Pizza, Cake, and a Giant Rat

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Today was my daughter’s 6th birthday celebration. For more than half her young life, she has chosen to spend her special day with a giant, buck-toothed rat. It’s really rather strange when you think about it. On any given weekend across America, hoards of children dance around this character while terrible renditions of 80’s rock blare over the speakers, their words replaced with bad rodent puns.

And the parents….poor suckers. They shell out upwards of a hundred dollars to party with the rat. What does this buy you? Some greasy pizza, an 8-inch “cake” (which is basically 2 pieces of Twinkie cut in a round shape and slathered with artificially colored cool whip), and a front-row seat for songs like “Overkill” by Men At Work. Really? That’s disturbing on at least two levels. First, what the hell kind of music is this for kids? And then there’s the whole extermination..rat…killing theme. Can you say nightmares?

Ahh, but you also get tokens. These golden coins allow you to play arcade games with the sole purpose of earning tickets. And then…you can trade the tickets in for fabulous prizes which more than justify the expense of the party. I scored some green vampire teeth and a roll of SweeTarts for a mere 237 tickets. You can’t get that at some lame house party!

Seriously though, I was thrilled to be at this party, at Chuck E Cheese or anywhere else. I can’t remember for the life of me what we did for her last birthday. It was the same week I was diagnosed with cancer, and although I felt I was handling it extremely well, the whole thing is an empty space in my brain. I plan to savor every birthday from now on, rats or no rats.

Did I mention that the have beer now at Chuck E Cheese?

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The Doctor Said “Eek!”

shouting doctor

I had my 3 month check-up with the oncologist this week. I’ve been dreading this appointment like a case of shingles for weeks. Why? Let’s see. Not only did I not start my Tamoxifen like a good girl in January, but I have been doing the polar opposite of what was recommended. I moved the appointment back 3 weeks to stall, in the guise of waiting for my BRCA genetic testing results (negative) to come back, but the truth is I would have told him anything to delay the inevitable. “I can’t come in right now because I’m recovering from ebola”, etc.

So, my oncologist has been in sweet denial for the past 3 months, thinking that I’m a compliant patient, resting comfortably at night with the knowledge that he is in charge. Let’s just say I burst that bubble with a pitchfork on Wednesday.

He walked in the room after knocking gently. He greeted me warmly and asked how I’d been. “Fine, really well”, I offered, almost sheepishly. I thought that maybe my fears had been unfounded, maybe he was just going to check in and leave it at that, assuming everything was going as planned. It wasn’t to be.

“Are you on Tamoxifen?” he asked as he sat down and flipped open my chart.

“Oh, crap, here we go!” I thought, the red heat of shame traveling steadily up my chest to my neck.

“No…I…decided not to take it.” There, it was out.

He looked at me for a minute, not quite sure how to respond. “What happened?”

“Well, I’ve done a ton of research and reading about it, and I don’t see anything good. I know four people who’ve had to quit taking it because they felt that they would rather live 2 years happy than live with the side effects.” I was scanning his face for a reaction.

“I see. So, did you even try it?”

I felt at this point that I had to offer up something to make my case seem stronger and more logical, so I began to spill the beans.

“Ok, Dr. A, I like you a lot and I respect you as a person, so I’m going to tell you something, but I’ll spare you all the details because I don’t want you to have a stroke.” His eyes widened and he sat back in his chair. “I’ve been seeing that integrative MD that I told you about.” He nodded. “We’ve been doing a little experimenting.” Deep breath. “He put me on some bioidentical testosterone and gave me Arimidex to keep it from turning to estrogen in my body. After 5 days on the Arimidex, I was in such a pit of depression that I stopped taking it. Now, that pretty much tells me how the lack of estrogen is going to affect me, no matter what drug we use.”

mouse

Dr. A sat up straighter and looked in my eyes. “Eek!” I thought that probably wasn’t because he saw a mouse out of the corner of his eye. “First of all, I had no intention of putting you on Arimidex because that is for post-menopausal women. There is no guarantee at this point that you’ll stay that way. I’ve seen women older than you resume their cycles after chemo. We just don’t know how the aromatase inhibitors effect pre-menopausal ovaries.”

He went on. “So I don’t know why he would put you on Arimidex; well, I understand it biochemically, but it’s not the path I think is best for you. Second, I would feel a lot better about your decision if you had tried the Tamoxifen and told me that you hate it and absolutely can’t take it. Try it for 10 days or 2 weeks. But don’t assume that you know how it will affect you. If you tell me you absolutely won’t take it, then we’ll figure it out and monitor you more closely, but give it a shot.”

Uggghhh! Dammit, why does he have to always pull out the logic? I tried another tactic. “The side effects aren’t my only worry here. I honestly don’t think long-term estrogen deprivation is healthy. I think everyone forgets that estrogen does some good things, like protect your bones and keep your brain functioning, not to mention allow you to have sex without pain.”

I could see that he understood my dilemma and really did sympathize. He almost teared up as he said something about his mom having osteoporosis and how he worried about her falling. But, no dice. “I agree. And if you didn’t have this”, he pointed to my chart, “we’d be in a totally different discussion. But we have to weigh the risks in your case.” He got really quiet for a minute and I could see him trying to find a way to frame his next sentence delicately. “I don’t want to sound crude”, he went on, “but the long-term side effects of estrogen deprivation will be kind of a moot point if this comes back, and I feel like the window of opportunity for the Tamoxifen to work is closing.”

Ouch! After an hour of gentle prodding, he finally wore me down. “Ok, Dr. A. I’ll try it just because I like you.”

“Don’t do it for me. Do it for you. I’m your advocate here, and I want you to live a long time.”

So, here I am again, doubting my choices and in turmoil. Now tell me how good that is for healing. I almost want to fill the prescription so I won’t disappoint the doctor, with his big pleading puppy dog eyes. I have an appointment, meanwhile, with the hormone doctor next week, and boy do we have a lot to discuss! I think my bottom line for him is “If this were your wife, would you feel comfortable making these same recommendations?” Waivers and consent forms aside.

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But, I have made one decision. I am absolutely madly and deeply in love with my oncologist. I have never met a man with his combination of intelligence, honesty, and compassion. And I have never met a doctor who wears his heart on his sleeve. I’ve decided that we’ll leave our respective spouses and make a new life together once the boobs are complete. They’ll just have to understand that fate has stepped in. Phew! At least I’m sure about something:)

New Boobs Ahoy

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Well, the time has come, almost one year to the day since my breast cancer diagnosis. I feel a little giddy, like a high school girl with a hundred dollar bill at the mall. Should I get these, or, no….wait a minute, I really love the way I look in these. Do you think these make me look fat? I’m not talking about a new pair of jeans or even a daring little polka dot bikini; I’m picking out something much more fabulous and precious, a new pair of boobs.

Yes, that’s right, on March 26 I will be undergoing the first step in the series leading to my new and improved “girls”. Now, my bar is set fairly low. After all, anything would be a drastic improvement compared to the flat chest desert with the matching horizontal scars I now sport. It’s cool in a way. I look a bit like a really simplistic treasure map. I’ve followed the map; now I’m ready for the prize.

tissue expander

This first step will involve placing two plastic tissue expanders, which consist of folded plastic bags, under the pectoral muscles. (That just sounds like fun, doesn’t it?) There will be a small port placed under the skin with a tube leading to each bag. For 6 to 8 weeks, I’ll have saline injected into the bags a little at a time via the port. This will allow the skin over the chest wall, which is now flat and taut, to stretch to accommodate an implant.

Once the desired size is reached with expansion, which I’m thinking will be about a perky “C”, the expander is exchanged for a permanent implant. I’ll then have nipples created from skin elsewhere on my body, and the final artistic touch will be tattooed areolas.

This sounds like a simple process, but in reality it can be anything but. It carries the normal risks associated with surgery, such as infection and bleeding. However, when surgery is performed on radiated skin, there are additional worries. The skin may not heal properly, or it may not stretch as expected. Also, radiation causes the skin to be thinner, so cadaver skin will be used on that side to “reinforce” the implant and prevent it from breaking through.

before-after-implant

After all is said and done, I would love to have a result like the one above, which is from a plastic surgeon’s website. Hey, maybe I need to go back and get that name! Now, I’m sure that this is probably a year or more post-op to have that much fading of the scars. But all in all, it looks great to me. Ok, I might go a touch bigger, but I won’t get greedy.

The best part of all this, aside from being able to wear normal clothes again, is that I’m having the procedure the day before my daughter turns 6. I’ve already told her that we will have to go to Chuck E. Cheese a little early because Mommy is getting new boobs for her birthday!

 

Love Gone Wrong….

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My friend over at candidkay.com intrigued me this morning with a writing contest she found on the Trifecta website. The challenge is to tell a tale of love gone wrong in exactly 33 words. You can’t use the following words:  love, sad, tears, wept, heart or pain. You can post a link on the site, and the community chooses a winner.

Here is my entry:

My eyes were glued to his red elephant boots as he stormed out one last time.

With tragedy unfolding, a burning question distracted me.

“Why the fuck is he wearing red elephant boots?”

Your turn!

Easy Ways To Get More Fruits and Veggies in Your Diet

I have a new toy. I don’t often buy things for myself, and when I do, I get immediate buyer’s remorse and contemplate taking them back to the store for weeks, wondering if I made the right decision. You should have seen me when I bought my IPad. I dragged my whole family around one night, going feverishly from store to store, comparing various tablets and trying to talk myself into settling for something cheaper.

At $499, the IPad left a gnawing pain in the pit of my stomach. Of course, after hours of agonizing, I ended up going back to the original store and buying that shiny Apple that first caught my eye. But was I content and excited with my purchase? No. I kept the receipt and all the original packaging “just in case” until the last possible minute I could have returned it. Only after that deadline passed did I begin to relax and fall in love with my tablet.

But, I digress. Somehow this post has taken a nasty turn from talking about my new toy to exploring the dark places in my brain where decisions are made (or more accurately, delayed). And no one really wants to go there. It’s kind of like those scare-tactic films you once saw in health class about drugs. You know the ones..the kid tries LSD one time and never comes back from his trip. Well, I’m going to let you escape, this time.

My new toy is mostly plastic, but it has a powerful motor and razor-sharp blades that tear through skin like nobody’s business. You’re scared now, aren’t you? No, I haven’t totally lost my mind from lack of hormones and started killing random people in fast food joints…yet. I bought myself a Ninja:

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This baby was $49.99 at Target and I got A $5 Target gift card. (No. I didn’t use my credit card) It includes a 48 oz blender pitcher and a 16 oz food processor bowl. Each unit has separate blades. The motor is shown on top of the blender in the picture. It can be moved from unit to unit as needed. And clean up is a breeze. The blades come out completely so you can wash the bowl and pitcher from top to bottom.

So far, I have used the Ninja every day since I bought it. I’m trying to eat more veggies and fruit to keep breast cancer at bay, but it’s been very hard to work, take care of kids, and prepare a healthy meal every night. My hat is off to those who work full time and still find time to juice daily and prepare vegan meals from scratch, like my blog pal at lightscanceraction.wordpress.com.

Well, this kitchen tool has made a huge difference in prep time. Dicing vegetables takes literally less than 30 seconds thanks to the “pulsing” action. I’ve made homemade butternut squash soup and fresh salsa. And tonight features vegan split pea soup with carrots, onions, garlic and spices. I’ve even added a daily green smoothie to my diet. This morning, I used the following:

1 Cup Almond/Coconut Milk

1/2 Cup frozen mango

1/2 Cup frozen pineapple

Handful Organic Baby Spinach Leaves

Pinch of Shredded Coconut

Add Water to Get Desired Consistency (about 1/2 cup)

It looked something like this picture from Somer’s awesome “Vedged Out” blog:

green smoothie

 

Head over to her page for some more great smoothie recipes. I promise, you can’t taste the spinach. It just tastes fresh and delicious.

I think I may learn to love this new Ninja even more than my IPad. Ok, maybe not, but it has given me a whole new appreciation for cooking from scratch. I saved the box and the receipt…..just in case.

 

Weekly Photo Challenge: Beginning

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Just a typical Sunday afternoon in my house. I was busy looking up recipes and trying to come up with a healthy grocery list with constant interruptions from my 5 year-old daughter. Like most young children, she was jumping around like a flea doing various “tricks” to get me to abandon what I was trying to focus on and give her my undivided attention.

When she asked me for the umpteenth time to watch her dance routine, I got a little irritated and told her that I was busy and would watch after dinner. “Go play with your toys”, I pleaded. She disappeared and was quiet for about twenty minutes. Just as I finished my grocery list, she called from upstairs.

“Mom. I need to show you something in my room.” Now, usually this is not a good sign, so I didn’t hesitate running up the stairs. “What is it?” I asked. She motioned over to her bed. “Sit down, Mommy.” I sat, curious about her odd behavior.  She pointed to the careful arrangement of stuffed animals shown in the picture above.

“Does this look like a sad person?” she quizzed.  I looked carefully and was impressed with her creativity. “Yes, it really does, honey.”

She sat down on the bed and turned to me with her best Oscar-winning expression of disappointment. “That’s how I feel, Mommy.”

I instantly felt a tug at my heart strings as I wondered what could have possibly prompted such a display. “Why on earth are you sad, baby?”

“Well, I really wanted to show you my dance performance, but you told me I had to wait until after dinner. That made me sad.”

Needless to say, we had a dance recital right then and there, accompanied by lots of hugs and praise.

This is either the beginning of a long, successful acting career for my girl or a long, arduous journey into being manipulated for me. I’m guessing it will be more of the latter.

 

Would You Rather Be Shot Or Jump Off A Cliff?

80’S CANCER JAM OF THE DAY:

Go ahead. Take a couple weeks before you give us your decision. It can wait until after the holidays. Now keep in mind that 2 out of 10 women actually survive being shot, while the whole cliff thing is really sketchy…not much good going on there. But…and this is a big but…being shot can lead to all sorts of complications, depending on where you choose to take the bullet. So you may just wish you were dead.

This is something like the conversation I had last week with my oncologist, slightly paraphrased of course. Yes, I’ve finished radiation and been issued my platinum invitation to board the Tamoxifen train. Toot! Toot! He actually turned to me at one point and said “Have you done any research about Tamoxifen?” I just looked at him with wide eyes and replied “Really?”. He quickly realized what a foolish question that was and chuckled softly. “Oh yes, what was I thinking? Go ahead, tell me what you found.”

Of course I had been feverishly burning up the internet for days trying to tease out minute details about survival and recurrence statistics from mountains of muddled data. And let me tell you, they make it next to impossible to find “the bottom line”, which in my book is the absolute survival advantage in those who take this drug. I don’t care about relative risk or any other statistical shenanigans that pass for science. I was finally able to get a 10-year absolute survival difference of 10.9%, meaning that of 100 women, 11 more will be alive in 10 years if they take Tamoxifen than if they don’t.

I told the oncologist about this, and he agreed, saying that the odds might be slightly better for someone my age with my cancer, perhaps 12-15% greater survival. I’m not sure where he gets those numbers, as I was unable to find them. However, I also told him that I had serious concerns about the potential side effects of the drug versus the benefit. Common side effects include: hot flashes and night sweats, mood swings, depression, joint aches, cognitive difficulties (such as forgetting words), weight gain and headaches. Rarer side effects include blood clots, stroke, and uterine cancer.

Now, I don’t know about you, but I am just not dying to get on this train. First of all, I am deeply mistrustful of drug studies. I’ve taken enough research courses to know that data can be manipulated to say just about anything. I also know that the FDA does not require these companies to submit data showing adverse outcomes or data which doesn’t support the benefit of the drug. You only have to look at the long list of drugs which have been approved and later pulled from the market due to serious, often fatal events, or lack of efficacy to realize that you can’t always count on the “peer-reviewed research”.

Those concerns aside, I am feeling healthy for the first time in a year. I ran 8 miles last week. My color is good, and my hair now looks like a cute, short style instead of a chemo-ravaged patchwork quilt. I don’t want to be sad and have achy joints. I don’t want to be fat and wringing wet every morning. It feels very unnatural to take a body that is on the mend and feed it a drug that wreaks such havoc. The doctor said we will deal with whatever side effects come up, meaning he can give me different pills to add to the first pill.

I think the photo below shows a much better idea of what can be done with Tamoxifen bottles and a little creativity. I have to give credit to “The Sarcastic Boob” at http://thesarcasticboob.com/2012/08/16/ten-things-to-do-with-tamoxifen/ for this hilarious post.

tamoxifen boobs

All kidding aside, I truly believe in the ability of the body to heal if given the chance. I’m not against medical intervention when necessary, but I don’t think it’s natural to have zero estrogen, which will be the effect of the Tamoxifen. I understand that my tumor was fed by estrogen, but I’m not sure if it was that simple. Cancer is a very complicated, multifactorial disease. My fear is that the cancer will outsmart all of these outside interventions and come back more ruthless than ever. I expressed this to the oncologist, and he had to agree that if we use Tamoxifen and the cancer metastasizes anyway, it will likely be very aggressive and difficult to treat.

So…here I am again, at the edge of the cliff with a 9 millimeter in one hand. I think I may just lay the gun down and back away slowly. You’ll be the first to know.