Sunday, October 24, 2010

So Chemo Goes Like This...

Since I last wrote I have undergone my first chemo treatment.  I have also met with my radiation oncologist, whose job it will be to radiate the heck out of me after surgery, but first things first.  Chemo goes like this:  the nice nurse tells you that she's going to "access your port."  This means sticking a needle where the perfectly skilled surgeon had just placed a chemo port a few days before (In case you're wondering, as I had been, a chemo port basically looks like a raised round spot under my skin -- not terribly visible).  It had only just healed, but never mind.  Luckily, that's as bad as the needles get.  All of the medicine goes through this one spot.  First they shoot in some anti-nausea stuff and allow it to work for 30 minutes.  Next comes the Adriamycin, which caused Aaron to remark "oh, it looks like Hawaiian Punch!"  A nice thought, but one look at the nurse administering the drug completely covered in plastic so as to protect herself from the drug, and you remember that cancer is some nasty business that requires some equally nasty drugs to bring it down.  The final medicine is the Cytoxin, which takes the longest to administer.  All together, the whole chemo process should take about 2 hours.  I say should here because my first chemo session took much longer due to computer problems.  (I told them I was fine with waiting and receiving the correct chemo cocktail as opposed to not.)  Luckily Aaron was there to wait with me, give me soup, watch Sports Center with me (Go Rangers!), and the whole process didn't seem that long or bad.
Now for the side effects:  The first day I felt great.  "This whole chemo thing isn't so bad", I thought.  A huge box of Omaha steaks had just arrived on our doorstep, courtesy of the wonderful in-laws, and Aaron had offered to grill something yummy.  My appetite was good, and the steak divine.  Then came the following day.  It started out alright with just a little fatigue, but slowly progressed into "I just don't feel right"-land.  Aaron took me to the hospital for my Neulasta shot (to make my white blood cell count rise), and while I was there the side effects started to take hold.  I rode back to the house with my seat reclined, thinking, "just a couple more minutes..." the whole way.  (How lucky are we, by the way, to only live 15 minutes from a world-renowned cancer institute?  Very, very lucky.)  So we made it home and I found I just could not get comfortable.  Stretched out?  No.  Scrunched up?  Not a chance.  Walking around?  Too tired.  Basically this turns into a lot of me whining with a very confused husband (poor fella).  I spend the next couple of days sort of nauseated, pretty tired, and all together uncomfortable.  I take my drugs and try to sleep.
It goes on like this for most of Wednesday and Thursday (chemo was on Tuesday), and Friday I feel a bit better.  Also helping my spirits, the aforementioned in-laws came to town.  It seems they couldn't trust their son to make all of the delicious steaks on his own ;)
So by now it is very early Sunday morning and I'm feeling the most like me since Tuesday night.  Granted, I'm up writing a blog at 4:15 am, but I can always take a nap later.  It's what we call "cancer time."  I'm operating on cancer time now, which means I can walk out of room mid-sentence if I think I need to take a nap or a breather.  Let's hope I don't abuse this too much.

Thursday, October 21, 2010

A Post from Aaron

My loving (and I must say quite adorable) husband, Aaron, wrote the following for his fraternity newsletter:


On October 4 of this year my wife, Joyce, was diagnosed with breast cancer.  This came as a cruel shock to both of us—she’s only 29, and women in her age range only constitute about two percent of all breast cancer cases.  As unlucky as the diagnosis made us feel, in another way we were fortunate.  Though women in their 20s and 30s are unlikely to be breast cancer victims, they often have worse prognoses than older women.  This is primarily because younger women don’t believe the disease can affect them, are less concerned if they do find a lump, and are thus slow to act if something seems awry.  Much to Joyce’s credit, as well as that of her doctor, she was quick to have more tests done on something both presumed would turn out to be benign.  This is not to say that women in their mid to late 20s should be scheduling yearly mammograms for themselves—their breast tissue is likely too dense for a scan to spot much of anything until it’s a palpable lump anyway—but it is important to note that this is not just a disease afflicting older women, and it’s much better to be safe than sorry when there is a reason to think one’s health might be in jeopardy.
The day of the diagnosis, as well as the next two days following it, were pretty jarring emotionally.  My immediate reaction was that I needed to be strong for Joyce, which was a great idea on paper, but quickly dissolved when I began crying next to her on the couch the first evening.  Her response to the news was initially anger; “why me?” is an understandable question to ask, though you can’t expect any good answers to be directly forthcoming.  The other emotion I think both of us experienced was fear. The word “cancer” can cast a pall over a room.  There’s an underlying enormity to it which causes the mind to race from one worst-case scenario to the next.  In my case, the fear was suppressed a great deal after meeting with Joyce’s team doctors who are currently providing her treatment.  This was not because they assured us we had nothing to worry about—medical professionals don’t give that sort of advice to people in these situations anyway—but rather because they replaced the abstract and amorphous fear that is “cancer” with an outline of concrete steps that would be taken to address the problem.  Clich├ęs exist because they have a kernel of truth, but taking things one day at a time can be much healthier from a psychological standpoint than dwelling on the unknowable future. 
At times humor even started to break in to our dealings with the disease.  For example, my wife is a big football fan, and both of us had previously been impressed with the lengths the NFL went to publicly demonstrate their support of women with breast cancer in the month of October.  However, when you personally are diagnosed with the disease, during breast cancer awareness month itself, you consider yourself sufficiently aware without seeing sweaty, 300 pound linemen wiping themselves off with pink towels that look like they belong in the linen closet at Barbie’s Malibu beach house.  As Joyce commented (and I’m simultaneously paraphrasing and cleaning up the language), “I just want to see Tom Brady get hit without having to look at a bunch of pink crap that reminds me of my boobs.”  Both of us know that seeing Brady makes many women more aware of their chests and other personal regions than they are otherwise, though not necessarily for health reasons.  Joyce, being a Colts fan, is not similarly affected, however.
The thing which strikes me the most about our short and ongoing experience with breast cancer is how many people you confide in have family members or close friends who were also afflicted with the disease.  Numbers, even large numbers, can be too impersonal to have much impact on one’s attitudes, but when you start putting faces and personalities on those statistics they get pretty real, pretty fast.  The good news, of course, is that many of these stories and experiences—while arduous--end in survival, and Joyce’s cancer is of the sort that responds well to treatment.  The reach of the disease throughout our society, as well as humanity’s general ability to be kind to those in need (and this is coming from someone who trends towards the cynical end of the spectrum), means that Joyce and I have been pleasantly overwhelmed with well wishes and generous offers of support from those closest to us and people we’ve just met.  It reminds me that if bad things, even awful things, didn’t happen from time to time, mankind’s nobler qualities like charity and empathy would burn a lot less brilliantly.  It may sound like pabulum, but it’s pabulum I believe in, and it keeps me looking on the bright side of things.  And when you get right down to it, that’s the best option you’ve got sometimes.

Sunday, October 17, 2010

Hat Diaries #1

This is the hat I referred to in the last post.  One of these days I'll post a picture of myself wearing it.

Ready for Chemo!

The "main event" since I last wrote was the meeting with my oncologist (cancer specialist) on Thursday.  This post gets a bit science-y at times, and I apologize, but I have many a doctor in my group of family and friends who actually want to know the details of my chemo treatment.  Sorry to everyone else!  The Oncologist explained we will be treating my cancer with "curative intent."  Any time I hear the word "cure" I get all kinds of excited and my eyes light up, so this is very good, right?  Next came the more unsettling part.  The sweet doctor said that this meant "hitting me hard" with all kind of drugs, surgery, radiation therapy and hormones.  So I'll live, but life may not be terribly fun for a little while.  Here's the science:  I'm going to be on 3 different types of chemo drugs.  The first two (Adriamycin & Cytoxin) will be given together every 2 weeks for 2 months (4 doses).  After that I will receive Taxol every 2 weeks for 2 months (4 doses).  This will be followed by surgery, radiation for 6 weeks, and finally hormones (which I will be on for at least 5 years).  All in all, it could be a LOT worse.  For example, I could have cancer that isn't treatable.  I could be without my amazing husband.  I could be without my huge support group --all of my dear family and friends!  Life could always be more unbearable.
They say there are amazing drugs now to help with nausea, which I will also receive.  It sounds like the biggest side effects associated with chemo nowadays is fatigue for a couple days after each treatment and, of course, hair loss.  This is going to be the trickiest part for me.  I think I am going to get my hair cut short this week in preparation for the bald head that is to come.  As of right now, my hair lands about 4 inches past my shoulders (probably the longest I've ever had it!).  Some women facing chemo are terribly brave and just go into the barber and buzz it all off without any concern for vanity.  Well, that's not my style.  (I must admit, however, I've had visions of walking into the barber shop down the street and pulling a Britney Spears.  Maybe I would make the local news?)  Alas, I am far too vain to go from long to bald in one day.  My thought is that hair falling out will be less traumatic if it is already short.  We'll see. 
In happier news, did you know you can get a prescription for a wig?!  I'm not yet sure how much (if any) our insurance will pay (fingers crossed!), but I plan on befriending the woman who runs the wig boutique at the hospital in any case.
This reminds me.  Yesterday I dragged Aaron into a vintage clothing store (we were in the neighborhood anyway!), and I talked him into buying me a fabulous hat.  It looks vaguely 1940s to me, but I will call on my fashion historians to correct me. 
*This is where I was going to paste a picture of said hat, but I appear to be having technical difficulties, as always.  I promise to post the pic ASAP!*
Finally, I'd like to close with a cute story.  At our breast cancer class on Friday, we were given more information than we could ever possibly retain, but it was good experience.  The class was for newly diagnosed women, so you really couldn't tell the cancer patients from the family members who were there for support.  Aaron was one of two husbands in the room, but the other man looked to be in his early 80s.  The final class presentation came from the woman who runs the cancer boutique at the hospital.  She was telling us about special post-surgery undergarments, wigs and, finally, prosthetics.  She was terribly excited to share with us a new prosthetic that NASA helped develop.  It was the latest product on the market, allowed the skin to breathe, and was just the best fake boob money could buy.  She was so enthusiastic about this product that she insisted we pass it around.  The elderly wife looked at it with great interest and passed it to her elderly husband who everyone was watching to see how he would handle it.  He simply passed it along to me as quickly as he could.  He then told Aaron "We're really gettin' into some sh*t now!"  Aaron joked later that the man had probably fought in the Korean war, but nothing in his life had prepared him to hold a fake boob.  Poor guy.

Wednesday, October 13, 2010

Good news!

Finally some good news to share!  Today I got the results of my PET scan, which showed that there is cancer only in my left breast and one lymph node.  This is what we already knew, but the PET scan confirms that the cancer has not spread to any other part of my body.  Aaron just commented on how quickly one's level of expectations can change.  Last Monday we were devastated when we found out I had cancer.  Today we were elated to hear that I only have cancer in one area of my body.  We know we still have a long road ahead of us, but every bit of good news that can lift our spirits helps. 

Since my last post there has been a flurry of activity in the Heckman-Rapport household.  On Thursday evening my parents came into town (a trip that had been planned for quite a while, pre-cancer diagnosis).  We had a great time eating lots, visiting Stone Mountain park, and putting up Halloween decorations.  Our cat, Ollie, got spoiled by his "grandma," who let him hang out on the porch as long as he wanted.  Grandma is far more patient than Aaron or me.

On Monday I had my PET scan and then visited with the reproductive specialist, upon the insistence of my oncologist.  Aaron and I would like a family SOME DAY, but when a woman of child-bearing age is facing chemo, apparently it is protocol to visit with a reproductive specialist.  Warning:  If you don't wish to read about my ovaries, please skip to the next paragraph.  Regarding my ovaries, the specialist told me that there is an 80% chance they will stop functioning due to chemo.  Following that, there is a 50-70% chance they will regain function after my chemotherapy is complete.  There is an injection I could take to make these percentages a bit higher, but it is both expensive (not covered by insurance) and uncomfortable (side effects include basically throwing me into early menopause).  We looked at this as well as other options, such as embryo freezing (crazy expensive!), and decided that we're just going to take our chances and not do anything.  If my ovaries don't regain function, there are other options.  I have a gorgeous niece named Sydney Grace who proves that.

This morning I had surgery to "install" a chemo port just under my right clavicle.  The surgery was quick, easy, and relatively pain-free.  The doctor gave me a prescription for pain-killers, but so far I haven't felt the need to take any.  Aaron joked that we should hand them out to trick-or-treaters.  He has quite the sense of humor. 

Tomorrow morning I go to "chemo training" with my oncologist.  This is when I learn all about my chemo plan.  Hopefully I will retain most of the information.  The general plan right now is to do chemo first to stall the growth of the cancer and then perform surgery to cut it out of my system completely.

On Friday I go to my first breast cancer support group meeting.  I have been wanting to make friends in Atlanta ever since we moved here in July, but I never thought I would do so by getting cancer!

This week has been amazing in terms of the love and support shown by our wonderful friends and family.  My phone has been ringing off the hook, my inbox is filled with loving emails, our mailbox is filled with cards and letters, and the doorbell rings at least twice a day with deliveries for me -- cookies, other edible treats, lots of books and even a pair of luxurious pajamas that I may never take off.  I turned to Aaron yesterday and said "Aren't you jealous?  Cancer comes with presents!"  Thanks everyone.

Saturday, October 9, 2010

Some News

Hi Everyone,

I have some unfortunate news to share.  The kind of news you don’t want to share over the internet because it’s just so impersonal, but by the time I get around to calling every friend and family member I have it would be December (I’m very lucky to have such a large support group!). 

On Monday I found out I have breast cancer.  Here’s what we know so far:  I have hormone-receptive stage II breast cancer.  This means that in addition to treating the cancer with chemotherapy and surgery, I will also be on hormones for a very, very long time to make sure the cancer doesn’t return once it’s gone. 

Here’s my schedule so far:  On Monday the 11th I’ll have a PET scan to make sure the cancer hasn’t spread anywhere other than my left breast and lymph node in my armpit.  Assuming that it has not spread any further (which is definitely what we’re assuming right now!!!), we will proceed with putting in a chemo port on Wednesday the 13th and starting the chemo process on Tuesday the 19th.

Here’s the good news:  I’m being treated at Emory University Hospital in Atlanta, which is one of the best hospitals in the country.  The Winship Cancer Institute has amazing, caring doctors who will be doing everything in their power to get me through this process.  I have every faith in this place and the people there.

Also good news:  I feel amazing!  Cancer doesn’t “hurt”.   Chemo will definitely be uncomfortable, but hey, so many women go through it every year in order to hop over to that “survivor” list, I can do it, too, by golly.  AND, Halloween is coming up which means I should be able to score some sweet wigs ;)

And another bit of bad news:  I felt I had to quit my job at the Art Institute of Atlanta while I undergo treatment.  My doctor told me that many women carry on full-time jobs while they go through chemo, however, my situation is just a bit different.  I was hired as the one and only textiles instructor for classes that meet once a week for almost four hours at a time.  If I were to have a day when I felt I couldn’t make it, there is no substitute who could be called in, and to cancel a class that only meets 10 times total would not be acceptable.  Luckily, the good people at the Art Institute said they would love to have me back as a teacher when I feel able.

So that’s my news.  Not the best news in the world, but I certainly don’t have to look very far these days to find someone much, much worse off than myself.  The last bit of good news is that I’m determined to kick this cancer in the you-know-what.  I have a very, very long life to live.  With my amazing husband by my side (along with all of my friends and family), I know I’m going to beat this!!!

Love,
Joyce