My six month date

It was very strange going back to the oncologist's office after a six month reprieve.  But once I was there, the old habits took over. I know exactly where to sit, (the waiting room shares space with cardiac and other internal medicine specialities).  I know to make a pit stop right after I get called in to get my vitals taken.  The vanity in me knows to wear flip flop shoes so I can shed those extra ounces before stepping on the scale.  Yes, I need an examination gown. I know where I'm going before being led there. Everything is still very much as it was when I left it.  Even the folders on the wall that say "hospice referrals." Yikes.

Dr. P didn't keep us waiting very long this time. I hopped right up on the table as he pulled up my chart. He asked how I'm doing and Eric referenced me doing "lots of miles."  That launched us into a conversation about running. I told him about the races I've done recently, and that I was training for the San Diego Rock & Roll Half Marathon in June. As it turns out, Dr. P runs a bit too, but he does triatholons. Cool!  I would love to get into that, but I would need a bike!  (Santa??)

He asked if there was anything he needed to know about. Nothing bad to report, I said. I used to talk about my paranoia about recurrence, but all he offered before was a referral to a support group or therapy. I think running is my therapy now.  So I didn't mention that this appointment had me a bit anxious for the past two weeks.  He did an examination: feeling the lymph node area around my collarbones; listening to my heart and lungs; examining what is now my chest for anything unusual. As usual, he asked if I was going to do reconstruction. Nah.  Being a runner now, it actually is convenient not to have breasts. Besides, I'm not interested in harvesting other muscles to make a couple of boobs. Just my personal choice.

The subject of my Vitamin D levels was brought up.  Actually, Dr. P was the one to bring it up, although I would have if he hadn't beaten me to the punch. He was looking at my results from 6 months ago when they were around 42.  He said that was really good. Is it? Says who?  He said its an inexact science. I told him I would like my D levels tested again. He asked me how much Vitamin D I was supplementing. I looked at him with a twinkle and told him the truth...6,000 IUs a day. His eyebrows rose as he said that was quite a lot. In fact, he recommends that I cut it back to 2,000.  I thought to myself that 6,000 was actually conservative considering I had been taking 10,000 before! Really, my levels were shockingly low a year and a half ago. The low end of "normal" was 30. I was at 14. He didn't think a re-test was necessary. I gently insisted and he said he would order it.

We also talked about switching me over from Tamoxifen to the post-menopausal drug. He said that younger women with breast cancer still may have some activity going on in the ovaries, even in the absence of having periods. Since I was having blood drawn for the Vitamin D, he ordered an estrogen level test as well.  I asked him if it would be worth considering having my ovaries taken out. He said there is a clinical trial going on right now to determine if that is of benefit to women taking Tamoxifen, so he couldn't answer definitively. I've known him long enough to know he has opinions. So I asked what his was. He thought that it probably did help outcomes. Well, we'll see what my hormone levels are and talk about it at that point.

All in all, everything looked as normal as one could look given everything my body has been through. It's as clean of a bill of health as I can get.  I still wonder if I would have more peace of mind with an MRI or a PET scan. Maybe.  Maybe not. I don't know. Does it matter? If it comes back, as he said before, it won't be curable. Talk about having to just trust God with everything!

Even though he's a man of few carefully chosen words, Dr. P is a nice guy. On my after visit summary he wrote, "Good luck with your running."  Nice, huh?   But even thought he's nice, I hope I don't see him until October!

Taking a day off

Yesterday was a beautiful and sunny day here in San Diego.  I usually dress up a little for church, and almost always wear my wig. I kind of take a mental day off from looking like a cancer patient.  I don't wear my wig all the time-I don't mind the visual reminder to the world that things aren't completely peachy for me right now. I'm not complaining, that is just what I'm dealing with. I've worn scarves to church before and I seem to cry during worship when I do. I'm not sure why.  I don't worship any differently, my heart is the same. But something about raising my hands in praise while I'm covering up a bald chemo-affected head. I don't know. I usually end up with tears streaming down my face while I sing. Then the nose starts to drip. It is distracting. The wig works for me on Sundays.

Anyway, because of the glorious weather, I decided to wear a dress that was sleeveless. After putting it on, I realized that a compression sleeve that goes all the way up to my armpit would really spoil my fashion statement, so I left it off.  Why not let my arm get a little sunshine?

So it was a day off from cancer AND lymphedema treatment.  Another reason I decided to do it was because my forearm tends to swell right at the point where the sleeve and the gauntlet meet, about 5 c.m. up from the wrist. Why not give it a break?

Of course, I kept a close eye on it all day and did two good sessions of manual drainage.  It didn't seem to swell at all.  Thank you, Jesus!

In the afternoon, I sat out in the sunshine in the backyard and let my arms soak up some sun.  I'm always looking for some Vitamin D, you know. It felt wonderful.  The only thing that came close to spoiling the day was a fussy and demanding 2 year old. He is a blessing, but requires a lot of attention right now. But I digress.  My arms, especially my left one, are so pale. The left one can look shriveled up, especially when I take off the bandaging.

Ah yes, the bandaging.  After my treatment free day, I dutifully wrapped my arm from finger to armpit in 5 layers of bandaging before going to bed and am still wearing it now as I type.  It is Monday, after all.  Back to radiation, and back to lymphedema.

But it was sure nice to have a day off from it all.

Relatively drug free for a week

I finished my Cipro yesterday.  That means I don't have to take any prescription drugs until next Thursday, the day before chemo round number 4.  Then I'll start the steroid in anticipation of the heavy stuff the next day.  Other than the cytoxan and taxotere that may still be in my system from chemo 12 days ago, I'm drug free!

I've never been one to take medicine much.  Not even for headaches.  I'd usually just drink a glass of water and ignore it.  I'm more than making up for it now.

One thing I've been considering is supplementing Vitamin D.  There have been studies linking low levels of Vitamin D to breast cancer.  Eric even showed me one study that indicated that supplementing Vitamin D may even help the effectiveness of chemotherapy.  In that study, they even mentioned cytoxan as being assisted by it. I e-mailed Dr. P to see if he would order a Vitamin D test to see if I have a deficiency. I was interested overall in hearing his opinion on Vitamin D and breast cancer.  He ordered the test, but didn't say anything other than it would be okay to supplement 1,000-2,000 IU.  Typical Dr. P--he doesn't spare many words.  I think I'll get the blood test this week. I want to see what my levels are before I start supplementing.  

I'm wearing my compression sleeve and gauntlet for the first time today.  It is kind of hard to get on, but once its on it is okay.  The manufacturer suggests you use a rubber cleaning glove on your other hand to help ease it on and I now see why.  Otherwise, you end up pinching the skin on your arm.  The gauntlet is like a fingerless glove.  I have to take it off a lot because of having to wash my hands, cook, etc.  I'll try to wear these garments for about 10 hours a day as my physical therapist suggested.  I want to do all I can to avoid swelling in the first place. It's hard to imagine that this is something that I will have to be mindful of for the rest of my life.  Breast cancer is the gift that keeps on giving.  Sigh.

As an attorney, I am used to citing "authority" for any assertion or statements made.  This morning, I found some confirmation in the ultimate authority...God's Word.  I've been saying all along that God has been strengthening me, sustaining me, and giving me the physical ability to fight this battle against breast cancer.  Check this out:

• For by You, I can run against a troop, by my God, I can leap over a wall.  (Psalm 18:29)
• It is God who arms me with strength, And makes my way perfect.  He makes my feet like the feet of deer, and sets me on my high places. He teaches my hands to make war, So that my arms can bend a bow of bronze (Psalm 18:32-34)
• For You have armed me with strength for the battle; You have subdued under me those who rose up against me. You have also given me the necks of my enemies, so that I have destroyed those who hated me. (Psalm 18:39-40)

There it is!  The Lord is my Rock! Therefore, I will give thanks to the Lord! (v. 49).  Blessed be the name of the Lord, and may you have a blessed day!