Kate's Cancer VIII

Kate had her second infusion last Tuesday and it looks as if we managed to get the acid reflux under control. Kate also seems to be suffering a less severe reaction to the chemo, but a bit more prolonged. However maybe because the first go ‘round was so unknown and overwhelming, that we were so relieved when she felt better we were fine with the aches and malaise. They also warn that the effects are cumulative, so she may be feeling the reduction of blood cells as well.

The first 5 to 7 days after the infusion seems to have her all over the board in feeling tired and bad. The first couple days and she’s just out. Come the 4^th day we usually can get out for an hour or so and that will slowly improve over the next couple. Also, the computer is out as it makes her queasy.
Between the first and second infusion we had dropped by my barber as Kate wanted to go even shorter and for the length we were considering, we felt a barber would be able to get at it best. So, when it was done Kate walked out with a “Boy’s Special” which was pretty cute on her. Real Sandy Duncan like.
We woke up quite early for her second infusion as she had to get there early to get a port surgically implanted. It goes under the skin on the chest near the left shoulder. This is so they don’t have to beat up her veins each time trying to give her and IV. They just find the end under her skin and poke. Anyway, the after-effects of the surgery were another thing she had to contend with this time.
While trying to get ready for the trip to MGH, it happened. Her hair started going. We rushed around, located the clippers, and buzzed all but a little shock of bangs down to #2. It’s a tough thing having to shave your wife’s head because she’s sick from chemo. It never was a problem when we were getting Mohawks, but this isn’t easy.

Mostly for me it’s the changed appearance. It reminds me every time I look at her that this is not normal. This is not how Kate should or wants to look. Not in a patronizing way, but the effect is the same as when you see sick kids on TV and feel sorry for them, because it seems unfair and that they really don’t look like children exactly. Kate is Kate, but again it’s just a constant reminder. I wish it would have struck me rather than her.

And last night, we had to clip her even further as it really started coming out in earnest. I must say though, the little pink hat with ears that Andrea knitted for her is fantastic and look great on her!

Speaking of friends, we’re overwhelmed by the kindness and generosity of the people in our life. Kirsten organized a casserole brigade and out of nowhere, dear friends show up with food. It really helps to not have to worry about a meal. One less thing to think about.
I don’t know how I can every repay everyone for taking care of the most special person I’ve ever will know. Kate’s feeling a bit guilty for not getting the Thank You’s out sooner, but it’s amazing how much time this whole thing takes up. However if anyone needs anything, please do not hesitate to ask. If I am able, I will be there.

I’ll stop here for now. Thanks everyone so much for the support you’ve given. It really means the world and helps us through this.

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.

Kate's cancer III

Here's the update:

Good news and bad.

The bad is a reiteration, so it's not really news. Kate will have to have chemo as they found cells in her lymph system which means they broke away from the original site. Again, they not metastatic, so right now they pose no immediate threat, but without the chemo to kill 'em, they could either metastasize or lodge somewhere and grow as a breast cancer tumor at that location.

I've done a bit of research, and in places they're trying cold helmets just prior and for a couple hours after being given chemo to help patients keep their hair. It's not written in stone that one will lose their hair, but I think it better to prepare for the eventuality and be surprised if it doesn't happen.

Personally, I don't think it will be a major shock if Kate loses the hair on her head, but the eyebrows and eyelashes might take a little getting used to. However, as long as I can keep seeing her big blue eyes, I'm a happy man.

Here's the good news:

Kate's going to have another lumpectomy. There were 2 discrete spots of cancer remaining after her first surgery, which we were certain meant a mastectomy. We were quite prepared for that when we met with her surgeon last Wednesday, but during that conversation she introduced the possibility of another lumpectomy. She said she had to check the slides to see if she thought she could do it.

Check the slides?!?! You mean you haven't looked yet. For us, we want everything to happen yesterday. Kate can't get to treatment soon enough. So after waiting a couple days (we expected a call the following day, but it didn't come 'til Friday afternoon) we got the word that her surgeon, Dr. Gadd, was confident she could get the remaining little bits.

If Kate were to have a mastectomy, again she would have to have reconstructive surgery right away or she wouldn't be able to have it at all because she's so slim and petite. And with the reconstruction, there's a risk that the radiation therapy could damage the implant and cause complications.

On a more personal note, this thing definitely makes one moodier. Some days I'm just waiting for someone to step out of line, because I know this is not their fault, no one is too blame really, but I'm loaded for bear and want an excuse to unload. That's tempering in the past week or so, but still a pretty typical response I guess. My patience is a lot thinner and I'm willing to be a bit snippy if someone deserves it. I'm taking a bit of a holiday from being the reasonable guy.

I also feel bad and guilty that sometimes I get tired of thinking about Kate's cancer. I resent the amount of attention Kate's cancer gets.

Don't get me wrong, I don't resent Kate getting attention, I resent Kate's cancer getting attention. I'm always happy to do for Kate, to be there at every turn, to carry the load but there are the occasional time when I think, "You know, give it a rest. Let's go live while there's some non-Kate's cancer time."

It's a little hard to go do stuff that moves us forward. It's a bit all consuming and there's a tendency to want to put everything on hold until the end of the treatments. We have to keep reminding ourselves that s#$t happens and we have to make the most of our time when we can.
I'm also super vigilant about trying to keep Kate from feeling sorry for herself or getting in too much of a funk. Maybe a little over protective of this. It's such a fine balance trying to be supportive and encouraging her to have her emotions, and making sure she doesn't wallow in self-pity (not that she's even coming close to that, but knowing how easy it could be for me to feel sorry for myself, I project).
Fortunately, our communication is great so all these things are out in the open where we can face them together as always.

Cheers!

Kate's Cancer II

Just the Facts

I'm working on the lead up to where we're at now, but I'll spare everyone the narrative for now and tell you where we're at:

Kate's cancer is Invasive Ductile Carcinoma in her right breast, non-genetic based, Estrogen Response Positive. The tumor was right at about 1 in or 22mm. She has had a lumpectomy which required day surgery so far, but it looks as if there is two little arms of the thing left which we're waiting to hear if she'll now need a mastectomy.

They found some cells in her sentinel lymph node near the site which means that some cells have broken away. These cells are not metastatic, which is very good news. However, finding them elsewhere means she will have to have 8 weeks of bi-weekly chemo and will probably lose her hair (it'll grow back).
If she needs a mastectomy, she has to decide weather she will have reconstructive surgery. If she doesn't now, she probably won't be able to in the future. She will have 6 weeks of radiation after the chemo which in a fraction of patients can have complications with saline implants.

She was quite worried that she would have to have more lymph nodes removed, putting her at risk for stiffness and pain in the area and her arm known as lymphedema. This could have hindered her work as a photographer. However, now that she's guaranteed to be receiving chemo, they do not need to take anymore lymphs.

After all is said and done, 6-8 months and she'll be done with this BS.

Kate's currently looking for a cool hat.

Kate's Cancer - I

A quick background
About a month ago, Kate was diagnosed with breast cancer. For a few years there had been an anomaly showing up in her mammograms causing her to have to go back for a second screening every time, but it was very small and disregarded. At this time we don't know if it was or wasn't the cancer.
In late June of 2011 she went in for a second exam and this time after studying the results they said they wanted to do a biopsy. There was a mass and they wanted to take a closer look. Kate had delayed by 6 months her screening this year to which she's feeling bad that she didn't go on time, but I reminded her that we don't know when it was big enough to bent able to be detected. For all we know, it might have been too small to be seen if she went her normal time of the year in which case it would have had a year and not 6 mohs to grow.
Kate went in for the biopsy and it came back positive for breast cancer. I got home from work and she told me. My guts dropped.