My Big Fat Hair Trim

All that hair!

In an earlier post, I mentioned getting my hair cut. Okay, maybe it wasn't so much a cut as it was a trim. It's like all my hair went into super-speed growth. Something had to be done. It felt great to knock off some of the fuzzy-wuzzy hairs around my neck and ears. I even got some of the peach fuzz on my face trimmed. No hair was trimmed off the top for obvious reasons.

Although the difference is slight, it made a big difference to me. No longer can Joshua pull on my neck hair and facial fuzz. Freedom!

Part of me felt silly going in for a trim. It's likely I'll lose my hair again while on the clinical trial drug cisplatin. Still, if I'm looking good and as close to normal as possible, it helps me feel that way, too.

Profile before trim.

Profile after trim.

Back before trim.

Back after trim.

Time to Fill 'er Up!

It's that time again: time to expand some more. The right breast is already fully pumped up; the left breast - as mentioned in this blog post - is under expanded. To recap where my volume stood before and during radiation: my right breast had 695cc, my left breast had 350cc.

On January 23, I went in for a fill on my left side and (surprisingly) took 120cc easily. The two muscle relaxing pills helped! Now I'm pumped up to 470cc on the left.

January 30 is my next fill appointment for the left breast and, if I'm able to get an additional 120cc in there, I'll be at a perky 590cc. This is the size I liked my right breast at before it was over expanded (necessary because of radiation effects to my skin). Unless I want to go bigger (I'm thinking not), it's possible that I'll be fully expanded next Monday!

Having evenly expanded boobs has not been much of a concern to me. I've rocked the lopsided look well with printed shirts, scarves, and just not caring too much about it. I view getting the left filled before the clinical trial as a bonus.

The expanders I have in my chest now are for expanding my breast skin and are basically placeholders for my implants. I'll have the expanders until my "switch-out surgery" sometime later this year. The expanders don't move, jiggle, or sag. They make sleeping on my side uncomfortable. I am reluctantly realizing that I'll be sleeping on my back - a lot - this year. Ugh.

How or when will I know an approximate timeline for my switch-out surgery? That surgery will be no sooner than 3 months after the clinical trial is complete or 6 months after radiation is complete, whichever is the latest. The best guess right now is that I may be a candidate for that surgery sometime in late August. -- We'll see. I may delay the grand switcheroo until I'm ready - like after I've gotten all my energy back and have sufficiently enjoyed the Colorado summer and early fall. Sounds nice, doesn't it? I'm giddy just thinking about it.

Jan 21/22 Weekend in Photos

What a wonderful weekend. Why so spectacular? Because we went snowshoeing!

Going snowshoeing was on a "bucket list" of sorts for me before the clinical trial. If I was able, I wanted to go - badly. Seven of us took advantage of the opportunity and headed to Estes Park to snowshoe. Here's a short photojournalistic view of our fun weekend:

Mom, Sandy, and Nolton getting fuel before heading out.

Kris and Karen looking ready to board...er...snowshoe!

Nolton and Sandy gearing up for their first snowshoe trip!

Fun pictures along the trail.

Guess who?

Looks like a freezing version of the Beatles' Abbey Road album cover.
 This gives you an idea of the snow/wind conditions.

Who knew you could row on a frozen lake with powder poles?
Kris did.

Sitting down for dinner. Ready to crash.

Sunday morning breakfast.
Time to load up!

To say it was a bit windy is downplaying things.

One of the few spots where it wasn't too windy on the second day.
A beautiful rock face view and the sun even popped out.

Someone's getting tired. Will he freeze in place?

Sandy taking an upright nap.
Or maybe mom told her to lick the tree...

Sandy HAD to make a snow angel.
So I HAD to document it.

Sandy's snow angel.

Joshua's snow angel.
Damn! Look at those wings!!

The end.

Top 10: Why Radiation Gets a "Glowing" Endorsement

Here's my crack at a fun audio introduction to this Top 10 list. Turn your speakers on, press the play button, and enjoy!

Acting tough.
(Oct. 2011 pic)

10. If you absorb enough radiation, you won't have to use night lights and can save on light bills.

9. I always wanted my freckles to link up and equal a great tan. Well, I may get a perma-tan on a quadrant of my body now!

8. I can have the highest Geiger counter score in a room full of people.

7. Have you ever powdered (with corn starch) your armpit, boob, and arm? Didn't think so.

6. It's a daily gig so it keeps me off the streets and out of the bars.

5. There are minimal side effects (compared to the rest of the BC journey).

4. It's fast and easy. Five minutes and treatment is over. No work required on my part; I just lay there.

3. You meet other people in the waiting room that are in the same (or a similar) boat and strike up conversation. You may even make a friend.

Skull and crossbones tatt.

2. Just the name makes it sound like I'm doing something tough. 

1. You can precisely target problem areas without damaging surrounding tissue/organs.

Last Day of Radiation

Today gets a two thumbs up rating.

This is it! It's finally here. After my bolus-enhanced radiation today, I'm done with radiation! In the photo, I look tired because I am tired. -- I guess the cumulative effect of radiation is catching up with me a bit, and today required at 6:45am wake-up, which doesn't help with looking good in morning photos.

Luckily, my skin didn't blister or peel. It is dry and sunburned and itchy, but now it has a few weeks to heal before the clinical trial starts. And I'll continue to do daily stretches for the rest of the year to keep my muscles and skin as supple as possible.

I'm hitting the road soon for a dental appointment, hair trim (yeah, I'm getting one), seeing family, then radiation. Woo-hoo!

Massage Therapy

Last summer, I found a brochure for a massage therapist at my oncologist's office. And like many other past actions in my life, I thought about calling her six ways to Sunday before actually making my move. Would massage help me through chemotherapy treatments? Probably couldn't hurt! Especially during the second week of each cycle, when I bounced back physically and had residual effects from bone pain and sitting/laying in one place for too long.

Ann with a singing bowl.

Enter Ann M., CMT. I was sold after my first visit with her and made regular appointments to last through my chemo treatments and lead me into surgery. She has advanced education in neuromuscular massage, vibrational healing, and oncology massage. Her tool set made me feel a heck of a lot more comfortable with receiving a massage. She is also familiar with the lymphatic system and how to massage post-surgery. She is an angel of goodness in my life and I am so glad she's part of my team!

I love entering her massage space. It's a light blue color, reminiscent of calm waters or a cloudless sky. There's a few pops of red in the room, namely the lamps. She also has a host of angels in the room, which I enjoy and find comforting. There's nothing but good vibes and comfort in that sacred room!

Where the magic happens.

The bare necessities:
balance and hydration!

We start each session by talking about how I'm feeling. Is there anything new to know about or out of whack since last time? What treatments are planned for the future? What would I like her to focus on? Sometimes we also add a special meditation for a card that I pick randomly from a pile. These cards have all been great reminders or things to focus on throughout my treatment. For instance: the card I picked right before the Christmas holiday was "balance." How apropos! Ann read a page accompanying the card (with word definition, word origin, and things to consider when trying to balance).

Then we begin. I usually choose to begin our session with a meditation. Ann guides the meditation time and uses singing bowls and ohm tuning forks for added relaxation. Her massages are not intrusive or painful, like some massages can be. She uses hot stones and bamboo to work muscles gently.

I'm appreciative of conventional Western medicine - after all, it has helped me. Even so, I'm equally thankful for the "alternative" medicines I've sought out: reiki, meditation, acupuncture, pilates, lymphatic PT, and massage. It's a privilege to not have to work during this life adventure. The "extra" time allows me to not only fit in all of the recommended treatments, but also some medical-related appointments that I can look forward to!

Thank you, Ann, for your healing touch and continual support. You're an inspiration to me.

Ann Martin, CMT
303-378-6250

Decisions, Decisions...

The latest "big" decision I've been dealing with is: Should I participate in a recommended clinical trial or not?

Seems straightforward, but it's not as cut and dry when you've already been through chemo and don't really want to revisit that - plus your body is still recovering from the last chemo, surgery, and radiation. Get my drift?

For those of you that want to know the answer up front -- yes, I've decided in favor of participating in the clinical trial. For those of you that want to know more about the trial and my decision to try to participate, keep reading!

What does this decision mean?
It means I'm willingly applying to be a participant in a clinical trial. Just because I'm a BC gal that looks to be a good test subject, I don't have an automatic "in" with the clinical trial. They need to run some screening tests (bloodwork, EKG, possible others) to make sure I'm a good candidate. I also need to make sure my insurance will cover this trial, as the trial does not cover all of the expenses related to participating in this study.

When does it start?
At minimum, I will need 14 days between radiation (which ends on January 19) and the beginning of the clinical trial. I can begin as late as 84 days post-radiation; however, I'm of the mind to get it started sooner so I can enjoy this summer! I'm tentatively scheduled to meet with the head of this clinical trial during the first week of February. At that time, I'll have screening tests done, sign the consent form in person, and ask any additional questions I have about the trial. It could begin as soon as the test results are in and I'm cleared to participate.

What phase is this trial?
This clinical trial is a randomized Phase II study. A Phase II trial is defined as: Controlled clinical studies conducted to evaluate the effectiveness of the drug for a particular indication or indications in patients with the disease or condition under study and to determine the common short-term side effects and risks.

What the study will entail: 
I will be randomized into 1 of 2 groups after my screening tests are complete. The two groups are:

Group A: Cisplatin through a 60 minute IV on Day 1, to be repeated every 21 days for a total of 4 treatments (12 weeks total) 

Group B: Cisplatin through a 60 minute IV on Day 1, to be repeated every 21 days for a total of 4 treatments (12 weeks total)  +  Receive study drug (PARP inhibitor) on days 1, 2, and 3 to be repeated every 21 days for a total of 4 treatments  +  After 4 treatments, go on a maintenance treatment of just PARP inhibitor taken by mouth once a week for a total of 24 weeks

After the trial, they will monitor my health through an end of treatment visit 1-2 months from my last treatment. And via follow-up appointments (done every 4 months for years 1 and 2 and every 6 months for years 3-5).

How did I make this decision?

With the help of my medical care providers, my family (they asked questions and researched with me), friends (bouncing ideas/concerns off of them), and by asking myself if I could live with a clear conscience if I didn't do the study. The benefits are at least two-fold:

1. No matter the arm of the study, I'm receiving Cisplatin - a drug that's proven to be effective in metastatic breast cancer cases. It should seek and destroy cancer cells if any remain in me.

2. The results from this trial will be used to help other breast cancer survivors.

I don't necessarily want do it, but realize the value in receiving Cisplatin at this point (and therefore a need to participate). I want to come to the cancer-fighting table with "guns blazing" and this trial offers me the chance to do one more thing to kick some cancer cell ass. (Remind me of the reasoning for this decision if I get grumpy about the study, please.)

Change Your Life With Green Smoothies

Green Smoothies can change your life.

Our first encounter with green smoothies was earlier this Summer when Laura and I watched Kris Carr's Crazy Sexy Cancer documentary. I made green smoothies daily for a few weeks and we really enjoyed them, Laura too! Getting the smoothies prepared and ready in the morning began to be hard for me to keep up with and I lost motivation to make the shakes. We would have one once every couple of weeks.

We like green smoothies...for real!!!

Recently Laura and I watched another health documentary called Fat, Sick and Nearly Dead. It was inspiring and after watching the difference a juice fast, or reboot as they referred to in the film, could alter a person's life, I was determined to start juicing for our health. I began researching how to make juices with our Vitamix, which it turns out is easy to do, with the help of a cheesecloth for straining.

As I'm apt to do when I get carried away on a new topic of interest I wanted to know more about green juices and smoothies and I stumbled upon Victoria Boutenko. Victoria and her family went on a raw vegetable diet to combat health issues, and found that after being on the diet for a year they were not feeling as energetic and well as they should have been. So she began researching and studying many things among them the diet of chimpanzees and found the missing link to her family's diet was more "leafy greens". Way more.

Standard American vs. Chimpanzee diet (courtesy of  http://www.rawfamily.com/green-smoothie) 

Chimpanzee vs. Raw-Foodist diet (courtesy of  http://www.rawfamily.com/green-smoothie)

Boutenky's asserts that leafy greens belong in a food category of their own and that it is a mistake to lump them in with other vegetables. I wholeheartedly agree. After reading two of Victoria Boutenko's more popular books, Green for Life and Green Smoothie Revolution, I was back on the smoothie bandwagon full speed ahead, although after Laura's upcoming clinical trial where there will be more chemo, I'd like for us to to try a juice cleanse.

There are some great free green smoothie recipes on Victoria's web site rawfamily.com, and here is the breakdown of our most recent "go to" smoothie. If possible, use organically grown ingredients.

• 1 cucumber (unpeeled)
• 2-4 kale leaves (the Vitamix blends the hard stems so I add them for extra fiber)
• 1-2 swiss chard leaves and stems
• 1-2 green collard leaves and stems
• 1 broccoli stem (these are usually leftover and we save them)
• 1 celery stem
• 1 banana (freeze them when they are green for less sugar content)
• 1 apple (or a handful of grapes or berries)
• 1-2 tablespoons ginger (whole unpeeled)
• 1 cup water (so it mixes and is thin enough to drink)
• 1 cup ice
• Small amount of fruit juice to taste (or stevia)

Another favorite variation is to leave out the broccoli stem and cucumber and add a whole golden or red beet with its leafy tops.

Anything goes, your imagination is the limit, just try to keep the fruit to 20% and leafy greens at 80%. For example I tried adding leeks recently and that was interesting, a bit too stout for our liking. It was a little like an Italian green shake. A clove of garlic is also fun and adds a zing and is good for you. Just don't schedule any meetings afterwards without brushing your teeth. We've also been adding homemade Kombucha tea to the smoothie, which gives it additional zing and helps thin out a thick smoothie. Apple juice and water also work fine to thin a thick shake.

The thing that has really helped us stay regular with the smoothies is to cut the veggies after cooking dinner and blend before going to bed. Put in the fridge for the morning and with another quick mix, you are all set to pour and go. The Sundesa 28 oz blender bottles with the metal ball in them are perfect for sipping on the go and easily allow you to remix, or add a little fluid whenever you need to.

Radiation in a Nutshell

Love heals.
So does radiation.

The type of radiation I'm receiving is external-beam radiation delivered in the form of photon beams. My radiation plan consists of 25 "daily" (weekday) appointments. I will receive a total of 5,000 centigray (cGy) during the course of this treatment. This cumulative dosage is a lifetime maximum; no more radiation in the same quadrant on my body after this stint.

Although my total dosage of radiation is 5,000 cGy, it is divided into 25 treatments =

200 cGy daily via two planes of radiation to my chest wall and breast skin + 2cm of skin all the way around my breast

-AND-
180 cGy daily via straight-on radiation at my neck lymph nodes

Each day I go in, get dressed in my smock, and wait for one of the technicians to invite me in. I walk through a doorway (the door is about 6" thick!) and into the radiation room. Here's a view of the room at that point:

The room is a cool temperature because of the machinery's needs. I take my smock off and lay down on the table, putting my arms up in the arm rests. I usually opt to have a warm blanket placed on my stomach/legs to feel more comfortable.

The frying pan.

It is important for my body to be in the exact same position as it was during the simulation, so all the planes of radiation are hitting exactly where it was planned to go. (Don't want to overshoot things and accidentally nuke my entire lung or anything!) How do they do this? Using tattoos! Yes, I received 4 tattoos (they look like black freckles): one on my left side, one on my right side, one in the middle of my chest (between my boobs), and another just outside of my right-side armpit.

Using fixed laser beams, they align my body to the beams and move the table to my "special" position: 97.7 on the dial. Then we're good to get started. My radiation treatment is a three step process:

1. Receive plane of radiation from upper left side: aimed at my chest wall and breast.
2. Receive plane of radiation from lower right side: aimed at my chest wall and breast.
3. Receive rectangle of radiation from directly in front: aimed at my neck lymph nodes.

Of the 25 treatments, 12 include this weird stuff called bolus. The best way I can describe it is: same feel as GelGems (those decorative sticky things you slap onto windows for decoration), but double the thickness. I have my own special cut sheet of bolus. It is used to "trick" the radiation into thinking the bolus is my skin; in a way, it forces the beam concentration to be on the breast skin (not penetrating further). The bolus is used for the first two steps in my radiation treatment. It is not used for the neck lymph node treatments. Since the bolus concentrates the radiation at my skin surface, my skin reacts by getting red a few days after those treatments.

A bolus day.

If you are still reading, you're a tropper and a curious human being. Hang with me - I think this stuff is fascinating.

With the beams of radiation, how do they "miss" my right lung and spinal column? By these neat things called multileaf collimators (MLCs). You can see them in the picture below - the top set of MLCs is mostly closed (with an open line down the middle), the bottom set is a trapezoid. These MLCs are customized for each patient. My plan, when loaded up into the machinery software, is set to block out as much radiation as possible to my lungs, spinal cord, etc. for each plane of radiation.

MLCs in machine.

There is a "step-and-move" done with the MLCs. Basically, the MLCs move while the radiation is administered. The MLCs not only block out other parts of my body that we don't want radiated, but they also focus radiation onto my chest wall by being open at first, then closing to block out most of the breast skin. Although they've blocked out the majority of my spine and lung from being radiated, there will still be some exposure. They want to be sure to get the entire chest wall and breast skin area - so compromises must be made. I may have some scar tissue on my lungs, but that will only show up in x-rays and should not change my lung capacity or breathing.

And that, dear readers, is radiation in a nutshell!