Smooth travels

Yesterday's chemo went off well. When I told the nurse that I did not want to even see the "red devil medicine (which is injected for about ten minutes through a large syringe) she kindly covered up the whole syringe and kept it out of my view...above and beyond!  Windy and Gary kept me company and provided lots of opportunities to laugh...we had the ward complaining about too much laughter...not really.  Thanks to good pre meds and follow up, I am able to eat, smile, laugh today.  And still get to enjoy grandkids, daughters and Gary.  I am so thankful.

We had a shave my head party this morning.  A combination of daughters helped carry it of (my hair, that is).  I had been sprinkling hair for several days and it was to the point that it needed to go.  It's a very strange experience that required laughter and tears. 

Just Thank You!

Oh, my goodness!
I am being inundated with cards and gifts!  Thought at first I would be willing and able to send thank you notes to everyone but, gracious, I give up!
I do appreciate everything...I look forward to Gary bringing in the mail everyday!  The notes of encouragement are wonderful.  The little baldy caps are at least unique!  Each one brings a smile to my face.  The little treats warm my heart.  I cannot keep track of who has given me what...forgive me, please...I can't even claim chemo brain yet.
Does anyone claim knowledge of something from "Good Wishes"?  Please let me know if you do.

More Really Good News!

The results of the second biopsy are in and it is benign!  So thankful!

Not feeling too rotten these days but profoundly tired!

Looking forward to a wonderful holiday with family.

Thank you again, one and all, for the good wishes and help.  We could not do this without you.

Whew! Don't Want to Go Down that Road Again

So the good news first--the genetics testing came back with no markers related to breast cancer!

And the not so fun...

We ended up in the ER last night after the first chemo yesterday. Nausea, diarrhea and abdominal pain not relieved by any of the meds I had been given.  ER wait was nothing.  Got put on an IV right away (that magic port!).  Took a while to find out what drugs/combination of drugs would work but by about 2:00 things were under control.  Michael Pate came out late on a cold winter's night to hold our hands.  This was very appropriate since Gary and I had remarked we felt like little kids facing a really new situation.  So with a change of meds and lots of IV fluids, I am home and feeling much better.

The adventures of December 12

Started the day with Gary going in for routine lab work...lab was backed up so I crossed the street to go to my appointment with the radiation oncologist, Dr. Brad Koffman, while Gary still waited.  This time I had the necessary paperwork ready and waiting!  When the nurse called me back in to the exam room I explained that Gary would be coming and would like to sit in on the meeting.  In the meantime, I texted Gary where exactly to find the office.  So I spoke with the nurse a few moments  and she then opened the door to go get something and there was Gary walking down the hall!  I grabbed him and pulled him in!
So, this meeting was similar to our meet and greet with my surgeon, a very preliminary information gathering/sharing session.

Options regarding radiation depend on:

       1.  Results of second biopsy and genetic testing which will help determine the type of surgery--lumpectomy vs. mastectomy
       2.  Results of  what type of surgery is done...lumpectomy will definitely lead to radiation, most likely no radiation if mastectomy

  Radiation would most likely be 5-6 weeks, 5 days a week.  (Shorter more intense radiation is sometimes an option but given my status, the milder, longer duration radiation is recommended.)
  Radiation if needed would start anywhere from 1 to 4 months after surgery depending on type of surgery and reconstruction if necessary.

So if all goes as planned, I should be done with chemo toward the end of March.  Surgery would then be mid to late April.  If radiation is in the picture, it could start the end of May and be over mid July!!!!  Or, radiation might not start until end the end of July and go to the end of August!!!!  Either way, there is an end to this business!

After this appointment Gary and I went to get some lunch...found an interesting sandwich place, WHICHWICH, where you order your sub sandwich on a paper sack and turn it in to the cashier.

After that we headed to the Menorah Breast Center for the biopsy.  This second mass was so small and elusive that the tech really had to search to find it.  The biopsy went smoothly until they tried to place the marking clip...they were not sure it deployed.  A routine mammogram followed the biopsy with the special intent of making sure the second clip was in place...it was, which saved me from having to have them go back in and put in another clip.  After being trussed up with ace bandages, I walked out to the waiting area and found Jessica waiting with Gary...A nice surprise.  Then, with my permission it was decided that they would haul me to a cancer support center where we would meet Stacy who had scouted out the joint. Of course, when we went to our car to drive over to the cancer center, we could not find it.  We were in the right lot but remember I said we went to get lunch...we forgot that we moved the car...   Anyway we made it and I got registered with them and I tried on wigs...not my favorite thing to do but we laughed a lot and picked a free wig that will definitely do in a pinch!  Thanks, my family, for making this journey as good as possible!

Came home and crashed!

PS   I forgot to mention that should I get radiation I will be awarded my very own tattoos!  Three dots to guide the beams!

Oops! Gotta Put It In Reverse for a Bit

Found out today that while my lymph nodes are not involved (which is the best news) there is another mass found by the MRI in the same breast that needs to be biopsied on Monday afternoon.  Chances are good that it is only a cyst of no concern.  Results take about four days.  If it is cancerous, it could effect the type of surgery that I have after chemo.

Blessings

Fantastic news.  Mom's MRI of both breasts and both armpits shows no additional lesions, and no lymph node involvement!  This means we have both feet firmly planted in the land of CURABLE.  Look out, cancer!  Here we come. 


We also learned a little more about the first 4 rounds of chemo today.  As you remember, these will be every other Wednesday, starting on the 14th.  The day will look like this:

1. Before leaving home, mom will put numbing cream on the port site
2. After arriving, she will go to a clinic room where the RN will access the port with a small needle (which will stay in, connected to the tubing), and draw labs from that site. 
3. While the labs are cooking, either the oncologist or her NP will visit.
4. Once the labs are back (and good), mom will move to an infusion room.  While they wait for the chemo to be prepared, she will get Zofran (nausea) and steroids (to combat side effects). 
5. The first chemo will be Adriamycin, which is the mean one.  This is a bright red medication which will be "pushed" into the tubing through the port over 15-20 minutes.
6. After that comes the Cytoxan, which will run on a pump into the port for about an hour
1. They don't anticipate any ill effects of these medications right away, unless she has some allergic type of reaction
7. When all the infusions are done, the dressing and needle will be removed from the port, and she will head home. 
8. The day after each infusion, she will return to the clinic to get a shot of a medication that will help her white blood cells rebound more quickly. This will only take 10 minutes. 

The list of "things that you could experience which would be expected after chemo" is sorta long, and includes GI issues, mouth sores, dry skin, nausea... but the list of medications to prevent and treat these is even longer.  And the end result will be that the cancer is GONE. 


Now, back to that awesome news at the beginning... We are so thankful to mom for getting her screening mammogram, which resulted in this being caught so early.  Please, if you haven't already, make sure yours is up to date!  We love you all, and we want you all to be here for a really long time. There is going to be lots of chocolate needing eating at mom's 100th birthday party...

Some Aid Along the Way

In order to more easily administer the chemo drugs, a port was implanted in my upper chest on Monday, December 5, 2016.  The specific devise I now have is called a Bard Power Port.  Below are a couple of pictures of the devise. On me it appears as a bump on my chest...completely covered. The worst part of the placement was my skin reaction to the dressings placed after the surgery! 

Movin on down the road

Hey all- It's Windy. For anyone watching the clock, Genetics went fine and testing has been sent.  Port is now in place, and mom is in recovery doing well. 

Some Beautiful Things

Although I would rather just go to sleep and wake up six months from now, there are and will continue to be some beautiful, thoughtful things that are coming my way...

A special visit from Windy and family
A family photo shoot
Gifts of food, chocolate, warm cozy items, chocolate, music, flowers, coloring books, chocolate, hugs and more hugs, prayers, and did I mention chocolate?  Pink ribbons, silly jokes, scary skull caps for bald heads, books, and offers of help from every direction.  Humbling...

Lots of Sites to See

Here is our current site seeing schedule!

December 1 (today)  8:15 p.m.  MRI

December 5 (Monday)  8:30 a.m.  Genetic Counseling
                                      Port-a-cath placement  12:30 p.m.
                                      Echocardiogram  3:00 p.m.

December 7 (Wednesday) 1:00  Chemotherapy Education (Individual meeting with Nurse Practioner)

December 12 (Monday)  9:45 a.m Radiation Oncology Consult

December 14 (Wednesday)  First Chemo
December 15 (Thursday)  First Injection of Neulasta

Chemo will continue every other Wednesday for 16 weeks, followed by surgery and finally radiation.  We will be heading home at that point!

First Meeting with Medical Oncologist

Here is the summary that Windy provided from her phone consultation during my appointment with the medical oncologist (Dr. Graff) today.

1)      The tumor is very small, and Stage 1A.  This means it is curable. 

2)      The markers are sort of a dud, which means it will be more of a pain in the butt to cure.

3)      In order to keep this little bugger from coming back, you need systemic therapy.  This means chemo. Traditional chemo.  The kind you think of when you think of chemo. 

4)      You will also need surgery, but how aggressive the surgery is will depend on the MRI and the genetic testing.  

5)      Your medical team recommends chemo before surgery.  This has the advantages of starting to attack the tumor before the genetic markers are back, and giving us a chance to see (at the time of surgery) how the chemo is kicking the cancer in the butt.  No, in the ass. 

6)      Now, back to that chemo thing (wish we didn’t have to come back here, but we do).  Your doctor anticipates

a.       16 total weeks of treatment, with one infusion every 2 weeks (8 total infusions).  Each infusion will take about  6 hours.

b.       Halfway through they will switch medications (Adriamycin/Cytoxan first, then Paclitaxel)

c.       On the day after each infusion, you will return to the clinic for a shot that will help protect your bone marrow and prevent infections (Neulasta)

d.       There will be side effects. You will lose your hair (unless you do that freezy thing). (Freezy thing not going to happen. ☺)  You will have nausea.  Your fingers may tingle. Your team has lots of ways to help treat symptoms, and wants to know about them.

      7)   Radiation will be very targeted.  5 days a week for 3 to 6 weeks

8)      So, what is next?

a.       Because one of the meds (Adriamycin) can stress your heart, you will have an echo before you start so they have a baseline

b.       Since chemo is best in a big blood vessel, Interventional Radiology will place a port, which is an IV with the hub under your skin on your chest. 

c.       The MRI will happen soon, but will likely only impact surgical planning, and not chemo.  (Scheduled for December 1 at 8:15 p.m.)

This crappy little tumor will start getting its ass kicked on December 14, assuming all goes as planned. 

Some day your oncologist will fire you because you are too healthy.  You will cry then, too. 

After a visit today with the surgeon, Dr. Nasim Ahmadiyeh, we have only the beginnings of a sense of where we are heading.  What we do now know is that the type of cancer I have does not have the typical profile for an old lady like me.  Unfortunately, it was negative for all three biomarkers regarding what stimulates its growth so some targeted therapies are ruled out.  In order to make any decisions on my care, more information will need to be obtained by an MRI which has not yet been scheduled but will hopefully be very soon.  I will have an appointment in the morning with the medical oncologist, Dr. Stephanie Graff.  She will be our guide.  She will make the recommendations regarding when to do the surgery and if/when chemotherapy will be necessary.  I will also meet with a genetic counselor with the possibility of getting some testing done regarding hereditary factors.

Just a bit of general information

My Nurse Navigator recommended the following pamphlet on breast cancer, stage 1  and 2.  (Mine is stage 1)

https://www.nccn.org/patients/guidelines/stage_i_ii_breast/index.html#102

This Is How It All Began

On October 28, 2016, I went in for an annual mammogram at the Menorah Breast Center where I have been going for years.  All my previous mammograms have been negative so it was a bit of a surprise when I was informed that I needed to come back in for a sonogram because of something they saw on the latest mammogram that had not been seen before.  They were very reassuring.  On November 3, I went in for the sonogram.  Clearly there were two small round masses that were adjacent and maybe even attached. Again my treatment was very professional but gentle and kind.  Before I left the office I was told that a biopsy was advised.  Since we were going to visit Matt in Arizona, for the next week or so, we scheduled the biopsy for Monday, November 21, right before Thanksgiving.  Gary accompanied me for this appointment at the same Menorah Breast Center...that was really comforting to have Gary and to be going back to a familiar setting. The biopsy was sonogram assisted so I was able to watch the screen and see the masses as they were suctioned.  After the biopsy they told me it might not be until Monday that I would hear any results because of the holiday.  But on Wednesday before Thanksgiving I got a call from the nurse navigator.  She was very professional and asked if I wanted hear the results or to wait to talk with my primary care physician with whom she had already talked and who had said she was fine with the Breast Center providing the information to me. (I had just changed primary care physicians because my last doctor had left the practice.  Dr. Humphreys had seen me only once on November 4, the day after the sonogram and before any other results had been obtained.)  I opted to hear what they had to say right away so the nurse navigator explained what she could.  I was diagnosed with Invasive Ductal Carcinoma.  Here's where the magic began. The nurse navigator has the job of coordinating my treatment.  That is a huge thing for me.  I would not have had a clue as to where to begin.  What a relief to have someone else contacting doctors' offices and scheduling appointments!  First she reassured me that she would only recommend the best doctors...after getting the doctors' names I did a quick Google search that showed each had excellent references.  All are women who specialize in breast cancer.  I feel like I am getting and will continue to get the best care.  So for now the first visit is with the surgeon on Tuesday, November 29.  Next is a visit with the medical oncologist on November 30.  Hopefully a plan will be developed and we will get the ball rolling on my treatment immediately.