Wednesday, September 9, 2009

AC (Slater)

Another 2 updates in 2 days? What have you done to deserve this? Probably something quite bad.

Things I've learned since my last update.
1) My new chemo regimen is referred to as AC in cancer circles (As you know, I didn't just learn this, but I'm providing exposition). It's a drug combination which consists of something that starts with an A, which looks like red Kool-Aid that they inject with a syringe (i.e., not an IV, so I get to sit awkwardly while the nurse pushes the drug and try not to make creepy eye contact) into my port, and Cytoxan, which looks normal but has a particularly distressing name. This regimen was developed in like the 1930s (the nurse told me the exact date, but I mostly retained that it was old).

1.1) I like to envision people wearing fedoras and drinking martinis while listening to Glen Miller and Tommy Dorsey and getting their infusions, because apparently the 1930s through the early 1960s are pretty much the same to me.

1.2) Because of the change in drugs, I will not be getting Neupogen (which we knew) or Neulasta (which we didn't know). That means that during this first cycle in particular, I'll have no additional immune support and will be especially susceptible to infection. If you see me around and happen to be sick, please avoid me. I won't take it personally. I promise.

2) The Cytoxan is excreted through the urine in little grains, so if I don't drink enough water, I could pee sludge. Take the nausea you just experienced reading that sentence and multiply it times like a billion or so, and you'll have an idea of my current nausea. This is the definitely the more classic chemo experience (which makes sense given that the drugs essentially exist in a Raymond Chandler novel in my imagination), and I feel much more classically sick. I, however, am not feeling the same nerve pain, fatigue, or brain dysfunction that I usually feel on Day 1, though, so that's something. Plus, maybe the nausea will help me lose the 9 pounds I've gained since starting chemo.

2.1) If I may rant, WTF, Cancer? Chemo is supposed to leave me svelte and ready for the recently passed bathing suit season. I was expecting to not have to work to lose my wedding weight and now I have extra to lose? Why didn't I get the kind of cancer which makes the brochure on cancer nutrition ask, and I'm not making this up, "Have you considered adding whipped cream? " Yes, I have considered whipped cream, but now I'm stuck considering broccoli. I was robbed. Uncool, Cancer, uncool.

2.2) Lying on the couch complaining that you're dying is super fun when you have a cold, but it really loses something when you're feeling sick because you are actually fighting a deadly illness. It also kind of kills the joy of talking about how awesome my goth-themed funeral would be. Cancer, you ruin everything.

2.2.1) Please note: The awesome goth funeral does not depend on cause of death. I'm only talking about it less, because it's kind of morbid now. Also, if I do die of cancer or anything else, please make sure that my coffin has a giant sticker that says "NINJA DOWN" on it.

3) In order to soothe the sting of not being able to complain as much as I'd like while feeling sick, I've decided to be "strong." Actually being strong requires me to triumph in the face of adversity with little complaint. Being "strong" requires me to point out how strong I'm being when I do stuff like make a bowl of cereal. God help you all when I go to class tomorrow and take a quiz. That's like the "strongest" thing anyone with cancer has ever done. I'm like a regular freaking Lance Armstrong over here (with less juicing...sorry, I couldn't help it). I'm also going to get one of those yellow bracelets to point out how strong I'm living. (Is it bad karma to wear those ironically?)

4) Speaking of things that are fun for me and annoying for everyone else (i.e., everything I love), my friend Mike Batz made me these absolutely AMAZING actual cancer cards. They are seriously not to be believed in either their sheer awesomicity, creativity, or humor. Remind me to show them to you next time I see you. You won't regret it.

5) I will probably lose my remaining hair (referred to by my father as "a downy covering," referred to as me as a "badass chemohawk," and referred to by my friend Brendan, who is my new best friend ever, as "hot"). I really, really, really hope this happens on a weekday, because last time it was fascinating to watch. I'd love to be able to share it with friends and colleagues.

6) Since I've spent a good bit of this update talking about the negatives of cancer, I would like to point out a positive. It's allowed me to blur the line between the personal and professional, and develop personal relationships with people that would have otherwise been strictly professional. It has long been my belief that professional productivity and overall corporate culture is enhanced when co-workers view each other as friends and people, and I'm really thankful that I've gotten to see that side of people and share those sides of myself. Plus, it's been just wonderful to get to see how loving and supportive the people I work with are. I never expected anything less, but I've just been overwhelmed. (I've been overwhelmed by this in general and feel constantly blessed, but the professional support has made this whole adventure so much easier than it could have been otherwise.)

7) Shout out to my cousin Thistle who ran a race for me! You rule, This!

Okay, I'll shut up now. I fail to see how I can be so verbose in these updates and yet struggle to make length on every paper I've ever written. I fear that it may be that I love to talk about myself more than anything else, but let's just keep that between us.

Tuesday, September 8, 2009

So, I've rewritten this update like 3 times because it's kind of boring, but somehow I feel like you'll manage to slog through it. I guess sometimes cancer is just boring.

Time for the end of cycle update. I don't have too much to say about this cycle, so maybe somehow I'll manage to refrain from turning this into a novel. But, before we get into a discussion about chemo, I have two pieces of important news.

1) Both my medical oncologist and my surgical oncologist agree that my cancer has gone down a stage. While clinical staging studies can't be completed until after my surgery, at diagnosis I was somewhere in the Stage III range (there are 3 types of stage 3, and I was either B or C). Now, both doctors think I'm Stage II. The 5 year survival rate for people with Stage IIIC breast cancer is 54%. It's 86% for people with Stage II breast cancer. So, IN YOUR FACE, DEATH!

2) I finally got a cancer puppy! Don and I have been talking about getting a second dog since we decided to move to State College, but neither of us had the time to invest in a new dog. However, since I'm spending a lot more time at home and we have 3 people on deck, we decided the time was right. Also, the cancer card may have been played. At any rate, our puppy is a black lab/golden retriever mix named Beulah, and I'm completely head over heels in love.

So, chemo news. Much like last cycle, the overt side effects, such as mouth and nose sores, have been pretty mild. I've still been having some nosebleeds, but they haven't been too bad. I did get a pretty awesome gusher in the first meeting of my Neuroscience and Memory class, but it stopped pretty quickly, leaving a giant bloodstain on my pants as the only reminder. I also got to say, "Sorry to inconvenience you by getting cancer," which brightened my day.

However, less obvious side effects, like fatigue, have been worse. At my chemo appointment, I managed to convince my oncologist to prescribe low dose ritalin, as it's been shown to help with chemo brain and fatigue in some small sample studies. (Note: I feel my doctors both love and hate having a patient that reads the scientific literature.) I figured it might help, and if it didn't I could make a quick buck selling it to undergrads (this is a joke). It's actually been fairly effective, so I won't be able to buy that timeshare in Colombia quite yet.

One of the weird things about chemo is that it kind of changes assumptions I've had about the way my body functions. This has been particularly evident with the fatigue. For example, I've always been a terrible napper. Usually, I can't fall asleep during the day, and if I do, I can only sleep for 20 minutes or so. I also am typically incapable of sleeping in, so regardless of when I go to bed, I nearly always wake up around 7:30. However, since I started chemo, I'll lie down for a nap, thinking I'll get up in half an hour, and wake up 2 to 3 hours later. Also, for the first time in my life, I've been oversleeping. This sort of thing has been happening with food as well. Chemo increases your metabolic rate, but it changes over the course of the cycle. It also changes the hunger signals. As an adult, I've pretty much always had the same "food budget" (i.e., the number of calories I can eat to maintain my weight), and now I'm never quite sure how to manage my food intake. It's an odd feeling to have all of these changes, and I feel like I need to watch some of those "My body is changing" videos from middle school health class.

Speaking of body changes, I met with the surgical oncologist, and we've decided to go with a bilateral radical mastectomy. It's going to be radical! I'll probably have surgery in late December or early January, followed by 10 more chemo cycles (I only get these b/c of the clinical trial) that will run concurrent with radiation. Then I get another reconstruction surgery (most likely) and later a revision surgery (also most likely). After that, it's 5 to 7 years of hormone therapy and then I'm done!

Okay, I'm off to the hospital for my infusion. I get different drugs this time, so it will be a new adventure. Yay!

Monday, August 17, 2009

It's Chemo Eve again, and as I prepare for chemo day (by taking steroids), I am compelled to pause and reflect on the ups and downs of chemos passed and consider resolutions for the chemo to come. (This is a lie. This update follows much the same format as the others, with little to no actual insight into chemos past and future.)

This upcoming chemo is the last of the docetaxel/xeloda/avastin chemos, before I begin the AC chemos. This makes it the halfway point of my chemo treatment. You may remember from past updates, that xeloda is a pill that I take for 14 days following my (fragrant, refreshing) infusion. For those of you who have never had chemo (hopefully most of you), swallowing the chemo pill is a much different experience than swallowing a normal pill. For starters, it comes in a bottle that has giant yellow stickers that say "HAZARDOUS DRUG" all over it that make it hard to forget that it's essentially poison. Also, unlike other drugs, which are nearly always designed to make you feel better, you know that taking your chemo pill is just going to make you feel craptastic. Psychologists will enjoy thinking about all of the aversive training that I must ignore just to choke down the pill. So, after today that will be done, and I'm pretty excited about that.

I also believe that I will be able to switch from the neupogen shot to the neulasta shot. As I've complained about in some detail, I have to go to the hospital to get a neupogen shot every day for seven days after each infusion. It's a pain and the hospital never has current issues of People (although it did have a brochure about sexuality and chemotherapy that suggested trying leather play. WTF, brochure?). I only get the neulasta shot once, and although the bone pain is supposed to be worse, it will be mitigated by not having to read a 2 month old tribute to Michael Jackson (may he rest in peace).

In other chemo related news, astute readers will remember that I (love the phrase "astute readers" and) recently mentioned that this cycle has been both the easiest and the hardest. It's been hard because the fatigue and chemo brain have been a disaster lately. My cognitive function is so messed up that I argued at length about Michael Vick on an Internet forum. Even my cat (the dumb one) knows better than to argue with Internet goons. Only stupid people without the sense that God gave a banana debate on the Internet, and yet, here I am, an over educated Ph.D. student, making a rookie mistake. What's wrong with me? (Oh yeah, cancer.) Hopefully, my doctor will recognize this as the colossal problem that it is and suggest a medical therapy (there is some evidence that ADD/ADHD drugs provide relief since the main symptoms of chemo brain are difficulty focusing and mental fatigue, both of which are common symptoms of ADD/ADHD).

On the flip side, this cycle has been great because, despite the nosebleed I fondly refer to as Old Faithful, I didn't have a lot of gross side effects. My mouth stayed healthy, and my nose seemed to move straight past sores and right on to bleeding (which, honestly, I prefer). The nausea was well controlled with my anti-nausea meds, because apparently, it helps if you take it before the nausea kicks in. Who knew? It's like all of the normal painful side effects were combined into 3 hours of utter annoyance. Again, I think I prefer that. Plus, I get to use a lot of expletives in my update e-mail, and cursing is one of my favorite hobbies (sorry, Mom and Dad).

I also wanted to mention that tomorrow I'm eating lunch with Bird (shout out!), the med student who sat with me while I waited to get my biopsies and then got said biopsies after the doctor told me I probably had cancer. I hadn't brought anyone to the appointment, because I'd been told previously that the lump was nothing and I didn't want to make a big deal of it. Even though, as a grad student, I can appreciate how precious time can be for a med student, she did a wonderful, humanitarian thing. It's the kind of thing that makes you glad that someone is becoming a doctor, and I think any one of you would be blessed to be in her care. She is also super, duper cool, and I can't wait to see her!

And finally, I can't even begin to describe how excited I am that school is starting up again. I'm looking forward to having some structure back in my life. I've been noticeably absent from the monkey lab much of the time, because I get pretty anxious about not having my wits about me when working with captive animals that have opposable thumbs and are about a billion times more agile than I am. So, the prospect of intellectual stimulation in a structured environment with all of my friends that involves sitting down, talking, and very few scenarios in which monkeys could die rules my world right now. I imagine professors are less thrilled about a bald girl nearly giving herself a hernia trying to form a coherent thought, but I'm sure we'll all manage somehow.

And one last finally. I've gotten a lot of comments about the nature of my outlook on this whole cancer thing. After I was diagnosed, I did a fair amount of soul searching and came to some explicit conclusions and decisions about how I was going to look at this life event (one of which was to think of it as an adventure). Is this something that people would be interested in reading or is it strictly masturbatory? My feelings won't be hurt if you say the latter.

How do these updates always end up so epic? Post-chemo update and a picture of my chemo outfit to follow at some point. Also, check out my awesome chemohawk, the most subtle (subtlest? I don't know. DAMN YOU CHEMO BRAIN!) of the rebellious hairstyles.

Saturday, August 15, 2009

For those of you who are here from ONTD, the comments that I got on yesterday's FFAF post were so touching and kind that I've been getting misty all day thinking about them. You made a girl with cancer cry. I hope you're happy! (srsly u guise, I'm all warm and fuzzy from all of the support and when the Make A Wish Foundation realizes that its policies are ageist and they grant my wish of RPattz in my pants, I will make him hold up the biggest, sparkliest I <3 ONTD sign ever. I will also make him hold up a sign that says "Twilight, I did it for the lulz.")

For those of you who don't read ONTD, it is, without question, the best thing on the Internet. And no, I'm not forgetting about Snacks and Shit.

Friday, August 14, 2009

I've taken to not wearing a hat any time I'm indoors. It's more comfortable that way, and I also think it's more obvious that I've got cancer. The hats kind of have this, "She looks like she might have cancer, but I'm not quite sure," vibe. The bald head says, "Yeah. I have cancer. What of it?"

Today, I was walking down the hall by the lab, and this creepy old guy who likes to recite scripture ad nauseum points to my head and says, "Bald is beautiful, or at least that's what the bumper sticker tells me."

Well, you know what creepy old guy, I'm fucking beautiful now and I was fucking beautiful with hair. I don't need your patronizing, backhanded compliment to know I'm hot. Cancer does not change the fact that I'm beautiful and awesome and badass. It only changes the fact that douches like you feel the need to comment on it. Go DIA(hell)F.

In other news, I saw a shirt at Spencer's that said "Lost the hair, kept the big dick." That shirt and I need to be together.

Tuesday, August 11, 2009

You know, I've been waiting to use that Christian Bale freakout line (does everyone call it the Bale Out, or is that just an ONTD thing?) in real life for months. So, I guess I can thank cancer for that.

Monday, August 10, 2009

Just a few words about my friend, Cancer

Cancer wears a hemp necklace and a white baseball cap. Cancer's favorite band is Staind, but Cancer puts on John Mayer when he's feeling sexy. Cancer waxes his eyebrows and shaves his chest. It makes the Axe bodyspray stay on longer (Cancer likes the chocolate scent). Cancer drives a Toyota Celica but really wants a Jeep Wrangler. Cancer's favorite movie is Van Wilder and his favorite TV Show is American Dad. Cancer takes his dates out to Olive Garden, Outback if she's really special (where they split the chocolate thunder from down under). Cancer wishes Abercrombie stocked Ed Hardy t-shirts. Cancer thinks he can play guitar, but can only play Redemption Song. Cancer's favorite Red Hot Chili Pepper's song is Under the Bridge and thinks Anthony Kiedis has a killer bod.
I started writing an update on Saturday in which I rambled on about all of the cool things about having cancer and all of the other blessings in my life and then maybe some other things that kind of annoyed me about having cancer. Well, I've scrapped that update. Now you get this one. And let me just start out by saying, this isn't going to be one of those "ha ha! Cancer is the best" updates or even one of those "look at that crazy thing cancer did to me" updates. Instead, this is going to be a bitchy, cranky, salty (I drop the F bomb a lot, consider the cancer card pulled) update about how I'm over this whole having cancer thing. Put your reading glasses on now, because it's going to be a doozy.

I'll start by telling you something awesome about my dad. In addition to being a former beer columnist and a longtime soccer player, my dad has played bass guitar in some band or other since long before I was born. Occasionally, he gets the band he played with in college, Waterfall, back together. They play pretty much the same set list they played at William and Mary in the 60s (read: lots of classic rock), and it's as rockin' and fantastic and tie-dyed as you're imagining.

Well, Waterfall played yesterday at the Watermelon Festival in Richmond, and I was supposed to go with Cassie to see them. But, when I woke up on Saturday morning, I felt like I might be getting a little sick. Did I actually feel sick? No. I just felt like I might potentially get sick. And that was enough to make me not go and risk my favorite daughter status (which I must say is a result of my current health condition). Before cancer, if I got sick in Richmond, I slept a little more and maybe took some Sudafed, and got over it. Now, if I get sick, I have to go to the hospital to get IV drugs, and while I'm sure the hospital in Richmond has the same trashy TV shows as the hospitals here, I'd rather be hospitalized near home. So, F.U. cancer #1: Fuck you cancer, for making my immune system so shitty that I skipped my dad's awesome band gig, because I thought there was a slight chance I'd get sick. Note: I never actually got sick.

Cassie, however, tried to worm her way into the favorite daughter position (nice try, Cass) by going to Richmond alone with the intent of returning Monday evening. Don, bacon supplier that he is, had to drive to Fort Belvoir for work Monday morning. That would have left me alone for a total of 8ish hours. No sweat, right? I'm an independent adult. Surely, I can handle 8 hours of me time. But, since this is the "go blow yourself, cancer" update, you know that is not what happened. Instead, 3 minutes before Don was supposed to leave, blood started shooting out of my nose as if I was an extra in Tarantino flick. I honestly think that if I hadn't been trying to staunch the flow, the blood would have arced out of my nose. The force was that great. I continued to bleed, albeit less dramatically, for the next 3 hours, necessitating a trip to get blood work to make sure I wouldn't need a platelet infusion. Since I can't shift gears, steer, and hold a tissue up to my nose at the same time, Don had to delay his work trip to drive my sorry ass to the doctor's office. So, F. U. cancer # 2: Fuck you cancer, for making a little nosebleed potentially life threatening, and while we're at it, F. U. cancer #3: Fuck you cancer, for making Don late to his work thing. Note: The blood work came back fine.

As a result of this snafu, Don, Cassie, and I decided that I am not allowed to be left alone anymore, not even for 8 hours. So, F. U. cancer # 4: Fuck you cancer, for making me feel like a freaking 2 year old who needs a baby sitter.

To add just a touch more drama to the nosebleed story, I'll supply some extra background about my life. Before this whole cancer drama started, I was supposed to be helping my beloved lab mate, Katie, run the monkey lab. Running the lab consists of running research trials (all behavioral, enriching, non-invasive trials, of course) and monkey husbandry. The research trials are flexible in terms of when we run them, as is some of the monkey husbandry. Some of the husbandry, such as weighing the monkeys, however, should happen every day, but missing a day isn't the end of the world. And then some husbandry, such as medicating any sick monkeys, is inflexible.

Since I seem to spend quite a bit of my time going to doctor's appointments, sleeping off chemo, or percoceting the bone pain away (monkeys + narcotics = a great idea for a movie, but a bad idea for real life), poor Katie has been running the lab singlehandedly while also trying to write and propose her masters. So, when she wanted to take some much needed and deserved vacation time during one of my Week 3s, and asked if I could fill in for her, I said, "Don't worry your pretty little head about it. Everything will be fine." But, everything was not fine. Even though my nosebleed finally stopped after 3 hours, if a drop of blood passes these nostrils for the rest of the day, my oncologist advised me to Stop! Do Not Pass Go! and head to the E.R. asap. Things that tend to make nosebleeds start up: bending over and lifting things. Things that happen as a routine part of monkey care: bending over and lifting things. Biohazards that should never be part of an animal care routine: bleeding on the animals. So, F.U. cancer #5: Fuck you cancer, for making me completely unreliable. And, F.U. cancer #6: Fuck you cancer, for interfering with my monkey care. And finally, F.U. cancer #7: Fuck you cancer, for making Katie feel like she doesn't have backup when she needs it. Note: the monkey got medication but no one got weighed.

Also F. U. cancer for making my nose hurt from the nosebleeds, for making pizza and grapes and Taco Bell and soda taste gross, for making my parents worry about me all of the time, for making me look like a vampire every time I floss my teeth, and for making me stupid in the brain. As far as I'm concerned, Cancer, you and I are fucking done professionally (please tell me someone gets this reference).

Sunday, August 2, 2009

What? 2 updates in 2 days? You better believe it!

And now, a continuation of the weeks of chemo. When we left our description of chemo, I was expounding on the gross things that seem to surface during Week 2. But all Week 2's must come to an end and give way to Week 3's.

Oh Week 3, the sweetest of all of the weeks. How I wish I was living in Week 3 right now! Gone are the nose sores and fungal mouth of Week 2. The nausea and fatigue of Week 1 is but a distant, ethereal memory. Week 3 rides in as if on a breath of fragrant Spring air, fresh and rejuvenating, ready to lift me to new heights of wellness.

In all seriousness (ha! like I can be serious), Week 3 is the BEST! WEEK! EVER! I've plowed through the white blood cell nadir of Week 2 and have regained a healthy immune system. I've stopped taking my chemo pills and have managed to excrete any infusion remnants. My bone pain has subsided, and I've slept off my percocet hangover (I like to picture this like something out of a drug movie, with puking and sweating, but it's just a long nap). Thinking no longer feels like trying to push a watermelon through the eye of a needle. In short, I'm pretty normal and healthy.

But the best thing about Week 3 is that I am not only normal and healthy, but that I'm in a position to compare that normal, healthy feeling to the rest of chemo. So, while I am really just regular HM, compared to the HM of weeks 1 and 2, I feel like super HM. To illustrate how amazing this feeling is, here is a list of things that I have resolved, in all seriousness, to do during the last 2 Week 3's: train for a marathon, write my young adult novel (kids, this will happen, but probably not during chemo), learn to skateboard, go clubbing in NYC, etc. I feel peppy and vibrant and inspired.

Unfortunately, Week 3 is followed shortly by another Week 1, but I'm encouraged by the fact that there will be a final Week 3, followed by no chemo. I'm hoping that going through chemo will prevent me from taking this feeling of vitality for granted, and that I'll have the perspective needed to really flourish once it's over. Then, I can become one of those people who gets really into the pink ribbons and starts talking about how cancer is the best thing to ever happen to me and living each day to the fullest. You'll love that.

Saturday, August 1, 2009

Update from the hinterlands of the chemofront (or something like that).

Whoa boy! This chemo has been both the easiest and hardest, and I shall wax poetic about both aspects now. To begin, some details of the infusion itself - The infusion happened in the brand new Cancer Institute building at Hershey, which is pretty nice. I think the word "infusion" needs to be stricken from the cancer lexicon, though, because I was hoping for a nice open room with lush plants and misters and tropical sounds and possibly a frozen fruity drink. Instead, I got some rooms with hospital chairs and nicer TVs. The actual infusion went fine except for the fact that, rather than run a Miami Social marathon, Bravo ran the last 5 minutes of an episode (I assume they ran the whole episode, but I only saw 5 minutes of it) before showing a boring movie. I'm going to write Bravo a nice letter with lots of exclamation points about how their schedule needs to show the trashiest TV when I'm infusing. Otherwise, the treatment was uneventful.

So, onto the easy aspects of this cycle - I've only had moderate fatigue and nausea. The nausea has been more nauseous (don't start with me, I have chemo brain), and less general stomach discomfort. This is actually good because I have meds to take care of the nausea (which, if you remember, also make me more social and attractive), whereas I have no meds for overall stomach ick. I also have had very little mouth pain and my nose seems to be doing okay so far. So, easy peasy on those fronts.

The harder aspects - As may be evident from this update, the chemo brain killed me this time. I'm starting to come out of it a little bit, but I've felt like a freaking vegetable. Actually, that's insulting to vegetables. I've basically been on communication lock-down, refusing to answer e-mails, the phone, or texts unless they are from someone who doesn't expect me to make sense in the first place (you know who you are). For some reason, the percocet has also been hitting me harder, which makes me even dumber. It's a one-two punch of stupid. I'm hoping that by the middle of next week, I'll be sharp again. Regardless, this is going to make for an interesting Fall semester!

And of course, the real news that everyone is waiting for - My tumor is down from 5.5 cm to 3 cm. The doctor didn't officially measure it (with her official measuring tape), but she did palpate and proclaim it around 3 cm. I will say that it used to feel like a D battery, and now it feels more like a gumball. If it continues to shrink at this rate, there may be no tumor left at surgery time, which is great prognosis-wise.

Soon to come - an update about what Week 3 of chemo is like and perhaps a soliloquy about my neupogen shots.