It's Hard to Blog When You Can't Sit

Taxol 2, Chemo 6 (only two left!)
On May 1st, I had my second dose of Taxol. It was a long infusion, but I slept through a lot of it. My good friend Suzie went with me, and I am very grateful to her for all she does for me. Sure enough the "leg pain" returned, but this time I was prepared with narcotics to manage it. Honestly I don't remember much about the week after chemo. I was in a fog of pain killers, the aforementioned rectal issues, and sweet anticipation of my romantic getaway to Mendocino with my honey.


The Romantic Getaway
Mendocino was indeed wonderful. It was a much calmer trip this time. Usually we take a hike or a tour, we even went rowing once. But this time we shopped a little, browsed art a little, but mostly stayed in our quaint room and enjoyed the sea air through the windows. The weather was gray, so we didn't even spend time on the beach. But we enjoyed great food, played games, and read together. It was a very nice break. One tradition I think we will abandon is our trip to the local theater to see a play. Three years in a row now we've seen plays that are either dull or offensive. Time to give up on Mendocino's theater scene.

This is our sunny, sea-breezy, quaint room. Such a comfort.  

"Excuse me, I believe I ordered the large cappuccino?"

Sisters Go to Stanford
Almost the moment we returned from Mendocino, I got in a car with my sister Stacy and drove down to Stanford. We met our other sister Jamie there and stayed in a motel that night so we wouldn't have to fight bay area traffic the morning of my appointments with Drs. Dirbas and Lee. Stacy and Jamie and I had fun together, as usual, and boob humor was rampant.

Stacy, copping a squeeze of Jamie

I am very lucky to have sisters that take an active interest in my fight against cancer. Jamie is valuable to have around. She is a nurse and knows the lingo, asks the right questions, and keeps my care providers accountable. Stacy is also valuable to have around because she knows how to be a sounding board for me in my decision making. On our way back to Chico we went over several options for surgery that were new to me (more about that later) and I was able to get clear in my mind what the pros and cons of each option are.


A Decision in the Making
Dr. Dirbas, the breast surgeon who will be doing my mastectomy, is all about my being cancer free. He gave me a lot to think about with regard to the double mastectomy. You see, I have one healthy breast and one diseased breast. The SENTIMENT I often encounter among the general and medical population alike is that someone with breast cancer in one breast should definitely remove both breasts. And indeed this is what I had planned to do. But it turns out the SCIENCE doesn't bear that up. Dr. Dirbas pointed out that there is no medical justification for removing a healthy breast. He explained that some doctors in fact are morally opposed to prophylactic removal of a healthy breast. He himself used to be one of them. But he has since realized there are some reasons that justify it, but wants to make clear that increased survival is not one of them. The data shows that once you've had a cancer, you have a 20% chance of getting another kind of cancer, in another part of your body. So when I say I want to remove both breasts because I never want to have to go through chemo again, I'm not actually decreasing my chance of going through chemo again. 20% is 20%, regardless of how much breast tissue I have. Furthermore, the chance of my getting breast cancer in the surviving breast is far lower than 20%---it's more in the range of 5-8%. Survival rates just don't justify removing a healthy breast. The reasons he listed as justifiable for removing a healthy breast are: 1) if you're BRCA positive (which I'm not), 2) for peace of mind (which is a placebo effect anyway), or 3) if you're concerned a great deal about achieving perfect symmetry (I'm not . . . really). So at this time I am leaning toward removing just the diseased right breast.

Dr. Lee, the plastic surgeon, is all about getting me the breasts I want. As feared, I no longer have enough tummy fat to make two my-size boobs. I stood in front of him bare from the hips up. He squeezed this and squashed that, took a step back and said, "I can give you small Cs." I said I could live with that, as long as I can get them perky and proud. Remember when I said, referring to a picture of my pre-biopsied bare breasts, "I want them just like this only higher?" He delivered the bad news that breasts made from tummy fat are, well, exactly like tummy fat. Squashy, hangy, mush. In other words, they look perfectly 'natural' as breasts. Forty-two year old, saggy, I've-nursed-three-babies 'natural.' Because I was hoping for an improvement on the 'height' (I'm not quite to the point of referencing 'length' yet, but I'm headed in that direction) of my breasts,  he informed me repeatedly that if I'm not happy with any result, I can come back for revisions. He told me implants are really the only way to achieve the kind of proud and perky I'm after. He's all for implants. His main goal is that I be happy with the breasts I end up with. This is tempting. I have to remind myself that there are reasons I didn't choose implants to begin with. Dr. Schrader said that on someone as young as me, implants are not a permanent solution. Plus, I consider implants a rather vain endeavor. I would never be one to get them under other circumstances. But, if I have to suffer with cancer, why not also benefit from it? Why not get spectacular breasts?

Anyway, lots to think about. Like I said, right now I am leaning toward single mastectomy with immediate reconstruction using belly fat. I'll get my tummy tuck, I'll maintain sensation in my surviving breast, and we'll work to achieve the symmetry, size, and height I want. The key to this decision is making sure my left breast is indeed completely healthy. We've really only examined it once. Well, in several ways, but still all in the same period of time. I had a mammogram, sonogram, MRI, PET/CT and needle biopsy, all showing a healthy, benign left breast. But I want to check it again to be sure before deciding absolutely to save it.


Upcoming Events
On May 28th I will go down to Stanford for additional mammography and an MRI. I will be going with Nicole, who also has appointments down there that day. I think it will be fun.

On June 11th I have pre-operative consultations with Drs. Dirbas and Lee, where my questions will be answered and a final decision made.

On July 2nd I will get something called lymphoscintigraphy. My best guess on what that means is that my lymph nodes will be examined closely and photographed, perhaps even biopsied.

My surgery, whatever the type I decide on, will take place on July 3rd. I am scheduled to be in the hospital for seven nights, and a 12 week recovery period is expected. I will be spending the next couple of weeks making arrangements for my kids to be off having fun somewhere, and not at home witnessing my misery. Any takers?


A Pain in My Rear
At about 2 a.m. on the morning of May 8th, after having no bowel movements for 6 days, I had an experience that rivaled the pain of childbirth in every way. My bowels were impacted and I de-impacted them with gloved hand. I lost a lot of blood. It was, as I said, every bit as painful as the crowning of a baby's head during childbirth. Afterward, I tried to resume sleep, but was in too much pain. My shmemorrhoid was prolapsed in the extreme and bleeding heavily. Dave took me to the emergency room. I anticipated they would hydrate me, give me pain meds and send me on my way. But my hemoglobin was down to 5.5 (normal is 12 and above), so instead I was admitted, given four units of blood through transfusion, and taken into emergency surgery. The surgeon was none other than Dr. Matthews, the colorectal specialist whose office couldn't see me for 6-8 weeks. I sure showed them!

My anesthesiologist was none other than my good friend Jeni Henrie Olson! I was in good hands!

Suzie was with me up to the very last moment, bless her heart. Dave made it home from Redding
just in time to kiss me goodbye as they wheeled me into the operating room.

Dave, Stacy and Suzie were often with me in the hospital. Pat Wilson also visited, as did my home teacher James Coles, and Eric Addington. They were able to give me a blessing. I don't remember much about it, but it was a comfort nonetheless. Rhonda Nelson also came and saved me from the decisions of one rather careless nurse. Most of my nurses were angels, but Rhonda was definitely my angel that night. I am so grateful for my awesome support group.

Girls' Weekend and Little Me
That next weekend (Mother's Day weekend), I was supposed to go with all my ladies on a Girls' Weekend in Vacaville (outlet shopping!). But instead I was in the hospital for five days. I should have gone home after two or three, but because of a bad drug reaction, a fever of 103, and pain control issues, I kept extending my stay. But my sweet girls (two sisters, my mom, my aunt, my daughter, four nieces, two nephews' girlfriends and one Katie) sent me constant pictures of what they were doing, with a Little Me in tow. Katie blew up a picture of me, cut it out, and attached it to a ruler so I could come along even though Big Me was ailing in the hospital. You have no idea how much it cheered me to see pictures of me "being there." It was so nice of Katie to think of me and bring me along.

While Big Me looks like this . . . 

Little Me buckles up for the trip.

While Little Me dines on fried shrimp . . . 

. . . and milshakes . . .

Big Me ingests four of these bad boys (intravenously).

Little Me tries on shoes.

Little Me tries on a dress.

Little Me browses the furniture store with Jill and Ashley.

Big Me is asked to rate her pain several times a day. It hovers around moderate to severe most of the time.

Little Me and the young ladies pause for a poser.
Katie, Marissa, Courtney, Ashley, Jill, Laura, Jacie

Here Little Me poses with the (mostly) older crowd:
Katie (not old), Aunt Corinne, Jamie, Jill (not very old), Stacy and Mom

Big Me's skin takes a beating from five days of adhesive and port access,

. . . while Little Me's skin glows between my two beautiful mother figures, Mom and Aunt Corinne.

I came home on Mother's Day. Pain control has still been a struggle for me. Sitz baths are plentiful by necessity. I am now almost two weeks post surgery, am just beginning to sit again, and have been so far unsuccessful in weaning myself from narcotic pain killers. My chemo was delayed by a week because of this debacle.

Because I sit so often in the bath tub, boredom takes over and I snap a shot of my reflection in the overflow drain.
Nice how its screw so aptly sensors me. Be grateful I'm not including the shot of my shmemorrhoid.

My next chemo is tomorrow. Seven hours of fun! At least the leg pain will drown out my butt pain for a while. Also on the bright side, I no longer have a shmemorrhoid. I'm glad it's gone, but it's strange to have a whole new landscape down under. (Any hope of this post remaining genteel is now obliterated.)

DeAnna
Last Wednesday I went in for Herceptin and was pleased to see DeAnna, whom I met mere days before I became bald. I told part of her story here. I felt at that time---and it was reconfirmed Wednesday---that DeAnna is someone with whom I most definitely want to be better friends. We have started down that path and are getting to know each other through facebook for now. She's finished with chemo as of Wednesday, but is still feeling its effects. I look forward to more pictures of us when we have hair again!

I am sometimes shocked by my appearance. Internally, I feel like a normal looking person.
Then I see pictures of myself like this one, and I realize I am sick. But there is a beauty about this fight.
DeAnna, in the act of receiving chemo drugs, fairly glows.