Month: January 2020

One Week

That’s how much time I have left in my treatment. I’m ready to be done. Yes, it’s been relatively easy. No, I haven’t had to had infusions. But I won’t miss hearing that alarm every night at 6pm telling me to go and ingest my poison.

A selfie of Amanda with her hair standing up a lot.
Still got the hair. And it does what it wants!

So, February 3, 2020 - my last time taking this pill. Hopefully forever. But, hey, cancer can always come back. At least if it does and it’s the same kind, we know where to start.

 

February 4, 2020 - my last oncology appointment during treatment. There will be more in the future, but this will be the end of the major part of my clinical trial and the beginning of the next phase: Surgery.

 

March 18, 2020 - probable surgical date. I’ll be signing papers on February 13th with my gynecological surgeon to perform a salpingo-oophorectomy with a hysterectomy. More papers to be signed February 24th with my breast surgeon. We’ll go over the surgeries in both appointments. They’ll be done on the same day, but one at a time so no surgeons accidentally elbow each other and drop a scalpel in somewhere. I’m sure that’s the reasoning. Anyway, they’ll get done on the same day.

 

So, I have 6.5 weeks to party with the tatas. It looks like I should be getting the drug out of my system within two weeks. So, that’s 4.5 weeks to party with alcohol. I’ll have to see if my neighbor is up for wine drinking any time soon - she just had surgery as well. You know who you are. 😉 Hugs!

Arthur chi-mix's head sticking out of blankets, he's yawning and looks kind of like a fox.
PARTY!!! Or nap. Either one works.

It’s just an unbelievably weird place to be in, I guess. I’ll be glad to be less tired, hopefully. And hopefully my red blood cells will become more plentiful and reduce in size so I am not sucking wind walking the dogs. I want to try to get in some sort of more healthy shape than I currently in, but it’s all very dependent on returning to normal.

 

And then I’ll be saying good-bye to my tatas and lady bits - technical terms - and going from a 38DDD or whatever I am right now to nothing. No nipples, nada. Will I flash people for reactions? Oh, probably. And also be thrown into menopause. Then I need to pay much closer attention to my diet and make sure I exercise. Menopause can increase your risk for heart disease. Mom had her first heart attack at 48. I don’t want to follow suit. I expect I’ll become a powerlifter, though, to prevent bone density loss.

 

I am really considering taking up running. I've never really been able to run that well - 8 minute mile was my fastest - but I think part of that was the fear of knocking myself ou

Edie beagle's head sticking out from under a blanket. She looks like she's listening for something.
Not impressed.

t. And asthma, but hopefully I can work beyond that.

 

So, expect to see me in the Olympics weight lifting competition and also running centuries. Yes, those are 100-mile races. Probably with a dog that I will have to carry part of the way with my power lifting skills.

 

And with that, I’ll see about setting up tata to the tatas events. Or at least leaving the house. I’ve been not doing that lately. So, so worried about getting sick. And it’s winter - kind of, this winter has been disappointing in the snowfall department - when I go into hibernation anyway!

 

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Anemia and You

Let’s talk about anemia! It’s been quite a while since I tried to educate you on anything important. I think this is important.

 

What do you think about when you think of anemia? Low iron is what most people would say. Yes! That is a form of anemia. Did you know there are other forms of anemia? Let’s go over the common forms of anemia. I used anemia way too many times in this paragraph.

 

According to the National Institutes of Health, there are four types of anemia. Iron-deficiency anemia, pernicious anemia, aplastic anemia and hemolytic anemia. Iron-deficiency is what everyone thinks about when they hear the word “anemia.” Most of the time, this type of anemia can be treated by eating more food with iron and/or supplementation. It is common in pregnant women as they are “eating for two” and also can be a side effect of diseases such as celiac disease or Crohn’s disease. Celiac being the actual disease, not the gluten-free trend.

 

Let’s take a step back for a moment and talk about what is involved in anemia. Red blood cells. That’s it. You either don’t have enough of them or they’re acting funny. So, iron-deficiency anemia is when you don’t have enough iron in your red blood cells, basically.

 

Pernicious anemia sounds scary. Pernicious: having a harmful effect, especially in a gradual of subtle way. This particular anemia is related to B12 and folate specifically. These assist in making happy little red blood cells in your body. I’m on the verge of having this one as my B12 is starting to tank a bit. I also have another genetic mutation that inhibits my ability to properly use B12, so… there’s that. I’m supplementing with B12 to help on this one, so hopefully it’ll stay where it is and not get any worse. Only a few weeks left of treatment and taking a drug that has been slowly whittling my red blood cell count down.

 

Aplastic anemia. It’s not a plastic anemia. Aplastic anemia can be lower numbers of red blood cells *and* lower numbers of other blood cells. This one can be acquired or inherited and is related to how well your bone marrow can make cells. If it’s damaged, it’s not making them fast enough. Chemotherapy and radiation can cause this condition, so I imagine it is fairly common in cancer patients. It can also be caused by autoimmune diseases and arsenic and other chemicals. Only my red blood cells are low so far, so it seems my treatment is acting on a different mechanism than ‘traditional’ treatments.

 

And hemolytic anemia. Did you know blood cells have life spans? A red blood cell apparently usually lives around 120 days. If they’re destroyed early and your body can’t produce enough replacements, that’s hemolytic anemia. Also, if your body decides it’s going on a killing spree of red blood cells when there is nothing wrong with them and they’re just minding their own business, that’s acquired hemolytic anemia.

 

These are just the main kinds of anemia. There is also sickle cell anemia, which is inherited, and makes your red blood cells inflexible and unable to go through small blood vessels. They’re shaped like little sickles, hence the name. Sort of like a crescent moon shape according to the Mayo Clinic. This starves those vessels of oxygen that is carried by the red blood cells. Reading a little bit about this one, it’s no bueno.

 

There are more! I’ll just mention others I found: sideroblastic anemia - acquired or hereditary, myelodysplastic syndromes - a type of cancer, congenital dyserythropoietic anemia (CDA) - hereditary, Diamond-Blackfan anemia  - probably caused by genes - that’s helpful, megaloblastic anemia - abnormally structured blood cells, and Fanconi anemia - too few blood cells, hereditary.

 

Except now I’m looking at it, maybe I have megaloblastic anemia. Or maybe I have all the anemias. Megaloblastic is cells that are too large or too young. Mine are fewer and larger lately according to my blood tests. I’m not showing any of the symptoms except shortness of breath though, so it’s fine. And that’s only when I’m walking the hills around here with the dogs. Or when I help too much around the house. It’s an excuse to not do chores. Ha!

 

So, please, the next time someone starts talking to you about anemia, because I know this happens to you all very often, don’t just assume they need to eat more red meat. There are many symptoms and causes and treatments. Taking an iron pill isn’t always going to solve the problem.

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The Verdict is In

I’m going flat.

 

Last week was the week of appointments. I had blood work and a mammogram + ultrasound on Monday, oncology on Tuesday, dentist on Wednesday - that was dependent on ‘passing’ my blood work and my oncologist saying yes, and they did! - Thursday off, Friday I met with a plastic surgeon, and Saturday was the chiropractor. Which doesn’t really have any bearing on my cancer treatment, but it was just another appointment. I also ended up at the doctor with my husband Friday afternoon, so technically it was seven appointments? He’s fine.

 

I’ve never been so excited to get my teeth cleaned.

 

Back on task! Why did I decide to go flat? Well, I was thinking of taking up skeleton racing - Google it if you don’t know what it is - and it’ll be much, much easier to lay down on the sled!

 

That’s not really it. No. It’s the surgeries. It’s the recovery. It’s the fact that I know I’d have to have an additional surgery if I wanted reconstruction because I’m a bit too chubby right now. But… if I lose the weight, I know the chunk ‘o pudge they’d want to use will get even smaller, and I was advised that I didn’t have much there to start with. That’s not where I carry my weight. I knew that.

Arthur on his bed, staring at me lovingly.
"I don't care about tatas, mum. Can I have a treat?"

 

I’ve also looked at pictures of the reconstruction surgeries, and I don’t see myself being happy with those scars. Depending on how they do the reconstruction, there are scars of different types on your breasts plus the scar across the belly where they cut you open to remove the fat. All of those wounds need time to heal.

 

I’m at peace with this decision.

 

Will I freak out a bit after surgery? Oh, probably. I’m asking someone to remove a piece of my body. Plus, I am hoping to get my reproductive organs all removed on the same day so I’ll pop over into menopause. Recovery is going to be a blast! Stupid BRCA gene thingy. Well, at least my tatas and my ovaries won’t try to kill me anymore. I hope.

 

I’m very thankful that I am able to make this decision. I’m always hopeful that no matter what decision a woman makes, her doctors will respect it and do their very best to honor their wishes. Reconstruction, flat; implants, flap surgery - we have choices, and I want everyone to be happy with their choice. Cancer takes away many of our choices, it’s good to have a little say in *something* in all of this madness.

 

Overall I am still feeling okay. I’m trying to push myself a little more with activity even though I’m still on my meds. I am so tired of having to rest so much. I don’t like it. I am planning to push myself in the short time between my end of treatment and my surgery. I want to try to get as strong as possible as fast as possible. And drop 10 lbs, which should hopefully be not too hard when I’m not taking a drug that is making me anemic.

 

No, eating or taking iron won’t help. I’m planning to write a post on anemia soon! I know you’re excited about it.

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Back to Reality

This week I start back at appointments. Some of the ‘regulars’ - blood work, oncology. Plus a breast ultrasound and a mammogram. I’ll take those any day over the Christmas Eve trans-vaginal ultrasound. Hopefully the dentist on Wednesday - assuming I pass my blood work - and then meeting with a plastic surgeon to discuss DIEP flap Friday. Highly recommended, one of the best in the area. See what they have to say.

 

Then the real reality will start. I have to make a decision soon about my surgery. Flat or DIEP? I have to stay healthy until all this is done. I have to start working out soon after I’m done with my drugs in February. All studies point to being physically active will make surgical recovery a little easier. Maybe.

 

If I go flat, I’ll need to try to mentally prepare myself for menopause since we’ll do the double mastectomy and the reproductive organ removal on the same day. If I do DIEP, am I prepared for the recovery? Am I going to be able to accept that I’ll need at least two surgeries then? One for the DIEP, one for the reproductive parts. They can’t do both at the same time because the DIEP takes too long and the OR is only open for so many hours/day.

 

I have to prepare for menopause either way. It’s just is it now, or later in the year? I wish my ovaries weren’t so likely to try to kill me. Pffft.

 

Making decisions like this is not fun. But I also try to keep it in perspective. I get to make the reconstruction/non-reconstruction choice. My treatment has been relatively easy. Am I spacey as hell sometimes? Absolutely! Do I get winded walking the dogs? You betcha! Have I missed out on any of the holiday fun because of cancer? Absolutely not. I’ve had a blast and enjoyed every moment. Did I have to have a port put in? No. My drugs are daily oral. Did I lose my hair? No. But I got to try new hairstyles because I figured short hair, if it fell out, would be less likely to traumatize me. Have I felt sick? Hardly. I took two Zofran - they control nausea - early on because I felt a little sick, but that’s it. Since then, I’ve felt fairly normal other than the spaciness and getting tired easily.

 

I’ll go on. I’ve been able to sleep 8-10 hours per night for almost my entire treatment. I work from home. I was able to do all of my scheduled travel jobs through November. After that, I still did big jobs, just from home. My loss of income was limited to having to not work on some doctor appointment days. I’ve been able to save up to prepare us for this year. Prepare us for me being out of work for a time. But I will probably be able to go back to work sooner than most because I can work from home and my job is sedentary. I just have to be able to lift my arms enough to get my hands on my steno machine.

 

My husband has taken on the bulk of the duties around the house. I am horrified when I read stories of women who have a spouse or boyfriend who can’t seem to help out at all. They’re at home recovering from a double mastectomy, and he’s angry that they can’t cook dinner. That makes me angry. Grow the fuck up. Do you love this woman or not? If you love her, you’ll take care of her and ‘suffer’ for the short time she’s unable to help out because she JUST HAD HER BOOBS CHOPPED OFF or SHE’S GOING THROUGH FUCKING CHEMOTHERAPY AND IS SICK FOR DAYS. I try not to swear on here much, but seriously? What the hell is wrong with people?? The humans in my house have thumbs and brains and they use them. The dogs are thankful. Especially for the thumbs, I imagine. Yay treats!!

 

I’ve never had to ask for help. He’s picked up the slack. If I can’t do something that I would normally do, I tell him. It gets done. He cooks - okay, he’s always cooked, I’m average at best - he cleans, walks the dogs on days I can’t - it’s my one exercise I can do, I like to do it - does the laundry, folds the laundry - again, better than I do it, so I help when I can, but… not upset when he gets it all folded before I’m available! He’s not perfect, thank goodness, but he’s perfect for me and loves me even though I’ve refused to kiss him this year because he’s been sick.

 

Gotta stay healthy.

 

And the best part? This isn’t just because I have cancer. We’ve always worked together to get stuff done around the house and take care of each other. It’s a partnership. I mean, I haven’t cleaned a toilet since 2008. It’s my most despised household chore. He doesn’t mind it.

 

Match made in heaven.

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