The Manogram

Hello again,
So, here's 2 cartoons one of our students (Courtney again) found . . . both based on the mammogram. Fun, huh? I'll try to get a joke and another picture or two tomorrow (but don't hold your breath!).

I spent today running some errands - one in particular was to gather all of my son's pictures with Santa and put them into frames. Most of the pictures I had were 5x7 or 8x10 so I asked my brother Scott to scan them so I could print out 4x6's for the picture frames. Boy, there's now 8 pictures of him from 2000 to 2007! It was fun to go back over the older pictures of him as a baby/toddler. This is a project I've been meaning to do for a couple of years now! Whew! Does anyone else have lists of stuff they've been meaning to do but they always get put on the back burner. Sigh . . . I guess that's life.

Happy New Year!
Dee

Some boob humor

Happy New Year!
So, I promised almost two months ago now (sheesh! where has the time gone?) that I would post some of the jokes and photos from my Boob Ball. First, I'll see if I can post a couple of the photos . . .

The first photo was a salmon spread with a candy on top made by friend and colleague Sandy Tsuneyoshi and the next picture shows these little cucumber shells with a crab filling and topped with ?? (can't remember now), made by the boyfriend of Courtney Everson, Dale. The next one is a picture of a boob cake made by one of my friends and colleagues, Alison Davis-Whiteeyes. This entry won first prize in the "boob food" category at my Boob Ball, as voted on by the other folks at my party. All of them were edible and the cucumber/crab one was delicious! There's a couple more I'll post, too.

Anyway, tomorrow, I will work on uploading some of the cartoons - just tried, but something went haywire. And, if I have some of the jokes on file here, I will post them, too.
Take care and Happy New Year!
Dee

Happy Holidays!

Hi everyone,
I haven't posted in about a week and I just wanted to tell everyone that I'm doing okay and in good spirits, especially now that I've made a decision about treatment. I talked to Dr. Kenyon the other day and we more or less decided that I would start Herceptin soon after January 7, 2008. I'll have a year of injections, given every three weeks. At some point, when I get my permanent implants, I'll have my ovaries removed and until then, I may be given a monthly injection to stop my ovarian function temporarily.

I've spent this week in Christmas preparations - my mom, my sister and her kids, and Eddie and I made 8 1/2 dozen cookies on Sunday, I finished my shopping on Monday, and then Wednesday, I spent all day wrapping presents while watching Heroes on DVD (I bought the first season for Scott and I to watch). On Tuesday, I went up to Portland and met with my colleagues, Tom Thornton and Arthur Mason, to talk about a project in which we study the affects of ANCSA (the Alaska Native Claims Settlement Act) on Alaska Native cultures and their political force in the state of Alaska. Tom and I had submitted a proposal last year to NSF that was funded - Arthur is interested in it so we had a conversation about how he might be involved also. It was a good conversation, which was augmented by the fact that it took place in Powell's, surrounded by books!

Anyway, have a great holiday! I wish you all the best and thank you so much for reading the blog and sending me your support. I do appreciate and am looking forward to a good holiday!
Love, Dee

Pump Up the Jam & A Second Opinion

Hello everyone,
On Monday, I had my first expansion appointment. It was interesting - Dr. Havard first injected some lidocaine and then injected 50 cc's of saline into the temporary tissue expanders. For those of you who don't know, these "tissue expanders" were placed under my pec muscles, but high on my chest, maybe only a couple of inches below my collar bone. They were not placed in the normal area for breasts because that area is still healing after the mastectomy and they didn't want the scar tissue to adhere to these tissue expanders. Then, when it's time to insert the permanent implants, they will "release the muscle" and the new implants will be in the normal place. I also found out that it takes about 450 cc's to get up to a "B" cup - that's nine injections! And, because Havard has a couple of vacations planned in December and January, that means that my expansion appointments will go into at least March. By then, the nurse said that it'll probably look like I have a chin rest!

I had my appointment with Dr. Luoh at OHSU yesterday. And, ironically, while he still really stressed that I should have chemo, what he had to say made me even more sure of my decision NOT to do chemo. First, he feels that this cancer is actually a new cancer and this is a good thing - apparently, the prognosis for "new" cancer is better than a recurrence of an old one. He said that if it was a recurrence, there's a greater chance for a "distant relapse" or metastasis to another part of my body. The chance is less for a new cancer. I also asked him what he thought my chance for a distant relapse was. He estimated 50% (whereas Kenyon thought it was 80%). Herceptin cuts that down to about 25%, ovary removal plus aromatase inhibitors puts it down to about 15% and chemo only gives me about another 5-7%. One of my colleagues, Melissa Cheyney, pointed out that a normal woman on the street has a 12.5% chance of developing breast cancer in her lifetime. Which basically means that by doing Herceptin and the ovary removal/aromatase inhibitors, I'm near the "normal" category, without chemo! So, in terms of quality of life, both short- and long-term, I will refuse chemo. The risks outweigh the benefits. Dr. Luoh kept stressing that he felt it was an early stage breast cancer and he usually wants to treat such cancers very aggressively, and especially since I'm young and relatively healthy, he thought I could handle the side effects. But having gone through those side effects before (while the nausea won't be as bad, I would suffer from new side effects like neuropathy - I'd lose some feeling in my fingers, hands, and feet), I have no desire to repeat them. And, as I said before, I think I am still dealing with fatigue from the first time around - why would I want to add to it?

Well, I'm going to sign off. I had a busy day yesterday - not only was I in Portland all day, but yesterday evening, my department chair hosted a celebratory dinner for one of my colleagues, which was fun, but I didn't get home 'til almost 10pm, which is about an hour later than I usually get to bed! I'm tired - yawning as I type! Take care and thank you again to everyone who brought meals!
Love,
Dee

The Mines of Moria

So, I've been reading this book by Bernie Siegel entitled "Love, Medicine, and Miracles". He talks a lot about how survivors of major illnesses tend to be those people who are more positive and at peace with themselves. Among some of the other suggestions he gives to become more positive is one where he asks patients to draw themselves, their disease, and their treatment. This would give the patient and hopefully the doctor some idea of the mental state of the patient and what they really think about their treatment options. I didn't actually draw anything, but I thought about what I might draw. I couldn't come up with anything for awhile, until I remembered an earlier post I had on this blog. It was about Gandalf sitting before two different doors in the Mines of Moria. (Okay, only Lord of the Rings fans will get all of this, but the more I think about it, this image really is resonating with me.) I felt that I was at a crossroads and needed to decide which door I should go through, like Gandalf.

What is interesting about that image is that both paths lead through darkness and that was what I was feeling this week. In the path they end up taking, Gandalf seemingly dies and is lost to the rest of the group for awhile, but the rest of the group makes it out to the realm of Lothlorien where they are able to heal for awhile before continuing on their journey. In a way, my own path seems like that – a path through darkness (i.e., more treatments), suffering a loss (i.e., the idea that I would have a normal life after surgery – which I now realize won’t happen), but making it to a place where I can heal and enjoy some level of peace (i.e., I’ll be okay in the end). The fun thing is that while Gandalf is lost to the group for awhile, he does end up returning in the end, which means, I think, that I will eventually enjoy a “normal” life. Now, how is that for a psychoanalysis of myself!

I have more or less decided on what I will do. In addition to the tissue expansion, I will go through with the Herceptin treatments (weekly injections for a year, although sometimes, they switch to every three weeks), having my ovaries removed and going on aromatase inhibitors. I found another woman's blog (the assertive cancer patient) about dealing with breast cancer and she said something like, "I love Herceptin! It doesn't have any side effects." Her own cancer has metastasized to other parts of her body, and she's been taking Herceptin for five years. Also, my concerns about heart damage were allayed somewhat because I found that those who tend to have heart damage are much older, perhaps in their late 50s/60s. Prior to treatment, they will check your heart function and then monitor it over the course of treatment. I found some information on side effects of aromatase inhibitors - holy crap! They include: some nausea or dizziness, hair loss, achey joints and bone pain, and fatigue. But generally only about 25% of patients feel those side effects. (I met Roy Arnold - retired provosot at OSU who also had breast cancer - a few weeks ago and he is on Femara, I think. He seemed to be doing fine.) Another point that Bernie Siegel makes is that if patients think they will have side effects, they will. Those who believe that the treatment will work and, further, they believe they will not have side effects, don't tend to have them. My plan, then, is to learn how to meditate better (another thing Bernie Siegel suggests) and start adjusting my thinking about both Herceptin and the aromatase inhibitors and see them more in a positive light rather than dreading the negative effects. That way, I will feel that I'm doing everything I can to keep the cancer from spreading anywhere else.

I am, however, going to refuse the chemotherapy. I don't think there is any kind of mind adjustment I can make there. My body and mind remember too viscerally how I did the first time and I don't think any amount of meditation will help erase that memory. And, to some extent, I think I am still dealing with the effects of chemo from the first time. I have been fatigued for quite awhile, and while other stress certainly compounds that, I think those other chemicals are still there somewhere.

Okay, there's another book to read . . . again, everyone, I appreciate your support and you reading this blog.
Deanna

A hard week

If I were to characterize how I felt prior to surgery, I would say that I was doing okay (as many of you noted) with periods of anxiety. Post-surgery, especially in the last week, I would have to say I have depression. It's taken me a few days to first identify it and then figure out why. Mostly, I'm depressed because: 1) I had envisioned what my next steps would be, but the fact that cancer was throughout the breast tissue means that my prior plan no longer applies; instead, I have to figure out what I will do, particularly in terms of making difficult choices like suffering from both long and short-term side effects (e.g., with chemo, I may have nausea, hair loss, and nerve damage in the short term and it might contribute to my long-term fatigue) or making sure I do what I can to be sure I'm around for a long time; 2) I don't like not having a plan in place - it's depressing - I hate being in limbo and at the moment, I am because I'm in an information-gathering mode and some of the info I need needs to come from doctors' opinons about my risk of recurrence or metastases and I won't know that info until next week; 3) I also realized that my treatments will probably extend through the next year and where surgery seemed the hardest part, now I'm pretty sure that I'm facing a year of Herceptin injections; basically, the light that was at the end of the tunnel has disappeared; 4) I also had to set aside some of my information-gathering activities to work on some NSF proposal reviews; the pressure to finish them combined with my frustration over being distracted from what I really want and need to do made me miserable; and 5) I'm not able to spend as much time with Scott as I might like and there are times when we can't even talk on the phone, so I end up taking it out on Scott, getting mad at him and pressuring him to do more than he really can. Ultimately, Scott has received the brunt of all of this and I want to apologize to him for that. And, oh yeah, a couple of days ago, I found myself looking at people walking around town or on campus and I thought, "these people don't realize how lucky they are because they don't have to worry about cancer and making choices about treatment"; I found myself resenting others for living "normal" lives.

Scott sorta suggested yesterday that it would be good for me to have some distractions. I resisted that idea because I felt I really needed to focus on treatment decisions. However, today, I think that he was ultimately right. I participated in a four-hour teleconference today related to those NSF proposal reviews and oddly enough, instead of resenting the distraction, I enjoyed talking to the rest of the panel about these proposed research projects. Some of them were quite exciting. Anyway, it helped me to change my outlook and reorient my thinking from victim to active participant.

I also had dinner last night with my colleague, Janet Lee. We went to Evergreen - yummy! We chatted about a lot of stuff, but mostly about my treatment options. She helped me to reaffirm my decision not to do chemo (also bolstered by a conversation with another colleague, Melissa Cheyney). In addition, she reminded me that while other people around us seem normal, we have no idea what sorts of things they are dealing with and then Janet told me about a neighbor of hers who died while driving home on Hwy. 99W - a trailer disengaged from a vehicle going the other way and killed her on impact. This woman, apparently, had three kids. So, it helped me to realize that things could be worse.

I also got to thinking earlier today that from the time I was diagnosed to surgery, I never really felt depressed; scared and anxious, but I never felt depressed or felt grief. A lot of you said that you would've probably been depressed given the news of a recurrent cancer and were amazed that I didn't feel that at all. Well, this past week has been my time for feeling depressed. However, I think I'm coming out of it all.

Other than that, no new news in terms of treatment decisions.

However, I do want to say thank you to a lot of people: for meals, I need to thank Sunil Khanna, Court Smith, David McMurray, Karen Mills, Bryan and Jenna Tilt, Loren Davis, Dave and Nehani Brauner, and Janet Lee. I have more meals coming up, from Melissa Cheyney, Joan Gross, Donna Champeau, Irene Rolston, and Sunil again. I also need to thank my parents and Scott for helping me with things around the house - housework, putting up the Christmas tree, etc. Also, I've received music from Mary Braun, Paula Long, and Greg Hyatt. I received orchids FedExed from Hawaii from Diane, Greg, and Jasmine Hammerstad. Greg Hyatt and Susanna Love sent me a book of essays by Carl Sagan. Paula Long also sent Sudoku puzzles. Linda Howard bought me a book by Bernie Siegel. Parcella Provence loaned me some other books by Bernie Siegel. Tammy Webb gave me a teddy bear that has a microwavable warmer inside it. I'm sure that I've forgotten some things . . . perhaps next week, I will be able to get out some thank you cards. So, for now, I hope that this post suffices to communicate how thankful I am for your generosity. Being surrounded by good food, gifts, flowers, and plants does help remind me how fortunate I am. So, thank you!