Four weeks since the last chemotherapy and now the beginning of the next step, radiation. As far as the effects of chemo, some are fading and some are still with me. My eyebrows and eyelashes are nearly all gone. I have sparse eyebrows and only a couple of lashes on each eye. I've been chemically plucked! But, on top of my head I have pure white downy fuzz growing. At first (last week) it was like peach fuzz, but now it is getting to be like the soft downy breast of a duckling. It is so soft that I have taken to stroking my own head like a little kid with a blankie. It is not yet thick or long enough for me to be comfortable going public, but it is coming along. I've read that hair grows approximately 1/2 inch per month so maybe by May I might go without a head cover. Pain in my feet and legs is lingering. I am weary of it. I still need alot of sleep.

The radiation treatment itself is quick, noisy, and kind of boring. But it only takes 3 or 4 minutes once they get started. The tricky part is getting me positioned correctly so that the beams treat what needs to be treated and leave everything else alone. I've done this twice so far. I suppose it will be easier as time goes on. I get treatment every day, Monday through Friday, at 2 pm, on my lunch hour. No more period of being able to sit and read or nap or knit as in chemo, I just go in, undress, get zapped, get dressed again, and back to work. It all takes about 15 minutes.

So far there are no effects showing. I expect there will not be for a while yet. That's what I've been told to expect. Funny, the unexpected seems to happen.

This has been a difficult period for me. The long slog through treatment is wearing me down. Fears and worries are mounting and I have a hard time keeping positive. Support from those who were once so concerned about me is waning. I feel quite alone in this part of the journey. Still, a good thing did happen last night. A good friend picked up and called me. I needed a friend to talk to and this call came right at the most needed time. It was a blessing to me. Not the first and I'm hoping, not the last.

Three weeks have gone by since the last chemotherapy treatment. I am slowly beginning to feel better. I still have some pain in my feet occasionally and I feel like I cannot sleep enough. The healing, cells rebuilding themselves, is still taking place. Apparently, it is hard work. I read at breastcancer.com that a woman should give herself just as long to recover as the time from the first diagnosis until the last treatment. I would ammend that to include the time from when you first become aware that something is not right, in my case, the discovery of the lump. Between the discovery of the lump and the day I was diagnosed I was in stress every day, not knowing, but certainly fearing the worst. Stress itself is debilitating. Anyway, if all goes well and the treatment is finished by the end of April, I will have spent 9 months dealing with breast cancer. Nine months is the time it takes in pregnancy to create a new life. I suppose one could say that for me these 9 months will have been spent in also creating a new life, the life of a cancer survivor.

The IV access port that was place in my chest has been removed and the incision is healing. It itches slightly. I guess that is a sign of healing. Anyway, that bump is now gone. The radiologist let me see the device after it was removed. It was white plastic, like an up-side-down cereal bowl with tubing coming out of the side. It didn't look as big as it felt when it was under my skin.

So, I now have had all the appointments to plan the radiation treatment. The doctors and technicians have done the measurements and calculations, the x-rays and CT scans. The "dry run" takes place next Wednesday and then, if all is well, the treaatment begins on Thursday. I don't know how this will affect me. I have been told that there will be a skin reaction. It could be anything from a mild sunburn to open sores. There can be pain in the breast and possibly, some irritation to a small portion of the lung. Everyone assures me that as the treatments go on I will have fatigue. How severe is unknown.

Living with the unknown is a cancer survivor's daily walk.

The End of Chemotherapy

I took the last chemotherapy treatment on Thursday, 2-09-06. So far, the side effects are minimal this time, thanks to the return to all the powerful anti-nausea / vomiting drugs they have prescribed. I'm experiencing the miracle of modern chemistry. Two weeks ago, I did not take the full complement of these drugs (that's another story), and though I do not know for sure, something caused me to get started on a vomiting episode that lasted almost 8 hours. I ended up in the Emergency Department receiving IV compazine and fluids. I was a very sick lady. So, coming up to this last chemo was a bit nerve-wracking because I don't want a repeat of my Sunday emergency dept. visit.

It was sad to leave the Oncology Treatment Center for the last time. I am so very appreciative of the good care, cheeerful staff, and possibly life-saving treatment. I want to do something to demonstrate my appreciation and I am contemplating just what that will be. Perhaps some baked treats . . .cookies, brownies, etc. Certainly, after my finances are more normalized, I will make some level of donation to the Cancer Center.

So, now I get a reprive for a month. Radiation doesn't start until March 8th. I plan to eat nutritiously, exercise at least 4 times a week, maybe 5, sleep regularly and deeply, and lose another 5 pounds. Since last May I have lost 40 pounds, most of it due to the changes since surgery last September. I have modified my habits to some extent and the changes in my system from the chemotherapy (tastes are different, sickness, fatigue, etc.) have also made the difference. My family doctor told me at my last visit that while this was not the way she would have recommended for weight loss, I did need to lose and now that I have started she is encouraging me to continue. And I want to continue. I have read the research reports that show women who exercise and lose weight are less likely to have a recurrance of cancer. I would rather walk to San Diego barefoot than go through chemotherapy again. Perhaps I don't know what I am saying, but I will try to walk, or bike, or swim, or something that will be the equivalent of a trip to San Diego to avoid cancer again.

My goal is to be healthy. Plain and simple. I want my health and exercise will help me to get in back and keep it. I will be looking for anything and everything that can help me stay motivated and focused on this goal.

Catching Up

I haven't written for such a long time, that I almost decided not to post again. But, that would defeat my original purpose so, I will not attempt to catch up every detail of the last 2 months, but rather just describe how I am doing today.

Last Thursday, January 12, I had the 6th of the 8 chemotherapy sessions scheduled. This has been an arduous experience. There have been some days that seemed almost normal and there have been many others that have been difficult and certainly harder than I expected. I have had a number of side effect issues including nausea, vomiting, continuous runny nose, coughing, and now, in the second half of chemo, difficulties with severe pain. I have a large number of drugs on hand to deal with each of the problems and sometime I think my body is becoming just a big toxic soup.

I have tried to have a good attitude and for the most part I have been successful. There have been times when I did feel discouraged and quite sorry for myself, but overall I think I have been hopeful and cheerful to most people. If I have had irritable and selfish times, mostly poor Craig has been the one to see and experience it.

I have continued working, not always easy to do. But, my co-workers are friends and their support has been important. Several of the nurses have been especially valuable to discuss symptoms, problems, and give big doses of sympathy. I have also valued the sense of purpose and accomplishment in getting tasks done and in fulfilling my role in the department. I need to keep trying to do that so that I do not adopt a "invalid" mentality.

Energy is a problem though. Sometimes I just feel incredibly tired. More than I ever thought I would. It is both a mental and physical exhaustion. Of course, sleep has not really been good through this period, again from a combination of mental and physical causes. It is hard to get good rest when you cough all the time. I pray that it is stopping now. Mentally, I get tired being a patient or sick person all the time.

Many, many wonderful things continue to happen. Through the holidays I had numerous kind and generous gestures, gifts, and cards. Kindness has been the most wonderful gift of the last few months. I have accepted greatefully and I hope, gracefully. I know I have never taken these kind moments for granted and will always cherish the memory of the people who have served me and shared their generosity.

There is still more treatment to endure. Two more chemo sessions and then radiation. I hear different stories of other patient's experiences so I just don't know what to expect. I am trying to be prepared for anything. Mostly I look forward to spring, to May and sunshine. I want to clean the house thoroughly, buy a bike and ride along the canal, find a place to sit in the sun and read a good book, eat a bowl of custard from Abbott's, have energy, feel my hair start to grow again, see flowers, watch birds, and do ordinary things in extraordinary ways.

Report on Chemo #1

So, the first chemo treatment happened 6 days ago. I have had some good results and some less positive. There has been little nausea, in fact none at all. But, there has been much digestive "tenderness." I think that my digestive tract is irritated (who can blame it?) and so digestive acids are making it ache. I have had a constant stomach ache. Not debilitating, but very, very annoying and emotionally draining. My scalp has become tender, perhaps a precursor to hair loss. I have been very tired and feeling a bit like I was getting the flu. I am learning what is possible to eat and what to stay away from. My appetite has changed. I get full more quickly and some things don't appeal much anymore. I am needing to rest and sleep more.

Yesterday a port was installed into my chest so that the chemotherapy can be delivered into my system through this device. It is a little plastic disk under the skin with a catheter running into one of the veins in my chest. The installation was done under "conscious sedation." I was awake and aware but under the influence of a tranquilzer and pain meds. I felt alot of pulling, tugging, and pressure while this was being done. There was definitely an "owie" factor. Today I feel bruised and sore from it. There is a thin covering of skin over the port. When medicine needs to be put in or blood taken out, a needle can be inserted into the port through my skin. I wish it had been installed before I took chemo and was feeling the effects, but it's done now.

Yesterday, probably due to anxiety and discomfort, I was emotionally quite low. Really wanted to just lay down and cry for a long time. I think that is a natural and understandable reaction. There are going to be tough days, certainly. That was one of them. Emotionally, I am better today.

Tonight is the haircut. All my long hair comes off and gets donated to Locks of Love. This will be a big change. But, I have come to believe I can cope easier with short hair and if it does start to fall out or thin significantly, shorter will be less trouble. I have a few turbans, scarves, and a donated wig, just in case. The wig may not be my ultimate solution, but it is a start.

There has been so much kindness directed my way. It is sometimes unlooked for, but always greatly appreciated. I am a very fortunate woman, despite a sore chest and an aching belly.

The Next Stage of Treatment

The treatment plan has been made. I met with the oncologist last Wednesday, Oct. 12. Dr. S. is a young woman, but I was impressed with her intelligence, presentation, and the way she treated me. She is recommending chemotherapy for these reasons. One, the size of my tumor. It was 2.2 cm in diameter or about 7/8 of an inch. That's not the largest tumor I've heard of, but big enough that she feels chemotherapy would be best. The second factor is the type of cancer cells seen under the microscope. They are labeled Stage III. That classification refers to how differentiated the cells are from the normal breast tissue cells. Stage III cells are highly different than the normal breast cells. These type of cells are thought to be more aggressive, but they are also more susceptible to the effects of chemotherapy. Third, is my age - 52 years. Ideally, I could expect many more years to live and chemotherapy will help to make that a reality. Without any further treatment, my chance of living 10 more years would be approx. 78%. The chance of a recurrence of breast cancer would be 44%. With chemotherapy treatment, longevity for at least 10 years would go up to closer to 90% and the chance of recurrence would go down to about 20%. That's what I want. A greater chance at long life without recurrence of cancer. In addition, the radiation treatment that will follow the chemotherapy should add to those percentages.

Although it seems that surgery was as successful as it could be in "getting it all", as some people like to phrase it, there is no guarantee that some microscopic cancer cells hadn't broken free and traveled to other locations in my breast or body. Breast cancer cells particularly like to migrate to the lungs, liver, bones and brain. I do not want to have any breast cancer setting up for business in these locations SO I will take the chemotherapy treatment and let it go throughout my whole body attacking any cancer cell that might have broken loose. The problem is that chemotherapy is a systemic treatment - it will attack or poison any fast-growing cell in my entire system. It will not just limit itself to the fast growing cancer cells. This is why there are side effects to chemotherapy. It will affect cells in my bone marrow that make blood cells, the cells that make hair and nails, the cells lining my entire gastrointestinal tract, and others. So, my ability to fight infection will be impaired because I will not have as many white blood cells, I might get tired because of fewer red blood cells, I might lose hair and nails, I might have nausea, vomiting, mouth sores or other gastrointestinal problems. It is impossible to predict what will happen to me because every person's body reacts differently. I do know that the doctor and nurses will have many drugs and other things to help me with these side effects.

Today I am getting a little preview of what may be. I caught a nasty cold (from Craig) and it has really taken a hold of me. The symptoms are the normal stuffy, runny nose, drainage down my throat, sore throat, ear ache, coughing, difficulty sleeping, and headache. A cold like this during chemotherapy will be a very serious illness so I am going to have to be very, very vigilant about exposure to germs and sickness.

The plan is for me to begin this treatment on Thursday, October 28. The next day, I will get my first injection of Nuelasta. This is a drug made of a growth stimulating factor, which we produce in our bodies normally. This medicine is a booster, to help the bone marrow begin forming the blood cells, particularly the white blood cells. I will receive it after every treatment in order to help me produce the white blood cells my immune system needs. If my blood cell count has not come back up to an acceptable level before the next scheduled treatment, then they will postpone treatment until it does come back up. There will be 8 treatment in all, spaced out every other week. So, it should take at least 16 weeks to do this. Hopefully, I'll be able to stay on schedule and finish up by the middle of February.

Honestly, I feel overwhelmed right now. That could be an effect of the cold I am fighting, however. I am planning to cut my long hair and donate it to Locks of Love, an organization that makes wigs for children who are taking chemotherapy. It think it will be less disturbing to have short hair fall out, than to have my long hair fall out. When my short hair does begin to thin or fall out, I may just go ahead and shave my head. That will be one small thing I can control. There is precious little I can control in this situation. Wigs, hats, scarves, earrings, etc. are all things I am considering. But, at some point, someone may just have to accept a bald headed me.

Of course, my attitude is something. I am trying to stay positive, but I am finding it difficult. I am learning that my resources are more shallow than I originally imagined. The support of my friends and family is critical. I am needing to lean on others for hope and encouragement. A breast cancer survivor that I know told me in the very beginning, "You will find out who your true friends are." I do believe that is true. It helps me alot to read the scriptures and pray. I am learning that these two activities are as vital to me as water and air. But, I have many, many blessings. Good health care, good insurance, a good employer, friends and family who love me, and my sweet kitty cats. Where would I be without all these?

Healing and Building Strength

I don't know why I haven't made an entry for almost 2 weeks. Perhaps the business of healing and then getting back to work took all my energy and thought.

Healing is going well. The incisions are not painful, although sometimes irritating. Finally I can take off my bra without getting an ache. When I saw the doctor 3 days ago, Wedsnesday, she drained 3 vials of fluid from my healing breast. She said the accumulation of fluid is called a seroma. The fluid is mostly made up of serum (I think) the clear fluid that is in the blood. There was some blood also in this fluid. After this was removed, the bulge where the tissue was removed was smaller and the site was not as sore. This is the fluid that collects in out of drains that some women have after surgery. I did not have drains. The plastic "tape" over the incisions is starting to peel off my skin, but I am too chicken to pull it off. I will just wait for it to become more detached and for the skin to heal more. When I first looked at the incisions, they caused me a little lurch of fear, but now I am becoming accustomed to the site of these two red lines on my body. I know that in time they will just be barely noticeable white lines. It's just going to take awhile.

Dr. A. carefully reviewed the surgical pathology report with me. The results that she gave me on the day of surgery are confirmed. The margins of tissue surrounding the tumor were clear of cancer cells and so were the 4 lymph nodes that were removed. The report describes the size of the removed tissues. The tumor was 2.2 cm, putting just over the boundary between Stage 1 and Stage 2. Dr. A. explained that this 4 stage system is old and not very useful because Stage 2 can define anything from a smaller tumor (like mine) to a 5 cm tumor and anything from no lymph node involvement to very many lynph nodes involved. They are working on a better classification system. Doesn't matter much to me now. She said she would call my case an early stage 2.

Still, she did prepare me for a strong chemotherapy recommendation from the medical oncologist whom I will be seeing on October 12. The size, the characteristics, and my age all are factors in making chemotherapy a good option. Surgery seems to have done all that it could. Now addition therapies will be helpful to give me the best chance for a long, breast cancer free life.

I was surprised, really, at how well and easily the surgery part of treatment went. Pain was only mild to moderate and I got back to normal in a week. I still do not feel that I am "sick." I feel extremely grateful for this outcome. I am trying not to be pessimistic, but I do wonder if the chemo and radiation that are to come in the future will actually be the more difficult phases of treatment.

Chemotherapy is poison. I heard someone describe it as being taken to the edge of death, killing every rapidly dividing cell in the body, before pulling back and considering that the cancer cells have eliminated. Even then, there is alway a chance that it will return. Sometimes that does happen. Going into surgery I knew that I could do that. I've had surgery before. Chemotherapy will something else. I've never been poisoned. I wonder if I can go through the experience well.

Yesterday, at work, I sudenly felt intense nausea and vomited. Then I got aches and fatigue. I have no explanation for the event. Felt fine up until the moment it happened. Just a little dizzy and then nausea. Will that be like chemotherapy? I think that I have, in my "mature years" become more susceptible to nausea. I dread that feeling. Never having had morning sickness, it is not a frequent experience for me. A couple of times a year, but very discomforting.

I need to keep building up my spiritual strength and faith. I may need to call more on my inner reserves in the next phase of treatment.

So, no it seems like I am in intermission. Act I is over and Act II is about to begin.