Monthly Archives: February 2008

Second Update

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I guess I’m just slow on the update…

On February 4, I had my first visit with my oncologist, Dr KP, in Cowboy Town. She’s very knowledgeable, experienced, nice, sincere and frank, and I appreciate those qualities in a doctor.

For a while there, it looked like I wouldn’t make it to my appointment. We’ve been having a lot of snow, and it was difficult for me to coordinate a ride. And to make matters worse, the 40 miles of road between Cowboy Outpost and Cowboy Town had been closed from time to time because of blowing and drifting snow.

Winter in the Washington Outback. Sigh.

I decided to book a flight from the Outpost to C-Town, and my BFF Randi picked me up at the airport. She also took me to my doctor’s appointment and sat with me through most of it, helping to bolster my spirits — and to remember and take notes, too! I appreciate her effort so much because she has two small boys, ages one and three. Her 3 year old had an appointment around the same time as mine and she deftly coordinated getting us both to our appointments and picked up and the boys babysat (by their loving Daddy) while she came to the oncologist with me. That was no easy task.

You must be on the edge of your seat, wondering what the oncologist said. 😉

It breaks down like this:

You’ll recall that I had a 4-5 cm tumor. This is large, and it was “staged” as Stage IIIa, beginning to spread to the lymph nodes.

I don’t have to do chemo if I don’t want to…however…

  • If I do nothing else, there is nearly a 50% chance of recurrence within the next eight years.
  • If I only do tamoxifen (hormone therapy), there is a 20% chance of recurrence within eight years.
  • If I do chemo and tamoxifen, the chances of recurrence drop to below 10%.

I don’t want to go through this again, ever. That means chemo’s on my calendar.

I’ll go through two rounds of four sessions each, for a total of four months of chemo. It breaks down like this:

First round: Adriamycin and Cytoxan
Side effects: nausea; hair loss can be total and begins two weeks after treatment starts (I’ll be bald by the end of March). The Adriamycin can also be hard on weak hearts so the doctor will schedule tests before treatment starts, to make sure my heart can take it.

First session: March 11, in Lewiston. I’ll drive myself and stay overnight with Randi, coming back on the 12th. The oncologist thought this was a good idea.

Subsequent sessions, in Pullman: March 25, April 8 and April 22.

Second round: Taxol.
Side effects: can cause numbness in fingers and toes.

First session, in Lewiston, May 6. I’ll drive myself and stay overnight with Randi. The final exam for my class is May 1, so I should be able to get my grades in before I start this next round.

Subsequent sessions, in Pullman: May 20, June 3, June 17.

Next week, I’ll have my second surgery: axillary lymph node dissection. The surgeon will take out the lymph nodes under my left arm. At the same time, he’s going to install the “port” that will make it easier for the administration of chemotherapy. Dr. Incredible, my surgeon, said we can leave the port in indefinitely, but I would really rather have the damned thing taken out after my chemo is finished.

I hate the idea of having a foreign object in my body in the first place —although I also recognize the need for it and its benefits— but leave it in? Forever? Ick. I don’t think so.

So while I’m recovering from my surgery next week (possibly at LeAnn’s again), my dear students will be taking their midterm exam. I’m sure they would rather do that than what I’ll be doing.

On the emotional end of things, my original hopefulness has been having fistfights with my panic disorder and depression. I had a visit with my oncology nurse on Monday, and she said this was completely normal, and to be honest, if I hadn’t started feeling this way, she would have been worried about me. Like, that’s got to be a symptom of serious denial. DR KP gave me Lorazepam, but that just takes the edge off the anxiety. The nurse in Dr. Incredible’s office said to call if I needed anything, including something to ease the depression if it gets too bad. Today I’m feeling much less despondent, and I’m going to try to hold out without pharmaceutical assistance for as long as I can. Unfortunately, depression sneaks up on you (like frogs in a pot of boiling water who don’t know they’re in trouble until it’s too late) so I’m counting on people who see me frequently to let me know if it looks like the water is beginning to boil, so to speak.

My oncology nurse, Michelle (my surgeon’s nurse is also Michelle!), gave me a packet of information, including local resources. This packet is so helpful! The first chapter, “Your feelings: learning you have cancer,” goes through the normal feelings people have when they have cancer:

  • Denial
  • Anger
  • Fear
  • Stress
  • Anxiety
  • Depression
  • Sadness
  • Guilt
  • Loneliness

I managed to skip the first two, because my diagnosis was completely undeniable. My only anger was at the American health care system. The rest of them, I seem to get in waves, sometimes all at once. I also don’t have any guilt.

I’ve always said, we’re all going through this together. The booklet the nurse gave me from the National Cancer Institute has a website URL where you can go for more info on cancer, and ideas about what you can do to help me: http://www.cancer.gov. There’s also the American Cancer Society, at http://www.cancer.org.

One of the support groups I joined recommended a website called “Lotsa Helping Hands.” This is a place where we can coordinate all kinds of help, from rides to shopping to cooking meals and moral support. If you’re in need of help, I recommend you sign up. It’s completely free. And if you’d like to join mine, let me know and I’ll send you the URL.

Knitty Titties

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I had a mastectomy last month.  Now I have to figure out a way to appear balanced and normal when I go out in public. I have “coconut” bras, the kind with the molded cups, and my doctor suggested a light fluff of gauze bandages would be appropriate at this stage, since my incision is still healing.

Once my treatment is finished, I plan to have reconstruction.

Mom today said that she and my sister Cher are going to the craft store tomorrow. They’re going to get the yarn and my SIL Ruth is going to knit me some boobies (see the site referenced in my “links” list).

Mom said, “you’re not actually going to wear them, are you?”

I said, “Of course. There’s no point in buying an expensive plastiboob (prosthetic breast), since I’m planning reconstruction anyway. I haven’t seen them for less than $50 each.”

Mom said, “OK then. After you don’t need them, you can hang them from your car mirror.”

I would totally do that.

My first update, January 26, 2008

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Dear Friends and Loved Ones,

I’m at home and resting comfortably.

The forecast was for 6-9 inches of snow between today and tomorrow, so LeAnn and I decided that I should come home today instead of tomorrow. The city closes my street sometimes in bad weather and we felt that for safety’s sake, we should get me here before the snow started.

You truly find out who loves and cares about you at a time like this, and I want to thank each of you for your help, prayers, healing thoughts and good vibes. I am completely convinced that without your help, I would not be in the emotional and physical condition I am in right now. Because, frankly, I’m usually a basket case and I do have a diagnosed panic disorder. One major panic attack (and a few minor emotional meltdowns) isn’t so bad under the circumstances. You have propped me up and I am grateful for that.

This is how I remember it; you mileage may vary, so to speak. The doctor has me on Hydrocodone Apap and I’m feeling no pain.

Millie took me to the hospital on Jan 4 for my mammogram which turned out to also be my biopsy (this short visit ended up taking hours, and Millie stayed there with me through most of it, while still trying to get some urgent business done before she returned to Hawaii.) She also took me to my first visit with “Dr Incredible,” my surgeon, on the 15th. Dr Incredible explained to me my mammograms. He was very respectful and kind, and spoke to me sometimes like I was his sister and sometimes like I was his Anthro prof! He’s a really sweet guy and a doctor who is primarily a healer, not just a guy with a scalpel and an MD. He showed me how much of my breast was cancer tumor, and clearly it was half. There was also some concern about whether it had spread to other parts of my breast. The area of biggest concern was whether it had spread to the chest wall muscles. It was hard to tell from the pictures.

He told me he could try to do a lumpectomy but that would leave me horribly deformed anyway, and he couldn’t be sure if that would get all the cancer. He was recommending a simple mastectomy. After some further discussion (maybe three mintues) I had to agree with him. You know how stubborn I am, so that tells you how good his explanation was of my condition. Clearly the breast had to go. He was also emphatic about my needing to have reconstruction. We had to find a plastic surgeon who would do it using the medical coupons. Not an easy task. The state pays what they consider reasonable and customary. Well, anyway, reconstruction would come later. He said it would be 6-8 weeks before I was healed enough.

Now, Dr. Incredible has no problem accepting “reasonable and customary” but the plastic surgeons I spoke with did have a problem with it. More on this later.

Terry took me to the hospital on Wednesday morning, a big sacrifice for him because he was at work late into the night on Tuesday. He stayed most of the morning (with a brief trip to take Puck, his dog, back home so the poor girl didn’t freeze in the back of the car), until he had to leave to teach class on campus. Terry is a professor in the Theater department and teaches directing. After same-day pre-op (they gave me this heated hospital gown to wear! It was wild!) I went to radiology for the dreaded radioactive dye procedure to find the sentinel lymph nodes. That was very, very painful. Ouch. Sticking a needle in a very sensitive area. The technician was almost as pained as I was. He apologized three times before he even started. However, the procedure went very well, and they found three sentinel nodes. He said the procedure isn’t always that successful; in fact, it usually is only moderately successful. I took that as a good sign.

Back to the pre-op staging area I went and Terry was waiting. My anesthesiologist introduced herself and I told her I get really jarred if I go under too fast, so she said she would do it more gradually if she could. They would also give me something to calm me down beforehand. Good idea. Panic attacks suck. Then my OR nurse introduced herself. She was really sweet. She’s worked with Dr Incredible many times and she left me feeling confident that I was in good hands. Then two guys wearing scrubs came in, one was from India and the other wore these geeky glasses. The guy with the glasses introduced the other guy as a student or something, I don’t remember.

I said, “so what are we doing today?”
The guy in the glasses, wearing a smart alek smirk, said, “surgery.”

I hadn’t recognized Dr Incredible in his geeky glasses, and he was enjoying it immensely. We talked a bit and I told him to do what he thought was best; if he thought we could do a lumpectomy, that would be good, but if he got in there and it looked as bad as we thought, to go ahead and do the mastectomy. I said I trusted him and knew he had more experience with breast cancer surgery than I did, so I would trust his better judgment on it. He thanked me for saying that. We talked a little more and he left.

Terry stayed with me until they wheeled me into the OR. On the way to the OR I had a minor meltdown, but that was all just fear, and the nurse said it happens all the time. Even with the calming drug, I was still scared out of my wits.

I had hoped to finish this update but it looks like naptime is creeping up on me.
More next time.