Today, Dr. G mapped out my plan of attack.  Based on all of the testing that has been done so far, this is his recommended course of strategy for my War with Cancer:

Battle 1:  The Chemical War Offense–  Considering how large my tumor is, Dr. G has recommended that I begin chemotherapy.  As soon as possible.  This will hopefully achieve 2 goals: A.) Shrink the tumor in my breast such that I will be able to have a lumpectomy instead of a mastectomy.  B.) Immediately stop the cancer from spreading through the rest of my body.  This battle will be the hardest.  I will have to endure one cycle of chemo every three weeks.  I will lose my hair.  I will be very sick.  I will suffer many unpleasant side-effects.  But, like all wars, I may have to suffer through some “losses” (i.e. my hair, my energy) in order to win the battle.

Battle 2:  Operation Surgery–  Assuming that I win the first battle (and I will win the first battle) my next course of action is to undergo surgery.  I will hopefully be a candidate for a lumpectomy.  With a lumpectomy, only the tumors will be removed so that I won’t have to lose my whole breast.  I may also have to have the lymph nodes removed from under my armpit. 

Battle 3:  Nuke Any Possible Survivors–  After I recover from the surgery, I will undergo 6 weeks of radiation of my breast.  The radiation will “sterilize” my breast tissue by killing any miscilaneous microscopic cancer cells that may not be visible at the time of surgery.  This will reduce the possibilty of the cancer returning by a considerable amount.

Battle 4:  Sanctions Against the Enemy–  Cancer violated and invaded my body.  Now I will starve and kill the cancer.  A Hormone Receptor Test (this is a test that was performed on the sample taken from my biopsy) has shown that the cancer takes signals from and “feeds” off of my body’s estrogen.  Hormone Therapy (a pill taken every day) will block the estrogen in my body and “starve” any cancer cell that may be in my body. 

Timing is of the essence, so Dr. G has requested that I meet with my Chemo Oncologist, Dr. N, today.

I met my Chemo Oncologist, Dr. N, this afternoon.  He’s a very confusing fellow.  I don’t think I’ve ever met anyone as stoic as he.  I guess that’s a good thing.  You don’t want your Oncologist playing the “got your nose” game with you or telling you, “Lighten up!  You’ve got cancer.”  It’s just that when I’m nervous, I make jokes or I try to say something that will break the tension in the room or get a rise out of somebody.  When Dr. N told me that I would be starting chemotherapy right away, I told him, “Good!  At least I’ll be Chemo-Skinny!”  Instead of cracking a wan-looking smile at my gung-ho spirit, he looked disturbed.

“Actually, Karen, you will most likely gain weight during chemo.”

“……….huh?”

“You should probably count on gaining between 20-30 pounds.”

“You’re kiddng me.  That can’t be right.”

He went on to tell me that I will experience many other symptoms:  Hair loss, nausea, anemia, my immune system will be compromised, pain, fatigue, shortness of breath, menopause, hot flashes…the list went on and on.  He told me that I would have one round of chemo every 2 weeks.  This is because I was young and strong and could take a  more frequent dose than the standard “one round every 3 weeks”.  All in all, he expected me to have chemo every other week for the next 6 months.  Now remember, Dr. G told me that I would be getting the standard every-three-weeks dosage.  I knew I must be in trouble, because already, they were upping my dosage.  (This, of course, would also mean that my husband would need to up his dosage of his little blue calming pills- his doctor put Michael on Valium because of my cancer.  We both get prescriptions.  Yea!)

“So, Doctor N-  Is there anything that I can do to not gain so much weight?”

“Not really.  Weight gain is a side effect of the chemotherapy.  The chemo will also shut down your ovaries and force you into menopause which will also cause weight gain.  But that’s really the least of your worries, Karen.”

“Wait.  Hold on a second. You’re telling me that I’m going to be bald and fat?”

At that point, I think the doctor thought my priorities were a little out of whack.  He gave me a strange look and then continued…

Dr. N told me that I would start chemo the upcoming Thursday, which was in 3 days.  He then told me that he wanted me to have one last test before I began chemo.  The test was called a PET Scan.  A PET Scan is the most sensitive cancer detecting test available at the moment.  This test will clearly show if my cancer has spread and where.  At this point, there are a couple of “suspicious shadows”, but the cancer could still be isolated to my breast.

When our meeting was over, Dr. N threw his arms around me in a very awkward bear hug.  I didn’t know how to react.  It was completely unexpected because up until that moment he personified stoic professionalism.  Dr. G never acted this way.  We always closed our meetings with a friendly handshake.  This contact, this hug, made me very worried because I realized on the way home that Dr. N…..felt sorry for me.  Uh oh.

I’ve been sitting here thinking about today’s appointment with Dr. N.  When I got home today, my husband grilled me about every moment of my appointment.  I’ve been going to the appointments by myself because my husband and I are self-employed with a very busy Arizona mortgage company.  (By the way, if you need a mortgage in Michigan, Iowa, California, Arizona, New Mexico, Utah or Wyoming- we would truly appreciate it if you would consider using us.  877-551-8188, ext 83 to speak directly to me- ext. 88 for Michael.  We will beat the best deal that you can find.  Ditech-schmytech.)  

My husband has to stay behind to process the loans and take care of general business stuff.  This arrangement makes him terribly anxious and upset because he wants to hear everything that the doctor has to say to me.  If he had the equipment to ”bug” my conversation with Dr. N, I’m sure he would.

Anyway, I was thinking about some of the things that Dr. N had said.  He said that I was going to lose my hair after the second round of chemo.   He then wrote me a prescription to have a wig made so that my insurance will cover it.  I’ve been thinking about the possibility of losing my hair for a while, and I don’t think that I want a wig.  In fact, I think that I’m going to just shave my head before I start to lose it.  My life is spinning a little bit out of my control and shaving my head is my way of letting the cancer know that I decide when I lose my hair.  I also don’t think that I will wear a wig.  Wigs creep me out.  When I was a kid, my brother hid my mother’s platinum blond Doris Day wig on the floor of the closet and told me it was a dead rabbit.  Also, I live in AZ where the temperature can get as hot as 115 degrees.  Wearing a wig would make me feel like I have a hot, dead rabbit on my head. 

When I made it known that I was going to shave my head, I was surprised at the mixed comments that I received.  My husband and parents were behind me 100%.  But, I had to convince a few other people that it was a good idea.  One friend told me that I shouldn’t shave my head because I might not lose my hair from the chemo, afterall.  Her grandmother had to have chemotherapy last year and didn’t lose her hair.  I didn’t know this before either, but it turns out there are several different types of chemo.  Indeed, there is some chemotherapy that will not cause hair loss.  Dr. N assured me, though, that I would be experiencing hair loss from my chemo. 

I thought some more about Dr. N.  Could I really put my trust in this man?  While he was giving me the gruesome details about all of the side effects that I would be experiencing, he would scan my face and look at his computer, but he didn’t really look me in the eye.  He spoke very calmly, but very deliberately, in a clear and somber tone.  Physically, he was about an inch shorter than me and (I hate to admit it) about 15 pounds lighter than me. 

In other words, I could take him. 

“Dr. N.  Are you absolutely sure that I need chemo?  Isn’t there anything else that I can do?  Any natural therapy I can try?  This just seems so ridiculous to me!”

“Karen, countless doctors at our facility have reviewed your file.  We all agree that this is the best course of treatment for you.  Please believe me when I say that the last thing that I want to do is take this beautiful girl (awwww, shucks.  Dr. N thinks I’m beautiful) and make her bald and sickly from chemo.  You do have the right to refuse treatment, but I can promise you that this is the best course for you right now and I recommend starting the chemo.”

“Okay Doctor.  I’ll do it.”

I’m going to do it.  I’m going to start chemotherapy.  I’m going to defiantly shave my head.  I think it will be good to let go of my vanity.  For my whole life, I’ve washed, conditioned, brushed, colored, high-lighted my hair.  I’ve spent countless dollars at the salon.  I’m going to let it all go.  I’m going to shave my head and be bald for a while.  I’m going to be free from caring about my looks so that I can concentrate on the essential:  Getting Well.

I just wanted to take a moment to reflect back on my previous post.  If you read yesterday’s post, you’ll see that my doctor told me that “countless doctors” have looked at my file.  This is the difference between going to a learning hospital that specializes in cancer- like the Mayo Clinic- and just seeing your local oncologist, who probably makes all of the decisions on his own.

The Mayo Clinic in Scottsdale has teleconferences with the Mayo Clinic in Minnesota and Florida- all the best breast cancer doctors in the U.S. discussing my file with faxes and television monitors and maybe even heated arguments- who knows?  Like, maybe Dr. House was there, telling all the other doctors that they are wrong and that I am definitely lying about something.

But I digress: Think about that.  Please, please, please don’t go “just anywhere” if you are ever diagnosed with cancer– and I hope you never are…but if you are ever in my shoes, think Mayo Clinic; think Northwestern University; think University of Michigan; think Harvard; think M.D. Anderson.  Going to your local hospital is just nuts- unless one of your local hospitals is known as one of the best in the world. 

This is your health.  This is your life.  This is cancer.  Do it right the first time.

“Steve McQueen without hair?  It’s a blessing he died young.” ~ Dr. House

See, that’s one way to look at cancer…

Today I went to Mayo so that I could have a PET Scan done.  A PET Scan is the most sensitive cancer detecting scan available.  If you have a cancer cell in your body, the PET Scan will find it.  In order for it to be effective, I was not allowed to do any strenuous activity or lifting for 24 hours.  I also had to fast.  I hate fasting, because I get really edgy and cranky.  Anyway, I was given an information sheet that explained how the PET Scan worked.  In a nutshell, it said that I would be given a radioactive glucose solution intraveneously.  Cancer is a sugar feeder, so it “feeds” on the sugar solution faster than any other cell in my body.  (Think about that the next time you have a piece of cake.) 

 

As the cancer ”eats” the sugar, it absorbs the radioactive element.  Once this step is complete, I will be led to the scanning machine.  The areas on my body with cancer will glow yellow and orange on the scan’s image.

PET Scans are great, but a lot of times it’s difficult for cancer patients to have one because the machines are so expensive that many hospitals do not have them.  In fact, the Mayo Clinic’s PET Scan is a mobile unit that they lend out to different hospitals around the valley.  Each PET Scan costs approximately $5000…at least, that’s how much they charged me.  Could be more or less somewhere else.

Anyway, I went to the Mayo Clinic early that morning for my appointment.  I was really cranky because I couldn’t eat and I had to drive in rush hour traffic.  I was probably also a little cranky about dishing out $5000 that morning- on the spot.  By the time the nurse called me, I was starting to feel really antsy because I wanted to get this test over with so I could eat. 

I was led to a room with several vinyl reclining chairs.  This is when I learned that the nurse was going to have to put the IV in my foot.  She told me it was because the Doctor needed the dye fed at the opposite end of my body.  Since the cancer was in my right breast, the IV needed to be inserted in my left foot.  I had a real problem with that.  I do not like the thought of needles being dug into my feet.  Still, I didn’t have a choice.  The nurse reclined me back and began to look for a vein in my foot.  She wasn’t having much luck.  When she thought she had finally found one, she began to dig the needle in.  She kept missing the vein so she had to keep digging.  It was very painful and I started to feel like I was blacking out.  My ears started ringing and I broke out in a cold sweat.  Slowly the blackness washed over me and I passed out.

When I woke up, I was confused.  Then I felt embarrassed.  There were nurses standing over me talking to me, but I couldn’t figure out what they were saying.  I thought I had fallen asleep when I wasn’t supposed to.  Then I noticed something really strange:  I was fully reclined in the vinly chair, I had an oxygen mask on, and I couldn’t put my arms down.  They were clenched straight up in the air, and I kept thinking to myself, “Now that’s weird.  Why won’t my arms go down?”  I was too dizzy and confused to formulate this question to one of the nurses (who was now yelling at me, but I still couldn’t hear what she was saying through the ringing in my ears) so I just looked at her, kind of smiled and said, “Hi!”

The moment I spoke, the ringing in my ears began to fade and my arms relaxed enough so that I could rest them on the chair.  Then one of the nurses explained what happened.  I had passed out, and I had had a seizure.  That was why I couldn’t put my arms down.  I hadn’t noticed before, but two nurses had been holding my legs.  The nurses had called for a doctor to come in and examine me quickly.  Once he reviewed my history, he looked at me and told me that he wanted me to have a CT Scan of my brain, right then and there. 

“Why?”

“Considering that you have cancer and you just had a seizure, we need to see if [the cancer] has spread to your brain.”

I felt crestfallen.  The idea of the cancer spreading to my brain made me feel so depressed and dejected that I started to cry.  I couldn’t do this.  Who the hell am I to think that I can handle something as big as cancer?  I was all alone at the hospital, sobbing like a baby.  It was all too much.