Jumping Off The End Of The Dock

I've never been one of those folks who wade gradually out from shore, acclimating to the frigid water a bit at a time. I know it's going to be miserable, so I just want to get it over with and get on with things. So I run out to the end of the dock and just jump in that cold lake. Take the hit and hope it gets better, or at least that I'll adjust.

In this case, of course, it won't get better. But maybe it could be kept from getting really unbearable for just a little while longer. Obviously I don't have the luxury of time for exploration and experimentation. I've researched until I'm blue in the face, and have done so from the time I was diagnosed. I'm not learning anything new, really, just "reviewing the situation," as our friend Fagin burbled so charmingly in the old beloved musical.

With my history with drugs, etc., I know I'm going to take a big hit, side-effects wise. All the options have lots of dire potential, and the main two at this point - Tamoxifen or one of the Aromatase Inhibitors (AI's) - are more or less equal in the awfulness of their different Worst Case Scenarios.

I don't have time to mull it over, really. If I don't already have brain mets (my own personal Worst Fear Ever), or spine mets (usually a quick ticket to the end - "Do Not Pass Go, in the laughably unlikely event that you reach it,") then they are unlikely to be far behind. I have to throw everything I can at it.

I'm not giving up on the alternative treatments. I'm adding more, and reinstating some old ones. It is possible that one of the several things I'd stopped doing since the last scan was critical to the stasis the cancer seemed to be at that time. It is possible that other options could bring some relief. But it is time to throw everything reasonable at this monster. And all things being equal with the hormonal chemo treatments, I guess I'll take the one that has even a very small advantage in time-to-progression**, percentage-wise.

So I'm jumping off the end of the dock. Aromasin it is.

Kindly ignore any screeching you hear in the next little bit. I'm hoping I will adjust.


**As my doctor reminded me several times on Friday, none of the options will lengthen my life. They might keep the tumors smaller for a while, and keep the spread down for a while... but then the progression will likely be faster when it does come. It's a case of balancing the side-effects of the medications against the side-effects of the tumors during that period when the meds keep the tumors at bay. Which is an unknown, in itself. We're just gambling here, folks, and it's pretty steep house odds.

Not What I Wanted To Hear

So the news is back from the scan, and it's not good. Spread at hip and femur, new tumors on chest and collarbone, and I lit up in the spine and liver. That's a fair amount of progression for 5 months. So my timeline has been shortened quite a bit from what we had hoped for. We knew the cancer was aggressive, but we weren't sure what exactly that meant in terms of time.

Now we have a better idea, even though we don't like the answer. From the sound of it, Dr. Bouncy wasn't liking it, either - I think he was hopeful, too.

I never seem to beat the odds in the right direction.

So. Nothing brilliant to say at the moment - I haven't had time to process it all. Not that there's necessarily much brilliant to say after processing, either. Pretty much what there was to say before the bad news:

We'll see.

Update, Because That's The Way I Roll

I had my latest PET/CT scan yesterday. I had been planning to have the next one in January, but a couple things pushed me into an earlier date with destiny, so to speak.

One is the lump that is growing on my chest wall, which is causing me some anxiety. About 20% of women my age get local recurrence of breast cancer - in other words, they get another tumor in the same breast (or, in the case for those of us no longer sporting those appendages, in the same region where the breast and its unwelcome guest previously resided). In my life history, I have shown myself gifted in beating the odds... in the wrong direction. So that theoretically lovely 80% chance that I wouldn't suffer a recurrence is not of any particular comfort to me.

If that lump is cancer, I want it out. Not that it necessarily will do me much good to get it out, or that it might not actually do me more harm than good physically - there is a good argument to be made against [more] surgery. It's not like I don't have malignant tumors comfortably growing elsewhere, tumors that are not amenable to excision and so must be left there in the dark to do as they will. But the lumps I can feel, the ones that wave cheerfully at me as they do their dirty work... well, it's just harder for me to get on with what's left of my life when I'm being mocked and badgered from the peanut gallery. They make me more aware that I am becoming an overcrowded, crumbling dwelling for unwanted and destructive tenants; if I can't evict them or restrict their reproductive proclivities, I at least don't want to be subjected to a constant play-by-play update on their daily activities.

The other thing weighing on the side of an earlier scan is a sort of vortex of treatment decisions and situations that have been going on concurrently to the appearance of the new arrival. The scan gives me a sort of feedback on what's been happening lately. With so many possible influences, it's a little difficult to know what is causing what, but a scan will give me an idea of whether I need to make changes in at least some aspect or other of my life. It won't, unfortunately, clue me in to which aspect/aspects need to be changed, or whether changing any aspect will actually do me any good - the percentages are not in my favor, and we've already covered my history with percentages.

But I'm a questing creature by nature, so I am always craving more information. Cancer may kill this cat before Curiosity does, but the odds are still pretty good that my last words will be, "What's that?" (A suitable end to a contrary, backwards life, since my first words answered the question: "That's a button!")

So now I get to wait for the results. Hopefully I will get them next week some time, although the holiday season is slowing things down considerably at the health care facilities around here. Hopefully I will get the results quickly enough that I can make an appointment with my surgeon that will allow me to recover by Christmas, if surgery is warranted.

In the meantime, there is Thanksgiving and Black Friday to keep me busy, and then the weekend and early part of the week to wait through. Looking at my calendar, I'd better think up a short-term but engrossing project to keep me from spending the time in unduly harassing innocent and powerless medical receptionists and schedulers. Maybe I should knit a house cozy...

A Nice Bit of Pink

I'm not sure how I feel about the whole pink thing... but for obvious reasons, this bit is Just Fine:

Alerts and Clarification

First of all, let me clarify:

I have a warped sense of humor, and sometimes it leads me astray. Or perhaps it leads others astray. In any case, for those of you alarmed by my last post: No, I do not think that a nurse spit anything into my gaping chest. I was being facetious, as I often do in times of stress and/or fear, in order to distract myself from my internal urge to panic and fret. I apologize if my attempts to amuse actually caused distress... that was certainly not my intention.

That being done and over with, let's get on to the next announcement:

If you live in Minnesota, you have a wonderful opportunity coming up this week. On Nov. 17th, from 8am until the following 8am, you can give a donation - it doesn't have to be big, any donation will do - to the charity or organization of your choice, and if you make that donation through Give MN, they will make a matching donation of 50 cents on the dollar.

So if you were to give $10 to, oh, let's say Pathways or Gilda's Club or Vail Place or the Weaver's Guild of MN (just, you know, choosing at random, *koff*), if you made the donation through Give MN, it would be worth $15. Great deal!

Here's what you do:

1. Go to www.GiveMN.org.

2. In the box that says "Donate," type in the org of your choice next to "Find a nonprofit."

3. Click on the link for your org when it comes up.

4. Enter your donation amount, click on Donate, then complete the form.

Give MN has a $500,000 matching fund available. I imagine your favorite nonprofit could use a little bit of funding at the moment - it's been a bad year for them, too. So scrape just a little bit together on the 17th and give. Starting a bit early in this Giving Season will go a lot further this Tuesday, and we're all for stretching our dollars this year!!

Is it Live, or is it Memorex?

There are lots of things that come with the privilege of having a terminal illness.

I am trying to think of some good ones, but the only thing I can think of is that you get to park in the handicapped spaces, which saves you money on the meter and is handy in icy parking lots between Black Friday and the end of 'Xmas Present Exchange Week'.

The rest of the effects are less desirable. For me - at least for now - the biggest issue is that decisions of all sorts become vastly more complicated by the fact that you don't know if you are going to be functional in X period of time. You don't even know if you will be around in X period of time. What you invest in, what you speed up the timeline for, what you ignore, what you get done Right Now... even what you dream about can change from day to day, depending on the configuration of your doctor's eyebrows during your last visit, the most recent mysterious twinge, the certain look in your child's eye as he gazes at you instead of the television screen. So right at the time when every decision you make becomes more urgent and potentially life-changing, making decisions becomes a much more complicated, uncertain, and tangled process.

One of the big decisions you have to make involve treatment options. And in my type of situation, you don't get to make the decision just once and then take a deep breath and move on. One of the only fairly sure things your doctor can tell you is that whatever treatment you decide on, it is not going to work forever. Sooner or later, nobody can say exactly when, it will stop working (if it ever works at all), and you will have to make more decisions. And each decision is likely to be on a shorter timeline than the last.

Cancer is clever, it learns and adapts on an accelerated basis as it goes along (unlike my brain, which forgets and gets distracted on an accelerated basis as I go along).

One of the side-effects of this is that doctors qualify nearly everything that they say to you as you try to get information on which to make a decision. They aren't trying to sidestep responsibility so much as they are just trying to be truthful; cancer is still mostly a big foggy unknown in which Stuff Happens.

So when you get a lumpectomy or mastectomy in hopes of getting rid of the primary cancer site, your doctor will warn you that although the tissue in which the tumor was nestled is gone, this is no guarantee that it will not settle back in at a later date. You can get rid of your breasts, but you can't get rid of your chest.

And that, Dear Reader, is where this past few weeks come in. Because I have a little lump in my chest, just an inch or less from where the original tumor was. My doctors inform me, with just that note of hopeful dubiousness that frequently leavens their statements about my future, that cancerous lumps usually aren't as easy to push around as this lump is. I guess the hope is that this might be scar tissue forming around the partly-dissolved Lemon Drop a nurse absentmindedly spit into my open chest during the surgery. I am to 'watch' the lump for signs of growth, and report back for surgery if it gets bigger. Theoretically it can be taken out 'fairly easily' - one gets the impression that it could, for instance, be popped out during a casual lunch date.

I can only hope that a passing teenager doesn't accidentally drop a scar-tissue-inducing french fry into me while my surgeon is ordering her half-caf latte.

In the meantime, this whole 'watching' thing is driving me nuts. Well, okay, more nuts than is occasionally the case. I show every sign of repeating the anxiously obsessive behavior that I displayed towards the original tumor:

Check to see if the lump is bigger, can't really tell; watch a bit of tv, check again in case the lump has grown in the last five minutes, it could be a little bigger than it was at the doctor's office, is it bigger? can't really tell; read a chapter of my latest library book (mostly funny book, but inevitably we have gotten to the Pathos Chapter where someone dies), cry a little, check the lump again, move it around a bit to prove that it still is in the 'not as likely to be cancer even though it could be' category; finish listening to a podcast while knitting a self-designed and dubious-looking hat for the husband, check the lump again, for some reason it seems tender (maybe from being prodded and pressed every five minutes, I really need to leave it alone); check my email, head to the bathroom and brush the teeth while struggling against the urge to check the lump again, snuggle up to the snoring husband, adjust my pillow, lay rigid for five minutes, check the lump again, it really could be bigger, I think it is... or maybe I just think it's bigger because I'm fretting about it, or maybe it's bigger because it's inflamed by all the messing about it's getting; grit teeth and make determined silent oath to leave the lump alone; lay in the dark, staring at the ceiling for at least two hours, thinking about the lump and the advisability of having a third surgery in one year; spend another hour thinking about how if I go to sleep now the husband's alarm is going to go off just as I really settle into slumber; lose control of hand, check the lump, startle guiltily as the alarm sounds; try to take advantage of subsequent lack of snoring companion by snuggling into his slumber-warmed cave of blankets; give up the effort when son's alarm goes off; lever self off bed, stumble out to the living room, check email, fuss at scruffy offspring as he runs out the door without his lunch or coat; remember to take bone-strengthening supplement only when I'm hungry, resent having to grudgingly wait another hour before eating. Check the lump.

Yesterday I had better control over myself, perhaps because I was able to talk about the lump to several people, mostly folks whose job it is to listen to me fret for fifty minutes. So I only checked the lump three times, and one of those didn't count because I only checked to see if the skin over the lump indicated something was there. It did. But I didn't check that before seeing my doctors, so I don't know if that's a sign of growth or not.

Obviously this behavior is not good for me, and it might be better just to get the damned thing out so that I could just deal with it, whatever the resulting biopsy might show. But again, another surgery so soon after the others, with the inevitable hit to the immune system and the eye function. If it's just scar tissue, I'd be weakening an already stressed system right when I need my immunity function to be as strong as possible (already asking a lot, since it was never very functional in the first place).

Decisions, decisions...