Post-Holiday Update

I hope everyone had a good holiday. I know I did.

I spent the holiday with some of my family on the other side of the state. I wasn't sure I was going to be able to make it, at first. I'd had chemo on Thursday, December 21, and I made the 3-hour drive over on Christmas eve. I felt great when I woke up that day, but spent most of the two previous days sleeping.

I think I paid the price for all that rich food though. I've been feeling slightly off (queasy, but not sick) ever since. And, due to a weird nightmare that woke up me the other night at 5AM, my sleep schedule is all off now. I seem to be sleeping during the day and not sleeping at night. Sigh.

My goal is to get everything back on schedule tonight. And I need to get more active because I think that's part of the queasiness. I really haven't done anything but sit on my rear end since I got home after Christmas.

It looks like my surgery date is going to January 29 now. My plastic surgeon is on vacation around the time I was hoping to schedule it (January 19/22). My doctor has told me that the reconstruction is a tougher surgery than the mastectomy. He is planning a six-hour surgery (yikes!), and I will be in the hospital for four days. Last time, I was supposed to be in the hospital for a day, and I ended up being there for 2 1/2 days. Of course, that was probably because I was sick the entire first day due to a reaction to the morphine. Note to all future medical staff: don't give me morphine.

It's hard to believe that this part of the journey is so close to being over. I have one more chemo treatment, then onto reconstruction. That's when all this extra weight I've been carrying gets redistributed to my left breast, my hair grows back (again), and I can start feeling like I can get on with the next phase of my life.

Oh, by the way, I want to share this. A friend of mine recently mentioned a natural alternative to chemo called paw paw (or pawpaw or papaw... I've seen it spelled all three ways). It's a fruitHe's going to be bringing me more information on it. However, from what I've read, it seems to be effective against what are known as "multiple drug resistance" cells. These are the cells that don't respond to chemo. Since I still had live cancer cells in the breast tissue and lymph nodes that were removed during my surgery, I wonder if this would be effective in helping to ensure no cancer returns elsewhere in my body.

For most of my treatment, I've been very focused on treatment through modern western medicine. I really wanted to add some energy work and alternative treatments to that as well, but I just got so overwhelmed by everything that I was doing with modern medicine, that I didn't want to add more to the pile. But, I'm thinking that now that I'm moving on to the next phase, this might be a good time to add in some of those alternatives.

I think these can help me on multiple levels, the first being that I'll be continuing to fight for my health and well-being. I think that will give me the peace of mind of knowing that I'm still doing something and just not waiting around to see if I survive the next five years. And, if there is still cancer in my body that has resisted any previous treatments, this will allow me to continue combatting it even though I may have exhausted some of my other options. And, finally, it hopefully will also help my body overcome some of the trauma inflicted upon it by all the cancer treatments I've undergone to date.

I'm going to be looking into several alternatives, including energy field work, for going forward, so I'll post what I learn as I learn more.

New Development

There's been a slightly new development in my current situation that I want to share.

Sometime in the last couple of weeks, I started experiencing a strange speech problem. The best way I know how to describe it is that it's like when you've had a couple of drinks, your tongue starts feeling "fat," and you have problems saying certains words or combinations of words as a result. It comes off sounding a bit slurred. Well, that's the problem I've been experiencing... without drinking.

It's really been bothering me, and I meant to bring it up to my oncologist when I met with him last week. But we had so much to talk about with my chemotherapy treatment that it slipped my mind. However, I met with my radiation oncologist today to follow-up on how I'm doing since completing radiation, and I mentioned it to him.

He asked me a few questions about other possible symptoms and did a brief, simple neurological test on me. Based on that, neurologically speaking, I seem to be doing fine. I passed all the tests (follow my finger without moving your chin, etc.), but as a special precaution, he ordered an MRI for me.

Most likely, this is a side effect of the chemotherapy. I recently read an article that said chemo can affect you for several months after you stop treatment. However, I don't have any of the other symptoms of "chemo brain," which include short-term memory loss and difficulty in focusing and concentration. He's not overly concerned, but we definitely want to rule out something more serious.

So, my MRI is scheduled for Saturday, and I should have the results sometime next week.

The thing I find so interesting about this is that when I first noticed an issue with my breast (that eventually led to my diagnosis), it took about three weeks to get a result. They did schedule a mammography within a week, but then I had to come back a week later to get an ultrasound, and then I was scheduled for a biopsy a week after that. With the brain, they got me in within three days, and I should have my result within a week of when I brought it up.

So, when it's your brain, they don't mess around. And, for that, I am grateful.

I'll admit to being a little scared. The reason I'm scared isn't because I think it's something bad. Actually, I really do think it's most likely a side effect of the chemo. However, I'm back in the not knowing stage again. And that is, by far, the scariest part of this whole process. The worst part is not knowing what's going on and having to wait for an answer. And, that's where I am now.

I forgot what that feels like. I felt it when I first started down this road last March. However, last March, even as I was going through the process hoping they would find nothing, I pretty much knew what they would find. This time, even though I'm kind of scared about the whole thing, I'm just not as concerned. I feel like there's a really good chance that this is nothing but a side effect of my chemotherapy treatment.

As always, I'll keep you up-to-date, but I won't have any news to share before the middle of next week.

Next Steps

Okay. I know what (and when) my next steps are, so it's time for an update!

First of all, my skin is almost completely recovered from radiation. I have one tiny little spot that has a little bit of dry skin left that will probably peel away within the next couple of days. All of the other affected skin has completely healed. I look like I got a very strange and selective tan, but beyond that, my skin is like new. If you're wondering whether radiation leaves any scars, mine did not. Once the dead skin peeled away, I was pretty much left with my normal, albeit slightly tanned, skin.

Anyway, I met with my oncologist again last week, and we discussed once again whether I should get more chemo. This time, we really just kind of went through all the reasons for and against it.

Here are the reasons against getting more chemo:

1. Consensus guidelines are against it (for lack of evidence supporting it more than anything else).
2. My latest staging scans do not show any evidence of cancer (although microscopic cells wouldn't show up anyway).
   
3. There's no way to determine if there is any microscopic cancer cells in my body, so there's no way to determine if I need more chemo.
   
4. Since we can't see any cancer, there's nothing to measure to determine whether the chemo is effective.
   
5. Even if microscopic cancer cells do currently exist in my body, it's possible that I may have already gotten the maximum benefit from chemo that I'm going to get.
6. There's a limit of how much of the chemotheraphy drug (andriamycin) that you can receive before heart damage becomes a risk (although we will be staying well below that threshold).
   

Here are the reasons for getting more chemo:

1. There were still active cancer cells in the breast tissue and lymph nodes that were removed during my mastectomy.
2. Although this has not been proven conclusively, studies seem to indicate there's a chance that people with active cancer in the lymph nodes/breast tissue removed during surgery have a higher likelihood of cancer returning than those people for whom all the cancer cells were dead.
   
3. Inflammatory breast cancer is very aggressive and has a significantly higher risk of returning (or metastasizing) than other types of breast cancer.
4. Microscopic cancer cells wouldn't show up in the staging scans even if I did have it; tumors or cancer cell groupings need to be a certain size before they'll show up in scans. If I do already have cancer cells that have metastasized (spread beyond my lymph nodes), then I don't want to have to wait for them to show up to treat them.
5. If there were live cancer cells in 4 of the 5 lymph nodes that were removed, it's highly likely that some of the remaining lymph nodes (not removed) also had live cancer (although these cancer cells should have been killed off during radiation).
   
6. Some studies have recently shown that 6 rounds of AC (andriamycin and cytoxin) chemo treatment may be more effective than just 4 rounds (and I've only had 4 rounds so far).
7. There doesn't seem to be any "time limit" on when to receive the chemo. Two additional rounds will still have a cumulative effect based on the first four rounds I've already received.
8. I'm young and in good health, so the overall impact of additional chemotherapy is going to be minimal.
9. Given reasons 1-3, I think I will have much greater peace of mind knowing that I did everything I could to make sure I really got rid of the cancer.

Not only do I have more reasons to get chemo than to not, but the last reason kind of says it all for me. I think if I don't do this now, I'll constantly be worried that I didn't do enough... particularly if I ever do have to be treated again. I would constantly wonder if I could have prevented it simply by doing two additional rounds of chemo.

I believe that peace of mind will make a huge difference in my recovery, as well. I really believe that your attitude is a critical part of recovery. If I believe that I've done everything I can do to recover, then my peace of mind will create an environment in my body that is focused on recovery. But, if I'm constantly worried that I'm going to get more cancer, then I'd be creating an environment in my body that is more susceptible to getting cancer again. So, what's two extra sessions of chemo if I can gain that peace of mind?

So, for me, the answer was easy. More chemo. And, I want to be done with it, so I'm starting right away.

My first chemo session will be this Thursday. My last chemo session will be Friday, January 5. I don't have my surgery scheduled yet, but hopefully that will be scheduled by the end of January. Then, I will be able to get onto the next phase of my recovery.

After chemo is done, they'll put me on tamoxifin (or an equivalent) for 5 years. They have to take you off of tamoxifin after 5 years, but some of the newer drugs, they keep you on for 10 years. By the way, those timeframes have another significance in my recovery as well. If I get through 5 years without any cancer recurring, then my chances for survival increase significantly. If I get through 10 years with any recurrence, then my survival chances increase exponentially.

So, that's where I am now. As always, I'll keep you updated as I learn more.