BC Becky

Never thought I'd want to be a breast cancer survivor

Category: Research Data

  • Nothing quite feels like you expect it

    One of my fears has been regarding neuropathy. It is a common side effect for the Paclitaxol (aka T-Chemo) which I start on Labour Day (September 1st). It is also a less common side effect for AC chemo. It seems that I’m destined to experience it now!

    It all started this morning, with some tingling in my feet. I noticed that the front pads of my feet were a bit tingly (sort of like they were about to fall asleep but had not yet). Unfortunately, it didn’t get any better, and now I’m finding it a bit painful to walk – I can feel myself compensating for the tingly (which is less tingly and more like fine needles stuck into my feet). I only seem to notice it when I’m standing / walking – so it doesn’t bother me at all when I’m sitting or laying down (which is good). It may seem counter-intuitive, but the more I walk, the less painful it is (it isn’t really that painful, rather it is annoying).

    So, now I’m going to put on my running shoes and go out for a walk – in hopes that getting the blood flowing to my feet through walking will make the problem go away.

     

  • Rethinking reconstruction

    I had a couple of doctors updates yesterday. One with the breast surgeon and another with the oncologist. On the good news front, my oncologist said that my left breast felt like ‘a normal lumpy breast’ rather than a breast with a large cancerous tumor! This is a sign that the chemo is working. He also commented that this point we are on ‘auto-pilot’, finishing off the chemo regime with switch to weekly Paclitaxol (T-chemo) starting Labour Day for 12 weeks. It also means I have about 12 weeks to figure out surgery.

    I was so confident in my decision for no reconstruction, but that confidence was built upon assumptions that are proving to be incorrect. The surgeon re-enforced my concerns about lumps and bumps. The reality is, that I’m not a skinny girl. There is only so much a breast surgeon can do – their priority it to remove the cancer and with a mastectomy to also remove all breast tissue. Even with no reconstruction, I’m looking at two surgeries – the first to remove the cancer, and the second to clean up lumps and bumps – in part because they cannot predict how you will heal. The surgeon strongly recommended a consult with plastic surgery and radiation oncology before I make a decision. So now I’m reconsidering my options.

    If radiation is not necessary – then I’ll be a strong candidate for immediate reconstruction. This would mean, during the same surgery I would have my breasts removed and a procedure done to replace my breasts with something. The something is either an implant or some fat from another part of my body (usually the stomach). Breastcancer.org provides a good high level description of the different reconstruction options.  Personally, I’d rather go flat then have implants – in part because my body tends to react negatively to foreign objects, but also because they need to be replaced every 10-20 years. There are a couple of options that use stomach fat (not muscle) that may actually work out for me (Diep Flap and Siea Flap). I despise how they advertise it on the comparison chart as getting a bonus “tummy tuck”, but in essence that is what happens. They move excess fat from your tummy and replant it in your breast – replacing the breast tissue with the tummy fat. If it works well, it gives a more natural look and feel as compared to implants – but the surgery time and healing time is greater.

    The surgeon did a good job of encouraging me to think beyond the immediate time – think one year, five years, beyond. One of my realities is that I’m not suddenly going to become a skinny girl. That isn’t in the cards for me. So, my body will inevitably have various rolls and folds. Previously, I wrote a bit about my concern for Buddha Belly. So I need to consider, what option is going to leave me with the better self-image of my body? Since being diagnosed, I’ve enjoyed a positive self-image (more so than before diagnosis), but I don’t know if that would still be the case after surgery.

    The other thing that is often pointed out is that you do not know how you will react post-surgery. You may not think of your breasts as an important part of who you are now, but that might very well change when you wake up and they are gone. This is one of the more frightening aspects of whole process. You could be ‘certain’ and wake up to discover that you were wrong. One of the common approaches is to leave as many doors open for surgery. So, rather than doing double-mastectomy with no reconstruction, they do a double-mastectomy with skin sparing techniques. The surgery takes longer, but it leaves you with more of your skin, making reconstruction easier. You can then decide later if you want reconstruction. Using this approach keeps the door open for options but also draws out the number of surgeries and the length of time you are being treated. If you make the reconstruction decision before the mastectomy and you are a good candidate, they can do the first two surgeries at once (reducing the number of surgeries and overall healing time, but increasing the healing time as compared to mastectomy alone).

    So now I shall wait again, for the next set of consults, to see what my options actually are. And then, maybe I’ll make a decision, but maybe not …

  • Persistence, Tenacity, and New Blood

    Persistence, Tenacity, and New Blood

    This cancer journey reminds me of some aspects of our Going East bike trip – particularly during those times when persistence and tenacity are what you need to make it over that one last hill. I always thought this picture from our trip made a great motivational photo (Scott pushes the loaded recumbent bike up the mountain – you can see the sweat on his back – unfortunately the picture does not do the steepness of the hill justice). The locals thought we were crazy trying to bike over this mountain pass – but we were both persistent and tenacious and we made it!

    OK, this is steep

    Perhaps this is a better persistence picture (also in northern Thailand):

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    My point here, is this is how I feel when I’m feeling fatigued. I feel like the entire road is uphill. And although these pictures show a struggle, they also bring a smile to my face. They remind me of challenges that I have overcome. They provide me with that little extra reminder, that yes, I can do this.

    Yesterday, I had my first transfusion. The AC chemo was knocking out my red blood cells (RBC), and they were not being given enough of a chance to bounce back between rounds. Folks have asked about drugs to help with RBC. Apparently the drugs take a long time (6-8 weeks) to boost production, and the side effects can be worse than the side effects of a transfusion. Given the more immediate need for a boost now, it made sense. And so, I had my AC chemo on Monday and a transfusion of two units of RBC on Tuesday. I cannot say I immediately feel better – but then the AC chemo knocks me down for a few days, so it is hard to say. What I can say is that I have more colour – my cheeks are pinker and my lips have natural colour again. I had not really realized how pale I was before the transfusion.

    Unfortunately, my phone doesn’t take very good photos.

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    We were also serenaded by the harp during treatment, which was nice. Apparently, med students who are also musicians volunteer to play in the cancer center. This is the first time we’ve seen the harpist directly in the infusion treatment area.

    The volunteers at the hospital make the nice head scarfs/hats. I discovered that it works well when the tie is on the side – kinda makes me think I should learn to read tarot cards.

     

    So, now I have some new blood. I am still feeling some fatigue, but hopefully in the next day or two I’ll bounce back :-).

  • AC Cycle 4

    So today was my last cycle of AC chemo (yay). In theory, the T chemo that follows has less side effects (little nausea). Brought in my new clown to show off to all the nurses. He was a big hit!
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    It turned into a long day. We had a delay seeing the nurse practitioner to get sign off on chemo – unfortunately that delay turned into a 2.5-3hour delay. Then we had another delay on the saline drip for rehydration, which caused about another additional hour. So we arrived at Stanford at 11:20 and did not finish at transfusion until after 7pm. Add in the 30-45 minute drive each way and it definitely made for a long day.

    It looks like I’ll be Stanford bound again tomorrow morning for a transfusion. My red blood cell and other related things have been getting progressively lower with each dose of AC. So, at this point they are recommending a transfusion. Apparently, any medication that would treat this would take 6-8 weeks to take effect, and the side effects are actually less with the the transfusion. However, I apparently have some anti-bodies in my blood which means that the donated blood needs to be more closely screened to match my blood. I have an appointment tomorrow morning, but the blood might not be ready – so we are to call first before driving up.

    The new blood is due to come at a time when I usually have a low – so it might turn into a real blessing – giving me more energy when I typically don’t have much. Crossing my fingers that they find a match before tomorrow morning.

    Either way, this is the last dose of AC – so worthy of celebration. 🙂

  • Courting a new lover

    Have not told anyone, but have been dating a gentleman named NED. I’m serious about the relationship – but he won’t commit and this is causing much anxiety and grief. I want to marry him and live happily ever after – but NED refuses to commit. He is an incredible lover and makes me feel alive and momentarily safe. Unfortunately, discovered that he is dating countless others – but I choose to continue our relationship. My past life is littered with commitment phobic guys – and I should know better – but I cannot resist this guy’s charisma.

    He knows just when to appear, and how to look into my soul to give me hope of a future together. I cherish him for the hope he gives, and how good he makes me feel. At the same time, I despise his fickle nature and question any promise he makes. Yesterday NED accompanied me to a doc appointment and held my hand. Whenever NED appears – he always brings temporary peace and joy – but I still distrust him and feel guilty for my lack of loyalty. Can anyone relate?

    Anyone diagnosed with Cancer probably already knows NED and are familiar with his charms. For those who are not familiar with NED – it is an acronym for: No Evidence of Disease. (by Cathy Foster)

  • Feeling strong

    I am surprised by how all of sudden my strength returns. Where only a week ago I could only swim 7 laps in the pool, I’m now swimming 30 and the only reason I stopped was because I had too many other errands to do.

    It seems that with each AC cycle the down days after neulasta are longer, but when my strength does return, I’m stronger than I’ve been before. In cycle three, I walked farther (10km on day 2), cycled farther (36km on day 10), and swam farther (we actually I swam this distance in cycle 2 as well 1200m) – than I had before chemo started.

    As I’ve discussed in my last post, I’m also struggling with increasing signs of depression – worsening with each cycle. This in part is related to not have access to my coping mechanisms (exercise) for the longer stretches each cycle. In part because the reality of having breast cancer is sinking in (denial is becoming less and less active in my brain), and a lack of knowing what will come next. Relating to exercise, each added day when I cannot get in a long workout, my stress and anxiety build. I’ll be working with the folks at onc-pysch on developing additional coping strategies, but will also be changing some medications to something new, where the side effects are actual effects that align well with counter-acting the effects of chemo (drowsiness, anti-neasea, and increase appetite). The new meds should also help deal with some of the ‘chemo-pause’ side effects (night hot flashes). We shall see how it all works – but for the next two or three days, I should be feeling strong – and will try to enjoy it while it lasts.

    When I was up at Stanford yesterday, I visited my tree. I wish pictures could capture the scent of the eucalyptus.
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    I’m not nearly as good at taking pictures near myself near the tree – but here I am sporting the new cap Maha sent me from Egypt 🙂

     

     

  • #thisiswhatdepressionlookslike

    This post has been inspired by a mix of things, not the least of which is how I am feeling at the moment. With the recent passing of Robin Williams, my Facebook and Twitter feeds have been filled with tributes but also warnings about depression. One of the Unitarian Ministers on my Facebook feed (yes I have several Unitarian Minister friends) posted a challenge to share pictures for people who suffer (or have suffered) from depression, as it helps to show the faces of depression. So, I took this picture today while I was out on my bike ride. One of the reasons I ride is to fight depression, but the fight is becoming more difficult.

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    I feel the need to write more about depression. The latest news regarding Robin William’s death just crossed my social media stream – that he had early onset Parkinson’s makes it seem that much closer to home.

    Yesterday represented a transition (last night really) – from control to loss of control. I took the above picture in the middle of my ride. I cried for most of the first 30km. It wasn’t until that point that I finally found myself back in control. I wasn’t sure the ride was going to work this time!

    Fortunately, when I felt the early signs, I began to reach out, and will have my first appointment with the oncology-psychiatrist tomorrow. It seems that at about the same time I reached out (about two weeks ago), Stanford opened a new oncology-psychiatry clinic. I will be one of the first patients!

    This is not my first bout with depression. I suffered from depression for about two years (2003-2005). Within the span of a year I (1) was laid off from my career at Nortel, (2) got married, (3) bought a house, (4) started a consulting career, (5) started grad school. By spring 2003 things were looking pretty good in my life, and yet I had difficulty getting out of bed in the morning. I was sleeping in excess of 10 hours a day, and I had no motivation. I wasn’t sad, I wasn’t anemic, I just wasn’t motivated to do anything. For me, depression appeared as a lack of motivation rather than sadness.

    On my bike ride today, I reflected on what I had learned about my earlier depression. First of all, I know which drugs worked! But more, I know that what threw me off balance was uncertainty in my life. Losing my job was not a bad thing, but not knowing what I’d do next was a challenge. Relaunching a career wasn’t a bad thing either, but there was just too many of life’s big changes happening to me in too short a period of time. My brain couldn’t keep up.

    This time it is definitely about uncertainty, although my mom also pointed out the issue with ‘chemo-pause’ as a contributing factor. One of the side effects of the chemo drugs is a temporary an onset of menopause (young warriors call it ‘chemo-pause’). In addition to the whole uncertainty associated with having cancer, I’m also dealing with emotions that may be enhanced by ‘chemo-pause’.  I’m thankful that there are now people at Stanford that understand the combination of factors involved.

    For those reading this who are also in treatment Stanford, if you are having any concerns (even mild concerns) with anxiety or depression, I urge you to ask for a referral to the new clinic. They have been fighting for three years to get it established. I’m grateful that it came to be just in time for me. Referrals do take time, and medications also take time to be effective, so don’t wait until it is really bad before asking for help.

    There is no certainty with cancer. Treatment is physically tough and the long road after treatment is emotionally and mentally tough. Be assured that I am well enough to know to ask for help when I need it.

  • The mixed blessings of support groups

    I have found that support groups are a mixed blessing. I have been going to two face-to-face groups, but also have ‘connected’ support groups on Facebook. The face-to-face and online groups provide different kinds of support, and I find that I need both.

    The online groups provide day-to-day support and often give me quick answers to questions. These are not necessarily the answers to the types of questions you get from your doctors, but rather more real-life suggestions that make it easier to deal with the unknown and help better prepare for what is to come. For example, it never would have occurred to me to rent a hospital bed for a month, to make sleeping after surgery easier. Many people sleep in loungers, and others use wedge pillows. The general problem is that for the first few days after surgery, the ability to sleep horizontal is a challenge. I found this an issue with my port, so I anticipate it to be worse with surgery. So, now we are looking into renting a fully electric hospital bed for a month – which is truly the best of all worlds – they deliver and pick-up, and insurance might actually cover at least part of the cost. It is a much better solution than a lounger (which we don’t need), and will be cheaper too.

    I’ve gone to two face-to-face groups, one for those who are newly diagnosed and in treatment, and another for young people with breast cancer. As I’m an extrovert and know very few people in the area, it is a challenge for me to get enough face-time with real people. So, face-to-face support groups give me energy – they feed me. However, timing is a challenge. The groups meet either Saturday afternoon or a weekday evening. The Saturday afternoon is often better, but as we have discovered camping to be a blessing, we shall try to do more of it, making me miss Saturday afternoon groups. Evening groups are a challenge (at least while on AC chemo) as I cannot drive home afterwards – so I need someone to come and sit for two hours (or longer) while I am in group, as I cannot guarantee that I will be able to drive home afterwards. The other challenge with the evening groups is that being around people gives me energy – then I have a hard time winding down and sleeping afterwards. Given that since chemo I have typically been in bed around 9 – 9:30, groups that often run past 9:30 and are a half hour drive home, making the drive and sleeping difficult.

    Then there is the group itself. In the newly diagnosed and in-treatment group, I’m often the youngest person there. I have a young person cancer, so I often have one of the more aggressive stories (although not always – we have lots of rareness in our group). More interestingly, I can relate to the older women better on a professional level, as many of them are self-employed or professionals.

    The young cancer group is full of inspiring women, but their challenges are different and they often have more aggressive cancers. It is difficult to hear women with metastatic disease speak of their journeys as they learn to accept and not fear death and those with aggressive cancers whose prognosis is in the ‘single digits’. This is much more the case with young women with breast cancer, as young cancers tend to be more aggressive in nature. I’m also one of the oldest people in the group – as I sit at that boundary. Young breast cancer is considered “under 45”, and I’m 43. So I am definitely at the edge. I’m also in a very different place professionally. Given that this is the group that meets in the evening, I find it especially difficult. Last night I came home charged with energy from being around people, but also struggling with depression as the reality of my journey sinks in (I’m thankful I’ll be seeing the cancer psychiatrist tomorrow).

    With this, I’ve come to a difficult decision not to attend the face-to-face young persons groups anymore (at least not for the time being). Although there are many encouraging women in the group, it does not leave me with the feelings I need. It may be doing me more harm than good. I will stay connected with the women through the Facebook group, as I find it a good virtual group, but the face-to-face is just too challenging (it is also the group that meets in the evenings and often runs overtime, so it is too logistically and physically demanding for me at the moment).

    I will make every effort I can to make the Saturday afternoon group. It has been a very supportive group. It is smaller, and rarely runs overtime. Since the group is smaller, we have more time to share and more time to ask questions, so it provides better support for me. I come home from the group feeling energized and generally in a better spirits. So, it is the group that is feeding what I need and not what I don’t. I’m also hoping we can get a Facebook group going, as I’d love the opportunity to connect with these women more outside of the 90-minutes once per week that we meet.

  • Wondering why?

    In a post today Nancy asks “Do you ever wonder why you got cancer?

    I did ask my oncologist that question, in part because not only do I have cancer but I have bilateral cancer which is rather rare. So much so, that much of the literature and support materials on surgeries talk about having a single mastectomy, which makes it more challenging for me to predict how things will go for me.

    I actually posted about exactly this question back before I started treatment in “Why me? versus It is what is.”

    Now I think that something in me just clicked. From time to time I question, is it my poor diet from my 20s? or drinking out of Nalgene bottles before they were PBA free? or do I eat too much food cooked on the BBQ?, or something I was exposed to while travelling in Syria or Jordan?

    But for me, the reality it that I will never know ‘why me’, and even if I did, it is in the past – it is nothing that I can change now. So I come up with my own answers. For me, the answer that I like it that something just click – some rogue something caused a bunch of cells in my body to go crazy. I kind of wish someone would take interest in the bilateral nature of my disease and try to answer “why” especially because of its uniqueness – but alas, it doesn’t actually appear to be that interesting from a research perspective. I don’t have anyone knocking at my door asking me to be part of a trial or experience to help figure out why. I’ve actually been excluded from clinical trials because I have bilateral disease.

    So, it is what is it … why won’t change anything. There is no point in regretting the past (I have had a pretty awesome past full of amazing experiences, so nothing to regret really). I’ll just choose to move on with making decision about how I want to live the rest of my life 🙂

  • The more you know the less you want to know

    This NPR clip (short 4 minute clip) talks about how colleagues of women diagnosed with breast cancer react regarding their personal health – http://www.npr.org/2014/08/13/340005026/how-a-co-worker-s-breast-cancer-diagnosis-affects-colleagues

    In the brief podcast (I encourage you to listen to it), it talks about how knowing a colleague has been recently diagnosed with breast cancer, reduces the likelihood of women to get screened within the year or two after learning about their colleague.

    I’m curious whether or not this applies to blogs as well. So women who read my blog, I’ve setup an anonymous poll (totally not scientific or anything). If you do not already have breast cancer and are female, has reading my blog encouraged or discouraged you from doing breast self-exams and doing your annual physical? Click here to respond – all responses are anonymous. I’m curious to see what effect, if any, my diagnosis has had on friends and followers.

     

     

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