One to Go

It's been a fun and eventful holiday season. And as I've maintained, the busy holidays have made the chemo trudge zip by pretty quickly.

Maggie's holiday choir concert was lovely, a week ago Wednesday. That's her, singing her solo, just to the right of their wonderful choir director, Kathe Jordan. Poppy and Grandma were there with us, and Grandma swears she got more pictures, which is somehow better. Being the competitive family we are, there was some discussion later about quantity vs. quality. The photo here is representative of "quality".

Christmas Eve was at our house. Jackie, Yusuf, & Shiraz Cassim, and Rick, Becky, Jake, & Nina Price joined us for a crab feast. Dinner was lovely and we all enjoyed the homemade "Bouche de Noel" that Emily spent all day preparing. Shiraz had recently shaved his head in a trendy fashion move and so I had company in the hairless department on Christmas Eve. Here's a pic of we hairless "twins".

Christmas morning was pretty wonderful and relaxing. Poppy and Grandma drove down from their comfortable sleeping quarters (at John & Lynn Price's--they were in El Salvador for Christmas) and we all opened presents sometime around 8:30 or 9, and then had a leisurely breakfast. That night we all went to Rick and Becky's for a wonderful prime rib dinner, and enjoyed the food and most excellent company. Andy, Nancy, and Allen Price were there, along with dear friends Robert Allen and Dennis Vaux.

And yesterday, Boxing Day, was my penultimate chemo infusion. Yay, yay, and double yay! Em took me to the cancer center after 1, and they were running a bit behind (four nurses had called in sick), so Frank picked her up at 5:45 so she could get ready for her guests (she had some of her friends over for gift exchange and sleepover), and then he came back to relieve her. We got out of the cancer center a little after 7 p.m.

And now? I have one infusion left. I'm still just-this-close-to-anemic (inching down from 9.6 to 9.2--where below 9.0 gets me the much needed aranesp shot). And I continue to suffer minor GI effects. All in all, really, nothing to complain about.

My folks left Fairfield this morning and should be in Pasadena sometime this evening. They're going to have tons of fun doing Rose Bowl parade touristing, along with some other SoCal delights, before heading on back East. We had a lovely visit and look forward to seeing their photos from their trip down South. Here's a parting photo of the lovely couple, from Christmas Eve.

It's the Holiday Season

Sorry I've been lax in updating the blog.

I saw my surgeon on Monday and all looks good. I scheduled the removal of my port (yay!) two weeks after what should be my last chemo infusion. He also gave me a referral for a new baseline mammogram, to be taken sometime in March.

And I missed my weekly check-up with Dr. Kuan. Blame it on the drugs, blame it on the holidays, blame it on me just being spacy. But I basically blew it. They had scheduled me for a Wednesday appt with a different doctor, but then that turned out to be unnecessary, and while I was having my chemo last week, they rescheduled me to my regular Tuesday afternoon. I never updated my calendar and, bother, I missed the appointment. Bother, bother, bother.

Oh well. Let's just hope there's nothing exciting in the blood work so that when I go in next week, all systems will be go.

And in the meantime, I went to my office holiday party at the Palace Saturday night. Frank and I had a really fun time. Here's a pic of Frank, me, Jackie, and Yusuf. We enjoyed cocktails at Ame (a nice bar at the Regis Hotel) with the development directors, and hosted by our wonderful boss, Martha. And then we all went to the Palace for a very fun party. Hors d'ouevres, dinner, door prizes, and dancing. I was a bit low energy, but I danced three songs before asking Frank to bring me home. And we were in bed by 10. Oy!

Glass More than Half Full

So we're 3/4 of the way there now. Yay!

I apologize for not posting in such a long time. The good news is that things have been pretty boring in cancer recovery land. The only ill side effect I suffered after the first Taxol (two weeks ago) was some muscle/bone achiness (it felt like I'd been working really hard in the garden the day before), which was easily remedied with some tylenol and advil.

In the meantime, we've been enjoying some holiday festivities with my folks, and getting some holiday shopping done, and writing Christmas cards, and working. Maggie had a nasty bug over the weekend (102.6 fever) and now is mostly better, but will have some trouble getting rid of the lingering effects, I think (coughs and sneezes). Basically, life goes on.

Mom accompanied me to my second Taxol infusion yesterday, and while things mostly went well, there were a couple bumps in the road. I was in the chemo room by 1:15, and the oncology nurse had my pre-meds all ready. She was having some trouble with the machine though, and so, while each of these three meds should have taken about 15 minutes, she had difficulty with the IV machine and there was a delay in getting each one going. It wasn't until my mom said, "maybe you should try another machine" that she seemed to consider this a viable option (there were at least two unused IVs in the room). Even taking these delays into account, I was ready for the Taxol no later than 2:30, and probably before. But my Taxol didn't get started until 3:10 p.m.

And then, about 15 or 20 minutes into the Taxol, I decided to throw some drama into the proceedings. The Benadryl (one of the three pre-meds) had pretty much knocked me out and so I was lying prone on the recliner. I was not necessarily sleeping, but I was dozing in an out and I was awakened by a tightening in my chest (felt like a classic asthma attack to me) and I could feel my cheeks flushing. I promptly knocked over my water bottle, reaching for my inhaler (poor Mom, trying to understand my mumbling and figure out what I wanted--sorry Mom!) while also trying to sit up and calling to the nurse, "I'm having a reaction to the Taxol..."

As soon as I was sitting up and had used my inhaler I was better. But the typical--and sensible--response to such a reaction is to stop the infusion. So, I got some O2 and felt better and the nurse took notes. A nurse and nurse's asst. ran breathlessly into the room, saying they'd been paged for a Taxol reaction and everyone told them all was okay. Good news--you don't have a crisis. Bad news--you ran down here for nothing. :-)

Since I was so clearly stabilized, they started the Taxol back up after about 15 minutes. Dr. Kuan dropped in to check on me, and to clarify what preceded my reaction, and we all think it would be better if I sat up during these infusions. Ah well. Only two to go.... :-)

Because I got started so late, I (and another patient) needed to be moved upstairs from the downstairs treatment room (where we were put because the main room upstairs was full when we started) around 5 p.m. Mom and I finally got to leave around 6:45 last night. I'm going to try to change my final two chemo appts to start earlier.

We got home, and Frank had made a nice roast chicken dinner for the five of us (Mom, Dad, Frank, me, and Maggie). And then my folks left for their RV up in Fairfield.

Oh! and this time, almost certainly because I did not do the steroids before going in, I got a full night's sleep last night. I feel great this morning and look forward to getting lots done. I'm sort of assuming I'll feel some aches and pains tomorrow, but again, I know it's easily remedied. It's not nearly as awful as the nausea, which required meds that knocked me out, and which has their own dopey residual effects. I prefer clarity, but that could just be me. :-)

In other news, Em has three finals this week, last one Friday at noon. So, we're hoping to see her bright shiny face by 8 or 9 on Friday night, when we'll be enjoying the company of John, Lynn, Kevin, and Sarah Price.

We're planning to get our Christmas tree on Saturday morning, and then Frank and I are going to my (always very fun) office holiday party at the Palace. We're spending the night there--carving out some romantic alone time in the middle of chemo and the holidays. All in all, it should be a lovely weekend. Hope your holidays are lovely and warm and (relatively) stress-free!

Change Is Good

Wow. My body is so very grateful to have been spared another treatment of Adriamycin. Tuesday's Taxol infusion and the aftermath have been much easier than the four prior AC infusions.

Mom and I arrived at the cancer center at 7:45 a.m. Tuesday morning. After blood work and some waiting, we were ushered into the chemo room and settled in around 9:15. I got the usual Kytril and Decadron (I had also taken some of these steroids the night before) and then got doses of Benadryl and Atavan. Those last two knocked me for a loop and I might misremember some details here, but nothing too awful, I'm sure. The Taxol infusion started, finally, around 10:45.

The nurse, Susan, was really helpful and explained to me and Mom everything she was doing. We both know a fair amount already, but I always prefer when a medico bothers to explain what they're doing--I much prefer a lack of mystery in my medical encounters.

All the little chemo cubicles have two chemo chairs (little recliners next to IV drips) and Mom and I were joined by a very nice woman named Pat, who was getting chemo for her second bout with ovarian cancer. One of the more interesting conversation points for me (well, at least, as much as I can remember) was about the concept of "chronic cancer". I've had several friends with breast cancer or with benign lumps or just cysts, and increasingly, breast cancer is being viewed as a treatable disease. It's kind of a freaky view after growing up with the notion that cancer equals death. (Well, a freaky view but also an extremely *welcome* one).

This notion, though, also requires a certain adjustment in one's thinking about life's duration. I will finish chemo in early January, undergo radiation, and then get a PET scan for the hoped-for "all clear". And then, because breast cancer can pop back after many years in remission, I will continue to be tested regularly in the hopes that I will continue to get these "all clear" results. And at some point, if the cancer makes an unwelcome appearance, I will go through some version of all this again. Kind of a drag. But, as they say, it sure beats the alternative.

I think if you had told me all this a year ago I would have found it extremely depressing. But after going through what I've experienced thus far, I am not so much "Zen" about it as I am matter-of-fact. The cancer is a fact. And so is the treatment. And there it is. Nothing more or less than that. (Frank might disagree with that perspective somewhat, as he told me at breakfast this morning that when this is all over I need to ensure it doesn't happen again. Because, as he noted, it's really not fun.)

So, anyway. Philosphical interlude aside, the treatment went well. Mom and I left the cancer center around 2 p.m. She drove me home and I settled into the sofa for an episode of Columbo and the occasional dozing. I don't even remember going to bed, but I obviously did because--and here's where the fun starts--I awoke at 1:23 a.m., and was not able to get back to sleep. I gave it the old college try for quite a while and gave up the ghost around 3. I've had insomnia before, post-chemo, but this was different. I had some energy and so decided to get some work done. I logged in on the PC and was amazingly productive.

Around 8:30 in the morning I went for a walk with Deirdre Greene, and then continued working until about 1 p.m., when I had to go back to the cancer center for my Neulasta shot. I figured that, after chemo and no sleep, I'd be ready to crash after that, but no! I went to Ashby Lumber and picked up a toilet to replace the almost useless upstairs toilet (Superior Plumbing installed it today and yay! we have a toilet that actually works now). After Ashby Lumber, I went to 4th Street and got a little bit of holiday shopping done. And then I went to the market to get some juice to ease the ingestion of the glutamine I'm taking to (hopefully) prevent the neoropathy associated with Taxol. Finally, around 4 p.m., I decided to take things easy.

This probably doesn't sound like a big deal, but given my past infusion experiences, this was beyond delightful. I was positively giddy with the energy I was feeling. Oh, and all this was without any drugs. No nausea, no nothing. It was lovely.

Yesterday, Thursday, I experienced some of the muscle pain my doctor warned me about, but that was easily handled with Tylenol and Advil. It could be that my body was just happy to have a change from the Adriamycin, and it could be that Taxol will just be easier. But for now, it's just really, really nice to not be doped up or nauseous or tired.

Now the only remaining hardship is the conjunctivitis I can't shake. I have an appointment with an opthalmologist on Monday to try to address this and in the meantime, I figure I can just deal.

And this weekend? Tomorrow is December 1 and that means I get to harrass my family into decorating for Christmas (not that it requires that much harrassment). We'll do everything but the tree, and then I hope to drag my mother around to some of the open studios in our area this weekend, just for fun and to get in the spirit.

...That Flesh Is Heir to

In Hamlet's "To be or not to be" soliloquoy, he talks about "The heart-ache and the thousand natural shocks that flesh is heir to." And he never went through chemo. :-)

What we all know (or think we know) about chemo is that it makes you nauseous and it makes your hair fall out, right? Well, not to be a downer, but there's a few other side effects that don't get as much press. They're not life-threatening, or debilitating, and also usually not apparent (like the hair loss), but they are a drag and when they're cumulative, they can be a real PITA.

Between mouth sores, a case of conjunctivitis I can't seem to shake, and some lower GI issues that have some other implications (I'm *trying* to be discreet), it's hard sometimes not to whine.

This reminds me a bit of when I was pregnant and I was left to discover some of the side effects of pregnancy and childbirth that aren't discussed in all those helpful books. While it's true that all my symptoms are listed on the literature for the meds I'm taking, I didn't really pay much heed. Because I almost never have the potential side effects they warn about when I am given new medication. But chemo is a whole new world, as I keep learning.

Meanwhile, my parents are visiting for the holidays and we're having a really nice visit. We've been playing card games and just hanging, for the most part. And Mom will go with me tomorrow to my first Taxol infusion.

Emily was home for the weekend and Frank was shocked to see that her head did not seem to have grown to accommodate her bigger brain. Our friend John says that doesn't happen until sophomore year, so we've relaxed a bit.

Happy Thanksgiving Week!

I am so very, very happy to say that I am done with Adriamycin and Cytoxan. Ick, ick, and ick again. I have reached that point in chemo where just the *thought* of chemotherapy makes me feel queasy, so I am especially pleased to be starting the next course of treatment next week.

Jackie was my chemo-buddy for the final AC. We got to find the other chemo room, downstairs, the existence of which I was completely unaware until we spent several hours there. Jackie was remarkably well-equipped with magazines, water bottles, and even a conversation topic game. She also brought her camera and so I am able to include this pic of me and Dr. Kuan.

I have my blood draw and check-up with Dr. Kuan tomorrow, at which point I'll schedule my Taxol infusions. If everything goes according to plan, we're most likely looking at one infusion next week, two in December, and one in early January, and then (dare I say it?) we're done with chemo. More importantly, the Taxol is supposed to be easier to take than the AC. A small percentage of folks have a bad reaction to the Taxol (such as my friend Karen C-O), and Dr. Kuan says we'll know right away if I'm in that minority (fingers firmly crossed).

Meanwhile? The holidays are starting! Yay! I'm a huge sucker for Thanksgiving and Christmas and already am listening to holiday music at work, and at home when I can get away with it (it scandalizes Frank, so, not too often at home). My parents are already in California after a mad dash across the continent (the story of their 2007 RV trials and tribulations are really fodder for a whole other blog) and should be at Travis Air Force Base in Fairfield early tomorrow.

Emily found a ride from UCSB and gets home sometime Wednesday evening.

We feel lucky to be spending Thanksgiving with John & Lynn and their table(s) of 27. I love big Thanksgivings, and we've been honored to be included in the Price family Thanksgiving for several years now. It will be lovely to relax and visit and just enjoy the holiday.

We wish you and yours the very best, happy, peaceful holiday. See you again after Turkey Day.

Just Hangin'

I was *supposed* to go shopping with my dear friend Jackie yesterday, but I was a weenie and I bailed. I felt somewhat guilty about it--she had, after all, made time for me during her weekend. It's not as if I was doing anything important yesterday. The most exciting thing I did was walk up Solano with Frank, to get some coffee at Peet's.

You might think (or at least, *I* would think) that during my "good" week, I'd be eager to get things done, to take advantage of not feeling nauseous or crampy or just generally icky. And Saturday morning, we ran quite a few errands and accomplished a lot. But I'm finding that during my so-called good days, I want nothing more than to laze around, enjoying the fact that I don't feel like crap. For example, I really had planned to get some laundry done yesterday. A modest ambition, right? Did any laundry get done? Absolutely none. Ah well. That's what the "is it clean or is it dirty" clothing pile is for, right? :-)

During our walk yesterday, Frank and I stopped at Five Star Video to get our week's worth of Columbo DVDs. We've always been big Columbo fans, and we have found these DVDs to be pretty wonderful for chemo recovery. We've seen almost all of them, but we can't always remember whodunit, and it's always fun to watch Columbo trip up the "smarter than thou" murderer. And the ones we haven't seen are interesting (and you can sort of see why they're not in constant rotation with the others).

Spielberg and Jonathan Demme both directed episodes. And Steven Bochco (Hill Street Blues, LA Law, and NYPD Blue) was an occasional writer. And the actors! It's so much fun to watch Roddy McDowall play an entitled nephew who rigs a cigar box to blow up in his uncle's limo (thus paving the way for him to run the family chemical empire).

And what can one say about Peter Falk? He's just brilliant, that's all. We're still in Season One, so we're enjoying watching the evolution of the idiosyncrasies that we have attached to his character over the years. In the first couple episodes, he drank bourbon. By the fifth episode, no more drinking. In the first season, his cigar is always lit, but we know that later, it never is. He talks about his wife, the famous-by-her-absence Mrs. Columbo, from the get-go. But the dog (named "Dog") doesn't show up till later.

If you've not seen Columbo in a while (or <gasp!> you've never seen it), rent some episodes from your local DVD shop the next time you're feeling under the weather. It's perfect sick-time viewing.

I Love My Oncologist

I had my check-up with Dr. Kuan on Monday, after a very rough weekend. My stomach still was causing me some distress on Monday and while I waited first for my blood to be drawn and then to see Dr. Kuan, I kept getting teary. I had to keep reminding myself to get a grip, that really I was doing fine, but I kept getting weepy.

So when she entered the examination room, and asked how I was, I just got weepy all over again. I apologized and explained that I am kind of spoiled by just how well my machine of a body typically works. And while there are lots of drugs for the nausea, the stomach cramps that I had been experiencing for three days were really just getting on my last nerve.

And what did my good doctor do? Well, she wrote me a prescription for something to reduce the acid in my stomach (still waiting for insurance to cover that, thank you). But first, she got up and gave me a hug. A really long one. Which made me cry again, of course, because I am nothing if not a one-woman answer to drought. Then she stepped back and said, "You need to do something for yourself this week. Pamper yourself. Get a massage."

Don't you love her? I'm getting a facial tomorrow (clean pores *and* a face, neck, and shoulder massage). Kisses to Dr. Kuan for the permission. If only insurance covered facials.....

Meanwhile, my numbers are still really good (like I said, I have a pretty good machine). So, on to the next and final AC infusion on Tuesday.

Chemo Stinks

I wanted to be a bit more rude in that headline, but decided to spare the feelings of some of my gentler readers. Suffice to say that I would happily donate to any cause that could find a way to cure cancer without chemotherapy. It is a serious drag.

We drove to Santa Barbara on Friday (about a five hour drive) to visit Em for Parents & Family Weekend at UCSB and I was feeling tired but mostly okay. Saturday I was wiped and losing energy fast and by later in the evening, I was accosted by the same cramps that had attacked me on the Saturday after my second infusion of AC. I was pretty miserable for most of Saturday evening/night and Sunday just kept nibbling at carbs to keep my stomach on a mostly even keel as we drove home.

Today, Monday, I feel mostly better but really am so ready to be over this. Ah well. One more infusion of the AC left (next Tuesday) and then we get to do a change-up to the Taxol. I figure, if nothing else, at least my body will be faked out by the change in meds and things should improve, even if just temporarily.

Meanwhile. It was wonderful to see our older daughter in her new milieu and thriving. She's a non-partier at a party school and so I think it's fair to say that she's not finding a surplus of new boon companions. But she's putting herself out there (interning for CALPIRG and working costume crew for the theater department's fall production of Woyzeck) and she seems to be loving some of her classes.

After a five+ hour drive, we arrived Friday evening and picked up Em and took her downtown to State Street for dinner. The next day, Saturday, I was partially mobile and after an aborted campus tour (We bailed after this pithy observation by one of our tour guides: "We have five nobel laureates here at Santa Barbara and they are professors. And they teach"), Em took us into the infamous Isla Vista where we had pizza for lunch. For the rest of the day, I hung out at the University Center while Frank and the girls walked the campus. Em and Maggie had some nice sister-time and went rock climbing at the Rec Center later in the afternoon (Emily: "I'm pretty sure Maggie is part spider monkey") while I got cozy on a sofa at the University Center and Frank checked out the bookstore.

The weather was mostly foggy and/or undecided, so we never did get to the beach or the pool, but that's okay. Emily was the main attraction and we got to see lots of her.

We're looking forward to having her home, if only for a few days, at Thanksgiving.

Wigs, etc.

Sorry for the delay in updating. I've been either working, socializing, or taking a much-needed break to veg.

First up! My co-worker Colleen went wig shopping with me on Thursday. It was quite the excursion.

When I googled for wig shops in San Francisco, the top-rated place that showed in the listings was a place called "Rosalie's". It's way out on Columbus Ave, at the edge of North Beach, almost to Fisherman's Wharf. Colleen and I managed to snag parking right outside the shop (virtually unheard of) and wandered in.

This place was amazing. First, the place was simply jam-packed with stuff. Wigs competed with dresses and accessories for space. There were dress racks suspended from the ceiling--you'd have needed a hook to get anything down. And second, the many styles of clothing and wigs available made me fairly certain that Rosalie's is frequented by our transgender friends. We saw the Liz Taylor wig, as well as the Jaclyn Smith, and even the Dodie Rosecrans--SF socialite--circa 1970.

Anyway. We made our way through the maze of wigs and clothing and started to feel that unless I wanted something truly outrageous, this might not be the shop for me. And then, we rounded the final corner and came across at least 4 wigs that would work perfectly.

The man working the store asked me to sit down in one of the barber chairs situated in front of a mirror, so he could try the wigs on me. (This man was teeny: I'd be shocked if he weighed 90 pounds, truly. And if he is under 70 years old, I'd be shocked. But his hair and moustache are both still jet black, so he's still working it.) He tried on two of the wigs Colleen and I picked out and as he prepared the third, he said that after we were done with these four wigs, he'd like to try one on me that he had picked out. We tried on the four wigs and got two "maybes" out of the bunch. And then he tried on the wig he picked out. Herewith, the "Bobbi" (though you have to imagine that "i" dotted with a heart). Bobbi definitely out-ranked the other wigs and the longer I looked at it, the more fun it was. I mean roots? On purpose? So, we purchased the wig for a *steal*. Quality wigs typically start at $250-$300. When I asked how much the wig was, he seemed to be somewhat embarrassed and whispered, "$65". Um, okay, we'll take it!

To see the other two fabulous wigs I've got, as well as a shot of me sans cheveux, you can go here: Karen's Hair Looks.

I've also got some new chapeaux to show off (including a fabulous hand-knitted cap that looks a bit like a fuzzy blonde fro), but that will need to be another blog entry.

The rest of the week was good. Work got done and then Maggie and I enjoyed The Magic Flute at the SF Opera, along with her friend Siobhan, and her mom (and my friend) Dierdre. We had brunch in the city (Absinthe, for those of you who know SF) and got to the opera for a 2 p.m. show. Nice end to a pretty weekend.

I had my third infusion yesterday and Maggie accompanied me. She missed a few classes at school, but I feel that right now, we have to have some perspective on our overall outlook. She learned, I think, what I'd hoped she'd learn--it's not scary and it's a bit boring. I gave her a brief tour of the cancer center and then we both did a lot of waiting, with the occassional bit of attention. We checked in at 1, and Frank picked us up at 4:45.

Today is Halloween and lucky Frank will be opening the door and handing out candy. I will be firmly esconced somewhere in a prone position, watching trashy DVDs. Or, hmmm, maybe Lord of the Rings.

Oh, and Frank has the best joke of the week. I was telling him that I can't sleep on my right side because that's where the port is. It's uncomfortable to put too much pressure on it, and I'd hate to dislodge anything. So Frank says, (are you ready? It's somewhat nautical in nature) "You can't sleep on your starboard because of your port!" Get it? No? Ah well, you can google it if you're really curious.

Not Much to Report

This is my "good" week and things are going very well.

The weekend was a bit bumpy. I developed some stomach cramps on Saturday afternoon and so was unable to enjoy any of the three parties we were lucky enough to be invited to. Thankfully, Frank was able to make a brief appearance at two of the parties, and I was able to have lunch with the other party boy today, so I don't think we've burned any social bridges. :-)

The past few days have been mostly about Maggie--trying to ensure she's got what she needs in terms of time, attention, and anything else. She's been weathering this storm very well, I have to say. She's quite the trouper. She slept late Sunday (thank heavens, as she had stayed up until 3:30 the night before, on a sleepover) and then she and I cuddled and watched the end of The Age of Innocence. Then we went to Macys because they were having a Clinique bonus (you buy something and you get groovy little make-up/skincare samples and a cute little bag of some sort). She also wrangled some very fuzzy slippers and a dress out of the trip. But I got tired after only about an hour and we headed on home.

Meanwhile, on the hair loss front: I think by Friday I had lost about 3/4 of my hair and the remaining hair both itched and hurt. It was insult to injury and I couldn't stand it anymore. So, I took some hair scissors and cut off the remaining hair and had a brief cry. I don't mind being bald--truly. This pathetic stubble just looks so sad. Bald would really look better than this. Frank tried to help by shaving the rest, but my hair is so fine, he had to give up after we got the nape of the neck cleaned up.

The good news is that it no longer hurts (I'm convinced that it was the weight of the remaining hair pulling on the almost empty follicle that hurt) and the remaining stubble continues to fall out. So, in another week or so, I should be hairless.

And Frank is allowed to call me "Sinead", but most definitely *not* "Kojak". Just sayin'.

My lovely and wonderful friend Robert brought two wigs in to work for me yesterday. One is long and auburn with bangs (Susanne) and the other is a short, black pageboy with bangs (Anna). I will be grooming them both soon for occasional hat-free days. When I have pics (hopefully next week sometime), I'll post them. I'll also post a bald pic, just because, I mean, please. You've got to document this stuff for posterity, haven't you?

And Here We Are Again...

....on the other side. Mostly.

Day + 3 this time is much the way it was last time. My stomach is feeling a bit timid, but I'm drug-free and so feeling pretty good. I'm pounding the saltines and drinking the water, and even better--I'm not doped up on the sofa all day.

Tuesday evening, after the chemo, I was fatigued, but okay. Wednesday I was mostly okay, but fatigued. Thursday I slept and watched DVDs and ate some pretty bland food. Frank made pasta carbonara for dinner, which I enjoyed, but might have been a tad bit heavy for me. I didn't suffer too much, though, so, all in all, a good couple days.

We're lucky enough to be invited to several birthday parties this weekend, but I think we'll be seeing how I feel tomorrow before we make any social decisions for the weekend.

Meanwhile, my hair is mostly gone. I'd say I've lost a good 3/4 of it and it's so very sad looking. :-) I really wish it would just finish falling out so I could be done with it. I'm wearing lovely hats, including this very nice cap that Michael knitted for me (the pic is from before hair loss), and I'm sure the hats would be more comfortable without the pathetic itchy remnants of hair.

Two Down

Well, the chemo part is done, and now we just get the next couple days of fatigue, headache, hair loss, and (hopefully limited) nausea. So, I'll more sincerely feel like it's "two down" sometime around this weekend, I'm guessing.

Once again, the adriamycin gave me a minor allergic reaction, which triggered my asthma. No biggie, just interesting. And I'll probably add a benadryl or something to my mix of pre-chemo drugs next time.

I'll be working from home tomorrow, and Thursday (based on my experience last time with Day + 2) I'm planning to take the day off and wallow in DVDs (Jeeves & Wooster is pretty high up on the list). If the pattern follows last time, I should be mostly okay by Friday. Time for more finger crossing out there!

It's also time for a big thank you to all the friends and family out there who are taking care of us. The emails and cards, the groceries and baked goods, the carpools and flowers. Really. I'm not sure we always show the appreciation we feel. Please know how grateful we are and how loved we feel. Thank you.

My Hair Hurts

I'm not sure how many men will understand what I'm talking about here, but I'll try to describe the current sensation on my head. When you have longish hair, and you wear it one way (combed this way or that) for too long, if you comb it the other way, sometimes the hair follicles hurt a bit. A classic case might be when you have a relatively tight pony tail for a long day and then you let it down and it actually hurts, just a teensy bit.

My entire head feels like that. No, I take that back. The lower back of my head (where the hair is shortest) doesn't really feel all that bad--though it is not without sensation. But the top of my head and the sides... ooof. Anytime I move my hair, it hurts. It's not debilitating or anything, but it is starting to give me a headache.

This started yesterday and it simply reminded me of the other times in my life I've felt that sensation and all I needed to do was give it a good brushing to relieve the discomfort. So I brushed my hair and an hour later, it still hurt. Today, it hurts a little less than last night, but still I have the hint of a headache.

I'm planning to go wig shopping next week. ;-)

Lesson Learned

I'm guessing there's a reason that when the nutritionist was talking to me about diet, she did not include Mexican food from Juan's on the list of "rebuilding" foods.

I was in a truly cranky mood on Wednesday and so decided I needed Juan's for lunch to help comfort me. The words "big mistake" don't do the idea justice.

I have told my friends at work that if I even mention Juan's again in the next four months, they are not only to dissuade me from such madness--they are to slap me. Hard.

I had serious indigestion all night and most of the following day. It didn't really dissipate until last night. I don't think it was the spiciness of the food, per se, because it wasn't all that spicy. I think it was just the overall lack of any nutritional value in what I was eating. Loaded with fat and flavor, yes. But not much else, and my digestive system let me know how much it disapproved.

I promise I'll be good from now on. Really.

Numbers Are Good

I had my bi-weekly checkup yesterday with Dr. Kuan. My white blood cell count and platelets are within normal range. My red blood cell count is a bit low, but still okay, she says. Given that yesterday was the 9th day, she said that if my white blood cell count was going to be low, that would have been the lowest day. Other than that, I'm healing just fine from the surgeries and, assuming my numbers are just as good next week (they test my blood before every chemo infusion), I'm good to go.

I told her that I'd heard that the side effects were "cumulative", inasmuch as your body grows weary of fighting this stuff and the side effects become worse with each infusion. She said that was definitely true of the "numbers" (white blood cell, etc.) but not necessarily true of the nausea. I'm wondering if she's just trying to help me maintain some cautious optimism, because then we started talking about the inherent suggestability of some words/sensations (like nausea).

I told her about the poor ill man at last week's chemo orientation, and she told me about a patient she had when she worked in Houston. He lived outside of Houston and so had to drive in for his treatments. It got to the point where all he had to do was see the sign for Houston as he entered town and he became nauseous. Another patient only had to hear her name and he became nauseous. So, there you go (and there you are). The wonderful world of chemo side effects. :-)

....And Back into the Light

Whew. That was certainly an interesting three or four days.

To recap: I had my first chemo treatment on Monday. All went well and I was fatigued Monday evening and experienced some insomnia that night.

Tuesday I felt okay. A little light-tummied and tired, but otherwise, okay.

Wednesday? Ick. Not so great. I was still using the Emend (the finest in anti-emetic medications) but the nausea would not be kept at bay. So, I supplemented with another medication that just wiped me out. So I felt nauseous and dopey. Perfect. By the end of Wednesday, I was starting to feel better and was actually able to eat some real food (as opposed to the saltines, almond butter toast, and yogurt I've been consuming since Monday afternoon).

Thursday morning I felt pretty much the same, but without meds, so I took that as a very good sign. I stayed on the saltine/toast/yogurt diet and got through the day just fine.

And today, Friday, I feel very hungry. Yay! Frank made me some very tasty bran muffins with flax seed for breakfast and I might get really crazy and have half a sandwich for lunch. No, don't try to stop me... :-)

In other news, Frank and I attended the Chemotheraphy Orientation at the ABCCC last night. It was interesting (intentionally and unintentionally). First the intentionally interesting part. Among other things, we learned that a) cancer cells rapidly divide, and b) the way chemo works is to attack rapidly dividing cells. Of course, your system has other cells that are rapidly dividing. These include cells in your GI track and your hair & nail follicles. Which explains many of the side effects of chemo. There was a lot of other information, too, and it was useful, overall.

The unintentionally interesting part was when the pharmacist kept talking about the N/V (nausea/vomiting) side effects of chemo. She was obviously knowledgeable and experienced and knew her field, but English was not her first language. And so everytime she said "nausea/vomiting", it sounded a bit harsh and abrupt. She described the various stages of "nauseavomiting" explaining that you could have Level 1 vomiting would would not be very much, or you could have Level 5, which would be pretty much all the time. The man sitting to my left had not, thus far, experienced any of these side effects, but confessed that with our friendly pharmacist constantly saying "nauseavomiting", he was beginning to experience some pschosomatic symptoms. This did not seem to impress the speaker as she continued to say over and over "nauseavomiting". Finally, the gentleman stood up and said he thought he needed some air. Before he could get to the door, he started to swoon, and luckily one of the nurses was there to catch him. The poor man was out like a light. When we went to bed last night, Frank and I kept cracking each other up, saying "nauseavomiting" repeatedly—remembering the absolute oblivion of the woman who tortured that poor man into fainting. (And have I made you a bit queasy with that charming story?)

Sleep patterns are weird, but that's a lot easier to handle than the ickiness of nausea. Typically, it's Frank who's up at 4 or 5 a.m. each day. Today, I was up, too. I was very hungry and so had a small bowl of cereal to tie me over until breakfast. But I got plenty of sleep, so I'm feeling fine.

So, while I wrote on Monday, "One Down....", today, I feel that a bit more sincerely. Here's to hoping the next infusion isn't any worse than this one was.

Symptoms Update

Monday (infusion day) was pretty much fine. I had a low-grade headache for most of the day and that evening. I had some insomnia between 1:40 and 4 a.m., but otherwise, things were okay.

Tuesday I was a little light-tummied and my cheeks were flushed (I wasn't feverish, but I looked like I was). But I was able to go for a nice walk and I was mostly okay.

Yesterday? Ugh. On the one hand, I am happy to report that the anti-nausea drugs appear to be working. While I am occassionally feeing nauseous, I'm not getting sick. On the other hand, they kind of knock you out. I felt tired and or dopey most of Wednesday and that is just a drag.

I know, I know. I really should quit my whining. Imagine going through this without all the many anti-emetics available to me.... <sigh>.

Anyhoo. I slept well last night and have my fingers crossed for today.

One Down—Nine to Go

Frank and I checked in at the Alta Bates Comprehensive Cancer Center (ABCCC hereafter) around 8:30 this morning. Around 9, they took me to the VAD Draw room where I was swabbed and then they put the totally cool little hooked needle/catheter into the port. They drew blood for testing and then sent me back out to the lobby. I took the first of the Emend 3-day anti-nausea treatment pills and prepared to wait.

Typically, we're told, it takes them about 20 minutes to do the blood testing and then they start to gather your chemo meds, but they had some issues this morning and I didn't go back to the treatment room until about 10. No biggie, really. As Frank reminded me, this is the beginning of a marathon--there's no need for sprinting right now (i.e., chill).

I neglected to take my camera with me this morning (maybe next time?) so I shall endeavour to describe the treatment room. Imagine a large room, maybe half the size of a basketball court. In the middle of the room is a nurse station/counter. Lots of carts, and monitoring equipment, etc. scattered about. (Probably not "scattered". Probably placed. But to my untrained eye--scattered. I don't judge. I merely observe and report.)

Around the perimeter of the large room is a succession of glass door cubicles. There must be 20 or so of these little cubicles. In each cubicle are two easy chairs, a TV, a visitor chair, a bathroom, and cabinetry with supplies, etc. Also, primarily, of course, the automated IV machines that let them administer multiple fluids simultaneously.

I was seated and they took my vitals (again. Three times today I had my vitals checked. They are nothing if not thorough.) Jessica, the nurse, explained that first, they'd give me some anti-nausea meds with the saline IV. When that was done, she had to "push" the nasty Adriamycin (also known as Doxorubicin) through a syringe into the IV. It was the color of Kool-Aid or Hawaiian punch and it triggered my asthma. Just a bit of a drag, and Frank retrieved my albuterol inhaler from the car, just in case, but my body sort of picked up the slack and the asthma started to dissipate on its own, so I was fine.

It took about 20 minutes to finish up the two fat syringes (looked like about 25 cc's each) into the IV, and then Jessica put the bag of Cytoxan on the IV rack.

While we were patiently waiting (me with my fabulous elasto-gel therapeutic cold gloves, to try to minimize the effect of chemo on my hands and fingernails), the pharmacist dropped in to see if I had any questions about the meds they'd prescribed for me (three anti-nausea meds, in addition to the Emend I take the first three days of the infusion, and an antibiotic for if/when I spike a fever) and to make a list of everything I'm taking (including my asthma control meds).

He was pretty young and cute and very earnest and he typed up the list and printed a copy for me, so when I see a different physician for any reason, I can just whip out my list of meds for them. Most excellent.

When he was done, the nutritionist stopped in to talk about my chemo diet. First week is to "dextox" and to make sure I'm not taxing my system but ensuring I get what I need. Second week is the building week--lots of legumes and other non-heavy proteins (sardines, wild salmon, cottage cheese, eggs). She also recommended Glutamine powder the first week (yum!) and ground flaxseed. Oh! and the good/interesting news: she'd prefer I drink green tea, but that it not be decaffeinated. She doesn't like to have the tea any more processed than it need be. So, there you go. I *can* have a cup of tea in the morning.

When the Cytoxan was done, about an hour after it started, the nurse "flushed" the catheter with saline and then shot me up with Heperin (anti-coagulant, to prevent clots). She removed the needle and catheter and Frank and I were on our way home by about 12:15. One treatment done. Yay!

With all the anti-nausea meds, I'm being cautiously optimistic, and thinking I'll be fine tomorrow. But, we've been told that, if it's coming, tomorrow is when the nausea will hit. So, keep your fingers crossed.

Sometimes Life Is Especially Unfair

Very soon after getting my cancer diagnosis, I went online and looked for "cancer diets". You'll be shocked to hear that it's mostly common sense: no caffeine, no alcohol, lots of dark green, leafy vegetables, lots of fruits, and anything with antioxidants. And I've been pretty good. I've pretty much completely dropped the caffeine and alcohol and it's a pain, and a drag, and a bother, but I feel like it's just not that hard to make those changes for the duration of this healing process.

But honestly, I figured I could dabble in caffeine and alcohol after radiation. I mean, why not, right? I'll be better and life should resume. And then stupid Kaiser hospital has to publish this.

Sometimes life is so unfair.

Ready, Set, Go!

What a busy couple of days we've had.

First: we got Emily happily esconced in her dorm room (Anacapa Hall) at UCSB over the weekend. We left home at about 10:30 a.m. on Saturday with a borrowed van (thanks again, Sarah & John!). We hit a bit of traffic around Watsonville, and some very icky rain a couple times, but got to Santa Barbara before 4:30. We managed to wrangle our way on to campus, stopped off at the bookstore (where we picked up Em's preordered books) and then left her bike locked up in front of her dorm. (Emily's room is one room away from this back door to the dorm. Not too shabby.)

After spending a lovely evening at the Ramada Limited and a quick morning visit to the Mission Santa Barbara, we got Emily moved in to her dorm, had lunch with her in the dining commons, and said "see you in five weeks" around 1 p.m. on Sunday. (I didn't get weepy until we were halfway down the hall.) Frank and I were back in Albany around 6:30 last night.

Second: On to today. I had a 10:30 appointment with my medical oncologist. All went well and she said that, as long as my surgeon is okay with it, I can start chemo next week. Finally! Don't get me wrong. I'm not exactly excited about chemo, but I do feel that the sooner I can get started, the sooner I can be on the other side of this, and I'm really ready to get started.

(It turns out I will not be doing the Taxol test. The treatment involved pills and self-injections and Dr. Kuan nixed the whole idea. It was kind of funny listening to her talk to the research department. "That's not a good test. No, you really should just scrap that test. What about this other one? <listening> No. That's not a good test. These are not really good tests." Anyway. We're doing the prescribed 4 cycles of AC and 6 cycles of Taxol, each two weeks apart.)

I scheduled a Monday morning first time infusion for the AC (I'll be there from about 9 till 1 p.m.) and a Tuesday follow-up for a shot of Neulasta (to get the white blood cell count going).

At 2:45, I met with my surgeon. He confirmed what Dr. Kuan told us--the margins were clean and there is no residual cancer in the breast or lymph node area. Yay! He said that, yes, I can start chemo whenever Dr. Kuan is ready. Then he brought up radiation. He talked about the "mammocite" proposal he had mentioned during our pre-surgery consult over a month ago. Mammociate radiation is when they put a balloon catheter into the tumor site and zap you with radiation from the inside as well as the outside, for five days. This greatly reduces the radiation time (from five/six weeks to five days), so that's a plus. On the other hand, there really aren't any long-term statistics for this form of radiation yet and so no one can offer assurances that it will be as effective, in the long run, as the good old six weeks of daily radiation.

If we pursued this form of radiation, we'd need to do it before chemo, and so we really needed to get Dr. Kuan's opinion. I called Dr. Kuan and after some phone tag, we spoke about the radiation. Given my high risk status, she doesn't recommend the mammocite radiation. So, there we are.

We'll start the AC on Monday and then do three more cycles over a period of eight weeks. When that's done, we'll get started on six cycles of Taxol over twelve weeks. Then we'll take a short break and get started on the radiation.

And, in the interest of fair and balanced reporting ;-), I have to say that I am in love with Blue Shield right now. They approved one of the more expensive anti-nausea meds (Emend) and so other than having a liter or so of toxic chemicals in my body next Monday, I should be feeling okay.

University of Casual Sex and Booze

Well, Em says she has heard UC Santa Barbara referred to in that manner. Of course, it was from a friend who was going to an even more notorious party school (not printed here for self-protection).

We're borrowing the Tonkyn's minivan (thank you Sarah & John!) to which they have attached their bike rack, and we're hitting the road tomorrow around noon. We get to move Emily in to her dorm (Anacapa for those of you looking at a map of UCSB) starting at 9 a.m. Sunday.

I've been a bit tired the past couple days and Frank keeps offering to do the trip solo with Em, but I don't think I could stand that. So, I plan to stay with the car while they're unloading and then go park and slowly make my way back to the dorm while they're putting things in the room.

Other than that, I shall be observing and trying not to interfere in the negotiations to fit three young women (and all their stuff) into a room built for two.

Maggie, meanwhile, will be spending the weekend with friends. She has a soccer game on Saturday, around noon, and after that, she'll go to Siobhan Bauer's house, where I know she'll be well tended.

Frank and I hope to get home Sunday before too late so that Maggie gets to bed at a reasonable time. Wish us luck!

Surgery: Double Check

....and just be grateful it won't be a "triple check".

There was some doubt as to whether or not we'd get approval for the port to placed during this surgery and I was starting to feel a bit pouty about the prospect of a third surgery. But, yay!, someone pulled a rabbit out of a hat, and they put the port in place yesterday, during the recision.

The recision doesn't hurt much, but the area where they put the port is pretty sore. I gather they had to move some muscles around to get everything in place.

But, all in all? Things went swimmingly. Surgery started a bit late (I was wheeled in to the OR a bit after noon, rather than at 11:30), but I was home before 5 p.m. and I got to sleep in my own bed (much more restful than sleeping in the hospital).

Thanks to Joanie, Karen, and Dorothy for cleaning our house again yesterday, while Frank and I were in the hospital all day. "Thank you" to Becky for a wonderful dinner. And thanks to my co-workers for the most fabulous box of chocolates (a box made out of chocolate, filled with chocolate), accompanied by the loveliest sentiments.

I will be meeting my oncologist next week to schedule chemotherapy. And in the meantime, we'll be getting Emily packed up and then settled at UCSB.

A New 'Do

I've decided that I don't really want to wait for my hair to start falling out, and then have a sad couple days with long grey hairs wrapping around my brush, etc. So, I took matters into my own hands (well, and those of Paul, at Festoon). I got a short cut I'm calling my Chemo Cut. To be more accurate, it is, of course, a pre-chemo cut, but I would not be getting it if it were not for the chemo, so I still think it's appropriate.

Okay, and now I'm babbling. :-)

So, ta da! Here I am. Freshly shorn.

Monday Recision

I'm scheduled for the recision surgery on Monday, September 17, which is easy for me to remember, as it's my parents' anniversary. (Happy Anniversary, Mom & Dad!) ;-)

I'll check in at the hospital at 9:30 and surgery is scheduled for 11:30. Assuming everything goes well (and remember, we have no nasty lymph nodes to deal with this time around), I should be done by 3 p.m. and then home around 4 or 5 p.m.

Meanwhile, the MUGA this morning was pretty boring. Frank and I showed up at Alta Bates hospital, where we checked in at Nuclear Medicine. I got shot up with some radioactive isotopes and then waited for about 15 minutes for them to circulate through my bloodstream. Then I was put on a narrow bed and had 3 leads put on me for the heart rate monitor. I had to put my left arm up over my head and the kindly nurse, Mark, strapped my right arm around me, so I'd stay nice and still. He positioned the circular scanning device over me and it slowly moved around my heart for 20+ minutes.

Frank asked if he could talk to me and Mark said, "yes, just don't make her laugh." So, at one point, Frank starts to tell me how he's going to prepare the Smithfield ham he just acquired.

Frank: I'm going to cook it the Alton Brown way.
Karen: And what way would that be?
Frank: Well, you braise it in Mr. Pibb.
Karen: Mr. Pibb?
Frank: Yeah, and sweet pickle juice.
Karen: You're not supposed to make me laugh, remember?
Frank: That wasn't supposed to be funny.
Karen: Sweet pickle juice?
Frank: Oh, okay. ......Iraq.

You gotta love him.

2B or not 2B?

Frank and I saw Dr. Kuan today, to go over the pathology report and to discuss chemotherapy. What a long appointment.

First, the details. The CT scan showed the breast lump and the rather large lymph node in my armpit, but that's it. So, yay, we get a zero on the M(etastisis) for the TNM staging for breast cancer. We told Dr. Kuan that Dr. Broderick had said I was staged at 3A (67% survival rate) and she looked confused. She said, no, a T(umor)2 and N(odes)1 meant a 2B. She looked through the pathology report and we talked about lymph nodes that are "matted," which can move a stage 2B to a 3A, but she said the pathology report showed no indication of this, so we're going to take that 2B with no further argument, thank you very much. All in all, given the TNM "score" combined with the fact that the tumor was "high grade" (i.e. aggressive), gives me a 75% survival rate. (But as my oncologist friend, Carla, reminds us, "these statistics refer to large numbers of people, not to individuals.")

After clarifying those details, Dr. Kuan let me know that the cancer center is doing a clinical test on Taxol infusions. If I sign up for the test, my chemotherapy would consist of 4 bi-weekly infusions of Doxorubicin (Adriamycin) and cyclophosphamide [abbreviated AC], and then either 12 weekly infusions or 6 bi-weekly infusions of paclitaxel (Taxol). The benefit of taking part in a clinical trial, of course, is that you have even more doctors watching your condition. So, despite the fact that weekly infusions would be a drag from the perspective of getting on with life, we are considering it.

We got to meet the nurse for Dr. Kuan's practice, Lisa Mune, who showed us how the "port" works for the chemo infusions. You can go here for an image of where the port goes. This port, which is surgically inserted under the skin, enables the nurses to give me my chemo meds and to draw blood without having to find a vein every other week. We're hoping that Dr. Broderick can put in the port when he's doing the recision to get more of the margins (still no word on when that will occur, yet).

But, if you look at the image, you'll note that meds go right into the vena cava, which leads right to the heart. So, to make sure my heart can handle all this (the Adriamycin, the "A" part of the AC, is hard on the heart) I'm having a heart scan (MUGA) on Thursday morning.

Whew. What a day.

On a positive note--I went camping this past weekend with the moms and daughters in Maggie's girl scout troop. There were four girls and four moms in Marin and it was lovely. I came home on Sunday utterly exhausted. But I'm figuring I won't be doing much of that kind of thing for at least the next six to nine months, and I wanted the Maggie time.

Houston, we have a "stage"

My surgeon removed the drain today--yay! I had no idea how much it was irritating me. No, I mean, I know it was bugging me, but I didn't realize how much of the discomfort in my armpit was due to the little plastic tube up there. Now it's out and I feel better already. :-)

Bad(ish) news--the margins on the tumor were a bit close, so he wants to go back in and remove more of the edge around the existing "cavity" (where the tumor was). (The tumor was about 2.5 cm.) Since there definitely won't be lymph node involvement this time, it actually *will* be same day surgery. But, of course, we have to go through the approval process (again) first. So, everyone be thinking positive thoughts along the lines of "surgery next week, surgery next week, surgery next week".

And of the 18 lymph nodes they removed, 3 of them were positive.

This makes me T2 and N1 in the cancer staging. We're assuming (hopinghopinghoping) that the M (metastisis) is a 0. Hopefully the CT scan taken last week confirms this. I'll know more, I'm sure, when I meet with the oncologist on Monday.

The surgeon says they're staging this as a 3A. Not fantastic, but not end of the world, by any means. And, we're lucky enough to live in a nice metropolitan area, with access to extremely fine care.

Meanwhile, we continue to be touched by the genuine help and good thoughts we're continuously receiving. We can't thank folks enough. Please just know how much we do appreciate your thoughts and words.

Surgery? Check.

To everyone who has been sending the positive energy and kind thoughts and words (and flowers and chocolates and tea and housecleaning and, the list just goes on and on....) thank you. We have felt your love most sincerely and we most sincerely appreciate it.

I got discharged a bit late today--it seems that my surgeon was assigned another case today and I'm thinking he assumed someone else from his office would see to my discharge, but, no such luck. So, after figuring I'd get to leave the lovely Summit hospital around 11 this morning, I actually got to walk out the doors around 4:30 p.m.

And sleep last night? Sheesh. You need sleep to heal, but heaven knows that the hospital is not the place to get sleep. Between being awakened to have my blood pressure checked every 4 hours, and my IV bag going empty and beeping at 3 a.m. and, well, oy vey, I got about 5 hours sleep last night. I'm sooooooo looking forward to sleeping in my own bed tonight.

For the very brave of heart, there is clinical pre-op info down below, but don't feel compelled to read this. I only put it here for the gluttons for punishment (like myself).

I'll be checking in with my oncologist on Tuesday and the surgeon on Friday. The surgeon will need to put in a port for the chemo, but I'm sure that happens a bit closer to chemo, which will likely start in about 4 weeks (after we take Em off to Santa Barbara).

So, there won't really be much news until next week, and so we'll have a bit of a lull in these updates. Thank you again, so very very much, to everyone.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Here be the icky clinicial stuff........

So, we arrived at the Breast Health Center at the Summit "campus" and first up were the "wires". Guided by ultrasound, the very nice doctor (Dr. Kanter is an opera fan, so he and I had a very nice discussion and he heartily recommends I take in the Seattle Opera's ring cycle), inserted wires on either side of the so-called mass, to guide the surgeon. The wire insertion was preceded by local anesthetic, so it didn't hurt. But he had to wiggle the needle inside the breast to see it on the ultrasound, and I was a teensy bit concerned that the lidocaine would wear off before I got the general anesthesia for surgery. (It didn't <whew>)

Then off for a mammogram that showed the wires.

I had to get in a wheelchair and then in an ambulance to be taken the whole 4 blocks to the hospital. Arrived there around 9:30, got checked in to Same Day Surgery, and then wheeled down to Nuclear Medicine. Probably the worst part. They need to shoot isotopes into the breast to "highlight" the sentinel lymph node(s). Which means a needle under the nipple. This, too, was preceded by local anesthetic. But still? Something I'd prefer to avoid in the future.

Loaded with wires and isotopes, I was wheeled back to Same Day Surgery, where I met the kindly anesthesiologist, who checked to make sure I had no allergies, blah, blah, blah. I got wheeled over to surgery, they put something dopey into the IV and then put the mask over my face. I remember thinking, "oh, the mask is over my face" and then I woke up in recovery.

I felt fine until the nurse told me I would not be returning to Same Day Surgery, but would be spending the night because I knew that meant they found something in the lymph nodes. Damn, damn, and double damn.

I'm not experiencing much pain and I've been good about moving the left arm. I have a drain from the surgical wound, and will need to empty it for about 4 days. But all in all, this is not all that bad. Certainly easier than chemo will be. More on that after we get the pathology report and have my doctor's appointments next week.

From Frank

Hi all friends and family and assorted loved ones. Karen is in the hospital tonight, so she asked me to post everyone about her status.

She is in good spirits and quite chipper after a rough day of surgery.

She has been pretty clinical and detailed, so in that vein, I'll do my best: After pre-op poking her with wires and injecting her with various unnatural substances starting at 7:45 a.m., she went into surgery at 12:00 noon, and was out a little before 3:00. They took out the tumor, and will be studying it for the next few days to gain confidence that they got all of it. They also took out her "sentinel lymph node" and tested it for cancer. It tested positive, so they had to go in and take out all her lymph nodes on that side. They will be testing them over the next several days to determine if they are cancerous. The prognosis will be influenced by the number of lymph nodes affected. Frankly, the oncologist has made it pretty clear that an aggressive treatment of chemotherapy is in Karen's future.

She's extremely brave and in good spirits. I have extended all of our love to her, and I know she appreciates the extraordinary kindness that has been shown, including notes, calls, flowers, dinners, cleaning, and checking in on the girls. Really amazing, and I know she feels very much loved. As she should.

Ming Kuan, Oncologist

I met my medical oncologist today (that's the one who gets to prescribe the ickiest part of this whole process, the chemotherapy). Loved her. Dr. Ming Kuan answered all Frank's and my questions and even put us a bit at ease. (Invasive does not imply, as I had assumed, that the cancer had necessarily invaded something. The biopsy merely indicates that it has the capacity to do so. And, as we all keep saying, we'll know more after surgery. Which is less than two days away. Yay!)

Dr. Kuan ordered a CT scan just to ensure the cancer hasn't spread, and I get to do that tomorrow afternoon, after I meet with my radiation oncologist, Dr. Roig.

The nicest bit of all this news is that all my cancer doctors (except my surgeon) and nurses, etc. are all in one wonderful facility. I get to show up and they have all my info. My CT scan tomorrow? At the Comprehensive Cancer Center. My radiation oncologist? Same place. And when I go back to my medical oncologist next Tuesday, post-op? Yep, at the Cancer Center. Makes things *much* easier.

They gave me a lovely, helpful binder, with all sorts of info in it. And it has tabs for things like phone numbers, and medication lists, and lab results. Which is great. Because my little folder was beginning to show the signs of wear & tear from too much paper and from being carted around.

So. On to the CT scan and meeting my other doctor, and then, *finally*, surgery on Thursday.

Oh, and, I've shared this link with a few folks, but I've really enjoyed this woman's blog from when she had cancer last year, so I thought I'd share it with everyone: http://www.alixnorth.com/navigational-chart-breast-cancer-patients.

Green Light: Surgery

Yay! After all the rigemarole of approvals and schedules, we have a surgery date.

Next Thursday, August 30, at 7:45 a.m., I'll check in to Summit West (in Oakland) where they'll begin the prep work (inserting a wire), then I'll move on to Summit North, where they'll do more prep work. Then on to the nuclear facility (I'm not even kidding, that's what she called it) for yet another wire. From there, it's on to the OR. Sheesh.

Assuming it's only a lumpectomy, I should be done by 3 p.m. and home that afternoon. If they have to take out the lymph nodes, well, then, I get to spend the night in the lovely hospital and go home on Friday morning.

I'm meeting my oncologist and radiologist this Tuesday and Wednesday, respectively, to fill out paperwork and do the pre-consults. After the surgery, I have been told it takes about a week for the full pathology report to have been digested such that my chemo/radiation treatment can be determined and begun.

And that's when the real fun begins. ;-)

The Waiting Game

Well, now we're just waiting. And rather than have people fret and wonder what the heck is going on, I'll just give you the situation, as we currently know it.

We got the pathology report last Thursday just before meeting with the surgeon. Technically, all we know so far is that I have "invasive DCIS (ductal carcinoma in situ)". It appears that there is lymphatic and/or vascular invasion. But they can't know anything for certain until I have a lumpectomy. Which will happen as soon as we can get approved. Which will happen in five to ten business days. Argh! Insurance: blessing or curse?

Anyway. We're probably looking at surgery next week, sometime.

The surgeon is on the young side (Frank might prefer it if he wasn't so handsome. Me? I'm wondering if he's too old for Emily....) But very capable and Frank and I both felt assured and confident in his abilities.

During surgery, they'll check out the lymph nodes. If they look bad, they'll remove them at the same time as the lump. Afterward, they'll test the margins of what they've removed, to ensure they got everything.

But meanwhile? We just wait.

I'll email again when we've got a date for surgery.

(Also, please feel free to forward this to whomever you like. If I've missed anyone, my sincerest apologies.)

The Journey Begins

So, my doctor thought it was a cyst, but the ultrasound and mammogram indicated otherwise. A biopsy taken Friday revealed that it is, indeed, breast cancer.

That's really all I know right now. I have a surgery consult on Thursday and my doctor should have more information on exactly what kind of cancer we're looking at, on Friday. And can I just say this sucks?

I'm sending an email because I'm annoyingly weepy right now. I'm at work because, really, what would I do if I stayed home? So, there it is.

I'll let folks know more as I know it.