Thursday, August 6, 2015

Radiation Oncologist

On Wednesday morning, I had my first appointment with a radiation oncologist.  This was something completely new to me, as I never went the radiation route the first time around.

After turning in the small novel of paperwork, I met the wonderful nurses, who were very sweet and personable.  The doctor was also kind.  However, the PET scan report wasn't in, so I was disappointed with the overall appointment.  I felt like it was almost a waste of time because I don't know much more than I did last week without the report from the latest scan.

We talked about plans in probabilities.  IF the cancer is just in my bones, it's something that is quite frequent, and they deal with it all the time.  MOST LIKELY I will have localized radiation for 3-4 weeks, 5 days a week, but that depends on the findings from the report.  More than likely, I won't have too many negative side effects from the radiation.  My skin will have minimal damage, and most people only complain of fatigue.  IF cancer is all over my body, radiation isn't as effective.  They are most effective in localization, and he predicts they will focus on my back--around the areas in my Thoracic that are also the sites of my fractures.  This will help with pain and also on prevention of the spread of cancer and on preventing further potential fractures.  

He suggested that I see a neurosurgeon for a consultation on possible bone strengthening measures.  This is contradictory to what my pain doc said about his discussion with the head radiologist who compiled the report on my MRI.

 I was able to see the pictures from my MRI, especially the large, dark, cancerous spots on the vertebrae with fractures.  Again, I kept thinking about how thankful I am that I fell and was able to catch this before it got completely out of control.

Overall, I came away with the feeling of needing more--more information, more answers, more of a plan.  It looks like I will have to wait.


PET Scan

Often getting an IV is the worst part of any medical procedure.  This was true, once again, for the PET scan I had on Tuesday.  I warned the tech that I am a hard stick.  Either she didn't believe me or thought her skills were that good.  She stuck me and dug around until she got it.  Then, when she tried to push that lovely radioactive tracer into my vein, it blew.  Try #2 on the other arm failed miserably.  "Have you had anything to drink today? That could be why your veins are being to difficult."  {Well, aren't you used to that, since in order to prepare for this scan, I wasn't able to eat or drink for 6 hours prior? Duh!}  Thankfully, she called in reinforcements, and I finally was able to be radioactive once again.

After the injection, I had to sit in a chair and wait for my entire body to absorb the tracer.  After a 45 minute nap, it was time to move to to the machine.  First, I was scanned with my arms above my head, then with my hands down by my sides.  The total scan was about 25 minutes of lying still in a cold room, listening to the hum of the machine.  Another quick nap, and I was ready to go.

On the way out, the 2nd tech was very comforting.  She apologized for things not going smoothly, but I assured her that it wasn't just them--I'm used to it happening!  I was told to not hug my babies and to keep them a few feet away from me for the rest of the day to prevent my radioactive state from passing on to them.  That was another reason to be grateful that the boys are away at Summer Camp Midland.

Now to just wait for the results to help us make a battle plan!

Tuesday, August 4, 2015

Angels Among Us

Many of the tender mercies we receive are because of the kindness of others.  Already I have been so blessed by the outpouring of love from those close to me, but am constantly amazed at the way that trials and suffering can connect us, even when we are strangers.  Our experiences do not have to be exactly the same for us to learn empathy and to mourn with those who mourn and comfort those who stand in need of comfort.

This box of "happy thoughts" was placed up in my closet when I heard those amazing words---"You're Cancer FREE!" last year.  I had kept it open as a place to keep all the cards and kind words of encouragement when I was fighting the first round.  I pulled it out again and have already added more cards and uplifting words.  Thank you to those friends that have offered uplifting words and to the anonymous letter from a caring 9 yr-old.  I have a feeling I'm going to need a bigger box!



We experienced the first of what I'm sure will be many blessings from the kindness of strangers last weekend.  On Saturday night, Stephen and I were able to got out on a date.  We went to a movie and zoned out.  It was much easier to get lost in the tension of whether or not Ethan Hunt will complete another impossible mission rather than focusing on cancer.  Afterwards, we went to the Outback to get a few appetizers and talk.  Of course, we were crying over our wings and tuna.....and cheese fries, coconut shrimp, and Dr. Pepper.  (I have cancer......do I REALLY need to go without fatty foods and my favorite soda?)  It started to get late, and I think our server was ready to close out her section and go home.  She kept coming by to ask if we were alright (not really) or needed anything else (a new body?).  I joked that everyone must think we are breaking up!  She brought the check and came by a few times, saying she could take it whenever we were ready (hint, hint....give me the check so I can go home!!) A few minutes later, she returned, put down a ripped up credit card receipt and this note:


Stephen had written a note with his tip, telling her sorry that we took so long and we were not trying to be rude, by we had just found out that I had stage 4 breast cancer.  She told us that she believed in the power of positive things and that here is one thing to get us started on the journey.  They comped our whole meal!  Thank you, Rachel F.  There is still good in the world!  I tell you, this cancer thing is far-reaching.  It allows us to be angels on earth and lift others in their times of need.

To those of you who have already given so much of your time, love, and prayers, I thank you.  To those I don't know who have been touched by reading this blog and perhaps sending it on to others, I hope my journey of faith can help you find yours.  To those who will be following along or giving service in my name or for countless others, thank you.

There are miracles all around us!  

A Range of Emotions

I've been going through several steps of the grieving process for the last few days.  There was the initial shock/denial upon first hearing that the MRI found metastatic legions in addition to the fractures we were trying to find.  (This can't be!  How could this have happened?  Are you serious???)

I've been angry.

How in the world did my doctors miss this?  I did EVERYTHING I was supposed to do!!!!!  I even went BEYOND with further preventative measures than I HAD to do.  I had a bilateral mastectomy, which was supposed to give me a 98% removal of breast tissue and therefore a 98% chance that my breast cancer would not return.  I took Tamoxifen, even when I hated the side effects!  I stuck to my low-calorie diet almost religiously---Dr. Naqvi wanted me to only eat 1,000 calories/day, and I stayed around 1100.  I gave up sodas.  I started working out almost everyday.

How could ALL of those doctors missed this???  I've been to the ER 3 times in 2 months.  I've been in the hospital.  I've had ultrasounds, surgeries, follow-ups, assessments, and MY ONE-YEAR CANCER-FREE appointment!!!!  It took a FALL and a follow-up trip to a pain doctor for SOMEONE to suggest an MRI.  Shouldn't there have been red flags going off?  I have a history of breast cancer, for crying out loud!!!!  How did that CT scan I had in March not find ANY signs?   Why didn't anyone connect the dots that all of this pain---especially in someone who has a crazy high pain threshold---should set off alarms?

I feel frustrated that I have worked so hard to fight and become a survivor, only to have one good year  and have to start all over again.

I've been sad.  Mostly the sadness surrounds my family.  I don't want to leave them alone!  I have so much more that I want to do!  I want to teach my boys to be hard-working, honest, caring, considerate, kind, funny, intelligent young men.  I want to prepare them to go out into the world and do something great with their lives.  They are so young to be without a mom--so young that I'm afraid they will have no real memories of me as the years pass, only those fuzzy memories that are just from pictures and stories you've been told.  My boys need me!

I'm sad for Stephen.  How hard it is to be the spouse of a terminally ill person.  He wants to be supportive and helpful, but he needs support, too.  He's scared and angry and sad, too.  We have so many goals and dreams.  How will we fit a lifetime of experiences into such a short amount of time?  How will he find the time and energy to take over being both dad and mom?  How will he stay strong for the boys when he is alone and grieving?

After the tears stop, all these emotions go back to faith.  No one knows how much time they have left to live.  We don't even know the full scope of my disease.  I could live 5 years or perhaps up to 15, or much less.  At this point, we are all just guessing.  When it comes down to it, there are ways to make every moment--every second of every day count.  There are small miracles and silver linings in every day.  Instead of focusing on the anger and sadness, I am looking for the tender mercies.  I am understanding how little control we have over this thing we call time, and that all we can do is rely fully on the power of faith and the promise of our Savior that when we take his yoke upon us, there is nothing we can't bear.  

I also feel grateful and happy.  I am reminded of that feeling from my first diagnosis.  I was sad and angry and scared, but also felt peace and love.


Friends and family step up in times of great need.  I have an amazing support group, and I can see how that will only get stronger and larger as this journey continues.  How can I not feel blessed when I've already had so many acts of service and kindness and I've only been re-diagnosed for 5 days? It's an overwhelming outpouring of love, and I am so grateful.
 

I have not quite dipped into depression and am not yet trying to bargain with God, but I haven't reached a level of acceptance.  Yes, I have this.  No, I'm not happy about it.  I haven't yet cried all my tears, but I am going to fight with all I have to overcome this----AGAIN!  I keep trying to channel the strength and determination of this girl.  I did this once, and I can do it again!  Never give up.  Never stop improving!



P.S.  The first time around, I was driving home from one of the early appointments with my doctor and heard the song Try, by Pink.  That became a theme and an inspiration for my battle, to get up and keep trying.  Today, driving home I heard a song called Fight Song, by Rachel Platten.  I think that will be my battle cry for this time around.

The words are amazing, and the music is quite empowering.

Like a small boat
On the ocean
Sending big waves
Into motion
Like how a single word
Can make a heart open
I might only have one match
But I can make an explosion

And all those things I didn't say
Wrecking balls inside my brain
I will scream them loud tonight
Can you hear my voice this time?

This is my fight song
Take back my life song
Prove I'm alright song
My power's turned on
Starting right now I'll be strong
I'll play my fight song
And I don't really care if nobody else believes
'Cause I've still got a lot of fight left in me

Losing friends and I'm chasing sleep
Everybody's worried about me
In too deep
Say I'm in too deep (in too deep)
And it's been two years
I miss my home
But there's a fire burning in my bones
Still believe
Yeah, I still believe

And all those things I didn't say
Wrecking balls inside my brain
I will scream them loud tonight
Can you hear my voice this time?

This is my fight song
Take back my life song
Prove I'm alright song
My power's turned on
Starting right now I'll be strong
I'll play my fight song
And I don't really care if nobody else believes
'Cause I've still got a lot of fight left in me

A lot of fight left in me

Like a small boat
On the ocean
Sending big waves
Into motion
Like how a single word
Can make a heart open
I might only have one match
But I can make an explosion

This is my fight song (Hey!)
Take back my life song (Hey!)
Prove I'm alright song (Hey!)
My power's turned on
Starting right now I'll be strong (I'll be strong)
I'll play my fight song
And I don't really care if nobody else believes
'Cause I've still got a lot of fight left in me

Know I've still got a lot of fight left in me

Monday, August 3, 2015

The First Miracle

 I have never been more happy to hear that my brain is "unremarkable!"

We got the results of my CT scan on my brain today. 

Findings: ventricles have normal size and position. There is no evidence of mass, hemorrhage, or infarct. On the postcontrast study, no abnormal enhancement identified. 

This is the part that needs more clarification:

Small metastatic lesions may not be apparent by CT and if there is clinical concern of beau. Metastases, recommend MRI with and withou tgadolinium.


Review of bones of the calvarium show normally aerated paranasal sinuses and mastoid air cells. There is no evidence of lyric or blastocyst osseous process involving the bony calvarium. 

Impression: Unremarkable head CT


 I have the next test tomorrow, a PET scan of my full body to see if cancer is anywhere below my unremarkable head. 

Thank you for all the prayers, fasting, happy thoughts, and love. We have our first miracle, and there is no reason we can't hope for more!

Love you all!!





Friday, July 31, 2015

Brain Scan

I had a CAT scan of my brain today.   Too bad it was not this easy:




I was so grateful that Steve was able to watch the boys and Timee drove me down to the hospital.  Stephen was able to meet us there, since he got off work at around the same time.  Even though no one goes back to the room with me, it's always comforting knowing some of my peeps are there. 

This procedure was one of the easiest in the history of my cancer journey. I didn't have to drink that *delicious* chocolate shake and wait an hour for it to become effective. The rad tech was great, especially at IVs; It only took one try, with no digging and adjusting, and I didn't even feel it. That is a small miracle! Plus, the entire scan only took about 8 minutes!

First, I had to take my hair down and my cancer love necklace off. (I remembered not to wear my other jewelry and watch, but forgot about the metal in my hair pins and that tiny necklace.). I laid down on my back, which is actually painful these days, but the wedge pillow under my knees made it bearable. I had to be completely still, but only for 2-3 minutes at a time, which was a piece of cake compared to the 2 25-minute sessions of Monday's  MRI.  After the first set of pictures, the tech injected the contrast through my IV. It almost immediately causes a warm, tingling sensation, mostly around the pelvic region, making you feel like you have urinated on yourself!  After a few minutes, I was ready for the scan with contrast.  Another 2-3 minutes, and I was done.

It basically looked like this:



I tried to convince the tech to give me some sign--a wink or a hug? A thumbs up/down? A smile/frown?---but the results go through my referring doctor. I pleaded to know something, since my doctor is on vacation, and I don't want to have to wait 10 days for that information.  In a gesture of kindness, on the way out she did remind me that I can come in and pick up my own reports as early as Monday. She even walked me up to the front and found the paperwork I needed to fill out to allow myself or Stephen to pick up the full report.  Now, even though DR. Fleener won't be back for another week, I *might* have some connections in the medical field who can explain the radiologist's findings just as easily. 








What the.....?

I have been so busy with other things this summer that I didn't even post my results from the one-year follow-up with Dr. Naqvi.  I planned in my mind to have a fun photo shoot---my pink tutu and crown, lots of balloons and glitter, perhaps the pink boxing gloves--something great to commemorate making it to one-year cancer free.  I even talked to a local friend and started planning things.

Then, summer happened.

Stephen had scheduled surgery the last week of May.  I hadn't been feeling well for a few days, but figured it was something I ate or nerves.  Then, 5 days later I was up all night with crazy pain.  Went to the ER and discovered I had gall stones.  My labs were SO high---like 650 when it should be around 50.  It was laughable how crazy they were!  I had my gall bladder removed the next day, only to discover there were TWO stones blocking my bile duct, even though an ultrasound found none the night before.  I had another procedure the day after, and was on to recovery.....well....I thought I was.

I was due for my one-year follow up with Dr. Naqvi, so I had labs drawn and went.  She was NOT HAPPY about my gall bladder and insisted that she told me at our last appointment to schedule surgery so this very thing didn't happen.  My labs were still high.  In fact, one of the nurses saw them and asked if I got really drunk right before getting my blood work!  Other than getting scolded for not being proactive about my gallstones, they appointment went well, and I said my goodbyes.  (I had already planned on transferring to a local oncologist for ease after my one-year date.)  It was like closing a bad chapter of life.  

The following week, I threw my back out.  I couldn't remember how.   I just woke up one day, and it hurt to sit up in bed.  I couldn't bend over well, and walking tweaked it.  I just thought it was muscular because stretching and heat and ice seemed to ease the pain.  I had people from church help with cleaning and mowing the lawn, and felt better the next week. 

A few days after that, all the boys went into the doctor with ear infections, sinus infections, eye junk (we thought it was pink eye, but it wasn't) and sore throats.  Strep was making its way around the family, so we got them all on antibiotics.  At the end of that week, my throat started hurting, so I started taking some.    Instead of seeing improvements, I got significantly worse----crazy night sweats, fever/chills, no energy, back pain again.  I went back to the ER and they found I was dehydrated, had low potassium, and kindey and UTI infections.  I was told this was "probably" why my back was hurting and explained some other symptoms.

The infections cleared up, the skies quit raining all day/everyday, and we were finally able to swim!  Things were going well, and it was starting to feel like summer. 

I was able to transfer to a local oncologist and had my first appointment with her last week.  I loved her from the start, and came home feeling great about the decision.  She explained that there was research that for my type of cancer, Tamoxifen might only be as effective as losing even 10-15 pounds.  {I was only 5% ER+, which makes Tamoxifen about 3-4% effective, which isn't much, and research has showed that weight lose and exercise can have a 3-4% increase in preventing cancer's return.)  We didn't make any decisions, but it was refreshing to have a doctor who was willing to take my personal case by itself and figure out what was best FOR ME and not just stay exactly to the plan. 

Things were going well---we were all healthy, I was starting to get back on track, and we were able to plan a few activities.  Then, I slipped and fell coming inside from the pool and hurt my back---again!  Back to the ER for me, and I was diagnosed with an SI strain and told to see a pain specialist if it didn't improve in 5 days.  Thankfully, Stephen was able to contact a doctor in his group who squeezed me in for later that week.  I met with Dr. Owens, and he did an assessment.  After asking me questions and then examining me, he had some concerns.  My actual pain wasn't quite matching up with the diagnosis.  I had too many other factors going on and it didn't all match up.  I got a pain injection, and he ordered an MRI to further investigate some of the issues.

I had an MRI on Monday, July 27, 2 months after my one-year cancer date.  I found out yesterday--July 30---that the MRI showed a fracture, but more concerning---metastatic legions, most likely associated with my former breast cancer.  (From the radiology report:  "abnormal signal involving all visualized thoracic vertebrae (T1, T3, T6, T7, T8, T10, T11, T12. Findings would be concerning for diffuse metastatic disease to the thoracic spine.....abnormal mottled signal seen involving all visualized lumbar vertebra. Abnormal low T1 signal is seen involving L1, L4, L5, S1, and S2.  There is abnormal mottled signal in the other visualized vertebral bodies.  Images through the sacrum show abnormal signal involving the posterior right ilium, which is worrisome for metastatic legion.  Diffuse metastatic disease is suspected.  Recommend further evaluation with bone scan to assess the entire skeletal system.)

Dr. Owens was able to contact Dr. Fleener, my new oncologist, and squeeze me in---barely.  I was her VERY last appointment of the day, since she was leaving on vacation.  I had 15 minutes with her, which was only enough to scrape the surface.  We still don't know a lot, only that it's back.  She couldn't believe I was walking around with this because I must be in terrible pain all the time.  She said I was either amazing tough or had a crazy-high pain tolerance.  She scheduled a brain CT, a PET scan, and meeting with radiation to get more information.  All this is happening in the next few days.
 I asked, "how could this have happened?  Why didn't this show up with my labs, which I JUST had 2 months ago?  Or on the CT scan I JUST had in March?"  She said she didn't think this was something that has been going on for 6 months---probably just a few months.  (I would have to have a super aggressive cancer.)  And, unfortunately, some of the same markers for this kind of cancer are also the same markers which are elevated with gall bladder issues.  So.......since I HAD gallbladder issues right before my last appointment, that made sense and no further testing was done.

Like I have learned to do,  I am looking for silver linings in this.  I am glad I slipped and fell because without that, I might have waited even longer to see a doctor.  That significant injury led me to have a valid excuse for an MRI.  Also, I'm SO grateful that I was already in Dr. Fleener's system.  If I hadn't already transferred my records, I WOULD NOT have been able to get in yesterday, or next week, and would be scrambling trying to transfer reports back to Houston and make plans to set up scans there, going back and forth and back and forth.  (It's all feeling very familiar---the 1st time, I found out right before my doctor went on maternity leave.  Now, it's right before vacation.  Nothing like dropping a big bomb on you without all the information!!!!)

It's scarier for me this time around.  Stage 2 seemed easy to beat from the beginning.  There never was a serious scare that I would die.  Stage 4 is terrifying.  Now the scare is facing me head-on.  It is always Stage 4 when it's metastatic, so we know it's bad.  We just don't know how bad.  The additional scans will let us know. 

I thought all of these issues were coming up as tests of patience and faith during times of getting to write several articles about my cancer battle and faith, plus preparing my son to be baptized.  It turns out that the tests of patience are only beginning.  I even talked about part of me wishing I still had a reason to turn to the Savior and stay closely converted to faith.  I guess I got that wish.

Cancer Warriors, you just thought the war was over.  We only won the first battle, so it's time to regroup and get ready to fight again!