Archive | May, 2009

I walked a mile in my own shoes today.

31 May

Not that I would walk in anyone else’s shoes . . . but I was glad to get back out there and get at least a little bit of exercise.

Exercise is really key for my treatment. All the research bears this out. In fact, women with breast cancer who maintain a low fat diet and a regular exercise routine decrease their chance of recurrence by 25%. And, women who exercise during chemotherapy dramatically decrease their chances of getting anemia (this is what can cause pretty severe fatigue in chemo patients).

I hope to also get to the gym today if I can. I have to first get ready for my next chemo which is this coming Thursday, June 4th.  So today will be about cleaning up my house, arranging for care takers (as I can’t be alone during the three or four days after chemo). And I need to shop for the right foods that I need during those days as well.  So that is my Sunday.

I am on my way right now to see my brother, sister-in-law and my 9 month old nephew for a late breakfast at blackboard bistro in Seal Beach.  It will be nice to see them.  Then it is back to my chores. 🙂

Making the most of the weekend

31 May

My next chemo is scheduled for Thursday, June 4th. So, I am trying to make the most of this weekend (I always feel my best the weekend before chemo simply because I am further away from the last chemo). This week will be a busy one, lots of work to get done before Thursday. Today though, I got to see lots of friends which was great. I played miniature golf with three girlfriends today. And, this evening went out with another girlfriend to a movie. It was great to spend time with friends and to get out.

My only regret for the day is that I didn’t exercise – shame on me!  I know that exercise is playing a major role in my getting well so I really can not afford to skip it. So, tomorrow I will do it first thing in the morning. And, since my white blood count is good, I think I will go ahead and make a trip to the gym too (not supposed to do that if my counts are low because of the risk of getting sick).  But, I am doing well so no excuses. I just have to do it.

My red blood count was gradually getting lower with the first two chemos and was below the normal range. This would not be a good trend and would lead to anemia if it were to continue. But, as I have stepped up my exercise, my red blood cell count has gone up. Just one week after my last chemo (my third chemo), my red blood count was back within the normal range. I think this is unusual. In any case, it is definitely a good thing.

So exercise, the gym, cleaning my house and getting ready for the next chemo round, that’s tomorrow’s plan. Oh, and also just relaxing and being happy about the great MRI results! Still smiling about that 🙂


30 May

I had my second breast MRI today.  I wasn’t expecting the results until Monday or Tuesday. But, my surgeon called me and told me that the MRI shows that my cancer is shrinking and that I am responding well to the treatment.  This means that I am now half way done with the chemotherapy.  At least as far as we know.  Chemo comes in many different cocktails, they combine what they think will work best with your cancer.  But, sometimes, the first choice doesn’t work and then you have to try something else – which means more chemo rounds.

So I am really relieved.  I have three more treatments to go.  Then surgery.  Monday my surgeon and my oncologist will discuss my case and make recommendations as to when I should have surgery.  But, all is truly going well.

Thank you to everyone for your prayers and support!  Please keep praying for me as I am not through this yet, but it is so great to have some good news!

MRI Tomorrow

29 May

Tomorrow I am having my second breast MRI. I am nervous about it as it will tell us whether the chemotherapy I am getting is working. Kind of a scary thought to think that it might not be. So, say some prayers, send some good thoughts out my way tomorrow. I will have the MRI tomorrow morning. I will get the results on Monday or Tuesday.

My next chemo round is scheduled for June 4th. But, I don’t know if I will be having that round or not yet – not until we get the results of the MRI. If the cancer is shrinking, then I will keep going with the chemo (having three more rounds, each every 21 days). I hope this is what I get to do. Well, because that means that everything is working well and I am responding well to the treatment.

As far as how I am feeling – other than being nervous for tomorrow and the results next week – I am feeling really pretty good. I walked a mile this morning (try to do that everyday now).  And, I have been able to work a lot since my third chemo (not something that I was able to pull off after the first two really).

The weird thing is that while I can do many things, there are little things that I can not – like open a water bottle, or most any screw top, or grasp certain things, or use a can opener. Another example, I can’t put sheets on my bed – the bottom sheet is impossible for me to get on. I don’t have this problem every day, just some. It starts right after the chemo and lasts a week or two. But, it gets increasingly better the further out I get from the last chemo round. It is just weird. The good thing is that it is temporary.

Well, hopefully the MRI brings good news!

Another Herceptin Treatment done

29 May

Today was my every Thursday Heceptin treatment.  My very good friend Sandy took me today and stayed with me during the treatment (thank you so much Sandy). The treatment went fine. Although I didn’t have my regular nurse – the one who knows how sensitive I am to the treatments and takes such good care to keep me upright – as in breathing – breathing is such a good thing 🙂

For whatever reason, I am pretty sensitive to both the chemo and to the Herceptin.  It seems partly due to the rate of infusion – how many CCs per hour are administered. Most patients can tolerate 550 to 600 ccs per hour.  Me, I start out at  about 50 and then they build me up slowly to about 300.  Any higher and I start to have pretty bad reactions.  So, that is just the way my body is I guess.  That means my treatments take twice as long and the nurses can’t leave until I am done.  I am sure they just love me.

Anyway, it went fine today (in spite of the fact that I didn’t have the nurse that I love — Dawn – she is so great).  When Dawn is not there, I have learned that I have to insist that things be done a certain way – otherwise, they (the nurses) do what they normally do and well, for me, it just doesn’t work too well.

But, that is part of why it is so helpful to have someone with me because if symptoms do arise they can get the nurse quickly.

My second chemo (this was on April 23rd) was a near disaster.  I had been told the wrong pre-medications to take the day preceding chemo (having the right medications the day before is really critical for any chemotherapy patient, but is particularly critical for someone who has any higher sensitivity to the chemo.  I am pretty allergic to one of the drugs that I get in chemo, it is called Taxotere and it is pretty nasty stuff. But, with the right pre-medications and monitoring, I can tolerate it).

But, on the second chemo I was given the wrong pre-medications (I think I was confused with another patient – this was while under the care of my former oncologist, the one I fired).  As a result, I went into anaphylactic shock during the Taxotere infusion.  I could not breathe at all, it was absoloutely horrifying. But, the nurses (Dawn in particular) acted really fast. Also, I was fortunate enough to have someone walk by at the exact right moment – she is the daughter of one of my fellow breast cancer patients.  Her name is Lisa and she just happens to be a cancer nurse and was there visiting her mom.

She saw me gasping for air and that I was apparently bright red – so she ran and got the nurses and I was taken care of.  I don’t even want to think about what would have happened if she had not walked in at that exact moment.  With anaphylactic shock your body just shuts down, first your respiratory system, then your arteries and organs. It’s painful and well, just not a good thing.  The very maddening thing about it (although I just don’t focus on being mad much) is that it was completely avoidable.  It should not have happened. The doctor made a mistake, a big one.

I will deal with him at some point simply because I can’t let this happen to someone else.

I recovered completely from this, but not without first having to go to the hospital.  My hospital trip was during the very beginning of the whole swine flu thing – so they were pretty crazy about my wearing a mask and keeping me isolated in case my immune system was compromised by the chemo.

It all worked out. I am so glad that I switched oncologists and so glad that the third chemotherapy round (which was under my new oncologist’s care) went so well.  What a relief. So things are going much better now.

Finally got some sleep!

27 May

Nothing really new to report. Everything is Good. Today I am feeling good.  Didn’t get enough water in the last few days – somehow lost track of that – which lead to headaches and who knows, maybe was part of the reason I am “overheating” so much at night.  There’s so much to remember to do to stay feeling upright – water, water, water and food every hour or so.  I have lost weight, but am at a healthy weight.  With the first chemo I lost about 6 pounds, then gained two more in between the first and the second chemo. Then I lost another 5 pounds with my second chemo. So, I started to panic a bit, because at that rate, by the end of treatment I would definitely be too thin.

But, since I changed oncologists (the best thing I ever did) I have been able to keep my appetite up during the chemo aftermath.  His approach to managing the chemo symptoms is much better and as a result my third chemo was just dramatically better than the first two.  I hope the rest continue with that same control over the symptoms, that would be great.

Anyway, I am at a healthy weight and glad that I did not lose any weight with the third chemo.

I have a Herceptin treatment tomorrow (have this every week on Thursdays). I have some very good friends who take me to and from (you know who you are).  I am so grateful for that help.  It is a bit frustrating that I can’t drive myself to and from these treatments – other women do.  But, for some reason, I am unable to tolerate the Herceptin without being first doped up on quite a bit of benadryl. It isn’t such a bad feeling really – unless of course you had any plans of doing anything like reading or any work – some people actually do this while they are getting treatments.  Oh, but not me, nope. I am practically passed out while I get the infusions – the benadryl definitely makes for a good night’s sleep on those days – so that is the bright side. Anyway, thank you so much for driving me you guys.  It makes such a difference.

Well, that’s about it for today . . . but wait, there is more, a very good friend of mine called and took me out to lunch today.  It was great to be out and to catch up.  Thank you GL!

It’s back to work now.

My Fortune Cookie: "Knowledge is Power"

27 May

That’s what my fortune cookie said today – “knowledge is power”. Not bad.

I went to a support group for women with breast cancer today. It was very helpful. I learned a lot about the different options, met women who have been through what I am going to have to go through and was even able to see the results of two different types of breast reconstruction. There is so much to know. But, I am getting through it and I do kind of believe in my fortune cookie . . . I just wish the lotto numbers on the back would work.

I am tired, but I am not getting much sleep. Today I called my doctor to ask about that – they can always give me yet another drug to take to help with that. But, I prefer to put as little as I can into my system. It’s just one more thing my liver has to process. Still, sleep would be nice.

The reason I don’t sleep is because I get incredibly hot at night. It is so uncomfortable. I can have my air conditioning blasting cold air and yet, my skin is so hot. It is really quite annoying.

But, when I spoke with the physician’s assistant today, she said it is pretty normal. And, MJ, my guardian angel, mentor, counselor extraordinaire (she has gone through breast cancer and has been helping me through mine) told me that it is definitely part of the package (the chemo package). And, I guess it is temporary, hopefully.

Somehow knowing that it is just part of the deal makes it easier . . . of course I have tonight yet to get through and I am warming up as I write. It is such a strange sensation really. It lasts for hours and hours and just doesn’t really go away until the light of day. While I do sometimes get warm during the day, it just isn’t the same as the night time.

Well, it is nearly nine pm, so I am going to take this hot bod out for a walk and try to cool off.

Treatment Plan

26 May

Well, this is the crummy part.  I can not sleep.  It is three in the morning and I still can’t get any sleep.  Last night was the same, so I am going on two days without more than an hour or two of sleep.  And I was doing so well there for a while.

I will get back on track.  Hopefully tomorrow will be better.

So, since I am still awake, I might as well write.

Treatment Plan: So here is the treatment plan that I was given.  I am to have a total of six chemotherapy rounds.  In addition to the chemo, I am also on a targeted therapy called Herceptin.  Herceptin works on HER2+ cancer (the kind I have).  It is an amazing drug and I am so grateful that Dr. Slamon at UCLA developed it.  He has saved the lives of so many women, curing a type of breast cancer that once was really not curable. The chemo will be followed by surgery and then, most likely radiation. Reconstruction will fit in there somewhere – but, I am still doing research, interviewing plastic surgeons and learning about the different reconstruction options (especially given the likelihood that I will have radiation as part of my treatment).

Neo-adjuvant Treatment: When chemo is given prior to surgery it is called neo-adjuvant.  In some cases chemotherapy precedes surgery in order to shrink the cancer so that surgery can even be done.  That is not the case with me.  My tumors are small and as a result I could have surgery at any time.  However, the reason to do neo-adjuvant chemotherapy in my case is to see if we can watch the cancer shrink.

The advantage of doing chemotherapy prior to surgery is that we can watch and see that the chemotherapy is actually working.  If I were to have surgery first, followed by chemotherapy later, then there would really be no way of knowing if the chemotherapy was effective with my cancer because we could not watch it shrink during chemo since it would already be removed.

This is significant for me and was a major reason why I chose to do the chemotherapy first. Everyone responds differently to treatment. And while it is more likely that the chemotherapy will work, I will have a greater peace of mind if I can know for sure.

For me it is all about making sure that I do everything I can to fight this disease now, stop it in its tracks and prevent it from coming back.  If we can watch the cancer shrink, then we know that the chemo is working on my cancer and that it is then also killing the microscopic cancer cells that are floating around in my body (that without successful treatment, would come back).  The kind of cancer I have – invasive breast cancer, that is HER2+, has a very high reoccurrence rate.  That is why the treatment is so aggressive even though my tumors are very small.  By adding radiation to my treatment plan, I can further reduce the chance of having a reoccurrence.

The other possible (hopeful advantage of having chemotherapy first is that I could have what they call a “complete response”.  About 40% of women with the kind of cancer that I have, who undergo the kind of neo-adjuvant therapy that I am doing, experience a what is called a “complete response” – meaning that prior to surgery the cancer is eliminated.

If there is a complete response, then when I have surgery the surgeon is removing dead cancer.  This would be best. It doesn’t change the need for surgery. But, it makes the surgery easier because there is no risk of infecting healthy breast tissue with cancer because the cancer is dead.  So, that is what we are hoping for.

I am nervous about the upcoming breast MRI. The specialist I met with at UCLA said she would not do one until I was done with all six chemotherapy rounds. She said that she would not interrupt the chemotherapy. When I asked her what if I was not one of the 40% that has a complete response prior to surgery, she said “You’ll be on Herceptin for a year, what are you worried about?”  Um, dying . . . that’s what I am worried about.

It was good to hear that she was so confident. But, unfortunately I don’t get that kind of reassurance from my actual team.  Instead, I am told that I have a good prognosis. But, I am also told that the kind of cancer I have has the highest reoccurrence rate.  I am also told that some patients come back with brain cancer.  It’s not all rosy sounding.  Well, okay, none of it is actually.  But, I cope and I am grateful, so grateful that there is a drug that targets the kind of cancer that I have. Not all women respond to the treatment, but hopefully I will.

My Own Treatment Plan: In addition to the treatment plan that my oncologist and surgeon have put together, I have also put together my own “treatment plan” that includes a very changed diet and as much exercise as I can.

From the moment I was diagnosed I changed my diet. I considered myself pretty healthy before, even was a vegetarian for a number of years (although not most recently). But, after being diagnosed with breast cancer, I immediately changed my diet.  I knew that my cancer was hormone responsive – meaning that in the presence of hormones, my cancer flourishes apparently.  So, I decided to eliminate sources of hormones in my diet.  I had also heard that sugar feeds cancer.  I got a lot of information in the beginning (some of it pretty wacky) that made me pretty crazy.  But, after doing a lot of my own research I chose to make changes that to me make sense.

I don’t know about whether sugar feeds cancer or not.  But, I don’t get a lot of sugar anyway, so that wasn’t a big issue for me.

I have eliminated all dairy products and all meat except for some chicken and fish.  Because my cancer grows with hormones, I have chosen not to get any (at least as little as possible) in my diet.  I was told to avoid soy for the same reason because it is a plant based estrogen and would only encourage the growth of my cancer.

I have gone to a nearly completely organic diet.  I do go out to eat and enjoy that still. But, I make choices that are lower in risk – for example potatoes are very high on the pesticide index – so these are pretty bad unless organic.  But, broccoli, avocado and other vegetables and fruits are on the low end of the pesticide index and so are pretty safe to eat even if not organic.

No doctor has told me that I need to go organic.  But, for me it makes sense.  And, my doctors can’t believe how well I am doing – my white blood count has never left a normal range (normal, as in a normal person who is not going through chemotherapy) and my red blood count (something that typically gets low, causing anemia and pretty bad fatigue in chemo patients) is also within normal range.  I think this is due to my diet and exercise (maybe more from the exercise, I don’t know).  All I know is that so far, I am doing really well with the treatments (except of course for the time my first oncologist – who has since been fired – tried to kill me . . . I will save that for another separate post).

I have also eliminated caffeine.  I was told that caffeine was okay.  But, it is not.  I stopped having coffee months ago. But, only just yesterday found out that the drug Herceptin does not interact well with caffeine – that caffeine reduces the effectiveness of Herceptin. This was in a study, not even all that recent.  Yet, my doctors were not aware of this at all.  Amazing. There must be so much to keep track of I guess, especially if you are a doctor treating many different types of cancers.

Still, I am just so glad that I had eliminated caffeine. I would have been devastated to learn that caffeine reduces the effectiveness of Herceptin if I were still drinking coffee. I wish I could tell every woman that is getting Herceptin treatments about the bad interaction with caffeine.

In addition to diet, I have begun an exercise plan too.  Recent studies show that exercise during chemotherapy increases T cells and reduces the rate of anemia (caused by a reduction in red blood cells).  70% of chemotherapy patients get anemia.  But, for some reason those that exercise regularly throughout their treatment, have a lower rate of anemia. So, I am trying to prevent anemia by getting as much exercise as I can.

Obviously some days are simply not an option. But, I try to get in a one mile walk every day.  I was able to keep that up this past week. I plan on going to the gym next week (after the MRI and before my next chemo on June 4th). Assuming, of course, that the MRI results are good and that I am then still going ahead with the fourth chemo round.

Well, I think I have had enough, it is 3:40 am.  Maybe now I will be able to get some sleep.

Feeling Good

26 May

It is Tuesday and I am feeling pretty good.  I need to get a handle on getting sleep.  But, otherwise I am doing well.  I will have another breast MRI this week. The MRI will tell whether the chemotherapy is working or not.  In all likelihood, everything is going well. But, my doctors want to make sure that the chemotherapy is working on my cancer.  I decided to schedule the MRI for this coming Friday. (I have had too many test results come back on a Friday – starting from my diagnosis). So, I decided to avoid that by having the MRI on a Friday. I should get my results from the breast MRI early next week and I will then know whether the chemo cocktail that I am getting is effective.

Here’s hoping for good news!