Life Changes

Everyone I've met that has had cancer has acknowledged that it's a life changing experience, and for each of those people, their lives changed in different ways. There are big ways and small ways my life will forever be different. There is, of course, the most obvious change in the fact that I lost a breast this year, but there are also many little things that I'm sure will change. For example, today, for the first time in my life I bought a sunscreen with a 30 SPF - I don't think I've ever worn anything over 15 and even that very sporadically (of course, I also bought sunless tanning spray). I realized with that small purchase my approach to life has changed.

Breast cancer can be environmental or genetic and with the results of my genetic tests being negative, I have to think that my cancer was mainly environmental and wonder what role my lifestyle choices played. I'm not beating myself up about it, but I am looking for change as I move forward. I know that the biggest change I have to make is a life-long commitment to 30 minutes of exercise a day. Until I wound up in the hospital I had been doing quite well with that, but haven't had the energy since then, although now 2 weeks after my last chemotherapy I'm beginning to bypass the afternoon nap and hope to get back to some form of daily exercise. The other, and for anyone who knows me will know this one is truly a big life change, is a change in alcohol consumption. Study after study point to more than 1 drink a day as a breast cancer cause. Well, I’ve certainly consumed enough alcohol to equal one drink a day for the next 200 years! As you can imagine, I haven’t had anything to drink since early January and without making a pledge to be the designated driver for the rest of my life, I have spent quite a bit of time thinking about how I will change my approach to cocktail hour. I have plenty of time to think about this, as all the literature on Herceptin Treatment discourages alcohol use during treatment and I’ll be receiving Herceptin for another 9 to 10 months.

And then there is the spiritual side. For many years now I’ve been telling my husband we need to do something about our lives – we’re weren’t actively living our lives, we were going from life event to life event and I’ve felt that something was missing. I’ve got my summer reading lined up; starting off with Jon Kabat-Zinn’s Mindfulness for Beginners and A New Earth by Eckhart Tolle and hope to come to a more enlightened understanding of the big and small pictures and what the future may hold for me now that I’ve had this life changing experience.

She's Radioactive

This week, I've been busy with a surgeon follow-up, a Herceptin Treatment and a MUGA Scan. I saw my surgeon on Monday afternoon and he was pleased with my progress and range of movement. Although I do still have quite a bit of numbness in my arm, chest and back, it is lessening and not unexpected from lymph node removal.

On Wednesday, I had my first Herceptin treatment since "the rash" and in all honesty, I was a tiny bit apprehensive, but nothing happened and the rash continues to be a mystery and luckily, just a memory. As I was scheduled for a MUGA Scan on Thursday morning, the nurse left my port accessed overnight, which took the IV anxiety out of the MUGA appointment.

Ok, you are asking yourself, what the heck is a MUGA. Here is more info than you wanted and this photo is of me having my MUGA! The MUGA scan (MUltiple Gated Acquisition scan) is a noninvasive test that assess the health of the heart's major pumping chamber (the left ventricle). The process is really very simple, but a little odd. They take a vial of blood and then go away for 25 mintues while they make your blood radioactive, then they come back with a white box with a big "Caution Radioactive" label on it, take a vial encased in metal out and then reinject the radioactive blood into the patient. The next part is easy - you don't even have to challenge the fashion police in a hospital johnny - just lie on the table, and the machine takes 16 pictures for each heart beat for 7 minutes. I had a MUGA back in March prior to beginning treatment and will have one every 3 months for the duration of my Herceptin treatment, as heart damage is a reversible side effect of Herceptin.

So, one week past my last chemotherapy treatment I am starting to feel much better. As expected, I did have a difficult weekend, and this one was a bit more emotionally difficult than in the past. I don't know if it was the change in my treatment drugs that Dr. Muss made, or the fact that it was wonderful weather and I was feeling a bit sorry for myself, but I'm sure I made my husband crazy on Sunday with a little more than my share of whining. Other than that, I did have a little more than usual nausea, but nothing too bad. I am beginning to feel better, and by all accounts will feel more and more like my old self each day now that the toxins are leaving my body for good.

A Supportive Husband

Check it out. My husband Charlie shaved his head so we could grow our hair back together over the summer. I have a feeling his hair will grow back a lot faster than mine – but he hasn’t yet agreed to keep it even with me! He has been a wonderful caretaker and co-survivor during this pesky bout with cancer, stepping up to help with my parents and taking on extra chores around the house when I’m not feeling well, but most of all being a rock of support and optimism right from the start. I’m forever thankful he is by my side and I plan for us to continue to stay side by side for many more years!

Chemotheray Treatment #4!!

Had my 4th and final chemotheraphy treatment yesterday and so far, so good. Dr. Muss (pictured) was still quite perplexed over my recent drug reaction, so he tweaked my treatment a little. He switched out my Taxotere with Abraxane which has less of a potential for rash. Dr. Muss also cancelled my Herceptin yesterday, and I'll receive a Neulasta shot today to ensure my white blood cell count stays up and I don't have another episode of Neutropenia and a stay in the hospital. In regards to my red blood cells, I'm still a little anemic, which accounts for much of my fatigue.

In an odd twist of fate, I knew 2 of the other women in my "pod" yesterday, one is a colleague of Charlie's and one is a friend of a friend who recognized me previously from reading this blog. We had an interesting discussion on the progession of the understanding of our pathology and treatment plan. Think about it. I "officially" knew I had cancer on January 7th, had two surgeries in January but did not find out about the pathology of my cancer until March 3rd. Although I knew immediately I was node negative, I still had to wonder what else was going to come my way. Then when I did learn of my pathology, it's a whole new language and it sounds bad - HER-2Positive, ER/PR Postive, High Grade, and on and on. This all sounds bad - you don't associate the word positive with something good when receiving cancer news and it takes a while for it to sink in that all these things are good because they allow you to fight the cancer with even more drugs - and the more tools in your toolkit, the more successful you are!

So, it is with this positive thought that I finished my fourth and final treatment yesterday and look forward to continuing my Herceptin treatments for another 10 months and moving on the Hormone treatment after that! I just keep remembering that all these treatments combined contribute to the reduction from 32% to 5% for the chance of a relapse and from 13% to 3% for non-survival over the next ten years. All I have to do is combine that with a dedication for 1/2 hour of daily exercise and 5 servings of fruits and vegetables which according to a recent study will increase my survival rate and I'll be all set!

Good Things About Hair Loss

Since I’ve opted to forego covering my head during this phase of my life, I’ve discovered the following “good things” about my hair loss from chemotherapy treatments.


• No more bad hair days
• Save money on hair products
• Help the environment – my showers are much shorter
• Drive with the window open and not worry about messing up my hair
• Sales clerks are very nice to me
• Strangers smile at me
• No need to be concerned about hat head
• Can wear pullovers without worrying about hair
• Can try on clothes while shopping without worrying about messing up hair
• Can sleep a little later – it takes less time to get ready
• When I run into someone I haven’t seen for awhile, they
immediately know what I’ve been up to

Medical Mystery Tour

Get a cup of coffee, tea or a glass of wine - this is a lengthy post.

Well...where to start. You may have noticed it's been quite awhile since my last entry. One reason is I was feeling so well that I was having a hard time thinking of something to write about - who knew there would be so much pressure in having a blog about yourself? Anyway, on Wednesday, April 30, I went for a Herceptin treatment and felt fine, left there and went to the grocery store, came home made lunch and then it was all downhill from there. In the mid-afternoon, I started having some chest pain and because I can't think of another way to describe it - my throat felt "full". I took some anti-naseau medication and took to the couch. By about 9:30, the pain in my chest was quite intense (but not like heart attack chest pain - I've been trying to describe the pain for a week now and can't quite put it in a way that sounds less scary) so I then took a Percocet. At midnight, I woke up with a very itchy foot and thought I was having an allergic reaction to something so I took a Benedryl and went back to sleep. When I woke up in the morning, I thought something might be wrong and asked Charle if my eyes were swollen. His response was "I think you need to call the doctor."

By the time I talked to someone at the clinic, my temperature was at 100.6 and my eyes were getting worse. My nurse Jean told me to go to the emergency room. This photo was taken when we got to the emergency room at about 9:30 in the morning. The Attending doctor identified my condition as a drug reaction, even though I hadn't taken any new drugs. My oncologist, Dr. Muss, came in at about 11:00 and was very perplexed because allergic reaction/rash (by now I had red blotches beginning to appear at various spots on my body) is not a side effect of any of the drugs I am taking. A nurse arrived to access my port, take a blood sample and inject 50mg of Benedryl (and I now know the rush a Heroin addict must feel - I've never gotten so high so fast). Because I'm a chemotheraphy patient and my temperature was above 100.5, they had to take a blood sample from 2 different places - one from my port and then one from my arm, which as usual, took 2 people 3 tries..... Once this was done, Charlie went to work for a while and they moved me to a private room to sleep off the Benedryl and await the results of the blood tests.

Then mid-afternoon Elizabeth, the medical student from the Oncology/Hematology floor came in to tell me I was being admitted. Next came Dr. Plank from Oncology to tell me that my blood tests had revealed that I Neutropenic - which means the number of cells called neutrophils in my white blood cells was too low. Neutrophils are a type of white blood cell that fights infection. Having Neutrpenia means I had to be in a room by myself and keep the door closed at all times. Meanwhile, the rash is spreading to more places on my body - my legs, feet, arms, chest and back by now were pretty well covered with red welts, my lips were swollen and I was very itchy. Once I got to my room, I was visited by the Oncology Fellow and then a doctor from Infectious Diseases (just to be sure they said). I started receiving IV antibiotics, and would continue to recieve 2 different types 4 times a day for the next 5 days. Overnight, my hands and wrists became so swollen that I had to remove my hospital idenfication braclet and couldn't interlace my fingers - a intense itch accompanied the swelling. Our hospital here is a teaching hosptial, so of course, Friday morning brought a large gaggle of medical students to view "the rash". Dr. Plank told me it was official - I was a medical mystery!

By Saturday morning, the rash and swelling was subsiding, but my white blood cell count was still low and I was also told I was anemic and there was some talk of a transfusion, but in the end they figured I was young and healthy and didn't need to do that. I was given an injection of Neupragen which is similar to the Neulasta injection I received after my first chemotherapy. Dr. Muss explained that Neulasta is much stronger since it has to work in the body over 10 days, but the Neupragen is a daily injection and I wouldn't have the same painful side effects. I received a Neupragen injection on Saturday, Sunday and Monday.

Sunday evening at about 6:00 I asked for a couple of Tylenol for a slight headache and by about 7:00 I had a fever, red and burning ears, itching hands and feet - all common symptoms of a drug reaction. This meant two more blood cultures had to be drawn, and I had to stay in the hosptial for at least another 24 hours. Finally, the good news came that my white blood cell count was up and I would go home on Tuesday.

Of course, there was just a little bit more drama before I could get home. By 2:00 I was all processed and ready to go home, just waiting for Charlie to call me when he was leaving the office so I could meet him out front and the vital sign taker arrived. I told her I was going home, but she said as long as I was still in the room, she had to take my vital signs - and I HAD A TEMPERATURE. Fear hit me - after 5 days in the hospital, I wanted to go home. She told me she'd have to tell the nurse. Meanwhile, Charlie called and I attempted to leave, but saw the nurse in the hallway. She took my temperature - in both ears - and get this - each ear provided a different temperature. Off we went to Dr. Plank, who said he didn't think I needed to stay, but he wanted to call the Oncology Fellow just to be sure - he termed my temperature interesting and sent me home with a 7-day perscription for an antibiotic. So even on the way out of the hospital, I continued to be a mystery!

My Herceptin treatment for this week was cancelled, and I'm scheduled to receive my 4th and last chemotherapy treatment next week!

Thanks to my great friends who visited me at the hospital when I looked like an extra from a science fiction movie and didn't say a thing, and to all of you who called and sent cards - knowing you were thinking of me meant so much. Also, thanks again to my wonderful friends who made my quilt - I had it with me right from the emergency room and it made such a difference having the comfort of friends with me at all times - I have to admit, it was a little scary there for a while.

Chemotherapy Treatment #3

Three treatments down, one to go. We had another busy and successful day at the Vermont Cancer Clinic. I was, of course, wearing my official chemotherapy ensemble which has at its foundation the wonderful Believe shirt provided by my friends Rob & Paula. When Charlie called them after my first surgery he used the phrase “we just have to believe we’re going to win, just like the Red Sox” (or something to that effect, I was still in recovery wondering if I was ever going to be able to open my eyes and not want to vomit). Rob got on the Internet and searched for a Red Sox Believe T-Shirt and shipped one up for both Charlie and I. As you can see I have worn this same shirt to each chemotherapy treatment because I do believe I will be a long-term cancer survivor!

Started off with a quick line insertion for a blood test (still loving that port), a visit with Dr. Muss, my Oncologist, who reviewed the blood test results and said I was doing great. Back to the South Pacific Pod to take my pre-med’s, which include a 125 gm pill and 2 bags of IV medication. The massage therapist came by and offered a foot massage, to which I happily agreed. Finally started with my first bag of toxins at 11:30 and finished up the third bag at 2:30.

Dr. Muss’ nurse Jean stopped by to check-in and say hello.

My quilt was quite topic of conversation in the clinic. A number of nurses and patients came over for a look and were very complimentary – both of the quilt and the great friends that put it together. I watched the video before I left home, so I started the day with an extra dose of love!