AC Chemo Day 1

Day 1 – not too bad.

So glad to be done with day 1 of chemo.  The whole thing felt like it took about three times as long as it needed with lab backups and a bunch of waiting around, but I had great visits from friends, some awesome anti-anxiety medication in my IV which made me feel like I’d been sipping margaritas all afternoon, and a lovely, kind nurse.  Today and tomorrow are supposed to be easier than the last part of the week, so hopefully things will continue to be pretty smooth. 

Tips for next time:

• I don’t need to lug around my power cords, or bring two books instead of one
• My water bottle was invaluable, but fill it out at the main lobby rather than in the kitchen
• Apparently Essential Baking Co and Pasta & Co are on the way to the hospital; my friend Michelle says those are the places to stop to pick up lunch on the way over unless you want to eat horrible sandwiches and over-cooked custard.
• Having visitors is essential.  I’ll need to figure out another rotation for the next few appointments so let me know if you’re interested!  I can tell you it was quite entertaining J  We were definitely the liveliest area of the chemo ward, and discussed wide ranging topics from current events and political appointments to planned haircuts for me before my hair comes out.  I’m thinking something like this, feedback welcome:
  

Now that I'm home I just feel a little woozy but otherwise okay.  Hopefully I’ll get some sleep and be able to function tomorrow!  

Coming Soon

Well it’s been a hard week – I go about my life mostly okay and then remember that I start chemo on Monday.

I hate the unknown; I hate not knowing how I will feel; and most of all I hate that I felt great and now I keep throwing myself into things that make me feel worse.  I know the surgery, chemo, and (now planned) radiation are necessary, but it sucks to feel healthy until the doctors start treating you and make you feel worse.  I’m still looking for the Star-Trek-like medical tricorder or something that could just use a nice painless laser to fix me up.    

So here’s the chemo plan:

Sept 30: AC Chemo

Oct 14: AC Chemo day

Oct 28: AC Chemo day

Nov 11: AC Chemo day

Nov 18: Taxol Chemo, weekly through Feb 10th

The AC is the hard stuff; supposedly the Taxol should be easier.  I’d love visitors though while I’m at the hospital – the AC in particular is kind of an all-day thing.  And I’ve been told I can get a private room and throw a party if I want to, so I just need the incentive of friends being there!

Then when we’re done with that, I take three weeks off and then start 5-day-per-week radiation for six weeks.  We weren’t sure whether I’d need it, but I met with Dr. Pelton, the radiation oncologist, yesterday, and he confirmed it.  He said that because there was such extensive (though non-invasive) cancer, even though the margins were clear they were not very wide (in other words, there wasn’t any cancer on the edges of the areas they removed, but it was pretty close).  That means there’s more of a chance that a little bit was left over somewhere, and so given that it’s an aggressive cancer, and that I’m young, he recommends radiation.  That sucks, partly because radiation is inconvenient since you need to go in every day for your 15-minute “suntan” and makes you tired, but mostly because it makes the reconstructive surgery much more challenging.  Oh well, I’d rather avoid getting cancer again down the line…

I also started physical therapy yesterday, which I’ll be doing for at least the next month and a half.  And I got a long list of things I need to do – forever - to help lower my chances of developing lymphedema, including avoiding sunburn, insect bites, tight sleeves, holding heavy bags, etc on my left arm.  I also can’t immerse my arm in a hot tub for more than a few seconds at a time.  And I am supposed to try to exercise with some special sleeve on. Ugh.  I’m sure I’ll adjust, but for right now it sounds like a major PITA. 

Finally, I have started browsing for wigs.  All the wigs seem to have names, which is entertaining.  So I can be Nora or Ophelia or Hope.  While I am kind of planning to do a different wig each day, I’m going to try to start with one that’s at least kind of close to my actual hair.  I have a friend of a friend who works in theater and has said she can order me wigs wholesale, but the photos on the site she uses are each more horrible than the next so I’m putting it off.  Go take a look though and let me know if you think any look good or, more likely, would be so funny I have to buy them.  

Pathology Report In

So a mixed bag on the pathology report; mostly good news with a couple issues mixed in.

The Good:

• The tumor was composed of mostly non-invasive cancer (a 7 cm section).  There were three invasive tumors, of 1.9 cm, 0.9 cm, and 0.8 cm each.  This is great because it means the dangerous cancer was fairly contained. 
• They were able to get “clear margins”, which means that no cancer cells have been seen at the outer edge of the tissue that was removed.  Also great news.
• And, there was no sign of cancer in any of the veins nearby.
• And no sign of anything on my right side.

The Not As Good:

• It turns out that of the 5 lymph nodes they removed, one did have “micro-metastases”, or cancer cells smaller than 2 mm.  That’s okay; the other 4 were clear and again there’s no need to go back in and take the rest out; if there’s any more it will get removed by the chemo.
• They found a little “DCIS” in my ducts, which is a non-invasive cancer, but it can put you at risk of getting invasive cancer.  That means that either I need to have radiation to take care of it, or they will have to remove my nipple during reconstructive surgery.  My doctor said that of the 75 times he’s done follow-up nipple removal, only 2 of them have required any additional surgery beyond that, and it can wait until my reconstruction either way. 

So the upshot is that I may or may not need radiation, but the cancer is basically gone.  Now on to schedule a couple more visits with radiation oncologists to get their opinions on what to do.  Radiation means that my reconstructive options are a bit more extreme, but still feasible.   

I am a little bummed the report is not 100% clear, but still happy to be recovering, and super grateful for all the nice emails, phone calls, flowers, and gifts folks have been sending.  Thanks so much to everyone!

Happy New Year

Right before surgery Tuesday morning my awesome surgeon asked if I had any questions, and I said no, but that I was confident that we were doing the right thing.  And he pointed out that after we were done, I would be cured…the rest of the treatments are just making sure the cancer doesn’t come back.    So here’s to a Happy New Year that’s cancer free!

Thoughts post-surgery:

• Considering that it was about a 6-hour surgery, it’s pretty crazy that I just had to stay at the hospital overnight, and was mobile just a couple hours after surgery.  
•  My lymph nodes were clear of cancer (hooray!) so they only had to remove the first set (5 of them in my case).  That means a lower risk of lymphedema in my lifetime.
•  I continued my trend of being dramatically ill from the anesthesia for the rest of the day post-surgery.  Ugh.  I’m so not looking forward to the two reconstructive surgeries I’ll have to have too!
•  I woke up super stiff - how did my neck and legs get so sore?  And why did my cheeks feel like someone had punched them?  But as of Thurs I was feeling mostly better on that front.
•  Drains are gross, and I can’t wait to get them out (usually 10 days post-surgery).  They’re the thing that still hurts right now.
•  I am a terrible patient; my wonderful mother-in-law and husband have lectured me at least 10 times a day to take it easier but I am bored out of my mind and terrible at sitting still.  So feel bad for my family; I think they’re tired of coming upstairs and finding me sitting up checking my email instead of sleeping. 

Pathology report is due back today sometime; hopefully it will say the tumor was smaller than expected.

Shana Tova to those celebrating!  

Ta Ta, Ta-Tas

Bye, bye, boobies.  (Credit for the ta-tas line goes to my friend Erin :)

I guess they’ve served me well.  I remember how embarrassed I was when I first got them, and how I perfected the art of tying my sweater over my shoulders to hide them.  And then there was the phase of showing them off in reasonably inappropriate low-cut shirts through my late teens and early twenties.  And finally the sweet quiet moments of nursing both my babies with them.  Throughout the last month or so, I’ve been mostly ok, focused on getting to a plan, with occasional bouts of fear or anger.  The last couple days, though, I’ve just felt sad – it’s definitely the end of a chapter of my life, but hopefully the beginning of a LONG and healthy chapter of being cancer free!

My surgery’s scheduled for tomorrow morning, and will run five and a half hours.  I’ll be having a:

• Double mastectomy
• Chemo port insertion
• Sentinel lymph node biopsy (which actually means removal) on the left side; and if that comes back positive for cancer Dr. Clarfeld will take out the remaining lymph nodes

I’ll be in the hospital overnight and then back home the next morning; then will have a few weeks to recover before chemo starts. 

See you on the other side.