A day of docs
Posted: October 12, 2011 Filed under: breast cancer, menopause | Tags: alcohol and breast cancer, artificially induced menopause, breast reconstruction, DCIS, hormone suppression, invasive ductal carcinoma, Linda McCartney, Lupron, oncology checkup, ovarian suppression, Paget's Disease, the Big Dig 6 CommentsYesterday was my regular check-up with my onco-crush, Dr D. 
He’s so young and so cute ya just want to squeeze him. And he’s a hugger, too, so squeezing him is definitely an option. Me, I’m not much of a hugger, as my book club buddy Laura will tell ya. She manages to get more hugs out of me than anyone. I’m not very touchy-feely by nature, but I’m working on it.
I got a couple of hugs from Dr D yesterday, and since I won’t see him again until January, he said Merry Christmas and Happy New Year, too. That makes me panic a little, thinking the holiday madness is upon us and I don’t have enough time to engage in the consumerism that has become de rigueur. I also don’t tend to think that far ahead. I’m more of a small-picture kind of girl who’s learned not to look too far down the road, because there might be something wicked lurking, like a 15mm invasive ductal carcinoma and its nasty friends, DCIS and Paget’s Disease.
Dr D is very big-picture, though, and he’s not at all worried about something wicked lurking down the road. That’s one of the many reasons I like him — every time I see him, he tells me he doesn’t think my cancer is going to come back. That’s music to my ears and a balm for my worried soul. When I told him that I think about recurrence every single day, he tut-tutted and told me to think about something happy instead. Duly noted.
We had a long talk about my love affair with alcohol, as we do at every visit. He knows I’m a fan of the sauce and while he would like to see me cut back because of alcohol being a risk factor for breast cancer, he also advises his patients to live their lives, and he’s realistic about the studies being inconclusive about just how big of a factor alcohol is anyway. I pointed out the tragic and really-not-fair example of Linda McCartney, wife of the famed Beatle, who died from breast cancer even though she was a hard-core vegan, ate 100 percent organic, had no family history of the disease, and never drank. You can’t live much cleaner than that, and the bastard still got her. I’m not vegan, but I am hard-core vegetarian, I eat a lot of organic, I actually like fruits & veg, and had no family history of the bastard disease, so I’m going to enjoy raising a glass here and there. Not every day, like I would like, but that’s my choice. There’s nothing I like more than having a glass of wine while I cook dinner every night. I don’t do that anymore. But I’ll still say cheers to the freaky weekend. And if a certain someone shows up with an unexpected bottle of bubbly because it’s Tuesday, then I say life is for living and pop that cork.
Once we discussed and debated the effect of alcohol on BC patients, we (thankfully) moved on to other topics. He has a very nice bedside manner that involves him spending a good deal of time looking right in his patients’ eyes and asking how the feel. How they are coping. How they are emotionally. He knows that fighting the vicious beast that is cancer is way more than a physical battle, and he spends the time necessary to check on the non-physical battlefield. Smart man. In this process, however, he might have bitten off more than he wanted to chew by asking me if I’m happy with my reconstruction. Cue the $100,000 question.
Do I think my surgeons did a good job with my newly reconstructed chest? Yes. A fantastic job. Does it look 1,000 times better than it did pre-reconstruction? Way. But am I happy? Not so much.
See, we had a conversation very similar to the one last week. And I pointed out to Dr D, as I have to other docs, that I am one of the uncommon BC patients who was happy with her body before cancer ignited a stinking bag of dog-doo on my front porch. Sure there were some things that I wanted to tweak, after having babies, nursing babies, and turning 40, but overall I was happy before. That makes it kinda hard to then be happy with the after side of multiple surgeries and their far-reaching side-effects. I predicted that long after my “journey” is complete and I go back to my pre-cancer life, I will always see the scars instead of the progress. Not to be a Negative Nellie, mind you, but because I am very realistic. I know that the 17-inch scar on my belly will fade. In fact, it already has, and it started out looking way better than a lot of what I’ve seen in doing my research. I know that the “flaps” of skin used to create my breasts will settle into the landscape of my battle-scarred chest. I suspect that some day I will be more “me” and less “it” when it comes to thinking about how cancer has changed my body. But I’m not there yet, and Dr D listened and counseled me.
He gave me a very good piece of advice. So good that Amy jumped up and wrote it down on a piece of paper towel in the exam room. He said, “Focus your attention on the things you have achieved, because you have achieved a lot, but you still have a ways to go.”
He’s right, of course.
I just don’t tend to think that way. I’m way too busy thinking in the here & now (do I have enough bread to pack the kids’ lunches? Did I move the clothes from the washer to the dryer? It’s Mary’s birthday tomorrow; where’s the card I bought for her 4 months ago?). I need to stop a sec and shift from the here & now and the never-ending “to do” list and think for a moment about how far I’ve come and what I’ve achieved. My “journey” has been far from ordinary, routine. As my nurse-friend Laura says, “Everything that could go wrong did, and you were as far from a textbook case as could be.” True dat.
Two really great things came out of my appointment with Dr D, besides the pep talk and his blessing to have a drink. The first is the end of the Lupron shots. Hooray! I endured a year of that blasted drug, and am thrilled to say adios to it. The needle was huge, the drug was of the ilk that burns like fire upon entering the body, and the side-effects were hideous: hot flashes often enough to power a small city. Sweating more than Leon Lett after his infamous fumble against the Dolphins. Mood swings that make people run and hide from me. Joint pain that sometimes catches my breath. Decreased bone density that I can’t feel but fret about anyway. Bye-bye nastiness. Of course the flip side to being done with Lupron injections for hormone suppression means that I have to get serious about the oophorectomy. Gotta get those ovaries removed for good. As much as hate the idea of yet another surgery and yet another recovery, I am of the “slash & burn” mentality when it comes to cancer. Get ’em out so they can’t cause any trouble.
Item #2 in the “this is really great department” was the very last port flush. Hooray! I’ve had my port for almost 18 months, and it has served me well. It’s made my life easier and saved my already-floppy veins from being blown out once and for all. It’s allowed me to endure so many needle sticks that a 20-gauger no longer makes my palms sweat. But I won’t miss it. I will happily bid adieu to the titanium disk sewn into my jugular. I will not miss the monthly flushes with saline and Heparin. I will keep it, though, as a souvenir. As a reminder of all that I’ve achieved. Of all that I’ve endured. Of all the crap that was flung at me but how little of it stuck.
Oncology report
Posted: April 13, 2011 Filed under: breast cancer | Tags: 20 gauge needle, Arimidex, breast cancer, cancer battle, femara, Jorge Darcourt, Lupron, menopause, oncologist, oncology consultants houston, tamoxifen 8 CommentsMy latest visit to Dr Darcourt was uneventful, which is my favorite kind of doctor visit. Despite the fact that I have to get stuck for blood work and step on the scale every time I go see him, I still like going. As much as you can like going to an oncology visit.
In the beginning of this “cancer journey,” it freaked me out to say “my” and “oncologist” in the same sentence. Not something one usually wishes for, to say the least. But if I have to have an oncologist, my guy is pretty great. Not just because he’s young and Peruvian, either. Although that doesn’t hurt.
Since you’re probably going to google him now, I’ll make it easy on you: 
There ya go.
Just a disclaimer: he was the third oncologist I consulted, and didn’t choose him based on the fact that he’s young and Peruvian. Not just.
Ok, so the appointment was uneventful, and he said the words I love to hear: “I have no reason to think your cancer will come back.” Music to my ears. We talked about Tamoxifen, the chemo pill I take every day and will stay on for 5 years, and the artificially-induced menopause brought on by it and the Lupron shot I get every three months for hormone suppression. In a nutshell, since my cancer was fed by estrogen, it’s easy to control it by depriving it of estrogen. It means I go through menopause a bit early, but that’s a small trade-off for ensuring the cancer doesn’t come back.
The trick is to determine if I’m really in menopause or if once we stop the Lupron shots, we also stop the ‘pause. This is important because it affects the chemo pill I take. Tamoxifen is for pre-menopausal women, i.e., if you weren’t in menopause at the time of diagnosis, you take it. If you’re post-menopausal, you take a different drug, mainly Femara or Arimidex. Either way, I will be on one of these drugs for 5 years. I’m ok with that, because I’m pretty reliable at remembering to take it every day, and it’s another weapon in my arsenal against my cancer.
And taking a pill every day is much easier than getting that Lupron shot. Even though Ionly get it once every 3 months, it’s dreadful. The needle is really big: 20 gauge.
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The 20 gauge needle is what is used for port access. It has to be big enough in diameter to not only pierce the skin and the membrane of the port, but also allow for blood to be drawn back out through it.
That’s a big needle.
If you don’t like needles, like me, you may get a little squirmy right about now. That’s ok. Don’t worry if your palms start to sweat, if your heart races, and you feel a little nauseated. All normal reactions to seeing a wonking big needle. But if I have to see it, so do you. I’m good at sharing.
The drug itself is very thick, and has to be warmed before being injected. You know it’s going to hurt. Because it’s thick, it takes several seconds to push the drug through the needle into the body. So the pain lasts. Then once the drug is in, it burns. On the skin and inside. I literally can feel the drug trailing into my body. And yet, I do it willingly. Because I want to starve any cancer cells that may be entertaining thoughts of reforming. I don’t want any uprisings on my watch.
I may take that shot willingly, but I still complain about it. I get it in my left arm, and the bruise from the previous shot, 3 months ago, is always still visible. For several weeks, I will have a hard little knot at the injection site. My arm will be sore for the rest of the day after I get the shot, but then life goes on and it’s business as usual, for the next 3 months.
But yesterday, I made a BIG mistake when getting the shot. I glanced over my shoulder as the nurse was getting ready to inject it. I saw that big-ass needle, glinting in the florescent lights, looking as menacing as an inaninate object can.
Oh, I wish I hadn’t seen that. Somehow the visual reality makes it so much worse. I had to grit my teeth and concentrate on not yelling.
I usually console myself with a beer or a glass of wine on shot days. But yesterday, I was trying to dry out from our Napa trip, so I tried to refrain. I didn’t get very far, and ended up with a Pinot Noir in my glass. But now I’m back to drying out, because I was reading one of my favorite blogs today, and misread one of the lines. It describes waking up and “waiting for the new day to open like a spring margarita.” Oh, wait–it’s
“spring magnolia.” Oops. Guess I’d better get on the wagon, sore arm and all.
A word about menopause
Posted: October 11, 2010 Filed under: menopause | Tags: age spots, breast cancer, cancer battle, ER postivie, estrogen, hormone suppression, hospital, hot flash, Lupron, meno, ovaries, Scrabble, SERM, surgery, tamoxifen, weight gain, world domination 10 CommentsIf you’re a guy, you might not want to read this because it’s, well, about menopause. If you’re a gal who’s not yet experienced the joys of menopause, you might not want to read this because it will scare you. A lot. If you’re brave enough to venture forth, don’t say I didn’t warn you.
Because my cancer was fed by estrogen, after we got rid of the cancer we also had to remove its fuel source, to discourage it from coming back. Hence the stoppage of estrogen. The most direct way to stop the estrogen is to remove one’s ovaries in a lovely procedure called oovectomy (which would also be a seriously high-scoring Scrabble word). If you’re still fighting a wily infection, like me, being cut open in a hospital of all places is a pretty risky move. Especially since the hospital seems the most likely culprit in the age-old question of “How the Hell Do You Even Get an Infection Like That?” While it’s unlikely that my infection would travel from the chest wall to the nether-regions, that’s a chance I don’t want to take, and frankly the idea of another hospital stay gives me the vapors.
Since I’m not ready for the oovectomy, I get the next-best option of hormone suppression, which is a shot of Lupron every 3 months, and a daily dose of Tamoxifen, which is a SERM (selective estrogen receptor modulator) drug. The latter half of that acronym makes me think of something coming out of the Johnson Space Center instead of a prescription bottle from Walgreens, and talk about some great Scrabble words. Build one of those on a triple word spot and you’re damn close to world domination.
So I’m going along in my cancer journey, minding my own business, doing all the things I’m supposed to do, no matter how unpleasant, and yes it’s really good news that the cancer is gone and the infection is on its last legs, too, but do I really have to deal with menopause, too? That just seems mean. You’re seriously going to tell me that battling both cancer and a nasty infection doesn’t exempt one from the hell of menopause? Mean.
I foolishly thought I’d have another decade before having to face the evil triumvirate of menopause: hot flashes, age spots, and weight gain. Even more foolish was the idea that, compared to cancer, menopause would be easy. Silly me.
Living in Houston, land of eternal summer, during hot-flash season, is a challenge. Come to think of it, neither Houston nor hot flashes have a season, so it’s game on, all the time. Local ladies, if you have any remedies for this please pass them on. I have yet to come across a mobile AC unit. I’d be waiting on the doorstep of Radio Shack to purchase said item and would wear it proudly, if only it existed.
So as I’m mopping my sweaty brow after one particularly potent hot flash, I notice some brown spots on my face. Little specs, bigger than freckles but not as big as liver spots. I tried to pick one off, wipe it away, flick it somewhere, anywhere, to no avail. These babies are staying. There’s a constellation near my left eye, and a nice fat one on the inside corner of my right eye. There’s a trio on my forehead, a few singles lingering on my jawline, and God knows where else that I’ve been too busy fighing cancer to really notice up close. Thank you to all my friends for not pointing them out to me. I know you’ve noticed, but were too charitable to tell me I was growing a connect-the-dot game on my face. And there’s a travel version of this game growing on my hands. I’m aging quite visibly as we speak. Thanks, cancer. You bastard.
While the hot flashes are unpleasant and age spots are depressing, the weight gain is really making me mad. I hope there is a special corner of Hell for whoever came up with the hair-brained idea that women will not only lose their breasts but also face scary treatments, complications and all manner of pain & suffering and then gain weight too? That is one messed up system.
The Pink Underbelly 