Thursday, March 29, 2007

A Quick Update

I am scheduled to take my acute care board exam tomorrow morning at 9 am. When I recieved notice that I was approved to take it, I called the exam agency. When they asked when I wanted to take it, I told them tomorrow. The guy told me that couldn't possibly happen. I told him my situation with chemo beginning on Monday and he put me on hold. When he came back, he said I could take it tomorrow morning at 9 am. That is perfect and exactly what I wanted. I think it is interesting that many people have told me that things "can't possibly happen" like I want them to until I play 'the cancer card.' At that point, things happen. I think that is so interesting. If they can happen after that, why can't they happen before that?

Thus far, the name for our new baby is still undecided. Those of you who have been sending your thoughts to us, have put Harley or Piper in the lead. We'll let you know.

We leave for MN on Saturday morning. I am anxious and dreading it at the same time. I am interested in being home again. I miss home. I miss my bed and my big girls but the same time, being home means starting chemotherapy and that is scary.

Tuesday, March 27, 2007

Meet Blue Collar Girl.

Yes. We are crazy.


Meet blue collar girl. She will be coming home from Florida this week. We probably need a puppy right now like a fish needs a bicycle but sometimes need is a secondary (or further down the list) factor in decision making.


When I was hospitalized for my mastectomy, my roommate told me about getting a red convertible after she was diagnosed with her breast cancer. She called it her cancer car. Hmmm....what did I want? I started out by asking for a cancer Harley. Mary agreed but pointed out that it would be a real shame to survive cancer only to be killed on a Harley. Ok. Point well-taken. She countered with a cancer Lexus but that wasn't too exciting. I recountered with a cancer boat but this year, that is out of the financial question. One night last week when we were out to dinner, we discussed getting another great dane puppy. I agreed but put some parameters on the purchase...must be black, floppy ears, ready to go now and remind me of Greta. Darn it all anyway if Mary didn't find the perfect little girl here in Orlando. She and Alvin did a preliminary visit with them last Saturday and today Mary and I returned to look. There were 5 females in the litter. I met the mom first and she reminded me of Greta immediately. Her puppies are beautiful and after an hour of playing with them, I chose blue collar girl. We will be picking her up on Friday night and bringing her home with us. Yes...we are crazy.


This baby has no name yet. She is 8-weeks-old (born 1/24/07) and has 4 sisters and 5 brothers. Her parents are beautiful. Since she is my cancer Harley, we have been trying to think of cancer/treatment related names. Some how though, Mamie and Chemo just aren't cutting it. In the front running is Piper (Piper Cancer Center) and Annie (a trimmed down version of zofran, one of the drugs I will be on). Let us know what you think her name should be...we'd love to hear your thoughts too.


In the meantime, call us the crazy girls in Florida.

Monday, March 26, 2007

What a weekend!

This past Saturday we had to move from Daytona to Orlando. I had a conference to attend beginning at 7 am on Saturday. Poor Mary and Allyson had to leave at 5 am with me! The conference was a review course for my Acute Care Pediatric Nurse Practitioner Boards. I am currently certified in Primary Care but need to be certified in Acute Care as well. If I complete the exam successfully before the end of this year, I am not required to complete any additional coursework. I had registered for this conference before receiving my diagnosis and delayed the onset of chemo so I could get this out of the way before I had any brain effects from my chemo.

The format is this: sit in a room listening to lectures while following along in your 560 page review book for 12 hours on Saturday and 10 hours on Sunday. On Monday morning you show up and take the test. Kind of 'dump it in and pour it back out' format. The two days were grueling only made better by hooking up with Kristin, one of the NPs I work with. Together we got through the sessions with muttered comments, wheat thins and really good cookies from the Disney Resort it was held at. Last night we returned to our condo and studied until midnight complete with oreos and milk. This morning we returned to the conference site to take the exam. Neither of us felt completely ready to do so, but showed up nonetheless. Unfortunately for me, my name wasn't on THE LIST of those approved to take the exam. By that they mean those that had all of their paperwork in and had paid their $385 test fee. If your name is not on THE LIST, they don't permit you to take the exam.

The women administering the test here in Orlando were friendly enough and did try to help me. They contacted the national office and found that I was missing one piece of paper...something that I had passed off to be completed and faxed to them on my behalf but in the midst of the past month, forgot to check on. I (stupidly) assumed it had been done as requested but it was not. I pleaded with the women on site to allow me take my exam. I had just completed the review course and my studying. As the standoff went on, I got more and more upset (tired and stressed to begin with!) and began to cry. I explained to them my need to get the test done before starting my chemo. I even told them they didn't have to grade my test until they had the right paper in the office, just allow me to take it today. I think they would have but they had to check with the CEO...her name is Dr. Janet Wyatt. I mention her name because she could not have been more rude and condescending to me. She is a nurse practitioner and I am glad she is working as a CEO because I cannot imagine her providing care to children and their families.

I am not the kind of person who asks for special favors or other shortcuts. I play by the rules. I ended up talking with Dr. Wyatt on the phone myself. I explained my situation to her to which she could not have cared less about. With a "how dare you" kind of attitude, she informed me that I had failed to provided the appropriate documentation to them in advance and therefore, should not have even tried to compromise their standards by asking for such an accommodation. She scolded me on the phone like I was some kind of naughty child. I did not take my exam this morning. After sitting on a bench sobbing (crying people make Disney employees very nervous! Apparently no one should be sad in the most magical place on earth.) Mary picked me up and we headed to Kinko's where I could print a new form, fax it to the appropriate person for completion who assured me she would fax it on the the Pediatric Nursing Certification Board immediately. IF...and that is a big word right now...everything is approved in time, I may be able to take the exam here in Orlando on Friday. That is if God, I mean Dr. Wyatt deems I am worthy and meet their standard for the exam.

Dr. Wyatt was right about one thing. I should have taken the time to assure that all of the necessary documentation was in place. I did not need to be humiliated and scolded about it. And there would have been absolutely no harm to anyone if I had taken the exam this morning. Perhaps I would have had to wait longer for my results or maybe even they would have thrown it out if they didn't feel I met their standard for testing. I could have lived with that. There is a big lesson here for me. As one who does not ask for special accommodations, I have had difficulty providing them for people. Here is the lesson learned. People have special needs and from time to time, things happen. There doesn't seem to be a good reason to deny people their requests just because their is some kind of rule in place. If there is not a good reason to deny a request, what is the point? Perhaps this frustrating and irritating experience can help me to become a more compassionate human, nurse and and educator. And yes, special care is just what some people deserve sometimes.

Kristin has returned to Minnesota, certain that she failed the exam. We will stay in Orlando through the week so I can take my exam on Friday...I hope. I will have a few extra days to study. Perhaps I will be better prepared for the exam this way. Perhaps Dr. Wyatt really gave me a gift in her stubborn self-righteousness. By delaying my exam, I may actually be better prepared for it. During the next few days, you will be able to find my poolside with my 560 page study guide.

Friday, March 23, 2007

Mrs. Edwards and me.

The news of Mrs. Edwards breast cancer metatsizing has me reeling a bit. This has got to be what every woman diagnosed with breast cancer fears the most...hearing the words that your cancer is back.

Breast cancer recurs...often. A recurrence can happen months or years after the original diagnosis and treatment. For example, even though a breast cancer tumor may appear small and localized, it may be aggressive and may have spread beyond the breast; this spread cannot always be detected by current methods. This aggressiveness, as well as other factors, can lead to breast cancer recurrence (Y-Me, 2007). Selecting a course of treatment that covers all of your bases (chemo, hormones, maybe radiation) is supposed to significantly decrease our risk of recurrence. At least that is what they told me and probably what they told Mrs. Edwards too. Now she is facing palliative treatment and a death sentence.

Other times in this blog I mentioned the fact that our heads (the rationale part of ourselves) and our hearts (the emotional part of ourselves) do not always match and this is one of those times for me. My cancer was not advanced when it was diagnosed as hers was. I should; therefore, fare better long term. But each new body finding is going to throw me into a tizzy. Like the lump I found earlier this week. The nurses at the Piper Center were wonderfully reassuring. So was my friend Kellee when I talked with her on the phone. I have every reason to believe that the enlarged node I am paying attention to is nothing but a localized reaction. After all, cancer doesn't spring up overnight. However, what if it is not. What if this node has been slowly getting bigger and just now, this week has grown to the point that I can feel it?

Please don't misunderstand. I am trying very hard to keep these feelings to myself this week. We are supposed to be relaxing on vacation. And for the most part, I am. But then it sneaks back in...the nagging doubt that like Mrs. Edwards, my cancer lays waiting to strike again.


While here, I have had time to think about all these things. Perhaps too much time. I spend my days on the beach watching Mary and Alvin trying to bogie board, reading and thinking. Perhaps too much time thinking.


Tomorrow morning we head to Orlando. I will be attending class for a couple of days and Mary and Alvin will be left to their own devices...kind of like not having a parent around. I suspect they will be heading to some Disney property. Good for them. I hope they feel just a tiny bit sorry for me sitting in class all day!


References

Breast Cancer Recurrence (2007). Y-Me National Breast Cancer Organization. Retrieved March 23, 2007 from http://www.y-me.org/information/concerned_about_breast_cancer/recurrence.php

Thursday, March 22, 2007

Do I miss them?

Yesterday our niece Allyson (Alvin) arrived in Daytona to spend a few days with us. It was nice to see her and we started out with a nice beach walk. She should be one of those 20 year old spring breakers trying to scam drinks with a fake ID, acting crazy and hanging out. Instead, she is hanging with us. We feel honored. She is going to be with us through the weekend as we move onto Orlando. I have my conference starting Saturday and she and Mary will hopefully, spend their time doing things I don't want to do like Disney. I have always been close to Alvin and it is a pleasure to see her growing up and an honor to be developing an adult relationship with her. She's way more fun now except that she was always my date to those animated movies that I wanted to see that were geared for the kids.

This morning no one wanted to accompany me on my daily beach walk. Alvin was still out cold (after all, it was 7:30 am) and Mary declined today too. So off I went, alone. As I walked along I started to get too warm and took off my t-shirt and continued in just a ribbed undershirt. It is quite obvious that I don't have breasts. I started thinking about something that happened yesterday after our walk. I was wearing the same thing...an undershirt and shorts. Again, it was obvious that I have no breasts. Two co-eds were laying in the lounge chairs...one nudges the other and points at me. They begin whispering and staring as I stood there on the pool deck waiting for Mary. It was quite obvious they were talking about me and I imagined they were noting my breastlessness. I wondered what they were thinking.

Today as I walked along, I pondered the question above...do I miss them? My initial response is no, I don't. Particularly as I walked along the beach. No sweating, bouncing or other discomfort related to them. No more having to buy expensive underwire bras, and no more mammograms. But those are the immediate and obvious responses. Many of you reading this would probably agree with me at this point. But in our society, breasts are a big deal. They are a symbol of womanhood, like it or not. They are extensively dressed and undressed, photographed, altered and otherwise revered by a significant cross section of the population. They are an outward identification of gender.

I thought about the co-eds again. I wondered if they thought I was a man. After all, short hair and no breasts. I was also wearing sunglasses and running shoes. Nothing on me to advertise gender.

I would like to think that in society, women are more than their breasts. In fact, I used to believe that we were. Now making observations of people as they look at me, I am not so sure we are in a societal way but I have to continue to collect data on this issue. One thing that I am learning is that I am sometimes too quick to judge others on their appearance. After all, I don't want people to judge me based on my appearance. This revelation is one of the gifts of my cancer. I can be too judgmental of others and must remember that each of us has a story and life events that make alterations in us that we cannot control. We are all more than our appearance.

And now, off to the beach. Sunscreen? Yea...I think we have some SPF 8 somewhere!

Tuesday, March 20, 2007

And so it begins...

My cancer phobia. Yesterday morning in the shower I found a lump. In my left armpit. It is obviously a lymph node...approximately 2.5 cm, firm, non-tender and not infected. I came out of the shower yelling that Stoller missed one. Mary thought I had slipped over the edge for sure this time. Of course I was on the phone to the Piper Center in minutes. Darla, one of the nurse called me back. We talked and she had a lot of reasons why this was a reactive condition rather than a missed cancerous node. Things like the airplane flight to Florida (we drove), swimming in salt water (haven't put one toe in the ocean yet), change in activity level (I've slept more since leaving MN than since my surgery), or cutting my armpit while shaving (no, not even a nick). Then she said that cancerous nodes don't "grow overnight." She concluded our phone call with the sage advice "Don't forget the sunscreen." As always, she was kind and compassionate. Ok. But let's go back to the node. Of course, I have rechecked it multiple times since discovering it. It's still there...I am trying not to focus on it and worry constantly. After all, I am in paradise.

Paradise was interrupted at 6:03 am today when the fire alarm went off in the building. Typically, I stayed in bed while Mary Mohn got dressed and went into the hall to check things out. I figured if there were smoke or an actual fire, she would come back for me. We are on the 18th floor and I didn't want to expend needless energy evacuating myself for nothing. All is well and it was a false alarm (thanks spring breakers...all that is evil in the world is because of spring breakers this week!). Now, she is back in bed sleeping and I am wide awake watching a spectacular sunrise over the Atlantic.
In true vacation style, we have no plan for the day. You can picture us in any one of these chairs or perhaps a bit further east, lying on the beach. Yesterday we did a casino boat trip. Something for everyone...boat trip for me and casino for Mary. I sat outside on the deck and relaxed, watching dolphins and pelicans while she lost some money. She assures me it wasn't much.
And now, a walk on the beach.

Sunday, March 18, 2007

Road Trip!

After 1600 miles and 24 hours in the car we have arrived in Daytona Beach, FL. We are pretending we are the typical spring breakers...except that we go to bed early and like to watch the sunrise!

After a 3-day journey we have landed in a place of beauty. The journey; however, was an important part of the process. On Friday night we stayed in Chicago with Uncle Dan and Auntie Lala. We like to call this staying at 'Lyons by the Lake.' The innkeeper is wonderfully accommodating and his wife is incredibly charming. They also have a son who is a terrific young man. The cuisine is exquisite and the company...unmatched. In all sincerity, we arrived at Dan and Carla's on Friday to be greeted with the words "you don't look like a sick person!" To this I reply, "check me out in a month." We went to dinner at a lovely French Asian restaurant in Wheaton, IL. Of course, we had some cocktails and some very deep discussion. Alcohol does seem to increase the depth of the conversation some but some there were some points made that were exceedingly important.

1) Be very careful of what gets into your brain now and going forward! No more reading obituaries. Obits are about death energy, so that's something that gets into your head and your subconscious gets thinking about that for hours or days, and it's the last thing you need. [What we hold in mind manifests in kind.]

2) Movies that have gloomy topics? Don't see them, you'll never miss 'em. Negative nellies? Move 'em off your list. You have different priorities now and if people can't understand that, too bad. You must surround yourself with loving, healing energy.

3) I am not a churchified person and I, like my Lala, absolutely abhor those big-mouth, Bible-banging hypocrites! But...this might be a time to consider a return to some sort of formal religion or religious affiliation. Definitely not the Catholic church of course...they are not friendly folks but there are other. For example, Unity is extremely gay and lesbian friendly, which is awesome. It has no "rules". It's all about positive thinking and prosperity. Prosperity means having everything you need, and that goes way beyond money, of course. And for some, Unity has helped some when their lives were in the "13th sub-basement." While it is not for everybody. It's comprised of many people who have been damaged by life. But what many people like is they admit it and they're doing something about it! They don't prance around pretending that nothing's wrong, when a lot is wrong. It's very authentic and a thinking-person's belief system, so no wonder it's not very popular!

My La La claims that she sticks her nose in everything but she loves us and offers us some incredibly wonderful support. Both Mary and I are so happy Dan decided to marry her and bring her formally into our family!

We are in a beautiful place. It is warm and sunny and the waves are breaking on the beach. I could forget that I have cancer...until I look down or get dressed and then I remember. When we left Chicago yesterday morning, I cried for many miles. It started when I said goodbye to Dan and Carla. It is in those moments that my cancer gets big. I think about how many moments I will have with the people I love. I know...all of our days are numbered but it is not until you have been diagnosed with a potentially life-threatening illness that you start thinking and counting.

Today, my cancer is little. I am in a beautiful place with someone I love and we have no schedule. We are having a drink together, overlooking the ocean. The perspective is correct.

Tuesday, March 13, 2007

Scars

Scars are areas of fibrous tissue that replace normal skin (or other tissue) after destruction of some of the dermis (the top skin layer). A scar results from the biologic process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound. Scar tissue is not identical to the tissue which it replaces and is usually of inferior functional quality. For example, scars in the skin are less resistant to ultraviolet radiation, and sweat gland and hair follicles do not grow back within scar tissue. Often physical sensations around scars are altered as well.


There's your physiology lesson on scars.

We all have scars. When you look at your body you probably can remember how some of them were created. Stupid things we have done to ourselves often end up with scars...riding your bike down a flight of steps, "helping" Grandpa's dog eat his food, or cutting the tip off you finger when 'trying' to do do food art. Other scars are from happy events. Some women very dear to me have some beautiful scars from their C-sections. Without these, I wouldn't have some great kids in my life. And other scars are caused by devastating life events like accidents or cancer.

Most scars show up on our bodies for reasons out of our control. They happen to us. They are the result of some action. For the most part, we don't pay too much attention to them. They become part of how we look to the rest of the world and we don't think about them. But some scars are different. They might remind us of a funny story or event, or something more joyous. They remind us of experiences and of lessons learned.

I have a number of scars on my body...a dog bite, some stitches in my leg necessitated by trying to be a boat mechanic and of course, knee scars from my skiing adventures. But now most of my chest is scarred. Actually, two separate scars. They are not very attractive. The first time I saw them I cried...sobbed actually. The process of embracing these scars is a difficult one. No woman wants to look down and see scars where her breasts were. Now, almost 4 weeks after my surgery I can look at mine more critically. And I now have a choice about how I want to label the scars. I can choose to look at them as being horrifically ugly or I can choose to look at them as something necessary to prolong my life.




I choose the later. I have these scars on my chest for life and for the rest of my life.

My friend Sue is a holistic healer. She brought me a lovely potion of evening primrose, lavender, rose and frankincense to rub into my scars. This soothing combination of essential oils not only smells wonderful but makes my scars feel better...and makes me feel better. Soothed and calm as I await the next step in my cancer journey, scars and all.

Sunday, March 11, 2007

Menopause and Mammograms

In the past month since my diagnosis, I have really tried to find the positive things in having cancer. I have two more things to mention today: menopause and mammograms.


My period began yesterday. My LAST period! When women get to be my age we start having irregular periods and funny little symptoms like hot flashes and night sweats. Each month we wonder hopefully, if this will be our last period. For me, this is it! The last one...because I start chemotherapy in early April which will stop my periods at least temporarily. At the end of my chemo I will be placed on tamoxifen for the next 5 years. That will further suppress ovarian function (and double my risk of ovarian cancer~but that's for another day) keeping me in menopause. By the time I am finished with tamoxifen, I will be nearing 54 years of age. Well into the time of my life in which I am naturally menopausal, therefore, I began my last period yesterday. Ironically, as I am writing this post, I am having a hot flash. Sweat is dripping from me and Mary just brought me towel.
I remember sneaking tampons from my mother's stock when I was in high school. Tampax was her brand and this started a life long relationship for me as well. I wonder how much I have spend on tampons during my life. The last time I bought tampons, I bought just the box of 20. I wonder how much I have spent on tampons in my lifetime That was before my diagnosis. I was hopeful that I wouldn't need them for much longer and I was right. I am ending a 31 year relationship with Proctor and Gamble, makers of lots of common household products like Tide and Dawn. Look around your house and you'll likely find their presence. I doubt their stock will fucuate any since we still will be buying other P&G products like dog food but they won't be making any money on my tampon purchases!
I will never need to have another mammogram either. No breasts=no mammograms! I will worry about other things. Like yesterday when I woke up with a headache for no good reason. Is it a brain tumor?
I guess when you get to a certain age, it is always something.

Saturday, March 10, 2007

Join my team!


Join my team to Race for the Cure!
Each year I think this will be the one the I actually participate in this race but never do. In the past, I have had to work, had other plans, was out of town, etc. But this year is different...my life has been touched in a new way. The research dollars raised for breast cancer are making a difference. Gone are the days when women diagnosed are all handled the same way with radical mastectomies and prolonged courses of chemotherapy and/or radiation. Because of the emerging information, each woman diagnosed with breast cancer can have choice about her health care.
The Race for the Cure is being held on Sunday, May 13 in Bloomington at the Mall of America. You can choose to walk or run a 5K course. There is also a way to register to "Stay in Bed" for the cure if you wish to support the cause but can't make it to the event. So many of you have asked what you can do to help me...and this is it! Join my team! Bring your moms too! I will be almost finished with my chemo on May 13 but I will be walking for the cure. Come and walk with me. Race organizers are hoping to register 60,000 people for the event.
If you are interested in joining my team, Women of Substance, you can register online by clicking this link: http://www.racecure.org/Susan_G__Komen_Twin_Cities_Race_for_the_Cure_.htm, then choose 'Register Online.' You'll be taken to another website where you will need to click on Register Now! Once you agree with the waiver and attest to the fact that you are older than 13 years, you can proceed. From the drop-down box on the next page, select 'Women of Substance' and complete the information. The registration fee is $25 if you walk or run or if you just want to contribute but can't attend. You can send additional donations too, if you want. This is all done electronically with a Visa card, of course! And men...don't let the team name stop you. We will allow you to be honorary women of substance with us. And you know, men can get breast cancer too.
C'mon...join my team! It'll be fun, you'll see.

Thursday, March 08, 2007

Do I feel lucky?

There are some words spoken in movies that are infamous. Dirty Harry said "You've got to ask yourself one question: 'Do I feel lucky?' Well, do ya, punk?" in 1971 (AFI, 2006) and many people have used that line in their own lives at some point. It is an interesting question to ponder...do I feel lucky?

Since my cancer diagnosis, many people have told me how lucky I am...lucky that I get routine health care resulting in an early diagnosis...lucky that the tumor was small...and lucky that my lymph nodes did not contain any cancer cells. But am I lucky? And, what is luck?

Wikipedia (2007) defines luck as 1) that which happens beyond one's control; 2) a fallacy: probability taken personally; 3) an essence or that which can be influenced through spiritual means by performing certain rituals or by avoiding certain circumstances; and 4) a placebo. I'm not sure I agree with any of their definitions or their assertions, particularly when considered in light of a medical condition such as cancer. I do not think it is lucky to be diagnosed with breast cancer. To me, luck is finding a great parking space on campus in the middle of the day or a quater in the Byerly's parking lot.

I do believe that all things happen for a purpose. There is a reason why your dog dies, you fight with your mother or your father dies why you are away on a family vacation. There are lessons to be learned from the events that we experience in our lives. Things may happen in the lives of those around us as a result of the events that take place in our lives. Sometimes, the more painful the experience is, the greater the lessons that result. It can, however; take years before we experience the lesson.

If I look at my cancer from this perspective, I can cite a few things that are happening around me as a result of my diagnosis. At this very moment, our friend is having her lumpectomy. She finally checked out the lump in her breast that she had been watching and learned that it was cancer. Another friend is scheduled to have a non-malignant lump removed...also something she thought she should have checked out as a result of my diagnosis. Several other women have had their routine mammograms done (including Mary) since my diagnosis. For me, there are several things that have occurred for me that I believe are directly related to my diagnosis. First, I have been able to reconnect with a couple of people in my life with whom I had become estranged. To have new relationships with these people is a wonderful gift. I have been offered kind words of support and encouragement from them. Second, I have been able to negotiate some new parameters in my relationship with my mother. I received a card containing some very emotional sentiments yesterday and I realized that, since my diagnosis we have a mutual relationship. I feel that I am heard, cared about and loved by her in a way that is new to my adult life. Our relationship is not totally focused on her any longer! I also am learning more about living in the moment. I have always had a tendency to do that so this is not entirely new to me but it has become even more important to me now.

I think the biggest gift of my breast cancer is my attitude. All of those little annoyances in the world are just that...little annoyances. It's not breast cancer. This has become the mantra at our house. "Hey, it's not breast cancer!" And if it's not cancer, it is manageable and not a big deal. This kind of fits with our other life rule that Mary and I live by: "It's not a problem if you can fix it with a Visa card."

Finally, I want to share something very touching that has occurred. Each April there is a large women's hockey tournament held to benefit breast cancer research. The tournament is called The Stick It to Cancer Tournament and will be held April 20-22, 2007 at the SuperRink in Blaine, MN (see the link at the right). In 2006 the University of Minnesota Cancer Center was the designated donation recipient, receiving 80% of the proceeds for this event. Come join more than 72 teams as they skate in support of family and friends in their fight against breast cancer. My team, Stickin' Around is playing and my former team, Icy Hot is also playing. You won't find Icy Hot on the roster though. You have to look for "Team Mack" which is how they registered for the tournament...in honor of me. Try to make time to get to this tournament. You'll be treated to some fine hockey and will have the chance to spend some money to benefit a wonderful cause.

A special thanks to Icy Hot.
I am so touched by your gesture of support and encouragement!


References

Luck (2007). Wikipedia: The free encyclopedia. Retrieved March 8, 2007 from http://en.wikipedia.org/wiki/Luck.

American Film Institute (AFI) (2006). AFI's 100 Years...100 Movie Quotes. Retrieved March 8, 2007 from http://www.afi.com/tvevents/100years/quotes.aspx.

Tuesday, March 06, 2007

Chemo class and back to work.

This has been a big couple of days. Yesterday (Monday) I went back to work at St. Kate's. I found myself feeling lots of different things as I returned. First, it was my first 'real' trip out of the house. By that I mean, the first time I had to be dressed in something other than jeans, wearing makeup and on time somewhere. It took me forever to figure out what to wear. I didn't want to look like a cancer patient. It was also the first time I wore the prosthetic breasts I got last week. I was so completely self-conscious of my appearance it was a bit irritating. I kept bugging Mary about how I looked. I must have asked her a dozen times if I looked like a cancer patient. Each time she patiently said no, that I looked great. She has little credibility with this question ; however, because she either doesn't look too closely or just tells me I look fine. Finally I was able to get out of the door and on campus. I was so nice to be back in my office! I had a nice stream of visitors as people noticed my office door was open~a bonus for moving up a level this year! It was also great to be back in the classroom and see the students again. I have been so moved by their responses to my news. I have received some very emotional and touching words of support and encouragement from some of them. As a group they have shown me some true compassion. I am so excited to see that side of them as people as that tells me so much about what they will be like as professional nurses. It is nearing mid-term so they are getting tired!

During the afternoon I had my post-op appointment with Dr. Stoller, my surgeon. No surprises there. She thought I was doing very well and my scars look fine. She said they would continue to remodel and "smooth" out over the next few months. Right now they are still a bit swollen, numb and tender. If you want to see them, let me know. Stoller lifted my restrictions with the exception of no skiing, hockey or piano playing. Since I didn't play the piano before surgery, that shouldn't be an issue! We also spent some time meeting with Joyce, one of the nurses. She had so much terrific information for me. We talked a lot about beginning chemo and managing the side effects, particularly the sudden chemically-induced menopause I will go through. She referred me to a nurse practitioner who works in the Menopause Center at United Hospital (who knew there was a Menopause Center!). The other thing we talked about is "chemo brain." This is a real side effect and includes cognitive changes including short term memory loss, fuzzy thinking and difficulty with multi-tasking. Since I just finished my PhD, I am particularly worried about this side effect. Apparently there is nothing to be done in terms of prevention or management. Not all women get it either.

Today Mary and I started out bright and early for my mandatory Chemo Class at Minnesota Oncology Hematology, PA (MOPHA). They pride themselves on being a one-stop shop for cancer and think highly of their patient education resources. They did give us a wonderful binder full of information. Today's class was disappointing though. Essentially, a nurse put in a 30 minute video which outlined their services and then went through the various side effect potentials with recommendations for how to manage them. Here is the level the presentation was at: "Many people feel fatigue, the most common side effect of chemo." Their solution: "Take a nap when you need it." OK. I admit. Both Mary and I have been doing a great deal of preparation for this next phase of treatment and are probably overly prepared. My friend Betsy is going to be my home health care provider back-up. She and I were going to go to Chemo Class on Thursday (she was busy this am) but based on what I experienced today, it is not necessary. We did tour the chemo administration room though. It's not bad. A bunch of recliners lined up around the room with a nurse's station in the middle. The patient gets the recliner and can have 1-2 people with them. The nurses and pharmacists mix the chemo right on site. There were patients getting chemo when we visited. They all looked like they were doing well enough. It helps me to know more about what to anticipate with these chemo days. I'll probably be there 3-4 hours for an MD visit, labs and a chemo run. Not bad!

At the end of these 2 very full days, I am tired. By the end of the days, my armpits are swollen and very tender. The pain has definitely increased now that I have been more active. I was tempted to use vicodin last night but really want to avoid it if I can. I am still having trouble turning off my brain to stop thinking about breast cancer. I don't want our household to become breast cancer 24/7. We need time to have some aspects of a normal life. To try to do this, Mary and I went to a movie this afternoon (Wild Hogs) and laughed a lot. That felt good. It was a dumb plot with lots of slapstick kind of humor and just what we needed!

But then I start thinking about the cancer again...I am anxious to get started with my chemo, mostly to get it over with. I prefer to take things head on and get through them. Waiting around doing nothing is not my style! Let's giter done.

I added a couple of things to my blog. First at the top, you probably noticed the chemo countdown. Once I start, it will become my counter for when I am finished. I also added my list of Good Reads. During the past two weeks when my days have been filled with complex decisions like, should I read or knit?, I've read some good books. I thought I'd share my recommendations...if you are interested in a good read!

Sunday, March 04, 2007

Contrasts and Opposites

This morning as I sat at the counter and sipped my coffee, I looked into the sun room and these beautiful spring flowers stopped me. This blooming garden was sent to me by my friends at the College of St. Catherine. The day it arrived, it was a basket of dirt. There was nothing showing and receiving a basket of dirt made me laugh. Now, 3 weeks later it is an incredibly beautiful assortment of blooming spring flowers...tulips, daffodils, hyacinth and iris. All of my favorites and it is as fragrant as it is beautiful (Thank you again my friends!). As I admired it, I was struck by the contrasts it has created. First, it was nothing more than an basket of dirt. Now it is a basket of beauty. Secondly, it creates a stark contrast with the view beyond the windows. It is on the table in our sun room which is open again now that the temperature is above zero. Beyond the beauty of these spring blooms lies acres of white and in front of a door, a snow drift about 36" tall. What a contrast to the view in the sun room. Even Olivia decided to stop and enjoy the fragrance of these blooms.

The contrast between the inside and the outside of this room made me start thinking about all of the ways in which contrasts and opposites present in our lives. I then started thinking about hearing my cancer diagnosis for the first time...somehow this always gets back to cancer! What a contrast these words created in my life. At one year (to the day) after my weight loss surgery, I was thinking about the improvements in my life. I was 90# lighter with a cholesterol of 155. I didn't ache anywhere even after skiing in the mountains all day or stopping 39 shots on goal. I could shop where I wanted to and buy what caught my eye and was pretty. I felt more attractive than I ever remember feeling. And then suddenly, the words on the other end of the phone changed all of that. While that tangible things were still true (my cholesterol is still 155...or maybe 160 now that the Girl Scout cookies have arrived) but the other things may not be so true any longer. I have now gone through a tremendously disfiguring surgery with the loss of parts of my body. So many questions are now running through my head...what will chemo bring? What about my future beyond chemo? While my partner still love me and want to continue to have a life with me? Where will I fall out in the statistics of breast cancer...the lucky 94% who live cancer free 10 years out or the not so lucky minority.

I think more of this is in my control that we imagine. Cancer sucks. That will always be a reality but there are a couple of ways I can view this disease. I can take the news in and lie with it in a sobbing ball in the dark. I can embrace it, tune out those around me who love me and allow this potentially terminal illness to become who I am now. Or, I can challenge it. I can learn all that I can. I can surround myself with light and information and healthcare providers who are my allies in this battle. I can choose to fight.

I am an obituary reader. It started after my Dad died and so many people learned of his death through the newspaper. I read them because I want to know if someone I know needs to know that I am thinking about them. I am particularly drawn to those obituaries of young people~you know, like my age. I read them searching for the cause of their death. Often, it is cancer. Frequently in these obits are the words "courageous" or "brave" associated with their battle of the disease. Before I knew I had cancer myself, I couldn't imagine how someone could face such a horrible disease in a courageous way. I think I am learning what that means now. I think that is the other side of one's choice with regards to cancer. I can choose to allow it to take my spirit and maybe my life or I can choose to fight it courageously.

I want my obituary, if it is related to cancer to say that I was courageous. I want that to be the true about me and my relationship with this disease. I don't want to be a coward, crying in the dark. Sure. I've had my moments...many of them. But thus far, they are moments. Memories of some of them will stay with me forever, like hearing the news of my cancer while waiting for the oil to be changed in my car or looking at my incisions for the first time.

There is no doubt that cancer is a dark disease. Each of us who is given this diagnosis will react differently to the words. There is no right way to be a woman with cancer. This is an individual as we are. For me, I choose to try to be as courageous as possible. I want to be the opposite of the woman who is crying with despair. I choose to live long.

Friday, March 02, 2007

Another woman diagnosed.

I've just returned from the home of some friends of ours. One of them was diagnosed with invading ductal carcinoma today. Another woman with breast cancer. With the current statistic of 1 in 9 women contracting breast cancer, I thought I would be the one among our group of friends. I thought I had them all covered but I guess I didn't.

This woman is a lesbian too. She was born the same year as I was, although with a January birthday, she is MUCH older than me. We have somewhat similar health histories although she hasn't dealt with obesity (I have) and I don't smoke (she does). When they heard the news, they asked me to come to their house. I quickly assembled some written information...afterall, knowledge is power, and headed to their home. She was right where I was exactly 3 weeks ago, believing I had just been handed a death sentence. At times I still feel that way but now, armed with 3 weeks of knowledge and the allies of wonderful specialists, I feel better prepared to face this disease. While this disease may ultimately be responsible for my death, I know that it won't happen for a while yet.

In reality, our friend has a small cancer like mine. 1.1 cm in size and a grade 2 (slower growing than mine) is a small cancer with the best of odds associated with it. Today though, it might just as well be the size of a bowling ball. That is what it feels like when you hear the news. She does need to have surgery, either a lumpectomy or a mastectomy with sential node biopsy. She then needs to spend time waiting for the full pathology report as well as the staging. That is the essential aspect to understanding long term treatment and outcomes. Those hours become endless. After that begins the process of making very important treatment decisions.

I am three weeks ahead of my friend, hardly in a position to offer much in terms of support or encouragment. I am still in the early stages of this disease myself. Everyday I read more and learn more. One thing that I know for sure is that this is a horrible disease that is altering our live in many important ways.

Remember...get your mammograms. Early diagnosis and treatment is key for long term, successful outcomes. Say a prayer for me AND my friend tonight.

Thursday, March 01, 2007

Making sure I am healthy enough to be sick.

It's rather ironic. Today I spent the afternoon at Abbott Northwestern making sure that I am healthy enough to start chemotherapy. Please don't misunderstand. I wouldn't want to start chemo if there is something else going on that needs to be treated but it is rather ironic to think that I have to have diagnostic testing to be sure that I am healthy enough to tolerate something that is sure to make me sick.

Today I had a CT (computerized axial tomography) scan of my chest. According to Zander, breast cancer can metastasize in patients who had lymph nodes that were clear of cancer cells. He also told us that the most common site for metastases is the bones. What they are looking for with this test is metastases. I am hoping that it is negative! It's an easy test. They inject some iodine-based dye into your vein and you just have to lay still for a few minutes.


The other test that I had is called a MUGA (Multiple Gated Acquisition) scan which is an extremely useful noninvasive tool for assessing the function of the heart. The MUGA scan produces a moving image of the beating heart, and from this image several important features can be determined about the health of the cardiac ventricles (the heart’s major pumping chambers). It is more specific and sophisticated than an EKG or an ultrasound. I needed to have an IV placed so they could inject me with a couple of things. The first thing they injected was pyrophosphate which makes the red blood cells sticky. I needed to wait around for about 30 minutes for this to circulate then I was injected with technetium which is a radioactive tracer. This attaches to the red blood cells (because they are sticky from the first injection) and makes them visible to the gamma ray camera. After that I just needed to lay there for about 15 minutes while they took the pictures. The photo is of a MUGA scan in process...that's not me in the scanner!

The MUGA scan is needed because adriamycin (one of my chemo drugs) can be toxic to the heart. Researchers believe that it is dose dependend and that it is rare in patients getting 4-6 cycles of chemo but "there may be long-term cardiac effects that we don't know about" (Love, 2005, p. 426). Love goes on to note that recent long-term studies of adriamycin use in women with breast cancer have found that "few" have heart problems even 10 years after therapy. She does add that one of her patients did have cardiac failure requiring a transplant...Swell. The MUGA scan will be repeated during and after my chemo.

On the way home in the snow, I had plenty of time to think about my day. I had another IV, was injected with iodine-based and radioactive dyes and exposed to x-rays and gamma rays. All in the name of health. How could this be anything besides ironic? Am I healthy enough to be sick? Will I tolerate the side effects both in the short- and in the long-term? And here's where we get back to statistics...80% of women experience this...35% never have this...and a "few" experience this. How many is a few? What side of the statistics will I fall into.


If only Zander had a crystal ball.


Reference
Love, S. M. (2005). Dr. Susan Love's Breast Book, 4th ed. Cambridge, MA: DaCapo Press.