Friday, May 31, 2013

Hubby's Graduation

Another very special event took place last week -- the week I graduated from a graduate program in Communication Sciences/Speech Language Pathology: my husband's graduation from his graduate program in Computer Science. This, too, was a super challenge and a very exciting event for our family.

A bit of background: my hubby and I met as post collegiate athletes training for an Olympic Development team 16 years ago. I was doing a graduate program in education at the time and he took an interest in both my academics and running. A friendship developed and the rest is history.

When I got a college teaching job both my hubby and I enrolled in HTML and C++ classes in the computer sciences department. This was during rhe dotcom era. He was much better at it than me. But then again, despite the fact that we both did language undergrad programs (him in English lit and me in Spanish lit) he rocked the gaming world. I remember saying "hey, you are so good at programming those games you do -- have you ever thought about going back and doing computer science?"

When the fall enrollment came up, we both went and had coffee and signed up for classes in this department together. That was enough to get him hooked. So, when we moved for another college position for me, he officially enrolled at that college as a computer science major, graduated with a second degree, this time a Bachelor of Science.

He was considering a high school teaching job until he met my co-worker's husband. This is a person we are forever grateful for. He asked my husband if he ever thought of the aerospace industry. We both were clueless. He got my husband an internship. Soon afterward he was offered a permanent job but then needed to enroll into a graduate program for job security. This was at a time when our son was born, our son had several medical complications along the way, then 4 years later we lost our daughter at delivery, I entered a graduate program to help our son 6 years ago, then his wife got cancer (me). He's had a full plate and reached the point where no more extensions for the graduate thesis was possible. He had a two week window of cranking out that thesis or the entire 8 years of sacrifice would expire without a degree.

So, he took a full two week vacation to crank that puppy out and did it with flying colors!

He originally didn't want to do the ceremonies since he's pretty low key -- but I convinced him that it is a family affair -- our son deserves to see BOTH his Mommy and Daddy walk at commencement since he's seen us as students pretty much his whole life. Thankfully he agreed after a few months of convincing. To see his happy face at graduation was amazing. He seemed so happy, proud, excited. Our son got to see both of us in this special event (his ceremony was a week ago today; mine was Tuesday of that same week). Our 8 year old son now talks about wanting to graduate from college. I'm just so so joyful of this experience. I feel grateful and blessed beyond words.

Thursday, May 30, 2013

Last Chemo Cycle and White Blood Cell Treatment

Can't believe we've made it to this day that once seemed so far away!!! At today's white blood cell treatment of neulasta, my son, the nurse and I were singing the song from the Sound of Music as I got my shot "These are a few of my favorite things....". Giddy. Excited. We see the finish line!

Yesterday's chemo went well. I was there from 930-4pm. I went in alone this time since we needed our son to be with one of us and this worked out. I chatted with other cancer fighters, read A lot, relaxed. No burning feeling this time. But super hyper from the three days of steroids they give. I slept 3 hours the night going in. Since I don't sleep well during the three days of steroid treatment, I nested by cleaning house while watching reruns of Grey's Anatomy on Netflix. Amazing show! I've never seen this and got addicted right away by watching 7 episodes last night.

Today my neck was stiff but this has been typical throughout chemo. It's like there is no fluid in my neck joints so I use my body to turn in the direction I need to see. Hoping this returns to normal after chemo leaves my body. I should be good in 20 days from this infusion. Hoping the good parts of my body recover well over this next year. Overall, super hopeful and excited that this chemo chapter is coming to a close.

As for what's next? Hormone treatment called Tamoxifen for 5 years --- but I'm doing some serious research into opting out since one of my markers of cancer was estrogen positive, I run daily to create bone density, white blood cells, red blood cells, platelets, I eat healthy, and having a baby is now no longer an option (adoption sounding really good. Our son keeps saying he wants a sister ... One that he can see and play with everyday. Still need to convince hubby ;) once I'm recovered ;).

As for surgery, I'm killing two birds with one stone: I developed a hernia in my abdomen so I'll get that fixed with the final reconstruction phase of exchanging the current balloon spacer for an actual implant. That will take coordinating two surgeons so hoping for a first week in August now. So far I've been healing fast so I'm optimistic that will be ok.

Thank you again for love sent my way!
Xoxoxo

Tuesday, May 28, 2013

Cancer Vein Burns: Chemo Cycle 3 Update

One of the side effects I've experienced throughout chemo is burn at the site of infusion. I'm told it is rare -- at my clinic I'm one of 6 experiencing this burn.

I learned from online breast cancer chat/forum posts that taxaotere -- one of my chemo drugs -- can have a nasty reputation of burn when an IV is not properly placed in the vein. Any spillage will burn the skin. So far this is all I've found and it's a mystery with doctors. All they can do is document brand, lot number, batch and hope in the future no repercussions emerge.

In my case, the scars appear ten days later. On this latest chemo cycle the veins did a funny connection of one burn scar to the next (new). Overall this previous cycle did its thing -- it is cumulative so I've been more fatigued and grumpier when I get grumpy. I sleep longer at naps.

The other thing Ive done which I count as treatment or therapy is run 5 miles as soon as I wake in the morning which Ive now completed 23 days of doing this (takes 20 days to form a habit?). On some days I cruise 8 to 9 minutes per mile; my worst was running 19 minute miles. That is how big the range of fatigue can be. Again, it's therapy. The running is pounding. Pounding bones creates red blood cells, white blood cells, platelets. Bone Marrow, bone density is created - it is the exact thing chemo robs you off. So, I fight the bone marrow robber by pounding the @$#*! out of it. And it's helped. Today's labwork is the best I've had ever. Normal white blood cells ranges 4.1 to 10; typical chemo white blood cells is less than 4 and even lower than 1-2 in many; mine was 5.1 today!! Red Blood cells were slightly lower than normal but higher than I've had throughout chemo. Super silver lining! I'm going in strong into my last chemo cycle tomorrow!!!! I get one more graduation this month and I'm on path to upcoming surgery, next phase treatment --- and recovery. The worst is soon over and I see the humongous light ;)

Thank you thank you thank you for positive vibes, thoughts, prayers....you've made a difference in my life and in the life of my family!

Graduation From Academic Program

Earlier this year I blogged about finding out I had cancer in January -- after a January 2nd, 2013 mammogram needing more imaging and testing -- while I was also in a graduate program for communication sciences. It was my third full time year, final semester after three years of prerequisites for a total of six years of our family's life which I did online, in the wee hours of the night when everyone was asleep so as to not use valuable homeschool and home therapy time.

The news of cancer not only initially brought fears of death, but it brought about great great fear as to who would continue my son's education and therapy. Our son is very bright, talented, skilled, warm, loving -- and he also lives with a duplicate chromosome 2 which has caused things like apraxia, dysarthria, hearing loss, GI challenges, and Autism Spectrum Disorder (ASD) in which he is high functioning. I entered the field 6 years ago with 4 other degrees which actually gave us a lot of insight into our son's needs. Therapists told us back then we might never talk or communicate and if so it would be like other clients they saw whose skills got stronger at maybe age ten or later. We were told reading would be the hardest area for us - suggesting we stay at two and three syllable word books until he could say them then move on. They said we would have trouble in other areas of academics and needs and so Special Day classes were our only option. Today, our son is reading 8th grade level as a second grader, he's bilingual in sign and English, he's learning Spanish and Japanese, loves math and science, he plays musical instrument, has reached 5 belts in karate, runs, sing, dances like no other -- he's done the exact opposite of what expectations were made of him. Sure we have challenges still, but our glass is never half empty.

Six years ago we also had to fight specialists in honoring sign language as a language deserving equal status as all languages. In our case, he has a moderate hearing loss and sensory challenges. A moderate hearing loss means he hears but it's like sticking your fingers in your ear then turning away from the person talking. In our case, due to strengths in his peripheral vision (also common in ASD), he picks up side vision movements in both sign and verbal language. But he also fatigues; gradually less over time but we still need supports and naps for instance. Without this, many areas of the brain start to deteriorate --- like the areas housing attention, hearing, brain coordinating and brain planning. Initially when much younger it was all this plus the fact that his mouth was weak (dysarthria) and it wouldn't do what his brain was thinking and wanted to do (apraxia). We had multiple areas of need which have gradually and steadily increased over the years with intervention. Signing is one way that allows access to information and therefore knowledge and access to an education in which one can continue with peers.

We spent years of advocating for our son and of showing them that there are alternative paths to the brain that not only included signing, but music, math, kinesthetic activities and so much more. The neuro field is showing this in its literature with proof of neuroplasticity -- the idea of getting to the same place a different way.

When it comes to signing, for instance, our field of speech language pathology on one end has come a long way in its acceptance of ASL or any mix of sign; and yet divisions occur in which the opposite is true where they say sign hinders language development (this I've never understood since ASL is a language), and is a crutch -- saying all of this with no scientific proof and yet the neuro field shows plenty of brainscans showing benefits. Ironically the negativism and exclusion comes from people who have never been bilingual. Fortunately, as a clinician, I've worked with awesome SLPs and professors. Multimodal and client choices are important. I'm also supportive of people's choices in bilingualism, of inclusion of all languages.

Alternative pathways to the brain means using the visual cortex (if not blind), the temporal, parietal, frontal lobes, the cerebellum, the midbrain through activities like music, math, kinesthetic movements, breathing and core activities -- using all possible ways. It is like if you are driving on the 101 and end up in a traffic jam on the way to downtown San Francisco, one has a couple of options: one could sit in traffic doing the same thing and never move at all OR one could actively take the streets or frontage roads. One could get there period by taking these alternate paths -- and in many cases, can get there even faster. In talking about brain injuries, for example, It's classic Aesop in the end -- I'd pick the constantly moving Tortoise on the frontage road over the non-progressing Hare stuck on the freeway any day (tortoise, by the way, doesn't imply slow -- have you ever seen one jump off a dock into water and seen it pass a fish? They are fast! And unlike the hare -- they have bi features of land and water). That's how the brain and neuroplasticity works and there's plenty of science behind this. It's the path we chose. It's the same path I chose years (hmm. I guess decades now ;)) when doctors told me my running career was over after injuries including a pulled achilles. And yet cross training proved otherwise, ultimately leading me to tasting a wonderful professional career as an elite athlete and later Olympian. And yet in January after learning about my cancer, the thought of continuing with the last items of this particular graduate program prior to this graduation -- the state license and the three year cumulative exam known as 'comps' -- was far from my mind. I was in survival mode fighting my way through mountains of information regarding upcoming tests, imaging, surgeries, chemotherapy, cancer causes, foods cancer likes, my plan to deprive cancer and much more. I had almost given up on my latest academic career in which all these degrees or areas of study are interdisciplinary, informing one another in a full circle of useful application.

I did a lot of soul searching, praying, bargaining, asking for positive energy around me... I wanted a window, not necessarily a big one but just any glimmer of a window that would allow me the opportunity to take my license and comps exams this semester. It was a long shot -- especially in coordinating the schedules of two surgeons and one oncologist AND beating the time they believed my cancer cells would continue aggressively and invasively doing It's thing. The four week window between mastectomy and chemo miraculously, it seemed, to appear. I took it as a sign -- I had to at least try. The worst that can happen is that I wouldn't pass this time around. But there really was no time thinking such thoughts since last moment studying and actual test taking was enough in itself.

Earlier when I blogged about passing that first exam -- the license -- I mentioned I cried like a baby. I was grateful, relieved, filled with purpose.

When we drove to graduation on
May 21st, 2013, I was excited--but, for me, putting that cap and gown on once we parked on campus was like actually getting on a plane to a much wanted trip; it's realness sent chills up my spine. I was literally flying! I loved meeting my flight companions, too, (my classmates of the past three years which I've had the privilege of getting to know and studying with over three full time years without a break; the ones who couldn't make it were there in spirit). The program was far from easy. In fact, for me, it was the hardest degree to get through for many reasons. It's a science field which demands a command of human anatomy, physiology, assessment, treatment while also working on fast paced teams of doctors, physical therapists, occupational therapists, nurses, administrators, families and caregivers (I typically read daily from 4am-8am and worked with clients on Fridays). For me and my family, we also buried our daughter, survived septic shock post delivery, experienced a tumor which appeared two years ago in my pelvis which required surgery, advocated for our son through various diagnosis assessments and treatments, and now fought an aggressive and invasive cancer that I only read about in others until this January. It is the most meaningful of degrees I've ever experienced.


Surviving for me has always meant a chance in life. I hope this chance, with this latest degree, gives me a chance to work with severe cases in which an alternative and yet evidence based scientific path can make a difference. I've seen it already in everyone I've worked with over these past three years, past 8 years with our son, and I am grateful that this path is open to me. None of this was on my own; I've had so much support in so many ways. I'm so grateful.

I'm grateful that my son has fueled this passion -- and I'm so so grateful I am getting to live, I am still getting to be the main driver of his education and therapy AND most importantly, I am getting to be his main advocate and mom.

Hair loss and Hair Wash

Hair loss with chemotherapy is a curious thing: it comes off in random areas at random times and in random configurations -- at least it seems so to the naked eye.

When I first started with the hair loss I first lost hair in the lower extremities like my legs; within the legs it started from the top, then fanned outward. The lower limb started its loss in the middle then fanned outward. It did the same thing on the head -- but it started in areas you typically see men balding first (the top of the head and forehead) then it fanned out to the ears and neck. Hair loss happened in one underarm pit but not the other. And now, in the end of this third cycle eyebrow loss starts at the area above the nose or nose bridge then it's fanning out to toward the ear BUT it's starting in the opposite direction with the lashes. With lashes the loss is starting closest to the nose then moving inward.

One has to wonder what is in the chemo cocktail to render hair loss so strategic less in appearance. I bet it would look so interesting if we could see through our veins and see the recognizance mission. Meaning behind the madness surely must exist -- or I wonder if it's like anaesthesia in that doctors know it works but they don't know why, really. There's a faith that the right cells in majority are being targeted but the innocent bystanders might strategically be at the wrong place at the wrong time.

In any case, I've now learned gradually over these past months how to wash the straggler hairs and surface below these hairs (when I shaved my head before Chemo kicked in I had stubble; since I'm hairy to begin with my stubbles grew fast and these flicked off my head once Chemo was in full throttle. For each cycle my hairs would seem to grow a bit in week three then they fall off again in weeks 1-2 of the next cycle).

Initially during my showers through my first couple of 21-day chemo cycles, I lathered the areas of existing hair as though they were fragile porcelain claymation-like fibers ready to break on any insult --- INCLUDING blowing wind. I was slow, not really fearful yet somewhat. I was like the scientist excavating fossil from some anxiously awaited dig. Then with time it was like my hand met hair which fell out as I lathered it and it subconsciously said "oh, I guess it's your turn to fall off." when the hairs were all off my heady lathering hands were like "ooh, is this where the hairline ends" as if my hands were going to fall off a cliff if they crossed some imaginary line. Today, I wash all areas of my head, face, ears, neck with organic excellence shampoo as if all one unit. It's taken time to get to this point because it just was not part of my regular routine. Despite the old saying, I CAN learn new tricks -- it just takes longer;)


Note in photos: below is a full face-head picture of me yesterday; another is just of my scalp with newest hairs coming out mostly frizzy and white which tend to grow in week three of chemo then fall out in week 1 of next cycle; the baby pictures are of me day 1 and 3 -- I've never been bald so it's really a new experience :)


Friday, May 17, 2013

Angelina Jolie's Double Mastectomy

On Mother's Day, Angelina Jolie wrote an article for the New York Times regarding her recent double mastectomy. See her article at link:

http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0

In this article, Jolie discussed BRCA1 and BRCA2 genes, her family history, the mastectomy and reconstruction all in an effort to educate and explain her personal reason for undergoing this process: to buy time with her children. Opinions vary on this topic -- but because she is a woman, it's her body, it's her options she's weighing without need of public scrutiny, it's her decision then-- for her -- it was the right decision. A mastectomy is no walk in the park; she is brave in choosing this route. But this approach is not for everyone. And, she is not advocating that women do what she did.

I applaud her in raising awareness the mastectomy, reconstruction, and the currently known genes that have been linked with breast cancer.

What I hope the media does with this information is further the awareness of breast cancer, the genes linked to certain cancers, and the reconstruction process -- especially in an appropriate way. I would hope that empowerment and not sensationalism is the goal.

For instance, if a parent has breast cancer then the child or children of that parent has an increased risk of getting breast cancer -- but this does not mean the message is to get a mastectomy at any age, like 12, 18, 21, etc. Other things go into the equation. Age, age the mother died with breast cancer, density of the breasts (if BRCA positive and the woman has dense breasts then it might be harder to catch using just mammogram), personal feelings, etc.

In talking about breast cancer as Venn Diagrams then if we draw three Venn Diagrams overlapping it would look like this: one big circle is all women with all types of active, invasive or aggressive breast cancer; the second big circle is all women with no breast cancer; the third is smaller one of all women with the BRCA gene of which applies only to women of a certain Jewish ancestry. The overlapping portion of all these three circles is women with breast cancer. So, if a parent died of breast cancer and did not have the BRCA gene, then it does not mean the child of that parent will get breast cancer. It applies only to the population of that smaller circle of the Venn Diagram -- and even within this smaller circle many factors are weighed when considering a preventative mastectomy. Different decisions are made depending on the circle one applies to; but in all cases or all circles of the Venn Diagram then all should monitor one's health including getting regular breast exams.

If a woman has the BRCA gene -- the one gene so far that has been identified as a linked with breast cancer- then we know for certain that a person's chance of getting breast cancer is 87%. That applies to subcategories of BRCA which one might see as BRCA1 or BRCA2 genes. A mutation here causes certain cancers-- like cancers in the uterus and cancer in the breast. This is what Angelina Jolie has. This is what her mom died of. This is what she had to weigh in her decision to have her breasts removed when no cancer is currently found. For her, factors like her age, the age her mother had her aggressive and invasive cancer, the amount of children she currently is a mother to, etc all weighed in her decision to take this route. Again, it was a good decision for her because it was her decision. The percentage of women having these particular BRCA genes is very small but if within this group a person must weigh several factors like Jolie did.

But in terms of the general public I hope the media educates us in sharing info about breast cancer, reconstruction -- and as far as genes are known in the breast cancer world -- how small the BRCA gene percentage is. In fact, it is so small that when I had my genetic test for the BRCA gene my doctor said she'd bet I didn't have the BRCA gene based on my ancestral history (no link to Jewish history or Middle Eastern countries with this particular Jewish history). The genetics test is an easy one in which you spit into a container (many genetic tests are available in this format nowadays). Sure enough, I tested negative for the BRCA genes.

An analogy to the BRCA breast cancer link is Autism Spectrum Disorder (ASD) and known genetic links. A child with ASD may have a known gene that has been linked to ASD (not caused, but linked); he or she may have a gene that is linked yet has not been discovered yet; but overall, when diagnosed, the doctor either knows of the gene that is linked with ASD or gies simply by the child's behaviors. The diagnosis is made by known genetics or by known behaviors. In my son's case he had signs of ASD but a gene linked to his ASD was not discovered until he was 4. There are now many genes discovered by scientists as being linked with ASD. Overtime, more will be discovered. The same thing can be said about genes and breast cancer. It just so happens only the BRCA has been 'discovered' but I'm sure in our lifetime more will be found.

Now let's say one did test positive for the BRCA gene and did not currently have breast cancer, then it does not mean that one would be recommended a mastectomy. Nor does it mean that one would be recommended a mastectomy because a parent who had the BRCA gene who died of breast cancer. The recommendation is to be proactive in monitoring one's health --- like in getting regular screenings including screenings now done for women with dense breast tissue (next level magnification mammogram, ultrasound, and yearly screens regardless of age). And, weigh in the options like age, age of parent with BRCHA gene when breast cancer was discovered and died from it, as well as other issues. It's a complex problem involving complex factors for decision making. That would be the message I would hope the media passes on to the public; that would be the message I'd want to pass on to my child.



Monday, May 13, 2013

Mother's Day

This was my first Mother's Day as a breast cancer fighter and I savored every ounce of the day. For me, it meant not rushing, looking around at my environment, taking in all the glorious living things -- like flying birds, blooming flowers, green trees of different sizes and shapes. For me, I wanted to record this day in memory as a day I appreciate all mothers who gave life and nurture life. And I definitely feel so grateful in being allowed the opportunity of being a mom -- I love this part of my life.

On Mother's Day we woke up and went to the beach to run. We then went and had breakfast at our local health food market, then we drove down the coast to take in the scene. Gorgeous day. It was truly the best Mother's Day ever.


Tuesday, May 7, 2013

Official Halfway Point With Chemotherapy and Final Stage 2 Reconstruction

Women can multitask: it's what we know, how we are wired, how we function. Sometimes it's too much, and at other times it's what we can handle given other circumstances or variables. It just so happened that my window of opportunity coincided with simultaneous breast removal and breast reconstruction. So while one surgeon removed my breasts for stage 1 of cancer treatment on February 20, 2013, in that same surgery another surgeon started the phase 1 or treatment of reconstructing my new breasts. Multitasking.

This past week, on Friday, we completed stage 2 of reconstruction. I'm happy with the amount of saline solution that has been pumped into the balloon -- a.k.a. Spacer -- that was surgically attached behind my pectoralis muscle. This was done over five sessions of saline solution injected into the balloon through my pectoralis. Sounds more scary than it really is. All my nerve endings were removed with the mastectomy so I didn't really feel the injections. The pressure afterwards I feel but that gets better after a few days. I always think braces. Instead if teeth its breasts. In any case, I'm done and I'm happy I went through this process. Stage 3 reconstruction now happens 6 weeks after my last chemo session finishes - so I'm right on target for an early August surgery with recovery through Labor Day as I told my son. It's a season. Valentines to Labor Day -- then life normalizes to my new normal which has pretty much been happening all along the way.

As for chemotherapy, tomorrow I am almost there. I should be done by end of June which is right around the corner. I'm currently done with my session 2 and tomorrow is session 3. So far all hair officially off on head and lower extremities. The arms, brows, lashes still holding on but signs of falling out are here. Same with toe nails. Currently I have a black ring on each toe nail and as for my fingers, my left thumb nail has a black ring. Fatigue Upped its ante this time around but extra sleep and naps helped. Chemo brain has also shown up but it comes in waves so I now write memos to myself on my iPhone notepad. Neuropathy is showing up but when my hands and feet start to tingle i take Lysine, B6, B12 and extra calcium which seems to do the trick for me. All these things are temporary for many women. Again, it's just a season with my eyes on the prize at the end of this season: cancer-free-survivor status. Worth it in every possible way.

My session tomorrow, May 8, 2013, starts at 930am and Ill be there all day. Thank you for keeping me in thoughts and prayers during this season. Big hugs to you all!

PS. Normally I go into chemo on Tuesdays during my cycles but we had to change for my husband's work schedule. Doctor said a day delay is fine. So will either keep old or new schedule for final session. Depends in what doctor says tomorrow.

Pss. Though impromptu, low-key and last minute plans, we savored our little boy turning 8 and our 13th wedding anniversary.

More photos tba....