Wednesday, December 31, 2008

Cancer War, Chemo #2 Battle

After seeing my doctor, I had the second chemo treatment today. Apparently, the doctor I saw last week (must have been a newbie, me thinks) over-reacted about the white blood count level. Mine was 2400, and I was told to not eat anything that had not been cooked. No fresh fruits or veggies. hmm. Today, my doctor said a "low" count that would be worrisome would be 900. 2400 was quite good considering the treatment.

I had been doing very well at controlling the panic - I was quite panic free for almost two weeks. But then, I stupidly read an obituary...of a young mom with breast cancer that traveled to her brain. Panic returned. Dr. Segal called in a refill of my sedatives, so should I need them I'll have them. I am not sure if the panic is a fear of dying, or a fear of the process of dying. Breast Cancer is testing my faith -- I SAY I believe that absent from the body is present with the Lord, and I THINK I believe that absent from the body is present with the Lord, but I admit that I have to go back to God's word to reassure me. I am coming to the conclusion that my fear is of the process of dying, not death itself, and it is fear for my family. Again, a test of my faith. As tremendously difficult it was for me when my Mom died, I am OK. I am OK. And my family can be OK, too. Surely, the Lord of the universe, the creator of heaven and of earth and of me, and of Don, Anna, Rachel and Eleanor, is capable of caring for His creation. And they all have accepted the gift Christ offers all by his death on the cross and resurrection. They too have eternal life with God in heaven. So what worries me? Still figuring it all out I guess. Please don't think I am expecting death from this round of cancer. But it is possible that I will always struggle with breast cancer. I am just being honest about my panic and fears and thoughts.

I did mention to Dr. Segal that I have had headaches (I have -- no lie!) since the last treatment. So he ordered another brain MRI, and this one was approved! Brain MRI scheduled for Monday, January 5th. Dr. Segal also gave me samples of a different anti-nausea medicine to try after the iv meds wear off in three days. We're hoping that will shorten the number of sick days.

Don had to work today, so Linda, Ron, and Janette worked together to make sure I was not alone for the appointments. THANK YOU. Even though I've done this once before, it is still scary and upsetting. It helps so very much to have someone with me. I enjoyed reading my "Chemo Notebook" that my family has prepared for me with photos and notes of encouragements. The additions for chemo #2 included precious art work and notes from my sweet Ellie and some of my younger nieces and nephews. One niece signed her art "your favorite niece Claire" and the other signed "from your dear Sophie". They are all so dear to me! I admit I cry easily (as in very) these days, but my chemo notebook had me teary again. I know I am so completely loved and supported by my family. Thank you Thank you Thank you.

Things seemed to go faster today, and we were done with everything in under four hours. Ron dropped us off, and drove in to pick us up as we literally stepped out of the office. Perfect timing!

I came home and ate lunch, had some raisnets, liquids, then took a short rest. I return for the neulasta injection on Friday afternoon. That isn't too bad, but it does make my bones and joints ache and ache and ache. But, hey, what's an ache or two, or five, when you're in the business of killing cancer cells?

Monday, December 22, 2008

3 Days After Chemo...

and I am still nauseated...but not complaining! I made it through without throwing up, and for that I am extremely thankful. The medicine the Dr. gave me really worked -- didn't stop the nausea, but made it bearable. If you were to look at me, you might think I am dehydrated...my lips are dry and cracked and peeling, but I have been doing my best to drink fluids. I don't know if the "cumulative" effect of the chemo will cause the side effects to worsen with each treatment, but I will continue to be hopeful that I have experienced the worst, and know that I only have three more of the "bad" treatments to go. That means I am already 25% done! with the first part...

The Dr. tells me that, after these first four treatments, the next twelve weekly treatments are much more easily "tolerated". And that the following 33 radiation treatments are also "tolerated" with only fatigue and leathery radiation-burned skin. Not awful when you consider the benefits derived from the treatments -- killing cancer is a good thing.

I am still trying to decide about participating in the new drug trial. I want God to give me a scroll from heaven that says "Drenda, do this: ____________". BUT, I want the blanks filled in! If it were only so easy. I know God has said "Drenda, trust ME", and "Drenda, I will CARE FOR YOU". He is the God of the universe, creator of heaven and earth, and He cares for ME. I WILL trust Him, and will use the brain he has given me to make the best decision I can.

I go back to the Dr. on Friday to have my blood counts checked. Then, back again on New Year's Eve for chemo #2.

Friday, December 19, 2008

Chemo Therapy #1 December 18, 2008

Yesterday was the first chemo treatment. Don and I were on our way to the appointment just before 9, when Don's phone rang. It was Ellie saying that school was closing, and we needed to pick her up! So, Don dropped me off at the Dr. ofice and turned around to get Ellie and take her home. Then her came back to be with me. By the time he arrived, everything was under way.

First stop is vitals -- weight (even lost a bit since the day before -- cancer is an odd way, and awful way, to lose that unwatned weight). Blood pressure and temp next - BE CAREFUL, Miss Vitals Taker -- no blood pressure to be taken on the right side where the lymph node was removed. (I have to remind every time).

Then upstairs to the "Infusion Room". I chose recliners near a window so that I could watch the beautiful snow, turned on the hot pad (supposed to use for warming arm viens for IVs, but in my case, I used it as a wodnerful neck and upper back warming and relaxiation pad). Wonderful! I asked for a hot blanket, and then I was set. I had my "Chemo Bag" with me. My sister Becky brought me the tote bag filled with goodies. A notebook that is titled "Drenda is Strong and Courageous" and filled with encouraging notes from family and friends, as well as lots of Christmas memories that my family wrote to each other a few years ago. I had magazines and suduko puzzles in the bag, too.

So, for the acutal treatment. The nurse numbed the area over the port with "freezing spray" that was very very cold. Numb. Then for the needle into the port. Not bad, except she had to press really hard to make sure it was all the way in because of the amount of swelling I have over the incicision. That wasn't the most fun.
Saline injected to clear the line, and then the meds and IV fluids start. First was one of the two anti-nausea durgs. I don't remember the order of the others, except that when it was time for the adriamyican, the nurse had to sit with me and push it in slowly. Three large vials. RED. I am recieving very close to the maximum life-time allowed dose of this drug. I can NEVER have it again. It harms the heart. I also received cytoxan, another cancer killer, and then another anit-nausea drug. All this along with fluids to make sure I stay hydrated and that the poisons don't stay in my body any longer than necessary.

Beginning to end, my visit lasted about 4 hours. Less than I had been told to anticipate.
I have been taking two more anti-neasue drugs regularly upon arriving home in hopes that the bad reactions can be held off. The weird part was that yesterday afternoon, I could literally feel each organ being attacked as the medicine/poison moved its way throguh my body.

After treament, we raced to Costoc and made a huge purchase of food to stock up freexer and pantry, and even managed to get a few Christmas presents checked off the list.

Don's sister Janis brought dinner for us. That was so sweet of her -- and a surprise for us, and it tasted very good. I risked eating because i was SO hungry.. So far,so good.

Ok, there you have it - the blow-blow account of my first Chemotherapy. I return today to receive more IV fluids and an injection of neulasta. Neulasta is the drug that spurs the bone marrow to produce more white blood cells so that the chemo can be administered every two weeks instead of every three weeks.

On another note, if you're missing these updates and want to receive them, I think you can subscribe -- but I am not sure how to do that. You are all probably much more facebook savvy than I....

Wednesday, December 17, 2008

Oncologist Visit #2 (Not that I'm counting, or anything...)

Saw Dr. Segal this morning. Original appointment scheduled for 2:30 -- moved earlier due to the weather. Problem was that Don was working until noon, and then planning to come home and take me to the Dr. visit. Ended up that I slowly drove to the appointment by myself, and Don met me there when it was almost done.

First, blood work. Even though I now have the handy-dandy port, I declined to allow the lab tech to draw blood from it -- incision still very tender. So, bring out the heating pad, and heat up those arm veins! The lab tech (probably has a professional label, but I don't know what it is...) brought out a "port" to show me what is inside my chest. Very interesting. Metal backing so that the needle can't go too far in. Nice safety feature.

I was reassured when I saw Dr. Segal in the hall -- he addressed me by name and asked if I'd received the official insurance denial of the brain MRI. He knows me! smile. I am not just a number.

Dr. Segal spent considerable time, again, explaining things to me. First, reassurance about the brain/cancer link. No reason to believe I have any cancer in my brain (no jokes, please), but he thinks a baseline test is imperative for comparative purposes. He will follow-up with the insurance company. He also explained the process should cancer ever be found in my brain, and while the situation would be very serious, it would not be a death sentence. whew. Treatable with surgery and drugs, and brain radiation if needed.

Chemo treatment will begin tomorrow at 9 a.m., if weather permits. If not, and the office is closed, I have an appointment for Friday at 9 a.m. One thing I learned today is that, because I am having "dose-dense" treatment with treatments every two weeks instead of every three weeks, I have to go back the day after each chemo for an injection of "neulasta" (sp?). This is the drug that allows for the two week treatment schedule. That means if I have chemo on Friday, I'll have to go to Providence hospital on Saturday to get the injection of neulasta. Dr. Segal also is calling in prescriptions for me for two ro three anti-nausea drugs, plus a numbing cream I can put over the port area to help facilitate inserting the needle for chemo. Along with the chemo, they will administer a new anti-nausea drug that is supposed to last for three days. I will also see the Dr. 7 days after each chemo treatment to check my blood counts, etc. We're going to be great friends!

I had lots of questions -- "should I come to chemo with an empty stomach?" "No, eat a light breakfast". "If I do get sick, when would it hit?" "Probably that evening or the next day". "should I call you if I get sick?" "YES! We have a doctor on call 24 hours a day, and if you're having trouble, we'll take care of you -- get you on iv's, or whatever is needed. We will be aggressive and pro-active in combating nausea". whew.

Dr. Segal asked me again about the drug trial. Still not decided. Dr. Segal said there is no rush, I have 2-3 weeks before a decision is needed. We did talk about the trial more, and he is so convinced the new drug is of great benefit based on the research so far, and even his own patients' response to it. I am leaning toward participating.

Then, Dr. Segal took us upstairs to see the treatment room. Filled with leather recliners, and quite busy! It was as comfortable and welcoming looking as probably possible. But no wireless access. That means you all will be spared the detailed account of what is happening as it is happening.

So, I am almost ready to start the next step in this journey called breast cancer. Thank you for travelling alongside me, and propping me up when I collapse. I am feeling very loved and supported by my family and friends. A number of you have told me how strong you think I am. But, alas, I am not. It is the strength of my God upon which I am forced to rely. I am putting aside anxious thoughts and imaginations, and saying continually "the Lord is my strength and my shield; my heart has trusted in HIm and I am helped. He is not only with me but in me and I in Him."


Sunday, December 14, 2008


I received a card in the mail yesterday from Joyce McElmurry. It contained such encouragement for me, I wanted to share it with all of you.

"Do not look forward to what may happen tomorrow; the same everlasting Father who takes care of you today will take care of you tomorrow and every day. Either He will shield you from suffering, or He will give you unfailing strength to bear it. Be at peace, then, put aside all anxious thoughts and imaginations, and say continually: "The Lord is my strength and my shield; my heart has trusted in HIm and I am helped. He is not only with me but in me and I in HIm." St. Francis de Soles

Saturday, December 13, 2008

~One More Surgery Down~

Yesterday, I dutifully reported to Providence Portland Medical Center at 6 a.m. for my 9 a.m. surgery to insert the port into my chest. Three hours is a long time...
Due to complications in the surgery prior to mine, my surgery was delayed until about 10:30. Long time waiting. Valium helps tremendously, I've learned.

General anesthetic again. Surgery was successful, and after waking up in the recovery room, I waited an hour and a half for "transport" to take me back to the post-op area of day surgery. Fine for me, but I was worried about Don, worried that he'd be worried. hmmm. too much worrying, perhaps. But then I'd doze off again.

Long story short, I was home by about 2:30 and went back to bed. Nice to be groggy and get to sleep. The pain from this surgery was significantly more than from the lumpectomy, but still not so bad. I am sore in my arm and shoulder muscles, and the surgery site is tender. Advil is all I am taking now.

The big news is that I am getting my hair cut today. And I mean CUT. Not bald, but shorter than I have ever had it in recent and not so recent memory. According to the calendar, I should be going bald on Christmas day or the day after, so I am taking the first step this afternoon. I may allow Miss Rachel to document the day, so stay tuned for the first photos!

Thank you, all, for your notes and words of encouragement. They help me weather this storm. I am trying to take one day at a time and not think or worry about "tomorrow". That is difficult, Very difficult. I go back to God's instruction to Joshua "Have I not commanded you? Be strong and courageous. DO NOT BE TERRIFIED. DO NOT BE DISCOURAGED. For the Lord your God is with you wherever you go."

Terrified is often a good word to describe my state of mind. But I know God and I know God's Son. Knowing them is different than knowing about them. I know I will be carried through this. I know God is at work in my life. I trust Him.

Tuesday, December 9, 2008

Another Cancer Note

Insurance update: Appeal denied. Doctor upset. Doctor dictating letter to insurance company. Drenda distressed that MRI of brain seems so very important. Doctor not so upset that CT scan denied -- good news is that all blood tests came back normal, so CT scan not so imperative.

More good news(?) is that delay of testing does not cause delay in treatment. Chemo slated to begin next week -- Thursday.

So here is my schedule, as it stands at this moment, for the next few days:
Wednesday (tomorrow) -- appointment with the surgeon to check incision sites; echo-cardiogram to check heart health
Friday, Dec. 12 -- surgery to insert port
Saturday -- cut that hair off!
Sunday - Tuesday: normal days (hopefully!)
Wednesday, Dec. 17: appointment with oncologist for blood work and ?
Thursday, Dec. 18: first administration chemo -- 4-5 hours
Christmas Day: remainder of hair should be falling out. Could be worse. It is only hair, and a "renewable resource" as my husband so lovingly reminded me! Sustainable, in other words :-) That is us -- we're all about being sustainable around here~

It is good to have a plan. I am anxious to start treatment so I can be done with treatment. then I realize, I will never be done with this cancer thing. that is difficult. I find myself dividing my life into "before cancer" and "after cancer". Life was so simple and, in retrospect, care-free "before cancer". But the interesting thing is that I thought I had problems then. If only.

So, if you think about me in the next few weeks, please pray that God will give me peace of heart, especially in the evenings and nights, that I'd be able to get through the chemotherapy with the least possible physical hinderances (aka vomiting), and that the treatment would be COMPLETELY successful and that I will be declared cancer-free. Pray, too, for Don, Anna, Rachel and Ellie. This is so difficult for them as well.

Wednesday, December 3, 2008

Another Cancer Update ~ If You're Interested ~

Ok, so two oncologists and one entire day --Radiation Oncologist seen first -- radiation will be AFTER chemo. great
Medical Oncologist, Dr. Segal, seen next - 2 1/2 hour appointment, 1 1/2 hours of which is with the oncologist. Too much information.

My cancer is stage 1 grade 3. Hormone receptor strongly positive for estrogen and progesterone. The pre-surgical MRI of my breasts showed a benign very little something in one lymph node (new news) on the right side. HER2-neu positive (new info). Her2-neu positive is the most aggressive type of breast
cancer. This type of cancer apparently can travel to the brain. The Dr. doesn't think my cancer has gone there, but I will have an MRI of my brain to be certain.

I will have a port inserted surgically (probably next week) for the administration of the chemotherapy. On Friday (12-5) I have the brain MRI, a CT scan of my body, and an echocardigram of my heart. I see Dr. Segal again on Wednesday 12-17 and anticipate the chemo beginning the next day.

The first round of chemo consists of two different drugs administered every 2 weeks for a total of 4 treatments. The side effects of this first regiment is total hair loss and vomiting/nausea. Then, I'll have Taxol administered every week for 12 weeks. Along with this, I'll have herceptin which is a drug
specfically to target the HER 2-neu issue. Dr. Segal has asked me to consider being part of a trial to try a new drug Tykerb either instead of or in conjunction with Herceptin. The possible advantage to Tykerb is that it does pass the blood/brain barrier and would attack any cancer cells in the brain.
Herceptin does not go into the brain. Herceptin would be injected regularly (weekly? can't remember what he said) for one year. So I have a decision to make -- and soon. There is a 24 page consent form that I have to sign if I agree to the trial.

After the chemo regiment, I'll have 33 radiation treatments -- every day M-F for 6.5 weeks. The first 28
radiation treatments are to the entire breast area, and the last five are a "boost" to the tumor bed. Either in conjunction with the radiation or after it is concluded, I'll begin taking Tamoxifen for
hormone therapy (suppression). That will continue for 2-3 years, and then I'll switch to a different drug for more years.

Too much information.

Oh, and Dr. Segal thought I was quite intelligent because I used the word "cumulative" in a sentence..."I've NEVER had a patient who has used that word!" My response: "that concerns me..."