Happy, Happy, Happy December 30, 2010

HAPPY! HAPPY! HAPPY! HAPPY! HAPPY! HAPPY! HAPPY! HAPPY NEW YEAR!

I'm sitting in my office at home writing to my family and friends, slightly more than one day before 2011 begins, and I don't think I've been happier or more relieved to see the new year arrive.  Last Wednesday, December 22, was my last radiation treatment and that little statement means that I am finished with what Jim so politely calls my "slash, poison and burn" treatment regime. 

I cannot tell you how good being "finished" feels!  There were times during these past eight months that the tunnel looked long and longer.  Each segment of this odyssey has had its own particularly nasty characteristics, which I'm sure were specially tailored to my own special personality and quirks. 

I used to be terrified of surgery and anesthesia - leftovers from an early and very different (medically) eye surgery as a child.  The anesthesia options are much better now and, of course, there are totally new philosophies and drugs for pain.  And yet, my fears at the time of surgery were around dealing with the post-op unknowns: How much pain?  What will the dressings be like?  You mean I have to deal with those drains?  For all of these questions, Jim was actually the answer.  He made sure I got the fluids I needed, emptied the drains until I could face them, made sure I walked and took medicine when I needed it.  After a total of three surgeries, we both had the routine down.  We began to take a "yah, yah, what's next?" approach...not really.

My initial knowledge and expectations of chemotherapy were all based on what I learned as a hospital-based oncology nurse...thirty plus years ago.  Believe it or not, we used some of the same drugs then - and I received two of them as part of my treatment course.  What I remember is, of course, the incredible nausea, diarrhea and misery that our patients experienced.  We would do our best with pain and anti-nausea meds, but they were so much less effective than they are today.  Women with breast cancer would bravely hold out their arms to have the IV placed - and then hold the emesis (throw-up) basin for hours as the chemo did its work. My hats (and I have quite a few now) go off to every woman and man who subscribed to and completed their courses of treatment during those days!  Talk about courage and will to live!

I believed the doctors and nurses who told me that my chemo treatments would be easier than in the old days - and they were.  I didn't actually vomit once!  I didn't have much diarrhea - and I think what I did experience may have been at least partly my fault (I got plenty of education about the likelihood of constipation...so, I made sure I had plenty of laxative help to avoid it.  Live and learn, right?) 

There is, however, a big difference between not experiencing the expected vomiting of chemo and having a wonderful, no worries round of treatment.  There are lots of nuances to the phrase "easier than."  For me, the biggest issues became my lack of appetite and lack of energy.  It's easy to say, "just eat something," or "go for a walk," but it can be really hard to actually do those things.  Some of the medications that are given to offset nausea and vomiting actually made me sleep and sleep.  Then, when the heavy duty nausea meds and steroids (given before, during and a couple of days after treatment) wore off, I experienced a 'valley' of miserableness.  No energy, no appetite and/or slight nausea, aching muscles and joints - all of which lasted until a few days before the next treatment cycle.  You get the idea.  I would just start to feel better and it would be time for another treatment.

And, radiation.  The 'burn' portion of my treatment plan was just weird and hard because Jim and I were apart for six weeks.  We have developed ways of coping with business travel over our years together, but this was the longest time.  I was so lucky that Jim was able to come to Sacramento every weekend - it made each week have something good and important to look forward to, and made the time go more quickly.

My fears around radiation were mostly about what the unknown and very potent rays were doing inside my body - which, of course, was totally out of my control.  The machine is big and makes strange noises.  It was several treatments before I could open my eyes and actually look at it to figure out what some of the noises were about (mostly changing the lens shape to alter the field size and shape).  It took days longer before I even noticed the blinking red light warning others not to enter the room.  I understood right away the importance of being completely still once the set up was complete each day...even moving my feet had the potential to alter my position by a millimeter or two and that was not OK.  I managed the short time I was on the table with lots of focus on breathing (yoga teachings that paid off) and counting each treatment segment length.  It worked - helped me stay calm and cool.

Really, one of the reassuring things for me about radiation is that it has extremely rigid routines.  I went to the same treatment room everyday.  I had a small group of techs that took care of me.  The techs were precise and focused as they adjusted my position and aligned all of the measurements and table settings prior to treatment.  These things and more communicated competence and awareness of the importance of getting it right every time.

I feel pretty lucky that the radiation hasn't really added significantly to my lack of energy issues.  I still have good and not-so-good days, but I think they are as much a lingering effect of chemo as related to the radiation.  And, overall I am making gains day-by-day, week-by-week - yeah!  The only real issue I've had is about the skin damage the radiation causes.  The right side of my chest looks like someone put a big hot iron on my skin - not painful ever and getting better now.  I'm in the itching (don't scratch!), peeling stage, just like an intense sunburn.  This too shall pass - and, as I said, it's actually getting better every day!

So, I'm finished!  I'm having a bit of a hard time believing it.  Although I will have oncologist visits at intervals, there will not be much in the way of additional testing unless I come up with symptoms.  In general, breast cancer patients are treated as 'cancer free' unless something comes up that needs checking out.  I'm not sure when I'll stop looking over my shoulder, but I'm focused on being happy, happy to be done and on getting fully back on my feet.

BTW: I did have a CT scan of my chest and abdomen a few weeks ago (because of a cough that I can't quite shake - I think it's asthma).  The great news is that the CT showed nothing that looked like cancer - in fact, it was unchanged from the pre-chemo CT I had done.

So 2011 is almost here.  Jim and I have been so ready for this new year for months.  In addition to this whole breast cancer thing, the past year has been filled with the loss of friends, colleagues, and favorite pets.  We know that we're old enough to have people around us - and maybe even us - become sick or die.  But, we hadn't experienced - or expected to experience - such an onslaught in one year.  As a way of protecting ourselves from considering that this might be an on-going phenomenon, we have decided that it's all about 2010.  The new year will be washed clean and will have an entirely different, more positive flair.

This is our wish for all of you and yours - that your 2011 is filled with love, blessings, happiness, good health and exciting adventures! 

Oh...speaking of exciting adventures, we're going to England and Nice, France in June.  Cross your fingers for us that we get Wimbledon tickets!  Much love to you all!