Cancer in My Rear View Mirror

Photo taken last year from my daughter's backyard in Des Moines, where I plan to be soon celebrating the arrival of my new granddaughter.

Sometimes I forget that I started this blog before I was diagnosed with breast cancer and that my intention actually was "to talk of many things." Breast cancer has dominated my life this year, and I'm eager to leave that experience behind and move on, but, of course, there are daily reminders.


My hair is now thick and covers my head, but it's curly and unruly. I've never had curly hair before and these are most likely temporary "chemo curls," but it takes me by surprise every time I look in the mirror. 


I'm experiencing some cognitive difficulties beyond the "senior moments" I had begun to laugh about over the last few years. Sometimes I have to stop and struggle to remember what I was just doing or saying or thinking about, which can be a challenge at work.This is probably a combination of lingering effects of chemo and side effects from my medication, Arimidex, which I'll be taking for five years.


My tear ducts haven't completely returned to normal functioning since chemo and sometimes I have tears streaming down my face when I'm not the least bit emotional.


For the most part, though, I'm doing well and feeling good. My red and white blood cell counts and energy level are back to normal. I'm a regular at the gym again where I do strength training on the weight machines and spend some time on the elliptical trainer and treadmill. I still go walking with Rick and the dogs daily and do some walking / slow jogging intervals and swimming while the neighborhood pool is still open for the season.


I've worked to get back to my Weight Watcher's goal weight, so as a lifetime member I can go to meetings and use their website free as long as I weigh in monthly.


I used to enjoy a glass of wine most evenings, but I've cut back to one glass of wine or margarita a week.


Last Wednesday, I was scheduled for my first post-treatment mammogram and I had a dental appointment scheduled two hours later. I worked a few hours in the morning and took off for my mammogram. Two hours later I was still at the radiology imaging center and had to call to cancel my dental appointment. That was when it began to sink in that I am still a breast cancer patient and that for the rest of my life I'll be a breast cancer patient or survivor.


These days I can't pick the location of the radiology practice that's most convenient to me. I have to go the location where they follow breast cancer patients and my images are carefully scrutinized by the radiologist while I wait. This first post-treatment mammogram did show something, so they took additional images and did an ultrasound. Then I was called in to look at the images with the doctor, who told me that I had new "calcifications" that could be due to tissue damage from radiation or could be due to new cancer. The only way to tell was to do a core needle biopsy. 


So two days ago I had another core needle biopsy, but it was different from the one I had in December that resulted in the diagnosis of my malignant tumor. I was on my back for that one and it was guided by ultrasound and was mostly painless. This time I was on my stomach, which was uncomfortable, and the procedure was guided by mammography. The numbing shots didn't work very well, so this procedure was painful and I bled excessively. I don't think that's how it usually goes, though. By the time I was cleaned up, taped up and bandaged, I was no longer in pain and went home to await the results. 


Today I was notified by phone that the biopsy showed no new cancer. The calcifications were due to normal tissue damage from my treatments. Needless to say, I'm relieved and thanking God for that good news. 


Monday I had my biopsy, yesterday I saw my oncologist, and next week I have a followup with my surgeon. I guess breast cancer will be in my rear view mirror for awhile longer and objects in the mirror are, after all, closer than they appear.


For now, I'm happily back to looking forward to meeting my sixth grandchild, who's due to make her appearance next month.

Getting My Life (and My Hair) Back

Since my last post two months ago, I've:

thankfully celebrated another Father's Day with my dad,

sadly watched the NBA finals as the championship eluded the San Antonio Spurs,

finished 25 radiation treatments, which marked the end of my "active" treatment for breast cancer,

started a medication I'll take for five years to help prevent recurrence of my cancer,

celebrated my 58th birthday and my granddaughter, Abby's 17th,

while enjoying a visit with her and her mom and sisters,

My oldest daughter, Kelly & I

Good times with Kelly's daughters, Emma, Grace & Abby

and had a wonderful time with my youngest daughter and her family who came to visit from Iowa.

Rick & I with Erika & her daughter, Lucy.

Erika's husband, Darin, our sleepy grandson, Collin & our son, Paul

Lucy & Collin, who are expecting a new baby sister in October

I've also gone back to the gym, started eating healthier and working on getting back to a healthy weight.

My year began with my diagnosis on January 2nd and the first half of 2013 revolved around breast cancer treatment, from surgery to chemotherapy to radiation to medication. The day I finished radiation treatments I felt like I got my life back and it was an amazing feeling.

I'm so thankful to my Lord and Savior for seeing me through and to my loving family and friends for their support and encouragement. I'm counting my blessings these days and feel like I could go on counting, as my grandson, Collin (and Buzz Lightyear) would say, "To infinity and beyond!"

Between Chemo and Radiation

It's been five weeks since my last chemo treatment and I've had two weeks worth of daily (5 days a week) radiation treatments, with three more weeks to go. It's been so good to gradually leave the side effects of chemo behind. I still have a nagging cough and low energy and my hair has a lot of growing to do, but I feel much better than I did.

Since I finished chemo:

...we enjoyed a visit from our niece, Natalie, and her husband, Scott, from Nebraska.We had last seen them when we went for their wedding last fall. Scott had just graduated from college before they came here.

...and an all too brief visit with our dear friend, Lori, who's more like family, and her children. They've been living in Virginia for the last two years and are headed to England where Lori's husband will have his next tour of duty with the Air Force. I wish we could have seen him too, but he had to stay in Virginia.

Our oldest granddaughter got a clear pathology report after her third surgery and has recovered well, for which we are so very thankful.

We learned that our eagerly anticipated sixth grandchild is a granddaughter too and we can't wait to go to Iowa meet her in the fall.

Our San Antonio Spurs won the Western Conference and are in the NBA Finals.

I had outpatient surgery to have my mediport removed. It served me well while I needed it during chemo, but I'm glad to be rid of it.

My medical oncologist referred me to a radiation oncologist and Rick went with me for my initial consultation. We both liked him a lot. He was friendly and compassionate and has been treating cancer patients for a long time. Rick thinks he looks a lot like his brother, Steve, and after he mentioned it, I could see the resemblance too.

I went for a CT scan and got tattooed and marked up with markers. Then the doctor worked up my treatment plan and I went to the treatment center for a sort of dry run called a "validation" or "simulation" before starting radiation treatments.

I may have some radiation burns before this is over, but I've had ten treatments now and so far, so far good. The treatment center provided some skin cream, which I'm using faithfully along with aloe vera gel.

I'll have 25 radiation treatments and possibly a few more called "boosts" after that. Fatigue is a possible side effect, but I won't be rid of the chemo-induced fatigue for awhile anyway, so I don't know if I'd notice a little more. I'm still working full time and driving an hour round trip five days a week for my treatments, plus staying up late to watch the Spurs in the NBA finals on game nights. I don't know how I could be anything but fatigued, but life is still good and God had given me much to be thankful for.

There are worse things than fatigue, like cancer for instance.

Hair Today, Gone Tomorrow

Talk about chemotherapy with any woman and the first question that comes up is about hair loss. Not all chemo drugs cause hair loss, but as of now, 100% of the chemo drugs used to treat breast cancer do.

Taxotere, one of the two drugs I was treated with, causes permanent hair loss in 3-6% of patients (supposedly it's closer to 6% when used in combination with Cytoxan, as in my case.) It has earned the  nickname "Taxotears."

Some women use a product called Penguin Cold Caps to prevent or lessen hair loss during chemo and it's supposed to work pretty well, but it was out of my budget. For someone undergoing chemo before a big life event like a family wedding, the expense might be well worth it. I never saw anyone using the cold caps at my treatment center.

In preparation for losing my hair, I went to my hairdresser and asked her to cut it as short as she could while still maintaining some style and femininity. She wouldn't let me pay for the cut, which I loved, but wasn't able to enjoy for long.

I had read on the discussion boards that with my chemo regimen, hair loss starts on average about 14 days after the first treatment and that was pretty accurate in my case. When small amounts of hair begin falling out, I just wanted to be done with it and asked Rick to use his hair clippers to buzz it down to stubble. A few people had told me I should have fun with it and buzz it into a mohawk or spike it first. Nobody who told me that has actually gone through this firsthand and I figured that when and if they do, they can "have fun with it" if they want to.

I'd also heard that some women are overcome with emotion and cry a lot when they lose their hair during chemo. Although I didn't have fun with the experience, I wasn't emotionally undone by it either. Rick and I had a few wry laughs and we both teared up a bit as he buzzed my hair off and we swept it up from the floor.

I never seriously considered getting a wig. I didn't think I'd feel comfortable wearing one and everyone in my life would know it wasn't my real hair anyway. Besides, what if I found a really cute wig and didn't like my own hair as much after it grew back? That would just be sad.

I learned that I wasn't going to be able to wear just any cute hat I happened to like. Hats not designed specifically to cover hair loss don't usually give full coverage of the hairline. I also learned that I have a fairly big head when I had to return a couple hats I ordered online that turned out to be too tight.

I had good luck with hats from "Just in Time" Soft Hats

and "buffs" from planetbuff.com although I've never watched "Survivor."

 It helped to have a daughter who knits

and a sweet, generous friend who shops.

At first I didn't like Rick to see me with my head uncovered and I wore something on my head all the time at home. After awhile I became less self conscious and as the weather got warmer, I was just more comfortable going "topless" at home. My head never became completely smooth and shiny-bald, although my poor pink scalp was and is still visible under the thin white stubble.

After my first chemo treatment, I got to thinking about those Penguin Cold Caps and the big frozen gel mitts and boots I wore during the Taxotere infusion to try to prevent nerve damage to my hands and feet. The idea behind all three was that the cold would cause the blood vessels to constrict and reduce the amount of the chemo drug that would flow to that area. My hair was already gone, but I thought, "What if I could reduce the risk of permanent hair loss by cooling my scalp myself somehow?" I knew I couldn't come up with anything nearly as effective as the cold caps, but I've always said that "something is better than nothing," and I figured that it couldn't hurt to try "something."

So before my next three treatments, I soaked and froze all five of the "Turbie Twists" I already owned. I have them in pink, purple, green and white and I took them all frozen in plastic bags in a small ice chest to the treatment center. After the Cytoxan was run into my veins and before the nurse started the Taxotere, Rick handed me one of the frozen terry cloth hair turbans, which had just thawed enough that I could arrange it on my head and fasten it. I covered it with a puffy pink shower cap, put a towel around my shoulders to catch the drips, and had Rick set the timer on his phone. Each time the timer went off, my long-suffering husband took out another frozen Turbie Twist for me, put away the thawed one, and reset his timer. I'm sure I looked ridiculous and the nurses seemed pretty amused. I have no idea if this really accomplished anything, but it made me feel like I was doing something and it didn't cost me a dime.

Now I am four weeks past my last chemo treatment and the pathetic looking white stubble is slowly starting to fill in. I'm trying to help it along by using CVS drugstore's brand of topical minoxidil (Rogaine) for women. I bought a one month supply after reading that most oncologists considered it safe even if they couldn't say for certain that it worked. I also bought a two month supply of over-the-counter biotin supplements for the same reason. There is only anecdotal evidence that it helps hair growth, but it shouldn't do any harm. It's also supposed to be good for the skin and if so, it might help during radiation treatments.

I hope that by the time I go to meet my newborn granddaughter in Iowa in October I'll have at least as much hair as she does.

And the Award for Best Husband in a Supporting Role Goes to...

"For better or for worse, in sickness and in health..." That was forty-one years ago. In those early days I didn't like him to see me without make-up. Now he knows what I look like without make-up or HAIR and from what I can tell, it hasn't diminished his love for me a bit.
 

Two clueless kids blessed on our way in 1972

"Dear, will you pose with me while I still have hair?" 2013

I am incredibly blessed and so very thankful to have had the love and support of my amazing husband throughout this breast cancer experience as I've gone through surgery and chemotherapy.  I know I can count on him to see me through radiation treatments and five years worth of "anti-hormone" therapy, which could turn out to be the most challenging experience yet.

He has done more cooking, cleaning, laundry and grocery shopping in the last few months than he's ever done in his life, and he's done it well and without complaining. During chemo, while I've been vulnerable to infection and illness due to low white blood cells, he's taken sole responsibility for tasks like cleaning the cat's litter box.

Yep, he cleans up after my faithful feline companion too.

He's been gracious as attention has been showered on me from friends and extended family while he quietly kept my world running as smoothly as possible. He used his hair clippers to buzz my thinning hair down to stubble when I asked him to and I think he was more emotional about that than I was. He has patiently humored me as I've asked him to take pictures of me for this blog and then asked him to retake them until my vanity was satisfied.

He's accompanied me to each doctor's appointment where there was an expectation of learning new information or having to make a decision. He made sure that during each chemo treatment I could watch a fun, lighthearted movie of my choice as a distraction while the dreaded stuff flowed into my veins. He was my hands when my own hands were stuck inside large clumsy frozen gel mitts.

Catching up on his work, while I watch a movie during a chemo infusion

He has consistently, but patiently encouraged me to go out for a daily walk with him and the dogs, sometimes walking all three dogs himself, while I tagged along slowly, feeling too weak to handle even one of them.

 They adore him almost as much as I do, even when he isn't doling out treats.

As I've gone through chemotherapy and worked full-time through most of it, a lot of you have told me, "I don't know how you do it." 

Well, now you know.

Tips I Hope You Never Need and I Never Need Again

I am thankful that my experience with chemotherapy was much better than it might have been and I attribute that to the grace of God in answering the many prayers made on my behalf by people I know and love.

There were also some practical things I did that may have helped and I want to record those here while I remember them, in case the information might help anyone else someday or if I ever need it again myself.

I had read some advice from an experienced chemo patient on www.breastcancer.org to try to get outdoors and walk each day. That was already part of Rick's and my daily routine with our three dogs and the four of them motivated and encouraged me to keep it up. If I had been on my own, I probably would have concluded that I was just too tired and weak to get out the front door most days. Some days, that's all I decided to do, get out the door, with the idea that I could turn around and come home if I needed to, although I never did. On the hard days, Rick held all the leashes when I felt I was no match for even one dog's energy level. But on most days, I managed to walk my loveable mutt, Gypsy, for the full hilly mile. The exercise, the fresh air, and just getting outdoors did me a world of good and improved my sense of well being.

Believe it or not these three did help Rick  motivate me to get some exercise by walking

I drank lots and lots of water, especially in the first 72 hours after each treatment, to help flush the chemo drugs out of my system and minimize the impact of the drug, Cytoxan, on my bladder.

I took ginger capsules twice a day in the first few days after each chemo treatment, to help with the mild nausea I experienced in spite of the very effective anti-nausea medication I had received by IV.

I found that my digestive system couldn't handle high fiber foods during chemo, so when I needed fiber I used "Miralax," which is pretty gentle, or a store brand knockoff.

One of the side effects of the chemo drug, Taxotere, that concerned me the most was peripheral nerve damage. If I had suffered even temporary nerve damage to my hands, it could have prevented me from working, but there was also the potential for permanent nerve damage to my hands and feet. I did everything I could to try to prevent that. During my infusions with Taxotere, I wore big frozen gel mitts on my hands and frozen gel slippers on my feet. The nurses at the treatment center kept those in the freezer for any patients that wanted to use them. I never saw anyone else use them, but I wore them for each treatment. Of course it was pretty miserable to freeze my hands and feet for ninety minutes at a time, but I think it made a difference. I never experienced much tingling or pain in my hands or feet and also didn't have any damage to my nails. The idea is that the cold constricts the blood vessels and reduces the amount of the drug that flows into those areas. There wasn't any concern that my cancer might spread to my hands or feet, so there was no medical reason not to try this.

My 3rd treatment, before putting the frozen mittens on.

I took other steps to try to prevent nerve damage, especially after I experienced miserable sharp, stabbing nerve pain from my first treatment. I took several supplements, all of which were either recommended or approved by my oncologist.

He prescribed "Metanx," a prescription form of high dose B-complex vitamins. This turned out to be very expensive, so I rationed those pills and just took them for one week after each treatment. I took over-the- counter B12 and B6 during the other two weeks of each chemo cycle.

My oncologist also recommended taking Alpha-Lopoic Acid, an antioxidant, to help prevent nerve damage.

For the first week after each treatment, I took a powdered form of L-Glutamine, 1 TBSP twice a day dissolved in juice or lemonade. L-Glutamine is an amino acid that may help prevent nerve damage and mucositis (inflammation of the mucous membranes of the digestive tract including the mouth) from chemotherapy.

I also rinsed my mouth several times a day with a solution of 1/4 tsp. baking powder and 1/4 tsp. salt dissolved in 1/2 C water for the first week after each treatment. I used Biotene brand mouthwash and toothpaste and extra-soft toothbrushes for my whole twelve weeks in the chemo zone. Thankfully I never developed any mouth sores.

I took a store brand version of the over-the-counter antihistamine, Claritin for a week after each treatment. This was to help prevent the severe bone pain that many patients suffer as a side effect of the Neulasta injection that is given the day after chemo to help stimulate the bone marrow to produce white blood cells. I don't think they know why Claritin helps with this, but the nurses at the treatment center recommended it and it is widely recommended on cancer and chemo related websites. It doesn't work for everyone and I don't know for sure if it is the reason I experienced very little bone pain, but I don't think it hurt.

My oncologist recommended taking vitamin D3 and calcium citrate during chemo and long term to help my bone density, which chemo compromises. There is evidence that vitamin D also may help prevent recurrence of breast cancer.

Women my age don't normally need supplemental iron, but chemo causes anemia, so I began taking a multivitamin with iron.

I will continue taking some of these supplements until I've recovered from the effects of the chemo and I may  take D3 and Alpha Lipoic Acid for the rest of my life.  I've been careful to get my oncologist's OK before I started taking anything I read about and I try to do my research on credible medical websites like www.breastcancer.org, www.chemocare.org, Memorial Sloan- Kettering Cancer Center, www.mayoclinic.org and others.

In Case You Ever Need to Know or I Ever Need to Remember

This post may be TMI for a lot of my readers, but while the experience of my twelve weeks in the chemo zone is fresh in my mind, I wanted to write about the answers to a question several people have asked me in one form or another: "How did chemo make you feel?"

Maybe someday my answers to this question will help someone else have some idea what to expect. It's not out of the question that I may go through chemotherapy again myself someday and may be glad I documented some of this experience.

Of course, no two patients' experiences with chemotherapy are alike. There are many chemo drugs and regimens and different people react differently to different drugs. Some side effects are common to almost all chemo drugs and others vary from one drug to the next.

Most chemotherapy involves a combination of at least two drugs. I was treated with Cytoxan and Taxotere. Cytoxan is particularly irritating to the bladder. Taxotere can cause peripheral neuropathy (nerve damage to the hands and feet that can be permanent) and is just generally hard on the nerves.

I received steroids and antihistamines by IV prior to each chemo infusion. With each treatment, the steroids kept the side effects at bay for about 48-72 hours, although from the beginning I felt odd and had the sensation that my skin was crawling. Once the steroids wore off, I felt my worst for the next two or three days. My first and last treatments hit me much harder than my second and third, but in different ways. By about two weeks after each treatment I was beginning to feel almost normal again.

So how did chemo make me feel? What were my side effects? Well, a lot of the things you hear about.

Fatigue that grew cumulatively worse with each treatment. I wanted to sleep all the time, but often had trouble sleeping at night. This was worse with my fourth treatment, which zapped my energy so completely that I spent the following weekend in bed.

Mental fogginess that made it hard to concentrate and think clearly.

Trouble focusing my eyes on small details and small print, more than I'm used to with my "over-fifty" eyes.

Ringing, roaring and pulsing in my ears.
 
A mild sore throat, irritating cough, dry mouth and heart burn.

Bladder pain, caused by Cytoxan, but I've had far worse from UTI's before chemo.

Mild nausea. Thankfully I didn't experience debilitating nausea. I received strong anti-nausea medication by IV with each chemo treatment and it worked well for me, but I felt queasy much of the time and had an aversion to many foods that I normally like. Most foods just tasted odd or like nothing at all. I have been a coffee drinker all my adult life, but couldn't stomach coffee during chemo. I also had no appetite for anything sweet.

Lower GI symptoms. These gave me new empathy and respect for people who live with chronic conditions like Celiac disease, Crohns disease and IBS. During chemo I experienced the worst stomach and intestinal pain and cramping of my life along with the kind of unpredictable lower GI symptoms that make you hesitate to go out for long or to get far from a bathroom. These symptoms were cumulative and were worse with my last treatment.

Mild bone and joint pain. Some patients experience worse pain than I did from Taxotere and/or from the Neulasta injection that is given the day after chemo to bring the white blood cell count back up.

Hair loss. This began right on schedule about two weeks after my first infusion. Like many chemo patients, I didn't want to let this phase drag on while I shed clumps of hair everywhere, so I had Rick buzz my head down to stubble.

Nerve pain. After my first treatment, the worst side effect I experienced was sharp, shooting, stabbing pains all over: in my head, throat, neck, jaw, back, stomach, side, legs. I probably should have called my oncologist, but I assumed this was just part of the chemo experience. At my next appointment before my second chemo treatment, he concluded that I had worse than average nerve pain from the Taxotere and he prescribed a high dose B-complex vitamin supplement that is more easily absorbed than over-the-counter vitamin B supplements. Although I experienced some nerve pain after my next three chemo treatments, it was much milder and less frequent.

In my next post, I'll share some tips that helped me cope with and prevent some of the side effects of chemo.

During my time in the chemo zone, I often felt like a shadow of myself. If you are a Harry Potter fan, you might say I felt like I had suffered a dementor attack. If you are a Lord of the Rings fan, you might say I felt like Frodo after he had worn the ring too long. Obviously I am a fan of both and I am happily starting to feel more like myself. 

Calling It Quits

Last Thursday I had my fourth chemo treatment. It wasn't until afterward, and before the side effects hit hard, that I began to think about the fact that from the start, my oncologist recommended "four to six treatments, six if you can tolerate the first four." I like and respect my oncologist, but as I began to think about that, I questioned whether it was best to have six treatments just because I could tolerate them. 

One of the websites my oncologist had recommended was www.breastcancer.org and I have gained a lot of helpful information from their articles and by communicating with other breast cancer patients on their discussion boards. I've learned that there are many types of breast cancer and many variations of diagnosis. When I first learned that my biopsy had shown a malignancy last January, a few people asked me if my tumor was DCIS. I had no idea what that meant, but the answer turned out to be no. It was a little more serious than that. 

Now, after my user name, my signature line on the discussion boards includes:
Dx 1/2/2013, IDC, 3cm, Stage IIa, Grade 2, 0/2 nodes, ER+/PR+, HER2-

I don't expect that to mean much to most readers of this blog, but it means a lot to breast cancer patients looking to share information with others who have a similar diagnosis. There are two bits of information in that line that make me comfortable stopping with four chemo treatments and made me doubt that any possible benefits of two more would outweigh the risks and side effects:

I had no lymph node involvement and my cancer was not "triple negative." 

Either of these details would have made chemotherapy a more critical piece of my overall treatment plan. I have no doubt that having chemo was a good decision, given the size, stage and grade of my tumor, but based on my own research and sharing of information with other patients, I'm also convinced that four treatments were enough.  Given the particulars of my diagnosis, the next two phases of my treatment plan, radiation and hormone therapy (make that "anti-hormone" therapy,) are every bit as important, if not more so, than chemotherapy. 

I didn't feel comfortable delaying radiation therapy any longer to have two more chemo treatments. Radiation is critical after a lumpectomy and it shouldn't be delayed any longer than necessary.

I told Rick that he was my witness that I had reached this decision before the pre-chemo steriods wore off and the side effects from last Thursday's treatment hit, because this fourth treatment has hit me faster and harder than any of the previous ones. I called my medical oncologist's office yesterday and told his nurse about my decision. She spoke with him and called back to tell me that he was fine with it and gave me a referral to a radiation oncologist. He will continue to follow me after radiation and through "anti-hormone" therapy.

It will take some time to recover from the side effects of my chemotherapy, but I'm thankful that I've been able to tolerate it as well as I have. In a future post I'll share some tips that have helped me get through it. I don't expect radiation or hormone therapy to be much fun either, but I'm glad to be headed out of the chemo zone and grateful to have multiple treatment options.  

I've learned a lot so far on this journey and I think it's important to learn as much as possible and make the wisest decisions I can. But one thing I had already learned from life before breast cancer is that when it comes right down to it, I'm really not in control of all that much. That's where faith comes in. God has been in control all along and will continue to be. I know that He is good even if some things He allows in my life seem far from it.

My fourth chemo treatment

More Than What's Going On With Me

"There's more going on here than what's going on with me." 

My pastor has often exhorted our congregation to keep this perspective as we ponder how God may be at work in the difficult situations in our lives.

When I began writing about my breast cancer experience in this blog, part of my motivation was the hope that my experience might be of help to others some day. I could not have imagined how soon that might happen or how close to my heart it would be.

A beloved family member of mine, who is statistically too young to worry about breast health or breast cancer, was nevertheless, more aware and began doing occasional self exams after my diagnosis. She found a lump. Benign tumors called fibro-adenomas are common at her age and are harmless. That's not what it was.

She had a phyllodes tumor. Less than one percent of breast tumors are this type and when they do occur, it is usually in women more than twice her age. Phyllodes tumors can be malignant, benign, or borderline, but even when they are benign, they are not harmless. They are extremely invasive and have to be surgically removed as quickly after diagnosis as possible. They grow so fast that there can be measurable increase in size in just a couple weeks.

So this precious loved one of mine had a lumpectomy less than three months after I did. There was not much I could do to help, but at least I could give her some idea of what to expect and how to prepare. No one else in our extended family had been through this. And I could pray for her.

As it turns out, her surgical experience has been much harder than mine, because although her tumor was benign, her pathology report did not show clear margins. Because these tumors are so aggressive and can recur, she had to have a second surgery a week later, this one more invasive and resulting in a more painful recovery.  

Then she got the discouraging news that her second pathology report showed that one margin was still not completely clear. A consultation with another surgeon for a second opinion confirmed that this scenario with a need for three surgeries is not unusual with phyllodes tumors.  

So her ordeal is still not over. Oh, how I wish it was. We are hoping and praying that her third surgery can be less invasive and that her recovery will be quick and complete. She will need to be closely followed up for the next few years and maybe for life.

She is absolutely a trooper, brave and beautiful, and I'm so proud of her. She has faced this trial in her life with maturity, faith and courage. If God has used any part of my experience to help her, I'm more than happy to have gone through it.

More to Life Than Chemo

Yes, there is more to life than chemo. Sometimes going through chemo does start to seem like it's all about me and it's all about the chemo. But life goes on and life is good.

Since I entered the chemo zone:

We celebrated the resurrection of our Lord.

Several of my loved ones have had birthdays:
My daughter, Erika
My granddaughter, Emma
My nieces, Meagan and Melanie, my brother-in-law, Eddie, my sisters-in-law, Sabrina and Linda.
Although I haven't been able to celebrate with them in person, I've been reminded of the gift each of them is in my life and family.

Rick and I celebrated our 41st anniversary, after I woke up that morning and thanked God that I wasn't a widow. We had takeout from the neighborhood Chili's at home with our son, and thanked God that he was there to celebrate with us too. (See the previous post for that story)

And we rejoiced that we could now tell everyone how excited we are that our sixth grandchild is on the way! When our youngest daughter, Erika, was here after my surgery, she shared with us that she had just learned that she was pregnant. She and Darin were going to wait awhile to announce the news to the wider world and now they have. Erika's first sonogram confirmed that she was carrying a beautiful, growing, healthy baby, but it was too soon to tell if we are expecting our fifth granddaughter or our second grandson. Either way I am excitedly looking forward to being through with chemo and then radiation, so that God-willing I will be healthy enough to go to Iowa in October and help welcome that precious new bundle of joy!

Life Doesn't Stop for Chemo

I've been living in the chemo zone for two months now and this week I will have my fourth treatment. I thought I'd take the next few posts to talk about some of the other things that have been going on in my life and the life of my family.

The first is an incident that took place about nine days after my second treatment. It was Saturday and I was off from work. That day my mind was focused on our granddaughter, Emma, who was having her fifteenth birthday up in Dallas. I was remembering the day she was born, reflecting on the beautiful young lady she has become, wondering how the festivities with her friends and family were going, and wishing we could be there.

The next day would be my and Rick's 41st anniversary, so I had spent much of the day also reflecting on forty-one years of memories and feeling glad that last year we had celebrated by visiting and taking pictures at all of our old homes and haunts here in town.

Remembering our 40th anniversary last year

As late afternoon transitioned into early evening I was feeling pleased that I had mustered the energy to clean up the kitchen, do several loads of laundry and start dinner for Rick and our son, Paul, who had spent all day in the driveway working on Paul's truck.

Suddenly I became aware of shouting and commotion outside and stepped out into the open garage where I could  see that Rick and Paul were both under the truck in the driveway and there was a group of  teenaged neighbor boys standing wide-eyed in the yard. There was fear and confusion in the air and it made my blood run cold. I couldn't assess exactly what was happening, but there were no other adults in sight and all I knew was that we needed help quickly. I shouted to the boys, "Somebody please call 911!" and then ran into the house to find my phone to do exactly that myself.

I couldn't tell the poor dispatcher exactly what we needed. I wasn't sure if Rick and Paul were pinned, but I knew that if they could get out safely on their own they would have and that at the very least, the truck was unstable on the jack stands. The dispatcher sent a fire truck and ambulance and then wanted to keep me on the phone with him. I stepped back outside in time to tell him that my son was now out from under the truck and bleeding profusely from a deep gash in his forearm, but my husband was still under the truck. Paul was shouting directions to Rick and finally, Rick too, was out from under the truck. The dispatcher gave me instructions to wrap a towel as tightly as I could around Paul's arm and hold it above his heart then asked to speak to Rick to better assess the situation. The fire truck wasn't needed so they drove on past, but the ambulance arrived shortly and the paramedics took over and were just wonderful. 

Rick and Paul both had lots of cuts and bruises, one of Rick's fingers looked crushed and Paul's arm was absolutely gory and obviously needed immediate medical attention. Rick said he could drive Paul to the emergency room, but then admitted that he felt lightheaded. Mainly to placate me, they agreed to go in the ambulance to the ER. I stayed home because I was at a point in my chemo cycle when I was too high maintenance to be of any help.

Rick stayed in touch with me by phone from the ER. I called and emailed family, friends and church to ask for prayer. Once Rick was sure he would be up to driving home, he called some good friends  who came by the house and drove one of our vehicles to the hospital and left it parked in the ER parking lot. Rick's finger wasn't broken, but Paul's arm was gashed to the bone and required careful cleaning and stitching. They got home late that night. Paul was at high risk of infection and was on antibiotics for the next week. Thank God he didn't develop any infection and has full range of motion in his wrist and hand.

Later I got a better understanding of what had happened, although Rick or Paul could explain it much more accurately. They both spent moments under that truck that they thought might be their last on earth. The truck had slipped off the jack stands as they were trying to put the transmission back into it. The transmission had come down and cut into Paul's arm, pinning him. In fact, it was the transmission that kept the truck from coming all the way down on both of them. They got Paul free, but then Rick was pinned by one gloved finger. It was at that point that I came back outside, still on the phone with the 911 dispatcher.

Over the next few days, I went back and forth between thanking  God for sparing their lives and preventing more serious injury, and freaking out over thoughts of what could have happened. It may sound like a cliche to say that God was in control, but some cliches are simply true and God was truly in control that day. And even if it had turned out much worse, that still wouldn't have changed the fact that God was ultimately in control. 

As I thought about how helpless I had felt that day, it occurred to me that even if I had been in robust good  health, I would have been just as helpless. I told Rick that I was glad that at least I was home and was able to call for help. He said, "Well, you're on chemo. Where else would you have been?" And that was the point exactly. If I had been healthy and feeling good on that beautiful Saturday off from work,  I probably would not have been there.

I Never Said I Didn't Have a Shallow Side

OK, Girlfriends, can we talk? Because you know, facing down a cancer diagnosis and chemotherapy, you try not to be shallow. You try to keep your priorities.

First, whether I live or die, I belong to the Lord and I trust in His promise of eternal life.

Second, I have many blessings to be thankful for: my supportive husband, family and friends, medical insurance, good medical care, early detection of my cancer...countless blessing really. 

And if this wretched chemotherapy kills off any rogue cancer cells left in my body, that makes any temporary side effects more than worth it.

Yes, I really, truly believe all that.

And I believe in the absolute sincerity of every loved one who has told me that I look beautiful in my hats and earrings and that I am beautiful on the inside. I do find those sweet comments to be very encouraging. And I do know that my husband loves me no matter what.

But dang it, this chemo hits a woman's ego hard and there's no denying it. You know those sort of cute pictures I post of myself on FB or on this blog? Well, anytime I put forth the effort to put makeup on, dress in something halfway decent and wear a hat and earrings that color coordinate with my outfit, I have Rick take my picture, because I know that's the best I'm going to look for awhile.

One of the drugs I'm being treated with, Taxotere, supposedly causes permanent, yes, permanent hair loss in 3-6 percent of women treated with it. I had already told my oncologist I didn't want to be treated with anything that might cause heart damage, because I really do try to keep my priorities in place. That didn't leave a lot of  options. I could have tried something called "Penguin Cold Caps" to try to keep my hair, but at the cost of $500 per month for 4 months? Nope, neither my budget nor my priorities would allow for that, although I wouldn't judge anyone who did want to try this.

I haven't lost my eyelashes or brows yet, but it's just a matter of time. I've heard from some chemo veterans that they didn't lose those until weeks after their last treatment, only to have them grow back and fall out several times. That's just cruel. 

There's a chance my fingernails will end up discolored and possibly lifting off the nail beds too, but my nails have never been anything but short and raggedy, so I won't pretend that would be a big hit to my self image.

They have very good anti-nausea meds for chemo patients now and that's a good thing. Not that I hoped to lose weight on chemotherapy, but I was unpleasantly surprised to find out that weight gain, yes weight gain, is a more likely side effect than weight loss. Yep, weight gain and fluid retention, especially around the middle. Isn't that special?

And from the first treatment, you can practically feel the stuff drying up your skin. I can certainly see it in the mirror. I keep seeing lines and wrinkles I know weren't there before all this. And I'm just getting tired of seeing my bald head in the mirror.

Some of the best advice I've read on the chemo discussion boards is not to look in the mirror too much. Not that I want to sweat the small stuff, but sometimes you just need to vent about it.  Thanks for listening.

And you know, sometimes it's just easier to talk about the small, shallow things than the big scary ones

Smile, You're on Chemo Camera

I don't know if a picture is really worth a thousand words, but I'm too tired to type many words, so this update will be in pictures and I figure it's worth four thousand words.

Trying to smile during my second infusion on March 28. This was before I had big frozen gel mitts on my hands, to prevent peripheral neuropathy, and Rick's laptop in my lap, so I could pass the time watching a movie.

Resting after a tiring workday with my cozy quilt (made by my sister-in-law, Sabrina,) my soft, comfy cap (knitted by my daughter, Erika) and my faithful feline companion, Luna. It's good to feel loved.

I got a little sad the other day to realize that I've pretty much missed our Texas bluebonnets this year. I don't think it's been our best spring for them because of the drought, but I never got out to see any fields of them in bloom. Oh, well, there's always next year. This picture was taken behind our church last spring.

Dressed for church. I think the pattern is going to be that I'll go about one out of every three Sundays during chemo. The first Sunday after a treatment, I feel pretty awful, the second I'm too vulnerable to infection and illness due to my low white blood cell count. Here I was feeling pretty good the Sunday before my third treatment. It was so good to go worship the Lord with friends and reconnect with them.

Keep Calm and Chemo On

It has been three weeks since my first chemotherapy infusion and I'm going for my second in the morning. I've been feeling pretty good this past week, almost normal.

I didn't start feeling bad until about three days after my first treatment, but right from the beginning I felt very odd, just strange and surreal. If you've seen the Lord of the Rings movies, picture the scenes where Frodo has the ring on his finger. That's the visual that comes to mind when I think of how I felt  for about the first week to ten days: like I was not quite in the real world, not quite in the land of the living. It was a struggle to focus my mind or my eyes. I heard roaring and ringing in my ears and they pulsed and throbbed. After a few days I felt random sharp, stabbing  pains in my head, jaw, throat, ears, back, pelvis, legs. 

I had an awful taste in my mouth and foods and beverages tasted odd. I've been a coffee drinker for over forty years and love a good, strong cup of freshly brewed coffee. Now, I can hardly taste coffee and the taste that does come through is off somehow. I did experience some nausea, but the anti-nausea medication they gave me with the chemo seemed to keep it in check. Of course there was fatigue, which didn't become debilitating, but I've been told to expect that to get worse with successive treatments. I had stomachaches and GI symptoms I won't go into detail about.

But after about the first ten days, I began to feel progressively better. It's good to know that this won't be four months of solid misery. I'm very thankful that so far I've been able to work and go out with Rick and the dogs for our daily walks.

About two weeks after the first treatment, my hair slowly started coming out, so Rick buzzed my head for me, but I still have a lot of stubble that hasn't fallen out yet. I wear hats or "buffs" except when I sleep now.

I've learned that there are scores of different chemotherapy drugs and regimens geared to different types of cancers and patients. The side effects and experiences can vary widely. I am being treated with two drugs: Cytoxan and Taxotere. I will have six treatments at three week intervals. The drugs are administered one at a time by IV into the port that was placed under the skin beneath the left side of my collarbone. Each treatment takes about three hours.

Just before I began chemo, we got the results of a blood test my oncologist had ordered that showed that I would have trouble metabolizing the drug, Tamoxifen. Taking Tamoxifen for five years was going to be an important part of my treatment plan to help prevent recurrence of my cancer. My tumor was strongly estrogen receptor positive and Tamoxifen is very effective in preventing recurrence of this type of tumor for most women. There is another class of drug I may be able to take instead, but we decided to table that decision until after I've completed chemo and radiation.

For now, knowing that Tamoxifen has been removed from my arsenal of anti-cancer weapons, it seems even more important to persevere through my chemo treatments. I'm confident that I can, with God's help and with the support of my wonderful husband, family and friends.