I am a Taurus, and You?

I had another ultrasound today. Dr. P is using the ultrasounds as a way a gauging the effectiveness of the chemo in reducing the size of the tumor. Today's results showed no change in size since the last ultrasound three weeks ago. This actually surprised me a little bit because I can definitely tell a difference, and my intuition is telling me the cancer is dead. It is harder to feel a solid mass now than it did several weeks ago. Delores, the ultrasound tech today, and the one who has been with me since this saga began on May 15, did confirm that the tumor is less defined now and that some of the tissue may be necrotic. It is impossible to tell without another biopsy, and at this point, they will just wait until the surgery to biopsy the tissue. I did not walk out discouraged. Again, the good news is that the tumor is not increasing in size. Also, it did take a couple months for the Adriomycin/Cytoxin to kick in, so it may take a couple of months for the Taxotere to work its magic as well.

I headed over to Dr. P's office for my weekly needle jab, I mean, lab work. You know how I feel about the $7,000 Neulasta shot, but man, does that stuff work! The house is still a mess, and we had to take the car to the dealership to get the oil changed, but my white blood count was fully restored. I asked to speak to Gloria. I start to miss her twisted sense of humor if I don't see her at least once a week. I shared the results of the ultrasound with her and asked her to please let Dr. P know that I wasn't concerned, as I can tell the tumor is changing/responding. If Dr. P was concerned, however, I asked that I be notified that mine was a false sense of security and that I needed to adjust accordingly. She agreed to tell Dr. P and to have Dr. P call me in the event that the results needed to be discussed in any detail. I didn't hear from Dr. P today.

Bo, after waiting over a week, finally has an appointment scheduled with the urologist on September 11. Although Dr. S wanted Bo to have an ultrasound, the urologist wants to examine Bo first to determine if Bo actually needs an ultrasound or not...

We had Lance at the doctor's office yesterday. He has a prominent swollen lymph node in his neck. It has been swollen for months, and when we had him checked out last week during his three year old check up, Dr. G said it wasn't anything to be concerned about. (Yes, I know he turned three over two months ago, but the corresponding annual exam slipped our minds at the time.) Well, this past weekend, we found another lump behind his ear. Anyway, I am not a worrier by nature, even with my kids, but I have always insisted on having lumps checked out.

This time we saw Dr. A, a new addition to the group of pediatricians we use. She checked out the lump behind Lance's ear and said it was also a swollen lymph node. (I didn't even know we had lymph nodes back there.) She also found swollen lymph nodes in his groin area. She said he appears to be fighting some type of infection as the nodes feel reactively swollen. She said if it would make me feel better, she could order blood work. I asked what she would be testing for with the blood work, and she emitted medical jargon for the next 2o seconds. Once she reverted to English again, she recommended that we wait a week or two and if the lymph nodes didn't shrink that we do the blood work at that time. If I would sleep better though, she was happy to order the blood work but she had interned in hemo/onc and she really didn't think it was leukemia. Whoa - who said anything about leukemia? That thought had never crossed my mind until she mentioned it, and now that she had, maybe sleep would be elusive...

Actually, I honestly believe Lance may just be a lumpy kid. My motherly intuition is telling me that nothing is wrong with him, and I am comfortable waiting a week or two. I wondered, however, about my husband, aka, Mr. Worrier, (and I say that with complete affection - one of us has to worry about things or our relationship wouldn't work as well as it does). I made an executive decision that he wouldn't mind waiting a week either - especiallly if he didn't know about it! Then I promptly went out to where he was waiting in the van with Cole and Clay and told him what the doctor had said. (Communication - another component of a healthy relationship.) The information caused Bo a few moments of anxiety, but I think he knows intuitively that Lance is fine too. It's just that now we have added yet one more family member to the medical limbo club. Hopefully Lance's membership, and Bo's as well, will be short in duration, and I will once again have the distinction of exclusive membership.

I really liked Dr. A, but she appeared young, and I got the impression she had just been released from the halls of academia to practice medicine. One clue: After a few minutes of discussing Lance she casually asked me, "What's your malignancy?" She said this in the same way you might ask, "So, what's your sign?" Maybe that's how they talk in hemo/onc. I wasn't offended. It takes a lot to offend me, and besides I know she was just curious. I can honestly say I have never been asked that question before, and I doubt I will be asked again - especially once my hair returns to its rightful places!

Bo's Update and More About Me, Too

Bo went to his doctor on Tuesday to discuss the results of his blood tests. All the tests results were fine except his testororone level was low. (That's what being a stay-at-home Dad for seven years does to you!) One of the causes of gynecomastia is hormonal fluctuations, but Dr. S isn't sure what is causing the fluctuations. There are some other issues going on as well, but I will spare you all the sordid details. I am sure Bo will also appreciate not having his sensitive health matters exposed to the world, so to speak. Next steps for Bo: an appointment with a urologist in which couldn't be scheduled until the middle of September and an ultrasound to rule out testicular cancer (a highly remote possibility). Thanks to everyone who called to check in on Bo and see how his visit went. He was quite relieved and will feel even better following the appointment with the urologist.

I had my sixth chemo treatment yesterday, and I only have two more to go. Woo hoo! I am 75% of the way there. In six weeks, I will be done with these toxic, yet life saving chemical drips. I have another ultrasound scheduled for next Wednesday, and I am hopeful that the tumor continues to diminish in size. As has been the case all along, I feel great. My energy level is normal, and I have been able to maintain a strenuous exercise schedule. I have not experienced any nausea either. I am truly fortunate. I do believe I am suffering from chemo brain, however. I went to yoga tonight and forgot to bring my yoga mat in, so I had to go out to the car to get it. As I was driving home after class, I realized I had left the yoga mat on the floor. Oh well. It's better than throwing up!

My son, Clay, the six year old, I am certain is destined for a career in drama (or a life of drama - one or the other!). I say that for a number of reasons including his active imagination, his creativity, his theatrical tendencies, his sensitivity, and his very loud voice which projects for miles. We were in Walmart shopping in the meat section one day when he bellowed in a voice made for the stage, "Mom, do you still have breast cancer?" Out of the mouths of babes... "Yes, honey, I still have breast cancer, but I am going to be just fine," I responded in my usual, soft-spoken voice. I didn't look around to see who witnessed this exchange, not that it mattered to me, but I didn't want anyone to feel awkward.

It didn't dawn on me until weeks later that if I had had the surgery first, I would have been able to answer that question differently. If I had had the surgery first, I could say that I had cancer and was now just receiving treatment to ensure it doesn't return. By having the chemo first, I still have cancer and will until the day of the surgery. Remember I said I would be celebrating on October 4, the day of my last chemo treatment? An even bigger celebration will occur when I awaken from the surgery and know that the tumor is gone. Then I can say that I had cancer.

Yesterday I asked Gloria, my oncology nurse and now good buddy, when the surgery would be scheduled, and she said it varies by surgeon, but it is usually anywhere from three to six weeks after the completion of chemo and is dependent on the blood counts. My preference is for the three week timeframe, so I will have to have a conversation with Dr. H about this. My preference should count for something!

I had to go back by the oncologist's office today for a shot of Neulasta since my white blood count last time didn't recover as quickly without it as was desired, and they want to keep me on schedule for treatments. Now that I know how much the shots cost, I feel that they should make the earth move under my feet, clean my house, and change the oil in my car, at a minimum. Alas, it just hurt going in as usual. I guess I will have to settle on just a speedier increased white blood count.

The Great Getaways

We were only gone for three days and two nights, but our little mini vacation was enjoyed by all. We stayed at the Virginia Beach oceanfront, and while the beach stretched for miles, the boys preferred the indoor pool at the hotel. That worked out well since I am supposed to avoid the sun while undergoing chemotherapy anyway. We also took the boys on a pirate cruise where they dressed up as pirates, fought Pirate Pete with water cannons, searched for treasure, and drank grog. We visited the Virginia Aquarium and saw an IMAX movie about the deep sea. The boys would have preferred to have seen Superman Returns, but unfortunately (?) there were no showings scheduled in the IMAX theater that day. I began training for next year's Pan Mass Challenge! I got in my first "official" training miles - six of them. We rented one of those family bikes and rode along the boardwalk, and Bo and I pedaled while Cole, Clay, and Lance fussed about who got to sit in the middle. It was a really nice getaway that I think we all needed, and I am glad we were able to squeeze it in before school starts in two weeks.

There's not much news on the cancer front. I have been watching my appearance undergo another transformation as my eyelashes and eyebrows fall out. I was hoping to have dodged that bullet, but no such luck. I am not sure if it is the cumulative effects of the chemo treatments or if the taxotere is removing the hair the adriamycin/cytoxin cocktail didn't. When I lost my hair, it all came out in one week, and what was left after that week, hung on - literally. (I have noticed that since the Taxotere though, my almost bare head is comes a little closer to approaching totally bare each day, but we're not quite there yet.) I was hoping the same thing would happen with my eyelashes and eyebrows - that whatever was going to fall out would make its departure within a week and that the rest would have the good graces to keep me company until the others returned. Each day, however, I lose more and more. My normally full, thick eyebrows are thinning rapidly, and I sense an eyebrow pencil in my near future. Between both eyes, I have about 18 little lashes left between the top and bottom, but their days are most likely numbered.

To commemorate my absent hair, eyelashes, and eye brows during their getaway, I have come up with the following advantages of having none of the above:

I save money on:
shampoo,
conditioner,
styling products,
hair cuts,
hair color,
hair accessories,
mascara, and
eyebrow gel.

I no longer have to worry about getting eyelashes stuck in my eyes.

I no longer have to pluck my eyebrows, and sprouting a uni-brow is a total impossibility now.

There is nothing blocking the view to my green eyes.

I no longer have to sweep up pounds of hair off the floor every week as was the case when I was endowed with a full head of hair. (Actually, I never did sweep it up, Bo does the sweeping.)

I no longer have to scoop the pounds of hair out of the shower drain each day as was the case when I was fully endowed. (Actually, I did do this chore myself.)

I no longer have to wonder whether to buy black mascara, brown mascara or brown/black mascara. Blue was never a consideration for me.

I don't have bad hair days.

I don't have to wash that gray right out of my hair anymore.

I get great scalp massages each morning in the shower - there is no hair in the way to block the streams of water.

I get to wear lots of cool hats.

I am sure I could come up with more advantages, but that's enough to keep me going until the hair, eyelashes, and eyebrows make their joyful return to my eagerly awaiting head.

Ever Wondered How Much a Shot of Neulasta Costs?

The blood test and the shot I received this morning are the only medical procedures scheduled for the week. Gloria asked if my mouth was feeling better, and did the mouthwash help? Oops. I forgot to pick up the prescription, but I told her I was back to eating salsa without any discomfort. The thought of suspending my salsa consumption never crossed my mind. For me, it is one of the primary food groups. Also, I seem to be craving it more than usual, and since tomatos are loaded with all kinds of healthy substances, my body may be telling me something. Who am I not to listen?

My white blood count is still very low, even though it has been two weeks since my chemo. It is higher than last week but still quite a bit shy of what it needs to be to receive chemo next Wednesday. Not to worry. Gloria said we had two options: At the time of my treatment they can give me a shot that will boost the white blood count very quickly or they can adminster the chemo and then give me the shot of the Neulasta the following day knowing that the Neulasta will elevate the count.

If you will recall, when I was getting the Adriamycin and Cytoxin every two weeks, I received a shot of Neulasta 24 hours following the chemo to raise my white blood cell count before the next treatment. Since the Taxotere is given every three weeks, the thought is that my white blood cell count has a longer period of time to recover and that the Neulasta is not necessary - and it may not be necessary. We will know next week.

According to Gloria, Dr. P. was thinking because I am young (At 41 I don't hear that word used to describe me much these days, but I will take it!) that my blood count would recover quickly on its own. I asked Gloria if there were any natural methods I could use to raise it, and she said to eat white vegetables, like potatos. It was a joke.

Of course, as flattered as I am by her confidence in my youthful regenerative abilities, Dr. P's decision not to give me Neulasta may have nothing to do with my age at all. I received a bill from Dr. P's office last week. (The mailman delivers bills on a daily basis these days, and Bo has a few thrown in now too for variety.) It was four pages long, and I couldn't decipher it. It could be totally wrong, and I would have no way of knowing. One thing caught my attention, however, and I did call the billing office. "Hello, this is Mary Beth Gibson, and I was just reviewing my bill. I wanted to make sure that breast cancer isn't affecting my eyesight. I see a charge for one Neulasta shot, and it says that it costs $6892.00." "Yes, ma'am, that is correct." "You are sure the decimal is in the right place?" "Yes, ma'am." "There aren't extra numbers in that figure?" "No, ma'am." Whoa - thank God I have excellent health insurance, but what about all the people who don't?

Speaking of Bo, he has an appointment with his doctor next Tuesday morning. He called last week to find out the results of his blood work. They were running eight different tests. Dr. S said that some of the tests came back good and that she would discuss the results with him next week but that he shouldn't be concerned. Of course, he has been concerned ever since that conversation. "What does she mean by 'some of the tests?'" "Does that mean some of the tests haven't come back yet or that some of them came back bad?" I am hoping he gets some answers next Tuesday because his imagination comes up with possibilities that are probably far worse than the reality. Hmmm.... sounds familiar. Yes, I know, but it's different when I do it!

The family is headed to Virginia Beach tomorrow for three days and two nights of rest and relaxation. Okay, with three boys there may not be much R & R, but we will have big fun. The summer has really gotten away from me, and while I haven't been able to work full time, neither have I taken any vacation time. Since I am now my own boss, I gave myself a couple of days off.

Hats Galore

My sister-in-law, JoLynn, sure knows how to throw a party. This past Saturday was the day of the hat party. A few people told me that they had never heard of a hat party before. Well neither had I, and it is something I wouldn't have minded going a lifetime not having, but if you have breast cancer, you may as well have a party!

We had the gathering at my mother-in-law's place down on the Rapahannock River, close to the Chesapeake Bay. It is one of my favorite places in the world to go. During one of my hypnosis sessions, when Andi told me to imagine a place of peace and relaxation, the loveseat on Mama's screened in porch, is where my mind took me. Charlene, my other sister-in-law calls that loveseat my happy spot. It really is.

It was a beautiful day. Even though it is the middle of August, the savage heat of summer had retreated, at least for that day. Being on the river, we were caressed by a nice breeze as well. At one point, I actually had to borrow a sweater. Ann and Abbie, two of my Mom's friends (and mine too) who traveled from Blacksburg for the party, said that I looked so much like my Mom at that moment. (My Mom was always cold and was never without a sweater, until hot flashes entered her life.) I have noticed the same thing as I get older. I will catch glimpses of myself in the mirror and see my Mom looking back at me. I can't help but think it must be bittersweet for my Dad...

Guests were asked to bring a hat and wear a hat. Everyone looked so great in their hats. I don't know why we women don't wear them more often. I am having so much fun with them that even after my hair grows back, I plan to keep wearing them. (I have only worn a wig once, and it just looked and felt so unnatural to me that I went right back to the hats.) I do intend to donate some of the hats to the Hat Trader to loan to other women who are experiencing hair loss as the result of chemo.

After chowing down on the yummy munchies that JoLynn and Mama had prepared, and following the serving of the cake that was in the shape of hat, we all settled down on the screened in porch so I could open all of the gift bags containing hats, hats, and more hats. Most of the guests also gave me the hats they wore to the party. I was overwhelmed by it all.

As I opened the bags, I tried on each hat. The first time I bared my head for all to see was a little uncomfortable (for me), but I knew I was among friends and family who didn't care about my almost bald head. Afterall, that was why they were all there - to support me during this time. I never thought I would be so self-conscious about it, but I don't really think you can understand how traumatic it is to suddenly lose your hair until you actually experience it.

I received so many beautiful hats in many different styles and colors. The predominant color of the day was pink, in various shades and patterns. Some hats were made from fabric, others from straw, and still others from paper that looked kind of like fabric. My Dad had picked out a very attractive wool hat during his recent travels throughout Nova Scotia that will be perfect when the weather gets cold. (By my estimates, I probably won't have a full head of hair again until late winter, maybe February or so...) The hat was from him and his signficant other, Laura, but because no men apparently wanted to endure the hat party, Laura brought the hat over by herself. (Mama sent her husband, Richard, upstairs to his room for the party, but I am sure he would have retreated there on his own had he not been banished.) I also received some scarves and maybe someone can help this fashion-challenged woman figure out what do do with them. Volunteers, anyone?

In addition to the more sophisticated hats, I received baseball caps in every color of the rainbow. Some were plain, a couple had fancy monograms, and one was even adorned with a huge plastic crib hunched on the bill with springy legs clicking away. (This was not indicative of my disposition but rather a reflection of this region which is known for its crabs). Charlene, who knows every one within a fify mile radius of the area, had collected caps from many of the local establishments, including J & W Seafood, and the Sandy Bottom Market and McCauley's Welding. (As I was cleaning up the house earlier that morning, I was trying to figure out what to do with all of the boy's caps, including, Bo's. I was thinking we may have to get rid of some of them. Now we definitely have to get rid of theirs - to make room for mine. I have more caps than the four of them combined!)

I was so touched by the effort that Bo's family (and now mine) put into the party, the generosity of all of the partygoers, and the love and support I continue to receive from everyone who was there and everyone who would have been there if they could have been. After all the hats were packed back into their bags, I told everyone how much fun I had, what a great party it was, and that I hoped that I, nor they, ever had to attend a hat party again! That being said, I would do the same thing for any friend or family member who had to undergo chemo. It was a special day.

Abbie and Ann came home with me and spent the night before returning to Blacksburg on Sunday. Abbie had breast cancer 17 years ago. She was diagnosed at 45, and her situation was similar to mine. She is an inspiration, and I really enjoyed the opportunity to talk to her about her experiences. It helps me to talk to long-term survivors since my closest experience to breast cancer is my mother's, and my mind can't help but visit that place occasionally, even though I refuse to have her outcome.

I happened to receive a PMC care package from my cousin, Kathy, that day, and it contained, of all things, a fluorescent, lime green Pan Mass Challenge baseball cap. The one color of the rainbow I was missing... While I haven't spoken to her since last weekend, she obviously survived her 90 mile bike ride to raise money for cancer research. She had called me the night prior to the ride to let me know that she would be thinking of me during the ride. I will have to check in and see how her fundraising is going.

If anyone needs to borrow a hat... I am your lady!

Confirmation

I was back at the Women's Imaging Center this morning with ultrasound films in hand. Of all the procedures I have experienced in the last few months, ultrasound has become my favorite because it is the least invasive procedure and involves no noisy or claustrophia invoking machines, sharp instruments, consumption of mysterious and nasty tasting cocktails, radioactivity, or side effects. Also, the results are available immediately. What more could you want in a medical procedure?

After the ultrasound tech took the measurements, she printed off the films and brought them to the radiologist on duty. Dr. D wasn't in today, and I had never met the other doctor before. He popped into the room long enough to share the results. On May 15, the day of the original ultrasound and the day I first heard I had cancer, the larger mass measured 3.5 centimeters. Today, that same mass measured 2.6 centimeters. The tenacious entity isn't as tenacious as I am! If the MRI is to be believed, that means the tumor has done all of its shrinking in the last two weeks. Ultrasound certainly isn't as accurate as an MRI; nonetheless, there is now confirmation, beyond just physical touch, that the tumor is diminishing in size.

I felt relieved and happy as I left the Imaging Center and headed over to the oncologist's office for my lab work. Gloria, my oncology nurse took a peek at my mouth and speculated that the chemo is giving me a sore throat, thus, the salsa effect. I have no evidence of mouth sores. She called in a prescription for a mouth wash that should help. I told her that I don't really feel tired, but I think the chemo may be catching up with me a bit. When I was on the treadmill yesterday, I was able to do my 45 minute workout, but it wasn't at my usual intensity. She said that the effects of the chemo are cumulative, so with each treatment, I may experience more side effects. Good thing I only have three left! My last one is October 4, and you all will be able to hear me celebrating all the way from Williamsburg!! Not that the chemo has been terrible for me. I have been very fortunate in that respect, but it will be one stage of the process I will be glad to have behind me so I can move on to the next, and be that much closer to cured.

My white blood counts were low, so Gloria told me to be aware of my weakened immune system and to take the appropriate precautions. She said that Dr. P did not want me on the Neulasta since my treatments are three weeks apart now, and the counts should recover in time for my next treatment.

After completing my medical appointments for the day, I headed over to Busch Gardens to meet up with Bo and the boys, his sister, JoLynn and her husband, Eric, and a friend, Marcie, and her young daughter, Casey. It was a beautiful day and was only in the 8os, compared to the triple digits we have been experiencing. Of course, that meant many other people wanted to enjoy the park as well, so it was very crowded. For me, it was a nice change from the usual work and/or medical appointments that have filled my days this summer.

The Second Opinion

Well, I guess the effects of chemo brain were demonstrated this morning. I arrived promptly at the Women's Imaging Center for my 9:00 a.m. ultrasound, only to find out that I was a day early. Oops. They were going to squeeze me in anyway (one of the perks of being a regular), but then they realized that my previous ultrasound films were at MCV for my second opinion appointment, and so there would be no basis of comparison for today's films versus the original films. We agreed that I would bring the films home with me this afternoon and return in the morning for my actual appointment. It worked out fine because if I hadn't shown up unexpectedly this morning, I wouldn't have known to bring the films back with me. The universe moves in mysterious ways.

Bo and I dropped the kids off at two different friends' houses this afternoon to disperse the energy output of three boys to a manageable level for our friends. We may need to call on them again! Then we headed for Richmond, about 45 minutes away. The Medical College of Virginia is a research hospital and as such, it was far more impersonal and much more institutional than my own doctors' offices. Everyone was very professional and very kind and compassionate, but I kind of felt like I was waiting for my number to be called at the deli counter. I shared this observation with Bo later, and he said that he had the same feeling. I didn't see it, but he said one of the rooms in which we waited had a sign, "Patient, please take a number."

Dr. B, the surgeon, said that since Dr. P had called him about me so he was already familiar with my case before my information was presented at the the "tumor conference" earlier this morning. Many doctors use a tumor conference to bring the various disciplines together (surgeon, oncologist, pathologist, radiologist, and the radiation doctor) to review and discuss their patients and determine the best treatment options. My surgeon, Dr. H, also engages in this practice.

Dr. B actually conducted one of the leading studies on neo-adjuvent chemo (chemo before surgery), and he confirmed that there is no data to suggest that neo-adjuvent chemo versus chemo following surgery has an effect on survival rates. Because the chemo can frequently shrink the tumor, it is often used by women with inoperable tumors or women interested in breast conservation. I have always known I was deploying the big guns (mastectomy), and so breast conservation has never been an issue for me. I'll trade my breasts for my life any day without a second thought about it! He also said that neo-adjuvent chemo also 1) allows the doctors to gauge the effectiveness of the chemo (although I need to ask my oncologist the significance of this data point), 2) helps facilitate the surgery if the tumor does, in fact, shrink, and 3) may promote early menopause and thus, cut off the estrogen supply. He said since the tumor does now seem to be responding to the chemo, it makes sense to continue the Taxotere.

Dr. B measured the tumor and thought it was about 2 cm by 2 cm. This is not a very precise method, but nonetheless, encouraging. When I had my first appointment with Dr. H back in May, the measurement was about 4 cm by 3.5 cm. Some of that was undoubtably bruising and inflammation from the biopsy, but even so, it is smaller!!! He asked me if it felt softer (it does) and indicated that softening is usually the first sign of response.

He then asked me what I intended to do about the other breast. That's easy. I am having a bilateral mastectomy. Take 'em both, and I'll start from scratch. This time around I can pick the size, and maybe I'll even let Bo have some input... Actually, Bo said he'll support whatever decision I make about having one or both removed and about whether or not I choose to have reconstruction. He has always been more of a derrierre man anyway.

Seriously, after learning that my genetic test results were inconclusive and that I did have some type of mystery mutation, I knew a double mastectomy was the best course of action for me. Bo is also of the opinion that I should have both removed - he doesn't want to go through this again anymore than I do. Dr. B said he had just seen a study that found women without the known genetic markers but with a family history such as mine had a 40% chance of getting breast cancer in the second breast. So there you have it. He just confirmed my decision. If I opt for reconstruction, he recommended I postpone reconstruction until after radiation because 50% of implants are damaged by radiation and end up being replaced or that I go for the reconstruction that doesn't involve implants. I will deal with all that stuff when the time comes.

A medical oncologist also dropped in and spent a few minutes with me. He said that he and Dr. B had discussed my case at length earlier that day and that he felt that continuing on the Taxotere was appropriate, especially since I was tolerating chemo very well. Well, yes, I am tolerating it well, except for the salsa effect. He was actually a little surprised that I was having any issues with my mouth on Taxotere as it is much more common with the other chemo drugs. He suggested that I suck on ice chips during the next treatment, and that will help minimize the effects of the chemo on my mouth. (A former colleague at the Department of Social Services who had breast cancer several years ago had recommended this tip to me, so I will definitely try it. Until then, I am eating only mild salsa. Green Mountain Gringo is particular yummy!)

It was reassuring to hear from two other cancer specialists that my course of treatment is appropriate and consistent with current knowledge (with the caveat that treatment is not an exact science). It was confirmation that nothing has been missed, and I am good hands with Dr. P and Dr. H.

My Rollercoaster Update

The week kind of got away from me, so it is now Sunday evening, and we are preparing for a new week at the Gibson household. Before I get too far behind, I wanted to write about my appointment last Wednesday with Dr. P, the oncologist. I also had my fifth chemo treatment on that day, and they started me on a different drug, Taxotere. It is my understanding the drugs I received during the first four rounds were supposed to attack the DNA of cancer cells. I believe Taxotere attacks the structure of the cancer cells. The two different sets of drugs, in conjunction with eachother, are supposed to produce a greater response than either used alone.

I ended up going alone because I didn't know until Tuesday afternoon that I would even be getting a treatment, and by then, I didn't try to get a sitter for the kids. My Dad is still in Canada leading a group of teachers and students on an unforgettable trip through Nova Scotia, so he hasn't been available for babysitting for a couple weeks. I am sure any of our friends would have been happy to do it, but at this point, it isn't a big deal to go solo. I know what to expect, and the staff keeps me company. I read a book one of the nurses wanted me to read entitled, "Not Today, I am Having a No Hair Day." It was written by a woman who had breast cancer. Like me, she also found out on her son's birthday that she had breast cancer. The book was amusing and reinforced the importance of keeping a sense of humor. She wrote it because at the time of her diagnosis, there weren't any humorous books about cancer. I doubt there are too many more now, but I haven't looked. It obviously isn't a funny topic, but I can tell you from personal experience, there are plenty of opportunities to laugh about it if you choose to.

Dr. P probably spent 45 minutes with me. We discussed the latest research. I had printed some articles off for her, and she had printed some studies off for me. She told me that she had reached out to three research institutions, including Duke and MCV, upon hearing my MRI results last week in order to discuss my case with colleagues who specialize in breast cancer. (She actually spoke to the surgeon whom I will be seeing for a second opinion on Tuesday.) I really appreciated her reaching out to others because it just reaffirms for me that she is truly advocating for me getting the best treatment.

After consulting with them, she said she was okay holding off on surgery as long as the tumor didn't increase size. She said that the fact I experienced no decrease in size means the disease is considered stable. She believes my tumor will be very responsive to hormone treatment (tamoxifen), and for that reason, she is anxious to get me started on that. Hormone treatment can't begin until after chemo and following surgery. Overall, she was encouraging, even though the tumor hadn't responded as we hoped, and I felt better after speaking with her.

Then, she did the physical exam. When she felt the tumor, her eyes got wide, and she looked at me. She said, "The tumor is definitely responding. It is responding!" I was so happy to hear her say that because for the first time ever, I really thought that the tumor did actually feel smaller this week. Then I started doubting myself because I just had the MRI one week ago, and it showed no change. Could it really shrink in a week? Apparently so. Her theories: We didn't give the dose dense chemo (every two weeks as opposed to the more traditional every three weeks) time to show a response. And/or since my periods have stopped because of the chemo, the tumor is no longer getting its needed food supply of estrogen. Who cares why or how? I am just thrilled that I am not imagining things. Chemo brain, I can handle. Delusions are another matter.

Dr. P literally skipped down the hallway, announcing, "It's responding! It's responding!" I was excited because 1) she really cares about what happens to me and 2) it is obviously a very good thing that it is shrinking or she wouldn't have been that enthusiastic about it.

Since then, the tumor continues to feel like it is shrinking. The location actually throbs almost continuously, so I can't help but think the Taxotere is doing quite a number on the tumor. I am going for an ultrasound on Tuesday, and another one at the end of the month to track the size. (MRIs are too expensive and cannot be ordered frequently because the insurance companies won't keep reimbursing for them.)

I have now had five of the eight rounds of chemo which means I am over half way done. Woo hoo!!!! The taxotere treatments are spaced three weeks apart which will bring me to the end of September. As has been the case with the preceding treatments, I am feeling great. My finernails feel very sensitive though...

Gloria, the oncology nurse, before she understood my personal theory on side effects, or because she felt obligated to inform me anyway, managed to blurt out before I could silence her that Taxotere can actually cause the nails to separate from the beds in some people. Ouch!!!! Ever since, I have been engaged in an active discussion with my subconscious that my nails are just fine. In fact, I took my mother-in-law to a day spa yesterday and treated us both to a manicure and a pedicure for her birthday. Now if spending over $60.00 on my nails is not communicating a clear message to my nails that I intend for them to stay firmly on their beds, I am not sure what it is.

I have also noticed increased sensitivity to hot water when doing the dishes. My mouth is not quite as tolerant of the hot salsas I can usually handle with ease. There are other little things like that going on that just feel a little different or strange, but certainly nothing that I can't handle. Because taxotere has fewer serious side effects, I no longer need the shot of Neulasta to promote white blood cell growth. I also don't have to take as much anti-nausea medicine. While I am obviously taking advantage of all of the medical treatments available to cure my cancer, I prefer to minimize the number of drugs I have to take. One of the most frustrating parts of this experience has been trying to get help with developing a holistic approach to the healing process. More on that another day. The rest of the house is asleep, and I am going to join them.

The Rollercoasters Continue

First Bo's roller coaster: His primary care physician, Dr. S (none of the doctors among our growing collection has the same last initials as any of the others so far, but at the rate we are added them, that may change), called him yesterday and said she wants to see him as soon as he is off the three weeks of antibiotics she prescribed for an infection. She also said she needs to send him for some blood work to see if she can determine the underlying cause of the gynecomastia. Although he is anxious to find out what is causing the swelling, he was quite relieved that it wasn't cancer.

Dr. S called back today and said that she had been thinking about his situation some more and wants to get him over to a urologist because of one of the underlying causes of gynecomastia is.... testicular cancer. Here we go again. My worrier of a husband now has another form of cancer to worry about. It is funny because each one of us is sitting here telling the other not to worry. Yea, right!!! I am still confident his situation is caused by something much less benign, but he now joins me in the test results waiting game.

He also made the mistake of reading the side effects for his antibiotics. Big no no. He is now experiencing three of the symptoms. Call me weird, but I am telling you from experience, never read that little pamphlet! Once the seeds are planted, they can trick your subconscious into creating reality from the possibilities. I told him that if I could keep my body from having side effects from the red devil chemo (except from the hair loss that was already planted so completely in my subconscious as inevitable that even hypnosis couldn't help that one!), he could certainly keep from experiencing side effects from wimpy little antibiotics. But then, he isn't quite the tenacious entity that I am. It is why we get along so well.

I am going to save my own rollercoaster update for tomorrow, but after the past week's uphill climb, I am back on top of the unnerving Breast Cancercoaster ride after my fifth chemo cycle and a very encouraging appointment with Dr. P today. It is nearly 11:00 p.m. though, and I am ready to call it a day. (By the way and for whatever it matters, the posting time on this blog site is not on any time zone I have been able to figure out. I posted last night's blog sometime after 11:00 p.m., and it is showing 1:09 p.m. )

My Husband Had a Mammogram!

We spent two hours at the Women's Imaging Center yesterday, and Bo doesn't have breast cancer! I knew he didn't. The universe just doesn't work that way. He was diagnosed with something called "Gynecomastia" which is a benign enlargement of the male breast. Now that they have ruled out cancer, his doctor will have to run tests to determine the underlying cause. I wonder if there is a test for sympathy... He had my sympathy because in addition to the ultrasound, they decided to do a mammogram. He said that it smashed what little bit of chest he had. Yes, I know exactly what he means!!

While I was at the Women's Imaging Center, I did meet with Dr. D, the radiologist, regarding my MRI results, and she showed me the actual images from the two MRIs. Sure enough, even to my untrained eye, there was no noticeable difference. That was the first time I have seen images of the tumor, and it was pretty ominous looking. It was one larger mass, with two smaller masses branching out from it. Dr. D considers it to be one tumor, and at its largest point, it is nearly 4 centimeters in diameter.

Dr. D told me that Dr. P, my oncologist, was supposed to call me last week and asked if I had heard from her. No. She then shared with me that Dr. P wants to go ahead and proceed with surgery. Dr. D was aware that Dr. H, my surgeon, wants to continue chemo and then do surgery. I expressed my concern and frustration that my two primary physicians were in conflict, and what kind of position that put me in - total limbo. Cancer is hard enough to manage, never mind managing the physicians! In their defense, however, treament is not an exact science, and there is no right anwer. She was sympathetic to my situation and when I asked her if I should get a second opinion, she said that was certainly an option and mentioned a couple of surgeons I could call.

I left feeling very discouraged and decided the best way to express that emotion was to let the tears flow. So I did, and then I got over it and took action. I can work a plan, but ambiguity is very difficult for me. It was time for a plan. I called my brother, John, who I knew was vacationing in Provincetown with a friend of his, Joe, who is an oncologist. Joe was very encouraging and said that even though the response wasn't what we wanted, the tumor didn't grow, so it doesn't appear to be chemo resistant. He also reiterated that the tumor may in fact be dying but that the MRI wouldn't show be able to show that. Additionally, some tumors, because of their composition, dissolve faster than others. Joe specializes in cancers of the blood, but he called an colleague who does nothing but breast cancer oncology. She recommended continuing chemo...

From the very beginning, Joe, has recommended that I get a second opinion at the Massey Cancer Center at the Medical College of Virginia (MCV) in Richmond, and John has really been pushing me to do the same. I felt the time had come to do that. It is not that I have any doubts about my doctors or about the care I am receiving. They are top in their fields in this region, and I know they are all committed to curing me. It is just that if they can't agree, a new and different set of eyes may help me evaluate the options. Afterall, I only have one life (depending on your religious beliefs), and no one cares about it quite as much as I do. (Bo says he does, and I know he does. I also know he would trade places with me if he could, but I wouldn't let him, even if I could.) So, I went ahead and made an appointment with a renowned oncology surgeon at MCV, Dr. B. I meet with him next Tuesday. He recommended I continue my chemo in the meantime.

Dr. Hoeffer called last evening, and he made his case for continuing chemo. If I heard him correctly, he said that there is a 10% response rate among women to Adriamycin and Cytoxin, but when you introduce the Taxotere, the combination of drugs results in a 44% response rate. The question he couldn't answer, because no one knows the answer: "Is the tumor's response, or lack thereof, indicative of the response to the cancer that may have spread beyond the breast?" No matter. The tumor responded because it isn't bigger, so that means, if it is anywhere else, that responded too!

I finally spoke with Dr. P today. She said she had tried to reach me on Friday but didn't want to leave a message. As I had already heard, she feels very strongly that we remove the tumor now and get me on hormonal treatment as quickly as possible. She doesn't even think that we should continue chemo following the surgery, just radiation. She discussed this course of action with her colleagues at Duke, and they were in agreement; although, I think she said that they didn't see any harm in continuing the chemo either. She did come up with a compromise that really put my mind at ease for the first time since Friday afternoon when I received the MRI results.

I am going to go in tomorrow for my fifth cycle of chemo which will be the Taxotere. She will measure the tumor at that time so we can evaluate if there has been any response at my next appointment. This means that I am receiving some sort of treatment while I am waiting for my appointment with Dr. B. I feel so much better because the tumor will again be under attack. Reinforcements are on the way to aid the pirahna with chainsaws!

With all that being said, I researched and confirmed with the doctors, that there is no statistical difference in survival rates between chemo prior to surgery (neo-adjuvent) versus chemo after surgery (adjuvent). Don't you think that would make me feel a little better that either way, I have an equal chance? Actually, it kind of does, but I still want to evaluate the options and understand the rationale behind each. It's that whole control thing I have going on - cancer hasn't cured me of that... yet!