Seven Down, One to Go

Yesterday was my seventh chemo treatment. You can't imagine how good it feels to know I only have to undergo one more treatment. Even though the effects have been minimal, I am anxious to drop this routine from my everyday life, to have the toxic chemicals out of my body for good, and to be able to move on to the next stage.

I didn't sleep very well on Tuesday night, and it finally dawned on me that I develop insomnia around the time of the chemo sessions. I wake up at 3:00 a.m. and am unable to go back to sleep usually until dawn, and by then it is time to get up. I know I can be a little slow to connect the dots at times, but I still can't believe it took seven sessions for me to figure it out. The only constant has been one of the anti-nausea drugs, a steroid. (That's what I get for not reading the pamphlets describing the side effects!) Both Gloria and Dr. P confirmed it was the "roids" causing the insomnia, and Dr. P said it was okay if I didn't take the drug anymore.

I had an appointment with Dr. P during this chemo session. As usual, she spent quite a bit of time talking with me and Bo. She said she supported my decision to have a double mastectomy, especially in light of my family history. Even though I don't have the known genetic marker, I am still at increased risk for it coming back in the "contra-lateral" breast. She said a double mastectomy would eliminate the need to monitor the remaining breast through mammograms and ultrasounds. Amen to that; although, I will miss my new friends at the Women's Imaging Center.

She asked me what I planned to do regarding reconstruction, and I told her that I hadn't made a decision yet. She thought my options were limited due to my size. I guess there are generally two options: implants or using abdominal tissue. She observed that I don't have any extra abdominal tissue. I told her I could eat more to increase the abdominal tissue. (I have also had several offers from friends since to use their spare tissue!) She offered to set up a consultation with a plastic surgeon so I could at least get some information. She provided the name of one surgeon who she said "makes the best breasts in Williamsburg." If that is not a glowing endorsement, I don't know what is! I have an appointment scheduled with this awesome breast creator next Wednesday.

I told her that I wasn't necessarily considering reconstruction from a vanity standpoint. As I have said before, breasts have never been a huge part of my identity because mine just aren't that noticeable to begin with, and they are not one of the physical attributes I have chosen to play up. It is just that if I don't have the reconstruction surgery, I am not sure that I can stand to look at the scars in the mirror every day. I remember my Mom's scars, and they were so disfiguring.

Dr. P said that it is easier to monitor the chest wall for a recurrence if I don't have reconstruction. Wait just one minute. You mean to say that even after I remove the breast tissue, the breast cancer can still return locally? Dr. P's answer was that yes, it could return to the chest wall, and that is one of the reasons that I will receive radiation, to reduce the likelihood of any cancer cells remaining after the surgery. So, I guess I really do need to get more information on the pros and cons of reconstruction and evaluate the risks accordingly.

I asked her once I have completed all of the steps of my treatment plan, what happens next? She said that I will be put on Tamoxifen to reduce the risk of recurrence. Breast cancer is only curable the first time you get it, so you definitely do not want it to come back. I will also be monitored regularly, the extent of that monitoring to be discussed when the time comes. It is kind of weird to think I have one chance to beat this thing, but in reality, that doesn't put me any closer to mortality than anyone else. It is just puts the concept of mortality more in my face and a part of my consciousness than it is for most people.

Her guidance from the very beginning has been to treat the cancer as aggressively as possible, and then to live my life. She's right. The rest is out of my control, and I don't want to spend the rest of my life, however long that may be, worrying that it may come back. In fact, I intend to spend the rest of my life affirming that I am healthy and that is isn't ever coming back. I intend to live the rest of my life with a greater appreciation of life than if I hadn't experienced cancer. There are too many valuable lessons, too many positive experiences and outcomes to be gained from this journey for me to ever go back to the way life was before cancer. (If I even could... I wonder if anyone can do that...) I want to use the experience to continue creating positive change as my life moves forward. Okay, time to get off the soap box.

After answering all of my questions, Dr. P conducted a physical exam and said that the tumor was 1,000 times better than when I originally "presented". She believes it is smaller than the last time she felt it too, and if she didn't know differently, she would think that I just had fibrocystic changes going on in the breast. (I have been not been able to detect a change lately and was actually imagining it feeling bigger. That's why I will be so happy to have this thing removed once and for all so I can stop obsessing over it once and for all!)

She also said that it is quite possible that some of what we are feeling is fibrous tissue (I think is what she called it) that may now be surrounding the tumor, so the tumor may even be much smaller than what we are feeling. She said she couldn't wait to see the "path" report on it following surgery. Me too! She wasn't even able to find the one swollen lymph node under my arm that she originally described as the size of a lima bean, and then as the size of a pencil eraser, and now I guess, is so small it defies detection and description. She also said that my breezing through the chemo in is probably a good sign that the cancer has not spread undetected to other parts of my body.

I asked her if she felt that we had really pursued the best course of action by delaying the surgery and continuing the chemo, since at one point, she had been so adamant about having the surgery. (Not that we could go back and change anything now, but I wanted to know her honest opinion, and she respected my need to process through all of this stuff.) She said that once she saw a reaction to the chemo, she felt very comfortable continuing the chemo and is glad that I did get the Taxotere up front. Her affirmation was what I had been looking for and what I needed to hear.

All in all, it was a very positive and encouraging appointment, (other than the unpleasant recurrence part of the conversation) and I walked out feeling better than when I had walked in. I went back to the office this afternoon for my $7,000 shot. I can feel my white blood cells increasing as I write this. Since the "roids" should be out of my system by now, I am looking forward to a insomnia-free night.