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This morning I’ll be making a return visit to the dermatologist that specializes in nails (the nail doctor) to have my big toes checked – this time he is actually checking the toes, as the nails are no longer there! From my view, they are healing well and almost ready to be left to their own devices (that is not having to be covered 24/7.

I have several pictures, that I’ll share via links in case you are not wanting to see directly the before and after.

• Left toe before surgery. Here you can see the greenness of the nail. Not sure if you can really tell that the sides of the nail are not really attached anymore. I felt like the nail was lifted off the nail bed (it had) and that it might fall off at any time (no chance, it was still rather attached at the bottom.
• Right toe before surgery. This one isn’t really green, but it definitely was starting to detach as well. It too feel like it was lifting. I had thought a new nail was growing underneath – I was wrong.
• Both toes right after surgery. I think they have vasiline on them in the picture. You can see the line where the nail had already lifted versus where it was still attached.
• Right toe one week later. My bandaging came off last night and I didn’t notice, which tells might that it might be ready to be uncovered. Last time the bandage came off, I totally felt it!

The nail doctor told me that it could be about a year before I have a full toe nail again. Before all the cancer treatments, my nails grew very quickly, so we’ll see if that turns out to be the case. I’ll update when my nails start to show, but for now, I’ll be happy when I don’t need to dress them anymore.

After my weekend writing spree, I haven’t been into writing so far this week. In part I’m struggling with motivation. Although I had started walking again on Sunday, I was still struggling with achy joints and swollen body parts. Now it is just plain motivation to sit in front of my computer. I’m not just interested right now.

It struck me that one of my issues was that my breasts were swollen. In addition to the swelling, they were really heavy. You see, with the lumpectomies, the doctors had taken out about a golf ball sized lump of tissue from each breast. The space that was once occupied by breast fat has now been occupied by fluid. In addition, my breasts were about 20% larger – also filled with fluid. This fluid was a lot heavier than breast tissue – so I was hauling around very heavy breasts – it was no wonder I was uncomfortable anytime I wasn’t wearing a sports bra – and most of my bras were too tight! This was the case right up until yesterday – yesterday morning (Tuesday) I woke up and for the first time my breasts didn’t feel swollen. They seem to be almost my normal pre-surgery size. They are still heavy, but much more reasonable.

I attribute this sudden change in swelling to the antibiotics I’ve been taking since Thursday. I had several doctors state that I had various signs of infection (breast scars, toes, swelling ankles) – so they all agreed on the same antibiotics I had during my breast surgery. After a few days, they seem to be working!

I’ve been so craving a bike ride on a two wheel bike. Now that I’m not experiencing the visual dissonance issues I had with taxol, I can balance on a two wheels. The question was whether or not I’d healed enough from surgery in order to ride. Yesterday, in addition to the reduced swelling in my breasts, I no longer felt like I had golf ball sized melons under my arm pits. So, my axial node dissection wounds are also healing well. With that in mind, I emailed my surgeon about approval for a bike ride and received a very supportive statement that I “must” go for a bike ride. And with that, I went for a 30 minute (10 km) ride on my foldie bike. I might get Scott to dig out my recumbent on the weekend. We’ll see. I have about a weeks worth of riding before my next surgery.

And that is how this whole process goes. Every time I feel like I’m finally starting to gain some ground, I’m hit again with the next phase of treatment. I’m optimistic that this upcoming surgery will be my last big knock down – after which I’ll begin the long journey through recovery. Unfortunately, this won’t be my last surgery. There will be at least one more surgery at least three months later (probably longer – as there is no rush, I’ll want to ensure I’m feeling strong before that one). That one is called a revision surgery, where the plastic surgeon goes in and re-adjusts things and cleans up any fat pockets and scar tissue.

In other news my hairs is growing back at a nice steady pace. I now have a head of peach fuzz with dark roots, making it look a little like I have a short dusting of grey hair.

And now, I shall go out for another bike ride before the storm hits … we are expecting 3.5 inches of rain tomorrow. To put this in perspective, we had 1.53 inches of rain in November, and 2.44 inches from June – November (November had more rain than all last year – and now we are expecting that make rain in a single day) … It will be interesting to see how this affects the Guadalupe river, which is currently looking twice as full as I’ve ever seen it (which is still pretty empty). I’m only hope that a bunch of this rain falls as snow up in the high Sierra’s, as California really needs the snowpack to keep the rivers flowing next summer.

Over the last couple of months, the city (or some other civic body) has been clearing out some of the larger trees and deadwood from the Guadalupe River. This has mean that when I go on my walks, I’m now able to see more of the river, which in turn means I see more birds without having to walk long distances.

On today’s 1km stretch of path that I walked a few times (over 8,000 steps today), I saw a blue heron, grey egret and a couple of white egrets.

Noticing that there are still many trees whose leaves are in various stages of changing colour, it occurred to me that we do see fall colours in California. The big difference between here and in Ontario, is the time span of the change. The colours are much more dramatic in Ontario because all the trees change at the same time. We get a brief period of 2-3 weeks in the fall where the colours are spectacular. In California, a few trees start changing colour in October and throughout the fall various types of trees change and lose their leaves. The process is drawn out, making it much less dramatic. Interesting.

Each year on December 6, I remember the École Polytechnique massacre. At the time, I was a student at the University of Ottawa studying computer science (which was in the Faculty of Engineering). I was one of 4 or 5 girls in my entire class. We didn’t have cohorts, so I don’t remember the overall size of the class, but it was not uncommon for me to be one of two or three girls in each of my classes.

It is hard to believe that it was 25 years ago today, that a misogynistic young man decided to single out the women studying engineering at École Polytechnique in Montreal Quebec, separating the males and females in the class, and shooting the women. So, today I remember, cause that is about all I can do about it.

Of all the things the resident said, this was the one that stuck – no coffee or chocolate (more specifically, no caffeine) for a month after surgery. You see, caffeine is a vessel constrictor (it makes your blood vessels smaller). Microsurgery involves reattaching things at the vascular level – and as such, you want the vessels to be as plump as possible. (not sure I’m getting the medical speak completely right).

Of course, I’ve learned that when a resident says something that I don’t like, to check with the doctor. The doctor said it was best to avoid caffeine for the first two weeks, but if I REALLY needed coffee, a little would be OK … the nurse said to start avoiding caffeine the week before surgery to help ensure the vessels are plump and to continue avoiding a least a week while things are healing.

And so, as of today, I’m drinking less coffee and eating less chocolate. My goal is to wean off the caffeinated coffee by mixing in larger portions of decaf … so as to avoid caffeine headaches. Hopefully, by the middle of next week I’ll be off coffee. We will try and stop by David’s Teas after my toenail removal appointment, and buy some kind of decaf sampler kit which should keep me happy until I can go back on coffee (cause I really enjoy my morning cup of coffee).

What we also learned was that I will not be in ICU after my surgery. Stanford does enough flap surgeries (not just breast reconstruction, other types too) that they actually have a flap unit in the hospital. Here is the description: “G2S (second floor of the main hospital) is the “flap unit.”  This specific ward manages the post-op free flap patients for extremity cases, breast cases, and other non-ICU cases.  The nurses here are trained specifically on taking care of the free flaps.”  This is good news, as it means I’ll have top notch post surgery care, and I won’t be spending two days in the ICU.

This next surgery will be challenging. I’ll wake up with an additional incision that goes from one hip bone to the other (right across my abdomen at the bikini line). With any luck, they won’t need to take away any muscle (extra motivation for me to avoid caffeine). They will also re-open my nice clean breast incisions in order to do the mastectomy and the breast reconstruction. I’ll have four drains (one in each breast and two in the abdomen). I’ll need to keep them until they are producing less than 25mL of fluid over two consecutive 24 hr periods (this is usually about 8-10 days). I also cannot lift more than 5 lbs for 4-6 weeks (that will definitely be a challenge).

If you live in the area, in January I’ll be looking for walking buddies. I’d like to do some short walks from home at first … but hopefully will start to work on longer walks. If you are interested and able, please let me know … thanks.

Yesterday was a whirl wind day, with lots of doctors appointments and lots of updates, so I’ll be braking this up into several smaller posts to make it easier to manage.

Here is a list of updates to come:

• My visit to the nail doctor (part 1)
• Upcoming surgery (Dec 17) pre-op appointments
• Pathology – what it says
• Pathology – what it means

So the neuropathy in my finger tips must be getting better because, when the nail doctor ‘trimmed’ off the bad nails, I was left with areas of my nails having a very odd sensation – and there is no mistaking that I’m feeling it! The doctor trimmed the bad parts but I told him that I’d have to fire him as an esthetician. For the remainder of the afternoon I was paranoid about my nails getting caught on things.

So, tomorrow I have a follow up appointment with the nail doctor – at his other clinic – where he will remove both my big toes. The one on the right is showing signs of cultivating an infection.

One the directions from the nail doctor was that I was not to do dishes until my nails have cleared up 🙂 … so there you have it … (to be honest Scott had already been doing the dishes 90% of the time, so this won’t really be a change) …

[Correction: For those who were overly worried (e.g. my husband) I will not be having my big toes removed! Rather, I’ll be having the nails on my big toes excised (removed) .. the toes themselves are perfectly healthy. Now the dishes, that relates more to the finger nails growing back properly rather than the toe nails, as I shan’t be doing the dishes with my feet! … perhaps I should not be writing blog posts when I’m tired]

I am looking for cancer bloggers who are willing to act as mentors to those who wish to start blogging about their cancer journey. I will be creating and facilitating a free online course that runs monthly (starting March 2015) to help those who have been diagnosed with cancer to decide if they wish to blog, and to help them get started if they decide that blogging is something they wish to do. I’d like to have a team of cancer blogging mentors to help newbies get started with blogging.

The initial group of ‘cancer blog mentors’ will act as a sounding board in the design of the course. In addition, if anyone wishes to provide a snippet of content for the course, I will welcome that as well.

In March, I will ask that cancer blog mentors write one blog post per week that addresses that week’s content (e.g. why you blog, how you decide what to share and not to share on your blog, where do you find inspiration for blog posts, and general advice for new bloggers).

To provide support for cancer blog mentors, I’ve created a Facebook group – Cancer Blog Mentors. The purpose of this group is to provide a communication channel for anyone that has volunteered to be a mentor. It is a place for mentors to ask each other questions, as well as a way for me to ask questions of the mentor community.

If you wish to volunteer as a cancer blog mentor, please email me (rhogue@pobox.com) or tweet me (@rjhogue). Also please request to join the Facebook Group “cancer blog mentors“.

I’ve been experiencing stiffness in my ankles for over a month now (before Hawaii). I blamed neuropathy on the stiffness. It meant that I wasn’t using my ankles properly while walking – causing my calves to get nasty knots in them. In Canada, I discover that using Voltaren cream meant a significant improvement in mobility in my ankles.

Although I thought my ankles were swollen before, something happened on Monday afternoon, and they became a different kind of swollen. I kind of feel like the Pillsbury Dough Boy … the rest of me isn’t swollen (other than my breasts – which still have some post-surgery swelling) … but these ankles are a little crazy (they are less swollen first thing in the morning). When you add neuropathy on top of swollen, things feel rather unusual.

So today I’m waiting for a call from the doctors office. My oncologist called last night – and has ordered a doppler test for sometime today to see how the blood is flowing in my legs.

You’ll notice from the picture that my big toes are discoloured. I’m expecting to lose them sometime soon, but I’ve never lost a nail before so I have no idea how the process works. I’m going to see a nail specialist on Thursday to ensure there is no infection. The discolouration and nail loss are side effects of the Taxol chemo. My finger nails are also funky colours – but the damaged nail seems to be growing out normally.

Since being diagnosed with cancer, one of the questions I find I ask myself is “what’s stopping me?” More specifically, “what’s stopping me from doing what I want to do?”

I now find myself questioning the answers. Am I not doing it because I physically cannot? unfortunately, this too often is the answer … but I hope to be recovering soon) … but sometimes I find myself answering with “because someday I might … ” … these are the ones that need further reflection …

And so, I’m now going to to question the “what’s stopping me” answers … and if they don’t make sense, then I’m going to start doing the things I want to do … because all too often, what is stopping me from doing what I want to do is me … and that isn’t a good enough reason to not do it!