Peace of Mind

So, the bone scan was negative.  Woohoo!

In true Dr. Sara fashion, he didn't beat around the bush but rather walked into my exam room and blurted out those words (well, maybe he left out the "woohoo").  Of course, I was relieved, but after he told me last time that he wasn't too worried about it, I wasn't too worried about it either.

Still, it's very nice to know for sure!  And, who knows, the scan could have showed nothing on my spine but new spots we didn't even know about, since it was a head-to-toe test, so that is nice to know for some peace of mind too.

Dr. Sara reiterated that I am not going crazy or turning into a hypochondriac to start worrying about every little thing.  He said that I am not a "worrier" and in fact I worry just about the right amount.  But once you're diagnosed with cancer, it's hard not to let your mind go there every time you feel a little ache or pain.

He told me that growing up in Lebanon, his family used to get fresh milk delivered every day straight from the farm.  Before they could drink it, it would have to be boiled.  Anyone who accidentally burned their tongue on boiled milk would be careful not to make that mistake again, because it was painful.  Now, yogurt is also a staple of the Middle Eastern diet.  So, they have a saying: anyone who has burned their tongue on boiled milk blows wind on yogurt!  Point being, you become a little paranoid, and that is normal.

Dr. Sara said that I am still a normal person, and I'm still going to get normal aches and pains, headaches, etc., just like I did before I got cancer.  The difference is that before, I would think nothing of it, and now I wonder if every little thing is cancer.  He said that one good thing to keep in mind is that aches and pains that come and go are almost always nothing.  Aches and pains that come and stay are still usually nothing, but should still be checked.  I guess that makes sense - if there is a tumor growing somewhere, it's not going to magically grow and shrink and grow again, but will probably be able to be felt constantly.

He also said that no matter what, if there is ever anything bothering me (even if it's a pain that comes and goes) I should never hold back from telling him, and we'll get it checked out.  I'm not really one to hold back, so that shouldn't be a problem!

Now, I am nearing the halfway point of this course of chemo.  I started in early October and it's meant to last about 5-6 months or so, and I am still feeling no side effects.  Still no numbness or tingling in my fingers or toes, and my blood counts are still good.  My eyelashes don't seem to be falling out as much, which is nice.  They're still definitely thinner than usual, but I'm probably the only one noticing.

My hair is still fully in tact and in fact, I got my first haircut this week!  I decided I wanted a little more shaping too it (longer on top, shorter in back), plus I felt like I had leftover damaged chemo hair on the ends so I wanted to get rid of that.

Check it out:

My mom took this pic in the hospital waiting room Friday.  I'm happy with my hair right now, and you know, according to Glamour magazine, the pixie cut is "in" right now, so I'm going to stick with this for a little while!  Special thanks to my stylist Rita!

Well, that is all for now.  I have two more treatments left in 2010, and then it will be on to 2011!!

I Think I'm Paranoid

(Another musical reference - remember the Garbage song from the 90's??)

For the most part, things are still status quo.  My treatments have continued on schedule (except I got to skip Thanksgiving week which was nice!), and I am still not feeling any of the expected side effects from the chemo.  No numbness or tingling in my fingers and toes (yet), and so far my blood counts are just fine.

Oddly enough, however, I think I'm losing my eyelashes.  It started a couple weeks ago - every time I washed my face I would seem to lose 2 or 3.  On the bright side, I made a lot of wishes by blowing the stray lashes off my thumb.  I still have some eyelashes, but they are noticeably thinner (at least to me) and mascara is becoming more difficult to apply.

I asked Dr. Sara about it and he said it's possible that this is a side effect of the chemo although usually the eyelashes are the last to go!  Which was the case when I lost my hair on the first round.  Weird.  I am not losing my hair at all (thankfully!) so this must be some kind of fluky thing.  Which is just fine with me, I guess - could be worse!

Now, you know how I always say that I am not going to worry about things until I have a reason to worry?  Well, I've found that promise a little harder to stick by the last few weeks.  I'm starting to experience some of the paranoia that I guess is inevitable when you have this dumb disease.

It all started in the couple weeks leading up to Thanksgiving.  I was really busy at work - staying late and coming in early, and even doing some work from home over the weekend.  Lots of time logged at the computer and then I went on a business trip for a few days where I brought my laptop and lugged the heavy thing through the airport.

So, naturally, I started to feel some tension and soreness in my back during this time.  The problem is that when you have cancer, you become hyper aware of every little thing in your body, and there is always the nagging thought in your head that "what if this is not run-of-the-mill soreness, what if it's not a normal headache... what if it's the big bad C make another appearance?"  It sucks, because once you entertain this thought it's hard to get it out of your head.

Every time I get checked out these days, Dr. Sara asks me if I'm having any back pain because of those two spots on my spine.  So of course I was very aware of this when thinking about my back soreness.  There've been times over the last couple weeks where I got really worried about it and I did lose a couple nights' sleep over it (but only a couple).  But things always seem 10 times worse at night for some reason and then in the light of day you realize how ridiculous you were being.

And then there were other times (especially in the morning when I was well rested) when I thought I didn't feel anything at all and I thought I must be going crazy.  And then the fleeting but quickly dismissed "oh no - if I'm going crazy does that mean the cancer could be in my brain?"!

So, on Friday I told Dr. Sara all about it.  He said I am not going crazy and it is perfectly normal to feel this way and be worried about things that I feel.  He examined me and said that he thinks it is just muscle soreness that I'm feeling, for two reasons.  One, the specific spot that I seemed to feel it most is not right on the spine, but a little to the left.  Two, he said the lesions that I do have (which have always appeared healed since they were discovered), are so small and located in a place that he wouldn't expect anyone to feel them.

But, just to give us all some peace of mind, I am going to have a bone scan on Wednesday.  Dr. Sara said that he is not worried and he is not going to lose any sleep over it, and neither should I, but it will be good to have the scan just to be sure.  I will get the results when I go for my regular chemo appointment on Friday.

This experience has made me realize that having cancer is like living under your own personal constant terrorist threat.  Terrorists are fearmongers, and that is something they have in common with cancer.  But I don't want to be the type of person who walks around with a gas mask in her purse because she's so paranoid!  And I don't want to go running to Dr. Sara to get scanned every time I feel something a little off.  But, it was good hear Dr. Sara say that I'm being completely normal, and even better to hear him say that he's not worried about it but we're going to get it checked out anyway.

Feeling Good*

So it's been awhile since I've blogged... but that's because I don't really have much to say!  I've now been through the second cycle of this new chemo, and so far, so good.  I have no side effects to speak of (yet), and actually right now I feel 100% normal and healthy.

Of course, I know that the more treatments I have the more likely I'll start to feel some of the side effects, most likely the neuropathy (numbness and tingling in my fingers and toes) and my blood counts might start to drop.  I'm going to have to be careful this winter to try not to get sick!  At least I had the flu shot so I should be covered there.

My chemo treatments are following the familiar routine: vitals, seeing Dr. Sara, then sitting in the infusion suite for a bit while I get my treatment.  I'm liking the shorter treatments, since I can go to work after.  I haven't had to miss a full day since I got my port placed!

I've even been contemplating getting back into a workout routine.  Of course, I haven't actually done anything about it yet (although I did watch the NYC Marathon on TV last weekend - does that count?) but there is really nothing stopping me from starting to work out here and there.  We'll see... maybe one of these days I'll get my mind around it and actually go for a run.  I'm sure it will feel good and I'll be glad I did, it's just that I need to get over the mental hurdle!

Other than that, I've just been living my life as normally as I can.  Of course, cancer is on my mind every day, but it's a "new normal" that I've gotten used to.  One of the many things that's annoying about cancer is that it makes you hyper-aware of your body, so every time I feel the slightest little soreness or twinge my mind automatically wonders if it's cancer-related.  As I said, it's quite annoying, but I'm learning to live with it and I know if any little thing I feel persists (which nothing has yet) I'll just tell Dr. Sara and get it checked out.

This Friday starts my third cycle, so I will have my Herceptin + Navelbine treatment.  Dr. Sara is very good about being flexible to work around my schedule, so I will get Thanksgiving week "off" and then will go back the following Friday for another Herceptin + Navelbine treatment.

So as I said, I don't really have much to report this time, but that is a good thing!

*Today's blog title is a reference to the Muse song by the same name.  They are one of my favorite bands and I thought it was appropriate.  There are lots of versions of this song (originally Nina Simone), so I thought I'd clarify that I mean the Muse version.  Not that anyone cares but me, I know, but hey - it's my blog!  :)

Port-a-Chemo

So, "Chemo: The Sequel" has officially begun.  But first, I had to get my port "placed."

This took place on a Wednesday morning a couple weeks ago.  My friend Bernadette came with me (since Mom and Dad were in Europe at the time).  We arrived at the Interventional Radiology department (sounds fancy, doesn't it?) right on time.  Only thing was, there was not a soul in the department when we got there.  Seriously, we could have tried surfing on the gurneys and no one would know!  I looked around for a bell to ring or something, but then I remembered that it's not a hotel.

After a few minutes a nurse came in and assigned us to one of the "rooms" (more like a bay).  After waiting there for a few minutes another nurse came by and asked me a few questions and had me change into a hospital gown.  She was bright and funny and before I got changed she closed the shades in my room so that "all of New York City" couldn't watch me change (because then my boob flash count would have seriously increased!).  She then gave me an IV, because even though the point of this procedure was so that I would no longer need IVs, I still needed one last IV so I could get the antibiotics and sedation.

Next, the Physician's Assistant  (PA) came by and explained the procedure.  She said first the area would be thoroughly cleaned three times - they are very vigilant about infection control.  Then, they would give me the sedation drugs before they started the actual procedure.  These drugs wouldn't put me out completely, but would relax me so that I didn't feel anything.  Also there was a chance I might not remember the procedure afterwards.

Before they placed the port they would temporarily have the catheter travel down to my vena cava, the large vein in the center of the chest.  She said as it went down, sometimes it diverted into the heart, and if it did this it might "tickle the heart" which would cause me to have an irregular heartbeat for a bit.  She said if they saw it go near the heart she might tell me to take a deep breath and that sometimes gets it back on track to where it has to go.

Once this was done the port would be placed.  There would be a small incision in the left part of my chest and the port itself would be placed just below the incision.  The catheter would lead up to a large vein in my neck.  When I was done I would have a bandage on the incision and another on my neck where they would make a tiny incision to get to the vein in my neck.

So after this was all explained to me, I was wheeled into the procedure room.  Unlike my big-time surgeries, I didn't walk in and climb up on the table myself - I was wheeled in and then had to scootch over to the table.  I noticed large monitors over the table, which would show the doctors what was happening during the procedure since this whole thing was CT-guided.

They had me turn my head to the right and placed a drape over me - including my face - so I really couldn't see anything during the whole procedure except for the wall.  After they washed the area three times as promised, the sedation drugs kicked in and the procedure started. 

Now, the night before my procedure I had watched the Britney Spears episode of Glee.  If you haven't seen it, in the episode several of the kids have to go to the dentist and while they're under anasthesia they have dreams that they are in Britney videos.  I'd had Britney songs in my head all morning (I've got to admit her songs are catchy), so of course as the drugs kicked in I was wondering if I would have a Britney fantasy too.  Sadly, it was not to be.  But they did play music and they even asked me if I had a preference as to what station they played, but I let them pick the station.  I think I remember some Rolling Stones and maybe some Springsteen, but the details are fuzzy.

I was awake for the whole procedure, and I remember it, but I didn't feel anything except pressure.  At one point, they did ask me to take a deep breath, so I wonder if the catheter was about to "tickle my heart"!

The whole thing took about an hour.  As it was finishing up I started to shiver - all of a sudden I was FREEZING.  This happened the whole ride back to my "room" (really not a long ride) and my teeth were chattering when I got back.  The nurse said that the drugs can cause this, and luckily it didn't last long.  When I got back I was perfectly lucid and "normal" - I think a little to Bernie's disappointment, since she was probably hoping I would say some funny things!

After the procedure they monitored me for a bit and during this time the nurse noticed that my upper back was very red - like I had a rash.  I didn't feel any pain or itchiness - in fact, I would never have known that it was red if she hadn't noticed it.  The nurse, PA and doctor all took a look and thought I might be having some kind of allergic reaction.  So they gave me some hydroxysine, had me wait a little while longer, and then when they saw the redness start to go down, they sent me home.

The Next Step

Well, look at that - I kept my promise.  After my last post came after my longest stretch ever without a post, I am blogging again less than 24 hours later - the shortest time ever between posts.  OK, I know it's all because so much has happened during the last few weeks that I couldn't fit it all into one post, but whatever.  Details, details...

Anyway, as I mentioned in my last post, in the last few weeks while all the radiation stuff has been going on, I've also had two Herceptin treatments.  The first one, back on August 25th, was the first time I'd seen Dr. Sara since my surgeries (he was traveling during my previous treatment and I saw another doctor that day in his absence).

Dr. Sara remarked on how well I'd recovered from surgery and said Dr. Attiyeh had told him he'd almost never seen anyone have to stay in the hospital for only two days after the kind of liver surgery that I had.  I said, "Well, I'm an overachiever, what can I say?"  :)

After the typical exam, where Dr. Sara and Deborah mentioned that my scars looked good - and that usually liver surgery results in a big horizontal scar that looks like a hockey stick, so I was lucky to have my vertical one - we sat down to talk.

Dr. Sara went over my the pathology results from both of my surgeries.  Of course, Dr. Rosenbaum Smith and Dr. Attiyeh had already gone over these with me, so there were no real surprises, but when I'd seen Dr. Rosenbaum Smith she hadn't had the final report yet, so Dr. Sara went over that with my parents and me.

As Dr. RS had said, there was still quite a bit of cancer left in my breast, and I did have positive lymph nodes - 8 out of 11 to be exact.  I didn't really understand the significance of the number of lymph nodes so I asked Dr. Sara if everyone has the same number.  He said no - the number can vary greatly.  Most people have at least 10, and some people have as many as 50.  And just because I only had 11 removed (all that Dr. RS had found) doesn't mean I didn't have more at one time - the cancer could have destroyed some lymph nodes along the way.

The results showed that the chemo I'd had before surgery had had a significant effect on the cancer, but not a complete effect.  Not that we expected that - we knew from my scans that there was still cancer in the breast.

One other significant thing that the pathology report did show was that 35% percent of the remaining cancer was estrogen-receptor positive.  Dr. Sara said he was very pleased to see that because it meant that he would be able to give me Tamoxifen, a drug that is given to breast cancer patients who are hormone-receptor positive for five years following treatment.  I've read that it can reduce the risk of a recurrence by up to 50%.  Now, my original biopsy results did show that I had some estrogen resceptor positive cells, but the percentage was not exactly known - it said "10-30% percent, mostly weak".  Now, we know that the percentage was high enough for the Tamoxifen to hopefully be effective.  Dr. Sara also said that this was good because the estrogen receptor negative cancer tends to be more aggressive, so hopefully that means any cancer that might remain is less aggressive (meaning slower growing).

As for the liver, just as Dr. Attiyeh had said, there was still a very small amount of cancer cells found in the liver, but it was greatly reduced from what my original scans had shown, and the part that was removed had clear margins.

Dr. Sara gave me copies of both pathology reports, and I have to say they are kind of funny and kind of weird to read.  Half of it I don't understand, of course, but there is a section where the "specimen" is described and it says things like "the specimen is received fresh" (ew) and "situated central on the skin surface is an unremarkable nipple" (well, exCUSE me!).  Also, the masses which I presume are the remaining tumors are described as "tan" and the previous biopsy site appeared "bright orange" - who knew?

Anyway, after going through the reports, Dr. Sara said that the results - especially the fact that I had positive lymph nodes - led him to decide that I should get more chemo.  There is still a risk that there could be microscopic cancer cells lurking in my body, just hunkering down until they one day decide to start colonizing.  Dr. Sara said that if these results had appeared post-surgery in a patient who had not had chemo first, they would definitely give that patient chemo.  And since we are being aggressive with my treatment and pulling out all the stops to cure me, not just treat, he recommends that I have more chemo.

This did not come as a shock to me.  During my previous Herceptin treatment, when I'd seen another doctor while Dr. Sara was traveling, I had asked if I would need to go on Tamoxifen. When I asked this the doctor and Deborah had said that that would be up to Dr. Sara - whether he would give me more chemo or put me on Tamoxifen (turns out it will be both).  It was kind of said in passing, but I caught it so I already had in mind that more chemo was a possibility.

Now the next round of chemo will not be the same as the first.  Dr. Sara said that they have to change up the drugs they give me because after a while chemo regimens sort of "run their course" and are not as effective.  It's hard to say for sure, but it's possible that either the chemo I had before had run its course, or that the cancer remaining was resistant to those drugs all along.

So, this time I will be getting a new drug (not new, but new to me) called Navelbine.  Dr. Sara said he chose this drug over some other options (including Adriamycin, which I'd read about and knew as a nasty one - it's called the "red devil" because of its red color and harsh side effects, so I'm glad I won't be having that) because Navelbine is known to have a compound effect when given in conjunction with Herceptin.  As Dr. Sara put it, Navelbine plus Herceptin is more effective together; i.e. 1 + 1 = 3, not 2.

The good news is that Navelbine is not so bad with the side effects.  I will not lose my hair again, I will not have that "icky" feeling I had for a few days after chemo last time, and I will not have the dry mouth nastiness again.  Also, I will not need any pre-meds, like Hydroxizine or the steroid Dexamethasone that I had to take last time, which helped contribute to some of the side effects I felt.

(As a side note, speaking of my hair... it has been coming back at a good pace over the summer.  Here is a picture of me and Claire on Labor Day weekend:

Not bad, huh?  As you can see, I definitely have more hair than her now! I probably never would have asked to have my hair cut this short, but I don't mind it at all.  And it makes it pretty easy to get ready in the morning which is a nice bonus!)

Getting Radiated

Uh oh.  It's been 4 weeks since my last post and I said I wasn't going to that, didn't I?  (Actually 4 weeks minus one day, if you want to get technical about it.)  Oops.  Well, this time I won't promise not to go more than a couple weeks without blogging - I'll just say that I'll TRY not to go too long between posts.  Sound good?  OK, I feel better now that that's out of the way.

Since my last post I've had: two Herceptin treatments, one appointment with a neurosurgeon, two MRIs,  one radiation "plan check", and two actual radiation treatments.  Whew!  That is a lot to catch up on, so let's get started...

When we last left off (I know, it was so long ago you don't remember...), I was waiting to hear from Radiation Oncology about when the radiation to my spine would start.  It turns out that a few things needed to happen before treatment could begin.

First, I had to go see a neurosurgeon, Dr. Cohen.  My radiation oncologist Dr. Evans just wanted me to meet Dr. Cohen and have him evaluate me before starting treatment just in case I ever needed a neurosurgeon (which freaked me out only a little).  The appointment was very easy - I didn't even have to change into a gown (one of the few doctor's appointments I've had recently that didn't involve at least one boob flash).  Dr. Cohen just asked me to do simple stuff like touch my toes, walk on my heels, etc.  He asked if I've had any pain in my back or any numbness or tingling (I haven't).

After this quick exam I went into his office where he told me that from a neurological standpoint I was perfectly healthy.  He said he considered the two spots on my spine "benign" - which doesn't mean that they were not cancer, just that they do not currently pose a threat to my spinal cord.  So that was good to hear.  He said he didn't even feel the need to order an MRI, but that if Dr. Evans did, which he expected (and he turned out to be right about that), he would take a look.  But all in all, it was a very easy appointment and I was in and out of there pretty quickly.

The following week I got a call from Dr. Evans' office that radiation would start on Tuesday, Sept. 7th.  But first, I needed to have an MRI, just as Dr. Cohen predicted.  So on the Friday before Labor Day weekend, I went to the imaging place for the MRI to my spine.  Isn't that how everyone kicks off a holiday weekend - with a medical test?  Oh, it's just me? :)

After waiting AN HOUR (at least they warned me and at least I had a book!) they finally called me.  This MRI was just like the others.  I had to lie still while the magnets clanged above me, though I had earplugs as usual, and then halfway through they gave me an injection of contrast through an IV before I had the second set of "pictures" taken.  Ever since my 6-needle-stick day I've been a little nervous about getting IVs since I know my veins are shot and I only have one arm available.  But luckily the technician got it on the first try.  Whew!

The Girl With Seven Tattoos

Now that surgery is behind me (whew!) it's time to turn our attention to the next step in my treatment - radiation.

A couple weeks ago I added yet another doctor to my repertoire when I met my radiation oncologist - Dr. Evans - for the first time.

After doing a physical exam, Dr. Evans sat down to talk to my parents and me.  He said he was already very familiar with my case, as he was present at the "tumor board" meeting where Dr. Sara had presented my situation after the two spots on my spine were discovered.  He told me that in the meeting Dr. Sara said that I was young, strong and motivated, and that he felt very strongly that these two spots to the spine should receive treatment, despite the fact that typically, a case like mine would not call for treatment to the bone.

The thing is, even though my bone scan came back negative, meaning it did not show evidence of active cancer cells, these tests are not foolproof and it doesn't mean that there are not still microscopic cells remaining even after the chemo.  Just as my PET scan before surgery did not detect any active cancer in my liver, but the pathology report following surgery did find microscopic cells, the same could very well be true with these two spots on my spine.  So we are not taking any chances and are going to blast those suckers with radiation to try to kill any cells that may possibly have survived chemo.

Of course, I will also need radiation to the breast, for the same reason.  I have always known I would need radiation, because radiation treatment is indicated in cases where the tumor is larger than 5 cm, which mine was.  And especially since my post-surgery pathology report found a fair amount of cancer still remaining along with positive lymph nodes, well it is all the more reason to blast the area with radiation too in order to kill any pesky cells that may have remained.

However, Dr. Evans said that the priority is to treat the spine first.  Unlike the breast radiation, in which I will have to go for treatment for about a half hour every day for 6-7 weeks, the radiation to the spine will take place in a total of 2-5 sessions, each of which will be about an hour or so in length.

The first spot will likely be treated in just one session, since it is not located near the spinal cord and therefore is safe to blast all at once.  However, the second spot is located much closer to the spinal cord, and so to be safe, treatment of this spot will probably take place in 2-4 sessions.

As far as side effects are concerned, Dr. Evans said that I will not feel anything during treatment - it is like getting an x-ray.  However, I may feel some fatigue as treatment goes on, and I may notice some scratchiness in my throat or lungs for a day or two after treatment.  Since one of the spots is located close to my spinal cord, there is also a very low risk (Dr. Evan said less than 1%) of paralysis.  But I am not really worried about this because the risk is so low.

I asked Dr. Evans what the "measurement of success" will be, i.e. how will we know if the radiation worked.  He said that I will have a PET scan following treatment, but because of the radiation itself can skew test results, we have to wait at least 3 months after treatment is complete before we can get an accurate reading.  Since my last PET scan did not show "active" cells, but rather two areas that appeared to have already been treated, between you and me I think we will know if the treatment worked when the cancer either doesn't come back or it does.

The first step in the treatment is to have a "treatment planning CT scan," which was scheduled for the day after my appointment with Dr. Evans.

Who Likes Liver Anyway?

Has it really been three weeks since my last post?  Oops, I guess I have been neglecting my blog during my recovery, but better late than never, right?

The truth is, a lot has happened in the last three weeks, and while recovery is going well, my energy levels just haven't been back to normal yet and I haven't really had the necessary combination of time and concentration to sit down and write until now.

So where did we leave off?  Oh right, I was just about to go in for my second surgery, to have part of my liver removed. 

The night before my surgery, my parents and I once again stayed overnight at the Holiday Inn just a couple blocks from the hospital, because I was due to arrive for surgery at 6am Monday morning.

We reported to the 5th floor Ambulatory Surgery department right on time.  Soon they called me back into the pre-op area, which I am now pretty familiar with.  They took my vitals, asked me all the same pre-op questions as last time, and asked me to change into a gown.

Then my parents were called back and we waited just a short time before the anasthesiologist came by.  She took me directly back to the OR, giving me a shower cap to put on my head along the way, and then set me up on a gurney in the hall just outside the OR doors.

She mentioned that I was very young for this surgery and went through the general plan for anasthesia.  She said once we were in the OR she would give me something to relax me (she said she's a good bartender!) and then once it was time she would of course put me completely out.

Then, someone came by to insert my IV - and they got it on one try this time, thankfully!  I also saw Samantha, who is my plastic surgeon's PA and was there to do the first expansion in my tissue expander while I was under anasthesia.  And of course, Dr. Attiyeh came by as well to see me before surgery.

I didn't have to wait long before they were ready for me and once again, I walked into the OR, trying not to look around too much, and climbed up onto the operating table.

I don't really remember much after this.  I do remember the anasthesiologist saying that she was administering the drug that would help me relax and I thanked her for this.  She said "I told you I was a good bartender!" and I don't remember anything else after that.

The truth is, I don't really remember much about the rest of that day.  I only have vague flashes of being in the recovery room.  I remember my nurse had curly brown hair, but I don't remember her name or anything else.  I remember when she gave me the clicker that I could press to give myself a dose of the painkiller they had me on, but I was too out of it to understand the instructions.  Not that they were hard - I just had to press it when I felt like I needed it, but I could only press once every 8 minutes (well, I could press the button as many times as I wanted, but it would only actually give me a dose once every 8 minutes).  This method is called a PCA - patient controlled analgesia.

I wasn't too keen on the PCA because I couldn't stay awake long enough to give myself enough doses to kill the pain.  So I would click, fall asleep, wake up in pain, click, fall asleep, wake up in pain, etc.  I kind of wish they would have just put me on something that I didn't have to think about, but oh well.

Anyway, unlike last time I did not have to wait in the recovery room for several hours for a patient room to open up.  Before leaving the recovery room, I remember the nurse expressing a bit of concern that I hadn't been pressing my PCA... but I was not even "with it" enough to think about pressing the PCA at that point.

Once I was in my room I mostly just slept.  When I did wake up, I was in pain.  It felt like I had had the absolute worst ab workout you can possibly imagine.  The most annoying part was that I couldn't take a deep breath because it hurt too much.  So when I woke up, I would instictively try to take a deep breath, then get frustrated when I couldn't, and the only way to not feel the pain was to fall back asleep, so that is what I did.

Emily is home!

I am happy to report that Emily was discharged this morning and is now home at our parent's house. She was able to go home sooner than expected! She is doing well and managing her pain. After she rests up for the next few days she'll be back with a blog post probably some time next week. Thanks for checking in on Emily!

Surgery #2

Hello Emily supporters! This is Sara again writing in to report on Emily's second surgery. Emily is out of surgery and her surgeon said everything went according to plan. Our parents met with her in recovery for a few minutes (until the nurses reminded them of the five minute time limit). She is in pain and groggy, as expected, and will be moved to her patient room soon. Once she is moved to her room our parents will be able to visit with her again. Since this surgery is a bit more invasive than the last, she will be in the hospital until Thursday or Friday. Thanks again for all the support and well wishes for Emily!

One Down, One to Go

I'm about a week and a half out from my mastectomy and it's already time for surgery #2, which will take place tomorrow morning, Monday, July 19th.  But now that I've been through one surgery, I know a little more what to expect. 

On the day of my mastectomy, my parents and I arrived at the hospital early - at 6:15am as requested.  We had to report to Ambulatory Surgery on the 5th floor - the same place I had to go for my liver biopsy months ago.  I signed in and took a seat with the other surgical patients and their families in the waiting room.  After a short time they called my name and I headed back and took a seat in one of the recliners in the "holding area" for surgery patients.

I got my wristband, changed into a hospital gown and then a nurse came by to ask me a host of standard questions.  Then they called my parents to come back and wait with me.

I didn't have to wait long, luckily.  Shortly after my parents arrived Dr. Samson came by to "mark me up".  He made a series of markings on my body with a purple marker - not places where they were going to cut (thankfully, because there were a lot of them!), just markings to help guide things I guess.

Then, the anasthesiologist came by to introduce herself.  She asked me a few questions then explained that I would be given a series of anasthesia drugs to keep me out for the duration of the surgery, and that they work as needed as far as duration - so once surgery is over, she can pretty much flick a switch to wake me up.  Of course, due to my anasthesia awareness fear, I asked if she could ensure I wouldn't wake up in the middle of surgery and she said that there are all kinds of monitors on me - heart, brain, etc. - that she keeps track of to make sure this doesn't happen.

I had to sign another consent form  for the anasthesia and then it was time to go.  I said goodbye to my parents and walked with the anasthesiologist back to where the operation rooms are.  Along the way she gave me one of those shower caps to put on my head to cover my G.I. Jane hair.  Then she led me to a gurney in the hall where I laid down. 

Since Roosevelt is a teaching hospital, a first-year resident was tasked with inserting my IV.  He was very determined but had a bit of a hard time... he did stick the inside of my elbow but I think he missed the vein or something because I don't think any blood came out (I'm not exactly sure because I didn't look).  The anasthesiologist came over to take a look and she took that IV out and put the IV in the back of my hand, apologizing along the way.  It really didn't bother me at all though because I am used to needle sticks!

While this was going on, Dr. Rosenbaum Smith came over all ready in her surgical scrubs and mask.  She said "fancy meeting you here" and asked how I was.  I said I was OK and she said that when I got into the OR, there would be a lot of people coming at me to put various monitors on me, but she said "don't worry, we won't do anything important until you're asleep in your happy place."  It was very reassuring to see and talk with her a bit.

Once the IV was in place I stepped down from the gurney and then walked with the doctors into the OR. I didn't look around too much because I was afraid of seeing a tray of scalpals or something that would freak me out.  But I did notice that the room was really large and very very bright - much brighter than how it looks on TV!  They asked me to climb up on the operating table and told me where to put my head.  Then I had to shimmy a bit here and there to get into the right position.  Dr. Rosenbaum Smith was right about various people coming at me to hook me up to monitors.

Then she said, "so where is the happy place you'll be going to?" and I said Bora Bora.  She said that sounded lovely and asked if I'd ever been there.  I told her that I'd been there twice since I have a client there and she said she wishes she had clients there too and that is the last thing I remember!  My parents later told me that when she came out to meet them after my surgery she told them that she thinks next time I go to Bora Bora I will need to bring my surgical consult.

The next thing I know, I felt like I was on a gurney that was being wheeled through the halls and I heard voices telling me to take deep breaths.  I felt like I was in a deep sleep and wasn't ready to wake up yet... like those mornings before school when my Mom would come to wake me up and I'd ask for "10 more minutes" (I never have been a morning person).  But then I remembered that I'd had surgery and I figured if people were trying to get me to wake up, I better listen to them.  So I made an effort to wake up and take deep breaths (even though I tried they still felt pretty shallow, but at least I was trying!).

When I woke up I found myself in the recovery room of the hospital.  I could only think of two things - one, that I really had to pee, and two, that I was really hot.  The first problem took a bit to fix - I felt like I had to pee but couldn't, which apparently is a side effect of anasthesia, but it wasn't too long before that system was back to normal.  For the second problem, the nurse took my socks off and affixed a fan to my bed to cool me down. Once these issues were resolved I realized that I did have some pain in my breast and upper arm.  The recovery room nurse, Rhea, asked me what my pain level was - I think I said 4.  She gave me a couple Percocets and they worked relatively quickly.

Surgery Day

Hello Emily Supporters! This is Sara, Emily's sister, writing in to report that Emily is doing great after her mastectomy today. The surgeons said she tolerated anesthesia just fine and that the surgery went just as planned. Our parents have been able to visit with her this afternoon and she has already been up and walking. Her pain is under control and she is actually a little bit bored! As long as she is comfortable she will be discharged tomorrow and will go to our parents' house to recover. Thank you all for the well wishes and all the supportive emails, text, etc. I know it means a lot to her to have such a supportive cheering section to help her get through this process!

Bone Scan Results - Extended Edition

When I think back to the events of last week, it all seems to be a bit of a blur.  My thoughts were almost entirely consumed by the news of these suspicious spots on my spine and what it could mean, but I also had to make room in my brain for pre-surgery testing and my last week of work.  Not to mention that I decided to refinance my mortgage (hey, interest rates are low!) AND got a toothache along with everything else.  I am not making this up, I swear!

My marathon of trips to the hospital (I graced Roosevelt Hospital with my presence no less than 5 times in three days) started on Tuesday.  First, I had a pre-surgery appointment with Dr. Samson, my plastic surgeon.  Dr. Samson's PA (Physician's Assistant) first had me sign several consent forms, then she went over my pre- and post-surgery instructions.  Pre-surgery instructions were mostly just to avoid certain medications (like aspirin) and don't eat anything after midnight the night before surgery.  Easy enough.

After surgery, I will have surgical drains - at least one, maybe two - that I will need to take care of.  I asked to see what they look like.  They are long thin tubes, part of which will be in my body, coming out of my underarm area.  The end looks like a hand grenade, and that is where the fluid collects.  I have to measure my "output" every day since that's how they will decide when it is time to remove them.  But typically, they stay in for about a week.  I think this is going to be a major drag because I'm not allowed to shower when I have the drains in.  No showering for a week???  I think I'll hold all visitors until they are removed!

They also recommend that you either safety pin the drains to your clothing or put them in a fanny pack.  So I will surely be styling after surgery with my G.I. Jane haircut, my button-down shirts and my fanny pack!  I will have to fend off the fashion photographers I'm sure.

After getting all of my instructions, Dr. Samson came in, did an exam and went over the surgery again.  Since I opted for an implant over the TRAM surgery, this means that I will have a temporary tissue expander inserted which will gradually be filled with fluid over a few "expansion" sessions until it reaches the desired size (i.e. until it matches my left side; I am not going to go for the Picasso look with one huge boob and one normal-sized one).  I also asked to see the tissue expander - it basically looks like a deflated implant with a medi-port in it, through which the expansion injections will occur.

Dr. Samson said when I wake up from surgery I will have some semblance of a "breast mound" but it won't be the same as the left.  So I guess I will be rocking the Picasso look for a little while.

Since I will need radiation following surgery, I will not be getting my permanent implant for quite a while.  As Dr. Samson had explained during my initial consultation, there is a risk that the radiation can damage the tissue, and so my "exchange" surgery - when they take out the tissue expander and put in the permanent implant - won't happen until at least 3 months after radiation is complete.  But that is OK as there is no real drawback to the tissue expander (especially once the size of it matches my left side!).

The PA gave my two prescriptions - for a painkiller (Vicodin) and an antibiotic - to have filled before surgery so I'd have them when I needed them, and then I was on my way.

The next stop was Dr. Rosenbaum Smith's office, to get my pre-surgery testing done.  Again, I had to sign a bunch of consent forms.  I was told to arrive at the hospital at 6:15am on the day of surgery and then I was asked if I wanted a private room.  Dr. RS's surgery scheduler, Jancy, produced a brochure that looked exactly like a hotel brochure (I know, since many of my clients are hotels) showing stylish rooms and advertising "south city views".  It all sounds very nice, but for $400 a night (during which I hope to be too drugged up to be able to enjoy any kind of view), I didn't think it was necessary.  I am just going to hope that I either have a quiet roommate or better yet, no roommate at all.  Maybe since it's a popular vacation week there will be a lot of doctors on vacation and so not as many surgeries scheduled?  One can only hope.

Bone Scan Results

This is just a quick post to say that MY BONE SCAN RESULTS WERE NEGATIVE!!!  Wahoo!

This means that there is no sign of active cancer in my bones.  Most likely, those spots that showed up on the PET scan were very small cancer spots that the chemo has now healed, although there is no way to know for sure if that is indeed what it was.

Even though we didn't know about them until after they were healed, it is still good that they were found, because now we can give those spots extra treatment (as a precaution) in the form of radiation.  In addition to radiation to the breast, I will also now get radiation to those two small spots on my spine as well.  It will be the new technique Dr. Sara mentioned last time that is extremely targeted and very precise and does not really have side effects.

I will write a longer post about my experiences over this past week soon, but right now I am too emotionally drained and exhausted to write any more.

But I do want to say thank you to everyone for all the amazing support and prayers I received this week.  All the phone calls, texts, emails, blog posts, etc., went a VERY long way in getting me through what was probably one of the hardest weeks of my life.  So thank you!

Curve Ball

Friday morning I had an appointment with Dr. Sara to find out the results of my PET/CT scan.  I think everyone - Dr. Sara included - expected that the results would show that the cancer in my breast and liver was no longer "lighting up" on my scans.

My parents and I were placed in an exam room and Dr. Sara came in shortly after.  He explained that he only had about 15 minutes to talk to us because he had to get to a conference.  I knew this already since his admin James had called me the day before to ask me if I could come in an hour earlier than my originally scheduled appointment time for this reason.  He apologized for not having more time, and said that he needed our full attention and concentration and that he would be very clear.  At this point I knew the news was not as simple as we all expected and my heart started pounding loudly in my chest.

Then he told us that the cancer in my breast and my liver was no longer lighting up on the scans. Of course, this is a good thing and what we expected.  However, the scans showed something else we did not expect: two small spots on my vertabrae.  When I heard this, my mind briefly flitted back to a time earlier this year when I'd heard - I think from Dr. Sara though I don't entirely remember - that when breast cancer has spread to the bones, it is usually considered incurable.  But I did not let my mind rest there, because Dr. Sara was still talking and I needed to hear what he had to say.

He said these are not new spots.  It appears that they have been treated by the chemo, which makes the bone denser and therefore they more easily appear on the scans.  He said he would not have expected any radiologist to find these small spots back in January.  He explained that the tests I had scan 3mm slices of my entire body.  I get the impression that finding these tiny spots would have been like finding a needle in a haystack.  But, now that the denser bone is causing it to show up, they knew exactly where to look and so they pulled my scans from April and January, and sure enough, they were there.

So what now?  It is not a clear cut answer by any means.  Dr. Sara presented my case at tumor board the day before, and, unlike the time he presented my case after the cancer in the liver was discovered, this time there was no consensus on what the course of action should be.  Many doctors would see evidence of the cancer in the bones, consider me incurable, and then change the course of treatment, possibly recommending that I not even go through surgery since the goal would no longer be to cure me, but only to treat the cancer and keep it at bay as long as possible.

Awaiting Surgery

It has now been three weeks since my last chemo treatment, and I'm currently in that period of "getting my strength back" before surgery.  So far, so good.  I feel pretty normal, and even went running again this past weekend.  Granted, I could only go a little less than 2 miles before I decided to walk - any further would have been pushing myself and I just didn't think it was necessary - but I was still pretty proud of myself for running at all.  I think I'll try again this weekend.

This past week I spoke to both Debra (Dr. Sara's nurse practitioner), and the nurse from my insurance company who calls me periodically to see how I'm doing (she's the one that sent me the cancer cookbook early on).  Both of them reminded me that the effects of chemo can last months, so it's totally normal if I don't feel quite like myself yet.  It got me thinking:  the truth is that I THINK I feel normal now, but what if I've forgotten what "normal" really feels like?  Oh well, it doesn't really matter.  I think I feel pretty good now (maybe still a little more tired than usual), so if I feel even better in a few months, well all the better for me.

Of course, surgery is right around the corner.  Only two weeks from today.  I have had months to "prepare" for it, but how do you really prepare?  I'm going to be unconscious after all.  I think I'm about as ready as I'll be.  I have never had any major surgery before and have never had anesthesia, so I'm a little uneasy about the unknown.  As much as I've talked to and read about people who've had surgery, I still don't really know exactly what to expect.  But, a lot of people have told me the anticipation is usually worse than the reality, and so I am trying to keep that in mind and I hope they are right!

I have one irrational fear when it comes to surgery.  I know I should be more worried about valid things like pain, but the truth is that I am a little scared of "anesthesia awareness," which is when patients wake up in the middle of surgery and can hear their doctors talking, etc., but most often can't speak up to say anything.  That sounds absolutely terrifying to me.  Ever since I read a news article about this happening to someone years ago, it's always stuck in mind as one of the things I'd be most scared of if I ever needed surgery.  And, of course, it happened on an episode of Grey's Anatomy this year, so that didn't help matters!  But, I've been told that it's very rare, and most often if it does happen the patient doesn't even remember it afterwards.  So, I've been trying to remember that and I think it's working.  I haven't been thinking about it too much lately (luckily).

I have been thinking a lot about how my body will never look the same after July 7th.  It's a big part of that "unknown" I'm facing.  Of course, I've seen photos of what reconstructed boobs look like, but I think it will be a different thing completely to look down and see it on my own body - the one I've had for 32 years.  Granted, in January my right boob started looking a little different thanks to the cancer, but the chemo has killed so much of the cancer that it looks pretty much back to normal now.  It's a little sad, of course, that just when it gets back to normal it has to come out, but I won't be holding any farewell parties for my boob.  It's necessary that it be removed and so it will be.

In addition to the mental preparation, I've also been getting ready for surgery and recovery from a practical standpoint.  Next Friday, July 2nd is my last day in the office before I go on medical leave for 4-6 weeks, so I've been busy getting things in order and making sure my co-workers have all the info they need to cover things while I'm out.  Two days before my surgery - July 5th - will be 10 years to the day that I have been in my career, and I don't think I've ever been out of the office for more than 10 days or so.  So it will definitely be weird to be out for several weeks.  I like my job so I know I will miss it, and I'll probably get bored pretty quickly, but I'm going to do my best to relax so I can recover quickly and get back to it.

Completing Chemo

I can't believe it's been a whole month since my last blog post! The reason for that is that not much was happening in Cancerland, which I guess is a good thing. After Chemo #5, I had the usual fatigue, which was a little worse than the previous treatments (to be expected since chemo is cumulative) but still not unbearable. I kept up my streak of not missing any workdays other than treatment days and after a few days I felt fine again.

I even went on a business trip to L.A. in late May - my first time on a plane since January (for me, that is a long time). It felt good to travel again and do something that was such a key part of my pre-cancer life. The truth is that largely, my day-to-day life has not really changed THAT much since my diagnosis, but there are some things like traveling, exercising, doing my hair, etc., that have been missing and as trivial as some of them are, I still miss them.

The trip was great and the only "cancer experience" I had was going through security at LAX. I wore my "chemo caps" on the plane because I thought I'd be more comfortable wearing a hat rather than a wig for such a long flight. But in LA, after I put my luggage on the conveyor belt and walked through the metal detector, the TSA agent asked me to remove my hat. I gave her kind of a blank look and said "Wha-at?" She repeated herself and then I said awkwardly that I didn't have any hair, and she quickly realized the situation and frantically said that was fine, I didn't have to take it off and she could just pat me down. So she patted my head (which was a little weird, and what she thought I could possibly hiding under there is beyond me) and then sent me on my way.

The weekend after my L.A. trip was Memorial Day weekend (also known as my birthday weekend), and my family and I spent it at the shore, as we do every year.  Since chemo is coming to an end, I have started thinking about when my hair will start coming back.  Dr. Sara said it would probably start coming back about a month after my last treatment, though my Chemotherapy and You book says it takes about 2-3 months for it to start coming back. 

In any case, I had still never completely lost all of my hair, though it was so thin that I felt like without a wig, hat or scarf to cover my head, I looked like a 70-year-old man with a bad combover.  In addition, the hair that did remain was not my normal, healthy hair; it was very thin and brittle.  My sister called it "troll hair" because I could make it stand upright on its own, just like those little troll dolls that used to be popular.  So when I started thinking about my hair coming back, I started imagining new, nice, healthy hair commingling with the old troll hair on my head and that did not conjure a pretty sight in my brain.  So, I decided to go ahead and shave my head.  My brother-in-law Kevin graciously volunteered to do it and so he borrowed his dad's beard trimmer and the day after my birthday, after a long day at the beach, he shaved my head.  Here's a picture of Kevin at work (yes that is my goofy sister Sara in the background):

I think he did a great job, don't you?  I know that the head shaving party can be an emotional event for a lot of cancer patients but it was not so for me because I had already lost so much hair and had already been living with wigs, etc., for so long.  And now that I have a shaved head I kind of wish I'd done it sooner.  I'm much less embarrassed of my G.I. Jane look than I was of the "troll hair."  Not that I'm going to start ditching the wigs and hats and "go commando" on my head, but if for example a hurricane-force wind suddenly came along and blew my wig off, well, it wouldn't be the end of the world.

Not So Fast

Just when I was starting to get used to the idea of the May 20th surgery date... Dr. Sara throws me a curveball (not a bad one though)!

On Friday morning, I had an appointment with Dr. Sara, and also a Herceptin treatment.  After my usual physical exam (three boob flashes), we talked about my test results.  Dr. Sara said he'd just been on the phone with the radiologist who examined my scans, and the radiologist said there was a "more than 80% improvement" in the breast, and he also said that the cancer on the liver is no longer showing up as "active" (which we knew).

Dr. Sara said he was extremely pleased with the results (and so am I!).  Then he said that because the chemo is working so well, and because I am tolerating it so well, he has decided that instead of sending me to surgery now, I will have two more rounds of chemo to try to reduce the cancer even more.

This is NOT a setback - again, it's because I've had such a tremendous response to the chemo.  In the beginning, Dr. Sara had said that the goal is to go to surgery with NO cancer if possible.  And because I had such a large mass, it's not something that can be knocked out in 2-3 treatments, so it's totally normal to go 6 rounds.  Plus, relatively speaking my side effects have been pretty manageable - I still have not had to miss any days of work because I don't feel well due to chemo side effects.  This all played into Dr. Sara's decision to give me two more rounds of chemo before I have surgery.

So now, I have a little more time to prepare mentally for surgery, which will not take place until late June or early July.  And although two more rounds of chemo means more fatigue, dry mouth, and fogginess side effects (which may get worse since chemo is cumulative), and although this means I will have to wait a few more weeks for my hair to start growing in, I am not disappointed in this change of plans.  Instead, I am happy that my test results are so good and my side effects have been manageable enough to allow for a more aggressive treatment.  I'm all about blasting the cancer with as much ammunition as we can.  I want every last possible cell to be killed or removed so that the chances of some of those cells lying dormant and reactivating in a few years is lowered!

And The Results Are In...

Today I saw my breast surgeon Dr. Rosenbaum Smith, and found out my test results.

The spot on my liver is clear, and the tumors in my breast are about half the size they were in January.  The largest was 6cm x 4cm when I was diagnosed, and it's now 3cm x 2cm.

WAHOO!  This is obviously really, really great news, and it means the chemo did it's job.  Of course, it is what I expected, since Dr. Sara had said he didn't anticipate any surprises, but it is still exciting to know for sure!

This means that I am most likely ready for surgery, and in fact, my surgery has been scheduled for May 20th.  Unbeknownst to me, Dr. Rosenbaum Smith had already set aside the OR time when she learned my last chemo was scheduled for April 14th, since it's easier to have it scheduled and cancel or postpone if need be, rather than try to get it scheduled last minute.

So, unless Dr. Sara (who is currently traveling) sees my test results and decides for some reason that he wants to give me more chemo before surgery (not likely), this means that I am DONE with chemo!  I will see Dr. Sara on Friday morning for a Herceptin treatment and will know for sure then.

I also have an appointment on Friday with Dr. Attiyeh, my liver surgeon.  I should find out then whether this will be one surgery, or two.  If it will be an open surgery, most likely it will not be done at the same time, but if it can be done laproscopically, it may be able to be done all in one.  Dr. Rosenbaum Smith said she has a feeling it will wind up being better to do two surgeries (breast first), but I will know more on Friday.

I've also gone ahead and made an appointment with Dr. Samson, my plastic surgeon, for next Tuesday.  This is when he'll go over the surgery again and discuss the pros and cons of silicone vs. saline, the next decision I will have to make.

Speaking of decisions, over the last several weeks, I have come to the decision that I am going to have a single mastectomy.  It is just the right decision for me.  While I think that all of the reasons some women elect a bilateral mastectomy are valid, I just do not feel strongly enough about them to choose that for myself. 

I decided that I'd like to keep it natural on the left side.  Two things that played into my thinking were the fact that I will lose feeling for at least a year, and maybe forever, in my right side, and I decided that I'd rather not lose feeling on the left side if I don't have to.  Also, if I ever want to be able to breastfeed in my life, I still have the option if I leave the left side natural - a very big IF to be sure, since it's possible I won't even be able to have kids after my chemo regimen, but having a new baby in the family made me think a little more about this, and I'd like to keep that option there.

Dr. Rosenbaum Smith said the surgery will take about 4-5 hours all together (assuming it is just the mastectomy and reconstruction).  During the surgery she will also take my lymph nodes.  There are three "levels" of lymph nodes, and my case calls for the removal of all level 1 and level 2 lymph nodes.  I will likely only have to stay in the hospital for one night, maybe two.  As for the recovery, everyone is different, but most likely it will be two to three weeks before I will be able to go back to work.

Of course, I'm very pleased with this news but also a little overwhelmed that surgery will most likely be only a little more than two weeks from now!  I know I've had months to prepare, and I think I'm ready (well, I have to be since I don't really have a choice), but it still feels very soon!  At least I have the next two weeks to get the rest of my mind around it.

In other news, this past weekend was the Revlon Run/Walk for Women.  We had a GREAT day, with beautiful warm, sunny weather!  Although the day turned out feeling more like August than April, the walk was early enough that it wasn't too hot.  I got there a little early so I'd have time to fill out the signs and have them pinned to my back.  I had to visit the "Survivors Tent" for the first time, but certainly not the last, for the first one.  Check it out:

Here's a picture of our team:

And here is me at the finish line:

It was a great day for a good cause!

Tests Galore

First of all, THANK YOU to everyone who came to our Hawkettes happy hour fundraiser last week, and to everyone who donated online to our Revlon Run/Walk page.  We raised $700 at our fundraiser, and last I checked our team's online donations had raised another $1100, so that is $1800 we've raised for this good cause!  I'll be walking proud on Saturday at the Run/Walk.  Thank you all again.

Yesterday was my long day (almost 6 hours!) of tests, but the true "test experience" really started the day before.

To prepare for a PET scan - one of the three tests I had yesterday (the other two being a breast MRI and a CT scan) - I had to follow a low-carb diet the day before.  It's restrictive enough that instead of giving you a list of things you CAN'T eat, they give you a list of the things you CAN eat.  If it's not on the list, chances are you can't have it.  I couldn't even chew gum!

Here's the list (yes, it's short enough that I can type the whole thing pretty quickly):

Veggies: green leafy veggies, bell peppers, cucumbers, carrots, broccoli, alfalfa sprouts, asparagus, beets, onions, mushrooms, zucchini and cauliflower.

Protein: tofu, beef, poultry, seafood, goat (Seriously?  I can't chew gum but I can eat goat?), lamb and pork.  (Note, being a vegetarian who doesn't really like tofu, this entire category was eliminated for me.)

Dairy: cheese, butter or margarine, milk, cream, fat-free yogurt and eggs.

Fruit: lemon, tomato, avocado, apples, plums, blackberries and olives. (NO fruit juices)

Yep, that's it.  Actually, it wasn't really that bad.  I had to forego my usual oatmeal for breakfast in favor of yogurt and blackberries.  I had a salad for lunch (balsamic vinaigrette is the only dressing allowed, and that I only found out via Googling, since there were no dressings on the list), and I even went to a couple different places near my office before I could find milk sold in a single serving (since Diet Coke was NOT on the list).  And then I made an omelette with cheese and veggies for dinner.  Special thanks to my brother-in-law Kevin for giving me "omelette lessons" over the holidays this year - who knew they would come in so handy!

So anyway, I followed this diet on Tuesday, and then I wasn't allowed to eat anything at all after midnight, and couldn't even drink water in the 4 hours prior to the exam.

Fourth and Final (hopefully...)

Last Wednesday was my fourth, and most likely my last, full chemo session.  WOOHOO!!!

I say "most likely" because there is a small chance I will need more depending on the results of my next tests - a PET scan, CT scan and MRI - which are already scheduled for next Wednesday, April 28th.  But Dr. Sara said that he expects my scans to be "beautiful" - he said he is not expecting any surprises!

In fact, he told me to go ahead and make appointments with my breast surgeon and liver surgeon, since he's pretty certain that I am ready for surgery.  So, I will see my breast surgeon Dr. Rosenbaum Smith on Monday, May 3rd, which is when I will officially find out the results of my tests.  Then, later that week I will see Dr. Sara again and will have a Herceptin-only treatment, and then I will meet the liver surgeon Dr. Attiyeh.

After my tests and all of these appointments, I should have a better idea of exactly when surgery will be, whether they can do the breast and liver surgery all in one (or if it will be separate surgeries), and what my recovery time will be - all things I am anxious to find out.

Although I will most likely be done with chemo, I will still need Herceptin treatments for about a year, but it's nothing compared to chemo.  There are no real side effects to Herceptin - it doesn't make me fatigued, or give me dry mouth, or make my hair fall out, etc.  And, it's only a 30-minute IV which doesn't even require pre-meds - simple!

My last chemo session was pretty uneventful.  After my very encouraging exam with Dr. Sara (who was not accompanied by Debra the nurse practitioner or the fellow Dr. Dy - so only one boob flash!), I took my usual spot in the Infusion Suite, flanked by my parents.  The nurse put the IV in the underside of my wrist this time, which was not my favorite spot because it made my hand hard to move.  It also left me with an ugly bruise, which can happen wherever you get an IV, but it looks worse on the underside of the wrist because the skin is so pale.

The nurse started up the Herceptin right away after taking some blood, and Quincy then came along for a visit.  He was gearing up for a two-week trip to L.A. with his owner, who grew up there.  I imagine Quincy is probably a pretty well-behaved dog on a plane!

My bloodwork came back relatively quick and so the nurse didn't have to wait at all before giving me the Taxotere and the Carboplatin.  As a result, I ended up finishing much earlier than I usually do, which unfortunately meant that I didn't get a music therapy session in this time.  Bernardo had stopped by early in the day, and was planning to come back in the afternoon for my session, but I finished early!  I know my parents were really disappointed that they didn't get their music-playing time in.  :)

Since my last chemo, I've had the usual fatigue and that "feel like I'm getting the flu" feeling.  Even after sleeping 9 or more hours a night, I still feel run-down and have a general lack of energy, but it's been manageable.  I've still been able to go to work each day, and I still managed to go to my friend's baby shower this weekend.

It's been good knowing that I'm nearing the end of the first phase of treatment... I still have a long way to go, but now I can at least start thinking about the fact that in a month or so, my hair will start coming back, and pretty soon I won't be feeling this fatigue or the dry mouth side effects any more!  I know I'll be trading these nuisences for new ones that go along with recovering from surgery, but that is OK.  As long as I'm getting closer to the finish line, that is all I care about!

A Few Good Causes

It's getting to be that time of year when there are lots of 5K and other runs, walks and various events happening.  As a casual runner, I've always liked doing these races, and usually do a couple a year.  I always did them more for the fun of it and as a motivation to reach some kind of running goal, but they always have some kind of charity tie-in which a portion of the entry fee goes to (and which the organizers encourage runners to vigorously fundraise for).

Of course, I now have a renewed interest in the charity tie-in part of all of these events, and there are many that benefit breast cancer groups.

One in particular is the 5K Revlon Run/Walk for Women which takes place in New York City every May.  I've actually done this race for the past 3 or 4 years.  At first, a friend and I ran it together, and then about two years ago, my office decided to get a team organized and we all did it together - some running and some walking - with outside-the-office friends joining too.  The race starts in Times Square and ends up in Central Park and I've always enjoyed running it (when else would the streets of Times Square be closed so I could run without fear of getting run over by a cab!).

Although the charity aspect was always secondary in my mind - really I was running it for fun and exercise - I always would get one of those "I'm running in remembrance of..." signs to pin to my back with my grandmother's name written in (she died of breast cancer when I was 2 years old).

This year, of course, it means so much more.  This year, when I registered, I checked the box to indicate that "I am a cancer survivor."  I never in a million years thought I'd ever have to check that box, but here I am.  I even debated in my mind of whether I really can be considered a survivor yet - after all, I haven't beaten cancer yet; I'm still fighting.  But there was no "I am fighting cancer" box to check and I figured I am a survivor so far, so I went ahead and checked the box.  This year, I'll need two signs to pin to my back - one for my grandmother, and one for my own fight.

The Revlon charity actually has even more meaning for me than just raising funds to fight breast cancer.  As regular readers of this blog know, I am on the drug Herceptin, a drug which has proven extremely effective against Her-2 positive breast cancer.  Back in the late 80's/early 90's when Herceptin was being developed, the drug company stopped its funding at one point, and the Revlon charity stepped in and provided initial funding to keep the research going. 

This drug is quite possibly saving my life as we speak, so supporting the charity the helped research continue suddenly has a whole new meaning for me.  Who knows what other drugs are in development now that my donation - however small - might help further along and save the lives of other cancer patients 5, 10, or 15 years from now?  So, I'll be participating this year with a whole new perspective.

And since taking part in this event this year has a whole new meaning not only for me, but for those that know and support me, my office decided to take it one step further this year.  Instead of merely organizing a team to take part in the Revlon Run/Walk this year, my co-worker Kristin had the great idea to do a happy hour fundraiser to help raise money for the charity!

It will take place from 6:30-9:30pm on Tuesday, April 20th, at Libation, a bar located on 137 Ludlow Street here in New York (between Rivington and Stanton Streets).  $40 at the door includes 3 hours of open bar and a donation to our team.  If you are in NYC, I invite you to come and bring friends - the more the merrier!  It will be a great night for a good cause.  And a huge thank you goes to Kristin for organizing it!

If you can't make it to the fundraiser but would still like to donate, you can do so by making a donation to my fundraising page here or to our "Hawkettes" team page here.

I've been truly humbled by how my fight with breast cancer has inspired friends to get involved too.  Two of my friends - Lori and Bernie - have decided to participate in the Avon Walk for Breast Cancer taking place in New York City in October.  This is no simple 5K - it's 39 miles over two days, and there is a substantial fundraising requirement that you have to commit to when you sign up. 

Lori and Bernie have started a team for the Avon Walk called Emily's Entourage.  Anyone who's interested in joining their team or making a donation can visit the team page here.

My sister and several of her friends in the Washington, DC, area, have also started an Emily's Entourage team for the Susan G. Komen Race for the Cure taking place in June in DC.  They're even getting Emily's Entourage t-shirts made!  Their fundraising page is here.

And my friend Dana is participating in the Susan G. Komen 3-Day for the Cure in Philadelphia.  She will be walking 60 miles over 3 days to raise money for breast cancer research.  Her page is here.  And Dana's sister Debbie who lives in Atlanta just signed up for the Atlanta Race for the Cure - we're blanketing the East Coast!

The fact that my friends are willing to make these commitments to run, walk and fundraise in my honor is truly amazing and means so much. I cannot possibly thank them enough!

Welcome Claire!

We interrupt our regularly scheduled cancer programming to bring you a much, much happier topic. 

On Friday, April 2, at 7:11pm my niece Claire Elizabeth was born!  She is 7lbs, 12oz. and is perfect.  Mother and baby are both doing well!

She was born with hair - the consensus is that porportionally speaking, Claire and I probably have about the same amount of hair.  Although I was looking forward to no longer being the one in the family with the least amount of hair, I've decided not to hold this against her.  It may have been a different story if she was born with more hair than me, though.

As I was picking out the "It's A Girl!" balloon to bring to my sister's hospital room, I asked my Mom if she's going to bring me an "It's A Boob!" balloon when I'm in the hospital for surgery.  I don't think I should hold my breath waiting for that one.  :)

Without further ado, here are some pictures:

Isn't she adorable?

Me with my new niece (and my relatively new hair).