Supernatural or Coincidence

The drugs Perjeta and Herceptin are a wonderful combination in terms of side-effects. I am hopeful this combination will last for some time because I really feel quite well in all things cancer related. Years would be ideal. I have heard for some people, this is their reality.  Maybe it will be for me too.

Supernatural or Coincidence?

In the last two weeks I have had two interesting experiences that caused me to ponder, as I often do, the “whys” of the world. For me, there is either a scientific explanation for the reason something happened or there is no reason at all – it just happened.

I don’t believe in anything supernatural. Well . . . except the supernatural event that made those three guys on the left so darn appealing.  Wait a minute . . . it's not supernatural – it's in their genes.  For those of you who don't know who those guys are, they are actors from a TV show called Supernatural.

Black holes I cannot explain.  My 10-year-old daughter (oops, April 6th she turned 11) can explain it and so can an astrophysicist.  Even though I can’t explain it, I know there is science behind a black hole's creation. It is not supernatural. 

There are some medical events that seem supernatural.  Why does one person survive but someone else with the same treatment and seemingly the same cancer does not.  I would even refer to those instances as miracles although really they are not.  There is a scientific reason found in a cell’s biology. It is not supernatural.                            

The two events that happened to me recently made me pause, for just a brief second, and think -- hmm, that’s interesting. When events happen that seem so out-of-the-ordinary, I can understand how someone might believe a supernatural intervention must have caused it to happen. But, I am too logical. My brain brought me back to my reality that explains these events as nothing other than pure coincidence – happenstance.

One week and three days ago I received flowers.  One week and four days ago I answered my cell phone even though the number was unknown to me, not something I usually do.  The person on the other end said, “You may not remember me”.  Though I had not seen this person since maybe as long ago as 2005, I remembered him immediately. 

On April 1^st it had been one year since I heard my oncologist give me the news that my disease had progressed beyond the breast.  I was receiving the call because word of my illness was reaching people I have not seen in years.  That is pretty amazing really because I don’t go out that much.  I assume someone must have seen me in some store wearing my head covering which doesn’t really conceal what is happening to me.  

Earlier in the day that I received the phone call, my mind had wandered back to the years that I was a member of a dog club, a dog club with individuals that taught me so much about training dogs.  I was a member for 5 years, taught some classes and was on the club’s board as their secretary for 3 of those years.  I had such a great deal of fun training my rescued border collie.  At 8 weeks of age that bundle of fur and I became a team.  Jet and I eventually entered 7 agility competitions and came home with 6 first place blue ribbons. But, then my children became heavily involved in extra-curricular activities so I resigned from my volunteer work with the club.

There are a few not so great memories too. Jet, my canine partner, had some fear aggression issues toward some dogs. His aggression would be a quick lunge toward a dog, and then it would be over. I felt like it made people uncomfortable to bring their dogs around me for fear that the lunge could turn into something far greater -- understandably so. It could have, if not for human intervention.  This was a source of frustration and sadness for me. In Jet’s youth we owned two other dogs so it was possible for him to experience social harmony with other canines. This was again proven over the years with our adoption of 4 other dogs. His unfriendly behavior toward some dogs did not offer me complete social harmony with the club, though.  I always had to be aware of what he was doing. 

As I thought about the club, I also remembered an incident that occurred with one of the members and his dog.  I thought about what I might have said differently to some of the members in that person’s defense. His dog had misbehaved, he reacted.  I certainly was no stranger to having a dog that misbehaved. A few hours later the phone call came.  What a surprise! It was the person I had been thinking about. It was so good to hear that he was doing well along with other members that were still part of the group.  Though this event did seem to exhibit supernatural tendencies with an out-of-the-blue phone call from someone I was just thinking about that I haven’t seen in years.  But it wasn’t, nope, just a simple random coincidence.

Then today, in the waiting area at UNC hospitals, I was forced to sit in a seat I would not otherwise have placed myself simply because I like to sit in places away from other people.  The only seat available was between a woman and a man.  As I sat down the man’s face became familiar to me.  I recognized him immediately. At our initial meeting, I had a conversation with his wife, but today I spoke only to him since she happened to stay at home on this day. In my post of July 29^th, 2013, I referred to his wife as the Godly woman because she spoke mostly of how good God is.  Rengate Austin, I discovered, is doing very well. We had a great conversation only to be ended by the summoning of him to an infusion chair.  I am pretty confident he didn't remember me, but I don't care. It was just nice to see and hear that another cancer patient was doing well in this path in life we did not expect to take. As we talked, he said that we are no different than anyone else in this world because the end result is the same.  We all die.  No guarantees of tomorrows for anyone.  I agreed.  I also learned that he is still in the same clinical trial that he had begun when I first met him. He is paving the way for a new treatment for some lung cancer patients.  Was this a supernatural encounter – an encounter that put this person in the same place as me on this particular day with only one seat available for me to sit in? Honestly, the odds of this event occurring are not very good.  But, no, it was just another simple coincidence. 

Side-Note

My pulmonologist told me just last week when I saw him for my allergy symptoms that when he graduated from college there were 6 different types of lung cancer. Now, there are many many more. That is why it is so difficult to find a cure for any type of cancer.  So many cancers; so many subtypes; so complicated . . .

The Infusion

Once a chair was available for me, it still took a while for the infusion to actually take place.  I was weighed, asked if any of my medicines had changed, my port was accessed, blood drawn, medicines ordered, and food, drink and a warm blanket offered and provided. Today a new question was asked.  Do you feel safe in your home?  I learned that the staff is now required to ask each patient this every time they are seen at the hospital.  That question will be asked along with have you ever smoked?  I was told by a nurse once that the smoking question was asked for governmental statistics.  Why?, she didn't know.  Of course I don't want domestic violence in anyone's home, but somehow such a question seems odd - just a little artificial- or perhaps, I thought, the people running the government must be trying to make sure their programs continue to be operational. In the future who knows what questions will be asked; questions such as are you practicing safe sex, are you eating 2 servings of vegetables each day, do you wear sunscreen when in the sun, do you have guns in your home (my kids’ pediatrician asked that one), and finally do you have alcohol in your home? Well, we have a program for that. Could more questions soon be coming my way before my cancer treatment can even begin?  I know people need or want help for variety of reasons.  A hospital can feel safe, but is this question or better yet is the service necessary?  Aren't programs already available to help in these situations? A scared person could reach out for help and social services could be called without actually having to ask the question. What would the hospital do anyway if I had said No, I do not feel safe?

These questions swirling around in my mind prompted me to ask my nurse.  She was happy to explain.  Apparently it has been protocol to ask all in-house patients this question. Now that the in-house and out-of-house patient clinics are using the same electronic records system, all patients are now asked that question including me, an out-patient. If someone said yes to the question then Beakon would be called. At first I thought Beakon might be the government agency I referred to earlier. The internet educated me.  Beakon is a service provided by UNC Hospitals. They would be called and would come and evaluate what kind of threat the person was experiencing. 

After digesting the nurse’s comment about family members being asked to leave so the person could respond without any inhibition, I began to realize that maybe the abuser, never wanting the secret of what they are doing to be known, may not ever let the person being abused go out into society alone. The hospital might be the first and only opportunity that someone could ask for help. Other questions kept entering my mind.  What are the statistics of how many people are actually helped by this service?  And, once Beakon is called, do they bill your insurance for the service?  Also, if the threat is severe enough, do they immediately prevent you from going home when released?  Is the hospital now a safe-house for people trying to get away from domestic violence?  Is this another way for the hospital to dig into your pockets or at least your insurance company’s or is it a service provided for free by the hospital?  Well, nothing is free. I did see on the UNC Hospitals website that Beakon accepts donations so maybe the money to run the program does not come directly from the people in need of help. But if my treatments are higher than they should cost because it is helping to fund the programs offered by the hospital then that is the point where I say enough is enough. I am not against people looking for ways to make money nor am I against my giving monetary donations, but I don't want to pay for it unless I know about it. Hopefully it is simply a great service that is needed and used by many to prevent abuse and to help people of domestic violence.   

So there you have it.  Infusion #17 is history!

Next time will be scan review time. 

Oh, and I also started going without a head cover around the house.  Eyelashes are starting to appear too, very thin tiny little hairs though.  I can’t wait to put on mascara again.  No eyelashes -- not a good look for me. 

A Gift

Treatment #16 went well, but it was an incredibly long day.  Chapel Hill had too many patients scheduled which caused long waits for everyone.

I only had one appointment, the infusion.  Because of this, I thought the time at the hospital would be a lot shorter than prior days.  I arrived at 11:30 despite my appointment time of 1:00.  My early arrival did not move things along any faster. I was not seated in a treatment chair until just after 3:00.  Finally at 4:30, my treatment began.  The whole process really doesn't take that long.  Once I swallow the two Tylenol pills and wait the 30 minutes for those to start working, the infusion can begin.  Each drug is infused for 30 minutes. There are two of those.  Once complete, there is a 30 minute observation period to make sure I don't have an allergic reaction to the drugs.  So, one might surmise that I could possibly be on my way home in three hours since the actual time to be treated is two hours.  This was not to be.

Luckily, I had received a gift from one of my daughters on Saturday.  It was an iPad mini!  I spent the entire time learning how to use it.  I searched the internet and did something I never do . . . played games!  Candy Crush is a game I knew nothing about, now I do.  Temple Run, oh my, what fun!  My husband laughed at me because the game involves a lot of finger swiping across, and tilting of, the screen.  My motions were much bigger than was needed for the game.  I guess if I was watching someone play in this way I would find it funny too.  On the way home I was so into the game I accidentally tossed the iPad right out of my hands. The iPad is fine despite its short trip through the air.

My sweet, wonderful daughter used the money she made working in a restaurant to bring me this technology. She wanted me to have a new computer. The one I have is bulky making it cumbersome to carry around.  Plus it is several years old which for a computer is ancient. Attached to the gift was a poem she had written.  It expressed how she knows how awful it is to be sad and how she wished she could grant wishes. With those wishes granted, she could fix things. Since she can't, maybe with this gift, she could make things for me a little better. And, she did!  While I was playing the games and learning how to use the device there were moments I did forget my sadness and actually enjoyed myself despite being hooked-up to a drug delivery pump.

Her gift to me is so much more than this iPad.  Her gift to me came when she was born.

I love her.

I love all my kids!

How Perjeta/Herceptin work

Herceptin and Perjeta

I learned something new!  The new learning began to unfold many weeks ago and finally peaked on Monday, February 24^th, when I met with my oncologist.  Prior to this day, I had discovered that there are other cancer types that over-express the HER 2 neu protein receptors like my breast cancer cells do.  Not only do some cancers, but normal cells have these receptors too.  It is only when there are too many receptors that the cell becomes dangerous.  With all of this information, I began to wonder about the two drugs that are part of my treatment plan, Perjeta and Herceptin.  Before this new knowledge became part of me, I understood these drugs to be targeted therapies.  The word “targeted” to me meant that the drugs only affected the cancer cells. When I met with my oncologist on Monday, I asked her a question.  Her answer has totally changed my understanding of how the two drugs I am currently taking affect my normal cells.

Let me provide some background information.

There are different types of breast cancers.  The ones I am going to address here are cancers involving certain receptors.  Normal breast cells have three types of receptors:  estrogen, progesterone, and HER 2 neu.  Breast cancer cells can have all three receptors, two types, one type, or none at all.  These receptors are within each cell or on the surface of each cell and give signals to the cell’s nucleus for the cell to grow and divide.  Two different receptors use the hormones estrogen or progesterone to send those signals.  The third type of receptor is HER 2 neu (Human Epidermal Growth Factor Receptor 2) located on the outside of the cell.  It does not use hormones, but still sends signals to the nucleus telling the cell it is time to grow and divide.  (There are other HER receptors, but I am not going to complicate things any more than needed.)

If a cancer tests positive for estrogen receptors then it is considered ER +, estrogen receptor positive.  The same is true for progesterone.  A cancer that is positive for HER 2 neu receptors must have a larger than normal amount of these receptors to be considered positive.  Although it is normal for breast cells to have estrogen and progesterone receptors, some breast cancer cells do not have estrogen or progesterone receptors.  Those are considered ER – and PR – (estrogen receptor negative or progesterone receptor negative).  Others cancer cells are negative for all three receptors.  Those are called triple negative cancers.  I am considered ER -, PR -, and HER 2 neu +.  This information of receptor status is vital in the treatment of these differing cancers.  Specific drugs are used according to the type of receptors present.

The estrogen positive cancers (ER+) are the most prevalent.  One way to control this type of cancer is by reducing the amount of estrogen in the body.  Since the estrogen is needed by the receptors to grow and divide, reducing it reduces the receptors ability to function. 

One way to stop the HER 2 neu type cancer is to intercept the signal the receptors are sending to the cell to grow and divide.  Herceptin and Perjeta attach to those receptors.  Then the cell no longer receives, or at least receives less of, those signals that are causing them to grow and divide abnormally.   The first picture below shows the HER2 neu signals being sent to the nucleus, and the second picture shows the drugs attaching to the HER 2 neu receptor and blocking the signal to the nucleus. 

  

                                                                       

                                                                          

(pictures-  http://www.perjeta.com/patient/receiving/howworks )     

The reason Herceptin and Perjeta do so well together is they attach to different points on the HER 2 neu receptor producing a better blockage of the growth and division signals. 

I can’t remember when I learned that normal cells also have HER 2 neu receptors.  It wasn’t until the last few weeks though that I began to wonder if Herceptin and Perjeta were attaching to the HER 2 neu receptors on my normal cells too instead of just to the cancer cells.  That brought me to pose this question to my oncologist when I was in Chapel Hill to receive my #15th treatment for this disease. 

I asked, “Since the normal cells have the HER 2 neu receptors, like the cancer cells, how do the normal cells continue to work properly if their receptors for growth and division are blocked by Herceptin and Perjeta?”

Dr. R explained that normal cells don’t rely solely on those receptors to grow and divide.  So, though the drugs interfere with the signals from the HER 2 neu receptors it is ok because the normal cells use other pathways for this function. 

After our conversation, I understood a little more about Perjeta and Herceptin.  They are “targeted” therapies, but "targeted" does not only mean that they target cancer cells only.  The target is the HER 2 neu receptor.  Normal cells are affected too.  In the future this learning may change.   For now I understand that since cancer cells are not functioning normally due to the high number of protein receptors bombarding them with signals to make new cells rapidly, the breast cancer cells are responding to those HER 2 neu signals only.  Because of this, the drugs are effective.  Overtime as those receptors are blocked by drugs, the cancer cells in their quest to stay alive, will find ways to overcome the blockage of those HER 2 neu receptor signals.  Other pathways for growth and division signals will be found and the damage will continue.  That is why eventually all drugs will no longer work against breast cancer.

Now that I have this new information, it causes me to wonder about other aspects of how these drugs work inside my body.  With the millions of cells in my body, if the drugs are attaching to the receptors of normal cells too, is there enough of the drugs given to me to attach to the cancer cells too?  So complicated. . .  I am going to hope that the clinical trials conducted long before I received these drugs already determined what amount was necessary to affect the cancer in the most potent way possible.

Another treatment is over for me.  My next one is in two weeks.  I won’t see the doctor on that day but will see her three weeks after that.  At that time, we will schedule a scan.  Oh, the never ending scary scans.  Such is the life I lead.  For now though, I think I am doing well, all things considered.

The above information is based on my understanding of breast cancer and the drugs that are currently in my treatment regimen.  Please check with your oncologist for accuracy.   

Radiation & Incurability

To radiate or not to radiate

On the 13^th of February, I met with a radiation oncologist.  My expectations of this appointment were that the doctor would have reviewed my recent scans and my past radiation treatment file from 2010 before I met with him.  This did not happen.  Instead, I discovered this doctor was acquainting himself with my health history for the first time as he sat before me.  My husband commented later that it was most likely done this way in order to avoid his not being compensated for his time if I did not show up for the appointment.  I see this as a possibility though it did not soften my annoyance. 

He began by starting from the beginning, my 2005 diagnosis.  I was perturbed a bit that we had to start from the beginning.  All of that doesn’t matter now.  Not only was he unfamiliar with my case, he further annoyed me when he said “Tell me about your first diagnosis in 2005 when you were in high school”.  Really, I look that young?  Oh yeah, and I look like a model too.  This type of talk may have at one time flattered me, but no longer.  I know better.  Cancer and its treatment does not make someone look young and vivacious, just the opposite. I have seen myself in the mirror.

With my health history covered, he next wanted to see my scans.  I thought how could he give me a valid opinion today about possible radiation when he is so clearly unprepared to do so?  He did do something no other doctor has done.  He invited me to look at my CAT scans.  I have been curious as to what those scans looked like.  My oncologist in Chapel Hill has never looked at them so I have never asked her to show them to me.  The scans looked exactly like those I have seen on TV or on the internet with one exception.  The radiation oncologist pointed out a black area on my right lung. 

“That is showing where your lung has scarring from your past radiation”, he said. 

The lungs looked great otherwise.  Soon the image of the area where the 1.2 cm tumor is located was reached.  The tumor was not easily revealed, at least in that image.  He did not look any further for a better image.  I guess he decided he had seen enough.  He turned to me and said he wanted to speak to Dr. Z, radiation oncologist in Chapel Hill, before he would give his opinion.  He said that I had had a great deal of radiation in that area.  The tumor would need a lot more than what I have had already to produce the result we would want.   The appointment ended without his opinion on treatment with radiation which was good because he did need some time to think things over, obviously.  I left with the understanding that he would call me on Wednesday. 

I went home with doubt that he would recommend radiation treatment.  There was something about his demeanor and the way he said, “This is a difficult area to treat”.  I also thought about what I would do if he said, “Yes”.  Would I want to take the risk of losing the function of my right arm?  (My tumor is close to the right clavicle bone deep within my chest.  The radiation would pass through motor neurons responsible for muscle movement to my right arm and might damage them permanently.)  Ever since the radiation oncologist in Chapel Hill let me know of the possibility of this particular side-effect I had been thinking about what I would do.  I was leaning toward taking that risk if it was possible to completely eradicate the cancer.

Wednesday came and Wednesday went.  I know I am not the only patient that this doctor sees, but when he said, “I will call you Wednesday”, I expected a phone call.    Late Thursday morning, I called his office.  A nurse said she would contact him and then call me back.  Not too many minutes later the doctor called.

Somehow I imagined that I would be given a choice about my being treated with radiation.  I thought the doctor would call me and tell me about side-effects and what the likely hood the treatment would work with his opinion included. Then I would go home and discuss it with my family and make a decision about this treatment.  This didn’t happen.  I won’t have to make a decision.  The radiation oncologist I saw on the 13^th made that decision for me.  He will not treat me.  The possible side-effects, due to my having had radiation in 2010 to the same area, could be so severe that the doctor felt the risk of damage to me was greater than the benefit.  D---! But, I am grateful that my treatment is about what benefits me and not how much money a doctor can make by treating me.

Incurability 

This life I lead with metastatic breast cancer can be so discouraging.  I am constantly reminded on the internet and in my oncologist’s office of the incurability of stage IV breast cancer.  In talking to the radiation oncologist on the phone, the words that my oncologist has said more than once raced through my brain yet again, “Your cancer is probably in other places, but can’t be seen yet”.  Another way to put what he said is . . . even if we get rid of that tumor in your chest, you are still going to die of breast cancer.  This reaffirms how impossible my situation is.  It explains why once breast cancer metastasizes doctors don’t go after it aggressively.  The goal is stability or shrinkage, nothing more.  According to my oncologist, studies have shown that getting rid of the tumor(s) that can be seen doesn’t save lives-- sneaky horrible breast cancer cells.

I did not truly understand how deadly metastatic breast cancer was until my cells found their way to this point of no return.  I thought that if it ever metastasized to an organ, if it was caught early, there would still be a chance to save me or anyone else.  Apparently, almost 100% of the time, this is wrong.  Nor did I know that 30% of early breast cancer patients will eventually be diagnosed with stage IV.  No wonder so many bloggers with stage IV breast cancer are sick of Pinktober because it creates beautiful images and stories of early-stage breast cancer patients all smiling because they beat the disease.  There is nothing happy in the pink party for people like me.   

OK, so radiation is out for now.  There may be a need to use it in the future if the cancer grows in such a way that it is necessary for my comfort to reduce it.  At least I have Perjeta and Herceptin.  I hope these targeted therapies continue to do their magic. 

Life without Taxotere

Life without Taxotere for this three week cycle of treatment has been wonderful.  I have felt tremendously better. 

·        The neuopathy caused by this drug was starting to make my feet hurt when I stood for any length of time. My feet did swell and pain was felt, but there was a definite improvement. 

·       The scalp sores I have enjoyed (ha ha) at the end of week two after treatment did not appear.   

·        I did not feel anxious by the end of the first week from the steroids taken because I did not have to take those pills.  Those steroids were responsible for lessening any nausea symptoms and reducing inflammation.  My body did not like it.  I could not concentrate on any one thing for very long.  The drug made me feel like I needed to jump out of my skin to find relief from the anxiousness. 

·        Mentally I was and am so much happier.  I didn’t go through the horrible sadness I have felt after Taxotere.

·       My mouth feels so much better. No more destruction to the cells of my mouth. Yipee! I couldn’t taste food very well for the whole week after my infusion.  Salsa would set my mouth on fire.  No amount of milk could alleviate the pain.  Now eating is fun again.  My teeth had even begun to hurt. 

·        I still feel tired at times, physically weak, and sometimes I can’t figure out why I don’t feel right, but overall this cycle has been the best since I started treatment.  There are moments when I feel almost normal – well, almost.

·        Diarrhea still plagues me.

Tomorrow is infusion day.  That will be the time for herceptin and Perjeta to attach to the receptors on the outside of my cancer cells and stop them from growing and dividing. 

Thanks for reading.      

Herceptin/Perjeta ONLY

February 3rd  No more chemo, for a while anyway

Treatment #14 

Good news, no. . . great news!  Best news I have had in a long time.

 

CT SCAN REPORT

The chest tumor is still present.  This scan showed a 1.2 cm mass compared to the November scan that showed a 1.4 cm mass.  This report noted “stable” disease, but as you can see it says the tumor is “slightly diminished in size”.  YEAH!

Notice “no evidence of pulmonary mass”.   That means no lung tumors were seen!  Either they are so small that the CT scan did not pick them up or they are no longer there.  There is also the possibility that the tumors seen in May 2013 where not tumors at all.  They could have been scar tissue from some illness in my past.  Either way, nothing was seen on this scan!

  

Today, I have been freed from the grasps of chemo, at least for a little while.  Now I will only be treated with Herceptin and Perjeta which are targeted therapies and won’t affect my normal cells.  The news gets better as I don’t have to take any steroids or nausea medication with this regimen.  I will feel physically better.   Taxotere works, but it is such a harsh treatment.  I was almost to the point that I was going to ask for a break from it.  This news brings me such relief.

Dr. R. said this is a great time to try to do without the Taxotere.  Eventually I would have to stop Taxotere anyway because the body can only tolerate it for so long.  As I have said in a previous post, Perjeta is new having only been available to patients outside of clinical trials since June 2012.  The use of just Perjeta and Herceptin is also new at least to the doctors treating me.  I am hoping this new treatment plan will work because it has several nice benefits:  a full head of hair again, physically I won’t feel so ill.  I am bursting with happiness about this.  For the next three months, I am free of Taxotere.  Then I will have another scan and hopefully another 3 months of just HP.   

I spoke to a radiation oncologist today about the possibility of radiating the chest tumor.  Because I have had radiation in the past, there are possible serious complications that could occur if radiation is given again, the worst being loss of the use of my right arm.  But before those complications are discussed, my past treatment with radiation must be reviewed to see dosage used in order to see if it can be done at all.  I really want to have radiation because this could actually completely kill the cancer in that area.  The radiation oncologist said he would be fine with the decision “not to” or the decision “to” take this treatment.  The thought of not having cancer in that area any longer is such a strong reason to take the treatment.  Losing use of my arm because of possible nerve damage to the nerves along my neck above where the tumor is located is a strong reason not to, but cancer is way uglier and is a killer where the other is not.  I really won’t know the true risks associated with radiation until my next appointment which will be with the radiation facility that treated me in 2010.  (Date still yet to be scheduled.) They will review my history and will make their recommendation.

Another plus today…I only had to take Tylenol before treatment today.  That is two pills compared to the 8 that I previously had to take.  Also, no Neulasta shot needed to help my white blood cells bounce back.  That is a $4,000 shot out of the financial equation!

Three weeks ago, I had a MUGA scan for my heart function.  It was at 68% which is good and not only is that good, my heart function has improved. 

From the American Heart Association website. http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Radionuclide-Ventriculography-or-Radionuclide-Angiography-MUGA-Scan_UCM_446354_Article.jsp

The test measures your ejection fraction, which is the amount of blood pumped out of the heart during each heartbeat (contraction). It’s usually expressed as a percentage. For example, an ejection fraction of 60 percent means that 60 percent of the total amount of blood in the left ventricle when it is full is pumped out with each heartbeat. A normal ejection fraction is between 50 and 75 percent.

It has been such a good day today.  I still can’t believe the report was so good.  Modern medicine is wonderful. 

Pleading with Cancer

Cancer . . . it’s me.

Come later

when my life

is more complete.

Let me see wrinkles

so deep

and skin

so thin

from elasticity gone.

I beg you,

stop

the lassitude,

the pain

Cancer . . . it’s me.

Let me see

my children grow

to be adults,

to be on their own,

that’s all I want.

Death too soon

is death unfair.

It takes from me

and from them,

too.

Memories missing,

pages empty,

lost to me,

by your bombardment,

hard to bear. 

Cancer . . . it’s me.

Stop this game you play,

out-smarting, outwitting, out maneuvering

us all.

Unfurl your madness

unfurl your mystery

so others will know

and early steps into the darkness

will cease

because your dress

will finally look different

than other dancers

and my body

will see you

and take back what is mine.

Scans show your control, 
reveal your destruction.

Each day

you grow.

Each day

I slow.

Cancer . . .  it’s me.

Stop hurting.

Stop growing.

Stop taking.

Stop stealing

my time.

Rationalization of death

does not exist.

No lessons learned.

Tragedy defines

my one day forgotten life!

Cancer . . . it’s me.

Chemo #13 Scans reviewed in 3 weeks

No news today, really.  The last three weeks were typical for side-effects.  My neuropathy in my fingers improved from my last treatment so that was a relief. 

Somehow I expected to have scans done before today and reviewed at this appointment.  I was jumping ahead too quickly.  The 3 week period I am now entering is the time for new scans to occur.  On February 3, those will be reviewed.  If everything is stable or if shrinkage is seen, a break from the beneficial but evil Taxotere, as far as side-effects go, may be the next plan for me.  Herceptin and Perjeta will act alone.  I am hopeful this is the case.  This scan really makes me nervous though.  I would really like a break from Taxotere.  Anytime I want something badly, the nerves can be troublesome.  It is not a happy drug as far as how it makes me feel.  If the two other drugs can do the job without it then that is a much better treatment option.  If my scans show growth, my treatment plan will change completely.  It is quite unsettling due to the fact that I am currently taking the best drugs available for my disease.    

For this appointment, the usual side-effects were discussed and lungs were assessed audibly.  All is fine.

This morning I had the 3 month MUGA scan to look at my heart function.  Herceptin can cause reduced heart function in about 2% of patients.  I have not had any problems so far and am hoping this will be the same today.  I will not know until my next appointment.

That is all for today.  Thanks for checking in on me.