Thursday, September 25, 2008

1 down, 7 to go

It's official, the first round of chemo has been administered successfully. I feel pretty good all things considered. A little queasy and sweaty (it's hot here) but really, since I've been on so many pain meds for the fluid retention and surgical pain, it isn't fazing me too badly. I met a couple of really nice women in the treatment room, watched old videos of Ryan on our portable DVD player, and listened to the new Ali Farka Toure cd my excellent husband bought for me. We saw Dr. Yen before the treatment began so he could go over my finger stick/blood counts, examine me, and make sure I was fit to poison. He said I was good to go, so I sat in my lay-z-boy and took those toxic chemicals like a good girl. I know some of you might think that's terrible but dark humor is of great comfort to me-especially right now. Sometimes the only way I can maintain my positivity is by being a little caustic. It keeps me from biting everyone's heads off. And I have been told that you just get more irritable throughout treatment, especially since chemo usually throws you into early menopause, so I apologize in advance for any offenses.

Really though, positivity hasn't really been an issue for me. Sure I have my moments, but if you're reading this blog, you probably know me and realize I'm typically an optimistic and hopeful kind of girl. And I do have faith and believe that I am going to get through all this (after a dark and difficult road ;), but when I'm in pain, it's difficult to maintain any positivity. Having said that, it's been kind of a rough week. My port installation went fine but my shoulder was barking like a pack o' hounds. So badly that it sent me back to the surgeon to make sure nothing on the hardware of the port had migrated. If you want to see a picture of what a port looks like, go to this link:

http://www.bardaccess.com/port-arterial.php

So the doctor decided to perform an immediate ultrasound and then sent me across the street to the surgical center to get a chest xray. By the time I took the xray & walked back across the street to his office, the digital xrays were up on his computer monitor. So cool! Everything looked fine, I could see the port under the skin and the catheter that was threaded all they way through the vein, and after talking for a while about what I was doing for the pain, he determined I need to take more drugs...Go figure! The problem is that I'm a lightweight when it comes to pharmaceutical drugs so I tend to take less than the suggested dose. However, I'm learning that pain is a funny thing. If you stay on top of it, you can usually manage it better than if you let it go too long and try to "catch up" to it. So anyways, I was skipping my mid-day dose and was just kinda trying to ride on the coattail of my morning dose, and then taking one before bed. Apparently that wasn't such a good idea. I know now. They also say with chemo to take the anti-nausea meds even if I'm not feeling nauseous so any nausea can get nipped in the bud before it bothers me. The thing is, with the pain meds, it's hard for me to feel so out of it and foggy. I'm trying to feel as normal as possible, be Ryan's mom and Howie's wife on top of all this, and I feel like such a zombie when I'm on em. Having said that though, I realize I need to maybe meet them halfway on this one because when I'm in pain, I'm not myself. And if you're not yourself, you're really not there in the first place. So cliche, so sorry. So anyways, I'm going to try and be a good girl and take my medicine. And really, I saw the surgeon on Tuesday and the port feels significantly better yesterday and today. Well at least it did until they stuck a giant needle in to administer the chemo. But I am being prescribed a topical numbing medicine to help for next time, so I'm looking forward to that. As long as everything lines up and I don't have any adverse reactions, my blood counts look good, and I'm not sick, next time will be 3 Thursdays from today.

I'm off to rest and try take a pill. Thanks for reading and commenting and for being out there for me/us. My love follows you all.

Oh, be sure to check our our Puggle Jojo in her diaper & collar (which she only wears when she's inside and has free reign of the house). Poor girl, she's so over it! But then again, so are we!

Friday, September 19, 2008

The trick, it seems, is to surrender to the flow...

You know what they say about the best laid plans....

We spent the time since the previous post doing all those things we talked about last week. A deep cleaning at the dentist, an annual at the OBGYN (her ovaries look clean but her doc did recommend they be taken out when she does her reconstructive surgery), a chemo 101 class, and lots of other random errands. And then Deb cut her hair - check the photos to the left if you haven't already. She brought Ryan with so the new look wouldn't be a shock and everyone's happy with the results. New sassy short hair Deb. Ryan's running around telling anyone who'll listen, "mama. cut. hair. bye-bye hair."

If you didn't already know, our little girl turned 2 this past Saturday. Can you freakin believe she's 2? Neither can we. The birthday party was a blast. It's so much fun to celebrate with so many fun people. Great company, great food, great beverages. These 2-year old parties are setting the bar pretty high for next year ;) Plus, Papa K and Grandma were here to share the day.

So, this week's been admittedly hectic. Michele and Will arrived just in time for the party last Saturday and have been (thankfully) staying with us since. I'm really getting used to having extra sets of hands as well as good friends to share the occasional "down time". To be honest, Deb would not have been able to get everything she got done last week etc., w/out all the help we've been getting. Our support network here in town, and from the out-of-towners has absolutely made us feel the love.

Medically, here's what's happening...We went yesterday morning to get a port installed under Deb's left collarbone. This is for administering the chemo treatments without having to insert an IV for each treatment. Deb's got crappy veins so the port will help to not make her feel like such a pincushion. It's a fairly common procedure recommended for those who will be enduring any long-term chemotherapy. Anyways, we were being "inserted" into the surgeon's schedule so that we could make it across the street to Deb's first chemo treatment that same morning. We got there at 7:30am only to be told that they didn't have any paperwork on us and that we weren't on the surgery schedule. The surgeon felt horrible and assured us that this was the first time in 20 years his staff "forgot" to schedule a surgery. But, after a pretty minor delay we were admitted and began the pre-op stuff, and then Deb underwent the procedure under general anesthesia and came out the other side just fine. A little drugged, loopy, and out of it but fine. The Sutter Surgery and Maternity Center here in Santa Cruz seems like a top notch place. Really cool nurses. Also very clean and modern with a really friendly staff. 2 complaints to keep it real: no wi-fi and pretty lame cafe. I submitted a comment card about the wi-fi but let the cafe slide since I found $5 on the ground - I figured the sandwich was free anyway...

The port installation went well but we were unable to start chemo. Apparently Deb needs a baseline echocardiogram prior to starting chemo, but there was a misunderstanding/miscommunication and it didn't get done. Some of the meds Deb'll be getting have slight risk of heart issues, so they'll be monitoring that (among other things; blood counts, etc.) throughout the duration of the treatment. We met with Dr. Yen anyways and he was able to clear up a few questions of ours. He's just a really good guy, and absolutely takes the time to help us understand what's going on. He always listens and answers all of our questions with such patience. I also had a chance to meet Kendra, the chemo nurse, and both Deb and I are already very fond of her. A sweet, kind and friendly woman was my first impression. We're realizing that it takes a special brand of human being to work with cancer patients.

We've been fortunate during this time of unfortune with regards to our doctors and nurses. Rebekah, Dr. Chow and Dr. Wapnir up at Stanford were/are awesome. Our team down here is equally as comforting.

The plan as it stands is that Deb will have the echo on Monday afternoon and her first chemo treatment will be this upcoming Thursday. Deb's really sore from having the port installed and still has fluid building up in her chest, so she hasn't been online long enough to do more than post those few new photos here on the blog and edit this post; but she's doing well and is in good spirits - we're both just anxious to get going on this next step of treatment, if only to be beyond it sooner.

We're trying to go with the flow and not get hung up on stupid scheduling issues - like the scheduling mishap that happened with our dog JoJo. Due to another miscommunication (I swear it wasn't my fault), she went into heat the day before her appointment to be spayed. I'll have to post a photo of the puggle with her e-collar and diaper. Another bright side to a lame situation; both Jojo and Ryan wear the same size diaper; though Jojo's needs a hole cut for her tail ;-)

Besides that, life goes on. It's good to be together as a family and here at home in such a lovely place. There are just too many good things to dwell on those things that are less than good. So, we go with the flow. In the face of suckiness, we will prevail!

Thursday, September 11, 2008

High Risk but Not Complicated

Good day good people...

We are up at Stanford right now waiting to have some fluid drained. Yesterday we met with Oncologist, Dr. Yen, to discuss Deb's pathology and his proposed treatment.

Due to the size and rapid growth of Deb's tumor and the fact that lymph nodes are involved, the treatment, according to Dr. Yen, will be "tough, but tolerable". He wants to attack it aggressively and quickly. It looks like chemotherapy treatments will begin next Thursday. Deb will receive chemo treatments in 2 phases; every 3 weeks for 4 times for the first round and then another type of chemo 4 times every 3 weeks to be followed by hormone treatments. After chemo treatments will be Radiation. Needless to say, the treatments will likely last between 8 months and a year.

So, before treatment begins, we need to:
1. Take care of this ceroma (fluid build up). That'll get done today and is the reason I'm typing this at Stanford. After that, today we'll also be measured by "Vic" for a clinical study on Lymphodema, for which she's been measured once before. This is just arm measurements to detect potential Lymphodema early.
2. Install a port for the chemo treatment. We got a call this morning from a Dr. David Rose in Santa Cruz and we'll go meet him tomorrow afternoon at 4pm.
3. Haircut - so as to avoid large clumps of long hair falling out and for a (hopefully) easier visual transition for Ryan; who will go with Deb to see the hair being cut.
4. Manicure/Pedicure -- a girl's gotta pamper herself, right? No, seriously, it's a good idea to take care of this before treatments begin to avoid potential infection.
5. Dentist - again, due to the bacteria that's released during regular teeth cleanings, it's advised to do this prior to treatment.

Staring towards the future, knowing that there's a long, tough fight ahead of us is daunting, but we're anxious to begin if only to move past this and get back to the life we know and love. Dr. Yen makes no promises or guarantees, but is reassuring in his acknowledgement of Deb's determination and attitude. When he said that people like her are the reason he went into Oncology it made both of us a little more comfortable with a situation that is so far from comforting.

So that's the news that's fit to print right now. The way things are progressing and developing I'm sure there'll be more to tell soon, but for now, I think that's about it.

Grandma and Papa K should be "Working on a T-bone steak a la carte, Flying over to the golden state" (well, except for the T-bone steak part). We're hoping that we'll be able to make it home before they do, but with the length of our wait here (so far), they might beat us back there. Either way, it'll be really nice to spend some time with them and get to watch them discover their grand-daughter's personality more in person.

Nothing like "waiting" in a "waiting room". Good thing for wi-fi, cell phones, trashy magazines and coffee :)

Thanks again to you all for the tremendous amount of support and food and good vibes - it all contributes to this palpable amount of love that we're feeling and soaking up. You are all incredible people and we value you so much more than words in a blog can communicate.

~Howie

Saturday, September 6, 2008

What's up with those Finfers?

First and foremost...apologies for not updating this earlier.
Second and nextmost...here's how it looks from here:

We went up to Stanford this past Thursday, September 4th.
Dr. Wapnir, who performed Deb's surgery went on vacation, so we were meeting with her "fellow," Dr. Chow, (who also helped perform the surgery) - who both Deb and I totally dig. Very easy to talk with, which is always a benefit for anyone in the medical profession, let alone a surgeon. Dr. Chow said Deb is healing well and removed her drains. This news came with great relief, until she actually removed the 1st drain. In Deb's words, if she didn't like her (Dr. Chow) so much, she would have hit her. Fortunately, the remaining 2 drains were removed without incident as well. That should alleviate some of Deb's discomfort...

So, now that that was taken care of, on to how Deb's doing in general. That discussion resulted in a slight tweak of the meds Deb's been prescribed and we're hoping that the Percocet treats her better than the Vicodin. Deb is also very fond of the valium. ;)

Next was the initial pathology from the surgery. The finalized version should hopefully be completed in time for our Wednesday visit with Dr. Yen (Oncologist, in Santa Cruz). The tumor was bigger than anyone hoped or expected (except for Deb, who hit it spot on from our first appointments when asked how big she thought it was)anyhow, the tumor came in at 5 1/2 cm. 24 total lymph nodes were removed from her right armpit. Of those, 5 showed cancerous symptoms. We knew of 2 on the day of the surgery, and all that I'm reading tells me that your course of treatment will be the same if even a single node was found to have the characteristics. The thing is, once cancer is found in lymph nodes, the next question that gets asked is, "where did it go from there?" and that's the real question. Dr. Yen will help us try to find that answer. So we're looking at more tests, scans, and the usual annoying path to discovery on these types of things. The course of treatment is also still to be determined, but after speaking with the surgeon and nurses at Stanford, and speaking with Dr. Yen on the phone yesterday afternoon, in addition to the series of scans to see if we can't figure out where, if anywhere, this cancer has spread, a course of chemotherapy will be followed by radiation. Treatment can't begin until Deb's healed from the surgery (which takes about 4 weeks on average or 3 weeks from now +/-). That's the end of September if my counting is right.

So that's about what we know now. Next, as I mentioned, will be to meet with Dr. Yen on Wednesday to go over the full pathology report and begin developing our plan to get Deb healthy again.

Meanwhile, back at the ranch....
Wendy went back to Eureka and it was kind of scary to watch her go. We SO SO SO appreciate that she put her life on hold to come and help with ours. Grateful doesn't quite sum it up.

Mike has been stepping into the role of "toddler caretaker" very gracefully. Ryan has what seems to be a crush on Mike. In fact, after Mike helped me get Ryan into the bath the other night and left just Ryan blurted out "Love Mike". I swear it was the first time I've ever heard her use the "L" word. She's signed it before, but the first verbal use was directed towards him. Gotta love that.

The food continues to roll in. Have I mentioned the food? Personally, and familially speaking, we're just blown away by people's generosity. I could individually list, but you all know who you are and how you have such special delicious places in our hearts.

But, the question on all of our minds, "How's Deb?"...here's my take on "how Deb is":
Deb's fine. She's sore and in some discomfort and on meds still (they make her high) and tired after she does stuff, but she's Deb. She's in good spirits and just trying to gain some sense of normalcy given how abnormal everything has been around her and around here. Basically, it sucks. Cancer sucks. We're just going day by day, trying to have as much fun as possible, which is very real and very normal for people like us.

So you all know, Deb really wanted to write this herself and will read every word of this before you do and I know she just really wants everyone to know how much she appreciates each and every one of you. Your love, support, generosity, friendship and willingness to listen mean so much to her, Ryan and me.

In our continued effort to stay distracted and busy, we'll be hosting Granmda and Papa K starting Thursday and I can't wait for them to hear Ry belt out "Pop K" -- pretty cute stuff. On Saturday the 13th we'll all be here to celebrate Ryan's 2 year birthday and we can't wait!

That's about it for now.
With much love from Sunny (and hot) Santa Cruz,
Howie (& Deb)

Wednesday, September 3, 2008

Post-Op appt scheduled for tomorrow...

Hey All,

Apparently, in my drug-induced haze, I was incorrect about my post-op appointment being today. It is in fact tomorrow (Thurs) at 10am. I believe, in addition to receiving the pathology results, I am hopeful my drains will also be removed. At least I hope so. Just wanted to let you know.

Love You All,
Deb

Tuesday, September 2, 2008

Tuesday AM Update...

I'm sorry it's taken me so long to post again. Recovery has been exhausting,a bit painful, and I've been heavily drugged for the past several days. Not all bad but needless to say, I've been a bit foggy so I haven't been spending much time on the computer. Plus, when you've got 3 drains sticking out of your chest, holding your arms out to type ain't all that comfortable.

Mentally I'm great. From the moment I woke up in the operating room and fully woke up in the recovery room I was smiling and touching (or really more like petting) people and thanking them for waking me up. I was just thrilled to have made it through the surgery. And I didn't think I was all that nervous to be going under but apparently my subconscious was reacting differently.

Emotionally I'm doing pretty well too. It's a weird thing to see giant divots or gaps in your chest where your breasts used to be but then again, I kinda knew what to expect having seen my mom after her mastectomies. I feel a lot worse for Howie and Ryan because let's face it, my body is drastically different and it's shocking to say the least.

Physically I'm getting better and less sore every day. The drugs help. I'm finding that I need to stay on top of them, especially the Valium (muscle relaxer) so that I'm not holding myself so tense. The Vicodin just kinda puts me in a perma-fog but that's ok too since I'm a happy foggy-drugged-girl. I'm a bit swollen and the drains kinda hurt but Wendy and I are getting pretty good at dressing changes, and we don't believe any of my incision and/or drain entries are infected. I have a post-op follow-up visit tomorrow.

The hardest part about all this has been how difficult it has been on Howie and Ryan. Ryan wants me to pick her up, and I'm just not physically able to do that, so that's been really hard on us both. Luckily we are well versed in the art of toddler distraction and I've been able (most of the time anyways) to just take her by the hand and lead her over to the couch, which she can climb up herself, and hold her up there. As for Howie, well, he wants to be able to do everything for me and be in 6 places at once...holding my hand, playing with Ryan, working, cooking, cleaning, folding the laundry, paying the bills etc., but there is only so much he can do and only so many places he can be at one time. Thank goodness for Wendy(a.k.a. Woo) stepping in. She honestly has been a godsend. There are only so many people you can ask to put their lives on hold for you and she has stepped up BIG-TIME. Plus, Ryan adores her. I don't know what we would have done w/o her.

It's been really hard not sleeping with Ryan. We've thrown so much at her these last few weeks and honestly, not only was I not ready to wean Ryan, I also wasn't ready to stop sleeping with her. We're a co-sleeping family but with the surgery, I couldn't risk having her flop onto my chest in the middle of the night so we've had to move her to another room. She's less than thrilled to say the least, and has been getting up extra early to rub it in. She is, for the most part, sleeping through the night but still getting up in the 5'o'clock hour so I'm not sure that counts. She's also more easily frustrated but that could be due to the fact that she's almost 2.

So, many of you have been asking what's next? Well, we're wondering the same thing. At this point we're hung up on the pathology. We have to wait to find out whether or not they got it all, and if not, how and when do we find out where else is has spread? Let's say they did get it all, well, then we'll need to figure out what further treatment I'll need. Given that the cancer did spread past the tumor, it's likely I'll need some chemo and possibly some radiation as well. If the cancer has spread past the lymph nodes, then we need to go look for it via cat scans, blood tests and more crappy doctor visits. So keep your fingers (and maybe some toes) crossed that they got it all. On the whole, I still feel good and positive and ready to take whatever comes next. I'm still not ready to leave my life and/or all of you. I want more time and more love and more life.

I also just need to say a G I A N T thank you to all my friends who have been dropping meals off for us. I can't tell you what a huge relief it is to not have to think about cooking and/or feeding my family right now. You all have gone above and beyond and I thank you from the bottom of my heart.

So that's it for now. I'm going to go get dressed and go to the park with my daughter (and Wendy) and resume some semblance of a normal life. But if you think about it, while none of this is "normal," 1 in 8 women face this disease (and treatment) so I really do appreciate the fact that I am not alone in this. That and knowing all of you are out there and pulling for me. And I know I've said it before but it needs to be said again; I've never felt more loved or more supported. So thank you for reading this, for being there, and for all your love and support.

Love,
Deb