This Too Shall Pass

I've fielded a lot of questions about my chemotherapy treatment, so I thought it would be a good idea to spend a post talking about exactly what it is. Warning: not much humor here - most of this post will be factual information, and most of it is stolen from various pamphlets I received on my first day of treatment.

Basically, chemotherapy describes a class of drugs that are used to destroy cancer cells. Cancer cells grow and divide quickly, and chemotherapy works best on fast-growing and -dividing cells. Unfortunately, hair, skin, and intestinal cells also grow quickly and these are also destroyed by chemo (which explains the trademark side effects of chemo).

There are several kinds of drugs that fall under the umbrella term of "chemotherapy." Some are injected, some are given in pill form, and some are topical. Most times, chemo is given in "rounds" or "cycles" where a patient receives treatment for a period of time, then gets a break so that healthy cells can regenerate. The length of the cycles depend on the drug(s) used.

The plan for my treatment is to have two separate courses lasting four months. For the first two months I am receiving two drugs by injection every two weeks: Adriamycin and Cytoxan. For the second two months I can't remember what drug I'm getting... it begins with a T. It will also be given by injection every two weeks.

The side effects of chemo are pretty well-known, but I'll review them. I have experienced or am experiencing most of them. At the moment, though, I'm feeling pretty damn good.

• Nausea and vomiting (along with lack of appetite). This is the big one. I started feeling sick the evening I received my first treatment. Since then, my appetite has been off and on. When I don't want to eat, there is nothing I can imagine putting in my stomach. But when I'm hungry, I tend to eat whatever I want until I'm full because I don't know how long it's going to last.
  
• Fatigue. Oh yeah. How can I possibly sleep all day and still feel tired? On Monday, all of my muscles felt like I'd exercised them to the point of exhaustion. Just being still hurt. The fatigue is also related to having low blood counts because the heart has to pump more to deliver oxygen throughout the body.
• Hair loss. Although some patients do not lose their hair with some types of chemo, I have been assured that I will lose my hair. At this point, it's coming out more than usual (I see more of it in the shower drain), but I haven't lost it in clumps, yet. One of the neat things is that I will lose all of my hair. No more need to shave my legs! :-)
• Various digestive problems. I don't want to dwell on this too much, but it's pretty twisted that you can have both problems... too often and not often enough. I hate cancer.
• Menopause-like symptoms. One other thing that can happen with chemotherapy is the damage or the temporary shut-down of the ovaries. Therefore, all the hormone-related things that happen with menopause can happen during chemotherapy. So when you all write those sappy responses to my blog posts and I start crying in my office, I'll blame it on the chemo :-) Just kidding. Mostly.
• I think that covers the most common symptoms, but here are some "extras" from my chemo booklet:
• Anemia, Bleeding, Fluid Retention, Infection, Infertility, Mouth and throat changes, Nervous system changes, Skin and nail changes, Photo-sensitivity, Eye problems, etc.

Well, that covers all the doom and gloom. I have to say, when I'm feeling like crap, I want the world to end. Part of that is because it's so discouraging. I wonder if it will ever end, or if I'll feel just as bad as I do that moment for the next four months. It's pretty depressing. That's why I didn't blog for a few days. I do not want to dwell on it when I'm still feeling it, because I feel like I'm just making it worse for myself. It's much easier to talk about it in the past tense when I'm feeling good. I know that the effects are cumulative - I will probably feel worse after my later treatments than I did after the first one. However, now I know what it feels like and I know it will eventually end. "This too shall pass." I can say that now :-)

Anyway, let me know if I didn't answer any of the chemo questions you may have had. I plan to do some other posts about some of the factual information (especially the genetics).

Where's the Gift Receipt for this Hideous Thing?

Sorry it's been so long since I've written. I've been feeling like absolute poop. I think I came down with a cold Sunday night and it seems to have completely taken over my body. I went to work for a couple of hours on Monday then I had to go home. I've been tired and ookey, and ugh. It's like every muscle in my body aches and my head feels like it's in the clouds. It's quite unusual for me not to want to eat, but the thought of food makes me sick. I never thought I would throw up plain popcorn. What on earth could be more bland than that? Well, I stayed home from work today and luckily I'm feeling a little bit less like I wish the world would end.

Anyway, a few weeks back, Rusty and I had a houseguest for the weekend. His name is Mike, and he's from New York, NY. We originally met Mike and his friend, Pat, several years ago through one of the hippie bands we listen to (the String Cheese Incident). We continue to stay in touch with Mike and Pat and we see them all over the country as we travel to see the band. Most recently we saw each other in Denver, Colorado, for the band's last concert at Red Rocks. (From Left->Right it's Rusty, Me, Pat, and Mike).


So, a few weeks back we were planning to have Mike over our house for the weekend to see a couple of concerts that were closer to our home. The plan was to meet him in Northampton, MA for a show and then take him back to our house and see another show in New Haven, CT later that weekend. This pre-arranged weekend happened to be only a few short days after we'd learned about my diagnosis. Rusty and I didn't want to tell him ahead of time because we knew he wouldn't come (and that wasn't the point). Mike is a good friend and we wanted to spend the weekend with him and enjoy ourselves.

We planned to meet at a brewpub in Northampton (I love beer). Pretty much as soon as he sat down I blurted it out.

"What's new with you guys?" he asked.

"Well, actually, a few days ago I was diagnosed with breast cancer". There was really no other way to say it, ya know?

We talked about it for a few minutes, he was obviously a good friend about it and we tried to explain that we really wanted him to come to our house for the weekend, so we didn't tell him ahead of time, blah blah blah. One thing he said kind of sticks with me because it was something I'd thought about myself, but he put it into good words...

"I don't know if you guys are religious at all, but I truly believe that God doesn't give us anything we can't handle, and I know the two of you will get through this."

And that would be the jumping off point for the main idea of this post. I do believe that I can handle this (if you had asked me 24 hours ago, I may not have had the same opinion). Rusty and I talked about what Mike said and I imagined a Yankee Swap. For those of you who may not be familiar with the concept of a Yankee Swap, it's a horrid Christmas party tradition where everyone brings a gift (usually something ugly, useless, or just plain hideous) and everyone draws for a number. Number 1 opens a gift. Number 2 opens a gift and decides whether they want to keep theirs, or swap with one that has already been opened (in the case of Number 2, there's only 1 other opened gift). This goes on until the last person opens a gift (Number N) and then they get to choose from all of the other gifts that have been opened thus far. But wait! Number 1 gets to go again. Number 1 is the only person that didn't have the option of trading, so they get the final trade. There are variations of this game, but that's the basic idea.

So anyway, I had this image of getting cancer at a Yankee Swap. I could have let the woman with 7 children have it, I could have let it go to the woman who was all alone and didn't have a husband to take care of her, or I could have let the person who was unhealthy or who had a mean boss have the breast cancer. But instead I got it. (Hey, I could have gotten stuck with a brain tumor).

But yesterday I was looking for the gift receipt so I could return it. I don't want it anymore. It kind of sucks worse than I had thought. I wish I had swapped for something like a hangnail.

Quick Update...

I know I don't typically post during the day (I do have to work sometimes after all...) but I thought I'd do a quick post of updates/additions, etc. I'm working from home today.

First, I'm feeling much better this morning. No nausea. No hunger, either, but I ate the same breakfast I normally do and it didn't make me feel sick. I've heard that there can be 2 types of nausea - (1) acute nausea (comes on quick, doesn't last long). (2) delayed nausea (takes a few days to kick in, lasts longer). At this point, I'll be happy if I stay the way I am and get sick right away but for not too long. I guess we'll see!

Next, as I was looking out the window at the chemo center I realized another thing that made me lucky. The weather! If it was winter, this would truly suck. Worcester is not at its best during the winter. At least now I can exercise outside and enjoy the temperature :-)

Also, Rusty and I will probably be going to Maine from Saturday -> Sunday, so I may blog less. I think they have one internet connection for all of Maine and we won't be anywhere near it this weekend. For all those Mainers reading my blog... JUST KIDDING! I <3 Maine.

Thank you all for your warm wishes and your wearin' o' the pink. BTW, it's tough to individually answer every comment, but I don't have everyone's e-mail and I'm VERY concerned about SPAM (so I don't want you posting it on the internet). I'm going to ask my mom to give me everyone's e-mail address, so if there's one you prefer, let her know.

Thanks, and happy working!

The shoe has dropped.

Alright. First things first. I am okay. Chemo went fine.

Now. I do feel a little bit like throwing up, so my post will be shorter and less humorous/insightful than usual. Well, at least I like to think that my posts are humorous and insightful.

The whole day took a little longer than we'd expected. My appointment started at 11:00 AM (with a 10:45 meeting with Mr. Wizard). Yeah, I don't think so. By the time they took me it was probably 11:30/11:45. But you know what? No big deal. I've learned to have patience and not sweat these things. In fact, that's what my sister wished for me today - patience. I thought it was odd at the time, now I'm glad I had enough of it :-)

have to worry about right now. Some It turns out that almost all the googling I did was for naught. Here are a list of things I read that I would have to do or worry about, but I have since found that I do not have to do them. Some become a factor later on, but most are either related to a different kind of treatment, and older treatment, or are just plain silly:

• Wash my clothes in hot water twice before wearing them or washing them with anyone else's clothes.
• Wash my bedsheets every day (seriously, who has this kind of time?).
• Eat only cooked vegetables (this may be true later on, but probably won't).
• Not fly on planes (yay! as long as my white blood cell count is up I can visit Jocelyn in Chicago)

So... that was kind of nice. Another interesting thing is that they said your propensity for morning sickness is usually a fair indicator of how you will do on chemo (well, I'm shit out of luck there, depending on how you look at it ;-) They also said that younger people tend to have worse nausea than older patients (maybe it's just because we complain too much!).

After the nurse left, we joked about how my only gauge for nausea is when I'm hung over. (I didn't want to say it in front of her because I didn't want her to think it was a common occurrence - no comments from the peanut gallery!) Then I had to also reassure Mom that this wasn't a common occurrence. But, when that does happen ("Twice," Rusty and I joked) Rusty is such a champ. Taking care of me, getting me water, bringing me a bear, etc. He is really quite doting, and never mad or upset or anything like that. He's had some practice ("Twice").

Anyway, after a few hours, we had a shopping list of things to buy. Some food, some medications, and some prescriptions. One annoying thing happened that may be contributing to my pukey feeling right now... They forgot to give me a prescription for an anti-nausea med that I was supposed to have an bring with me to the appointment. Oops! Don't worry, there are plenty of other anti-nausea meds I have, but I'm hoping that one is contributing to the ookieness because I'll have it for next time.

So, that's enough for me. I kind of feel gross so I'm not up for much more writing. Thank you all for your texts, e-mails, comments, thoughts, prayers, and gifts. I realized that some of you may not know what I look like, and some of you may not have seen me in a while so I decided to take another picture with my bear, too.

I've Got a Four Leaf Clover

I kind of new this day would come. Up until today (and really, up until a few hours ago), I've been pretty darn positive. I just knew that everything would be okay. It was pretty easy to feel that way, because up until now the worst thing I've had to endure was really not that bad (maybe the biopsy was the worst).

But 'round about 4:00 today I realized that I still didn't really know what was going to happen tomorrow. I know that at around 10:45 I will go to the same place I've been several times before and I will meet with my medical oncologist (Mr. Wizard). I will have some kind of an IV where they will put chemicals in my body to try to kill my cancer and some other cells will die, too. Other than that, I don't know much. So what did I do? I started Googling. That was a bad idea.

So, now I'm feeling kind of scared and sorry for myself, and I think today is the perfect time to write about why I feel lucky. I think it will make me feel a little better. So here goes.

• I'm lucky that I found it. Typically, even women with my kind of family history only have their first baseline mammogram at 30. I'm 27.
  

• I'm lucky that I am otherwise perfectly healthy. I eat well, I exercise, I have no other major illnesses or ailments.
  

• I'm lucky that I have a great job where I can work from home and my employer considers my health to be the most important thing I have to worry about. That was not always the case. Only two short months ago I was working at a completely different job where I was at the office 10-12 hours per day on most days (and I had to work "half days" on Saturdays) in a client-focussed position. Whoa. I would have had to quit if I was still there. A few months ago, something told me I should go back to engineering and I did. I consider that some kind of divine intervention. I really think this whole situation would be a total mess if I hadn't left finance.
  

• I'm lucky that I cut my hair. I used to have hair down past my waist. Ugh, that would have been so traumatic to lose. Now I'm losing about 10 inches of hair. Here's the irony - I have actually grown & cut my hair a few times, and I've donated it to "Locks of Love" 3 times. "Locks of Love" is an organization that makes wigs out of natural hair for children who have lost their hair during cancer treatment.
  

• I'm lucky that I have my copilots, Rusty and Mom. They have been with me through all of my appointments and tests. There's something so comforting about knowing that when I'm done with whatever it is, I can give them a big hug when I get out.
  

• I'm lucky that I have a nice park right down the street from my house. A few times a week, I go with Sarah and/or Rusty (and sometimes Alex!) to jog. It's so much more beautiful than jogging on a treadmill, and it's pretty peaceful and relaxing. Very therapeutic.
  

• I'm lucky that my family and friends and coworkers are right here with me every step of the way. I see my dad a couple of times a week. I get these supportive and helpful (sometimes embarrassing!) replies to my posts. I've gotten several thoughtful and inspiring gifts from friends and family that I know will be helpful along the way. Too many to enumerate, because then I'd forget one and alienate someone. ;-)
  

• I'm lucky that I have a great team of doctors in Worcester. Every treatment, every appointment, every doctor is just 10 minutes away (15 in rush hour traffic). That's going to mean a big difference when I have to get radiation 5 times a week.

I could go on and on. I really could. It's easy to think of all the bad things because they're so obvious, but the good things are the things we oftentimes take for granted. They're not obvious because we live them and feel them every day.

Well, anyway, I've got to go to bed. I'm tired and I've got a big day tomorrow. I will certainly update the blog tomorrow after my first treatment.

Cliff's Version

This post is for Greg. Greg is our financial advisor, and he's also a good friend. We had a meeting with him tonight and he said that he read my blog and he liked it but that he wanted a "Cliff's Notes" version of it. He thinks I write too many words (Greg likes pictures - he's used to reading things like "One Fish, Two Fish..."). So, in honor of Greg, I decided to make this post short on words and long on pictures.

On Monday, we went to Fenway to watch the Red Sox on Patriot's Day. Here is a picture of us in the bleachers. From left to right is Bret (friend from college), Rusty (best husband in the world), Sarah (best friend in the world), and Me. The picture isn't that great, but it's from my cell phone. If you saw how drunk the photographer was, you'll understand why I'm glad it's not a picture of the cement ground.After a great win by the Sox, we headed to "Boston Billiards" (or, as Rusty likes to call it, the "Hot Chick" bar). Here is a picture of my sister, drinking a beer. We like beer. Ryan is in the corner, probably trying to pretend he doesn't like to be in photos.

And this picture is for my Dad. Boston Billiards has really taken it a bit far with the Miller Lite decor.The funny story of the day was in the wee hours of the morning (around 6:30), when we were preparing to leave, and I was telling the story of how on Saturday I started out with zero Red Sox bandannas and in the space of 5 minutes I had two. Ryan, my sister's friend, came up with a great idea. Instead of expressing frustration in a blog, and getting duplicates (horribly inefficient), someone should come up with a cancer registry. You know... I can go to the store with that little lazer gun and pick out towels, and glasses, and bandannas, and maybe flower arrangements so that people know what to give me. Just kidding. Seriously, I'm just kidding ;-) That was supposed to be a joke. I really don't want 4 replies showing me where I can register for stuff because I have cancer.

Anyway, I hope this was short enough for you, Greg, and I better be able to retire when I'm 35 like we talked about. We <3 Greg.

Retail Therapy

As many women know, shopping can be a wonderful way to relieve stress. We begin by perusing and picking out the things we like. Next, if it's clothing we're searching for, we try things on. Sometimes we whittle down our things by budget. Then, we buy. Lather, rinse, repeat. I think shopping is uniquely feminine - it's the gatherer in us. Now, I don't mean to say that men don't or can't like shopping, or that all women like shopping. Not at all. In fact, I was not always a big fan of shopping. I found it exhausting, and kind of a waste of time. Now, unless I know exactly what I want, or have something like 4 minutes to buy 5 things on a list, I do really enjoy the act of shopping.

I do believe it was Sarah who taught me the art of retail therapy. I don't quite know when it started, but I really enjoy shopping with Sarah. She's the person that will encourage me to try on something that might not look quite right on the rack, but might look absolutely fabulous on the body. She's the person who is not afraid to tell me that, yes, that pair of pants really does make my ass look fat (Rusty would just say that I look beautiful - it's supportive, but sometimes just plain dishonest ;-) And she's also the person that helped me go from a wardrobe that is 98% jeans and t-shirts and 2% ill-fitting miscellaneous special occasion clothing to something that's more along the lines of 75% jeans and t-shirts and 25% classic and cute. I will never give up my jeans and t-shirts.

Oftentimes we play the "How Much Would You Pay For This?" game. There are two reasons we play it - one would be to illustrate how insanely expensive an item is, the other would be to revel in how ridiculously cheap something is (and that, combined with how much we LOVE it, would mean that we have to have it). Here's an example from a recent trip to the home section of TJ Maxx:

"So, how much would you pay for this Italian hand-painted terracotta cake stand?" questions Sarah.

"How aobut $15?" I said. I'm thinking it's not all that pretty to begin with, so I wouldn't really be willing to pay much more than it's functional value.

"Higher."

"$30", Vicki says.

"Higher."

"$50?" By this time I'm thinking there's no way in hell I'd buy this ugly cake stand.

"Higher!"

I think it ended up being $90 or something like that. It will never sell. In case you couldn't tell, this was an example of the "insanely expensive" version of the game.

Anyway, this past weekend was full of wonderful retail therapy. On Saturday, Sarah and Vicki and I went shopping together all afternoon and capped it off with a great dinner at a local tapas restaurant. The entire day was fun, invigorating, therapeutic, "distracting", and it allowed me to be myself, without thinking too much about my cancer or what was going to happen to me in the coming months. I can't really ever forget about it (nor do I want to), but it's good to be thinking and talking about something else. I also got new clothes :-)

On Sunday, I went for another round of retail therapy with Jocelyn. Luckily, as long as one is careful about one's budget (and I am always careful about my budget), retail therapy can be performed often without negative side effects ;-) Jocelyn and I were able to get new Red Sox gear for the game we were going to the next day (today), and we bought her a cute dress that she will wear to a wedding this summer. I also bought a new shirt that says "Green is the new Black". Yay!

Anyway, thank you for letting me indulge in this story that has little to do with being sick, but more to do with having fun.

Also, an update - I do, indeed have a Red Sox bandanna. In fact, I have 2. On Saturday, Sarah and Alex gave me one (thank you!). It's one that was not intended for canines. Also, I got a really soft one made out of jersey material that Melissa sewed for me. I love them both and now I have one for me and one for my bear ;-) BTW, Melissa is my friend from college that is now in medical school, and I believe she is thinking of going into plastics. I wish she could be my surgeon because I have no doubt that she will have all the capabilities of the finest doctor (that should be a given), but most importantly she is has the attention to detail, appreciation for design & symmetry, and precision of Martha Stewart. That's exactly the kind of person I would want to fix my boobs. :-)

Anyway - thank you all for your help with the bandanna search. I thought I'd call off the APB before I got 10 more.

Date Night

Yesterday I had blood drawn and 2 tests that will ensure my body is prepared for chemo. I had a chest X-ray and a MUGA scan (which takes pictures of my heart). Chemo can damage the heart, and they want to make sure my heart is in good shape before they go killing all of my fast-growing cells ;-) The MUGA was very similar to the bone scan - very still for what seems like very long. It really only lasted about 30-45 mins.

After the test, Rusty and I went for a run in the park down the street from our house. I'm training for a 10k in October, and I really want to keep up with it as much as possible. It was an absolutely gorgeous day outside - about 80 degrees at around 4:30 (which actually slowed me down a little, but I never run for time :-)

After burning all those calories we decided it would be a good idea to ingest some more, so we planned to go out to dinner at a place where we could eat outside (that's a very rare thing to do in mid-April in Massachusetts). We had an awesome dinner at Tribeca on Shrewsbury street that left us very satisfied but not overly-stuffed. We were really craving some gelato for dessert, but they didn't have any :-( We decided to buy some at a store and eat it while we watched some old episodes of LOST.

Now, this next part of the story could make you feel a little uncomfortable if I am your daughter, your niece, or your granddaughter. You have been warned. I know you'll keep reading, but now it's not my fault if you're offended ;-)

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The first day I met my surgeon, he informed me that I would have to stop taking birth control pills, because it was possible my tumor may be estrogen-fed (and birth control pills contain estrogen). It turns out it is. But he strongly warned me that I must not get pregnant. Being pregnant would complicate my treatment, interfere with testing, and could result in harm to the fetus. No problem - there was a reason I was taking birth control pills and it was because I didn't want to get pregnant anyway.

So, we decided to go to Walgreen's where we could get ice cream and, well, you know. So, we're walking through the store, trying to find the darn "Family Planning" section, and it was elusive. There's no way in hell we're going to ask for help, and eventually we found it. In highly ironic fashion, they put the pregnancy tests near the pregnancy prevention section. This can make for some really strange interactions. We saw a couple standing in front of the pregnancy tests and the woman was kind of crying (oops). Meanwhile, we're staring at a rather complex and varied array of condoms. It was uncomfortable enough just being there, and now I have to decide between various materials, textures, liquids... It was pretty awkward. We were pretty confused, but ultimately made our selection and went on to ice cream.

Over in the ice cream section, I went for some mango sorbet. It was all-natural and relatively low in calories. Rusty bought the new Ben & Jerry's flavor, "Americone Dream" (which is a tribute to Stephen Colbert, the comedian on the Comedy Central network who has his own show called "The Colbert Report").

When we went to the cash register, the bill rang up around $32. I had a very funny thought, but I held in my laughter because I wanted to act mature :-) (I couldn't look at Rusty or the cashier - I would have completely lost it).

As soon as we got outside I burst out laughing and turned to Rusty and joked, "Damn, that ice cream was expensive!" Then, Rusty shared his funny thought with me:

"I bet that couple next to us was wishing they were standing where we were a few weeks ago!" I just couldn't stop laughing after that and decided the story had to go in my blog. Yes, I'm sure it was a sad situation for the crying couple, but hey - it could be worse. One of them could have cancer! ;-)

Waiting for the other shoe to drop...

I have no idea what to write about today. I've thought about maybe a list of Do's and Don'ts regarding what to say to someone with cancer (I think I'm a bit of an expert at that now), but I'm kind of feeling down and exhausted so I thought it might get a little negative and make me feel even worse. (But don't worry - I really looking forward to writing that one...) I'm really trying to keep my spirits up and not dwell on overly negative topics because I feel like it won't be good for myself and those around me.

Today I found out that my first day of chemo will be next Thursday, April 24th. I really hoped it would be sooner. I just want to start it. It's like "waiting for the other shoe to drop." I'm already prepared for what chemo is going to do to my body. I'm not all that distressed about losing my hair (of course, that's easy to say now). It will be a good conversation starter. :-) Seriously, though... every time I see someone I make a decision in my mind about whether or not I should tell them. If I do, it wears me out. If I don't, I feel like I'm hiding something. If I have no hair, there will be no avoiding it.

Speaking of losing my hair, I'm thinking I'm going to go bandanna. I figured I can get lots of different colors and then it will be fun. I will have as many bandannas as my sister has hoodies (you should see her collection). The only weird thing is that I couldn't find a Red Sox bandanna, and that makes me kind of mad. The only one they have is for dogs and I refuse to wear something that was marketed to canines. That really pisses me off. I can get a Nascar bandanna, but not a Red Sox one. I can get a Jack Daniels bandanna, but no Red Sox. Professional Bull Riding, but no Sox (seriously... what's "professional" about bull riding?)

Whatever. I ended up buying lots of other bandannas online. I ordered a pack of 20 paisley ones of all different colors. This way, I will always have a bandanna to match my outfit :-) I also got several Grateful Dead bandannas in different colors. On the bottom is a purple one. Notice the Dancing Bears and the Steal Your Face's in the corners.

If I have to lose my hair at least I can have fun with it. And at least I can be thankful that I don't have hair down to my waist anymore. That would be pretty dramatic. I'm not as attached to it anymore.

Anyway, sorry I couldn't be a little more interesting for today's post. Tomorrow I have a chest X-ray and a MUGA scan. It's a test that makes sure my heart is functioning properly because chemo can damage it, so they want to make sure I'm healthy from the start. Shouldn't be any problems there.

And the verdict is...

Today I had a half day of meetings with various specialists related to my care. There was the nurse practitioner (I'm going to call her the Energizer Bunny), the radiation oncologist (The Zapper), the behavioral therapist (Lady Frasier), the medical oncologist (Mr. Wizard), and the plastic surgeon (Tabouli McSteamy). Today was the day for them to meet me (ya know, put a face to the mammogram) and let me know what to expect for their particular course of treatment.

First was the Energizer Bunny. I think she's going to be my go-to throughout a lot of this. She gave me some tips on losing my hair (shave it once it starts to come out so that I don't have to deal with a clogged shower drain on a real bad day), she offered to speak to my boss if I thought he would give me a hard time (he won't), and she also informed me that it would be okay to continue with regular massage treatments (yay!). The Energizer Bunny is also a fellow Wait Watcher - she has lost 70 pounds to date! (good for her - I've only lost about 15 on WW so far - but something tells me I had a bit less to lose).

Next was The Zapper. It took her a little bit to get up to speed with my case, but she informed me that I do, indeed, need radiation therapy. Not much to say about this because it will be a few months before she comes into the picture. One interesting thing I learned is that aside from the armpit lymph nodes that you normally think about there are some in the neck area, too. She will zap these just in case any cancer has spread here because it won't be possible for my surgeon to hit that area. Another interesting thing I learned is that whatever is left of my boob will be tan.

Onto Lady Frasier. This consult was kind of useless for me. Let me summarize - I am doing about as well as can be expected considering I have cancer. End of story. When I heard "behavioral medicine" I was hoping I'd hear about complementary treatments (like yoga, massage, etc) or certain exercises I should do. Instead, it was more about how I was doing and coping. I'm sure there are plenty of other people that don't have as good of a support system as I do, but I'm doing just fine, thank you.

Then, Mr. Wizard. I call him this because he was pretty unanimated until we started talking about some of the more technical aspects of his work. He described how the pituitary gland sends signals (oscillating signals, in fact) to the ovaries to activate them. There is a pharmacological way to neutralize these signals and basically "deactivate" the ovaries (thereby causing them to stop producing estrogen) without permanently removing them. Yay! This got him really excited when he explained it to us. This is important to me because my cancer is estrogen-receptive (meaning estrogen makes it grow) and also although I have zero interest in having children right now this is something I may change my mind about in the future (as a woman, I reserve the right to change my mind about anything and everything :-). As a sidenote, my cancer is also progesterone-receptive, but we don't yet have the results regarding HER-2 NEU (I'm really pulling for that one!). My final question to him was that when we decided to do chemo (which, at that point, was looking to be pretty soon) would it be possible not to schedule it this coming Monday? You see, I have tickets to the Red Sox game that day (Marathon Monday/Patriots Day - I really can't miss this). He was totally sympathetic because he has tickets to Wednesday's game!

Next, the plastic surgeon. I call him Tabouli McSteamy because he was Egyptian and you know that plastic surgeon on Grey's Anatomy, "McSteamy" (can't wait 'till that show starts up again). He was kind of weird. He kept looking at Rusty when he talked about my boobs (might be cultural, I don't know). I didn't really make a connection with him like I did with the other doctors, but he did explain things fairly well. Unfortunately, there are so many different options that may or may not come into play depending on what kind of surgery I have. At this point, I could have a lumpectomy (where they remove the tumor and some surrounding flesh), a single mastectomy (whole boob), or a double mastectomy (you guessed it - both boobs). Clearly, that has entirely different ramifications on the plastic surgeon's job. We decided that as my surgery gets closer, we'll meet with him again at his office where we can see pictures of the different options and actually feel the different implants. Sadly, some amount of disfigurement seems inevitable. It seems small in comparison to dying of cancer, but I've got to look at this every day for the rest of my life. This is one of those things I'll have to come to terms with. Fortunately, the "verdict" means I'll have some time to do that.

So what exactly is the verdict? Well, next week I will begin chemotherapy and that will last approximately 2 months. Treatments will be once every two weeks (or, once a week every two weeks, as Mom would say :-). During this time, they will be closely monitoring how my cancer responds to the chemo. After that, I will have a bit of time off and then I will have surgery. What kind of surgery I have depends on the size of the remaining tumor as well as the results of the genetic test (if I have the BRCA mutation, they will want to be more aggressive... i.e. take more boob). There is something like an 80% chance that I have the BRCA mutation but I think, if there's a .5% chance that a 27 year-old could have breast cancer and I have breast cancer... that 20% is looking damn good. After surgery I will undergo radiation (Mon-Fri for 6 weeks I think), and then it's on to reconstruction.

Well, that's about all I've got for today. You all have to stop commenting on the bitch post. I'm beginning to regret writing that. ;-)

Oh and BTW, you can all be as opinionated as you please (including you, Mom!). I shouldn't be the only one that gets a free pass on that stuff.

Testing... Testing... 1, 2, 3!

I was thinking about writing something very positive and slightly sappy today, and I almost did, but Vicki called me today to ask me a couple of questions about the tests I had. I figured today would be a good day to write about them while it's still fresh in my mind.

Yesterday and today were diagnostics days. In fact, I did have 3 tests (4 if you count blood being drawn for a genetics test). I'll write about them here so that everyone knows what's been done, and then if you ever have to get one of these yourself, you'll know what to expect.

On Monday, I had a contrast-dye MRI. Yeah, that kind of sucked. They had me lie face-down with my boobs in two holes (that was kind of comical!) and they gave me a set of headphones with the music channel of my choice (I picked Late Classic Rock). They also spoke to me through the headphones periodically to make sure I was doing okay. It was kind of funny the channel I picked. Every time I heard a song it seemed to fit my situation. I admit, I can't recall all the songs, but one of them was "Life Goes On" by John Mellencamp. The MRI was so loud that eventually I ended up tuning out everything I heard (including the music), so I can't remember much more than that.

A few minutes into the MRI they injected the contrast dye. This was pretty scary. The nurse, Jules, (who happily made me think of Jules that I used to work with :-) told me that I would feel kind of like hot flashes, and that if it got too bad and I wanted them to stop, there was a bulb I could squeeze. However, she reminded me that it would be difficult to still get this test in before my "big day" on Wednesday, so I should really try to get through it. I got through it alright, but I did kind of feel like the start of an asthma attack. I just thought of how disappointed all the doctors would be if they couldn't have the results of the MRI because I freaked out. Then I basically went to that happy place where nothing bad or scary gets in, and I was fine. The whole thing lasted about 20 minutes, or so I'm told. Luckily, I was face down and therefore had no hint of claustrophobia that I often hear when people talk about MRI.

Today was bone scan and CT scan. For the CT scan, I couldn't drink or eat past midnight. No breakfast. Rusty was so sweet - in sympathy, he didn't have anything to eat, either. Starting at 9:30 I had to drink a thick, sweet-tasting solution at half hour intervals before the scan. Not bad, really. Before the CT scan I needed to have an injection of radioactive solution for the bone scan (they were really good at coordinating all this). I could feel tingles in my veins when they put it in. eew. Then the CT scan. This test also had a contrast dye injection. Once again, the nurse warned me that it would be a warm feeling all over my body, and it would feel like I had to pee. This kind of scared me because I have an awfully little bladder, and I was concerned that I really would have to! Alas, there was no peeing my pants (thank God). The whole thing lasted about 3-5 minutes and the warm feeling went away rather quickly.

Next, we were able to go out to lunch because the bone scan was a couple of hours later. We went to a restaurant down the street. During lunch, I expressed sympathy for my Pepere when he had to go through all these tests for his treatment and diagnosis of bladder cancer (which subsequently spread to his bones). It's one thing for a 27 year-old girl to have be poked and prodded (4 needle sticks in 5 days) but I couldn't imagine him going through all this. My mom kind of went through a brief synopsis of my Pepere's treatment and it was really helpful to talk with her about the decisions he made and the treatment he had and all that stuff. It's hard to overstate how therapeutic it was for all of us to talk about it. My mom and I shared a hot fudge sundae after lunch (Rusty had a couple of bites). It's been so long since I've had a sundae. It was worth every calorie but I think I crashed really hard after the sugar rush (slept for over an hour), so I don't think I'll be doing that anymore :-)

Anyway... to the bone scan. For this test, I had to lay very still for several slooooow scans of my pelvis, head, and entire body. It was pretty easy and I could totally relax because it was quiet, painless, and lasted about 30-45 minutes.

The results of all of these tests will probably be reviewed tomorrow when I have a big day of meetings with all of the oncology specialists. Really only the MRI was intended to be diagnostic. It's possible they can use those results in determining the next course of care. The bone scan and the CT scan are intended to be used as a "baseline" to determine if the cancer has spread. According to my characteristics, there is a 50-60% chance that it has spread, but there's no way to tell just yet because it would be too small to detect. Later, they can run these same tests (ugh) and compare them with the tests I've had today to see if there are any changes.

I've got cancer, bitch!

She was nothing like all of the other nurses, doctors, and technicians that I've met so far. She was wearing earrings I would expect to find on a hooker and she had long fingernails (unsuitable for typing) and a bad attitude. She was one of the receptionists at the pediatric wing of the Benedict building. There was nobody in line, so we stepped up to the desk to check in for my appointment with the genetic counselor - we weren't late, but we were less early than I'd like to be for my 10:00 AM appointment.

Her: "Hmm, you're not in the system" (keep in mind, her tone of voice and pattern of speech was less-than-refined. I couldn't possibly do it justice in print)

Me: "Well, I know we made this appointment kind of late on Friday..."

Her: "You had a cancelled appointment at 8:45 this morning" (how helpful...)

Me: "Yeah."

Her: "And somethin' later this week"

Me: "Yeah, but I know I have an appointment with Dr. So-and-So this morning at 10:00 AM"

Her: "Well, I don't have nuthin' in our system. You gonna hafta step around the corner and talk to one of those ladies over there who can do some research". (seriously - did she think I was lying? What kind of "research" does this entail? Is someone going to write a term paper about what an idiot this woman was?)

There was no one else in line behind me, but somehow she couldn't deal with me and this mythical appointment that I must be lying about. So, we stepped "around the corner", faced with several ladies to choose from (it would have been nice for her to be more specific...). We stood in a line that shortly turned out to be the wrong line, and finally I arrived in front of another (thankfully, competent) receptionist who promptly took my information and found that I did, indeed, have an appointment with Dr. So-and-So at 10:00 AM. (Thank you!)

Ahh...

Later that day, Rusty and I were alone in the car and I immediately said something about that hooker-earring receptionist. I wasn't really upset about it. It's just that I'm the kind of person that enjoys dwelling on these bite-sized happenings - those snippets of life that just seem a little crazy, a little silly, a little ludicrous. The incompetence and the 'tude of the hooker-earring receptionist was just so appalling. When you deal daily with people who have cancer (especially little people - we were in the pediatric wing, after all!) I would expect a little more compassion. She was a stark contrast to the sweet and gentle nurse who took a small vial of blood for my genetic testing (so gentle I barely felt it - she truly has found her calling in the pediatric ward).

Anyway, once we were in the car I said to Rusty, "Man, I couldn't believe her attitude. Seriously, I mean, 'I have cancer, bitch!'" He laughed, and we proceeded to talk about how awesome every single person has been thus far. She just didn't belong in a pediatric cancer ward. We agreed that she was better suited for cleaning up someone's poop. :-)

As we were driving, we got stuck behind someone going about 50 MPH on the highway (I may be exaggerating - I do have a bit of a reputation as a leadfoot). As we passed her we both looked at her and I yelled (totally jokingly) "Get out of the way! I have cancer, bitch!" That provided another round of laughs.

So, I've decided that's going to be my new catchphrase. (When appropriate, of course.) It's much easier to say something silly and slightly profane in the face of insensitivity than to let it get to me.

The rest of the day was fairly hospital-y. I had a contrast-dye MRI (not something I'd recommend for passing the time on a Monday afternoon) and I met with a genetic counselor who's going to help me try to save my boob(s). I hope that works out. I'm kind of attached to them.

My mom also gave me the cutest bear:

In this picture, you can see one of my other bears (of the Grateful Dead variety) holding the new bear. The new bear is from the American Cancer Society and he has daffodils on his feet and he's holding a daffodil in his hands. It's one of those things that I think is so thoughtful and I'm not sure if my mom knows exactly how excited I was when I saw it. Sometimes you just need a thing. A thing to have and hold and bring with you to comfort you.

I decided he's going to come with me to all of my appointments. I was thinking about bringing my pink Grateful Dead bear (not the one pictured here - I have several). However, she's a little... um... obvious and oversized (but don't tell her I said that). I may be on the young side for breast cancer, but it is a little silly for a 27 year-old to be carrying around a big ol' pink bear. The Daffodil Bear is just the right size to tuck in my bag and he's really soft.

Anyway, tomorrow is my bone scan and CT scan. Looking forward to not being able to eat or drink anything from midnight 'till 11 AM. Ugh.

D-Day (Diagnosis Day)

Two days later, I received a phone call from my doctor's office. My doctor would like to see me to review the results. Hmph. I was kind of annoyed that I would have to drive all that way just to review the results (I work about 45 minutes away from home and from my doctor's office in Worcester).

Me: "Well, I work an hour away..."

Her: "Oh, that's great."

Me: "Well, no, not really. It will take me an hour to get there, so can we do it toward the end of the day?

Her: "How about 11:45?"

Me: "Uh, okay, fine."

So now I'm thinking she's incompentent (since when is 11:45 toward the end of the day?), but I figured I could just work from home for the rest of the day.

Wait.

Why do I have to go to my doctor's office for the results?

I called Rusty to let him know what just happened and he said "Oh, no." At this point I'm getting a little freaked out. Rusty would be on the next train to Worcester (he works in Boston), but he won't be back in time for my appointment. I immediately went to my boss's office to tell him that "something medical is going on" (so he would understand why I was out two days earlier and why I would be out the rest of the day today). I started crying. I told him that I had a mammogram and they had to do further testing... blah blah blah. Poor guy. He's like in his late 40's and he's got his new employee in his office, a 27-year-old female, blubbering and going on an on about her boobs. He said that I would be in his thoughts, and that my health was the most important thing right now... blah blah blah.

I kind of wanted someone to be there with me, but I'm thinking "this is no big deal" and refused to call my mom at work to come to my appointment with me. Boy would I look like a retard when my doctor says "well, we didn't get a good tissue sample with the biopsy so..."

I left for my appointment. On the way home, my mom calls. "Oh God" I think. What am I going to tell her? She knows my results are coming in today.

Mom: "Hi Megan, where are you?" (Damn she's good)

Me: "Hi Mom, I'm uh driving to my doctor's appointment" (choking back tears)

Mom: "Ooooh"

I don't remember much of what was said after that, but she was on her way. I do remember crying for most of the drive to the doctor's office. Every once in awhile I would stop crying and I'd feel silly. I knew the odds. Something like a .05% chance that I would get cancer based on my age. And I think something like .3% of breast cancer cases are detected in women under 30 (not entirely sure about that one). If I'm this lucky, why do I always come home empty-handed from Vegas?

Anyway, I get to my doctor's office, and eventually she came into the room. She sat down, and she had a pretty good poker face. Very slowly, she said what I was waiting for. Her words were something to the effect of "they found some abnormal cells in your biopsy"... "and those cells are cancerous". And I was shocked. "Oh, wow" and I started to cry a little.

She had already set up an appointment for me with a surgical oncologist that evening. Pretty quick. She really seemed just as surprised as I was by the whole thing, but she was already getting the ball rolling. Our conversation only lasted about 15 minutes. She described a few things about the results (none of it meant very much to me) and she made sure I had a good support system. I remember her telling me that I would have to have someone at the appointment that could be calm, level-headed, and could take notes. I knew that would be my mom. She didn't really believe that my mom could do that but I knew she would.

I called my mom, who was on her way to Worcester, and told her the news. I bawled my eyes out on the way home.

How it all began...

I figured my first post would be a great place to tell the story of how this whole thing happened. Warning... this post is a little detailed and you may not be interested in reading about how one finds a lump in her breast...

About a month and a half ago I noticed a "lump" - a dreaded lump. I remember exactly when I felt it. I was actually driving my car to dinner and my seatbelt cut across my chest and I felt a small pain in my chest. I though it was just the seatbelt, but later on I touched it (probably because it hurt still) and I felt a lump in my breast.

A few days earlier I had a treatment at my chiropractor's office where he really stretched out my arms and pecs. I figured somehow he pulled my muscle and maybe it was a lump of muscle that kind of surfaced. In any case, I was certainly not raised to be a hypochondriac. I figured it would go away on its own, but I knew I had a doctor's appointment coming up in about a month and I could deal with it then if it still even existed. (And I was sure it wouldn't).

I continued to monitor it periodically, noticing it growing and shrinking. Sometimes it hurt, sometimes it didn't. By the time I went to see my doctor, it was still there. She knows all about the history of breast cancer in my family, so she immediately took it seriously and scheduled me for an ultrasound of the area. However, she did reassure me that she's had many many patients with the same kind of concern and "the overwhelming majority" of them have a benign condition. I felt better. Now I was doing something about it.

A week and a half later I went to my appointment for the ultrasound, which actually turned out to be several mammogram pictures, two ultrasounds, and a biopsy. Whoa.

The ultrasound was first. This wasn't really a big deal. They basically take a wand and they run it over your chest for several minutes. The radiologist couldn't quite tell what the lump was, so I had to go for the dreaded mammogram. I say "dreaded" because I'd heard that this was pretty painful. Basically, in a mammogram they squish your boob between two plates and take an x-ray of it. Sometimes they contort it in curious shapes to get a different view. The only thing that comes to mind is a balloon animal. It's not really that bad, but it is kind of weird watching someone manipulate your boob that way. I had several of these. Honestly, I was prepared for way worse pain. It wasn't fun, but I don't think there's any reason for a woman not to get one if she needs it.

After several balloon animals, the radiologist still couldn't tell what it was, so she recommended a biopsy. They were able to do it that day if I was ready. Now, at this point, I'm thinking "damn... I am never going to get to work today!" But, I'd rather get it over and done with in one day (so I didn't have to explain two mysterious absences instead of one), so I told her to go ahead with it. Let me tell you... this was pretty freaky. At this point, I think I was starting to understand the gravity of the situation. But still, it was probably nothing.

I was awake during the biopsy, but they numbed everything. I didn't feel anything when I was on the table, but I had a huge core needle sticking out of my boob. I tried not to look, but it was kind of in my peripheral vision. They left it in there while they took several tissue samples (better than them having to poke me with that monstrous thing more than once!). They also took a sample of fluid from my lymph node.

When they were done, I was told I should not go to work. I had to keep an icepack on my chest (now I know why I can't go to work...) and I was to "take it easy" for the rest of the day. My doctor would call me within 2 days with the results.