Ringing the bell on chemo

This past Monday was my 11th and last chemotherapy treatment. At the end, the nurse handed me a beautiful Tibetan bell to ring, which is a custom at the clinic when a person has her or his final treatment. It was a very nice feeling to ring that bell.

When I got home I was feeling a bit queasy. Up to this point, there was one chemo side effect that I had escaped. Well, forget that. I had the most horrible diarrhea all evening. Even prep for a colonoscopy wasn't as bad as this. When it finally subsided around 9 p.m., I was too exhausted to do anything but fall asleep. I was still feeling a bit sick to my stomach the next day; but seem to be OK now.

I met with my oncologist before my chemo treatment, and asked her a lot of questions about surgery and follow-up radiation and medication. She confirmed that a lumpectomy followed by radiation gives the same result as a mastectomy…reducing the chances of recurrence to 10%. We discussed the side effects and risks. I've decided to go with the lumpectomy.

My surgery is scheduled for June 19. The plan is to get me in at the crack of dawn, subject me to some unpleasant procedures, render me unconscious, remove the remnants of the tumor, check my lymph nodes and remove one or two of those, sew up the wounds, and send me home by the end of the day. If any complications arise, David will have to take me back to the hospital. God forbid that I should have professional care overnight. Might cut into the insurance company's profits.

I have a few weeks to heal and will then start radiation treatments five days a week for six weeks. That is going to be soooo convenient.

I admit to feeling some anxiety over the surgery. It seems that I am constantly running into reminders of death. I was waiting for a streetcar the other day, for example, when I noticed a newspaper box for the The Portland Mercury, which had a cover story on "How to Die in Portland." Then we saw a film in which Bill Paxton was one of the actors, and I remembered that he died this year from complications following surgery. I opened the newspaper and saw two obituaries for women who have died of breast cancer. The rational side of me says I don't have a lot to worry about, and I have been doing my best to keep a positive attitude and build up my strength. (I finally went back to the gym this past week.) But I feel that I have to take care of some things like updating my will and organizing a list of all my various financial accounts and explaining them to David.

On the other hand, I have started working on a client's newsletter that I will publish in July, organizing a silent auction that will take place in August, and thinking about where to go on a "road trip" in September so it's not like I am steeped in gloom. It's just this sense of a cloud hanging over me.

The choices all suck

This past Friday, I met with a surgeon to discuss "what comes next." She answered all my questions about the various options and gave me a lot of information.

My choices come down to a lumpectomy to remove the remnants of the tumor, some surrounding tissue, and 2-3 lymph nodes-- or a mastectomy to remove the whole breast and 2-3 lymph nodes. We also discussed the possibility of a double mastectomy and reconstructive surgery. If I have the lumpectomy, I also would get six weeks of daily radiation treatment. With a mastectomy, radiation may or not be on the agenda, depending on what is going on with the lymph nodes. 

All the options basically suck.

I asked her which option she would advise and she said the choice has to be mine, because it's really more of a psychological than a medical decision. With the kind of breast cancer I have, statistically the outcomes are about the same in regard to chances of recurrence and survival rates.

So, I jokingly told her I would get back to her after I go to medical school for four years. 

Whichever way I go, I will also be taking oral medication for the next five years … the main side effect of which is hot flashes, which I already have had too much experience with. And I will have to go in for check ups every six months. So even after all the chemo and surgery, cancer will continue to be the Sword of Damocles hanging over my head.

I have my final chemo treatment coming up on May 22, and I can't have surgery until my white blood count rebounds from that, so I have some time to mull over the various unsavory options. 

On the plus side, I feel pretty good physically, except for some lingering neuropathy and ankle/foot edema. The vegetable-intense diet, glucosamine, vitamin-B supplements, and daily walks all help me feel like I am actually doing something, rather than just having things done to me.