Last Chemo Treatment in 16 Pictures

Sixteen pictures; each to signify a week I will have spent going through chemotherapy. My last treatment was yesterday. I made it! Yay! I wish I could high five you all in person. 

We arrived at my final chemo infusion.
Yep, I wore an awesome head topper on my last day. 
Pretty rad t-shirt, too. Read it in another picture. :)

Why the funny face?
Because Michelle is mixing my meds back there.

Mixing the meds is hot, sweaty business.

I didn't know my face could look like this. 
And also: someone believed this was my real hair today! Pretty funny.

Pointing to Abraxane on my chemo cart. Thanks, Michelle! :)

The final chemo posse in full effect.

Ohmygosh. Is that cake? And icing?? We brought in a cake for all...we had some, too.
(Yes, this is called cheating on my alkaline diet.
But hey, it's life. I chose to enjoy a piece of cake.)

Mom and I flashing our chemo gang signs. Ha!

Dr. K wearing her newly-acquired gold chain with her initial on it (also in gold).
It's kinda a joke between us.
me: "I have breast cancer. Will you be my chemo homegirl?"
Dr. K: "What's that?"

I do believe I saw a full-on smile on Dr. K's face yesterday.
She is a good choice for me: answers my questions,
gives me abundant relevant information,
and doesn't want to mess around with cancer.

Tuesday's chemo nurses: Michelle on left, Linda on right.
They are fun, lively, and enjoy good conversations and laughs.
Ellen is another chemo nurse and wasn't there yesterday, but she was there today when I got my last Neulasta shot. She'll be in the next blog post.

After chemo, we went to WaterCourse Foods, a vegetarian restaurant in Downtown Denver.
The lights caught my attention for quite a while.

Check it out (courtesy of the WaterCourse Foods web site): WaterCourse Foods is proud to serve a 100% vegetarian menu. Our style of comfort food has won over the hearts and stomachs of people from all types of dietary backgrounds. The greatest compliment we hear (and we hear it often) is when a initially reluctant patron, who was dragged in by their spouse or kids, says they never thought they would eat vegetarian food and now WaterCourse is their favorite restaurant.

Joshua was happy to receive tasty vegetarian treats.

Here it is! I got a polenta-crusted portabello with avocado, brown rice, refried beans, chipotle aoli, carrots, lettuce, pico de gallo, and black beans.

Joshua got a meatless meatball sandwich, grilled sweet potato, and grilled seasonal veggies.

Mom got a wheat tortilla wrap with cilantro pistachio pesto, grilled sweet potatoes, mushrooms, onions, and smoked mozzarella.

That's what the day was like. I drank a bit of sparkling cider and toasted to you all, to the medical team I've come to know and rely on, to what I believe is out there that's bigger than us, and to LIVING life!

Phase 1 of Operation Kick the Crap out of Cancer? 
(Thanks Grey/Amber - great name! :)   )
OVER!!!

50/50: An above average comedy/drama.

Don't worry, no spoilers.


Laura was given movie tickets from the Livestrong foundation for us to check out a "sneak preview" of the film 50/50. We had a great time that evening in downtown Denver and I wanted to share my review.

This movie shows us what happens when Adam the young male protagonist played by Joseph Gordon-Levitt is diagnosed with a rare form of cancer and discovers he has a 50/50 chance at survival.

Although hilarious, touching and light-heartedness occurred throughout, the film left a lot to be desired. There was such rich potential, given the magnitude of circumstances the characters were going through, that this should have been much more than another "touching, but funny, good movie". The performances by Seth Rogan who played Adam's best friend and Anjelica Huston who played Adam's Mother, Diane were quite funny. Coming out of theater we both enjoyed the film and thought back positively on the many funny and and occasional poignant scenes.

Gordon-Levitt did a good job portraying the sullenness of someone who is delivered such a heavy hand, but it would have been refreshing to see some real growth in his character. Instead we saw what he was going through and the effects of life altering news, but there was little focus on any inner dialogue that goes along with this trip. Perhaps it was Seth Rogan's unmistakable silly nature which complemented, but also detracted from the movie becoming anything more than a comedy in the cloak of a drama.

The ending was a let down. It made me wonder if there was some kind of time table for how quickly this movie had to end. It was too happy path and reeked like month old Parmesan. I find it common nowadays to see movies with so much vested in them, and great potential, which deliver mediocre plots, and blase endings.

There is a lot to be gained from hard times. Some of our best teachers are things that make us fearful, insecure or angry. While humor is a necessary and wonderful tool for dealing with pain and suffering, this movie shows  Hollywood's infatuation of avoiding mindfulness and missing opportunities for displaying human growth in difficult times. Though don't mistake this for an indication of ticket sales...

Q #4: What makes you happy/forget your worries for a little while?

A: 
Thank goodness there are things that make me happy and help me forget my worries - even if only briefly. Here's some of what I've found brings me joy and peace, in no particular order:

• Watching a movie
• Helping others
• Reading a book and emails from friends
• Getting involved in a craft project
• Receiving acupuncture, massage
• Being outdoors with Joshua
• Going to IKEA
• Being busy - getting involved in something that takes over most of my brain
• Listening to biolateral music, walking meditation
• Living one day at a time

Thinking about the future and "what-if" scenarios is what gets my worries and fears activated. So as long as I focus on the now, I'm okay. I'm doing a lot of work in this particular area right now...this young grasshopper has much to learn in the ways of being present and not letting my amygdala run rampant! (The amygdala plays a major role in the processing and memory of emotional reactions.)

Q #3: Have you watched The Big C?

A:

Photo courtesy of:
http://www.sho.com/site/thebigc/home.sho

Yes I have! A friend in Oklahoma mentioned this show and we added it to the Netflix queue after I was diagnosed. Joshua and I began watching Season 1 about a month ago. My mom and aunt have also watched some episodes with us. I've enjoyed watching it - the irreverence, the humor, the candid way about it. It also touches on the serious ways in which cancer effects not only the one that's got it, but the support system that surrounds that person. Now it looks like we'll have to wait for Season 2 discs to get on Netflix...

Unlike the main character, I have not ignored my diagnosis, rescued any lobsters from restaurants, had a pool hole dug in my yard, or bought a shiny red sports car. Seems I'm much more practical than that. - Ha!

What do you (anyone that's seen it) think about the show?

Appointment Set for the Double M

I've let the information percolate in my head over the weekend to get used to the idea. Now I'm ready to share with you all: the date for my Double M is set.

Funny, I felt both relief and anxiety once I heard the information. Relief that the cancer will be taken out of my body and more information will be known about my adversary. Anxiety about the new unknowns. As totally outta this world this may seem, I've "gotten used to" chemo. That's not to say I like it - I don't - but there has been a somewhat predictable ebb and flow of energy, physical limitations, and mental tricks chemo brings to the table each time. It was also scheduled at regular intervals (I have been fortunate to not have to delay any treatments thus far) and took up over 3 months; I've been on autopilot.

Soon it's time for the next step. A new unknown. What will surgery be like? How will I recover? What will the pathology report tell us? What will be next after surgery? (Here I go again thinking in the future...bad girl! This is something I'm working on, and obviously still have a ways to go. More on this in a future post.)

I'll cut to the chase and keep today's post short and sweet. My Double M is scheduled for October 25. 

Friday Date Night

A hot couple!

Last Friday, we went to see Les Misérables in Denver. It was a fun night! We bought the tickets way back in early March of this year. We weren't sure if I'd be up for going once the chemo schedule was laid out; however, we were fortunate in that the tickets were for a performance during my second week post-chemo (a good week, usually) - so we went for it!

It was grand. And I felt like a million bucks going out with Joshua. My wig and makeup "disguise" helped me easily blend into all the other folks there.

Interesting: I even got a comment on my cute haircut and my shiny, healthy hair when in line for the ladies' room. Ha! (And yes, I admitted that it wasn't my hair.)

Dressin' up and goin' out.

"If the rumor is tumor, then the issue is tissue, and the answer is cancer."

When Laura began chemotherapy, it seemed like a there was a long road in front of her, full of unknowns. We've seen her tackle each and every hurdle like a warrior princess - scared at times, but ready to face the next hurdle. Last week we had two important appointments concerning the next steps after her last chemotherapy treatment on September 27.

In a pre-op appointment with the general surgeon, Laura was informed that the surgery would likely take place two, possibly three, weeks after the final September 27 chemo session. Now that the team has been chosen -- general surgeon and plastic surgeon -- it's a matter of scheduling and we should learn the date this week. It will likely be the middle of October. The surgical procedure will include a "modified mastectomy" on Laura's right breast, which will include the removal of her level one lymph nodes, approximately 12-15 nodes, according to the surgeon. Laura will receive a "simple mastectomy" on the left breast, which has no involvement of the lymph nodes. We are anticipating Laura spending one night, possibly more, at the hospital for this surgery. The final pathology report on the breast tissue will be completed two to three days post-surgery, and the results will influence the course of treatment following surgery, either radiation or participation in a clinical trial for triple negative BC patients such as Laura, followed by radiation. Physical therapy begins quickly, two weeks after surgery, to help Laura regain strength and to avoid lymphedema, a swelling in the arm area caused by fluid retention and resultant swelling of tissue.

Because her treatment includes radiation at some point following surgery, Laura also scheduled an initial consultation with a radiation oncologist last week. There we learned that assuming a complete response to the chemotherapy (i.e., no live cancer cells in the pathology report), Laura's radiation treatments will likely begin 6-8 weeks after surgery. Laura will receive 25 radiation treatments, each lasting about 15 minutes, stretching over 5 weeks. Because of the level of involvement in Laura's right breast, the treatments will be comprehensive, not pinpoint, so her entire chest wall, the lymph node area, and some of her neck area will receive a 5000 centigrade dosage each time. Possible side effects Laura may experience include fatigue, possible swelling of the chest wall and arm, and sunburn-like effects on her skin such as redness, soreness, itching and peeling. The doctor described the various steps we can take to help lessen these effects, such as using certain lotions and soaps and wearing loose cotton clothing, etc. Because it is so important to keep her skin supple in order to prevent the buildup of scar tissue, Laura will have to massage the area, essentially circling at least 100 times, on a daily basis.

After meeting with the physicians that will complement the work done by her oncologist, Laura is ready to finish her last two sessions of chemotherapy, let the potent drugs do their work, and then let the surgeon and radiation oncologist add their expertise. We all feel confident that the Laura has a superb team, that she is receiving the best of care, and that she is handling the entire experience with courage and grace.

We are praying, and would like those of you praying for Laura to include in your prayers:

God, we thank you for the progress made thus far in the treatment of Laura's cancer, and now we ask that you renew her immune system's memory to seek and destroy any remaining cancer cells.

Our Weekend Getaway

We were refreshed from this trip!

In late August, on the best weekend between chemotherapy appointments, we had a weekend getaway together in Dillon, Colorado. The drive was long enough to make it seem like a road trip, but short enough to not be too cumbersome.

We enjoyed our time away from the everyday stuff at our own home. It was nice to get away and have time to talk, read, watch movies, hike, cook, and enjoy each other's company. It was food for my soul.

We managed to climb quite a bit in elevation
at the beginning of the Ptarmigan Trail.
Lake Dillon in distance - see the sailboats?

Each day, we went outside at least once for a walk/hike. There were trails right outside of the condo we stayed at, which was so nice and simple! Joshua took me on a "beginner's" hiking trail one day - Ptarmigan Trail - and it conquered me! We should have had a clue with these words describing the beginning of the trail: "ascends briskly." Yeah, it was definitely brisk! My legs and lungs couldn't normalize easily and we eventually decided to turn around and head back down while I still had the muscle power to do so. Still, it was fun to challenge myself physically and to see views of Lake Dillon and other mountain peaks nearby. The area we were in, Summit County, is gorgeous and makes me appreciate nature's beauty and the peace it offers.

A magnificent double rainbow - it was the brightest we'd ever seen.
We saw this on our first hike while it sprinkled on us.

Pathways, wildflowers, aspens, and mountains.
What more could a hiker want?

A path leading into an aspen grove.

On our last hike before returning home.

Does this really need a caption?

My Gramma was Here!

Gramma's famous roast beef dinner.
Notice the meat-to-veggie ratio - we did it right!
(All natural, grass-fed beef, too. )

Gee, I'm behind on some news tidbits--oops! I have had good intentions of doing a photojournalistic blog post of "this is the last two weeks post-chemo in pictures," but uploading the pictures, organizing them, naming them, cropping them, exporting to email, saving to blog...it's all too much the day before treatment. That's when I'm running around like crazy to appointments and also trying to get as much done at home as possible. :)

My Gramma Birch came to town for a couple of weeks in mid-August. She stayed at my mom's place but I saw her frequently. Sometimes for a meal and a visit, sometimes for 5-10 minutes between appointments, sometimes as I ran into mom's house to grab'n'go, and a few times she came over to our house and hung out with me. I enjoy her calm presence. I also appreciate her being at ease with going with the flow of whatever, whenever!

The time-share shower stool!

One thing I noticed while Gramma was still here: the peripheral neuropathy effects of Taxol. In combination with the ear ringing and joint pain, the neuropathy sensations leave me feeling weak and unsure about my body in the whole time/space sense. Gramma witnessed what my first Taxol treatment's effects were like...which led to a discussion between us about making showering easier - for both of us! We came up with the idea of shopping for a shower stool that we could "time share" between us here in Colorado. She could use it when visiting mom and I could use it on my tingly/weak days. Right after the meal, we hopped on Amazon.com and found one that we both thought would work. It's lightweight, has handles, has stable rubber feet, and can bet set at various heights. Voila! Problem solved. So far, I'm loving the shower stool. It's a big help. And it strikes me as funny (and cool) that Gramma and I have more in common now, too!

After a taco feast at our house in Gramma's honor.

A Picture (or 6) is Worth a Thousand Words

Sharing images of my breasts is not a decision I take lightly. I'm not sure what images, if any, I'll share in the future. However, given the good MRI results, and people wondering what metabolic activity looks like, I thought sharing these near* apples-to-apples images below might be of use and interest.

* I use the term near here, because I am by no means an MRI-reading expert, and I doubt these are exactly the same images with the same parameters, etc. I'm simply matching image numbers from both MRI dates from 1,400+ images taken during each MRI.

The metabolic activity is shown with brighter areas. They inject a contrast into me during the last long image collection time and it highlights the active cancer cells.

June 6, image 20 

Aug 29, image 20

Clearly, a difference in metabolic activity from the two MRI dates. We already know this from the pros telling us, but it's nice to see myself and share with others. I have also (for quite some time now) noticed not only a visual difference in my breast, but also it feels different. 

June 6, image 23

Aug 29, image 23

Visually, my breast had become a little lopsided on the right side due to the cancer's growth over time; I noticed it changing back to looking like a "normal" breast after my second chemotherapy treatment. Tactilely, the bump has become less prominent and seems not to be as close to the surface of my breast. I still feel a good sized lump when I press down and feel for it. The rest of my right breast also seems less dense than when I began chemotherapy.

June 6, image 28

Aug 29, image 28

Q #2: Do people in the every day world (grocery store, etc.) ask you about your hair loss?

continued: What do you tell them?

A:
Out of all the people that notice (surely), only two people have said anything. Incredible! I truly expected to field more inquiries. Then again, people probably don't want to ask some stranger about an obvious medical issue. Here are those two experiences:

Hair Loss Sighting/Questioning #1: Joshua and I went swimming in mid-July at a local rec center. Not wanting to draw attention to myself, and also out of habit, I put my swimcap on before entering the pool. We swam, which felt fantastic, and then came the whole predicament about the locker room. Should I change out in the open like I usually do? No, I didn't want to do that because of my port (still was sensitive about it at the time). So I showered and change in an individual stall. Next up: putting on face/head moisturizer. By this time I was fully dressed and out of the shower stall. I had a bandana on my head already, but was getting itchy...I needed to moisturize! Only one other gal was in there with me, and she was changing in another part of the locker room. So I decided to go for it. I took off the bandana and began rubbing my noggin with moisturizer. She came out just as I was finishing and said "Wow - neat haircut. May I ask: why did you decide to cut it so short?" To which I answered, "Well, I really liked the buzz cut I had before this, but chemo decided to make it shorter."

From there, we had a nice conversation about what my diagnosis was, how treatment was going, and how I'm feeling about things. She had worked with sick children, which I believe gave her insight as to how to have a comfortable conversation with someone like me. She probed, but not too far. And we shared several laughs at the "being a cancer patient" experience. And then, as our conversation was winding up, she said she'd like to give me a hug if I was up for it. And I was. I mean, what can it hurt that someone you don't know wants to give you something to convey their hope for you? It was the longest "stranger hug" I've ever had. It lingered longer than family hugs usually last. And it felt 100% genuine and good. I loved it and was happy she saw it fit to stop and talk with me that day.

Hair Loss Sighting/Questioning #2: I was at a local bagel shop with Joshua, Adam, Jeney, and mom. I felt eyes on me the second we walked in and thought maybe I forgot to wear a head topper. But I checked, and my baseball cap was indeed in place. So I let the paranoia go. While we were waiting for our drinks, I felt (and saw?) someone in my peripheral vision ever so slowly getting closer...closer...closer. I couldn't stand it. I turned around and said "Can I help you?" And the woman standing there just said "Are you a survivor?" AWKWARD! She proceeded to ask me my diagnosis, tell me what hers was, and then started talking about spiritual stuff that was just too much to take in while waiting to get a drink at a bagel shop - with onlookers. I felt cornered. Oh yeah, and did I mention she was sitting at a table with 8-10 of her friends and they were watching? I wanted to melt into the floor.

I am sure this woman did not mean to make me feel weird or on the spot. I like to think that she thought she recognized an individual going through a bad experience like she had and she wanted to offer what she could in the way of positivity. Even so, it did not come across to me in that scenario like she probably wished it would have. I was glad it was over quickly.

Rockin' skull and crossbones head gear. Thanks, Chana!

Speaking of head toppers...I don't think I've posted many pictures of those yet. (Side note: it's been nice to rock my bald look this summer - it's more comfortable than covering up and I don't feel ashamed. After all, I can't help it!) So here is one to nibble on...and I'll try to remember to post some more in the future.

This Week's News

Smart-looking Laura
(it's all about the glasses).
Pre-total hair loss.

Tuesday's chemo treatment provided much information - about the treatment I'm receiving and about my upcoming "alternatives." I'd like to share those with you.

There is a Taxol shortage - but have no fear!
No worries here. I am still receiving the same drug/same dosage - only in a different form (and therefore, under a different name: Abraxane). Guess the manufacturers/distributors of Taxol are in short supply; my oncologist's office is now being told that they "might" get more in at the end of 2011. There are two clear benefits to this:
1. The alternative - and more spendy - treatment I'm receiving takes 30 minutes to administer versus 4 hours. Bonus - I get to reclaim >12 hours of my life!
2. The alternative treatment may very likely not give me the drug rash I got the first time around. ~ Don't think I mentioned that before. It wasn't anything major, just a bumpy rash I could feel on my shoulders and upper chest/back - nothing you could see. I'm taking additional meds for now just in case I have a reaction to the new stuff, but might get off of those the next go-round if I don't experience any symptoms.

Pretty little pills.

We want to see a "complete response" by the time of surgery and/or the resulting pathology report.
Yeah...medical terms. What's meant here is that, while my cancer's response to chemo thus far is good, we want better. Complete response = no living cancer (only scar tissue/dead cancer cells exist). Ultimately, for me to be in a way better statistical group of survivors, this needs to occur. This is where alternatives come in:
1. If my cancer does have a complete response: I will have my surgery with probable reconstruction (expanders put in place) at the same time. I will be expanded at a rapid pace (ouch) so I can get the radiation I need 6 weeks after surgery. Once radiation is complete and we see what we have to work with boob-wise, I'll get implants or resort to Plan B: another surgery if the expanders/implants option isn't going to work.

2. If my cancer does not have a complete response: I will have my surgery with reconstruction (expanders put in place). Then I will go through 4 more chemo treatments, this time three weeks apart, as part of a clinical trial. This isn't something I want, but if it helps bump me into a better statistical group, I'm all for it. There is no negative to doing the trial; I will either come out better because of it or stay the same - that depends on which group I'm randomly assigned to. The good news (?) about this option is that my skin would not have to be on a super-expando schedule. I'm sure my skin and pain receptors would appreciate that part. However, I still would prefer option #1 above. After the clinical trial, it would be onto radiation, and reconstruction happening after that.

What's a girl to do when early for a chemo session?
Go to Ikea for 35 blissful minutes! That was fun!

Q #1: How did you originally get diagnosed?

Question continued: Did you find a lump, was it part of a routine exam, etc?

A: 
In late March, while recovering from a tonsillectomy, Joshua noticed a bump in my right breast. He brought it to my attention and I decided to keep an eye on it by checking it (visual + tactile) weekly. I had stopped taking birth control recently, I'm youngish, and I know my breasts go through cyclical changes. To me, I felt like alarm bells weren't necessary until I detected a change. I've also been told by every other doctor since that they would have said to "keep an eye on it for a month or two," given my scenario with stopping birth control and recent surgery.

There was no noticeable change until ~May 10. Between coming home from a trip to help my mom pack and driving back down to Oklahoma for my grandmother's funeral, I felt a significant change in size and hardness. I also began experiencing shooting pains in that area that were quite uncomfortable. On the road trip down, per Joshua's urging, I called and made an appointment for the morning after we returned.

The rest is now history.