Thanks to everyone for your emails and calls over the last few weeks as I returned to work. It has been hectic coping with the tiredness I felt the first week working and getting my youngest ready to go spend the year at a university in Germany. This morning I sent Ali off to Konstanz by way of Washington D.C. and then Zurich. Courtney is busy awaiting the birth of her daughter and Corey and I are looking forward to a nice bike ride this weekend and another sailing lesson.
I hope to have time to continue my breast cancer primer and work on blog weekly in the weeks to come.
Penny
Wednesday, August 26, 2009
Saturday, August 8, 2009
Back to Work
I am headed back to Phoenix tomorrow and to work on Monday. I am feeling pretty good. War wounds still evident: one large scab on my right breast and 5 other scars of various sizes and in various states of healing, 2 scars on my left. Corey says every day, "Well, Pen, today you are cancer free". I hope he is right!
We had signed up to start sailing lessons before last May but had to put them off - started them last weekend. The first lesson was a day with a gentle breeze. We rigged the boat ourselves and that was fun. Corey took the first turn with the rudder and mainsail, I did the jib ( front sail). It was fun but I was nervous.
The second lesson was on a very windy day. Steering the boat was hard and Corey was a little nervous by the time he sailed us out of the docks past million dollar boats and with a ton of traffic. I was even more nervous when my turn at the rudder came. Every time you sail across the wind (tack) you need to shift sides of the boat and if the boat goes too high one side you release the mainsail a little.
Our poor instructor could see we were stressed and suggested that he sail us out of the harbor and onto the open water so we could have some fun. We readily agreed and the instructor took the rudder and main sail while Corey had the jib. I could relax. We sailed out and were getting ready to turn back when the instructor called for us to switch side and Corey to release the jib. It was a little too quick for Corey to respond ( this is a big guy on a little boat) and over the boat went ( this is called turtling or capsizing). The instructor scrambled up on the side and then onto the centerboard and Corey and I went for a swim in the Pacific!
Wow - you could tell the instructor was mortified but Corey and I are both comfortable swimmers and we calmly untangled ourselves from the lines and moved away from the sail so he could right the boat and we did get back on the boat but non too gracefully. Actually, Corey and I were much less tense after that but the instructor was really nervous! I told Corey that we might have to go back to kayaking.
The girls and Ryan have been out this week. We have had fun but will probably go to Newport next August. Just think, next August we will have Ali home from Germany and baby Zebedee to spoil!
We had signed up to start sailing lessons before last May but had to put them off - started them last weekend. The first lesson was a day with a gentle breeze. We rigged the boat ourselves and that was fun. Corey took the first turn with the rudder and mainsail, I did the jib ( front sail). It was fun but I was nervous.
The second lesson was on a very windy day. Steering the boat was hard and Corey was a little nervous by the time he sailed us out of the docks past million dollar boats and with a ton of traffic. I was even more nervous when my turn at the rudder came. Every time you sail across the wind (tack) you need to shift sides of the boat and if the boat goes too high one side you release the mainsail a little.
Our poor instructor could see we were stressed and suggested that he sail us out of the harbor and onto the open water so we could have some fun. We readily agreed and the instructor took the rudder and main sail while Corey had the jib. I could relax. We sailed out and were getting ready to turn back when the instructor called for us to switch side and Corey to release the jib. It was a little too quick for Corey to respond ( this is a big guy on a little boat) and over the boat went ( this is called turtling or capsizing). The instructor scrambled up on the side and then onto the centerboard and Corey and I went for a swim in the Pacific!
Wow - you could tell the instructor was mortified but Corey and I are both comfortable swimmers and we calmly untangled ourselves from the lines and moved away from the sail so he could right the boat and we did get back on the boat but non too gracefully. Actually, Corey and I were much less tense after that but the instructor was really nervous! I told Corey that we might have to go back to kayaking.
The girls and Ryan have been out this week. We have had fun but will probably go to Newport next August. Just think, next August we will have Ali home from Germany and baby Zebedee to spoil!
Sunday, July 26, 2009
Sunday Times
Enjoying today because I am finally starting to feel better. My sister and brother-in-law Phil came out to Redondo for the weekend. I walked on Friday. Saturday, Corey and I walked down to an old car show and I made the four of us fish, curried rice and coleslaw for dinner. We all watched The Big Bang Theory afterward. They left today. We plan to walk to the library later today.
I head back to Phoenix on Tuesday morning for a full schedule of doctor appointments on Wednesday and Thursday. Ali will be home on Tuesday as well and I can't wait to see her.
A Creed
There is a Destiny that makes us brothers;
None goes his way alone:
All that we send into the lives of others
Comes back into our own.
I care not what his temples or his creeds,
One thing holds firm and fast-
That into his fateful heap of days and deeds
The soul of man is cast.
Edwin Markham
Trivia: I love this poem of Edwin Markham's but he is really famous for another very short poem that my Dad used to recite all the time:
Outwitted
He drew a circle that shut me out—
Heretic, rebel, a thing to flout.
But love and I had the wit to win:
We drew a circle that took him in!
To read more of his poems see http://www.sjsu.edu/reading/markham.htm
I head back to Phoenix on Tuesday morning for a full schedule of doctor appointments on Wednesday and Thursday. Ali will be home on Tuesday as well and I can't wait to see her.
A Creed
There is a Destiny that makes us brothers;
None goes his way alone:
All that we send into the lives of others
Comes back into our own.
I care not what his temples or his creeds,
One thing holds firm and fast-
That into his fateful heap of days and deeds
The soul of man is cast.
Edwin Markham
Trivia: I love this poem of Edwin Markham's but he is really famous for another very short poem that my Dad used to recite all the time:
Outwitted
He drew a circle that shut me out—
Heretic, rebel, a thing to flout.
But love and I had the wit to win:
We drew a circle that took him in!
To read more of his poems see http://www.sjsu.edu/reading/markham.htm
Thursday, July 23, 2009
Positive Energy Needed
Please keep these people in your heart today, Linda K's sister - she had surgery on Tuesday and needs to heal well to continue the journey. Elle starts chemo tomorrow and I am sure she is scared. Kathy W. moving through the process of early breast cancer. Tracy B. lost her gallbladder and is worried she becoming hooked on the 3 vicodin she has taken for pain. My brother-in-law Phil.
I am back on the Toradol for my Lupus and starting to feel better already. I am trying to walk everyday.
I still have a tiny opening present where the SAVI device came out. No drainage.
Genetics came back negative for the BRCA1 and BRCA2 gene mutations. BRCA1 and BRCA2 stand for Breast Cancer Susceptibility gene 1 and 2. These are human genes that help supress tumors when they are normal. If the genes have changed or mutated they can increase the chances that breast or ovarian cancer will develop. Mutations are also linked with other types of cancers as well. In my case, this means my ovaries stay put.
I am not in menopause- I could have told them that because there are days I still feel those hormones pumping! This means I am not eligible for the alternative to Tamoxifin or any research studies which would get me other alternatives. I will write more about these drugs in a future post.
Still waiting for my vitamin D level to see how the mega doses that I have been taking helped and becoming a freak about taking anti-oxidants.
I am back on the Toradol for my Lupus and starting to feel better already. I am trying to walk everyday.
I still have a tiny opening present where the SAVI device came out. No drainage.
Genetics came back negative for the BRCA1 and BRCA2 gene mutations. BRCA1 and BRCA2 stand for Breast Cancer Susceptibility gene 1 and 2. These are human genes that help supress tumors when they are normal. If the genes have changed or mutated they can increase the chances that breast or ovarian cancer will develop. Mutations are also linked with other types of cancers as well. In my case, this means my ovaries stay put.
I am not in menopause- I could have told them that because there are days I still feel those hormones pumping! This means I am not eligible for the alternative to Tamoxifin or any research studies which would get me other alternatives. I will write more about these drugs in a future post.
Still waiting for my vitamin D level to see how the mega doses that I have been taking helped and becoming a freak about taking anti-oxidants.
Tuesday, July 21, 2009
Second Things First. Update 07-21-2009
The first thing you should do when diagnosed with breast cancer is get a second opinion. Dr. John Canady, MD, a professor at the University of Iowa is a firm believer in second opinions. "It's amazing to me," he says, "how people will go to multiple places looking for a car but go to one doctor's office when making a decision that they will have to live with for the rest of their life."
I interviewed two doctors for each phase of my treatment and am so happy that I did. There are many ways to approach medicine and I found that while many practitioners will treat cancer, not all are on the cutting edge. Not one physician was upset when I said I would be seeking a second opinion or that I had come for a second opinion.
Ask people who have already had breast cancer what they would do and who they had for doctors. Elle H., a new friend with breast cancer, said that making that call to another person with breast cancer was the hardest call she ever made during her treatment, "...but it turned out to be the best call as well. After getting off the phone I had more confidence in my doctors and decisions." I hope this blog will serve to support others with breast cancer as well.
In Arizona there is a wonderful service called the Arizona Institute for Breast Health (AIBH), which is a non-profit organization that provides education and support to newly diagnosed patients about their treatment options, completely free of charge. These second opinions are offered through a multi-disciplinary panel of Breast Cancer Specialists and each patient that is seen through the program is guided and supported by a patient advocate, a breast cancer survivor herself. Contact AIBH through their website http://www.aibh.org/or by calling 480-860-4200.
You do not have to be a resident of Arizona to take advantage of this service!
I interviewed two doctors for each phase of my treatment and am so happy that I did. There are many ways to approach medicine and I found that while many practitioners will treat cancer, not all are on the cutting edge. Not one physician was upset when I said I would be seeking a second opinion or that I had come for a second opinion.
Ask people who have already had breast cancer what they would do and who they had for doctors. Elle H., a new friend with breast cancer, said that making that call to another person with breast cancer was the hardest call she ever made during her treatment, "...but it turned out to be the best call as well. After getting off the phone I had more confidence in my doctors and decisions." I hope this blog will serve to support others with breast cancer as well.
In Arizona there is a wonderful service called the Arizona Institute for Breast Health (AIBH), which is a non-profit organization that provides education and support to newly diagnosed patients about their treatment options, completely free of charge. These second opinions are offered through a multi-disciplinary panel of Breast Cancer Specialists and each patient that is seen through the program is guided and supported by a patient advocate, a breast cancer survivor herself. Contact AIBH through their website http://www.aibh.org/or by calling 480-860-4200.
You do not have to be a resident of Arizona to take advantage of this service!
Monday, July 20, 2009
Walk to the Edge
“Live with intention. Walk to the edge. Listen hard. Practice wellness.
Play with abandon. Laugh. Choose with no regret. Continue to learn.
Appreciate your friends. Do what you love. Live as if this is all there is.”
—Mary Anne Roadacher-Hershey – author, speaker
Update: I am in Redondo and out of the 113 degree heat so that is a blessing. I seem to be having auto-immune symptoms, my mouth is filled with sores, I feel like I have pleurisy on the right side of my rib cage and I am tired. All that said I took a little walk along the beach today which I have not been able to do. I am embarrassed to say this in case anyone reads it in Phoenix but it was hot out there!
What a blessing it is to have something happen that reminds you of all that is important. My husband, my family, my friends, my work; all seem a little bit sweeter. The earth seems more important, the ocean a little bluer, time a more important commodity.
Play with abandon. Laugh. Choose with no regret. Continue to learn.
Appreciate your friends. Do what you love. Live as if this is all there is.”
—Mary Anne Roadacher-Hershey – author, speaker
Update: I am in Redondo and out of the 113 degree heat so that is a blessing. I seem to be having auto-immune symptoms, my mouth is filled with sores, I feel like I have pleurisy on the right side of my rib cage and I am tired. All that said I took a little walk along the beach today which I have not been able to do. I am embarrassed to say this in case anyone reads it in Phoenix but it was hot out there!
What a blessing it is to have something happen that reminds you of all that is important. My husband, my family, my friends, my work; all seem a little bit sweeter. The earth seems more important, the ocean a little bluer, time a more important commodity.
Thursday, July 16, 2009
Radiation Helpful Hints - Updated 07-20-2009
Please feel free to add these hints if you have ideas from having radiation or from other types experiences. I would love to have a really comprehensive list for people to peruse.
Bring an IPod or an MP3 Player: Listening to your own music is so soothing and keeps your mind off the machine noises. For days when you do not feel as well try uplifting, classical or light tunes. Some days when you feel the fire - rock and roll is just the thing.
Reading material or puzzles are indispensable. I like to read series starting at the beginning and work my way through so I always have something to pick up and go with.
Try to look happy when checking in and leaving. Most of those waiting in the lobby are at the beginning of the journey and we need to show them that we can do it and so can they.
Plan a treat. If you are having brachytherapy you may want to schedule to have your hair professionally washed and styled - no showers for the duration of partial breast radiation. Try a pedicure, a facial, or a new dessert.
Thanks to other readers for these tips:
Finding a good lotion to use on the breast afterwards is important to keep the skin from becoming leathery. Lots of readers mention this and these lotions were suggested by them. (You might try to get a sample or small size first. )
*Dove Cream Oil Intensive Body Lotion
*Lubriderm Sensitive Skin Therapy Lotion
*Lubriderm Shea & Cocoa Butter Lotion
*Bliss Naked Body Butter
*Avon Naturals - comes in several flavors but the reader preferred Cucumber Melon or Vanilla.
*Several readers raved about Aquaphor and others hated it.
Other tips included:
Tell your friends, "It’s okay to ask me how I’m doing. Just don’t ask every day. "
Ask if you can participate in any research studies.
Bring an IPod or an MP3 Player: Listening to your own music is so soothing and keeps your mind off the machine noises. For days when you do not feel as well try uplifting, classical or light tunes. Some days when you feel the fire - rock and roll is just the thing.
Reading material or puzzles are indispensable. I like to read series starting at the beginning and work my way through so I always have something to pick up and go with.
Try to look happy when checking in and leaving. Most of those waiting in the lobby are at the beginning of the journey and we need to show them that we can do it and so can they.
Plan a treat. If you are having brachytherapy you may want to schedule to have your hair professionally washed and styled - no showers for the duration of partial breast radiation. Try a pedicure, a facial, or a new dessert.
Thanks to other readers for these tips:
Finding a good lotion to use on the breast afterwards is important to keep the skin from becoming leathery. Lots of readers mention this and these lotions were suggested by them. (You might try to get a sample or small size first. )
*Dove Cream Oil Intensive Body Lotion
*Lubriderm Sensitive Skin Therapy Lotion
*Lubriderm Shea & Cocoa Butter Lotion
*Bliss Naked Body Butter
*Avon Naturals - comes in several flavors but the reader preferred Cucumber Melon or Vanilla.
*Several readers raved about Aquaphor and others hated it.
Other tips included:
Tell your friends, "It’s okay to ask me how I’m doing. Just don’t ask every day. "
Ask if you can participate in any research studies.
Wednesday, July 15, 2009
How I met Iridium -192: A Savi Story
Radiation is used to kill any stray cancer cells left over after surgery. The traditional whole breast radiation delivers radiation to the whole breast using a machine called a Linear Accelerator. It is outside of the breast .
Breast Brachytherapy is the application of radiation near where the cancer cells were taken out. It is delivered through a device that is placed inside the breast and the radiation is deliver through small small catheters that look like straws. The device was placed in my breast by my surgeon about two weeks after surgery. Part of the device is inside and part sticks out.
My device is called a SAVI. You can see it where it comes out the skin near the bottom of my breast.
This is the CAT scan image of the device inside of me. You can see the device on the left and shadows of my ribs in the middle portion of the image.
The machine that delivers the radiation for brachytherapy is called a High Dose Rate Remote Afterloader or HDR. It has tubes called catheters that hook up to the tubes on the SAVI device and the HDR sends little seeds of Iridium-192 through the device stopping the seeds every 5 mm for a very short time.
HDR Machine as seen by me while hooked up.
Me as seen by the HDR machine while hooked up.
The radiation treatment itself took about 15 minutes but I had a CAT scan to check the placement of the machine before each treatment and the doctor and the physicist checked the device and the HDR before each treatment. I had 5 days of twice daily treatments.
Jenn was one of my radiation therapists. She went to school in Wisconsin at the University of Wisconsin in Lacrosse, I believe and she and her husband are looking for a house.
This is the CAT Scan machine.
I have now completed my radiation and meet for a second time with the oncologist on the 29th.
Thanks Dr. Kuske for helping me with all the radiation lingo and description!
Breast Brachytherapy is the application of radiation near where the cancer cells were taken out. It is delivered through a device that is placed inside the breast and the radiation is deliver through small small catheters that look like straws. The device was placed in my breast by my surgeon about two weeks after surgery. Part of the device is inside and part sticks out.
My device is called a SAVI. You can see it where it comes out the skin near the bottom of my breast.
This is the CAT scan image of the device inside of me. You can see the device on the left and shadows of my ribs in the middle portion of the image.
The machine that delivers the radiation for brachytherapy is called a High Dose Rate Remote Afterloader or HDR. It has tubes called catheters that hook up to the tubes on the SAVI device and the HDR sends little seeds of Iridium-192 through the device stopping the seeds every 5 mm for a very short time.
HDR Machine as seen by me while hooked up.
Me as seen by the HDR machine while hooked up.The radiation treatment itself took about 15 minutes but I had a CAT scan to check the placement of the machine before each treatment and the doctor and the physicist checked the device and the HDR before each treatment. I had 5 days of twice daily treatments.
Jenn was one of my radiation therapists. She went to school in Wisconsin at the University of Wisconsin in Lacrosse, I believe and she and her husband are looking for a house.
This is the CAT Scan machine.
I have now completed my radiation and meet for a second time with the oncologist on the 29th.
Thanks Dr. Kuske for helping me with all the radiation lingo and description!
Tuesday, July 14, 2009
www.armyofwomen.org
I am finished with my radiation, have a terrible headache, and can't wait to get to Redondo, hopefully later in the week. Corey has been more than patient with me this week, Courtney & Ali have kept my spirits up and so have the army of women friends who I have known for years and new friends I have met in the past few months as I have been treated for cancer.
My heart is with my cousin Wendy as she undergoes continuing chemotherapy for breast cancer. Wendy and I are the cousins who are the same age and we were diagnosed with breast cancer within months of each other!
Please send out special energy to my new friend Pam P. Pam has two more radiation treatments to go and then a break before chemotherapy. She is so pretty and calm and I felt such great strength from her as we passed twice daily to receive our treatments!
The army of women site listed recruits healthy women with no history of breast cancer, breast cancer survivors and those at high risk for breast cancer to register through the site to become potential clinical trial participants. Check it out! You may be help even if you do not have breast cancer!
My heart is with my cousin Wendy as she undergoes continuing chemotherapy for breast cancer. Wendy and I are the cousins who are the same age and we were diagnosed with breast cancer within months of each other!
Please send out special energy to my new friend Pam P. Pam has two more radiation treatments to go and then a break before chemotherapy. She is so pretty and calm and I felt such great strength from her as we passed twice daily to receive our treatments!
The army of women site listed recruits healthy women with no history of breast cancer, breast cancer survivors and those at high risk for breast cancer to register through the site to become potential clinical trial participants. Check it out! You may be help even if you do not have breast cancer!
Tuesday, July 7, 2009
Update
Thanks for all the calls and good wishes. The device for radiation was placed yesterday late afternoon. I spent this morning getting CAT scans and with the radiation oncologist and his group. I will start radiation twice daily tomorrow and will try to report more about the experience later in the week. Right now I feel like a truck ran over me but a small truck.
Peace!
Peace!
Monday, June 29, 2009
Respite, Redondo and Crumb Cake
The last week has been a respite from cancer. No treatments, only one doctor's appointment and everything healing well, the hematoma in my right breast seems to be resolving. I am working four hours a day from home and enjoying that very much.
I spent the weekend in nice cool Redondo and Corey and I catalogued and organized all the DVD's here. (He has so many we couldn't find anything and they were all over.) We had fun mostly doing nothing.
Looking forward to another peaceful week in which nothing reminds me or anyone else that I have breast cancer and then my family joins us in Redondo beginning Thursday to celebrate the 4th. Until then I am working on my gluten free cake and bread recipes so I can make something special for Courtney. Here is a recipe for a gluten free cinnamon crumb cake that I have nailed (if I do say so myself).
Gluten Free Cinnamon Crumb Cake
Batter:
2/3 cup milk ( room temp)
1 tablespoon yeast
1/4 cup sugar
2 tablespoons butter or margarine
1 egg
1/4 cup canola oil
1/2 cup potato starch
1 cup corn starch
1/4 teaspoon baking soda
2 1/2 teaspoons xantham gum
2 teaspoons baking powder
1/2 teaspoon salt
1 teaspoon vanilla extract
Cinnamon Crumb Topping:
1/2 cup chopped nuts ( walnuts or pecans)
1 teaspoon cinnamon
1/2 cup brown sugar
Icing Ingredients:
1/2 cup powdered sugar
3/4 teaspoon vanilla extract
2 tablespoons milk - enough to make icing easy to drizzle
Batter:
Add yeast to milk - stir until dissolve. Cream butter and sugar together. Pour yeast/milk mixture into sugar and add the rest of the ingredients. Stir together until blended then pour into buttered pan ( about 8 X8 or 9X9). Cover with plastic wrap and let sit at room temperature for about 1 hours.
Mix topping ingredients together and sprinkle over the top of the batter. Bake uncovered for 20 minutes at 375. Cool for 10 minutes. While cake is cooling mix together icing ingredients and after 10 minutes drizzle the icing over the top of the cake.
I spent the weekend in nice cool Redondo and Corey and I catalogued and organized all the DVD's here. (He has so many we couldn't find anything and they were all over.) We had fun mostly doing nothing.
Looking forward to another peaceful week in which nothing reminds me or anyone else that I have breast cancer and then my family joins us in Redondo beginning Thursday to celebrate the 4th. Until then I am working on my gluten free cake and bread recipes so I can make something special for Courtney. Here is a recipe for a gluten free cinnamon crumb cake that I have nailed (if I do say so myself).
Gluten Free Cinnamon Crumb Cake
Batter:
2/3 cup milk ( room temp)
1 tablespoon yeast
1/4 cup sugar
2 tablespoons butter or margarine
1 egg
1/4 cup canola oil
1/2 cup potato starch
1 cup corn starch
1/4 teaspoon baking soda
2 1/2 teaspoons xantham gum
2 teaspoons baking powder
1/2 teaspoon salt
1 teaspoon vanilla extract
Cinnamon Crumb Topping:
1/2 cup chopped nuts ( walnuts or pecans)
1 teaspoon cinnamon
1/2 cup brown sugar
Icing Ingredients:
1/2 cup powdered sugar
3/4 teaspoon vanilla extract
2 tablespoons milk - enough to make icing easy to drizzle
Batter:
Add yeast to milk - stir until dissolve. Cream butter and sugar together. Pour yeast/milk mixture into sugar and add the rest of the ingredients. Stir together until blended then pour into buttered pan ( about 8 X8 or 9X9). Cover with plastic wrap and let sit at room temperature for about 1 hours.
Mix topping ingredients together and sprinkle over the top of the batter. Bake uncovered for 20 minutes at 375. Cool for 10 minutes. While cake is cooling mix together icing ingredients and after 10 minutes drizzle the icing over the top of the cake.
Saturday, June 20, 2009
One More Reason to Eradicate Breast Cancer
In this strange new world the whole family gets to go to the ultrasound of babies. Below is a picture of my grandaughter who will be born in late September. We call her Zebedee right now but I hope her name will change after she is born! 
Friday, June 19, 2009
On the Job Training
Dr. Kuske gave me a nice compliment the other day about how calm and peaceful I seemed through everything. Over the last few weeks I have come to realize how much I have learned about how to gracefully live with cancer from my patients. Some of the most inspiring people I know have Cystic Fibrosis.
Adults with Cystic Fibrosis lead dual lives. On the one hand, they live with the constant threat of becoming ill even as they practice a regime of medications and airway clearance that is taxing and tiring. On the other hand, it gets old being sick, it gets boring talking about it and it gets irritating to have other people telling you what you should be doing. The worst part is when other people cry for or about you. I am done crying about having breast cancer and am ready to live with the diagnosis and the treatment.
Yet, despite having CF, many of my patients have a calm, brave spirit that does not give into the disease but accepts the reality and navigates through life with this strange companion. They have learned from the experience of having CF but it does not define them. These incredible people inspire me and provide unknowing mentorship for my life with cancer. That is a blessing that I am sure many others with cancer do not have! On the job training is a benefit of employment in a job that I love.
Kim Peet gave me a poetry book with this interesting poem written by a cancer survivor:
Adults with Cystic Fibrosis lead dual lives. On the one hand, they live with the constant threat of becoming ill even as they practice a regime of medications and airway clearance that is taxing and tiring. On the other hand, it gets old being sick, it gets boring talking about it and it gets irritating to have other people telling you what you should be doing. The worst part is when other people cry for or about you. I am done crying about having breast cancer and am ready to live with the diagnosis and the treatment.
Yet, despite having CF, many of my patients have a calm, brave spirit that does not give into the disease but accepts the reality and navigates through life with this strange companion. They have learned from the experience of having CF but it does not define them. These incredible people inspire me and provide unknowing mentorship for my life with cancer. That is a blessing that I am sure many others with cancer do not have! On the job training is a benefit of employment in a job that I love.
Kim Peet gave me a poetry book with this interesting poem written by a cancer survivor:
ENLIGHTENMENT
by Sylvia Thompson
I prayed to the Heavens
for a great teacher
dignifying, enlightening and steady.
With desperate pleas,
in silent conveyance,
that I, the student, was ready.
And so the Heavens,
obliged to my need,
sent a great teacher
to answer.
When I asked him his name,
he smiled at me warmly,
bowed down to me
and said,
CANCER.
Thursday, June 18, 2009
Clear Margins - Yippee! On to Radiation.
The margins around the surgical site were free of cancer. That means on to radiation. I visited the Radiation Oncologist, Dr. Kuske, this morning and we again discussed the, "suspicious lymph node" that showed up on the MRI. It was not the sentinel node. The question of the day is whether to aspirate it before radiation or just wait until after treatment. The chance that there is cancer in that node despite none being noted in the sentinel node is less than 4%. Dr. Kuske and Dr. O'Neill are going to discuss today and get back to me.
There was another radiation oncologist working with Dr. Kuske today named Dr. Chowdry. He came from Alberta, Canada to learn more about partial breast radiation. Both the docs were very impress with my surgical site. Dr. Kuske said, " You don't know how many surgeons hack off 1/3 of the breast to get the same size area. We have seen several concave breasts this morning already with actual cancer sites the same size as yours. " I am really pleased with the results myself - I still think Dr. O'Neill is amazing!
Karise gave Courtney, Ali and I each a pink wish necklace. They are delicate and beautiful. The idea is that you wear the necklace until the string breaks and then your wish will come true. We tried them on and rushed into the mirror to look at them. Here is a picture of the three of us with our wish charms.
There was another radiation oncologist working with Dr. Kuske today named Dr. Chowdry. He came from Alberta, Canada to learn more about partial breast radiation. Both the docs were very impress with my surgical site. Dr. Kuske said, " You don't know how many surgeons hack off 1/3 of the breast to get the same size area. We have seen several concave breasts this morning already with actual cancer sites the same size as yours. " I am really pleased with the results myself - I still think Dr. O'Neill is amazing!
Karise gave Courtney, Ali and I each a pink wish necklace. They are delicate and beautiful. The idea is that you wear the necklace until the string breaks and then your wish will come true. We tried them on and rushed into the mirror to look at them. Here is a picture of the three of us with our wish charms.
Wednesday, June 17, 2009
Fortunate Lives
This morning I am still bruised and have pain to whole right chest. I have to have labs drawn this morning, pick up some copies of the last MRI's for tomorrow's appointment and see the surgeon at 2:15 pm where I will find out if the margins are clear of cancer cells. I am trying to walk a little each day for exercise using my pedometer. Yesterday I was up to 5,000 steps done in 1/2 hour sessions throughout the day. My goal is 6,000 steps today.
I am rereading Dead until Dark and watching the first season of the HBO series based on the Sookie novels, True Blood. So far I like the books better but I am an Eric fan and the HBO Eric is pretty cute.
I found this poem that my daughter, Ali, wrote in high school. I thought I would share.
Fortunate Lives
by Ali Overgaard
Appearances are deceiving
For the windows of the mansion on the hill
Appear to sparkle in the evening sun
Yet inside, no children play
No laughter rings
No lovers dream or whisper
Secret fears.
These jewels are worn
Unseen in the village house
Where the light shines
Not for those outside, but
Warms those who come within.
No one is happy who does not think himself so.
I am rereading Dead until Dark and watching the first season of the HBO series based on the Sookie novels, True Blood. So far I like the books better but I am an Eric fan and the HBO Eric is pretty cute.
I found this poem that my daughter, Ali, wrote in high school. I thought I would share.
Fortunate Lives
by Ali Overgaard
Appearances are deceiving
For the windows of the mansion on the hill
Appear to sparkle in the evening sun
Yet inside, no children play
No laughter rings
No lovers dream or whisper
Secret fears.
These jewels are worn
Unseen in the village house
Where the light shines
Not for those outside, but
Warms those who come within.
No one is happy who does not think himself so.
Monday, June 15, 2009
All about Friday.
Friday morning we arrived for surgery at Banner Good Samaritan at 8:30am. My husband, Corey, and my younger daughter, Ali, accompanied me. I checked in and the three of us sat around in the lobby of the same day surgery department until around 10:15. The long wait was a little annoying. During the wait a woman with no hair who said her surgeon was Dr O'Neill was called in to be prepped and I felt a little tearful for her.
A lot of time in the waiting room allows for family bonding and contemplation of the events to come!
At 10:15 someone came over from the Breast Center and got me so the guide wire could be placed. Corey and Ali transferred to the Breast Center waiting room and I went back into the center. Dr. Nino placed the guide using the same technique as my first biopsy. This involves laying on a sling face down with your breast hanging through a hole and then paddles similar to the mammogram paddles are placed on either side of the breast to secure it. An xray is taken and then when they see the clip they can tell from the markings on the paddles where it is within the breast.
I was worried about them marking the correct clip because by now I have several in each breast now but Dr. Nino showed me that each clip has a different letter on it. He then cleaned and numbed the area and placed the guide wire in a matter of minutes. A follow up film showed that he hit the right spot on the first time and I was done. The procedure is relatively painless, the numbing stings quite a bit but the sensation only lasts about 5 - 10 seconds.
We then went back to the same day surgery waiting room until after 12:30pm when they finally called me in to prep me for surgery. Corey and Ali stayed in the waiting room. By now they were beginning to make a few friends with other family members waiting. In between visiting with their new friends, our older daughter, Courtney, and my sister, Faith, would call to see what was going on. All of this activity kept them very busy. The two of them came back into the pre-op area after I was in my lavender gown and had my IV started. The pre-op nurse, Kim was not only a Stephanie Plum fan but also excellent at starting IV's.
Kim started my IV but did not mention if she prefers Joe or Ranger for Stephanie Plum.
Corey and Ali took some more pictures to pass the time.
At a little after 2 pm, Dr. O'Neill came back and we met the anesthesiologist, Dr. Brennan Watkins.
Dr. O'Neill and myself. I think she is the best breast surgeon in Arizona and I am glad she is on my team!
Shortly after that I had some Versed through my IV and went back in the surgical suite, I did not wake up until after 5 pm. Dr. O'Neill checked on me twice in post op and made sure I knew that the sentinel node was clear, the other nodes were enlarged but we had decided not to touch them if the sentinel node was clear and will follow them later.
The area removed was a little larger than a golf ball and then she shaved a bit more tissue all around the site. Although my whole breast is very, very bruised, the pain is quite tolerable. The lymph node site is a second incision & stings more than the breast incision. Sometimes I getting shooting pains into my collar bone but the prescription pain medication, Toradol and Tylenol taken in between works pretty well. My lymph node site is continually leaking a clear fluid which I guess is lymph fluid but the site on the breast itself is clean and dry.
On Wednesday, I follow up with Dr. O'Neill and she will let me know if the margins of the surgical area were cancer free. If they do have any cancer cells, I will need a second surgery next week but I feel pretty optimistic that this phase is done!
Sunday, June 14, 2009
The Sister Study - Breast Cancer Research
Woman by Woman...
Sister by Sister...
This Study May Make a Difference!
This is a landmark study of how environment & genes may affect the chances of getting breast cancer. This study is now closed but enrolled 50,000 women whose sister had breast cancer.
Participants were eligible to join the study if-
*Their sister (living or deceased), related by to by blood, had breast cancer.
*They were between the ages of 35 and 74.
*They never had breast cancer themselves.
Follow the Progress at:
Look to see if you qualify for the Two Sister Study.
This study is conducted by the National Institute of Environmental Health Sciences
Thursday, June 11, 2009
Second Opinion & the Big Dilemma
Yesterday I went for a second opinion at the Arizona Institute for Breast Health which is a free service and quite unique to Arizona. Any woman diagnosed with breast cancer can have a panel of breast cancer experts which consists of surgeons, oncologists, radiation oncologists, psychologists and more. The panel reviews your case and the plan and makes recommendations and give opinion(s) on the course of treatment. I will post more information on this great service in a future blog.
I was glad to get this because although originally it was thought that I have DCIS (ductal cell cancer in situ - which means cancer in the breast duct that has not spread to surrounding tissues), I have had several indications that there is cancer somewhere else. Between the MRIs and the xrays that show a suspicious lymph node and several "hotspots" it appears that there could be cancer somewhere else. But, three biopsies, multiple MRIs, mammograms and multiple tests have not turned up any more cancer. The only thing that has turned up is that there are 10 spots of cancer near the original site not the five first seen. All of the spots are high grade so they are fast growing. The biggest worry is the suspicious axillary lymph node which is on the right side. No one can tell if that is the sentinel node (the one that leads away from the duct with the cancer) or another node.
Our current plan is to take the area with the known cancer, take 2 centimeters clearance around that whole area and shave the edges a bit more. At the same time, dye will be injected to lead back to the sentinel node which will then be tested for cancer cells. If the node is negative for cancer, Dr. O'Neill will close up without testing any more nodes. If the node is positive then she will take the next nearest node, test that for cancer and do that up to four nodes. If the fourth node is positive then Dr. O'Neill will remove the whole string of nodes. After the surgery we can check via MRI to see if the "bad" node is gone or not.
The second opinion team offered one alternative. They suggested checking the suspicious node using ultrasound and then aspirating it and doing a pathology on it to see if it has cancer. This seems like a good plan except it would entail waiting on the surgery. I have been spent the last month being diagnosed and want to get the known cancer out of me so I can finish the treatment and get back to work and my life.
So... tomorrow around 9:00 am... they will place a guide wire for the surgeon, I think via one of those not so great MRIs. At 11:00am I will have surgery and hopefully go home in the early evening!
Positive energy and prayers accepted! Peace.
I was glad to get this because although originally it was thought that I have DCIS (ductal cell cancer in situ - which means cancer in the breast duct that has not spread to surrounding tissues), I have had several indications that there is cancer somewhere else. Between the MRIs and the xrays that show a suspicious lymph node and several "hotspots" it appears that there could be cancer somewhere else. But, three biopsies, multiple MRIs, mammograms and multiple tests have not turned up any more cancer. The only thing that has turned up is that there are 10 spots of cancer near the original site not the five first seen. All of the spots are high grade so they are fast growing. The biggest worry is the suspicious axillary lymph node which is on the right side. No one can tell if that is the sentinel node (the one that leads away from the duct with the cancer) or another node.
Our current plan is to take the area with the known cancer, take 2 centimeters clearance around that whole area and shave the edges a bit more. At the same time, dye will be injected to lead back to the sentinel node which will then be tested for cancer cells. If the node is negative for cancer, Dr. O'Neill will close up without testing any more nodes. If the node is positive then she will take the next nearest node, test that for cancer and do that up to four nodes. If the fourth node is positive then Dr. O'Neill will remove the whole string of nodes. After the surgery we can check via MRI to see if the "bad" node is gone or not.
The second opinion team offered one alternative. They suggested checking the suspicious node using ultrasound and then aspirating it and doing a pathology on it to see if it has cancer. This seems like a good plan except it would entail waiting on the surgery. I have been spent the last month being diagnosed and want to get the known cancer out of me so I can finish the treatment and get back to work and my life.
So... tomorrow around 9:00 am... they will place a guide wire for the surgeon, I think via one of those not so great MRIs. At 11:00am I will have surgery and hopefully go home in the early evening!
Positive energy and prayers accepted! Peace.
Wednesday, June 10, 2009
One Month Anniversary
Today is my one month anniversary of knowing that I have cancer. Yesterday, I chose a new team member, my radiation oncologist. His name is Dr. Robert Kuske and I liked him. He is one of the innovators of partial breast radiation which I am planning on having unless something new pops during surgery on Friday.
Dr. Kuske's gut feeling is that my cancer is still in situ which means it has not invaded the surrounding cells and remains inside the milk duct. This has been the question that has plagued the doctors since I was diagnosed. Some indicators seemed to show that in my case the cancer had invaded other cells - when this happens it is called invasive cancer. Each indicator has turned out to be negative in my case. The last test will be the nearest axillary lymph nodes to the cancer sites which will be tested during surgery and I should have final results of that next Wednesday.
If I have invasive cancer then I need to have more extensive chemotherapy along with the radiation and medications to block the estrogen and progesterone. If the cancer remains in situ then I will have radiation and medications to block the estrogen and progesterone only.
Trivia: in situ is from the Latin term which means in it's place.
Dr. Kuske's gut feeling is that my cancer is still in situ which means it has not invaded the surrounding cells and remains inside the milk duct. This has been the question that has plagued the doctors since I was diagnosed. Some indicators seemed to show that in my case the cancer had invaded other cells - when this happens it is called invasive cancer. Each indicator has turned out to be negative in my case. The last test will be the nearest axillary lymph nodes to the cancer sites which will be tested during surgery and I should have final results of that next Wednesday.
If I have invasive cancer then I need to have more extensive chemotherapy along with the radiation and medications to block the estrogen and progesterone. If the cancer remains in situ then I will have radiation and medications to block the estrogen and progesterone only.
Trivia: in situ is from the Latin term which means in it's place.
Saturday, June 6, 2009
The Winds of Fate
This poem is by Ella Wheeler Wilcox.
One ship drives east and another drives west
With the selfsame winds that blow.
'Tis the set of the sails
And not the gales
Which tells us the way to go.
***
Like the winds of the sea are the ways of fate,
As we voyage along through life:
'Tis the set of the soul
That decides its goal,
And not the calm or the strife.
***
When my girls were growing up I would I say to them each morning, "Decide right now what kind of day you are going to have." I've tried to live that credo as well. It is not easy nor did I always achieve it but practicing that conscious decision made it easier to do over the years.
***
Now that I know I have cancer, it is even more important to set my sails and decide my own course as best as I can and not let the calm or the strife be what pushes me along. I hope I can do it. I have to try.
***
TRIVIA: Ella Wheeler Wilcox was an American popular poet at the turn of the last century. (A popular poet is one that critics don't like but other people do.) Her most enduring work was "Solitude", which contains the lines: "Laugh, and the world laughs with you; Weep, and you weep alone". She also wrote the lines: "Love lights more fires than hate extinguishes" which was a line popularized by Jack Kerouac.
Friday, June 5, 2009
Almost Ready to Start Fighting Cancer Again.
Whew!
Last week really left me feeling beaten up. I was bruised and exhausted but yesterday I felt like I could have gone to work. I miss my friends at work and my patients. (Hope that Chelle, Barb, Nat, Monica and the others are keeping my desk warm.) Instead, I walked down to the farmer's market and bought some fruits and veggies and then had a tamale from a little stand there for lunch. I ate my tamale while looking out at the ocean and wearing a jacket which was some recompense for not being at work, after all it's 105 degrees there. .
The problem is that just when you start to feel like you are yourself again, it's time to get back to fighting cancer.
Corey is working half a day today and then I hope to feel good enough to ride the bikes for a bit along the beach. One day I will write about how great Corey is and has been but honestly right now it makes me teary just to think about it.
I cooked the last three nights which I love to do but hadn't really felt like doing for a while: Steaks on Tuesday, Spaghetti with black and green olives on Wednesday and Scallop Helper on Thursday (one of my signature dishes!)
Monday, I head back to Phoenix to my usual two doctors a day routine except for Thursday when I am getting my hair done so I look cute on the operating table. Corey is coming in next Thursday night. Wish I could stay with him but Ali put the cats on a diet so I think they need me more right now.
Have a good weekend!
Last week really left me feeling beaten up. I was bruised and exhausted but yesterday I felt like I could have gone to work. I miss my friends at work and my patients. (Hope that Chelle, Barb, Nat, Monica and the others are keeping my desk warm.) Instead, I walked down to the farmer's market and bought some fruits and veggies and then had a tamale from a little stand there for lunch. I ate my tamale while looking out at the ocean and wearing a jacket which was some recompense for not being at work, after all it's 105 degrees there. .
The problem is that just when you start to feel like you are yourself again, it's time to get back to fighting cancer.
Corey is working half a day today and then I hope to feel good enough to ride the bikes for a bit along the beach. One day I will write about how great Corey is and has been but honestly right now it makes me teary just to think about it.
I cooked the last three nights which I love to do but hadn't really felt like doing for a while: Steaks on Tuesday, Spaghetti with black and green olives on Wednesday and Scallop Helper on Thursday (one of my signature dishes!)
Monday, I head back to Phoenix to my usual two doctors a day routine except for Thursday when I am getting my hair done so I look cute on the operating table. Corey is coming in next Thursday night. Wish I could stay with him but Ali put the cats on a diet so I think they need me more right now.
Have a good weekend!
Thursday, June 4, 2009
Breast Cancer Primer
People keep asking me about these terms so I thought as a health educator, I would describe them. I will add to them over time. Any errors in these definitions are my own except for the one Shirley defined. You can see the Primer by scrolling down to and looking on the right side of the screen.
Wednesday, June 3, 2009
More Six Word Stories ... What's Yours?
I am loving these six words stories. More examples are posted under comments from May 28th!
Vitamin D, Breast Cancer & Me
Laboratory studies have shown that vitamin D stops cancer cells from dividing and actually makes the cancer cells die out. Previous research has shown that enough vitamin D and exposure to sunlight has been shown to reduce the risk of developing breast cancer. Vitamin D is made in several ways. The body produces its own vitamin D in the skin when it is exposed to sunlight. Vitamin D is also found in certain foods, including eggs and fatty fish.
In mid -March of this year I had my vitamin D level tested and found it was low – 20. Soon after I went to a conference and heard Dr. Michael Holick, one of the world’ s leading vitamin D experts, and began taking 50,000 units of D once per week for 8 weeks and will continue with 50,000 units every other week for the rest of my life once I get my level up to 50.
I live in Phoenix with sunshine most days of the year and eat a healthy diet as well as take a supplement. It seems ridiculous that I could have a low vitamin D level, in fact, a level that is lower than many of my patients with Cystic Fibrosis who are at risk for low vitamin D. The Linus Pauling Institute recommends aiming for a serum 25-hydroxyvitamin D level of at least 32 ng/mL and more recently 50 seems to be the number to aim for.
What I did not know is that almost everyone diagnosed with breast cancer has a low serum vitamin D level. And researchers do not yet know is if the low D level is a cause or a symptom of breast cancer.
Dr. Chistakos, a professor of biochemistry, has researched and published extensively on the multiple roles of vitamin D, including inhibition of the growth of malignant cells found in breast cancer. Her current findings on the vitamin D induced protein that inhibits breast cancer growth are published in a 2009 issue of The Journal of Biological Chemistry. Previous research had determined that increased serum levels of vitamin D are associated with an improved diagnosis in patients with breast cancer.
http://www.sciencedaily.com/releases/2009/02/090204172437.htm
I wonder if a serum vitamin D level should be a regular test for women.
What I did not know is that almost everyone diagnosed with breast cancer has a low serum vitamin D level. And researchers do not yet know is if the low D level is a cause or a symptom of breast cancer.
Dr. Chistakos, a professor of biochemistry, has researched and published extensively on the multiple roles of vitamin D, including inhibition of the growth of malignant cells found in breast cancer. Her current findings on the vitamin D induced protein that inhibits breast cancer growth are published in a 2009 issue of The Journal of Biological Chemistry. Previous research had determined that increased serum levels of vitamin D are associated with an improved diagnosis in patients with breast cancer.
http://www.sciencedaily.com/releases/2009/02/090204172437.htm
I wonder if a serum vitamin D level should be a regular test for women.
Monday, June 1, 2009
Finally, some good news!
The MRI showed only the one cluster of cancer cells in my right breast! This means that we are going to go back to plan A which is to remove that section only and not the whole breast. The lymph nodes will be checked at the same time. The surgery currently is scheduled for the 12th.
I will need radiation treatment for sure. I am meeting with the radiation oncologist on Monday and have a second opinion on Wednesday morning. If the lymph nodes are positive then I may need chemo but we won't know that until later.
I will need radiation treatment for sure. I am meeting with the radiation oncologist on Monday and have a second opinion on Wednesday morning. If the lymph nodes are positive then I may need chemo but we won't know that until later.
Waiting for the Possibilities
The MRI guided biopsy was done in a new spot on the right breast and a spot on the left breast. Here are the possible outcomes of the MRI:
Neither area shows cancer which means we go back to the original plan of taking out the cancer we know is in the right and using radiation to get rid of any cancer cells that could be remaining.
If the right breast shows more cancer and the left does not. Any additional cancer in the right breast translates into a right mastectomy. If they do a right mastectomy then I can elect to have a left as well. The doctors say this is the most aesthetically pleasing option but I can wait and do the left later if there is no cancer there.
I then must decide if I want immediate reconstruction which Corey and I decided would be best. There are two schools of thoughts on this - one is wait about a year to allow time for grief and the other is to get the whole thing done at once. If I have to have a mastectomy then I want to put this behind me. Our only disagreement in this area is that Corey thought I should get a D - cup and I wanted an A - Cup. We compromised on a B-Cup.
If both sides show cancer then I must have a double mastectomy. One scenario we did not talk about is what would happen if the left showed cancer but the right was negative.
I will have the pathology back tomorrow and post again then.
Neither area shows cancer which means we go back to the original plan of taking out the cancer we know is in the right and using radiation to get rid of any cancer cells that could be remaining.
If the right breast shows more cancer and the left does not. Any additional cancer in the right breast translates into a right mastectomy. If they do a right mastectomy then I can elect to have a left as well. The doctors say this is the most aesthetically pleasing option but I can wait and do the left later if there is no cancer there.
I then must decide if I want immediate reconstruction which Corey and I decided would be best. There are two schools of thoughts on this - one is wait about a year to allow time for grief and the other is to get the whole thing done at once. If I have to have a mastectomy then I want to put this behind me. Our only disagreement in this area is that Corey thought I should get a D - cup and I wanted an A - Cup. We compromised on a B-Cup.
If both sides show cancer then I must have a double mastectomy. One scenario we did not talk about is what would happen if the left showed cancer but the right was negative.
I will have the pathology back tomorrow and post again then.
Saturday, May 30, 2009
An MRI can be Fashionable
The MRI biopsy was done at Good Sam. After checking in, I met Dr. Alfredo Nino, the radiologist who would perform the biopsy. He was something of a shock. Instead of the pleasant, short, plump, Hispanic looking man that I had envisioned, he turned out to be one of the handsomest men I have ever seen in my life. He is tall with golden hair and light blue eyes.
Dr. Nino explained that they would try to isolate the same spots seen previously seen on the MRI to biopsy and take a sample from the most promising section. If they couldn't see them then they would not do a biopsy and we would recheck in six months. That seemed like a good scenario to me.
My girls kept me company!
The MRI is done with me laying face down on the MRI table, breasts hanging through a hole. Each breast is squeezed by paddles just like the ones for mammograms except these have gridlines on them and open areas for the biopsy catheters to go through. One MRI is done to see if they can find the spots they saw previously ( they could see them both) and where the spots are in relation to the grid. This took two tries and then they brought me out of the MRI tunnel and cleaned the skin and numbed the area. After a few minutes, Dr. Nino placed the catheters in each breast using the grids to find the correct area. A quick trip back into the MRI machine was done to make sure the catheters were in the right spot and then the tissue samples were taken and titanium clips placed to make it possible for the surgeon or a future radiologist to find the exact area at a later time.
After the procedure a mammogram is done, ice applied. There is a lot of bruising and more discomfort after this biopsy because the MRI identifies areas that are needing more blood supply so there is more blood in the areas they sampled than the last biopsy.
Results sometime Monday!
I look adorable in my MRI gown.
Dr. Nino explained that they would try to isolate the same spots seen previously seen on the MRI to biopsy and take a sample from the most promising section. If they couldn't see them then they would not do a biopsy and we would recheck in six months. That seemed like a good scenario to me.
My girls kept me company!
The MRI is done with me laying face down on the MRI table, breasts hanging through a hole. Each breast is squeezed by paddles just like the ones for mammograms except these have gridlines on them and open areas for the biopsy catheters to go through. One MRI is done to see if they can find the spots they saw previously ( they could see them both) and where the spots are in relation to the grid. This took two tries and then they brought me out of the MRI tunnel and cleaned the skin and numbed the area. After a few minutes, Dr. Nino placed the catheters in each breast using the grids to find the correct area. A quick trip back into the MRI machine was done to make sure the catheters were in the right spot and then the tissue samples were taken and titanium clips placed to make it possible for the surgeon or a future radiologist to find the exact area at a later time.
After the procedure a mammogram is done, ice applied. There is a lot of bruising and more discomfort after this biopsy because the MRI identifies areas that are needing more blood supply so there is more blood in the areas they sampled than the last biopsy.
Results sometime Monday!
Thursday, May 28, 2009
Six Word Stories
Corey found an article in the AARP magazine ( yes, we are card carrying members now) that said that someone once challenged Ernest Hemingway to write a story in six words.
He came back with the following story: For Sale, Baby Shoes, Never Worn.
Wow - to pack all the possibilities in just six words! AARP is publishing six word stories based on themes and we are attempting to write some. The first theme was enduring love and friendship.
My attempt: We still fit together like spoons.
Theme #2: Holiday Traditions.
My attempt: In Iraq, no trees to trim.
I would love to see your six word stories!
He came back with the following story: For Sale, Baby Shoes, Never Worn.
Wow - to pack all the possibilities in just six words! AARP is publishing six word stories based on themes and we are attempting to write some. The first theme was enduring love and friendship.
My attempt: We still fit together like spoons.
Theme #2: Holiday Traditions.
My attempt: In Iraq, no trees to trim.
I would love to see your six word stories!
Wednesday, May 27, 2009
Pathology Update
The pathology is back on the original slides. The cells were Estrogen Receptor Positive, Progesterone Receptor Positive and Her-2/neu Negative.
Estrogen and Progesterone positive cancers can be treated with medicines that lower the estrogen in your body, as well as medicine that blocks estrogen from getting into the hormone receptors of the your body’s cells. This means that my cancer should stop growing or be prevented with hormone suppression treatment, such as tamoxifen. I have not talked to the oncologist yet but my surgeon thinks I will need that medication for at least five years.
The HER2 is a gene that sends control signals to your cells, telling them to grow, divide, and make repairs. A healthy breast cell has 2 copies of the HER2 gene. Some kinds of breast cancer get started when a breast cell has more than 2 copies of that gene, and those copies start over-producing the HER2 protein. As a result, the affected cells grow and divide much too quickly. This is not a factor in my case as the Her2 cells are normal.
Today another biopsy will be done on both sides under MRI at 1pm. I should have results by Monday will let us know if I need a mastectomy.
Estrogen and Progesterone positive cancers can be treated with medicines that lower the estrogen in your body, as well as medicine that blocks estrogen from getting into the hormone receptors of the your body’s cells. This means that my cancer should stop growing or be prevented with hormone suppression treatment, such as tamoxifen. I have not talked to the oncologist yet but my surgeon thinks I will need that medication for at least five years.
The HER2 is a gene that sends control signals to your cells, telling them to grow, divide, and make repairs. A healthy breast cell has 2 copies of the HER2 gene. Some kinds of breast cancer get started when a breast cell has more than 2 copies of that gene, and those copies start over-producing the HER2 protein. As a result, the affected cells grow and divide much too quickly. This is not a factor in my case as the Her2 cells are normal.
Today another biopsy will be done on both sides under MRI at 1pm. I should have results by Monday will let us know if I need a mastectomy.
Tuesday, May 26, 2009
Ups and downs for May 26th
My next procedure is Thursday at noon - an MRI guided biopsy of both breasts. I have a doctor's appointment tomorrow and one on Thursday morning. Some of the tests are in but I have to wait to get results until someone calls me. ( I'll know instantly if it is good or bad news... the doctor's always call me themselves with bad news.)I had a great weekend with Corey, my girls and my family.
My cousin Wendy, who is just six months younger than I, is recovering from her double mastectomy and had her first chemo treatment. Her hair is gone but my cousin Tracy reports that her spirit is bright.
A favorite patient died on Sunday, I went to see her on Saturday and am glad that I did. She was very sweet and so brave throughout her illness that I know she will live on as an inspiration to me and to those knew her.
On the flip side I had an article published with a group of colleagues from the CF community.
You can find it at:
http://respiratory-care-manager.advanceweb.com/Article/Airway-Clearance-Revisited-2.aspx
That inspires me to get back to work as soon as I can.
Friday, May 22, 2009
Imagining the Sphere
A comment from my friend Kathryn Sabadosa brought to mind this favorite poem of mine. Thanks Kathryn!
Happiness is like a crystal,
fair and exquisite and clear ,
broken in a million pieces,
shattered, scattered far and near.
Now and then along life's pathway.
Lo! some shining fragments fall,
but there are so many pieces,
no one ever finds them all.
Yet the wise as on they journey
treasure every fragment clear,
fit them as they may together,
learning to be thankful,
though their share of it is small,
for it has so many pieces,
no one ever finds them all.
Poem by Priscilla Leonard AKA Emily Bissell.
I have always loved this poem thinking it a great accomplishment to find the little bits of happiness in each day. This is my goal for this weekend...to look around for all the things that I might have missed.
TRIVIA: Emily Bissell was not only a poet but has another claim to fame. She made a name for herself at a young age as the founder of Wilmington's (DE) first public kindergarten and for her efforts to introduce child labor laws in the state of Deleware. She also introduced the Christmas Seal Campaign to the U.S. in 1907 as a way to raise money to help people with TB.
Happiness is like a crystal,
fair and exquisite and clear ,
broken in a million pieces,
shattered, scattered far and near.
Now and then along life's pathway.
Lo! some shining fragments fall,
but there are so many pieces,
no one ever finds them all.
Yet the wise as on they journey
treasure every fragment clear,
fit them as they may together,
learning to be thankful,
though their share of it is small,
for it has so many pieces,
no one ever finds them all.
Poem by Priscilla Leonard AKA Emily Bissell.
I have always loved this poem thinking it a great accomplishment to find the little bits of happiness in each day. This is my goal for this weekend...to look around for all the things that I might have missed.
TRIVIA: Emily Bissell was not only a poet but has another claim to fame. She made a name for herself at a young age as the founder of Wilmington's (DE) first public kindergarten and for her efforts to introduce child labor laws in the state of Deleware. She also introduced the Christmas Seal Campaign to the U.S. in 1907 as a way to raise money to help people with TB.
Thursday, May 21, 2009
"Cancer is not just about one person."
Wise words from my friend Shirley.
On the Sunday before the surgery, Corey and I had a cookout with my family and good friends Michelle and Shirley in the backyard. Our backyard has been the site of many happy times! Sunday was no different.
Shirley, Michelle, my daughter Ali, and I were sitting in the family room by the french doors when Ali looked at Michelle and they both teared up soon to followed by Shirley and myself. Shirley, who qualifies as an expert in this area, observed, "That's the thing about cancer, it doesn't just affect one person."
Cancer means that nothing in your life will ever be the same. When you hear the diagnosis - you know that in some way your vision of the future has shifted and nothing will ever look as it did or as it might have. You may walk the same path and see the same things that you saw yesterday but they just do not look the same. You drive the same places, pay the same bills, read the same magazines and except for the endless procedures and therapies, you are living in the same city and state as you did yesterday, but you know that nothing will ever be quite the same again.
For a while the road not taken has been mostly my choice. To paraphrase Robert Frost, I could peer down one path or another as far as I could see and choose the one that looked most fair. For now, I fear the path will be chosen for me, and "knowing how way leads on to way", I doubt I will be back to this great spot again.
Read Robert Frost's Complete Poem:
http://www.wsu.edu:8080/~wldciv/world_civ_reader/world_civ_reader_2/frost_road.html
On the Sunday before the surgery, Corey and I had a cookout with my family and good friends Michelle and Shirley in the backyard. Our backyard has been the site of many happy times! Sunday was no different.
Shirley, Michelle, my daughter Ali, and I were sitting in the family room by the french doors when Ali looked at Michelle and they both teared up soon to followed by Shirley and myself. Shirley, who qualifies as an expert in this area, observed, "That's the thing about cancer, it doesn't just affect one person."
Cancer means that nothing in your life will ever be the same. When you hear the diagnosis - you know that in some way your vision of the future has shifted and nothing will ever look as it did or as it might have. You may walk the same path and see the same things that you saw yesterday but they just do not look the same. You drive the same places, pay the same bills, read the same magazines and except for the endless procedures and therapies, you are living in the same city and state as you did yesterday, but you know that nothing will ever be quite the same again.
For a while the road not taken has been mostly my choice. To paraphrase Robert Frost, I could peer down one path or another as far as I could see and choose the one that looked most fair. For now, I fear the path will be chosen for me, and "knowing how way leads on to way", I doubt I will be back to this great spot again.
Read Robert Frost's Complete Poem:
http://www.wsu.edu:8080/~wldciv/world_civ_reader/world_civ_reader_2/frost_road.html
Wednesday, May 20, 2009
Change in Plans
Sadly, the MRI showed much more extensive cancer than orginally thought. I am being scheduled for an extensive MRI guided biopsy of both breasts at the Breast Center at Good Sam probably with Dr. Nino ( spelling?).
I doubt that will be until next week due to the holiday. This undoubtedly makes the surgery much more extensive... sigh.
Peace.
I doubt that will be until next week due to the holiday. This undoubtedly makes the surgery much more extensive... sigh.
Peace.
Check Back for Exciting Updates!
No news about times for tomorrow. The radiologist needs to study the MRI. They then call me back in to place a guide wire to help the surgeon get to the right spots. The placement of that might be today or tomorrow and the surgery tomorrow sometime depending on when they can place the guidewire.
Just a quick note. There is a chance that I will need a second surgery next week. A second surgery is dependant upon the pathology reports from tomorrow. Most surgeons have about 40% chance of needing to go back in, Dr. O'Neill runs about 20%. Let's hope that for once I can follow the crowd!
I will post updates on this later this afternoon.
Just a quick note. There is a chance that I will need a second surgery next week. A second surgery is dependant upon the pathology reports from tomorrow. Most surgeons have about 40% chance of needing to go back in, Dr. O'Neill runs about 20%. Let's hope that for once I can follow the crowd!
I will post updates on this later this afternoon.
Tuesday, May 19, 2009
Right Now, I am in Pretty Good Shape
I once heard Len Doak say, "You have to be in pretty good shape to be sick." He was so right.
Not only do you have to feel pretty good in order to keep up with everything; you need a lot of time as well. Medicine is an art delivered on time schedule.
When I called the disability administrator this Monday, the intake nurse asked why I needed any time off before my surgery which is not until Thursday morning. I explained that I had spent the morning with one surgeon before rushing off for a second opinion, and then I had an MRI scheduled for 3 but needed to check- in at 2 and in addition, I had yet to have labs, pick up old records, have an EKG, have a guidewire placed before the surgery, make appointments for the oncologist and radiation oncologist, and pick up prescriptions. Oh, and I might spend some time getting used to the fact that I have cancer. "My office is not going to like me just coming in for lunch!", I told her. " She responded that they usually did not approve time off before a surgery.
Not all of the time is productive of course, there is time spent commuting to and from the various testing sites, consultations, treatments and pharmacies. Waiting room time is enormous. Coordination between the various points is... uncoordinated.
Even when you know what you want or need, someone thinks that he or she knows better. And when you are a patient, too few people listen to you.
Everyone in the waiting room wants to talk to you (or to me at least). I never mention that I am a nurse because no matter what is wrong with them, the stranger next to me will invariably say, " Oh, if you are a nurse you will then you will be interested in this." They then proceed to launch into a long drawn out story about their hemmorhoids (which I not only have no interest in but can't even spell), constipation or some other aspect of their disease process.
There is a slight advantage in having cancer though. If you need a bit of peace and quiet, you can just say rather bluntly, " I have cancer." It makes most people so uncomfortable that they let you get back to your murder mystery!
Not only do you have to feel pretty good in order to keep up with everything; you need a lot of time as well. Medicine is an art delivered on time schedule.
When I called the disability administrator this Monday, the intake nurse asked why I needed any time off before my surgery which is not until Thursday morning. I explained that I had spent the morning with one surgeon before rushing off for a second opinion, and then I had an MRI scheduled for 3 but needed to check- in at 2 and in addition, I had yet to have labs, pick up old records, have an EKG, have a guidewire placed before the surgery, make appointments for the oncologist and radiation oncologist, and pick up prescriptions. Oh, and I might spend some time getting used to the fact that I have cancer. "My office is not going to like me just coming in for lunch!", I told her. " She responded that they usually did not approve time off before a surgery.
Not all of the time is productive of course, there is time spent commuting to and from the various testing sites, consultations, treatments and pharmacies. Waiting room time is enormous. Coordination between the various points is... uncoordinated.
Even when you know what you want or need, someone thinks that he or she knows better. And when you are a patient, too few people listen to you.
Everyone in the waiting room wants to talk to you (or to me at least). I never mention that I am a nurse because no matter what is wrong with them, the stranger next to me will invariably say, " Oh, if you are a nurse you will then you will be interested in this." They then proceed to launch into a long drawn out story about their hemmorhoids (which I not only have no interest in but can't even spell), constipation or some other aspect of their disease process.
There is a slight advantage in having cancer though. If you need a bit of peace and quiet, you can just say rather bluntly, " I have cancer." It makes most people so uncomfortable that they let you get back to your murder mystery!
Our First Team Member - Dr. Jennifer O'Neill
Corey and I chose our first team member. This is a key person because they essentially follow me for the rest of my life although hopefully she will retire first! Dr. O'Neill is a hugger (which I am not) but I liked her anyway.There were five spots of cancer. The cancer appears to be "in situ" which means that none of the cancer cells have leaked from those spots into the surrounding tissue. That will be confirmed in several ways. Yesterday, I had an MRI which measures the blood flow to the cells. The idea is that rapidly growing cells need more oxygen so there should be more blood flow to any spots of cancer that are active. The second way to confirm that the cancer has not spread is through pathology tests. This is actual samples of the tissue that are looked at under a microscope and abnormal cells are identified.
The first pathology report did not reveal any cancer cells in the surrounding tissue that they took from my breast during the biopsy. This makes the cancer "Stage 1" which means the cancer has not spread anywhere else.
Stage 1 is a good thing but the cancer is "high grade" which means that the cancer cells are rapidly growing. I think they can tell this by the amount of mitochondria in the cancer cells that they tested. I wish now I had paid more attention in biology class.
There is no survival advantage in having a mastectomy versus having the cancer cells and an extra 2 centimeters all around the cancer areas removed so we decided on the second option. We then headed to the Good Sam Breast Center for an MRI and hopefully will hear about that later today.
Stage 1 is a good thing but the cancer is "high grade" which means that the cancer cells are rapidly growing. I think they can tell this by the amount of mitochondria in the cancer cells that they tested. I wish now I had paid more attention in biology class.
There is no survival advantage in having a mastectomy versus having the cancer cells and an extra 2 centimeters all around the cancer areas removed so we decided on the second option. We then headed to the Good Sam Breast Center for an MRI and hopefully will hear about that later today.
Corey headed to California this morning and will be back tomorrow night. We will then interview radiologists and oncologists and make plans for the next step in treatment.
Thursday, May 14, 2009
Are you some place you can talk?
Oh,dear. The instant knowledge that those words impart.
Dr. Vanesian called me after 3 days of waiting. With those words I knew that good news was not to follow. The cells that had been removed the Thursday before, all five spots were cancer, officially, ductal cell carcinoma. He went through what might follow, a surgical consult, an MRI, surgery, radiation and chemo. No lump, no bump, no pain. The cells in right breast had been picked up at my annual mammogram and that news has sent me on a journey.
I called my husband and asked him to call my girls, Courtney & Ali. I called my sister who came to pick me up from work and helped me make appointments. And I deeply appreciated the comfort and strength from my friends and co-workers. No need to call them – they were just there.
The many, many calls I have received have been welcome but to be honest, I just get tired of talking about it, thinking about it, explaining it. This blog was the ingenious idea of my friend Kathy Promberger to keep people in the loop when they want to be and to keep me from obsessing.
Next comes my husband Corey returning home tonight from California. That will be a huge relief. On Monday we go to the surgeon and the plan will clearer after that.
Dr. Vanesian called me after 3 days of waiting. With those words I knew that good news was not to follow. The cells that had been removed the Thursday before, all five spots were cancer, officially, ductal cell carcinoma. He went through what might follow, a surgical consult, an MRI, surgery, radiation and chemo. No lump, no bump, no pain. The cells in right breast had been picked up at my annual mammogram and that news has sent me on a journey.
I called my husband and asked him to call my girls, Courtney & Ali. I called my sister who came to pick me up from work and helped me make appointments. And I deeply appreciated the comfort and strength from my friends and co-workers. No need to call them – they were just there.
The many, many calls I have received have been welcome but to be honest, I just get tired of talking about it, thinking about it, explaining it. This blog was the ingenious idea of my friend Kathy Promberger to keep people in the loop when they want to be and to keep me from obsessing.
Next comes my husband Corey returning home tonight from California. That will be a huge relief. On Monday we go to the surgeon and the plan will clearer after that.
Fortune Like the Moon
O Fortuna!
Velut Luna
Statu variablis
Semper Crescis
aut Decresis.
(From a poem I read in Latin Class in High School)
Oh, Fortune!
Like the moon, changing.
Forever waxing and waning.
Velut Luna
Statu variablis
Semper Crescis
aut Decresis.
(From a poem I read in Latin Class in High School)
Oh, Fortune!
Like the moon, changing.
Forever waxing and waning.
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