Sunday, June 27, 2010

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.

Wednesday, June 23, 2010

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.

Wednesday, June 9, 2010

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.