Archive for September, 2008

24
Sep
08

September 24, 2008

Brian was reading an article about volunteering tonight, and quoted the following statistic:

The biggest difference between people who volunteer and people who don’t is that people who don’t volunteer watch 23 hours of television per week, and people who do watch 15 hours per week.

I don’t watch TV at all, but I also don’t have time to volunteer.  So my new plan to make more time for myself is to start watching 15 hours of TV per week and add back in some volunteering.  I figure that should add enough time to my schedule so that I can get all the knitting and quilting I’m doing for Christmas and baby gifts done by the end of October.

My previous plan, to have insomnia a lot, doesn’t seem to help with the volunteering, although some of the knitting is coming along.

17
Sep
08

September 17, 2008

Today I’ve been thinking about optimism and pessimism, in general as they relate to having cancer, and specifically as they relate to *me* having cancer.

Friends and family have told me, especially since the recurrence, that they are impressed with my positive attitude in the face of having cancer (thank you!).  I guess that it comes across that way, as a positive attitude, or optimism; but in my own head, I’m just living my life the same as I always have (with the exception of a lot more doctor appointments than usual), and dealing with a bad situation in the only way I know how, of facing it head on, and ruling it, rather than letting it rule me.

Historically, that was not the way I dealt with bad situations, and I’ve seen first-hand how escapism, denial, recreational drugs and alcohol, and a very pessimistic outlook on life, myself, and society made my life worse as I avoided dealing with problems, and merely wallowed in my own “helplessness”, ruled by the problem.

But I will concede that not being pessimistic is in its own way a form of optimism.  In the sense that I believe that statistics on breast cancer are in favor of me surviving, and that treatment will (eventually!) control or even rid my body of cancer, I am falling on the positive side of the optimism/pessimism scale – that I believe the glass is half full, rather than half empty.  I certainly have met people who have heard the same statistics, but still believe that their stage 1, non-metastasized cancer is a tragedy, and is a death sentence.  And because they believe it is a tragedy, it is.

I don’t mean to make light of anyone’s fear of cancer or fear of death – cancer is scary stuff, and I have had times when I was very scared, sad, depressed, worried, and wondered if I would survive.  But again, by not believing it is tragic, it isn’t tragic for me.  I also don’t mean that I believe that by being optimistic or pessimistic one sways whether or not one survives; I just mean that we experience cancer and its treatment the same way we experience life.  If we think of life as scary and bad, we will certainly perceive our experience of it as scary and bad.  Some people’s lives really fall into the scary-and-bad category, and my heart goes out to them; but a lot of people (me for one, at least in my youth) look at their lives and see unhappiness, believe the world is out to get them, and live their life accordingly.  And if we think of cancer and its treatment as scary and bad, it will be.

(I could write a whole ‘nother post about how I moved from a pessimistic world view to a non-pessimistic world view – the short version: Thank god for Brian, and for my own choice to start facing life directly and with a different attitude.  I also credit “The Four Agreements” by Don Miguel Ruiz for helping me reshape my life by reshaping the way I perceive my interactions with others.)

But when does optimism become “irrational exuberance”?  When is it denial and/or escapism?  Even though there are definitely books and blogs and websites, oh my, that claim that you can beat cancer with a positive attitude, studies have shown that this is *not* the case.  Does that mean that you shouldn’t have a positive attitude, that it is simply denial to be optimistic in the face of a cancer diagnosis?

Mayo Clinic debunks the cancer myth that:

A positive attitude is all you need to beat cancer.

Although many popular books on cancer talk about fighters and optimists, there’s no scientific proof that a positive attitude gives you an advantage in cancer treatment or improves your chance of being cured.

What a positive attitude can do is improve the quality of your life during cancer treatment and beyond. You may be more likely to stay active, maintain ties to family and friends, and continue social activities. In turn, this may enhance your feeling of well-being and help you find the strength to deal with your cancer. A positive attitude may also help you become a more informed and active partner with your doctor during cancer treatment.

*********************************

So I guess I will choose to keep landing on the positive-attitude/optimistic side of the bar, even if it feels in my head and my heart as if I’m just being me.  And I will take inspiration from the women I know with stage 4 metastatic cancer, who face life, and death, with optimism and not as if it is a tragedy.

16
Sep
08

September 16, 2008

Today the surgeon called.  I saw her number on Caller ID, and almost didn’t answer, because it seems like doctors never call with good news – if it’s good, they wait to tell you when you have an appointment.

But I picked up the phone anyway, and it turns out it was actually great (although not unexpected) news – the path report shows that there was no outlying cancer – the first surgery got it all!

So the cynical Julie wants to know why I had to have the second surgery, then?

And of course, the calm, logical, reasonable Julie reminds me that we wouldn’t know for sure without having done the additional tissue excision.

The medical researchers really need to come up with a method for determining spread of cancer in situ (Brian misheard me, and said “Inside you?” – well, it all comes to the same thing).  They figured out how to make a monkey phosphorescent – there’s got to be a way to insert jellyfish DNA into a cancer tumor so surgeons can track its spread.

At any rate, I meet with her on Thursday, and at that point, she’ll give me the names of a couple radiation oncologists, and a date as to when she’ll clear me to start radiation based on how I’m healing.  I’m ready to go on this – I still have a dream of finishing by the end of the year.

Last night I couldn’t sleep at all – I’ve been using a guided imagery program to help with my insomnia, and for the most part it’s been helping, along with some melatonin; but last night I heard every word, and even tried taking another dose of melatonin in the middle of the night, but I just lay there flopping around, having hot flashes and listening to Brian and the dog snore.  I even checked my temperature just to make sure I wasn’t developing an infection.  So instead, I got up and worked on my latest quilt pattern, read, checked the news, and finally logged in and did a little bit of work.  I had some breakfast and went back to bed – funny, I get the best sleep during work hours ;-}  I ended up working from home in the afternoon, and I’m planning on going to bed shortly.  As tired as I am, I suspect I’ll sleep well tonight.

14
Sep
08

September 14, 2008

Well, I’ve been negligent (yet again!) in keeping up on posting – between vacation, work, and medical-related appointments, I will claim lack of time as the culprit.

As I mentioned in the previous post, we had a lovely relaxing vacation down at the cabin, and arrived home late in the afternoon on Labor Day.

I jumped right back into the fray on Tuesday, when Brian and I met with the oncologist.  He told us that nobody really has a “normal” treatment plan for a recurrence like mine, basically because a recurrence like mine is anything but normal.  However, pending the results from pathology on the tumor, his plan would be to treat as follows: less than 0.5cm mass, no chemo; 0.5 – 1.0cm mass, we’d talk about whether chemo would be beneficial or not; greater than 1.0cm mass, definitely chemo.  As the words are leaving his lips, his assistant knocks, and passes the path report in.  The doctor looks at it, and says “Oh. 1.3cm.  That’s bigger than one of the original masses, isn’t it?”  The end result is that I will be having chemo; the only decision was whether or not I would do chemo or radiation first.  He knew I would be meeting with the surgeon later that week, and said that she would discuss the rest of the path report with me.

The next two days started very early, because I had dental appointments both mornings at 8 – I’m in the process of getting my braces into the “retainer” stage, with a little additional work on one of the front teeth.  I will be *so* glad when I’m done with them!

The meeting with the surgeon started out with her coming into the exam room, commenting that I had been “the hot topic of conversation at the breast conference” that morning – in case you’re wondering, that isn’t a good thing.  Basically, a lot of surgeons, oncologists, radiological oncologists, and related medical personnel get together and discuss each case they have.  The consensus was that this recurrence needs to be treated very aggressively, since it is very aggressive itself.  So I said, “So I will be having radiation *and* chemo, then, right?”  She said “Yes,” but then went on to ruin my day by telling me that because the margins were so narrow on the lumpectomy, that she wanted to go back in and take some more tissue.  The big problem was that she felt like that meant removing the implant because there wasn’t enough skin/muscle to take out enough otherwise.  While I was there, she called my plastic surgeon, who is in the same office complex, and he had her send me down so he could take a look.

He sounded much more hopeful that it could be done without removing the implant (which would actually be a remove/reinstall, using a somewhat smaller implant) – basically he gave me a 50% chance that it could be done that way.

So the end result was that we scheduled the surgery for the 12th with both of them there, with a couple smaller implants just in case.  I went into it not knowing how I would come out.  7:30 Friday morning came way too early, but the surgery schedule was on time, so they took me in right at 9:30.  I spoke to the surgeons and the anesthesiologist beforehand, and asked if they could start me out with the twilight sedation, since that’s all the surgeon would need if she was able to do the excision without removing the implant; with the caveat that if the implant did need removal, *then* I would be given the general.  Everyone agreed, and I was pleased to wake up in the operating room at 10:30 with the final dressing being applied to the incision – it gave me a bit of a start to see the plastic surgeon working on me, but it turned out that the surgeon asked him to deal with the closure because there was some concern about the blood supply in the area being interrupted from all the scar tissue, and she felt that he was more experienced with that kind of situation.

An hour in recovery, and a short ride home (via DQ for a Heath Bar Blizzard and some french fries!), and I spent the rest of the day relaxing in our backyard under the elm, lying in one of our new zero-gravity chaise lounges – what a lovely day, sunny, warm, and firmly C-cupped still ;-}

I’ve spent the weekend taking it easy, including a lot of naps (some short, some long), and doing some reading, a little bit of knitting, and a lot of talking on the phone.  I’m going back to work tomorrow, although I don’t know if I’ll be up for a full day or not.  There’s not a good place to lie down at work if I need to, although I could try lying under my table – I should take one of our camping air-mattresses in…

I’ll meet with the surgeon again on Thursday, and expect to find out then if there was any additional cancer found in the excised tissue; and what the next step is.  If they did find any cancer, I don’t know what will happen next – otherwise, it is going to be radiation starting in two or three weeks; that usually runs 5-1/2 or 6 weeks; then I’ll have chemo for somewhere between 4 and 8 sessions.  The radiation is first because all the doctors are sure it hasn’t spread, but it was very aggressive locally; thus they want to do the local attack first.

Anyway, even after the 3-1/2 hour nap I took this afternoon, I’m ready for bed already.  I’ll post the results from the surgeon’s meeting later this week.

01
Sep
08

September 1, 2008

Ah, Vacation!

The surgery on Friday the 22nd went well, the surgeon got clean margins, and gave me drugs for pain, nausea, and potential infection.

My chest is beginning to look like the Nazca Plains in Peru.

Travel went well, with Brian doing all the driving down.  We stopped in Corning on Saturday evening, and visited with my Dad that night and the next morning; drove to Vacaville, where we had a party with Brian’s family.  Monday we drove up to the cabin, had a lovely, relaxing week; and reversed the trip yesterday.  I even drove some this morning, although I slept most of the way home – I didn’t even notice the cat climbing on my lap from the footwell, or jumping back down.

More about vacation later, just wanted to thank everyone who wrote, called, posted, etc., for the love and support – we meet with the oncologist tomorrow morning, so I presume I’ll find out about whether I’m doing chemo or not this time.  Then we meet with the surgeon to follow up on the incision – if I’m not doing chemo, then I’ll probably be starting radiation soon.

I’m actually going to go to bed shortly, in spite of having slept so much of the way home.  I’ve got an early day tomorrow, and pretty much the rest of the week.  I’ll update as I can.




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