A peanut butter cup broke my heart today. It tasted like the wrapper it was packaged in, plus a little peanut-butter-flavored sawdust! You'd think that this would keep me from eating candy or cookies or brownies, etc. But, alas, no. I am ever hopeful that some of the yummy taste I love so much will shine through. I should really remind myself at times like this that tastelessness is an indicator of just how well the chemo is working! Also, I am extremely lucky to have entered this battle healthy and strong because, so far, I am essentially bulletproof. Even the worst of the chemo, back in January and February, couldn't send me all the way down into disability. That thought gives me a thrill that no peanut butter cup can match!

Laundry List

Sometimes, people ask me what it's like to be on chemo; specifically Taxol and Herceptin. So, here are a few things that happen:

+ I eat like there's no tomorrow; I eat anything and everything. My appetite is unquenchable. I eat like Kirstie Alley when her show's been cancelled. I'd better stop soon because, before you can say Kobayahsi Maru, I'll be as big as Kirstie (she of the beautiful eyes and lush hair). This is different than being on Adriamycin and Cytoxan which pretty much destroys the pleasure of eating for 5-6 days after a treatment, mostly by making digestion a scary prospect.

+ Can't taste food in the same way. I can't tell if somethings too salty or too sweet. Feels like my tongue is wrapped in a layer of gauze. Fortunately, this doesn't interfere with talking but might have something to do with why I want to eat so much. I just might be trying to get more joy from food than my tongue will allow.

+ My feet and hands are tingly and a bit numb. I drop things a lot. Can't open packages - that sort of thing. I have to be careful about my feet, so they don't get injured. I might not feel it and, with healing taking longer, could be in for trouble.

+ Some balance issues. Have to hold the handrail on the stairs.

+ I'm not only STILL BALD but am losing my eyelashes and eyebrows. On the plus side, I haven't had to shave my legs since before Christmas! Ha!

+ They call it 'chemo brain'. I'm not as quick on the uptake as I used to be. Can't remember names, forget what I wanted to say, walk into a room and forget why I went in, etc. I have to admit to having some of this before any chemo, but now it's more noticable. I also tend to be more irritable although I might not be able to blame this on the chemo as much as the fact that I have cancer and I'm pissed!

+ Fatigue. It's a problem. I try to push past it as much as I can. I do acknowledge that resting is now one of my most important pastimes, but I'm losing every bit of conditioning that I'd had. Sometimes, the fatigue seems to inhabit my joints and muscles and I grunt and groan when I push up off the couch. Seems like walking out to the car is way too much trouble. But, there are bad days and not-so-bad-days.

+ Dental problems. As referred to in an earlier post, I've already cracked two teeth. I understand that these tooth problems can continue after the chemo's over. Yikes! I've had some mouth sores, too.

+ Gas. Really bad gas. About 1/2 hour after a meal, I need to remove myself from human company for a few minutes. The poor cats; I don't extend this courtesy to them. It's not like I can just wait a while till the coast is clear. It's too painful. Oh, no! I sound like an old bachelor now, talking about my farts! Eeew...

+ Near zero exercise tolerance. You can build yourself up for a few days but then you crash right back down for one reason or another soon thereafter. It's very hard to get past the point where my heart starts racing when I walk fast.

+ Colds last a long time and cuts take forever to heal. Kind of expected with my immune system under attack.

There are probably more things that should be on this list, but with chemo brain, I can't remember them right now. There are other things going on, like depression, that aren't directly caused by chemo. I also take Prilosec every day now. If I didn't, I would be having killer heartburn. But, overall, Taxol is a lot kinder than Adriamycin and Cytoxan were. Those two were horrible! I'm so glad they are far behind me now. The other women in my Breast Cancer support group say it's like childbirth - horrible when you're going through it but you forget how bad it was.

The good news is that, almost without exception, all of these side effects are temporary. I'll be bouncing back strong this Fall, when everything's over. Count on it!

Public Service Announcement

So far I've had two broken teeth during my chemo. It's so unusual to break off part of a tooth while eating that I started surfing the net to find out if the chemo was causing it. If you recall from a very early post of mine, I had decided to stop surfing the net for cancer information. It was just too scary and overwhelming to read about all the possible effects from chemotherapy. I decided to trust my doctors, and especially the Infusion Center nurses, to convey any and all knowledge about side effects I might experience. This turned out to be a very good idea because I wasn't being terrified all the time by internet babble about symptoms that were likely never to occur. But, I was sitting at home one day recently, eating a Snicker's ice cream bar when a piece of my back tooth broke right off. Okay, I shouldn't have been eating a Snicker's ice cream bar, but it could have just as easily happened while eating a celery stick! This incident happened about a month after a large filling popped out of a back tooth. I think I was eating a piece of candy at the time. Is a pattern emerging? No, no ,no, no I can't give up sweets! I have cancer, dammit, and I'll eat whatever I want! So, I finished the Snicker's ice cream bar. Afterwards, I sat down at the computer and, lo and behold, all kinds of dental problems can happen with chemo! Didn't know that. The enamel is weakened and plaque tends to build up a lot faster due to decreased saliva production. So that's why I can't spit out the car window while driving down York Rd anymore! Kidding! Anyhoo, lesson learned. I need to take even better care of my teeth. Maybe I'll try a fluoride rinse too, like the nurse recommended 5 months ago! They told me about mouth sores and dry mouth, which I've experienced, but not about cracking teeth. Oh, well, you can't be perfectly prepared for everything and I still stand by my decision to avoid searching the net...

Here are a couple of good sites I found for info about chemo and teeth:

www.livestrong.com/article/31610-effects-chemotherapy-teeth/       Lance Armstrong's cancer site
www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page5   from the National Cancer Institue

It happened again. This week I saw a patient for a PET/CT scan with a history of breast cancer. She told me that she had had cancer in her right breast four years ago. She had a mastectomy, chemo and radiation. Recently, they found cancer in her left breast and she was beginning the process all over again. Even before I knew I had breast cancer, I noticed that I was seeing a fair amount of women in this same situation. You know, I just don't want to go through the whole cancer treatmernt process again, although I'm sure the PET/CT scan patient didn't want to either! Having a bilateral mastectomy instead of removing just the affected breast seems more and more like the way to go for me. Some of the cancer info out there, especially the things about recurrences, can be very confusing. You really have to dig in and concentrate or the message is muddled. What I think I'm hearing and reading is that having only the affected breast removed does not increase the likelihood of a recurrence manifesting as distant metastases as opposed to opting for bilateral mastectomy. What a mouthful! See what I mean about confusing?! I interpret it as: having the bilateral mastectomy doesn't change the possibility that the cancer won't show up again outside the breast, in the liver, say, or in a bone. But, having the bilateral mastectomy removes billions and trillions of breast tissue cells, cells that have the possibility of changing into cancer again. Some of the messages might not be so straightforward but, the situation I'm seeing as a Nuclear Medicine Technologist is quite clear so I feel like I have to act on it.

My hair has been gone so completely for so long now, I hope it doesn't forget how to grow back! With everything going on, I should be more worried about other things, but vanity will always rear it's ugly head! I just have to remember what my balding friend said a few months ago, "It's a bummer that you don't have any hair now, but at least yours will grow back!". There are a few positives about having no hair. I shower in five minutes flat. When I put the car windows down on a beautiful day, no worries about messing up my hair. It's a lot cooler, having no hair, so you're going to be jealous of me in the hot, hot summer!

Here's the blog entry where I tell you what I've decided I want for my surgery on July 6. I'm going to discuss breastises in general and mine in particular as it relates to the removal of them and what I think I'll gain and lose. So, you might want to stop reading now and go back to Facebook or your email if you don't want to read the really personal stuff. It might seem odd that I will share all of this but I do it for two reasons. One- it's my blog and I get to say whatever I want with no comments (while I'm writing, anyway!) and, two - I have found it extremely helpful to talk to other women who have gone through the same thing. Not only is it helpful, but it makes me feel part of a community of sisters who share a life-altering experience. It's so nice. Some of my darling sisters have even gone so far as to show me their scars and how their chests look now, without breasts. Wow. I am grateful and humbled. So, if anyone reads my blog who is facing down the same type of breast cancer that I am - Stage III, HER2-Neu+ - I hope it helps.

I want to have a bilateral (both breasts) mastectomy and bilateral breast reconstruction.This could change after I talk again to the surgeons - plastic (for reconstruction) and general oncology (for mastectomy and lymph node removal). A few weeks ago, we were talking about a much lass drastic surgery than mastectomy. Mt oncologist felt that a 'wedge' could be taken out where the 'thing' they saw on MRI was. A primary breast tumor was not found. The surgeon is recommending a left mastectomy because we really don't know where the original tumor was. It had to be there! It was dissolved by my body but not before it sent some tumor cells out to the lymph nodes.

My reasons:
- I found out that even with only one breast removed (unilateral mastectomy), the remaining breast would  need surgery, too. Not as drastic as a mastectomy, but the remaining breast will change over time; OK, it will sag, and it will need to be surgically lifted. Also, in my case, the remaining breast will likely need to be reduced. I'm not braggin' but my breasts are not small and it would require a bigger surgery to make the reconstructed side look the same as my 'real' breast without a reduction. So, both breasts would need surgery anyway.
- To continue somewhat the above thought, I look forward to the time when I don't have big boulders on my chest. When I bike or run or even go for a fast walk, well, any kind of exercise, I have to wear a chest-crushing binder so that I won't bounce. I really don't like bouncing! It not only looks painful, it is! It's a bit lewd, too. And there's no tearing off of the t-shirt to reveal a cute little sports 'top' underneath. If I took off my tee, what you would see is a giant, medical-grade-geriatric-looking, wide strapped monster bra. Ugh! Not that I'm thinking of tearing off any tops, but I sure would like a more streamlined chest for being active.
- I think that one boob on a woman's chest becomes an oddity. I mean, what's it for? My sincere apologies to women who opted for unilateral mastectomy. I respect their decision and am not accusing them of being odd. These are simply my thought processes, right or wrong, good or ill. I met a woman who was young when she went through cancer treatment. She wanted to have another child and breastfeed so she saved the good breast. Other women want to absolutely minimize surgery. Also consider that women found in Stage 1 can have a lumpectomy only and their survival rate is still very high. But, back to my reasoning, such as it is. I believe that breasts are great and that they are great when they come in pairs. Lord knows, I have enjoyed having a very nice pair! But I just can't imagine that one real and one fake, with no nipple and a different size, would have the same impact, for me or for him. Someone reminded me that, if I kept one natural breast, I would maintain some sensation. But, could I ever get over the fact that my 'pair' is gone? It seems weird, wrong, to think of just one breast as an errogenous zone! Other body parts are a bit more critical than my breast. I would definitely save my other arm or my other eyeball. There is no practical reason to save that one breast.
- This could be the most important reason for bilateral mastectomy: I would worry about recurrence less. My oncologist told me research has shown that having the unaffected breast removed doesn't decrease the recurrence rate. I trust my oncologist and have great faith in her, but I'm not thinking about research results, I'm thinking about how I will feel. Surgery cannot remove every single breast cell. What a gruesome operation that would be! But with all the breast tissue that is removed in a mastectomy, there will be trillions and trillions less breast cells to convert to cancer cells in the future. Several breast cancer survivors said that they really didn't start worrying about recurrence until after all the treatment and the unilateral mastectomy was over. Then, anxiety kicked in. I can understand that since the treatment and surgery is overwhelming and you concentrate on the day-to-day.

Some of these reasons are justifications, I know it. Don't think for a minute that I wouldn't love to have never, ever gone through this hellish process. But, I am trying to be as positive as I can. Dwelling on the negatives is just not healthy. I will never have a normal body again. (Wow, it was hard to write that last sentence!) I can make myself totally miserable about it or I can be optimistic. I choose to find the good when I can and relish joy when I find it.

I went for a mountain bike ride with David yesterday. The woods were so fresh and green! The sun was out and everything sparkled. Saw some spring ephemeral wildflowers. And I fell off my bike! That's right, had a big ol' fall. Almost went down into a stream gully, too. I did something that I've known not to do for years. I looked right at that big pointy rock I didn't want to hit and my bike followed my eyes. But, even with three months of chemotherapy, I still bounce pretty good and only got a couple of scratches. I also got one horrible photo of big ol' fat, bald me in bike clothes that not longer fit! Ugh! Chemo isn't pretty!