Surgery

The time has come to start thinking about surgery. It's still a couple of months away, but I'll be having a consultation with the plastic surgeon who will be doing the reconstruction next week.

I have to admit that I'm feeling a little anxious about surgery. I've never undergone any kind of major surgery before. I have no idea what it's like to be anesthetized. The surgery is supposed to be long... on the order of about 10 hours. The hardest part about the surgery, or so I understand, is the reconstructive part.

Right now, some of the nervousness is due to knowing nothing about it. I feel better when I know something about what I'm facing. I know it's all the "fear of the unknown" and such, but it doesn't really help knowing that. The fact is, I still don't know anything about it. But next week, I'll have a conversation with the surgery. I have questions for him, just like I did my oncologist. And when I walk out of his office, I will be armed with knowledge. For me, knowledge makes things better. Knowing, even if it's hard to face, is a whole lot less scary than not knowing.

Tomorrow, I go to my 5th chemo session, and my first session with Taxol. I'm halfway through... halfway through chemo, that is. After chemo comes surgergy. And the the other stuff that I'm nervous about... recovery. I'm not nervous about recovery, per se... I'm just nervous about how difficult it's going to be and how long it's going to take. I know just enough about the recovery phase to be dangerous. I won't write about it until I know more.

I am going to tell you all now that I don't want to go through that alone. After I know more about how long I'll be in the hospital after surgery, and what I need at home after surgery, I'm really going to be calling on my friends. I'm hoping Cathy will be able to be here for part of it, but I know that I'm going to want my family near for this. And when I say "family," I'm including all of you who have been my family throughout the years, even though we have never been related. You have been so supportive of my through this, and I'm definitely going to need that support a little bit longer.

Firsts and Last

This week's chemo was made up of some firsts and one last. First, the firsts.

This was the first time I used my newly installed port to receive chemo. It was kind of weird at first because they inserted the IV needle like a thumbtack into my arm. That was strange and a little disconcerting. They kindly numbed the area before inserting the needle, so that was good. But it was weird to watch them insert it. It would have come in handy if there was any little note that they needed to post to remind them of anything. As it was, they just used it to administer the chemo.

The other first was the administration of something to raise my red blood cell count. My doctor pointed out that this week's blood test showed that I was a little anemic this time. After last week's chemo, I'd also experienced my heart racing anytime I exerted myself even a little. We decided to try the shot to see if it would help. Unfortunately, it takes a couple of weeks to kick in, so I can't really tell a difference yet.

Receiving that shot was not the most pleasant experience I've had. It was like getting a really long bee sting. You keep wanting to swat the bee away, but you know that the sting is going to help you in the long run. Not pleasant. But not completely horrible either. You find, in these circumstances, that you can tolerate more than you expected.

The chemo session was pretty normal... with the exception of the thumbtack administration. Actually, that was kind of nice. Before, it was administered into the back of my hand... which meant I had to keep my wrist perfectly still for the entire time. It was nice to be able to move around a bit. Cathy and I even played cards. And I kicked her butt!! Oh. Sorry. I got a little competitive there.

Anyway, the thing that was a last was my chemo treatment. Or, more specifically, that particular chemo treatment. Yes, this week was the last of my AC treatment. Next time, I start on Taxol. This means that I am halfway through my chemo treatment. (Insert mini-celebration here.) I'm glad to be done with the AC. It was getting harder and harder to recover each time. Even today, I'm not fully recovered. By tomorrow or Wednesday, I should be back to feeling 100% again. But today, I'm still a little tired.

This week, Cathy flew in from Florida to accompany me to chemo and keep me company in the days the followed. I'm afraid that I wasn't the best hostess this time around. She didn't seem to mind though. ;) Saturday, I slept the entire day. That's all I did. I woke up, went downstairs to lay on the couch and immediately took a nap. I think we watched a movie in there somewhere, which I followed with a nap. Then, I went back upstairs to take a bath followed by, you guessed it, a nap.

I felt better yesterday and we were actually able to get out for a little while. Of course, I still had an afternoon nap, but at least it was a short one.

It was so good to have Cathy here. I didn't have to worry about entertaining her or being "on" or anything. But her presence was a huge comfort at a time when I wasn't feeling well. It's been so long since I've had someone take care of me when I was sick that I forgot how comforting it can be. It couldn't have been a better choice than Cathy at that moment. The key is that the person taking care of you is someone that knows you so well that they know how to slide into your life, give you comfort, and allow you to feel vulnerable and safe at the same time. So, essentially, Cathy was my comfort food this week.

Thanks, Cathy. There's a reason you're my best friend. :)

Weight Loss

Last summer, I had a check-up with my doctor. At the time, my cholesterol was higher than it had been in the past. I've always had high cholesterol, but it finally reached the point that my doctor wanted me to lower it. One of the reasons I like my doctor is because his first option wasn't to put me on medication to lower it. He wanted me to do it with diet instead. He suggested I lose 20 pounds by the end of the year and suggested certain foods to avoid.

I made some progress, but three weeks of heavy travel in September/October followed by Thanksgiving negated my progress. Over the holidays, in Spain, I managed to re-lose a few pounds. When I came back, I met with my doctor again. He still didn't want to use medication to control my cholesterol, so he encouraged me, once again, to control it using diet. We set a goal weight that was a loss of about 25 pounds.

With the turn of the new year, I was more determined than ever to leave my baggage behind... unresolved emotions, lack of self-confidence, and excess weight. By the time I was diagnosed, I had lost about 15 pounds. Since I've been diagnosed, I've lost an additional 6 pounds. This weight loss has been intentional. Since I've been diagnosed, I've been eating healthier than ever. Yes, I've also been experiencing a decrease in appetite. Is it the cancer? Or is it a shrinking hunger to match my shrinking waistline? It's probably a combination of both. Whatever it is, not only have I been eating healthier, but I've also been eating less. And, I'm well on my way to my goal.

You may be wondering why I'm telling you this. A friend of mine recently revealed that she and a few others were under the impression that my weight loss was a direct result of my cancer. I don't know how many people are thinking that, but I wanted to let you know that it's not. My weight loss is intentional... suggested by my doctor. It was also time. I carried the extra weight around too long. I was tired of it... as I was tired of the other baggage I've been carrying around.

In some ways, the cancer has made it easier to lose weight, but it hasn't been the cause of it. I don't want my friends looking at me thinking I'm shrinking away to nothing. I have a goal weight that I established with my doctor. I'd like to make that goal this summer, as I originally planned. I have 5 more pounds to make my goal. However, that's not my ultimate goal. My ultimate goal will take me 15 pounds beyond that. However, 5-10 would be just fine too.

Port in the Storm

Okay, so the storm is over. I feel great today. However, I am still getting a port put in today. What is the port of which I speak, you ask?

When they give me chemo directly as an IV, it travels through some smaller veins to get to the larger veins that will carry it through my system. Because chemotheraphy is toxic, it can do damage to these smaller veins. A port bypasses these smaller veins in order to avoid the damage.

Because I could receive treatment in both arms, I had originally decided to forego getting a port. However, when I attended the support group a few weeks ago, everyone there recommended getting a port. ..regardless of whether they had one or not. I don't want my veins damaged, so I've decided to follow their experienced advice.

The port I will receive today will be placed in my arm with a very small incision. It is completely hidden under the skin, so unless I point out the incision scar, no one will even know it's there. This is outpatient surgery, so it should be rather minor. I'll admit that it makes me a little nervous when they cut me open... even for a small incision. But, I think that I will be glad I did this if it means I won't destroy my veins.

I'm also feeling back to normal this morning, which is perfect timing. I can't eat or drink anything before the surgery. Yesterday, this would have left me feeling queasy. This morning, I feel just fine. I'll post a photo of the port after it's in. But, now it's time to go.

Comfort Food

Mmmm. Comfort food. Food that is familiar and nourishing and wraps your tummy in a blanket of comfort.

I had that tonight. It was good timing too. Comfort food was a perfect way to put the kibosh on this rough patch I've been having the last few days.

I haven't been out and out ill. I never feel completely ill. I just haven't felt 100%. On Saturday, I probably hit a new low at about 40%, but the gauge has been inching up ever since. I just haven't recovered as quickly as I have in the past few weeks. Usually, by Monday, I'm feeling pretty righteous again. But, today, I was tired and felt off all day. However, thanks to the gift of one of my favorite comfort foods, I'm back up to about 85% right now. I'm confident that after a good night's rest tonight, I'll be feeling normal again tomorrow.

So, I just want to give a shout out to Dave for the lamb lentil stew. It's still my fave, and it was totally what I needed tonight. And, yes, it's an extremely good batch. :)

Rough Sailing

Yesterday, I had a particularly rough day. I don't have many of them, and even as rough as it was for me, I recognize it could have been a lot worse.

The thing is, I feel so good most of the time, even on chemo days, that I forget how much it affects me... particularly when it comes to energy. I got up feeling great yesterday, so I cleaned my bathroom and my kitchen. I had people coming over for rehearsals for my film project (the one that's not a documentary), but I knew I'd be sitting most of the time, so I wasn't too concerned.

By the time they left, however, I felt terrible. A woman in my support group once remarked that she often had trouble distinguishing between nausea and hunger. Yesterday, I learned what she meant. By the time everyone left my house, I had a splitting headache and was queasy from hunger.

I immediately ate some lunch and then took a nap. My nap lasted 4 1/2 hours, so I'm not sure it can still be considered a nap. I woke up feeling better, but soon after that queasiness set in again. I wanted to eat, but I didn't feel well enough to eat. Finally, I pulled some saltine crackers out and ate a few (okay, more than a few), and instantly felt better.

During the three days around chemo, my body feels different to me. I am acutely aware of my stomach, my heartbeat, my breath, and my head. Normally, I don't feel sick at all, but on those three days, I do have an "awareness" that isn't there the rest of the time. Yesterday, was the first time that awareness moved into something other than just that while I was still on my anti-nausea regimen. (I experienced this once before when I stopped taking the anti-nausea meds too soon after chemo.)

Today, I'm fine. It's reminded me of the importance of feeding myself regularly. I really think that it all stemmed from my being hungry. Except with the chemo in my body, it didn't register as hunger... it registered as queasiness. (Still not enough to register as out-and-out nausea, thank goodness.)

Happily, I'm feeling recovered today and will be eating on a regular schedule today. :)

Chemo Brain

I thought I would share with you the after-effects I feel after having chemo. These usually stick around the 3 days that the chemo is in my system, and then I return to normal afterwards.

One thing that doesn't happen: I never feel sick. Though it is one of the side effects of the chemo I'm on, the anti-nausea meds I'm on ensure that I never feel it.

Day 1
This is the day that I get chemo. After my first session, I felt like I could run a marathon. I had a ton of energy and even took a 1+ mile walk with a friend that evening. That level of energy has not returned after my subsequent chemo sessions. In fact, just the opposite has happened. My chemo starts in the morning and it takes several hours after I've had blood drawn, visited with my doctor, received my anti-nausea injections, and finally received my two different types of chemo injections. Everything is administered slowly. The anti-nausea meds are adminstered over about 20-30 minutes. The first chemo drug is administered over about 15-20 minutes. The second is administered over an hour in an IV drip. (By the way, all the drugs are administered through IV.)

It is usually as I'm receiving the drip of the 2nd chemo that I start to notice chemo brain. This is when my brain gets a little scrambled. Not so much that it's scary. It just becomes more difficult for me to think of specific words when I'm trying to express an idea. I find myself "stumped" a little more frequently. It is this particular phenomenon that makes it particularly hard to work (as a writer) on the days that follow chemo. It's much harder to make my brain make connections that are ordinarily pretty easy. I don't turn into a stammering idiot or anything. I can still carry on a conversation, but every once in a while, it just goes blank. It's kind of standard. Nurses and patients alike have nicknamed this phenomenon "chemo brain."

Afterwards, I usually go grab a bite to eat with whoever has accompanied me to chemo. I'm usually pretty hungry by this time... and so are they. After they drop me off, I begin my at-home anti-nausea regimen. I immediately take some compazine. I want to ward off any nausea before it starts. With the exception of my first session, when at this point I decided to take a walk, I usually start getting pretty tired about this time. If I've got a good book, I'll lay down on the couch with it, but within half an hour, I'm into serious nap mode. This nap usually lasts about 4 hours. I wake up from this nap feeling like I could go to bed. I usually don't. I putter for a couple of hours, maybe watch some TV, clean my kitchen, or just read some more. But within 2 hours, I'm in bed... right after I take my ativan.)

Day 2
Already my energy is starting to return. I'm still on a nurse-recommended anti-nausea regimen, (1 Emend in the morning, 1 compazine in the A.M., 1 compazine in the P.M., 1 ativan before bed). The Emend is the super-drug that comes highly recommended by my doctor that they were worried my insurance might not approve. They did. Apparently, this is a very good thing, as I have yet to really feel sick through this experience. On the second day, I get up, take an Emend, take a compazine, take a prilosec (I like spicy foods and heartburn seems to come with them during chemo), take a senocott (constipation is a lovely side effect of all the anti-nausea meds), and a one-a-day (just to keep my body healthy).

Yesterday, I actually forgot to take everything. That's a good second day. I remembered to take my Emend around noon... and, yes, I took it. I wasn't messing around with the magic that is Emend. I took the prilosec just before I ate... and took the senocott at the same time. I'm not messing with constipation either. Unnecessary. I can't remember if I took a compazine then, or if I skipped it. I think I took it. But I know I didn't take another one yesterday. I skipped straight to ativan as I was crawling into bed. Now, before anyone scolds me about messing up my regimen that has been working so well, my nurse had actually recommended it. She said that if everything is working so well, I was welcome to start experimenting with it to see how things go. Maybe I won't need as much. I like a nurse who pushes fewer drugs rather than more. That's my kind of nurse! ;)

I did sneak in another nap yesterday. I got about 2 hours. I love the naps. I wake up from them feeling energized. These naps are especially good on days that I'm feeling low energy to begin with. It's nice to wake up from one of these naps feeling refreshed.

Day 3
When the day begins, I'm starting to feel pretty normal. Actually, day 2 started for me that way yesterday. However, day 3 feels even moreso like normal. Today, I've taken my Emend and my compazine right away. I don't want to mess with fate. I have rehearsals (for my film) on Saturdays and don't want to feel poorly during that time. I have enough energy that I can even do a little housecleaning before anyone arrives. (I'm so my mother's daughter.)

By the end of my rehearsal, however, I'm feeling the energy drain. Particularly because I've had to be "on" for 3 or more hours. When rehearsal is over, I want to curl up on the couch and take a nap... and frequently do. Last time I had rehearsal on a chemo week, I took a 4 hour nap. We'll see how it goes today.

The rehearsals take place at my condo, by the way. Because the other way that chemo brain affects me is when I'm driving. I learned after my first session, that I absolutely should not get behind the wheel of a car the three days around chemo. The connections in my brain are much slower (and, hence, my reflexes) and all the meds make me just sleepy enough that driving is very difficult. So, I don't attempt it now. I don't know if it affects everyone that way, but it definitely affects me that way. And the good thing about that, is that it forces me to slow down on chemo days and take care of myself.

Okay, I've got to go eat some breakfast and clean my bathroom before my cast arrives.