LIVESTRONG:

What started as IDC (Infiltrating Ductal Carcinoma) in 2011, then turned into CHF (Congestive Heart Failure) in 2013, probably partially caused by chemotherapy along with a genetic pre-disposition. Here we are now in March 2016 and I am newly diagnosed with Stage IV breast cancer in the left breast and liver (LMBC - liver metastasized breast cancer).


So the focus has shifted yet again, BUT... I continue to THANK YOU for your prayers, love & support. I receive them with open & loving arms. My wish is that I will gain strength from you, will provide helpful information and strength to others & will help to strip away the fears we each experience.


I am strong. I am loved. I am healthy. I WILL SURVIVE!

Have you or your loved one had their annual mammogram? PLEASE, don't put it off. Speaking from experience, I highly recommend monthly self exam as well. And if you are now cancer free of breast cancer, do everything you can to insist that your doctors follow up with an occasional PET Scan and labs for tumor markers.

WARNING:
Contents may be uplifting, sad, funny, scary, downright depressing ~ THAT IS CANCER .... at it's best, at its worst.

PLEASE ~ Feel free to share this blog with anyone who is interested to learn about my journey. While I welcome their support, I hope that by sharing this experience freely to the universe I may help to support others by breaking down some of the barriers and fear associated with breast cancer and the treatment.

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Wednesday, August 31, 2016

Breast Surgeon, Cardiology & Oncology Appointments ~ All This Week

Here is my post on the last two days of doctor appointments. I know it is a long one, but I feel like we covered a lot of information during these latest three appointments this week. And thankfully, each day was followed by a nice lunch out with my hubby.

But first off, let me say THANK YOU to all my followers who steadfastly offer their words of support so often when I post these Blog updates and share on Facebook. You don't have to take the time to do so, but I treasure your words of love and support. It gives me something to look forward to and is a nice distraction from reality. ❤️

Yesterday, August 30th, I saw both Dr. Elboim, my breast surgeon, followed by an appointment with Dr. Dhar, my cardiologist.

My exam and consult with Dr. Elboim resulted in the fact that it is still too early for a mastectomy. The tumor appears to be attached to the chest wall somewhat, and it is too large and consumes too much skin necessary to do the surgery. Dr. Elboim is hopeful that the tumor doesn't involve any bone or muscle, but is unsure at this time. Besides, since my breast cannot be radiated a second time, and my ICD is kind of overlapping into the breast area, this is all more complicated than just a simple mastectomy (Is a mastectomy ever simple - NOT!!!) So he would need to take enough tissue to be sure to get all the cancer. Basically, the smaller we can get it first, the better for me, for healing, etc. So the chemo needs to do more work. The fact there is no end in sight with chemo, is the best plan for me right now. And that won't really change after a mastectomy; at least not because of the surgery. I may get a break somewhere down the road, but this really is my reality and I have learned to accept it. People do occasionally ask when the chemo will end. The truth is, probably never. I may get a break for a few weeks, heck maybe even a month or so if I get to a maintenance point. But I just gotta roll with this, as I really can't change it. 

I'm not excited for surgery for sure. And then, this surgery is not a curative, it is purely for quality of life. So this new information will be shared with my Oncologist tomorrow, and I'm sure he will get the written report with all these details as well.

My appointment with Dr. Dhar, my cardiologist, resulted in us learning that things are going OK, but more episodes of congestive heart failure have occurred this past couple of months since my last checkup. As the dates of these episodes were being called out by the ICD technician to Dr. Dhar, Mark noticed that they mostly (yes, there were several) seem to correlate with my chemo schedule. Even though outwardly I'm feeling pretty good, Dr. Dhar says by the time I would notice a problem, it could be too late. YIKES! He has decided it is good to keep my heart meds at the reduced levels he had me change to with a phone consult a couple of weeks ago, since my blood pressure is pretty good now and not so terribly low anymore, where it was causing light headedness and some mild dizzy spells. He did increase my lasix to what it was a few weeks ago (back up to 40 mg each morning and afternoon).

Then Mark and I headed to a new breakfast/lunch spot to try out, called Collibri Grill, on Montgomery just off Summerfield Road. We had a delicious brunch. This is kind of our highlight of getting into Santa Rosa for all these doctor appointments ~ a nice meal out, and finding and trying new places. It's always a plus when we are successful.

Enroute to my appointments today


Now it is Chemo Day ~ Wednesday, August 31st 
 Office Visit with Dr. Anderson & Chemo Infusion

Who's idea was it for an 8:15 am chemo appointment in Santa Rosa, anyway? I mean, I've been a morning girl until cancer returned earlier this year. But up at 7:00 am was a real hard one today. And who are all those people out on the road already??? Actually, I do recall that the only way I could see my Oncologist today was to make this early appointment, and he was actually going to have to come in early to accommodate it. So I am very thankful.

Let me first say that all the Oncology nurses, and the entire staff, at the Round Barn location of St Joseph's Cancer Center are such amazing people. Always cheerful and positive, helping each other and working as a team, stepping in to adjust a patient's pump for someone who is not their assigned patient for the day, gently saying "I got it, xxxxx (insert assigned nurses name), when that nurse is already occupied with another one of their patients. They share their personal lives with me, and listen about mine. Tears are creeping just knowing how wonderful they all are, and how welcome they make me feel to this place I come to get chemotherapy drugs infused through my port and into my body. It is an interesting and amazing experience.

After hearing about, and reviewing his notes from my two appointments yesterday with Dr.s Elboim (breast surgeon) and Dhar (cardiologist), my Oncologist, Dr. Ian Anderson, reviewed two strategies we might consider for my continuing treatment.

Option #1 is for maximum shrinkage of the breast tumor to provide for a surgical option for the mastectomy (no reconstruction - I do not want to go through that anyway; and it is not viable with my situation). The down side of this "maximum shrinkage" option is using up tools for the future that would then no longer be available to prolong my life. You see, in simple terms, cancer is a smart devil and might figure out a way around these drugs which makes them less effective later on, if effective at all. So using those options up now might not be the best choice.

Option #2 would be to prolong treatment to prolong my life by using an arsenal of drug options over a longer period of time. This would hopefully get me to a point where hormone treatment is appropriate, and perhaps some type of immunotherapy is then available. 

I like the Longer Life option, myself!

We decided that if we do get to a point where the mastectomy option is available, just through Option #2 above, it would be best to take advantage of it. Again, this is a quality of life decision, but would require 3 or so weeks off of chemo to allow for healing of the surgery wound with a good immune system. And I need to take that option if the window opens, as it may not happen again. But, removing the breast has no evidence of advancing the cancer attack in my situation. It does nothing for prolonging my life, and is in no way a curative - it is purely a quality of life issue. I understand all of this; but again, it is always good to hear it from my doctor once again.

Basically, it's all a balancing act at this point; and I know this too. One day... one foot... inch by inch; closer and closer...

So.... Holy shit batman (pardon the French), we're mixing it all up. I hadn't quite expected this when I came in for my appointment today; and I'm so glad that Mark was with me to hear it all first hand.

The new plan is to remove the Carboplatin from my chemo cocktail, and we will do this today. (Who came up with the name cocktail??? It certainly doesn't taste or feel like a cocktail to me.) I've been on Carbo for 16 treatments so it has probably done what it can for now. By removing the Carbo, I can stop the Dexamethazone as well, which is the steroid. I'll continue with the Abraxane only, since it seems to be doing the trick in reducing tumor size in both breast and liver; and this will continue as a weekly infusion indefinitely. This will cut infusion time down by about an hour. And actually, since I have missed a few treatments and been doing more of a 1-week on and 1-week off for a month, I feel like I'm starting to see some outward sign of cancer increase in the breast, with the exterior blistering/wart-like growths -- all very small so far, but still signs I need to get back on track. In making these changes, Dr. Anderson feels I will be able to better tolerate a weekly schedule of the Abraxane chemotherapy.

Dr. Anderson will be calling in a prescription for Xeloda, which is a pill I will take: 2 in the morning and 2 in the evening every day for two weeks, then a one week break; then repeat. All this is provided I get insurance approval for the Xeloda tablets. There is a Xeloda infusion option, but this requires I come home with a pump and have it continuously infused for a period of time. Since this is not the option we are striving for, Dr. Anderson didn't go into details about length of time, etc. Xeloda is an orally-administered chemotherapeutic agent used in the treatment of numerous cancers. It is a prodrug that is enzymatically converted to 5-fluorouracil (5-FU) in the body. My oncology nurse today was quick to tell me about the 5-FU reference - kind of appropriate, isn't it?

As in all drugs, there are several side effects that may happen with the Xeloda; but my Oncologist warned me of the worst, which is diarrhea severe enough to cause hospitalization. If I have a day or so like that, he said I need to stop the Xeloda right away, and contact him.

And of course all of this is dependent on me tolerating this new plan. So, I will give it a try and go from there. I'm game!

I know some of my writings cause alarm and seem scary to some, especially family; but it is good to hear these strong reminders from my doctors that I must be diligent with watching sodium, walking, staying positive. I'll be okay. I'm ready for the challenge. I have no choice.

But to end with a little humor, I have a bit of a story to share about what comes to mind when I refer to one step at a time, one day at a time, inch by inch... 

My Dad was a huge fan of The Three Stooges, as was, I believe, my four oldest siblings, as we watched many a episode. Well, the one that always comes to mind with the  one step at a time, one day at a time, inch by inch is the Slowly I Turned, Niagara Falls episode. This is a short 4-minute video I think you'll get a kick out of so, please use the link to view. Enjoy!

By the way, Relay for Life Sonoma was a wonderful event this past weekend. It was a bit different as we were at a much smaller venue with a much changed schedule. But I was able to hang out for 4 hours with Mark, Sarah, Jenise, Lisa, Dick, Christine, Joanie and many others. And thank you to the friends who came out after I had called it a day, as well. But most importantly, thank you to all my supporters who made donations to the cause on my behalf. Because of you, we raised nearly $3,500 dollars under my name, and nearly $6,000 dollars for our team, Denise's Darlings. Our local event has raised over $46,000.00 so far. THANK YOU, from the bottom of my heart.

Our Relay Team ~ Denise's Darlings



Thank you all for your continued support and well wishes.

Debbie... aka the cancer FIGHTER, AND Cardiomyopathy warrior!!!
B E L I E V E

• I AM STRONG • I AM HEALTHY • I AM LOVED •
THANKS for visiting!        I look forward to your comment.






 

1 comment:

  1. Thank you for allowing us into your life. Love you. You are so strong and positive. Keep it up.

    ReplyDelete

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Debbie