Kate's Cancer VII

Well, that was rough.

We spent most of the day Monday at MGH, getting blood work done, getting flu shots (myself as well, because the chemo will impair Kate's immune system for periods of time after the infusion), and then hanging out for a few hours while she takes the IV's. She such a sweet person and it's incredible to watch her soldier through, but it's also harrowing for me because I can't punch or beat anyone or thing that's causing her to feel bad.

Anyway, it made her pretty sick. At first we thought it was nausea keeping her up, but over time as she told me her symptoms I realized she was suffering from acid reflux, which is a symptom they did warn about or we missed it in the hail of information that been thrown at us. I suffered for about a year with bouts of it, eventually being rid of it after being put on Prilosec. I got her to check with MGH and they said Pepcid and Prilosec were OK and with that I loaded her up and it seems to have helped along with time. Next time I'm having her get on the Prilosec 2 days before and keep a healthy supply of the Pepcid on hand.

Fluids taste weird to her and she's been busy trying to navigate her frequently changing palate. Particularly for the 72 hours following chemo, she's got to take a minimum of 64 oz.'s of fluids, which has been doable, but a challenge.

Today we go to get her to the barber to get her hair even shorter. They say two weeks after it comes out. With that, I've recommended a Tank Girl style. Half inch or so everywhere, with a shock of bangs. Because of the cut, we thought it best that she goes to my barber, who has experience with such short hair.

I was hoping to brew another batch this weekend to blow off steam. A good porter this time. But alas, I think the odor from the wort will be too much. (It just hit me, maybe I could cook it on the grill!)

This morning, she looked so much better. It's a bit lonely when The Kate's out of action and the cats don't quite cut it. Tonight though, I have beer and an Angry Scotsman Tavern.

Kate's Cancer - VI

Tuesday Kate starts her infusions. Bloodwork in the morning follow by 3 hours or so of them injecting 2 drugs into her intravenously. She likely will have an injection port installed for the duration which will reduce the chance of there being a problem with multiple needle sticks. They've loaded up the anti-nausea Rx's up front as that's a guaranteed without them.
What we took away from meeting with the nurses on Monday is:

There's no dietary restrictions, but she's got to drink fluids. Lots and lot of fluids to flush the chemo out after it's done for the session.

They said food can sometimes taste tinny so her palate might change while being treated.

The biggest side-effects of chemo usually hit 4-7 days after infusion. Fatigue comes from the fact that during the week many of her blood cells, white and red, are dying off as well as any cancer cells. All rapidly growing cells (including hair) are attacked by by chemo. After bottoming out, it takes up to a week to regenerate to normal.

The nurses said to skip Ensure because it tastes like crap and get Carnation Instant Breakfast which is about identical in nutritional content.

Ice Cream, Ice Cream, Ice Cream. Calories and liquid at room temperature therefore good for hydration. (Not so good for my diet, but we must make sacrifices).

On the personal side, our history of punk rock cynicism, working class upbringing, and gallows humor I think has given us an edge in coping with this thing. I was thinking how horrible it must be to be raised in some disney-fied reality and then get smacked with something like this. Sure it takes it's toll, mostly for me the running around and such, but I know to my very core that Kate will be fine.
I used to question altruism a lot more than I do now as well. I used to debate whether it was possible to truly want to sacrifice for another and whether or not the desire to sacrifice was still within rather than without. I guess at some levels that's still true, but now in the sense that I really wish I could take this bullet for Kate, but is there even more I might be able to sacrifice and am I just being selfish in some unrecognized manner to where I don't see what more I could do.

Not to be too...whatever, but I'm coming to understand the idea that dying for a cause is easy, living is hard. I could easily take this cancer that Kate's going through upon myself, but the hard part is not feeling sorry for myself and having the strength to overcome/deal my own frustrations, aggravations, and such in a positive, healthy way so I can be better support for Kate.

This thinking occurred to me yesterday while driving with her through some pretty tough traffic and expressing forcefully my displeasure at my fellow commuters. It helped nobody and worst of all, added to Kate's tension unnecessarily. Or as a lesson from Freemasonry, we must try and circumscribe our passions.

With that tomorrow we embark on the second phase of this process.

Kate's Cancer - IV & V

Update and some miscellaneous reflection:

Good news! After the first surgery to remove Kate's tumor, the pathological report that came back on the tumor left us a bit disheartened. They take the tumor and check it on 6 plains and if there's any cancer in the slides (in the margins), that means that cancer continued beyond the surface of the removed tumor.

We thought this meant that a mastectomy was the next step. However, Kate's surgeon said she felt confident she could remove the two remaining tentacles completely. So another surgery.

Yesterday (Wednesday) she missed a call from the hospital. Thinking it was her doctor's office (which it turned out to actually be a the medical oncologist who is in charge of the chemo side of things) she called there. The secretary said it wasn't her office, but she would check with Dr. Gadd. Dr. Gadd's secretary returned to Kate and said that it while the doctor hadn't called, she was just thinking of her (Kate) because she just got off the phone with pathology regarding her case.
The Margins Are Clear!

No more surgery for Kate! No more lymph nodes to come out and no mastectomy.

While we've been playing it fairly cool, there's tension lurking under the waters, so with this news there was a great burst of relief. Unfortunately I was at work with some stupid crap unfolding, but Kate made all the calls to the immediate must knows (mom, dad, etc.) and then took a nap. I worked through lunch and left early.
So on to Phase II - Chemo.

We have yet to meet with the medical oncology side of the house, but that's coming up on the 14th. Since there were cells found in her sentinel lymph node, they know some broke away from the tumor. To make sure they don't get lodged somewhere and become a breast cancer tumor somewhere else in her body, Kate will need chemo. Along with the radiation afterwards, chemo is really a mopping up procedure in this case.

More on this later.

On a personal note, this is all taking a bit of a toll. So many different emotions are jammed together and many not good. For one there's a bit of what I can best describe as survivors guilt. I wish I could shoulder the burden of treatment, but I can't. And now, with our life on hold, there's desperation for me to try and do normal things when Kate's up for it. Just getting out and doing the things we used to do is difficult as even food seems to have lost its flavor.
And there's a dark, resentful side which I'm ashamed of. I resent the cancer in that any ailment, funk, frustration that I might have expressed can now be easily met in my head with the thought that I have no right to complain because at least I don't have cancer.

9/19

It's hard to stay up to date with this. When we're not actually in the thick of treatment, we're just trying to be as normal as possible.

We met with the medical oncologist last week, who happens to be a proper Scots woman with an Oxford education. Kate's done a little background on her and it seems that here and her husband are a bit of mad scientists (they're researchers as well) when it comes to chemo and cancer. Anyway, the accent gave me an immense amount of confidence.
Here's what we expect:

starting the last week of this month, Kate will begin a series of 4 infusions every 3 weeks. Kate's decided Tuesdays is the most manageable day. The doctor asked Kate if she's chosen a wig yet. In other words, she is going to lose her hair. There will also be nausea and fatigue. Kate's put on a hell of a brave face although she's admitted that she's a bit nervous (as well as me). There's a likely hood she will need a port for the IV so they don't have to keep sticking her.

After this course, she's getting another course of one drug for 3 months weekly that will be less taxing on the system, although it may have some impact on the nervous system that will have to be monitored as she goes along.

Then, finally the radiation at the end. 6 weekly shots of that.

Today we get more details, so I'll provide specifics (drug types, etc.) for those interested in the next day or so.

I know I've been beating on this drum for a while, but it really is true - We are overwhelmed by the care and support from friends and family. It really has been the best medicine. I can't thank you all enough for taking care of The Kate.