Surprise New Ultra Endurance Event

Pictures from Faces of Courage Camp 2008- Brandon

2009-08-02T18:27:00.005-04:00

Masters Regatta WOMEN playing for T.I.M.E

2009-06-30T10:49:00.003-04:00

When I got invited on a sweep boat that Orlando Health was sponsoring with Women Playing for T.I.M.E group I accepted immediately as sweep rowing was something that I had always wanted but never was willing to dish out the 300 usd required for the whole training.
Thought this was a neat opportunity for ORMC to put me back on the water, after all they were the ones that took me out of water / sculling in August 2007.
There were 3 survivors on the boat and my sisinlaw and my friend Z also joined. We had very difficult practices in the afternoon choppy waters but managed to finish the Masters Regatta on Lake Fairview !
Now I have Crew under my belt too and I am hooked and will be joining the Novice Group in Orlando Rowing club.

FLORIDA HALF IRONMAN- GETTING BASELINE

2009-06-30T10:34:00.008-04:00

FLORIDA HALF IRONMAN - Race Report
May 17, 2009
Fort Wilderness Lodge

Training: Practically none. Due to plantar fascitis which I had just managed to get under control with graston technique, and the chemo induced neuropathy which is now getting aggravated with Femara and my neuroma I had not run for 5 months exceptthe Danskin shuffle I did last week. I had only been in the pool 2-3 times, and had done some longer bike rides.. so this race the plan was to just do the swim, try to finish the bike.

But I learned that I could not even get a t-shirt unless I passed the finish line. So I thought that if I can finish the bike/swim I would just go 1 loop and get my medal t-shirt.. probably not the right thing to do but I really wanted a new medal in my rearview mirror.. Danskin mirror is ok but I;'d rather had an IM one.

Wake up : 3:45 (without alarm)

I had a short but peaceful sleep as I had made a point to completely relax one night before and not even go out to dinner since I had been out on the sun for the Masters Regatta that we participated in as the Women Playing for T.I.M.E team. I got a 30 minute massage the night before and ate stupid amounts of food to replenish glycogen stores. I had gone on a very low carb nutrition until 2 days ago to make sure that the stores were depleted so I could really top them off when I start eating.

Although my friend Z had generously offered to come with me this morning (or night) I wanted to go by myself and drive with my favorite music blasting this was my past race ritual, where I also added a yoga vinyasa, which did not happen this time because the transition area was a zoo, and my place was right beside a speaker which was blasting some un-cool music. Had a mishap with the tire valve and could not inflate it, luckily the bike mechanic handled it along with a stuck brake pad. I saw Rosie at transition she was still nursing a call and had quit the antibiotics for the race she looked nervous but I know she is strong as an ox.. ready to take on the field. Portalet line was not acceptable and the hygiene was questionable.. now come on .. it is a huge hole how on earth could you miss it while doing #2 !!!!!! Luckily I was warned before I went into that portalet otherwise my race would not have started on a good tone for sure.

Pre race nutrition:
Breakfast: 1 Plain toasted bagel with 2 Tbsp Almond Butter, Coffee
On the road/transition: another coffee
Transition : chocolate boost shake + 2 antifatigue caps
waiting for swim : Gatorade

Bike nutrition:
1.5 hammer bars
2 anti fatigue caps
2 succeeds (electrolyte tabs)
2 servings of accelerade
About 2 aerobottles full of water

Swim: we started as the 5th wave out of 22 waves and the waves were 2 minutes apart I braced myself for hearing the churning of water behind me and getting passed, hopefully without being smacked in the face.. chest.
I had 2 options either seek for clear water and go out, or stay close to the course/buoys and risk getting trampled on. I chose the latter since I had not done a proper swim in quiet a long time and I was counting on my weight training and rowing to get me through the swim. I could not afford any extra distance.

I think I got passed by total of 3 waves, it was not too bad only got kicked in my right hand little finger - which already had been injured by a basketball thrown by Ferit when we were teenagers-. Overall it was a pleasant swim like past weekend Danskin which was held at the same venue. I got a couple of foot cramp flareups, but was able to swim/breathe through them.

As soon as I exited the swim the left foot plantar fascitis started talking which totally baffled me. I had not even walked on it.. guess keeping the foot in kick position in cold water froze it in that position and when I flexed and stood on it the injury reared. It took me forever to get to the bike, great I thought will I even be able to finish the bike with this foot ?

Bike:

So many thoughts crossed my mind on the bike that I decided to have some kind of a voice recorder in my next long event. One of them was getting the boat from our neighbor and putting a scull on top of the boat.. guess there would be no rules for stacking boats up right ? lol... that way I could scull out of the club. hmmm...
The plan was to go embarrasingly slow and focus on staying fresh and fueling for the run(walk) so I was eating the hammer bars(1/2 at a time) making sure that I finished 1 bottle of Accelerade which had 1.5 servings in it, and taking anti-fatigue caps and succeed tabs every hour. I saw 2 crashes one happened right in front of me where 2 cyclists collided while trying to grab bottle at the water stop, the other one was a guy who fell on his face.. urgghhhh at one of the U turns that looked really painful and nasty. As expected I was having the doormat feel all these cool bikes and ultra fit people pass me (these were the latter waves) I saw Hector a couple of times, he was trying to give me some encouraging words. The bike was going really good and I almost averaged around 17 until we started heading south on 535
Just at that time started having cramps on my right side, first felt like stitches then I worried whether I was having an appendicitis attack.
On 535 after hitting pretty bad headwind and by that time with my feet aching, tummy aching I almost went home from there (the course passed dangerously close to my house almost 5-6 miles). By that time I also had to stop my nutrition to see whether the cramps would ease.
I had to take my feet out of the pedals every 15 minutes and help them recover the balls were aching, especially the neuroma on the right foot which I had acquired when I rode with the bike computer in my cycling shoe at the Big Kahuna half ironman couple of years ago.
It definitely took a lot of mental determination to finish the ride, I really was done with pedaling and did not want to see my bike for a while.

Run nutrition:
handful of cheese combos at beginning, 4th and 8th miles everytime I passed the loop to finish
4 accelerade gels (2 with caffeine)
Lots of Water and gatorade at each mile stop.
2 anti fatigue caps
2 succeeds (electrolyte tabs)

Run water stop ritual:
Fill up cap, jersey and shorts with ice.
Wet 3 sponges with ice water 2 on shoulders one on back of the neck
Wet the froggie washcloth in ice water, wipe face, arms, legs.
Drink water, gatorade.

Run plan:
Jog 50 steps at 2:30 and 5:00 minutes. So that kind of came to a 1 minute jog 5 minute walk. I probably spent at least 2 minutes extra at each water stop but there was no other way that I could have finished that distance without having run for 4 months.

Run: Due to my plantar fascitis and the pain that I had during the bike I really was not sure whether I would be able to make even a single loop which was the initial plan. Although there are timing chips at the turnarounds I did not care about the result listed as DNF I basically wanted a cool medal for my rearview mirror.
So I took my time in transition to assess status/damage. As soon as I was off the bike and out of the bike shoes my feet felt good. After putting on my running shoes they even felt better. I also was pleasantly surprised to see that there were still some bikes not in from the bike in my wave ! indicating that I did have some time on others. So decided to start walking.After eating a couple of my cheese combos and downing the antifatigue caps,succeed I was able to do my 50 step jog that I had tested in last weeks Danskin and the feet still felt ok. At tri's I never plan on the run beforehand because I never know how I am going to feel after the bike. After assessing myself came up with the following which seemed doable for 4 miles (1 loop)

I saw a lot of Central Florida Triathlon Club members racing and also cheering at the finish exit loop. Having a cheering squad is a double edged sword. It gets you motivated going, they give you energy on the other hand one really does not want to do bad in front of others. So I went on the 1st loop, it was nice since almost everyone was still on the course doing their 2nd or final loop. I was only able to find 1 person who was on their first loop. During the second loop the field started to get thinner but still I had people that I hung out with to chat or pace from. Now the third loop looked very pathetic I only saw a handful of people battling the heat and trying to crawl, I actually felt and looked a lot better than most of them to my surprise. Guess the nutrition preparation and extreme !!! taper did its job. I was able to do the pathetic 50 step jog 2 minute walk and jog to the finish line upright ! Life is good. I am back ! Now I can kick back and relax for a while.

Now let me see what else is out there that I can tackle ;o)

Races are already here

2009-05-11T15:52:00.003-04:00

We did the Danskin tri last weekend and although i was not supposed to do the run I was soo tempted I kind of winged it doing a 50 step walk 50 step jog, averaged 13 min/miles which is good considering that I have not been running for the last couple of months.
Well time really flies before you know I was complaining about 167 pounds now I am at 172. And yes I can partially blame femara mostly for not being able to train and eat like a horse as if I am still training.
Did some graston therapy, acupuncture, took a 2 weeks femara vacation and it seems like the foot is almost good ! However do not know how it will react when I return back on Femara next week.
Now spoiled and psyched about being able to complete the sprint tri run I am getting ambitious and thinking that I might try to do the half ironman walk/run. Just to finish, the run is 3 loops so worst case I will hobble to the finish after the 1st/second loop. Definitely worth trying.

Life without estrogen

2009-03-31T16:37:00.002-04:00

Well I thought leggo of eggo is not a biggie and was really happy that they were gone since my tumor was estrogen/progesterone receptor positive, apparently those little beanies were really working hard to make me happy keep me going.
With the main estrogen factory eggos being gone the body could have still survived but we had to also start Femara which is preventing from any estrogen being produced by my adrenal glands and fat cells. Possible side effects would be weight gain ( as if I needed another excuse to be added to a chocoholic state ) ,fatigue, hot flashes, night flushes, foot pain, joint pain, vision loss, brittle nails, thinning hair ...lets see what else I missed.. oh of course insomnia (due to night flushes), cardio problems, mood swings, bone loss, dry skin.. ok I am getting depressed writing these.
So which ones hit me so far ? Insomnia major !, night flushes major !, hot flashes soso.. my bones were osteopenic so I am getting 2 Zometa infusions annually which is also supposed to prevent any bone metastasis if anyone in there gets a bad idea ! And foot pain, I already had neuroma, add heel spurs and plantar fascitis and neuropathy which I believe are also increased with the Femara = delay in returning to the triathlon scene.
But life is still good, as I read in 'Atlas Shrugged' Fear of death does not necessarily mean love of life and I love my life even though there are small challenges.

I am getting really better at my biking again, did my longest ride on Sunday under wet conditions 65 miles Strawberry metric century. Running has to wait until my feet calm down and I lose some weight as I am at 167 now. My swimming is also almost back to where it was. I also started weight lifting, maybe I am pushing it but it seems like my right arm is ok with it might need to get a sleeve for insurance against lymphedema.

Robotic Laparoscopic Hysterectomy , oopherectomy

2008-10-16T01:29:00.002-04:00

Well had my robotic assisted davinci hysterectomy, oopherectomy on wednesday and was released home the same day. Besides having some gassiness, everything is fine !
They should have done this last year as I asked them to !@#$!!!

House pictures

2008-05-23T14:43:00.022-04:00

One last post - Before and After !

2008-05-08T14:43:00.002-04:00

And the Finish Line

2008-04-25T16:45:00.004-04:00

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271 days later I am at the finish line, almost like pregnancy. Here is a picture with one of my September Chemo buddies Paxton, she is from Minnesota and came down to FL to visit her parents.

Interestingly I feel almost as good as I started out this whole ordeal,I do not seem to have that much fatigue ( of course I am not going outand doing 60-70 mile rides and am not running ) but day to day activities with 1+ hour exercises are doable.

My mental state has recovered and I have accepted my favorite motto ' Shit happens' and will try to move on.

A lot of people say that they changed after having the c experience. I am not sure whether I changed but for one thing I will not take my health for granted from now on, or any day that I am feeling good either.

Last day of my radiation I went sculling to watch the sunrise, then headed to my last radiation session, did power yoga at college park yoga, got a manicure pedicure then a facial. Major pamper day !

Now is time to move on, we are planning on moving. Well I can say that my life is never boring !

Radiation lifestyle

2008-04-09T13:16:00.005-04:00

Started the radiation on March 6th I will get 33 sessions 25 to the whole breast, axilla and the back, the last 8 boosts to the tumor site to do a really thorough clean up.

Here is how my daily schedule looked like for a while.

Get up, work for 2 hours, drive 20 miles to the hospital, get zapped, drive 20 miles back. Work .. sometimes take a nap.

I tried to keep up my workout schedule but the driving in the middle of day sapped some energy and time resources even though my mom had been visiting and had relieved me from all housework(shopping! cooking ! tidying) for 3 weeks.

After my 6 weeks post surgery exercise limit was lifted off I changed my radiation session to the mornings and am hoping to go rowing before I get zapped everymorning, since I am already driving all the way up there might as well makethe most of it.

I have been riding thursday evenings with Z and Penny and some of the bobbies in winderemere(27 mile ride) and also try to ride a 30 miler on the weekends. Since my weight is a bit on the heavy side to run, I have been walking ( 163 pounds.. from 146 in August). Started going to weightwatcher meetings that program got me on track always in the past so it should to again now.

No swimming yet since the skin is really sensitive due to radiation I do not want it to blister or act up and have to give a break to radiation.

The sleep problem finally has been resolved by taking Ambien Cr, I hope I am not sleep driving/eating !! It gave me a headache the first day I took it since I had to get up and did not get 8 hours of sleep. But this was the best med so far. Even the nightsweats are not waking me up.

My car is trying to die on me but I am adamant in making it live ! It had poured oil in the driveway changed the gasket cover, changed the spark plugs. Now the gasket chain ?? blew out. I am figuring that if it starts to cost more than 200 usd/month on a regular basis then i am reading to part with it. I can not affort a new one of those and really did not like any of the cars in the market within my price range. If I have to I probably will go with Scion TC. Drove a Scion Xb yesterday, although the boxy look certainly leaves much to be desired the interior was really nice. Road handling and stability though are far off from my dear TG and since they are a high demand car the finance options are not that desirable.

We went to Fort Lauderdale with family and my mom overnight it was really nice, we stayed at the Gallery One Double Tree Guess Suites was perfect with a view of the Marina and the Ocean.

My mom at the terrace:

Radiation - daily tanning sessions start March 6

2008-04-09T13:15:00.001-04:00

Radiation - daily tanning sessions from March 6 to April 21st

( had to repost to delete a spam comment)

The radiation suite is covered with murals of lake views, they are trying to make the place look cute since what happens in there is almost illegal and fatal !! nuking people. Well I look at it as scrubbing with Cholorox.

My radiation oncologist (Dr. S) appointment was on the 4th of March. I started the conversation by saying:
'You did a hell of a job convincing me to do rads despite my oncologists opinion that I might not need to'
He was slightly taken back, but then chuckled and shared some interesting information.

Apparently although I was under the impression that he was trying to blow my Plastic Surgeon Dr. P off about taking my case to the hospitals tumor board he actually did so without giving my name. There were several oncologists and surgeons on the board and given the information about my case all aggreed that radiation was the way to go for me, and that if I was going to get radiation there was no point in overkill by removing the remaining axillary nodes. There is something about this radiation oncologist that I like, and I really trust him in his field.

Secondly another study( which I must have missed somehow ) was published after we last talked which proved the benefit of radiation for people in my condition.
So these facts further sealed the deal about being right about choosing this path.

Dr. S was not against supplements when I asked whether I could take Curcumin which according to some research and actually a trial that was started ( but never completed due to financial reasons.. of course turmeric plants do not have $$$ in banks to sponsor this research !! ) by MD Anderson helps protect skin during radiation and could even enhance the efficacy of the radiation. Interestingly curcumin is also said to be good while taken with Adriomycin, but counteracts with Taxol. These things about supplements are really getting confusing, I am almost getting to the point where my oncologist is where I will not mess with them at all. Dr. S's message wa that he believes that radiation is so powerful that it will zap through anything no matter what I do.. hmm that is good and bad to hear, anyways. Shared my skin protection plan with him which was 2 gr curcumin daily, Pure Aloe gel ( with no alcohol) immediately after each treatment, and Aquaphor at night.

I will be seeing the Radiation Oncologist Dr. S every Monday throughout my treatment they have not done any bloodwork I guess they get it from my Oncologists lab.

In my mapping session(where they take multiple films and determine the position I will be on during every session) I went into treatment room 1 and was taken care by extremely nice radiation technicians and another person who I am suspecting is a supervisor or another rad doctor who was responsible for the mapping of the zap site.

I laid down on a narrow table ( I cannot believe how narrow these scanning, treatment tables are, what happens when a really large person comes it could be hard for them to balance on it I am no twiggie but I am sure there are more impressive butts out there than mine!) there is a round contraption as big as a car/truck tire that is attached to the base that rotates around me. There is a glass window from which the rays are directed for scanning or zapping. In the glass window of that contraption there are multiple leads(which reminded me of hundres of allen wrenches) which open and close, limiting the field of radiation given (OK I am making this up but it certainly looks like the scenario) They make a funny clicking noise as they are aligning between scans/zaps.

They made me lay on an air pillow and raise my right arm above my head to a - as comfortable as one can be when laying beneath a radiation bombardment line - and the air pillow molded to my shape using some kind of vacumming technique, hi Aylin meet your pillow for the next 33 days wonder if they'll let me take it home as a souvenir although I am highly suspecting that I will be more tempted to throw it in a bonfire.

The round contraption zoomed whirred around me technicians going in and out of the sealed room ( there is a curtain that they pass out from but behind the curtain is a lead door - they probably have the curtain so one does not freak out or get claustrophobic of being sealed in a lead room ) they told me that they had a camera in the room and when they go out they see me and can hear me. There were red laser beams aligning the machine with the wall ( I was looking to the left where there was a cross like opening in the wall which matched with the laser that was coming from the machine). I was not allowed to move a muscle or twitch !! for about 50 minutes, I wish I had known this, then I would have worked up to keeping my arm up for that long, it only had been 3 weeks since my exchange surgery and my shoulder mobility was not quite there. They were taking scans marking my chest with sharpies ( my chest looked like an elementary student geometry notebook !) my shoulder started aching, and despite all efforts of trying to relax I started tensing up. they told me to breathe normally so they could do the mapping of the radiation to avoid my heart and lungs but it was really hard to keep a relaxed state while on the verge of having a hissy fit. I almost felt like I was having a panick attack (like I did in my Ironman Swim in Austria last July) hyperventilating, I was sooo close to jumping off that table. If I meet anyone that will be going through radiation my first suggestion would be for them to ask whether it is ok to get something before the session to relax them like Xanax.

It took a lot of willpower to stay in that position for that long my shoulder was aching I was freaking out.. but it was finally over ! And my first treatment was also done at the same time. Usually I hear that they first do the mapping one day, then they do a dry run, then they start treatment, well we got all 3 in 1 ! That must have been because I was freaking out that my radiation should start latest 8 weeks from last chemo which was on March 6th exactly.

The radiation therapists/tech's are really nice with sense of humors I guess you have to be extremely nice to your patients if you are going to see them every single workday for 33 days and nuke them! Almost like working together on a temporary job.

As stated the following sessions were a lot quicker, I would be in and out in about 10 minutes. They did take xrays everyday, I was worried about the increased radiation exposure but my rad oncologist said that all the exposure was accounted for and the total mattered. He said I was getting about 61 greys ?? ( do not know what that means)

I started getting to know the radiation therapists and some patients that come at the same time as I did, everybody is so nice. This place is a lot different than the chemo ward, patients are not as sick, and they are at almost the end of their treatments which is making a huge impact on their morales. The only thing I do not like is being exposed to cookies that are in the waiting room everyday, even if I sit at the other end of the waiting room the vapors of those chocolate chips and vanilla travel across the room directly to my nose. Do not know how much more I can resist without taking a handful. Eating dessert should be fun, and doing something in moderation is NOT fun.. so if I want to have fun with cookies I have to have a lot of them. Warped thinking I know but thats how my brain seems to operate, so I do not take any cookies.

The drive to the hospital is about 20 miles, so I have been taking long lunch breaks from work. It is actually a nice break during the day I like going out listening to good/loud music and driving TG and the traffic is not bad.

The first couple of days I felt a lot of fatigue then figured it was really psychological. About 2 hours after each session I have a feeling similar to that of a 'coming cold/flu' and if I hydrate enough and eat a lot of fruits veggies, basically 'be a good girl' the fatigue goes away in a couple of hours.

My skin is holding up well as of end of the 12th session ( have 21 more to go), and I do not seem to have any nausea either.

In my 3rd day of rads I do not know where that idea came from but I decided that I would try fasting, giving the body a break and a chance to recover on a weekly basis. What a totally stupid thought, I can not believe that I even considered doing it during radiation treatment, I guess all the chemicals got to my brain and are impacting my judgment too. I crashed so badly that day took 2 days to recover from it.

But once the rads are over and my body is recovered from the wars I will do some kind of fasting on a periodic basis cause it certainly makes sense. 2

Ongoing Workout Log

2008-03-03T15:37:00.010-05:00

Bilateral Mastectomy with Immediate reconstruction August 31
Port placement Mid September
Chemotherapy - September 27 2007 - January 11 2008, every other week
Expanders exchange for reconstruction February 14
Radiation start - Thursday March 6 - monday through friday everyday for a total of 33 sessions.

October
10/16 - 1.5 miles walk 27:37 18:20 mn/mile 3.3 mph maxhr/avhr-127/117
..........time in heart rate zone: 13:36
10/17 - 2.25 miles walk 38:26 17 min/mile-3.5 mph maxhr/avhr-138/125
..........time in heart rate zone: 30:26
10/18 - First bike ride after surgery 33 minutes 5-6 miles avhr/maxhr 127/150
10/19 - 3.3 mile walk 56:00 17 min/mile-3.5 mph avhr/maxhr-121/137
..........1.5 hour Kundalini yoga
10/20 -16 miles bike ride on trail avg speed 11 mph avhr 124.
10/22 - 4.5 miles walk/jog 1:13:47 16:10 min/mile avhr/maxhr- 124/154
..........Time in Target Heart Rate zone ( 116-135): 55 minutes
10/23 - Spinning class 43:47 avhr/maxhr - 132/150
..........Time in Target Heart Rate zone ( 116-135):20 minutes
..........1.5 hour Kundalini yoga session
10/25 - chemo
10/26 - 1 mile walk 20 minutes avhr/maxhr - 114 125
..........Kundalini Yoga session.
10/30 - Spinning class 42 minutes avhr/axhr - 132/160
..........Kundalini yoga 1.5 hours

November :
11/2 - 2.8 mile walk 44 min 15:45 min/mile avhr/maxhr- 134/160
..........Kundalini yoga 1.5 hours.
11/3 - Spinning class 40 min avhr/axhr - 142/167
11/4 - 6 mile walk 1:40 mins 16:22 min/mile avhr/maxhr - 129/163
11/5 - 17.2 mile bike ride 11.7mph speed avhr/maxhr-133/147 time in zone 1:00
11/6 - Spinning class 40 minutes avhr/maxhr- 141/169
..........1.5 hour Kundalini Yoga
11/7 - 3 mile walk 48:00 mins 16min/mile avhr/maxhr - 134/
11/8 - 1 hour hot power yoga
..........Chemo #4

11/10 - 2.5 hour Kundalini Yoga(mainly meditation and breathing-breath of fire)
11/12 - 3 mile walk
11/13 - 3 mile walk
.........1 hour Kundalini Yoga
11/14 - 17.4 mile bike ride 12mph average 1:27 mins avhr:136 maxhr:151
........time in zone 47 minutes
........1.5 hour Kundalini Yoga
11/16 - 1.5 hour Kundalini Yoga
11/18 - Horrible Hundred ride- did only 26 miles 2:00 hrs 13 mph average.
........avhr/maxhr - 161/190
11/20 - according to my heart rate monitor did some kind of 44:00 minute cardio, do not recall what !! avhr/maxhr - 146/171 .. looks like spinning.
11/21 - weight training
11/22 - 1 hour indoor cycling/spinning - avhr/maxhr- 150/171
11/23 - weight training
11/24 - 41 mile bike ride with Florida Freewheelers C/D group picnic ride, 14.2 mph, 2:47:00 hrs avhr/maxhr-155/177
11/25 - 6 mile walk/jog shuffle, 1:27:00 hrs avhr/maxhr-160/184-- a bit high have to check whether my red blood cells dropped. 14:30 min/mile. 1.5 minute jog, 1 minute walk. Expanders which are looking like monster boobs might also be compressing my rib cage preventing me from breathing well.( rumor is a gals ribs cracked from the pressure of an expander)
11/26 - Weight training and 10 minute erg - left chest muscle is challenged might need to give a break.
11/28 - 1 mile run 12:40 min/mile. weight lifting
11/29 - 1st Taxol treatment chemo#5/8

December

12/5 - 1 hour lower body weight training, 1/2 mile run. Chest muscle still compromised cannot do any upper body or core.
.......1.5 hour Kundalini Yoga
12/6 - 1:08 hr bike ride, 14 mph, avhr/maxhr-158/170 17 miles
12/7 - 1 hour weight training, 1 mile run.
12/8 - 1.5 hour Kundalini Yoga
12/9 - 33 mile bike ride, avspd 15mph, avhr/maxhr -
12/10 - 1 hour weight training, lower body, 1.5 mile run
12/11 - Led the 40 minute spinning class(for the first time)avhr/maxhr-163/178
12/12 - 1/2 mile run,1000 meter erg at 2:13 pace. 1 hour weight training ( upper body, the chest muscle did not talk back I was even able to hang )
12/13 - 6/8 Chemo taxol.
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12/23 - 6 mile jog/walk. 1 min run/1+ min walk. 1:30 hours 15 min/mile -
........avhr/maxhr - 158/183.
12/24 - 53 minute spinning class avhr/maxhr - 161/178
12/26 - 51 minute spinning class avhr/maxhr - 154/174 - was able to exert myself really good this time.
12/27 - 43 minute 3 mile jog avhr 166 maxhr 172 14:20 min/mile 2 minute jog at 5 mph 1 min walk at 3 mph.
12/27 - 7/8 Chemo Taxol 1 more to go !
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January

1/2 - 54 minute spinning class avhr/maxhr-151/171 - not able to exert
1/3 - 3 mile jog/walk- 1 min jog at 5mph, then walk until recover(1-2 min)
.......48 minutes 16 min/mile. Avhr/maxhr- 158/174 Treadmill - felt quite wiped out
1/5 - 1:29 hrs easy bike 12 mph 17.3 miles avhr/maxhr -151/171 -- this not sleeping
.......is really getting to me.
1/6 - 7.3 mile walk/jog 16:10 min/mile 1:58 hrs. avhr/maxhr - 151/172
.......Started with 1 min walk 1 minute jog, then the jogs got a lot longer, I am
.......glad that I was able to finish did not feel wiped out, but the knees were
.......a little weak.
1/7 - 45 minute assessment with Personal trainer, going over the machines at the
.......gym.
1/8 - instructed 50 minute spin class avhr/maxhr - 159/180
........1.5 hour Kundalini Yoga Session
1/10 - 1:24 hrs bike ride intervals about 16 miles.. avhr/maxhr - 161/191
1/11 - LAST CHEMO TAXOL yey !!!!
1/12 - 2+ mile walk with Candy- 40 minutes
.......1.5 hour Kundalini Yoga session
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1/16 - 3 mile jog/walk with Candy 41 minutes 13:36 min/mile avhr/maxhr - 163/185
1/17 - 500 yards in the pool(first time in 6 months) my arms are tired.
.......30 minute express weight workout at the gym, 20 minutes elliptical,verytired.
1/20 - 9 mile jog/walk- 2:24 hrs 16 min/mile avhr/maxhr - 156/182
1/21 - 3.5 mile walk with Candy, 1:10 hours
.......1:30 hour bike ride from WaterFront Park at clermont on the trail with
.......rolling hills, about 16 miles. avhr/maxhr - 140/168
1/22 - Lead the 50 minute spinning class, and this time pushed myself.
.......40 minutes power yoga(downward dog pose is not aggreeing with my arm having
.......lymph nodes removed, have to find a pose modification.
1/23 - 40 minute chi kung - AM
.......40 minute light weigths - PM
1/28 - 3 mile jog/walk avhr/maxhr-168/189 -- stressful day reflecting on heart rate
1/29 - Instructed 45 minute spin class avhr/maxhr - 160/180
1/30 - 3 mile jog walk 42:00 min 14 min/mile avhr/maxhr - 153/181
.......30 min light weights pm
1/31 - 2.85 mile jog walk 41:00 min 14:24 min/mile avhr/max-142/185

February :
2/1 - 9.5 mile bike ride 40 minutes avhr/maxhr-?
2/2 - 6 mile - 1 minjog/2 min walk 1:25 hrs 14:10 min/mile avhr/maxhr-153/180
2/3 - 33 mile bike ride moderate effort. 2+ hours
2/5 - lead 50 minute spinning class
2/7 - 3 mile jog/walk on dreadmill 1% incline. 48:30 min/maxhr - 140/169 16 min/mile
2/8 - 40 mile bike ride avspd around 14, planned 53 miles but got fatigued.
2/10- my first 5k race Lady Track Shack, 39:23 min.
2/12 - my first sculling day ! easy rowing around Lake Fairview in about 40 minutes.
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2/14 Expander exchange surgery ( 2 week minimal activity, 6 weeks no intense workouts allowed)
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2/23 - 1.5 hour Kundalini Yoga session
2/25 - .6 mile walk with Candy
2/26 - 50 minute spinning session
2/27 - .6 mile walk with Candy - 1.5 hour Kundalini Yoga session
2/29 - .75 mile walk with Candy

March :

3/1 - 1.5 hour Kundalini Yoga session
3/2 - 2 mile walk with Candy
3/3 - 1.5 mile walk with Candy
3/4 - 40 minute walk with Candy
3/5 - 1.5 hour Kundalini Yoga
must have done some daily walks with the pup do not recall.
First radiation session 3/6
3/8 - 42 min spin session -avhr/maxhr -148/170
30 minute swim
3/9 - 28 mile bike 2:12 avhr/maxhr -148/172
3/10 - 3 mile walk with Candy
3/11 - 2 mile walk with Candy
41 min spin class - avhr/maxhr -158/173
3/12 - 1.5 hour Kundalini Yoga session
3/13 - 1 mile walk with Candy
27 mile bike ride 2:03 - avhr/maxhr - 165/193 ( ????)windermere rolling hills
3/14 - 1 hour hot yoga ( bad idea..!)
3/16 - 30 mile flat ride 2:31 min avhr/maxhr - 155/178
3/18 - Lead the 53 minute spin session avhr/maxhr - 165/182
3/19 - 50 minute walk with Candy
.......1.5 hour Kundalini Yoga
3/20 - 27 mile Windermere ride(solo a bit windy) about 2 hours 14.1mph
.......average avhr/maxhr - 160/177

Well I think this workout log served its purpose since I am towards the end of my treatment. I am not keeping a workout log here anymore, cause my workout has stabilized as the following:

Teach spinning class/once a week.
Do 2 outdoor rides about 25-30 miles.
Walk a lot.
Some rowing...

Training plan for the Jacksonville Breast Cancer Half Marathon February 17-not running it but will go to the event.

Week Start Date Length of long jog and/or walk

08-Oct-07 Chemo on thurs 4
15-Oct-07 4
22-Oct-07 Chemo on thurs 5
29-Oct-07 4
05-Nov-07 Chemo on thurs 6
12-Nov-07
19-Nov-07 chemo break for t-giving before going on to Taxol !
26-Nov-07 Chemo on thurs
03-Dec-07 6
10-Dec-07 Chemo on thurs
17-Dec-07 8
24-Dec-07 Chemo on thurs
31-Dec-07 6
07-Jan-08 LAST CHEMO ON THURSDAY ON THURSDAY JANUARY 10 !!!
14-Jan-08 8
21-Jan-08 10
28-Jan-08 6
04-Feb-08 4
11-Feb-08 Event on Saturday

Trying to recap

2008-03-03T14:58:00.004-05:00

There is a lot to recap as life is picking up I am having a difficult time keeping up with my blog, which is good I presume.

The Breast Cancer Support Group of my hospital got canceled, I was really looking forward to it. 1 day before the scheduled meeting I received a call from the counselor who heads the support group - aka icequeen ! - saying that since no one rsvp'd they were cancelling the meeting for the month. I thought that was very rude she could have asked whether I still wanted to have a meeting with the counselor even though no one else would be there.. Anyways I did later find the opportunity to give feedback as to her 'not exactly fitting the type ' for heading a breast cancer support group to the other counselor that I really liked at the same institution.

28th of February was our 21st ex-wedding anniversary and we bought ourself a great juicer (Omega 800), I have read a lot of good things about juicing and its benefits. The juicer we got has a ceramic auger that has low rpm 80 so oxidation is minimal while juicing.Eating the veggies is also necessary however there are certain veggies that are easier consumed when blended in with other stuff. So I am focusing on cruciforous vegetables,(broccoli, cauliflower) beets, ginger root, kale - I figured that if I top anything with a couple of carrots the taste becomes OK.. (nothing exciting) These juices also keep me very full which is interesting because they do not have any bulk to them. I add a drizzle of olive oil so that it will stay longer in my system and the nutrients get absorbed.

Ferit also surprised me and made a reservation at Jeffrey's restaurant so we got to eat my favorite dish there the sea bass.

I seem to have acquired a taste of 'beach'ing. Unfortunately when radiation starts I will not be allowed to have that much sun exposure so depo'ed some sunlight, sand the last couple of weekends at Cocoa Beach.

Started the Kundalini Yoga sessions again.

The hot flashes at nights ( night sweats ) are becoming unbearable, the chillow, the ice water that I drink at night do not seem to help. I am being sleep deprived again, have to address this somehow I might even agree to take Effexor which is basically an antidepressant but is stated to tame the night sweats. It is kind of stupid to take an antidepressant without being depressed but pretty soon if I do not catch my zzz ! I will be a basketcase.

My work performance is fluctuating wildly, one moment I am all ramped up and excited the next moment I could care less. I am hoping that this will settle in time.

My second tumor markers were a lot better within normal range although I really would like them to be 0 ! I do not want to have a tumor marker number. Lets see how it goes next time.

Beach day

2008-02-24T18:00:00.003-05:00

Sunday morning we went to the golf driving range where I videotaped Ferit who is trying to improve his swing. Then I sat on a benchand read a magazine enjoying the quiet/busy atmosphere of the golf course, it somehow reminded me of a ski resort, don't know why.

All week I had an intense desire to go to the beach, checked the weather report and headed off to Cocoa beach with Ferit,Elif and Gina(Elif's friend) after dropping my car to the service. Not my favorite one but the closest that would let me breathe sea and feel sand.

Turned out to be a perfect day and for the first time I went commando, it was just too hot and I did not have a solution for swimming. Implemented my 'whatever' motto.

The water was a bit refreshing but felt perfect.

First of : hair(fuzz) trim, PS visit, Oncologist visit

2008-02-21T10:16:00.007-05:00

The Plastic surgeon visit was as I expected, the band that was there with the expander was still there with the implant pushing it up making that side tight/uncomfortable and uneven. He said that he did not see anything when he went in for the exchange and he would do a corrective action (that needed to be done to complete the reconstruction) 5-6 weeks after radiation.
Overall the reconstruction turned out ok(I will give it a 6 out of 10 in its current state and if the band is fixed later might bump the grade up to maybe a 7+ not more) My Plastic surgeon did not use the brand that I heard that was really good (Mentor) but used another one. Still can not complain that much, I just am not as comfortable as I thought I would be.

After looking in the mirror and getting annoyed with the baby fuzz(I have heard some bc gals actually savoring the little duck hair but I certainly am not one of them) asked Ferit to buzz it off, not a complete shave, but as much needed to get rid of the baby feather and leave hair stubs. It certainly looks a lot better/healthier.
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The oncologist said 'hmmm what are you doing here I was expecting you after radiation ?' They took blood (ouch since I had my port out they had to do it the regular way) and sent me off asking me to come back in 12 weeks. When I asked whether any scans will be performed to monitor, he said if he wanted he could do a 'panic' scan, but from what I am reading there is actually not that much point in doing any blood/scan monitoring unless there are physical symptoms. They needlessly panic the patient because they could give signs that are totally unrelated to the bc. My tumor markers have been going all around the place which I was told was normal when one is going through chemo and were not necessarily an indication of anything going wrong.
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Another lesson for me to let go I guess.
My attitude going forwards will be 'Whatever' and move on.
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He also shot down any hopes of natural remedies for the hot flashes that wake me up every night 5-6 times.
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I know that if I go on Effexor an antidepressant that would take care of the hotflashes but I do not want to take medication, will try to see whether I can somehow manage through them.
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Focusing at work is getting to be challenging, interesting because I thought that as I neared the end of treatment I would feel more comfortable relaxed, not being monitored carefully is making me feel like walking on a tight rope with no safety net
urghh...
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Friday night went out to celebrate N's birthday and went to Luma on the Park, had a great time, although it is getting challenging to find clothes that I can squeeze myself into something has to be done re: this weight gain. And wearing a wig is getting really old, can't wait till I have a boy cut lenght hair.
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Saturday went to the Kundalini Yoga that I have not attended for awhile, it was a perfect day. The studio is overlooking a garden with large trees, it was raining outside.
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I am looking into supplementing my treatment with Dr. Richard Schulze's system, but it seems a bit intense might tone it down a bit and implement some parts if I can.
There is also Johanna Budwig's flaxseed oil and cottage cheese regimen which I am debating on, as flaxseed supplements are a controvertial topic for hormone positive bc's. Found a reputable research that was stating that flaxseed indeed resulted in tumor shrinking, but the study was done with about 40 gals I think.
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As our wedding anniversary present we ordered ourself a Juicer (omega 8005) will also change my nutrition to include those regimens.

Can I color my hair ehem fuzz yet ?

2008-02-18T14:01:00.007-05:00

It has been about 5 weeks since my last chemo and the fuzz is growing pretty fast but it is almost all white. The wig/bandanna look is getting kind of old and the weather is warming up, so I thought that if I colored my fuzz maybe I might be able to go commando ?? Ferit as usual very politely said ' I do not think so' but I decided to try it out and applied mascara to one half of my head.. urghh.. as always he was right, I do look like I have mange not enough follicles yet. Gotta double up the Nioxin Follicle booster.
Elif said that I looked like her favorite black and white cookies that we buy from Too Jays, in any case seems like I will be fancying head covers for a little bit more.
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My favorite pictures

2008-02-18T09:13:00.002-05:00

Pictures from the Race

2008-02-18T05:56:00.012-05:00

href="http://2.bp.blogspot.com/_9-rfw22gk-Y/R7mMf1PvmbI/AAAAAAAAAVk/Hi6DyxT2mUo/s1600-h/jacksonville+012.jpg">

Race Day National Breast Cancer Marathon, 26.2 with Donna

2008-02-18T05:04:00.005-05:00

Ferit was trying to wake me up gently, however I was enjoying my precious sleep and did not have any intention to get up until one of my 2 alarms went off, then at 5:45 did not have any excuse to linger in bed longer when my phone alarm went off. I am losing my touch as an early morning bird for sure.

Met with the crew for breakfast at 6 am, we had gotten mixed messages regarding the weather stats today, initially it was thought to be cool (it was supposed to be starting at lower 50's only to warm up to mid 60's by noon)however my friend Mary Ann had called and warned me that the forecast had actually changed and it was going to be unseasonably warm, close to record heat.(about 80).Except Sibel and her friends everyone else was wearing long pants and settled on short sleeves(which was extremely wise) Teenagers certainly have an invincibility regarding sleep deprivation and heat/cold.

Drove to the Morocco Shrine where the shuttles were going to take us to the race start. I believe we waited close to an hour and was able to get into the 9th bus that came and was at the race site around 7:45 lingered a bit and then headed to the start area.

One of the local news crews interviewed Sibel and me, caught me off guard and I said pretty stupid stuff which I later thought was pretty much off base oh well.. luckily I am not making my living by talking live on the air ! I thought I sounded a bit too arrogant, actually taking credit for others accomplishments.
It can be viewed from :

http://wm.wtlv.gannett.edgestreams.net/news/2008-02-17/grayson6pm.wmv

Since I had a race number I was able to go to the start line with the racers(if only they looked at my shoes they would have definitely figured out that I was in no way competing), hoping to be able to see Mary Ann and maybe walk/jog the first mile with her. However despite all the hollering of the 6:30 marathon race group members we could not locate her (later I learned that she actually had started out with the 4:30race group and let the 6:30 catch up with her). The horn went off and the racers started to move as a single body, I actually had a hard time getting out to the side after walking with them for a couple of hundred yards, it was kind of tempting to try hooking up with them for a couple of miles after all I had trained throughout chemo for this event.. but I knew better 3 days after surgery. Good thing I had not worn my running shoes (knowing myself I did not even bring them to Jacksonville)

Met with bil who had driven there and parked at a nursing home's parking lot to drive to the beach area close to the half marathon turnaround to 6th avenue so we could cheer our crew which would be running on the beach and then also coming back inland. I was trying to shop for Marathon souveniers for the first timers,we stopped for Starbucks and also we were not able to find a safe parking place(ended up parking in a non-parking but safe spot) so we missed the a couple of our runners. But I was able to see Mary Ann and give her a hug ! I do not even recall the last time I saw her.

Of course the plan of snoozing on the beach with my book which I was looking forward to while everyone was running did not happen.

Then we went back to the finish line to greet the runners. By this time it had gotten really warm and I was getting worried about everyone when I heard sirens I was worrying that someone got dehydrated and had to be picked up spectating seems to be really hard.

One by one each showed up pretty exhausted but everyone also had a huge smile, and a story to tell. There were 7 first timers in the crew of 8 and everyone met or exceeded their pre-race goals which was impressive because the course was harder than what they had trained for and the weather conditions were not optimal( high humidity starting at 99% then dropping to 70%, temperature close to 80)Carolina actually pulled a 2:07 !!! her hard training had definitely paid off what a performance on a first half marathon !

I tried to find Jan my friend from work but could not spot her, later when i looked at the results I saw that she must have passed right in front of me at the finish line but I did not see her.

Waiting at the finish line feeling a bit tired(I think I had walked about 2 miles back and forth that day) I sat down on the curb and Sibel came and sat with me, she literally had salt cakes on her eyelids !

Later as I was watching the runners come in I thought how exhausted they looked and how much energy they had spent during the last 2-3 hours, then I thought that all this energy was intended to be directed towards the fight against bc. I almost felt all this energy radiate from the finish line and thought that I was lucky that I was close to it and was able to feel it firsthand.

Went into the Racers Village with the last runner of our crew and since I was holding my race number in my hand they gave me a finishers medal,I rejected the first one, but then it was hard to resist taking the second one(it is beautifully designed and has a suncatcher in the middle). Thought that I would decide on what to do with it later.

Did not lollye around in the Racer Village and headed off to the hotel to clean up and head out of the endorphin filled world of post-race-high to our normal lives. War stories were exchanged in the cars and I am suspecting will be part of the runners conversations for some time coming.

Stopped at Panera, picked up some pick-me-up Java from Starbucks and headed back home trying to beat the post-Nascar/Daytona traffic.

It is quite entertaining to watch people try to get out of a car after sitting in it for 2.5 hours following running a half marathon. The nursing home patients of the facility that we parked in front of probably looked like olympians compared to them ! If they are like me tomorrow might be more painful for them unfortunately.

Told Ferit that we had to do such an out of town event(not necessarily a race but some kind of activity ) once a month. He gave me a funny look, I bet he was thinking about a golf getaway.

Back to normal life tomorrow is a work day, how is one to appreciate vacations/short getaways if not experiencing the frustration of ones daily lives burdens. ( yeah.. I will keep on repeating this to myself while working tomorrow maybe I actually MIGHT believe it ! )

Saturday going to Jacksonville,26.2 Run with Donna Breast Cancer Marathon

2008-02-17T21:08:00.004-05:00

Saturday morning I felt a lot better and my mood improved, maybe there was hope that I would actually go and breathe the air of the half marathon and support my friends and family who were participating in the event.

Before we left the house we noticed that I had not registered Ferit or Sibel yet, ooppss. The last couple of weeks had been such a turmoil that I had left the registration to the last moment and then totally forgot about it. My friend Mary Ann who was also doing the event had called and told us that there still was onsite registration. A major crisis was avoided. Can you imagine that after training for a half marathon logging those grueling miles you are told that the race was closed and because someone forgot to register you, you could not race ?

We left towards noon and picked up Z and P and arrived at the expo which was held at the Morocco Shrine at Jacksonville around 2 pm without getting lost (oh yeah we had a gps and mapquest directions.. but leave it up to me and I go in circles within 1 miles to my destination- I was the copilot responsible for naviation so there was ww3 in the car of course ) My daughter Sibel was driving from Gainsville with 3 of her friends. We met there with them and my sil and bil. The expo was nice but I somehow was expecting a lot more vendors, I picked up a pink ribbon bumper decal saying 'cancer sucks' and a pair of running glasses.. The race shirts were technical long sleeved, very cool !

We also got a lot of other goodies, the book written by Donna Hicken(who is the organizer of this race) The Good Fight, which was about her second bout with Breast Cancer., and the most delicious brownie that I ever tasted !!! Butters Brownies !! www.buttersbrownies.com I think those brownies started their lives as fudges but at the last minute decided to be brownies, but did not quite succeed ! I would not suggest looking at the nutrition facts though.

Went to the hotel to check in and then went to drive the race course, there were 2 climbs(overpasses) and then just before the 1/2 marathon turnaround the run was on sand which seemed pretty hard packed.

Was delayed to get to a restaurant we were not even able to reach the hostess table to ask the wait time at Carabbas, just as we were getting desperate we spotted Sweet Tomatoes and had our dinner there.

Went back to the hotel and I tried to give some tips/advise to the first timers. chatted a bit then went to bed around 11. Took 2 benadryls to knock me out I definitely was feeling better by now and pumped up and ready to support the crew the next morning !

Friday I was cuddled with TLC by my friends

2008-02-17T20:06:00.006-05:00

My body had a hard time shaking off the drugs that they used this time to knock me out. I had constant shivers and nausea that came in waves. I tried to flush it all out of my system by hydrating with water and tea.

I will contact the hospital next week and ask them to provide me with the drugs and dosages used in each of my operations, I am almost sure that something different had been used the last time or the dosage was a lot higher. The other option would be that since I had finished chemo recently my body had a lot harder time to flush it out.

Zeren came early in the morning to keep me company and brought an awesome homemade lentil soup, we brewed tea the old fashioned way with a double boiler and chatted along, towards noon I started feeling ill again and took my comfort corner on the loveseat covered by my quilt that my mom made from my race tshirts. Watched the Movie 'Sun Also Rises' on tv and dozed for a while. I ran a slight fever which worried me because I am not quite sure of how my white blood cell counts are after the chemo, I definitely did not want to risk getting an infection that would delay radiation.

Around 3 o'clock N brought all the ingredients to make her infamous scones along with a wonderful bouquet of yellow roses; hearing this of course, P and S also stopped by. I was still on the couch not feeling that well and was watching the parody in the kitchen during the scone assemblies which was a combination of food network,golden girls, sex and the city and desperate housewives (no offense ok !! ) I felt cocooned by the tlc that these gals were showing me, and the enormous sense of gratitude for having them in my life swept over me like it did so many times this past 6 months.

They stayed until the evening, we took advantage of the beautiful weather and sat on the porch enjoying the olive, cheese and apple scones along with freshly brewed tea. Although probably having friends over did tire me it also gave me an immense amount of recharge that overcompensated and made me feel really good. I felt myself slowly bouncing back.

That evening I still was not sure that going to Jacksonville the next day would be a start move. As far as I knew all my symptoms seemed to be stemming from the anastesia drugs used, so decided to tell Ferit that we were still going. I did not have any pain related to the surgery, just felt tight across my chest.

I know that several people thought that me going to Jacksonville to spectator a half marathon 2 days after surgery was not a wise move. I would have thought the same way if I were them. But this race meant a lot to me was counting on my body not to betray me and bounce back Saturday. And I was positive that I would be really frustrated if I did not go and stayed cooped up at home.

Took a Tylenol PM and was able to sleep for about 4-5 hours that night until 4 am.

Exchange Surgery Day

2008-02-15T01:03:00.008-05:00

Woke up around 7 am and realized that I had waaayyy too much time on my hands since I could not plan on what TO eat, plan on what NOT to eat, worry about what WOULD I eat. Could not work out either since I was supposed to fast until surgery.
I also wanted to get some housework done so I would be able to recover and not do too much in the next couple of days.

So did laundry, dishes, tidied kitchen,fridge,did a quickie pantry makeover, cooked soup(whenever the temperature goes below 50 I cook soup) did a pile attack(all the paperwork that accumulates unless I hit it diligently every day). By the time Ferit came to pick me up to leave at 11:30 I was still in the shower.

I wore the beautiful BC scarf that Erin my friend from work had given me since it was Valentines day I proceeded with wearing a pink sweater too. The only pants I can fit(if you do not count the stretch jeans which if absolutely necessary I basically squeeze myself into leaving minimal amout to breathe( in are my blackstretchy yoga pants so that makes getting dressed fairly easy.

We were a bit late and on our way there received a call from the Hospital (Ehmm.. Ms Arditi you are scheduled for surgery ?) Oh well, I always have to wait for them, and I was positive that today I would be waiting for them a lot at one point.

Told Ferit that I would like to stop by Einstein Bagels on our way back from surgery to grab a bit.

I am going public with the following phat picture ! That should give me some motivation NOT to chomp down everything that is not moving.

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Checked in the Admissions and was rushed off to Surgery Waiting Room, without even having time to settle into a chair I was rushed off to Surgery Prepping room by myself. I was given the usual gown (that opens in the back I really do not know why these gowns open in the back whereas all the time the nurses have to fumble through the front to get electrodes in.. etc.. no one is usually interested in the back/butt so why are they left open ?)

This gown though had a cool feature it had a large hose attached which blew hot air to keep me warm I had this before and I really liked it. Got some cute hospital socks too, along with funny white compression stockings which have holes on the bottom ??

Since my port was getting removed they had to put an iv on my arm, the tech that initially came first wanted to Lidocaine the area before sticking the needle and I was like ' hey why will you be pinching me twice ? just get going forget about the lidocaine' -- I do not like lidocaine the couple of times I put it on at the dentists office it made me even more sensitive feeling like frost bite.
He proceeded with trying to find a vein in my hand.. twisting the needle in ok I am very patient and have a high pain tolerance but guess I must have sighed with frustration. Then he gave up on that one and applied a tournique to my upper arm and tried to find a vein there. Again no luck, at this point I must have shown my thoughts like ' Ok dude if you do not know what the.. you are doing get someone who does in here asap' and he said that he would find someone who was really good at finding veins. Smart move on his part, he swerved a beatchh attack which was coming at him.

The 'vein guru' came and she stuck me with a needle in a second saying ' this should do it' I was very tempted to say not to let that other guy near the patients but decided to shut up since I would be unconscious pretty soon and did not want anyone having any ill feelings towards me.

On my right arm which I had 6 nodes removed, they wrote with permanent markers No Blood Pressure/ No IV since I would not be awake to defend myself.

There was a problem about the consent not including the port removal so we had to go through the paperwork again. The anasthesiologist came and was a very scary looking guy !! Then the anasthesiologists nurse came, then Dr. Pope's nurse Debbie came oh and there was also NP Kim who was prepping me along with some other nurses which I do not recall, I answered the same questions over and over again. Did I have anything to eat/drink after midnight-NO, ( I am not going to tell the little snack I had at 1:30 am ), did I take any meds today - NO, was I allergice to any meds -NO, did I have reaction to anasthesia last time - NO. What was my birthdate, what procedure was I having done today .. blah blah... I know these are to protect the patients.

They allowed Ferit to come and visit for a couple of minutes and he was ushered out.

I was looking forward to getting knocked out by Valium presurgery but they could not do it until Dr. Pope came and marked me. That happened at 2:15 he was running late, he made several marks on me to determine where the expanders are I asked him again about Jacksonville trip this weekend he said that as long as I kept the body temperature down and did not exhaust myself I should be fine. Yey!!!

Then they gave me the Valium and wheeled the bed into the surgery room. They placed me on a very narrow table which had 2 narrow extensions for the arms to be stretched out,they tied my arms there, I basically was in a position to be crucified were my last thoughts just after I saw the scary anesthesiologist talk to me.

I woke up at 4:30 shivering like crazy and a nurse was sitting with me, I felt sooo cold. I asked whether it was normal she said yes. This had never happened before in my previous surgeries. I was feeling kind of sick in my stomach too, and my throat was very sore from something that they must have stuck down. Asked for ice chips since my mouth felt like parchment. I did not feel any pain but asked for pain meds anyways and as soon as the nurse injected it into my iv my shivering stopped.
I certainly was feeling worse than I had felt after my mastectomy which was interesting this time the anesthetic drugs just did not agree with me, I did not have any pain in my surgery site.

Around 5:00 they brought Ferit in and wheeled me to another discharge room where the nurses dressed me in the bed and I was transferred to a recliner. I was really dizzy and hardly walked from the bed to the recliner, it is amazing how quick they try to get rid of patients, I think I was one of the last ones there and they were closing shop. One of the nurses did a scarf design which I really did not like but was too tired to do it myself and I did not want to hurt her feelings.

And I got an awesome Valentines day present from Ferit ! A Beautiful Valentine's day card and the printout of a Sales order for a pillow that I have been wanting to buy for about a year ! The Sofitel pillow ! Can not wait until it comes.

After going over post-surgery details with Ferit I was wheeled to the discharge area where Ferit picked me.

After about 10 minutes in the car I really got sick and luckily they had given me the little bowl where I was able to relieve myself,so thats why they do not want one to eat. This was the first time that I got sick after getting anaestesia, I think it is because my body has really not recovered from chemo and the balances are still fragile. Even the idea of food made me sick so of course there was no stopping at Einsteins.

After getting home cooked a chicken noodle soup and ate it with lots of lemon juice, that felt semi-good and I was able to take half a pain killer ( I did not have pain) that I was hoping would ease my uptight state. Hydrocodone immediately relaxed me and I was able to veg in front of the tv dozing on and off wathcing Lost.Ferit prepared me some feta cheese and muffins/tomatoes,olives, my stomach is still not ok but kept them down. Around 10 o'clock I started feeling really good and proceeded with tidying the kitchen, finally the drugs were getting washed out of my system.

Took a whole Hydrocodone and went to bed around 10 and was able to sleep until about 1 o'clock(then got up and started writing this) I ate a bowl of cereal and started feeling nauseous again. My arms have almost full mobility and there is very little pain in the surgery area.

Still contemplating on whether to go to Jacksonville or not Friday morning is a bit early to make a decision but we have to tell the hotel by noon if only my stomach would settle.

Zeren is coming to babysit me tomorrow when Ferit leaves for work.

Back home

2008-02-14T19:12:00.002-05:00

It is 7:00 pm and we are at home. Dr. Pope told Ferit that everything went as planned, feeling nauseous and tired but overall good.

Exchanging the Turtle Shells for Soft Cushies

2008-02-14T10:19:00.005-05:00

Really felt like sitting down and updating my blog sipping a cup of coffee but unfortunately I am fasting for surgery. In about 3.5 hours I will be going into surgery to get my expanders replaced by silicone implants. I had gotten used to these expanders, no need to wear a bra ( they are basically like bike tires cemented to my chest) they looked ok, I was even able to sleep on my stomach. The only problem was that I had to be careful bumping into and hugging people, those acts caused a tramboline effect and initiated shocked stares !

I have been extremely busy since my energy level came back in about 3+ weeks after the last chemo. Work is picking up and I am able to do more with each day. The only problem remaining is my sleep, and since I was not able to take Melatonin (2 weeks before surgery) I have been waking up about 7 times with hot flashes, they are really annoying. Luckily I can usually go back to sleep but would have loved to have an uninterrupted 6 hour sleep.

Chemo damage status:
======================
My hair is growing like a white fuzz (fur) up and outward so I look like I got electrocuted, it is about 1/3 inch and very fine so not looking quite like real hair. Actually I look like I have mange .. urghh.. thank god for the wigs and bandannas. I am diligently using the most expensive hair products that I have ever purchased for a non-existent hair. ( the complete line of Nioxin) once I am done with surgery will check with the radiation oncologist to see whether I have any herbal supplement/vitamin limitations like I did in chemo. Want to take Biotin to help my little follicles shake the chemo shock off.

My finger nails seem to have survived taxol but can not say the same thing for the toenails (probably because I tried running through taxol which I have no regrest about btw) I think I am losing 3 of them, well I am used to losing those anyways in my long runs, no biggie. There is still some neuropathy in the balls of my foot but it is fading quickly.
The eyelashes are coming back along with the eyebrows(they are microscopic but I see them with a magnifiying mirror)
The weight gain has been major though, to give the scope:
november 2006 : 128 pounds ( ok this was a bit too low)
April 2007 : 140 pounds - -I think this was a good weight for me.
July 2007 : 146 pounds
February 2008 : 162 pounds !!! ( and I can not blame steroids I really ate junk - yesterday I even ate a Whopper and fries from Burger King, it has been years since I had that tho and proceeded with attacking the Girl Scout cookies .. chocolate mint!!)

There were a lot of firsts after my diagnosis during this time:

Did my first 5k after my surgery, Lady Track Shack- which was an all women event benefiting FL Hospitals attempts to get underinsured women mammograms. We ran it as a big group. Jan from work came and Debbie also joined us in the middle of the run with Heather ( which was a great surprise !!).
It was the perfect event to end leg2 of my 4 part journey(today is the 3rd leg and radiation is the last leg)

For the first time since surgery went to college park yoga for the 1.5 hour power yoga session, except the bridge pose and the poses that I was supposed to lay facedown(face down on the floor does not go to well with the turtle shells) I was able to do almost everything I used to do 6 months ago it was so nice to see Theresa and Calvin again.

Again for the first time in 6 months I went out for a short row at Lake Fairview ! I was able to balance and come back dry yey !!

And the finale celebration will be Danskin tri on May 11 !

I am not sure whether I will be able to make it to Jacksonville for the half marathon this weekend I need to be careful that I recover quickly/nicely before I start radiation.

No caffeine -- no writing fairies stopping here as I am just feeling blah ! with hunger ( I actually want my coffee !!! ) Ferit should be updating if I can not after the surgery.

My oncologists take on the Equivocal HER2/neu and other stuff.

2008-02-05T21:32:00.000-05:00

Received a call from Dr. M on Tuesday and he started by saying that he should be hiring me (Ferit said it was a polite way of saying that I was too nosy) - I had sent a 5 page fax to Dr. M asking the following questions:

1. Why did they need to do a FISH test since my original IHC was .9 which
was not even close to borderline?
2. What is the relevance of FISH showing Equivocal on my treatment plan ?
3. Will I benefit from a second (or third look) at my individual situation,
particularly by a clinician expert in HER2 positive disease states.
4. Do equivocal results themselves merit Herceptin treatment under close
supervision, due to the known benefits of decrease in recurrence with this
monoclonal antibody?
5. Being ER/PR+ with equivocal HER2+ status is Herceptin treatment of merit?
(This point is driven by data suggesting ER+ status crosstalks with HER)

Here is what he said in a nutshell:

He is very confident in their HER2 expertise saying that they were one of the pioneers who worked with UCLA.

The tumors are not heterogeneous so different parts might show different results ( IHC showing HER-, whereas FISH showing Equivocal. The result is not very surprising and it happens a lot.

From these 2 test results apparently my HER+ is not established and is not highly positive.
Herceptins benefit is directly proportional to the degree of HER positivity so it will not be very beneficial for me.

Even if I was proven HER+ at this point my treatment plan would not change because the benefit I will gain from Herceptin will be greatly be offset and exceeded by the potential cardiac toxicity that a treatment containing Adriamycin topped by Herceptin could cause.

The chemo regimen I received Dose Dense 4 X AC and 4 X Taxol is a perfect chemo for a possible HER+ situation.
( here I have to thank him because I had wanted to drop the Taxol, since the research establishing the fact that HER- patients had not benefited from taxol was published at the beginning of my treatment, and he had not let me drop it )

He said if I wanted to I could still send the slides out to UCLA but I would need to think whether a different outcome will change my treatment plan ( probably not)

He also supported his view of removing my port during surgery ( the other oncologists usually want to leave it in for 2 years in case there is a recurrence)
- To leave the port in is a negative thought.
- The likelyhood of getting an infection or other complication related the port is higher than the risk of recurrence.
- I will be getting surgery anyways (getting the expanders replaced by silicone implants)

The radiation delay ( I will be starting radiation about 8 weeks after my last chemo) did not worry him for my situation either.

So he pretty much put my mind at ease which is what I desperately needed now. I am happy that I am able to believe him and trust his judgments.

A forum post regarding my HER question.

2008-02-03T21:29:00.000-05:00

One of the 'Forum Guru's responded to my Help !

Your situation gives me pause.

It appears that your equivocal results on HER2/neu testing may prompt a second (or third look) at your individual situation, particularly by a clinician expert in HER2 positive disease states.

I can think of two scenerios for discussion:

a) Do equivocal results themselves merit Herceptin treatment under close supervision, due to the known benefits of decrease in recurrence with this monoclonal antibody?

b) Being ER/PR+ with equivocal HER2+ status is Herceptin treatment of merit? This point is driven by data suggesting ER+ status crosstalks with HER, and is best left to discussion with your doctors.

Here then is the ASCO guidelines on HER2 testing, specifically discussing "equivocal" states.

"American Society of Clinical Oncology-College of American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer

Antonio C. Wolff*, M. Elizabeth H. Hammond*, Jared N. Schwartz*, Karen Hagerty, D. Craig Allred, Richard Cote, Mitchell Dowsett, Patrick L. Fitzgibbons, Steven Gutman, Wedad Hanna, Patricia Keegan, Amy Langer, Lisa M. McShane, Soonmyung Paik, Mark D. Pegram, Edith A. Perez, Michael F. Press, Anthony Rhodes, Catharine Sturgeon, Sheila Taube, Raymond Tubbs, Gail H. Vance, Marc van de Vijver, Thomas Wheeler, Judy Yost, and Daniel F. Hayes*

*ASCO/CAP Expert Panel Co-Chairs

Purpose: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker.

Methods: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel, which conducted a systematic review of the literature and developed recommendations for optimal HER2 testing performance. The guideline was reviewed by selected experts and approved by the board of directors for both organizations.

Results: Approximately 20% of current HER2 testing may be inaccurate. When carefully validated testing is performed, available data do not clearly demonstrate the superiority of either immunohistochemistry (IHC) or in situ hybridization (ISH) as a predictor of benefit from anti-HER2 therapy.

Recommendations: The panel recommends that HER2 status should be determined for all invasive breast cancer. A testing algorithm that relies on accurate, reproducible assay performance, including newly available types of brightfield ISH, is proposed. Elements to reliably reduce assay variation (for example, specimen handling, assay exclusion, and reporting criteria) are specified. An algorithm defining positive, equivocal, and negative values for both HER2 protein expression and gene amplification is recommended: a positive HER2 result is IHC staining of 3+ (uniform, intense membrane staining of > 30% of invasive tumor cells), a fluorescent in situ hybridization (FISH) result of more than six HER2 gene copies per nucleus or a FISH ratio (HER2 gene signals to chromosome 17 signals) of more than 2.2; a negative result is an IHC staining of 0 or 1+, a FISH result of less than 4.0 HER2 gene copies per nucleus, or FISH ratio of less than 1.8. Equivocal results require additional action for final determination. It is recommended that to perform HER2 testing, laboratories show 95% concordance with another validated test for positive and negative assay values. The panel strongly recommends validation of laboratory assay or modifications, use of standardized operating procedures, and compliance with new testing criteria to be monitored with the use of stringent laboratory accreditation standards, proficiency testing, and competency assessment. The panel recommends that HER2 testing be done in a CAP-accredited laboratory or in a laboratory that meets the accreditation and proficiency testing requirements set out by this document."

From: http://www.asco.org/portal/site/ASCO/menuitem.c543a013502b2a89de912310320041a0/?vgnextoid=e73791f49e96d010VgnVCM100000ed730ad1RCRD&vgnextfmt=default

And here is an eligibility statement of HER in a clinical trial that got me thinking on your situation:

"Patients will be considered to be eligible if HER2 expression is documented by one of the following methods: - IHC, 1+, 2+, or 3+ levels of expression or -Gene amplification [FISH], positive as determined by the laboratory performing the test or - Serum HER2 ECD greater than or equal to 15 ng/ml". (Note, this is just to illustrate a clinical trial example).

Our personal oncologist's carry great knowledge on HER2 disease states. As one can see though, you fall in a gray zone which may benefit from the "two heads" theory of help. Hope this helps.

All the best to you and other HER ladies.

Nice weekend

2008-02-03T21:10:00.000-05:00

Friday had the chance to meet a BC survivor Tr.. who had coached me with her emails when I first got diagnosed. We went on a short ride in our neighborhood on my lunch break , it is nice to be able to exhange war stories with another survivor. (forgot to take a picture of us together)

Saturday morning on the spur of the moment decided that I wanted to do a 6 mile shuffle and went out, the weather was beautiful. When I came home looking forward to the couch and good book, was greeted by Elif and her friend Lily very enthusiastically cause I was expected to go to the mall with them. Sigh.. I really do not like shopping, but I know that I do damage to the plastic if I go to the mall. Oh well I needed some 'retail therapy' anyways.
Bought 2 books 'Skinny Bitch'
Skinny Bitch in the Kitch: Kick-Ass Recipes for Hungry Girls Who Want to Stop Cooking Crap and a mini book light.

Sunday went to the Florida Freewheeler ride to Lake Mary with Z, and Penny did a nice 33 mile ride ( although Z tricked me telling me to go ahead and get the car to pick her up at mile 28 but then rode almost to the end by the time I came back to pick her up )

This is pictures from Z's first ever group ride.. she looks psyched !

Thought I would be tired when I got home however I had not been to College Park yoga since August and really wanted to make the 2 hour power yoga class Sunday Afternoon at 4:30. I am so glad that I went there. Theresa always talks about life and stuff.. and today she went over falling down and getting up. We were actually in 'plane pose' and pretty much everyone was tumbling down so she said ' You fall you get up, you fall again you get up again.. that is life .. just like this pose' That pretty much is summing my attitude now. The Her/neu being - or positive first freaked me out, but at this point I got soooo fed up with conflicts and grey areas at this point I really do not care. Will send a fax to my oncologist to see whats his take on it on Monday, cant let this linger and spoil my weekend.

HER2 status from Moffit pathology report

2008-02-01T17:42:00.000-05:00

I am totally confused and just got this pathology report a friday evening ( will reach out for my oncologist next week)

I had my biopsy on 8/1/07 and the result of the Her2 with IHC was .9 so it was stated that I am her2/neu negative.

However as I was seeking a second opinion from another major cancer center (Moffitt) for my future treatment options ( rads) they requested my slides and following is the report that they faxed to me...

I am not sure what this really means, IHC(the technique that was initially used) was not borderline it was .9 so I do not even know why they decided to do the FISH(which is the next test that is done once the IHC is borderline). What is the next step for equivocal FISH result ? how can the IHC be clearly negative ( .9) and FISH be equivocal -- which I am not sure what that even means in this context arghhh...
I do NOT want to do Herception ( which I should have been doing with the chemo if I am HER+.. )

HER2/neu by FISH: EQUIVOCAL

Ratio of HER2/neu signals to chromosome 17: 1.7
The average of Her-2/neu copies per cell: 1.1
The cutoff point for reassessing Her-2/neu gene amplification is a her-2/cen17 ratio of 2.0

Some google info:

"The original FISH test results were defined as either positive or negative, but an intermediate range (from hereon referred to as equivocal range) has since been described and the clinical significance of this observation remains unclear.34-3
[16:42] arditiaylin: This strategy classifies patients as having HER2-positive disease based on positive results with either test. It is recognized that current data are insufficient to define whether these patients represent true- or false-positives

It is also clear from the panel discussion and literature review that patients with equivocal HER2 test results constitute a poorly studied subgroup with uncertain association of test scores to benefit from HER2-directed therapy.60 The panel suggested that further studies of this patient group would be promoted by defining these test results as equivocal or borderline. The panel elected to use the term equivocal to avoid confusion with borderline positive and borderline negative terminology which is sometimes used in the interpretation of FISH assays. Equivocal results of a single test require additional action which should be specified in the initial report. Equivocal IHC samples must be confirmed by FISH analysis of the sample. Equivocal FISH samples are confirmed by counting additional cells or repeating the FISH test. If FISH remains equivocal after additional cells counted or assay repeated, confirmatory IHC is recommended so that HER2 protein expression is known for the sample with true equivocal gene amplification status. "

" An important gap in the literature identified by the panel concerns those patients with test results in the intermediate or equivocal range. The decision to treat with specific therapies like trastuzumab is by necessity dichotomous (yes or no). However, HER2 test results are derived from a continuous variable, which can be expected to lead to some results falling into a gray area. Adding to this confusion is the fact that there is significant variation in the intermediate ranges for both the IHC and FISH assays. "

"The results of these surveys have shown that there is variation in laboratory performance, particularly for immunohistochemical assays with equivocal positive results or FISH testing with borderline results. The variation in immunohistochemical testing is greater than the variation in FISH testing. These results need to be interpreted with caution; however, as far fewer labs perform FISH than perform IHC, and FISH testing tends to be done in higher volume laboratories. The voluntary enrollment in this educational program leads to only a minority of laboratories doing this testing. Although the exact number of laboratories involved in HER2 testing is unknown, it is thought that about 2,000 laboratories perform HER2 IHC and about 500 laboratories perform HER2 FISH testing in the United States. "

If someone else says that I am in the gray area in anything I will surely rip their heads off !!

Ongoing Workout Log since surgery

2008-02-01T07:43:00.003-05:00

October
10/16 - 1.5 miles walk 27:37 18:20 mn/mile 3.3 mph maxhr/avhr-127/117
..........time in heart rate zone: 13:36
10/17 - 2.25 miles walk 38:26 17 min/mile-3.5 mph maxhr/avhr-138/125
..........time in heart rate zone: 30:26
10/18 - First bike ride after surgery 33 minutes 5-6 miles avhr/maxhr 127/150
10/19 - 3.3 mile walk 56:00 17 min/mile-3.5 mph avhr/maxhr-121/137
..........1.5 hour Kundalini yoga
10/20 -16 miles bike ride on trail avg speed 11 mph avhr 124.
10/22 - 4.5 miles walk/jog 1:13:47 16:10 min/mile avhr/maxhr- 124/154
..........Time in Target Heart Rate zone ( 116-135): 55 minutes
10/23 - Spinning class 43:47 avhr/maxhr - 132/150
..........Time in Target Heart Rate zone ( 116-135):20 minutes
..........1.5 hour Kundalini yoga session
10/25 - chemo
10/26 - 1 mile walk 20 minutes avhr/maxhr - 114 125
..........Kundalini Yoga session.
10/30 - Spinning class 42 minutes avhr/axhr - 132/160
..........Kundalini yoga 1.5 hours

November :
11/2 - 2.8 mile walk 44 min 15:45 min/mile avhr/maxhr- 134/160
..........Kundalini yoga 1.5 hours.
11/3 - Spinning class 40 min avhr/axhr - 142/167
11/4 - 6 mile walk 1:40 mins 16:22 min/mile avhr/maxhr - 129/163
11/5 - 17.2 mile bike ride 11.7mph speed avhr/maxhr-133/147 time in zone 1:00
11/6 - Spinning class 40 minutes avhr/maxhr- 141/169
..........1.5 hour Kundalini Yoga
11/7 - 3 mile walk 48:00 mins 16min/mile avhr/maxhr - 134/
11/8 - 1 hour hot power yoga
..........Chemo #4

11/10 - 2.5 hour Kundalini Yoga(mainly meditation and breathing-breath of fire)
11/12 - 3 mile walk
11/13 - 3 mile walk
.........1 hour Kundalini Yoga
11/14 - 17.4 mile bike ride 12mph average 1:27 mins avhr:136 maxhr:151
........time in zone 47 minutes
........1.5 hour Kundalini Yoga
11/16 - 1.5 hour Kundalini Yoga
11/18 - Horrible Hundred ride- did only 26 miles 2:00 hrs 13 mph average.
........avhr/maxhr - 161/190
11/20 - according to my heart rate monitor did some kind of 44:00 minute cardio, do not recall what !! avhr/maxhr - 146/171 .. looks like spinning.
11/21 - weight training
11/22 - 1 hour indoor cycling/spinning - avhr/maxhr- 150/171
11/23 - weight training
11/24 - 41 mile bike ride with Florida Freewheelers C/D group picnic ride, 14.2 mph, 2:47:00 hrs avhr/maxhr-155/177
11/25 - 6 mile walk/jog shuffle, 1:27:00 hrs avhr/maxhr-160/184-- a bit high have to check whether my red blood cells dropped. 14:30 min/mile. 1.5 minute jog, 1 minute walk. Expanders which are looking like monster boobs might also be compressing my rib cage preventing me from breathing well.( rumor is a gals ribs cracked from the pressure of an expander)
11/26 - Weight training and 10 minute erg - left chest muscle is challenged might need to give a break.
11/28 - 1 mile run 12:40 min/mile. weight lifting
11/29 - 1st Taxol treatment chemo#5/8

December

12/5 - 1 hour lower body weight training, 1/2 mile run. Chest muscle still compromised cannot do any upper body or core.
.......1.5 hour Kundalini Yoga
12/6 - 1:08 hr bike ride, 14 mph, avhr/maxhr-158/170 17 miles
12/7 - 1 hour weight training, 1 mile run.
12/8 - 1.5 hour Kundalini Yoga
12/9 - 33 mile bike ride, avspd 15mph, avhr/maxhr -
12/10 - 1 hour weight training, lower body, 1.5 mile run
12/11 - Led the 40 minute spinning class(for the first time)avhr/maxhr-163/178
12/12 - 1/2 mile run,1000 meter erg at 2:13 pace. 1 hour weight training ( upper body, the chest muscle did not talk back I was even able to hang )
12/13 - 6/8 Chemo taxol.
.
.
12/23 - 6 mile jog/walk. 1 min run/1+ min walk. 1:30 hours 15 min/mile -
........avhr/maxhr - 158/183.
12/24 - 53 minute spinning class avhr/maxhr - 161/178
12/26 - 51 minute spinning class avhr/maxhr - 154/174 - was able to exert myself really good this time.
12/27 - 43 minute 3 mile jog avhr 166 maxhr 172 14:20 min/mile 2 minute jog at 5 mph 1 min walk at 3 mph.
12/27 - 7/8 Chemo Taxol 1 more to go !
.
.
January

1/2 - 54 minute spinning class avhr/maxhr-151/171 - not able to exert
1/3 - 3 mile jog/walk- 1 min jog at 5mph, then walk until recover(1-2 min)
.......48 minutes 16 min/mile. Avhr/maxhr- 158/174 Treadmill - felt quite wiped out
1/5 - 1:29 hrs easy bike 12 mph 17.3 miles avhr/maxhr -151/171 -- this not sleeping
.......is really getting to me.
1/6 - 7.3 mile walk/jog 16:10 min/mile 1:58 hrs. avhr/maxhr - 151/172
.......Started with 1 min walk 1 minute jog, then the jogs got a lot longer, I am
.......glad that I was able to finish did not feel wiped out, but the knees were
.......a little weak.
1/7 - 45 minute assessment with Personal trainer, going over the machines at the
.......gym.
1/8 - instructed 50 minute spin class avhr/maxhr - 159/180
........1.5 hour Kundalini Yoga Session
1/10 - 1:24 hrs bike ride intervals about 16 miles.. avhr/maxhr - 161/191
1/11 - LAST CHEMO TAXOL yey !!!!
1/12 - 2+ mile walk with Candy- 40 minutes
.......1.5 hour Kundalini Yoga session
.
.
.
1/16 - 3 mile jog/walk with Candy 41 minutes 13:36 min/mile avhr/maxhr - 163/185
1/17 - 500 yards in the pool(first time in 6 months) my arms are tired.
.......30 minute express weight workout at the gym, 20 minutes elliptical,verytired.
1/20 - 9 mile jog/walk- 2:24 hrs 16 min/mile avhr/maxhr - 156/182
1/21 - 3.5 mile walk with Candy, 1:10 hours
.......1:30 hour bike ride from WaterFront Park at clermont on the trail with
.......rolling hills, about 16 miles. avhr/maxhr - 140/168
1/22 - Lead the 50 minute spinning class, and this time pushed myself.
.......40 minutes power yoga(downward dog pose is not aggreeing with my arm having
.......lymph nodes removed, have to find a pose modification.
1/23 - 40 minute chi kung - AM
.......40 minute light weigths - PM
1/28 - 3 mile jog/walk avhr/maxhr-168/189 -- stressful day reflecting on heart rate
1/29 - Instructed 45 minute spin class avhr/maxhr - 160/180
1/30 - 3 mile jog walk 42:00 min 14 min/mile avhr/maxhr - 153/181
.......30 min light weights pm
1/31 - 2.85 mile jog walk 41:00 min 14:24 min/mile avhr/max-142/185

February :
2/1 - 9.5 mile bike ride 40 minutes avhr/maxhr-?
2/2 - 6 mile - 1 minjog/2 min walk 1:25 hrs 14:10 min/mile avhr/maxhr-153/180
2/3 - 33 mile bike ride moderate effort. 2+ hours
2/5 - lead 50 minute spinning class
2/7 - 3 mile jog/walk on dreadmill 1% incline. 48:30 min/maxhr - 140/169 16 min/mile
2/8 - 40 mile bike ride avspd around 14, planned 53 miles but got fatigued.
2/10- my first 5k race Lady Track Shack, 39:23 min.
2/12 - my first sculling day ! easy rowing around Lake Fairview in about 40 minutes.
.
2/14 Expander exchange surgery ( 2 week minimal activity, 6 weeks no intense workouts allowed)
.
2/23 - 1.5 hour Kundalini Yoga session
2/25 - .6 mile walk with Candy
2/26 - 50 minute spinning session
2/27 - .6 mile walk with Candy - 1.5 hour Kundalini Yoga session
2/29 - .75 mile walk with Candy
3/1 - 1.5 hour Kundalini Yoga session
3/2 - 2 mile walk with Candy
3/3 - 1.5 mile walk with Candy
3/4 - 40 minute walk with Candy

Training plan for the Jacksonville Breast Cancer Half Marathon February 17-not running it but will go to the event.

Week Start Date Length of long jog and/or walk

08-Oct-07 Chemo on thurs 4
15-Oct-07 4
22-Oct-07 Chemo on thurs 5
29-Oct-07 4
05-Nov-07 Chemo on thurs 6
12-Nov-07
19-Nov-07 chemo break for t-giving before going on to Taxol !
26-Nov-07 Chemo on thurs
03-Dec-07 6
10-Dec-07 Chemo on thurs
17-Dec-07 8
24-Dec-07 Chemo on thurs
31-Dec-07 6
07-Jan-08 LAST CHEMO ON THURSDAY ON THURSDAY JANUARY 10 !!!
14-Jan-08 8
21-Jan-08 10
28-Jan-08 6
04-Feb-08 4
11-Feb-08 Event on Saturday

My irondawg Candy has a sympathy fatty tumor

2008-01-31T18:30:00.000-05:00

In the past week Candy developed a lump right underneath her right rib cage which was basically sticking out when she was laying down. She is 7+ and I knew that doggies did develope harmless tumours at that age and she was full of energy obviously feeling like tugboat in our morning jogs, but given our present state of mind we could not just let it be so took her to the vet today.
They aspired the lump and it was a fatty tumour.. yey ! and it is 2+ cm.. Hmmm.. did candy develop a empathy fatty tumor the same size as mine and on the same side ? I could not help but think.
Anywhoo... I think I am thinking a bit too much and this should not be healthy lol..

First 5k After starting treatment !

2008-01-31T12:39:00.001-05:00

On February 10 Track Shack has a 5k walk/run for only women which serves a great cause.

About this Event
The Lady Track Shack is a one-of-a-kind event set in the beautiful and lush surroundings of Mead Garden in Winter Park. For over 30 years, community leaders, mothers and daughters, sisters and friends have been taking part in this event to celebrate women's health and fitness. Be a part of the Lady Track Shack 5k as a runner, walker or supporter along the route. Be part of something amazing.

Beneficiary
Race proceeds go directly to the Florida Hospital Track Shack Cancer Screening Program. The Florida Hospital Lady Track Shack Cancer Screening Program provides mammograms to under-served women in our community.

Emailed my friends who have been by my side all throughout stages 1(surgery), and 2 (chemo) they also will be doing it ... I am totally psyched what a great way to finish stage 2 of treatment and move on the 3rd stage(expander replacement surgery).. the last stge will be radiation.

Oh and the Plastic Surgeon gave permission to go to Jacksonville to watch the Breast Cancer Marathon on the 17th, I really wanted to go and watch, get my t-shirt registration packet even if I can not do it this year.

Decision made for sure

2008-01-31T10:08:00.000-05:00

Tuesday had a great time at the 5:45 am cycle class, sometimes the classes just work out ok. Other times I just cannot capture the essence and it does not feel right and in the end we end up dodging along waiting for the class to finish which is a waste of a beautiful morning. Have to find a way to catch the 'mojo' in every class. Music selection is very important. Luckily we had a new microphone this time I hate trying to scream over the music while cycling at the same time that does a trick on ones heart rate for sure.

Someone from work will be getting bilateral mastectomy with reconstruction this Thursday I got her the Fuel Belt to use with the drains (since she will also have 4 and that was a life saver for me for the first 2 weeks) I also rekindled my project of sewing something similar and donating it to cancer centers for bilateral mastectormy/reconstr. patients. Have to find someone who is handy with the sewing machine, or might wait for my mom who will be coming next month. If one takes out the flasks and adds 2 flask holders it makes life a lot easier compared to walking around with 4 dangling drains pinned to ones clothing.

In the afternoon went to the Breast Cancer Support group meeting at the Florida Hospital there were 3 facilitators and 3 bc patients so we certainly got one on one attention, wonder why other bc patients did not come. This meeting is open to public not only for the patients of FL hospital. The topic was Journaling and how it helped people in times of crisis(I guess I could totally relate to that .. see blog ! ) the benefits stated were:

Journaling: Write Brain activity

1) Slows down racing thoughts, you can't write as fast as you can think
2) Provides a history lesson: Shows how your life unfolds
3) Presents reality as documented history : Specific time and date
4) Identifies patterns and trends: day of week, time of day, angry, sad
5) Specific and measurable progess or regression
6) Practice being vulnerable- a safe place, helops build trust within yourself able to be painfully honest
7) Mentally an physically healthy: right and left brain activity
8) Practice area : writing, saying, exploring
9) Portable - take with you, do anywhere
10) Focus and clarity- thoughts become visible words sound differently on paper , development of contemplation.

I was extremely pleased that a tool for dealing with stress was covered, however the other participants expectations were more of an informal support group, probably something like a group therapy session with the counselors. Luckily I have my own bc support group similar to that in my neighborhood. Next months topic is Music should be quite interesting. I had read in the Cure magazine that there were some art therapy sessions although I suck at drawing (as seen that my drawings with my eyes closed were as good as the ones that I made with my eyes open) I loved the idea of just doodling with lots of color. I was told that FL Hospital had that service for inpatients hopefully they might consider it for one of the montly support groups. The main facilitator is the girl which I had done a session of counseling with, she is really well intentioned but she is way too uptight to deal with the bc gals! The guest counselor was much more warm/caring.

That night I was extremely wiped out could not even walk straight looked like a drunk ! I am not sure what drained my energy I think all the decision making process is getting to me. I had to make a decision by Wednesday pre-op visit to my plastic surgeon.

Went to bed at 7:30 after a little binge episode. Had a restless night but was able to stay in bed(not hitting the fridge was a huge accomplisment ) until 7:30 Wednesday morning The chill pillow is working for hot flashes for sure. I do not recall the last time I was in bed for 12 hours not even after my surgery/chemo, hmm wonder whether sleep was an excuse/escape to delay making the surgery decision ?

Did a short jog/walk with Candy and went to the office. My decision had solidified, I am not getting the axillary node dissection as I do not believe that is part of my treatment and only will hinder my life quality.

We went out to our weekly lunch with my local team (it is only 3 of us including our manager)and learned that one of the remote team members had resigned. The team had already been operating on fumes.. and this was certain to make things go out of control. I knew what was coming next so chose to take the first step since I knew it was coming my way anyways and stated that with the help from the group I would take over her issues.(better take credit for volunteering) This might help me focus as it has been one month since I started work but I certainly have not been a poster child for dedicated focused employee ! Maybe for ADD ( except medical research)

That afternoon went to the Plastic Surgeons Dr.P office and his nurse G approached me with a paperwork and when she saw my puzzled face she went 'NOW WHAT ?' When I told her that I was only getting the implant exchange and not the axillary node dissection she first was mad at me for changing my mind all the time however when I explained a little bit about the dilemma I was in she goes ' I am really confused and I do not know how you are dealing with this ' yeah.. well tell me about it.
I was jotting down a couple of statements to explain Dr. P why I was switching decisions but he was perfectly fine with it, and actually seemed to avoid the subject. He took pictures of the expanders and said that he might not be able to fix the buckling of the left side, I said I really did not care and was not that anal about the boobs anyways did not start with picture perfect ones anyways, and now that is the least of my concerns.
He also explained that if I was going to get radiation he would not be able to graft the nipples since operating on radiated skin causes lots of problems. oh well I guess I will go the tattoo route if I have to.

After that went to pick up a bike from someone that I knew from the Masters Swimming team(he had just came back from Kite surfing ??? that sounded soo cool) for my brotherinlaw who was looking for an entry level road bike. It is a cool Red/Yellow Cannondale CAAD3 Saeco I am guessing it is about 8+ years old but could not find anything re: manufacture date on the bottom bracket. Not sure whether it will fit him or whether he'll like it, if not Ferit might keep it. Nowadays I seem to be into 'finding homes for lonely road bikes', kind of like a 'road bike rescue'

Did a short weight lifting circuit at the gym, prepared dinner and went with a couple of friends to Timpano to have a drink. Even though I had a single glass of wine this affected my sleep quality. But at least I did not wake every hour thinking about another search keyword that I might have missed to google on ' sentinel node biopsy auxillary post mastectomy radiation '

Here I go again, another surgeon - Moffitt not giving pathology result ?

2008-01-28T11:59:00.000-05:00

Went to get an opinion of a surgeon who had not asked for AND (Axillary Node Dissection) from someone that had 3/3 Sentinel Nodes test positive to see whether he had any scientific research that I somehow missed to back his decision with hard data.
What he said was basically the same line with the radiation oncologists. He does not see removing of the Level 1 & 2 nodes as a treatment, but more of a staging tool.
He also said that at a conference that he attended there was a heated discussion on this specific subject and no consencus was reached of course.

His main points were:

1 - My lymph node involvement seems to be minor, 10-15 years ago my case might have tested as Node negative, the IHC(Immunohistologic staining) is too accurate and captures even minute amounts now.
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2 - The c cells are trapped into the lymph nodes ( who were doing their jobs of capturing bad stuff from going into the system) and they do not go anywhere from where they are captured.
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3 - All Lymph nodes are not removed anyways only Levels 1&2 are removed, what happens to the rest ? ( levels 3&4 )
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4 - The area will be monitored closely for any enlargement of the lymphs and then the AND will be performed if such a thing occurs.
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5 - The chemo and rads should take care of any micromets that are in that area.
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6 - He has only done 1 AND in the last 5 years and that was done at the request of the patient.

I was not confused when I left the doctors office because I really do understand what is going on now. This issue of AND being part of the treatment or not is at a turning point in the medical community. And those who do not want to stick their necks out are erring on the side of convention/caution. If one looks at the evolution of the mastectomy which was a totally debilitating surgery when it first was done- removing chest muscles and everything .. to how it is done today, just removing the breast tissue by ensuring of clear margins.
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So I do have a surgery date of February 14th but am not sure whether I am going ahead with it.
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When I got home I decided to give a call to Moffitt c center who still has not returned my pathology slides to ormc. The breast center coordinator stated that they were looking at the unstained slides and were doing the her2/neu test.. WT >????????
I asked whether they were doing FISH she said yes.
Hmm.. this is a bit worrisome my initial pathology said HER-, and if they are suspecting HER+ this will change the treatment going forward. But then why the the surgeon at the Moffitt center say that they agreed with the pathology ? Could it be that they had not reviewed it actually at that time ?
This really sucks !!!

Checking into what the stinky FISH means:

"Testing for the overexpression of the HER2/neu oncogene can be done with immunohistochemistry (IHC) (using a special protein to identify the gene's protein) or with FISH (fluorescent in situ hybridization that measures the genes that direct the production of the protein). FISH is somewhat more reliable than IHC, but IHC is most readily available. If your test showed a 2+ by IHC, that is considered "HER2/neu negative," which means a better outcome than if the test were positive. If you did FISH testing on all 2+ by IHC, about 25% of the samples might actually prove to be positive. In any case, Herceptin (trastuzumab) is only indicated presently for women with metastatic disease that is HER2/neu positive. It is also available on a number of studies for earlier-staged patients."

"Two tests are used to figure out if the cancer is likely to respond to Herceptin. One test measures HER2 receptor protein (IHC), and the other test counts copies of the HER2 gene (FISH):

IHC (ImmunoHistoChemistry)
IHC is the most commonly used test to see if a tumor has too much of the HER2 receptor protein on the surface of the cancer cells.

The IHC test gives a score of 0 to 3+ that indicates the amount of HER2 receptor protein in tumors. If the tumor scores 0 to 1+, it's called "HER2 negative." If it scores 2+ or 3+, it's called "HER2 positive."

Women with IHC positive scores tend to respond favorably to Herceptin. The drug is not considered effective for tumors with IHC scores of 0 or 1+.

It's important to remember that results on the IHC test may vary from lab to lab, and that some labs are more proficient at HER2 testing than others. Discuss with your doctor whether you might want to get a FISH test, especially if you have a 1+ or 2+ result from IHC. That way you can get another measure of whether the tumor might respond well to Herceptin.

The IHC test results are most reliable for fresh or frozen tissue samples. IHC tends to be an unreliable way to test tissue that's preserved in wax or other chemicals. FISH testing is the preferred way to assess preserved tissue samples.

FISH (Fluorescence In Situ Hybridization)
The FISH test looks for the HER2 gene abnormality. This test is the most accurate, but less available, way to find out if a breast tumor is likely to respond to Herceptin. The FISH test shows how many copies of the HER2 gene are in tumor cells. This gene directs cells to make the HER2 protein. The more copies of the gene, the more HER2 receptors the cells have.

With the FISH test, you get a score of either "positive" or "negative" (some hospitals call a negative test "zero"). If the tumor is "FISH positive," it will probably respond well to Herceptin.

"HER-2 is a gene that helps control how cells grow, divide, and repair themselves. About one out of four breast cancers has too many copies of the HER-2 gene. The HER-2 gene directs the production of special proteins, called HER-2 receptors, in cancer cells. Read recent research about treatments for women with early-stage cancers that are HER2-positive.

Cancers with too many copies of the HER-2 gene or too many HER-2 receptors tend to grow fast. They are also associated with an increased risk of spread. But they do respond very well to treatment that works against HER-2. This treatment is called anti-HER-2 antibody therapy.

There are two tests for HER-2:
IHC test (IHC stands for ImmunoHistoChemistry)
The IHC test shows if there is too much HER-2 receptor protein in the cancer cells.
The results of the IHC test can be 0 (negative), 1+ (negative), 2+ (borderline), or 3+ (positive).
FISH test (FISH stands for Fluorescence In Situ Hybridization)
The FISH test shows if there are too many copies of the HER-2 gene in the cancer cells.
The results of the FISH test can be "positive" (extra copies) or "negative" (normal number of copies).
Find out which test for HER-2 you had. This is important. Only cancers that test IHC "3+" or FISH "positive" will respond well to therapy that works against HER-2. An IHC 2+ test result is called borderline. If you have a 2+ result, you can and should ask to have the tissue tested with the FISH test"

My result for the HER2 was .9 according to the pathology report.. wonder why they are doing the FISH ???

At that point since my head started spinning there was no way I could focus on work, the weather was gorgeous(around low 60's) I called P and asked whether she would be willing to slug a 3 miler with me. She graciously agreed and we went out for 45 minutes of jog/walk/talk getting some air helped me recompose.

Immediately after we split my surgeon (Dr. Chambers) called (I had called her) she said that, she received the report from Dr. Sollacio (radiation oncologist) if it was her, she would not get the AND.. since I was getting rads.
She also added that If there is still c sh..t in the lymph nodes after chemo and rads I should really be worrying about the systematic mets since that means that chemo and rads did not work, local recurrence is not worrisome no one got into trouble cause of lymph mets. She also added like everyone else(except the Moffitt guy) that there were any positive lymph nodes left there anyways.
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My million $ question was that whether the c could possibly spread from the lymphs where they were living (if there is still stuff in the remaining ones), of course no one can answer that.

So far those who say go for node dissection:

1 - My oncologist -- has a HUGE weight

1 - Major cancer center(Moffitt) surgeon(who is kind of a rookie)

Those who say no go for node dissection, but just do rads:

2 - radiation oncologists

3 - surgeons

1 - major cancer center tumor board(MD Anderson).(that includes my surgeon)

So no rads are winning 6 to 2.

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If I do not do dissection my oncologist said that he was ok with it, however then that means that I can not trust him 100% in my treatment going forward..and I need to find a new oncologist ( he already is my 2nd one !)

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I know at this point the response from everyone will be 'good grief girl, just let it go'

BUT I CANNOT THATS NOT ME !!!

I am being tested but not sure on what

Road I course

2008-01-27T03:51:00.000-05:00

This week work has started to crank up and my mind which has been pretty much on vacation since August is having a hard time focusing. I am hoping that it will get better quickly.
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Friday evening from 6-9 PM and Saturday from 8AM-3PM we attended the Road I cycling course given by Florida Bicycle Association with my friend Z. I was delighted to see Several Bobbies (Ellen, Keri,Pauline) ! I love bikes so much that I had a great time. Just being around cyclists and bikes gives me such a warm feeling.
We also had a session where we practiced various bike handling skills (quick stop, obstacle avoiding manueveur, quick turn) on top of the parking garage. Then went on a road test on how to cycle in traffic in Downtown Orlando.

Z getting fitted on her bike by Tina.(she was trying to take off the aerobars despite our objection .. Ohh but they look really cool !lol ...they make the handlebars heavier and actually do impact steering quite a bit.. but still they make the bike look 'hot' which is important for us gals.

I learned a lot from the course, I am curious to find out about my test results (we also had a written test, and an assessment of our riding - Keri was going to assess our group)
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I need to work on my nutrition, I have slacked off gained weight which in turn is making me lazy,I feel fatigued and do not want to get caught in this vicious circle. It would be nice to have a coach that I could work with, but am not sure whether I can find one in this area.
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Went out to dinner with Ferit Saturday night, I feel a bit tired and snoozed off early. The weather has been pretty lousy lately not only a bit chilly but rainy too, will not be able to go riding outdoors this weekend.
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Sunday was basically mope around the house day.
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I think I know what is happening,my body was expecting to be down since this would have been a chemo week.. so in anticipation of getting hit by the toxins, it kind of wanted me to slow down.. at least thats my explanation of the lack of energy state. Wonder if I had a 'anticipated chemo' syndrome ?
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I am off all meds, no sleep aids(not even over the counter), or antidepressants..
LIFE IS GOOD !!

Wednesday Was it a pink day ?

2008-01-24T04:10:00.000-05:00

At the office I went down to say goodbye to my friends who were working in the first group that I had ever been in and we realized that we all were wearing pink, that was really funny.

My daughter seems to have found her way to overcome the shortcome of the school that she is attending, due to it being a new school there are kinks that are affecting her education she is taking an online course in which she seems to be doing a lot better. She is a smart girl but seems to have different reasons for going to school ( socializing) well, which teenager goes to school for the love of learning anyways. Sometimes we as parents do need to let the kids figure out the solutions for themselves.

Ok I am getting the surgery - rads ???

2008-01-22T21:42:00.000-05:00

After another sleepless night( the chillow did not work somehow) I went and lead the 5:45 am indoor cycling class, although I have to literally scrape myself out of my warm bed once I get there I enjoy it immensely. None of the sleep aids touch my insomnia..the only thing that has helped so far was 3 mg Melatonin but that did not work either last night somehow.
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Went to the office but was not able to get much done due to the 'ongoing final research and marathon surgery scheduler phone calls'. Had lunch with J who is also a bc survivor, we exchanged battle stories.
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After doing a 'deep dive' into the Breast Cancer treatment plans I have decided again to go ahead with the axillary node dissection.
Just as I was comfortable with hitting with all the ammo that I can find ( surgery + rads) another article got published on the Journal Of Clinical Oncology.. go figure..another decision to make nothing comes for free, each option has its own price to pay.

Effect of Breast Cancer Radiotherapy and Cigarette Smoking on Risk of Second Primary Lung Cancer

Conclusion: PMRT(Post Mastectomy Radiation Therapy) after a diagnosis of BC sharply increased the risk of second primary LC(Lung Cancer), especially in the ipsilateral lung, among ever-smokers. Clinicians should consider including smoking history in their discussions with patients about the risks and benefits of PMRT.

Trying to schedule the Plastic Surgeon and Breast Surgeon will not be easy I will be pushing to get it done asap, but they do not have availability.

Did 30 minutes of power yoga, I definitely am so tight, have to work on that before I get the surgery since I will be down for a couple of weeks after that too. Recevied the book on Lymphedema that was suggested will start studying that to be proactive about that subject, dont' want to be caught blind sided.

Z and I are on the track of weight loss, I have finally been able to harness my appetite and am keeping the calories between 1200-1500 the weight has started to drop slowly. I will try to limit the weight loss to 2 pounds/week cause I have to keep my immune system high and increase the White Blood Cell count till the surgery for good recovery.

One of my forum friends gave me the following info:
"In its latest edition, Prevention magazine says a poor diet is a top factor in making us susceptible to illness. It then lists the top five foods that give your body the best immunity: beef, sweet potatoes, mushrooms, tea and yogurt. " interesting I was trying to avoid red meat.. however it also adds the following comment:

"Of the five immunity-boosting foods, beef may be the most surprising, considering health experts recommend limiting our red meat intake. But moderation is still key.

"People should still not be eating a 24-ounce porterhouse on a daily basis," Skolnik said. "A three-ounce portion of beef -- and importantly very lean beef that is low in fat -- is an important source of zinc."

Zinc deficiency can greatly increase your risk of infection. Zinc helps develop white blood cells, the cells that we really need those to fight off foreign bacteria and viruses."

I also learned that lack of Vitamin D lead to Extremely Dense Breast Tissue ( mine was that before it got scooped out.. the mammogram reports were red flags staring from day one I still do not have a clue why no one got alarmed and ordered an MRI !). And that when vitamin D levels were measured for Breast Cancer patients they measured really low. So Vitamin D3 is one supplement that I will be using after my treatment ends.

Love having a Monday off.

2008-01-21T22:16:00.000-05:00

I do not even recall when was the last time I was able to sleep through the night ! Yey ! I think the chillow helped, although it was toasty warm by the morning, exhausted from catching my hot flash energies I slept like a baby.
The weather forecast was predicting it to be in the 40's with 20 mph winds, so we had scrapped the ride that we had planned with Z.
Went on a walk with Candy, as I was walking I was also asking for a sign to come from somewhere(some cloud formations ? writings on the lake by the 2 swans.. or designs on a dog poop .. don't ask me what I was waiting for ) to help me make up my mind regarding my future treatments.
The weather was so beautiful we ended up changing plans and coming home after walking for 3.5 miles and planned an afternoon ride at the Clermont trail with Z. I was never able to see a sign btw.
The girls were not home and had the house to myself, took an early nap, that recharged me. Although I am recovering really fast I seem to need a lot more down time to bounce back from any activity. Well I guess considering that I am only 10 days out of 4 months of Dose Dense chemo it is still a good performance.
Went to the WaterFront park and biked to Killarney station and back, the wind was brutal and the rolling hills ( did they install these hills now ? I have biked there so many times and really do not recall that trail having that many hills .. ) We managed to get about 16 miles in 1:30 minutes and my quads definitely felt it.
Stopped to have coffee on our way back at N's house, it was about 7:20 by the time I got home.
It was a really nice day overall.

Discovery of fat around belly --- long run..

2008-01-19T19:18:00.000-05:00

Why do gals who go through menopause gain weight in their tummy's, found an interesting explanation on one of the forum threads:it is the body's response to estrogen deprivation.Bellyfat puts estrogen right near our organs, which are deprived of estrogen They keep trying to get estrogen from the bellyfat.

Hmm that might explain the spare tire that plays the jello-man when I run, my ovaries have been taking some vacation due to chemo blast. However I do have to lose the 20 pounds that I gained before I start tamoxifen I will not use the chemo / drug excuse to balloon up any further.
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We decided with Z to share our fitday journal links and start logging our food and workouts starting Sunday
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Sunday did a 2:24 9 mile walk/jog with Z at the gym alternating between 1:30 min walk/1:30 min jog and 1 min jog 2 min walk. Walks at 3 mph, jogs at 5 mph, with 1%incline.
We gave 2 breaks at hours 1 and 2 for a couple of minutes. The first hour was fun we were chatting along and Ferit also came and ran with us(that is the beauty of the treadmill you can run together with people who leave you in the dust) I am getting slower and slower and can't figure out why(Other than the weight gain)
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I emailed the coordinators of the 2 studies that I am interested in which were closed to get any preliminary results that they might be able to release on studies ACOSOG Z0011 and S9927.

What I need is the result of the ACOSOG Z0011 trial ! Which is still going on.

2008-01-19T18:50:00.000-05:00

The ACOSOG Z0011 trial is a prospective study that randomizes patients with a positive SLN biopsy to either completion axillary dissection or no further surgery

Preliminary Outcome Analysis in Patients With Breast Cancer and a Positive Sentinel Lymph Node Who Declined Axillary Dissection

The arguments that suggest that it may be appropriate to avoid completion dissection fall into the following categories:
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(1) the incidence of positive nonsentinel nodes is low for micrometastasis,
(2) the adjuvant chemotherapy is likely to destroy any microscopic involvement,
(3) information obtained from completion axillary dissection rarely alters treatment recommendations,
(4) there is no conclusive evidence that immediate dissection is better than observation and delayed dissection if metastatic growth in the axilla is subsequently noted.

Hmm.. an interesting info from this article:

There was a low incidence of positive nonsentinel nodes in patients with micrometastasis (ductal, 0%; lobular, 31%) compared with macrometastasis (ductal, 29%; lobular, 75%). Likewise, Chu et al.12 reported a 7% rate of further disease in the axilla when the SLN had a <2-mm focus of tumor and 55% if a >2-mm focus of tumor was identified. Kamath et al.,13 in evaluating SLN micrometastasis alone, found a 15% risk of residual disease.
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Next, adjuvant chemotherapy may contribute to the locoregional control of axillary metastases. Furukawa et al.14 evaluated the response of lymph node metastasis to various chemotherapeutic agents and found that nodal tumor was chemosensitive. It has also been shown that patients with a primary tumor response to neoadjuvant chemotherapy are less likely to have nodal metastasis at surgery.15,16 Fisher et al.,17 in reviewing data from National Surgical Adjuvant Breast and Bowel Project B-18, found 36% of clinically node-positive patients were pathologically node negative after receiving neoadjuvant chemotherapy. Together, these studies suggest that chemotherapy is likely to ablate residual microscopic axillary metastases.

Also, information obtained from completion axillary dissection may not change the patient’s treatment. Baxter et al.18 have shown that most patients with invasive breast cancer undergo adjuvant systemic therapy regardless of axillary node status, a finding supported by the data of Fisher et al.19 and discussed by Singletary20 in her review of systemic treatment after SLN biopsy. Miltenburg et al.,21 in their meta-analysis of SLN biopsy in breast cancer, question the therapeutic benefit of total level I and II lymph node removal, estimating that 70 of 100 axillas will not contain cancer.

Limited information is available regarding the outcome of patients with positive sentinel node resection and observation after adjuvant therapy. The data presented in this study suggest that SLN biopsy without axillary dissection may be an acceptable alternative to completion axillary dissection. However, longer follow-up and prospective randomized studies are needed to delineate appropriate criteria for patient selection and confirm the safety of this approach. Patients should be encouraged to enroll in ACOSOG Z0011, which randomizes to completion dissection or no further surgery. On the basis of the preliminary results of this study, the latter approach is both ethical and justifiable.

Friday Saturday

2008-01-19T18:18:00.000-05:00

Friday went out to dinner to Jeffrey's to celebrade S and Z's birthdays, then had our Book Club meeting we read 'Eat, Love and Prey' this time. I was hoping for a more heated discussion but somehow we must have spent too much energy at the dinner and the discussion was not as climactic as I would have liked. Maybe my expectations are a bit too high from these get togethers but they are just turning out to be really mellow. Came home around 1:30 am found a defenseless veggie pizza on the table and wolfed it down.. my Chillow came .. yey ! This is supposed to be really good for the hot flashes that I am having at night. ( a cooling pillow)
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Saturday morning went to Gaylor Palms hotel for my mil's 70th birthday. I ate like a PIG ! not sparing donuts, cream cheese.. someone has to stop me. It was a very nice family get together.
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Vegged out the remainnig of the day.
Tomorrow is going to be in the 40's so decided to do our long walk/jog with Z on the dreadmill.

2008-01-17T14:22:00.001-05:00

Since I had not gotten a call from the Plastic Surgeon yesterday decided to call in his office and talk to his nurse G. I knew that he would not be in the office seeing patients on Thursday.
I was put on hold and then suddenly transerred to Dr.P .. I was pleasantly surprised he apologized for not calling me yesterday and said that he had a lengthy discussion with Dr. S the radiation oncologist who stook his ground saying that I did not need surgery but radiation. Dr. P said that they were taking my case again to the tumor board at the hospital today and he would join the call and call me on what the final decision was. Oh boy I feel like I have stepped into some kind of power struggle between my oncologist and radiation oncologist. I understand and respect their difference in opinions however they should get together to deliver a treatment plan to me as a Team !!! Bouncing me around is really not acceptable.
I AM ECSTATIC !!! Finally one of the doctors is taking responsibility to coordinate and it is not my oncologist, surgeon or radiation oncologist but my plastic surgeon !!
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At noon since it was raining scrapped the plan for riding outdoors and decided to hit the pool to see whether I could still float(have not been in the pool for about 6 months at least). Was able to get in about 500 yards (took at least 15 minutes with stops every 100 ) I suck.. but it seems workable.
Then went into the steam room for about 10 minutes, felt kind of good, will do the sequence like that from now on.
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At night did a short weights workout for about 30 minutes. And did the elliptical for 20 minutes. I was really tired, still not recovered I guess from the chemo last week.
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I was glued to the phone for the whole day waiting for a call from the PS, he called around 6 PM stating that he attended the call but the radiation oncologist had submitted my case to be addressed in the call 2 weeks from now !!! WHAT ?? They wanted to review my pathology slides ( oooppss. they are at Moffit need to bring back to Orlando ASAP ). He apologized that he could not provide any more insight. Somehow I got the vibes that his involvement in this was not welcomed. I am thinking more and more that I am caught between the fight of 2 major school of thoughts. The surgery principles regarding node management might be in a turning point within a couple of years just like my friend K who is also a surgeon stated.
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I am at the high end of the studies.. my Sentinel Nodes being positive at .2(micro), and >2mm(cutoff for macro), the studies not favoring ALND have tumor size 2cm ( mine is 2.5 cm).
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Axillary Node removal is going to be considered more of a staging tool then part of the treatment for cases where there are no clinical diagnosis of c(that is if they are not palpable or appear in the scans ) in the lymph nodes and the c in the sentinel node biopsy is microscopic(less than 2mm.. I have 1 that is 2mm just at the borderline ) I do believe that chemo and radiation actually will wipe out.. radiation acting like 'bleach' in doing a major cleanup. It might be an overkill to do the ALND.. hmm.. again..
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The direction seems to be going towards expanding the scope of the Sentinel Node Biopsy, by taking not only 1-2 but 4 or more nodes. ( which is my case 6 nodes ).However at this point there are not enough studies ( I only found 2 studies
Axillary Recurrence After Sentinel Node Biopsy

which says in the end :

The introduction of sentinel node biopsy (SNB) into breast cancer care marks a further progression in our understanding of this disease and has permitted a less extensive surgical option for many breast cancer patients.9–13 SNB allows the removal of fewer lymph nodes and has afforded a more targeted evaluation of the sentinel nodes, with decreased morbidity when compared with axillary dissection.6–8,14 The identification of histologically negative sentinel nodes indicates that an axillary dissection is unnecessary.7,9,12,15–17 The role of axillary dissection for patients with microscopic involvement of the sentinel nodes remains in question.

Thus far, 2 preliminary studies with 31 and 46 women with positive sentinel nodes and no further axillary surgery have recently been published. They showed no incidence of axillary recurrence after at least 2 years of follow-up. The extent of nonsentinel nodal involvement has been shown to decrease with smaller primary tumors and decreased axillary tumor burden. Thus, axillary dissection may have more limited utility with early-stage disease.

One hundred fifty-eight (68%) sentinel node–positive patients underwent completion axillary dissection (Table 4). The mean age for this patient population was 57 years, the mean tumor size was 2.4 cm, the mean and median number of sentinel nodes were 1.8 and 1, respectively, the median number of additional nodes harvested during axillary dissection was 12, and the mean follow-up was 28.6 months. Seventy-six (48%) of these patients had additional axillary disease, with an average total number of 3.7 (median, 2) positive nodes. Thus, an average of 1.9 additional positive nodes were yielded through completion axillary dissection. The median size of nodal metastasis for patients undergoing axillary dissection was 7 mm; the mean size was 8.4 mm (Table 5). Of the patients managed with breast-conserving surgery, 85% received radiotherapy. Eighty-one percent received systemic therapy. No sentinel node–positive patient who underwent completion axillary dissection has had an axillary recurrence.
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The remaining 73 (32%) sentinel node–positive patients were managed with observation alone (Table 4). The mean follow-up for this patient population was 27.6 months, with a mean age of 59 years. The mean tumor size for these observed patients was 1.9 cm, the mean number of positive sentinel nodes was 1.2 (median, 1), and the median number of nonsentinel nodes harvested was 0. The median size of nodal metastasis for patients managed with observation alone was 1 mm (median, 2.7 mm; Table 5). Tumor size and pathologic grade distribution for this patient population was reflective of the larger sentinel node–positive patient population (Table 3). In this group, 58 (79%) of the observed sentinel node–positive patients were ER positive, and 15 (21%) were ER negative. Of the patients managed with breast-conserving surgery, 92% underwent radiotherapy. Eighty-five percent received adjuvant systemic therapy. No patient in the sentinel node– positive observation group has had an axillary recurrence (odds ratio, .37; P = .725). Management with axillary dissection or observation had no influence on recurrence in node-positive patients (P = .578).

Background: Sentinel node biopsy (SNB) has evolved as the standard of care in the surgical staging of breast cancer. This technique is accurate for surgical staging of axillary nodal disease. We hypothesized that axillary recurrence after SNB is rare and that SNB may provide regional control in patients with microscopic nodal involvement.

Methods: With institutional review board approval, SNB was performed with peritumoral injection of 99mTc-labeled sulfur colloid. From 1996 to 2003, 1167 patients were entered into a prospective cancer database after surgical therapy; 916 patients consented to long-term follow-up. Fifty-two patients (5.7%) did not map successfully and were excluded, leading to a study population of 864 patients. The median follow-up was 27.4 months (range, 1–98 months).

Results: The median number of sentinel nodes harvested was 2, and 633 (73%) patients had negative sentinel nodes. Thirty (4.7%) of those sentinel node–negative patients underwent completion axillary dissection, whereas 592 (94%) patients were followed up with observation. A total of 231 (27%) had positive sentinel nodes: 158 (68%) of these patients underwent completion axillary dissection, and 73 (32%) were managed with observation alone. Two (.32%) patients who were sentinel node negative had an axillary recurrence; one of these patients had undergone completion axillary dissection. No patient in the observed sentinel node–positive group had an axillary recurrence (odds ratio, .37; P = .725).

Conclusions: On the basis of a median follow-up of 27.4 months, axillary recurrence after SNB is extraordinarily rare regardless of nodal involvement, thus indicating that this technique provides an accurate measure of axillary disease and may impart regional control for patients with node-positive disease.

2nd one:

Is Axillary Dissection Obsolete for the Management of Breast Cancer?

3rd one:

How Much Is Enough? The Continuing Debate on the Axillary Lymph Node Dissection in Breast Cancer

( I do not have clinically positive lymph node disease)

Currently, it is accepted that ALND(axillary node dissection) is indicated when a patient presents with clinically positive axillary lymph node disease. As stated above, there is also agreement that no further ALND is indicated when the SLNB shows no disease. The major point of debate now is what to do with positive SLN in patients with otherwise clinically negative regional disease in early breast cancer. Studies have shown that the SLN is the only positive lymph node in 38% to 67% of cases when completion ALND was followed.7 This reflects dramatically changed presentation over the last decade of breast cancer with decreasing primary tumor size and lymph node positivity in patients with invasive breast cancer.8 Unfortunately, there is no proven method other than ALND that can identify the group with additional axillary nodal disease.

There is no clear indication that ALND provides a survival benefit. In the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-04, ALND did not show survival benefit in patients without clinical evidence of axillary adenopathy. With 25 years of follow-up, no significant survival differences have emerged.9 Proponents of ALND argue that B-04 did not have enough patients in the trial to see a survival benefit. A metaanalysis of six trials evaluating the impact of ALND on breast cancer survival showed an average survival benefit of 5% with ALND (95% CI=1.7-8.0%, probability of survival benefit >99.5%).10 It warrants mention that these patients received no adjuvant therapy and that tumor size was larger in these studies than the tumor size we see now. This exemplifies a common problem in evaluating the issues surrounding breast cancer treatment. The problem is that only a small benefit can be seen many years after the studies are started, and that demonstration of the benefit requires large numbers of patients as in a meta-analysis.11 Thus, the data may no longer be applicable because of improved survival from other new treatment modalities.

4th one:

There is currently a large national clinical trial called Z0011, which is evaluating exactly that question. In this trial some patients are chosen (randomized) to receive a full axillary lymph node dissection if their sentinel lymph node is positive. Some patients are chosen to not undergo any further lymph node dissection, and they are carefully watched. All of these patients will receive chemotherapy. The two groups of patients will be compared to see if there is a benefit to doing the full axillary dissection if the sentinel lymph node is positive. Or, alternatively, they will be compared to see if there is a detriment to not doing a full axillary dissection if the sentinel lymph node is positive. This is still experimental, and should only be done under controlled circumstances after being enrolled in this trial by a participating breast cancer surgeon. Doing a full axillary lymph node dissection if the sentinel lymph node is positive is still considered “the standard of care” with which all patients should be treated. To do otherwise, risks under treating your breast cancer.

5th one:

Preliminary Outcome Analysis in Patients With Breast Cancer and a Positive Sentinel Lymph Node Who Declined Axillary Dissection

Limited information is available regarding the outcome of patients with positive sentinel node resection and observation after adjuvant therapy. The data presented in this study suggest that SLN biopsy without axillary dissection may be an acceptable alternative to completion axillary dissection. However, longer follow-up and prospective randomized studies are needed to delineate appropriate criteria for patient selection and confirm the safety of this approach. Patients should be encouraged to enroll in ACOSOG Z0011, which randomizes to completion dissection or no further surgery. On the basis of the preliminary results of this study, the latter approach is both ethical and justifiable.

6th one:
Axillary Dissection Is Not Required for All Patients With Breast Cancer and Positive Sentinel Nodes

7th one: a smaller trial but interesting results:

Sentinel node biopsy should be supplemented by axillary sampling in patients with small breast cancers

For patients with a positive sentinel node, the finding of additional positive nodes in the axillary sample strongly indicated the likelihood of further positive nodes in the axilla, therefore, justifying an axillary clearance. If the SNB was positive and the ANS(axillary node sampling-getting a few more after SN) negative, the likelihood of further malignant nodes being revealed by an axillary clearance was much lower (1/12, 8%) but with only this limited evidence we still feel that this figure justifies proceeding to ANC.

8th one:
Is Axillary Dissection Obsolete for the Management of Breast Cancer?

9th one:
[P-3] Micrometastases in the sentinel node: take it or leave it? -well I have macrometastases.

10th one:

Clinical practice guidelines for the care and treatment of breast cancer: 16. Locoregional post-mastectomy radiotherapy

Wednesday -- I need to determine my action plan asap

2008-01-17T14:00:00.000-05:00

Well it has been almost 1 week since my last chemo and I have to make arrangements for whatever further treatment I will be getting.
Called all 4 doctors and left messages with their nurses saying that I had decided on getting radiation for sure and whether they still wanted me to get surgery to remove the axillary nodes.
Surprisingly when I said that I wanted to talk to my Plastic Surgeon the receptionist must really have felt for me cause he came to the phone. I told him that I had decided on radiation and had some concerns about doing the implant exchange that close to surgery due to possible healing concerns. While we were talking I also mentioned the dilemma I had regarding my further action plan and he said that I should not be dealing with such things the decision should not have been mine to make. He offered to talk to the radiation oncologist about my treatment plan and the surgery (wohooo, finally someone IS talking to the other ) and call me back later during the day.
Wednesday i was not able to get much done at work since I knew that I had to make a decision within the next days. I went online and read too many medical articles to help me make a decision.. some are :

http://www.dcmsonline.org/jax-medicine/1998journals/march98/RadiationTherapy.htm

http://www.cancer.gov/clinicaltrials/results/additional-radiation0205

http://patient.cancerconsultants.com/CancerTreatment_Breast_Cancer.aspx?LinkId=53880

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Radiation_Helps_Survival_After_Mastectomy_and_Chemotherapy.asp

http://www.breastcancer.org/treatment/radiation/when_appropriate.jsp

http://www.unc.edu/news/archives/oct05/masectomy101005.htm

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VHS-47S52FH-6&_user=10&_coverDate=02%2F28%

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VHS-47S52FH-6&_user=10&_coverDate=02%2F28%2F2003&_rdoc=1&_fmt=summary&_orig=browse&_cdi=6074&_sort=d&_docanchor=&view=c&_ct=1&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=25e759b9dd1a901c2e6da4c4d5610a52

http://www.ro-journal.com/content/2/1/40

http://www.medscape.com/viewarticle/431672

http://xnet.kp.org/permanentejournal/spring07/enough.html

http://www.medhelp.org/forums/BreastCancer/messages/1265.html

http://jco.ascopubs.org/cgi/content/full/17/1/143

http://www.medscape.com/viewarticle/412495

http://www.asco.org/ASCO/Abstracts+&+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confID=34&abstractID=34038#

http://jco.ascopubs.org/cgi/content/full/17/5/1465
http://jco.ascopubs.org/cgi/content/full/17/5/1465

http://www.asco.org/ASCO/Abstracts+&+Virtual+Meeting/Abstracts?&vmview=abst_detail_view&confID=34&abstractID=34038#

http://www.annalssurgicaloncology.org/cgi/content/abstract/5/2/131

http://www.breastcancerupdate.com/miami-conference/2005/MBCC05_Poster22.pdf

http://books.google.com/books?id=op7lm69RypkC&pg=PA291&lpg=PA291&dq=axillary+node+dissection+versus+radiation+breast+cancer&source=web&ots=-00Gl02sMT&sig=8g2H-CVDdEVlnOmadFMTCLemI98#PPA291,M1 ???? -- from the book :
Breast Cancer: A Guide to Detection and Multidisciplinary Therapy

http://www.bccancer.bc.ca/NR/rdonlyres/16B06932-272E-4467-B4A6-6BD6A8EB4913/19788/NDavisAxillaryStaginginBreastCancer.pdf

http://www.cfpc.ca/cfp/2002/Jun/vol48-jun-cme-1.asp

http://www.cmaj.ca/cgi/content/full/170/8/1263

I am getting pretty frustrated, I had actually left a voice mail to the surgery schedulers of both my Plastic Surgeon and my Surgeon to coordinate a date for my surgery and they had not called yet !

My oncologist called and said in an impatient tone that regardless of getting radiation he wanted me to get the axillary nodes removed. Ok now I have to hear from the others.

Went home, the last Taxol symptoms were going away only there is some neuropathy on my feet which goes away when I wear my running shoes with orthotics. Went on a short run/walk with Candy on the trail. It felt really good to be out with Candy but I really need to do something about her taking off while running she thinks she is a tugboat.

Additional drawings for conflict resolution

2008-01-17T13:49:00.001-05:00

Well since my main conflict at this point is whether to get additional surgery and/or rads I draw 2 pictures one myself getting surgery the other radiation.
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Then I went ahead and drew with my eyes closed (Ferit said that my drawings were so bad that my eyes closed ones were almost the same as the ones that I made with my eyes open ! ), choosing the colors blindly also..

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The radiation one is like being abducted by an alien ship(according to Ferit) both seem ok.. although the stuff taken out is bright colors not yucky stuff hard to tell none are talking to me yet.

Can my drawings tell me what to do

2008-01-16T21:57:00.001-05:00

In the book I am reading it is suggested that our subconscious self knows everything we need to know( or at least thats how I interpreted) and Bernie Siegel gave a couple of steps that he used with his patients. Well at this point since the medical community cannot give me a firm path but only options I guess it will not hurt to explore alternate inputs to make up my mind. So far I have always made good choices regarding my treatment(they had suggested lumpectomy instead of mastectomy but I went with the mastectomy which was the right move) however at this point I feel like I need some tools to listen to my inner voice that will tell me what is good for me. There is too much distraction for me to hear it.

So here is what I did..
1st step : draw a picture of yourself, treatment , disease and white blood cells eliminating the disease.
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2 - Draw a picture or scene (since nothing was specified went with a picture where I am rowing in a river by the mountains.. )
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Tuesday - Radiation oncologist visit .. I irritated myself

2008-01-16T21:05:00.001-05:00

Went to see the radiation oncologist in the PM. They actually thought that I had came to get mapped ( they do some kind of mapping session as a dry run for radiation) and the doc was not quite happy that I was in the room again with a lot of questions.

- If I need radiation is the size of the implant ok or does it need to be deflated ?
- Does silicone implant withstand radiation in case we do the exchange before radiation?
- How long after the surgeries(axillary node+port removal+implant exchange) can rads start ?
- what should be the timing for the rads after chemo ? How soon, what is the latest ?
- Is it possibility to do longer duration lower dose radiation to prevent implant damage?
- Will your decision change regarding me getting rads if no additional nodes test positive from the axillary node dissection ?
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But before I was able to start the questions the conversation drifted to a totally different state. I could say that he was getting annoyed with me circling the same questions over and over again well I was getting annoyed with myself too! Sometimes I think my body manufactured this disease so I stop trying to be in control of everything giving the message ' Hey ! You always want to be in control, you never go with the flow.. here you go try to be in control of your treatment.. now how do you like that ???'.
He went over the same things that he had told last time, basically that in his opinion I needed radiation even if there were no nodes that were positive, his decision based on the multifocal aspect of the tumor and vascular lymphatic invasion. He certainly did not believe that axillary node dissection was needed or was even helpful. His point was that axillary node dissection is not part of the treatment but was just for staging purposes.There already had been 6 nodes removed so there was no point in going in and removing more. And I had already planned out my treatment so additional information on staging was not going to change anything. He dis'sed the surgeon opinions that I got and went as far as saying that the if any other non-radiation oncologist doctors were giving opinions on whether or not to radiate me they were practicing medical malpractice !! Oh geeshhh.. now what ???
My oncologist is not coming outright saying that I do not need radiation but he is saying that I need the surgery and the next step will be determined after I get the surgery.
The rad onc.. also did not like the idea of my getting the implant exchange at the same time with the axil node dissection, he said that the radiation had to start 3 weeks from the end of chemo and it was not a wise thing to delay the radiation for a plastic surgery.
I got out of the office totally puzzled AGAIN. What he said really made sense but I have to trust my oncologist ( which I do ) since he will be monitoring me from now on... just as I thought that I had reached a decision.
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Saturday through Monday

2008-01-12T22:48:00.000-05:00

Saturday morning did a systems check and all cylinders were still firing 110%. Even though I had only slept 2 hours ( from 2 - 4 AM) but this did not worry me I got used to the 1 week no-sleeping phase after each chemo.
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Oh and there is a peach fuzz appearing on my scalp, seems to be totally white, I heard that hair did start growing during Taxol treatment although sluggishly,and tends to come out curly. My psoriasis spots came back (the Cytoxan had treated them once that washed out of the system they are back) and I am losing the clear complexion too, breaking out a bit. Oh well.. it is a good sign that the drugs are getting washed out of my system.
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Did a short walk with Candy, even though I felt good I do not like doing cardio the week following chemo, my body is already busy with all the toxins there is no point into introducing additional stress.
Then headed off to the Kundalini Yoga session. By the time I came back I started feeling weak and went to Blockbuster rented off a couple of movies to keep me busy the coming 2-3 days.

Took the hint from my body to start shutting down, basically just moped around Saturday and Sunday allowing myself to do absolutely nothing.. going on online chat rooms for hours,getting a lot of reading done. After this was my last chemo so decided to take the down time as really down.
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Monday was pretty much the same. This time since I did not get the Neulesta shot the side effects were a lot less and keeping off my feet somehow helped me avoid severe GI problems, I still was not 100% comfortable but it was a lot better than the last times but did not have enough to log onto work and get stuff done.
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There was a book that my coach had given me last year Peace,Love and Healing.. interestingly I had seen the same book at my counselors office, so decided to read it and could not put it down. It is about the mind-body connection, how to connect with the subconscious and its effects on healing, a pretty old book but the principles clicked with me.
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Monday night while trying to find a way to go to sleep got pretty creative and realized the peach fuzz that was trying to grow on my scalp aha.. so hair is trying to grow back on Taxol. Decided to take weekly pictures of the hair growth.

January 14- scalp

Friday LAST CHEMO !!!!

2008-01-12T22:35:00.000-05:00

Armed with a huge cooler with foods ranging from turkey burger sandwiches, chips, grapes, chocolate cherries.. and 24 'Better than Sex Cupcakes' that I made for the oncology nurses for my last chemo we headed to Suite 381 with Z who is again my babysitter for todays chemo. It is her birthday, I felt bad for asking her to come with me but she convinced me that it was ok.
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By the time she went to Starbucks to bring me my 3.41 tall decaf soy latte I was zoned out with a suspected Benadryl overdose that the nurses might have given me to stop blabbering ;o). And I slept pretty much the whole treatment(only waking up to chomp all the chocolate cherries,2 sandwiches and the chips) , and continued sleeping in the car on our way back and immediately went to bed and took a 3 hour nap when I got home.
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Then around 8:30pm the Benadryl must have started to wear off cause I started to think that I most probably would be feeling ok that night and the next day but will start crashing Saturday evening and recovering earliest on Wednesday and I wanted to do something to celebrate my last chemo and take advantage of the 'up' that was accentuated even more with the abundant amounts of steroids circulating in my bloodstream. Ferit was at Hooters with a friend I texted him saying that I wanted to go to Blue Martini to listen to some music.
P also came with us we really had a good time the band was nice, the crowd was quite interesting.

Oh and I loved the haircut of one of the bartenders and had to take a picture so I can get my hair that style once it grows out. It was similar to the Posh cut that I got before my hair decided to evacuate my head.

Thursday - Bike ride Last Oncologist visit before surgery

2008-01-12T22:29:00.000-05:00

Met with Rosie and Z to go on a short bike ride on my lunch break. They are both just starting out biking but are really strong. I will be having a hard time keeping up with them pretty soon. We did intervals around the neighborhood.
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Went to my last oncologist visit today to see Dr M with Ferit.. he was happy about my decision to get the axillary node dissection, since he was pushing for it from the beginning. . He also wanted me to push to get both surgeries done at the same time and he also said it was ok to remove my port !!! yey !!
He does not think that I will need radiation if everything comes out fine from the surgery.
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He hugged me and said that he'd see me in 6 weeks, now why do I feel like a kid who is watching his parents drive away after having been dropped off to Summer Camp for the first time ?
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He was my security blanket, felt like seeing him everyother week was keeping the c at bay..
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My next step would be hormonal therapy since I am ER/PR+, and will be put to Tamoxifen those will be discussed in my next appointment with him.

Crazy Tuesday

2008-01-12T22:22:00.000-05:00

I definitely overdid it. Somehow when I returned to work at the office I suddenly thought that I could do everything that I used to do immediately.. so I gave the spinning class at 5:45 in the morning, stopped by another gym to talk to a personal trainer, went to work, went to the tire store ( got 2 nails in 2 different tires yesterday )had lunch with a friend while waiting for the new tires, went back to work, drove 20 miles to pick up a friend to go to a Kundalini Yoga session which was a further 15 miles away. Did 1.5 hour K yoga, then went to the friends house to dinner.. then came home.. but I was literally falling asleep at the red lights .. for the first time in months I was able to get some sleep without even any sleep aids. Wednesday I still was feeling the fatigue.. that was stupid of me.

Going back to work really helped my mood, the people who did not know what I went through just thought I was working from home. They complimented on my new hair color (a redhead !) I guess Iwas pretty good in camouflaging that I did not have any eyelashes and only a couple of strands of eyebrows. I put the others who were 'avoiding eye contact with me' at ease by starting out a conversation from where we left never mentioning anything about my treatments unless they asked.. that seemed to work pretty well.

after having 3 days in the office here is how it went.

There were 3 types of collegues:

1 - Did not have a clue I was sick just thought that I had colored my hair red(I had long brown hair, got a red wig).. who were shocked when I told them..

2 - Some were giving me big hugs.. taking me to lunch, bringing me coffee.. really sweet.

3 - Some that were avoiding looking at my eyes,having a 'fear in their eyes' so I had to be proactive for these.

- for those who I wanted to maintain a friendship I approached them smiling and started up a conversation about the things that we used to talk about before my dx.. that seemed to loosen them up and they started talking about stuff.. and then eventually - although very shyly - approached and asked about my treatments.. I gave them the minimum info as those are the type which really do not know how to handle this. I was able to see the relief in their eyes.. cause they were just clueless on how to interact with me.

-For those that I did not really care I did not bother doing anything.

Sooooo it was not that bad !! Other than the first 10 hour wig wearing day wanted me to rip it off my head !

Surgeon meetings on Monday

2008-01-08T15:55:00.001-05:00

Got a busy start to the week.
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Had a personal trainer appointment for my second assessment at 7:30 to go over the 24 minute workout sequence. I was not able to do several because I want to baby my chest muscles. Does not make sense to make them stronger while at the same time I actually am tring to expand/stretch them out. But Eddie was ok in giving me alternatives whenever I could not do a machine.
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Headed off to my first appointment of the week. With Dr. Chambers - my original surgeon. Talked about scheduling the axillary node dissection surgery, when I asked why they ( the previous group she was in) did not do it immediately after my mastectomy she said that they chose to proceed with a less agressive, less conservative approach considering my lifestyle and did not want to jeopardize me getting lymphedema. Well initially I was thinking the same way however later after talking to multiple doctors I really thought that I should get the lymph nodes out and see where I was at, and where I am at now. She will be able to request certain pathologists to review the slides to make sure that nothing is missed and I also will have an option to send the slides to a different facility to get them reviewed.
She does not want to do the axillary node dissection on the same surgery as the expander exchange with the plastic surgeon, and I do not recall exactly but I think her concern was that in case I needed radiation then that could cause capsular contrapture of the final implant. However the plastic surgeon is under the impression that reconstructing a radiated breast is a lot harder then fixing one that could get capsular contracture.
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In the afternoon I had an appointment with my plastic surgeon who was adamant in conducting the surgery before radiation during axillary dissection operation. They also expanded 100cc more, now I am totally Hooters material, can not even wear my sport tops !! I really am looking forward to the exchange where I will look a bit more normal.
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So the next step would be to talk to the radiation oncologist to see how comfortable he is with radiating through silicone implants, then if he is cool need to run this by Dr. Chambers to push the get both done in the same operation. Although the consensus seems like I will not need radiation, but I will decide on that after the outcome of the surgery.

Busy Saturday Sunday - found a bike for my friend in the spice aisle of Publix !

2008-01-06T20:39:00.001-05:00

Friday evening returning from Mimi's Cafe stopped at Publix to get
some spices that I needed. In the spice aisle ran into M from the morning cycle class while we were chatting he mentioned that he had a small size women's road bike that he could sell. I was so excited since we were going to go cycling with Z the next day and my old bike Stitch was at least 3 sizes big for her, thought she might be interested and M was able to give it to me that night for Z to test it out !

Saturday morning we went out with Z towards the airport, unfortunately since we socialized a bit too much before riding we were stuck riding in traffic. It was her 3rd time on a road bike and we did 17 miles in moderate traffic the bike was a perfect fit !
At night had the Y family over for dinner to test the flank steak marinade.

Sunday went on a 7.3 mile jog/walk with Z took close to 2 hours, I am getting slower but thats ok, as long as I can get the distance in I can work up the speed later.
Later drove up to Gainsville to check out the apartment that Sibel wants to rent with her friends next year. I want to be a college student ! The apartments were sooo nice.

When we came back home I realized that I had overdone it, wiped out on the couch watching the Desperate Housewives.

The ticker is just fine !

2008-01-04T16:59:00.000-05:00

Went to the cardiologist today to get my results. My LVEF (Left Ventricular Ejection Fraction) was 64% compared to 67% before chemo, however she explained that this number was not exact and it would vary on a daily basis. Phew.. seems like I dodged the serious side effect of Adriamycin.. yey !!!
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They wanted to put me on beta blockers cause I seemed to have a lot of palpitations according to the halter reading(when I asked when they mainly occurred they said throughout the day about a total of 750 of them). It is not anything worrisome but it might bother me she said, maybe thats why I keep on waking up? I told that as long as it was not something that would harm me I did not want to take any meds. Will look into natural remedies to the same effect. She also added that this could be a temporary thing because of the chemo or the stress I have been under. They want me back in 6 months just for a follow up.
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Had to drop by Track Shack(since the Heart Center was practically acroos the Trackshack and I have a informal commitment to go to Track Shack of Orange Cycle whenever I am within a mile radius of either ;o) , and saw a lady with a 'suspicious scarf' hmm.. at the risk of being nosy I asked her in the best way that I would have liked to be approached ' Are you going through something or is your head cold ?' She started laughing and it turns out that she is being treated by my original oncologist. Asked what chemo treatment she was on she told me that she was on AC .. hmm I thought that they should have changed the protocol after all those research studies were released. The Lady ( D) has also registered to the Breast Cancer Marathon but said that she probably would not be running it but just will go as a spectator.

Further treatment decision made

2008-01-03T10:12:00.001-05:00

Got an early call from the Moffitt C Center doc I was impressed, he said I was the topic of several heated discussions, it appears I can even cause a turmoil when I am ill !
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They had discussed my case and the input was given by 3 surgeons, 1 radiation oncologist and 1 oncologist.
The Radiation oncologist said that given my present state I would definitely need rads.
However this is where it gets tricky, if I get an axillary node dissection I might not get rads depending on the outcome.

I will get zapped(rads) if
2 more nodes
or
More than 20% of total nodes removed
Test positive for having/or having had (wiped out by chemo)
.
.
.
Do not get rads if:
None of the nodes show present or past sign of cancer.
.
I was really baffled/pulling my nonexistent hair out on how to put all the variables together to plan the treatment Ferit came to the rescue as the ultimate organizer.

My variables are:

1 - Getting axillary node dissection (for certain)
2 - Getting radiation (depending on the outcome of the 1st)
3 - Swapping out the expanders with silicones - surgery (together with axillary node dissection or later the later could be up to 6 months if I get radiation to let the tissue heal)
4 - My Plastic surgeon preferring to do the exchange before the radiation ( he said he has been seeing too many healing problems of doing the exchange after the radiation)
5 - The optimal time to start radiation (if needed) is 4-6 weeks from last chemo
6 - The axil node dissection can be done earliest 3 weeks after my chemo.
7 - Radiation doctor might not be comfortable with big implants and might want to deflate before radiation(which is not an option if I get the exchange with real implants at the same time with the axillary node dissection)
8 - If the exchange and the axillary node dissection can be done in the same operation have to coordinate the plastic Surgeon Pope and surgeon- chambers
9 - Finding a pathologist and getting the pathology reviewed by one that is really careful and can spot any signs of past cancer in the nodes.

So Ferit came up with the following plan :

1 - Get an appointment with Surgeon and tell her you want the axil node dissection and ask if she can in any way assist in getting the pathology assigned to a specific pathologist.
2 - Ask the Plastic surgeon to continue inflating the expanders (we had stopped because of possibility of radiation)
3 - Get the results of the axillary node dissection.

If no nodes are/were positive :

Rads are not needed continue with oncologist with hormonal treatment(tamoxifen) and continue with reconstruction at a leisurely pace have the 2nd surgery to swap out the expanders with the real implants.
.
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If nodes are/were positive and they meet the criteria of >4 or >20% of total nodes:
Get radiation, and if needed get the expander deflated.
Wait for 6+ months then get the reconstruction.

So far everyone is under the assumption that I will not have additional nodes test + I am praying for that scenario !

Got an appointment with my surgeon for Monday 9:15

Ongoing Workout Log

2008-01-01T17:46:00.001-05:00

October
10/16 - 1.5 miles walk 27:37 18:20 mn/mile 3.3 mph maxhr/avhr-127/117
..........time in heart rate zone: 13:36
10/17 - 2.25 miles walk 38:26 17 min/mile-3.5 mph maxhr/avhr-138/125
..........time in heart rate zone: 30:26
10/18 - First bike ride after surgery 33 minutes 5-6 miles avhr/maxhr 127/150
10/19 - 3.3 mile walk 56:00 17 min/mile-3.5 mph avhr/maxhr-121/137
..........1.5 hour Kundalini yoga
10/20 -16 miles bike ride on trail avg speed 11 mph avhr 124.
10/22 - 4.5 miles walk/jog 1:13:47 16:10 min/mile avhr/maxhr- 124/154
..........Time in Target Heart Rate zone ( 116-135): 55 minutes
10/23 - Spinning class 43:47 avhr/maxhr - 132/150
..........Time in Target Heart Rate zone ( 116-135):20 minutes
..........1.5 hour Kundalini yoga session
10/25 - chemo
10/26 - 1 mile walk 20 minutes avhr/maxhr - 114 125
..........Kundalini Yoga session.
10/30 - Spinning class 42 minutes avhr/axhr - 132/160
..........Kundalini yoga 1.5 hours

November :
11/2 - 2.8 mile walk 44 min 15:45 min/mile avhr/maxhr- 134/160
..........Kundalini yoga 1.5 hours.
11/3 - Spinning class 40 min avhr/axhr - 142/167
11/4 - 6 mile walk 1:40 mins 16:22 min/mile avhr/maxhr - 129/163
11/5 - 17.2 mile bike ride 11.7mph speed avhr/maxhr-133/147 time in zone 1:00
11/6 - Spinning class 40 minutes avhr/maxhr- 141/169
..........1.5 hour Kundalini Yoga
11/7 - 3 mile walk 48:00 mins 16min/mile avhr/maxhr - 134/
11/8 - 1 hour hot power yoga
..........Chemo #4

11/10 - 2.5 hour Kundalini Yoga(mainly meditation and breathing-breath of fire)
11/12 - 3 mile walk
11/13 - 3 mile walk
.........1 hour Kundalini Yoga
11/14 - 17.4 mile bike ride 12mph average 1:27 mins avhr:136 maxhr:151
........time in zone 47 minutes
........1.5 hour Kundalini Yoga
11/16 - 1.5 hour Kundalini Yoga
11/18 - Horrible Hundred ride- did only 26 miles 2:00 hrs 13 mph average.
........avhr/maxhr - 161/190
11/20 - according to my heart rate monitor did some kind of 44:00 minute cardio, do not recall what !! avhr/maxhr - 146/171 .. looks like spinning.
11/21 - weight training
11/22 - 1 hour indoor cycling/spinning - avhr/maxhr- 150/171
11/23 - weight training
11/24 - 41 mile bike ride with Florida Freewheelers C/D group picnic ride, 14.2 mph, 2:47:00 hrs avhr/maxhr-155/177
11/25 - 6 mile walk/jog shuffle, 1:27:00 hrs avhr/maxhr-160/184-- a bit high have to check whether my red blood cells dropped. 14:30 min/mile. 1.5 minute jog, 1 minute walk. Expanders which are looking like monster boobs might also be compressing my rib cage preventing me from breathing well.( rumor is a gals ribs cracked from the pressure of an expander)
11/26 - Weight training and 10 minute erg - left chest muscle is challenged might need to give a break.
11/28 - 1 mile run 12:40 min/mile. weight lifting
11/29 - 1st Taxol treatment chemo#5/8

December

12/5 - 1 hour lower body weight training, 1/2 mile run. Chest muscle still compromised cannot do any upper body or core.
.......1.5 hour Kundalini Yoga
12/6 - 1:08 hr bike ride, 14 mph, avhr/maxhr-158/170 17 miles
12/7 - 1 hour weight training, 1 mile run.
12/8 - 1.5 hour Kundalini Yoga
12/9 - 33 mile bike ride, avspd 15mph, avhr/maxhr -
12/10 - 1 hour weight training, lower body, 1.5 mile run
12/11 - Led the 40 minute spinning class(for the first time)avhr/maxhr-163/178
12/12 - 1/2 mile run,1000 meter erg at 2:13 pace. 1 hour weight training ( upper body, the chest muscle did not talk back I was even able to hang )
12/13 - 6/8 Chemo taxol.
.
.
12/23 - 6 mile jog/walk. 1 min run/1+ min walk. 1:30 hours 15 min/mile -
........avhr/maxhr - 158/183.
12/24 - 53 minute spinning class avhr/maxhr - 161/178
12/26 - 51 minute spinning class avhr/maxhr - 154/174 - was able to exert myself really good this time.
12/27 - 43 minute 3 mile jog avhr 166 maxhr 172 14:20 min/mile 2 minute jog at 5 mph 1 min walk at 3 mph.
12/27 - 7/8 Chemo Taxol 1 more to go !
.
.
January

1/2 - 54 minute spinning class avhr/maxhr-151/171 - not able to exert
1/3 - 3 mile jog/walk- 1 min jog at 5mph, then walk until recover(1-2 min)
.......48 minutes 16 min/mile. Avhr/maxhr- 158/174 Treadmill - felt quite wiped out
1/5 - 1:29 hrs easy bike 12 mph 17.3 miles avhr/maxhr -151/171 -- this not sleeping
.......is really getting to me.
1/6 - 7.3 mile walk/jog 16:10 min/mile 1:58 hrs. avhr/maxhr - 151/172
.......Started with 1 min walk 1 minute jog, then the jogs got a lot longer, I am
.......glad that I was able to finish did not feel wiped out, but the knees were
.......a little weak.
1/7 - 45 minute assessment with Personal trainer, going over the machines at the
.......gym.
1/8 - instructed 50 minute spin class avhr/maxhr - 159/180
........1.5 hour Kundalini Yoga Session
1/10 - 1:24 hrs bike ride intervals about 16 miles.. avhr/maxhr - 161/191
1/11 - LAST CHEMO TAXOL yey !!!!
1/12 - 2+ mile walk with Candy- 40 minutes
.......1.5 hour Kundalini Yoga session
.
.
.
1/16 - 3 mile jog/walk with Candy 41 minutes 13:36 min/mile avhr/maxhr - 163/185
1/17 - 500 yards in the pool(first time in 6 months) my arms are tired.
.......30 minute express weight workout at the gym, 20 minutes elliptical,verytired.
1/20 - 9 mile jog/walk- 2:24 hrs 16 min/mile avhr/maxhr - 156/182
1/21 - 3.5 mile walk with Candy, 1:10 hours
.......1:30 hour bike ride from WaterFront Park at clermont on the trail with
.......rolling hills, about 16 miles. avhr/maxhr - 140/168
1/22 - Lead the 50 minute spinning class, and this time pushed myself.
.......40 minutes power yoga(downward dog pose is not aggreeing with my arm having
.......lymph nodes removed, have to find a pose modification.
1/23 - 40 minute chi kung - AM
.......40 minute light weigths - PM
1/28 - 3 mile jog/walk avhr/maxhr-168/189 -- stressful day reflecting on heart rate
1/29 - Instructed 45 minute spin class avhr/maxhr - 160/180
1/30 - 3 mile jog walk 42:00 min 14 min/mile avhr/maxhr - 153/181
.......30 min light weights pm
1/31 - 2.85 mile jog walk 41:00 min 14:24 min/mile avhr/max-142/185

Training plan for the Jacksonville Breast Cancer Half Marathon:

Week Start Date Length of long jog and/or walk

08-Oct-07 Chemo on thurs 4
15-Oct-07 4
22-Oct-07 Chemo on thurs 5
29-Oct-07 4
05-Nov-07 Chemo on thurs 6
12-Nov-07
19-Nov-07 chemo break for t-giving before going on to Taxol !
26-Nov-07 Chemo on thurs
03-Dec-07 6
10-Dec-07 Chemo on thurs
17-Dec-07 8
24-Dec-07 Chemo on thurs
31-Dec-07 6
07-Jan-08 LAST CHEMO ON THURSDAY ON THURSDAY JANUARY 10 !!!
14-Jan-08 8
21-Jan-08 10
28-Jan-08 6
04-Feb-08 4
11-Feb-08 Event on Saturday

New Years Eve

2008-01-01T14:59:00.001-05:00

We went to N's house for the annual New Years party, I had to rest in the afternoon keeping off my feet to gather enough energy to make it through midnight. The Neulesta gave its usual shiver/fever feeling late afternoon but was gone pretty quickly. The GI problems peaked and then they poofed also !
.
Ditched the wig, found a really nice scarf at home which I had for ages but never used. Wore a black dress which became a bit too revealing for my taste considering my new expanded boobs. Hopefully they will look more natural once I get the exchange, but now I could practically apply to Hooters ! Wore heels which came off of course a couple of hours into the party the slight neuropathy of the toes dont go too well with them.
.
Once there, hit the buffett since I was ravenous as usualy the food was great, I was supposed to bring my traditional fruit salad but was not able to get it done cause I was really tired and needed to save my energy for the night, I felt bad about having time to put on make up and get dressed but not having the time to cut up the fruit salad, Ferit just would not let me.
.
N had arranged for a belly dancer who pulled everyone to the floor to join her. She had also arranged for a corner in her bedroom in front of the tv that I could just escape and relax for a while when I got tired -- that worked perfectly, 2-3 times I went there kicked off the shoes and recharged and was able to rejoin the party, after all partying 5th day of the chemo is a bit overzealous but hey it worked out even though I was not able to enjoy the margharita(did not want to drink the same day I got the Neulesta shot)
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Annddd she had gotten all the gals red underwear.. yip ! One is supposed to have a prosperous year if one wears red underwear greeting the year.. we had quite a chuckle over this !

Saturday,Sunday, Monday at the office

2008-01-01T13:31:00.000-05:00

Well I talked too soon,Saturday/Sunday Taxol hit me like a mac truck urghhh.. The most severe side effect I get is GI problems which is not what everyone gets and the doctor was kind of puzzled that I reported it.(ok I will admit that I realized that the more sugary stuff I eat the more GI Problems I get but that does not seem to stop me from hitting the pantry-cereal box) I do get slight tingling in fingertips and I am losing 2 toenails(I think my running shoes are not fitting me well after gaining weight my feet spread out) but those are no biggies, I would not probably have realized them as side effects if I had not read about them. I am managing the insomnia with 2 Ambiens/night I have come to peace with taking some sleep aids temporarily one week after each chemo, cause there is no way my bodies own melatonin production can fight with the poisons they are pumping in to me. Outside help is needed. Fight is not fair.
.
Saturday night watched 'Emperors club' with Kevin Kline which was really good movie, delivering a message of 'no matter how much you can try you cannot change people'
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By now I learned to listen to my body and I can tell when the chemo is relatively washed out after each treatment. I see that with each subsequent treatment it takes longer to wash it out. When it is still in my system my upper right arm(where the lymph node removal impacted), my port incision,my expander stitches and also my scalp hurts(nonexistent pony tail in too much feel)
.
As I was laying in bed, with my nice frilly nightcap(my head gets cold, still not used to the bald feel) borrowed Ferit's reading glasses I started laughing cause I thought we were a scene from the Little Red Riding Hood. Me - the grandmother with the cap and glasses in bed, Ferit the wolf - he came in to kiss me. Sibel - Little Red Riding Hood - was going to give her bf some christmas cookies.
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Sunday went to Crackel Barrel for breakfast, the pecan pancakes that I really like did not taste good, either my taste buds are not normal or it was a lousy batch. Then checked out Ikea(do they have a requirement to have a minimum number of crying babies present at any given moment???) and checked out Marshalls. Resting when I feel down from chemo does not seem to make a difference in the time of recovery(of course I will not go and run or bike but resuming daily normal activities seem to help) the feeling was similar to the way I felt at the last hours of my Ironman events, going on autopilot not really thinking about moving but just moving forward.
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We were going to head to the movies but felt wiped out so rented a pay perview movie 'Mr. Brooks' while several friends of Elif invaded the house and had their own little party going on. I like the house being crowded.
.
Got a blood blister under my middle right toenail, will need to reasses workouts having impact. The muscles are feeling tired so I have given a break to weight workouts.
Was going to go swimming(have not been in the pool for 4 months now) but since my white blood cell counts were low thought I would better hold off until I get my Neulesta shot.
.
Monday felt a bit better and went to the office for the first time. Pulling into the parking lot after 4 months felt really weird, there were a couple of people at the office, since it was New Years Eve everyone who was working (or pretending to be working) was working from home. When I got in the elevator I had to think which floor I was on luckily I did remember the logon passwords for my computers. The wig really bothered me, do not know how I am going to work with it all day on Wednesday, I am considering wearing a scarf seriously. Had difficulty focusing at work, hopefully will get better.
.
Went to lunch with a friend who has been diagnosed with bc recently and tried to share some of my experiences with her those first days are really the toughest, as I told her ' until you cross the line' once you accept what you are dealing with everything else gets easier, similar to anything in life, I know it is easier said than done.
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Later got my Neulesta shot I really did not want to get it on New Years eve because I feel like running a fever after I get it, but since my Taxol had finished at midnight they could not give it to me on Friday and the oncologist office was closed for the weekends.
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Took the advantage of resting got far into reading 'Middlesex', a great book about several generations of Greek immigrants a definite page turner.
.

Friday - Tampa C institute umpteenth opinion visit

2007-12-28T19:14:00.000-05:00

We made a family outing of it and went to the Tampat Moffitt C hospital all four of us.
The doctor that we saw was quite young and his opinion was as the following.
.
I better get the surgery and get other lymph nodes removed because since there were involvement in the 'gatekeepers-sentinel nodes' the gates were open and we do not know which animals escaped and whether chemo was able to zap if any were still out there.
- If they all come out clear, that will be really good indication of my prognosis going forward, meaning that I only had 2 infected, losing the lymph nodes will be collateral damage on the expense of a peace of mind(cant they take them out, analyze them and put them back ???)
- If dead c cells which were fried by chemo are found(he said that they can tell whether they were killed by chemo cause the lymph nodes would have scar tissues on them) that is a very good indication that the chemo worked.
- If live cancer cells are found then that is also good that we removed them.
He repeated what Dr. M said that there is no guarantee that the radiation could kill any remaining cells.
But there is no guarantee that getting surgery will spare me the radiation.
He also said that he was told that swimmers did not get lymphedema, so the worst case I just have to be an ultra distance swimmer, hey I can do that.. but gotta change my gym membership to the Y then, I would get bored out of my head in my gyms pool.
.
He had a cool software from Memorial Sloan Kettering in which he plugged in some variables from my pathology (number of + lymph nodes, tumor grade, size.. ) which spit out that there is 25% probability that there is more lymph node involvement. Asked him to change the #of lymph nodes involved to 1 and recalculate and it only dropped to 17%. Hmm.. 25-17 percent are respectable/scary percentages.
He also said that I was too young to take this gamble, and in his opinion not getting the lymph nodes removed is a pretty big gamble. If I was 90 years old he said he would not be that worried.
I am getting more and more pissed off at my first group which did not remove the lymph nodes after the mastectomy they should have done that !!! My surgeon somehow was not able to stand up against the radiation oncologist there and obviously the oncologist(oh I just loathe her)did not care to interrupt anything.
.
We agreed that the doctor take my case to their weekly meeting on Thursday to get the opinion of the other surgeons, oncologist, radiation oncologist and call me with what they agree on.
I liked that plan, I will not get my operation there cause I am planning to get it and the boob exchange surgery at the same time if I can. And although the surgeon looked/nice knowledgeable ( well.. not considering that he did not know the most important breakthrough in breast cancer treatment about taxol -- which really surprised us)he really looked kind of young and inexperienced, and I hmmm.. really prefer to have someone with a bit more mileage cutting me open and carving out my lymph nodes.
.
After leaving the hospital went to a really cute restaurant Penne Rustica and had great pizza and an amazing frozen banana, cream, caramel icecream.

.
I am still feeling really good, wonder when the Taxol will hit me this time it usually hit me on late saturday and sunday.
But I am taking the 30 mg Glutamine (to prevent muscle problems) and the Vitamin B diligently. Have also bumped up eating Activia at least once a day to get the GI track ready for the bombardment, and have hydrated really good this week, and will include diluted Cranberry juice to help the kidneys and the Urinary track.
I am telling you, I am getting to be a pro at this chemo.

Thursday - Chemo #7 , 1 before the last one

2007-12-28T18:39:00.000-05:00

Although it is really getting hard to ramp up for working out and just as I am feeling ok get hit by the chemo truck and start over again (this is so demoralizing) I was able to get dressed and head to the gym before work. I think Ferit is right, it is good that I started working, of course right now I really want to do the things I did not do while I was off (curl up on the couch with a book, go window shopping) naturally I had to start to work to appreciate the freedom I had.
I was able to do a 2 min jog at 5 mph, 1 min walk - total of 3 miles averaging 14:20 min/miles with average/max heart rate 166/173 - not bad.
I also set up my 2nd assessment session with the trainer at the gym.
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After getting some work in, we left with Sibel to the chemo session, I recalled how scared/excited I was for my first one, now it just seems like a chore, how ones perspective of things changes I thought, and one gets used to the things that were once viewed as horrible. Chemo is doable and not a biggie, the thing that bothers me most are the wigs, I wish I could go 'commando' but my scalp is soo white.
.
Because the oncology office was overbooked, they did not have any 'recliners' for me I was booked to get my chemo somewhere else after I saw Dr. M.
.
After grabbing some takeout from Panera, and taking 2 movies to watch during chemo we were at the office at 2:30 and they informed me that my chemo was scheduled to be tomorrow Friday WT.. ??? We had discussed this and I had told them that I was going to the cancer center at Tampa tomorrow and could not make it and definitely did not want to push my next treatment to Monday. They told me I was not booked at the other facility either(which I was assured of 2 weeks ago on the phone). Just as I was sharpening my chemo b..tch teeth to give it to them (even my usually very low BP went up ! ) Dr. M's nurse jumped in rolling her eyes and immediately fixed the things phewww..she warned me that things did NOT go that fast in the other facility and get prepared for a long night.. hmmm.. taxol takes about 4 hours here I thought, how worse could it get?
.
During visit with Dr. M we again went over what we were going to do after my chemo. He is standing his ground that I need to get an axillary node dissection and then only if needed( total of 4 nodes test positive) get radiation.He also added that if I chose not to do the surgery ' he is still my friend' that is he will not dis-client me. This is so frustrating that the same group doctors are not agreeing, can't wait to get the opinion from Moffit tomorrow. I am hoping that he will also say no surgery.
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Since I had not gotten my neulesta(white cell booster) last time my blood counts were pretty low, so they scheduled me to get the neulesta tomorrow at 4:30 or if I can not make it in time back from Tampa to get it on Monday at 2:30 which I really do not want cause it is the New Years eve.
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We were able to make it to the hospital which I was scheduled to get my chemo around 5 pm.
First they made us wait at the lobby,
Then I had to go and do the new patient registration .. oh c'mon I thought don't you guys have a central database that they could pull from the oncologists office ? After all it is the same hospital !
Then they brought the wheelchair. That was the last drop, I must have opened my eyes soo big and hollered at the nurse so bad that I just went jogging and what was she thinking ! She said ok .. ok.. and let me walk upstairs. Good thing about being a c patient noone tries to push back that much.
And surprise !! I will be getting the chemo in the hospital room by myself, woohooo I thought, I can even nap if I want to on the bed.
Released Sibel and Ferit came over around 6.
Finally ate my Panera sandwich and salad.
The nurse came around 6:30 and said I will assess you now, and went over the things, blood pressure, weight.
Then around 7 she came again and said ' good news.. the pharmacy got your prescription and it should be ready in 1.5 hours ???????' so this is what Dr. M's nurse was talking about, these people are slow.
They gave my premeds which knocked me out around 7:30.. but then everyone went MIA, we could not find the nurse, finally figured out that there was a shift change and the night nurse was supposed to start my chemo. Ok.
Night nurse came aroun 8:30 finally and started the drip, and informed me that they would be taking my vitals every 15 minutes huh ? no sleep for me ? this is a bit too much I want my oncologists office recliner.
After the 1st 15 minutes the BP measuring cuff on my foot got really claustrophobic and I took it off, and got yelled at 'you are not supposed to take it off, it will measure your bp every 15 minutes'. So no potty break either, ok .. this is not going good. Was able to persuade her to take my vitals every 30 minutes after the hour so i would take it out and put it on before the 30 minutes.
That was the longest chemo session I did. The drip finished around 12 am and we were home around 1, what a night life.
Then we figured out why that facility was so anal, only the chemo patients who have severe problems while getting chemo are sent there, so they really have to be careful with those people. I was just there cause my oncologist office was overbooked.
I was able to sleep well, only got up once around 3 and read QiGonk book until 5 and went to bed again.
Elif had tricked me that there was another package of fudge in the freezer and I spent 10 minutes rummaging through the fridge.. all frustrated, good thing I could not find it. I settled for applesauce with cinnamon, that somehow satisfies my cravings.

First day back at work after 4 months

2007-12-26T21:24:00.000-05:00

First went to the heart center for my scheduled echo. It basically is an ultrasound of the heart and all surrounding plumbing I believe. When I asked the technician what the difference between Muga scan ( where they injected radioactif stuff and then took pix of the heart ) and Echo she said they give the same results but the Echo was more comprehensive.. good and I am also being spared the radiactiv injection!
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As soon as I got in the room took the risk of acting obnoxious and said that I really had lost my trust in ultrasounds since I thought that my c should have been caught on my yearly ultrasounds that I had done along with my mammograms, the lady assured me that she'd be really careful. I somehow do not feel comfortable when a health care provider starts chatting at that point I really want them to focus 110% on their jobs, but my technician had different ideas I guess. After a monologue of 10 minutes she finally understood that I was not up to it and continued silently taking pictures. At one point I also fell asleep, because I had this appointment I had not taken any sleep aids so really needed some zzz...
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Took about 20-30 minutes, I asked whether everything looked ok and whether she would be able to give me the number for the LVEF ( Left Ventricular Ejection fraction) which is the number that the Muga scan spits out ( it was 67%) she said that she could not and I had to discuss it with my doctor in my next appointment. I must have given her the 'sad puppy' look cause just as I was leaving she said ' I would not worry about it' And I have learned so far from the healthcare system that if they see something wrong they want to throw that ball waaaayyy out of their court to yours asap to unload the responsibility. So the ticker is good !
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My first working day was interesting, I felt like I had add and had difficulty focusing on the project that was assigned to me,I will not be doing my regular job for a while and will be working on different things which do not have as much urgency.
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And for the first time in a long time I took a nap on my lunchtime.. unbelievable.. forget about Ambien, Xanax, Ativan, Rozerem.. just go to work, somehow that put me to sleep .. tsk tsk...
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After work went to the 1 hour spinnning class and really was able to push myself hard for the first time in a long time.
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There is a salsa class starting mid January we decided to hit the 8 sessions with Ferit that would be awesome to celebrate the ending of my chemo (last session so far is planned to be on January 10)
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Started a new book - Middlesex very interesting.

Christmas day

2007-12-25T22:21:00.000-05:00

Hosted a really nice cozy breakfast for family this morning and played greedy Santa. My energy levels are off the roof, so better enjoy this 2 days before my 7th treatment on Thursday. We all ate way too much ( including Candy who was getting little snacks from everyone).
I really lost my efficiency I was dropping stuff, spilling coffee all around the place if it were not for my daughters help I would have definitely messed everything up, I need to catch up on my entertaining skills they certainly have rusted.
All the side effects of chemo except some neuropathy on my feet are gone, and that is not so bad. I had Neuroma which I wore prosthetics for anyway seems like Taxol gave those nerves a nice kick. My sleep seems to have recovered too.
Today we had a conversation about rating how happy one is with their lives and was asked to rate it from a scale of 10. I thought and said 6, but thinking about it I actually fluctuate between 3 and 10, since I have started experiencing my high states which I just love ! And of course there are those down moments where my treatments just bring me down. I hope I never ever need to go on antidepressants, no wonder the fine print says that they could cause suicidal thoughts ! geesh I really find that funny in a sick way.. Oh so and so committed suicide cause he was on antidepressants, I thought the whole point of antidep.. were to make someone feel happy or maybe not ?
Tomorrow first day back to work after my echo appointment at the Heart Center. I actually am kind of excited. What a way to start work after being off for 4 months, first day .. coming in late doctor appointment, second day off in the afternoon - chemo, third day off in the afternoon - seeing another surgeon in Tampa.
Now that's what I call easing back into things ;o)

Kundalini applied to RPM-cycling ?

2007-12-24T18:38:00.000-05:00

Well since I was able to get some zz.. for the past 2 days(did not even get out of bed once last nite yey !!!) I started to resume the life of a normal human being, and dragged my sorry butt to the 9 AM cycle class.
Ok the class is nice.. but what if I try to incorporate the breath of fire (A cleansing & energising breath, powered by abdominal contractions). So I started to do it during the fast sections and did the hills breathing normal with the group, it was amazing to watch the breath of fire first increase then stabilize my heart rate !
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Spent the rest of the day doing last minute shopping since we are hosting the christmas breakfast for our family every year. Maneuvering my shopping cart through the bumping cars maze in Publix I finally was done and made it home.
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The house had really been neglected and totally messed up during these past couple of months so tried to bring some kind of order. Surprisingly the girls cooperated and actually helped out ? Could it be because there were some presents under the christmas tree that were not opened yet ?
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Managed to squeeze in an hour of Kundalini basic breath and spinal flex too !
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Today I realized how much I lost from my pre-illness efficiency, I used to get a lot done during the day even when I worked now it feels like I am spinnning my wheels.
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HOW ON EARTH AM I GOING TO START WORK WEDNESDAY ???

6th treatment .. hmm this is not like training

2007-12-23T11:28:00.000-05:00

When I am training for an event I break my body down and then when I rest it overcompensates and makes me stronger so in my next session I go in stronger. Well that logic does not seem to work with chemo. My body somehow is not overcompensating after each treatment but is actually taking more time to recover. Or the insomnia is taking a toll on me. I prefer to think the latter cause sleep is when I am supposed to recover most.
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Last week I caught a cold bug(ran a slight fever), or got hit with allergies, had some GI problems that mimicked IBS(the oncologists nurse said that this was one of the side effects of taxol) .. and to top it off had severe insomnia basically I was kind of out of it for about 8 days, no working out just idling around did a lot of good reading though. Some weird weight gain also occurred ( honestly there was NO bingeing ) and I started to lose my eyebrows !Just as I am coming to the end of treatment all these hit me.. arghhh ! I had heard that the eyebrows go last sometimes even after the chemo ends, but was hoping that my bushy ones would withstand the chemo blast. Oh well I still have some that I can draw/fill in hopefully a couple will stay if not, not a biggie they are supposed to come back in really fast.
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Because my white blood cell counts were so good Dr. M decided not to give me the Neulesta shot this time after chemo. I actually was very happy about his decision cause that 6000 usd shot gave me some weird side effects. However the lack of it might have caused me to catch a cold but I am able to control it with Claritin-D so I am thinking that it is allergies.
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There was also a slight feel of neurapathy (tingling sensation like when you come in from the cold) in my toes but probably because I forgot to take the Vitamin B I was supposed to be on .. tsk tsk..it is gone by the 9th day.
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Insomnia was the real problem, after my 5th taxol treatment I was not able to sleep well for about 1 week, but this time it really got worse. Tried several sleep aids ( Ativan, Xanax, Ambien, Roserem ) the only one that slightly knocked me out for a couple of hours was otc Benadryl surprisingly. Finally the oncologist gave up and told me to contact my pcp for a sleep study. But on the 10th night (Saturday) I was able to get a good nights sleep with 1 Ambien yey ! Although they are saying it should not be the steroids or the chemo I strongly think it is so. I just have to expect having sleep problems after the last 2 chemos.
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Sunday I was able to do a 6 mile long run although I have not run for almost 1 month (except the 1/2 mile jogs that I did before my weight sessions) and felt really good.
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I have to keep up with the Kundalini Yoga practice the center has closed for the winter solstice and I had not been practicing. Last night when I was feeling really drained just did the breath sequence and that immediately perked me up, it might even have helped me to go asleep finally.
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Right now reading about Qigong my therapist practices it and suggested that I look into it.
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I also had an appointment with a cardiologist, I do not have any problems and my oncologist did not think I needed to see one but I insisted just to assess the ticker after the Adriamycin treatment. He hooked me up to a holter which is basically a little device that I hung on a lannard which recorded the 3 electrodes for 24 hours. I did a short run at the end of the 24 hours just to give them some data from the ticker when I am working out. Next wednesday they will also do an cardio echo ? The cardiologist had done the ekg and listened to me and said that he did not think anything was wrong. I have the follow up appointment in 2 weeks to go over the results from both tests.
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Got a 1 hour massage at the spa, it was good when it lasted I wish they would have let me just take a nap right there ;o).
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This Friday I also have an appointment at the Moffitt Cancer center in Tampa top get another opinion regarding further treatment. I like my oncologist and he is the one who will be following up on my treatments going forward but I am not leaning to getting more surgery at this point which is what he wants me to do. We'll see.
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Starting work this wednesday it will be quite interesting since I have been away for at least 4 months now !

Chemo 6/8 - DONE ! Boobs inflation - DONE

2007-12-14T14:48:00.000-05:00

The plastic surgeon expanded me up for the last time now I am at 500 cc's I guess if I ask he could pump me a bit more, will think about it.
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Interestingly I have another decision to make now in this area. If I am getting radiation treatment the standard protocol is to do the exchange surgery(where I trade my turtle shells for soft silicone cushies which will enable people to hug me instead of bouncing back from a hug) 6 months after the rads are done, because the flesh there basically becomes as inflexible as a beef jerkie after being fried by the rads and healing problems are encountered. He has presently dealt with several problems with exchange surgeries done that way (6 months after the rads) so he suggested that he do my surgery before I get rads after chemo. The radiation apparently is not impacting the implant material itself but my skin,flesh. It is a probability that the radiation might cause capsular contracture which might require a bit tweaking in the future but he seemed to be more comfortable with that.
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So yet another decision to make.. joy ! He will call the radiation oncologist to see his take on it.
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Went to my chemo and went over my conversations with the Clearwater surgeon with Dr. M, he is still standing his ground insisting that I should get the lymph nodes removed and if no more test positive I should not get radiation at all. He thinks that radiation in my case is an overkill and definitely is not agreeing with the other doctors. So I will be waiting to meet with the Tampa Moffitt surgeon who hopefully will refer me to the radiation oncologist at Moffitt ( they would not give me a self appointment) and then the final decision will be made.
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At this point I am really torn. My gut feel says go radiation, but am not quite positive.
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My older daugther Sibel was my chemo babysitter and I loved it! We watched a movie ' My Super Ex Girlfiend' by Umma Thurman(well I kind of konked out at the beginning thanks to the benadryl). At some point I got craving for a frosted chocolate cake and she went down to the cafeteria and grabbed me one. It lasted forever we were there at 11 oclock and it was about 5 by the time we left.
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As expected I did not get any sleep that night, thanks to the steroids ! We got the tree decorated though !

2007-12-12T16:39:00.000-05:00

The surgeon that we saw at Clearwater pretty much said that the decision to have further surgery or not had been made after my mastectomy before chemo, as the additional surgery would have been needed to be done at that time. At this point he does not see any reason for me to get further lymph nodes removed especially if I am going to have radiation.
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We have 1 more doctor to see in Tampa, however he is a surgeon too, I wanted to talk to another radiation oncologist.
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I wonder if my hospital has the latest radiation technology ? Hmm.. have to check into what to look for.
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Restarted upper body weights today and was able to do a 1000 meter erg ! Maintained a 2:10 pace for the first 500 meters but then blew up and finished it at an average of 2:13.

Back leading the 5:45 am cycle class.

2007-12-11T09:41:00.000-05:00

Last night the aerobics coordinator called and asked whether I would like to take the Tuesday morning 5:45 am class back and that she would be my permanent sub if I needed to take off for any reason. She has been really nice in accomodating me for the past couple of months, told her that I would gladly take it back and would call her if I did not feel up to teaching at any point. It was a great class this morning and I was really happy to be back with all the early morning cyclists ! I just have to make sure that I challenge them enough because I can not gauge the intensity accurately from my own effort level.( my only challenge was to find a top that fit since all my old ones are feeling really tight with the expanders now ;o) )
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I had a lot of fun stuff going on this weekend went on an easy 33 mile ride with the slower bike gals 'The Flamingos' then went to the christmas party for the fast rider gals which I used to ride with (Bobbies.. babes on bikes) gals on Sunday- won a pump at the raffle ! I really needed a new pump because my old one requires a lot of effort and my chest muscles were kind of talking back every time I try to hit 110psi. Friday evening went to a xmas party for my rowing club and it was great to see the scullers since I have not been out on the water for 4 months now almost.
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The lake Fairview water is so contaminated that I am scared that if I take a spill I will catch some weird bacteria so no rowing until I am out of chemo.
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Today we are heading off to St. Pete to see another surgeon to get an opinion on whether I should be getting further surgery to remove more lymph nodes ( since 2 out of the 6 lymph nodes in the sentinel node biop had tested positive but were relatively small - .2mm and 2 mm)
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I am having major mood swings but I now know that no matter how bad they are I will swing out of them, so I just keep low and do not bite anyone during those times. I guess I have hit the chemopause since I also seem to be getting 'head sweats' especially at night. It is a weird feeling and I am glad that I am bald !
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Started reading the book 'Meditation as Medicine' which my father had given me a couple of months ago, because I intend to work on the mind-body connection to ward off this C to get a foot hold again.( I thought I was previously doing everything else that was suggested this is the only piece that was missing)
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Little did I know that this book was about Kundalini Yoga which I am definitely becoming addicted to.. well.. signs are pointing towards this from different sources, so I guess I will pursue this path. I have heard that the Tuesday evening one is the real good session ( plus they have soup after the session !!)will try to hit that one next week.

They lied Taxol sucks too !

2007-12-04T18:30:00.000-05:00

When I was on the AC chemo all I heard was that ohh.. once you are done with this, Taxol is a breeze. Maybe I was expecting to be perfectly normal and had high expectations of myself( which is unrealistic duhh.. this stuff is designed to kill cells !!! ) or this stuff really did not agree with me.

Since they gave a huge amount of steroids I was the Energizer bunny next day but crashed the following day, no nausea but felt really tired. It also did away with my sleep(which was probably looking for an excuse for pulling an MIA anyways) for at least 3 days. And gave me restless leg syndrome where I was constantly fidgeting. Ativan and Ambien are not doing the trick. I was also given a high dosage(30 mg/daily of Glutamine )to prevent neurapathy and muscle aches paind.

We had gone to Ft. Lauderdale for Ferits Company Holiday dinner past weekend and being stuck in a hotel room unable to sleep was no fun. I was cracking up at myself, while trying to keep warm wrapped in blankets, futile attempts to get rid of the restless leg syndrome,jumping up and down, doing yoga in the small bathroom, trying not to wake up Ferit. I gave up trying to go back to sleep and ended up getting a lot of reading done sitting on the toilet.

Sunday when I tried to walk around the block I had the feel of my legs buckling underneath me and my ankles ached ??? I thought wtf !! ( pardon the lang) I never ever had muscleskeletal problems this was a huge surprise. I got really upset until I posted my symptoms to an online forum and the girls there said that interestingly the 1st treatment of taxol was the worst, somehow the body does get used to it. Phew !

Today is the 6th day and my joints feel recovered we'll see how my weight session goes tomorrow.

Some weight damage was done though, I do have an excuse this time= The steroids ! ( not really it was my usual 'comfort food seeking when sh.. hits the fan') I am up at 156 pounds.( gained about 14 pounds since this all started back in August)

Went to see a radiation oncologist to continue my poll on whether to get further surgery to remove more lymph nodes or rads and this guy who is in the same group as my oncologist and he basically said that I needed rads for sure and additional surgery to remove more lymph nodes was a totally useless act only for staging purposes to determine the treatment(whereas my oncologist wants me to get the surgery).

We have appointments with 2 more doctors in Clearwater and Tampa the upcoming weeks and by the end of this year our decision will be sealed. I am swaying from one side to the other, all the doctors seem so convincing !

Resuming/ recap

2007-11-19T14:25:00.000-05:00

Well after a short break from blogging I am back with a new mindset.

See it is really hard to 'not' think about cancer all the time especially in my case since my treatment plan is still not finalized and pretty much left to me. What happened was I read so much to the point that I spiralled out of control in my 'quest' and burnt myself out going into kind of a denial phase which made me go down since I felt that I did not have any control over all the crap that was happening. So no more medical reading for me (at least for now)Going cold turkey on the anti-depressant Paxil that I was on did not help either ( yes I did know that one is supposed to wean off not stop suddenly but thats me, I was done with it the stuff made me a mellow person which I did not like so I just had to get rid of it to get 'me' back ) Compliance never agreed with me.

With my 45th birthday which was on the 18th my perspective has changed. There is also a saying that I really liked from the last book I read ' Eat Love and Pray' that agrees with my mentality. I could not find it to quote right now but basically it said never let go of yourself always go up.

I will basically kick ass my own way.I was previously trying to follow other peoples footsteps during my recovery phase trying to sit at home relax, read book and all that 'sounding relaxing' stuff that cancer patients are supposed to be doing. Well that just plain drove me nuts I had to get out of the house or keep busy. So I guess everyone has their own way that they are comfortable dealing with life changes.

Either there is some negative energy in the house or there is something wrong with my mind because I just can not sit at home.(when I said I want to totally redo our bedroom cause the 'feel' is not right Ferit with his usual down to earth attitude said 'Honey I will not let you translate your mental problems into $$ since that is not going to solve them' . It was a good try on my part though)

I am in search of a personal trainer who would be willing to work with a chemo bitch(which I can be) since I have gained some weight which is making me feel bad about myself. The hard part of my treatment is over and the next one is starting on the 29th of November I am ready to get back there. To test did 27 miles of the Horrible Hundred ride which is my birthday tradition since 2002 and although the heart rate was about 10 bpm higher than usual I was ok. ( since I wrote this I started working out with my old trainer.. it is challenging but he is managing to give me stuff to do that makes me sore in a good way taking into account my surgery / chemo)

Decided to start back to work in 2008. My chemo will still not be over but will only have a single treatment left. Then there is a high probability that I will be getting more surgery to remove additional lymph nodes, I will be meeting my surgeon and 2 others for secondary opinions on this.

What I learned from talking to other survivors with removed lymph nodes is that if one is careful to build the strength back up lymphedema is not a problem although there does not seem to be much research on this subject. Dana Farber Institute from Boston had a research on analyzing lymphedema in rowers which I believe showed that the rowers did not get lymphedema. I was thrilled to hear about this and have called the contact provided in the research article to get the complete research article published on this. So as of now I will not be working my upper body with heavy weights for at least 5-6 months after surgery, then will start back up very slowly. Swimming is said to be really good for me so I think I will start hitting the pool pretty soon although I really do not like the LAfitness pool, it is like bathtub too warm, however there are too many kids practicing in the Y pool and I am not positive on how hygienic it is ! Maybe if I go in the mornings it might be cleaner than evenings.

Emailed my Breast Cancer support group stating that I would be happy to share training plans/tips for any gals who might be thinking about tackling the Danskin tri in may. So far only 1 seemed to be interested.

Contacted the aerobics coordinator stating that I could start subbing some of the Tuesday morning 5:45 am classes if she wanted me to.

As of remaining physical symptoms with the expanders I feel like having 2 turtle shells on my chest and there is no way I can lay facedown they still have not blown them up to where they want them to be. There is a constant tight-bra feeling but I got used to it and it does not bother me anymore. Arm/upper body strength and range of motion is almost back to where it was.

One other important thing, I think it was 2 weeks ago I got the weird feeling that the last trace of cancer had left my body at that specific second. I said ' I'll take that ;o)

Life is good !

Couple of pictures from the time gap.. I have 6 wigs now !

Hay ride at the christmas tree place and various other events.

Ongoing - Workout log

2007-11-04T19:03:00.000-05:00

10/16 - 1.5 miles walk 27:37 18:20 mn/mile 3.3 mph maxhr/avhr-127/117
..........time in heart rate zone: 13:36
10/17 - 2.25 miles walk 38:26 17 min/mile-3.5 mph maxhr/avhr-138/125
..........time in heart rate zone: 30:26
10/18 - First bike ride after surgery 33 minutes 5-6 miles avhr/maxhr 127/150
10/19 - 3.3 mile walk 56:00 17 min/mile-3.5 mph avhr/maxhr-121/137
..........1.5 hour Kundalini yoga
10/20 -16 miles bike ride on trail avg speed 11 mph avhr 124.
10/22 - 4.5 miles walk/jog 1:13:47 16:10 min/mile avhr/maxhr- 124/154
..........Time in Target Heart Rate zone ( 116-135): 55 minutes
10/23 - Spinning class 43:47 avhr/maxhr - 132/150
..........Time in Target Heart Rate zone ( 116-135):20 minutes
..........1.5 hour Kundalini yoga session
10/25 - chemo
10/26 - 1 mile walk 20 minutes avhr/maxhr - 114 125
..........Kundalini Yoga session.
10/30 - Spinning class 42 minutes avhr/axhr - 132/160
..........Kundalini yoga 1.5 hours

November :

11/2 - 2.8 mile walk 44 min 15:45 min/mile avhr/maxhr- 134/160
..........Kundalini yoga 1.5 hours.
11/3 - Spinning class 40 min avhr/axhr - 142/167
11/4 - 6 mile walk 1:40 mins 16:22 min/mile avhr/maxhr - 129/163
11/5 - 17.2 mile bike ride 11.7mph speed avhr/maxhr-133/147 time in zone 1:00
11/6 - Spinning class 40 minutes avhr/maxhr- 141/169
..........1.5 hour Kundalini Yoga
11/7 - 3 mile walk 48:00 mins 16min/mile avhr/maxhr - 134/
11/8 - 1 hour hot power yoga
..........Chemo #4

11/10 - 2.5 hour Kundalini Yoga(mainly meditation and breathing-breath of fire)
11/12 - 3 mile walk
11/13 - 3 mile walk
.........1 hour Kundalini Yoga
11/14 - 17.4 mile bike ride 12mph average 1:27 mins avhr:136 maxhr:151
........time in zone 47 minutes
........1.5 hour Kundalini Yoga
11/16 - 1.5 hour Kundalini Yoga
11/18 - Horrible Hundred ride- did only 26 miles 2:00 hrs 13 mph average.
........avhr/maxhr - 161/190
11/20 - according to my heart rate monitor did some kind of 44:00 minute cardio, do not recall what !! avhr/maxhr - 146/171 .. looks like spinning.
11/21 - weight training
11/22 - 1 hour indoor cycling/spinning - avhr/maxhr- 150/171
11/23 - weight training
11/24 - 41 mile bike ride with Florida Freewheelers C/D group picnic ride, 14.2 mph, 2:47:00 hrs avhr/maxhr-155/177
11/25 - 6 mile walk/jog shuffle, 1:27:00 hrs avhr/maxhr-160/184-- a bit high have to check whether my red blood cells dropped. 14:30 min/mile. 1.5 minute jog, 1 minute walk. Expanders which are looking like monster boobs might also be compressing my rib cage preventing me from breathing well.( rumor is a gals ribs cracked from the pressure of an expander)
11/26 - Weight training and 10 minute erg - left chest muscle is challenged might need to give a break.
11/28 - 1 mile run 12:40 min/mile. weight lifting
11/29 - 1st Taxol treatment chemo#5/8

December

12/5 - 1 hour lower body weight training, 1/2 mile run. Chest muscle still compromised cannot do any upper body or core.
.......1.5 hour Kundalini Yoga
12/6 - 1:08 hr bike ride, 14 mph, avhr/maxhr-158/170 17 miles
12/7 - 1 hour weight training, 1 mile run.
12/8 - 1.5 hour Kundalini Yoga
12/9 - 33 mile bike ride, avspd 15mph, avhr/maxhr -
12/10 - 1 hour weight training, lower body, 1.5 mile run
12/11 - Led the 40 minute spinning class(for the first time)avhr/maxhr-163/178
12/12 - 1/2 mile run,1000 meter erg at 2:13 pace. 1 hour weight training ( upper body, the chest muscle did not talk back I was even able to hang )
12/13 - 6/8 Chemo taxol.
.
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12/23 - 6 mile jog/walk. 1 min run/1+ min walk. 1:30 hours 15 min/mile -
........avhr/maxhr - 158/183.
12/24 - 53 minute spinning class avhr/maxhr - 161/178
12/26 - 51 minute spinning class avhr/maxhr - 154/174 - was able to exert myself really good this time.

Training plan for the Jacksonville Breast Cancer Half Marathon:

Week Start Date Length of long jog and/or walk

08-Oct-07 Chemo on thurs 4
15-Oct-07 4
22-Oct-07 Chemo on thurs 5
29-Oct-07 4
05-Nov-07 Chemo on thurs 6
12-Nov-07
19-Nov-07 chemo break for t-giving before going on to Taxol !
26-Nov-07 Chemo on thurs
03-Dec-07 6
10-Dec-07 Chemo on thurs
17-Dec-07 8
24-Dec-07 Chemo on thurs
31-Dec-07 6
07-Jan-08 LAST CHEMO ON THURSDAY ON THURSDAY JANUARY 10 !!!
14-Jan-08 8
21-Jan-08 10
28-Jan-08 6
04-Feb-08 4
11-Feb-08 Event on Saturday

Day 6 I am coming back up again-taking a break from blogging

2007-10-30T16:03:00.000-04:00

Well it seems like by day 6 I am up and about again. Went to the 5:45 am spinning class then went to my kundalini yoga session, went to Nuge who prepared me an awesome lunch,ran some errands and took the girls to the swim practice. I still have nausea however I learned to live with it and am eating well to recover from the treatments.

I will be giving a break from keeping my blog. Just a change of life need to stay away from the pc a bit to enjoy my days off from work between treatments.

Couple of down days

2007-10-28T17:49:00.000-04:00

Well it seems like chemo took my 'edge' the 3rd time.

1st day was ok.

Friday I had boundless energy (2nd day )I even took a 1 mile walk and drove to my Kundalini Yoga session was out all day and even had company for dinner.

Distance: 1 mile
Duration : 20 minutes
Average heart rate: 114
max heart rate: 125

Then Saturday the 3rd day nausea/fatigue took over big time so I was kind of dragging in the house and took a big nap. I am taking every anti-nausea med that i am aware of except steroids which I refuse to take, but they are not quite cutting it. No throwing up but just an constant ewww feeling.

Saturday night Ferit took me to see 'Dan In Real Life' it was a cute movie.

I am so lucky that I had completed Ironman events before, this is the exact same feeling I had after each one for about 1 day, fatigue, nausea. I feel for pregnant gals who feel this way for a couple of months !

I read some research papers on Lobular Breast Cancer and felt the need to reach out for another opinion, now I am considering Dr. Massimo Cristofanelli (MD Anderson Houston), www.breastlink.com or Benjamin O. Anderson from University of Washington
I have to do this asap.

The highlight of my weekend was that Sibel came home and is staying until Monday morning.

Hold on tight for a sample chemo cost table

2007-10-26T09:11:00.000-04:00

In a forum post saw the following breakdown for the treatment I am getting, oh boy am I lucky to be insured.

Treatment 1 through 4 ( AC-chemodrugs +Aloxi-antinausea med+Decadron-steroid)
4 X 1200 = 4800

Treatment 5 through 8 ((taxol, decadron, aloxi, benedryl and zantac)
4 X 3074 = 12,296

Treatment 1 through 8 Neulesta shot to boost the white blood cell production.
8 X 5600 = 44,800

This is only the treatments given at the doctors office until end of chemo, I am not even considering all the different the antinausea meds that I am given ( one is 100 usd a pop, the other is 500 usd for 18 tablets)

Total : 61,896

Mind you this is only the cost of chemo.. the presurgery diagnostics cat scans, mris' biopsies, surgery costs are not included.

Plus the antihormone meds that I probably will be taking after chemo are an arm& a leg do not even want to think about that.

Chemo week- prechemo burst of activities -Instant Boob job-Bye Toto

2007-10-24T10:39:00.000-04:00

Monday I recovered from the busy weekend doing nothing, since my energy levels were kind of low.

Tuesday bounced right back with a vengeance, I was determined to do a lot this week before Thursdays 3rd chemo session:

Tuesday:
Did the 5:45 am spin class, this time I was even able to break a sweat !!

Duration: 43:47
Average Heart Rate: 132
Maximum Heart Rate: 150
Time in Target Heart Rate zone ( 116-135):20 minutes

Later went to the Kundalini Yoga session at Altamonte. This is so different than the traditional Power Yoga I have been going to. There is a lot of breathing exercises that work with body movements to massage theinternal organs(at least thats what it feels like) and one exercise is 'belly laughing' where everyone has a laughing fit, well I found it so stupid that I actually broke into laughing histerically. They say laughter is a healer guess thats what we were doing, got a kick out of it.

The owner never claimed Toto(isnt this so sad) so Erin adopted him. We are already missing the little bouncey rascal !

Wednesday :

Did a walk and threw in a couple minutes jogs here and there. Finally we are back out there with Candy the Irondawg with a long run !

Distance : 4.5 miles - 16:10 min/mile
Duration: : 1:13:47
Average Heart Rate : 124
Maximum Heart Rate : 154
Time in Target Heart Rate zone ( 116-135): 55 minutes

Went to the plastic surgeon who finally was able to start the inflation of the expanders, it is really weird to see your boob swelling while you look at it. They injected 100 cc's saline in each breast. I am up to 250 ccs in each, I think they will go up to 400. Did not have any discomfort from the inflation or afterwards, just the regular feeling like wearing the heart rate monitor strap too tight.

I feel like a kid trying to cut school.. or a cat that is being dragged to a lake, I really do not want to go to chemo this thursday argghh.. I have heard that the 3rd one is hard cause you know how crappy you will feel and it is not the last one either. Just have to suck it up and do it. I will be hydrating like crazy today and take lots of good protein so I can recover quickly from the hit I will be getting tomorrow.

Swim to bike transition video and biking pix

2007-10-23T04:20:00.000-04:00

Finally snagged the camera from Elif to download the picture/video from my camera. Wetsuit stripper video

Picture of me and Penny after our 16 mile ride.

And another Toto picture I just can not resist !

Enjoying days before treatment #3

2007-10-22T13:09:00.000-04:00

Well as far as I can tell I am pretty much shot for about 1 week after chemo then slowly start back up.

Enjoying the car show with Ferit and Stephanie on Sunday. They would not even let us TOUCH the cars..

Toto Toto Toto !

2007-10-22T12:20:00.000-04:00

We had an interesting (to tell the least) start to Sunday. To cut a long story short we ended up with a Yorkie mix(do not think she is fullbred) adorable(not potty trained we are working on that) doggy who wandered into our garage.

This is how she looked when we found her:

Spent the whole afternoon posting posters around the neighborhood to find the owner, at night was advised that it might belong to a house 5 houses down the street. However .. the owner has not claimed her yet even though I left a message on her door. I am tempted to keep her as they play great with Candy( 2 of them look hilarious together .. the little one - Toto as we named it - going on its hind legs to make itself bigger and trying to attack Candy) and it certainly has a spunky character, is not a incessant barker, is extremely social and is very smart. But.. she will have to go :'o(

After some TLC ... here is Toto

with Candy :

GFT Bike Ride and Welcoming Stephanie to Orlando

2007-10-22T07:34:00.001-04:00

Saturday started pretty gloomy we drove up to Clermont in heavy rain,so changed our plan to first watch the GFT swim to bike exit, then do a short ride if the weather lit up.

Parked the car in a 'really good ;o) ' spot ! Headed down to waterfront park and watched the sufferfest begin for the Great Floridian and Florida Challenge.

An interesting video to check out if you have never seen what a 'wetsuit stripper' does on the swim to bike exit..hey ! don't get all excited nothing too kinky (although I was secretly hoping that a 'mishap' would happen lol)

Here is a picture one of the spectators who came to cheer their participant on.

At one point we decided to head back to the car and start our ride on the trail, as we approached the spot where we parked the car we saw a commotion.. they were towing cars !! And had the car who had parked in front of us already on the tow truck ! Yikes ! Penny ran up and at the last minute was able to save her car from being towed. Boy would that have been an expensive parking fee.

Started our ride from Waterfront Park to Killayney which was about 8 miles one way keeping the heart rate below 135 was really a challenge at one point I wondered whether I could still balance on the bike at that low speed ! I never worked out at that range and there were very slight hills on that portion of the trail that made the heart rate creep up a bit. A cyclist in front of us saw a bobcat I have never seen one yet. Overall it was a great ride and I was tired, came home and took a 3 hour nap.

Stats:
16 miles
average speed 11 mph !!!!!
average heart rate: 125
max heart rate: 204 --- not true must have crossed some power lines.
Time in Zone ( between 118 and 135 :)

In the evening we went to pick up Stephanie from the airport, I was really excited since I had not seen her in 2 years and we had a lot of catching up to do. From the airport directly headed to the Fundraising party for my relay team (Breast Friends) for the Relay for Life which I am raising funds for. Won an Entertainment book, a Tijuana Flats gift certificate and a Gift certificate from a nail place in the drawing. Did not get that lucky with the Chinese auction.. was trying to get the doggy bag.

Going to watch the Great Floridian ! And my tri buddy Stephanie is coming !

2007-10-19T21:11:00.000-04:00

Tomorrow saturday October 20 the Great Floridian Ironman distance triathlon and the 1/2 Ironman 'The Challenge' will be held in Clermont.

Me and Penny will ride from Killarney station to Waterfront park to watch the participants exit the 2.4 mile swim and head off to the 112 brutal bike course around 8:30. The energy in these events are spectacular and really is something to experience even as a spectator.

Great Floridian has a special place in my heart because it was my first Ironman event ( completed GFT in 2003 and 2005) I always try to be there, either as a participant, a volunteer or like this year a spectator.

Dug out some pictures from GFT 2005,

My shorts had smiley face reflectors sewed on :0) you can tell that I am extremely happy to start the final leg of the tri after 2.4 mile swim and 112 mile bike.

Me and my daughters at the finish line after a sufferfest for 15 hours and 40 minutes. It is hard to believe that I was actually hosting the C beast at that time too.

Tomorrow is also very exciting because one of my tri-buddies is coming to visit us for the weekend, Stephanie !!

Here is a picture of me and Stephanie at Santa Cruz ( where I had completed the Big Kahuna Half Ironman) in 2005 it was an awesome event although it was kind of scary being that close to the sea lions !

Kundalini Yoga

2007-10-19T16:30:00.000-04:00

Started the day with a brisk walk with Candy:

Distance:3.3 miles
Time : 56 minutes - 17 min/mile - 3.5 mph
Average Heart Rate: 121
Maximum Heart Rate: 137

Went to the Kundalini Yoga Center at Altamonte unfortunately was late due to a horrible accident on I4 but was able to join the session.

This was not an intense session like the Healing Circle and I was able to work on my breathing and meditation. Will try to go there 3-4 times/week this upcoming month.

Stomach is still not 100% up to normal but energy levels are coming up definitely.

First Sun Salutation attempts and bike ride

2007-10-18T15:23:00.000-04:00

Last night the binge wagon hit again, it seems like the body is trying to compensate for the lack of food intake on the 7th day of chemo when the nausea lightens up a bit. This time the damage was hostess cupcakes (7 of them) and a couple of caramel candies.

Greeted the morning by doing a couple of sun salutations.. to my delight the chest muscles are even allowing me to plank for a couple of seconds woohooo !!! I heard that expansion weakens the pectorals, might take that into considering while inflating the boobs.

Later went on a bike ride with Zeren who turned out to be a 'natural cyclist' she was hauling .ss with excellent bike handling skills even though it was her first time on a bike since several years. Unfortunately my heart rate monitor was dictating my pace and I had to slow her down. The pix is a bit crooked but we- the biker chicks look darn good ! :

Duration: 33 minutes
about 5-6 miles forgot to reset the bike computer
Average Heart Rate: 127 - definitely higher than it was before.
Max Heart rate: 150

It was my first time on my bike since the surgery.. and it felt really good.

Workouts monday-wednesday

2007-10-17T13:24:00.000-04:00

Taking advice from Mary Ann keeping the heart rate in check, which requires me to walk not even jog.

Monday:
.75 miles walking with Candy
16:23 minutes - stopped a lot to talk to neighbors who noticed my 'new hairdo'
not much of a workout.

Tuesday:
1.5 miles walking with Candy
27:37 minutes 18:20 min/mile 3.3 mph
maxhr: 127
avhr: 117
time in heart rate zone: 13:36

Wednesday :
2.25 miles walking with Candy keeping the heart rate between 118 and 134
38:26 minutes - 17 min/mile - 3.5 mph
maxhr: 138
avhr: 125
time in heart rate zone: 30:26

hmm so if I keep this pace at the half marathon it will take me 3:45 hours.. it will be interesting to get lapped by the fast marathoners which will happen since it is a 2 loop course.

Pleasant Tuesday Afternoon

2007-10-17T10:03:00.000-04:00

Had a very pleasant afternoon thanks to Zeren who suggested to go to a movie, and to our delight the movie Jane Austen Book Club had started. We have a pretty volatile (to tell the least) book club and it was quite entertaining to see that similar group dynamics/dilemas which were present in other book clubs too ( the 1st episode of Losts 3rd Season also started with a brawl at a book club - you can watch it online from abc.com it was a hoot ).

Books are so personal that it is really hard to keep the discussions ' not personal' ;o) but I look forward to our meetings every month even though we have met some rough spots I still think it is a great get together.

Went around The Pointe for a while before the movie, did some plastic damage. Got a chuckle when the girl at L'Occitane suggested that I use a certain kind of shampoo- we laughed and had to explain to her that I actually was bald and had a wig on - guess that is proof that the wig looks natural ( or the girl needs glasses.. will take the first one )

After the movie we were both 'Jane Austen'ed, I confess to not having read any of her novels but I do have a Jane Austen Collection at home which I will start asap as soon as I finish 'The Sun Also Rises' - Hemingway which is draggginggg !

Afterwards when I went to pick up Elif from the Aquatic center her friends first said 'Hi' and then they went 'ohhh and came and started touching my wig' when they first saw me they had forgotten that i had my hair chopped off, then realized it. So I think this wig (the long one) passed the test.

My nausea is still continuing but I am just learning to live with it. Found that if I forced some food down it actually helps. The challenge is not to succumb into the urge to gorge on comfort foods all the time because I know too well where that leads to.

Bonfire for cancer books ? Something funny

2007-10-16T23:46:00.000-04:00

It's really good to have a lot of resources but I think I am really overloaded with brochures, books, self-help for C.. stuff and today got a sudden urge to make a big bonfire on the lawn and torch them all.

Guess it is time to give a break from researching/reading, need to refocus and start living my normal life asap. Guess returning to work next month after the first part of the chemo is done will be good for me.

Learned that people who did not drink alcohol were more susceptible for chemo-nausea, so as Ferit says : 'Smoking does not hurt you, drinking is good for you'

A twisted way to put things into perspective but right within this context I must agree at least in the literal sense.

Relay For Life - I am in the Breast Friends relay team

2007-10-16T23:31:00.000-04:00

Every year I try to participate in an event that is benefiting a certain cause. For the past 5 years this has been the MS150 bike ride benefiting the National Multiple Sclerosis society.

This year due to apparent reasons I will be participating in events that are benefiting the fight against cancer and cancer awareness programs and have joined the 'Breast Friends' team for the Relay for Life that will be held in Hunters Creek on November 10.

This is an overnight relay walking event where each team will be represented by at least 1 member at all times.

Unfortunately that is the week of my chemo treatment ( all of the events that I want to join seem to be on my chemo weekends ! ) so I think I will still be able to do the opening lap at 3 pm, but am not sure whether I will be able to hang around for a long time.

Here is my web page:

Look Good Feel Better program

2007-10-16T23:23:00.001-04:00

Monday I went to the Look Good Feel Better program sponsored by:

National Cosmetology Association (NCA)
Cosmetic, Toiletry, and Fragrance Association (CTFA) Foundation
American Cancer Society (ACS)

Here are all the goodies that I got in my bag, woohoo pretty cool stuff from Estee Lauder, Chanel, Aveda, Mary Kay and other brands. Some bags had a Mac brush. Darn ! not that I needed any more makeup brushes but I still was eyeing other participants goodies like a kid looking at other kids halloween candies/ christmas presents.

We were 4 gals facing the chemo challenges, the session was led by a counselor appointed by Florida Hospital Cancer Institute and a lady who helped us do a 'makeover' starting from cleansing to putting on makeup. There was a 77 year old lady who had never done makeup and I suspect who never was exposed to the sun, her complexion was as translucent as a babies !

We were also instructed on how to 'dress' our heads, how to wear the wigs, how to care for them how to manage nails during chemo ( yes nails are also affected, manicures/pedicures are a no-no for infection concerns)

I am not going 'commando' yet and am wearing a wig for the first time, I had it on for total of 7 hours and did not have problems that some people had(feeling itchy.. hot ) although I was extremely relieved when I got home and took it off.

Although it is the 5th day of the 2nd chemo I was not totally over the chemo effects and I think I overdid it again. By leaving the house at 9 am (I am on a mission to find new tableware) coming back at 4:30, I was totally wiped out and fell asleep in front of the tv and slept like a baby throughout the night.

The nausae is continuing but I am showing an effort to get good calories and especially protein in.

Ferit asked whether Feta cheese bills would be considered as a reimbursable medical expense ;o) since I literally have been living on it post-chemo.

Ok the buzz !

2007-10-14T15:29:00.001-04:00

OMG did not realize how comfy and cool is 'da bald' and thank you mom ! I do have a nice scalp !

Ferit did an awesome job of 'da buzz' !

Do not know whether I will go commando since I invested a lot in wigs and headcovers but might pull a 'hot topic day' or Britney spears day ;o) since it is so airy.

Couple of post-chemo dull days

2007-10-14T09:20:00.000-04:00

It feels like the chemo takes my 'edges' off. I feel and act kind of dull.
I also have the cold like symptoms ( congestion ) which is one of the side effects of the chemo agent. Nausea has not tapered yet although it is the 4th day.

I was actually toying with the idea of doing the Breast Cancer Awareness ride on Saturday morning but Saturday when I got up I was not feeling that well. Unfortunately all the events that I would like to go to happen to be on my chemo weekends arghh...

Saturdays highlight was a free facial that was offered by Face Logic Oviedo to Breast Cancer Patients and Survivors, it was really a treat I wish it was not 2 days after my treatment so I could have enjoyed it more. It was not like the usual complimentary spa offerings where they pamper for 15 minutes then you have to listen to sales spiel for the remaining 45. There was absolutely no sales pitch and a full hour of facial,face-arm shoulder-nect massage. And my complexion really looks better ( and if they can make a chemo skin look good and not get irritated I would say their products are pretty good )

The hair fall is getting to the point that I will need to buzz it off very soon no point in holding on.

I have a lot of cute headcovers and 2 wigs, will start making use of them. I also have the Look Good Feel Better appointment tomorrow that is an offering made by the American Cancer Society on Monday. Perfect timing I say.

Trina one of the Bobbies kindly shared the following with me, and I do agree with her it certainly sounds heavenly !

A reflection from an individual that rode cross country as a fundraiser and awareness experience.

I achieved the nirvana I was hoping for on a stretch of highway between Gordon and Valentine Nebraska : Picture gentle rolling hills stretching into the horizon under an infinite blue sky with only a hint of clouds. Crickets, grasshoppers, or locusts are chirping in unison all around you, and occasionally jump from the grass and bounce off your leg. The occasional cow ponders you suspiciously as you enter its territory. The feeling out there is remarkable – remote and serene, yet the road beneath you is a safety tether to civilization somewhere. With heart thumping, lungs expanding, and legs pounding like pistons, your bike moves effortlessly up and down as you weave through the rolling hills. With the wind whipping all around you, it’s hard to imagine that there is a care in the world, or that there ever will be…..

Research published by New England Journal Of Medicine

2007-10-12T09:39:00.000-04:00

HER2 and Response to Paclitaxel in Node-Positive Breast Cancer

Result:
Patients with a HER2-positive breast cancer benefited from paclitaxel,
regardless of estrogen-receptor status, but paclitaxel did not benefit patients
with HER2-negative, estrogen-receptor–positive cancers.

I am HER2-negative, estrogen-receptor–positive..

The only difference in the test cases are that I am getting Dose Dense ( instead of traditional. every 3 weeks ).

I have 1 month to research on this to see whether I still want to continue with Taxol after my AC finishes.

Much better this time

2007-10-12T09:19:00.000-04:00

Although I did have substantial nausea last night I was able to sleep and did not purge so this time we seem to have gotten it right.

So my new regimen seems to work which consists of :

- Aloxi with infusion
- Steroid amount doubled while getting the infusion.
- Taking Emend for 3 days.
- Taking Compazine every 8 hours for 3 days.
- Over the counter Zantac twice daily.
- Ativan before going to sleep for 2 days ( was warned that this could be addictive so will use sparingly)

Oh and I also have to add that I chomped down a whole bag of Corn Chips that Ferit got me during treatment, I suddenly had a craving for chips luckily he was able to find a vending machine.

But one thing that really helped that I was not able sit down and listen to my nausea Elif had 2 of her friends sleeping over. They made their custom homecoming day t-shirts and they tried to get their hair in a mohawk for the homecoming game. Well first they tried putting on Elmors glue that did not go quite well so we went to Wallgreens begged them to open up ( they had just closed) and bought 5 jars of #10 hair jell. Came home and tried to set it with hair dryer... nada.. it just was not happening there was gel all over the place (luckily we were on the driveway) We gave up and went to bed at 1 am, I think I of them slept in the gel.. dunno how that turned out.

Pictures are worth a thousand words :

Teenagers on a good mission in a good mood are even more fun to swatch then a kitten playing with a yarn... they could get hilarious !

2 chemos done 6 more to go !

2007-10-11T20:39:00.001-04:00

Well I got my 2nd chemo today, they gave me an additional medicine ( Emend)for the nausea ( which is about 100/per pill and I am taking it for 3 days luckily my insurance covers it ) this usually stops any nausea immediately I was told. Plus they doubled the steroids that they gave with the infusion.

Our cute doc did the juggling trick again and one of the gals was telling a joke. The goal is being able to juggle until the joke finishes. First he started juggling 3 plastic cows then went back to regular balls. Time passes pretty quick there with Ferit and watching whats going on.

I got all clear for working out from my oncologist and plastic surgeon. The plastic surgeon just wants me to refrain from major upper body movements involving the pecks(like bench presses, pushups- golf is ok) . Oncologist said that I should do whatever I felt like doing and there was no limits.

Have an appointment with a Physical Therapist to asess me and work on any shoulder, chest weaknesses/flexibility issues that are due to the surgery.

The Plastic surgeon still did not inflate me ( the incision sites are still red), and I started losing my hair... joy ! Bald and flat .. hmmm.. will look like one of those aliens in the cartoons, especially when the 'red devil' chemo agent turns my skin greenish the second day of treatment.

Today a research had been published about Taxol the second chemo agent I am scheduled to get end of November..

"The widely used chemotherapy drug Taxol does not work for the most common form of breast cancer and helps far fewer patients than has been believed, surprising new research suggests.

If further study bears this out, more than 20,000 women each year in the United States alone might be spared the side effects of this drug or similar ones without significantly raising the risk their cancer will return. That would be roughly half of all breast cancer patients who get chemo now."

Well I happen to be in the category who will not benefit from this chemo agent.
My oncologist said that the research was conducted by a very reputable person and should be trusted, this study was done on traditional ( not dose dense like I am getting ) chemo, however he said that he thought that the results would probably be same for dose dense patients too.

Ohh.. and we brought up the issue of radiation or further surgery.

He is definitely against radiation, and said that I might want to consider removing additional lymph nodes after chemo if I choose to do so but he really did not think that is really mandatory either.

Hmm.. so maybe I can get away with no additional surgery, no radiation and maybe not get the taxol treatment ? That would free me mid-november. But my hunch is that I will go ahead with the taxol and not risk anything...

Geeshh I thought that I was done with the decision making, here we go again !

Backing off activities a bit

2007-10-09T20:42:00.000-04:00

It is 2 days before my second chemo session I feel totally recovered except for a slight glitch in my sternum.

I guess I overdid my activities, and started having some pain in my lower sternum which I initially had after the surgery but had went away 2 weeks ago. I think the golf swing might have done it or the jog/walk.
My friend Mary Ann helped me come to my senses by sending me a serious email on not jeopardizing my health by exerting myself needlessly at this stage of my treatment. Will take it easier from now on.

Today I went to the 5:45 am spin class and cranked up the intensity(the resistance) a bit controlling the heart rate with my new cute Heart Rate Monitor and felt extremely good. Came home and took an hour nap (this is my new routine, workout - eat - take a nap)

Stats from my spin class:

Time: 46 minutes
Average Heart Rate: 135 ( 77% of max)
Maximum Heart Rate: 159 ( 90% of max)
Calories: 345
In Zone (127-143) time: 22 minutes - I will focus on staying more in the zone.

At lunch met with my friend K at the mall and had a delicious Pizza while we caught up on stuff. Afterwards did some shopping at the mall. Baked some chocolate chip cookies as my friend Seda and her daughter dropped by for tea. I am kind of getting used to the 'Stay at home mom with grown up kids' although I do not think that I can do this for very long.

Yesterday I received 2 large gift bags from my friend Deb at work ( we have the same birthdays so I call her my twin ;o) ). It was such a nice surprise and really brightened my day.

In the bags there were a bunch of running/cyling magazines, an book with inspirational poems, novels, sudoku books, a notebook, matching notepads.... But that was not all.

There was a bag with 40 little rolls, labeled 'Daily Inspiration' "Grab a thought"

I do not know how long it took her to put this together considering the fact that she also does have her hands full with 2 wonderful little munchkins H and V but it was an amazing idea, I will have fun with it !

Started hydrating for the chemo tonight need to go into it fully prepared.

Starting jog/walking & went to the golf range

2007-10-08T14:25:00.000-04:00

Activities:

Sunday:

2 hours at the golf range, it is definitely a very meditative activity ( can not think of anything else), I thought we were there for about an hour and then realized that I had been trying to whack the ball off the ground towards the flag for close to 2 hours.
No wonder Ferit was checking out with the pro about lessons, he surely is very patient but I am seriously doubting my golf ability, losing the T, or slamming it into the ground.. sometimes breaking it.

If you look at my picture I look more like dusting a rug with a racket, rather than driving a golf ball.

Surprisingly I was wiped out after this.. yes.. and took a 2 hour nap afterwards.

Monday:

I decided to give the jog/walk a try. Did 2 minute jog at 12 min/mile and 1 minute walk at 2.8 mph.Watching 'Tim the Toolman' made time pass quickly, there was barely anyone at the gym at 12 pm.

Here are my stats.

Distance: 3 miles on the dreadmill with 1% incline.
Time: about 43 minutes
Calories: 372
Heart rate average :155
Heart Rate maximum: 175

The heart rate was pretty high but my legs felt really good ( naturally from a major taper since end of August) I am hoping that I will eventually be able to bring the heart rate down to a reasonable number.

Had to take a 1+ hour nap again later, I think I am kind of getting the hang of what my body needs while undergoing treatment.

This Thursday is my next chemo session lets see how I will react this time.

Today I also realized that when managing my 'unwanted hair' the roots were kind of sluggish, guess the mohawk cut that my daughter is looking forward to is coming near. I am expecting it by this weekend.

Other stuff:

Other than that I am gravitating towards the kitchen in my spare time, I am not sure this is such a great idea since the last time I was this involved in baking was 10 years ago and I was about 40 pounds heavier. But my deserts are just 'scrumptious' !!! ;o) Today I am trying out a new marble cake recipe. Yesterday I had baked a strawberry cream tart which was sinful but delicious which we took to my sisinlaw where we had an excellent dinner (as usual !)

Training plan for the Breast Cancer Half Marathon

2007-10-07T05:01:00.000-04:00

Here is a draft of my training plan to walk / maybe jog/walk the breast cancer half marathon that I have registered for in Jacksonville in February.

Every week I will do 2 X 3 mile walk and in addition to these I have scheduled a long jg/walk working up to the distance so the plan is to do walk/jog total of 3 times a week. I do not need to complete a 13.1 mile to prepare for a half marathon my longest walk/jog will be 10 miles.

Long walk/jog will be on the Monday,Tuesday or wednesday of my chemo weeks ( I get mine on Thursdays, that way I will be at my peak of my treatment cycle for these workouts)

Week Start Date Length of long jog and/or walk

08-Oct-07 Chemo on thurs 4
15-Oct-07 4
22-Oct-07 Chemo on thurs 5
29-Oct-07 4
05-Nov-07 Chemo on thurs 6
12-Nov-07 4
19-Nov-07 Chemo on thurs 4
26-Nov-07 4
03-Dec-07 Chemo on thurs 6
10-Dec-07 4
17-Dec-07 Chemo on thurs 7
24-Dec-07 4
31-Dec-07 Chemo on thurs 8
07-Jan-08 4
14-Jan-08 9
21-Jan-08 4
28-Jan-08 10
04-Feb-08 4
11-Feb-08 Event on Saturday

Presently I did a 3 mile walk at 3.2 miles per hour speed on the treadmill with 1% incline.

Feeling almost normal again 8 days after my 1st treatment

2007-10-06T18:22:00.001-04:00

Activities:

Friday :

3 mile walk on the dreadmill, average heart rate 125 at 3.2 mph speed. Can not wait until the Plastic Surgeon gives me the go ahead to start jogging. Luckily this gym has tv's on each treadmill ( thats why I got the membership) so I get to catch up with whats going on.

Afterwards came home and took a 2 hour nap.

Saturday:

40 minute RPM ( spinning class at the gym) kept the RPE ( Perceived exertion level ) 5/10, Heart rate less than 140

Was not able to put on much resistance and mainly did high cadence spinning. Felt awesome after the ride although I did not even break a sweat. During the ride I was imagining that as my heart rate increases any stray cancer cells are exposed ( they stay black whereas the good cells start glowing with endorphins) and my immune system was sweeping them away.

I am feeling better with each passing day the throat is a lot better although I still have difficulty swallowing solid stuff. I do not have the metallic taste that everyone had warned me about having when going thrugh chemo and my appetite is back( at least as of now). I do not have fatigue that affects my daily activities but I do not think I can go and ride my bike for 2+ hours either. Well I can live with this for 4 months.

Friday night Went out to dinner to Red Lobster, forgot my throat and ordered a spicy dish.. yikes.. Ferit had to switch his entree with mine.

Sibel and 4 of her friends from UF came over and we watched the movie 'Troy' together. It is so uplifting/fun to hang out with 17 year olds ( ONLY when they are in a good mood ). I had made 'Better than Sex Chocolate cake' - weightwatchers recipe ) luckily they wiped it out pretty good before I had a chance to inhale all of it.

My father who is visiting ran into his room scared from the overdose of estrogen of 8 gals ( me + Elif and her friend + Sibel and her friends ) Ferit as usualy braved us all and hung out.

Saturday night was a different version of Friday.After seeing the movie 'Game Plan' went to Applebees for dinner had a really nice steak I have been craving red meat lately. Then came home to the same group of gals watching the UF and LSU game .. had to run outside to the patio they were a bit loud even for my taste. My father hid in his room again. lol...

I am playing 'Monk' at the restaurants, cleaning the table with Antibacterial wipes, wiping the silverware with the wipes and constantly putting on hand sanitizer. I must look pretty weird, but better safe than sorry.

A very sad day

2007-10-06T18:07:00.000-04:00

This is a roller coaster ride indeed, having a support group and connecting with other BC patients has immense benefits, however this also makes one exposed to very unfortunate events.

One of the girls from the breast cancer internet forum passed away due to complications from chemo. She was 34 years old had to little kids ( 2 and 3 years old), had gotten her 2nd chemo and got exposed to a virus and came down with pneumonia her immune system was challenged from the chemo and her family lost her within 2 weeks. This came as a shock to all of the forum members.

Here is a link to her posting on utube getting her first chemo, ( it is very sad, you might not want to watch it ) her spirits were so high !

http://www.youtube.com/watch?v=cdMbrGMTF-o

although probably none of you know here here is her online obituary link in case you want to light a candle:

http://www.normandean.com/?p=obituary_view&id=45280

They have to find a better way to cure this shit other than breaking down all parts of ones body.

Paid dearly for a binge

2007-10-04T14:56:00.001-04:00

By Wednesday I was feeling really good ( if not 100% back to normal) around 5 pm I went through a lot of comfort food, literally stuffing them down my throad happy that I was able to consume large amounts of food again ( a sign that I have somewhat recovered from the toxins of the chemo) At night we ordered Pizza and I ate some of that too, afterwards I got the feeling 'something is stuck in your throat but actually nothing is there- or - I just ate a potato which decided to hold on to my throat fighting not to go down ' which just did not go away and got worse and started hurting.

I am not sure what irritated my throat(while eating pizza I do recall something cracking in my mouth) but I guess from now on I have to be careful about chewing foods thoroughly before inhaling them whole like my irondawg Candy as the chemo meds are supposed to impact my stomach, mouth and digestive track making it vulnerable.

All day long I was only able to eat soft foods and liquids.

Sleep is still not settled I was on an online chatroom until 4 with other bc gals who are sleep challenged as well.

My oncologist is my home boy

2007-10-03T13:24:00.000-04:00

Hehe.. thats a pin that one of the patients of my oncologist has -- I was told, found it was pretty accurate since he will be controlling my life at least for the next 4 months.

I went to a chemo training class at the office tuesday evening and gathered some information from the nurse who did the presentation regarding the different oncologists and their treatment styles.

So I am getting to know Dr. Molthrop and his treatment style now.

No vitamins no complimentary medicine.. Actually no medicine other than the chemo unless I really prove that I need it. ( other oncologists prescribe and instruct their patients to take the antinausea medications proactively even if they do not feel nauseaus, I think he is trying to limit the meds given which I can understand.. but in my case they ARE necessary)

His point is simple regarding vitamins/supplements. " Cancer cells are your cells, if you take antioxidants and other boosters they will boost the cancer cells also not only your good/healthy cells, we are trying to kill the c cells with the chemo"

So all I can do is to rest, and eat sensibly not piling on junk calories and maintain my current weight. I am really being thankful that I did all my long distance endurance training, the discipline for it is basically the same.

First spinning class

2007-10-03T13:02:00.000-04:00

Tuesday:

I attended the spinning class that I used to instruct and had a great time. Since my heart rate monitor did not come yet I really had to listen to my body to make sure that I kept the effort in zone1 very easy, barely breaking a sweat. I think I did a good job of pacing myself no sprinting, no major hills. It was great to see the group again ! I had to wipe the bike with antibacterial wipe, from now on I will be playing 'Monk' I guess.

I might consider wearing a t-shirt saying :

WARNING -- IMMUNE SYSTEM CHALLENGED PLEASE KEEP YOUR DISTANCE.

Because one of my dear friends gave me a huuugggeee hug and a very warm kiss.. could not stop her but got pretty scared.

Wednesday :

Walked on the dreadmill for 3 miles at 1% incline at 20 min/mile pace, and interestingly I felt kind of tired this is really weird. It took FOREVER !

The Plastic Surgeon did not inflate me since the necrosis was still not healed, he cut off some parts to help it heal quicker and gave me another appointment for next tuesday, he said that he wanted to make sure that everything was ok before starting expansion and he was not in a hurry. I tend to agree I am not looking forward to the expansion process and going on for Dolly Parton yet. They can only do the inflation the week that I have the chemo ( before chemo) because that would be the time when my immune system will be at its peak during treatment cycles.

The chemo feeling so far has been similar to a major hangover ( if I can recall what a hangover is from decades ago since I have not been wasted since then ) nagging headache (like a dehydration headache- do not want to go into details but I know very well that I am fully hydrated ;o) ), sinus pressure and queasy stomach just feeling BLAH .. altogether.

I have not been getting adequate protein that is essential for my body to rebuild the healthy good cells destroyed by chemo so bought couple of high protein EAS bars. The meal replacement drinks were another option but even thinking of downing one made me gag.. ewww. I hate those. For 5 days after the chemo I have basically been living on soup, feta cheese, tea and toast, with an occasional craving for corn chips. I do not think I had major fatigue, but the nausea sucked on my energy.

Actually the feeling is exactly the same as the feeling that I had after my Ironmans.

Day #4 Bouncing back

2007-09-30T19:03:00.000-04:00

Thanks to the Ativan I was able to sleep throughout the night. It was prescribed for nausea but I believe it also helped me sleep.

When I got up in the morning I just did not feel like going on a ride, felt really fatigued. Penny stopped by on her bike ride and brought 3 different kinds of fresh delicious breads from the Cuban bakery, we sat on the patio enjoyed them together chatting along. The weather was simply gorgeous. Honestly that felt a lot better than sweating on the bike. Maybe next week I will get on the bike again no need to rush things now. Hey I can even ride during the weekdays !!

Stopped taking the antinausea medication, ate my lunch of salad and lentil soup ( that Nuge - who I declare the soup queen - made ) took a nap, and I was almost good as new !

I was beating myself for not being a good host and not being able to do everything I wanted on Friday evening as Nuge sent me an email that helped me set my priorities right. In a nutshell she told me not to focus on or get distracted by all the obstacles/inconveniences that I will have during my journey to health but focus- direct all my energy on the end result/goal.. getting myself healed completely ! It is so nice that I have wise friends around me, as in my current mental state I sometimes can not think objectively and tend to get stuck on minor details that set me off from my course.

Ferit came from golf and took me to the Home Show at the convention center. house stuff was nice but I just loved the Saturn Sky (it should be against the law to have this car with automatic transmission ! )

Tonight is the season premiere of Desperate Housewives and tomorrow I have an appointment with the Plastic Surgeon who knows maybe he will give the go ahead to increase the PSI in my chest tires ( ehem expanders ! ).

Life is good !

Ride has gotten a bit bumpy

2007-09-29T19:30:00.000-04:00

Well since I regard myself strong as a horse I was having high expectations of not having much side effects from chemo ( or was expecting that I would be able to control them). So the first chemo night was a humbling experience, I got quite ill and had to even call the doctor on call at 2 am ( who luckily was my doc ! ) cause I just not could keep anything down and was afraid of dehydrating and not being able to flush all the toxins out of my body. Luckily I had gone into the chemo totally hydrated.

They had not given me the max nausea medication probably because I did not get any morning sickness when I was pregnant and I usually do not have morning sickness either. They prescribed Emend which is supposed to be really good for the next chemo.

The next morning got a lot better even if not back to normal.

I had the bone marrow stimulator shot ( nuelesta) yesterday luckily I did not have the side effects from that one, which was said to be bone pain. I am supposed to get this after each chemo session, that is the requirement to do the dose dense treatment ( every 2 weeks instead of every 3 weeks).

Last night we had the book club meeting which everyone had generously agreed to switch to have at our house but I just could not give myself to the discussions, very weird feeling almost like being drunk.

Later at night felt very jittery and could not sleep at all paced in the house all night, I am not sure why this happened since I was expecting to be fatigued.

It is the 3rd day now and I can not even stand to look at food on tv commercials, basically living on tea, toast, feta cheese and some gatorade but it is getting better I started taking an antinausea medication proactively. Ferit took me out shortly for a change it feels good to go out in short outing. I have lost about 5 pounds in the last 3 days luckily I have some buffer there.

Tomorrow will try to go out on a short bike ride with Penny if I can sleep well tonight.

Finally the second stage has begun

2007-09-27T18:36:00.000-04:00

And here is my guy ! Dr. Molthrop.

Phew ! I finally I found an oncologist that I am really comfortable with down to earth, up to date and communicable ( and NO my decision was not affected by his looks lol... although it certainly does not hurt to have such a nice face to walk one through the chemo journey)

Went over the sleuth of questions I had ( Fred called it 'the interrogation' ) with the nurse.

There was one thing that I was not warned about though. That I would have toxic bodily fluids/excretions the next 24-48 hours so I was supposed to flush the toilet twice if I was sharing or if i was in a public restroom. Yikes !!

The disability extension report which the nurse said that they had faxed had NOT been faxed.. well finally Ferit took care of it himself we made sure that we put the dates in specifically as the disability company required. So as of now I am on disability until January 14. I will reevaluate my state once I know how I react to the chemo and might go back earlier.

Went to the back where there were several recliners with a couple ladies with wigs/ no hair. 'Welcome to your new peers' I said to myself.

My 'Tits in Progress' t-shirt got some chuckles, I was told that there was a lady who came to every treatment with some kind of funky stuff and that I should meet her.

Settled into the recliner and was briefed about the toxic concoctions and the possible side effects that I might have during treatment. Although as always said the effects are different for every person. They gave me steroids and a shot of aloxi for the possible nausea it is supposed to be effective for 5 days. I also got a prescription for a nausea medication to be used in case I felt nauseous.

I got a goodie bag with water bottle and books and mouthwash,toothpaste sample ( I am supposed to use special mouthcare to avoid mouth sores)

Was given the 'red devil' first chased by the other toxin. Everything went pretty smooth I did not get the headaches that some people do when the infusion is given. Went online with Ferit's pc and chatted a bit, then the Dr. Molthrop came in and started juggling 3 balls.. saying ' I really do not want to do all the paperwork that is waiting at my desk.. c'mon tell me some jokes' it was too funny. I shared one of the 'you know you have breast cancer' lines.

"You know you have bc when your wardrobe is Pink"

I kept on drinking water and nibbled on the saltines making sure that my stomach did not stay empty.

I did not need all the stuff that I brought in my backpack.. I had packed for a sleepover one would think.

And it was over, I was not feeling anything.

Only a slight discomfort when one has when they are coming down with a cold.

Around 8:00 though a slight nausea/fatigue showed up. hopefully will be able to manage it. Could it be from the watermelon ? Or maybe too much water to flush the poison off my body. I have to learn to work this thing. Sucked on some lemon drops which helped it a bit. Better take the prescription med now.

Oh well chicken noodle soup for me for tonight I guess.