Thursday, September 27, 2007

December 2007 A sunny spirit is my weapon

The human race has only one effective weapon, and that’s laughter. The moment it arises, all our hardness yields, all our irritations and resentments slip away, and a sunny spirit takes their place” -- Mark Twain.

I originally started this post in September. It's now the END OF DECEMBER. So much has happened and I want to catch everyone up. Here's some music

to accompany the next several paragraphs.

I started daily radiation treatments around October 1. The total dose was about 5040 centigrays, which is a lot of radiation, with a daily dose of about 180
centiGrays (a centiGray is a unit of absorbed dose, equivalent to about 1 rad) in addition to a "boost" to the area of the scar on the left side. I went to the Cancer Center every day, and once a week I saw Dr. Goss, the radiation oncologist, who explained what was

happening. It was interesting to see his reaction when he examined my skin and listened to my complaints. Many women have to stop their treatments because their skin gets too raw and burned to continue. I seemed to be OK and didn't have to stop. I continued for six weeks (weekends off) and it just about killed me to drive to the Cancer Center every day in that horrible traffic on Paseo Del Norte, but I did it. Fortunately the techs were cool. Isn't that a big scary machine?

When I first arrived, the nurses showed me the gowns and gave me a cubby with my name on it. Each day I would sit in the women's waiting room and wait for my name to be called. I met a diverse group of women who waited at the same time every day. We chatted and read the same old magazines cover to cover. At first I didn't want to say anything. I'd just listen, fool around with my Blackberry, or read a book and never made eye contact. Then I slowly started to speak up. By the time the six weeks were nearly up, I had developed first-name friendships with the other patients and workers. When a new patient would arrive, we'd gang up on her and tell her what to expect so she wouldn't be frightened. Honestly, towards the end when I would walk in, they'd say "Grace!" like they were greeting Norm on "Cheers" (if you don't know who he is, you're too young to be reading this blog). On my last day in mid-November, I brought in cookies and a music CD for the treatment room -- it helped if there was good music playing while the machine whirred and clunked.

Some of these women were so scared! And they had reason to be. They had cancers I had never heard of. Some were in chemo and radiation at the same time. The same time! And some were so frail, in wheelchairs or on crutches, that we weren't sure they'd make the entire treatment period. Yet they all seemed to be handling it well. There wasn't any chance to feel sorry for yourself in that waiting room. It was so uplifting.

Some days I'd go to Starbucks after treatment. Sometimes my friends would meet me there. It made me feel normal, sitting there having coffee in the morning with all the working people. Here is a photo of Ben, one of my excellent flickr friends, who was happy to take time out of his day to get some caffeine. (sorry, ladies, I know he's attractive, but he's taken). Don't you think Starbucks should pay me for this shot?

Mid September I'd gone back to work and had to start radiation treatments soon after. I began to be really tired during the day (as they predicted). I don't think I'll ever be back to normal. I have been good about resting at night, but I always feel like I could nap during the day. I told some friends that the fluorescent lights were sucking the life force out of me, and it had to be from the radiation. They said, "Nope, that's how we feel, too. "

Here's wha
t I tell everyone: Go outside. Don't sit inside all day. Get some sunshine and fresh air, and you'll fire up a few neurons. It's amazing. Even standing in the sun outside of your building for five minutes is worth it. Find a plant or a tree and breathe in some oxygen.

Another good reason to head for the sunshine: to fight off depression. Some of us get seasonal affective disorder (S.A.D ) in winter when it gets dark and dreary.

I miss the sun. I miss the beach! I enjoy the cool weather, but it's hard to fight the winter blues. To top it off, I've had some bad news lately. A friend of mine has had a recurrence of her breast cancer, and it just breaks my heart. I'm also a little afraid -- what happens when mine comes back (not if, but when). Two other friends have had major surgeries, and although I'm worried for them, I think they will pull through. Finally, I've had a close companion and confidante leave me recently. I'm surprised at how much I miss him. It's hard to count your blessings at times like this.

Then I remember: I have wonderful friends. How can I be sad when I have friends like this? Check it out! that's Catherine and her daughter Christa looking fabulous.

Recently one of my male friends gave me some guidance and advice about continuing to learn and sharpen my senses. He encouraged me to plan for my own future (who else will if I don't?), just like I do all day long for my customers at work. It took a week or so to sink in, but I've come to realize it's time for me to really focus on myself and figure out what I want to do next. For me.

I have never in my life felt so alone. It is always tough being alone during the holidays. But though I am alone, I feel strong and ready.

This morning I found one of my favorite passages from the Bible: Ephesians 6:10-17:

Finally, be strong in the Lord and in his mighty power. Put on the full armor of God so that you can take your stand against the devil's schemes. For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms. Therefore put on the full armor of God, so that when the day of evil comes, you may be able to stand your ground, and after you have done everything, to stand. Stand firm then, with the belt of truth buckled around your waist, with the breastplate of righteousness in place, and with your feet fitted with the readiness that comes from the gospel of peace. In addition to all this, take up the shield of faith, with which you can extinguish all the flaming arrows of the evil one. Take the helmet of salvation and the sword of the Spirit, which is the word of God.

Isn't that vivid? The "belt of truth buckled around your waist" and the "breastplate of righteousness"! Even in different translations of the Bible, this language is never tamed down.

Many doctors advise that patients use mental imagery to fight cancer or imagine the cancer leaving the body. This passage reminds me, as I wait for the doctor, that my hospital gown is cinched with the belt of truth and underneath I'm wearing the breastplate of righteousness. I'm invincible.

What's next? I will have surgery again in January to take another layer of tissue near the tumor site. I will have these huge implants removed, and new ones put in. It will take me a few weeks to heal again. I hope to remain in good shape during this time and not let my training lapse. I'm training for a short race (the Susan G. Komen in June) as part of a training plan to improve my fitness and reduce my likelihood of recurrence. My chance of recurrence is 25%. (That seems pretty high for all I've been through, but I had what they call a "stubborn" tumor. I'm on tamoxiphen now, every day for two years, followed by an aromatase inhibitor. I'll have MRIs every so often to check for recurrence.

All of these surgeries, treatments, medications, and my training regimen serve to strengthen my armor. They just have to. I don't think I can go through another year like 2007.

Smile, everybody, and go soak up the sun.

Sunday, August 26, 2007

August 26, 2007 Just breathe . . . .

It's been a memorable few weeks since I last wrote. I have been really afraid of meeting with my doctors and hearing what happens next. I have had good days and bad days, masked by Percocet and worry. My mood fluctuates and the dark moments are frightening.

I finally weaned myself off the Percocet, but
not before embarking on a new course of reconstruction. Fortunately for me, Advil (ibuprofen) works better than Percocet at managing the pain. You can't even imagine the extreme uncomfortableness of these procedures. Dr. Tsao Wu takes a giant syringe (60 cc of sterile saline) and slowly injects it into my expander implant, asking me "How does that feel?" about every 23 seconds. It took me a while to realize I wasn't breathing, which made it difficult to answer the question. Oh, and it gets better! When she's done on the right, she fills up the syringe and does it to the other side. AAAACK!

I look like an absolute freak, with these hard things under my skin. I wouldn't call them breasts. I will never have breasts again. I have rock-hard bumps where my breasts used to be. Eventually, after I complete radiation, the expanders will be removed and I'll get more natural-looking implants. (I hope I don't become one of those women who shows off her boob job to her friends like a fashion accessory.) These do not feel like a part of me and I am not attached to them. They're just there so I look more normal in clothes.

During every procedure, my friend Colleen has been the
re, literally holding my hand and watching the doctor. Visualize this: I am holding my breath, eyes tightly closed, and trying to focus -- or maybe not focus -- on what's happening to me. This isn't like any of the cancer treatments I've been through. It's just extreme discomfort for the sake of vanity, so I don't wake up some day and realize my breasts are gone, and then fall into a deep, dark depression from which I never emerge.

I just don't think that's gonna happen, implants or no implants. I know lots of women who lack breasts, and they're not unhappy. To put a positive spin on it: we are all happy that our cancer is under control. We are satisfied with life!

Admittedly, we have scars, both emotional and physical. Lots of people have scars, have experienced life's ups and downs, have weathered a few storms, and have great stories to tell. I have heard so many of these stories, and I'm here to tell you there are people out there who are a lot tougher than I am. What I'm going through is trivial.

Studies have shown that the patients who fare the best during these kinds of trials and struggles are those with a
strong support structure. Knowing that people care makes all the difference to me. My friends have been so helpful and supportive. My INMM colleagues send their best wishes in the form of a weekly cleaning service (isn't that nice?). The soccer team parents bring over yummy food and provide rides for Rachel. Friends have persuaded their prayer groups to pray for me, and I've received dozens of cards in the mail, verses, inspirational books, and a prayer cloth from my sister-in-law Karla. The folks from work call and send emails to brighten my day. My bunco girlfriends (pictured above) provide food, laughter, and rides to the doctor. My Kappa sisters call, write, and arrange fun get-togethers (those are the Kappas below). And my family has been so good to me.

The most incredible thing happened this weekend. I had a knock on my door on Saturday mor
ning, and my boss, Al, was waiting there. Earlier in the week, he and I made arrangements for a landscaping contractor to do a few jobs around my house. "What are you doing here?" I asked. He said the crew would be showing up momentarily, and soon after a dump truck came with a load of landscaping rock. Then, the crew started to arrive. Surprise! Fifteen people from work showed up with wheelbarrows, trucks, chain saws and shovels to landscape my yard. Fifteen people! On their day off! They worked for six hours to give me the most amazing gift. I couldn't believe my eyes. I am so humbled, so overwhelmed. MY FRIENDS ARE SO KIND AND GENEROUS!

I have been worried about my radiation treatments and what the pathology report meant in terms of my overall prognosis. I met with my radiation oncologist, Dr. Goss. You may remember I had an unsettling meeting with him before surgery, and I was freaking out about the upcoming radiation and some of the comments that he made. My medical oncologist said she would find another doc for me if I wanted someone else. I refused, saying I thought I wasn't in the right frame of mind to really hear what he had to say last time. Now that the pathology report was out, I was ready to listen to him.

I was happy with our visit this time. Colleen went with me and took copious notes. (Colleen preps me before each doctor visit; we go over every question that I need to ask). He said he had talked to the pathologist, my medical oncologist (Marshall), my surgeon (Smith), and my plastic surgeon (Tsao Wu). Yes, all of them. He talked about my treatment (radiation only on the left side to blast all the remaining lymph nodes and muscle tissue) and was confident that I was going down the right path. He explained the benefits of radiation and the downside too. He said I'm doing the right thing for my reconstruction; he was concerned earlier, but he spoke with my plastic surgeon and she straightened him out. He explained the results of the path report in a way that helped me understand what the pathologist saw. He described the additional surgery that Dr. Smith wants to do, and said it was a "no brainer" to do this after radiation when Dr. Tsao Wu replaces my expanders with real implants rather than to have a separate surgery. He talked about the likelihood of finding any additional cancer cells (low) even though it's prudent to go back in to get a clean margin. And finally, he explained (with a little bit of hedging) about my prognosis. He said the most important indicator was that I had responded to the chemotherapy. The chemo trumps everything (assuming you remove the tumors surgically). He said my response to chemo was "excellent", which gave me a much better prognosis. Using modern radiation methods will improve my chances of survival by 7 percent, which is significant, but not as important as chemo.

Did I mention that Colleen holds my hand during treatments? The power of human touch is amazing. But I suspect she's really restraining me, and not trying to make me feel better. Otherwise I would run out of the room. FYI, a picture of Colleen appears on this post somewhere. See if you can find her. Ha!

My next step is to get a compression sleeve for my left arm. This w
ill help prevent lymphedema from developing when I fly on an airplane. I'm going to Tucson next month for a soccer tournament, and I sure hope this sleeve works. My fellow cancer survivor friends tell me I'll never fly without one again. Oh, the joy.

Starting in mid-September, I'll have radiation for six and a half weeks, then another operation to r
emove the expanders, remove the additional layer of pectoral muscle to get a clean deep margin, and put in the permanent implants. The reconstruction should be finished by the end of the year, and the new, improved version of Grace will be back at work in 2008.

And then I can breathe again. Whew.

Sunday, August 12, 2007

Monday, August 13, 2007 It only gets better from here

When I last wrote, I was waiting for my appointment with my surgeon, Dr. Smith. My friend Debi took me to see her. (Thank you, Debi). Boy, was I nervous. She sat down and told me the news. My pathology report showed no cancer on the right breast, and 0 of 2 sentinel lymph nodes excised were positive for metastasis (cancer). So far, so good. On the left, 3 of 11 lymph nodes excised were positive for metastasis. One tumor was found, and it was positive for invasive ductal adenocarcinoma. Ready for the really bad part? As if that wasn't bad enough. The tumor was stuck to the chest wall, and the margin was "focally positive". In other words, the margins were not clean. The tumor was within 1 mm of the the deep margin (the muscle) on the left side in two separate specimens. Dr. Smith explained that she and the pathologist in the operating room felt that they had gotten clean margins during surgery, but this is what the lab found. In her opinion, she wanted to go back in and scrape a little more of the muscle to get more of the cancer cells, in hopes of getting a clean margin. She told me that if her sister were in my shoes, she would advise her to to the same.

She asked me to consult with my plastic surgeon to determine the best time to do this surgery, to work it in with my reconstruction, but that the operation had to be done before radiation started. In the next few weeks, she said. I asked a few questions, but I was in shock.

Denial. Anger. Bargaining. Depression. Accepta
nce. I felt myself going through all these stages that night. Debi stayed with me that evening while I had a small reception for my son, who was home for a few days. He left the next morning for Texas before I had a chance to tell him what was going on. Later that week he called me, angry and frustrated. "Mom, why didn't you tell me? I could have stayed home with you. You told everyone else, but you didn't tell me. I had to hear it from Meggie!" I explained that I was not sure there was anything he could do, and he might as well have some fun on his little break. I needed more information!

I definitely needed more information. I left Dr. Smith's office without a copy of the pathology report. I didn't ask her about my classification or staging. I forgot to ask a lot of questions.

By Friday I had an appointment with Dr. Tsao-Wu, my plastic surgeon, who was planning on draining a seroma that had developed on my right side. Colleen was the lucky gal who went with me. As Dr. Tsao-Wu worked on the seroma, Colleen and I bombarded her with questions. She said she wasn't sure how this additional surgery could fit in with the reconstruction; she would have to think about the best way to do that. Dr. Smith hadn't contacted her, so she would give her a call. I saw her again on Monday, again with Colleen, and she still hadn't heard from Dr. Smith
but had left her several messages.

Later that day, Barb J. took me to see my oncologist, Dr. Marshall, who had the pathology report in hand when she came into the exam room wearing the cutest little gold dingleball earrings. She explained in detail what the path report said, and why maybe it wasn't necessary or advised to have more surgery. As she spoke, the gold dingleball earrings swung back and forth, mesmerizing us. She said I needed to discuss this with the radiation oncologist and with Dr. T
sao-Wu again. I would definitely need radiation on the left side, and that's the purpose of the radiation -- to zap any local cancer cells that may have been left behind. (good news -- I probably won't need any radiation on the right side).

After my appointment, I called
Dr. Tsao-Wu's office to ask her a question, and she got right on the line. "I spoke with Dr. Smith," she said. I strained to listen. "I told her I wasn't planning on opening you up again until after radiation." She explained that Dr. Smith said it was pretty rare to have to go back in to remove more muscle, and the surgical community didn't have enough case studies to determine the best time to do it, so it would probably be okay if she waited until after radiation. ??!?! What?
Now, this doesn't make any sense to me. If the radiation gets it all, why do we have to go back in again? And what was the reason for the initial urgency?

[NOTE: It has been brought to my attention that this post is completely depressing and unfunny. Therefore I will relate a funny story I heard, which provided me with the one belly laugh per day that I so desperately need for healing. My friend Joe called from El Paso, and I told him that my hospital bill arrived (wow, almost faster than the pathology report). The total came to $30,000. Joe reminded me that on the Sopranos, they refer to that as 30 boxes of ziti. Ha! OK, resume reading post now]

When I got home, I started reading my favorite breast cancer book, Dr. Susan Love's Breast Book, to find some answer
s. Dr. Marshall had given me a copy of the pathology report, so I began to "stage" my own cancer. Here it is, folks. Stage IIIB. It's a locally advanced cancer (what Dr. Love calls a "special case"). It's also pretty rare to have tumors in both breasts, which is what I had before chemo did its job. However, the staging depends on the worst tumor you have, plus affected lymph nodes, which gives me Stage IIIB.

For all you analytic types who want to know where it lies on the Nottingham scale, it is Tumor Grade-1, Nuclear grade-2, Mitosis score-1, tubule
formation-1. The Tumor Grade helps determine my prognosis. More on that later.

All along the protocol for my cancer treatment was in the Breast Book. I had never found that section because I didn't know exactly what we were dealing with. Here it is: neoadjuvant chemotherapy using Adriamycin & Cytoxin, followed by Taxol (A/C+T), four treatments each. Frequent examinations and diagnostic tests to be sure the tumors are responding to the chemotherapy. Bilateral modified radical mastectomy, followed by radiation on the side where positive lymph nodes are found. I did all of this, and I'm now awaiting radiation.

Some cancer patients have asked me why I am undergoing these particular kinds of treatments. They seem to feel in some way that I got better treatment, or they weren't offered the latest and greatest. Now I know the answer. I was placed on this particular protocol because I am a "special case", a locally advanced cancer. Boy, do I feel special.

I was never told that I was a special case, that my odds of survival are not good. Grade 1 tumors often show an 80 percent survival rate after ten years (80 percent of the women with Grade 1 tumors survive). Here's what
Dr. Love's book says on the subject: a study of a group of women with Stage IIIB cancers, treated aggressively, show a median overall survival rate of 12.2 years and event-free survival of 9 years. That means half the women in this study have had no recurrences in 9 years and half are still alive at 12.2 years. Fifteen-year overall survival rate was 23 percent (at 15 years 23 percent were still alive). Let's see, that would make me 63 years old. Rachel would be about 28. I probably wouldn't be a grandmother yet.

Makes you think, doesn't it?

What would you do if you only had 15 years to live? Would you be doing the same things you are doing today?
What will you do today that will matter tomorrow?

As for me, I think I will take a few trips to see parts of the world I haven't seen and maybe revisit some that I really love, like Hawaii, Alaska, and Italy. I want to visit some friends and write about my experiences. It will probably cost me a couple of boxes of ziti, but it will be worth it. I'll bring my camera and sketchbook, and you can enjoy it with me. Ciao, baby!

Sunday, August 5, 2007

Sunday, August 5, 2007 Grittin' my teeth

Hi All, It's me again. I hate to complain, really I do. But the pain! Ouch! Surgery is not for wimps. Ouch! Don't ask my why I'm smiling in this picture with Catherine. Ouch!

Just kidding. It's not too bad. And a ride in a red mustang convertible is enough to put a smile on anyone's face!

I had the surgery as planned on July 30. The surgeons tell me it went well. I lost
more blood than they expected and had to have a transfusion, but I survived the four and a half hour surgery. The anesthesiologist did his job well, and I didn't get sick. It was the best anesthesia work ever (is that possible?). Dr. Tsao-Wu put some freaky expander thingys in me, and Dr. Smith gave me an On-Q pain ball to deliver lidocaine to my surgical site. It's the coolest thing ever invented. Dr. Smith took out all my axillary lymph nodes on the left, and just a handful on the right. Preliminary results of the right lymph nodes showed the cancer had not spread there. Those giant circus boobs are gone, and the cancer with them. I hope.

I will find out on Tuesday. Yes, I'm anxious. I will find out if the margins were clear, and what the tumors looked like. Unfortunately, because I had chemo prior to surgery, it will be hard to actually locate all the tumors in the tissue
. I think Dr. Smith will stage my cancer. I'm pretty sure it's just Stage II. I am not really sure because I had 5 tumors, and one of these was in a lymph node. The TNM classification is really just for one tumor. The staging helps determine my treatment and prognosis. My earlier pathology reports indicated that the neoadjuvant chemo and bilateral mastectomies were the right approach. These new path reports will determine if I need radiation treatment. I assume I will hear something about my prognosis (depending on whether I do the radiation or some other treatments). Five years? Five months? Blah blah blah.
Rex and I are pretty tired of all this cancer talk.
He and I have been bonding over the past few weeks. A while back I decided he needed to have a doggie date, so I took him down by the river for some fun with a little friend, Chaco. We had a ball! Unfortunately, he got some weeds in his fur and it went from bad to worse. $750 later he is wearing a stupid cone (elizabethan collar) and is taking lots of antibiotics to cure the hot spots on his neck. Poor Rex! That's what I get for trying to be a cool dog mom. I should stick with what I know best, which is, um . . . . . I'm pretty sure all I'm good at is lying on the sofa and moaning. Oh yeah, and waiting for the doorbell to ring, and hoping it's a friend to come visit me.

Number of books finished: 1
DVDs watched: 5
Hours spent on sofa: 60
Age of last home health care nurse: about 95. I am serious.
Phone calls received: at least a hundred.
Visits: about 15 (Yay! I love them! Please call first, though)
Bon bons eaten: 6 (but who's counting)

Pounds gained : None, so far. You would think I'd lose weight during surgery! Duh! But hey, people, you try losing weight when people bring you food all day long and all of it tastes wonderful!
Runs to Flying Star for eclairs: 2
Calories in 1 Flying Star eclair: 2000, more or less

I read a study today that said people with strong social connections tend to experience less stress and depression than those who are more isolated. Just sharing your feelings can be helpful. One recent study used MRI brain scans and demonstrated that putting feelings into words does help reduce distress. And laughter, of course, is the best medicine.

(in case you were wondering, that's why I blog)

I am so grateful, really I am, that I have the support of great friends like you all. Every conversation we have is meaningful, important, uplifting, and encouraging. I will never take our friendship for granted, and I hope you don't either.

You people are amazing. Everyone last one of you.

I give special thanks to my friend Catherine, who drove me around town in her red convertible Mustang, blasted out Bon Jovi music, and gave me a dose of Vitamin D and fresh air that I badly needed. Thanks!

Thanks to Catherine and Rachel and Callie for taking Rex to the vet to finally get him fixed up. I apologize to all you people who saw him at his worst, stinkiest state, and acted like it was no big deal. He was vile! But he's all better now, and he loves everybody and he loves breakfast most of all (he wanted you to know that).

Thanks to all of you wonderful people who are determined to stuff me full of fabulous food. My mom, Rachel, and I are so grateful.

Thanks for all the fabulous flowers, too! You know how much I love them.

Wait! What's that noise? Oh, it's my thighs rubbing together! Must be the chocolate! Or it could be that giant box of southwest goodies. Who knew that carmel coated popcorn was a high-fiber snack!

Kurt's coming home in a few days. I can't wait to see that little stinker. He's been at field training all summer. I miss him. He makes me laugh! I hope I don't pop a stitch.

What I know for sure: Never underestimate the power of eclairs, err, I mean friendship.

Sunday, July 29, 2007

Sunday, July 29, 2007 Letting go

What a day, weekend, month, and year it’s been. Tomorrow is a major milestone, when I have the biggest surgery of my life, and I leave my care to two female surgeons, Linda Smith and Gladys Tsao-Wu. I will remember July 30 for the rest of my life.

Sometimes (OK, a lot of time) I stumble through life, being a mom, going to work, sitting through soccer or football games, making dinner, reading, watching movies, making appointments, traveling here and there, and generally doing the things that fill up my weeks and years without putting much thought into it. This surgery has required me to put a lot of thought into it and make a lot of choices. I am pretty calm considering what a big deal it is. I think that’s because many of these decisions have been made and I’ve come to understand what’s within my control and what’s not within my control.

First of all, the cancer and the way it behaves are not within my control. I had no idea I had cancer a year ago, and now it’s taken up residence in body. I have put my body through the paces (chemo, surgery, and radiation to come) trying to get rid of it, shrink it, and control it. It’s still not under control. The surgeon will remove it, and it will not be completely gone. Cells will remain and will be poised for a big comeback. So all I can do is work hard to eradicate it now, hope, and wait.

Secondly, the advancements in cancer treatment are not within my control. I get what I get There are no miracle cures out there, but there may be some on the horizon. I can’t get wistful and think, “If only I had cancer ten years from now.” There will NEVER be a good time to get cancer. As I’ve said before, I feel fortunate to have it now, when I am young (ha!) and strong enough to fight it and my attitude is in the right place. Ten years from now I might not be this strong. Today we are seeing major improvements in what docs know about surgical techniques, managing side effects of chemo, targeting radiation to the correct spot without a lot of collateral damage, and many others. I am glad I didn’t get cancer ten years ago . . . again, out of my control.


There are other things that are out of my control, but frankly if I think about them it makes me pretty sad. I can’t control the fact that my children’s father and grandmother died of cancer. If anything happens to me, my children will be orphans. I just hope that it’s later rather than sooner. I can’t control the fact that my children may get cancer at some point in their lives. We are mortal and imperfect. That is life.

What’s within my control? My choice of doctors – and I think I have good ones. My choice of treatments, to some extent. I chose to have my chemo before surgery, and that was a good choice. My surgeon says it shrinks the blood vessels as well as the tumors, and so the surgery isn’t such a bloody mess. (aaaaaackkk). I may have some choices about radiation treatment, depending on what the tumors look like after surgery and biopsy. I also have a few choices about reconstruction, none of them really good, but it sure beats having cancer boobs!

I can’t express enough gratitude for all the friendship and support I’ve received, and I’d like to think my choice of friends was also within my control. Maybe it wasn’t. Maybe you all are just gifts from God and I had no choice in the matter. Thanks for sticking around. I’m going to lean on you more and more after tomorrow.

I have choices about how I live my life from now on. I have put a lot of thought into that. Of course I will always be cautious when it comes to my health, and I know I’ll take better care of myself now. I already do, and it’s been rewarding. I’ve tried to keep a positive outlook, and I’ve begun to plan activities and trips for the fall and winter. That definitely helps my attitude. I have some other things cookin’. You’ll have to read about them in future blogs.

My friend Sandra called today. She listened to me whine and moan for a while. In her strongest voice, she said, “You have no choice. You HAVE to do this.” We cried, and she got me through the darkest moment of my day. And then we laughed so hard until I almost cried again.

Here’s something funny – another thing I have no control over. My eyebrows fell out during chemo, and now they’re growing back. I have eyebrow stubble! I look so goofy! But eyebrows are not important.

It’s late, and I should be getting to bed. I had to do some really important things tonight. You know what I mean, right? I had to give myself a pedicure! My toes look gorgeous. (toes aren't important, either)

Thanks to everyone who called and stopped by. I didn’t get nearly enough done today but it was worth it. My brother-in-law, Ted, came over with his family, and the high point of my day was watching my nephew Brandon walk across the floor. He’s just one year old. Isn't he darling? He's got attitude!

Attitude and gratitude are important things. Here's a little bit of mine. This prayer was given to me by a preacher's son and it just makes me feel good to hear it (especially in his voice, which I am imagining right now):

"Dear Heavenly Father, Maker of all things and Mother of all Nature, praise be to Thee!!
We thank You for the very gift of life itself and the added blessings of family, friends and our health; may others be so blessed.
Now we ask that You guide us and protect us and keep us safe always and forever. Dear Lord; this we beg of You, this we pray, have mercy on us and may there be Peace on Earth. Amen."

Surgery is tomorrow at 7:30 am. I will be in the hospital only two days, and then I will be home. I will be up and around soon. You can count on it.

LOVE YOU ALL . . . . . .Grace

Friday, July 6, 2007

July 7, 2007 I'm a lucky girl

What can I say, I'm a lucky girl. Here are the Top Ten Reasons I feel lucky:
10. I'm lucky I have a very treatable form of cancer. I'm estrogen receptor positive, progesterone receptor postive. Her2 negative. Very treatable.
9. I'm lucky I was diagnosed with cancer in my 40s, after having my children. I'm glad so many new treatments and medicines are now available, after years of clinical trials.
8. I'm lucky to have friends and acquaintances who've gone through this before me and have taken the time to explain to me what to expect and t
o share with me their experiences so I'm not as afraid.
7. I'm lucky I was diagnosed with cancer when I was OLD (mature?) enough to know how to deal with doctors, insurance, appointments, schedules, prescriptions, and all of that. At my age, and having had 2 kids, I am pretty bold when I talk to medical professionals. I do a lot of research and I ask a lot of questions.
6. I'm lucky I have a great job with good insurance benefits, a generous leave policy, and kind bosses.
5. I'm lucky I have the best (in my opinion) OBGYN, r
adiologist, oncologist, breast surgeon, plastic surgeon, and radiation oncologist that I could ever hope to find. I have no worries.
4. I'm lucky I have my mom, also a breast cancer survivor, in my life. She helps me so much and keeps me sane.
3. I'm lucky that my two children are being so great
through all of this. If you know them, you know they've been through a lot of bad stuff. They remain mentally and physically tough and very positive. And they make me laugh so much! Craaazy!
2. I'm lucky I have my faith, and it has not been shaken by this minor bump in the road.
1. And the #1 reason I'm lucky: I have the kindest, smartest, loveliest, most generous and loving friends in the whole wide world! Yay for friendship. I owe you all a big one. I will never, ever forget your kindness.

I have had the good fortune to be able to spend a lot of time with old friends lately. It has been a laugh riot (remember my earlier pledge to have a belly laugh once a day? This has not been hard to achieve!) Catherine W., who lives in Alexandria, Virginia now, is such a great friend to me. She has flown out to NM a few times since my diagnosis, and even sat with me through one of my longer chemo appointments. She's been so strong for me when I was at my weakest, and always tried to make me laugh. I thought I'd include a photo of her (and she's wearing my shoes, thank you very much). Gawd. Look at us. I'm going to start bawling again. (no, not about the shoes!)

One of my work friends, Phil F., wrote me an email, saying, "Grace, thanks for inviting me to your last chemo treatment. I couldn't attend, but wanted to extend an invitation to my next colonoscopy." I love his d
ry sense of humor. That's most people's reaction: Why would I ever want to go to a chemo treatment? Well, I totally understand. I don't even want to go!

And yet, lots of people came and sat with me through the last 4 months of treatments. So much gratitude and love go out to those brave souls (you know who you are) who sat with me when I freaked out, when I
fell asleep, when I wanted to pull the tubes out, when I started to cry. I really couldn't have done it without you. I'm lucky to have you in my life.

My last chemo treatment was Tuesday, June 26th. My latest MRI was nearly clean, meaning the tumors have disappeared completely on the right and 75 percent on the left. My oncologist HIGH FIVED me when she read the report. Have you ever been high fived by one of your doctors? Seriously, hav
e you? I feel like a champ and very, very lucky.

I still will undergo surgery at the end of the month, but the prognosis looks very good. I will need a sentinel node biopsy to determin
e the extent to which my surgeon will dissect the lymph nodes on the left. I'm getting ready by having some diagnostic tests (chest x ray, EKG, MRI) and blood work done prior to surgery. I also will need radiation, but don't know all the treatment details yet. I'll post again soon when I know more.

This much is true: Even if you wouldn't trade places with me, I still kn
ow I'm the luckiest girl in the world.

Thursday, June 21, 2007

June 22, 2007 Summer is here!

A moment in the sun. . . .

So here we are, the little family, on the beach in Orange County. We had so much fun! This day we met with my friend Melinda and her family and all went to this place, just north of Laguna Beach, called Crystal Cove. You couldn't have picked a more beautiful place for us to spend the afternoon.

I had a great time in California. We played hard from morning until night. My friend Karen was a huge help to me, making sure I knew what rollercoasters were the "good" ones and keeping us all laughing with Roger the Cockroach and "crazzzzzyyy" driving. I honestly had some bad days out there, lots of aches and pains and fatigue. Karen even rubbed my neck with Biofreeze to keep me going. I was so tired by the end of each day.

Did my wig fall off? Almost. On one ride at Magic Mountain, I realized it was probably going to come off, so I grabbed it at the last minute and held on to it. I got some stares as we pulled into the unload station! I guess I scared some people. After that I put a scarf on and stopped worrying.

We shopped at all the cool stores in Santa Monica, including Fred Segal's (that's Rachel and me vogueing). We played at Six Flags Magic Mountain and Knott's Berry Farm (that's not me on the roller coaster). We met with Greg and Renee Bujewski and their adorable little kids. We ate at great restaurants. We drank a little beer (Karen had a big beer!) and thoroughly enjoyed ourselves.

We're back home now, and Kurt is gone back to West Point. I had an MRI today, and I'll get the results on Tuesday. We are checking to see how much the tumors have shrunk. I'll meet with my oncologist, Natalie Marshall MD, on Tuesday and get my final chemo treatment. In early July I'll meet again with my surgeon, Linda Smith MD, and we'll discuss the surgical procedure. We have tentatively set the week of July 23 for surgery. I'm so freaked out by that . . . .but anxious to get the cancer out of my body and live a long, happy life!

Things I've learned over the past month:
1) Help and support can come from surprising places.
2) I love my kids so much! Where would I be without them?
3) The only person who can take care of your health is YOU. Other people can help, but the responsibility rests with YOU. Can't blame anyone else for being out of shape or missing doctor's appointments.
4) Asking and asking and asking still works. Whenever I have doubts, I ask.
5) I've started to expect that I will forget things, i.e., assume I have chemo brain fog! I almost give up sometimes when I can't think of something in the first five seconds. Actually, my brain seems to be working OK. I'm just really tired all the time, and my brain is clogged with dates, numbers, appointments, work stuff, family stuff, and other things I have to remember to do. Walk the dog! Fix the roof! Sell Kurt's car! Buy airline tickets! This is how it is. Just like any other day. Except all the appointments and medical stuff are now at the top of my list, and I can't keep track of the little stuff anymore.
6) My friends are awesome!!

Thanks to everyone who has listened to me, done me a favor, made me laugh, sent me gorgeous flowers, travelled across the country to visit me, or said a kind word lately. I'd like to think I'm getting tougher every day, but I feel kind of weak and pathetic some days. Your kindness really helps me.

I get by with a little help from my friends!

Tuesday, May 29, 2007

May 30, 2007 Rollercoasters and roses

Yesterday was my 6th chemo treament of 8, so let's do the math: 75% done! The last two treatments (5 & 6) were taxol instead of adriamycin and cytoxin. Taxol works a little bit differently and doesn't cause the nausea of adriamycin and cytoxin. It has its own peculiar side effects, such as numbing and tingling of the toes and fingers, muscle pain, bone pain, anemia, and fatigue. There are other symptoms but these are my main ones. The bone pain is incredible. I can only describe it as the feeling that you got hit by a truck and every bone in your body aches. The doctor says the tumors continue to shrink. The palpable ones are measured with a micrometer. After the first Taxol treatment, one particularly resistant tumor shrunk 0.5 cm! I was more than pleased. This is the advantage of doing chemo before surgery. You can see that the chemo mixture is working.

Surgery is planned for the week of July 23. I have a few more tests to do before surgery. I hope I get an A!
Unfortunately, the chemo brain fog continues. I am getting pretty spacey these days. It helps to have a sense of humor. I laugh at the silliest things and daydream a lot. I have amazing dreams at night. I sleep about 4 or 5 hours a night, but I sometimes nap during the day. I occasionally get irritable and frustrated, but mostly I'm optimistic and hopeful. I find myself being introspective a lot. For example, I was pruning rose bushes the other day. They are my neighbor's bushes and they are close to our property line. We have been pruning, watering, and feeding these bushes for years. He has thanked us many times. They are the only healthy plants on his property, and I really enjoy them, so we keep doing the work and sometimes we even cut some roses for the house! I was deadheading the rose bushes the other day. Most of you know you have to carefully snip off the dead rose blooms, along with a good bit of stem, so that others may grow. I throw the dead roses away and don't hang on to them for any sentimental reasons; I don't know anyone who keeps them or composts them! But a lot of people don't have time to do the deadheading. I like to do it. On this day it reminded me of getting rid of old baggage in my life. If I want to get some beauty in my life again, I am going to have to carefully remove the old, dead blooms along with a good bit of stem and get rid of them permanently. Close the bag and put it out on the street for the garbageman. Water the bush and feed it and, with luck, more beautiful blooms will arrive soon. This could apply to generic, old baggage in my life and also to the cancer that I'm hosting in my body. . . . .I can't look forward to new beauty and joy in my life until I get rid of all the cancer. Next to the old dead blooms on the neighbor's bushes are some new, delicate buds. I recognize that I have lots of beauty and joy in my life right now if I could only see it! Sometimes it's hard to see the beauty and joy when there's junk in the way. I have had other mini-epiphanes lately, some way too personal to share in this public blog. Even with the chemo brain fog, I have had some clarity about some things that have been bugging me for a long time. I suppose it's about being fully present in the moment, and aware of all the signs that are out there. Reminds me of one of my favorite movies from the 1990s, L.A. Story. Do you remember Steve Martin (Harris) and Victoria Tenant (Sara) looking at the signboard on the freeway? The signboard says (quoting Hamlet): "There are more things in heaven and earth, Harry, than were dreamt of N your philosophy." The signboard is saying that if we open our minds, we can envision a better world than the one we think we live in. Now that's optimism.

Speaking of LA, I'm off to LA with my kids next weekend. That should be interesting! They want to ride rollercoasters. I think I'll be the bag lady, sitting on the bench holding the cameras, bags, etc. I hope to ride many rollercoaster in the future, but not this month. I'm afraid my wig might fall off! California, here we come!

Wednesday, May 2, 2007

May 2, 2007 Halfway there, livin' on a prayer!

Been feelin' pretty crappy since my last treatment. I had a little breakdown during the chemo drip and felt a little claustrophobic. I just wanted to get out of the place. The nurse gave me a prescription for some anti-anxiety meds because I was FREAKING OUT. I haven't taken one yet, but my stomach is in knots. I have a bunch of anti-nausea meds that I'm taking, so I should be OK until about 4 pm on Wednesday. I'm lucky two friends, Trixie and Barb, stopped by in the middle of my treatment, so I was immediately distracted. The nice man in the chair next to me described his treatment and that made me feel better. I was overreacting, I know.

So here's something funny: I had been reading about this chemo brain fog, a condition that includes forgetfulness, spaciness, etc. For a while I was spared but this last week was a doozy. For example, I just wandered around my house for about 45 minutes after getting ready in the morning before work, wondering what I needed to do. Total fog! I told my doctor and she laughed (apparently she thinks I'm funny). She said only professional women & men with tight schedules notice that fog. She said I will be fine after it's all over, but here's my thinking . . . . I want to have this excuse for a long time!

May 6, 2007, finishing this post. It's the weekend and I haven't felt right since my treatment. I am drowsy and fatigued all the time. I can't even think of the word "chemo" without my stomach turning. I really don't know how I'll get through the next four treatments, even though they are supposed to be easier. I don't know how I'll get through working next week! Eating has been weird. Sleeping has been weird. I'm just not myself anymore.

The fog continues. Plus, my allergy to mulberry tree pollen is in full swing, so that adds to the misery. I have had the most amazing nightmares. The last one involved work and it was so real that I woke up thinking it had actually happened. I almost called my boss!

So you want some good news? I had a great time on the Making Strides Against Breast Cancer walk last Saturday. The weather was gorgeous and I walked with Team Green Alene, with Alene Hardin as the chief survivor (I am just the junior survivor). Team Green Alene does it up right. We had a tailgate party at 7 am with breakfast burritos, fresh, giant, nuclear strawberries, and juice. We started at 8 and were finished before many had even started. It was so fun to get out there, even though I felt like a freak in a way. But I didn't care! Here we are at Mile 2.

In the photo are the Hardins (Alene took the photo) along with the biggest flirt in Albuquerque, Karen Hoffert. Beside me is Callie Bryan, my daughter's friend, who ran the 5K. Rachel was hiding. She probably was embarrassed because I wore the Breast Cancer Survivor Sash they gave me as a necktie. I mean, honestly, who wears a sash? Besides the homecoming queen, I mean.

I sure feel better when I get outside and exercise. So that's good news. And some of my tumors continue to shrink, so that's good. The others aren't growing, but they don't seem to be shrinking as much as the other ones are. Surgery is still scheduled at the end of July.

Take care everybody!

PS the title is for all the Bon Jovi fans out there!

Thursday, April 19, 2007

April 20, 2007 Just gotta ask . . .

I have learned a lot about myself lately and a lot about the world around me (my ecosystem, I like to call it). I am aware that I have fears about this cancer and about the effect it's having on me, my family, my friendships, and even my adorable little puppy, Rex. Poor thing hasn't been walked in forever. He's definitely suffering along with me as I moan on the sofa.

I saw my oncologist on Tuesday before chemo and she didn't have enough samples for me of the "good + expensive" antinausea meds. She cheerfully wrote me a script, telling me that my co-pay would only be $50 or so. What???!! Later I had it filled at my local Walgreen's, and she was right. I asked the pharmacy clerk, "What is the regular price for this pill?" He said, "About a hundred bucks." I was stunned and said, "Last time you told me it was a THOUSAND bucks a pill." He politely said, "Nope, three pills, $320, without insurance." And I had been fretting about this for weeks, wondering where I was going to find some more free samples. Boy, am I glad I asked, and asked, and asked, instead of giving up. I just couldn't believe the pharmacy company would gouge cancer patients for $1000 a pill.

Another fear, another moment of Zen:
I'm lying on the exam table, arms above head, as my oncologist examines me and measures my shrinking (yes!) tumors, and I say, "So . . . I have this fantasy. " She and I both laughed (I'm glad she didn't run from the room). I went on to say that my fantasy is that the chemo will shrink all the tumors so much that I don't have to have the axillary lymph node dissection. We had a long discussion about what would happen in surgery, my prognosis, and other things I had been wanting to discuss for a long time but was afraid to. While the news wasn't all good, it was heartening to know that the surgeon I had been referred to (Linda Smith) was highly skilled and I could expect an excellent result. Another fear -- zapped!

Thursday was rough. Two days post chemo #3 and I hadn't eaten much, had more nausea than I could stand, headaches, and body aches from the Neulasta shot. By 10 pm I felt a little bit better. I had a half a banana and a little rice for dinner!

Here's good news: I have discovered the worst weight loss diet ever: chemotherapy! Darn it, it works. I'm down ten pounds. I wouldn't recommend it.

During my chemo #3 I asked the nurse, Kellee, what she wanted other women to know, something I could share in my blog. We talked about the latest research, about uses of new drugs for different cancers, and other newsworthy items. But the most startling thing she said to me was that of all the breast cancer patients she sees, the overwhelming majority of women find their cancers themselves through self-checks. Well, that's how I found mine, but I thought I was in the minority. Kellee reminded me that we can do self checks anytime, and once a month is recommended, so it's more likely that you'll find a lump than with a once-yearly mammogram.

Aren't you glad I asked?

Thanks to all the fabulous females and sweet-as-candy men (you know who you are) who helped me this week. Sorry I've been incommunicado lately but it's hard to talk when I feel so horrible. Today I feel much better, and I think I'd better go walk my dog and get some sunshine before he revolts! and bolts!

WHAT I KNOW FOR SURE: Living with fear is a lot worse than living with cancer.

Wednesday, April 11, 2007

April 11, 2007 Struggles and laughter

I have had an interesting week, to say the least. First, let me introduce you to my lovely Bunco nursing team who has reached out and helped me every step of the way. From top left, it's Barb J., Di T., Trixie, Jayne, Barb W., Colleen, (bottom row, left) Debi, Karen, me (in black), Dee-Dee, and Di C.

They are an illustrious bunch of women, and I thank them all for the wonderful gifts of emails, food, laughter, and time they have shared with me over the past couple of weeks. When this picture was taken in February, we had gathered together for a cancer exorcism. I can say with a measure of certainty that the tumors shrunk after this! The pomegranate martinis helped!

This group is just a part of my ever-widening circle of support from friends and family. Without you all, I can't imagine how depressed I'd be right now.

I often neglect to mention the male friends in my life that have offered me support. I am impressed by the knowledge they have about breast cancer, my diagnosis, my treatment, and what the emotional rollercoaster is like. It's because they've all experienced it with someone else in their families. Thanks for all the support and laughter, guys! Today I went to a baseball game with a couple of male friends from work. We laughed, booed, cheered, swapped stories, and had a blast. Just like regular people. It made me feel great to be alive.

I have decided that I need at least one belly laugh per day in order to beat this thing. I know it's a stretch goal, but it works. You should try it.

About my struggles, I wasn't as strong this week as I had hoped to be. I found out that my white blood counts were drastically low. My throat felt sore, I had a headache, and ached all over. I decided to take it easy and rest and recover. It was probably the smartest thing I could have done.

All I need now is fresh air and sunshine. Bring it on!

Thursday, April 5, 2007

April 5, 2007 A head start . . . .

The picture you've all been waiting for. Amanda came over to do a professional job, for which I am eternally thankful. I am smiling in this picture because I am happy! Happy not to have hair falling out all over the place. Happy that I've passed another major milestone towards recovery. Happy that I had friends and family with me at this moment. Nope, didn't cry. Still haven't. A bald head feels very, very tingly and fresh.

It's the second day post chemo and I'm pretty sick. The new meds are working but I still don't want to go anywhere, see anything, cook anything, or eat anything. I sipped on some broth earlier, and that was okay. I just want to crash on the sofa in a quiet house, no music or movies or Oprah.

On Tuesday my oncologist gave me some free anti-nausea meds -- I thought $9000 worth! But as it turns out, it was just $4000 worth. Just four pills. I thought they were in a three-pack, but they were just singlets. Oh well, I am not going to complain! I'm still counting my blessings that she gave me free samples. I am very lucky.

Yesterday my friend Debi met me at her friend Lorenzo's salon, and he styled my wigs. Lorenzo is the best wig artiste in town and we had a blast! But here's the deal. My scalp is still tender and the wigs bug me. I'm much more comfortable in hats and scarves. I'll keep trying the wigs, and I hope I can get used to them.

Thanks to everyone who tried to make this week tolerable for me. Karen H., you are a nut! Thanks for taking Kurt's Easter basket to the Post Office for me, and for all the goodies you brought. The tulips from your garden are divine. Trixie, I felt like a parade queen in your grandma-mobile! Colleen and Tim, thanks for hangin' with me during the Red Devil Drip! DeAnna, the Easter goodies are so cute! To the large contingent of chauffeurs for Rachel, she and I both are grateful. She was on time all week! And to all the people who took the time to call or write or bring food over for my family, I really appreciate it, and I'm sorry if I'm not able to keep up my end of the conversation. I'll be back to normal in a few days!

Have a great week everybody! Wish I could be enjoying all that chocolate!