1/5/11 - Moving Forward

I'm Fine!  Just Fine!

On Tuesday, I had an appointment with Dr. Cohen at David Lee Cancer Center.  I'm not a fan of late day appointments, because there's usually more waiting time.  And although I long for doctors to control the waiting time better, I know the reason why things get backed up by the end of the day.  I was reminded first-hand today, when Dr. Cohen spent a long time discussing my treatment with Ric and me.  But before the doctor came in...

Even though I've had some really good days, I've been back to being extremely tired by the end of the work day, and of course arrived at the cancer center in that condition.  I was called back shortly after I arrived, but then sat in the examining room for over an hour.  I was clothed in my jeans and a hospital gown on the top half of me... a hospital gown so gigantic it felt more like I had nothing on, and could not keep the opening in the back closed.  My back was freezing.  Sitting on the end of the examining table was also making my cold back ache!  (Yeh, I know... poor me.)  I had run out of patience, and in my fatigued state, started to cry.  Ric told me I needed to talk to my doctor about an anti-depressant.  Seriously, I'm fine, I told him... just tired of waiting.  So I jumped off the table, held my gown together in the back, and marched out the door to find out if the doctor was still there, while Ric was saying, "Don't do that."  Dang, I don't want to be the bitchy patient.  But I couldn't quit taking the steps to find some tired-after-a-long-day nurse to bitch to. When I found one, I was assured that the doctor would be with me very soon.  Went back to the room, and tried to stay angry, simply because I thought that would mean I was stronger.  But instead my head took the pathetic route and I started to cry again, actually sobbing, asking Ric what happened.  Once again, I was happy, healthy and walking my dog three times a day... and once again, I'm told I have CANCER!  I thought it would be easy this time... and in many respects it is easier... but, here I am... I bundle of emotions once more.

Dr. Cohen came in and apologized for being late, and expressed his sadness that I had cancer once again, and said I could have the whole box of tissues.  I became nice again. 

Treatment Plan

He thoroughly and clearly explained to Ric and I four different treatment options to consider.  Because my cancer was strongly ER and PR positive, I will definitely be taking Arimidex after the chemotherapy.  (It's a good thing that I was ER/HR positive because there are meds to prevent recurrence of this type of cancer.) The type of cancer this time was highly dependent on estrogen and progesterone to grow.  The Arimidex will stop estrogen production, which will help prevent recurrence.  (Types of Breast Cancer)  I asked Dr. Cohen if I would grow a beard if I had no estrogen.  He said I was the first patient to ever ask that question!  He assured me that I would not, unless I decided to take testosterone for some reason.  LOL!

Before taking Arimidex, I'll receive chemotherapy.  I had 4 treatments of Adriamycin 5 years ago.  Because of the risk of heart muscle damage, a person can only have 6 treatments of this chemo drug in a lifetime.  Taking 2 more treatments is doable, but the risk of having some heart damage is more likely.  Because there is only about a 2% less chance of a recurrence of cancer, I opted not to take Adriamycin this time.  Additionally, since this cancer was so strongly ER/PR positive, it is not certain, but quite likely that the Arimidex will be very, very effective for me.  (The more estrogen/progesterone receptors there are, the better the medicine works!)  So why take a chance on heart damage, when the Arimidex is likely to be quite beneficial for me?

This time I will receive 4 treatments of a combination of Cytoxan and Taxotere, three weeks apart, for a total of 12 weeks of chemotherapy.  (Last time it was 8 treatments every 2 weeks for a total of 16 weeks.)  Chemo will be followed by radiation and that plan will be determined by a radiation oncologist at a later date.  (Chemotherapy Medicines)

Before I start chemo, I will have to have the one more minor surgery to insert a port for the chemo delivery.  Dr. Cohen with coordinate with Dr. Covelli as to when this procedure can be done.  There will be some healing time and then chemo will start.  So now, I'm waiting again.  That's okay, though... I'm familiar with the waiting by now... and when I can wait at home or at work without a big hole in my clothes to let cold air in... I wait without much complaining!

Present state:  Healing very nicely.  I'm using cocoa butter on the scars... that keeps them soft and helps them to heal without lumps or ridges.  I still have a little swelling under my arm and the feeling that my arm has been burned (which it hasn't... it's just an effect due to the surgery irritating the nerves), but that is getting better each day.  I recall now how horrified I was when I saw my breast the day after the second surgery... but except for the scars, it has returned to a normal shape and doesn't look bad at all!  I suppose when all the swelling goes down, it'll be a little smaller than the other one... but that's okay - I'll just make sure I turn my perky side toward the camera.