An Ordinary Day

There was nothing but leftovers in the fridge, so we ordered the "Canadian" pizza (with pepperoni, bacon and mushrooms). We ate in front of the TV as we usually do on a pizza night. Plus, the hockey game was starting: Ottawa vs. Toronto. I had one eye on the iPad through the game, playing Hay Day and reading the Twitter feed. Unfortunately, the Sens lost. We hate to lose to Toronto, but so many of our top players are out with injuries that we really didn't expect much scoring. After the loss, we sent the Bean to bed. I should have gone up at the same time; instead, I promptly fell asleep while we watched "Monk" on DVD.

In the morning, I slept in. And then slept some more. The Bean and I had breakfast together and watched the Family Channel while my Sweetie was at the gym. Next thing, it was time to shower, while Sweetie sorted the dirty clothes. Sunday is laundry day at our house. After lunch, the Bean and I went to Loblaws for groceries. Tomorrow is Family Day and the grocery stores will be closed. Sweetie is making carrot ginger soup tonight. Mmm... I also got all we need to make Baked Pasta tomorrow. Despite Family Day, tomorrow night the Bean has her first tryout for competitive level soccer. We learned last summer that pasta and sauce is the fuel she needs to play her best soccer.

So I'm sitting on the couch with the iPad watching "Income Property" and thinking about my day. It's an ordinary day really. It all depends how you look at it. But this can be a day with Stage IV breast cancer.

We Can't Not Treat It

Yesterday, we saw Dr. M, my radiation oncologist. The first time we saw her, over a year ago, we were a little bowled over by her approach. Unlike most doctors we see, she took us on a journey through her thought process. She did the same thing yesterday, and I like it. I came out feeling like I understood exactly how and when I would be treated, why I would be treated and even what the risks of the treatment would be. Really, that shouldn't be too much to ask.

Having looked at the CT and X-rays as well as the orthopedist's report, Dr. M was clear that my hip needed to be treated. The problematic tumour is in the femoral neck, the thin part of the femur leading to the ball that fits into the hip joint. It is a vulnerable spot. I should get a call soon to go in for marking in the next 10 to 14 days. The marking (tattooing, actually) is done before the radiation to allow the beam to get the right spot each time. After that, I will get five sessions of radiation to the femoral neck as well as up towards the ball and down a bit into the femur. She informed me that after the radiation, the blood vessels in the area would dilate, which may put me at increased risk of fracture for a period of time. While this risk is known, there isn't sufficient research to determine how long the increased risk would last. Given my health (good compared to many cancer patients) and mobility, she estimated that within a month, my hip should be healed. We also talked about the possibility the orthopedist would recommend surgery, or a fracture would require surgery. She assured me that the radiation and resulting dilation would not have an impact on any subsequent surgery.

As you may know, typically with breast cancer, patients receive 20 to 30 sessions of radiation after surgery and chemo. Bone metastases are treated very differently. Dr. M does five to ten sessions on bone mets. As I understand it, they limit the number of sessions because the radiation can seriously affect patient's bone marrow.  This isn't an issue when the breast is being radiated.

I am preparing myself for two side effects from the radiation. First, I am likely to experience some increase in bone pain in the days after the radiation sessions. That shouldn't last long. I may also get a "sunburn" from the radiation. I still have a darkened, dry area on my back from the radiation I had on my spine. This morning I started applying Dream Cream from Lush to my hip. Perhaps if I keep the area moisturized, it won't burn.

In the meantime, I'm to continue to be careful of the ice. And no jumping off buildings, Dr. M said.  That's a shame. Tomorrow is Superhero Day at the Bean's school. I won't be able to join in.

Thank You For Being There With Me

Over the last couple of days, I have read a couple of blog posts about Stage IV cancer patients feeling abandoned by their friends, colleagues and even family who "can't handle" their cancer diagnosis. One of my favourite bloggers, Ann at "Breast Cancer? But Doctor... I Hate Pink" shares her very personal story in her post Abandonment is not a form of love. I've read of women with Stage IV cancer even feeling snubbed within the breast cancer community, like we are the wicked stepsister in a pink fairy tale. If you have come to this blog looking for guidance on that sort of situation, I can't really help you, other than to recommend you click on the link to Ann's post.

I feel compelled to write about the level of support I have received because it has truly been incredible, unexpected... even overwhelming.  Since I got sick, you have all been there for me:

• the Bertolo cousins who phone me to see how I'm doing;
• the teachers that filled our freezer to overflowing... twice;
• the neighbour who loaned my her wig;
• the second cousin I met online who emails to check on me if I haven't blogged in a couple of weeks;
• my boss and coworker who have tried to crochet me back to health;
• the coworkers that collected money to buy me a tablet to keep me connected at home;
• my high school buddies that came to Ottawa for my birthday;
• everyone who donated money to the Run for the Cure on behalf of me, Sweetie and the Bean;
• the neighbour who looks after the Bean when my chemo and doctors appointments run late;
• my brothers, who check up on me even though life has thrown then a lot of shit this past year;
• my aunties and uncles who call, email me about cancer-fighting foods, and have masses said for me;
• old friends sending me messages of support on Facebook;
• the Bean's friends' moms who have invited her for playdates and offerred to take her any time we're in a bind;
• neighbours and coworkers who gave us suppers and sweets last year when we were overwhelmed with all the appointments;
• friends that visited me in the hospital;
• friends that came to our house to make us pizza;
• friends that sat with me during chemo, even though the Benedryl threatened to put me to sleep;
• everyone who put up with incoherent emails and voicemails back when I was adjusting to the painkillers;
• my sweet girl, who cut her hair for cancer wigs, and makes her own breakfast;
• my Sweetheart, who does everything for me.

I am afraid that I am leaving someone out! Believe me, you're in my prayers. I am so grateful for the support I have received from everyone I know. I am carrying a heavy load with this diagnosis, but you have helped me every step of the way.

Thank you.

Sometimes I Lie

Little white lies. I feel I have to tell them. Why? Mostly for the sake of the Bean, my little girl.

Frequently in the neighbourhood, at school, or this week at the dentist, people ask me why I am using a cane. I explain that I was diagnosed with breast cancer and it has spread to my liver and bones. God bless them, they usually say something like "but the cancer is all gone now?" Uh, well, no. "But you'll be alright, won't you?" That's when I tell a modified version of the truth. I say that the doctors treat it as a chronic disease, like diabetes. If I mention that there is no cure, I do it in my sweetest, most hopeful voice. Why? BECAUSE MY DAUGHTER IS STANDING RIGHT THERE!

Yes, the doctor really is treating it like a chronic disease... because there is no cure.  Trust me, it's not like diabetes. With all due respect to my dear friends with diabetes, it's not the same. They wouldn't want to trade diagnoses with me.

In front of the Bean, do you think I am going to mention that breast cancer is likely to kill me before she grows up? Come on, nobody wants to hear that. Especially me.

I really wish there was meaningful awareness of breast cancer. I wish people understood how common it is, that there is no cure. Damn Lance Armstrong and the Pink Police for convincing everyone that cancer is easy to fight. It isn't. It is an insidious demon attacking me daily. I fight it with handfuls of pills, IVs and radiation. I fight it with every stubborn breath I take. But it isn't easy. Unless you ask me in front of my girl, in which case I'll say, "I am fine, really. The doctors have it under control."

Flashback to the Biopsy Table

"But my girl's only eight," I cried! The radiologist and technician stopped making their "no need to worry" noises as the image on their ultrasound screen became clear.

I knew, before the needle biopsy. The CT had already shown apparent metastacized tumours in my liver and bones. We could feel the breast tumour. It wasn't pea sized. It was huge. I knew what this meant.

"But my girl's only eight!"

Can you hear the terror in my voice? I can hear the paper on the biopsy table, under me and feel the cotton robe against my cold, frightened skin. I can see the dim light coming in from that north-facing window. And I can feel the terror. Not that I might lose my life, that's not the issue. That my daughter's health and happiness would forever be tainted by my diagnosis, by my prognosis.

I will need a miracle to survive this disease. But every morning that I can face my dear girl with a smile is a miracle for which I thank God.

Mackenzie King, My Orthopedic Surgeon

I still have a lot to learn about the medical system. For example, when I was told I would be seen by an orthopedist, I didn't realize he was a surgeon. Interesting guy. He introduced himself by way of saying that he loves operating. It's his thing. But... His mortgage is paid off. Bottom line of yesterday's appointment was, to paraphrase Mackenzie King, "surgery if necessary, but not necessarily surgery."

He explained that the CT wasn't sufficient to assess the risk I will fracture my leg. He sent me straight over for plain old x-rays of my pelvis and both femurs (thighbones). He will see me again in four weeks. In the meantime, I will see my radiation oncologist, and now she will have the benefit of the X-rays to decide whether to radiate. And, if my hip pain (which we all agreed could be psychosomatic) spikes, I'm to get on crutches and get to the hospital. Unlikely, I expect.