Monday 20 February 2012

Check Your Boobs!

I know I said I'd give monthly reminders to do breast self-exams but I forgot to in January -- part of that awful drowsiness I was experiencing.  No excuse this month.


You probably remember the drill from high school health class, but in case you don't, here's a link or two to help you out:

Try doing it in the shower, or laying down in bed.  Get your arm way up out of the way.  Check your pits too.

My breast lump was something like 5 cm x 4 cm x 2.5 cm.  I believe the adjective my GP used was "huge."  I love him; he was right.  It was huge and by the time we had found it, it had metastasised extensively to my liver and bones.  You've got to think that, if I'd done monthly breast exams, I would have found it when it was smaller and maybe before it had metastasised. 

So, my question to you, dear readers, is "When do you want to find your breast lump?"

Poke around.  See what you find.  Get to know your boobs.  I'll be bugging you again next month.

P.S.  I'll be reminding you on the 20th of each month because that's my birthday.  When you're diagnosed with Stage IV breast cancer, your birthday starts to take on new meaning.

Sunday 19 February 2012

Chemo Update: February 19, 2012

I had my chemo treatment again last Friday.  As promised, the doctor reduced the Taxol dose by 20% and I believe he changed the dose of steroids given before the Taxol.

The session went as normal.  What was new was that my mom and dad came to visit, to see what the chemo was like.  They left as the Benedryl drip was ending.  At that point, Geoff came in and watched me sleep through the rest of the session.

Early in session, I noticed a dietitian speaking to some of the other patients.  Given the lost appetite I've been suffering after chemo, I may ask to meet with her myself.

That said, I haven't yet noticed any loss of appetite since Friday's chemo.  From the previous week's chemo session, my appetite left on Saturday and returned on Thursday.  I expected it to be gone by now, but it's not.  In fact, I really enjoyed my cereal for breakfast this morning.

The other thing that is new is that I noticed this morning that the swelling in my feet was virtually gone.  You wouldn't have believed the swelling I had on the tops of my feet.  But now I have a normally shaped foot.  You can almost see my ankle bone too!  This is incredible.  In fact, I went over to the scale and was amazed to see that my weight had dropped about 12 pounds since I was at the doctor on Wednesday.  That's really something!  A lot of water gone.

I have one non-chemo update for you as well.  I've virtually stopped using the walker in the house.  And I've been forgetting my cane here and there, which means I can walk short distances without either cane or pain!  To be truthful, I can't get very far without some pain in my lower back, but I feel like I have regained the strength I had in November before the pelvic fracture and my hospitalization.  Again, this is great progress.

Pretty much all good news.  Hope that pleases you as much as it does me!

Wednesday 15 February 2012

Update: February 15, 2012

I'm overdue to update you on last Friday's chemo session.  Plus, I met with my oncologist this morning and got some unexpected news.

First, chemo.  It went pretty much the same way the last couple of sessions have gone.  The chemo itself is fine.  Afterwards, though, I end up tired and lose my appetite.  I haven't eaten much since Friday.  Even my favourite things, like Saint Hubert chicken and cream of wheat, I could only eat a bite or two of them.  My cousin Sam mailed me some of my grandmother's best cookies, genetti.  Even the genetti I have to eat slowly to get them down.  It's a shame.  Still, considering how difficult chemo is for so many patients, I know I'm getting off easy.  I can't really complain.  And that is why my appointment with my oncologist was somewhat surprising.

His focus is on maximizing my quality of life while controlling my disease.  He wanted to get my liver metastases under control and then reduce my chemotherapy.  The last CT scan showed that the liver mets have shrunk significantly, but it appeared that the bone mets had grown.  My oncologist pointed out that it takes months for bone mets to heal, and for the healing to be visible on a scan.  His interpretation of the CT results is that the bone mets may have grown while my chemo was interrupted in November/December, but they are probably responding as well as the liver mets are -- we just can't see it yet.  He's now going to reduce the amount of Taxol I'm getting by 20% to improve my quality of life (that is reduce the extent of tiredness and lost appetite I'm experiencing).  On another note, he will be reducing the amount of steroids I'm getting with the Taxol, which should reduce my swelling.

In a couple of months, he'll repeat the CT scan and if the results are good, he expects to cut my Taxol to once every three weeks, rather than twice.  Eventually, if my results remain good, after another couple of months, he'll cut the Taxol entirely and stick with the Herceptin for "maintenance."

He also mentioned that the liver is the most important organ in my treatment, the one he was most concerned with controlling.  This makes me feel much better, given the dramatic results I had on the liver mets.  I had been worried about the bone mets, but his comments this morning made me less concerned.  I just have to be more patient with the bone mets.  The fact that my pain levels are greatly reduced is probably a more accurate reading on my bone health than the CT scan was.  That's good.

Monday 6 February 2012

Now that I'm awake, I Can Fill You In

Over the last month, I have certainly reduced any sleep defecit I had!  Honestly, I have had days where I napped for hours in the afternoon, slept on the couch all evening, had a normal night's sleep, and then fell asleep reading the newspaper at breakfast.  You have to agree, it's a bit much!

Finding a solution hasn't been easy.  Our working theory has been that my pain level has reduced enough that the level of hydromorphone I was getting in the pump was causing me to get drowsy.  It seems that you can tolerate high levels of this drug withough side-effects if you have high pain levels too.  But once they drop, weird things can happen.  In fact, when they first put me on the pump in the hospital, the levels were so high that I was sleepy and hallucinating.  Truly loopy.  Lately, just sleepy.

Realizing that my pump was set at a pretty low continuous dose, my pain nurse suggested we remove the pump and replace it with the right doses of both continuous and breakthrough levels of oral hydromorphone. We've spent the last couple of weeks adjusting the oral medications. The trouble is, I'm still drowsy.  And I've had more pain, especially in the morning.

My pain nurse, who is fabulous, has referred me to the Complex Cancer Pain Clinic in the hope that it will offer new alternatives that will help me.  Here's hoping. 

Geoff's Take on the Folks at the Ottawa Hospital

On Geoff's own blogsite, he recently posted on the type of people he has met at the Ottawa Hospital.  I encourage you to have a look at the post.