i do not make new year resolutions, but i can tell you what i am most thankful for this year......

i would like to be able to say that i have never made ANY  new year resolutions. but of course, i did when i was younger. i quickly learned that not only did i end up not keeping any of them, but it was pretty much pointless because who of us knows what the future will bring? as someone whose life has turned on a dime, i can attest to the fact that making promises to yourself to do this or that without knowing what the future holds is pretty useless.

of course, i am thankful for my family and friends most of all. without their love and support, i do not think that i could have endured this past year. i am so very grateful to all of you- you know who you are- and i will never be able to thank you enough.

 another thing that i have  been thankful for this year is good health care. i have had wonderful doctors, nurses, and other health care professionals who have done their best to help me get well. i am grateful to live in a country where i can have access to the best hospitals and treatment options. i have never taken that for granted. i will admit to doing some research on choosing the " who, what and where " in my health care, but it was available and i am very appreciative for that.

 i am thankful for  music. over the holidays, my sister and i noted the fact that when we were growing up, we were always surrounded by lots of  music. we both sort of took it for granted. our dad and uncle played guitars, and there was always music playing somewhere. when i was so sick this summer and fall ,during and  after chemotherapy, and i  found it hard to get out of bed, i listened to music. the music that i was most thankful for was the music of george gershwin. i "discovered" him thanks to my eight grade teacher. she assigned research topics for all of her students, and she gave me george. i fell in love with his music, and love it to this day. so as i lay in bed, cold washcloth on my head and trying not to be sick, i concentrated on gershwin's beautiful music. listening to music not only helped me pass the time, but gave me something wonderful to experience and focus on. if there is anyone out there  who somehow doubts  the existence of God or heaven, just listen to "rhapsody in blue".

of course, i like all GOOD music. i am not just about classical. i enjoy rock music of my generation, jazz, world music, reggae, gospel, about anything except hard rock- just never got into that. i am sure that there is some good hard rock out there, but it just always gave me a headache. my husband says that my CD selections probably baffle amazon. they never know what to recommend for me! if they tried to add all of my selections into a computer to figure out exactly what i liked, the computer would probably explode or something. one thing i do know, though, is that  music can improve my mood, lift me past my troubles, and sometimes even transport me back to the time when i first heard a particular song.

i received the remastered CD of " rubber soul" by the beatles for Christmas this year. that was my favorite album when i was a young( very young, lol) teenager. one of my cousins gave it to me for Christmas right after it first came out. my cousin was working on the west coast, and had purchased it before it had been released around where i lived. i played that album so much, i practically wore it out! i know that my parents got tired of hearing that album over and over. in case you wondered, my favorite song on the album was ( still is) " norwegian wood". it was the first time that i had ever heard a sitar, and i was just blown away. to this day, just  hearing this CD just takes me back to when i was very young.

so, i will not be making any new year  resolutions tonight. i am being thankful for all the good things that have happened to me this year, and will be hoping for better health in 2016. happy new year to all of my family and friends out there, and my wish for you is good health and lots of good music!

2105 in review, or my year of the roller coaster ride

2015 started out well enough for me. you know that feeling  when you are on a roller coaster and at first you think, " hey, this will not be that bad!". then you start to go slowly  up the first hill and your stomach starts to drop.the feeling that" everything is o.k." is pretty much over after that.

i looked back on my national wildlife calendar- which is pretty much an outline of my life for a particular  year. ( by the way, my dad started the tradition of giving us all calendars from national wildlife so that we could keep up with events, birthdays,etc. i have continued that tradition since my dad's  passing by purchasing one every year  for me and both of my children. ) anyway, the first of the year found me working full time and taking care, as much as he would let me, of my husband after his second hip replacement. he should be the poster child for how you do a hip replacement. he went to all of his physical therapy sessions, did the exercises at home, and returned to work in record time. well, there was that one time he went outside USING HIS WALKER to clear snow off of the walkway to our house. but i will let that go since fortunately there was not a trip to the emergency room involved.

if you are like me, you remember the "ides of march" from high school literature. i am not sure if it was shakespeare, my english teacher, or a combination of both, but i have always felt a little uneasy this time of year. the actual date to beware of, is  march 15th. on march 18th of this year ( close enough to the ides of march, in my opinion) i had my first mammogram. a few days later i had my 3D mammogram, then the first biopsy-a few days after that. and so i began my journey. the day that i got my cancer diagnosis from the surgeon was on my wedding anniversary ( april 2nd) . my husband was with me that day, of course, and we went on with our plans for the day. but it was not a happy day by any means.

this being said, my roller coaster ride of 2015 had some very good "highs". my first granddaughter was born on september 16th of this year. her name is violet, and she is a sweet little flower. she has managed to capture the hearts of everyone in our family with her good nature and sweet smiles. i have a feeling,  though, that she will rule the roost, so to speak, when she gets together with her brother and cousin at our family events.

my journey with breast cancer has had a lot of unexpected twists and turns. there have been many bumps in the road. but, i have a lot to be thankful for. the cancer had not spread to my lymph nodes, even though i had the three tumors and a random smattering of cancer cells on one side. i had to take the chemotherapy because my cancer was an aggressive type( invasive lobular). i opted for  bilateral mastectomies, with my surgeon's blessing. he said that if i had not chosen to do it now, i would no doubt be back in a couple of years for surgery on the other side. i decided to just take care of things now. i have NO intentions of doing this again!

of all things to worry about, i worried what the oldest of my grandchildren, who is 4 years old, would think about my appearance. i did not want him to be worried or afraid of me. leave it to sweet little children, though. all that he has said is " i really like your scarf, mimi!"( i am keeping my head covered until my hair grows out a little bit more ).  he knows that he has to be somewhat careful around me, but other than that, things have been pretty normal.

i have  to have blood work done in march of this year to check for tumor markers. i am not sure how close it will be to the ides of march since my doctor's office has not contacted me with the exact date as yet. in april, i have a CAT scan scheduled to make sure that the cancer has not spread to my chest,lungs,etc. i also have a big thyroid cancer check up in april. april sounds a little scarier than march this year, but i am hoping for good news. i would like to spend this year away from doctors, hospitals, and roller coasters. i am praying for good health in 2016- for me and for all of my family and friends.

FYI

i was  encouraged by Cure Forward to write an open letter to a  newly diagnosed cancer patient.  i have been hanging out here in my breast cancer blog for a while. i feel that i needed to write a new blog for my thyroid cancer blog. so for those of you who are newly diagnosed with breast, or any other cancer , you might want to check it out. the link to my thyroid cancer blog is : losingthebutterfly@blogspot.com. i hope you enjoy reading it, and i hope that it perhaps will help newbies  who are beginning their cancer journey.

as always, thanks to everyone for their support, and thanks for reading my blogs!

ten ( mostly) good things chemotherapy taught me

i was thinking ( sometimes a dangerous thing) the other day, that thanks to chemotherapy i could now paint my fingernails and have them look better than if a five year old had  painted them. well, i know there are some talented five year old finger nail painters out there, but you get the idea. i also decided that thanks to chemo, i learned to apply my make up a lot better. this i realized whenever i was deathly pale, yet applied my make up and was told " i looked so good." i know, if you are like me, you have read many " what i learned from this ,that, or the other" lists. i am not sure if someone has done one about chemotherapy, but here goes.

1. never, ever complain about " bad hair days". i mean, a bad hair day beats a no hair day, any day.

2. a stash of barf bags is a precious thing. i had several- they slept beside my bed, and accompanied me on road trips. i named them all " barney."

3. enjoy your food. revel in the taste, texture, and temperature. never take eating for granted.

4. learn to paint your nails. the type of  chemotherapy that  i was on turned all of my nails brown- yuck. and they all split and splintered off. a nicely applied nail polish not only looks good, but it improves your spirits. not to mention it does not scream " nail fungus" to others.

5. make up is a wonderful thing. i could be sick as a dog, but when i put some nicely placed make up on my face, i tricked others ( as well as myself) into believing  that i was feeling fine.

6. you actually do lose a whole lot of body heat through your head! mom was right. wear a nice warm hat.

7. drinking lots of water keeps you healthy. water in, bad old chemotherapy out- well, some of it, at least. also, your kidneys will thank you.

8. learn to let others help you. i am still working on this one. i think that i have to do everything myself, but when you are having chemotherapy, you have to depend on others to help you with certain things. and it has been my experience that people really do like to lend a hand to those of us who are dealing with cancer.

9. be grateful for the small stuff. a cold, wet washcloth, a nice hot blanket, something cool to drink,etc. these things are priceless.

10. i forgot number ten! lol. actually using the " chemo brain is real card" has come in pretty handy at times.

so that is my list. i am sure that i will think of others when i am trying to go to sleep tonight. oh, be thankful for a good night's sleep. you will never sleep as well as you do when you get to that last chemotherapy treatment.

in the spirit of full disclosure, AKA, time to fess up, i must tell a story on myself...

for quite some time, i have been telling a funny story about  my husband which happened after one of his hip surgeries. he has had them both replaced, and must be a tough guy or the bionic man- i have not yet  decided which . anyway,the day of his surgery  he had missed supper because his surgery ran late. he was unfortunately looking at a questionable cold cut sandwich from the hospital kitchen. our son, who had come by to visit his dad, asked my husband if he would like something better for supper. my son left the hospital and went out in search of the perfect fish sandwich per jeff's request. what he came back with was the most ginormous fish sandwich that i have ever seen in my life! it was a very large bun, but the piece of fish was so large that it was hanging over both sides of the bun. my husband lit into that sandwich like there was no tomorrow!

my son and i looked at each other for a few minutes, then stared, open mouthed at my husband as he quickly consumed the entire whale (haha) of the sandwich. my son had to leave for home, so i sat there by myself keeping an eagle eye on jeff. i knew that the fish was not a salmon, but i fully expected the fish to be " swimming upstream, from whence it came" at any moment. it turned out, and very  thankfully, that this did not happen. and the funniest thing was that the next day my husband did not even remember that he had eaten a sandwich. much less one that could have been a spawn of moby dick.

so, time to fess up. in my defense, i was not myself. i had just had pretty major surgery, and was still under the effects of the anesthesia( that is my story, and i am sticking to it). on the way home yesterday,  jeff had to go by the pharmacy to get my antibiotic prescription filled. he asked if there was anything else  that i wanted, and i said yes there was. my throat was and still is hurting from the intubation tube they used in my surgery. i told him that the pharmacy usually carried individual servings of haagen dazs vanilla ice cream, and that i thought this would be very good for my throat. when he returned, it was not with the small, individual size, but a full pint! he told me," well just eat what you want and we will discard the rest."  as the old, but popular commercial said, I ATE THE WHOLE THING! i even poured a little coke on what was left after i had eaten about two thirds of the container to make myself a nice, little coke float. let me say here  that i have never before eaten a whole pint of ice cream at one sitting. maybe half a pint, but not the whole thing!

even funnier, was the fact that later on that night, after i had "sobered up" a bit, i asked for a little ice cream. my husband said, " really? i thought you might have had enough for today!" i was totally unaware , until then, what i had done. i can barely remember the wonderfully delicious ice cream. i definitely do not want to remember the AMOUNT that i consumed. all i can say, is that perhaps my husband was playing a little trick on me and the whole thing was just a "whale of a tail" after all! oh, had it not been for that huge, empty container of haagen dazs ice cream in the car...

" so comes snow after fire, and even dragons have their endings." from the hobbit, by J. R. R. tolkein

i guess that this is my favorite quote from the hobbit. i know that i have used it a few times in my blog. but it is a good reminder to me that unpleasant things do not go on forever, although they might seem to. i can really relate to  bilbo baggins, though. here is this person who is just going about his normal daily life, when out of the blue, fate dropped a bomb shell and his life changed forever. that pretty much sums up what happened to me. i was just going about a "normal" life, when a yearly mammogram sent me on this unexpected journey, and changed my life forever.

just when i thought that i had this "new normal" life almost figured out, i encountered some more twists in the road yesterday. i went for my three month check up with the oncologist, and blood work. with the exception of about three lab values, that are not critical ones, my blood values have returned to normal. score one for me. i have been having some pretty severe  muscle and bone pain with the arimidex( estrogen blocking drug). it is the best choice for my situation and age group, so i am trying to see if these side effects will go away. at first, i also had nausea( the bane of my existence) and night sweats. thankfully, these two side effects are mostly gone. i am hoping that my body can adjust to the bone/ muscle pain and i can continue to take the arimidex. the oncologist said that we would give it two more months and see how i do. there are other choices for estrogen blocking drugs, but they may not be quite as effective as this one. twist number one: the doctor said that new studies have shown that instead of taking the estrogen blocking drugs for 5 years, as previously thought, it may be beneficial to take them for TEN YEARS.holy cow, i was not expecting that! my eyes must have gotten pretty big, because the doctor said, well, we will evaluate the situation in 5 years and make a decision at that point.

this is the biggest twist in the road: the oncologist also said that i would come back for more blood work and another office visit in march( i had expected that) but he also wanted to do a CT scan with contrast dye in may, 2016 to make sure that the cancer had not spread to my chest, lungs or bones. the oncologist said that even though my cancer had not spread to my lymph nodes, it was an aggressive type, and having had three fairly good sized tumors and an area of different cancer cells, i was at risk of the cancer spreading. i was pretty shocked to hear this, for some reason. i guess that it is good that the doctors do not give you all of the information at one time because it could be pretty overwhelming.

several people have asked me what stage breast cancer i have. ( or as  i like to think, HAD). i asked the oncologist, and he just shook his head. he said that it is more complicated now to assign a stage to breast cancer. there are so many factors to consider - how many tumors, what size they are, what type of breast cancer( mine was invasive lobular- a fairly rare kind), and of course lymph node involvement to name a few . and if that was not complicated enough, not every physician agrees on the guidelines for staging breast cancer. some consider the size of the biggest tumor, some add the tumor sizes together,etc. so the oncologist said, if he had to guess, it would probably be a stage IIb or so. sounds good on paper, but that does not tell the entire story, so i will just not worry about staging. i plan to follow up with all testing and therapy recommended, and maintain a positive attitude.

on a lighter note, thank goodness, there was a lot of interest in my "hair" yesterday. i saw the nurse practitioner first, and she asked to see my hair( i was wearing a pre-tied chemo beanie. plenty of bling on it, i might add!) she asked if she could feel it- i said o.k. no it was not creepy. she laughed and said that it was so very soft- like baby's hair. when the oncologist was getting ready  to leave, after his visit, the nurse practitioner said to the doctor " you have got to feel her hair!". to my amazement, he did, and said that it was indeed very soft, and that i was doing a fine job growing it out. he said that pretty soon i would not need my scarf. i told him i was not sure i was brave enough to go without my scarf just yet. besides, my head gets cold! it is so true about losing your body heat through your head. my two month old granddaughter and i are having a " hair growing contest". she was winning, but now i think that i am ahead. pun intended! there has to be some good news, right? even if i am having a little difficulty slaying that darn dragon.

so my surgeon said to me yesterday, when he removed the bandage on my chest, " i think we dodged a bullet "

i was really dreading going back to the surgeon yesterday. i had not removed the dressing on my chest because i was afraid to look! the surgeon told me that i could remove the bandage in 5 days or so, and that i could then take a shower. but i think that i made the correct decision to wait another day or two. ( don't worry, i took tub baths !) i was afraid that the surgeon would want to add more saline or remove some of the stitches( while it seemed like i had 50 or so, i only have  7 stitches). my chest is very sore now- at least the part that is not numb. i was thankful that the doctor wanted to wait until next week to continue with the "expansion process.". yes, that still makes me think of the oregon trail computer game.

when the doctor  told me that " we dodged a bullet", i got up enough nerve to look at my chest. it does not look as bad as i had imagined , and i have to say that while the suture material was probably thick enough to knit a sweater with , the surgeon has made nice, tidy little stitches. the most important thing to note, is that the procedure that he did in the office last week,  along with the oral antibiotics that i took, prevented any infection. while i am sore, i am still on track for my final surgery date. that is provided that the expansion process goes well.  i am so thankful that i am going to be able to get this surgery done next month so that i can begin to put at least some of this behind me.

i saw a cartoon on face book of a butterfly being pulled over by a police officer. he was telling the officer that the picture on his driver's licence was an old one. it showed a picture of a caterpillar. i thought that it was funny until a store clerk told me, while she was checking my driver's license, " oh, that is a picture of you when you had hair!". ha-,ha,-ha. i think my husband was waiting for some sort of explosion, but i just calmly told her that yes i had hair then, but that  i would have hair again before too long. there are so many unexpected events that go along with having cancer. procedures do not go as planned, and sometimes people say the strangest things. i have found, though, i do best when i just try to make the best of things. i suppose if i wore wigs, it might be easier for me? but i have discovered  that scarves just feel right for me. they are soft, comfortable and as one person told me, " they fit my bohemian style". i took that as a very nice compliment, because i do like to be myself . as i get older, i find that the person  i need to please is  me. after all, in the end, i will be the one responsible for all of my life choices. i want to be happy and proud of the decisions that i have made.

sometimes, in life, it seems there is so much that is not under our control. it feels to me like i have been dodging a lot of bullets for a while now. some found their mark, of course. but overall, i am thankful that things have happened as they have. i am grateful to all of my family, friends and of course to all of the wonderful medical staff that have helped, and continue to help me along my journey with breast cancer. my faith is a personal thing to me, but it is stronger now,  and i am not sure that i could have gotten through this journey without it. it has been said that it takes a village to raise a child and i agree. i also think that it takes a village to successfully get through cancer.

Yo, Ho, Ho.......and a bottle of Advil (??!!!)

my faith, family, and friends are what got me through chemotherapy. i will admit that one other thing that really helped me get through the hard times was the promise of a beach trip. we did not get to go on vacation this year, during the summer, as we usually do. my husband promised me that just as soon as i finished chemo, and was feeling better,  we would take a trip to the beach.


we usually go to the outer banks, but due to distance and weather concerns, we picked a place closer- on the north carolina coast. i was going to be happy anywhere that had an ocean and fresh seafood! it took us about 6 hours to get here. that is about 3 hours shorter than if we had gone to the outer banks, which as it turned out, was a good thing.

on the saturday night, before we left for our trip on sunday, the place on my chest which was not healing decided to break open again. this time, it was a rather large hole. my surgeon said that he would do the surgery on that place at the same time as he would do the surgery for my permanent implants. with that in mind, i just re-dressed it as i have been doing for about 5 months now , and finished getting ready. long story short, i knew that something was "different" this time, so i called the surgeon on monday morning. he asked me to text him a picture of the area, which i did. within just a few minutes, his nurse called me back and said for me to come to the office immediately! when i explained that i was at the beach on vacation, she said " sorry, but the doctor wants you here ASAP". we had just unpacked the car less than 24 hours ago, but early tuesday morning, we found ourselves packed up and headed to the surgeon's office.

i was hoping that he would just look at it and give me some antibiotics. i was afraid that he might put me in the hospital. what he did was something in between. when i got to the office, his nurse took me way down the hall to the "sterile room". she said, " you have never been  to this room before, have you?". that was my first sign, you might say. so, after a quick exam, the surgeon told me that first,  he was going to remove quite a bit of the saline from the implant on that side. it was disheartening to see my chest go down on one side. i just joked and told him " you sank the Titanic!". he laughed and said that it was " deflate gate" all over again. he must be a football fan.

then he got out the topical anesthetic and told me that he was going to numb me up for some surgery. i am so glad that i had not thought of him doing this ahead of time. my husband thought there might be a chance the surgeon would  do this, but he wisely kept that thought to himself. at least i did not have too much time to worry about what was going to happen.. so he did the " re-cut and re-stitch" part of my surgery yesterday. he told me to look the other way and i usually look, but this time i took his advice. good idea.the surgery actually  took quite  a while, but my husband was waiting for me in the waiting room and helped me out to the car. i did get a prescription for antibiotics, and  i have to check my temperature and watch for signs of infection. my surgeon told me that i could return to the beach, but that i have to be back at his office on monday.

 thankfully, there are several good things to report. i am sore, but i seem to be doing o.k. i am taking my antibiotics and there are no signs of infection. i am dreading the, at least two, sessions where the surgeon will have to add the saline back into my temporary implant. this has to be completed and there be no infection before he can do my final surgery. AND I AM AT THE BEACH!! nothing quite like a little "vitamin sea" and flounder to make a person feel better. hopefully this has not delayed the final surgery, which has already  been scheduled for december 4th. so, a pirates life for me- at least for a few more days. thanks again for everyone's prayers and good wishes!

back to making lemonade!!

yesterday i went to see my plastic surgeon. it was for a follow up visit, and also to schedule my last surgery. the one where i will get my permanent implants for reconstruction. for five months now, i have been working on healing up a place on my right "foobie" where the stitches broke open. some of it was my fault, i will admit. i am not a good patient. i went grocery shopping by myself too early, and on top of that, i carried in all of the groceries. it would have been o.k. if i had made 70 trips or so, but me being me, i carried them all in in about three trips. it was shortly after that when the stitches broke open. my plastic surgeon said," well sometimes things like this happen." yesterday when he looked at my chest he grimaced. never a good thing when a surgeon makes a "yuck face" when checking you out!

i have been using hydrogen peroxide and bactroban( antibiotic ointment )  as per the surgeon's instructions all this time. i think that some of my slow healing was perhaps due to the chemotherapy. it was all happening at the same time, and i think that the toxic drugs slowed down the healing process. my white blood cells did plummet about 3 times, so that played a part. so, the surgeon said that he now has to " re-cut and re-stitch" that place on my chest. he will do it when i am under anesthesia ( thank God) for the reconstruction. just thinking about this makes me cringe! i really do not have any or very much feeling in that area, but it is just mainly the idea of the procedure that makes me queasy.

i was pretty depressed yesterday, i will admit. the idea of having to fix my incision too, means that the surgery will take longer and i run a higher risk of infection, to quote the surgeon. what should be a " same day" surgery , now  could possibly   involve an overnight stay. also, there is a possibility of a DRAIN. i had four drains  when i had my bilateral mastectomies. they were cumbersome to say the least, but i will admit that although i really dreaded having the drains removed in the office, it was not that uncomfortable. if anyone reading this has to have drains removed, just remember to take a deep breath in and blow out when the nurse removes them. i am not sure if this helps with the removal process or just takes your mind off of what the nurse is doing. either way, it works.

i thought that my surgery would probably be the second week in november. that would have worked out perfectly. notice i used the words WOULD HAVE. as it is, my pre-op appointment is on november 23rd, and my surgery is not until december 4th. #everybodylovesmysurgeon  and #thatiswhyheissobusy. it is my turn to have all the family over for thanksgiving this year. we have a Christmas celebration planned for the week before Christmas. (we do the" every other"thing in my family since we are a little scattered out). i think that the holidays/surgery will sort itself out, but one of my grandson's birthdays is on december 3rd. i am pretty sure that his party will be on december 5th, due to his parent's work schedules. i probably will not be able to make the party this year. i have decided to spend some time with him on his actual birthday, and hope that he will understand why i will not be able to attend his party( he will be 4 this year).

so, after getting a bunch of lemons yesterday, i decided, after a short while of feeling sorry for myself, to make lemonade. after all, i have so much to be thankful for. things could be a whole lot worse for me, and i have great family and friends for support. things may not be going the way that i thought that they would, but at least they are going. and as a bonus, i finally get to go to the beach next week! a little beach therapy is just what the doctor ordered, i think.

where to now, on my journey?

when i started this "unexpected journey with breast cancer" i was pretty numb. i knew the facts of my situation, from a health stand point, and i knew, after research and discussion, what my treatment options were going to be. i just did what i had to do to hopefully get rid of this cancer and get better. a lot of people that i know have said that i am brave, but i do not feel brave at all. i suppose that if you consider a quote that i have come to consider my  motto of sorts, and i will paraphrase, " being afraid of the horse, but saddling up to ride anyway" then i am somewhat brave. that is what i have had to do. i have had to make difficult health choices, and i have been scared to death at times, but i have followed through with what i believe will be best for my health. or to put it another way, i have done what i had to do, so that i can be here to  spend more time with my family and friends.

i purchased  a new cell phone this weekend. it has been fun exploring  all of the new gadgets that this phone has, and i am really looking forward to taking better pictures of my children and grandchildren. last night,  i was playing around adding ring tones for various contacts and message alerts when  i came across the theme song  from the "hobbit, an unexpected journey". and of course i had to add that one. for some reason, that music makes me very sentimental. o.k. , i might tear up a bit. but when i hear it, i think of my journey- when i started it( this past march- believe it or not) with my first mammogram. from there things moved so fast, it seems to me. i took a few days off, when i had the fine needle biopsy, and then again for the sterotactic biopsy, but i worked up to the day before my surgery. i see my plastic surgeon again on october 26th, and he will decide when my last surgery for the reconstruction will be. i think it will probably be the second week in november, from what the office staff has told me. the surgeon said that i would need about two weeks to recover from the surgery- it is an out patient procedure.

one of the hardest parts of this whole process has been the chemotherapy. i am not used to being in bed with a cold wash cloth on my head for large parts of the day! as my dad used to say, it was something that really " got my attention" ! the nausea was something that really sidelined me for more time that i could have imagined. but of course, another challenge has been losing my breasts. i was switching out my summer night gowns for my winter night  gowns last night, and i came across all of my old bras. i had just stashed them in a chest upstairs, and had forgotten about them. of course, i can not wear them anymore. i suppose that it was just too difficult for me to throw them away at first.  my husband offered to throw them away for me, but i wanted to do it myself. i constantly  remind myself that i am so fortunate to have had my children and breast fed them before i had breast cancer. my heart goes out to those women diagnosed with breast cancer  who are young, and have not had this opportunity. i think that working in health care has enabled me to see that whenever i start to  feel sorry for myself, i can think of so many others who have had a more difficult journey than my own.

so, i am beginning to ask myself some difficult questions, such as  where to now on my journey? i am still somewhat in the recovery stage. i have occasional nausea and headaches, and a few of my toes are still numb from the chemotherapy. my hair, eyebrows, and eyelashes are finally starting to grow back in, so i look " less sick". i do get pretty tired in the afternoons, and i am not  as patient with myself, perhaps, as i should be. but i am beginning to wonder where i am going from here. what do i want to do with my life?  i received a good thyroid cancer check up this week, but all and all i am pretty tired of cancer. i do not want it to define my life, as others say, but in reality,  it just does. everything has changed- but not all of it is negative. i am still humbled by all of the cards, gifts, and comments on facebook that i have received from friends that i know and do not know. i hope that everyone knows just how much that has meant to me. some days, when i was feeling so poorly, a card would come in , or i would read a supportive post on facebook, and it would just make my day. the good thoughts, best wishes and prayers helped me get through the really tough parts. and i am so very grateful for that.

so like the hobbit on his journey, i am not sure what is waiting for me on the road ahead. i am trying to put one foot in front of the other, and hoping that i make good decisions along the way.  i think that in some ways, the first part of my journey was a little easier than it is now. at this point , i still have some health choices to make, but it has  become  a question of not so much how, but where i am going. i will have to get back to you on that one.

new treatment guidelines for some women with early stage breast cancer? is it me, or does anyone else hear kenny rogers singing his song, " the gambler"?

last night on the cbs evening news, i heard a report about the possible change in treatment for some women with early stage breast cancer. the study was reported in the new england journal of medicine- the gold standard of medical journals,  in my opinion. there was not enough information,( for me )  so i went to the cbs news website and listened to the report again. from what i could gather, was that in women with early stage breast cancer, and considered to be very low risk- tumors that are estrogen receptive, no lymph node involvement ( i assume, do not quote me on this one), and small size tumors, chemotherapy may not be the answer. instead of the traditional chemo cocktail, these women were given an estrogen blocking drug only. the recurrence rate was less than 1% after 5 years. this is a major breakthrough in treatment, i think.

i think that early detection of breast cancer is essential, of course, in order for this to be a viable treatment option. and i still think that it is a bit of a, as kenny rogers would put it,  gamble. of course i believe that treatment for every cancer is a gamble to some degree . it is crucial for the patient to gather as much information as possible and get second opinions, if possible, before deciding on what treatment may be best for them. this refers  back to what i am always saying- everyone needs to be their own  best patient advocate. research, research, research and ask plenty of questions along the way.  no one has a crystal ball, unfortunately, so no one is certain that the choices that are made today will be the correct ones, as far as treatment and recurrence are concerned.

in my case, for example, i was not certain at first if i would need chemotherapy. my general surgeon said that he usually could tell a patient if they would be needing chemotherapy or not. he said in my case, he had absolutely no idea what the oncologist would say. ( figures, right?). the staging of breast cancer has changed dramatically from what it once was. no more just stage 1,2,3,4. now there are many factors to consider- is it estrogen/progesterone receptive? how large are the tumors? what type of breast cancer is it? are the lymph nodes involved? etc, when i asked my oncologist what stage i was in, he just looked down and shook his head. he said that it was not cut and dry any longer. all i could pin him down on, and believe me i tried, was that i was at " moderate risk" and yes, i would need chemotherapy.

i also read a study about patients who have had  thyroid cancer and then were diagnosed with a second primary cancer. this was a study that was conducted in taiwan ,with a population size of about 19,000 patients. two things struck me, almost literally. first, for patients who had had thyroid cancer, there was a 33% increase in the risk of a second primary cancer, breast cancer being one of the " choices". another horrifying result of the study was that the median survival rate after the diagnosis of the secondary cancer was only 4.7 years. (the full article title is: second primary malignancies following thyroid cancer: a population based study in taiwan, eur j. endocrinol 2013. 169.577-85)
after freaking out a little bit, i realized that several facts, that i needed to consider, were missing from this study. what stage thyroid cancer did these patients have? how was it treated? what type of cancer screening did the patients have? what stage was the second primary cancer and how was it treated? health care in taiwan, i assume, is different than health care in the united states. i am not saying one is better than the other, just different.

i think that all  cancer treatment is a gamble. the best that  anyone can do is to gather information and make, what we think, is the best decision for ourselves. no one has all of the answers. i decided to be aggressive with my breast cancer treatment, and my physicians agreed. i have my big thyroid cancer check up in a little over two weeks. you can bet that i am going to discuss the article on thyroid cancer and second primary cancers with my endocrinologist. one of my doctors told me that i have " the most positive attitude" about my cancer. i think that it is important to be positive, but at the same time, realistic. who knows what the future holds for any of us, but all of us need to make our time count and enjoy every minute of it.

well, my last surgery is what you might call a "farsee"

a long, long time ago, when my husband and i were younger, we went back pack camping. i had an old back pack, that was so uncomfortable. it hit the small of my back with every step that i took, and after a while i began to ask- like a little child on a long road trip would ask - how far is it to our camping site? jeff would reply," oh, it is just a farsee away. see those trees up ahead? just a little past that." as you might imagine, this " farsee" kept moving forward a little- every time that i asked.

today, i went back to my plastic surgeon. i wore one of  the button up blouses that i usually wear to work, just to see how things look now. i asked my husband's opinion, and ever the diplomat, he said you look just great, sweetheart. the nurse thought that i looked fine,too. the blouse fit well, without that little gap about the third or fourth button down. most of the  women reading this blog will know exactly what i am talking about. i really hate trying on a blouse and it fits everywhere except that one button that has a gap large enough to give someone a peek at your bra. the surgeon said, well, we could add some saline to give more " forward projection", but if you are o.k. with things, we will just stop. HOORAY!!! no more saline filled needles in my chest. my chest is still tight, and i feel phantom breast pain( this is so weird) on occasion, but just knowing the " saline stops here" makes me happy.

i thought that i would be having my last surgery, to remove the temporary saline inserts, and insert the permanent silicone implants, in october. the surgeon sort of hinted at that time frame. turns out, it will not be in october, but will be in november.  the surgeon said that i needed more time for my blood work to come back up to " normal" as well as more recovery time  from other side effects of the chemotherapy. the oncologist filled out my paperwork on my medical leave of absence. part of it was a paid leave, which i really appreciated,  but i am now on unpaid leave. when i looked at the paperwork, and this was before i started the chemo, i almost laughed at his end date. i told jeff,  " look, sweetie, he put down that i needed to be out until the end of december! how funny. i know i can go back before then!". famous last words, as they say. now i know that i will indeed need this much time off. the receptionist told me that it generally takes about 2 weeks to schedule the last surgery . after my visit on october 26th. if all goes well, it will probably be the second week of november before i will be able to have the permanent implants inserted. also, the surgeon said that it takes about one or two weeks to recover from this surgery. i will spare you the details of this surgery. it is same day surgery, though, so unless something happens, i will be going home the day of the surgery.

i did get some good news about the surgery, though. the plastic surgeon said, " your double mastectomies were a 10 on a scale of 1-10 as far as pain goes. this last surgery will be about a 3 or 4."  yippee, i guess? i do handle pain way better than nausea, though. i know that i will have a little nausea from the anesthesia/pain medicine in the hospital, but it will be short lived , unlike the nausea with chemo. yes, i am still having nausea from the chemo. i thought that there was something wrong with me, but i have read that other women have this problem,too. at least it is not an all day event, like before. and some days of course, are better than others. so i am getting there. slowly making progress. my last surgery, as well as my recovery from chemo, is a "farsee". and i can almost see it now.

this blog is a 2-fer or as they sometimes say, a bogo

right before i started my unexpected journey with breast cancer, i was anticipating my six month check up for thyroid cancer. i am a five year survivor from that, but still have to go every six months for ultrasounds, blood work,etc. because my thyroid cancer was the "aggressive type" and two of the tumors had spilled out into my lymphatic system. my big thyroid cancer  check ups occur every april and october like clockwork, that is until this year. in march of this year, i had the infamous screening mammogram, then the 3d mammogram, then of course, my cascading domino path to breast cancer.

so, i did not get to have my april thyroid cancer check up this year. i have the one for october already scheduled, but i have to work in another surgery to finish my breast reconstruction in october as well. around the first of this year, i noticed a change in my overall health. i was exhausted- and i do not have to tell anyone with thyroid issues, much less those of us who are missing a thyroid, how exhausted we get. but this was somewhat beyond that. also, i had begun to lose a little weight without trying( for a change). my allergy to sulfite preservatives had gotten a little bit better for a while, but was now back with a vengeance. in other words, i knew something was wrong, but i honestly thought that my thyroid cancer had returned somewhere. to say my socks were knocked off when i got my breast cancer diagnosis is putting it mildly.

one of the first things that i asked the surgeon after my operations was if there were any thyroid cancer cells in my breasts. this is how thyroid cancer spreads. some rogue, or sarah palin if you will, cells migrate to another place in your body to cause mayhem, and well, cancer. he said no, that all of the cells were breast cancer cells. i suppose that is good news. if the thyroid cancer cells did not move to my breasts, i can probably assume that they have not taken up residence somewhere else in my body. of course i will not know for sure until my check up next month, but i am hoping for the best.

i have personally known of three people who have had thyroid cancer, then had breast cancer. is this a coincidence? are they somehow related? a bogo, so to speak? there has been no research, to my knowledge, to prove any connection between having thyroid cancer and then breast cancer . one of my thyroid cancer books tried to dispel a rumor that the treatment with the I-131 could cause breast cancer. i mean, it is not like we thyroid cancer patients really have a choice. the I-131 is the only treatment drug so far that is available to kill any thyroid cancer cells that escape the skilled hands of our surgeons. the advice that the author gave in her thyroid cancer book, was to get the I-131 treatment, but be sure to get regular mammograms- a good idea anyway.

now that i can see the light at the end of the breast cancer tunnel, i have started to ponder what news my october thyroid cancer testing  will bring. as i have said before, if you have breast cancer you have more support and understanding from the general public. sad to say, but some people do not know where the thyroid gland is located or what it affects ( everything) in the body. thyroid cancer happens to be the fastest growing cancer now. in a few years, it is supposed to top colon cancer in the amount of people who have it. i really  appreciate all of the support and love that i have received during my breast cancer journey. losing both of my breasts was one of the most traumatic things that has ever happened to me. chemotherapy was one of the roughest things that has ever  happened to me. that said, i wish that thyroid cancer patients were afforded more understanding and compassion.

someone told me that after reading my blogs, they thought that maybe thyroid cancer was indeed " the good cancer". i disagree. no cancer is anywhere near a good cancer. there are challenges, heartbreak, and life changing events that come with any cancer. i am praying that someday we can treat all cancers successfully. until then, we need to keep searching for cures, and most of all make sure that we treat ALL cancer patients with compassion, respect, and loving care.

"where did you go, if i may ask? said thorin to gandalf as they rode along. to look ahead, said he. and what brought you back in the nick of time? looking behind, said he. " from the hobbit by j. r. r. tolkein

yes, i know that i have used this quote before, but it is so fitting for this blog today. today marks the 3 month anniversary of my surgery. as i think about that day, i remember coming out of the recovery room and making the trip back to my hospital room. there were lots of people surrounding me, and the lights were so bright. i remember that someone asked me " who is the president of the united states?" my first thought was, " seriously, you don't know??" but then i realized they wanted to know if i knew. for a split second, i thought about saying " george washington", but even in my drugged state i realized that was not a good idea. so i told them the correct answer. and by the way, our president's name is not very easy to say when you are on pain medication. it seemed like i was talking  in slow motion and that it took forever for me to finish speaking. after answering another question, "what is today's date", i threw up. test over. good thing, because if they had started on, say, the state capitols, i would have been in trouble.

so, i have begun part three of my unexpected journey with breast cancer. i am still dealing with the side effects of the chemotherapy, the worst being the nausea,and not sleeping well. it will certainly be a happy day when i can get through just one day without side effects. i feel like they are going to last  forever, but of course, they will not. i have thought about my future a little, but i have not made any firm plans as yet. it is sort of like when you are in your car, with the nav system on, and you make an unexpected or wrong turn. that voice comes on and says " redirecting route!" one day i was going to work every day, doing ordinary stuff, and then the next day i was having a routine mammogram which definitely redirected my  route.

some people say you should only live in the present. i am a worrier by nature, so i think about the past, present and what could possibly go wrong in the future. i think that it helps us decide about our future when we look over our past a little. almost 5 years ago  to the day that i had my breast cancer surgery, i had surgery for thyroid cancer. i thought , at that  time, that i had figured out what was most important in my life and that i knew where my life was headed. i still have my priorities straight, i think, but my path has changed a bit. i want to be really, really happy. i do not want to have to deal with an overabundance of stress in my life. a stress free life would only be possible in fairy tales, i think, so i do not wish for that.

for now, i try to be focused on the present. i need to concentrate  on feeling better from this chemotherapy.  i have one more surgery, probably in october, to get through. i am still  in "discussions" with my plastic surgeon about the amount of saline to add to my temporary inserts, which is entertaining to say the least. at some point, i will make more decisions about my future. i am still a work in progress, as they say, and on top of that, i am on a redirected route.

part three of my adventures with breast cancer: healing from the chemotherapy, and reconstruction. or as my plastic surgeon calls it " the expansion process.". we are headed out west, i guess......

there are so many parts to a journey with breast cancer. i had no idea. i am finished with part one, the surgery, and thank goodness with part two, the chemotherapy, i am still struggling with some nausea and a few other side effects from the medications that they gave me,  but i am so relieved to be finished with that part! i just have to rest and be patient with myself. it is going to take some time. more time  than i had imagined when i first was diagnosed. it helps, i think, to try to take things one step at a time. there is so much to consider- it is really overwhelming to try to think about everything at once. of course, i have researched, and tried to be well informed about my choices, but sometimes it is good to just consider what is right in front of you.

and speaking of what is right in front of me, that brings up the subject of my " foobies". i have had difficulty deciding what to call my reconstructed "breasts". foobies is a term favored by a lot of women who have had breast cancer.  my real breasts are gone. i regret having had breast cancer, but i think that i made the correct decision in having the double mastectomies. as my  general surgeon said, you sure do not want to have to do this twice! i told my surgeon that i wanted to be aggressive in my treatment, in hopes that the cancer does not return. hopefully, that will be the case. now, back to the foobies. breast reconstruction is different than breast augmentation. or as my plastic surgeon put it, " you are not getting a boob job, honey." some people have said that i am lucky, that i will have" perky breasts". here is the truth: they feel like rocks on my chest.  at times, i can feel the metal ports where the saline is injected and it is uncomfortable. a wide part of my chest is permanently numb, but i can feel the areas above and below  where my breasts were. the inserts that i have now are temporary. when the surgeon and i quit "discussing" how much saline that needs to be added, i will have another surgery and the permanent ones will be inserted.

i have opted for the silicone inserts. the saline ones can " pucker". boy, that gives you a good picture in your head, right? also, thankfully, there has been much improvement made in the silicone inserts. instead of a possible leakage if somehow they are damaged, the new silicone inserts stay together. and they are soft- something my plastic surgeon has reminded me of several times when i complain about the stiffness of the temporary saline inserts. i love my plastic surgeon, but he always tells me how it is.

so for now, i am trying to rest and get rid of some more of this nausea. i am also continuing along with the reconstruction process, aka the" expansion process". my surgery can not take place until mid to late october because the doctors want me to be recovered and my blood work to be back to normal before i have more done . so, i am continuing to see my plastic surgeon every couple of weeks or so, and we go a few rounds about how far out west my foobies will travel. i know that he has my best interests at heart, but i would just as soon keep my foobies closer to my chest.

" may the wind under your wings bear you where the sun sails and the moon walks!" from the hobbit, by j. r. r. tolkein!

in other words, i am hoping for better days to come! my last chemo was yesterday. the nurses said that i went out with a bang( why did i expect anything else?) five needle sticks, three nurses later, and as i said yesterday in a short post , it was not any one's fault. i have deep veins and they hide- not a bad idea considering what was coming. at one point, the nurses said that i might have to go home and come back on monday. now this scared me to death. i was prepared for friday, and i certainly did not want to worry about it over the weekend.( i am pretty good at worrying, unfortunately.)

so the third time was the charm, as they say. this little nurse , who had not stuck me before, came in my treatment room. frankly, i thought it was probably no use, but she found a good vein hiding out on the underside of my wrist. sneaky little vein and probably  thought perhaps no one would notice him, but bam! she got him, and all was well. i thanked her about 100 times before she left. she was not even my chemo nurse for the day. the other nurse who tried ( nurse number two )  was the phone nurse for the day. she  had stuck me successfully last time, but she just shook her head this time.

i would like to say that this time was easier. it was not. but, i was happier, for sure. i know that after the medications that they give you for nausea wear off, and that would be sometime tomorrow, i will no doubt be struggling with the nausea again. darn, that red devil, or adriamycin as others call it. the nurse practitioner did give me some new anti-nausea medications to try this time. i am hoping that they will work. of all of the side effects that chemo has caused, nausea is certainly the worse one for me.

jeff and i wore our " bea strong" shirts yesterday, and the staff just loved them. i told them that my wonderful coworkers had made them for me. i also took along my precious scrapbook that my friends april and charlene had made for me and made the nurses look at the pictures of everyone wearing their tee shirts. they were justifiably impressed. i can not even begin to express my thanks to all of my family and friends for your support. i do not think that i could have made it through all this without your love, prayers and support. i will always be thankful for this.

another person i need to thank, although he does not have facebook, or really does not even know how to work his cell  phone all that well, is my husband, jeff. he has been my rock through all of this. he has comforted me, dried gallons of tears. held my hand when i was so very sick, and most of all, told me i was beautiful, even though i look like a plucked chicken right now. i get teary just writing this, but i really, truly thank God for jeff.  he did however fall for my joke when we were about to turn into the oncology center from the main road. i said, " sweetie, you are in the wrong lane!", jeff said, " no, i am not, this is the turn lane to the doctor's office!". i said, " don't you remember? we are not going to the doctor today, we are heading to the beach!". even though this was the fourth time, he still  fell for it! we did however, go on to the oncology center :(

so, one day before too very long, we WILL be headed to the beach. it will probably be this fall- sometime in october after my last surgery, which will be the final  part of my reconstruction of my "foobies" as some women call them. i guess that is as good a name as anything else for them. this has been an interesting process, and will probably be a blog in itself. i will save that for later...

so, to use my favorite quote from the hobbit " so comes snow after fire, and even dragons have their endings."

"where there is life, there is hope", from the hobbit, by j. r. r. tolkein

yesterday, i went back to the oncologist for my third neupogen shot and more blood work. to refresh, the neupogen raises my white blood cell count and hopefully keeps me from getting sick. the cancer center is an hour away from my house. my husband is usually off on wednesdays, but had to be out of town for a business meeting. luckily, my son , who lives nearby, was able to go with me. i will have to admit that this has been about my lowest point in my treatment so far. i can handle a fair amount of pain, but when it comes to nausea, i am pretty much a weenie. the new chemo drug that the oncologist had to switch me to causes a LOT of nausea.

when i checked in yesterday,the receptionist asked me what was wrong- i looked like i was not feeling well. i almost cried. my emotions are all over the place now.  anymore, it does not take a hallmark commercial to make me cry. someone can step on an ant, and i am looking for a kleenex. i told her that i was struggling with persistent nausea and she told me to be sure to mention it to the nurse. i did not have to, though, because not only the nurse who gave me my neupogen shot, but the med tech who got my blood work asked me why i was not feeling well.

i can not imagine going through this alone. i have so much love and support from my family and friends. i feel incredibly sympathetic for those people who have no one to offer up a word of encouragement, a smile, a hug. frankly, i am not sure how a person who is alone manages cancer. i have certainly prayed a lot and depended on my faith, but knowing that you have a support group is priceless.

before i left the cancer center yesterday, i told the nurse that i was not sure that i could manage my next treatment, which is scheduled for a week from this coming  friday. she said, " oh, do not give up now! you are almost there. one more treatment and you will be finished. YOU CAN DO THIS!". well, i got some tears in my eyes( remember the ant story) and just nodded, saying  that i would finish. perhaps i am getting my second wind as i head towards the finish line. today, eight days after my last chemo, the nausea is still present, but is getting a little bit better. j. r. r. tolkein said " after fire comes rain, and even dragons have their endings." after the most brutal storm is over, if we are lucky, we can see a rainbow. i said that.

"there's nothing like looking, if you want to find something" from the hobbit, by j. r. r. tolkein

yesterday, i had my third chemotherapy. it was almost like starting over, because i knew that the doctor would be changing one of the chemotherapy drugs due to some neuropathy in some of my fingers and toes. it is a little bit better, by the way, but not completely gone. he told me that even if he were to slash the dose to one that would do little, it could still cause permanent neuropathy.

so the doctor told me that i had two choices: choice number one was to do nothing. to stop the chemotherapy and go home. my eyes got bright, i sat up in the "chemo chair" ( the nurse had already started my fluids, as the doctor was delayed for a bit), and smiled. he said, well this one is not for you. :(    my second choice, i felt as though i had chosen the wrong door on a game show, is to use the adriamycin and cytoxan. i told him that i was very wary of the adriamycin. he laid out the pros ( mostly) with some cons thrown in  for good measure. i told him that he would have made a very good salesman, because i now was agreeing to the adriamycin. i will say that it took less time yesterday. instead of the 5 pre-medications that i had received before the taxotere and cytoxan, i now was only having to get three. and the adriamycin is given IV push. although it is still a slow process. i was very, very fortunate to have gotten such a wonderful chemo nurse yesterday. she hit my " old faithful" vein on the first try, and when she was giving the adriamycin, she did it just as she was supposed to- injected 2ml, check for blood in the line, inject 2ml,etc. that is so she does not accidentally push the drug into my tissues.

which brings up why i have such an aversion to adriamycin in the first place. when i was younger, 30 years bc ( before children) i worked as a staff pharmacist at wake med raleigh. there was one particular doctor who wanted the pharmacists to mix his chemotherapy, which he gave in the hospital. we all took turns and one day i drew the short straw. i scrubbed down, headed for the sterile flow hood in the IV room , and proceeded. when i first injected the diluent into the adriamycin i was shocked at the color. it was red, and i mean stop sign, hunk of burnin' love, blood red. as soon as i got my breath, i mixed the adriamycin and was almost home free, when a couple of drops the the drug dripped onto my fingers. i washed my hands at once, but in a few days  all of the skin peeled off several of my fingers. our pharmacist manager did not think that we needed any sterile gloves, a cost issue i guess. now it would not be acceptable not to use them. that made me think, if a couple of drops can do that to the skin on my fingers, what on earth is it doing in some poor person's body? i vowed then and there to never , ever have this drug! well, i can tell you that i do not say never, ever anymore. gets me in trouble every time.

i have also heard the patients' horror stories of the " red devil". no, i did not nick name adriamycin this, someone beat me to it. nausea and vomiting have been two of my greatest fears of  having chemotherapy. this drug has a bad rap for causing that. also, i have to now have an echo cardiogram at the end because the red devil can also damage your heart. i will not bore you with the rest of what the red devil can do, i will just say that it comes by it's nick name honestly.

so far, i have had more nausea than usual. tomorrow is the " dreaded third day" after chemo. i am hoping that things will stay about the same, and if so, no problem. i am drinking 5 of the 20oz tervis bottles full of water every day. one of the best pieces of " cancer advice" that i have received was to drink lots of water. this sweet little old lady told my husband to tell me to drink lots and lots of water. she said that she did just that, and had no nausea( i think she did not get the red devil, but i am not sure).

they have changed my chemo date from every three weeks to every two weeks. that is because taxotere is given every three, and adriamycin, every two weeks. so my last chemo, thank goodness, is august 14th, instead of august 19th. i am hoping that i will feel good enough to start again. i think just knowing that it will be my LAST CHEMO will be a big incentive. i am, as always, thankful for the thoughts, best wishes and prayers that i receive from my family and friends. i am so very grateful for this.

" it does not do to leave a live dragon out of your calculations, if you live near him." from the hobbit, by j. r. r. tolkein

this coming wednesday, july 29th, i will be receiving my third round of chemotherapy. since i have some neuropathy, the chemotherapy nurse said that the doctor would probably change the taxotere (the most likely culprit) to something else. i have mixed feelings about that. not that i am enjoying numbness and tingling in some of my toes and fingers, but it is sort of like " the devil you know" kind of thing. i know what side effects that i get from the pre-meds, the most uncomfortable being the red, and hot face, neck and chest that i get the day after i get some iv decadron. before i started treatment, the oncologist went over all of my pre-meds and i asked him if we could leave off the decadron. he said, probably not, as this hopefully prevents anaphylaxis from the taxotere. the sleepless nights and fluid retention seem insignificant compared to anaphylaxis, so i am getting the decadron.

as i said, i know what side effects come with the taxotere. i am also getting some cytoxan, which is the " milder" ,haha, of the two chemotherapy drugs. i had a problem with the cytoxan with my first chemotherapy session. they ran it in a little fast and i had these intense sinus pressure pains in my head and face. last time, i asked the nurse to please slow down the rate of infusion, and it went a lot better. instead of being hit by a ton of bricks, it was just a few pebbles.

the way that the chemotherapy goes, is that you have blood work done that morning, and the oncologist looks over that, and speaks to you about what side effects that you had last time. he then makes the decision on what drugs to use and the dosage. nothing is pre-mixed, or set in stone, as the saying goes. i have no idea what drug he would use instead of the taxotere. he might just decide to reduce the dose. my husband does not want me to get the taxotere this time because he is afraid that my neuropathy will be permanent, which is a possibility.

i also have noticed that not only did my side effects start a day earlier this time, compared to the first time, but it has taken me longer to recover. the first time, i had a full week of feeling better before i had the next chemotherapy session. this time, i have only had a few days. i know the reason for this, and it is, of course, that my immune system has been compromised. that makes me a little more anxious  about my next round. i try to stay positive and keep in mind that many women have gone through this, and with tougher drug regiments than mine. i am already looking forward to august 19th, though, which will be my LAST chemotherapy. i think just knowing it will be my last session will make it easier to get through.

along with the chemo sessions , i am undergoing the reconstruction process. my plastic surgeon, who i really like, calls it the " expansion process". i can not help but think of the oregon trail computer game that my kids were so fond of, when he uses this expression. head them up, we are moving west! we are moving along slowly on this. sometimes i do not feel like getting the saline injections( side effects from the chemo). also, unfortunately my stitches broke open on one side, and it is still healing. last time the surgeon decided not to " fill "er up" because of the way the incision looked. like all plastic surgeons, i guess, he seems to think that most women want to look, well, endowed. i told him that in my case,on a scale of 1 to 10,  if a 10 is dolly parton, and a 1 is pee wee herman, i wanted to be about a 5. i have to keep reminding him of this for some reason!

so, i am not sure how this next chemotherapy session will go. i am a person who does not like to be surprised. i like to research and be prepared. but in life, of course, unexpected things happen. i would never in a million years think that i would be writing a blog on my experiences with breast cancer. living near that dragon has been a life changing experience for me. this has been a new chapter in my life, a very complicated one at that. not everything has been bad, of course, there have been uplifting and positive moments for sure. but overall, things in my world have changed forever.

" roads go ever on, under cloud and under star, yet feet that wandering have gone, turn at last to HOME." from the hobbit, by j. r. r. tolkein

i had a doctor's appointment- with my oncologist- today. it was just supposed to be for lab work. i had extreme bone pain with the neulasta injection last time, so they decided to skip it this chemo and just monitor my blood work. unfortunately, my lab work showed that i have neutropenia- a fancy word for very low white blood cell count. so, the decision was made to try the neupogen- which is like neulasta, but has to be given over at least three consecutive days. the neupogen will  still cause bone pain, but it is not long acting, and the bone pain is not supposed to be as severe. the nurse who gave me my first injection today told me that her observation has been that if you did not do well on one, you could tolerate the other. i sure hope she is right! along with the neupogen, i am having to take a pretty strong antibiotic, just in case i should get sick. the physician's assistant told me that i could get out, but to avoid large crowds and whatever i do, avoid walmart. ha- ha- ha.

so, i have decided to stay at home. i have to go to the doctor's office for the injections of course, but other than that, i am what you would call " home bound" for now. the doctor will check my white blood cell counts again on friday. if they have not gone up sufficiently, then they will " do something else". i was not brave enough to ask what that " something else" was. i am just hoping that the neupogen does it's job, and i will not need to find that out.

my sister has been down to visit me the past couple of days. i had a pretty rough weekend, and was not feeling up to being by myself monday or tuesday. i really appreciated the company, and we had good visits. it has been somewhat difficult to find silver linings in the cancer cloud, but one thing that i am thankful for is the strengthening of my relationship with my sister. we were close growing up, but as adult children often do, drifted apart. now we are about close as we have ever been, and it is very comforting to me.

i do enjoy being at home, thankfully. i have beautiful flower gardens to enjoy, and it is peaceful and quiet here. i have my computer, my little window to the world, and now that i am feeling up to it, i can check in with my friends every now and then. i know that social media can become a problem, but for us home bound folks, it is pretty important. of course, i talk to my children about every day, and that is definitely a blessing.

i suppose some journeys have a life of their own. so many twists and turns, so many decisions to make about where to go, what to do. but one thing is for certain, at some point, everyone will end up at home. and that is the best journey of all.

" you certainly usually find something if you look, but it is not always quite the something that you were after." from the hobbit, by j. r. r. tolkein

well, i had my second chemotherapy session yesterday. or i am half-way to finished, as i like to put it. i was in the office for six hours. of course, that included a short trip to the lab for blood work, and a short doctor's visit before the infusions started. in case you wondered how chemo goes down, i will tell you how it happens. there are many treatment rooms around a central nurses/doctor's station. some of the rooms have ( heated!) recliners- i use one of these. they have rooms with hospital beds for the really sick guys- usually the elderly.

the nurse starts your iv, and begins a little saline drip. there are 5 different pre-chemo medications that are given. these are mostly in small iv bags, and do not take too long to infuse. first they give me a pepcid iv. this is to help protect the stomach. then comes the emend iv- this is a long acting drug to help prevent nausea and vomiting. next comes the aloxi- a drug that i had never heard of before i started my treatments. it is sort of like a long-acting zofran. it is for nausea and vomiting,too, but it stays in your system for 3 days. then comes the decadron- which is a steroid. i did not want to have this one, but the oncologist said that it helped in preventing anaphlaxis from the taxotere, so i put my worries aside, and am getting this,too. last thing they give you before the chemotherapy drugs is an iv push dose( not in a small bag, they shoot it right into your iv line) of benadryl. the nurse always tells me " nighty- night" when she gives it to me. i fight sleep because i know that the next bag will be the dreaded taxotere, and i do not want to be asleep for that!

so the big, bad, bag of taxotere is now infused. the oncologist lowered my dose from 150mg to 125mg because of all of my intestinal problems last time, i will spare you the details, so i am hoping that i will get along a little bit better this time. the reason i do not drift off to sleep after the benadryl dose  is that unfortunately a patient can have anaphylaxis at any time to this drug. it is not guaranteed that if you do not react to it the first time, you will not the second, third, fourth,etc. my nurse told me that in her experience about 95% of patients who do not have anaphylaxis the first time, will not have it at the other times. lets hope i am in the 95%! worrier that i am though, i just can not relax until i see how it goes. they slow the infusion rate down for me at first, too. i appreciate this on many levels.

last comes a smaller bag of the cytoxan. i had intense nasal and sinus pain from the first infusion. it did not last too long- about 30 minutes after the infusion was over. i asked the nurse to slow down the infusion rate on this one,too. that helped a lot. i had only minor discomfort, and it was only in part of my sinuses, not in my face or eyes.

the nurse then runs in a little more saline, to clear the lines and just for your comfort. i drink a lot of water, but i do not want to get dehydrated! this time i felt a lot more " loopy" if you will. i am not sure why, but i think that it was the benadryl. i sent a facebook message to someone, with about every other word misspelled, so next time jeff has instructions to remind me to put down the cell phone before the benadryl comes out!

saturday will be the third day after the chemotherapy. that is when the long acting medications are gone, and i am on my own with the chemo drugs. not having to have the neulasta shot this time, which gave me extreme bone pain, will be a major advantage. i just may be dealing with the intestinal problems, which actually have already started, and perhaps nausea/vomiting. i have medicine for both, so i will be o.k.

i have gotten a lot of good advice from my "chemo buddies" concerning how to deal with the cancer, chemotherapy, hair loss,etc. i appreciate all of  the advice and tips that i have received. here are my top four favorite pieces of advice that i would like to pass along to you.

1. pray daily. prayer is powerful, calming and will give you strength.

2. drink lots of water! i drink 5 of the 20 oz. tervis bottles of water every day, starting on chemo day and for several days following. on chemo day i drink one bottle on the ride over, one during my chemo, and one after. two more when i get home. then, 5 bottles a day for several days afterwards. there are two reasons for this. one, it helps prevent nausea because it moves the stuff out of your system. two, the cytoxan accumulates in your bladder and may cause bladder irritation resulting in painful cystitis, even bloody cystitis. this was enough to convince me!

3. be good to yourself. it does not have to be big things, although i have ordered a few things from amazon- a little more than usual. one of my favorite things is to sit on the front porch when it has cooled down, and admire the flower garden that my husband so lovingly planted for me. i call it my healing garden, and it it peaceful and beautiful.

4. show gratitude and appreciation. this is my own advice. i try to be grateful for even the smallest things, and have  appreciation for the cards, letters, emails, gifts, hugs and smiles from my family and friends. it benefits everyone, i think. and it means the world to me.

i can NOT  say that i am grateful that i have breast cancer. or had, hopefully! but i can say that i have learned a lot on my cancer journey. it may not always have been  what i was  looking for, but i have learned a lot of valuable life lessons so far along my way. and for that, i am grateful.

" may the hair on your toes never fall out!" from the hobbit by j. r. r. tolkein

i knew it would happen. my oncologist tried to prepare me. i knew the reason behind it- the chemotherapy kills cells that multiply rapidly, mostly the cancer cells, but our hair cells multiply quickly, too. i have always liked my hair, but i will admit that i have taken it for granted. my sister and i used to tease our mother about her devotion to her  weekly hair appointments. we told my mom that if a natural disaster ( tornado, hurricane, blizzard, etc.)  happened to be going on at the same time as her hair appointment, she would surely make it to the salon somehow! lately, though, my sister and i agree that we both really look forward to our own hair appointments, and barring natural disaster, will always keep our own appointments.

so, a couple of days ago, i happened to look down on my sweater and was shocked. yes, red hair on a black sweater is hard to miss. and it was quite a bit of hair at that. i tried to tell myself that perhaps i would be lucky somehow and my hair would hang in there. today, the hair loss continued all day long and was substantial. i could not postpone the inevitable - i would need to shave my head. it has been just a hair( good grief, no pun intended) over two weeks since my first chemotherapy. that is right on schedule for the hair loss according to the oncologist.

my husband and i  decided to buy a shaver and agreed that he would do it- privately at home , just the two of us. a couple  of techs that my husband  works with have had some experience in hair styling, and they picked out a shaver and told him how to do it. i guess we could have figured it out by  ourselves, but it was really nice of them to help us. that said, it was one of the more traumatic experiences that i have ever had. i cried, a lot, but my husband just kept on gently shaving until he got it down to a buzz cut. we will go further in a day or so. i showered the hair off, and slipped on my sleep chemo beanie. it is so soft and light weight, but also warm. i am thankful that i am not having to do this in the winter.

i have ordered a couple of wigs, but of course they have not arrived as yet. i do have some rather pretty chemo beanies which i can wear until the wigs get here. my next chemotherapy is coming up this wednesday, july 8th. it would be nice to have the wigs by then, but if not, i will just wear one of my pretty beanies. it was incredibly hard losing my hair-harder than i had imagined. i kept telling myself that it is only hair, and it will grow back eventually. all that hair hitting the floor unleashed some pretty major tears. what got to me the most, though, was when my husband stopped for a minute and looked me straight in the eyes. he told me i was beautiful and he would love me forever. it was hard to feel sorry for myself after that.

so, i sincerely hope, that if you are a hobbit, the hair on your toes never falls out. for the rest of us, i wish that no one would have to have the hair on their heads fall out, or have to shave their head. but i suppose we can always buy pretty wigs,scarves and chemo beanies until it grows back. and i am looking forward to my next hair appointment- whenever that may be.

" the quiet was so deep that their feet seemed to thump along while all the trees leaned over them and listened". from the hobbit, by j. r. r. tolkein

so, yesterday,  i went for my first check up with the oncologist after my first chemotherapy. i had had the usual side effects that i suppose everyone has to some degree- taste changes, sore mouth, a slight fever, some nausea. but i also had some very significant abdominal pain ( the taxotere) and the delights that come with that. just as bad or worse than that really, was extreme bone pain. that was from the neulasta shot that i was given the day after chemotherapy. the purpose of this is to stimulate your body to make white blood cells. it is a long acting drug- stays in your body for 2 weeks- and most people do pretty well with it. i have learned to expect the unexpected when it comes to me. every bone in my body hurt and i could hardly walk saturday night. when the nurse looked at my blood work, she said that my white blood cells were very high. who knew my body would try for the world record in white blood cell making? the nurse said that she had observed that the people who made the most white blood cells had the most pain. i could have told her that.

so, after a little discussion, i am not to be receiving the neulasta shots again. what the doctor will do is to monitor my blood work a little closer, and if my white blood cells do go down, they can give me an injection to stimulate production that is short acting, and hopefully less painful. the doctor is also going to reduce my taxotere dose a little bit so that perhaps the abdominal pain,etc. will not be as severe. i started out asking nicely about these changes, but was willing to beg or whatever if that was necessary! it was not. from this, i can conclude that it is necessary to have an oncologist who is willing to make adjustments, though not ones which would  jeopardize your health, when it comes to a chemotherapy regiment.  

so today has been my first good day after chemotherapy. i still have some of the above mentioned symptoms, but i do feel a little bit more like myself. when i had my first infusion, there was an almost unbearable quiet. there was plenty of noise going on around me - other infusion rooms, nurses station, people moving around, but when the nurse started my infusion, the world went totally quiet. jeff and i were holding hands and were  just waiting to see what would happen. hopefully, my second chemotherapy, which is scheduled for july 8th, will go well. at least now i know what to expect, somewhat. i think the world will still be a little quieter then as well, though.

" escaping goblins to be caught by wolves!" he said, and it became a proverb, though now we say, out of the frying pan, into the fire. in the same sort of uncomfortable situations." from the hobbit, by j. j. tolkein

one chemotherapy session down, three to go! what was supposed to take three hours, ended up lasting six. one reason was that the chemotherapy nurse took it easy on me, and reduced the rate times on all the drugs i received today. the other being, they were terribly busy. i even had to share, though i did not mind, my room with someone. she got off easier than i did. she was only there for about an hour.

i do not have a port or a pic line. the doctor said since i have only four chemotherapy treatments( his assessment, not mine), that we can just do them straight IV unless my one good vein runs away. after today, it might just do that! i started off with a little normal saline, to hydrate me. then, they added a pepcid drip. this is usually used for stomach trouble, but it is technically an antihistamine, and is also used for allergic reactions.( hint, hint, the taxotere). then, i got a small bag of the decadron, which is a steroid and is also used to help prevent allergic reactions. next, was the aloxi. now, i had never heard of this drug. it is used to help prevent nausea, but it really stings as it goes in. last, but not least, was an IV push of benadryl. this usually puts people in la-la land, but i fought to stay awake  and alert, well, as alert as you can be with all of these  medications on board.

just as the nurse was getting ready to hang the dreaded taxotere, i asked her if it was preservative free. she said no, and i explained my sulfite preservative anaphylaxis to her. while she was on the phone to the hospital( i had a great nurse), i got my smart phone out and looked it up myself. it does not have sulfite preservatives, score one for me! what it did have, however, was a " black box warning". now if you are a pharmacist and you are dispensing a medication to a patient that has a " black box warning" you worry, a lot, and you definitely counsel the patient. if however, you are a pharmacist and you are RECEIVING a drug that has a " black box warning", you nearly pass out! a very small number of patients have had anaphylatic shock and died during the first few minutes of a taxotere drip. my nurse came back in, with an epi pen, no less, and told me that we were going to take this very slowly since i had never had it before. i never knew that i could hold my breath for so long! since i am here, writing this blog, we can all assume that this had a happy ending.

the last IV bag that i got was the cytoxan. here is where the " escaping goblins to be caught by wolves" part comes in. i had not worried one bit about this medication.i have dispensed the tablet form of this on many occasions, and it has been around for years.  they administered it slowly, which i was thankful for, but this drug causes( short term) extreme pressure in the sinuses, eyes, forehead,etc. think of the worst sinus headache that you have ever  had- bingo! long term, it can cause urinary tract infections from, well, you know where. i was drinking water like crazy because you have to flush it out of your system. it has a rather short half life, so it is very important to get on with the water before, during, and after chemotherapy- especially with this drug. the terrible " sinus infection" went away about 30 minutes after the treatment ended , thank goodness.

so i survived my first chemotherapy infusion. jeff was loyally by my side, and was very supportive. the nurse told me that the nausea, vomiting,etc, from the taxotere would happen on day 3 through day 7. i have zofran, which is a drug for nausea/vomiting, that i plan on taking every eight hours around the clock starting about thursday  night. tomorrow, i go back to get a neulasta injection. it stimulates the production of new white blood cells. this reduces the risk of serious infections. of course, this drug has side effects,too. i always tell my pharmacy patients  that they need to weigh the side effects of any drug against the health benefits. in the case of neulasta, it can cause extreme bone pain in some patients. my nurse told me that  taking aleve and zyrtec could possibly prevent or lessen these side effects. i understand how the aleve would help with bone pain, but i am not sure how or why an antihistamine( zyrtec) would help. i already take zyrtec for my allergies, so this is a moot point, i guess.


i like to have information about my health care. i feel more secure when i have knowledge about medications and their possible side effects. i would still get the treatments, of course, but knowing makes me less scared. and even if i escaped ( i may have to wait until friday to say that conclusively) a goblin only to be caught by a wolf, i feel that things went about as well as they could today.

thank you to all of my family and friends  who said prayers for me  and sent good wishes my way. i really appreciate each and every one. i hope that the information that i have provided may help someone else who is dealing with this health issue. and i sincerely hope that goblins and wolves can be avoided.

" never laugh at live dragons, bilbo you fool! gandalf said it to himself, and it became a favorite saying of his later, and passed into a proverb. you aren't nearly through this adventure yet, he added. and that was pretty true as well. " from the hobbit, by j. r. r. tolkein

today i went to the oncologist's office for chemo 101. or to put it more correctly, for orientation. my husband and i met the head chemotherapy nurse, and she went over the medications that i would be receiving, as well as possible side effects. the process takes about 2 and one-half hours, she said, if everything goes well. first, i get the medications that will hopefully help with the nausea. there are three scheduled, and a fourth one, if i need it. then, i get an IV dose of dexamethasone- which is a steroid and is used to prevent ( hopefully) my body having a reaction to the chemotherapy. these infusions take about an hour.

next comes the big bad drug, or dragon if you will. this dragon goes by the name of taxotere. it takes an hour to infuse this one. since this is my first chemotherapy session, they will be watching me carefully for immediate problems. anaphylaxis, i assume. the somewhat milder drug comes after this one, and is called cytoxan. it takes about 30 minutes to infuse the cytoxan. my husband will be with me for support, and to drive home afterwards. it takes an hour to get home from the oncology center to my house. i am not sure how the ride home will be. i think that the fear of not knowing is the worse part for me. hopefully, after the first chemotherapy treatment, i will know what to expect and it will not be so terrifying.

tomorrow, i go back to the plastic surgeon . he is going to remove more stitches, and possibly add some more saline in my implants. no, i am not going for the " dolly parton" look. i just want to look a little less like a young boy. and, also i would like  to have my clothes fit a little bit better. the reconstruction process has been more difficult than i had expected. the doctor is expanding my chest wall out- so it hurts and i feel a lot of pressure in my chest. i am also  having " phantom" pain, which is very strange. i thought i was losing my mind until i read in a breast cancer book that it is fairly common. the article that i read said that it takes a while for the brain to know that a part of the body is missing. wow, i thought that my brain was smarter than that. i hope that my brain gets up to speed soon.

i have a basket in the kitchen that i call my " sunshine basket". it is filled with get well cards from my family and friends. probably the best thing is the cards that my grandson's daycare have made for me. they could not possibly imagine how much their colorful drawings mean to me. i look at the cards a lot, and it is very comforting. i am fortunate, as i have said before and will probably say again, to have such a great support system. i honestly do not know how people go through something like this on their own. my faith has also deepened- and has been a great source of comfort to me.

i am not laughing at the live dragons. i think that i have done pretty well so far, but as gandalf said, " you aren't nearly through this adventure yet.". nothing could be any truer.

"a sudden understanding, a pity mixed with horror welled up in bilbo's heart. a glimpse of endless unmarked days without light or hope of betterment, hard stone, cold fish, sneaking and whispering. all these thoughts passed in a flash of a second. he trembled. and then quite suddenly in another flash, as if lifted by a new strength and resolve, he leaped. " from the hobbit, by j. r. r. tolkein

i thought that i had prepared myself pretty well for this news. i have researched breast cancer treatments, and i was fairly certain there was a good chance that i would need to have some chemotherapy. my general surgeon hinted at it at my visit last week. he told me, " well, you know, your lymph nodes are clear, which is great, but the kind of cancer that you have, and the fact that you have three lesions- two of which are fairly big, the oncologist just might advise that you have chemotherapy." he went on to say that he really was not sure what the oncologist might say for sure. my surgeon told me that if i had had  only had two lesions, or if it had not been the " invasive lobular" kind that he was pretty sure that i would not need chemotherapy.

invasive lobular is the maverick of breast cancer types , evidently. i have heard this from several doctors. they have used the words " unpredictable" and even  " sneaky". the oncologist told me today that it sort of spreads out, like fingers , and tries to invade other organs in your body. he told me that he recently had a patient return after 9 years in remission, to have this cancer appear in several other organs in her body. that sort of sealed the deal for me. i would rather suffer though a round of chemotherapy than to gamble that this cancer might return in a few years.

so, my " introduction to having chemotherapy, 101" so to speak, is next wednesday. a chemotherapy nurse will go over what will happen, side effects, medications used,etc, and i will ask questions. then, the actual chemotherapy is the wednesday after that. the oncologist told me that i would get four treatments- each three weeks apart. it is a combo therapy of two drugs, one which has fairly severe side effects. yes, i will lose my hair. but the scariest one is the fact that i could develop leukemia from the treatment. they will boost my white blood cell count with an injection that i will receive on the thursday after my first chemotherapy treatment. i will see the oncologist the week after- to tell him how badly i feel, i imagine, then just every three weeks when i get another chemotherapy treatment.

my husband and i listened to what the oncologist had to say and tried to process everything. i will say that the words "horror" and " pity", as noted in the hobbit quote above , did cross my mind. medically, logically, this makes sense. but when it comes to the reality of the situation, and the fact that this is something that is going to be happening to YOU - well, it scares me and my husband to pieces. i am certainly not the first or last woman to have to have chemotherapy. i am sure that it is much improved from just a few years ago. i appreciate all of the research that has gone on, and the fact that early detection was available to me.

so, after a time of fear and apprehension, which i am sure will come and go over the course of the next week, i am planning to gather my strength and faith, and leap into the only course of action that i can. i have to go forward, and i have to try everything that i can to be here for my wonderful and supportive family and friends. to use one of my favorite quotes from the hobbit, and one that i have used before, " so comes snow after fire. and even dragons have their endings".

"where did you go, if i may ask? said thorin to gandalf as they rode along. to look ahead, said he. and what brought you back in the nick of time? looking behind, said gandalf." from the hobbit, by j. j. r. tolkein

i had one of my  three doctor's appointments this week,  today. this one was with the plastic surgeon- to remove my bandages and check my incisions and the four drains . jeff drove me over of course, but i wanted him to wait outside in the waiting room this time. i had decided not to look yet, but of course i did. i held my tears until i got back to the car, but i did cry a little. to me it seemed a little like when someone dies and you do not get to go to their funeral. their passing just does not seem real unless you are there. so, by looking at my chest a little today, this whole thing seems more real to me. crazy as it may sound, we sometimes protect ourselves from seeing/knowing things until we are ready for them.

yesterday was the infamous "third day after surgery". i thought it was just an urban legend, but i felt so bad! all i could do was to lie down in bed and try to sleep. when the nurse called to see how i was doing, she confirmed the " third day theory" and said that if my body needed rest, do so! in my job, i have to have complete control over whatever is going on. i am responsible for things, especially when i am the only pharmacist on duty. this illness and recovery has been an out of control experience for me. in fact, there has been little that i feel i have any control over.

on thursday, i will see the general surgeon for the final pathology report and check up. i suppose that we will go over any further treatment that i will need. i am trying not to get my hopes up that i will not need chemotherapy. i know that i will have to take some kind of estrogen blocking drug. my cancer was estrogen and progesterone positive- which means that there are currently more drugs to treat it. if the doctors think that i need a round of chemotherapy, i will of course do it. at this point, i am just trying to do everything that i possibly can to be here for my family.

on friday, i go back to the plastic surgeon for the removal of the four drains. i am not looking forward to this! i asked him how it was, and he hedged a little. he said, " well, as soon as we get them out you can take a shower again!". that is some good news, though- for ALL of us. i have never gone a week without a shower before.

so looking ahead and looking back. i guess life is a little of both. some people like to say that they live in the moment only. while i like the concept of that, truthfully i do think about what has happened before and what may happen in the future. and just try to choose the best road for me to travel on.

"gandalf: all good stories deserve embellishment. you'll have a tale or two to tell of your own when you come back. bilbo: can you promise that i will come back? gandalf: no. and if you do... you will not be the same.'" from the hobbit, by j. r. r. tolkein

what a journey so far! and of course i made it back, more or less in one piece. i had wonderful doctors and nurses to take care of me. a lot of my family was there to see me off, to my adventures in the operating room. and my daughter and her family came yesterday afternoon. i think that i have done pretty well. my plastic surgeon said that i was a "trooper", and let me go home early. the average stay for this is three days. i made it home in a day and a night.

as the saying goes," the kindness of strangers", always overwhelms me. the anesthesiologist talked to me as i was getting ready to go into the operating room. i told him that i got really sick from anesthesia( when i had my thyroid cancer surgery, i got sick four times. not good when you have an incision in your neck!). anyway, the anesthesiologist told me that he would pull out all the stops for me, and he did. a patch behind my ear( kept me from seeing double), a long acting drug- called emend for nausea, and zofran given iv while i was on the table. of course, me being me, i still got sick once after surgery, but i will take it. it was much better than last time. i got a small dose of phenergan after i got sick. so you might say that i had a smorgasbord of all of the anti- nausea drugs, and it took every single one of them! the anesthesiologist told me that his wife had had a bilateral mastectomy. he was extra sympathetic, i think because of this. i told him that i was sorry to hear that. he looked to be in his 40s, so i assumed that his wife was the same age.

i am certainly over the child bearing years. to me, that is the saddest part of losing my breasts. i fed my babies until they were 11 months, and 13 months of age. it was hard to do at first, but i persevered( or i was stubborn, you choose) and it paid off. good nutrition for them, and it was special time for just us. i also think that it establishes a bond between mother and child that can never be broken. i am so glad that i had the opportunity to do this for us. but it does make me more than a little sad to lose my breasts to breast cancer. on the positive side,  i have good memories, and i will continue to do what i gotta do to be around for my family.

as gandalf reminds bilbo, " when you return, you will never be the same". and that is very true of any unexpected journey. some bad ( well, awful) things happened to me , and some very good things came out of this as well . i always have loved and appreciated my family, but i do so even more now. i have had my faith strengthened, and i continue to work on a positive attitude. i am examining the next steps in my life. what do i want to do now? i still do not have all of the answers, but i am getting there.