kind of.

I mentioned in an earlier post that when Dr. M palpated Darth he measured smaller. Well, according to the ultrasound, he's probably only about 10% smaller. He's just changed shape. Flattened out a little so he doesn't feel so big. But he's not growing, which is the good part. Darth may, in fact, be hollow inside, or filled with holes like swiss cheese. The chemo may be doing great things, but at this point it's hard to say whether Darth is a shell of a tumor or solid. Either way, he's still pretty big. Which means a probably mastectomy after all. We just have to......you know it......wait and see.

Dr. M put in a referral for me with a plastic surgery group in Denver that does a surgery called DIEP flap reconstruction. Unlike the surgeries I was looking into that involve taking muscle from other parts of the body, the DIEP procedure only takes fat and skin as well as the blood vessels attached to them from the lower abdomen. It does require an incision in my belly, but overall results in no resulting muscle weakness. The results are more natural since no implants are required, and there actually is a chance of retaining or regaining some sensation in the breast.

I wasn't really all that hot on the plastic surgeon I consulted with initially, so I'm happy to have a second opinion. Plus, when my oncologist recommends a procedure and some great doctors, I'm pretty inclined to follow her recommendation. Here's the trick, though. The doctors and the facility do not seem to be on the provider list for my insurance. So what do I have to do? Yup. Wait and see if they decide to cover it.

The cancer roller coaster rears it's ugly head again.

I was also waiting to hear whether or not I had gotten into a clinical trial that might prevent me from having to have a full axillary node dissection - or the removal of 5-30 lymph nodes under my arm. Apparently, since I also have a small lymph node on my breast bone that is affected, I am not eligible for the study. Dr. M thinks there might be a way to just take out a few lymph nodes instead of all of them, but again.........I have to wait to find out.

So I just keep plugging along. I generally feel pretty good, so it's much easier to deal with my physical effects. The mental side of the waiting game is starting to wear on me, though. I should be done with the Taxol at the end of March. And then I'll have to go back in for more tests - MRI, ultrasound, etc. - to see how Darth is behaving. And then hopefully I'll have some answers.

But until then, I wait.

With all the poisons I've been dosing myself with, I've been laying low on the cocktails. I figure my liver could use the break. But I've been having a little Irish Cream in my coffee.

You should definitely have a cocktail for me, though. Cheers!

Day 3 and 4

Day 3 and 4 are the worst of the week.

I wake up on Day 3 already feeling bad. My skin on my body is hyper-sensitive. My skin from neck to waist feels sore when you touch it, and it almost feels like I'm buzzing. Not sure why it's only from the waist up. I can't find any record of anyone else experiencing this side effect. Lucky me.

As long as I'm laying in bed, I feel ok (apart from when Bridger jumps up onto the bed and steps all over me), but once I get up, the nausea and headache set in immediately. I get up and take my meds (Claritin, Pepcid, Ibuprofen) and eat a bagel.

I lay on the couch pretty much all day feeling nauseous, sore, and heachachy.

I don't seem to be having the aversion to food that I had the first two rounds, but I don't really have any appetite, so I eat ramen for dinner around 5. Ironically, simple things with lots of salt actually taste pretty good. Who knew?

Around 7pm, I let myself fall asleep on the couch. I made it through the season finale of The Amazing Race (Yay for Joey and Kelsey for winning!), so I feel like I've been productive. I wake up at 9pm and take myself to bed. Nauseous again, so I switch to Ativan which helps me sleep. Unfortunately, it also makes me very unbalanced when I get up in the middle of the night to pee....which I do several times a night since I'm supposed to be hyper-hydrating. I think I barely missed stepping on Bridger.

Day 4 I don't even get out of bed until about 1pm except for a trip to the kitchen for meds and a piece of dry toast. I just try to lay as still as possible as horizontal as possible. A great time for listening to books on tape. I can't watch anything as even my eyes hurt to move.

Around one o'clock, Husband goes to get a haircut (one of us has to have good looking hair, I guess) and I drag myself to the shower. I've noticed that I don't smell very good. It's amazing how not having hair makes you lose track of when you need to bathe yourself. Also, as if cancer is laughing at me, I notice that I need to shave my legs. No hair on the head, but shaving the legs is still on the list of things to do. Irony abounds.

Afterwards, I crawl back under the covers and continue to curse my stomach. Husband comes home and we watch the Broncos game on his phone in bed. They lose. Hoorah.

Around 5, I feel myself perking up just a bit. Headache has subsided and after taking another Compazine, I'm not feeling quite as bad.

A weird metallic medicine taste is beginning to creep into my mouth, too. This is good and bad. It's good because it means I think I'm moving on to the next stage of nastiness and leaving the main nausea behind. It's bad because it means I will have a metal taste in my mouth for the next few days. I feel like I am in the Chemotherapy Hunger Games. As soon as one challenge ends, the next one rears its ugly head.

When medication is injected into the bloodstream, it also gets into your saliva. This can cause a bitter metallic taste in the mouth and/or can make food taste different. Last round I combatted it with spicy foods for meals and lemon drops in between. Gum, too, seemed to help. I just need to be careful with the candy because I don't want to end up with cavities in addition to the cancer.

So with Day 3 in the books and Day 4 almost over, I'm happy to be moving into the next phase of the week. The next few days will still have nausea in the mornings and headaches in the afternoons in addition to the metal mouth, and will also find me falling asleep on the couch by 7 every night. But these next few days should be better than the last two.

Day 3 and 4 this week were MUCH worse than last week. I am already dreading the next round. My tentative plan is to just start with the Ativan on the night of Day 2 and try to sleep through Day 3 and 4. The next one will be my last round of AC chemo, though, so even though I'll be dealing with it on Christmas, at least it will be the last one.

Every morning I give the cancer a squeeze and see if I can feel it getting any smaller. It would be great to visit with Dr. M on the 24th and have her say the magic "L" word (lumpectomy), but I'm not holding my breath. I still have plenty of chemo to go, though. Things can change.

Still no cocktails for me.
Looks like Husband is having Boulder Beer Shake (one of my favorites), so you should definitely join him.

Cheers!

Day 2

Day 2 is not usually too bad.

Slight nausea always kicks in first thing in the morning, so I start the day with a plain bagel. Yum.

I'm pretty tired and slightly nauseous for most of the morning, but I manage to knock out a few chores and make it to the post office around 1pm. When I get back I'm exhausted and my stomach is doing flip flops. I hate taking the Ativan for nausea because it knocks me out, so I decide to try the Compazine again. It didn't work the first time I tried it, but this time it seems to do the trick. I lay down on the couch and knock out 3 episodes of the Great British Baking Show (thanks, BFF, for the recommendation!).

When Husband comes home, I rouse myself and try to act a little less slothsome. It doesn't last very long though.

Just as I finish my dinner (pizza - don't judge) the Neulasta injector on my arm starts beeping. Again, I feel like I'm about to blow up. The beeping is a signal that it is about to inject, which takes about 45 minutes. I can't feel anything, but I start feeling kinda bad - I think it might actually just be a mental thing, but it's all the same in the end. I take an Ibuprofen tablet to try to stave off the headache I know is coming, and wait for the injection to stop. I peel the injector off when it's done and settle back onto the couch.

Within 30 minutes I'm passed out. Husband lets me sleep for about an hour and then sends me off to bed. I take a few Senekot pills (hoorray!), gently wash my face (so as not to encourage my eyelashes and eyebrows to fall out), and crawl into bed.

End of Day 2.

No cocktails for me.
Hope you had one. :)

Round 3 - Day 1

Many people have asked about chemotherapy - what do I have to do, how long does it take, how does it make me feel? So I'm going to attempt to capture the day by day for this round. Here we go:

Day 1 - Chemotherapy is scheduled for 10:30am at the Front Range Cancer Specialists Office at Poudre Valley Hospital. For the last 2 rounds, Husband has driven me down and back, but he's been really busy at work lately so I decided to see how it was to take myself.

First thing in the morning I got my "Chemo Bag" together: books, magazines, coloring books, food and snacks for lunch, kleenex, pens, chapstick, headphones and ipod, cup for water. I also take a Claritin and a Pepcid. These two normal everyday drugs apparently help counteract the mind-killing headaches I get from the Neulasta injection. I start them the day before to start getting my system ready. I jump in the car at about 9:15am and head down the hill.

When I get to the clinic, I check in with the receptionist (who sometimes remembers my name, but doesn't' recognize me this time with my koala bear face hat and lack of hair). The nurse comes to get me and weighs me in (my favorite part!). Ironically, before I got cancer I was very aware of my weight at all times and have been working on losing weight for the last, I don't know, 800 years. However, since getting the big C, I've been working out less and eating worse food, and have weighed the same at each session. Of course, I eat a lot less during the first week of each round, so maybe that evens things out. Either way, I try not to think about it too much - except at the weigh in.

After the weigh in, I'm taken back to the Chemo Clinic. It's a big room with 3 different groupings of big brown leather recliners. There are windows all around looking out at the surrounding fields and mountains. One wall has a long cabinet on it where people place snacks to share and things that they are passing on to other patients (hats, books, wigs, etc.) There is a refrigerator in the back part of the room for water and to stash lunch if it needs to stay cold. There is also a coffee machine that creates smells that I personally have trouble with when I'm going through my session. There are also about 6 private rooms where patients can go if they don't want to listen/watch others or if they have a bunch of people with them and they want to have some space to themselves.

I usually pick a chair in the back pod facing out at the mountains. This week there are a lot of people in the clinic. My pod has 3 other patients and 2 associated family members. The two ladies across from me are chatting away about their cancer journey - sharing their symptoms and side effects. They are both on their second to last session of Taxol (the drug I switch to in January). They are complaining about the muscle weakness, restless legs, and nueropathy that is causing them to lose feeling in their fingers and toes. They are also comparing how many nails they have lost to the drug. Super! Things to look forward to. The lady to the left of me has immediately fallen asleep and is snoring lightly. I find out later that she has been fighting cancer since 2009. Her breast cancer spread to her liver. She does, however, assure me that the mastectomy surgery was not that bad. I take what I can get.

So after sitting down, my nurse comes to "plug me in". You'll remember that I received a port in my right upper chest which I lovingly refer to as my alien. The nurse cleans off my alien with chemicals that smell really bad to me and make me slightly nauseous. My sense of smell has gotten really sensitive and picky during this process. Some strong smells are ok, but most turn me a little green. She tells me to take a big breath and inserts the needle for my IV into the port. There are three little bumps that you can feel through the skin that she aims for. Each time, the needle breaks the skin, but all it takes is a little band-aid when I'm done.

The nurse takes 3 vials of blood to send off for testing. My Complete Blood Count (CBC) is checked to make I'm handling the drugs ok. If I'm not, I would have to get a blood transfusion. I sit and wait (and eat my pretzels) for about 45 minutes until my CBC comes back normal. So now it's time for the drug therapy.

My first two drugs, Aloxi and Emend, are designed to block the signal that causes nausea and vomiting. The Aloxi also contains a steroid (Decadron) to help with general chemo symptoms. Possible side effects of these two lovely drugs include fatigue, headache, constipation, insomnia, hiccups, and loss of appetite. After the first round, I ended up with a horrible headache on day 1 so my nurse slowed down each of these drugs to be administered over about 45 minutes. It's important to be super hydrated during this who process, so I end up wheeling my little IV stand with me to the bathroom at least 3 times during this 90 minutes. I keep noticing people giving me side long looks and wonder about it until I remember I'm wearing my koala hat. It's so busy and there are so many conversations going on in the clinic that I have a hard time concentrating on anything, so I page through the magazines I brought with me, eat my lunch, and eavesdrop on all the conversations around me. Eavesdropping on cancer conversations is not good. It makes me kind of sad, actually, because it reminds me of all the things I have left to go through.

Drug #3 is my first cancer med - Adriamycin. This is one is delivered by IV push instead of IV drip, so the nurse comes and sits next to me and pushes the medication into the IV slowly through a couple big syringes. The side effects for this beauty are nausea/vomiting, bone marrow suppression (which causes a drop in red and white blood cell and platelet production, and makes you more prone to anemia, infection, and bleeding), hair loss (yup, got that one), mouth sores (I suck on ice chips during the delivery of this drug to shut down my mouth cells so they don't suck up the drug), heart toxicity (there is a lifetime maximum of this drug that you are allowed to be given so as to limit this side effect), urine color change (pink pee!), and fatigue. Needless to say, this one is a fun one. It only takes about 15 minutes to administer. I ask my nurse if it's hard dealing with cancer patients all day. She says, "No, dealing with my teenagers is worse." :)

The last drug is another cancer drug - Cytoxan. This one is another IV drip that is given over 90 minutes. By this time, the clinic is starting to empty out. I pull out my phone and watch an episode of NCIS on Netflix. Thank goodness for wifi! The side effects of this drug are nausea/vomiting, bone marrow suppression, hair loss, bladder inflammation, decreased fertility, and fatigue.

At this point, I've been at the clinic about 5 hours. Once I switch over to the Taxol, it will be a lot shorter, but for now it's a pretty long day. Once the Cytoxan is done, the nurse comes over to place my Neulasta injector. Neulasta is a drug that helps my body make more white blood cells and protect itself against chemotherapy complications like infection. Unfortunately, it comes along with mild to moderate bone pain (caused by your blood marrow going into super production). This is what caused my big headaches in round 1 and what the claritin and pepcid are supposed to help with. The Neulasta is given through an injection - or, in my case, through 2"x 1" auto-injector that it attached to the back of my arm. This makes it so I don't have to drive all the way back down to the clinic just to get an injection - which I appreciate. The nurse places the injector and about 30 seconds later is starts beeping like it's going to explode (maybe I've been watching too much NCIS). It shoots a tiny catheter into my arm so that 27 hours from now it can release the medication.

And that's it. Time to go. After my session, I feel relatively normal. It's hard to explain, but it's kind of like I'm buzzing.....or maybe like I've just been pumped full of drugs for the last 5 hours. Either way, I feel ok and walk back out to my car to drive home. It takes about 2 hours before I start feeling bad, so I have plenty of time to make my 1 hour and 10 minute drive home.

I've figured out how to handle the first day effects better and better as I have my sessions. Slowing down the anti-nausea drugs has lessened but not eliminated the first day headache, so I take an ibuprofen to help with that. I've been craving salty food lately, so I help Husband make some frozen Chinese food. My taste buds have been affected by this process, so spicy and salty foods have tasted pretty good lately. I eat a little food and then settle myself onto the chaise of our couch to await the shitty feelings I know are coming. I sip on club soda to keep my stomach from rolling too badly. Mostly I just try not to move. Even my eyes. If I just sit and not move, I can make it through with only mild discomfort. The nausea is almost always just right on the edge, but I just try not to think about it too much. I have a whole regimen of anti-nausea drugs they have prescribed me, but the only one of them that seems to work is Ativan, which knocks me out for about 8 hours if I take it, so I try only take it when I have to....especially when Husband is home. I try to stay awake for him to try to maintain some sense of normalcy. The dogs, too, seem to sense that something is up and try to squish themselves onto the couch next to me. With Bridger being 100 pounds, this is always a little entertaining to watch.

This week I actually stay up to a normal time and watch a few episodes of Top Chef and Survivor. When it's time for bed I take all my little bottles of medication into the bedroom with me and put them on the nightstand just in case I wake up in the middle of the night feeling sick. I also take 3 Senkot-S tablets to help with the constipation. I will not burden you with all the things I've learned about my digestive tract during this whole experience, but needless to say, it has not been a pleasant learning curve.

The one thing that hasn't been affected by this whole thing is my ability to sleep, so I drift off to sleep pretty easily and wait to see how the rest of this week will play out.

So there you go.....that's what going to chemo is like. On the whole, not too terrible, but not pleasant either. We'll see what tomorrow brings....

No cocktails for me today. Seems like it might be a bad idea. Husband bought some holiday beer on the way home. It's description says it has hints of cinnamon -which makes my stomach do a little flip flop just thinking about it. Sometimes just the suggestion of a particular food or smell is enough to set if off.

So I think you're on your own for a cocktail. Cheers!

A Toast

My stomach churns as I think about heading into Round 3 of chemo.

This round wasn't horrible. At least that's what I tell myself. 

I mentioned this to Husband today and and he said, "Really? You spent 6 days straight on the couch."

Hmmm.  I stand corrected.

But nothing was really horrible. An extended course of Claritin headed off the horrible headaches that caused me the most problems during Round 1. Otherwise, I managed to escape with slight nausea and a slight headache for most of the first week. 

My eating wasn't quite as affected by this round as it was by the last. I was able to break away from my "white food" diet a couple times. This round I was lucky enough, though, to experience a huge change in my tastebuds (I could eat things, but they didn't taste very good) and a lovely metallic taste in my mouth for the first week. Thank god for the friends who sent me lemon and peppermint candies to counteract the taste.

The second week has been ok, too. I've been run/walking 3-4 miles most days, and generally feel pretty good. I usually have to eat a couple small meals throughout the day to keep my stomach settled. Afternoons usually find me with a headache and a little more fatigue, but at least I haven't been passing out on the couch at 7pm like I did in Round 1.

So, overall, not horrible. But not great either.

Round 2 has, however, brought about the end of my hair. It was coming out in clumps, making a mess, and causing me great distress, so last Saturday I decided to take control and shave it off. Thanks to the support of BFF and Husband,  I got through it with no tears.

I will admit that, although there were no tears at the actual shaving, the process of losing my hair is the hardest thing I've gone through so far. As a woman, a lot of my identity and self-image has been built around what I look like with hair.

I am not fond of myself with no hair. I do not enjoy the shape of my head. I will never "like" the way I look with no hair. Right now, I don't even have a nice cleanly shaven head. It's patchy and falling out at different rates depending on where it is on my head. It makes me look sick. And it makes it impossible for to fool myself into thinking that everything is fine.

However, after a week of being depressed and feeling sorry for myself (and a super pep talk by Husband), I have decided that I will get through it. 

I have had to do many things I haven't liked in my life. To date, I have gotten through them with grace, success, and courage. This is just another thing. I don't have to like it. I just have to get through it. And, in the process, I will own it. 

I will wear many wonderful hats.

And I will break out the purple wig for special occasions.

Perhaps I will have a cocktail. I'm thinking hot chocolate with a little Bailey's Irish Cream?

I think you should have one, too. 

A toast to my hair.....and while I'm at it....a toast to all the wonderful people who are taking care of me. Thank you for keeping my spirits high and thinking of all the things I haven't. Cheers!

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.