Tuesday, December 30, 2008

Radiation / Surgery Update


Hi Everyone,

Sorry I have not written sooner, I know some of you have checking my blog regularly. With radiation therapy and the holidays I just really didn’t feel like writing anything, I’m sure you understand.

Well radiation therapy is over with. In the grand scheme of things it wasn’t all that bad. Compared to chemo it was a dream come true. It was not without its issues though. The first annoying thing about radiation is showing up every day for it. It’s very disruptive to your schedule and each day is just another reminder that you’re a sick person. I hate that part. And you’re surrounded by other sick people; some who you know are not going to make it to the end to the month, so that’s depressing.

I did have some side effects from the radiation. Because the cancer is in L3 and L5 of my lumbar spine, they had to radiate the lower portion of my torso. To avoid leaving “hot or cold” spots on the spine, they radiated me from the front and the back. The radiation machine was actually pretty cool. Once they get you positioned, the machine rotates to different angles to treat the appropriate area. I was nauseated most of the time, specifically after treatment and was real tired. At the end of each week I also had some diarrhea. You can just imagine how messed up my intestinal track would get after 5 treatments in a row. After 2 days without treatment I’d start to feel better only to turn around and do it all over again. They told me to expect skin irritation but I didn’t have any of that.

I had an interesting conversation with one of my technicians after treatment one day. It started with me asking about the sign that read “If you are pregnant, please tell the physician and technician”. I couldn’t believe some one would be that stupid to have radiation treatments and be pregnant. She said that sign was there for a reason, someone did that very thing and the baby did not survive.

She then proceeded to tell me how radiation works. It targets fast growing cells in the body, like chemo does. Fast growing cells in the body could be cancer cells, a fetus, hair, nails, stomach lining, and things like that. What the radiation will do to cancer cells is rearrange the DNA so that it can not reproduce. If it can not reproduce then the cells will just die off. We like dead cancer cells. So it’s the hope of the Dr.’s, and me, that the radiation will kill the existing cells and prevent it from spreading.

They didn’t just treat the L3 and L5 lumbar. They also treated L4 and the bone above and below the compromised areas, just in case there are cells there that do not show up on any scans yet. The radiation that I received will keep doing it’s thing for another 8 weeks. Go radiation! I’m pretty tickled that I only had to do this for 3 weeks instead of 4. I could have stretched it out to 4 but I was able to get the recommended dosage in 3.

The day before radiation was done I had a long talk with Dr. David Schwartz, mostly asking him what he expected this to do for me. He was reassuring without blowing smoke and said that since we caught this early that he expected this to do what it’s intended to do, kill cancer cells. If it doesn’t, then I will go back and do more radiation later. He also said that technology and medicine has gotten so much better in such a short amount of time that life expectancy has really increased. He said one of his patients is nearing the 20 year mark. Now that is rare for a person living with cancer but it’s not unheard of. Now I have a target. ☺ So radiation is over.

I had another dose of Zometa on Monday, I did not have any significant side effects but the thing that I noticed while I’m getting the IV, the liquid is cold. Not a big fan of that but it’s certainly not the worst thing that has happened to me. I’ll deal with a cold IV.

I think I mentioned in my last blog that I was taken off of the hormone meds Tamoxifen. One of the main reasons was a trip to the OB/GYN alerted us to a potential problem with my uterine walls being too thick, which is a side effect of Tamoxifen but also an indication that cancer could be present. I will spare you the details but after all is said and done I had to have a uterine biopsy. I told my Dr. that I was convinced she was going to call me with news that in addition to my breast cancer returning, I had uterine cancer too. I love this woman because her response was, “Well at least you’re prepared for bad news.” As it turns out, I was wrong; thank the Lord, I got a call last Monday that my test results were benign. We love the word benign; it might be my most favorite word in the whole world. So that drama is over with.

And lastly, because I am a glutton for punishment and a good amount of the time I’m cheap, I had more reconstructive surgery on Tuesday, December 23rd, to replace my implants and do scar revision. Our deductibles and out of pocket expenses have been met so I sucked it up, took some time off work and had surgery.

It was an outpatient procedure and unlike most surgery where they’re taking out body parts that you will truly miss, I was pretty excited about this surgery. With all the previous drama of the nipple falling off and an implant slipping a little, scar tissue not looking the way I’d like, I knew it was going to end up being a better result this time around. For those of you gals who are going through reconstruction surgery, (I know who you are) forget the nipple reconstruction part, go directly to tattooing, don’t pass Go, don’t collect $200. Give me a call if you want to talk about it. In any case, I’m still sore but I am happy with the result. Of course there will be more scar revision but that I can handle.

So that’s it for now, as if that wasn’t enough, right? We had a wonderful Thanksgiving and Christmas season together, J.R. and the girls took really good care of me and we had a nice relaxing holiday. We are truly blessed. We hope that each of you also had a wonderful holiday season and wish you all a very Happy New Year! Bring it on 2009!

Love to you all,
Jen

Tuesday, December 2, 2008

Radiation and Zometa

December 2, 2008


Hi Everyone,

I’ll make this one short and sweet. Yesterday afternoon I had my first dose of Zometa and radiation therapy. We met with Dr. Bowers to make sure nothing was going to change from the original treatment path that was laid out for us last week. The last thing I wanted to hear was “And after radiation, we’re going to start you on chemo”. It may be an option down the line but right now it is not. Thank God.

So my treatment path will be this; Three weeks of radiation every day, followed up with Zometa once every three weeks until Dr. Bowers says otherwise. She said that there have been some people on this drug for years. I’m OK with that, I like strong bones. I do not have to get a port again to receive Zometa and it does not destroy veins like chemo does. The worst side effects can be slight nausea, flu like symptoms and achy bones. I actually did have a little nausea when we got home and woke up with aches this morning. Sleep and Advil took care of those.

Radiation was probably the easiest thing I did all day yesterday. I did have to get some new marks before we started though. Dr. Schwartz, the radiation oncologist, after further review of CT scans and X-Rays decided instead of just treating me from the back to treat me from both the front and the back. They need to mark you with small tattoos so they can line up the radiation beam the same every day. So they gave me three marks last week and then yesterday I got another five. They are very small and look like little black moles. No big deal and yes they are permanent.

After that I went into the radiation room and laid on the table, they lined me up and zapped me twice. It didn’t feel like anything was happening, I just laid there and was done within five minutes. It was all very X-Ray like. Not that I’m complaining but after the last treatment path I was expecting something a little more invasive this time around.

Apparently the radiation will keep working for another eight weeks after treatment is complete. That’s pretty cool. I will also start a different hormone drug. In addition to radiation and Zometa, bone responds very well to hormone therapy drugs. Dr. Bowers took me off of the Tamoxifen last week, one, because it’s obviously not working for me and two, it’s causing me some issues with my uterine walls which could eventually turn cancerous. The news just keeps getting better doesn’t it?

So that’s really about it. I will be done with radiation before Christmas and I’ll keep getting the Zometa for an indeterminate time. Hormone therapy will probably start after the New Year. I will keep you all posted and will update my blog as things progress. Again, thank you all for your words of encouragement and prayers, they are both very helpful and much appreciated. God bless!
Love to you all!

Jen

Monday, December 1, 2008

Here We Go Again

December 1, 2008


(Steph, Jen and Nicky at 2008 3-Day, 60 Mile walk - Thanks Girls!)


















Hi Everyone,

As most of you know, I have recently been re-diagnosed with metastatic breast cancer. It has reappeared in my spine this time. If you remember from previous blogs breast cancer can come back in the lung, liver or spine. Back in October I went in for my 3 month check up with the oncologist which consisted of the CA 27.29 blood test, a chest x-ray and bone scan. The chest x-ray and bone scan are an annual test with blood draws every three months. When we got the test results back the chest x-ray and bone scan came back clear but the blood test numbers were elevated above normal parameters.

Now I’ve always tested a little high so it wasn’t a huge concern since I’d been high before, but Dr. Bowers wanted to test me again in 6 weeks instead of waiting another 3 months. When I got those test results back the CA 27.29 numbers were even higher than they were 6 weeks previous. Typically they consider numbers between 0 and 35 normal. I usually hover around the 40’s. My first numbers came back at 53 and my second results came back a 79. Not good.

So based on those numbers they recommended a PET / CT scan the following day. I was not allowed to eat anything for 12 hours previous to the procedure and when I got there I went back to the little “relaxation” room. There really isn’t much relaxation going on in here. Here they injected me with radioactive glucose. Gross. The reason for this is that the cancer cells are attracted to the glucose and will show up on the scan because of it.

They also had me drink some barium drink that was equally gross. It was this huge bottle of what tasted like cold, berry flavored Elmer’s glue. I don’t recall why I had to drink this crap but apparently it was necessary. They also left the IV in my arm so during the procedure they could administer “contrast”. You may remember me telling you about “contrast” from my earlier blogs and MRI. When they add the “contrast” it gives you a warm feeling all through your body and you feel like you are going to pass out.

The PET and CT scan lasted about an hour total and I was lucky to have music pumped into the room. This just in, if you are in a PET / CT scanner and “Radar Love” comes on the radio, you can’t tap your feet or sing, it’s very hard to sit still when that song comes on the radio. Try it the next time it comes on the radio, it’s near impossible. Minus all the gross stuff they injected me with or made me drink, in the grand scheme of things this test isn’t so bad.

Later that afternoon it was confirmed that they found two lesions on my L3 and L5 lumbar spine. So we sat with this knowledge over the weekend and as you can imagine did a lot of crying and drinking. We really didn’t know any more than that until Nan called on Monday morning. She is one of the nurses at the oncologist office. She gave us a little more info and had us scheduled for an MRI later that day. Great, more tests.

So the MRI was no big deal either, it’s just loud in there. The reason for the MRI was more or less to eliminate other things that could be on my spine, like arthritis. It wouldn’t necessarily confirm cancer but eliminates a lot of other things. That test result came back as “probable” for cancer. When you get that news and then go on line and start looking up bone cancer, it’s not good. So don’t do it. I was seeing things like a life expectancy of a year, it can’t be cured, and the bones will start collapsing on them selves and causes a bunch of pain, paralysis and incontinence. Terrific. So we were really freaked out and Dr. Bowers met with us and essentially talked me off the ledge. Bless her heart. She said that she plans on treating me for a very long time and that medicine has really changed recently. Before we could start any treatment we still had to do one more test, a CT guided bone biopsy. Are you kidding me with this? I know what a biopsy is and the thought of having someone take some of my bone was just unbelievable to me.

After my meeting with Dr. Bowers we went downstairs to Radiology and had another CT scan. I’m now getting very sick of scans. And I’m thinking to myself, all these scans are going to give me more cancer, cut it out. The purpose of this CT scan was for the physician to determine if a CT guided biopsy was better than one guided with I believe a camera. It was determined to be CT guided and I had to be there the next morning for the biopsy.

Since this is considered surgery, I was not allowed food 4 hours before the procedure. When I got back to the Care Units where they prep you with IV’s, take blood, ask you a billion questions and talk you through the procedure I started to become very angry. I didn’t want this damn test, I wasn’t going to like having a surgeon cut through my back and bone to get a sample, I didn’t want any more drugs, it was just all pissing me off. We waited in the Care Unit for about and hour and a half for a couple of reasons. One, they were running a blood clotting test before they did the biopsy and two, the Dr. was doing several procedures before me. As far as I was concerned he could have left me in that room all day long.

When they were finally ready for me they gave me the option to walk down there myself or be wheeled on the gurney. I chose the gurney because if it were up to me I don’t think anyone would have gotten me in that room willingly. Much to my disappointment they do NOT knock you out for this procedure. Anyone with a weak stomach or those of you who do now want to know how this procedure is run should probably skip ahead a few paragraphs.

So because I haven’t had enough CT scans, I had to lay face down and have several more before the procedure. Now, there are two sets of bones protecting the spinal cord. The lesions on my spine are on the side of the bone in front of the spinal cord. To get to it, the Dr. had to go through the bone in back to get to the side of the lesion. I’ll let that one sink in a minute.

So they did a local on my back where they were going through to the bone. They also gave me two other drugs, one for pain, I told the nurse she could be very generous with that one, and another drug to relax me. It’s essentially a drug that puts you into “conscience amnesia”. They want you to be semi alert so the Dr. can talk to you and you can take direction, like holding your breath during a scan. Fortunately for me these drugs work pretty well. The worst part was getting the long needle in the back to numb the area.

The actual biopsy was not as bad as I thought it was going to be but it was still on the good side of horrible. Once the Dr. was through the skin and muscle to get through the bone he used something to “tap” it through the bone. That part I did not like in the least. Because you can feel and hear the tapping, and even though bone does not have feeling you can still feel the vibration through your whole body. Again, gross.

I told the Dr. he’d better get a really good sample because I was not going to come back a second time for this. He got a great sample. After the procedure I went back to the Care Unit and JR helped me eat a little sandwich, pasta salad and some juice. I wonder how much the insurance company got charged for that meal.

After that we went home and I rested. The day after the pain in my back was worse than after the procedure. I felt like I had a really bad backache. The test results took 3 days to process so again we waited over the weekend wondering. In my heart I knew that it was going to come back cancer, you just do not go through all of those tests and have it not be cancer. Although we were really praying for arthritis.

Of course it came back cancer and a treatment path was laid out for me. We met with the Radiation Oncologist that afternoon and got the lowdown on how it was all going to happen. He decided that since I had not had radiation before and I am young and healthy that he could shorten the time and increase the daily dosage. So I will have 3 weeks of radiation therapy every day after work. The time spent at the office should not exceed 30 minutes, apparently positioning me on the table takes the longest time.

Unlike chemo I should not have many side effects. The two we talked about were skin irritation and possible diarrhea, because the lesions are on the lower bones. I can handle skin irradiation and diarrhea. Everyone seems to be a little surprised that I don’t have any back pain, out side of what I consider normal back pain for me. He said that 4 years ago their goal would have been to make me comfortable and to give me time to get my affairs in order. Now with new technology and medicine people live for many years.

In addition to the radiation I will start a drug called Zometa. It’s a bone strengthener that keeps the cancer from eating through the bone until it collapses. It also creates an undesirable location for cancer cells. It’s pretty new to the market and the results of how successful it is in fighting cancer just came out this past June. It is taken via IV and takes about 20 minutes to administer. I should not have any side effects from it either.

I know it goes without saying but I’m going to anyway, JR has been just amazing and has been by my side for every Dr. appointment and procedure. I am so lucky to have him by my side fighting all the way. I love you Anderson.

So that’s it for now, sorry for the lengthy update but we’ve had quite a bit happen in a short amount of time. I will start the Zometa and radiation therapy this afternoon. I’ll update you all as things happen.

Thank you to everyone who has reached out to JR and me with your words of encouragement and prayers. We appreciate them very much and are so very lucky to have you in our lives. Love to you all and God Bless!

Jen