The Third Chemo

Tuesday, Oct. 25: This past week has not been too bad. I had chemo on Thursday. We had friends come into town Friday night and we went out with them. We stayed out pretty late and I didn't get tired. Saturday night was homecoming night so I knew that Allison would be out late. Two friends were also spending the night with her. Jason ended up having 2 friends spend the night (6 kids--what was I thinking!?!) I was up 'til about 1:30am. I did pretty good though. I rested on Sunday and took it easy. The only side effects I seemed to have is sneezing and runny nose once the benadryl that they give me in my IV wears off. I take more benadryl today and tomorrow and it seems to get better after that. I got the taxol and avastin today. They speed up the time it takes the avastin to go in. It took an hour and a half the first time. This time they said they will put it in in an hour and then the next time 30 minutes. It is the same amount, they just speed up the time it goes into the IV. I am also on prilosec for the heartburn and indigestion and I don't have any problems with that. I didn't feel so out of it this time and was not drowsy on the way home. I did take a nap in the afternoon because a friend gave me 2 tickets to see the Blue Man Group tonight so I am going to try and get rested for that.

The Second Chemo

Thursday, Oct. 20: Kit is going with me to chemo today. I only have the taxol so it should not take as long. I do the usual: take blood to check everything, see the Dr. then off to the chemo room. Everything went fine untl the end when I was hit with the worst heartburn ever. Right at the end of the taxol, the pain was so bad I didn't know if it was heartburn or my heart. I felt bad enough to call the nurse over and she checked my blood pressure and put some little clip on my finger. I think that checks blood oxygen and heart rate. She told me to stand and see if the pain eases up. It did, so much so that I didn't sit back down. It seemed to get worse if I sat down. She watched me for a little while longer and then gave me some prilosec. I took that immediately. I felt horrible on the way home. Kit dropped me off and I went to bed and slept for an hour and a half. I don't even remember the ride home hardly. Allison called me from work in the middle of my nap to let me know that she was there. I mumbled something to her and her boss, who heard the conversation, said, "is your mom drunk?" I was out of it. I guess the benedryl really knocked me out this time. Late in the afternoon I started the sneezing again. I sneezed, had a runny nose and watery eyes. I took more benedryl and that seemed to help. I guess this is a side effect I am going to have. Oh, after I slept in the afternoon I did feel much better and felt back to normal.

The mid-week update

Saturday, Oct. 15: I haven't had any bad side effects yet. I was really tired yesterday. I am keeping a daily treatment log to see if there is any pattern to any side effects I may be having. But so far everything seems to be going well. My oncologist is out of town this week so I will be doing chemo on thursday instead of tuesday. Then I will be going back to the every tuesday schedule. I have figured out that I get tired easily. If I have a lot to do in the morning then I know that I will be tired in the evening. If I have something in the evening then I will take it easy during the day. I have not gone back to work yet. I may think about it in a week or so.

The Chemo

Tuesday, Oct. 11: I have my appointment at 9:30. Robert is there with me. I first have blood drawn from my port. This will be done everytime I come in to check white blood cells and numbers for organs, like liver. If my white blood cell level drops too low then I will have to skip chemo and take shots to raise the levels before I can take the chemo again. Dr. Maity comes in and explains the treatment. I will start with Taxol every week and avastin every other week. Taxol is a chemo drug. The side effects are joint pain and tingling in hands and feet. There can also be nausea, hair loss and a few other things but it is more mild chemo and the side effects aren't as severe. Avastin is not a chemo drug. It interferes with a cancer cells ability to grow vessels to a blood supply. If it is not able to grow these vessels then it will die. So, we get all of our questions answered and go ahead with chemo that day. It takes a much longer time than I had anticipated. It goes like this: They already have a needle in the port from checking my blood so I go into "chemo room" (is what I call it.) There are lounge chairs lined up, 5 on one side 5 on the other. There are tvs with remotes in front of each chair so you can watch tv. The nurse comes over and hooks up a bag of fluids and that goes in. I forgot to mention, they also give a steroid, benadryl and anti-nausea medicine in my IV too. Then they gave me avastin which took an hour and a half to go in. They then gave me taxol, which took an hour to go in. I then get another bag of fluids. The nurse then gives me a syringe of saline followed by heperin to keep my port clean and so it will not clog up. And then I am done! I was finished with my first chemo at about 2:00. I didn't have any side effects while my chemo was going in, but I sneezed all day and night. I even woke myself up sneezing. I also had horrible heartburn. I am going to see if it is a chemo reaction or if I am getting something form Allison, who is sick.

The Follow-up..again

Monday, Oct. 10: I have a follow up visit with the surgeon again from the second surgery. My port looks good. I have another insision that is only covered with dermabond--great stuff. I went for my echo of my heart and the Pet scan last week. She is able to get my results and everything on the scan shows no sign of cancer tumors anywhere in my body! YEAH!!!! I feel so much better knowing that. But I did get some bad news. I had ordered some books and I was decifering different things on my path reports. I noticed that on one of my reports it said that my HER2/neu was 1.9. Above 2 is positive, below 2 is negative. But I also noticed another report called a FISH test, it is more accurate and the test that you would want to have done to test if you have this protein. The FISH test said "positive for overamplification of HER2" Now, that doesn't sound negative to me, which is what I was told I was. You want to be negative, not positve. So, I showed my surgeon this and she realized that they had done the first test. It showed 1.9, which is borderline so they sent if for the better test, the FISH. This came back positive for HER2. So, I thought I was the better, negative but I am not, I am positive. This is a more aggressive cancer so it is fought more aggressively. Dr. Barber called the oncologist to make sure that she knew that I was positve and she did catch it. So the treatment that the oncologist told me they were going to do still stays the same. So, I got some good news, no cancer anywhere else but also bad news, I am HER2 positive. It seems I never get just good news, always some bad comes with it. It is like its 50/50 all the time. Well, tomorrow I visit the oncologist and they want to go ahead and start chemo. I think I will if I get all my questions answered. The sooner I start, the sooner I will get done.

The Supporters

Before I post anymore about myself, I would like to say that there is no way that I could have gotten through a lot of this without all the people around me. I had no idea that so many people would reach out and be so nice and supportive. All the cards have meant a great deal. I have kept them all and re-read them quite often. I have gotten many pairs of pajamas and I am so thankful for those because I am usually in them by about 4:00pm! I think I wear those more than normal clothes! I think I took it a little too far though--I wore a pair to the grocery store because, heck, I have cancer and I just need some milk and bread and I'll wear these pj's. I gotta lot of stares. I think I will put on clothes for errands. I appreciate so much all the care packages from back home. I believe I am on every prayer list there is back in North Carolina and I know that it has helped greatly. I know that everyone is doing all they can back there and this is the time when being so far away isn't much fun. What has surprised me is how many people have been so helpful here. People that I would have never expected to think to do something for me. It has truly made me a better person and made me learn that when you do things for others, how uplifting it is for that person who is sick, injured or whatever the cause may be. I have had friends and family bring dinners after my surgery. And now that I am in chemo some have gotten together and made me 7 dinners to put in my freezer for future use. Also, co-workers at Four Seasons got together and gave money and gift certificates for restaurants. I have friends and family that go with me when I need them for chemo--I am not supposed to drive because they give me so much benadryl. I really have everything I need for a complete recovery. I am overwelmed by the generosity and kindness of everyone during this time. "Thank you" just doesn't seem to be enough!

The Second Surgery

Friday, Sept. 30. We' re off to the same hospital as before. It should not be as long as the first surgery because I don't have to have the procedures before the surgery. Everything is the same, they start an IV, come and talk to me in the room. The anesthesiologist comes in and it is not the 12 year old asian girl this time. They don't knock me out in my room. They wheel me to the operating room and then knock me out. I am also having a port-o-cath put in. When I have chemo they will use this instead of going in my veins. I have the surgery, but this time I wake up in the first recovery room. I am shaking all over. I hear one nurse say, "she's got the shakes, I'll give her some demerol." Whenever I opened my eyes the room looked like it was rolling over and over. It made me nauseous. I just wanted to get in the other room with Robert. I wanted to get home. I didn't geel good at all. They finally take me in the next recovery room with Robert and the nurse there gives me something in my IV for the nausea. Whatever it was that she gave me made the nausea go away in a snap of a finger. Good stuff. I was so worn out. I told Robert that I wanted to sleep but I wanted to go to bed at home. We left at about 2 pm. I went home and went straight to bed. I laid in bed a lot over the weekend after this surgery. It seemed to have wiped me out more that the other. I thought maybe it was the anesthesiologist. Maybe what the little asian girl did was much better, but some people say that 2 surgeries in a week and a half is pretty rough on the body.
Monday, Oct. 3: I get a call to have my echo of my heart on Thursday and my PET scan on friday. For a PET scan they inject glucose. I then wait for 30 minutes while it goes through the body and then I lay in a scanning machine for about 30 minutes. It scans my body for any tumors that may have spread in my liver, brain. lungs, etc. Wonderful thing to have.

The Follow up Visit

Monday, Sept. 26: Today I go for a follow-up visit with the surgeon. I get all the pathologist reports too so I am anxious for that. Robert and I go to the office and she says that everything looks good. I forgot to mention that I have no stitches ( on the outside) and no bandages. The incisions are held together by dermabond. Best stuff EVER!! I have a few stitches where the drain is held in place but that is all. I get the drain taken out. They snip the stitches and she yanks on the drain tubing...HOLY COW did it hurt. It was up there about 6 or 7 inches Robert said. He said she pulled that tube out like she was starting a lawnmower. That few minutes of pain was worse than the mammogram machine for 30 minutes! At least it is out. So I find out from my path report that my tumor is hormone recepter positive, HER2/neu negative (more on that later), stage 2 because it was in the lymph node. I had 9 other lymphnodes taken out and they were all clean. So some really good news there. Hormone receptor positive means that it takes estrogen adn progesterone to grow. That means that I will take tamoxifen for 5 years after chemo and radiation. HER2/neu is a gene (not a hereditary gene) that is measured to show how fast the tumor multiplies. You want to be negative-not positive. She also gives me some not so good news. I have to go back in for more surgery. In addition to the mass that was taken out, she took out another piece of something that didn't look right. It tested as cancer so they have to go back in there for clean margins around that piece. I leave sort of confused about that. I can't seem to understand what she means--is it another tumor or what? I asked her several times and I never could figure it out. I go to the oncologist tomorrow and hope to get more answers from her.
Tuesday, Sept.27. Robert and I head to the oncologist. Her name is Dr. Maity. She tells me that she needs to do an ultrasound of my heart and a PET scan. After she gets the results back she will tell me what kind of chemo she recommends but tells me that it is usually 8 treatments:one treatment every 3 weeks. I try to talk about the whole "which mass was malignant" question. She just got my chart so she wasn't all that knowledgable yet. She gave me copies of all my path reports and they told me they would call to schedule all the tests.
Wednesday, Sept. 28: I get a call from the surgeon's office to see if I would be available for surgery this friday. Well, I guess so...I was supposed to go on a girls weekend to the mountains in Utah but I guess this is more important....So here I go again. I call Robert.."guess who gets this friday off work again??"

The Surgery

Wednesday, Sept.21: I am going to a hospital about 45 minutes away from my house because that is where the surgeon is Chief of General Surgery. It is a new hospital, kind of small and ranked the top womens hospital in the Las Vegas area. They waste no time in getting things started. They take me and Robert back to my own little recovery room and start with the IV-- I have no visable veins and it took the nurse several times to get a vein. They take me to a small room with a mammogram machine. There, they take a mammogram making sure they have the mass in a certain place so they can put the wire in it. But what I didn't know was once they put my breast in the mammogram, they never take it out for a LONG time! So once they get the film and see that it is positioned ok, they go get the radiologist. He comes in to inject novacaine, numbs everything up and then puts a wire from the outside of the breast in through the tumor. I am still in the mammogram machine. So, he thinks he got it in the middle, but they have to take another xray, develop it and have the radiologist make sure that it is centered. This takes about another 20 minutes...in the mammogram machine...with a wire sticking out of my breast. The lady doing the mammogram said that the person before me got so upset and nervous during the procedure that her blood pressure rose too high and they had to cancel surgery. This is not going to happen to me because there is no way I am doing that again! So fortunatly for me the first time is a charm and I get to get out of the machine. Now I head to the radiologists room were the inject a tracer into the breast 4 times. The first 3 didn't hurt but the last one was painful enough to cover for all of them. Then, they tape a plastic cup over the wire so it doesn't get moved. I look like Maddonna in her pointed bra era. Now I go lay under a scan machine so they can trace the dye to the lymph node. They said that it could take 5 minutes or an hour. Just depends on the person. Well, lucky me gets to lay in the machine for an hour and a half because mine doesn't move at all. It is getting close to my scheduled surgery time so they go ahead and send me back to my room. I like to say that my surgeon was a woman, my nurse was a woman and my anesthesiolosist was a woman (although she looked more like a 12 year old asian girl). The radiologist was a man and that is the only thing that didn't go right that day!! So I go back to my room and Robert is there. He has some news. Allison got kicked out of school for dress code violation and is here in the hospital. My dad and Dian had to go pick her up.Even after Robert tells the school the situation they will not let her stay. Now, you know that Allison is a good student and I saw her before she went to school so she is not in trouble. She has a hole in her jeans above her knees and they are making her go home for that. But what is even funnier is that her shirt is actually a mini dress..if she would have thought to take her pants off, the mini dress actually was long enough to pass dress code. We had a good laugh thinking she should have just taken her pants off right there in the office to show the absurdidty of the situation. And of course, now Allison is here so Jason is going to be mad that he is at school. The surgeon, nurse, anesthesiologist all come in the room and give me the stuff to knock me out for surgery. I am going to try to put pics in of Allison and Robert. I don't even remember those pics being taken. I head off for surgery that lasts about an hour and a half. When I came to I felt very good. I awoke in the room with Robert. Kinda went in and out for a while and then felt awake enough and asked if I could go home. At some point the surgeon came in and told me that they did find cancer in the sentinal node so they took more out but I don't remember much else. Darn, I was really thinking that it was not in the lymph node. We headed home about 5 pm. I honestly felt ok. Much better than I imagined. I had a perscription for Lortab every 4 hours and I had a drain under my arm because of the lumph nodes being taken out. Robert fixed me some soup and crackers. Dad and Dian stayed with the kids after school and took them for dinner. They came home as I was eating dinner. I stayed up with them and felt pretty good. Robert took care of me and my drain all weekend. I only had one day that was bad. I thought it would be a good idea to take some milk of magnesia of 5 in the morning--it was not. I threw up anything that touched my lips. Luckily I got better as the day went on. Robert stayed home from work Wed, Thurs, and Fri. We are very fortunate that Robert's boss is so nice and compassionate. Robert told him that he would use his vacation or sick days and his boss said no, not to worry, just take care of me. Very nice.

The Biopsy and the Results

Thursday, Sept 1: Today is the day for the biopsy. I am having an ultrasound guided needle biopsy. They used the ultrasound to locate the middle of the mass and took 2 samples. They numb everything up pretty well so it did not hurt. It bruised up pretty bad afterward though. I told the surgeon that I wanted the results asap over the phone instead of waiting for the office visit.
Friday, Sept. 2: Well, I asked for the news asap and I got it asap. It is Invasive lobular carcinoma, about 1 cm in size. This type of cancer only accounts for about 10% of breast cancers. Most are ductal cancers. The treatment is the same though. Getting the diagnosis confirmed really didn't devastate me or anything. I think I was already prepared for it, as I said I had a bad feeling from the beginning. The surgeon said that there was some good news--Two bad things that you can have: perineal invasion (cancer around nerve or group of nerves) and angiolymphatic invasion (tumor cells in blood vessels or lymphatic vessel spaces) is not seen on mine. Absence of these is a favorable prognostic sign. So the next move is to see the surgeon again and schedule surgery.
Thursday, Sept. 8: Robert and I meet with Dr. Barber and discuss treatment. I will have a lumpectomy on Sept. 21. I go in at 7:00am and I will have a needle loc and dye injected for a sentinal node biopsy. With the needle loc they put a small wire into the middle of the tumor. They do it to tumors that are small so the surgeon knows where the middle is. The sentinal node biopsy is something that is new in the past couple of years. Instead of going in and taking a bunch of lymph nodes, now they inject dye into the breast, put you under a scan to see the dye drain to the lymph node. During surgery, the surgeon inject more dye and they take out only that one node that the dye drains to. They send that to the pathologist and if there is no cancer in that one then they don't take out anymore. If it does have cancer then they will take out others. I am nervous because I have not had surgery before. So I go shopping for cute surgery clothes. I found a "longewear" outfit from Dockers that has a zip up jacket that is perfect for the surgery.

The Visit to the Surgeon.

Monday, Sept. 22. This day will be chalked up as the worst day of my life. I had to go get my films and take them to the surgeon with me. They don't seal the films so of course I open it and read the radiologists report. I lost it. The report said a catagory 5 carcinoma (95% probability that it was cancer) and highly invasive...I think that means that it has spread throughout my body. Robert got a phone call I am sure that he hopes he never has again. I couldn't speak, I was crying so hard and he was yelling WHAT,WHAT!!! On top of that, I had to run into Khols to pay off my charge for that month--It was ugly. I was sitting in Kohls parking lot and Robert was working the internet, trying to decifer the information from the path report. Trying give me some kind of information to calm me down. I finally get calmed down enough to drive to the surgeons appointment.
It doesn't get any better. The surgeon pretty much tells me that it is cancer. The invasive part means that the cells have broken through the cell wall and this is the type that can spread to the lymph nodes or other parts of your body. But it doesn't mean that it HAS spread. Good news for me. We need to have a biopsy and that needs to be done as soon as possible. I broke out in hives in the office and my blood pressure was through the roof. The doctor tells me to not worry that nobody dies from breast cancer anymore. But I am thinking, well, maybe not breast cancer but I have this hip pain, and headaches and I think my lungs are now hurting......
I like the surgeon, Dr. Barber. She is very knowledgable and head of general surgery at one of the hospitals. She has a lot of accommadations and went to good schools. I think she's a keeper.

The Itch

Sunday, July 31. I t all started with an itch. Robert an I were laying in bed watching a movie. I had my arm above my head and felt an itch at the top of my breast. When I rubbed it I noticed that the skin felt different, kind of like a rectagular area that was thickened. I asked Robert to feel it and he thought it felt strange and I should go have it checked out. I had just gone for a yearly check up about 2 months before and I know there was nothing different then. I could not feel a lump-just a thickening. I called the gynocologist the next day.

Tuesday, August 2. I went to my doctor. They could feel the thickening but you could not feel a lump. And the only way that you could feel that there was anything different was if I was laying down with my arm behind my head. It would disappear in any other position. I feel very fortunate that I had to itch that night! The doctor sent me for a mammogram, ultrasound and a phone number to a surgeon to follow up even if the mammogram showed nothing suspicious. I had a benign lump removed form the same breast when I was 23. You would think that that would make me believe that this was the same thing, but I didn't. I told Robert that I didn't have a good feeling about this.

Friday, August 5. I went for my mammogram and ultrasound. You could definitly see a lump on the ultrasound. They said that it looked to be about a centimeter. My doctor would get the results in a few days. Anyway, I was preparing to come to North Carolina for our visit in the next week. On Monday, August 8 I got a call from my doctor asking if I made an appointment with a surgeon. This should have been a clue, I guess. I didn't even ask for results--I thought they took a long time to get back. But I made an appointment with a surgeon for August 22. Two days after I got back from N.C.