So Far So Good

Larry and I went to chemo today (despite our marital vows where the two shall become one, I was the only one to actually receive the drugs) and things went well.

They did as they promised in the training, first pushed in the anti-nausea medicine and Benadryl.  Then they let that percolate for a little while as I sat in the heated recliner with a cotton blanket; nice.  The nurse did tell me that I shouldn't wear shorts next time because it is always cold in there; sweat pants are more the expected attire.  Not sure I would survive the drive home in sweat pants and with the blanket I was just fine.

Next, they started the first chemo drug and pushed it in really slowly.  It was well tolerated--meaning I didn't have any wild eyed looks going on, the nurse did tell Larry that he should be checking on me regularly to see if I looked any different because if there is a reaction going on, it usually starts with wild eyes.  They continued to increase the speed that it was going in over the course of an hour or so until I was at full speed ahead.

When drug one was empty, the loaded drug #2 and got going with that one.

We headed home around 2pm.  I even got to pick up my free Chick-fil-a sandwich that was expiring today and enjoyed it on the way home.  I was afraid I was going to miss out.
 
I'm seriously considering heading off to bible study this evening, presuming I still feel like I do now.

Thank you so much for all your prayers and texts of prayers they are so wonderful!  God has truly answered each one.  He is so gracious!

I read this during my homework/devotional time the other morning and thought it would be a good verse to share.  Talking about how thankful Paul was for the Thessalonians.  I checked it out with Clayton too, in full disclosure, he had me share these verses instead of 9 and 10 because there is the whole discussion about how we are all still growing in our faith, but verse 10 ends in a way that taken out of the context of these new believers sounded a bit odd to say to you, dear readers,  who are people I am trying to imitate (which is from 1 Thess 1:6-7).

Now may our God and Father himself and our Lord Jesus clear the way for us to come to you [or you to come to us].  May the Lord make your love increase and overflow for each other and for everyone else, just as ours does for you.  May he strengthen your hearts so that you will be blameless and hold in the presence of our God and Father when our Lord Jesus come with all his holy ones.  1 Thessalonians 3: 11-13

Next Steps:
Monday 7/7   Blood work to make sure my CBC is still good; they took a baseline today.
Monday 7/20 Chemo round 2

Chemo Training 101

Today I completed my one hour one on one training session to learn how to 'do' chemo.

Janet asked the most important question this afternoon.  "After the training was complete, was there a t-shirt?"  Guess what? Yes, there was indeed!  I didn't take the time to pick it up today, but I certainly will.

Clayton established early on in his college days that if I didn't go to the event, then I couldn't wear the t-shirt, even if he was not going to wear the shirt anymore.  Well, I don't want to anyone else to get this t-shirt.  At least for me it was a bonafide training.

The chemo cocktail I'll be taking is Docetaxel + Cyclophosphamide or TC.  We went over all of the expected side effects, what is normal, what is rare, when to call the doc, etc.

I'll have two different drugs to combat the nausea, a steroid to help keep up my energy and a lidocaine cream to put over the portacath.

Monday I did have a successful portacath insertion.  I slept off and on Monday, and felt well enough that I caught a ride to Bible study that evening.

The first treatment will be this coming Monday, the 30th.  They said to plan on being there five hours!  Yes, you can bring food along.  They will take their time putting in one drug and then another to be sure I don't have any adverse reactions to them.  Future treatments won't take this long.

The second treatment will be 7/20, yay for being after my birthday!  That is when my hair is expected to be on its way out, but we girls have a plan for beating it to the punch during girls weekend starting on the 18th.  Ok, it is possible, that I might have a few control issues (at least around the edges).

Then two more treatments each three weeks apart.

So we (do you love how I'm dragging you along??) are on our way... Thank you so much for all your encouraging notes, texts, emails and especially all of your prayers.  They make such a difference, my stress level which has been very low. It is a peace that passes all human understanding.  Praise be to our great and gracious God.

Memory Monday

One of the things that I have been so thankful for these past two months is some unintended prep work that I have done over the last couple of years.  That is bible memory.  I'm by no means super memory girl or anything like that.  I thought it would be FUN if you guys did a little memory too, starting on Monday, of course to pick up on the alliteration; Memory Monday.

All of the boys have had memory work as part of their elementary and middle school years. Each of them needing various levels of help to complete the assigned verse(s) for the week. It's natural that when you hear them repeat the verse 6-10 times you start to pick up on them as well.  J's strategy is to teach the verses to me in the car while we drive to school.  Then after I learn it, he works on teaching it to himself.  Of course we all know that in his teaching is where he learns it.  Admittedly, some are only kept in the memory long enough to complete the week's assignment.

In 2012 my good friend Cindy challenged her blog followers to memorize a verse every two weeks and to make it fun, she did them in an A to Z order.  You can read about it here.  Her friend Darlene even has a business that prints verses on business card size card stock that fit neatly into your purse (if you carry one).

God asks us to hide his word in our hearts.  And while I'm not great at it, I am happy that I've taken the time to do some memory along the way.  Especially the day that I was strapped into the mammo machine for quite some time.  I was happy to be reminding myself that, "Nothing is impossible with God."  Sparing you further details, let's just say reaching for my phone and looking up a good verse on my bible app was not a possibility that day.

How can you incorporate some memory into your daily life?

• Write a verse on your mirror with a dry erase marker
• Make a little card and keep it on your dashboard (I used one of Darlene's cards)
• Change your computer password to be a verse (it meets the new super security standards)
• Sing it in a song

Here are a few of my favorites these days, I'm terrible at remembering their address (where to find them), but I figure that is when The Google can come in: 

• He works ALL things to the good of those who love him.  
• Consider it pure joy my brothers when you face trials of many kinds (ha ha, I first typed kids)
• Devote yourselves to prayer, being watchful [for the answer]and thankful 
• Every good and perfect gift is from above
• God is our refuge and strength, an ever-present help in trouble
• Love the Lord your God with all your heart, with all your soul, with all your mind and with all your strength
• Nothing is too hard for God
• Trust in the Lord with all your heart and lean not on your own understanding
• Victory rests with the Lord
• I can do all things through Christ who gives me strength
• Rejoice always, pray continually, give thanks in all circumstances; for this is God's will for you in Christ Jesus

'Life' is going to happen.  Attitude can make all the difference in whether you have a pleasant or miserable time along the way.  The choice is yours.  99% of the time, I'm choosing the positive route, how about you?

Wheels are in Motion

Friday I received a call from the surgeon's office that they were ready to schedule the porta-cath installation.  Turns out that the only available spot next week is Monday morning at 7am.  That means that we will need to be there by 5:45am.  Ouch.  The good news is that we shouldn't run into any traffic at that hour.  :)

I won't be going fully under, the nurse said it was called conscience sedation, but it out enough that you can't eat after midnight and you need someone to drive you home.

The procedure lasts 30 minutes and then recovery for about an hour before they kick us to the curb.  So I'll be taking it easy on Monday, but should be home before lunch.

Never mind all the work that took place on Friday, chemo training was also scheduled for this coming Wednesday.  Janet suggested it might be like fish Orientation Week at A&M and I should be practicing my "Sir, yes sirs," just in case.

Also next week on Thursday, (oh sure I love driving to Austin every day) I have a follow up appointment with Dr. N, but I'm not exactly sure what that is for. I expect that will be when the first chemo treatment will start and they will shift the time around a bit from where it is now.

I should mention too that we have a new family member these days.  Last week we adopted Hank from the animal shelter.  He is a 2-3 year old wire terrier and has a great disposition. We are glad to have him around.

We Have a Plan of Action

Sorry that the poll did not work well yesterday, but I'm glad I didn't order an entire roll of these stickers.

When Larry and I left Dr. N's office today we did not have a plan.  Instead we had more indecision from the Tumor Board.  They were still on the fence and because they met at Olive Garden this week the janitor didn't bother to attend (he's gluten free) and therefore there was no deciding vote.  Just kidding about the attendance of the janitor.  The Tumor Board really was still on the fence,said it was 'patient choice' and they meet via web conference call.

Based on that indecision Dr. N had called two additional docs and was considering taking my case to the city-wide tumor board.  We left with the plan that he would hear back from these last two docs and call me and let me know their opinion.

The indecision by the numbers:
Out of 100 women with same size tumor, no node activity, estrogen receptor positive, histologic grade 2, only further radiation treatment:

• 80% are alive and without cancer in 10 years
• 17% relapse
• 3% die of other causes

If you look only at the 17% who relapse if they went through additional treatments:

• Hormone therapy alone (forced menopause to get rid of the estrogen source feeding any microscopic cancer cells floating around) helped 7 more women
• Chemo alone helped 10 more women
• Combined helped 13 more women

That 7 to 13% benefit is a 50% improvement on eliminating the relapse.  Yes, it's a percent of a percent, but that very circumstance made me laugh.  Tim B, if you were reading I know you would be laughing too.  

But really that 50% improvement of chances was already swaying me to a decision.  I mean what self respecting over-achiever would ever want to score in the 80's when they could go the extra mile and get an "A".

We left, still in undecided mode, but stopped downstairs to talk amongst ourselves when Dr. N called back and we went back upstairs to hear what he had learned in the subsequent 10 minutes.  A doc had reviewed my case and because of two factors she recommended chemo.

1. The tumor was multi-focal (the seeds of the strawberry).
2. There was lympho-vascular involvement in the tumor.

Neither of those two factors were considered in the numbers above, which are riskier.  So we have a decision.  I feel fine about it.  I just want to get started so I can get finished.

Next Steps:

• Next week I will need to go to 'Chemo Training'.  I have no idea what that might entail.  
• I also need to get a copy of my heart echo tests, he wanted to order new ones, and I quickly stopped him and said wait I just had that done less than two months ago.  
• I will also need to get the port-a-cath installed.  I suppose that's better than a port-a-potty.  

The chemo plan will be 4 total treatments at the lowest dose.  Have a treatment, wait three weeks, have another treatment, wait three weeks, etc. until four treatments are completed.

J was instantly wondering if I would lose my hair, doc says yes.  Oh man, you're going to look weird.  :)

THEN, start radiation.  Only one torture at a time. No further details about that yet.

Answered Prayers:

• I am so thankful that there is so much data available for a person like me to use for analysis
• That so many have been praying for me
• That treatment options are available
• I feel great physically and emotionally
• That the genetic tests showed that nothing cancer related (that they tested for) passed down to C, S, J, c and e
• We have a plan of action

Prayer Requests:

• God would be glorified
• I would be cancer free
• Appointments next week would be easily coordinated
• That I wouldn't feel too sickly when treatments start

I'm gettin my boots on.  

Will I need...

Will I need...

When Negative is a Big Positive

Today I learned that I am not related to these guys.

Praise God.

The results of the genetic testing came back negative, which is a good thing.  It means that I don't have the mutated gene and therefore I am not exceptionally predisposed to three other kinds of cancer.

The last few days I've been as nervous as a cat in a room full of rockers, not sure how this test result would come out.  I have appreciated your prayers of support for those of you who have asked.

Next appointment is tomorrow (no, I couldn't have two appointments in the same day due to insurance so I get to drive back to Austin again), where I hope we will finally have the results of the Tumor Board and a plan of ACTION.

The options so far are
Radiation or
Chemo+ Radiation

Not sure if this link will work to take a poll.

More tomorrow!

Dr. N Update

Today was the long awaited visit with Dr. N. I was expecting some definitive plans of ACTION about what treatment plan I’d be getting started with.  However, that is not the case.

Turns out I’m in a gray area for what happens next. Ugh.  Ok... 

We already knew that radiation was on my horizon and treatment plan, but because of today’s revelation Dr. N has said that he is really on the fence about whether or not I should also do some chemo. 

Why you ask, because the tumor had multifocal spots (those were the seeds on the strawberry, click here if that makes no sense), inside those individual spots/seeds the cancer was in the lympho-vascular system of the tumor itself. 

Yes, you remember correctly that the larger lymph system is not involved (negative sentinel node), but within the tumor itself it was in that lymph system, which means a few bad cells could have snuck out.

So how do you make a good decision on this topic?  You take it to the Tumor Board.  Who knew there was such a thing; not me.  I've recently contributed to a work project that went to the Board of Directors and they heeded our advice, but I’m not sure I’m as well qualified to weigh in on this topic. 

Apparently Dr. N will present my case history to six oncologists, a handful of radiologists, a handful of surgeons, and the janitor (just kidding on that one).  They will go through all of the details and then they will vote on whether chemo is recommended or not; majority rules.

My goal remains unchanged, to be cancer free, so if chemo is needed, I’ll sign up.  Dr. N said that he would recommend four treatments each three weeks apart (over the course of 9 weeks).  Larry asked if this would make my hair fall out, and yes it will.  I think I will cancel my haircut next week and wait and see what the Board decision is before I spend any extra money on coiffing my locks. 

Dr. N also ordered the oncodx typing of the tumor.  Both L and I thought that Dr. A had already done that, but Dr. N called him right there and no, he hadn't.  So that means that we’ll have to wait two weeks to have those tumor slides from the lumpectomy tested. 

The on-co-d-x is genetic testing on the tumor itself to see how receptive the tumor would be to chemo. A score of >18 = chemo for sure. <18 it’s more of a toss-up (those are my words). 

I've been doing pretty well keeping my mind off the waiting.  Sissy reminded me this evening that patience is a virtue, but let’s get on with it. Amen, Sissy. 

While I’m sharing I’ll also tell you how I’m really doing… I did have a bit of a freak out moment on Saturday at a graduation party, it wasn't the graduate, but the casual conversation among party guests. One of their mutual friends has cancer and has the positive gene and sure enough it’s currently popping out all over her body. I got really antsy after that and left the party not long after.

Then I was reminded that God already knows how all of this is going to work out. The genetic testing that I’m having done will not be a surprise to Him.  He was there when I was knitted in my mother’s womb.  He knows EXACTLY how I am put together, and whether or not I have a gene mutation or not. So I’m back to feeling ‘normal’ and not freaked out. 

The summer bible study that started Monday on 1 & 2 Thessalonians is going to be fabulous; Linda this is what I was going to tell you.  

Matt does a great job of keeping me busy, by our mutual agreement, so that I don’t think too much about all of this crazy stuff.  However, by Wednesday afternoon I had reached my personal capacity for the week (I can’t remember the last time that happened, but it was crystal clear yesterday). I did get everything completed that needed to be done for the week and so I could take a couple of days off, and keep things on track with the project I’m working on. 

Today J and I are off to visit c & e and their parents Janet and Clayton in their new house with a YARD, so I’ll get a few days of rest and relaxation, though Clayton did tell me he’s been saving some of his honey-do’s for when I’m there so I don’t get bored. 

Next steps:

• 6/18  (Happy Birthday Garrrr) Genetic read out; previously scheduled
• 6/19  Tumor Board read out and perhaps a plan of ACTION???? Let’s get this show on the road already.

Answered Prayers:

• Based on several people’s feedback to me, God has been glorified
• Healing from surgery (I’m back to exercise walking at regular distances and speeds and gardening aka weeding)

Prayer Requests:

• God would continue to be glorified
• The Tumor Board would have wisdom and discernment in making their decisions
• That I would be well enough to make it through the full nine weeks of Bible study
• I would be cancer free