Time in a Bubble

I don't know where to start with this post. Everything has come to a halt in my life for the next five days until I have another appointment with my oncologist.

I went to see him today on my scheduled appointment post-chemo treatment. The first thing they do is draw blood and run a complete analysis to determine what the white cell blood count is, as well as the rest of the blood parts - red cells, platelets, etc. In a couple of minutes they brought in the report, as I had asked for a copy for myself, and I immediately knew all was not well. My white cell count was 1.1K/ul and the reference range is between 4.8 and 10.8 K/ul. The granulocyte count was 0.2, reference range 1.9 - 8.3. Granulocytes are infection fighters.

Ok, what does all that mean? It means that I have no immunity - no ability to fight off germs or an infection. It means that the Neulasta shot I had the day after chemo did not do what it was supposed to do - boost up the white cell count. Dr. Silva and staff were all totally alarmed and checked three ways to be absolutely sure I was given the Neulasta shot, which they confirmed that I was. I was given a prescription for an antibiotic and some advice about what to do to keep myself from getting sick or infected in the next few days, including taking a multi-vitamin with iron, a B complex. Plus a list of things I need to avoid - gardening, emptying cat litter, petting dogs or cats who have been outdoors, salads, fruit without peels (but I can eat fruit with peels, as long as someone else peels them for me), restaurants, crowds, other people in general. In a nutshell, I can stay inside my own house, read a book, play on my computer, rest, but avoid housecleaning, strenuous activity, and no fresh flowers in the house. Don't risk cuts or burns.

And oh woe, no trip Sunday for a week's vacation to St. Martin's in the Caribbean. I've been trying to maintain a good attitude, be a good trouper throughout this cancer diagnosis, but I was so looking forward to this last vacation before the long and wearying year ahead. It had been planned months ago, before we had any idea that I was ill. And now that plane's leaving without us. Well, I know it's all for the best. A twelve hour air trip in all those crowds could easily have put me in the emergency room in a foreign hospital. I'll just stay here in my safe bubble and behave.

Wig Work

Today I took the two wigs that were given to me by the American Cancer Society to a wig salon in Towson and had them thinned and styled. Another surreal experience. First the skull cap to cover my own hair, which I still have, at least for the next seven days before it falls out from chemo. Then she pulled on one of the wigs and we discussed what I thought I wanted with it - conservative? fun? wispy? severe? - and she began whacking away small pieces with thinning shears, at an alarmingly fast pace. I had to hold my tongue and let her do her thing - after all she had been cutting wigs for 30 years, so she knows what she's doing. I wasn't real good at giving her direction. Basically, I wanted the wig not to look like a wig. Not an easy job, because often wigs are so full of hair that everyone knows nobody has that much natural hair. The wigs I brought in were both shorter styles than my own hair is presently, and layered, which mine isn't. Mine is currently a blond bob, not quite to my chin, no bangs. The stylist considers my style conservative. I would have said classic, but what do I know. These shorter styles make me look younger, or so she says. Sigh ...

Anyway, the wigs are now styled, and I guess I'm okay with them. But I must not be, because there they sit, still in the bag, not even on their stands. I bought the requisite "wig spray" because if you put regular hair spray on synthetic fiber, it ruins them. Who knew? And never use a comb, only a pick. So of course I got a pick.

But naturally I couldn't get out of the salon without trying on some of her wigs, which were still man made but of a superior quality to my synthetic ones. Found one that looked and felt better than the other two, silkier and more realistic. Tried it on, and - natch- had to buy that one. I rationalized getting it because I hadn't paid for the other two, and I deserve it, or someting like that. This one is darker - more like the brown my hair was before it started graying and I started coloring. It's more messy, unruly, natural, and slightly unkempt. Kinda describes me, I suppose. Some light highlights and a little longer at the neck. I like it. It's waiting on the wig stand.

Good News to Report

I got a call today from the cardiologist who did my stress test. That test came up because of an abnormal EKG during the physical exam prior to my port surgery. The cardiologist had me in for a consultation, read the EKG, and said it indicated I had had a heart attack at some point. I didn't take that news particularly well, considering I was still reeling from my new breast cancer diagnosis. He did try to assure me that these "abnormal" EKG's often show false postives. Anyway, the stress test results were NORMAL, and I don't have to do any followups or testing.

My worry about having had a heart attack was partly due to one of the treatments I am supposed to have, a weekly dose of Herceptin. That is a powerful arrow in my cancer-fighting quiver, a biological therapy and a mono-clonal antibody. In general it is a more targeted form of therapy than chemotherapy. It works by blocking the tumor cell growth, or targeting the cell for destruction by the immune system itself, or working with chemotherapy to destroy the HER2 positive cancer cells. But a possible side effect (3%) is that it can cause heart problems, including congestive heart failure, particulary to women who are also getting chemotherapy - me. If that were to happen, I would probably have to stop treatment, perhaps permanently. Since I am not a candidate for hormone therapy, such as Tamoxifen, Herceptin is a good alternative. I figured that if I already had some heart damage, I might not be a candidate for the Herceptin treatment, but that's my guess, not a question I had posed to my doctor.

Well, let's put that boogeyman back in the anxiety closet. No heart damage at this point. Yay!

Is This Chemo Brain Already?

What a super day! Had a great crafting day and cookout at Cathy's and Greg's house. Wonderful cooperative meal with great food and even greater company. We laughed a lot and had a glorious time. It was perfect, weather couldn't have been better. Loved sitting out on their deck enjoying nature and their beautiful gardens. Even heard a wild turkey once.

I'm noticing difficulty trying to express myself when carrying on conversation. The words are often lost to me. I'm wondering if this is what is referred to as chemo brain, and if it is, I'm concerned. I've only had the one treatment, and I know the effects are cumulative. My mind's been going blank when searching for common words. Everyone has that happen sometimes, and that's been my experience as well, but this feels somehow different, and it's worrying me. I always do mind-sharpening puzzles like Sudoku and crossword puzzles to exercise my brain, and I hope it helps. I'm just hoping the chemo effects, if that's what it is, are temporary.

Lazy Sunday

Still not doing too well sleeping at night. I toss around quite a bit, waking and looking at the clock every 45 minutes or so. Had to get up around 3 because of nausea - took a pill and eventually it went away. Woke up groggy and unrested. I seem to be experiencing that nasty chemo-mouth taste. After a leisurely morning reading the paper and drinking coffee, Jim prepared a great breakfast for us. It held us both until a dinner of leftover Chinese.

It was a really nice day , and I spent a couple of hours working on some chores upstairs, worked on organizing our closet, then crashed for my afternoon nap. Had great intentions of getting a lot more accomplished, but it just didn't happen. Not much energy. If I actually had to finish some projects, I probably could have, but just didn't bother to push it.

Tomorrow is Memorial Day. We have plans to get together with friends - crafting with the gals, followed by a cookout with the guys. I want to take a moment to thank all those who are serving our country, now or in the past, and say Thank You. I don't believe in this war, but I believe in you, and I appreciate your sacrifice.

Wilting in the Sun

A beautiful but very hot day here, 90°. Today was the Catonsville Yard Sale, a huge event with lots of vendors and plenty of stuff for serious junkers to poke through. However, the beating sun and the heat made it less than ideal, and we couldn't give it the full attention it deserved. Regardless, had a wonderful time and found yet more treasures we had no idea we needed. Thank goodness for cell phones. Sharon and I were able to easily catch up with Cathy and Co. and chat for a minute.

After a (long) time, I was feeling a little tired and hot and had to sit under some shade, while Sharon commandeered a passing golf cart to porter us back to the car. The girls driving it were on trash detail, and were glad to give us a lift. I climbed aboard. We had so much stuff that the boxes were piled on the seat next to me and at my feet. No room for Sharon, who trotted along side. We can't imagine how we would have managed without the ride. They dropped us off just outside the gate, probably 200 feet from the car, and she went to get it while I waited with the bundles. Packed up the car, and we were off. Sharon found us our way home and we pulled into a Bob Evans for salads. Revived, we headed to our favorite consignment shop to see how Sharon's things were selling, which they were! and then on home.

All I could think of once I got home was a nice long nap. The chemo effects today were just some fatigue, very manageable. I don't wan't to lie around. Made sure I drank a lot of water. Need to keep active, but I'm all for napping afterwards!

First Day After Chemo

Not the most productive day, I have to admit. I haven't felt badly, just tired/sleepy. Went in for an appointment this morning to have a Neulasta shot. It will be a routine - chemo, followed the day after with the shot. The purpose of Neulasta is to raise the white blood counts, which can drop significantly during the treatment, possibly delaying the next chemo treatment. A very expensive drug - $2503.00 per shot. At 24 treatments, that's just over $60,000. Wow.

The extent of my chores around the house included watering the patio plants, loading the breakfast dishes into the dishwasher, and making two sandwiches for lunch. I sat and read for a while, used the computer, and took 2 naps. Jim's cooking, that means we're going out for Chinese tonight. Suits me fine. I am not in the mood to cook.

I'm such a wimp. Many women, and men, who are undergoing chemo continue working and taking care of their families and homes. How on earth do they manage? I'm retired, so the only ones depending on me outside the house are the folks at the library where I volunteer. They know I will be back into a routine soon, and it will feel so good to do that, but I'm sure it is a scheduling inconvenience for them right now.

I'm really tired of myself and our household revolving around me and my medical appointments. Bleah...

First Timer's Chemo Experience

It was a lon-n-n-g day. Started by leaving the house at 8:15 am and getting home around 4:00. I think just now the initial effects of chemo are hitting me. I feel a little weary and headachy, and bed sounds like a good place to be right now, but it's important to me to write about the day before I head off to bed.

The chemo room was a full house, with all 10 chemo loungers occupied when it was time for my appointment, people leaving and others taking their places as time went on. The staff of nurses and techs was a really great team. It's easy to see how well they mesh with each other, taking on one another's patients' needs if their nurse is busy doing something else, changing IV bags and turning off beepers as they are finished. And they were busy the whole day. I was so impressed with their charm, their compassion, their connection to the patients, and their humor. They did a great job making the patients comfortable, offering snacks, drinks, blankets, a handheld TV with headphones, scheduling next appointments, coordinating with other facilities over the phone, making photocopies of blood reports and prescription options for the patients to take home - at least for this patient. I was very impressed with the whole operation. Gold stars all around.

Many of the patients were older people, in their 70's or 80's, others perhaps in their 50' or 60's, and a younger woman who looked to be in her 30's. Many of them looked weary or sad, or resigned. One fellow who looked in his 40's was a real chatterbox, very jolly, and kept a running conversation with his seatmate - a woman perhaps in her 80's. They seemed to have a good time talking to one another. No one else kept up conversation, just a friendly nod or hello or a wave. I remember reading in a website a woman's rant about being cornered in a chemo chair with no way out, being evangelized by someone determined to save her soul. She wasn't at all happy, I remember, and vented that with a vengence.

Lots of people napped or read books. I enjoyed peeking at the titles of their books, saw a couple I might also enjoy reading. I was in my chair from 12:00 to 3:30. I passed the time people watching, reading, trying to sleep, (didn't work) eating a sandwich I had brought, and keeping an eagle eye on the chemo bag lines dripping away. I was given some saline with some Benadryl, I think, Adreamycin, and Cytoxin. The Adreamycin is nicknamed "The Red Devil" for it's color and toxicity. I was forwarned that it immediately turns your urine deep orange, and they were right. (I wheeled my pole into the bathroom with me after a couple of hours of being hyrdated, more from boredom than need.)

One thing that I had to amuse me while passing the time was a beautiful gift bag labeled "Diane's Khemo Kit," presented to me yesterday by my friend Cathy. What fun! She had included Soduko books, pen, note pads, tissues, her own professional-quality handmade note cards and bookmarks, lotion, snuggly socks, and - of course - Snickers Dark Chocolate!

My mentor Kim came to visit me from Dr. Schultz's office to check in with me and offer support. We share many similarities in our breast cancers, however she has been cancer free for 2 years now, and is doing great. She's an inspiration to me with her positive attitude and as a resource for what to expect navigating through this process. She spent perhaps a half an hour with me, and it was a really nice gesture that she took her time to do that.

My chemo schedule for the next 23 treatments will be every 3 weeks. Time to plan the next stage, surgery. Since I don't know what I want to do for that, I'm glad I have these next nearly 6 months to decide.

And all the while, my patient husband Jim sat out in the lobby, slogging through, uh, I mean READING his Michener book, Alaska. He would poke his head in every now and then to check on me, but other than grabbing a bite to eat in the cafeteria, he was there all day with me. I really appreciate his dedication, determined to walk with me in my shoes. He keeps saying we are going through this together, and he wants to be there, that we are going to fight it together. He's really taking that "in sickness and in health" vow seriously. What did I ever do to deserve such a great guy?

Wigging Out

This was a really full day. I had a nuclear stress test this morning that took about 2 1/2 hours, followed by a trip to White Marsh for a wig appointment. I won't know the results of the stress test until next week, but apparently they can tell through photo imaging comparisons whether there is a reduction in blood flow to the heart that would be the result of having had a myocardial infarction (heart attack) some time in the past. I had to have this test because my pre-surgery EKG showed an abnormality that indicated I have had a heart attack, but not to worry, many times these results are false positives. From what the cardiologist told me, 30% of the people who have heart attacks never know they have had them. I really hope this one was a false positive. With everything else going on right now, I don't need to hear that I need some sort of a triple bypass.

The trip to White Marsh was a lot more fun. Cathy, Sharon and I went in to the American Cancer Society for a free fitting of a wig of my choice - actually TWO free wigs of my choice, from a whole room full of them. The volunteer who helped me was wonderful, with style tips and advice and good suggestions. My friends helped by telling me what looked good, what didn't, and got me to try on a few that were really wild, rocker-chic types. Cathy got a few photos that should be fun to see. The whole experience had a surreal feel to it, as if I were just playing dress up. Still having my hair, it was a little difficult to figure out what fit and what really didn't because of all the hair pushing up underneath. I was assurred that a good hairdresser can style the wig in the most natural way with a good cut. Never having had a wig before, I was surprised to learn all the do's and don'ts of wig care...such as "never wear wig near an open oven or hot stove! Extreme heat will cause the wig to frizz." Hmmm... not such a good idea with one's own hair either!

All the wigs are new, never worn, in every imaginable style, length, and color. They are all beautiful. Free to any cancer patient who requests them. I chose two that are similar in color and length to my own hair, but with prettier styles. I also was given my choice of two scarves or hats or turbans from two full drawers of every style and color possible, and lots of useful resource literature. We were all very impressed with the generosity, the kindness, and the practical help given by the ACS and their staff. What good people!

By that time we were hungry and had a great Mexican meal, topped off with a Volcano for dessert. Chocolate heaven! Since Sharon and I weren't driving, we both splurged on 27 oz. Margaritas that were served in birdbath-sized glasses. Delicious! On to A. C. Moore's for some serious craft shopping, then on home. In Cathy's yard, we were delighted to see several families of Canada Geese with their goslings, from little ones to the teenagers, running and flapping their wings. Cute!

Tomorrow begins the chemo treatments, and if I am like most women undergoing chemo, I'll lose my hair after about 14 days. Who cares? I'm all set! I wouldn't have missed this day for anything. What might have been a traumatic experience was instead a day full of fun and laughter and good times. I am blessed with great friends.

A Day Off

Today was a day to kick back and relax a little. Slept pretty well last night with the port, but it was pretty sore and tender, so I had to be careful how I turned over. Today it's been a lot better. Didn't take any pain medicine today for it. Removed the dressing, and I'm pretty bruised, but it's fine.

Jim and I finished doing the planting today. He planted "Granny Smith," our new little apple tree, and I planted the last of the potted plants for the patio. Gave everybody a good drink and sat back to enjoy the view. Another gorgeous day.

Tonight we had 5 deer in the back yard chowing down the grain Jim puts out for them. One looks like she's carrying a fawn. Can''t wait to see the babies.

Busy day tomorrow - my 3 hour stress test. Oh joy.

Hospital Calling, Where Are You?

This day was a little tough, but I slept through a lot of it. As we were just leaving the house this morning at 6:45 am, the phone rang. It was the St. Joseph's Hospital, wanting to know why we weren't there yet. I should have been there at 6:00 am. Apparently, I misunderstood my surgery time. At least there was miscommunication on somebody's part. I thought they told me to be at the hospital at 7:30, when actually the surgery was SCHEDULED for 7:30. Yikes! She asked how long it would take us to get there, and Jim said 30 minutes, depending on traffic, and she said just come on in. So we were off, and I was totally bewildered, wondering if I was the culprit, or the nurse on the phone. She asked me what time I was supposed to be there, I said 7:30, she said then your port au cath surgery will be at 9:00.

Oh well, it all worked out just fine. Traffic wasn't too bad and we made it by 7:20. Then registration, etc. IV, no problem, a million questions, asked my name and D.O.B. about 20 times, which I understand. They are very careful not to make any mistakes. I think they switched some surgeries around, and I went in about 9:00 or so. Doctor and Anesthesiologist came in and chatted for a minute. Got wheeled down to surgery, which is a kind of scary room. They gave me warmed blankets, which was a nice thing. Supposedly I had a twilight anesthesia, in which I think you're partially aware, but I was so tired from not sleeping last night that I literally zonked out during the surgery and in the recovery room. The staff were wonderful. Everyone is very pleasant and helpful at this hospital. Had a little soreness from the port incision, but not too much.

Came home, had some soup, and slept again for several hours. Still sore, but the pain pills did a good job. Tomorow I should be pretty much back to normal, whatever that is these days.

Window Washers

A gorgeous day today. Sharon came over to help me wash windows. She had asked what she could do to help me out with any project I wanted to get done before my treatments start, and all I could think of at the time was my dirty windows. She kept after me until I set a firm date, and today was the day. Our house has the kind of windows that can be easily washed on both sides from inside the house, so after a few confused attempts, we got ourselves into a rhythm, me on the ladder doing the top window, and Sharon underneath washing the bottom one. Before long they were all sparkling. Looked beautiful!

It was a sweet and generous gesture from a very good friend. We had fun doing it - we always have fun together, but it was also an act of kindness that I truly appreciated. I don't know many people would give up a Sunday afternoon to wash windows with me. What a gem of a friend.

Tomorrow morning we leave the house at 6:45 am for my port surgery. And no coffee for me.

More Yard Sailing

Today was really a lot of fun. Went out with 2 dear friends, who both enjoy being on the hunt for bargains as much as I do, and we had a great time. Had lunch out as well, of course. Couldn't believe how much we found - really awesome stuff - for hardly any money. I even came home with a six-foot tall granny smith apple tree! Great toys for the kids - still in shrink wrap - pictures for the walls, and treasures for our jewelry crafting. The van was literally packed.

Great fun therapy, that I really needed after yesterday's trauma. Lots of laughs - especially having to do with one very questionable treasure Sharon had brought from home to give to one of us - a very homely, homemade pink plaster pig. Two pieces, a top half and a bottom half about the size of a huge meat loaf. We still haven't figured out how it's meant to be used. Anyway, being women of good taste, both of us refused said pig, so Sharon simply left it at the curb in front of one of the yard sale houses. We pulled away, and the poor thing was abandoned there on the grass. We can just imagine that woman worrying about our having accidently left our pig at her house. What to do? Leave it there in hopes we would find our way back to reclaim it? Advertize it in the newspaper? And what would her hubby say? Where on earth did you get this thing? Don't tell me you paid good money for it! We came up with all kinds of hysterical scenarios. But truly, I do hope the little piggy found a good home.

Quick, Where are the Chocolates?

Went to the cardiologist's office today because they called me yesterday and told me to come in. Never been to a cardiologist before. Apparently they wanted to discuss my EKG that was done last week in preparation for the port surgery on Monday. After a barrage of questions, the doctor did another EKG and after reading it, came back and said it shows that I've had a HEART ATTACK.

Oh swell. He emphasized that these things often come up with false positives that mean nothing, but it wasn't the kind of possibility I was at all prepared to hear. In order to answer the question one way or the other, I need to have a nuclear medicine cardiac stress test done. It will be squeezed in next Wednesday in between Monday's surgery and Thursday's chemo. I must have been in shock, because everyone, including the doctor, kept thrusting kleenexes and chocolate at me. I just wanted to go home and go back to bed, which I did for 3 hours.

Toothy Smiles

Yesterday I had my routine 6-month dental cleaning appointment. Another happy coincidence, because once I begin chemo treatment I can't have any dental work done until after chemo has finished. There is a risk involved from the plaque removal instruments cutting into the gums, and bacteria finding it's way through the bloodstream. That can cause an infection or problems of some sort. I'll have to be careful with heavy-handed flossing or harsh brushing, which I don't do anyway. My problem is absentmindedly jamming the head of the electric toothbrush into my gums. Anyway, the dental verdict is that my mouth is very healthy. Yes!! I take all the good news that comes my way.

A storm yeserday afternoon knocked out our internet connection, and I was napping and obliviously slept through the whole noisy thing. Woke up groggy after complicated dreams, but nothing bad, just my normal mishmash. Had a nightmare a couple of days after my diagnosis and Jim had to wake me up because I was whimpering. I was being chased, along with a young girl, and we were carrying trays of food while escaping for our lives. I'm sure you see the import food has in my life. I had to laugh when I finally was able to calm down and catch my breath.

Scheduled to Begin

Finally had my appointments with the doctor who will be doing my port-au-cath and the one in charge of my chemo. Turned into a very long day with a lot of waiting, but the final outcome is that I will have the port surgery on Monday May 21 at 7:30 am and will start the chemo on Thursday the 24th at 11:30 am. The first 3 months the drugs will be Adreamyacin and Cytoxan, given same day but separately, every three weeks, 4 cycles, and then Taxol and Herceptin weekly for 3 months. Totals 6 months of chemo. That means I should be finished with chemo around the end of November, if all goes on track. Lots of testing during the whole process to make sure I'm doing ok, with blood checks and monitoring heart, etc. Had an opportunity to see the room where the chemo is administered. Lots of recliner chairs in a big circle. The treatments will last for a couple of hours. I can have snacks or drink whatever I want, and if I need to use the bathroom, I can just take the pole with the hanging bag with me. I know I'm in for a lot, but I'm well prepared to begin, and I expect I will get through it with all the help and support from Jim, family, and friends. The staff are all very pleasant and friendly, and I expect we will become good friends over the next months.

Afterwards we went to the Apple store and bought an iPod for me. I wanted one to take with me to my chemo treatments, to listen to music and to download audio books. I think it will be great to pass the time with, and very portable. When I tried setting it up, I inadvertently started it out in Japanese, and had a heck of a time getting rid of it, because I couldn't read the screen. Finaly got it back to the factory settings and had to reload all the music that I had transferred from my computer, but all is well. After practicing with it a while, I finally think I'm getting the hang of it. Nice Toy!!! I'm in with the "In Crowd."

Bookies

Today was our monthly book club meeting. There are six of us women, and I'm the third to have breast cancer. One woman had her diagnosis 39 years ago, and the other more recently, I believe perhaps 6 or 7 years ago. Both of them are cancer free and healthy, so that's inspiring. I find it amazing though, that half of us have been affected by breast cancer.

The lunch was delicious, and the new book for next month is called Ava's Man, by Rick Bragg. It's apparently a best seller, and looks like a winner. I love our monthly lunches, and we're all really good friends. We have a wonderful time together.

Mother's Day

I called my mother today. She's 88 years old and lives in an assisted living facility in Parma Hts., Ohio. She doesn't know about my diagnosis, and I don't plan to tell her. Her health is very good physically, however she has Alzheimer's disease. Her short term memory is very bad. She can be quite charming, but she can also be combative, rude, insulting, and mean. Not to me, but to the people around her. My Uncle Russell, my mother's brother, died of Alzheimer's disease. I have a fear of getting Alzheimer's myself when I get older, so when I heard that I have cancer, I had an odd reaction to the news. I was actually relieved that I would be spared growing old, alone, with severe dementia or Alzheimer's.

My doctor is very positive in his prognosis that my cancer is treatable and curable, and while that is of course good news, I was secretly not as pleased as I should have been. Longevity is predominant in my family. People on both sides live far into their 80's, 90's and even over 100 years. In a perverse way, I had viewed cancer as a way to avoid the curse of lonliness, aging, and mental disease. Sigh...

I know that is a shocking way of thinking. In my more lucid moments, I am truly grateful that I have a superb medical team and will be getting the most progressive, cutting edge breast cancer treatment, but there is still that small part of me that hesitates ... and wonders.

Treasure Hunting

Had a great day today, going church flea market junking and "yard sailing" with my friend Sharon. We had a great time and found lots of stuff we didn't know we couldn't do without - at bargain prices. The best finds were some collectible Kewpie Dolls Sharon found at a yard sale for 25 cents each, eleven of them. Her aunt had given her a collection of them years ago, and said they were valuable. Sharon checked after she got home, and three of the Kewpie Dolls are each worth $300. Score!!! We have also been making jewelry lately, and found a number of containers to store all the wire and beads and embellishments. Also had a nice lunch.

The day was perfect. I had been feeling a little sad before we went out, but that mood soon evaporated once we were on the hunt. I want to make sure I keep doing the things I normally do with my friends to keep my spirits up. The mind can only think one thought at a time, so if I'm busy concentrating on other things, I won't think about myself and what's ahead. And today, life was a lot of fun!

On Fridays I Don't Have Cancer

What a beautiful day today! Since Jim is obviously unable to mow the lawn after knee surgery, I got a turn at it. Donned a surgical mask I got at the doctor's office to filter out some of the pollen, and spent a couple of hours on the John Deere. Haven't mowed since early last year after I developed a bad allergy cough that turned into into a seasonal asthma. But now I'm prepared with my Advair and I'm totally fine. I love to mow, so it was good getting back to it.

Went to Lowe's and loaded up on some container flowers and plants. I've heard Mother's Day weekend is perfect for getting the garden into gear, so now i'm prepared. I love this month. So much color, and few insects and weeds yet. It's gorgeous.

I was thinking about Debbie today, my younger sister who also had breast cancer. Actually, my mother and older sister also had breast cancer, but thankfully theirs was cured. Debbie didn't survive hers, which was more aggressive and metastasized into her liver after her chemo treatment. She wasn't able to endure the second chemo treatment because her body reacted to the chemo fluid, and she died at age 50, 20 months after her initial diagnosis. She used to tell me that she had decided that on Fridays she didn't have cancer. All week long she had to deal with all of the various aspects of the disease, but on Fridays she did what she wanted to, ate whatever she wanted to, and planned special treats for herself - a trip to an art museum, renting a movie, dinner at a favorite restaurant, a bottle of wine. I thought that was a great idea, and since today is Friday, in her honor I made banana splits for dinner. That's it. Three different scoops of ice cream, coffee, strawberry, and vanilla, two different sauces, hot fudge and butterscotch, nuts, whipped cream, and cherry on top. We're both too full to eat anything else anyway, but they sure tasted good. You were right, Deb!

Doctors

Got a call today from Dr. Schultz. They have decided there's no point in performing the Sentinel Node Biopsy at the same time that I'm having the port installed. As he said, they already know that there are cancer cells in those nodes from the PET scan hot spots. By waiting until the chemo is finished, they can do the procedure during the mastectomy, and hopefully the nodes will be cancer free, assuming the chemo does what it's designed to do. Makes it easier on me as well, which is nice. One less thing to deal with right now. We love the methodical and thoughtful way his team approaches their medical decisions. No shotgun approach, but instead a well-thought out plan.

Went to Dr. Dellosa's office today (my primary care physician) for my pre-op physical and to bring hiim up to speed on what's been going on. It was just a month ago that I had my regular 3-month follow up with him on my cholesterol med and other blood work, and now look what's going on. We were both shaking our heads over that one. He's a great doctor, and both Jim and I like him a lot. He's also Jim's primary. When I told him that Jim is home today after yesterday's arthroscopic knee surgery, he couldn't believe it. He brought up the emergency room trips Jim's had with cutting off the end of his thumb, the mystery stomach pain, the racing heart and arrythmia, as well as the salmonella fiasco. As I told him, we're both going to hell in a handbasket. He laughed. Anyway, we had a nice chat. He never rushes, and if he treats all his patients as well as he treats us, they are all well taken care of.

Kindnesses

Jim's arthroscopic knee surgery was today, and went very well, other than a 6 hour delay. Snafu. Poor guy was starving by the time we got home at nearly 6. But tonight it's all over and he's doing fine. Having a little trouble negotiating the crutches - first time in his life - but he'll get the hang of it. Only has to use them for a few days. The worst for him is no driving for a week. Good distraction for me. He's been pampering me lately, now it's my turn to take care of him for a while. Good therapy.

Many good wishes today via phone and email from friends and family. I feel more emotional from the kindness of friends and family than from the worries ahead. It's really, really nice to know that people care. We know they do, in an abstract way, but when there is a rallying cry, people express their feelings, and it comes as a shock to realize that, to quote Sally Field "You like me, you really like me!"

Sniff, sniff ...

Good News

Today Dr. Schultz presented my case to the 25 doctors who make up the tumor board at the Breast Center at St. Joseph's. (The timing of the board's meeting was perfect, since it only meets once every two weeks.) He prefers to do chemo first (neo-adjuvant), then surgery, then radiation. The other alternative would be surgery first, then chemo, then radiation. Dr. Schultz called me this afternoon as soon as his meeting was finished with the news that they were all in complete unanimity to go forward with neo-adjuvant chemotherapyt, along with Herceptin (a mono-clonal antibody), then the mastectomy surgery, then the radiation - the course he wants to take. The reason for treating with chemo first is that they will be able to see during the course of the treatment if the tumors are shrinking and the chemo is working, and if not, to make corrections in the drug cocktails accordingly. Otherwise, if they had already removed the tumor(s) surgically with the mastectomy, they wouldn't know if my body would respond to future recurrences. This is what happened with Elizabeth Edwards, according to him. Makes a lot of sense to us, and I'm really happy that they all agreed to this course of action.

I've been set up with an appointment on May 15th with Dr. Hector Silva, a breast cancer oncologist at the Breast Center. I will need to have two surgical procedures done before they start me on the chemo - installation of a "port" under the skin and a "sentinel node biopsy" (to see if the cancer cells are there.) Those two procedures will probably be done within a week or so, once I get a pre-op physical with my family doctor, and have Dr. Schultz schedule the surgery. It will be done as an outpatient procedure under general anesthesia. That port will make getting chemo so much easier. They won't have to find a vein each time, which can also be dangerous if the chemo leaks out of the vein into the arm. I'm feeling really upbeat about all the positive information I've received, and have a great deal of confidence in the team at St. Joseph's. The next months - more likely a year or more - aren't going to be pleasant, I know that, but there are so many positives to focus on that I know afterwards I'll be just fine. My doctor says the treatment I'm being given is "very cutting edge" - the very latest in breast cancer treatment. Especially using Herceptin.

Here's the published information about Herceptin: "Herceptin is a monoclonal antibody therapy used to treat some kinds of breast cancer. It targets a protein called HER2, which is produced in excess in about 25% of breast cancers (known as "HER2+" cancers) and is used only for those cancers. Because the HER2 protein appears mostly on the surface of tumor cells, Herceptin is designed to target those cells. This is a significant difference from chemotherapy, which may affect cells throughout the body." My tests show that my HER2 status is positive, therefore I am a candidate for this new treatment. No hormone therapy treatment for me, as my tumor was ER/PR negative; thus, Tamoxifen is of no value either for treatment and apparently, not for prophylaxis, either.

I think the chemo will be for 4-6 months, then the mastectomy surgery, heal for a while (a month?) then 33 radiation treatments (5 days a week for 6 1/2 weeks). Herceptin will be for a year. The reconstruction of the left side and the reduction of the right side will happen at some future point, but I don't know now if it will be partially during the original mastectomy or following the radiation. Yes, I will lose my hair. And I just found a good hairdresser! Damn!

The Results

Today Jim and I went to Dr. Schultz's office to learn the results of all my tests last week, and the results are mixed. I had a MUGA scan, CT scan, PET scan, Bilateral MRI, and bone scan. There is no cancer in other parts of the body. However, there are more than the one tumor in the left breast, smaller ones, or at least calcifications, therefore I will be having a mastectomy instead of a lumpectomy to get it all. That's actually better in the long term. No muscle taken, just breast tissue and fat. Also breast reconstruction of the left breast and reduction of the right breast. The tests also showed a "hot spot" in the axial node, which probably means that the cells have spread to the nodes. They will check those during the surgery, and will be removing perhaps up to 15 nodes. (There are 45.)

Dr. Schultz will present my case to the 25 doctor panel tomorrow to decide the consensus on treatment, and will call me tomorrow night with their decision. Tomorrow's meeting will determine if I will start with chemo, have surgery, then radiation - or, surgery first, chemo, then radiation. My doctor prefers the chemo first. He will call me tomorrow night to let me know what the course of action will be, and perhaps timing.

I need to go over the notes from our meeting. It lasted about 2 hours. Just got home about 8 following dinner afterwards at the Outback. After the meeting with both Dr. Schultz and Kim, Kim spent perhaps an hour with us answering questions about chemo, radiation and her personal experience with breast cancer treatment 2 years ago. Also talked about having a port put in under the skin for ease of having the chemo administered. Dr. Schultz was her doctor then, and now she works for him as a patient liason/advisor/breast coordinator. A wealth of information and a very nice person. She and I had similar cases - she had a lumpectomy, chemo, and radiation, and she's also ER/PR negative, as I am.

My head is swimming with all this information. I've been emailing and talking to friends for nearly 2 hours, and I'm wiped out. Best to quit for now. I was a little anxious on the way to the appointment, but once there, I was and still am surprisingly upbeat and feeling pretty good. I think perhaps because I will finally get a breast reduction and won't feel like such a freak. Hell of a way to have cosmetic surgery!

Creating my Journal

Life as I knew it has taken a dramatic turn. The news was expected at some point, given my family history of mother and two sisters having breast cancer, but nontheless it comes as shock. On April 26th I was diagnosed with Infiltration Ductal Carcinoma. Tomorrow I will learn the results of all the tests I had this past week - blood tests, MUGA scan, CT scan PET scan, Bilateral Breast MRI, and Bone Scan. There will be a lot to learn, many new terms, a team of medical professionals, and difficult treatments with unpleasant side effects. As time goes on, I want to document what is taking place. This is a good place to record my feelings and experiences.