Wednesday, February 27, 2008

From Treatment to Prevention

The appointment went well. The team at Dr. B's office oohed and aahed over my new hair, and were - of course - thrilled to see Zack. I even got to see my chemo-buddy, which was an extra treat. Dr. B says my radiation burns don't look fabulous, but are within the bounds of normal so not to worry.

Surgery:
No major surprises, just some tweaks. The surgery to remove my ovaries needs to happen ASAP, rather than in May as I'd planned. So, we're trying to get it scheduled for the week after we return from vacation. On the positive side, Dr. H can probably do the surgery. Zack is excited to meet her, as he credits her with saving my life. By working her personal contacts, Dr. H bustled me into the offices of Dr. S and Dr. B within a few days of my visit with her. Without her direct intervention, that process could easily have taken a month. A month, it turns out, I didn't have.

Drugs:
I start Tamoxifen tomorrow. I'll take it until the surgery, then switch to an aromatase inhibitor. I also start calcium & vitamin D supplements, since both early menopause and the AIs tend to increase bone loss. So, osteoporosis is the newest item on the list of things to worry about. I figure this gives me all the justification I need to eat Cabot's cheese by the brick and drink lattes all morning. There's calcium in butter, right?

Monitoring:
I'll have checkups every three months to check for any possible cancer recurrence. Any new tumors would be most likely to grow in my bones, liver, chest wall, or lymph nodes. Although the evidence is mixed on their utility, Dr. B and I decided to go ahead and test for blood borne tumor markers. The problem is, the tumor markers often spike without the doctors being able to find an actual tumor anywhere. However, a tumor marker spike does throw up a red flag, and in the best case scenario this could give Dr. B a three month head start finding for a new cancer. Based on the incredible growth rate of the first cancer, Dr. B wants every time advantage she can get, as long as I am willing to live with the potential for unnecessary anxiety that false positive results could bring. (we are.)

Other than that, Dr. B wants to do symptom-triggered scans, rather than have me do CTs every three months. She feels that I will pay close enough attention to know when something feels strange, and she'll do careful checks whenever I see her. She'll use regular bloodwork to check up on liver function and my other organs.

Summary:
We're living in a coin toss world. Think tails!

Nerves and News

So, we leave in a few minutes for my post-radiation "so now what" appointment with my oncologist (the much praised Dr B). Before I came down, I found myself dithering about lipstick, and what to wear. I even tried to brush my hair. (For the record, half an inch is still too short to brush...or even to do that brush it all forward and make the front stand up hairstyle that has been popular among my students. The male ones.) I caught myself doing my nervous routine and laughed. Do I think my prognosis will be better if I look better? That I can somehow get out of the next steps if I just look healthy enough? Ah well, we all need these reminders that human logic doesn't always correspond to cold logic.

Tuesday, February 19, 2008

Old Friends, New Friends, Good Friends, True Friends

I've finally finished radiation! Although, according to Dr. I, I've 'hit the peak' of the side effects - explaining the splitting, bleeding skin - it should clear up in a week or so. Beyond some strangely placed freckles, some redness, and the bleeding, I'm just plain tired. However, all of this is easily fixed with some quiet time. Emotionally, I am ecstatic to be finished, and am busy reveling in the huge luxury of two whole weeks without a doctor's appointment.

Speaking of revels, the party this weekend was completely, totally, and utterly wonderful. Zack and I had a thoroughly marvelous time. In my favorite moment, I walked into the back room (the room everyone painted for me at the beginning of this saga) and realized that instead of separating into clusters by type (school friends in one corner, Chicago friends in another), people had moved all the chairs and couches into a big circle and were talking together. That could, of course, have a little to do with the incredible food that people had brought and placed on the coffee tables in that part of the room, but I like to think that such great people just naturally gravitate toward each other.