Tuesday, July 30, 2013

Poison, aka chemotherapy

Apparently I was overly cocky last week--this week I have not run once! There seems to be a bit of a pattern to this chemotherapy, where week one is kind of low, and week two is a rebound week.

Like parenting and other things I have experienced, cancer is yet another lesson in letting go. Knowing that these poisons are circulating in my body is a little discomfiting for someone whose normal drug intake averages 1 Advil annually. I've always been kind of a control freak about drugs and alcohol--everything from antibiotics to wine to pot to cigarettes. I even limit my coffee intake. I am just innately, almost prudishly, averse to things that take away my sense of control over my body.

There are strange and subtle ways the chemotherapy makes itself known--a slight metallic taste, pinkish pee, lethargy, a sense of inner imbalance. A friend warned me that her mother didn't drink enough and has permanent numbness in her toes because the chemo pooled in her extremities. Don't worry, I said, I'm so paranoid I spend half my time drinking water and the other half peeing.

Needless to say, it's also a little creepy to think of the cancer inside me, and I'm grateful the chemotherapy is fighting the good fight. I'm also lucky the chemotherapy side effects I feel are so minor; many people experience debilitating nausea, among other plagues.

The most important side effect from a medical perspective is a suppressed immune system. Chemo attacks any fast-growing cells, including white blood cells. So I'm supposed to bathe daily, wash hands obsessively, avoid crowds, avoid unwashed fruit (sorry, I'm picking and eating the blackberries all over the island) etc. No more eating food off the floor or my children's plates. Such a waste!

In other news, I have a new short do, at least while it lasts. Therese's barber friend Santino offered to shave my head, but when I showed up he insisted my hair was still so thick I might not lose it and I should think positively. I've accepted that it's going to go, but I'm in no rush to buzz it off before I have to. He promised to shave it for me when I start looking like a mangy dog. (I think he'd do anything for another chunk of the smoked salmon I brought him.) 

I'm basically at peace with losing my hair, though I believe it's unnecessary and I feel no sense of cancer identity or cancer pride with hair loss. All things being equal, I'd rather not be identified as a cancer patient the instant someone meets me. There is a psychological boost to being perceived as healthy and whole. And like anyone with a visible difference--dwarfism, a missing limb, dark skin--I'd rather not be slapped with a label that represents one small facet of my identity. Which brings me back to the Pat Benatar wig: I don't know how much I'll actually wear it, but it's nice to know I can go incognito to PTA meeting or swimming lessons if I so choose.

I'm really touched by all the love and support and encouragement people have offered. Thank you! If I don't respond individually, please know it does bolster me. 

Some pics on the hair theme...
Alder's hair is longer than mine now.

New hat from the grocery store. 

*The technology exists to spare people's hair, but it's a few years out from widespread use--something called cold caps that chill the hair follicles during chemo infusions. While there is a lack of clinical data on cold caps (there is a hypothetical possibility of metastases to the scalp), they're fairly widely used outside the U.S. The real hurdle right now is that the infrastructure doesn't exist in most infusion centers to accommodate cold caps, so you have to rent your own cap and haul in coolers to keep it cold. I believe within five to ten years as clinical data becomes available and infusion centers are built or remodeled, they will be set up to provide for cold caps, and chemo-associated hair loss will be a thing of the past. Of course, as more targeted therapies emerge, the current nuke-it-all chemo approach will wane as well.

Recent article on cold caps: http://www.seattlepi.com/news/medical/article/Cold-caps-tested-to-prevent-hair-loss-during-chemo-4678788.

Friday, July 26, 2013

I have breast cancer

Dear friends and family,
I've decided with some trepidation to start this blog, a highly public act for someone with fantasies of privacy that seem to run contrary to my fundamental sharing nature. In any case, this seems like a more efficient way to share what's going on with me than writing a zillion emails.

Last month I found a lump in my right armpit, assumed it was nothing, but follow-up mammogram indicated cancer and subsequent biopsy in Seattle confirmed it. Here are the basics:

-I have infiltrating ductal carcinoma, the most common breast cancer, most likely stage 3 (for the cancer wonks, staging and TNM won't be definitively determined until surgery).

-Treatment plan calls for chemotherapy (started two weeks ago, hair is beginning to fall out...), followed by mastectomy and axillary dissection (removal of cancerous lymph nodes in armpit), then radiation and long-term hormone therapy.

-I'm getting treatment at Swedish Cancer Institute and we're living on Bainbridge Island in the peaceful home of my sister-in-law and her husband, who have been incredibly generous and accommodating. I get to go to the hospital via ferry and foot, which is ideal for my psyche. And the school district is... well, let's just say it's the upside of the socioeconomic monoculture we've landed in. Sad to say, in this country high SES = good public schools.

So far I am feeling great. They force-feed you meds to combat the side effects of chemo and although the side-effect-fighting meds come with their own potential side effects, it's all been fine so far. Once I got out of my travel-diagnosis-moving-surgical procedures-and-naysaying nurses-induced doldrums and started running again last week, I started feeling better in every way.

I'll leave you with some pics. My luddite brain managed to upload them but they refuse to stay in the order I put them in! Oh well, consider this a work in progress. 

With love and gratitude,

Second infusion of adriamycin-cytoxan

The "red devil," aka adriamycin, which is so toxic it has to be injected by a nurse rather than by drip. The nurse actually buttoned her jacket to the top before administering it.

Alder at skateboard camp. Couldn't resist sharing this gem. 
Settled on this one. Libby says I look like Pat Benatar.

Wig shopping with Layla and Alder. This one did the best job capturing the general messiness of my hair but was too red and more compellingly, too expensive (my insurance wasn't impressed with the "cranial prosthesis" prescription the doc helpfully wrote.)
Me in my mom's hair! Alder was alarmed.