Liver Function Numbers Improving

There's always something new at the conservatory!

Silly me, this was sitting in my drafts folder for over a week now...well, better late than never.


I've been on the new pills for three weeks. Today (July 13) I had blood work done and saw my oncologist. The good news is that the pills have caused my liver function numbers to improve. Yay! They are still "abnormal" (I mentioned last time they have been for months) but are trending in the right direction.

I'll have lab work done again in mid-August and will have another appointment with Dr. N. I'm not sure when the next CT scan will be.

Compared to many other patients, my doctor says that I am tolerating these new medications very well. Afinitor isn't chemotherapy, but can cause some yucky side effects I've avoided.

The new symptom I've been managing this month is fluid retention in my legs, ankles and feet. This is a common issue with liver problems / cancer. I can walk but very slowly, like your grandmother in slow motion (alright, that's a bit of an exaggeration). I will probably need to rethink my shoe situation pretty soon, as most of mine don't fit. I'm sure there are many stylish orthopedic options out there for swollen feet.

There's not much to be done except hope it gets better and keep my feet elevated when I'm sitting around. The whole thing is uncomfortable and annoying, but I'm adjusting.

So far my summer has been slow-paced for the most part, which has been fine. I am learning not to expend energy on a lot of unimportant things or things other people can help me out with. I'm making progress with asking for help - that's just going to be an ongoing process. I am really up and down emotionally, which I think is just par for the course.

Some of the best things about this summer so far:

• Stunning weather
• Time with the kids
• Reading
• Hearing from so many people in my life who care about me

Off of Chemo

Back to the Conservatory

I wish I could say that I'm off of chemotherapy because the disease is stable, but last week's CT scan showed that it still continues to progress and my liver is not functioning well enough to tolerate chemo right now.

My liver function tests have been abnormal for months but not to a point that I couldn't accept chemo. Now there are a couple of "worrisome" numbers.

Yesterday I met with my oncologist and she is having me take two medications (both are pills I take at home): Aromacin (an aromatase inhibitor that lowers estrogen levels in postmenopausal women) and Afinitor. Neither of these are chemotherapy and my doctor has seen positive results with these drugs in some patients like me.

This is also the course of treatment that the oncologist I've seen at the cancer research center recommends. 

So this is a week by week (or day by day) experience now. I'm hoping the particularly troublesome liver tumor shrinks and my liver function improves.

I continue to feel good on some days and not as good on others. It varies quite a bit.

Update as of June 8

C with Caleb the Corgi (I'm branching out from just featuring plants!)

The weeks are flying by. The girls have 6 more days of school (not that anyone's counting), and then we enter that season I kind of love and kind of hate - the kids' summer vacation. Usually I think it's pretty great for 5-6 weeks, and then it's high time for school to start again.

I've had a harder time the last few weeks with some symptoms, some attributable to the treatment and some probably to the cancer itself. But there are also plenty of days I feel pretty good.

Friends and family have been helping us a lot, giving rides to C, making us food, doing some yard work, running to Costco and to Trader Joe's. I know I haven't put out requests on Lotsa Helping Hands - these are offers that people have made outside of that website. There will be other requests coming!

Liver Problems

My liver is acting up. Long story short, last week my bilirubin level was getting too high and was climbing. I had an ultrasound of my liver to check to see if a tumor is blocking a duct, but it showed no blockage. Today my oncologist cancelled my chemo treatment because of the level of bilirubin. She has referred me to a gastroenterologist to consult with (tomorrow) and I have a CT scan on Wednesday to see what is going on. Those are all the facts I have at this time - not too many! I'll write more when I know more.

Cancer as Chronic Illness

I've lived with stage 4 cancer for over a year and half. I found an unusually insightful article about what it's like practically and emotionally for cancer patients like me called "The New Survivors", Psychology Today published it in their March/April issue. I recommend it if you'd like to know more about what I or someone else you know is going through.

Increasingly cancer has become a chronic illness, yet it's very different from say, asthma or diabetes. The article describes several different patients and their stories, and I found I could relate to each one in some way. Although it's a sobering subject, overall the tone is hopeful.

But the primary reason I was glad to find the article and point you in the direction of it is that it expresses truths (some very painful and poignant) that validate my experience that I also I find difficult to write about here.

"This range of emotions - the simultaneous gratitude and dread, the intense awareness of both the exquisiteness and capriciousness of life - may of course be felt by anyone with cancer, from those with the most promising prognosis to those with the least. But for people whose cancer can be explained only as a chronic condition, the inner stew is often far more pronounced because of the sheer length of time they have to deal with it and the utter uncertainty about how it will unfold."

Here's the Latest

Central Park from my friend's parents' apt on the 78th floor

New York was great! I had a great time with old friends and seeing Byron and the kids and various sights. I was pretty exhausted by it all, but who isn't? That city has a lot of intense energy, especially compared to my laid-back Northwest city.

So now back to reality. I started the gemcitibine last Friday, April 17. I receive that once a week for two weeks, have the third week off, and then start a new cycle of two weeks on / one week off. I'll keep going with this and then have another CT scan in July to see what's happening.

I'm not feeling as good as I was a couple of months ago, and that has made me think more seriously about asking for help. It's been hard to recognize when we need help, what to ask for and how to ask for it. I just wrote about this on the "Lotsa Helping Hands" website that local friends and family are hooked into to learn about our requests for help. If you are not a member of my community on Lotsa Helping Hands and want to be, just go here and request to join the community.

Rather than be like your Aunt Mabel who has trapped you at the buffet table at the family reunion to describe all of her ailments in detail, I'd like to tell you a little bit about what I'm dealing with in the context of activities that I frequently do with you.

Taking Walks

I love walking with friends. I love walking the dog (when he is not being Mr. Dawdlepants). However for the last several weeks I get short of breath very quickly, especially going up stairs or walking up even a slight hill. I need to sit down for a little bit and recover, even if I've been walking on flat ground for as little as 10-15 minutes. Standing still for any longer than 5-10 minutes can be challenging. Just picking out birthday cards at the store today required me to lean on the shopping cart (not a big deal, but a change for me). Waiting in the security line at the airport (25 minutes) was a real endurance test.

So please understand that if we go on a walk, it will be slow and kind of short. I will huff and puff. You will not get a workout. But I do need to get out there and get fresh air and walk some, for my health and sanity. I just need to do it differently.

My doctor thought I might have blood clots in my lungs, but this was ruled out by a CT angiogram. So the latest theory is that the shortness of breath is overall related to the cancer changing and not just the last chemo I had. I don't really know what that means, but I'm just working on adapting to it.

Eating Out 

I also love going out to lunch, dinner, and coffee to restaurants and people's homes. But for the last couple of months, my appetite has been down (very common side effect) and some food just doesn't sound good to me at all. I'm not nauseated or sick, but I am often not very hungry.

So if we go out or I go to your house and I don't eat very much, please don't take it personally. I'm kind of funny about food right now.

Making Plans

I love making plans. However lately it is not uncommon for me to develop a fever out of the blue, and then I need to lie down and rest. These are usually pretty low grade and sometimes last for just 3 hours, but I feel very, very tired. If I ignore a fever and push through with my plans instead of lie down, it all just gets worse.

The last full day we were in New York I got a fever and spent most of the day in the apartment while the rest of the family ran around. That was a bummer, but I did what I needed to do. Sometimes I feel very tired even without a fever, and I need to rest rather than go do that next thing.

So if we make plans and I cancel even at the last minute - sorry, I just have to lie down sometimes. We will reschedule!

So in addition to being more open to asking for help, what I'm adjusting to is living life more slowly. I need to take it at my pace, which is slower than the pace of other people my age. I need to pick and choose more carefully what I take on in a day. I still have days when I feel pretty "normal", and that of course feels great.

The Hair Report

Oh yes, the hair. The last time I mentioned it I said that hair thinning / loss was a common side effect of the last chemo I was on. As it happened I did experience hair thinning for a few weeks in January-February, and then that stopped. Good thing I had a ton of thick hair to start with.

So now I have thinner hair and have new bangs to sort of mask the thinner hairline, but I am thrilled to still have my own hair.

This new treatment can cause hair thinning / brittleness, so we'll see what happens.

Thanks for hanging in there with me. I always like to hear about YOU and your life, because God knows I spend more than enough time thinking about my own.

I hope you're enjoying all that's blooming in your part of the country right now.

Lucky Number Six

Orchid at home

I had a CT scan last week, and unfortunately the disease is progressing. Only one tumor (the largest one) is growing but it's growing at a rate that shows "progression", so I need to go off the clinical study and do something new.

My oncologist would like me to see the oncologist from the cancer research center again to see what new and exciting trials there might be there for me. Since I can't get an appointment until May 7, I will start a new chemo plan, Gemcitabine (plus Herceptin), around April 15.

I've been planning a vacation to New York City in April, and my oncologist sees no reason for me to skip that. We are planning my treatment around it. I'll be spending some of the time with very good friends and some with B and the kids. I haven't been to NYC since the time of The Bonfire of the Vanities, and I hear it has changed just a little bit.

I'm sorry that the Eribulin did not work for me, although it was getting to be somewhat annoying, side-effects wise. We'll see what "Gem" as it is called for short, is all about.

So Gemcitabine will the the sixth drug I will try against the disease since September, 2013. Two drugs worked for six months each, two didn't work, and one I couldn't do because I was allergic to it. Hopefully Lucky Number Six here will do some good.

I'm still not in any pain and am managing the nuisance side effects alright. They will probably diminish the further I get from the Eribulin.

This has not been a fun week. Besides the disappointing news about having to switch plans I developed a fever last Thursday and had to have a bunch of tests at the "Urgent Care" clinic to rule out neutropenia and infection. The tests weren't hard, and I wasn't neutropenic nor had an infection, but the fever held on and I felt icky and tired for a few days.

I feel back to normal now and am looking forward to family things and of course New York!

Happy Valentine's Day

Hearts I've been given

Hallmark holiday or not, I like Valentine's Day. I love chocolate and I love flowers, and God knows February needs something to cheer it up a bit.

Since B's birthday is a week before Valentine's Day and he and I always go out for dinner to celebrate, at our house Valentine's Day is a family event at home. I cook something comforting and we always have chocolate fondue for dessert. It is ridiculously easy to make and you want to eat it about once a year, so it fits the bill.

I'm continuing to do well on this chemo plan. There are some minor nuisance issues that I am managing, but they're not too bad. Also I'm more tired, but almost everyone I know is tired (again, February, you are most uninspiring!) You have probably heard about cancer fatigue, and I've had some of that, but thankfully it isn't constant.

I think it's fair to say that overall my stamina is down. Down from when I'm not exactly sure, but I can't do quite as much in a day as I used to, and I need to rest or recover more. This has been happening gradually, but when I'm around people with high energy I am reminded of it. Some days I have pretty high energy, and some days I don't. Considering I've been on chemotherapy continuously for over a year, I'd say I'm doing quite well.

Heather in our garden right now

B and the kids do a lot around the house. B cooks dinner now (previously my job), and the kids pitch in and are very capable. Last weekend M cleaned almost the entire house without being asked while the rest of us were out for a few hours. (Don't worry, she's a normal 16 year-old most of the time).

My spirits are good a lot of the time. I don't write in this blog when I'm feeling down, so I'm realizing now reading over it that I sound pretty damn plucky. There are plenty of low points, and I'm thankful to have people to turn to when those times come.

The next milestone will be a CT scan probably the week of March 16. That will be after three cycles of this drug and we'll see if it's doing some good.

Doing Well

New Treatment

I started the Eribulin about 10 days ago, and so far it's been going fine. I've just had two out of three weekly treatments in the first cycle, so I'm still feeling my way through it.

The effects feel minor at this point, and while I don't feel quite as good as I did on the Navelbine, it's a little early for me to come to any big conclusions about how I'm going to tolerate this regimen. Overall I'm aiming for being aware of effects without obsessing over every little thing.

Genetic Testing Results

I received results from the genetic testing I had, and the news is good. There was no mutation found in any of the genes on the High Risk Breast Cancer Panel. This includes six genes related to hereditary breast cancer - BRCA1 and BRCA2 (which we've all heard about and which I tested negative for in 2012) plus CDH1, PTEN, STK11 and TP53 (which I'm sure you haven't heard of yet).

Because there is no history of cancer on B's side of the family, and because I do not have these gene mutations,  M and C also do not have them. Hopefully that will mean a little less stress for them as they move into their 20s and 30s and are talking with their doctors about cancer screening.

Of course it may be that I have a mutation in one of these genes that current technology cannot detect. It may also be that my family has a mutation in a gene that was not included on this panel, or that there are multiple genes that in combination point to a higher risk of cancer in my family that have yet to be discovered.

Why?

We don't know why I developed breast cancer, and I'm past being bothered by that (you know, for the most part).  I'm a lot more focused on just living with this chronic illness the best way I can. And obviously I'm also focused on doing anything I can to help M and C (and their future children) learn about and minimize their risks for getting cancer.

One thing I've learned in the last few years is to take what I read in the mainstream media about cancer with a grain of salt. Most of the articles require some digging on the reader's part to substantiate the claim that grabs your attention in the headline.

For example, you may have read recently an article claiming that a new study shows that about 70% of cancers can be chalked up to "bad luck". Turns out not everyone agrees with this statement. This is a pretty good analysis of how good the reporting was and how tricky it is to synthesize studies for a mainstream readership, in case you're interested.

I don't rely on just one article in even the New York Times to inform me fully about an issue related to cancer. I check different sources and also ask my doctor.

New Photos

The Conservatory, where most of the photos on this blog were taken, is finally open after several months of remodeling. So I'm happy to have some new photos to add. For those of you who may be new here, the Conservatory is close to the medical center where I receive treatment and in 2012 during radiation I started visiting it almost daily. It's in my favorite city park.

I don't go as often as I used to, as treatment days are Mondays and the Conservatory is closed on Mondays, but it's still a special place I like to visit, even for just 10 minutes now and then.

Follow the Blog By Email

Just a reminder that if you want to stay updated with the blog, you can simply enter your email address in the box in the sidebar on the right side of this page and you'll receive every post. No more cruising by here to check to see if there's anything new!

New Plan Begins December 29

An angel from my childhood

I'm going to start the new chemotherapy plan December 29. The drug is called Eribulin, and I'll be receiving it as part of a clinical trial. It's already FDA-approved for breast cancer treatment; the study is looking at whether it's effective and causes fewer side effects given more frequently at a lower dose.

I'll continue to receive Herceptin infusions (fights cancer) and Zometa infusions (helps prevent bone fractures) while I'm on the study.

I'll be receiving treatment once each week for three weeks, then I'm off for one week. Then I start the four-week cycle again. After three cycles I'll have a CT scan to check on progress.

I stay with the study for as long as it's effective against the disease. Six months is a typical length of time. Then we look at the additional treatment options.

This drug is generally well tolerated. There are the usual possible side effects (low blood counts, fatigue, nausea, numbness and tingling in hands and feet), but it might be as easy for me as the Navelbine I've been on for six months. I'll just have to see.

It does cause hair loss, so that's a big bummer. A friend and I picked out a wig a few months ago, and I'll order that in January. Mavis, being long and auburn, just isn't me anymore. I've been short and blond for almost two years and I like it, so the new Mavis will be short and blond. This wig may or may not get a name - I'm not really at a point yet where I can feel whimsical and lighthearted about this whole wig thing. I'm not sure what I'll decide to wear on my head most of the time, but it's good to have a hair option.

Thanks so much for your calls, texts, emails, cards, etc. It means a lot to me to hear from you and know you're in my corner! I hope you understand if it takes me a while to get back to you. Always know that I welcome your thoughts for good ju ju or your prayers if that's your thing.

I'm going to return to putting some requests for meals on the Lotsa Helping Hands website (see sidebar if you want a link to that). If you're already signed up to hear about requests, you'll get something in your inbox within the week.

I hope you have very Happy Holidays! I'm looking forward to Christmas and two weeks off before I start the new treatment. I will definitely need something to look forward to in January, though!

Good News

What a nice surprise - the CT scan I had Tuesday showed that the chemo is still working (contrary to what the tumor markers were telling us). The liver mets are still shrinking, and the other areas are stable.

So I get to stay on Navelbine + Herceptin for a while longer. I go in on Monday to start another round. A round is three weeks long - I have an infusion two Mondays in a row and am off the third Monday.

I'll still meet with the other oncologist next Thursday to talk about clinical trials and her take on standard treatments that are still available to me.

I've got several fun days ahead, and knowing I can stay with the status quo will make them even more relaxing!

Mixed Results

I do love a dahlia

I've been so busy living my regular life that I haven't written in a while. 

There hasn't been much to report lately. The navelbine chemo treatment I started a couple of months ago has been pretty easy and life's been smooth. I've been busy with work, and there's plenty to do at home and with friends this summer.

CT Scan

I had a CT scan to check on things yesterday, and the results are mixed.

The good news: Several of the liver mets are smaller. Yay! I haven't had this kind of good news since November.

The not-so-good news: The cancerous spots in my bones are larger and there are more of them. I don't even have a specific number. Let's call it several to many. They are in different places in my pelvis, spine and one in a femur.

The mystery: There's a spot in my lung that could be cancer but it's too small to tell. It's larger than it was in the last scan.

I don't have any pain. I'm very grateful for that. So all in all, it could be worse.

And it could be better.

The Plan

I will stay on this navelbine treatment for another two rounds (about six weeks) and then have another CT scan. Hopefully the liver mets will still be shrinking.

My oncologist says that especially as cancer spreads to other areas it may not all be responsive to the same treatment. She decided since it's very important to keep the liver mets under control, and that the navelbine has been doing that, we'll continue with it even though it is not shrinking the bone mets.

At the dahlia garden at my favorite park. You know, the one with the Conservatory!

How I'm Doing

Scan and results days are never fun ones. So my week so far has not been the greatest. But overall, I'm doing very well. The past nine months are some of the best in my life, and they've also been some of the hardest. Funny how it works that way.

I haven't been asking for much help lately for several reasons. One is that I've been feeling good most of the time, so asking for help feels strange. Another is that as long as I don't ask for help I can tell myself how well I'm doing and then that's not so depressing. And yet another is that even with the Helping Hands website up to make it easy, I still don't find it easy. I'll work on that.

In the meantime, we're going on a vacation in about 10 days to San Francisco, and I'm really looking forward to that. We're going to spend Labor Day weekend on a nearby island with old friends,  I've got a weekend lined up in September with my two BFFs from college, and time with sisters-in-law here right after that. It's always good to have fun stuff on the calendar!

I hope you are having a wonderful summer, and I'll keep you posted.

New Chemo Again Today

Time for navelbine today, the lastest (and greatest? I'm ready for something like that) chemo drug I can cross off my bucket list. Were I to have a bucket list of chemo drugs, that is, instead of European countries or types of chocoate dessert...

Navelbine is given through my chest port at the medical center, and it's a "push", meaning the nurse spends about 6 minutes holding the medicine in a syringe and slowly pushing it into my line. Easy peasy. I also had a 30 minute Herceptin infusion today, so it was a much shorter and less eventful trip to the medical center than 3 weeks ago.

Some people have asked me about the allergic reaction to Doxil I had. Immediately I had trouble breathing, my face swelled up and I had back pain. The nurses came right away, and the benadryl and pain medication kicked in and I was back to normal in a few minutes (though loopy as hell for the rest of the day).

I forgot to write with the results of my bone scan. Thankfully that didn't turn up any new surprises. So I still "just" have the two spots of cancer in my spine and left hip that the abdominal CT scan turned up last month.

I have no pain or side effects from the cancer - all the side effects I've experienced so far are just from the treatments. And right now I don't have any side effects from the treatments besides maybe a little fatigue (who knows?) So I'm in a good place.

Assuming I tolerate this plan OK, my oncologist thinks we'll do another scan after three rounds of it (that's in about 8-9 weeks).

In the meantime I've got plenty else to do and think about. Work has picked up more lately, the girls have dance performance dress rehearsals and shows this week, Father's Day is coming up and C's 13th birthday is the 20th, the day after the last day of school.

New Chemo Today

Quick update using my phone app to write this.

I was scheduled for a new chemo regimen today - herceptin (have had this before) plus Doxil (aka liposomal doxorubicin). Earlier I posted that I was going to do Navelbine, but my doctor and I decided Friday to go with Doxil first.

I had a severe allergic reaction to the Doxil so that was abruptly discontinued. Thanks to Benadryl and a pain med the reaction was quickly managed, and I'm totally fine.

That was really freaky and not fun. But the nurses were completely on top of it and an oncologist came over right away, so I was in good hands.

Tomorrow I'll have an appointment with my oncologist to see what the next step is.

I had my first Zometa infusion today, and that will be every 4 weeks. This is a medication that prevents calcium loss and keeps bones stronger. Ironically it can cause bone, joint and muscle pain. 

On Saturday I began taking Femara, a medication that suppresses estrogen. That goes along with my monthly "hey you're now post-menopausal" injections. So far I've done very well with those - no big deal.

So that's the latest from Great Aunt Edna, who has trapped you again at the buffet table to go on about her health problems!

I had a wonderful weekend with my best friends from college and a great family dinner last night at B's brother and sister-in-law's house. The weather is good, I've got a good book going, and am free to go take a nap now.

Time for a New Plan

Just when I was getting used to Tykerb and Xeloda, I need to switch to another plan.

I learned today that the CT scan shows the cancer is getting bigger in the liver, and unfortunately there are now two spots on my spinal column in the bone. They are very small and are not causing me any pain. But of course this is not the news I wanted to hear.

I'm to go off the current chemo pills starting now, and next Friday, May 16 I'm going to go on Herceptin (which I've had before and is easy) and Navelbine, which is supposed to be generally well tolerated. I'll have infusions weekly for two weeks, then off for a week. Looks probable that I'll keep my hair.

I'll also get an infusion of Zometa every three weeks, which is a support medication to decrease complications caused by bone metastasis.

So even though Tykerb and Xeloda didn't work for me, it doesn't mean that Herceptin and Navelbine won't either. Everyone is different, so we just try different plans and see what works. There are more options available after this, too.

Now on to the weekend, Mother's Day, my birthday, and all that good stuff.

Healing the Whole Self

At the Conservatory

I've got a lot to say today, but let's start with the facts.
  

Medical Update

I'm in the middle of the 3rd round of the "new" chemo plan, and I feel pretty good most of the time. There isn't a pattern of symptoms and side effects that is consistent from one round to the next, but I feel good that I'm tolerating this well and no longer feel anxious wondering if it's going to be really awful. It's so far very doable for me, although more taxing than the last regimen I was on from late September - mid-March. Each round is three weeks long.

I developed a problem with my feet (due to one of the chemo medications) in the middle of the 2nd round, so discontinued that drug for a while until my feet got back to normal. I went back on the drug at the start of the 3rd round, and we'll play around with the dosage if I develop that problem again.

This Friday, May 9 I have an abdominal CT scan to check on my liver and see what's going on. This is a standard scan that has been planned for a while. Of course I'm hoping there will be some positive progress since the last scan. I'm not sure if I'll have results later that day or on Monday.

The last tumor marker checks were done on April 25 (there are two that are checked in my case), and one was unchanged since the last check and the other one was elevated. There's no way to interpret what's really going on from those checks - the scan will give us the key information.

Last week I had the first of however many monthly injections I'm going to have of a drug called Zoladex (where DO they come up with these names?) which will put me in "medical" menopause. We're doing this so that I can take yet another drug, an estrogen suppressor for post-menopausal women. Since estrogen is a fuel for this cancer, we're gong to cut off the supply. (I was on tamoxifen last year, an estrogen suppressor for pre-menopausal women, but that was not effective for me). So far I'm doing fine with the Zoladex. Hot flashes, mood swings, etc. are common with this drug, so we'll see how it goes.

Wow, after typing all that I feel like one of those old ladies who has trapped you at a family reunion and is going on and on about all her ailments. But I hear from many of you that you're interested to know what's going on, so there you go!

Lilacs from Our Yard

Healing

Thankfully there's a lot more going on in my life than going to oncology and scan appointments. I'm still working part-time, I drive the kids around, we went to the Oregon Coast for a few days during spring break, I see friends, do dishes, walk the dog and everything else that people do just living their lives.

However, healing and staying healthy and strong do take up a chunk of my time and attention. As B put it a few weeks ago to me, healing is one of my jobs. I am still working on giving it the priority attention it deserves daily, but I'm doing a lot to support my immune system all the same.

Just spending time thinking about other things other than my health is a very healing experience, as is being with and helping other people.

I haven't written much about all of the complementary care that I'm getting, but it's a huge part of my experience. I want to share a little bit about it because I've learned a lot over the last couple of years about what's available and what's helpful, and you might know someone who could benefit from some of these disciplines and practices (they don't have to have cancer).

Acupuncture

I've been receiving acupuncture on a very regular basis since I went through the first chemo in the summer of 2012, and I am big believer in its power and efficacy. In a nutshell it helps my entire system have the energy it needs. The practitioner I see is absolutely wonderful, and it helps body, mind and spirit.

There are different styles of acupuncture - I happen to go to someone trained in the "Classical Five Element" style.

At the Conservatory

Naturopathic Oncology

Living in the Pacific Northwest, there is no shortage of integrative/alternative healthcare. Some of it is quite woo-woo (which I am not opposed to - whatever doesn't hurt might help, who knows) and some of it is quite grounded in science that traditional medicine has accepted or is accepting more and more.

I see a naturopathic oncologist periodically who is familiar with all of the traditional cancer treatments and recommends things I can do and supplements I can take that will support my immune system. The body is incredible at healing itself, but ironically chemotherapy takes a whack at the immune system as it destroys cancer cells. So I need some extra support.

Counseling

I've found seeing a therapist to be essential to getting through this experience without going completely insane. 

Yep, Conservatory Again

Mindfulness Meditation

Another sanity saver. I can't say enough about the effectiveness of mindfulness practices, especially meditation. If you have a lot of stress, pain, anxiety or chronic illness, or just happen to be alive, mindfulness can help you get through it a lot easier.

I'm taking a class on Mindfulness-Based Stress Reduction (MBSR), which is an 8-week program developed by Dr. Jon Kabat-Zinn in the 80's. It's taught in hospitals, clinics and other settings across the country.

In this same vein is guided imagery. I listen to guided imagery on my iPod many nights to help me get to sleep and in the middle of the night if I wake up and my mind is racing. Basically it gives my mind something to focus on that is relaxing and helps my body to relax as well.

There are many CDs/digital downloads available to choose from. Note from experience: I've found it's good to get a preview of the person's voice before you buy!  

Qi Gong and Tai Chi

I'm fortunate to live in a city that not only has state-of-the-art healthcare within 20 minutes of my house (which I have access to because I'm fortunate to have health insurance) but also many free programs for cancer patients and their families through organizations such as Gilda's Club (as in Gilda Radner) and Cancer Lifeline (which is an organization just in my city).

One of the free classes I've taken is on qi gong and tai chi, which are both mindfulness practices and light exercise. Like acupuncture, they've been around for thousands of years. There are many different forms, and the forms I'm learning are medical/meditative rather than martial.

I could go on and on about how beneficial I find these practices to be and how much I've learned about the body and the mind by attending the classes and practicing at home. They're not just for elderly Chinese in the park!

Oregon Coast

Massage and Physical Therapy

I sought physical therapy after my surgery two years ago to help with some range of motion and scar tissue stuff, and it was also helpful for that after I completed radiation. Physical therapists understand how connected everything is in the body in a way that few practitioners I have visited seem to do.

Massage feels good. So sometimes I get a massage. I'm sure it's got a wealth of actual health benefits, but even if it doesn't, I don't care. And my visits are partially covered by insurance.

Hypnotherapy/Suggestion Therapy

I've dabbled with this, and found it useful. If you want to know more, just contact me.

Energy Work, EFT,  and Other Things Off the Beaten Path

I've also dabbled a bit in healing modalities that are more "out there" and am happy to talk with any of you about them if you want to know more.

Books

I like to read books to gather information. Sometimes I can overdo it and overwhelm myself with other people's ideas and kind of lose my own way. But I've found some books that have really helped me with making my way through having a chronic illness. One of the best is Jon Kabat-Zinn's Full Catastrophe Living. That's where I heard about mindfulness-based stress reduction.

Nico Having a Stressful Day

 The Basics

So many other things are helping me heal and thrive. Beauty, nature, music, reading, kids, movies. Just having a good time. Relaxing, hugging people, meeting friends for coffee or a book group. Ridiculously cute dog videos on YouTube that people send me. A date with  B. Celebrating birthdays and other milestones. Having the cat snuggle with me. Road trips, the beach, planning fun things ahead. Inspiring messages and people at my church. Walking three blocks from my house to an incredible city view by the lake. Watching M play water polo or watching C dance. I have an abundance of wonderful in my life.

At the heart of healing are the basic essentials - enough rest, good food, regular exercise - and most especially, love. I am surrounded by love daily.

Even at my low points of feeling afraid, anxious. lonely, isolated - those human experiences that are so challenging - I know that I am surrounded by the love of family and friends, near and far. The acts of love - giving, receiving, caring, listening, sharing, holding, accepting, witnessing, supporting - are incredibly healing and give me the strength to push on and savor all the good that is life.

Quick Update

I've been on the new chemo program for a little over a week, and it's going alright. I haven't experienced serious side effects or anything too difficult.

I'm getting in the routine of taking the three sets of pills when and how I'm supposed to (some are before a meal, after a meal, etc.) Of course I've got an app for that.

I don't feel in full swing, but I didn't really expect I would at this point. One day at a time.

Change in Plan

Early Spring at the Conservatory

Well, it was nice while it lasted, the months of no medical drama.

At my last tumor markers check, the numbers were a bit elevated, which prompted a CT scan in early March, which showed that the liver mets are increasing in size again.

So I need to switch to a different chemo plan. Thankfully there are several to choose from. Two oncologists reviewed my case and both recommend the same plan. It's two different drugs, lapatinib (aka Tykerb) and capecitibine (aka Xeloda), for those of you playing at home.

Both of these drugs are pills I take orally at home. I started them yesterday, and so far so good. I'll stay on this plan for as long as it's effective against the cancer and I can tolerate it.

There's a plethora of unpleasant side effects that I could get, but I just have to go through a cycle or two to find out which of them, if any, will bother me. So I'm trying to be prepared without being obsessed, with varying degrees of success. (It does seem likely I'll be keeping my hair!)

I think there's another tumor marker check in 3-6 weeks, and we'll learn if this chemo is doing some good against the cancer.

This is a setback, and the last couple of weeks I've been on an emotional roller coaster. I've been on this same roller coaster a few times now, and many of the dips and flips are familiar. But unfortunately, just because I remember how scary the ride is, doesn't mean I get a free pass to skip it.

Being an experienced rider,  I've got a number of strategies to help me get through. Here are two of the most important ones:

1. Be Here Now

2. Lean on Family and Friends

After the CT scan about 10 days ago, B and I walked through the Conservatory. I'm not sure I'd been there in March before. Such loveliness!

It always makes me feel better to walk through there. Considering at home we have a total of two scraggly houseplants and a yard that is in constant need of attention, I find it a little surprising.

I've never cared for gardening and know very little about it. But I feel the Conservatory, with its fascinating collection of artfully arranged trees, plants and flowers that change seasonally is an oasis of calming beauty in the middle of stress and strife.

As I move into the new chemo plan we'll update the "Lotsa Helping Hands" website as needed with requests for help.

I'm still working - fortunately I'm in control of my hours and who I take on as clients - and am leaving room for adjusting to this new plan.

In the meantime, I love seeing you and hearing from you. Thank you for sticking with me during the ups and downs.

Doing Very Well

So the latest news is that there really isn't any news. I'm continuing to do very well. Except for feeling more tired than usual at times, I feel like my regular self. Most of the time I go about my business and don't give cancer much thought. I'm not in pain, my stomach feels fine, and my hair is growing. My liver continues to function normally. I'm working, I'm exercising, I'm nagging the kids - it's all pretty normal stuff.

Some things have shifted. Small pleasures seem bigger than they used to. Life has more Technicolor, poignancy and intensity. I feel grateful for how much abundance I enjoy.

But I'm also in the soup of mundane, day-to-day living. I'm running out of bread and taking pets to the vet. I'm behind with email and am putting off a hundred boring projects, just like everybody else.

Right now I think of the cancer as a chronic condition that needs to be attended to. This is the most helpful way I've found to frame it, especially since I feel as good physically as I do. It doesn't define me, and it doesn't need my constant attention.

Of course it has changed my life forever and can feel very heavy and burdensome at times. But I've got a lot going for me right now and am just trying to focus on and enjoy that.

The Treatment Plan

Today I had my 6th round of this chemo drug (Kadcyla). Since it's working and I'm tolerating it well, I'll continue getting it every three weeks.

I'll have another CT scan to check on things in May. (November's scan showed 50% shrinkage of the tumors.) In the meantime I'll continue to have a couple of tumor markers checked (via blood draw) every three weeks. Those measurements give clues about how well the cancer is responding to treatment.

In a couple of months my doctor and I will talk about starting me on an aromatase inhibitor, which is a type of drug for post-menopausal women that lowers estrogen levels in the body and is used for treating advanced breast cancer. Since I'm pre-menopausal I would need to receive injections that put me into menopause. I'm sure that will be tons o' fun.

I hope the start of 2014 has been good for you. As always, I love to hear what you're up to.

Good News

More beauty from the Conservatory

It's about time for some good news. And I received it today: The CT scan I had yesterday showed that all the tumors in my liver are shrinking. Yay!

So this means the chemo is doing some good and I can stay on it. Since I'm managing this drug really well, that's another reason I'm so relieved today - I don't have to switch to something different.

So woo hoo - time for some champagne tonight!

Bring on the holidays. I'm ready to celebrate.

Costa Rica and My Fuzzy Memory

At the Conservatory

I had my 2nd chemo infusion a week ago, and it went without a hitch. Just about the only side effect I'm noticing is fatigue, and that's manageable (if I prioritize managing it!)

The fatigue isn't constant and it's not predictable. Well, if I have a short night then I can predict a lot of fatigue the next day. But what else is new?

Perhaps because I'm tired more often or because I'm 46 or distracted or stressed or on chemo or just not very good at remembering things in the first place, I'm having a lot more "senior moments". I suppose those were bound to happen eventually, but they're a little disconcerting.

Like many women (and one or two men), I like talking to a lot of different people, and over time exchanging quite a bit of information, big and small, about our lives. I have a large repository of facts and stories about other people's lives, such as their kids' ages and schools, the health conditions of their aging parents, what movies they've seen, where they went on vacation this year, whether they're allergic to red wine, the latest drama with their brother-in-law, what their work hours are, and so on.

I've never been the greatest at remembering all these details, but now I'm extra slow at recalling them and have to be told some things several times. Case in point, Costa Rica.

I know a couple of families who've traveled to Costa Rica in the last year. The other day someone (of course I can't quite remember who!) was telling me that they were thinking of going to Costa Rica, and I thought, Wait, didn't you go to Costa Rica last year? No, that was someone else. Who else was I thinking of who has been at Christmas? Or was that spring break? Wasn't _________  just talking to me about this? Um, what was it we were talking about?

Suddenly I was in Fuzzy Town.

It's not a big deal, but it's different for me. So I apologize if you have to tell me something three times or I can't remember what you're doing for Thanksgiving. I do care! I'm just in a bit of a fog. So far I haven't mixed any clients up with one another, and I can occasionally make it through telling a story without losing my train of thought, so all is not lost.  

Team Heather

Several people have asked me about the Lotsa Helping Hands online group, Team Heather, and whether I'm posting much in there and how they will find out what we need.

We've only posted a few requests (all of them filled, thank you!) and we've learned that after we add a request to the calendar we need to send out an announcement through that site telling you that there's a new request (or set of requests).

So if you haven't gotten an email from "Lotsa" lately, it's because we haven't posted any requests lately. I'm still working on deciding what to ask for directly, through the online site or just do myself.

The hardest things to ask for are the things I need at the last minute because I realize I've run out of steam. Hey, I'm not in a coma, so surely I can do this myself and not bother other busy people! I know, I've got a ways to go -  I really will get this asking-for-help thing down soon.

I have a couple of friends who've told me, "Call anytime, even if you need something weird". My goal for the week is to do just that.

Team Heather

Yeah, I know the name is corny. But it beats "Heather's Homies" and "Heather's Honchos", two stellar ideas contributed by B. and M. for what to name the online group we set up through Lotsa Helping Hands.

So Team Heather it is. If you're in our city and want to know about meals, rides, and whatever else we think of that would be helpful, you can go to https://www.lotsahelpinghands.com/c/710014/ and request to join the community. Then after you're "approved" you'll receive instructions on how to sign in.

You can check the calendar on the website showing what we're asking for and sign up for anything that works for you.

I'm glad to have learned about this website because I think it will make it easy to ask for support, even with little notice, without feeling like we're putting anyone on the spot. (I won't hesitate to go ahead and put family and close friends on the spot, however!)

If you know someone who might be interested in helping out sometime, please feel free to share the above link. I don't think I can have too many people in this group - the more the merrier.

How I'm Doing

I continue to do very well after the first chemo treatment. It's been wonderfully uneventful. Also the trip that B. and I took a week or so ago was incredibly relaxing and a true vacation. You parents especially understand the difference between a vacation and a family trip. This was a vacation!

Not going to the medical center in the past two weeks has certainly helped me get back into "regular" life and feel less like a full-time patient with a really depressing diagnosis.

So I'm savoring the good times and moving through this, step at a time.