As I’ve mentioned, Dr. S now makes all calls to me, regardless of “good” or “bad” news. This has worked out well since I don’t feel like vomiting every time I hear her voice.

“Eileen, it’s Betsy. Is now a good time?”

“Sure.”

“I’ve got the pathology results and I wanted to go over them with you.”

*I feel nauseated at this point*, “Okay”

Here’s where I go from remembering everything clearly, to having an overall sense of the conversation:

• the TRAM tumor is gone, and the margins are clear;
• the 3 lymph nodes are all clean, meaning that the pathologist does not see any cancer cells invading these lymph nodes.
• the original axillary tumor has shrunk from an overall size of 33mm to 11mm with about a 6mm core of active cancer.

So, all in all, this is very good news. Clearly the chemo protocol worked against my cancer, and we are in much better shape than we were in September.

Now, you’re probably wondering about that last annoying little bugger…the 6mm area within the axillary tumor, and what that means in the grand scheme of things.

For that, I don’t have an answer.

See, in my extreme efficiency of scheduling my surgery, I scheduled it during a week when my oncologist was on vacation. I have not spoken with Dr. A. I do not know her take on things. I am sure that she’ll be very happy with all the clear areas (I’m smart like that), but I don’t know what she’s going to think of 6mm of active invasive ductal carcinoma left inside the tumor.

I am preparing myself for the possibility that I will be doing 2 more rounds of chemo. Dr. A has not said this, made no suggestion of this, nor even hinted that this was an option. This is purely my own mishigas. So, left to my own devices, I have decided that another 2 rounds will be necessary (please don’t ask me where I went to med school). Fortunately, I have my next Herceptin and Zometa appointment on Monday, and I will see Dr. A then.

As a quick update on my post-surgery recovery, I am doing quite well. I had my JP drain removed on Monday and the incision sites are less sore each day. I do have some issues with tape, even paper tape, so my skin is a little blistered and red. Next Tuesday I’ll be headed to Turning Point for physical therapy, which helped tremendously after my last surgeries.

I’m out, about and ain’t doin’ too bad.

I am finding a lot of happiness in the unexpected these days. One of the unexpected benefits of cancer….

Thank you for all the texts, calls, notes and emails.  I appreciate all your words of support and encouragement and friendship.  It would be near impossible to get through this without you cheering me on.

For now, it’s time for a cup of coffee, some breakfast and another dose of Tylenol.  Then a shower.  How glorious that will be.

Yesterday was surgery.  It started out as most surgery days go, early and hungry.  I had to be at the hospital by 6 so that we could check in, get my IV started.  And wait.  I was prepped for my first stop, mammography with a needle localization, by 6:45, and sat until 8:15 when it was my turn at radiology.

When a doctor does a biopsy, often times she places a tiny little clip in the tissue so that the she can easily identify the area in the future.  The clip is metal, I believe, and shows up on mammograms very well.  In my case, the secondary spot, internal to the breast, was all but gone from the chemo.  But Dr. S wanted to excise the clip and the surrounding tissue to make sure that there were no more cancer cells hanging out in the turmor’s margins.  So, I had a mammogram to find the clip.

At 8:15, Holly, the radiology technician, came to grab me for my needle localization.  It’s always interesting when I get to do a new procedure, because I’ve been around the block, and feel like I’ve done it all.  But, I had not done this.  At this point, I go into some rather graphic medical procedures, so if you want to skip ahead, go down a few paragraphs…I’ll bold the first few words when you can pick up reading again.

I was brought into a room set up with a mammogram machine.  However, Holly used a special plate that had a small rectangular opening in the top (about 2″x3″) and located the clip using a grid pattern that showed up within the rectangle and also the mammogram screen.  Once the clip was located on the grid, the doctor used the opening in the mammogram plate to inject some lidocaine into the breast before she inserted what is best described as a large pushpin with an open back into the spot where she believed the clip to be.  Another mammogram picture was taken, and a small adjustment was made to the pushpin.  After confirming that the pushpin was in the correct spot, the doctor took a needle, probably about 5″ long, and inserted it into the back of the pushpin, through the breast and stopping at the clip.  The pushpin was removed, and the tail-end of the needle that was sticking up through the skin was taped down so that it wouldn’t catch on anything.

A last mammogram picture was taken to make sure that it was in the correct spot, and then I was sent off to the ultrasound department.  For the original tumor in my armpit, we couldn’t use a mammogram.  The spot was too far under my arm to capture between the mammogram plates, so the doctor used an ultrasound to help place the second needle. The procedure was nearly identical: lidocaine, pushpin, needle and tape.

After my two needles were placed, I returned to my pre-op area where I was given some Versed.  I love Versed.  It completely takes the edge off for me…I wish that the anesthesiologist could have given it to me earlier (believe me, I asked).  Anyway, Versed given, I gave C a last kiss and hug before surgery and was wheeled down to the OR.  I don’t remember getting onto the table, but I do remember laying there with my arms splayed and looking at the huge lights overhead.  I also remember that the room was cold, and so were the heart monitor pads they placed on me.  Then the anesthesiologist said “Goodnight.”  And I remember nothing else until I woke up in PACU (what used to be known as Post-Op).

The 2 times I remember being in the PACU, I have hated it.  I don’t do well post-anesthesia.  I want to be awake, but I hate that drowsy, drugged, fighting to get back to consciousness.  C and my friend L came back to see me.  L had to leave and Mom came in.  I remember the nurse asking how my pain was, but I didn’t have pain, I had nausea.  I think she gave me some Zofran, and I spent another few minutes getting my bearings.  C pulled the car around and we went home.

I spent the better part of the day sleeping it off, and now it’s morning and I feel fine.  I’m a little sore, but I don’t do pain medication (it makes me manic/depressed) so I’ve taken a little Tylenol, and that has taken the edge off.  I do have 1 JP drain which Dr. S said I’ll have at least until my post-op appointment next Monday.  I’m sure that I’ll be laying low over the next few days,  just sleeping as my body demands it.  But, I’m so happy that these tumors are gone.

And now a quick debrief on what Dr. S told C: there was a lot of scar tissue from the TRAM reconstruction, which was no surprise.  What was surprising, was that the tumor under the arm had grown around the main blood vessel that Dr. B used to attach the TRAM.  After an emergency OR call to Dr. B, Dr. S was told that the body should have regenerated enough blood supply in the 2 years since reconstruction, and that the TRAM should be okay.  We have a few more hours to watch things, but so far, so good.  As for the other spot, it was pretty much a non-event.  It’s gone and I’m happy.

Good riddance, you tumors.  May you and your friends never come back.

She still hasn’t talked to Cliff, but she did review my results with her in-house colleagues and they’ve decided that I don’t have a metastatic spot, I just have a regular old sternum with no cancer in it.

I guess one of the things that can happen when you have a large baby is that the lower part of your sternum (the xiphoid process) can either break or bend and protrude forward toward the skin. J, my oldest, was big. Very big. 10 pound 13 ounces and 23 1/2 inches long to be exact (and since the next question typically is “You didn’t have him naturally did you?” the answer is yes, I had him vaginally, but I had an epidural). So, for the last 10 years, I’ve been waltzing around with a protruding xiphoid process. Who knew?

Anyway, when the doctors reviewed the PET scan and the underlying CT scan, they saw that my xiphoid process was bent and that this invariably leads to larger than normal uptake of the radioactive isotope and thus the glow during the PET scan. This is the first reason that they believe the spot isn’t metastatic. Secondly, the CT scan showed no underlying tumor or pitting of the bone (which is typical of cancer infiltrating the bone and metastasizing). And so, based on all the knowledge in the room, the docs are almost certain that the metastasis is, in fact, not a metastasis.

I don’t know how to explain the relief that I feel. I am very happy beyond measure.. This is the kind of happy that I’ve felt few times in my life: my wedding day and the first time I held each of the boys. I hope that you all know that kind of happy, regardless of what life event you celebrated. Bottom line: I feel as if I can take on life and do anything at all.

However, almost concurrently, self-preservation mode kicks in, and I’m reserved, and entertaining when-is-the-other-shoe-going-to-drop thoughts. I want to believe that things are going to be all right, but somewhere during my journey I’ve lost that innocence. This adage is perfect: “Fool me once, shame on you. Fool me twice, shame on me.” I’m old and jaded and scared to stray too far into euphoria for fear of being crushed by another change in direction.

All that being said, I know that my fear will not stop the many of you who rejoice in the good news I receive. Since I am not quite there with you yet, I will celebrate all of you, and tell you all how much you mean to me.

I thank you for every kind word, email, card, note, wall post, and comment. I’ve read each and every one of them many, many times. They have carried me when it has been difficult to find the strength to move forward. Thank you for every prayer said in my honor; I am blessed beyond measure. Thank you for reading and following my progress. I am always shocked when I publish a new post and so many of you come to check it out.

I look forward to the next phase of this journey. Moving forward out of chemo and into surgery and radiation will bring new challenges and lessons. I cannot wait to share them all with you.

Yesterday, I had to run and meet C for a quick minute and realized that I didn’t have much gas left (the light wasn’t on, but it was close), so I jumped out and started the pump. Of course, I left my phone in the car. When I opened the door, I heard the last of my ringtone, and saw the caller ID, “Breast Care Specialists.” I immediately called the office, and they put me through to Dr. S (I guess enough biopsies later and the Dr. will take your call if you catch her between patients).

“Hey Eileen, it’s Dr. S. I wanted to let you know that all 5 spots came back clean.”

I don’t think I understood for about 5 seconds. I’ve never gotten a call for a biopsy that came back without something showing up.

“All 5, are you sure?”

“Yep. I already talked to Colleen [Dr. A] and we’re going to go ahead with the lumpectomies rather than the TRAM reversal.”

The rest is pretty much a blur of pre-operative tests and appointment dates, but bottom line is that I am going in for outpatient surgery on March 1 to finally get these stupid tumors out of my body. I will probably have a few days of down time, but nothing like after the bilateral and TRAM.

I see Dr. A on Monday, and now, armed with a surgery date, we will be able to set the dates for radiation. We will also talk about that spot on my sternum that her friend has been reviewing on my PET scan, and see what we are going to do about that.

I am still smiling, but feeling a little unsettled. I know how to do the crap news pretty well at this point. Maybe I’ve forgotten how to process good news. Or maybe I’m just distrusting of the results. Regardless, I’m trying to revel in the good news…

In other news, my hair seems to be regrowing, which is weird to me. I’m not out of my last chemo for a full 3 weeks yet, but it’s definitely starting to sprout. Don’t get me wrong, I’m still bald and I still see plenty of scalp, but there is more dark stubble than there’s been. I may move back to bandanas soon because Lola is rubbing the hair down at my temples where her seams join. All-over baldness from chemo is one thing, but intentionally causing male-pattern baldness is another thing entirely.

And lastly, there was news out of Harvard University this week about using aspirin as an arrow in the quiver against breast cancer. The article cautions women against taking aspirin since the study is inconclusive as it was merely a lifestyle follow-up survey and not a blind study with half the women using aspirin and half using a placebo.

Let me tell you, if a daily dose of aspirin shows promise in keeping breast cancer at bay (and apparently colon cancer too), I’ll be taking a low dose every day. I know that there are some issues with aspirin thinning out the blood, so I may have to wait until I’m done with radiation, but Bayer will be a staple in my morning pill regime along with my Vitamins D and B12. How great would it be to have a low-cost, readily available, non-prescription drug to use in the fight against cancer?

Now, I just pray for the news that it’s effective in the fight against all cancers.

Last Monday, Feb 1, was my last chemo. Chemo was fine, uneventful and the laugh-riot it always was. Tuesday and Wednesday were typical and I was doing okay getting my water down. I hadn’t been quite as obsessive about getting in a gallon each day as I was last round, but I was still pounding down 12 cups of Pur filtered water.

Thursday I woke up with a little bit of a chill running through my bones. I took my temp and had a slight fever. The directives I got prior to my first round of chemo were that any fever over 100.5 was to be called in immediately. So I stayed in bed, tried to warm up and slept a good bit of the day. At 2:30, my fever hit 100.6 and I called. There were a few messages left on various voice mails at the dr’s office, and finally at 4, I called and demanded to speak with a live person. When I told the nurse that my fever was now 101.7 she told me to head to the ER.

We got to Northside Hospital and after some Tylenol and many tests (CBC, sedimentation, x-rays, EKGs, urinalysis), I was declared healthy. But, because my fever was 102 when I arrived, the doctor decided to admit me for overnight observation. C stayed with me and Mom went home to watch the boys. I got 2 huge bags of fluid overnight, and early the next morning Dr. A sent me home with orders to take Tylenol if the fever came back. It never did.

The rest of the post-chemo week was typical and went off just like it has the last 5 times. Chemo is officially over for now, and wer’re ready to move on with the surgery and radiation phase of treatment. Which brings us to today.

We’ve been debating for several weeks now, how to proceed with surgery. There are basically 2 options on the table: first, a double lumpectomy removing the 2 spots that we’ve already identified; second, removal of the original under-the-arm tumor and reversal of the TRAM and reconstruction. Obviously there are benefits and drawbacks to both, but we were stuck in choosing the best option for us. We finally decided that these punch biopsies were the best way for us to narrow in on the right choice.

So, today I had the biopsies. A punch biopsy focuses on the skin of the breast, not so much on the underlying tissue. The assumption is that my secondary spot (the one that we found on the MRI in October) came from the skin down into the reconstruction. Today was a fishing expedition to see if there is anymore cancer hiding out inside the skin tissue.

Dr. S took 5 samples. I can’t really explain what she did, I didn’t look and I didn’t really want to know. What I do know is that there were shots of Lidocaine and then samples put into jars. The resulting holes look like she punched a piece of Velveeta with a drinking straw. The spots form an “X” similar to the 5 side of a die.

The jars will be sent off to the pathologist and I will hear the results next week. If each of the samples are clean, then we will only do the lumpectomies. If any of the samples show cancerous cells, we will likely move ahead with the TRAM reversal.

It’s been a big day, full of anticipation and anxiety. With those punch biopsies done, I am ready for our plan to come together.

To honor the event, I decided that I would video document some of a chemo day. I am not a videographer and some of the footage is of half my head, but I kept that part in for the dialogue…ah well, a new career to work on when I’m done with procedures. There is a part where you may get squeamish (getting my port accessed). It features a shot or two of my doctors and chemo friends, and many shots of me in my bandana with barely any makeup on. You cannot hide the bloated Taxotere and Dexamethasone (steroid) face and chin with no hair. For those of you who have been so kind to tell me how good I look, this is not one of those days.

So, here goes. Watch if you’d like (it’s 10 minutes long)…it’s shows some of the treatment and the laughs and, what it looks like to be in an infusion suite…which is really just part of the life of a cancer patient.

I find myself drawn ever tighter into a network of intricate bonds of support that I am both humbled and amazed by. Most times, I don’t feel worthy of the generosity that we have been shown. I feel like I haven’t been a generous person, and maybe that is why I strive to give back in this way. In sharing my journey with you, warts and all, I feel like I am giving of myself…even if it is through words and not currently of deeds.

One of the most surprising of bonds happened this week. As some of you may have noticed, to the left of my writing there is a section down the page called Blog Roll. Here I list a smattering of blogs that I personally follow, most of them non-cancer related.

A few weeks (maybe 6-8) ago, I had written a post about my wig, and being curious I typed “wig” into the search engine for wordpress, which is the host site for my blog. Up came a few blogs, and one caught my eye immediately, The Carcinista. The blog is written in a funny, snarky, irreverent way by a 2 1/2 time ovarian cancer survivor. I loved the tone, the cadence and the storytelling of her blog. I loved the spirit I heard in her writing, and the honesty that she brought to difficult, emotionally draining subjects. I dropped a few comments, and we became fans of each others blogs. And, by all rational assumptions, it should have ended there.

But, Karma has an interesting way of doing her thing. After my last post, a friend from my Gymboree days dropped me a note by Facebook. She had two high school friends that were currently dealing with their own battles with cancer, and maybe I would like to connect with them. She didn’t say what kind of cancer they had, and she didn’t say how she would put us in touch, but that was quickly answered by this email that she forwarded to me (I put in all the asterisks so as to protect personal information that The Carcinista and KLB might not want you to have):

Kick Ass Cancer Girls !!Sunday, January 31, 2010 10:29 AM
From: This sender is DomainKeys verified “KLB” View contact details
To: “Eileen”
Subject: Eileen….My friend S****’s information….Please connect ! I think you two would have a lot to talk about……

i’d be happy to speak with your friend. if she’s not ready to chat she can hit up my blog (www.carcinista.com) but feel free to give her my email address (s**********@***.com) and you could also send her to planetcancer.com or i2y.com (i’m too young for this/stupidcancer) for more young-cancer-survivor fun. i’m sorry to hear she’s out there, but happy to band together with like-minded ass-kickers. thanks for thinking of me!

she doesn’t by any chance blog as “my name is not cancer girl”, does she?

s

It took me a minute to wrap my head around it, how could KLB have known The Carcinista from high school, and still be in touch, and all the other tenuous circumstances that made it so that we were actually “meeting?”  The line from Casablanca still keeps reverberating in my head “Of all gin joints in all the towns in all the world, she walks into mine.”  It’s not quite a gin joint (and I’d prefer Hangar One Vodka over gin anyway), but a random cancer blog on the internet…that’s pretty remarkable.

So while there is much to be said about all the crap we endure, there are so many good things.  Thank you Karma for taking care of me, and my family, as we navigate this craziness together with those that support us.

And let me tell you, I don’t feel very much like I’ve got room to fight. My friend L lost her Mom about 18 months ago. She’s often explained it like she’s waiting for her Mom to come back, for this part to be over. I completely understand that. I am waiting for my cancer to be over, for me to be healthy and done with this. Unfortunately, as my doctors have informed me, when you have a bone met, there is no “over”, there is no being cancer-free. I no longer get to live with that hope…at least not now. Maybe we will be able to keep the disease at bay for long enough that a new drug therapy will be available and I will get to live that dream.

So, while I’ve been preparing for my last chemo on Monday, I’m living with a gnawing fear of what happens when we stop pumping my body full of the chemo drugs. Since October, when all of this began, I’ve been excited to finish chemo and have my hair grow back, but now I am scared to death. If my hair is growing back, that means that the medicines are out of my system…the fast growing cells are growing. Are the cancer cells growing too?

People ask me often if I trust my doctors, and I had a grand epiphany this week. I do, I trust my doctors. I know, without a doubt, that they are knowledgeable and conscientious. But, I don’t trust my own body. I have no faith that my cells want to give up this disease. At every turn, my body has held on to and allowed the cancer to return or spread.

I guess you could say that I’m mourning my loss of innocence. There are worse things to mourn, and I do know that. But that doesn’t mean that the tears haven’t flowed, a lot. And it doesn’t mean that I am not constantly scared. But it also doesn’t mean that I’m giving up hope. And it certainly does not mean that I am giving up the fight.

I know that speaking with Dr. A on Monday will bring some answers and, I hope, some sense of peace about what everything means. Until then, if you see me with red, swollen eyes, just know my party continues.