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July 31, 2007

Anger and Frustration

I am not feeling good today and I am angry and frustrated about it. Last night I felt pretty good. Not normal, but not bad. I went to bed expecting to wake up and feel good enough to exercise and to go about my day more normally than I have for the past several. But it didn’t work out that way at all. I woke up today feeling sick and tired, and it has lasted all day. I have no energy, no will, and no strength. I have spent the day trying to will myself to get up off the couch and move…to do something. But I keep falling back, exhausted and tired and angry. Angry at my body, angry at this cancer, angry that I have to go through this.

I didn’t expect this. I was certain that after the weekend I would feel better each day and I counted on my body to recover and to bounce back and to feel normal again by now. I keep picking up my cancer books or getting online to read about side-effects to find out whether or not this is normal, and I keep reading about how many people have few if any side-effects and about how many people go about their normal lives with no problem between treatments. I also keep reading suggestions about how exercise can help with the exhaustion. But I am too exhausted to think of attempting even a walk around the block, let alone real exercise.

I know that chemotherapy affects everyone differently and that there are no guarantees that your body will react one way or the other. But I am realizing now that I expected to be one of those people everyone keeps telling me about who just sails through it. I am not sailing so far, and I am not happy about it at all.

July 30, 2007

The Sun Also Rises

I feel better this morning, no question about it. The bone pain has subsided to just a mere ghost of discomfort and the nausea is gone. I still feel…not perfect. But at least I feel as if I’m fighting off a cold now, instead of the flu. And I’m so happy to be done taking drugs for a couple of weeks.

I am so tired of just sitting around, so this morning I did some laundry, picked up things around the house, made the bed, made some phone calls, etc., and now I’m ready for a nap. And it’s only 9:15 a.m. I know that I probably need to continue to take it easy as much as possible, but I have my fingers crossed that the worst of it is over. I have come to the conclusion that I am not a very patient patient. All this forced down-time makes me stir crazy, even when I don't have the strength to do anything about it.

Interestingly, I find that I’m already trying to steel myself up for the next treatment (which is still a week and a half away). I’m going to need to work to get myself psyched up and mentally prepared to go through it all again. I thought I might feel as if I could start to count down to the end once I got through this first one, but instead, when I look at the calendar and see all those treatments listed, it feels as if these next three months are going to be interminable.

July 29, 2007

Holding Pattern

Not much improvement to be reported this morning. The list of side-effects is about the same: unrelenting bone pain, slight nausea, no appetite, all-over general feeling of yuck. It can best be described as having a really bad hangover and a really bad flu all at the same time.

Cancer cells are strong and tenacious. It takes strong and tenacious medicine to kill them. I keep trying to think about the fact that if these drugs are making me feel this way, they must really be doing a number on any cancer cells that thought they were going to be hanging out in my body. Those thoughts don’t make the discomfort go away, but they do help to put it in perspective and make it a little easier to “just keep swimming.”

July 28, 2007

Post-Chemo: Day Three

Evening Update: Little did I know that this morning's manageable side-effects were going to be the high point of the day. It's been a very rough afternoon and evening...lots of pain in my hips, legs and back, some nausea, mostly just feeling really, really awful. I'm okay..soldiering through as best I can..but anxious for this part to be over. I hope it is just temporary, anyway.

So far the chemo side-effects have been very manageable. I'm knocking on wood that it continues. Today and tomorrow are supposed to be the rough days, so we'll see what happens.

Yesterday I received the Neulasta injection in the back of my arm. It hurts and it takes a good minute to administer it. I won't be looking forward to that one every two weeks.

Yesterday evening after dinner I was so exhausted that I absolutely could not keep my eyes open and I feel asleep on the couch for an hour or so. When I woke up we watched a movie and then went to bed, where I fell asleep as soon as my head hit the pillow. But then I woke up at about 4:30 a.m. this morning and have been up ever since. I'm not sure if it's the steroids or what, but when it became obvious that I was not going to be able to fall back to sleep, I got up and began working on my to-do list. I got several school and household business e-mails sent out, refilled my prescriptions online, ordered my books for next semester and made a shopping list for Randy.

My hips and legs are beginning to ache now, which is a side-effect of the Neulasta, so I'm going to take some Tylenol and hope that helps. I have felt slightly nauseous both yesterday and this morning, but the cheaper anti-nausea medication has been helping (as opposed to the $400-for-twelve-pills Zofran [and that's for the generic version!]). I have also experienced a significant loss of appetite...nothing really sounds or tastes very good...but I'm trying to find things to eat. The nausea, hip pain, and loss of appetite can best be compared to pregnancy side-effects so far. Been there, done that a few times and if this is as bad as it gets, I'm good with it. I'll update later if there are any changes.

Update: Because I'm also looking at this blog as a journal to record my experience, I want to be sure to note a couple of other side-effects I have experienced so far. Unfortunately, constipation has to be added to the list (caused by the anti-nausea meds, I'm told). That's a fun one, and one I'm thrilled to be sharing with everyone I know. I'm trying to work on it with diet and hopefully some physcial movement soon, but I may have to resort to pharmaceutical help. TMI, I know! Also, I should note that I experienced a pretty bad headache the evening after my treatment which turns out to be an uncommon side-effect of the anti-nausea meds I received during the chemo treatment. Patty (my nurse) told me yesterday during my injection that it was the cause, and that not everyone experiences that. So I'm 2 for 2 with the unusual side-effects so far. Let's hope the record stays right there. I don't like the unusual ones.

July 27, 2007

You Are the Best Part

For the past couple of months, I have been trying so hard to stay on top of my correspondence with all of you. I am woefully behind at this point, and will probably never catch up. Most of you know enough about me to know how much that drives me crazy. I want so desperately to be able to respond to each comment and e-mail, write thank you notes for your gifts, and return your phone calls and I just can’t keep up. And I am afraid it’s going to get even more difficult as chemo gets under way. I hate to have to send a generic thank you like this, but I want you all to know how much I appreciate everything that you all are doing for me and my family.

I don’t think I can even find the words to begin to express the depths of my gratitude to all of you, from my IRL (translation for those of you not hip to the techno-lingo: In Real Life) friends and family to my internet friends to the complete strangers who have visited this site. Your cards, gifts, letters, dinners, blog comments, e-mails, help with the kids and phone calls have been amazing and mean so much to me. Every single day I am overwhelmed by your love and support, and I read your words and listen to your messages several times. In the darkest moments (and there are some dark ones), and even in the not so dark ones, knowing that you are all out there truly gets me through.

I read The Diary of Anne Frank for the first time when I was in sixth grade in Miss Ellenwood’s class at Aboite Elementary School. I believe that was the first time that I had ever heard of Anne Frank, and I remember being incredibly moved by her words and by her story. I became fascinated with the Holocaust and I was horrified (and still am) by the atrocities that took place during that time. Knowing everything that Anne Frank and her family went through before and while they were in hiding and knowing that they were well aware of the horror of what was going on in Europe at that time makes the last words of her diary even more poignant. “[I]n spite of everything, I still believe that people are really good at heart.” Those words struck me immediately when I read them at 12 years old and I never forgot them because I have always felt the same way. Your powerful and unrelenting support for me since the moment I announced my diagnosis has proven to me over and over again how true those words are. People are more than really good at heart; people are quite amazing. Their generosity and kindness and love for their fellow human know no bounds.

No one wants to go through anything like this (and believe me, now I know that you REALLY don’t want to go through anything like this), but I hope that anyone who finds themselves on a similar path discovers the wealth and the joy in the love of their friends and family that I have found. I think I am actually one of the lucky ones, because I get to see and feel the outpouring first hand.

There are many bad parts of cancer. All of you, however, are the best part.

Thank you.

July 26, 2007

Let the Countdown Begin

When I said I had a date with nurses and needles in my last post, I wasn’t too far off the mark.

I’m writing this post while sitting in my spring-green vinyl recliner in the chemo room at my doctor’s office while hooked up to an IV pole full of drugs. There’s a basket sitting next to me full of the drugs still to come. My roommates are a woman who is about ten years older than me with a full head of long blond hair and an elderly woman with dainty, bird-like features and pink cheeks wearing a bright pink baseball cap, a lavender sweat suit and no hair. My third companion is another woman who is about fifteen or twenty years older than me wearing a red blouse, glasses and a light brown wig. (I can’t see her very well because she’s around a corner across the room, but I think it might be her last treatment.) The room is L-shaped, with the tall part of the L approximately 10’ wide x 20’ long and the short part of the L about 10’ wide x 15’ long. Every available bit of space in the room is filled with recliners just like mine, eight or nine in all, each accompanied by a small white bedside table and several IV poles and pumps.

The previous paragraph is as far as I got in my Chemo: Day One narrative, because I spent the rest of the appointment talking with my amazing nurse, Patty. Patty greeted Randy and I when we arrived, accessed my port, and was in charge of the administration of all those drugs while I was there. (The room was so small and crowded that I urged Randy to leave once I was hooked up and to return when I was finished, and he did.)

Most of the chemo drugs are administered via an IV bag, but the Adriamycin is administered by the nurses themselves using a very large syringe. It takes 8-10 minutes for them to pump it into us through an IV line, so they sit next to us on a stool while they do it. Patty sat next to me while she was administering the Adriamycin, and then stayed while the Cytoxan was administered as well. I was happy about that because we had a great conversation and I thoroughly enjoyed talking to her. We discussed everything from our kids (she has four) and their driving to wigs and Wisconsin and blogs. (I told her I was going to write about her here and gave her the address so she could check it out.) Talking with her made the time fly and I found that I was actually disappointed when it was time to go. (I will take my camera next time to get pictures of Patty and of the chemo room so you can see what it looks like.)

Just as WhyMommy observed last week at her first chemo appointment, when I first arrived I felt like the new girl at school. I didn’t really know anyone there, I didn’t know where to sit or what to expect, and it was all a little intimidating. The nurses and the other patients were all kind and friendly, however, and thanks to them I quickly felt at ease.

After Patty accessed my port (which was completely painless), she gave me saline, an anti-nausea med and a steroid, followed by the bright red Adriamycin (it looks just like cherry Kool-Aid) and the Cytoxan. She described everything she was doing before she did it and reviewed all the possible side-effects of each medicine. The whole process was quite painless and relatively easy.

Lucky me, I did have one side-effect while I was receiving the Cytoxan that she had forgotten to mention. At first when my sinuses began to feel clogged and to burn a little bit, I thought maybe it was my imagination. It kept getting worse, and in addition it felt like water was coming out of my ears (kind of like after you go swimming). I finally mentioned it to Patty and she told me that only one in ten women experience that particular side-effect and that it only lasts while they are receiving the Cytoxan. I hope that doesn’t mean that I’ll be experiencing other rare side-effects. I don’t want to be that special!

I’m home now, drinking lots of water (to flush the Cytoxan out of my system in order to fend off potential bladder damage) and resting. I’m actually feeling okay right now, although I’m a little tired. I think that’s just from being hyped up about all of this more than anything else. Patty said that I will probably experience insomnia tonight (an effect of the steroid) and that I will still feel pretty good tomorrow. Saturday and Sunday will be the days when I might feel really exhausted and possibly nauseous. I’ve got my fingers crossed that these anti-nausea medications do their job.

Tomorrow I have to return to the doctor’s office for a Neulasta injection. This injection will help my bone marrow and white blood cells recover so that my body will be ready for the next treatment in a couple of weeks.

The good news is that the first treatment is over. I’m no longer nervous about that part of it. The big unknown now is which side-effects I will experience, but that mystery will probably be cleared up in short order.

July 24, 2007

Anticipation

This week feels like the worst finals period ever in the history of law school. And it’s not because of the law school final which takes place tomorrow night. Granted, I’m probably less prepared for this one than for any other law school final that I’ve ever taken and that’s causing me some anxiety. But I will be spending all day today and most of the morning tomorrow studying—cramming—to get ready for the test. Even though I’m less prepared, I’m also less nervous about this one. There’s something about cancer and chemotherapy that takes all the scariness out of law school exams. It no longer seems like the test is a matter of life and death. The “exam” I’m most nervous about is the one that’s taking place on Thursday.

The anticipation I feel about Thursday’s first chemo treatment kind of feels like the anticipation of a law school final, but one for which I am completely unprepared and for which there is no way to prepare. There’s no study guide, no practice exams, no lecture notes, and no commercial outline to help me get ready. I’m just on my own for this one. Like a law school final, it will last for three hours and I won’t be able to get up and leave or move around if I want to. Also like a final, I don’t know exactly what to expect or what is going to be included on the exam. Instead of having to wait four weeks to get a grade, however, I’ll only have to wait a day or so to get possible side-effects.

I think I should probably be happy for the intense exam prep that I’m working on this week, because it prevents me from being able to focus too much on the upcoming chemo treatment. I would be a basket case if I was thinking solely about Thursday with nothing to distract me. So it’s back to hearsay exceptions and prior inconsistent statements for the next 36 hours or so, then on to my date with nurses and needles on Thursday.

July 19, 2007

On Chemotherapy and Wigs

I met with the radiation oncologist today for a radiation follow-up visit and to talk about the chemo start date. We have decided that next Thursday, July 26th will stand as the official chemotherapy start date unless my skin reaction to the radiation worsens. So far it still looks and feels like a bad sunburn, but it’s not terrible. If it does get any worse in the next couple of days I will postpone the start date in order to make sure that I’m on the up side of healing and to prevent any further complications. The Adriamycin (one of the drugs I’ll receive during the first four treatments) in particular can retard the healing process, so we have to make sure that I am well on my way to being healed before we start.

After that appointment, I jumped in the car with my friends Kim and Suzy (both are neighbors…Suzy is my hairdresser extraordinaire) and headed to a local wig shop. Although I was looking forward to hanging out with them, I was NOT looking forward to wig shopping. I couldn’t wrap my mind around the idea of wearing a wig…ever…no matter how much I hated being bald.

And wouldn’t you know, I left the shop carrying a receipt for not one…not two…but three wigs. Suzy and Kim and the incredible staff at the store helped me choose a blond wig that is very similar to my normal hair style and actually looks real, a partial fall that I can wear under hats when it’s hot, and a completely unexpected and kind of cool dark brown wig to boot. (For those of you who know her, with brown hair I look eerily like my sister Molly.)

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Exhibit A--Is it Kim or is it Molly? (For the record, I did NOT buy this wig! Can you say "1980s?" All I need is shoulder pads and I'd be set.)

The best part was how much fun we all had trying on wigs. Kim and Suzy tried on just as many as I did, and I think we tested every single hair color and style in the store between the three of us. We tried on gray, red, brown, pink, black, all shades of blonde, long, short, medium, braided, curly and straight hair. We laughed constantly and it turned into a fun excursion rather than a painful one. I was truly amazed at how real the wigs looked and even felt. I still can’t imagine wearing one, but I’ll have several to choose from if I want them.

I still don’t have any pictures of my new super-short haircut, but in the meantime click below to see a few pictures from the Great Wig-Buying Adventure. (I know that the pictures below are cut off...I don't have time to fix it right now, so just click on the photo album link over on the right to see the full pictures for now!)


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The brown wig I bought is this color, but not this style.

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July 16, 2007

Time to Celebrate!

Battery of tests? Check!
Surgery? Check!
Radiation? Check!

Radiation is over and I am celebrating with a glass of champagne this evening. (The nurse told me I could only have a little bit. The doctor said I could go for it, as long as I was sitting down. Guess whose advice I’m taking?)

My last treatment went quickly and once I was done the nurse practitioner removed the catheter. She had given me a topical anesthetic in the morning and told me to apply it to the skin around the catheter and to take some Vicodin before I left the house on my way to the afternoon treatment. These suggestions were supposed to help with the pain of the removal. Since “removal” consisted of pulling the entire length of the catheter and balloon out a 1/4 inch hole in the bottom of my breast, I kind of think that general anesthesia would have been more effective.

In reality, it sounds much worse than it actually was. It was mildly uncomfortable, but the only time it really hurt was when the catheter and balloon passed through the hole near the surface of my skin and that only lasted for a few seconds. Then it was over. The nurse closed up the little incision with couple of steri-strips and I was on my way out the door. As I left the office, many of the nurses came out to hug me and congratulate me on being finished. It was very touching. Although I won’t miss the radiation treatments, I will miss seeing the nurses in that office—they were all incredible and I got to know many of them as the week progressed.

Before I left, the nurse practitioner also presented me with the catheter as a souvenir. I will post a photo of it soon so that you can see how big the darn thing is. I can’t quite believe I walked around with it (mostly) inside of me for a week and a half!

I am still scheduled to start chemo on July 26th although there is some question as to whether I will actually start that day. The radiation oncologist wants me to wait another half a week to make sure I’m as healed as possible, but my oncologist says it’s okay to start as planned. Today I asked nurses in both of their offices to have the two of them talk about it and to make sure it’s really okay that I start that day.

While I’m waiting to hear the final verdict on the start date, I will be visiting my friend/neighbor/hairdresser tomorrow to have my hair cut yet a little shorter. Later this week she is going to accompany me to a local wig store to shop for a wig. She has been so helpful; she even called the shop to discuss my situation with the owner, to get information about the selection available, and to make an appointment for me. She is truly watching out for the aesthetic issues involved in my treatment and I am so grateful for her help. I will post a picture of the new haircut as soon as I have one to post.

But right now I’m going to open a bottle of champagne and celebrate the victory of passing another milestone on my journey through and beyond breast cancer. Salut!

July 13, 2007

The Light at the End of the (Radiation) Tunnel

Today marks my fourth day of radiation. The last two treatments will take place on Monday and then that’s it for me. Radiation will be done. I’m still very tired, but it could just as easily be from not being able to sleep well for a week (because of the catheter) as from the radiation.

One side-effect of this type of radiation is skin irritation, just like the skin irritation experienced by patients who receive standard radiation. In regular radiation, I'm told, the skin irritation feels like a really bad sunburn. As Alison described it, “At first, it’s like getting a bad sunburn, but instead of staying out of the sun, you go the next day for your new sunburn.”

With the MammoSite treatment, of course, the radiation is inside your body. However, the radiation burn travels up through the tissue and eventually comes out as a burn on your skin. My skin above the balloon started to hurt a little bit last night, but I just tried to ignore it. As the day has progressed, however, it has gotten worse and now it does feel like I just spent 8 hours in the sun with no sunscreen, except that only my left breast was exposed to it. And it’s pretty uncomfortable. I’m really glad I don’t have to go back for a couple of days.

My plan this weekend is just to rest, to catch up on Evidence reading and lectures (and I need to start preparing for the final which is coming up in less than two weeks!) and to gear myself up for Monday’s catheter removal, which I am told will hurt.

Because we want to try to fit as many medical procedures as possible into as short a time as possible, however, Randy had a vasectomy today. He will be resting this weekend right along with me. He is currently “elevated” in his recliner with a pack of ice and the remote control at hand. So far he’s feeling okay, but many of you have so generously shared your vasectomy horror stories with him and he’s just hoping that he doesn’t end up in one of them. If nothing else, at least we can catch up on our Netflix cache.

July 11, 2007

Radiation Update

So radiation is uneventful and boring. My days look like this: drive...CT scan...radiation...drive...drive...CT scan...radiation...drive. Throw in some eating and sleeping for good measure, and that's about it. I think tomorrow will be the same thing but without the CT scans. By all accounts, it's going well and exactly as it's supposed to.

As for side effects...I'm exhausted already, but I'm not sure if that's from the radiation or just from all the driving. It feels like that deep exhaustion many women (including me) experience during the first trimester of pregnancy, so I'm thinking it's probably the radiation. But it's very manageable, and a good excuse to take naps.

The good news is that after tomorrow morning's treatment I'll already be half-way done and I can start counting down to the finish.

The bottom line is "so far, so good" and I'm doing fine.

July 10, 2007

One Down, Nine to Go

This morning’s radiation appointment was long and anti-climactic. The best part about it was how happy I felt when I was on my way home. It feels so good to be doing something proactive about this. It feels good to be finally getting active treatment besides surgery. And the worst appointment of these ten is over…the rest should be cake.

When I arrived at the radiation oncologist’s office a nurse, Mary, took some blood and then removed all of my surgical dressings. (She didn’t use my port this time since it still hurts from the surgery.) Randy was in the office with me while she was removing the dressings and as she began she looked at him and asked him how the dressing went this weekend. We all paused for split second, Mary waiting for an answer and Randy and I wondering what she was talking about, and then I realized that she was asking him because she thought that he had changed them for me each day. I told her that he wouldn’t know how the dressings went because I did them myself. She looked at me in astonishment and said, “You did it?!” I reaffirmed the fact that I did, and she seemed to think that was pretty great. To be honest, though, I can’t imagine asking Randy to do it. It wasn’t exactly the most pleasant experience. Plus, I probably wouldn’t trust him to do it exactly right. After all, I was given two pages of instructions about how to do it and there’s no guarantee that he actually would have read them. (By the way, Randy’s answer to her question about the dressing was something about the fact that it usually goes pretty well despite the fact that he’s about ten years behind the latest fashions. I married such a comedian.)

Once the dressings were removed we went into a CT scan room. One of the technicians in the room was the mother of one of Blake’s former classmates, so we spent a few minutes trying to figure out why we looked so familiar to one another. It was a bit odd to have her taking positioning pictures of me a few minutes later since the last time I saw her we were both helping out our children’s fifth grade teacher with a Valentine’s Day party, but I got over that pretty quickly. In the CT scan room I laid down on a large square piece of blue plastic filled with some kind of foam. The nurses formed the plastic and foam to my head and upper torso. It hardened and will be the mold that I lay in for each treatment in order to make sure that I am positioned exactly the same each time.

After a few minor adjustments, the technicians took a couple of quick scans that the staff physicists would then use to determine the precise position for the placement of the radioactive seed. I laughed to myself at the further oddity of lying in a room filled with five other people with half of my torso exposed, all of them studying it and discussing it and making adjustments and calculations. Nothing like a little breast cancer to chase away any modesty or hesitation about exposing myself to strangers.

After another quick CT scan, I was shown back to a room where I read Evidence cases for an hour and a half while the doctor and the physicists all consulted about baseball statistics the best placement for the radioactive seed. At one point the doctor came in to tell me why it was taking so long, for which I was grateful. They have to be very careful and very precise about the radioactive seed placement because part of the MammoSite balloon is close to my chest wall. They worked to adjust the radiation by millimeters so that a lower dosage hit that part of the balloon, thereby preventing any damage to the tissue of my chest wall. Once I knew why I was waiting, I agreed that I would much rather have them take their time and make it perfect than risk any kind of damage.

Once they had the positioning figured out, things moved quickly. I was taken into a large empty room, about 14 ft. x 14 ft., that contained only a bed, the radiation machine (about the size of a large vacuum cleaner) and, in one corner of the room, a tri-fold screen. I laid on the bed in my now-hardened mold, the doctor hooked the radiation machine up to my MammoSite catheter, and then everyone (the doctor, the nurse and the physicists) left the room. A few seconds later the doctor’s disembodied voice boomed out through an intercom in the ceiling telling me that we were about to start. I felt nothing while the radiation machine next to me started clicking and humming, and 7 ½ minutes later it was finished. Soon after that, I was on my way home.

I have to go back this afternoon at 4:00 p.m., and then I’ll return Wednesday, Thursday, Friday and again next Monday, twice each day at six hour intervals. I will have CT scans done again this afternoon and tomorrow, but after that each treatment should go rather quickly. I feel absolutely fine and normal right now, so if there will be any side-effects I haven’t experienced them so far.

In addition, Mary told me that while I am there this week I can take advantage of any or all of their special services. They offer the services of a cosmetologist for a make-over, a masseuse, a nutritionist, a spiritual advisor, and a social worker, as well as access to a secluded little zen garden filled with lush green foliage, a waterfall and pond. In fact, between the special services, the muted lighting, and the heated gowns and towels, it’s nearly spa-like. Okay…I admit that you might be a little hard-pressed to find a spa that specializes in exposure to radioactivity and toxic poisons. Not to mention the fact that you probably wouldn’t really want to find one like that. But hey…the glass is half full, right?

July 08, 2007

You Can Help!

My kids have been blessed with some truly wonderful and amazing teachers in their lives. Many of them have touched our lives personally as well as through their work as educators. One of those special teachers is Matthew’s third grade teacher, Michele Busky.

Michele is walking in Avon’s 3-Day Breast Cancer walk in Chicago on August 10th-12th. She is walking because people she knows have been touched by breast cancer and because she feels the need to do what she can to fight. This is her way of fighting.

Avon asks walk participants to commit to raising at least $2,200 before the beginning of the walk on August 10th. Please join me by clicking on this link and by making a donation in support of Michele. Every single donation helps, whether it’s $5.00 or $20.00 or more. In fact, 85% of the donations received for this event benefit the Susan G. Komen for the Cure network. (If you would prefer to send a check rather than making a donation online, just send me an e-mail and I will get Michele’s contact information for you.)

I am so grateful to her for doing this. Please help if you can! Thank you.

July 07, 2007

You Need This Book!

I think it’s long past time for a non-cancer related post! Back in April before all of this cancer stuff started, I promised my friend Martha Kimes that I would send an e-mail about her to many of you. Once I found the lump my promise kind of got pushed to the back burner, so I’m going to try to make it up to her now by posting about her here.

I first met Martha through her blog. She is an excellent writer and a great storyteller and I always enjoyed everything she wrote. Since she is also a lawyer, I asked her to edit my personal statement for me when I was applying to law school. We didn’t really know one another very well and she was familiar with the ins and outs of applying to law school so I thought that she would be able to give me a truly objective opinion of my essay. And she did.

Not long after that, Martha found out that someone wanted to publish a book about her first year law school experience…kind of a OneL meets The Paper Chase, but from a woman’s point of view. And so she wrote it and it was published in May. I bought a copy as soon as it came out and I finally got a chance to read it last week. It’s an excellent book!

If you are thinking about going to law school, if you’re in law school, or if you’ve ever been to law school, you must read this book. If you know someone in law school or if you have ever been curious about the mystery that is law school, you should read this book. If you are just interested in a funny and entertaining read, you should also read this book. Really…Martha has perfectly captured all the nuances of the 1L year with her highly entertaining and humorous words.

Here’s a link to her book, and here’s a link to her blog. Go…read…enjoy!

Just Call Me Robo-Mom*

I’m writing this on Saturday morning while still feeling a little groggy from the general anesthesia. No promises that this will be exceptionally clear or understandable, but I want to try to keep up with everything that is going on.

I arrived at the hospital early Friday morning and was quickly wheeled into the operating room with just a little bit of pre-surgery excitement. The first exciting moment came when I noticed an air bubble traveling quickly through my IV tube toward my hand. I was slightly alarmed because in the back of my mind I remembered hearing some story about the dangers of something like this, so I buzzed for the nurse. She came right in and reassured me that the tiny bubble I saw was perfectly normal and was nothing to be concerned about.

The next exciting moment came when the anesthesiologist told me that I would be receiving sedation instead of general anesthesia for this surgery. I was immediately freaked out, envisioning that I would be awake while they were working inches from my face. The anesthesiologist left and then returned a few minutes later to tell me that my surgeon had actually ordered general anesthesia for me since he had to make a bigger incision than he normally would for my surgery. (This was because it had been so long since my lumpectomy—usually this kind of surgery takes place before the lumpectomy incision has fully healed.) I was very relieved.

The procedure was a bit different from my previous two surgeries because I didn’t receive any kind of sedation before I went into the operating room so I was wide awake when they wheeled me into the room. I took the opportunity to look around and to chat with my surgeon and the nurses, although it wasn’t long before I felt the anesthesia working its way through my veins and I was out.

Once I woke up I recovered for a short time, they took a chest x-ray to make sure the port was placed correctly, and then I left the hospital. I went straight to the radiation oncologist’s office for a teaching appointment. The nurses there showed me how to care for the MammoSite catheter and gave me play-by-play instructions about what would happen during next week’s radiation.

I will describe the MammoSite catheter and the port below the fold. If you’re interested, click below and keep reading. If you prefer to skip the graphic medical details (Dave! :) ), then you may want to stop reading here.

I have four new incisions on my chest now. One is on the right hand side just below my collar bone and one is on the inside of my right breast. The one below my collar bone is the mediport, which feels like a small disk (about the size of a penny), and the one on my breast is the spot where they will access the port to administer my chemotherapy drugs or to take blood.

The other two incisions are on the left side. One is not really new because it’s just a re-incision of my original lumpectomy site. The surgeon implanted the MammoSite radiation balloon in that incision. The second one on the left freaks me out, however. There is a hole at the bottom of my breast which measures about ¼ inch in diameter. Protruding from the hole is a plastic tube which is about 2-3 inches long. Attached to the end of the tube is a smaller, flexible tube. Both the end of the straight tube and the end of the flexible tube are capped off. During my radiation treatments, the nurses will remove the cap from the flexible tube and they will insert a long wire with a radioactive seed on the end. They will then irradiate my breast, which will last anywhere from 4-5 minutes. (You can see a picture of it here. Instead of coming out of the side of my breast, however, the tube is coming out of the bottom of my breast. Otherwise it looks just like this.)

During my first visit on Tuesday morning they will do a CT scan so that they know exactly how the balloon is placed in my breast and exactly where they need to place the radiation seeds. They will repeat this scan every day before I receive the radiation. They will also make a mold of my upper body and arm on the first day. I will lay in this mold for the CT scans to ensure that I am positioned exactly the same way for each scan.

The radiation treatments will take place twice a day at six hour intervals for five days. My first treatment will be on Tuesday and my last will be the following Monday. As I mentioned before, the radiation itself will only last for 4-5 minutes but each appointment will last about an hour. I understand that the main side-effect of the radiation will be fatigue. A nurse told me yesterday that by then end of the week most women are exhausted. However, this exhaustion can be caused by the frequent traveling back and forth as much as by the radiation treatments themselves.

I will be missing both of my classes next week as well as my class next Monday, which I am definitely concerned about. When I got home from the hospital yesterday, however, I had an e-mail from my school telling me that they will be taping all the classes I will miss. That is a big relief…especially since there will only be two class periods left before the final after next Monday’s class. I’m behind in my reading right now, so it looks like my week will be spent in the company of radiologists and my Evidence casebook.

*Kudos to Dave! for the nickname.

July 05, 2007

Moving Right Along

Just a quick update to let you know that things are hopping today. The surgeon got my MRI results and the good news is the images were “clear.” This means that they didn’t see anything else that looks like cancer in my breast and that I am therefore a candidate for the partial-breast radiation. It also means that I am scheduled for surgery bright and early tomorrow morning to have the MammoSite balloon and a mediport implanted. The surgery will be followed immediately by a teaching appointment with the radiation oncologist and I’m guessing that I’ll start radiation on Monday. (I’m waiting to hear back from the radiation oncologist’s office with the exact days and times for this.) The radiation will take place twice a day at six hour (I think) intervals for five days.

Having radiation next week will push the beginning of my chemo treatments back a week. I am planning to ask my oncologist if we can push them back one additional week so that I can take my Evidence final before the chemo begins. (And because we have tickets to go see Jimmy Buffett on July 21st!) I’m also going to cross my fingers that my school will be able to tape class lectures for me next week because I won’t be able to make it to class.

This has all happened so quickly that I’m a little overwhelmed. I haven’t had time to wrap my mind around the fact that I'm having surgery again tomorrow (!) because I’m trying to coordinate the times of all these appointments, next week’s classes, rides for the kids, etc. I’ll update again when I can to let you know how the surgery goes.

July 03, 2007

I'll Take the Chemo With a Side of Fatigue

Today brought my chemotherapy “teaching appointment.” Randy and I met with Nicole, one of the wonderful nurses at my oncologist’s office, who gave us the chemo 411. She described each drug that I would be receiving, how it would be administered, and how long it would take to receive it. She also talked about the side-effects of each drug and how long they would last and told me what I could do to combat those side-effects. Most of what she told me I had already read in various books, but she was able to answer several questions for me. I get to look forward to alopecia (hair loss), nausea, fatigue, bone pain, mouth sores, constipation, and diarrhea, among others. I may not experience any of those, or I may experience some of them, or all of them. The side-effects might last for one day or three days or a week. I left with a handful of prescriptions for some very expensive drugs, including one for a wig (the medical term for which is a "cranial prosthesis"), and a lot of trepidation about what I’m about to go through.

Nicole also gave us a tour of the office. One of the rooms we saw was the chemotherapy room where I will have my treatments, which was lined with twelve big fancy recliners. There were about 4 or 5 people scattered in chairs throughout the room, men and women, some bald, some not. The one common denominator about all the other patients was that they were all older than me.

I didn’t hear anything about the results of my MRI today so I don’t know yet if I’ll actually be starting on the 12th or not, but I do have one more decision to make before then. My surgeon has mentioned several times the possibility of having a port implanted to make delivery of the chemo drugs and blood tests easier by saving me some needle sticks. My oncologist has said that he thinks the best way to receive the chemo is via an IV in the back of my hand. After talking with Nicole today, I think that I would probably prefer to have a port implanted, despite the fact that doing so means an additional surgery. If I end up having surgery to implant the partial-breast radiation catheter I will definitely choose to have a port implanted at that time. If I am not able to do the partial-breast radiation, I’ll have to decide whether to have the port installed or not.

July 02, 2007

MRI Adventures

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The MRI today proved to be yet another new and interesting cancer treatment experience for me. I had it done at Lutheran-General Hospital in Park Ridge on the advice of my oncologist who said they were the best in the area. The technician, Denise, told me the same thing, so I’m going to assume it’s true.

I arrived at the hospital 45 minutes early as instructed, registered and then waited for about 40 minutes to be called back into the MRI area. I changed into a hospital gown and removed all my jewelry and then I was questioned several times about the possibility of there being any metal in my body at all. Once they were sure I was a “safe” candidate for an MRI, a nurse inserted an IV port in my arm and Denise led me into the MRI room.

This time, instead of the machine being a big inner tube, there was a long thin tube waiting for me in the room. I had to lie face down on a table and Denise hooked my IV port up to an IV which would administer a contrast dye half-way through the MRI. She explained to me the importance of holding very still and then she gave me a small rubber ball to hold which was hooked to a tube or wire. She told me that if I needed her I could squeeze the ball. My face was placed in a contraption that provided support across my forehead and on either side of my head. I was looking down through a hole and I would have been able to see only the bottom of the table if not for the nifty periscope that allowed me to look straight ahead and out of the machine. I think this is supposed to help lessen the feeling of claustrophobia. I also think that lying face down is probably much easier and less claustrophobic than lying face up.

The table I was lying on then slid into the machine, Denise left the room, and the MRI began. The whole thing lasted 40 minutes. When Denise first told me that it was going to take that long I was very worried about my ability to hold still for that amount of time in that position. I started out trying to do some labor relaxation breathing, but it was hard to concentrate because of all the noise in the machine. The noises alternated between what sounded like a beating heart deep within the machine to various loud noises that I think signified the pictures being taken. They were all different…one sounded like I was in Notre Dame’s bell tower while the bells were ringing (that was by far the most pleasant one), another sounded like a jackhammer, and one sounded like a Star Wars light saber war going on over my head. The earplugs that Denise inserted into my ears before we began didn’t help much. Later I found out that they usually play relaxing music for patients while they are in the machine, but their CD player was broken so I got silence instead. Since I couldn’t really relax, I tried to concentrate on something specific. I started out thinking about the post I was going to write about the procedure and about my trip to Maui a couple of years ago and ended up thinking about the first three hearsay exceptions and running hearsay hypos in my head. And then it was over. I got dressed, Denise removed my IV, and I was on my way home.

Just to keep things interesting, however, Denise told me that she thought that the doctor was going to want to see my most recent mammogram films in conjunction with reading the MRI results. Since the hospital neglected to tell me that when I scheduled the MRI, the mammogram films were about 40 miles away back at the cancer center near my house. If I want the films to get to the doctor quickly, I have to pick them up and courier them out to him myself. No problem, I thought, I’ll just add that to my schedule since I don’t have anything else to do this week! I don’t know when I’ll actually be able to get the films out there, but I’ll worry about that later.

The MRI wasn’t awful….after all, there were no barium drinks to choke down. I don’t want to have to go through it again anytime soon, however, and I’m glad it’s over. Hopefully I’ll get the results soon, with or without the mammogram films, so that we can really pinpoint the next step. In the meantime, tomorrow I have a teaching appointment at my oncologist’s office where a nurse will go step-by-step over the chemo treatments with me so that I know what to expect.

July 01, 2007

People You Should Know

As impossible as it may seem, there are some benefits to a cancer diagnosis. One is the unexpected result of facing death square in the face, which I will write about in the future. Another benefit, and one which I didn’t expect, is the amazing people that have come into my life because of this diagnosis.

There are actually so many new and wonderful people who have come into my life since I first found the lump back in April that I could probably never name them all. I hope to be able to introduce you to some of the through this blog and today I will start with two.

Alison is another young breast cancer survivor. I met Alison through a mutual friend, Mieke. As soon as Mieke found out about my diagnosis she sent my contact information to Alison, who contacted me immediately with amazing words of encouragement and support. Mieke lives in California, I live in Chicago, and Alison lives in South Carolina, and yet thanks to the wonders of this modern age we have all been able to connect with one another despite the thousands of geographical miles between us.

You’ve seen Alison’s presence in the comments here, but that is just a mere sampling of her presence in my life. She sends me e-mails several times a week and contacts me before every procedure and doctor’s appointment to tell me she is thinking about me. She has described her cancer and radiation experience to me in great detail, sharing what I know are intimate and sometimes painful memories in order to help me know what to expect and to know that I am not alone. We have never met in person and we have never spoken on the phone, and yet she has made a big difference in my life. This is a testament to the power of the Internet, of course, but it’s even more of a testament to the kind of person Alison is.

After I posted the story about my Save the Ta-ta’s t-shirt, Alison clicked over to the website and bought a t-shirt of her own. She sent me the picture a few days ago accompanied by the simple sentiment, "I'm behind you!.” I asked her if I could share the picture with you. So without further ado, I’d like you to meet my friend Alison.
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The other person I’d like you to know about is actually two people—Andy DeYoe and Jon Imerman. During my second week of class this summer, just after my lumpectomy and breast cancer diagnosis, I sat down in the seat that I had chosen during the first week of class and looked at the back of the classmate sitting in front of me. He was wearing a t-shirt with the words “One-on-One Cancer Support” and a website address printed on the back and a yellow LiveStrong bracelet on his wrist. I approached him after class that evening and asked him if he knew someone with cancer. As it turned out, he did indeed know someone with cancer—himself. Andy is a thyroid cancer survivor and is involved with an organization called Imerman Angels.

I had previously met Andy at orientation during his very first week of law school last fall and I had seen him in the halls around school from time to time since then, but I had never spoken with him extensively before and I didn’t really know anything about him. That changed that evening. Andy was kind and supportive and understanding as he told me a little bit about his story and a lot about Imerman Angels. I am still astounded at the fact that of the one hundred seats available in our Evidence class room, we chose to sit in the two seats that put Andy and Imerman Angels right in front of me at a time when I needed them most.

Jon Imerman, a testicular cancer survivor, came up with the idea of Imerman Angels during his fight with cancer. He struggled with the fact that he had a hard time finding other cancer patients and survivors who were like him—he was only 26 when he was diagnosed—and he decided to do something about it. Imerman Angels makes sure that cancer fighters don’t experience the sense of isolation and loneliness that often accompanies a cancer diagnosis by pairing up cancer survivors and cancer fighters with other people who are the same age and have similar life experiences and who have experienced the same kind of cancer.

I had the great pleasure of meeting Jon Imerman in person a few weeks ago. We got together to talk about my experience and my situation and I found a dynamic, passionate man who has devoted himself to easing the experience of other cancer fighters through support and understanding. He paired me up with a breast cancer survivor from his network who knows precisely what I am thinking and feeling and experiencing right now because she is a mother and is my age. His organization is needed and welcomed by cancer fighters of all ages and I feel so lucky to have discovered it. I have posted a permanent link to the Imerman Angels website over in the sidebar on the right.