Sunday, November 29, 2009

The far so good

I guess I've been sounding grumpy in my blog postings of late (Chris informs me of this--he says I'm dangerously close to the "hey kids get off my lawn" old person except we have no lawn). Yeah, there's a reason for that (hint: I am grumpy). But I will say, the holidays have officially started and so good. Of course, it helps tremendously that I don't really have to deal with them at all this year. Chris and I are off to Hawaii in 16 days, 11 hours and oh, call it seven or eight minutes. That's a whole heck of a lot better than this time last year.

Around this time a year ago I had felt "the lump." Chris had felt "the lump". Although then we were in the "it's not really a lump--it's more of just a thickening" stage. And I was in the "I don't really have time to get to the doctor and sit around for an hour or so waiting for my appointment" stage (my primary care physician is never, but never, on schedule). Eventually I got to the doctor and we all know what happened next.

My what a difference a year makes. I may have been not-horrified to hear Christmas carols recently. It's possible the commercials that already say "last minute shopping deals" aren't bothering me. I'm not throwing things at the television when sappy holiday movies are advertised.  I'm still not at the "I'm looking forward to Christmas" stage. Heck, I'm not even at the "I acknowledge that it's Christmas" stage. I'm at the "I'm so excited all this stuff is 'not applicable'" stage (also, I'm thinking I would like being Jewish right about now every year). But, I am acknowledging that Jimmy Buffett's birthday is coming up and I'm really, really looking forward to celebrating that on a beach with a mai tai and Chris and not a care in the world (I can barely type that without thinking I'm jinxing myself, such is my fear of this time of year; knocking on all sorts of wood).

Oh and the photo, that's Chris and I with our friends Sheena Meder, Roryann Clements, Barb Abel and Ronaldo Fierro after we closed down the wine bar at Mission Inn post-private party at Bistro O at Omakase for the Festival of Lights Friday night. I'm not going to say it was a holiday celebration, I'm just going to tell you we had a great night.

So far, so good.

PS. My next post will be my 200th post. Wow. Yeah, that's quite a year. Thanks for hanging in there with me.

Monday, November 23, 2009

Talking Task Force

I feel the need to comment on the US Preventive Services Task Force report on mammograms that was released last week. The report essentially said that most women don't need mammograms until age 50 and then only every other year. Since I was 45 when diagnosed with breast cancer, several folks emailed me about the report and even more asked me how I feel about it. And well, I have to say, I kind of get what they are saying. In the sense that I understand. There is a way in which I agree as well.

Because here's the thing-- It wasn't a mammogram that caught my cancer early. It was me. It was a self-exam. I had my regular annual mammogram in July of 2008 and no cancer was visible. It was there, it just wasn't large enough to be picked up by the mammogram. By November (yep, 4 months later) it was large enough to be felt by me so I went to the doctor. Another mammogram was ordered, along with an ultrasound. That's when the cancer was diagnosed. But there's a big difference between the first and the second mammogram. The first mammogram is a screening mammogram--and that's the one they are saying I could have done without. And they're right--it was not of any use in catching my cancer. What was of use was the self exam. Based on that and the doctor's exam a diagnostic mammogram was ordered, and that's a mammogram that is different from what the task force is discussing. The task force isn't saying no mammograms until after 50. They are saying that in most cases it's not necessary. If there is a reason for a mammogram before age 50 (a lump is felt; family history; higher risk) then of course the doctors should order the mammogram.

This seems reasonable to me, on one hand. There are risks associated with the mammogram and if those can be avoided (not to mention that it's a really uncomfortable experience!), then so be it. And I do understand that there is a limited health care resource available. It comes down to the rationing of health care of course. Let's be clear--we are doing that now; it's like any other resource--there is only so much of it and choices have to be made as to where the resource can be spent. (Right now it seems we give any and all health care to those that can pay for it, and much less or none to those who can't.)  So if there is only so much that can be allocated to "breast cancer care" well, it makes more sense to allocate it to pay for the care of those that have been diagnosed and need treatment and cut back on screenings where it seems, according to the report, 1 life in 1,900 screenings would be saved (in women aged 40 to 49).

So that much I get. What I don't get is the discussion of self exams and women being stressed out or hysterical over possible breast cancer. First off, they can't stop us from doing self exams! That's a little ridiculous. And again, it was a self exam that allowed me to catch mine early (and even so, my cancer was at stage 1c--which means it skipped on aggressively through a and b in the four months since my July mammogram). No self exams and no mammograms for a woman in her 40s seems like saying "well if you get it in your 40s, just die." Makes no sense to me at all. Early detection is key. Of course you have to do your self exams! Just be realistic about it. Not everything you feel is cancer, but when you feel something unusual get it checked out and talk it over with your doctor. That's simple enough. Nothing to get hysterical about.

Oh, and the other thing I don't get? Why mammograms? Why is that what they were looking at? That doesn't seem like that expensive of a test. Since the US Preventive Services Task Force has such a broad, far-reaching name...I'm assuming we'll hear about some other procedures they're looking at for effectiveness as well. Right?

PS. I've still got the annoying cough. The positive thinking didn't work. And, I discovered yet another side effect of BC treatment. You know how sometimes when you cough so hard for so long your rib cage and stomach muscles start to hurt? Mine only hurt on the right side--the side that was radiated all summer. Hmmm. I guess it's been weakened.

Friday, November 20, 2009

Positive Thinking, I think

This has not been my year of good health. So, while I complain for a moment, bear in mind that you cannot say to me "at least you have your health." You can't say this because, well, this is a blog, but also if you were actually in earshot of me I would just give you "the look" that says "think about what you're saying and who you are saying it too." The look might also add "you twit" but that would depend on my feelings about you in general.

Allow me to whine (or, just, you know, close out the blog and don't read my whining). If you've been a careful reader you may have noted that I had breast cancer this year. (Really!) And then last month I had my first ever bladder infection (yes, I know, you're welcome; I share--it's what I do). And now, I've had that nasty cough, cold, sore throat bug thing that is not the swine flu (even though everyone wants to freak out that it is) for most of this week. And, sorry, but it kinda pissed me off. I think I've had my share of sick days this year, thank you very much. Now I feel like I'm going to become one of those people who catch everything that goes around-- pre BC I didn't really get sick very often at all. Pre-BC and stretching back to my early childhood I generally got sick once a year--usually around Halloween, which was just my elaborate ruse for getting out of trick or treating (I hate costumes and I dislike most candy--particularly chocolate; yes, you read that correctly). I don't have the time or patience to be a "sicky."

Sure, sure, my body has been through a lot this year and it's probably still in repair mode. Whatever. Health again, please. And the somewhat ironic thing is, I think I whined more about this cough sickness than I did during chemo. Chris can probably attest to that fact (see likely comment below). Like I said, I was pissed, I was not willing to admit I was sick (I did work at home on Wednesday but then on Thursday everyone in my office told me to go home. I think the mailman mentioned it too), and then when it was totally obvious I was indeed sick, I was a giant baby. But that got me thinking. I was wondering why I was a bigger wimp about my cough/cold than I was about chemo. And I had a little revelation.

I think I may have figured out that whole "keep a positive attitude" thing! When one gets diagnosed with breast cancer (or any other serious illness, I imagine) everyone says "just keep your positive attitude" or "stay positive" or some version of that. And I think most of the newly diagnosed think "what?" Okay, and me, I also think "we'll sure you're saying that--you don't want me breaking down and getting all crazy and sobbing on your watch because then you'd have to deal with that, so sure you want me to stay positive!!" And of course there is the "I can be all happy and giddy and downright perky and, um, I'm still going to have cancer" so what good does this staying positive thing do?  But here's the thing---as I went through all the slash, poison and burn stages of breast cancer treatment, for the most part it wasn't as bad as I was expecting so I pretty much thought, 'Huh, okay. I can do this." And I did.  I just marched on without spending too much time thinking about how awful it all was (okay, except to laugh at it in the blog; well, mostly laugh). I don't think I whined too much (see inevitable comments below from those in the know. ;-)  )  But now, this cough/ cold thing was totally unexpected and I wasn't prepared for it--so it was worse than I was expecting and I let that get to me. I didn't "stay positive." (um...I may have been feeling sorry for myself; I had a really shitty week last week and then got sick this week). Now that I get that whole "mind over matter" thing--I expect to be up and about and doing just fine tomorrow. Sure, I'm hacking up a lung, but it's all temporary. This too shall pass. All that happy, perky stuff.

Chris has escaped down to San Diego today and tomorrow for the Food & Wine Festival--I was too sick to go and he needed the break. That gives me 24 hours to perfect this "positive thinking" thing. Hey, I've done it before. Sort of.

Friday, November 13, 2009

Breast Cancer: Now What?

The Pink Ribbon Place (our new Breast Cancer Resource Center serving Riverside and San Bernardino Counties) hosted its first professionals panel entitled "Breast Cancer: Now What" this past Monday night. I was tasked with moderating the panel, but hey, they hardly needed me. The panel was comprised of the physicians a patient encounters in dealing with breast cancer: surgeon, anesthesiologist, oncologist, radiation oncologist, and plastic surgeon (breast reconstruction). In the first photo is the good and great Dr. Amer Karam (surgeon to the stars, or, er, to me...and many other lucky UCLA patients; but he treats us all like stars), Dr. Candice Ruby (onocologist), and Dr. Jean Sprengel (anesthesiologist and author of "Chemo Companion" which is a fantastically practical book that she wrote when she was helping her sister deal with stage III breast cancer).  In the next photo is Dr. Janet Hocko (radiation oncologist; and more specifically, my radiation oncologist!) on the far right, and Dr. Ben Childers (plastic surgeon) at the podium. (Oh, and I have no idea why I look so frightened in the photo, but yeah that's me to the left of Dr. Childers; okay, I'll admit it--I was just intimidated moderating all those doctors!).

There were 53 folks in attendance--most were breast cancer patients in various stages of treatment and their family members. We had a very lively question and answer period and we asked the audience to write their questions down and hand them in (to protect privacy) on index cards. We had more cards than we had time, but the doctors all hung out afterward and answered many questions from many inquiring minds. Significant, practical information was shared and each of the doctors was compassionate and very "human" in their responses and in how they took the time to explain complicated medical matters in terms a lay person could understand. Really, really impressive.

I think the whole Pink Ribbon Place advisory committee (we call ourselves the "BRA" committee--Breast Resource Advocates) was proud of what we put together. The doctors were all from various organizations (UCLA, Kaiser, Loma Linda University Medical Center, Vantage Oncology, etc.) and all gave freely and graciously of their time. Rosa Olaiz, the program director of The Pink Ribbon Place also secured a Spanish translator so we had several Spanish speaking breast cancer patients who were able to participate as well. Several folks made donations to cover the food and drinks; Captain Meredyth Meredith from Riverside Police Department secured the Community Room at RPD for the event. The whole evening was also videotaped (for free!) by Captive Audience productions and will become part of the library at The Pink Ribbon Place. And look at the "gift with attendance" that was put together by volunteers and handed out at the end:

Yeah, baby...that's chocolate!

The Pink Ribbon Place is going to make a big difference in our community and I'm really grateful and happy about that. When I can I will post a link to the video. Also, our "survivors" video is complete and we played it at the beginning of this panel. I'll link to that when it's available as well. It's too good not to share.

For now though, I'm going to enjoy the martini Chris just made me. Other than Monday night's event, this has been a really, really crappy week. Really.  But hey, here's to a good weekend. Cheers.

Tuesday, November 10, 2009

Before, During and After

I've gotten comfortable with my hair. I might even like it. I would never, ever in a million years have voluntarily cut my hair like this or become a brunette. And yet, I sort of like it. I'm not leaving it this short, and I may add a few (incredibly natural) highlights, but I am starting to look at shorter hair styles as the end goal instead of just wanting to get back to the same old same old long blonde hair.

Sunday I went to brunch with friends from junior high (oh, that terrible, mean, difficult junior high time!!). One of them (Hi, Tana!!) has a haircut sort of like mine (only hers is more stylish, because, well, she got to actually cut and style it that way). And that made me feel good; especially since she was the girl in junior high with the really long really gorgeous hair. She still looks gorgeous (and a lot taller!). There will be more on the brunch later, because of course, I have pictures.

Then, last night was the "Breast Cancer: Now What?" professionals panel that the Pink Ribbon Place put on. Over 40 women and men attended to hear our panel of doctors discuss breast cancer treatment and answer their questions (more on this later too; geez, I better start blogging more). I was the moderator so I was up at the podium and could see out over the audience. A roomful of women with hats, wigs, and scarves--all looking fantastic. It was a terrific event and I felt sort of oddly proud to be part of the group and I felt proud of "the battle." I realized again that the hair or lack thereof is the most and maybe only outward sign of this breast cancer battle. It's the only one I have still remaining (okay, two scars, but they're barely visible and only two of us ever see them). So maybe rather than thinking of the new hair as a scar or wound from the battle, I can think of it as a medal. I battled through breast cancer. I won. And the hair is well on it's way back.

Naturally, I have that journey in pictures:

December 26, 2008:

May 9, 2009:

And October 25, 2009:

And did I mention we're going to Hawaii in 35 days???! 2009 is looking better and better.

(P.S. Seamus is actually in all three of these photos--if you look closely at the last one you can see the very top of his head; it's just really hard to get a photo with Seamus actually facing the camera; especially the last two photos which we were taking ourselves. But he was there. He's part of the  kickin'  cancer's butt crew after all).

Thursday, November 5, 2009

Open House Awesomeness

So, we had the festive Open House celebration of the new breast cancer resource center "The Pink Ribbon Place" last week. Over 100 people showed up, toured the facility, chatted, admired the newly decorated office, and applauded and cheered wildly as the pink ribbon was cut. Oh, and speaking of "newly decorated"--Chris donated his furniture (couch, loveseat, coffee table, dining room table and chairs and a few other items) to the center and all he asked was that if I ever kick him out of the house he wants privileges to sleep on the couch at the center. They agreed. He's had the furniture in storage since he moved in 3 years ago. I'm thinking he'll enjoy saving the $80 a month for the storage unit. (And...there's no way I'm kicking him out, so ladies you can stop lining up!)

Anyway, in the first photo that's me holding one end of the ribbon; two people to the right of me is T.C. Bond, another Advisory committee member and then City Councilman Mike Gardner (whose wife is a breast cancer survivor), Rosa Olaiz, the director of The Pink Ribbon Place, and City Councilman Andy Melendrez. Mayor Ron Loveridge had stopped by earlier as well. The next photo is Chris being "pinked." Quite a nice event to launch a much needed resource center.

This Monday night (November 9th) we'll be presenting our first "professionals panel" which will feature 5 physicians who treat breast cancer patients--including the good and great (and also cute) Dr. Amer Karam (yep, trekking all the way in from Los Angeles for us again!) and my radiation oncologist Dr. Janet Hocko as well. We'll also have Dr. Ben Childers (plastic surgeon/ breast reconstruction specialist), Dr. Jean Sprengel (anesthesiologist and author of "Chemo Companion") and Dr. Candace Ruby (oncologist). They will each be talking about their role in the care of a breast cancer patient, what the patient can expect, what's new in treatment, as well as giving helpful tip and answering questions from our audience. The event will be held at the Riverside Police Department Community room.We're expecting around 50 breast cancer patients and family members.  How quickly, efficiently and fantastically the advisory committee was able to put this together has been truly amazing. And it's heartwarming to know these physicians were all willing to donate their time and energy. (If you're local and you want more details, please feel free to email me. We'd love to have you.)

Oh, and speaking of donating time and energy..... This photo is of Mike Easley of Vital Excess designs. He designed The Pink Ribbon Place logo, made the brochures, got 100 t-shirts made, business cards, bookmarks, and giant photo portraits for the walls of the center (he's the one who took my new post-chemo glamor shot!) all in a very, very short time period so it could all be available for the open house. Then he showed up and photographed that too!

Don't you just love it when awesomeness occurs?

Sunday, November 1, 2009

Top of My Class

You, my faithful readers, left me for a bit awhile back and it appears I've returned the favor. I'm like that.
Actually, I hadn't even realized I went over a week without blogging until I sat down tonight to write. And wow, so much to cover.

Let's start with the important news about "The Cancer." Or, to be precise, "The Cancer that no longer is." I had my first 3-month check-up last Wednesday. Chris and I trekked back to UCLA Medical Center and I have to say, it was odd being back. You'd think it would be fresh in my mind (I spent quite a bit of time there and was last there in July) but no. It felt like a long, long time ago I was there and I was even noticing things I'd never noticed before. Hmmm...ya think I was a little focused on the immediate task at hand previously? Yes, perhaps.

We met up with Dr. Glaspy for a quick exam and chat. Dr. Glaspy was the oncologist I originally consulted with, although I had the chemotherapy with Dr. B (and we all know what that stands for!). Since Dr. B didn't want to see me when I was in chemo, I figured she didn't want to see me for any sort of follow-up treatment and thus I returned to Dr. Glaspy's care. You may recall him from prior postings--he's the one who explained his role with a river boat gambler metaphor. Basically, it's his job to review the cards I'm holding (i.e. my pathology report) and let me know the best moves (i.e. chemo and radiation, in my case) and my odds of winning the hand (click here to read the posting about this). He's also the one who told me my hair would fall out "guaranteed." Both things were a little tough to hear in the beginning, but I came to appreciate his directness. In essence, the cards were dealt long ago and all I can do is play them the best way possible and then go on about my life. And when the time came for my hair to fall out, having the "guaranteed" voice in my head made it easier to just go ahead and shave my head without thinking "well what if I'm part of that 1% whose hair doesn't fall out?" Because, well, with my chemo there was no such 1%.

So back I went to Dr. Glaspy in July and again this last week. He asked me questions, joked a bit, answered a few questions I had (mostly reaffirming that I have no restrictions whatsoever. None.), and said that basically everything looks great. No concerns. (If you are wondering, the 3-month exam is a lot like a regular check-up any non-cancer patient would have and that's it; I'll have another mammogram at the next 3-month check-up). Then Dr. Glaspy said "Are you seeing Dr. Karam after this?" To which I answered "Yes." And he said, "Well, we don't both need to grope you, so you can have the breast exam with him."  "Um, no doctor, that would be awkward seeing as we're meeting up with Dr. Karam at Literati for a glass of wine!"  Dr. Glaspy did the groping. And then (after I was dressed again, let's be clear) came the favorite part of the day. He told me that I had handled this whole cancer thing really well and had the right attitude. In fact he said that I was in the top 1/2 of 1% of women as to how I handled this! And hey, I have to say, I'm kind of proud of that. Because, as you know if you've been reading along, mostly I feel like I've been Cancer Dork. I seem to not do things like others generally, and that seemed particularly true as I went through breast cancer treatment. I wasn't emotional enough, I wasn't exercising enough, I wasn't having epiphanies, I kept working, I kept joking, I didn't think I was going to die, I didn't get spiritual, I had parties, and I didn't change a single bad habit (except blow-drying and poofing out my 80's hair...but that wasn't by choice!). I kind of thought I screwed up. Especially in the last few months where I was wondering if I was supposed to be different or somehow a "better" person for all of this. But here's Dr. Glaspy telling me that no, I'm supposed to just get back in that river of life and keep swimming. He said "some women make cancer their whole life. You don't want to do that. This is not likely coming back. Just go on with your life." Which is pretty much how I feel, so that worked out well. Dr. Glaspy is the one who told me I was "the poster child for chemotherapy" (meaning, I absolutely needed ifs, ands or buts). So now I'm the poster child for cancer treatment. Yeah me! ;-) I'm feeling a little less cancer-dorkish these days.

And part of that might be the post-chemo glamor shot photo in this post. I'm kidding. But the photo was taken for the new brochure for The Pink Ribbon Place which  my friend Mike Easley of Vital Excess Designs put together. He did these great photos of several breast cancer survivors, and this is the photo he took of me. Lovely touch-up job don't you think? Yeah, please say you like it because there are also 20"x 30" posters of each of us in the actual Pink Ribbon Place office! I haven't totally gotten used to this look (I can still be caught off guard and surprised by my own reflection), so it was a little freaky to see the giant poster. But, you can see that my hair is growing. In fact, it's growing enough that Chris announced on Friday morning "Hey, you have bedhead!" And I did--one funky little section on the side of my head was just sticking straight up and out. Never has a woman been so excited to have bad bedhead. I'm contemplating my first official hair cut.

Alrighty then, that's enough for now. I will share with you the exciting grand opening of The Pink Ribbon Place and a few other things from a very eventful week in the next few posts. For now, there's some trash television just calling out to me. And there may be wine. Because that's the river of life I'm swimming in.