Cancer Snobbery

I sense a tendency for cancer patients to size up other cancer patients by the extent of their disease. Or maybe its just me, a-hole that I am. I silently mock the tribulations of those stage-nothing, hormone receptives, who need only a quick shot and some radiation before they're "cured." That's barely cancer at all. I am, in turn, completely humbled by the stage four metastatics who are in it for the long haul. They are the mac daddies of my world, the kings and queens of endurance, the Guiness Book record holders.....for them, I have utmost respect.

Christmas Week

I made it into the hospital every day this week in spite of Arctic Blast 2008 (TM). Didn't see any of my usual waiting room cohorts. But all the staff were there, so I was served by up to four nurses at a time every visit. Remember my Formula One pit stop analogy from the lumpectomy? It was kinda like that.

I got a break on Christmas Day. Nice to lie in for a while before heading up to the home of Rhett's Aunt where we experienced the heaviest snowfall I've ever been in. V. romantic, actually. Especially when it was followed by a burst of sunshine making the scene truly Alpine and Christmas-y.

Yesterday I only left the house to go to radiation. Then I sat through three movies consecutively: Howard's End, Kinky Boots and Calendar Girls. Yes, I was watching BBC America.

My hair is growing back - and much to my disappointment its coming in the same old color. I was hoping for red. And, I do, in fact, have a bit of burn going on under my left armpit but I've only four treatments to go. Hurrah!

OK, No Breast Mask

I got that wrong. They don't put anything on me. But the attachment for the radiation machine that they use to administer the electron beam looks like something straight out of an Austin Powers movie. I had to ask whether Dr. Evil will be in attendance for the rest of treatment.

Holiday Fun

"Rudolph The Red Nosed Reindeer" was the musical accompaniment to treatment this morning, which led to a discussion as to whether the red nose might have been caused by some kind of radiation accident. The nurse technicians were quick to point out, however, that they don't actually make body parts glow.

Waiting Room Updates...

Cancer Girl finished treatment today. What will she do now? Also, I found out that Bobbie does in fact have a husband currently who is very much alive. Funny that she mostly refers only to the dead one.

Port Still In.....

Sadly Dr Lim canceled the port removal because most of his staff didn't show up yesterday due to the snow. I would have showed up. Sigh. But for now the port remains under the surface of my chest skin until the new year.

In better news I am, apparently, very good at radiation. Not only do I hit my marks on the machine almost every time, but the burn really is minimal. The nurse technician told me today that at this stage many others have blisters and open sores from treatment. All you can see on me is a faint pink tinge.

I have four more regular radiation treatments then we go to the "boost" phase. This will be seven treatments of an electron beam that is focused only on the tumor location to make absolutely sure that there's no more cancer around the margins. I think they have to create some kind of breast mask to ensure the beam hits its mark every time. Neat.

Snow Stops Play?

I'm supposed to have the port removed tomorrow. I'm pretty anxious about this. As my dedicated readers may recall, port insertion required general anesthetic, a half hour of surgery and a chest x-ray. Dr Lim informs me that he can whip the thing out in his office. I mean, this port is a) long, b) held in by stitches and c) very close to my lung. And I'm supposed to be awake?

Blimey.

Current arctic conditions, however, may require that surgery is deferred until some later date which is, actually, annoying since I'm trying to get as much medical stuff done in this calendar year as possible before my insurance deductible kicks in again.

Separately, the breast is definitely turning pink with burn now. Its a very geometrically precise burn which, I suppose, makes perfect sense given that light travels in a straight line and all.

Side Effects?

The truth is that I still don't really seem to be having any side effects from radiation and I'm now over half way through treatment. The tingling and discoloration I noticed a couple of weeks ago may have been more to do with the bra I was wearing at the time. And while I am pretty tired, I suspect that's the result of burning the candle at both ends. I could test that theory by working minimal hours and curtailing all social activity....but its the holidays and that would be boring.

Of course, this time next week I'll probably be complaining of agonizing breast burn and chronic fatigue. But until then......

And just when my eyelashes were starting to grow back....

......my eyebrows fell out. Its a cruel, cruel world.

Updates

:: Bobbie's weight is down to 100lbs. She's most comfortable around 110 or so.
:: Cancer Girl's hair has grown in - although its still sufficiently short that she looks like she's in the army. Turns out she and I had the same drug regimen during chemo but her hair started coming back before that treatment had finished. Mine didn't. Am somewhat paranoid - what if it doesn't come back? I'm already tired of the whole turban business.
:: The nurse technician spent all yesterday putting up holiday lights (timed to illuminate automatically at dusk) outside his home.
:: My breast is beginning to burn. Definite discoloration and tingling. Stocked up on all-natural, colorless aloe vera gel this evening.

Stories from the Waiting Room

Bobbie's husband was originally diagnosed with contact dermatitis. It was at her insistence that the hospital scanned him, at which point they discovered he had cancer.

When the nurse technician shows up to give Bobbie a hand to get to the radiation room (she's a little unsteady on her feet) I yell out "It's show time Bobbie!" and she gives her best interpretation of a high kick - her foot maybe makes it 10" off the ground.

This week we've been joined regularly by a woman I've mentally nick-named "Cancer Girl." A breast cancer patient like me, she's one of those people who has readily embraced the cancer treatment lifestyle. She knows everything there is to know about traditional and alternative healthcare options at the hospital. She has a lot of tips on managing side effects. She has a strong POV on the perfect headgear and where to get it. I'm confident she'll be all over the Race for the Cure next year.

I suspect there's two types of cancer patient: those like Cancer Girl for whom this experience has provided a whole new community, a sense of focus and a way of life; and people like me who really want to get out of this club as soon as humanly possible.

Here's to January 3rd, when I will become a civilian again.

Fade Away and Radiate

I just juiced up the following cleansing concoction recommended by my friend and colleague, Pat:

bunch of kale
bunch of romaine lettuce
lemon
1/2 apple
knob of ginger

It's delicious, actually. Hopefully I'll be cleansed of radiation (week one), the Portland Advertising Federation award show celebrations and all the crap I've eaten of late.

As for radiation, its been a mildly entertaining and totally side-effect-free week. Almost disappointing. Since my only reference for radiation is early James Bond movies, I was expecting a bright orange beam of searing light and the smell of burning flesh. In fact, the only evidence that anything is happening is a buzzing sound as the machine zaps the offending breast six times - three on each side. The whole process (set up and zapping) takes maybe three minutes.

The distractions they provide in the room include a picture of Mount St Helens in spring on the ceiling, which I think is really funny - it is, after all, a large breast-shaped object with a big chunk blown out the side with some steam emerging from the crater. There's also music playing - this week it ranged from a Bollywood soundtrack to Free Bird (which almost had me crying with laughter.)

In truth most of the action takes place in the waiting room. One of my regular radiation companions is Bobbie - an older, lung cancer patient. She used to be a dancer. And she can't believe she's receiving treatment in the hospital that killed her husband. Also, she kept all her hair as it fell out and was surprised to discover it only weighed four ounces.

Sooooo, so far so good. Apparently the side effects (burning and fatigue) might become more apparent in week three. More on that later.

Diversions V

:: Quantum of Solace - get to the theater immediately. HOT. I mean SIZZLING.
:: Lake Oswego High School's spirited performance of The Wizard of Oz - final performances on Thursday and Saturday of this coming week. Special mention goes to my nine-year-old friend Forrest Johnson for his rousing interpretation of a Munchkin.
:: Atwater Place - if you have a spare $900K or so, help me out, would you, and buy a condo in this magnificent building at South Waterfront. It's a client of NORTH (my place of work.)

Tatts

So I got "mapped" on Tuesday. This involved lying very still while Dr. Bader marked me up with a Sharpie (or medical equivalent) before a nurse technician (they call her "The Wasp...") gave me four little tattoos - either side of the offending breast and either side at the bottom of my rib cage. I also got a CT scan.

The radiology office is all about efficiency. On arrival you grab a gown, get changed, leave your stuff in a locker and take a seat in the waiting room (which has a TV...) There are two cameras in the waiting room so the technicians can see when you've arrived and ready. A little bit "Big Brother."

My first "zap" is on Monday. I'll describe that process thereafter.

Treatment Continued....

I met with Dr. Bader (radiologist) this afternoon. He's anxious to get going with radiation soon because of the size of the tumor (largish) and my age (youngish.) So I go in next week for measuring up, tattoos etc and they'll start zapping on the 17th. Treatment will probably last six and a half weeks - 10 minutes every day, five days a week - which is a little longer than standard, again because of the tumor size/age factors. And so it remains only for me to get the port removed and pick a super power :)

Election Euphoria

After drinking 853 glasses of champagne last night, I announced my candidacy for US Senate in 2012. This morning I realized a key impediment to this plan: I am not a citizen. I guess I'll have to review Schwarzenneger's path to US government success for tips and inspiration (acknowledging that he's on the other team.)

Completely Unrelated

Poor Annie will be joining me on the couch for a while. She sliced open some of the webbing on her foot this morning while on one of her more enthusiastic walks. Actually she embraces pretty much all activities with boundless enthusiasm, which is why it's a little sad to see her all drugged up and sacked out.

Separately, why is it that all veterinarian bills net out at around $200?

Next up

I should qualify the last Benadryl-fueled post, by explaining that a) its not completely over - still got six weeks of radiation to go and b) I had hoped to go for big laughs by including a file with the actual sweet voice of Roy Orbison singing the words "It's over..." but this was beyond this blog's (and this blogger's) technical limitations.

Anyhoo, yesterday was amost (dare I say it) fun. My bloodwork is within degrees of normal, weight stable, blood pressure a little high, Oxygen 100%, pulse 75. Which is all good. We took cookies in for the nurses and it was hugs all round as I left. I'll miss those guys. We then went out for a celebration lunch at Evoe where Kevin obliged us with the most delicious salads and omelettes.

For the record the Benadryl + steroids + wine combination does not make for an easy night of sleep.

Apparently I'll be phoning Dr. Bader next week to determine the next order of events: port removal, radiation and the like.

And so.....

In the words of Roy Orbison.......it's over.

Errr......

I just emerged from the bathroom wrapped in a white towel and my husband told me (while laughing) that I look like one of those pedigree cats that has no hair. Sigh.

Last chemo today. Thank God.

Serious Observations

Some conversations with my friend and colleague, Mark, led me to conclude the following (and I can change my mind at any time, by the way):

::When thrust into this situation, I don't think you need to relate to your surgeon. He may be as mad as a snake but as long as he's not a complete a-hole it doesn't matter. You're not going to need much in the way of bed-side manner at this stage since you're going to be asleep for the longest stretch of your relationship with him. You just need to be in agreement on a course of action, and for him to be a precision cutter with a meticulous eye for detail.

::You do need to relate to your oncologist. You're going to see him a lot, and during some very difficult times. More importantly, you need to relate to the oncologist's nurses. At the end of the day, you will be sharing the more personal (gross) details of your side effects with them. And, in general, they have had more intimate experience with more cancer patients for longer than anyone.

::This is a deeply personal experience. Although many people continue to volunteer tips and stories about their's (e.g., the drunk lady at the opening of the new Ann Sacks showroom last week whose eyelashes fell out and grew back twice, apparently), no one has had the same as mine. I guess it's the same with the disease itself - no two cancers are alike.

I shall opine about radiologists some time in the next few weeks when I might know what I'm talking about.

Armstrong's Endorsements

This blog in no way endorses the viewpoint of some of the advertising that may appear herein. In fact, the blogger would like to take this opportunity to endorse Jeff Merkley for US Senate. And, in fact, Obama for President. Also David Wu, Earl Blumenauer, Peter DeFazio, Kurt Schrader for US House of Representatives. And pretty much straight down Democrat party lines for everyone else. Thank you.

Safeway Redeemed

Last night Erika the checkout guy (yes, he's a guy named Erika) told me I look fabulous which was really nice because I know I look like a cancer patient, especially now my eyelashes are falling out.

Minor Observations

The magazines in the oncologist's office are, for the most part, good and current (OK, I did find a Sunset from December 07 the other day.) Presumably this is because people spend a lot of time there. Sometimes there are donuts and cookies. I'm guessing these are provided by grateful patients. I should probably take some tasty thank-you treats with me when I go in for the final session (which is, by the way, October 29th should anyone want to throw me a big party some time soon thereafter.)

Chemo VII: Uneventful

I considered inventing some side effects to impress Dr. Urba but he takes all input very seriously so that would have been, most probably, inappropriate. Nothing much has changed: weight stable, blood pressure average, red blood cell count within reach of normal etc etc. I do get very itchy hands at times during the cycle but that's to be expected (apparently.)

And the first pre-meds I receive in the infusion room include a big bag of Benadryl so I'm basically knocked out for the whole process. If something interesting happened I missed it.

The next and final treatment might be more compelling. Then, hopefully, I'll get a better understanding of what happens next (port removal and radiation.)

Chemotherapy: Upsides

1. System-wide annihilation of cancer cells.
2. License to eat whatever you want whenever you want (example: ice cream sandwiches for breakfast.)
3. No bad hair days (but there is the occasional bad turban day.)
4. Never having to shave one's legs.
5. Bathroom time greatly reduced (top benefit for husband, especially.)

Downsides: too many and too gross to mention here.

Overheard in the checkout line at Safeway

Clerk: "Would you like to round up your total with the difference going to finding a cure for breast cancer?"
Man: "I've got enough problems without having to worry about women."

Nice.

Diversions IV

::Evoe - This is the new bistro/cafe/tasting room in Pastaworks on Hawthorne. I've lunched there three times now (twice on consecutive days.) Casual dining with exquisite food offering - salads, charcuterie, soups, sandwiches and, importantly fried items. The grilled cheese sandwich is to die for. Plus you get to watch the chef in action. Good theater.
::Gordon Ramsey's Kitchen Nightmares - I'm not sure I like Gordon Ramsey but I've become obsessed with this show in which he visits failing restaurants and attempts to turn them around in an unfeasibly short period of time. It has made me rather suspicious of restaurant kitchens, hence my current preference for the open options (see above.)
::Brideshead Revisited - Nowhere near as good as the 1981 TV series with Jeremy Irons, this film version of Evelyn Waugh's 1945 novel bills itself as a "poignant story of forbidden love." I had thought it was about the disappearing tradition of aristocracy and the outworking of God's grace in people's lives. Maybe that doesn't sell films.
::The Duchess - I was really excited to see this film version of the book Georgiana, Duchess of Devonshire which kick started my ongoing interest in 18th century aristocracy. And I do think that high praise should go to Ralph Fienne's portrait of the duke. Best performance, however, must go to Keira Knightley's eyebrows which truly dominate the action. Seriously. Never seen anything like it.

Chemo VI: Groundbreaking

As I neared the end of the Taxol infusion and realized that it had only taken 1.5 hours, Nurse Laurie told me some interesting news: since my last treatment some research has been published demonstrating no difference in patients who had received Taxol over three hours or one hour. The research was, apparently, spearheaded by my very own Dr. Urba. So I am one of the first patients to receive the treatment in this newly-approved "fast" time. Naturally I was relieved to get out of the clinic earlier, but I was a bit unnerved when Laurie exclaimed "I can't wait to see how this turns out for you!" So now I'm anxiously awaiting a new slew of side effects (see September 9 posting: Paranoia.)

In other news my mouth has cleared up and my red blood cell count is on the increase so I'm back to being only slightly anemic. Taxol is, as they thought it might, taking much less of a toll on my system.

Diversions III

::The Enchantress of Florence, Salman Rushdie - Am feeling intellectually superior. Have read an entire Rushdie. It's a very beautiful book - like reading an extraordinarily detailed, magical, colorful painting. I recommend picking this up ONLY if you have long stretches of time in which to read it. Its not for dipping.
:: The Twilight Saga, Stephenie Meyer - To balance out the Rushdie, I've now read two in this series of four monster vampire teen chick lit books. They're complete rubbish actually, but very compelling. My friends have been scouring them ostensibly to vet their daughters' reading matter which, of course, doesn't really explain why they've had to read the entire series. No matter how old you are, it seems, nothing beats a good vampire love story, in spite of the Palin-ian viewpoint on sexual relations. Yes, in these books even the vampires believe in saving themselves until marriage.....
:: Foreign Girls, Joseph Arthur - Another brilliant EP from the original Ugly Sexy guy. I love Joseph Arthur. 'Nuff said.
:: "The Worst Financial Crisis Since The Great Depression," today's NYT - Bloody hell fire. The pundits are saying this morning that we've not even begun to experience the full impact of this fiasco. The repercussions will last at least two years. Interesting that its completely marginalized both presidential campaigns this week. All eyes are on the incumbent and Secretary Paulson. Time to move to some remote Pacific island, I think...

Chemo V: Perspective

I showed up at the clinic yesterday ready to complain about the ulcers that lace the entire perimeter of my tongue, causing me to drool excessively and forcing me to speak through clenched teeth. Dr Urba was sympathetic. And went on to tell me how severe this condition can become in patients with more deadly diseases. In those who are preparing for a bone marrow transfusion, for example, the chemicals can cause sores not only in the entire mouth but all the way through the digestive system; sores that prevent them from being able to swallow so they are hospitalized for feeding/hydration through a drip; sores that are so painful that they are treated with morphine.

In the infusion room we sat opposite a really nice couple. The husband was in for treatment, but it was his wife who interested me. She had no hands. I'm guessing this was a birth defect given that what she did have - the "heel" and thumb/little finger stubs - was the same on each side. But she was as dexterous as anyone with hands, managing cell phone, iPod Touch, sandwiches (distribution and consumption), NYT crossword and so on with ease.

Later on a petite Asian woman arrived for her infusions. She greeted everyone energetically before settling into her chair. Nurse Mary told me that this lady is amazing, resilient, upbeat, a pistol and sharp as a tack. I asked about her situation. "Oh, she's terminal."

Needless to say, yesterday was a humbling experience for me, even with my mouth sores and the news that I'm now fully anemic (yes, there may be a transfusion in my future.) These, after all, are just temporary discomforts. My turban goes off to those brave souls who flourish in spite of debilitating and/or life-ending conditions.

Random Friday Night

Last night Rhett and I went to see Zidane: A 21st Century Portrait which is featured at PICA's TBA Festival. Centered on one match - Madrid v. Villareal, April 23rd 2005 - the film's 17 cameras focus not on the game, but on Zidane himself. It's eerily brilliant and I urge anyone who hasn't seen it to get down to the Portland Art Museum pronto.

Zinedine Zidane (see left), for those of you who don't know (sigh), was possibly the greatest football player in the world (now retired.)

After the film we stopped by Cafe Castagne for a quick dinner where two unnerving things happened:

1) A really nice lady approached us as we ate to tell me that she'd been in my situation a year or so ago. So clearly I look like a cancer patient. At least to those in the know. And I thought I was getting away with it....

2) The elderly couple sitting at the next table paid for our dinner. I was completely floored by this. I'd actually asked for the check when the waitress announced that this "lovely" couple would be picking up our tab. Unfortunately Rhett was in the restroom at the time - I know he would have handled the situation more gracefully than I - and I just sat there looking dumbstruck while the couple in question wrapped up their dinner and left without even making eye contact (seriously, they were a maybe three feet away from me.) I was actually a bit annoyed. Do we look needy? We were splitting a burger because I wasn't hungry, not because we're short of cash. Maybe its the now-obvious cancer patient thing. In any case, I drafted a thank you note promising that we, in turn, would practice random acts of kindness, and gave it to our waitress to give them next time they come in. Just in case they're tuning in: THANK YOU SO MUCH MR & MRS DICKEY!

Things Not To Say In The Oncologist's Office

"I sleep like the dead": this is an unfortunate expression that I've used for years. I do sleep very well. Always have. "Rebecca needs a lot of sleep," Mum would say. I could sleep for England. But the "dead" reference is not something my doctor wants to hear when he asks whether I'm sleeping. It's a little unnerving apparently. Understandable.

Paranoia

I'm forever on the alert for new side-effects from chemotherapy. It's a little obsessive. Yesterday I was horrified to note a new bruise that spanned the length of my forearm. I've always bruised easily and now, with the chemicals wreaking havoc on my platelets, it's worse than ever. But I really couldn't remember smacking my arm even lightly over the last couple of days. Some time later while reading the newspaper, I idly rubbed the bruise with my forefinger. And it came off. Because it was just dirt. I need to calm down.

Chemo IV: Farewell To Adriamycin, Cytoxan And All That

I was searching the web for images of Adriamycin and Cytoxan but the very sight of them turned my stomach so this will be a photo-free post.

So I'm done with these drugs. Apparently the next (final) four treatments will be a little easier on the system. They will involve only one drug: Taxol. My oncologist (Dr. Urba) described only a few side effects: hair loss (too late to worry about that), constipation (whatever) and, in some cases, neuropathy (numbness and tingling) which will likely go away eventually but can be permanent in some patients. I think I feel that coming on already.

My dear friend Amye came with me to this last session. Great company and a new dimension for me, since I got the opportunity to show her the ropes and introduce the staff at the Oregon Clinic as well as provide commentary on my progress (blood pressure high, temperature slightly high, weight down seven pounds since last visit, all blood counts good except still anemic etc etc.) On reflection this may have been very boring for Amye.

Not much more to report about that session. My usual nurse was off sick so the office manager hooked my port up for the blood draw and infusion. Which is not to say that they were so short staffed that the person fixing the photocopier and ordering the staplers was administering to my needs. Oh no. The office manager at the Oregon Clinic is a seasoned nursing professional.

The infusion room was more crowded than usual. So it was entertaining when Nurse Mary yelled out the results of my blood draw and admonished me for losing weight from across the room. Glad everyone got to join in.

One final note: I overheard another patient (who I always see there alone) talk about how she has to get the bus to and from treatments. Heart breaking, and a reminder about just how lucky I am to have such supportive family and friends. Thank you.

Diversions II

::My Crisp Collection - see left. Thank you, Niki.
::Teany - Making the world a teany bit better. These delicious iced tea/juice drinks rock. A delightful change from water for me. Created by international recording star, Moby. Available only in NYC (sigh.)
:: Pho Bo by Pho Van - You would think (and I've noted) that spicy food is a little difficult for me. Why then, do I continue to enjoy this spicy Vietnamese soup (# 8 - lean brisket)? I don't know, but it's tasty and comforting.
:: Democrat National Convention - This was my TV companion last week. Its exhausting to watch the whole thing. OK, I didn't - but I saw A LOT, and dwelt on the cult of personality in US politics. In Britain (it seems to me) we fall in behind our parties' philosophies and manifestos. We vote for the party. But here, apparently, we vote for the person, in this case Barack or Hillary. And, absent Hillary, its entirely possible for us to switch party and philosophy or not vote at all, because we don't like Barack. I know this isn't a prevalent trend but I was sufficiently aggravated that I threw things at the TV at times during the week. Separately, I promise to watch the Republican National Convention all this week so my viewpoint is informed, if not entirely balanced (most people know I'm a bleeding heart liberal.)

Am feeling pretty good today. Probably a good idea to get out and stretch my legs. Hopefully the Labor Day weather will oblige.

Block Party?

Typically on day 3 post chemo I would not be excited at the prospect of a hundred plus people assembling outside my house for six hours of live music. Actually, that would be typical of any day, chemo or no. But for some reason, I was not as tired as expected yesterday, and I kinda got into the show.

This was the third annual block party hosted by my neighbor, Brian, in large part (I believe) as a showcase for his band Outpost - possibly the happiest band I've ever seen.

The spectacle was enhanced by a handful of falafel and smoothie vendors plus scantily clad hula/fire dancers. Oh, and the aforementioned hundred plus, each of whom seemed to arrive with a 12-pack. By the 9pm curfew, this crowd was loaded. But Brian and the band had the wisdom and courtesy to move the after party to a bar up the street and not his house for which I'm very grateful.

I'm very tired today. The chemicals must have kicked into high gear. So far have read the NYT (good one today), done one load of laundry and made bacon & eggs. That took seven hours. Arguably a typical Sunday.

Bend Memorial!

Yeah, not a glamorous facility but the doctors and nurses were super nice and super fast. I was in and out in three hours total. Their blood analysis machine (take note, Oregon Clinic) took only fifteen minutes to deliver the report showing that all my numbers are "within normal" except I'm a bit anemic ("to be expected.")

Thereafter everything was routine except the surroundings. Their infusion room has the chairs surrounding a central nurses stations. There's very little natural light and not much to look at except the other patients. As usual, I was the youngest person in the room by about 50 years.

The very elderly lady to my left was obviously anxious to have people to talk to. She kept her daughter and the nurses very engaged in her recent calamities (chemo halted because of blood clot on the lung and two-week stay in hospital etc etc.) Because I am a big meany, I became totally absorbed in my book whenever she looked in my direction. The less elderly lady to my right was in chemo for the first time and, I think, her course will last a whole year. Poor thing. She was most interested in how long it took me to learn the art of turban tying (basically trial and error for the last couple of weeks.)

Top tips from Bend:

:: Keeping your mouth cold with popsicles and shaved ice while the Adriamycin is being pushed into your system may decrease the chances of mouth ulcers etc during the cycle. We'll see.
:: Taking two Prilosec per day is a) OK, by Dr Kornfeld, b) the same dosage as one Nexium and c) most importantly, will likely help curb the nightmare acid reflex situation I have on days 6 through 8.

Interesting. Might be worth getting chemo at other clinics to learn their secrets......

I'm feeling OK today (as usual on day two.) Should crash tomorrow just as we head back to PDX.

View from a different couch

This is the fairway of the 10th hole at Glaze Meadow, Black Butte. From my vacation couch I can watch predominantly rubbish golfers smack their balls from left to right, zig zagging their way to the green. I don't really envy them.

I've been using this window of feeling OK before chemo 3 to get in some good walks around the ranch and I'm being macho about drinking wine with our friends though, in truth, its still a bit "burny" and doesn't go down terribly well.

We went to the pool this morning. I wore my green turban to match my green bathing suit. I was about to don the fabulous white, fluffy, cotton hoody that Niki sent me but my discerning husband said I'd look like a pretentious, attention-seeking, aspiring starlet so I abandoned it for something more subdued. To be honest, I think the pretentious, attention-seeking, aspiring starlet (PAAS) look is actually appropriate for the pool complexes of Black Butte. Whatever.

My hair stubble is gradually falling out. It's very scratchy. And when fallen out tends to stick in place on my head like iron filings. My friend Melissa recommended using a sticky lint roller to remove these last vestiges. It works, as does a slightly damp, rough towel of the "stolen from the gym" variety.

Chemo 3 takes place at Bend Memorial on Thursday. Am slightly anxious about this, but since my treatment is standard procedure I don't suppose they'll mess up. Besides, I know the order of proceedings now so I can always keep check on them. I'm sure they'll love that....

I was funny before this, you know

My friend and colleague, Chris, drew my attention to an article in last Monday's New York Times: Having cancer and finding a personality. The author describes her personality change post cancer diagnosis: "When I found out I had breast cancer 12 years ago I became a comedian." I think it is probably true that one's coping skills can manifest themselves in a myriad of unexpected ways (there can't be much that's more stressful than a cancer diagnosis) - but I challenge the assumption that it introduces personality facets that one has never had before.

A couple of people have said to me in reference to this blog: "Cancer has made you funny." Respectfully, I must counter that. To my mind, I was pretty bloody hilarious before all this. And, thanks to my private school/Cambridge education I've always been a good writer. It's just that I've never written a blog before so not many have experienced my well-written hilariousness first hand.

And in case anyone thinks that I'm jesting and joking my way through all this, I think its worth pointing out that I do have moments (often) of misery. Days three through five after infusion, when you're feeling like a shriveled up shadow of your former self - hairless, unable to get up off the couch, battling indigestion and a host of totally gross side effects that I shan't mention here - are really no laughing matter.

One of my doctors described a cancer diagnosis as potentially "liberating." Other than being able to get out of a couple of social obligations, I don't feel particularly liberated. I feel, in fact, chained to a new master. One that mandates a strict regimen of treatments and drugs that keep me confined to the house for one week of every two. One that doesn't allow me to think about much else than the disease and how to deal with it. It sucks.

But it will be over eventually and I'll be allowed back to my normal life. Hopefully I'll have learned a couple of lessons. Undoubtedly I'll have a greater appreciation for normalcy. And I'm confident I'll be as funny as ever although I may have to keep up the blogging to prove that to others.

Feeling pretty good today. So that gives me six days in the world before going back to the fog. Am off to Black Butte on Sunday so, web access permitting, I may be posting from the road.

On having no hair

My friend Paola shaved it off a couple of days ago when I realized that I was habitually tugging at it, and pulling it out in chunks. It's not bad, actually. See Sigourney, here, whom I like to think I resemble in some way. I practice looking really mean in the mirror - all good prep for my Halloween costume.

The thought of not having a bad hair day for a while is liberating. But I've had to get busy with the head coverings - I think I've finally mastered the turban using long strips of cotton knit fabric courtesy of American Apparel.

The weirdest thing is how cold my head gets at night. One really does lose a lot of heat via the head. I've been sleeping in a cap which is so Wee Willie Winkie (or something.)

Day 7 and I'm still feeling crap. Continued wooziness and fatigue. I'm going to will myself better tomorrow so I at least get one week out in the world before round 3.

A funny thing happened on the way to chemotherapy....

Well, it didn't actually. The journey to, and the process of chemotherapy were relatively incident free. But I spent time collecting the following thoughts and observations:

:: The clinic's blood analysis machine was broken. Again. And I thought this was a state-of-the-art facility? I actually ran into the bloke trying to mend the thing and made the mistake of asking whether he was the IT guy. Apparently (clearly) this business ranks way above software updates and the like. I was firmly put in my place. But it took a boring hour to get my blood results back from some far distant lab. On the upside, my blood counts were all "perfect."

:: Nursing staff very impressed with my reaction to the chemo so far, especially the "no vomiting" part. Yay! I am bullet proof. Well, apart from the whole cancer thing.

:: I had read that one shouldn't get a manicure/pedicure during this process due to the risk of infection which is a bloody disaster for me. I mean, I can live with no hair...but unkempt nails! God forbid! I mentioned this to the nurse practitioner who said that in her 30 years of being in this business she had never heard of such a restriction. Which is funny because I read it in this very clinic's helpful "dos and don'ts" literature. Still not sure how to proceed. Might risk it when my white blood cell count gets back up (10 days or so.)

:: Every time an infusion bag is changed on my drip, and even when the syringes are introduced for the "push," the nurse has to confirm my identity. It takes all my strength not to fire off some zinger or other."Are you Rebecca Armstrong?" "Yes, things haven't changed much in the last 30 minutes" etc etc. I'm pretty sure there's a brilliant Jekyll and Hyde gag somewhere in here given all the chemicals I'm taking on but I'll save that for the last infusion.

:: Emend is saving my life. It's the anti-nausea drug they infuse before the chemo drugs. It was only approved by the Feds for intra-venal infusion in the last three months. THANK YOU FEDS. It is also very expensive. I have to take the same med in oral form on days 2 & 3 following infusion. My co-pay for these 2 pills is $50. I believe the total value of them is $220. Meaning each little life-saver is worth $110. THANK YOU REGENCE BLUECROSS BLUESHIELD.

:: Many chemo survivors have recommended Magic Mouthwash to me to combat the inevitable sores and other mouth distress. It's like a secret among those "in the know." Look it up on Wikipedia for full description including its alleged use in the military for rather gross reasons (not that I would deny our boys and girls on the front line anything.) Anyway, the clinic wrote up a prescription for my use, though I'm not totally excited about it since Novocaine is an ingredient. I'm quite enjoying still being able to taste things.

In general I'm feeling OK. Still nausea/vomit free and not much in the way of indigestion. Still have hair but that situation will likely change this week. It's weird waiting around for it to fall out so I might actually get it shaved off this weekend. Stand by for GI Jane posting.

What this blog needs is some pictures

Here's one: part of my new reality. I wasn't kidding when I mentioned in an earlier post that until this point I hardly ever popped an Advil. I almost have an aversion to meds.

But not any more. No, sir. Meds are my friends. This selection here includes anti-nausea, steroids, pain killers, blood pressure, antacids and anti-anxiety. I'm a big chemistry experiment.

Actually as of yesterday I feel almost normal. I even sucked down a glass of wine last night (OK, several...) without the sensation of quaffing on hydrochloric acid. Just in time for round two (sigh.)

Regression

As you might expect, my diet has changed significantly. The only foodstuffs that appeal are of the variety served to me by Mum circa 1968 to 1978; specifically:

Scrambled egg on toast
Cheese on toast
Beans on toast (Heinz vegetarian, although we don't have to specify "vegetarian" in the UK - they're just "beans." Per the advertising: "Beanz Meanz Heinz")
Cauliflower cheese
Spaghetti

I'm only frustrated that I can't get shepherd's pie (giant hint to my British friends.)

Imagine my delight when my dear friend Niki sent me a care package from NYC that included British foods from my youth:

Marmite (natch)
Heinz tomato soup
McVities digestive biscuits
Jammie Dodgers
The aforementioned Beanz courtesy of Heinz
Hoola Hoops (salt & vinegar - a special treat after swimming lessons...)
Miscellaneous chocolate including Aero, Curly Wurly, Crunchie and Maltezers.

And, of course, Heinz Salad Cream. Actually the only reason we ate salad cream back in the day was that Hellmans hadn't yet introduced mayonnaise to the British market. As soon as it was freely available, we wondered what we had been thinking all those years. Salad cream is vile. And possibly as toxic as chemotherapy. Sorry, Niki, you wouldn't have known this. But I shall keep it for nostalgic reasons and the occasional good laugh.

One other really weird 70s flashback happened this morning: I woke up to the tune of The Proud One by The Osmonds running through my head, followed shortly by Abba's Hole In My Soul (which is an obscure Abba song, let me tell you.)

Am I subconsciously seeking the comfort of my coddled youth during this troubled time?

Just to be clear

I probably need to back up a bit for those not intimately familiar with my situation.

I have Stage 2 invasive ductal carcinoma (i.e., breast cancer.) 1 in 8 women get breast cancer. Most of them (75%) have a hormone receptive cancer. Many of them have the her-2-neu gene. I have a triple negative cancer meaning its neither hormone receptive nor connected with any gene. It's a particularly aggressive cancer.

The good news is at the time of surgery it was determined that I'm "node negative" meaning the cancer doesn't appear to be in my lymph system. That's good.

Many people have asked why I need to have chemotherapy. Truth is, I could decline treatment, stick with the lumpectomy + radiation and go on my merry way. Odds are, I'd have a 70% chance of making it another 10 years. I don't like these odds.

It is widely agreed (and I consulted with three oncologists on this) that this cancer is very responsive to chemotherapy. With eight treatments over 16 weeks, my odds of 10 year survival increase to 85%. I like these odds a lot better. In fact, it seems to me that most people have an 85% chance of surviving the next 10 years, cancer or no. We could all get run over by a bus tomorrow.

Naturally this all totally sucks. Especially the treatment. This really has been the worst year on record (more on that in my memoirs which will not be written for another thirty years.) But as it happens, and as freaked out as I am by what's happening, I've never once thought that this thing would kill me.

So please don't worry about that.

But here are two very important words, ladies: SELF EXAM. This thing didn't show up on mammogram. Not even on the day of biopsy.

Diversions

::Assisted Loving by Bob Morris. Hilarious account of a an 80-year-old man's dating escapades as narrated by his son. Has equipped me with sound advice for my mother as she navigates "courting" for the first time (I think...) since my dad's death. Top tip about elderly widowers: "They're not just looking for love, they're looking for lunch."
::Acai. Brazilian fruit super high in anti-oxidants. Sumner Redstone swears its the key to his longevity (and he's, like, 150 or something.) Actually he's a fan of MonaVie - which at $40 a bottle is clearly not the cheapest guarantee of eternal life (but what does he care.) Available only through a direct sales force (a la Avon), my friend Sarah and I are testing this out. You'll know if it works if you're still around to hang out with us when we turn 100.
::Bacon Egg Bolo by Grand Central Bakery. I suddenly fancied one this morning after a bit of a hike with Annie the dog. Made welcome change to the nursery food I've been eating for the last couple of days. Real bacon with real egg plus tasty salsa over fresh bolo roll made by someone other than me.

In general am still feeling wiped out but my head doesn't feel like its about to fall off. Hopefully this means I'm emerging from the fog of cycle one.

Somewhat related observations

:: I forgot to mention that on the day of Port surgery, yet another super elderly volunteer led us into a prep room in the short-stay unit at Providence. Her name was Elma. We followed her at snail's pace into the room. She gave me a bag for my shoes then crossed to a cupboard to retrieve three more bags for my shoes (I was wearing flip flops - one pair.) After some discussion we agreed that what was missing was a bag for my clothes.

But I suppose it makes sense that all the Providence volunteers would be very senior citizens. They're in a good place for when the inevitable happens.

:: Late yesterday I was sufficiently recovered to attend a swimming party for my nephew, Max, at The Waverly Country Club (swank, exclusive retreat for the wealthy.) I wore part of my cancer-treatment disguise: complete all-over-body protection from the sun, huge sun glasses - but no hat yet. Am still sporting the ultra-blond, pixie cut provided gratis by the lovely Alissa at Tiger Tiger (tigertigersalon.com) as a pre-empt for inevitable baldness.

Once seated in complete shade I was able to survey the scene - a scene that included a huge, fancy birthday party for some 4-year-old twins that looked more like a wedding: white table cloths on long trestle tables, matching balloons and floral arrangements, huge bbq and full bar, and hundreds of guests - you know, standard procedure for celebrating the fourth year of life.

Imagine my peaked interest when we spotted Michelle Williams with her little girl Mathilda wandering among the partying throngs. What the F? Is Portland, OR that hip? Or just a retreat from all the shenanigans and Heath references surrounding the opening of The Dark Knight? And then imagine how appalled and concerned I was for them when the birthday party entertainment showed up: a clown. Someone wasn't thinking.

In case you missed it - here's the review of the lumpectomy:

June 26:

Unable to sleep, I proceeded to the kitchen at 5:30am so I could at least get some calories down before my eating curfew of 7:00am. Scrambled egs. My drinking strategy (8:00am curfew) was not brilliant. I downed three pints of water within about 10 minutes causing me to throw up and have to start over.

It was a morning of acute anxiety. Unable even to bite into half an Ativan, I paced the house furiously waiting for the 10:15am departure time.

On checking in to the hospital, we were guided to a “prep” room by a very nice ancient lady volunteer whom, I feared, would fall over and die before we got there. Seriously, we crept to the room at a snail’s pace. She kept offering to help us when we knew, most surely, that we should be helping her.

My roomie: Evelyn, aged 63, was getting a hysterectomy. I never laid eyes on her and her friends because of the discretely drawn curtain but I could hear them clearly. Evelyn had arrived with a typed-out list of the meds she is taking. The nurse praised her for her organizational abilities. I assumed I was going to get minus points. I mean, I know I must have taken Advil at some point in the last six months but there’s no way I could remember when.

At 11:30am Dr. Lim arrived to shoot me (the tumor, to be precise) up with some radio-active gunk to track the progress of the cancer from the breast to the lymph nodes. It had to be hand delivered by a technician and was packaged in a large metal canister from which I was sure a fog of dry ice would eminate as it was unscrewed. Not so. It was all very unexciting.

1:45pm: a team of nurses swept in to prep me for surgery. I felt like a Formula One car on a pit stop. The head nurse asked me questions and fitted my compression socks, while nurse # 2 hooked me up to a drip, nurse #3 did an ECG and nurse #4 drew blood. Seriously I thought they were trying to beat their best time.

2:30pm: show time. Hot anesthesiologist (yeah, baby) gave me some calming meds through the drip (which did instantly calm) and wheeled me to the OR. I’ve never been in an OR. It was much larger and “whiter” than I imagined. I asked about music and they offered up Creedence Clearwater Revival….”fuck that” I thought and said something much more polite.

Cut to the recovery room. I woke up as they wheeled me in and, in all honestly, immediately felt pretty good. Much better, in fact, than I felt after I had my wisdom teeth taken out. No nausea and they’d shot up my boob with a ton of analgesic which wouldn’t wear off for some hours. The only reason I was in there for over an hour is because there was no room ready for me in the hospital (apparently they were packed that night.)

Dr Lim delivered the good news while I waited. The procedure went as well as had been planned. The tumor hadn’t grown – still only 1.5cm and he’d only had to remove one “hot” sentinel lymph node*. I’m pretty sure he didn’t mean cute (a la anesthesiologist.)

Originally, it had been planned that I would stay over night; however, on meeting my next roomie – who moaned and howled in pain while watching Jeopardy – I felt the need to get out as soon as possible. So, possibly unwisely, I resumed my early morning drinking strategy so I could pee more than 100ml and prove absolutlely that I was fit to go home. I made 600ml my first try and they let me out at 10:00pm.

*post-surgery pathology determined that the tumor was actually 2.1cm - stage 2 - but that I am node negative...some good news there.

The Day After Chemo

I'll caveat the whole of this business by admitting that I had vowed not to blog. But there are so many concerned friends and darling well-wishers that it's clearly easier to do some kind of "state of the nation" that everyone can tune into on their own time (oh, and that I don't have to repeat over and over.)

Anyhoo....the last couple of days have been stressful. I went into Providence late on Tuesday to have a port put into my chest. The procedure was to take only an hour and the instruction to the surgeon was to leave the needle in so that the nurse at the oncology clinic wouldn't have to dig around to get access the next day. My surgeon, as it turns out, does not believe in doing this. And my only opportunity to debate the issue was in the OR in the few minutes before they knocked me out. He closed up the incision and left a big blue pen mark as a target for the nurses. No needle.

I felt OK coming out of the anesthetic - not as great as after the lumpectomy when I was practically euphoric. But OK. They told me to go home and eat Jello, dry toast and apple sauce. I had a steak. Later in the evening my right arm became mysteriously painful to move. Vicadin was my friend that night.

So yesterday I showed up at The Oregon Clinic with my brand new Port (still bloody) and the poor nurses' faces blanched at the sight of its needlelessness. They all (nurses and doctor) commented that my surgeon is the ONLY surgeon that won't do this. And, indeed, it took two pokes with increasingly large needles to get into the artery. Rhett (attentive husband) pointed out that there was a big target mark in blue pen for the nurses to use, but they said that was rather condescending of the surgeon. What do we know? I thought the "poke me here" indicator was kinda handy. Needless to say, I had to have extra Ativan during this bit.

Thence unto the Infusion Room. I sat as far away from anyone else as I could and focussed on Elizabeth. The Golden Age. provided by the clinic on handy mini DVD player. She had a lot of good wigs. She also had to run a country at war, which, I imagine, was very stressful. And no Ativan! Anxiety-management must have been nigh-on impossible in those days. Just get drunk and execute people for distraction?

They dripped anti-nausea meds into me for an hour then the big stuff: two huge tubes of bright red chemicals were pushed into me by the nurse for twenty minutes then one big bag of white chemicals were dripped into me. This takes us to 5:30pm. So, clearly, this is going to be a 3-4 hour process everytime.

Thereafter I felt like I had a chemically hangover. Not unmanageable. I ate some broccoli and fish for dinner and went to bed to watch So You Think You Can Dance which, actually, post chemo, is really a crap show. Maybe chemo will show me the truth.

I felt, and continue to feel, a bit like I have minor indigestion and there's a tingly sensation in my hands and around my face which is subsiding as time goes one. I have to go back this afternoon for a shot of something that will help get my white cell count back up. I also have to remember to take additional meds around lunchtime today.

All this for someone who rarely ever took Advil.