September 2013 Chemo Group

Oh, shoot...chemo brain...I forgot about the H.  Well hooray that the worst of the nasty stuff is done...and hopefully the worst of the side effects will stay away, and I hope the H does it's targeted cancer stuff without targeting anything else...in other words, I hope your side effects from it are few.  I think we all need to have big group mini toast in february when everyone is done with the big guns, and then a big huge group toast next September when everyone is totally done!

KBee,   Thanks.  I think the Herceptin alone will be much easier.  And the ECHOs will be much easier too because my breasts won't get in the way.  ;-)

Knightzoo, I've got a little more shopping to do Friday evening (after chemo) and Saturday morning (after the Neulasta shot), then I'm planning on staying home until Christmas.  I figure I'll wrap gifts in spurts between naps on Sunday, Monday, and Tuesday. 

Yeah... bald and flat... more being identified as 'sir'... I think I miss my hair more than I will miss my chest.  ;-)

Alfranco, I hope you are feeling better. Those expanders sound painful.  Kinda glad I'm not having them put in.

Spoke to the surgeon's office today.  Sometimes I feel so silly asking questions.  Sometimes I feel like they are silly for not remembering that while they answer these questions a dozen times a week, I only go through this once (hopefully) and don't have the knowledge base they have.

In one of the questions, I just wanted to be reassured that when I wake up from surgery that the left side and the right side will look the same because they are calling the left side a 'mastectomy modified radical' and the right side a 'mastectomy simple'. She was very kind in explaining that the only difference is that they will be taking everything, including lymphs from under my armpit on the left but won't be taking lymphs from the armpit of the right.   I would be very upset if I woke up unbalanced. :-o

Here's my blog post from today.  It's long, but I'm tired after all of the medical stuff today & then a 3 hour drive home so I don't feel like editing it to make it shorter.  

Christmas came a little early for me this year.

Today Hubby and I were in Dallas for six different appointments. I had a breast MRI, a mammogram and an ultrasound - all to see how well the chemo worked. I also met with my surgeon (Dr L), my plastic surgeon (Dr T) and my gynecological oncologist (Dr K).

I was feeling a lot of anxiety on the way to today's appointments. I'm usually calm and very easygoing with doctor visits and tests, and I feel very comfortable with all of these doctors, so I'm not really sure why it affected me so much today. I guess it was just the unknown - how well did the chemo work?

My first appointment was the MRI. This only takes about 15 minutes, so by MRI standards it's not bad at all. Getting stuck for the IV is the worst part. From there I went to the mammogram. I've had a handful of mammograms in the last few years and I have to say this one was the most uncomfortable. Let's just say the girl who did it was very thorough and very determined to get everything in the picture. Ouch! Last but not least I went to get an ultrasound of my cancer side. I had the same doctor who did my lymph node biopsy back in August. He's young and smart and very, very nice (and his name is Dr. Mann....for some reason that strikes me as funny). I was happy to see him, and he made me even happier when he said, "I guess I'm supposed to be doing an ultrasound on you, but after seeing your MRI, I'm not really sure what I'm looking for." He went on to explain that my mammogram from last year didn't really show the cancer very well. The MRI and ultrasound back in August showed a large mass and the biopsy on my lymph node was positive for a grade 3 (very aggressive) breast cancer. All bad news. Today was nothing but good news. During the MRI, they injected a contrast in my IV to better show any abnormalities. Dr. Mann said that today's MRI showed no unusual contrast uptake. In layman's terms, that means it didn't show any active cancer cells in my breast or lymph nodes. Hallelujah!

The first thing my surgeon said to me when she walked in the room was,

"Well your images from today look great. Pretty miraculous, even."

How's that for a body's response to chemo! She was very pleased and reiterated what Dr. Mann said. The tumor can no longer be seen on MRI and the lymph nodes appear normal. What still shows on ultrasound (located only by the titanium clips they put in during my biopsies) and what can still be felt is most likely scar tissue or dead cancer cells.

Now, to keep it all in check, we won't know anything for sure until I have surgery and they perform the pathology on my breast tissue. This is all just what the imaging showed today. Could there still be cancer in there? Yes. Is there a LOT less cancer in there than there was four months ago? Hell yes! Basically the chemo did what it was designed to do - attack the aggressive cancer cells and not only stop their growth, but make them disappear. I won't be able to say I am cancer-free until I have surgery and Dr L assures me she was able to remove it all. Until then, I will rejoice in the fact that prayers have been answered and the last four months of chemo hell have been worth it.

My other two appointments were rather uneventful. No other exams, no pictures taken (thank you God), no new tests ordered... Dr T, who will be my plastic surgeon for reconstruction, did advise me that it would be helpful if I could gain ten pounds so he would have more tissue to work with. Seriously? A doctor is telling me to gain weight right before Christmas and right before I'm laid up for a few weeks after major surgery? I don't think that will be a problem. On the other hand, Dr K gave me the standard warning of my susceptibility to osteoporosis since I'm only 40 and in chemo-induced menopause. She advised me to increase my calcium & vitamin D intake, as well as exercise and do strength training. I didn't have the heart to tell her Dr T wants me to gain weight.

KJ - GOOD LUCK tomorrow with your last one!!  Woohoo!!!  My surgery is listed the same as yours, and I'm glad you explained, because I didn't even think to ask about the modified radical and simple...  Did they mention doing anything with the lymph nodes on your prophylactic side?  I'm still on the fence about doing the sentinel node biopsy on that side.  Not sure about the swollen feet - definitely ask at your appt tomorrow!

Swollen ankles are a sign edema.  It can often be related to heart function, and since some chemos (like Adriamycin) are cardiotoxic, it can be quick way to check on heart function and fluid buildup.

lighthouse, so happy for you, im right behind you on taxol. 9 more to go then surgery and so far my tumors have reduced by at leadt 40% more physicals next week. I sincerely wish you the best, lets hope its all good news in 2014! 

Cougar unbelieveable! Giving birth to a precious baby during chemo! Hope you have help to give your body a rest during this trying time and enjoy your son. 

Nice to put a face to all the posts, my daughters and below my furry baby alba, husky shepherd mix always looking for a hug.

Looking good mercedes60; love the pictures.

Good news KJ!!!

I had my 4 week follow-up today.  All looked good, but hemoglobin, RBCs and such were still low.  It was not news to me that I am anemic...didn't need a blood test to know that!   I had a few questions about a few different topics, and will post what he had to say.  I know a lot of MOs have differing opinions, and i am interested to hear different opinions on these topics if they come up in conversation with your MOs over the next few months.

Tamoxifen and reconstructive surgery: he wants me to stop it 4 days before surgery and not start it again until 4 days after due to blood clot risk.

Soy:  said that he used to tell patients avoid completely, but newer studies have shown no problems, but he still thinks use caution...so... little is ok, but do not go overboard.

Vitamin recommendations:  Definitely calcium and Vitamin D for the next several years.  Recommended a multivitamin too (surprised me) for the time being.

Hoping everyone is having a good day today.

Just hanging out today....resting.  My UTI seems to be on the mend, but otherwise I don't have a lot of energy.

just 2 hours to being DONE! Since I'm  triple neg no herceptin, tamoxifen or hormone inhibitors for me. So glad to be moving on to rads..even if they suck it's not chemo. lisaSP...fatigue on rads? Will they make me sleepy? So tired of not being tired, tried to go last night without meds..nope! Couldn't get to sleep even at midnight and having been up since 530am and with no nap. Congrats Kjsimpson....we are done!

Peacock girl and KJ - SOO SOO SOO HAPPY for you! Kbbe - We do need a party in Feb and Nov (for baby ruth) when this is all over!  But wonderful news LHL and while my chemo was post surgery I am going to take heart that your results are the only results and chemo killed any wandering cancer cells in my body.  What validating news!  By the way - I loved the long post!

Kbee - Washington State has the highest incident of BC in the USA.  A lot of the discussion here has been the role of Vitamin D in that.  I know my level in July (after diagnosis) was super low.  Dosage matters though so ask your doc about what dose is good.  I am on a super high dose (25,000 IU).  My doc said taking the 1,000 IU (the one I bought at super supplements before asking) would do nothing!  But I am also seeing a naturopath so they have a lot more faith and time to invest in supplements.  He did not recommend calcium for me.  He did say that for high levels of Vit D you must also take Vit K to ensure maximum uptake.  I was also told to just stop every supplement 3 or so days before and not restart until 3 days after surgery.  I think blood thinning problems, etc.  No liability / unknowns out there!!

Soy- My onc (who is a vegetarian for full-disclosure) said no to soy supplements or 'unnatural form' but said tofu, tempeh, edamame, all ok.  I love tofu and eat it maybe once to twice a week and he said no problem.  Just no supplements!!!! He was adament about that.  I have seen studies (older) that say all soy is bad for ER+ patients and others (newer) that assert it has a protective effect.  It is true that asians whose diet is eastern (not immigrants to the USA for example) have the lowest BC rate of any population. But once they immigrate here their rate slowly becomes higher.  So I believe soy (in that form) is good as is a diet rich in fish, green vegetables, and low on sugar.  But saying it and doing it are so different Just after I finish a few chocolate pieces.....

Just in case anyone is interested - these are the supplements my naturopath put me on (and verified by my naturopath oncologist, and approved by my med onc and rad onc):

Vitamin D (25000 IU)

Vitamin K (3600 IU)

Fish Oil - holy crap - YUCK!

Curcumin (500mg)

B12 (not sure dosage)

Melatonin (20mg)

Ginseng (haven't started cause they wanted to put a special blend together for me and I haven't been able to swing by and pick it up) 

I am not a supplement gal but hey whatever might work.  My vitamen D counts are certainly getting better (almost in the normal range last test) and when they do get there I will lower my dosage to a maintenance level.  And the B12 is helping with energy.  The rest - heck I don't know but they don't hurt me - they do cost a little though...nothing is perfect.

Kbee - Testing my vitamin D levels initially was at my well woman's apt so that might be a good option.  Also for what it is worth (and not to start something here but) my insurance is changing for the better next year and will cover naturopaths (with a $35 copay).  But regardless since they often work with patients that don't have insurance or insurnace that covers them they are way more reasonable with pricing than conventional docs are.  An hour apt for me (in Western WA) was $100 that's without insurance coverage.  My opinion, the initial consult after bloodwork is taken is the most critical and wonderful addition they can offer.  They have such a different style and really ask questions.  It is like an hour apt (crazy I know - with only the doc) but I feel like I walked out of there with more control over my life and as importantly an individualized plan.  I use my naturopath as an addition to all my conventional treatment and really feel like I understand the methods and hows of cancer and ways I can best help my body feel better and fight harder.  But I guess what I am trying to say is the visit with bloodwork (bloodwork is critical) is so worth it.  Especially if you are thinking of taking supplements - with a naturopath you are not left asking the super supplements clerk.  Just a thought....

And I think (not 100% sure about this) but the soy in soy milk is not the same as tofu or tempeh which is why he was drawing the distinction.  It's not a 'supplement' but I think the process may be similiar.  All my docs basically tell me dairy isn't great and alternatives aren't either...well maybe almond milk...but I was never much of a milk girl anyhow.  My best advice has been to treat dairy as a condiment.  I love ice cream and that has been tough to reduce but the rest of it - I am really trying to minimize my daily consumption.  Some days I am way better than others with this diet stuff.....just can't wait to get back to consistent exercise.  Speaking of - off to the gym...

Peacock Girl and KJ - doing the happy dance yet?  I know the side effects are still coming but last go round....

Last heavy lifting chemo view.  That is my lovely daughter in the chair...

I like the plants, our place is so antiseptic and nothing pretty

Congrats KJ and Peacockgirl. Yay!!!!