I'm Going to Disneyland!

Steve and I met with my surgeon yesterday, Dr. Jessica Deree. After much discussion and deliberation, we decided that I would have a single mastectomy as well as removal of my lymph nodes on my right side. The surgery is scheduled for April 14. During the appointment, as previously reported, we learned that my cancer is approximately 25% of its original size. I left Kaiser walking a little lighter and feeling like a giant weight had been lifted off of my shoulders. It was a great day.

I have always liked Dr. Deree, but as we were discussing the possibility of a bilateral mastectomy, I had requested and received a second opinion. We liked him too (Dr. Ditmars). I also talked quite a bit to my American Cancer Society Reach Counselor and also learned a great deal through the research of Kelly and Darin. (Sorry for kind of late night call, Kelly!) We were prepared.

Still, as Dr. Deree explained her recommendations, I began to get scared. It was real. However, by the end of our discussion, I was even more convinced that Dr. Deree was the right surgeon for me. Her recommendations seemed to be truly in my best interest. She did not tell me her plan; she presented options. Good options.

It is important to note that while my tumor has shrunk approximately 75%, it is currently disk-shaped and flat. Since the tumor was initially the size of a golf ball and is located at the very top of my breast, it is easy to envision why a lumpectomy or a quadrantectomy (basically a larger lumpectomy) is not a desirable option. Plus, neither of these options ensures that the maximum amount of the cancer and/or micro-disease can be removed.

So my best option is mastectomy. Because I am a candidate for radiation post-surgery, re-construction cannot occur at the time of surgery. Instead, the tentative plan is to have re-construction once I am healed from radiation. At this time, they will remove my other breast and re-construct both during the same surgery. Overall, this is a much less painful/traumatic surgery for me now and ensures that I will be the happiest with the results of reconstruction when all is said and done. The whole process will take up to year.

Dr. Deree also referred me to plastic surgery for a consultation. While the consultation is not really necessary before surgery, from what I have learned, I would feel better about having it. Dr. Deree is trying to make this happen for us.

What now? We are going to Disneyland! Steve is on Spring Break and tomorrow, the kids are flying as "unaccompanied minors" to see Darin and Kelly in Portland for the weekend. On Friday, Steve and I are heading out! I am really excited to celebrate this milestone at the Happiest Place on Earth...because really, I am the happiest I have been in a long time.

Good News!

Good News! We saw the surgeon today and she told us that my tumor is approximately 25% of its original size! More news on surgery as soon as we have a date schedule; and I will more than likely also need radiation. I just could not wait to share the good news on my blog.

Have a great week, all!

Friday, Post Chemo Six

Well, I have almost made it through the week. I continue to overestimate my strength...but I kind of like it that way. I did lay in bed all day yesterday, outside of the hour I took to sit in the sunshine - grabbing some much needed vitamin D, while eating lunch and reading my book. I also coaxed myself out of bed in time for Steve and the kids' arrival home. We had a nice dinner. Families of San Diego United Futbol Club continue to amaze me - the dinner provided last night was fantastic. However, my strength wained after a couple of hours and I found myself back in bed.

I was disappointed but not surprised. This is chemo number six and I was only three days post. I just always hope that my super powers will kick in and I will utterly astound myself, though I know that my high expectations make this hard to do.

Today I sit in wait for a couple of my colleagues who are coming to take me to lunch. I have been moving around quite a bit this morning. So, just sitting and waiting is probably a good idea. In doing so and typing this entry into my blog, I find my choice of words ironic.

One day, my colleague, Judy explained her distaste for the word just. In the context of work, people ask, "can you just take a look real quick?"; "will you just try to finish a week early?"; or, "will you join us for a meeting just for a minute?" Judy warned requests as such usually require much more work than is implied. Her point resonated with me. I avoid its use and even tell my kids repeatedly not to use that word, literally saying to them, "Mommy does not like it." I have attempted to explain why they just can't watch five more minutes of t.v., or whatever the case may be where they think using the word just is additive to their argument. I am not sure that they have grasped the concept.

I find the irony in the fact that now that I am sick, the word just has a different context for me. I use this word at least 50 times a day now - almost always about my condition and commonly about things I find myself doing or not doing, as the case may be. If I just had a little bit more energy...if I could just sleep a little bit longer...if I could just taste my food...etc., etc.

I do not mean to imply that I am miserable. Complaining is not my thing (I like to keep telling myself this). However, now as I use the word just, I realize that in a backwards sort of way I am sending a message of hope to myself, willing myself to be and get better.

The biggest hope of all......that I will be just fine...and I will be. Just you watch....

Six and out!

As promised, pictures from today. As you may recall, a group of girls and I put purple streaks in our hair in honor of the first chemo. Since I no longer have any hair and there was no real time for tattoos, I borrowed Maddie's purple Crayola marker for some fun.

Chemo went well. I am very nauseous and very tired. I already had a three hour nap today, but thanks to my steroids that I take through tomorrow, I got up for dinner with the family and am moving around a bit right now. Taste buds are going fast. Dry mouth has already kicked in. Symptoms seem a bit accelerated, all and all.

Just hoping this is the last set of chemo treatments....so this can truly be Six and out!

Late Night Entry

Chemo number six is tomorrow. Six of six. Time has flown. I have a nervous pit of mixed emotion brewing. As excited as I am to complete this step, I am really, really nervous of what is to come.

I think this brings me to this late night entry. I cannot blame Daylight Savings Time. I cannot even blame the pre-chemo steroids I took at 6:30 p.m. I just am wound up, I think.

It has been a great week, in a backwards sort of way. Steve was really sick this week. Worrisome sick. I felt so helpless not being able to do much (I was still sick too), especially in the transportation department. Then again, my feeling a helpless in the transportation department is not abnormal. Mostly, I try not to think about it. We do have help. So many people are so gracious.

On another note, we had the ceilings in our house scraped this week. Silly me did not even think about the fact that I am allergic to dust. Goofy. That what I have to say about that. If I had hair, I definitely was a blond in the thinking through the selection of these dates. No offense to my beautiful blond friends. (I actually used to be a natural blond until I was about 25 years old, so I feel like I can make this kind of statement, anyway.) Needless to say, my allergies are a mess, but my ceilings are gorgeous.

We saw Dr. Sweet on Friday. He was not concerned about my allergies and the cough that has ensued. Everyone else is. My parents went to the see him with me. I think they liked him a lot. I was pleased that Dr. Sweet prescribed Neulasta for me, replacing my Neupogen shots. While (fairly) easy at the start, after chemo session five, my skin was so sensitive, I dreaded giving myself Neupogen shots every day. I knew it saved Kaiser thousands of dollars and was OK with that. However, at this point, I am done saving them money - so I asked for the $5,000 shot of Neulasta. There is an associated risk with this new drug, if I am to become neutropenic again. I'll risk it.

I did have to laugh though. My medical record now looks something like this:
Sunday - Pre-chemo required blood work
Monday - Chemo
Tuesday - Neulasta shot
Wednesday - Spa Day

Does Kaiser have a spa? We all laughed when he said it. I did not think it was in my official records. Now that it is....hmmm.....I hope the Neulasta shot is not some horrendous procedure that I do not know about yet. Better not think about that either.

So, also this week, I made my appointments for a second opinion and an appointment with my surgeon. This will immediately be followed by a family counseling session, that has been on the books for about a month. I should have a plan for next steps next week.

I have been handling my chemo well. I have to imagine that I will handle the surgery and radiation just as well. However, in the back of my mind, I just can't help but worry about hidden cancer cells that they could find when surgery is performed. I just can't help but worry about what my right arm is going to feel like after they sacrifice the main nerve in my armpit to remove my lymph nodes or vainly, how I am going to handle looking at myself in the mirror flat-chested. Outside of hating the feeling of air circulating on my bare head, I am OK with my bald head, mostly. Some pics taken by my friend Stephani Dennis (Steph also took our family pics this past Fall) really made me feel beautiful. Maybe I can feel that way about my chest? I am getting the idea from talking to people that reconstruction may not be possible for up to nine months post radiation. Could be same time next year?

I will handle it all, I know it. That is just how I am built, pardon the pun. But really, life goes on. We all have our own "stuff" - mine just happens to be on the life-threatening side. This really does not mean that my life is in danger, in my mind. It just means that I am sick and "cancer" is a big scary word. Maybe I just need more Ativan.

So, wrapping this entry up may be a good idea since it is now really, really late. Thank you to all who rose to the occasion to help us this week. Boy, did we ever need it. You all continue to inspire me - the dinners, the lunches, the notes, phone calls, emails, cards and Facebook posts are awesome! I really hope I responded to you all and if I did not, please know that you made me smile and I appreciate each and every one of you!

Six and out! (Picture to follow tomorrow.)

The Calm Before the Storm

It is raining outside. Love it. We have had a lot of rain this year, as most of you know. It makes for a lot of cancelled kids' sporting events and lazy days. I just wished we could go skiing - Mammoth Mountain has a 400" base. Wow. Steve and I have not gone skiing in a number of years and had decided this past summer that this would be our year to take the kids for their first time. Better luck next year, I guess. Our kids have been on many fun vacations in their time - do not feel too sorry for them.

As I type this, I sit in my new living room. Well, not exactly new in decor - yet. Though, I am viewing the rain fall through my beautiful new windows and shutters. Cooper is sitting in Steve's chair looking at me wistfully. Die Hard, one of my favorite movies, is on television.

Where is Steve? Well, he is preparing for the storm - our ceilings are being scraped this week and also as important, but not quite as messy, my new living room is being painted. My parents have been extremely helpful in helping us to prepare and are even coming over today to help make final assessments and give direction for prep work that needs to be complete.

The caveat to all this is that Steve finally caught the nasty cold that Harrison, Maddie and I have had all week. This is where it gets frustrating. My stamina is just not there. As soon as I finish typing this, I am going to start some laundry, help Steve and make sure Harrison gets started on his homework assignment. I am determined and I will accomplish my goals today. Steve thinks he can do it all and he probably can. However, sick as he is, should I let him?

I should mention that I love the way our house is coming together. Steve and I both feel that anything that is postponed in the house's remodel progression now, might as well be put off indefinitely due to my health. We can see the light at the end of the tunnel. We know our stopping point is not too far off, after which point, projects will be more manageable and/or can wait until after my surgery.

Personally, I am feeling better, though my cold and cough linger. I suspect they will for awhile. I am curious what my white count looks like. Regardless, like my goals today, I am determined to carry out my plans for the next week. What are they? Two of my close friends have birthdays - I intend to celebrate with both. I have special lunch invitations for tomorrow and Tuesday; I am getting a pedicure/manicure on Wednesday; and, I am also celebrating my grandma's birthday with my mom on Friday. (Grandma passed away this summer and Mom and I are going to see Grandma's newly installed gravestone. Grandma's birthday is March 11.)

So, today, truly is the calm before the storm. I am going to enjoy every last moment of it and even "the storm" that is this week, as March 15 (a week from Monday) is my LAST chemotherapy treatment. It is going to be a tough one. The fifth was a tough one. I am going to try not to think about it too much. Something tells me that the chemotherapy is going to be much easier than the surgeries that are in my future. But I am going to try not to think about that either. My best bet is just to think about the here and now.

Or in the great words of John McClane, "Yippee-ki-yay...." Oh, you know the rest!

Neutropenic with an Attitude

I knew I was not feeling quite right at the beginning of the week. However, generally I need 10 days to spring back from a chemo treatment. So, I did not give the fact that I really was not feeling well much heed. I tried to slow down and nap on Monday, but by midnight, I had spiked a fever high enough to condemn me to taking my temperature every hour and prepare for an ER visit. Oddly enough, my fever bounced from 99.1-100.2 all night long. A 100.5-degree fever mandates a trip to the emergency room.

Since I never got to this point, I called Dr. Sweet's office the next morning, guessing I was slightly neutropenic. The tests my doctor ordered confirmed it. I found a great definition online that I thought I would share with you all. It is from cancercare.com, hosted by Scott Hamilton:

If a patient has a fever and low neutrophil count (less than 500/mm3) (febrile neutropenia) they are at risk for infection they may be hospitalized, monitored and receive antibiotics. The concern is that an infection can develop in the blood and lead to a life-threatening condition - sepsis. So the patient is admitted to receive antibiotics until the fever resolves, and neutrophils increase to safe levels - if no source of infection is found.

I have had a slight brush with this problem before and was aware of its dangers. However, the last time, they told me to stay home and where a mask and the symptoms where gone within 24 hours. This time around, I knew I was at the most dangerous point of the 21-day chemo cycle. Days seven through 14 I am most prone to infection. i.e., my white count is the lowest. Monday would have been day seven and hence, another reason for my phone call to Dr. Sweet.

When Dr. Sweet called to confirm my test results, I was not surprised by the results but more by the surprise in his voice. He gave me a new prescription to Neupogin (this is something I take for seven consecutive days post chemo) and strict orders to go to the ER if my fever reaches 100.4. Thankfully, it never did.

However, I can tell you that by the time I got home from the lab (thanks for taking me, Laurie!) and got Dr. Sweet's phone call, I was feeling really weak. I knew I had a bit of a cough/cold caught from one of my children, but more than anything I just felt extremely weak. A strange weak. Thank goodness for my mom, who came over to manage homework and Maddie's biography project, while Steve took Harrison to his first baseball game of the season. I was in bed.

I also stayed in bed yesterday. A new experience for me. I think I slept on and off until 1:00, getting up only for lunch, which my mom had prepared for me, Tom and my dad, who were all here working on our house.

The experience of the last couple of days has taught me to appreciate these down times. I do not know that I have ever spent days in my bed. I never felt justified in doing so. Now, I have an excuse - a good excuse - an excuse that will help ensure I live a long happy life. So, here I sit. My lap top even plugs in down here now (usually it charges in the family room).

The good news is that I have no fever yesterday! As far as I can tell, I have had not had a fever since about 3:00 a.m. on Wednesday, when it was 99.1.

I have a few more physical symptoms that I am dealing with, though. Nothing serious, just some odd ball skin stuff, a little bit more pain (I am working my way off the Vicodin now that I have no fever and can take Tylenol) and the ever constant taste bud issue. I just look forward to having a little bit more activity next week, a few more taste buds and to kick this silly cold.

I got this - or at least I am working on getting this. Going from working, to not even driving, to now having to stay in bed has been something. But I am just trying to keep my eye on the prize and learn to appreciate the choices I get to make in my daily activity now. Different from what they would have been six weeks ago, at least I still have them. Besides, who can resist a nap in the afternoon?

Expectations

I ache. I think I may have finally caught something resembling Harrison's cold. Only mine went straight to my chest; it is not really in my sinuses at the moment. The kids are off to school though - BOTH of them! I scaled back my plans for today, have taken my vicodin and have my trusty thermometer by my bed. My parents are coming over to help around the house and maybe with an errand or two. I am looking forward to it. I think spending time alone with my mom and dad will be good for me.

I know why I feel run down. I had a weekend where I rarely sat still. Friday night, I was at my friend's house. Steve was exhausted, Harrison sick and so a couple of my friends came over to get me. Another one of my friends stayed sober to bring me home. I have good friends. I need to get out more - to remind me that life is good.

I have been depressed lately. No one has been able to make me happy. I have not been able to tell any one how to make me happy. Psychologically, I am still reeling from the after affects of my seizure. There is no way to explain how it feels to have a grand Mal seizure in front of more than 100 people. To be referred to in discussions, as "his wife is the one who had the seizure." I do remember a seizure that I had at the flower stand that I worked at while in high school. I was 17. Mind you, I put on a brave face then as I do now. The after affects of having the seizure and now not being able to drive send me to that depressed place I knew as that 17 year old. As my cousin rightly pointed out, Steve does not know me here and I need to let him in a little more, so he can help me. I am working on that.

Steve is a remarkable man. However, it was during a tearful discussion that we had on Saturday morning that I made my decision: the only person who can help me get out of this depressed place is me. I know it involves Steve, but also know that Steve has the weight of the world on his shoulders - our world. And he constantly puts pressure on himself to get it all done. I think it is this pressure that stagnates his focus and makes him miserable. The last thing I want to do is contribute to making him miserable.

He is doing a great job. The way he deals and discusses my cancer with me brings me great comfort. However, for the betterment of our home life, I need to take more responsibility for making myself happy. For example, for a while now, I have craved some grand romantic gesture, generated by Steve, without my knowledge or input. What I am realizing is that Steve finishing our house projects which have enabled so much positive change in our living space, is a romantic gesture. I am more thrilled by the day with the new look/function of our home and this new viewpoint is a more realistic expectation, I think.

Also, I do a lot of sitting on my couch. I tell myself that I do not have the strength to do much more. Maybe this is true; maybe this is not necessarily the case all of the time. I am not saying I can go for a six mile walk, but maybe sitting in the sunshine reading a book would change my state of mind. I guess what I am saying is that I think I could be happier, if I was more productive.

So my reason for not feeling good right now? Probably because I worked for four hours on the house on Saturday as a family. We also went to OB yesterday for breakfast and to check out the surf, post Chilean earthquake. We walked around for nearly three hours. It felt great. It felt normal. Of course, had I come home and rested, I may have felt a little better this morning. However, feeling as "normal" as I did, there were a hundred other little tasks thought I should do. (I also had an MRI of my brain yesterday. No results yet but hopefully soon.)

All in all, I am physically exhausted today, but mentally, I think I am happier. I know a lot has to get done on the house this week and some of it needs my input; we have sports every night; and, there will be rather large homework demands due to Maddie's biography report being due and as Harrison continues to make-up school work missed last week. I am thinking I can handle it; not in the same fashion that I may have six months ago - I will be slow; I will need naps. Maybe that is OK. As long as I am being honest with myself about how productive I can be at any given time, I think I can meet my own expectations. Then, we will all be happier.

Click here to link to the video we shot a the beach yesterday. Gorgeous day, happy memory!