Herceptin Drip

The herceptin drip is one of the more troubling aspects of cancer treatment.

No, I'm not talking drip like a needle/bag/infusion drip.

I'm talking about a well-known side-effect of herceptin - a runny nose.

Warning: The following may be TMI. It contains an in-depth discussion of nasal discharge. The squeamish and prim & proper should skip this post.

It started off slowly. For a few days after herceptin my nose would run, and I began packing tissues with me. Like your granny, I had crumpled tissues in my purse and my coat pockets.

But, it has gotten progressively worse each week. My nose, which first was like an occasionally drippy faucet, has now become a full-fledged, always-on shower. Stand under me and you are sure to get wet.

My laptop is wet as I type this.

I told you, TMI.

I now carry a tissue in my hand at all times. I can never be without as I must constantly stem the tide. I have a portable tissue packet in all purses, jackets, and in my car. I have a full-sized box on my dining room table, in my bathroom, on my coffee table, in the kitchen - anywhere I'm going to be for more than 30 seconds. I have crumpled tissues in my pockets, stuffed down the front of my shirt in my "cleavage" and always, always in my hand.

It's messy too. I have tissue lint on my clothes from forgetting to empty my pockets before the wash. Crumpled tissues are all over the house - on the floor, on the tables, on the counters, in my car. (Don't forget, I'm ADD - we forget where we leave stuff.)

Honestly, Kleenex needs to use me in their advertising.

Not that I can afford Kleenex at the rate I go through it. Generic all the way.

This herceptin drip is actually interfering in my life. If I move my head, the waterworks start. If I walk, the hose goes full force. Even if I sit still, I'll feel it running down my Philtrum. (Your word for the day.) I've avoided doing anything that causes me to bend over, because then it's the worst, a flood of epic proportions. Pairs of animals start following me; it's that bad.

Now, this nasal drip is not like when you have a cold. It is not thick, mucusy, or hopefully, full of germs. You can't sniff it up. It's watery, like tears - like when your eyes are watering from smoke or chopping onions and you can't control it. It's just water coming out of your nose and you really can't even tell it's going to happen until it's running down your face. Which it always is.

I just spent the last fifteen minutes trying to mop my floor.

I didn't need any mopping solution. That's how bad it is.

When you have a cold, blowing your nose can give you a minute or two - or more - of relief. But, no such luck with the Herceptin Drip. It's a chronic, constant, uncontrollable stream.

My eyes do it too, but so far, only when I go outside and then come in. I'm sure all the store clerks at my regular haunts think I have an emotional disorder by now, since I'm always showing up teary-eyed and nose running.

With all that water loss, no wonder I'm always thirsty.

I must say, it's a testament to the advances in cancer treatment that the worst long-term side effect I have is a dripping nose.

Soon, I will go back to work. And, I will have to type things, and file things, and walk around and do things. I will have to use two hands in my job.

I have a plan for doing that without wetting the front of my shirts and needing to go home to change, or without having to type while liquid streams down my chin. Since chemo has sent me into menopause, and since I have leftover tampons....well, you get the idea. If you see me walking around with strings hanging out my nose, just say hello and move along.

A girl's gotta do what a girl's gotta do.


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Chemo Changes

Last Wednesday I went in for my weekly herceptin. I whined to my nurses about the neuropathy I am experiencing in my hands and feet. I was nervous about my next chemo since the tingling and burning got significantly worse after my third infusion - and I still have three more to go.

The discomfort in my feet was so bad a week after my last chemo that I canceled a shopping trip.

Me, not shopping. Unheard of.

Cancer has taken my breast, and I'll be damned if it takes my hands and feet too. I'm out of heels as it is, and I'd rather die than end up in crocs.

My doctor is going on vacation and I wasn't scheduled to see him for six weeks, so the nurses kindly did their magic with the schedule and fit me in. Not only that, but they wrote down all the things I'd wanted to discuss on a piece of paper for me (a couple of things were questions they had). Smart move, as I would have forgotten.

Chemo nurses understand chemo brain.

After my herceptin drip, they put me on the scale and I was shocked to discover I had gained more weight. I'm gaining a pound every two weeks and now I'm 103.5.

I know, don't hate me. But, my entire life I've been that skinny person everybody either made fun of or secretly thought was anorexic. (Couldn't be further from the truth - I'm a foodie who loves to eat.) The most I have ever weighed in my life was 125 and that was when I was 9 months pregnant. I'm supposed to be thin. I hated it until I was about 48, and then realized it wasn't so bad. I'm used to it by now, even with the downside of still having to shop in the Junior's section of department stores.

"No, I'm not shopping for my daughter, and is it possible you have any jeans without a 3 inch rise?"

The only place I ever gain weight is in my belly, and I don't want to end up looking like a spider - big body, skinny arms and legs.

So, rapidly gaining weight is concerning to me and I hope it's steroids and not menopause, or I'm going to have a serious problem on my hands.

I might actually have to exercise. God help me.

Anyway, I digress. I discussed all my concerns with the doctor, none of which included weight. I know better than to complain about weighing 103. Except to you readers, of course.

He prescribed me trazadone for sleep.

To prevent further nerve damage, he is going to try me on Taxol instead of the Taxotere that I have been taking. Instead of having chemo drugs every three weeks, I'll have Taxol weekly for 9 weeks.

More time in the infusion room, just what I wanted.

On the advice of another blogger, I am taking L-Glutamine. It has promise as something that can help neuropathy, as shown by some small clinical trials - but not studied enough to be fully convincing in all circumstances. I don't want to count on that alone to prevent neuropathy, although I will continue to take it. I really hope the Taxol will do the trick.

And, I finally got my referral to the radiation oncologist. I am hoping I don't need radiation. The doctor said I was on the bubble but he didn't think it would be necessary. I am going to make sure to tell the radiation oncologist if there is even a chance I can get away without it, I want to take that chance. He's in the business of giving people radiation, and I'm in the business of getting this over with. So, unless he tells me that it will improve my chances of living a longer life by a significant percentage, I'm thinking I'll refuse.

Radiation would be daily for about a month, and would put off my reconstruction by a year.

So, as much as I love medical procedures, this is one I want to skip.



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Cyst Aspiration

My newest goal in life is to have every single medical procedure relating to breasts. I'll bet I'm 80% there. So far, I've had mammogram, sonogram, sonogram-guided core biopsy, stereotactic core biopsy, MRI, MRI-guided biopsy, sentinel node biopsy, mastectomy, tissue expander placement and fills - in the future I'll have breast implants and a breast lift, revision surgery, nipple reconstruction and areola tattoos.

Guiness Book of World Records, here I come.

Fortunately, the cyst farm in my remaining breast started growing, probably due to the lack of estrogen-based fertilizer. One was growing so big you could see it through my clothes, and because sleeping my stomach felt like I was sleeping on a bag of rocks, I decided to add a cyst aspiration to my procedure collection.

So, Monday I had my cyst farm plowed.

The procedure was simple and very cool if you like to watch medical things performed on your body, as I do. A nurse came in, explained what was going to happen, and then poured conductive material on my breast and looked at the cysts using sonogram. She found the very large cyst that was causing me problems (not a hard task since it was visible to the naked eye, like a harvest moon in October) She imaged five others, including one "complex" cyst. Those are more concerning as there is debris inside them that could be indicative of a cancer. Then she said the doctor would be in shortly, and explained that because a large one was showing through the skin, and the skin was shadowed above it, she wouldn't bother marking me up with a pen.

I played Collapse on my iPhone while I waited, which seemed very appropriate. I like to match my games with my medical procedures.

The doctor came in, checked out my breast and exclaimed about how uncomfortable it must be to have a cyst that big. Then she wiped my breast with alcohol, injected me with zylocaine, and put the needle in. It was attached to tubing with a syringe thing at the end - the doctor was going to place the needle into the cysts while the nurse pulled the plunger to draw the fluid out.

They did the complex cyst first so they could send that fluid to the lab separately. No pain at all. And, it was interesting to watch, really, I should have been a doctor. Except for that pesky school thing, I probably would have been good at it.

I was not in a position where I could take a photo of my own aspiration, but I found this one online that looked like what I saw - you can see the needle in the cyst:



As the fluid is pulled out, the ends of the cyst collapse into each other and no more cyst.

After the fluid from the complex cyst was marked, they worked on the smaller ones surrounding the large one. Still no pain. Then they hit the big one and at that point, it did hurt. Nothing horrible and not even enough to make me jump but sort of a cramping, suction type pain. If you ever had an amniocentesis, it felt like that, only in your breast. It took two syringes to get all the fluid out of that one before it collapsed into nothing.

The doctor said everything looked perfectly normal and cyst-like - even the complex cyst. All of my fluid would go to the lab but she expected normal results.

Two days later I did get the results: benign.

First time I ever heard that word after a breast procedure.

Now I have a huge divot where the cysts were. The doctor said it would fill out in a day or two, but so far, no luck there. I have my doubts it ever will. It's pretty big and those cysts were there a while and made up pretty much the top part of my breast. But, it doesn't matter as that side will get an implant too, at some point.

I have to say, it's very nice to feel that breast or lie on my stomach without those big rocks inside. Maybe I should have done it long ago - having had cysts for my entire adult life.

There is a 50% chance they'll return, unfortunately.

So, hopefully, the Guinness Book of World Records people will find this blog and see if I can be in the running for record number of breast procedures.

Breasts sell, and with Guinness, the lack of one might sell even more.

I deserve that kind of fame, don't you think?


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The State of my Bosom(s)

I suppose I should update you with the progress of my breast reconstruction. I have had my third saline injection into my tissue expander, AKA as "fill."

I have retired my "foob." There is enough saline in the expander to create the look of a sorta breast thing-a-mabob.

In clothes, that is. Outside of clothes, it looks like something is growing on my chest that shouldn't. I hope an alien doesn't pop out and try to kill me.

I am wearing a regular bra and now am padding my good side because, like I said before, I'm getting that baby's head look. My right, missing breastical area is high and round and my left side looks like a 51 year old old who has hit menopause. So far, the padding/propping is fixing the external appearance, but I sure hope the scarf across the chest look is in for a while, because after the next fill, I think I'm going to have no choice but to rock that trend.



Although, you never see the scarf across the chest AND across the head on What Not to Wear. I guess I won't be hearing Stacy tell me to "shut the front door," at least for a while.

One another front (well, actually it's the same front but different topic) Monday, I go in for a cyst aspiration. Considering how big the cysts in my remaining breast are, this should deflate me like a balloon. I might have to get the foob out for the good side, who knows? The cysts have grown so big that sleeping on my real side is like sleeping on a bag of rocks, and is worse than the tissue expander side, so I'm glad to have it done. They said to block off the entire afternoon for the procedure, which makes me really happy. It's been 1 1/2 weeks since I spent an entire afternoon having medical tests and procedures. I was beginning to feel like a wallflower.

So, that's the State of my Bosom(s). God Bless America.


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Ambien

One of the pleasures of breast cancer treatment is the variety of drugs to you get to try. As a child of the '70s you can imagine how exciting it is to watch my pill bottles stack up.

My night stand rivals that of any senile 85 year old.

So, lately, having some new-found sleep disturbances, I figured I could add to my collection.

First, let me explain to you that trouble sleeping has never been part of my makeup - difficulty waking up? Yes. Sleeping? Hell no.

Being a night owl, my habit (when not working) has been to watch TV until 1:00 am, then to go bed and sleep until 10:00. Sometimes I'll even throw in an afternoon nap for good measure.

Now that chemo has taken out my ovaries, I only seem to be able to sleep mornings. 5:00 am to 9:00 am seems to be my schedule. When I try to nap - nothing. I just lie there, brain buzzing, but still tired.

At night, even after a couple episodes of Hoarders and Intervention, I'm not ready to drift off. I can't think of anything more soothing than watching an alcoholic start their drinking at 10:00 a.m. or watching people high-step over piles of garbage in their homes - but still...no relaxation.

No sleep.

Knowing I'm going to go back to work soon, knowing it will be difficult enough to function even if I do get enough sleep - I finally asked for a sleep aid, and was prescribed Ambien.

I took my first one last night.

I also took my last one last night.

Maybe I was wrong about the '70s.

I took it at midnight after watching Little People, Big World. It worked. I was sleepy ten minutes later and was sound asleep by 12:30. But, as usual for me lately when I do fall asleep, it doesn't last long. I woke up at 2:34 am.

I was disappointed. It didn't work. So, I did what we all do when we can't sleep: Toss, turn, check the clock, plan the next day, adjust the covers, imagine a blog post. The cat was next to me so I scratched her ears. My eye was bothering me and I hoped I wasn't getting another infection. I made a mental note to order more contacts. I checked the clock again, felt too hot, then too cold.....tried to concentrate on the sounds of the rain to lull me to sleep... I remember it all clearly.

I was still awake when my husband's alarm went off at 5:20 a.m. I thought, "well now maybe I can get some sleep" and started thinking about the dreams I'd just had and how weird that house on the pole had been.

Wait.

Dreams?

Yes, very detailed dreams.

That'd I'd just had.

But I'd been awake. Almost all night! Were the dreams 3 hours ago and did I think they were recent? No, I'm pretty sure I'd just had them - they were vivid. As vivid as the hours I'd just spent awake.

I really WAS wide awake and really DID dream. Weirdest damn thing.

It's like the drug split my brain in two.

And, I continued to do that until noon. I was awake, feeling really hot and wondering if I had a fever while neutropenic, while at the same time, I was dreaming about kids on a playground who could fly.

Plus, it gave me a killer headache. I finally ended the whole experience when I got up to take an imitrex and take my temperature, and decided not to go back to bed.

If I'm going to be awake and sleeping at the same time, I might as well read the newspaper.

I guess I'll add not sleeping as one of the things I have to put up with, because I'm done with Ambien.

My collection of pharmaceuticals just got smaller.


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Me, Guest Blogger

I was asked to write a post on a new breast cancer blog. This is a magazine-style blog, with writers, newsy bits, social networking/twitter feeds and commentary. It's a valuable and entertaining addition to the breast cancer blogging community, and I was happy to share my thoughts with them.

You can read my article here at Join Our Loop.

While there, stay and browse.

Jeannette and Burt

After 7 weekly visits to the infusion room, head buried in my kindle or facebooking on my iPhone, I've finally made some chemo buddies.

Jeanette has breast cancer too, and her husband, unlike mine, comes along to her infusions for support. We've struck up one of those friendships that happen only because of a shared experience. We would have certainly missed each other otherwise.

It began one boring Wednesday as I checked the other patients in the room to see who might be interesting. A couple nearby were flipping through an old Better Homes and Gardens, laughing at a photo. Burt pointed out piles of pillows on a bed that looked like theirs. I saw a chance to butt-in, and we got to riffing about pillows, beds, and access to naps.

Naps: Something all chemo patients can discuss passionately and at length.

Apparently, their husbands can too.

Jeannette is way ahead of me in her treatment. She's finished with chemo and is almost done with herceptin. According to her husband, she no longer needs her sassy black wig, but she says she doesn't feel comfortable with short hair, so on it stays. A lot of us don't bother with wigs in the infusion room - after all, we're all in the same boat. But, Jeannette is one of those women who likes to keep her appearances up, from head to toe. I'm the same way, but now mostly from neck to toe.

Wigs are uncomfortable.

She also just began radiation and like everybody, mentions how time-consuming it is. (Radiation requires a daily appointment.) Burt sees it differently. Like my youngest son, Burt enjoys puzzles and there's a jigsaw puzzle in the radiation oncology waiting room. He's worried he won't finish it before Jeannette is done.

I think he should just go finish it without her.

But, I doubt he will, they seem very close. They even make pies together. Burt makes the crust because Jeannette sucks at it, and she does the filling. Last week they made lemon meringue but the whites wouldn't set up.

Burt is very solicitous of everybody in the infusion room - even the whiners. (My word, not his). There are often snacks sitting around in case people get hungry - stuff like oranges and peanut butter-filled pretzels and cookies. Burt, who likes to eat, gets up and offers them around, mostly, I think, so he can feel comfortable eating them on his own. He even peeled an orange for me while I was having an IV put in and my blood drawn and couldn't use my hand.

That's a gentleman.

They like me to sit next to them each week, and it makes me feel like the cool kid in the school cafeteria. Their jokes and positive attitude make them popular among the nursing staff too. Cancer can be a frightening experience and sadly, we see a lot of people in the infusion room who don't handle it with equanimity. (The aforementioned whiners - again, my words only.) I'm sure nobody blames them for their fears and needs, including me, but when you are stuck there for five hours, it's nice to find others who can take it in stride without begging for ativan every 15 minutes, discussing every ache and pain, or complaining about trivialities such as the IV needle and having to go to the bathroom.

I enjoy people who don't over-dramatize their illness.

I imagine Jeannette and Burt feel the same way about me, although naturally, we never discuss it. We just create our own fun little sanctuary between the IV poles, sharing cookies and jokes.

It is amazing to me that people of that age can have so much energy, be so modern, and have such a loving relationship. Gives me lots of hopes for the future. I find them inspiring.

Jeannette and Burt are almost 90.



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Obituaries

Ever since I got breast cancer, I have cultivated a new hobby.

I read the newspaper obituaries.

Not just any obits - I have a goal: I'm looking for women who died of breast cancer.

I know, it's morbid.

I'm not sure why this started. I've certainly never been a death notice reader. Unlike my husband - who during weekend breakfasts would scour the obits and seem delighted at seeing one of his dead mother's old friends listed - I found it a peculiar thing to do. I assumed his habit was some way of connecting with his mother, but I never understood using death as a means to reminisce.

When I was diagnosed with breast cancer, my newspaper reading habits changed. Dear Abby? Out. Death Notices? In.

I'm not sure why I do this. I know most of us, when we read stories in the paper about somebody who has tragically died, look for reasons why it could never be us.

"Well, I wouldn't have been out at 1:00 a.m. so that random freeway shooting couldn't have happened to me." It's a mental trick we use to distance ourselves from tragic accidents and death.

Obviously, since I have cancer, that reasoning is out.

Am I looking for clues as to what they did wrong in treatment so I can feel I'm doing it right?

Unlikely, as I haven't seen any "refused chemo" or "believed only in spirulina and reiki" obituaries.

When I see a woman in her 30s who has succumbed, I do find myself saying, "Oh, she was young, it's worse for them, that's why." but I have no such excuses when I see somebody 50 - and there are more of them. Or us.

Perhaps it's my way of facing an alternate reality. I've never believed I would die of this cancer, and I still don't. But, technically, I could. People with my pathology do, all too often. It's not completely out of the realm of possibility.

Maybe my obituary reading is my own mental trick, except rather than using it to distance myself, I am reminding myself that yes, this is a disease that one dies from.

And, I have it too.



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Flashes, Feet, and Chemo #3

So, apparently I have been put in "chemopause" by my treatment. Knowing it was coming and preparing for this day, I had used up all my tampons and was happy to have the shelf space back. Then, Aunt Flo, that old pest, visited me twice last month and I had to go shopping for supplies. She's not come back on time, and now I'm left with tampons and a lack of shelf space again.

If that wasn't enough to make me sure I was menopausal, the 14 hot flashes I have a day is. I'm sure it's hilarious to watch me pull my hat on and off all day as the flashes come and go. My husband and son have both taken to yelling "hot flash" when they see me pull the cap off or pick up a paper and fan myself.

The joke's on them. After a flash, of course, I'm freezing so the heat is left on at 77 at all times. Now they get to experience hot flashes in their own way.

Why should I be the only one to suffer?

My doctor says that at my age, my ovaries won't recover from this assault. I'm now an official hag and have to finally give up my dreams of having another child.

On to nagging my eldest for grandchildren.

My 3rd out of 6 chemotherapy sessions was yesterday. It almost didn't happen due to the Lukeine problem. The leukine did arrive - Tuesday night. With no syringes. Those arrived an hour ago.

(I was still in my pajamas)

No matter about the late Lukeine, I'd gone in for a blood test Monday and they said that I could do chemo - my whites were high enough.

But yesterday, when I went in for the actual chemo, I was told, "Why no, your whites are not high enough and you might have to skip it." They couldn't test my blood again because their machine was down. They had somebody running it to their other office in another city, so they took mine and ran it up but they had no hopes I would get it back in time.

Skipping a chemo session probably doesn't mean certain death but it does mean I do this for an extra month and I'm ready for this four doctor's appointments a week thing to end.

After my herceptin infusion, they gave me my pre-meds anyway. Doctor wasn't in yet but they said he's usually pretty good at letting people a little low start chemo.

And, then my blood tests came back and I was in the range, so the drip went in.

After my third chemo, my insides feel like lead. Like everything just stopped. I am drinking my water and eating my high fiber but things seem to be slowing down. Chemo is cumulative - it kills off cells every three weeks and it takes them longer and longer to regenerate. Especially your red blood cells - they don't give you anything to regenerate those and mine have dropped lower each time. It means I am anemic and need more sleep. The only way to improve that is with a blood transfusion and hopefully, I won't ever need that.

And, as I get to the bottom of this note, I will talk about my feet. I am beginning the signs of neuropathy. My feet are very sensitive and feel tingly and slightly painful. The tips of my fingers too but that is much milder. However, from this point forward, you may now blame all typos on this blog as being caused by finger neuropathy.

My tongue is still dead.

I have to go back to work. My oncologist reluctantly released me to go back part-time February 1st. Schools are not healthy places for people with no white counts and I have been told that once neutropenic, it will happen every time. I hope they realize part-time doesn't mean half-time. I think it'll mean a few hours a week. Especially if I have to give myself four painful Leukine shots a week. The side effects of those shots were much worse than anything else and getting up and commuting with that kind of neck and bone pain probably isn't going to happen.

We'll see. I think at this point, they'd be better off without me but I need my job for next year when I'm healthy again and if I snooze, I lose. My leave is over.

So, time will tell.

Me, bald

Somebody kept asking me on YouTube to show my hair now, after the last video of it falling out. So what the hell, I'll show you too.

Lacking Leukine

Last Wednesday I had my typical herceptin infusion and blood test, after waiting for 30 minutes past my appointment time. Also typical.

I was handed my bloodwork, as always, and was told everything looked good. I checked and my whites were very low but they are always low, so I figured if they said it was good, it was.

Later that evening I got a call from the nurse. My whites had not come up from the last week, and it was time for colony stimulating shots to prevent lethal opportunistic infections.

(They couldn't tell me that when I was there?)

I was told I needed to come in four days straight to get Leukine shots. It was very important that I have all four shots, she said.

That included Saturday and Sunday, and they wanted me there at 9:00 a.m. The nurse is only there for 20 minutes on weekends to do this shot thing so I had to be on time.

Um, I'm not the one who's not on time but I let that one go.

I have a hard time being anywhere at 9:00 a.m. when I'm healthy, much less now when I'm exhausted from chemo. But, I knew that the injections were important. Without them, I can't fight off any infections.

On Thursday when I went in, I asked if I could give myself the injection at home? I've been giving myself subcutaneous Imitrex injections for 16 years so I already know how. She said sure. Come in the next day for the shot and they would arrange for me to have it for the weekend.

I went in on Friday, waited the typical 30 minutes past my appointment time for the five second shot and asked again about the home injections - I asked if they had checked to see if my pharmacy had it? Sometimes my pharmacy is out of meds - I've had to wait for both Imitrex and Compazine before. If they didn't have it, I'd come in for the shots, I said. She said "Oh no, we're having it sent from a special pharmacy."

Surprised, I said "Oh, does that mean I have to be home to get it?" She said that I would, that they won't leave medication at the door. And, that it would probably arrive Friday afternoon.

I had errands to run and my husband (on Furlough Friday) did as well, so we tag-teamed so that one of us was always home.

6:00 came around, and no medication arrived.

Well, I suppose it could arrive on Saturday - today - especially if it's delivered from a pharmacy.

Right?

I made sure to get up at 9:00 today to call the oncology office, since I knew the nurse would be there. Just to check and make sure the call had gone to the "special pharmacy" you know? Not that I don't trust them or anything.

But, naturally, nobody answered the phone.

Silly me.

It's 12:30 now - so far, my Leukine hasn't arrived.

Want to take bets on whether it will or not?

How important is it for me to get this medication, again?

Clearly not very.

In a way, I'm glad I don't have the shot, as these injections have caused me some serious bone pain and also heartburn.

But, I also have an eye infection and having white cells to fight it could be kinda helpful right now.

(Don't worry, as a school employee I always have antibiotic eyedrops on hand.)

If there is no knock on the door by 5:00, I'm going to have a little talk with my oncologist on Wednesday.

Perhaps we need to switch pharmacies.

A fine line

I had an ultrasound on my remaining breast today, after finding a lump. The great news is the lump is just the newest member of my cyst farm. It would seem my farm is not your regular old barnyard animal farm, with chickens and pigs and a dog or two.

No, mine is one that specializes in exotics, like giraffes and lions and hippos. According to the sonogram, there are lots of very large animals in there. And, the newest member of my exotic animal farm is a huge African elephant: one so large and growing so fast that it's pushing its pen out of shape.

I'll have to talk to my plastic surgeon about giving it a bigger pen.

While I'm quite relieved that it's not cancer that has reared its ugly head again, having a cyst that grew so large, so rapidly, and which is visible to the eye does present a problem.

How am I to know when a lump is normal or not?

I thought I knew. I thought I was an expert.

My cancer was a hard lump, visible through the skin, with a bruised appearance above it that changed the shape of my breast.

My newest cyst is a hard(ish) lump, visible through the skin, with a bruised appearance above it that changed the shape of my breast.

The main difference between the two is that the cancer was immovable while the cyst is not. And, of course, the dimpling I eventually experienced with the big C. Dimpling is a pretty clear sign of cancer. Movablity is iffy - it could go either way.

So, how do I know what's a normal animal and what's a predator? When do I go to a doctor?

When dimpling appears? With each appearance of an elephant head?

It's going to be a fine line to walk, and I fear I'm going to step in a lot of exotic dung before I get it right.

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Once you have cancer....

...do you always worry it will come back?

I swore I would not do that to myself. Yes, I had the bad luck to get breast cancer at a relatively early age. Yes, I faced the loss of a breast and am dealing with the aftermath of that loss. I now know what a chemo infusion room is like and how it feels to be a bald woman. I have even discovered the secrets of wig shopping.

These are the facets of having breast cancer that I have faced, and in some cases, even embraced.

The one thing I would never do, I told myself, was worry about recurrence. I would not live in fear and define myself forever as a cancer patient. The majority of us go through our treatments and live long lives. I am statistic-minded and logical. I only had an 11% chance of getting cancer in my first breast. Metastases to other areas happens, of course, but for a Stage II person with no nodes, it isn't likely.

I was never going to attribute age-related hip pain to bone metastases. I wasn't going to see a pimple in an odd place and immediately think cancer. No headache of mine was going to be thought of, even briefly, as brain mets. Lumps in my remaining breast were going to be the cysts I know are there.

I was determined: this cancer and the subsequent treatment was going to comprise an interesting and difficult year and then it would - forever - be over. Lightening doesn't strike twice.

So, a couple weeks ago, when I found a lump in my left (and remaining) breast, true to myself, I assumed it was another cyst. When it grew a little bigger, I didn't change my opinion. It can't be anything but a cyst, logically. Back in October, an MRI showed a cancer-free breast. I am undergoing chemotherapy - nothing serious can grow in the toxic environment that is now my body, and certainly not grow that fast. Anyway, in three months I'll have another MRI, so even if it is cancer, well, it can wait.

I won't worry.

But, a week ago, when I noticed bruise-like shadowing above the lump, I paid attention. Worry crept in. Yesterday, when lifting my arm above my head showed the lump through the skin clearly and deformed the shape of my breast, I sighed and acknowledged the universal truth: once you have cancer, you will never be the same. You will always live in fear of it returning.

Today, I had my herceptin treatment. I told the nurse about the lump, who told the doctor, who saw me immediately. He felt it, told me something was definitely there but to try not to jump to conclusions.

He knew that would be difficult, he said.

An ultrasound is scheduled for tomorrow.

It's probably a cyst. Logically, statistically - it's a cyst.

But, emotionally, I'm afraid it isn't.

Can lightening strike twice?



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An example of chemo brain

Here is an exact conversation I had with my husband last night.

Me: "Honey, who is the bald character on Lost?"
DH: "You mean Locke?"
Me: "Yeah, thanks."

Five seconds go by.

Me: What was his name again?
DH: "Locke"
Me: "Oh yeah,thanks."

Five seconds go by.

Me: "What show is he on again?"

Notice

Since sitting down in between naps is all I seem to be capable of these days, I thought I'd try to sit and be productive. I'm updating this blog template to something a little less...uh....pink. Please be patient as I update and fix errors, and please do leave a comment and tell me what you think of the new look.





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Chemo Fatigue

Fatigue has descended upon me like Sacramento's tule fog. It's heavy in my bones; each movement requires a resting period. My fog lights are dim and my brain is soft and wet. I am a cold, dank, January morning.

Awaking from sleep uses enough of my energy so that a nap is required. My normal 9 hours of daily sleep has become 15, but even with that, I don't feel refreshed.

The effects of chemo are cumulative. At this rate, by April I'll have been sound asleep for a full month, much like Rip Van Winkle. But, hopefully, I'll awaken to a new, healthier life.