It's Been Brought-en!

Hey all~

Got a surprise late afternoon phone call from a woman who felt it necessary to call me. She had the radiologist's report in-hand (from my MRI this morning). In June, my main tumor (the "Big One") measured 4.0cm x 2.9cm x 2.5cm. She wanted to call to tell me some good news - the type of news she could tell I hadn't gotten much of along this journey thus far. I am so thankful she decided to call; she didn't have to today.

First of all: AAAAAAAAAAAAAHHHHHHHH - yes, Yes, YES!!! The best news so far along this journey:

The Big One is now measuring in at: 2.4cm x 1.7cm x 1.5cm. A decent decrease is now evident in the metabolic activity of this crap inside of me. Hallelujah! All other areas of enhancement (in my breast and my effected lymph nodes) on the MRI also show similar decrease in size/activity.

I feel like my roller-coaster chemo ride is vindicated by this news. And it is awesome to have solid, non-biased evidence that I have dealt this cancer crap a swift round of jab-cross-hook-uppercut punches! After an exhilarating weekend recharging and reconnecting with Joshua, and now this dynamite news, I am ready not only for tomorrow's chemo session, but for the remaining two treatments afterwards. Bring it. 

In case I forget or am feeling low, this mug reminds me:
I have the strength.

Just Putting it Out There

This morning brings MRI appointment #2. This is the first MRI I've had done since beginning chemotherapy. I'm hoping for and thinking of great results...that the cancer is slowing/stopping metabolic activity. (Especially since the ultrasound did not show it shrinking at all.)

So...please put it out to the universe, your higher power, general thought process, or whatever that the results from this MRI will be in my favor. After all, I've been working hard to go with the flow of the effects of chemo to help eradicate this stuff - or at least give me a good head start in the fight! :)

We should know the results in 1-2 days. We'll be sure to share them here.

Revisiting Breast Reconstruction

To be sure, Laura's number one priority is eliminating cancer from her body. So, she endures the long hours and side effects of chemotherapy and is preparing for the surgery that most likely will take place near the end of October. But, as with most challenges Laura has faced, she is doing so much more, most of which has already been described in this blog, including her strict diet of fresh vegetables and other foods that combat the acidity in her body in order to strengthen her immune system. She is also trying alternative therapies offered and recommended for cancer patients and it is wonderful to see the peaceful and relaxing effects of the acupuncture and Reiki sessions offered to BC patients.

Since this week afforded Laura an upswing in energy, she scheduled an appointment with another plastic surgeon yesterday. Earlier Joshua aptly described the August 11 appointment concerning advice about breast reconstruction, where it was recommended that Laura wait one year after her bilateral mastectomy before beginning reconstruction via a second surgery utilizing a latissimus dorsi flap procedure (using back muscles/tissue) or a TRAM flap procedure (using abdomen muscles/tissue).

It was a good thing we are now more familiar with the reconstruction options, because the second plastic surgeon talked very fast and we had to digest his information quickly! He was a "take charge" type of person (Laura liked that) and wanted to at least explore the first and more common option of inserting a tissue expander for implants at the time of Laura's first surgery - one he thought might be available if there was enough time following surgery before radiation and its effects on the skin. He immediately contacted Laura's oncologist, and based on the information he received, he called Laura to let her know that insertion of tissue expanders just might be an option. We were all happy to hear this bit of good news, as this option has an obvious emotional and psychological advantage. Of course Laura wants to fully consider the viewpoint and recommendations of her oncologist and general surgeon, since surgery and subsequent radiation is a vital part of Laura's treatment plan. So, we'll explore these options further during the next chemotherapy session on Tuesday.

All of this to say that Laura faces more decisions -- immediate reconstruction without knowing the effects of later radiation or delayed reconstruction with further surgery. Not an easy task. But she is up for it. She and Joshua are a fearsome team and they know how to handle one day, one issue at a time.

Inquiring minds want to know....what, exactly?

Since many of the people following this blog are curious by nature, I thought I'd inquire:

What questions would you like to ask me/us?

Is there something you want to know about my treatment?
About what I'm experiencing?
About Joshua and what he's experiencing?
Do you have any questions for the other blog posters (Eddie, Anneliese, Joe, Linda, Adam, Joshua)?
About breast cancer in general?

I have no idea what to expect to see in this blog post's comments, but if you have a question, ask. I'll/we'll do my/our best to answer questions in future blog posts. (Except for any crazy questions - we reserve the right to refuse, you know.)

Maybe we're putting so much information out there that there are no lingering questions. Still, my curiosity made me pose this question to the Ta-ta Times' audience.

So Much In Love

During our vows.

Last weekend marked a special day for our marriage: our 7 year anniversary. 

No great pomp and circumstance like our wedding day, but we both agreed that the weekend was a "good weekend." Which is a wonderfully positive thing for us! In these often unpredictable times as of late, it's hard to obtain a sense of true balance when the weekend comes. Joshua would like to spend it knocking off some to-dos, but mostly enjoying ourselves together doing the things that make us feel good. I, on the other hand, am usually Taskmaster General. It's hard to let go of the myriad of to-dos that exist and build in my mind while I'm experiencing the chemo roller coaster lows. This weekend, without really even trying, it seemed to be a perfect combination of both. 

We started the weekend by getting some to-dos done. That satiated me enough to move on to something more enjoyable. We talked together in the craft room - not a planned conversation, just one that happened (and sometimes that's the best kind). We also spent a few hours meeting with another BC survivor and her husband. They are where I'd like to click my heels and be right now - but can't. Spending some one-on-one time with them pumped us both up: we can do this! We gleaned so much from our time with them and feel as though a new relationship is budding. I'm so glad we reached out to another couple. 

On Sunday, while Joshua hooked up some speakers downstairs, I hopped on the treadmill and did hill intervals for an hour. It was low speed, but my heart was pumping and it felt great to not only be able to exercise, but to WORK my heart and lungs. It had been too long. We were both happy that my peripheral nerve symptoms had lessened significantly so I could exercise. Then we went to a Farmer's Market to meet up with a friend and her kiddos. How fun to get out, enjoy some sunshine (with SPF 70, of course), visit with a friend, and get local produce for the week. The remainder of the weekend included computer time for Joshua and an extended napping period for me. It was a good weekend.

This coming weekend, we'll head into the mountains for a couple of nights to have a delayed celebration of our anniversary. I'll be physically capable of more then and know we'll both really enjoy the time away together. It feels so good to still have those same feelings I did 7 years ago when I look into Joshua's eyes...and it feels even better to know our relationship has grown stronger with each passing year. 

I'm still so much in love with you.

"As we stroll along together

holding hands, walking all alone.

So in love are we two

that we don't know what to do

so in love (doo, so in love)

in a world of our own (doo, so in love)."

-from the 1963 hit So Much In Love by The Tymes

The Taxol Experience

No, I'm not frozen waving "hello" to you.
This is treatment #5, baby!

Getting Taxol treatments is similar to the AC treatments in some ways:

• I apply a Lidocaine blob to my port site prior to my treatment to numb the port area.
• A "sucker fish" needle is stuck into my port. 
• The port is flushed and several vials of blood are taken to make sure I can go ahead with another treatment and also check for other important markers.
• I'm given anti-nausea medication in addition to the rest of my meds via the port IV.

The ways in which Taxol differs from the previous four AC treatments is:

• I'm given a decent amount of Benadryl via port IV (not sure how much, but I want to find out) to mitigate any allergic reaction to Taxol.
• The Benadryl makes me a sleepy person! It was all I could do to go down my list of questions during the office visit with my oncologist. I hope to try to see her before the full effect of the Benadryl is upon me next time - I was loopy and thankful that mom took notes. All I wanted to do was hand off my list of questions and slink down onto the exam to take a nap.
• The entire treatment time is ~5 hours.
• I eat and drink a bit between naps and wake up to various other women receiving their treatments sitting in recliners across from me. Kinda weird when you see one person, close your eyes, open them again, and poof!--there's a different person sitting in front of you. What happened?
• Taxol should be easier on my system (less anti-nausea meds since it's "easier" and therefore should give me less constipation problems). This doesn't seem like a big deal until it's a problem. Then this is a VERY BIG DEAL. It's also not a double whammy of meds, which is also a nice thing for Laura-the-chemo-patient.

The day after my first Taxol treatment, I felt like a star! I drove to my appointment that morning for my Neulasta shot (to get my WBC count up). Gramma Birch came back with me to see it happen; she's a sport! Pretty uneventful, though...the shot takes <1 minute and then they Band-Aid me up and send me packing. I ran an errand afterwards with my mom and Gramma, then came home to eat. After eating, I could tell I was getting tired. So once I had digested lunch, I settled down for a nap and slept a couple of hours. The rest of the evening I felt fine.

Then it was Thursday. Ugh! Thursdays are tough. I forget how cumbersome it is to be in pain all day: bone pain set in. What's bone pain? That's what I wanted to know when the oncologist's nurses were telling me about side effects of the Neulasta shot. Their answer: "Oh, you'll know when you're having bone pain." Indeed. There is nothing quite like it and if you don't know what it is yet - quit wondering when you'll experience it! Nearly all touching is off limits: hugs, pats on the back, laying down, sitting back, etc. Seems like each time I get one of these shots the bone pain goes a little further. By that, I mean into more long, bone marrow producing bones. This time I'm also experiencing some joint pain, which is a first. 

Bone pain + joint pain = recliner time for Laura.

Today the bone pain is beginning to ease; the joint aches are not. Still, I'm feeling better than yesterday which is a positive in my books. These few days after treatment are predictably a low time for me. However, I'm happy to report that it's still better than AC treatment #4! That still wins out as being the ultimate crappy treatment thus far. 

One Day at a Time

It's been a busy week for us. Feeling good during my 2nd week post-chemo is wonderful. I feel as close to normal as ever and I want to conquer everything: bills, house work, fun with Joshua/family/friends, lots of healthy food, exercise, help mom continue to unpack, network with other survivors, attend BC appointments, and work on my wellness. It's a big list for such a (relatively) short time. Sometimes I'm overwhelmed by it all.

A big thank you for all of your cards,  uplifting emails,  surprise gifts, and  offers to help. It's just amazing to see support from near and far...and to feel that you mean it when you're offering. Joshua and I continue to navigate through the weird process of figuring out what we need - our space, fellowship with family/friends, meals, work around the house, etc. Just this week we had help from a couple of people to move our furniture and take a door off its hinges before and after new carpet was installed. It's so wonderful to know we have clean, safe carpet to walk and lay on. (We had an issue with one of our cats and that needed to be resolved ASAP as it was a hazard to my health.)

So now onto some bits of news to share:
(Disclaimer: yes, I know my bullets are long. But I don't care. Deal with it, self!)

• This week's ultrasound did not live up to expectations. The positive: my largest tumor is not growing - nor are the lymph nodes with cancer. Visually, my breast is different - it looks normal! We can all feel a big difference in my breast. The negative: the tumor has only changed shape and still measures the same as the original size.
• Next Friday or the following Monday, I will have a second MRI. Different from an ultrasound, the MRI will tell us about the metabolic activity of the tumors in my breast and lymph nodes. We expect to see lowered metabolic activity. My oncologist is sure of it, given the dramatic positive visual and palpable difference in my breast. I hope to see something drastic, people! And it'll be 'fun' to hear the loud magnets again. Did I ever post a picture of the MRI machine? If not, I will this time 'round.
• Met with a plastic surgeon last week. If you want to know more, check out the blog post Joshua wrote by clicking here.
• Today marks my first of four treatments of Taxol. I'll be getting this treatment every other Tuesday - four times total. Each treatment lasts 5 hours. It's a long stay, but I occasionally walk with my IV pole (to an exam room for an office visit and to take lots of pee breaks). They give me Benadryl via my port before administering the Taxol and that had quite a sleepy effect on me today. I took a few naps and woke up to seeing different people getting their treatments around me. Really missed out on some action! Dang. It helped pass the time, though. So far, I'm feeling well - I'd even say 200% better than my last treatment. We'll see what tomorrow brings, but today I'm happy about my first Taxol treatment.

I cannot say thanks enough to everyone for their support. Your love is shown in so many various ways! It is noticed. We do appreciate it. Please know that we read every comment on this blog, every email in our inbox, and every card in our mailbox. We do not have the time to respond to all of them, but we are thankful for you lifting us up with your strength in our times of weakness - and we do have those times.

For example, yesterday evening was a tough evening for Joshua and I: digesting the ultrasound results, talking together...getting into deep conversation. It's good to do this - to check in with each other and to dive into the reality of the situation. And once you've done enough and felt those feelings, it's good to "take a deep breath, pick yourself up, dust yourself off, and start all over again." (Lyrics by Dorothy Fields from the 1936 film Swing Time, for you movie buffs.)

The journey continues.

Meeting with the Plastic Surgeon...

Pema Chödrön posing as "Rosie the Riveter"

We had our first meeting with a plastic surgeon today. It had been awhile since we had thought about surgery and we needed to brush up on the breast cancer books we devoured early on in this journey to come up with pertinent questions. (It is a good idea to have an idea of what is going to be covered before you meet with a surgeon. One, so you are not surprised as to what will inevitably come up and two, because surgeons are usually very knowledgeable people and you want to make sure to have your questions ready -- the next time you see them could be in the operating room or immediately beforehand.)

A bilateral mastectomy sounds scary. And it is. This is the recommended surgery by Laura's general surgeon to remove as much of the cancer in her right breast and the remaining breast tissue to reduce the chance for recurrence. We've known this for some time. It is more common to have this type of radical surgery when a woman has a large tumor (check!), it is aggressive and fast growing (yep!), and the patient is young (we have a winner!); all because there is a higher chance for the cancer to come back. Put bluntly, the procedure permanently disfigures a person, which is why we were meeting with the plastic surgeon to discuss options for reconstruction. 

Laura, Linda, and I arrived at the office and were taken to a nice meeting room and waited patiently for the surgeon. There were implants on display which we played with and Laura found a three ring binder that had about 50 pages of pictures inside with women who had breast cancer and were proceeding through various phases of reconstruction. The photos were graphic and not easy to look at. This would definitely not be left in the room if you were there for a typical "boob job" (i.e. without cancer). You need to have a lot of backbone to look at those photos and know this is something you will also go through.

One of the more ideal situations for reconstruction after a mastectomy is to have "expanders" inserted into the breast at the same time the breast tissue is removed. The expanders have a large metal port and are injected periodically with saline to slowly stretch the skin. Following an additional surgery, the expanders are exchanged with a proper silicone implant. This is probably more similar to the typical "boob job," but breast cancer patients have to work with a lot less, since a lot of stuff (skin, fat, and tissue) is removed along with their cancer.

Along with breast tissue, fat and sometimes the outer skin on the chest will need to be removed depending on how the cancer has spread. In Laura's case, the cancer is near the surface and all around her right breast, which will make reconstruction difficult at best.

The goal of the general surgeon who will perform the double mastectomy is to get rid of all the cancer, including in the lymph nodes, and she will also be removing as much breast tissue as possible, to limit the possibility of recurrence. It only takes one cell of breast tissue to allow the cancer to come back and although it isn't always possible to get rid of it all, less is definitely better. It's important to have clean margins which will be determined through pathology tests post-surgery.

Unfortunately the goal to be cancer free sometimes comes in direct conflict with what the plastic surgeon would like for great reconstruction results. They want lots of healthy, supple skin left to work with. The other big negative Laura faces for reconstruction is that she will be undergoing radiation after her surgery. The radiation will lower the statistics of a recurrence, but also will likely change her skin. Radiation can tighten the skin, discolor it, and may rule out the possibility for using expanders. The plastic surgeon said it is likely that the left and right breast will not match exactly if the effects of radiation are severe. By massaging and moisturizing the irradiated skin, we can hopefully help keep the remaining skin supple and prepare it for reconstruction.

Without going into too much detail with regard to the many surgical options for reconstruction, the best option for Laura will be to wait one year following her radiation therapy before doing anything. This means Laura would not have breasts for a year. That is a tough pill for all of us to swallow, but we are ready to smile at fear.

Although there is a small chance that she could have enough skin left for expanders post-mastectomy, and that the skin would stretch after radiation, she is much more likely to have to undergo an additional surgery to have muscle pulled from her latissimus dorsi or tunneled from her abdomen to make up the reconstructed breasts. The loss of the muscle from this surgery is permanent, although patients can resume activities they did before, like lifting things and swimming, after many months of physical therapy.

Whether the type of reconstructive surgery be a DIEP flap, whereby only a few muscles are taken along with arteries and are then transplanted into the breast area, or one of the myriad of other surgeries is unknown at this point. We can only educate ourselves and meet with other plastic surgeons to get multiple opinions. Much of what will happen is dependent upon the outcome of the mastectomy and the ensuing radiation treatment/its effects on Laura's skin.

This was definitely a hard appointment for us all and throws cancer right back in our faces with all of its force and might, particularly for Laura. She lives with her cancer every day, without escape, and will likely do so for the rest of her life, until a cure is found.

We all look into the future sometimes thinking on a time when all of these surgeries will be behind us and Laura will be without the big C, but right now all we can and need to muster is to be in the moment. It is too easy to get sucked under and into the depths otherwise. Being in the present is the greatest lesson we are learning through this experience. All we have is right now. Be thankful for this moment, and that one. We are and so can you.

"In our sleep, pain, which we cannot forget

falls drop by drop, upon the heart,

until, in our own despair, comes wisdom,

through the awful grace of God."

— Aeschylus (Oresteia)

Adam

Adam in Seattle...displaying the ample comfort
of said recliner.

My brother has always been a generous guy. Still, I'm feeling quite "special" that he wanted to offload his coveted recliner here in Colorado on his way to New York. I've got it on a long-term loan, and am so appreciative to have a big, cushy chair to sit and sleep in. It's hard to be or get comfortable in the days immediately following chemo treatments. My stomach is "unsure," my body is weak, and I begin experiencing bone pain. All not fun stuff. This chair is really great to have - it can allow me to eat snacks throughout the day and nap soon afterwards while not technically "laying down" - a no-no. :)

It's impossible to just say "thanks for the recliner, Adam" without showing HOW the recliner got here. To begin, a picture to accurately illustrate just how jam-packed Adam's 4Runner was. See the shiny surface behind Adam? That's one piece of the recliner.

Just enough room for driver and passenger.
And that's pretty much it.

Next up, a picture of Jeney trying her darndest to pull the recliner base out of the driver-side back door. It budged - a lot. But then there was this little piece of metal...on the base of the chair...

Go, Jeney, go!

We all realized that yep - the recliner would have to be unloaded through the back of the car. Which meant EVERYTHING else had to be unloaded first. Not quite what the dynamic duo had planned, but they were up for the task. Onlookers helped some.

A place for everything and everything in its place.

Aww, yeah! Happy to have a cushy chair a la my "little" brother!

Adam, without getting too squishy on this blog, I want to acknowledge your generosity and thank you. I know you *heart* this recliner; it was going to make the move with you regardless. I appreciate you leaving it here on a semi-permanent basis so I can kick back and relax a little, tolerate chemo effects better, and sleep while not laying horizontal. I will think of you each time I'm in it. Like a big, brother-sister hug.

Although he dropped it off, he still wanted to sit on it.
:)
Who knew we looked so much alike, anyway?

Movin' Mom

So I'm behind on blog posts. Big deal. Cut the cancer chick some slack! I'm coming out of quite the rollercoaster low...this past chemo treatment was like no other. Anyway, I'm happy to report that I'm on the uphill side of things today - so here's a blog post that should have been posted a couple of weeks ago.

On July 16, mom and Brandon (my cousin) rolled into town in a HUGE truck affectionately called "Big Bird 1." (Why Big Bird 1? Because yes, there was a Big Bird 2 - only not as big as the first.) It was a shiny, newish Penske truck with only 2,000 miles on it, superior A/C, and a cab way up in the sky. They looked like weary travelers when they rode in, but no doubt they were happy to have made the OK->CO drive in a single day.

Dad cooked up some good food for all of us and we sat down and ate family-style.

The next day, mom was witness to a Herculean effort: a team of four unpacked the entire 26-foot truck in a matter of hours! Brandon did a wonderful job packing the truck and securing sections down.

Brandon displaying his muscular physique before unloading Big Bird 1.
He's proud. And should be!

It truly was a group effort. 

Dad and Brandon unloading the elliptical beast.

THANK YOU, guys, for getting 'er done! 

The unpacking team:
Ken, Joshua, mom, Brandon, & dad.

Chemo Quattro

Today's was Laura's last treatment of Adriamycin and Cytoxan. Up next are four treatments of Taxol. Laura and her Mom went to the treatment appointment today's so I don't have many details about that.

After today's treatment Laura felt pretty tired and queasy. Hot flashes have been bothering her and shes felt moody and out of sorts. She is very grateful to have the easy chair her brother Adam left behind. It helps her relax, while not fully laying down, which can make her uneasy. Thank you Adam.
 
Laura ate soup this afternoon and cottage cheese with peaches in the evening. Her appetite is a lot lighter than usual. She told me that she thinks more about food, than actually wants to eat anything. Her water also tasted weird all day and I had to take a sip to ensure her it was really normal water.

Right now she is laying in bed listening to a guided meditation CD given to her by a good friend to relax and ease any pains she has. It sounds very peaceful and has me breathing easier too. When there are pauses in the meditation I can hear Laura's gentle breathing from the adjoining room and I think she is sleeping now. This must be a similar feeling a parent has, when they hear their baby sleeping nearby. I'm glad she is at rest right now, she is my little angel.

It has been raining off and on today and was a lot cooler than past days. The weather is indicative of both of our moods today. We've been overcast and a little drizzly.

Embracing the Waves of Change

Its been said that change is a constant you can count on. Time slips away so easily when we are focused on change. An important part of this journey through cancer is finding time for Laura and I to connect in the present moment, as a couple, and not lose sight of who we are to each other throughout all of this change.

Getting lost in the wave of emotions, visitors, appointments, and incoming information happens often lately. We are working to better understand the boundaries we each need, so there is room to renew and grow our relationship.

Letting go of things has been a helpful coping mechanism when times get tough. Letting go of the weeds in the yard. Letting go of facebook. Letting go of being in control. Letting go of guilt. Letting go of the kitchen floor. Letting go of anger.

In the midst of all the letting go, there is also a strong pull to regain control. This must be the yin to the yang, nature's way of balancing out things in life. 

Right now it feels so good to put together a grocery list. To walk through our house when we are the only ones here. To embrace each other and take time to cry in the middle of the afternoon. To escape and watch a TV show. To get through a serious discussion and finish without lingering heartache. To look into each others eyes and feel what the other is going through.

Cancer has given us new perspectives on life and we are doing what we can to embrace and grow through this experience, although occasionaly we do get lost in this sea of change.