Friday, November 28, 2008

Turkey Day

So yesterday was eventful. I was lucky enough to not get my period (hooray!), so we don't have to go home until tomorrow, like we had planned all along. So here's hoping nothing happens down there until at least 5pm, so we don't have to go home early (I'd really like another Jersey Mike's before leaving. Mmmmmm). However, my dad managed to throw a kidney stone right before dinner. So he, my mom & my cousin went off to the hospital. He'll be fine, and so far he hasn't really had any pain since they gave him some serious medicine, but man, what timing. So he didn't really get any Thanksgiving dinner. Our hosts were kind enough to pack up a bunch of leftovers, so at least there's that!

I hope everyone had a good Thanksgiving! And gets to have Friday off! I feel bad for those poor saps who have to work today (I'm looking at you, Bermuda. And Britain. And Ireland. And the rest of Europe. Don't you wish you had Thanksgiving??).

Tuesday, November 25, 2008

Thanksgiving Day! (Early)

I don't know if I'll be able to blog anything until next Monday, since I don't currently have internet at home, and also I'll be out of town. So here's what I'm thankful for: early detection! Rah rah!

So I'm going in for (hopefully) my last drainage. I think after this I ought to be able to reabsorb any fluids. Bleah, so gross. My skin is still pretty sensitive, but I guess that's something that's here to stay. For awhile anyways.

I'm going up to NJ, where, hopefully I won't have to turn around and come back before Saturday. See, when you're having your eggs harvested, everything is turning on when you start your period. When you get it, you call them up & then go in to see them the next day, where they do blood work & vaginal ultrasound. Since you have to go in the next day, I am really really hoping that I don't get my period until at least 5pm Wednesday, since 5pm is when their appointment line closes. So here's hoping I can hold out. I'm a little worried, b/c my boobs are getting really sore (let's hear it for PMS, ladies! Ok, maybe not). And since I haven't really had PMS since I was 19, I'm not sure how many days that gives me until I start menses, to use the terminology.

I warned you about TMI! If you've gotten this far (and even if you haven't), Happy Thanksgiving everyone! Have a good one!

Friday, November 21, 2008

More Drainage

This is getting to be a bit repetitive, I know, but yesterday morning I had another date with drainage. They got out 75 ccs this time. So, hey, moving in the right direction! The whole area is feeling better now - I think I've finally turned a corner. Am thinking about trying to not have a Percoset today . . . we'll see how that turns out. It still hurts, but I think it's more from the nerve damage in the skin, and less from the actual surgery. The doctor yesterday said that the skin issue could take a few months to stop, but hey, at least it should stop at some point. My understanding is that it's just the nerves firing away, trying to regain their connections. I picture little nerve cells searching in the dark with tiny little flashlights. "Nerve 103, where are you??" "I'm over here!" "Over here?" "No! This way!" Ugh, find each other so you can cut it out.

Wednesday, November 19, 2008

Update (Warning: Disgusting Discussion of Bodily Fluids Ahead)

I went back to the doctor on Monday to have more fluid extracted from my underarm, and I found out those big syringes hold 60 ccs. On Friday, they took out 160 ccs, so 2+2/3 syringes full. Monday, they took out anothe 95 ccs. I have another appointment Thursday morning, so we'll see how much they take out. I think it'll be quite a bit less, as I'm not feeling any discomfort yet. Here's hoping! My friend was impressed with the size of the needle they stuck in me, but I didn't feel a thing. I haven't really looked at the needle during any of these procedures, because I really don't want to see how big that thing is. I guess that's one good thing about having nerve damage - I can't feel the large-gauge needle going in. My under arm area has this weird combination of numbness and pain - sort of like life. Woah, dude, that was deep. So the skin itself is numb in places, but everything underneath is painful. I'm trying to go a little longer between Percoset doses. I might try to just have Tylenol today during the day, and see how that goes. Around the surgery site, a few inches up the inside of my arm, and a couple inches around my back, the skin is pretty sensitive, like when you have the flu. I can deal with the numbness - as aggravating as that is, the worst part is when I'm trying to shower or put on deodorant - but the sensitivity is driving me nuts. Every time I move, and the fabric from my shirt draws across my skin, it's like a little wisp of insanity. Gah. I hope that goes away soon.

Sunday, November 16, 2008

36 Hours in the Life of My Hair

Here's my hair Saturday morning. Ok, it wasn't totally styled - it should be almost stick straight, but a) it was raining, and b) I was due for a trim. But look at it! So shiny! So healthy! So . . . well, not long, but at the start of getting there!

And here's my hair Saturday afternoon. Side A:

And Side B:

I told my stylist to do whatever he wanted, just make sure it can be wash & go, since I don't have a lot of energy these days. It's all I can do to get out of bed, let alone style my hair. Makeup is right out. So this is what he came up with. I like it! And now for something I can't blame on anyone but myself. Ha ha! I kid. I think it turned out well, many thanks to my intrepid helpers Nichole, Molly, and Candy.

Step 1: Put on Vaseline, to prevent skin dying.

Step 2: Apply dye (colour name: Pomegranate).

No, my hair isn't already red here. I guess it's just Nikki's shirt reflecting on my head. But, hey, preview!

Step 3: Wait for 25 minutes.

Step 4: Style as usual. Bonus step: match hair to 'after' & see how close it was.

Step 5: Check out your rockin' self! Holy crap! I can't believe that worked!

Thanks once again to Candy, Molly, and Nikki! You guys are the best!

Meeting with the Surgeons; And More!

So I had appointments with three surgeons. Some of the stuff I read said you should meet with a few surgeons, to find one you were comfortable with. So I met with 3. One that my GP recommended & works with, one a co-worker recommended from her bout with breast cancer a few years ago, and one from Georgetown U. Hospital. I would have gone to see more, but one was on vacation the week I was looking for surgeons, and the other didn't take my insurance, which made that decision easy. On Tuesday, 10/14, I went to see the first surgeon, who was as cute as my GP had warned. Tee hee! Hello, doctor! I went to see two others on Thursday, 10/15. The one at Georgetown in the morning, and the other in the afternoon. I ultimately decided to go with Dr. Costanza Cocilovo at Georgetown, who is great. I liked all three doctors, and I wasn't worried about any of their credentials, so it was nice to have a choice. Georgetown is halfway between me & my parents, plus it's pretty close to work, which will be a lot easier for follow-ups, etc., especially if they're in the middle of the workday. Also, Georgetown has a whole cancer center (the Lombardi center, named for the famous football coach, who went there during his bout with cancer), and within the cancer center is a center specifically for breast cancer (the Ourisman Center, which I believe is the same Ourisman family who owns a bunch of car dealerships in the DC area). It's also nice to have almost everyone under the same roof (more on that in a sec). During that initial appointment, we discussed treatment options. She said I would definitely need chemo, so goodbye hair - and I had just started growing it out. Sigh! She also mentioned the possibility of egg harvesting, as chemo can push you into early menopause, which you may or may not come out of. She referred me to Dr. Eric Widra with Shady Grove Fertility (who is supposed to be on the cutting edge of freezing things), so he's the one guy who's not under Georgetown's purview, since GUH is a Catholic hospital, and the Church still frowns on those sort of 'playing God' kind of things. Hey, at least they're consistent.

So in between these visits to surgeons, Wednesday 10/15 specifically, I had a breast MRI, which was interesting. They put an IV in, and take some pictures without a dye, and some with. You lie face down on a board with a face support, like on a massage table, and two holes, for the subjects in question. Then they take a picture for 3 minutes, then a picture for 1 minute, then a picture for 2 minutes. Then they turn on the dye, and repeat the process. All the while the MRI machine is making these loud buzzing & humming noises, in different tones. Sort of musical, if your mind tends towards those kind of things. That loud clubbing, type of music - you can feel the vibrations going all through your body, because it's very loud (they give you earplugs).

Next appointment was on Thursday, 10/23 with Dr. Minetta Liu, oncologist. She's also great. Very warm, (hooray for bedside manners!) and knowledgeable, and has no problem taking extra time to explain things, and make sure you understand all your options. In fact, we ('we' is generally my mom & I) didn't see her until a good couple of hours after my appointment time . . . but what's a couple of hours for a doctor you like? And what would I be doing anyway, working? She was upfront about the fact that she's always running behind, so I guess that's all you can ask for - forthrightness! In fact, when we got out of there, everything was shut down, and everyone was gone. It was kind of spooky, like being in your office on a Saturday. Dr. Liu suggested neoadjuvent chemo, which is chemo before surgery. The benefit of this would be a) seeing if the chemo is actually working in shrinking the tumor, so they can adjust what kind of chemo or dosage or whatever, and b) shrinking the tumor, so the lumpectomy will not have to be as invasive, and I have a better chance of coming out of surgery with evenly-sized boobs. The downside is that I'll still have the tumor inside of me, which some people have a problem with, still having the cancer sitting there inside you where you can feel it. I hadn't really thought of it that way until she brought it up. Thanks, Dr. Liu! One more thing to panic about! No, I'm not panicking about it. I like the idea of seeing the chemo shrinking it, so we know it's working, an option that's not available if you go ahead with surgery first. In some (relatively rare) cases, the tumor will shrink so much, they'll have hardly anything to excise. Here's hoping!

So that afternoon, and Friday (10/24) morning, I joined a study for genetic counseling. We don't have a family history of breast cancer, but we also have a very small pool of women. We also have a strong history of cancer, in general. Three out of four of my grandparents died from one cancer or another, and my dad had prostate, which he has thankfully beaten. So, given that genetic mutations in the BRCA-1 & BRCA-2 genes are rare, and only account for 5-10% of breast cancer cases, chances were that I didn't have a mutation. So why get the testing? Well, having cancer doesn't imply that you'll have the gene, but having the gene strongly implies you'll have cancer again. Maybe in the other breast. My results have come back negative (phew!), but if they had come back positive, I would have seriously considered a prophylactic double mastectomy and possible oopherectomy (not sure on that spelling - it's removal of the ovaries, as the mutation also affects ovarian cancer rates). So, I am relieved to have one thing I don't have to worry too much about!

Monday, October 27 through Monday, November 3, Mom & I went out west, first to San Diego to visit some cousins, then down to Cabo San Lucas for another cousin's wedding. It was fantastic, and I forgot I had cancer for awhile! Be careful of the water, though. I had a (very mild) case of Montezuma's Revenge. It went away when I did like the pilgrims & drank beer instead of water. Hey, it was Corona, so it wasn't far off from water. Also: all-inclusive resorts are the way to go. We didn't have a mini-bar - we had a mini-fridge with sodas (aka mixers) & a bar with full-sized bottles of tequila, rum, vodka, and whiskey. So after a lovely wedding, with lovely people, and releasing of some baby sea turtles (SO CUTE!!!), we flew home. Keanu Reeves was on our plane going back to LA! He was just as gorgeous as ever. And we were thisclose to making eye contact. It's true! I think, much like me, he was trying to get away from his troubles for awhile. We have so much in common! Call me, Keanu! Luckily for him, his troubles are over, since he was cleared in that paparazzo case. If only we were all so lucky!

So, the following Wednesday (11/5), I went to meet with Dr. Widra about egg harvesting. He had some blood drawn (last time for my left arm!) and did an ultrasound of my ovaries. I'll spare you the details of how he did that, but no, they don't just put the ultrasound on your belly. Yeah, they do it that way. I had 10 developing on the right and 6 on the left. Come on, leftie, catch up! So everything points to a good possibility of having a good-sized litter, which is really what you want when you're harvesting. And, bonus, it looks like insurance is going to cover it. Which is nice, because I really have no money right now.

Thursday, 11/6, I went in for a sentinel node biopsy and possible axillary dissection with Dr. Cocilovo. I couldn't eat, or even drink water, after midnight. I went in at 10, and was given a Valium, to take the edge off the day, just like a 70s housewife. I went up to take some pictures of my nodes, with the help of some radioactive dye they had to inject just under the skin. Let me tell you, that was probably the most painful part of the day. It's like those TB tests, if you've ever had one. I haven't had one for twenty years, so I forgot how much it hurt. And they had to do three! Right around my nipple! That is a sensitive area, people. So we went down, and around 1pm (starving!), they came by to put in the IV & take me into surgery. I've never walked into a surgical suite before. For both my appendectomy and my bladder surgery, I was wheeled in, so that was different. And wow, there's a lot of equipment in there. Which, I guess, should be comforting. This ain't no M*A*S*H-style field surgery. Afterwards, I went over to my parents house with a prescription for Percoset. So now, I can't have blood drawn or have my blood pressure taken from that arm. Ever! This is one of the problems of having no lymph nodes. You have to be extra cautious about possible infections. They say you should even shave your underarm - use electric clippers instead, which, guys, tell me I'm right when I say that won't be as smooth. I'm thinking I need that laser-hair removal. I can't not shave my pits. You all will thank me in the summer.

Next Friday, 11/14, I went in for my follow-up appointment with Dr. Cocilovo. I noted that it was actually hurting more on Thursday and that day than it had earlier in the week. She said "Yep, you've got some fluid build-up", and drained almost 3 of those big 6-inch long & 1.5-inch wide syringes full from under my arm. Immediate relief! And results of the biopsy: 2 out of 3 sentinel nodes were positive and 2 out of 13 of the rest of the axillary. So 4 out of 16 total. Ideally it would have been 0 out of 3 sentinel, then they wouldn't have had to take out the rest, but them's the breaks. It sounds like 4 out of 16 isn't too bad, in the grand scheme of things.

Yesterday morning, I went in for what I thought would be my final haircut until P.C. (Post Chemo). I went shorter so it'll be less traumatic when it falls out. My hairdresser (Dusan from Vidal Sassoon! Love you!) then told me about how he needs hair models in a couple of weeks, and would I like to be one? Oh, and bring a friend. So I will be having one more haircut - and it'll be pretty funky. They'll do color correction and a new cut. I think he's going to give me the same cut, but edgier. Stay tuned for pictures from that. Later this afternoon, I will dying my hair a crazy shade of red. I never did this stuff in college (I had so much & so long hair - it would have taken 3+ boxes and if I didn't like I was screwed - it was down to my waist so it would have taken forever to grow out), so I think it's about time.

So that brings us up to now, I think, pretty much. I have an appointment tomorrow morning to drain more fluid, and I think I need it. It's getting uncomfortable again, and it's kind of firm. A lot firmer than my other underarm. The over/under on number of syringes-full she gets out this time is 2. Any takers?

Coming up this week: I make an appointment for the go-ahead for egg harvesting. Apparently I'll be a raving lunatic for a couple of weeks while I'm on the hormones. I will warn you here when I start, so you can avoid me. I also will be making an appointment with my oncologist. She should know now what kind of chemo I'll be needing and how long I'll need to have it for, so stay tuned for updates.

Wednesday, November 12, 2008

The Story Thus Far in Brief

So as you probably know, I've been diagnosed with breast cancer. I've been thinking about starting (or re-starting, as the case may be) a blog to keep track of how things are going, so people can just check in, or go back & see what's been done, or whatever. I guess maybe it'll be therapeutic. I've never been very good at keeping a diary consistently, so we'll see how long this one lasts. Given that the last entry in this was 2 years ago . . . .

So a brief history of week one of all this crapola:
Early September 2008 Annual physical. Doctor says "Did you know you have a lump in your left breast?" I say "Uuuhhh . . . ." because I had noticed it a few weeks earlier, but had dismissed it. Hey, I don't have a history of breast cancer. And geez, I was 34 at the time (ok, 35 minus 4 days) So ladies (and gentlemen! You're not immune!) check yourself - and don't dismiss anything! She goes on to say "Well, you can wait until after your next period to get it checked out if you want. It might just be a hormonal thing."
Rest of September I wait. It doesn't go away, in spite of daily palpations on my part. Minds out of the gutter, boys. Also news flash: doing your monthly breast exams doesn't prevent cancer! It just detects it! I clearly had some mental shifting to do.
Friday, 10/3/2008 In spite of the lump seeming smaller and less distinct, I go in to the radiologist & have a mammogram & sonogram. Planning on going to work that afternoon, because hey, I'll be in and out of here. Results: "highly suspicious of malignancy". "You need to have a biopsy asap." Wha happened?!
Monday, 10/6/2008 Needle biopsy. They numb the entire boob & go in through a tube (I didn't look, but I think it was somewhere between the size of a regular straw & a coffee stirrer straw) & take 4 core samples.
Tuesday, 10/7/2008 Biopsy results: positive for invasive ductal carcinoma with an in situ component (warning: this is just the first of much medical jargon to come.). Meet with my GP who advises going off the pill, which I was taking for cramps, and which was also the 3-month pill, so bring on the monthly & crampier periods. Argh.

Next time: I meet with the surgeons