De-Liver Me Tour ~ Game Changer ~ February 5, 2015

A "Game Changer" is a newly introduced element or factor that changes an existing situation or activity in a significant way. The adenocarcinoma on my pancreas is a different cancer than Audrey and Carmine, the hepatocellular carcinomas on my liver. What this translates to is that I am off the liver transplant list for now. I will have to remain clear of pancreatic cancer for 3-5 years before I can be reconsidered. I totally understand logic, especially with so few livers to go around. Truth be told I am actually a bit relieved. The prospect of major transplant surgery, being out of sorts for several months and on steroids and immunosuppressents is a little hard to fathom right now.

Storm Clouds and Sunbeams

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Small blessings ~ Sometimes the least expected is a blessing in disguise. I was close to the top of the transplant list when the pancreatic tumor was discovered with a CT scan and biopsy late last Fall. Had it not been discovered early, and before the liver transplant, the immunosuppressents and steroids dictated by a transplant would have prompted the pancreatic cancer to run wild. 

We met with my oncologist today and as he walked in the door he smiled at me and said "Survived another one, eh?" Here is what we learned. 

Staging ~ The staging of cancers is a complicated process, but here is the country girl's guide to short and simple. 

1 ~ tumor is 2 mm or smaller and hasn't spread to lymph nodes
2 ~ tumor is over 2 mm and hasn't spread to lymph nodes or body
3 ~ tumor has involved lymph nodes but hasn't spread to other parts of body
4 ~ tumor has spread to other parts of the body

I rank as a Stage 3: My surgeon removed six lymph nodes, though only one of the six was was involved. A generalized rule is that patients at Stage 3 have a 60% risk of recurrence of cancer returning or showing up someplace else. 

Normally, in this scenario, chemo would be offered as a preventative measure to keep cancer from returning to my pancreas. However, at this point the cancer is gone and chemo could facilitate the growth of the liver cancer because of compromised immune system from removal of my spleen. It might also cause a flareup of the Hep C which has almost reached "cured" status. Can you spell NO THANK YOU? I swore years ago that I would not do systemic chemotherapy. I've watched too many friends endure hell for no apparent benefit. It's all about the quality not the quantity. 

Under the microscope - Starting today I'll be doing a quarterly blood test called CA19-9 which helps detect early recurrence of cancer. At surgery the marker registered 294. Today's blood test will establish a new baseline, hopefully with a much lower one. I will touch bases with my oncologist again in May. Also, the letter from Kaiser that approves an additional year of medical care from the Liver Transplant Unit at UCSF just arrived in the mail. This is all good news. My orders are to continue to take care of myself: exercise, eat healthy and travel at will. We can do that!

Life Expectancy ~ I had to ask the question ~ There is no one answer, only averages from large trials and large patient data bases and it is only a rough guideline. In a worse case scenario, if the cancer comes back or spreads and cannot be removed surgically, life expectancy is about two years. We are all different though so you cannot read much into that. Considering the odds and bullets I've dodged so far, things are looking brighter than expected. I may indeed outlive the October 2017 expiration date on my American Express Card and see my mid seventies. 

On the Horizon ~ Damn the torpedoes, full speed ahead! We have friends to visit, seasons to experience, and blue highways to explore. Alberta is calling, we've never seen the east coast in the fall, the aurora borealis, or the poppies in Antelope Valley. The possibilities are endless. 

Alberta 1997

Northern Lights

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Horse Bridge Pawtuckaway State Park

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De-Liver Me Tour ~ Sisterhood of Traveling Body Parts

January 7th: Oh boy surgery day. The game plan was to remove the tail of my pancreas (home of said adenocarcinoma) and my spleen with a combination of a laparoscope, robotics and the capable hands of my doctor. The surgery took about 6 hours. I was, of course, on another planet and haven't a clue as to what was going on. Since the doc was in the neighborhood she also checked on my liver and found a small hepatocellular tumor and with Rod's permission removed it. 

January 8th - 9th: Me and Mr. Wheels my best buddy and travelling companion for 3 days. Patients are encouraged to get up and walk as soon as possible, as it helps get your digestion system moving again. You are also encouraged to make good use of the patient regulated pain medication day and night. It's easier for your body to heal if you're not dealing with pain. Sounded reasonable to me. And who knew a catheter could be such an asset when the simple act of getting out of bed was to much to contemplate. 

Day 2

Clear liquid and liquid diets suck big time. I realize it's necessary, but where's the nutrition? They kept trying to push soy milk, fruit juices, vanilla pudding and bouillon, holy blood sugar Bat Girl. The one positive note is that I developed a new fondness for Cream of Wheat. Once I graduated to real food on Day 4 the menu was a lot better. 

I can't say enough about the doctors, nurses and staff at Kaiser SF. Some of them were working long shifts, but always made sure their patients were their first priority. They were professional, caring, supportive, and full of fun. Laughter is, after all, the best medicine.

Got unplugged day 4 and graduated to a walker and free range of the corridors. Also got to take a shower. I had a little private bathroom with a hand held shower head. The stuff they gave me for shampoo (I use the term loosely) was the consistency of snot and didn't soap up. It made my hands slick and it was hard to control hand held. I ended up spraying down my nurse, the towels and my gown. We both about collapsed in a fit of laughter. 

You know those little things in life you often take for granted? Well surgery brought the concept to a whole new level. Farting, pooping and walking were manna from heaven in my book. Whining, being cranky and cursing like a sailor are part of the healing process, so attitude is encouraged. 

Rod busted me out of the hospital on the afternoon of the 12th. Evidently one of the side effects of surgery and being on your back for 5 days is inflamed joints. I walked out of the hospital unassisted but Holy Knees Louise I could hardly walk the next day. I went to see my primary doc at Kaiser SR and had to have a wheel chair. She came in, gave me a smile and said "You are human, this is the first time I've seen you even look slightly tired during this entire journey. You must be related to the Energizer Bunny." 

Show me the exit

Things are pretty much back to normal and then some. We're back to walking 1.5 to 2.5 miles a day. My belly still looks like I walked into a load of buckshot: four holes for the laparoscope and drains and one incision with five or six stitches. All were closed with Steri-Strips that were supposed to fall off in two weeks. Mine seem to be related to NASCAR 200 mph duct tape, 19 days and they were still holding fast. Got permission to gently pull them off. Oh Yeah!

WTF moments: Since the surgery my platelet count is adequate for the first time in 2 years and I'm not bruising at my insulin injection sites. The answer is no spleen, platelets can once again roam at will. I'm sleeping better, my acid reflex has abated, the sporadic leg cramps have ceased and my alligator skin has improved. You just never know.

De-Liver Me Tour Segue ~ The Visitor ~ January 6, 2015

The results of the endoscopic ultrasound on December 16th confirmed that the mass on the tail of my pancreas is indeed an adenocarcinoma. On December 26th I had a PET Scan to see if the tumor was stable or had metastasized. The good news is that there was no evidence of metastatic disease. 

We went to see Dr. Bolinger, my specialist at Kaiser SF yesterday, and unbeknownst to me she had already set up the surgery appointment for Wednesday, the 7th.  Holy Crap: no time to fret, worry, or think about it. So off we go to San Francisco at o'dark thirty. 

She hopes to remove the tail of the pancreas and my spleen with a combination of laparoscope and robotics (brave new world). Best case scenario I'll be there for 3 days. If it turns into regular surgery, worst case scenario is that I'll be there a week. We're focused on the short term incarceration, even if that means we have go over the Bay Bridge  and Richmond San Rafael Bridge to get home. The Golden Gate Bridge will be closed for modifications from midnight Friday to dawn on Monday. 

I have always believed in signs and the power of animals totem. While I was at my volunteer job this morning Rod happened to look out the window and see a Great Blue Heron glide down the driveway and land on our neighbor's play set (lower left corner of photo). We have never seen one up here in the 27 years we've called this place home. Rod came in and decided to do some research. This is the message that Blue Heron brings, from Animals Speak by T.Andrews

"According to North American Native tradition, the Blue Heron brings messages of self-determination and self-reliance. They have the innate wisdom of being able to maneuver through life and co-create their own circumstances. 

Blue Herons reflect a need for those with this totem to follow their own unique wisdom and path of self-determination. These individuals know what is best for themselves and need to follow their hearts rather than the promptings of others. And, when they follow the promptings of the heart, they are one of the most magnificent when they choose to soar." 

Our Great Blue is here for a reason, it's symbolic attributes weave the tale:

Calm, Grace, Patience, Longevity, Versatility, Tranquility, Intelligence, Determination, Independence and Resourcefulness. 

Once home and secure I update you the rest of the story. 

De-Liver Me Tour, Top of the 7th, Rain Delay Part II ~ Dec 15, 2014

Update ~ It was raining cats and dogs on the way to San Francisco. We were expecting the worst, but much to our surprise drivers were being sane, courteous and careful. Decoding the parking map for Kaiser was a bit of a challenge but we prevailed and got a bit of a walk in.

Raining Cats and Dogs
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My doc told me ahead of time that he was going to do a biopsy so we could get a definitive answer as to what we were looking at. Cystic masses are quite common on organs of the body, but this one appeared denser than anticipated which was the cause for concern. We should have the results in 7-10 days. I'll remain on the Liver Transplant "pink list" accruing points, but not eligible for transplant, for the time being. 

All went as planned, and it only took about two hours. The crew was great from admissions, to the procedure room, to the "park her here until she lands back in this world" recovery area. There is something to be said for conscious sedation. I don't remember a thing, even the post procedure conversation with my doctor. Good thing Rod was there. 

Rays of sun peaking through the clouds

Watching the sunset of nature's splendor 

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Just heard from my Team Pharmacist ~ There is no longer any evidence of the Hep C virus detectable in my blood: zip, zero, squat. I'll remain on the Ribivarin and Sofosbuvir drug regimen to keep it so until the transplant. 

Time to Celebrate

 December 21, 1986

Gold Hill Hotel in Gold Hill, NV

But Seriously Folks

with our witnesses Barbara and Steve Novacek

Our 28th wedding anniversary is on Winter Solstice, December 21st. Since I am on medical hold at the moment and off my leash, we've decided a little adventure would be an great way to celebrate. We're going to spend a couple of days at the Timber Cove Inn north of Jenner. Foul weather means fireplace, reading, King's Cribbage and great food. Good weather means exploring the neighborhood, coastal walks and great food. We're talking win win here. 

Bottom of the Third ~ July 23, 2013

Could the third time be the charm? Only time will tell. We're off to SF once again and back to our little aerie on Cole Street.

Steam Punk Spiral Time Clock

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It's kind of a damp and blustery day, otherwise known as summer in the Bay Area. Our hosts gave us a suggestion for a place to eat so we took off on a late afternoon reconnaissance mission to the Haight-Ashbury to find Magnolia. Unfortunately it's crowded, loud and just pub food ~ so not what we're looking for today. We did get a mile and half walk in and enjoyed people watching, window shopping and the street art. Conclusion was that it's a perfect afternoon to be curled up with a good book.

The City from the Marin Headlands 

Decided to dine in and went next door (literally) to Say Cheese to pick up goodies for an indoor picnic. We had hot apple pie for dessert ~ brought one of Rod's to share. Oh Baby!

TACE  III went well, my usual overnight in recovery was quite comfortable except for the fact my bed was a stones throw from the ice machine and one of the self closing, I can be loud if I want to, slamming doors. Oh well, my night nurse wakes me up every two hours to check vitals so it's really a non issue.

Vintage JJ Cat Broach

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I asked the attending physician to come talk to me before I was released on the 24th. I'd had my first MRI a few days before this TACE and felt it might be a good time ask some questions about progress. A good portion of the tumor is dead, but tumors are tenacious and will try and get other arteries to feed them so they can grow and not die. Think Audrey II from Little Shop of Horrors.

He said "the whole process is akin to that kid's game called Whack-a-Mole". I hadn't heard those words in 30 years. I just burst out laughing, talk about lightening a load a bit, I get it now. 

I do need to return to UCSF for TACE IV on August 20th: for a follow up look at Audrey II and to go after a small abnormality first seen in January. It may not be another tumor but it's prudent to proceed as if it was. 

Aside: So I'm at the Post Office this morning to mail a package (August 6th) and start chatting with the lady in front of me in line. There was a really large and strange piece of equipment visible through the walk up window. I said "I wondered what that is?" and she replied "Must be a Whack-a-Mole". I rest my serendipitous case! 

Things are good, I'm back in the pink once again after TACE III. We've been making apple sauce, canning pears, and gardening. I'm spending a lot of time in my studio. Not off on any camping trips yet, but we have an invitation to spend a few days at Emandal Farm outside of Willits near the end of the month and we have a date for the Giants tomorrow. Think we'll take the Ferry out of Larkspur for a new adventure.





Top of the Second ~ June 23-25, 2013

Early Sunday afternoon and off to San Francisco for TACE II and a return visit to the flat we rented in May. It turned out to be a rainy day so instead of a 2 mile walk, we spent the afternoon curled up reading with a couple of breaks for sustenance. Two doors up we discovered Say Cheese and picked up some scrumptious goodies for an indoor picnic.

Around dusk we toddled a little further up Cole Street to Zazie's for dinner. It's amazing to have so many choices within walking distance. I'm beginning to understand why some folks like living in the City.

Monday was going to start early so we hit the hay about 9:30. I don't know if I mentioned it but the flat is over a restaurant. We had expectations for a certain amount of noise at closing time but we definitely weren't expecting construction, breaking glass and furniture being moved between 10pm and 2am. So much for a good night's rest!

A little aha moment at UCSF heading up in the elevator Monday morning. A gentleman with a dolly holding 3 boxes got on the elevator and someone at the rear asked what was in the boxes. He told us two kidneys and a liver. Three people were going to get a new lease on life today.

Window Lit Flowers

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Second TACE went much better, no nausea or pain this time. At my doc's suggestion I brought my own jammies and was able to dodge a second episode of the RASH. Shoulder pain and semi-sleepless nights seem the worst of it.

The irony of hospitals is that they are supposed to be quiet. There are signs on all the doors that say "Shhh" but each one has an automatic closer that slams it shut. Go figure!

Shhh

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The recovery room is like a 16 bed dorm with curtains separating patients. There are alarms, announcements, medical staff and cleaning crews working day and night. Nurses dutifully wake you up every three hours to check on one thing or another. There are dramas and laughter, conversations in animated tones and different languages. It's like you've been dropped into parallel universe for 24 hours: educational, thought provoking and at times entertaining. Sleep is not really an option, but reading and cat napping will get you through the proverbial night.

Quimby Cat Napping

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The drive home Tuesday was delightful, the world washed from two days of rain. We got back to the cross street just below our driveway and found a fire truck parked across the road. We were told we couldn't go through because there was a tree down on Lynch Road. We told him we could see our driveway and there was no tree down between here and there. No matter, he had his orders. This doesn't make my day. We head for the grocery store to pick up some supplies and head back. There is another truck blocking the road this time. I told Rod to pull the "my wife just got out of the hospital card" and sure enough the young man let us through. Home at last.

I'll need to return to UCSF for a third TACE on July 23rd. Certainly hope that's the last one. Seems like life has been on hold since January.

On Being an Advocate ~ June 21, 2013

One thing this little excursion into the health care system has taught me is that it's critical to be your own advocate. Kaiser and UCSF are world class institutions but that doesn't mean that things can't get lost in translation, transition, or Timbuktu. I have an awesome medical team, but regardless of the expertise represented, you need to find your voice and speak up. Telling me no or I don't know is not an option.

We Can Do It

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It's akin to herding cats or cattle, to make sure everyone is on the same page, headed in the same direction. As Will Rogers once said "If you're ridin' ahead of the herd, take a look back every now and then to make sure it's still there".

Long Shot

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So whether you're looking after yourself, a friend, or family take the bull by the horns, do some research and educate yourself. If you're not satisfied with an answer take it up the chain of command. 

What I find most amusing is that the watchwords and catch phrases of my youth have come full circle and make as much sense now as they did then: assume nothing, ask questions, take notes, question authority, be a squeaky wheel and persevere. Who knew?

The Art of Giving and Other Thoughts ~ June 17, 2013

In Fall of 2009 I did a three part series called the Art of Giving. In the last few days readers have checked out one of the posts. I realized, after a quick glance, that the links no longer exist so I took a few minutes to update the trio. This of course got me to thinking and I've decided to expand on the series, to give my readers some ideas and food for thought for the coming seasons.

 

Inspire Me

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A lot has changed for me in the last four years and that in turn has changed my perspective, the lens through which I see the world. All of it has been documented in my blog but the gist of it is: don't waste time on the unimportant shit, appreciate the little things, choose your attitude, and cherish your friends.

 

Friendship is Wealth

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Now go play outside. Unplug from all things electronic and share yourself with the world, one on one. We're off for a picnic and a walk in the park.





Cha Cha Cha ~ Changes April 17, 2012

Everyone looks at time in a different way. Everyone looks different in time. It's always on the move, but I've never considered its passage as something to be feared. With age we gain perspective, wisdom and sense of self. 

Rod and I have travelled through three decades together, now waltzing blithely through our mid-sixties. Oh sure the hair is silver, we've cornered the market on wrinkles and age spots and the sound effects of moving around are getting louder and more frequent. Like everyone else, we have our share of ups and downs. But when we catch ourselves whining (to protest in a childlike fashion) we invoke the "There's a $5 Fine for Whining" rule immortalized by songwriter Chris LeDoux.

No Whining

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Whining, complaining or dwelling on the negative accomplishes absolutely nothing. Attitude is everything, so get up in the morning and choose a good one. If you're having a crappy day, it's probably your own fault: clouds have silver linings, doors close windows open, plant a seed harvest food, call in well and take a time out. As a cancer survivor I know the power of staying positive. Life is too short to waste any of it on the dark side. You have choices and options Cupcake so make 'em count. I mean really: 

• We no longer give a rat's patooty what others think
• We get senior discounts
• We are free to move about the cabin and not act our age
• We are free to follow muses and dance with abandon
• We know things that younger generations are still in the dark on
• Live up to your expectations not those of others
• Let people go who bring you down
• Keep a journal (they're fun to read decades later)
• Take a camera every time you go outside
• Mentor a kid
• Research your history
• Volunteer some time ~ you'll be amazed at the returns
• Commit random acts of kindness

Time Stream 

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Life is a moveable feast and the memories will travel with you for the rest of your life. Build some good ones! Henry David Thoreau got it right:

"Time is but the stream I go a fishing' in"

Breast Cancer Journey ~ 1st and Goal

My 20 day radiation schedule has gone quickly, only 2 marbles left in the out box! Monday was the last day of traditional radiation which targeted the whole breast. The last four days target the area of the original tumor and incision, it's called a "boost" and is site specific.

My "A" team of fellow travellers at the cancer center have all been a part of the journey and we sometimes have a chance to visit while awaiting sessions. On Friday we got off on a tangent talking about the ailments du jour. Suddenly everyone got really quiet and then we burst out laughing, aghast at the idea we were becoming our mothers. One said her grandmother used to call it "organ recitals" and they were banned from family gatherings and dinner conversation. A conciousness raising moment for sure.

 

Spirit Horse

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As for the decorative sunburn and random rash I was blessed (too bad there's not a font for sarcasm) with just the rash. It looks like someone placed a pancake over my breast as protective gear and then dusted the surrounding treatment area with buckshot. I don't have kids but I'll bet it's akin to diaper rash and it itches like poison oak. I quickly found a solution to that little inconvenience: Mama Meryl's Healing Salve. It's made here in Sonoma County and available at Sebastopol Hardware. We've been using it for years for everything from cuts to scratches and burns to stings. One of the main ingredients is calendula which is in a number of recommended potions in the "dealing with it primer" for radiation patients so you may be able to find something akin to it closer to home.

Not feeling the predicted fatigue or I've just been too busy with life to notice it. The serendipitous timing of our four craft fairs following each week of the radiation sessions is perhaps no coincidence, but a handy coping tool nonetheless. I will say that during the last week or so, when 4pm roles around the barcalounger, a tall glass of water and a couple of chapters of an NCIS marathon are a pleasant diversion.

Once I graduate on Friday I'm going to take December off and give my body a rest. The next step in this journey will be five years on an estrogen inhibitor called Anastrozole which of course has a host of potentially nasty side effects.

I've always be one to question authority so I'm doing some homework. First I'm looking into an alternative to ingesting medication orally by talking with a compounding pharmacist who can use my prescription to make a topical cream. We also have local MD who believes in incorporating alternative therapies into her practice and some of those may mitigate potential side effects of the medication. Her specialties cover my gambit of concerns: women's health, oncology and hepatology. Both are willing to work with my oncologist at Kaiser so once I have more information I'll contact him to discuss possibilities.

Apologies for the football analogy in my title today, but our beloved SF 49ers have come back to life after what seems like decades. It just goes to show you should never give up hope ~ ever!

 

Breast Cancer Journey - Off Season Training

I usually avoid traveling to the east side of Hwy 101 into Santa Rosa or Rohnert Park like the plague. I save up errands and appointments so I only have to go in every week or two. This week was an anomaly for sure, but all for a good cause ~ my future health!

I met with my Oncologist on Monday ~ reports are good, the tumor removed was about half the size they anticipated. I have positive estrogen receptors so it has been suggested that I start a regimen of Anastrozole to help lower estrogen levels ~ as if menopause wasn't enough! One of the possible side effect is hot flashes ~ Geeze Louise, I made it all the way through menopause with one night sweat and no hot flashes, so I'm hoping that whatever my body knew then it remembers now! Due to a long list of other potential side effects I've asked if I can start when I'm done with radiation. I should hear back in a couple of days. I don't want to hammer my body with too much all at once. Tuesday was a follow up mammogram to see if there were any residual calcifications. Report back from radiologist was that films were clean and clear. Oh Yeah!

Wednesday off to the Rohnert Park Cancer Center (RPCC) to meet with my Radiation Therapist and discuss preliminary treatment plan: five days a week for four weeks. We've got it worked out so I'll be done about a week before we take off on our 25th wedding anniversary adventure (destination pending ~ we keep getting new ideas).  

I got Thursday off and didn't leave the property except to attend a concert at Studio E with singers/songwriters Tom Russell and Thad Beckman. It was an amazing evening full of laughter and outstanding music dedicated to my late friend Trisha and shared with family and friends.

Friday took me back to RPCC for a CT scan, to document my treatment plan, design positioning devices to keep me in same position for each session and tattoo my skin for positioning accuracy (we're talking four blue freckles here, nothing major). I met with nursing staff for patient education and got more homework. On Nov 9th they'll do a Sim Verification or dry run and perhaps my first treatment.

Trisha's Bobcat ~ Cherry Camp Vineyard 2009

For anyone who knows me, Bobcats hold a special place in my life. As I walked into my Radiation Therapist's office and sat down I looked up at the calendar on the wall ~ there looking back at me was a Bobcat and the words of William Wordsworth "Let nature be your teacher". I no longer question these experiences, I just know my husband, friends and spirit guides have my back and are with me for the duration of this journey.

Choose Your Attitude

I've always had a positive attitude: it could be genes, it could be growing up in a small town, or the shear luck of the draw. Whatever the reason my outlook on life is a key ingredient of my well being.

Life continually throws us challenges but how we choose to grow from the experiences are the important lessons. I lost my parents when they were in their 70's ~ far too young. Little did they know that the lifestyles sold to them as healthy in their youth would be their downfall. They were not of the generation who chose to question authority and trusted the family doctor without a second thought. What I learned is that we have to be our own advocates and take responsibility for our well being.

I've lost close friends to disease and accidents, beloved pets when I made the choice to let them go with dignity. I've faced medical challanges for 20 years and have recently been dealing with breast cancer. Each experience has helped me grow, made me wiser and taught me how to deal with adversity. I've learned that exercise and changes in diet are the best things you can do for yourself at any age. But probably the most important lesson is that life is short: do what makes you happy, start work on your bucket list, keep people in your life who love you for who you are and make you laugh.

This brings me to a conversation with my surgeon when I had my stitches removed last week. Much of the information given to you regarding surgery and recovery tells you to rest and don't do much. I told her it wasn't my style to sit around and I was off and running (albeit carefully and with some common sense) on autumn projects around the house and at a neighbor's the day after my surgeries.

Point of View
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She said to me "Your big picture perspective, positive outlook and sense of humor play a huge part in your overall health and healing". She drew a box in the air and then made a small box in the lower corner of that square. "You have chosen to perceive your cancer as only a small part of your life experience, it will never rule you. Unfortunately many patients choose to let cancer become their life, they become victims of their diagnosis rather than taking on the challenge and looking ahead".

No one said life would be easy, or fighting a life threatening disease would be a cake walk. I just want to encourage anyone dealing with cancer to remember your friends, family and a army of survivors have your back and are there for you. Call in the troops!

This morning's Press Democrat has a great article about cancer survivor Nina Sibert. Her cancer and treatments were far more radical than mine, but her outlook is very similar. Please read and share it. I hope to meet her someday. Here is the link:

http://cloverdale.towns.pressdemocrat.com/2011/10/news/pinktober-comes-to-cloverdale/

Now go outside and enjoy your day!

Breast Cancer Journey - D Day

Yikes, lumpectomy surgery is tomorrow but my proverbial ducks are lined up and my questions asked so I'm as ready as I'll ever be. Taking notes really helped! Kaiser staff and doctors played a huge part in preparing me for this journey and lessened my fears of the unknown. There is the great interactive program on their website that walks you through each step and what to expect at https://my-emmi.com/

The X Factor: The biography I wrote for my 40th Tamalpais HS reunion (2003) was entitled "My Middle Name Should Have Been Serendipity". If you've read any of my blogs you'll begin to understand this cosmic force of nature has been a huge part of my life's journey. I found out today that not one, but two of my friends had the same surgeon and said she was the best. Works for me!

My knight/chef will be there at every turn and has promised to spoil me rotten and give me foot rubs while I heal. Friends from near and far have checked in with good wishes, healing thoughts and humor. What more could a girl ask for?

D-Day starts early

At 7:45am I head to Nuclear Medicine for an injection in my breast of a blue and/or radioactive tracer that travels along the same path cancer cells travel as they spread. I've been told the injection can be uncomfortable (might sting a bit, uhuh!) and asked if there was something available to mitigate the discomfort. Found out there is topical compound that will numb the area and asked for a prescription. Never be afraid to ask about options!!!

That done, I'm off to the mammography clinic. My tumor is so small it cannot be felt so I'll be having something done called a "wire localization". The area will be numbed with a local and then using ultrasound or x-ray images a very thin wire will be guided to the tumor. My surgeon can then follow the wire to the tumor during surgery. When the tumor is removed the surgeon will also take a margin around it to be tested.

My cancer is called "invasive ductal carcinoma" which means it has escaped the duct wall and may have moved into the lymph system. If it has reached the lymph system, the sentinel lymph node, the one that is the brightest blue or has highest level of radiation from the tracer injection will be removed for biopsy along with a few others. 

The ideal scenario would be to find that: (1) the margin will test negative, meaning no cancer cells have spread from tumor and (2) sentinel node will confirm no cancer has reached the lymph nodes. I'm voting for this one. A possible scenario is that the margin is positive and/or nodes are involved. If that is the case additional surgery may be required. I'll know stage and next steps in a few days. Surgery will only take a couple of hours, then a couple of hours in recovery and I can go home. I can't wait for Thursday because that will mean Wednesday is history!

Yes, I'm a little nervous, but whatever the outcome I know I have a dedicated posse riding shotgun. This is just a bump in the road, or maybe one of Petaluma's infamous potholes, but my ponies have always been 4 wheel drives, so out of my way world I'll be back in the saddle in no time.

Original Posts:
A Journey of Another Kind 08/23/11
Nobody Told Me There’d be Homework 09/06/11
Required Reading:
Just Laugh Out Loud 09/09/11

Nobody Told Me There'd be Homework

Information: Kaiser and the American Cancer Society provide copious amounts of helpful information for patients to read: explanations of diagnosis and treatment, different procedures and therapies, how to understand pathology reports, integrative health and healing services resources, post operative exercises, living smart and more. It’s all good, but a bit overwhelming. So where do you start?

http://www.etsy.com/people/soulfulsayings

Get Organized: I sat down one morning with all the booklets and flyers, a yellow highlighter and post it flags and began the task of educating myself. This is going to be an ongoing adventure so I figure it’s in my best interests to stay on point.

A binder sounded like a good start. I setup tabs for questions, notes, schedules, pathology reports, doctors, anesthesiology, post operative care, resources and a section for communications received from friends, acquaintances and total strangers who have sent humor and positive thoughts, offered to answer questions and forward information to help me on the journey. I also taped my team's business cards to the front inside cover for easy reference.

What's Next: At my age memory isn’t something that can always be relied upon, so I decided type up an outline and make a list questions to ask doctors. Several of my friends who have been through this offered to provide me with additional questions that I may not have thought about. I intend to use all resources offered.

On the Horizon: Due to an annual mammogram the cancer was caught early and the consensus is that it is Stage I, confined to a small area. My decision is to have a lumpectomy and radiation rather than a mastectomy. Surgery is scheduled for late September, followed by a radiation therapy for a minimum of four weeks. The game could change some if we find out that lymph nodes are involved, but the answer to that question will have to wait until surgery day. My take is to keep a positive attitude.

Community: This has become a community excursion. Countless women have made the journey before me, and others will find themselves in the shoes of the new kid on the block as I did, all members of the club no one wants to join. I am happy to have a sisterhood of strong women along for the ride and hope by sharing I can help take the thunder away from someone else’s fears.

Stay positive and dance your cares away.

Check out some amazing art in my latest Etsy Treasury

http://www.etsy.com/treasury/NTk2NTA5OXw2NzU1OTQ1NTk/dance-your-cares-away