YES! Some Really Awesome News!

Yesterday (February 24), I had an MRI on my breasts to assess my response to the chemotherapy.

I am so happy to report the following.

Right breast findings: No suspicious mass or nonmass enhancement. Specifically, no significant residual enhancement is seen at the extensive sites of previously noted abnormality involving multiple quadrants.

Right lymph nodes: No suspicious axillary or internal mammary lymphadenopathy.

Conclusion: No significant residual abnormal breast enhancement or enlarged lymph nodes, compatible with complete imaging response to neoadjuvant chemotherapy.  

Yes, yes, yes!

The MRI showed that I had what is known as a pathologic complete response (pCR) to chemotherapy. (When I have my mastectomy, they will test the tissue that they remove to confirm this fact.) This is a huge thing for someone with triple negative breast cancer. Patients who achieve a pathologic complete response with neoadjuvant therapy tend to have a good prognosis. That is, patients who have pCR are at a much lower risk for subsequent distant disease recurrence. Some studies have found that in cases of aggressive breast cancer, like triple negative, that the benefit is as high as 75%/ one-quarter of the risk of recurrence compared with patients who did not achieve a pathologic complete response.

I have appointments in the upcoming weeks with my surgeon and plastic surgeon. My mastectomy is scheduled for March 22. I am not yet sure what, if anything, the pCR means for my treatment plan. I should know more in the upcoming week.

While I wait, I am simply going to bask in this good news. Good news helps with nausea. It's a scientific fact.

Chemo Round 6 ... Last One!

Since I started chemotherapy in November, I have had the date February 21, 2017 circled on my calendar. February 21 would be the day of my last chemotherapy. Just hang in there until February 21, I would think.

I am happy to report, I made it! (Kitty is still hanging in there. :-) )

Love my nurses! 

I'm at a little bit of a loss as to what to say. It is now a few days after the chemo. I still feel sick to my stomach a bit and a little dizzy. But I also feel awesome. To not have to mentally prepare for another round of chemo right now is the most amazing feeling. Thank you to the wonderful staff at UCLA Hematology and Oncology for taking such good care of me. What a wonderful, compassionate group of people.

The after effects of chemo can linger for years. I'm hopeful that all of my side effects will go away. Also, I'm ready for hair again. It's been nice to not have to shave but I'll gladly take that on again for a thick head of hair.

Know what I DO have to prepare for? The CrossFit Open!!! I'm going to attempt the 17.1 workout tomorrow. Dumbbell snatches and burpee box jumps here I come.

 Coach Marie and me before my last round of chemo. 

Seth loves these types of photo opportunities. 

I've still got it. Right?

Slay ... Jon Snow

My Mom had breast cancer. She found a lump when she was 55. She went through a lumpectomy, chemo and radiation. I'm very happy to say that the cancer has not come back.

I'm not really much for support groups so being able to discuss cancer stuff with my Mom has helped immeasurably. One of the things that she told me was that it was helpful to her to visualize the chemo as a small army of soldiers killing the cancer cells.

People who go through chemo are tough as hell mentally. Yes, chemo is absolutely awful physically. There is pain and nausea and awful physical side effects. But mentally, it is a beast. As a chemo patient, you have to walk into a clinic and let someone put an IV filled with chemicals into you, when you know ... you know ... how awful it is going to make you feel. And, not only do you do it, you do it gladly and with a smile on your face because you know that it is your best chance to live.  

So, yes, visualizing tiny soldiers killing cancer cells is one thing that helps when you are so dizzy you can't sit up or you feel so nauseous that you can't imagine eating again.

At one point during all of this, I decided that if I was going to think about soldiers killing my cancer cells, it was going to be my ultimate solider.

Slay that cancer, Jon Snow.

44 and F$$$ing Fabulous!

Yep, that's a gun filled with tequila. 

I love to throw parties--especially birthday parties--so I didn't let the cancer stop me from my 44 and fucking fabulous birthday party. I had a lot to celebrate, including having some of the best friends and co-workers anyone could ask for. I had such a great time. Also, I had three birthday cakes.

Just another reminder to not wait until cancer or something awful comes along to live life to the fullest. Throw yourself a party! I highly recommend it.

My dear Macalester friends, Dianna, Jake and Maia made it to the OC for the party. Thank you!!

  Also, thank you to Tim and Willow for the sweet Duke sweatshirt.

Chemo Round 5 and More Fun with Insurance

Best shirt ever.

I had my fifth round of chemo on Monday, January 30. It was similar to the other rounds but they gave me some additional anti-nausea medication since I was pretty nauseous after the last round. Dr. Coluzzi didn't do an exam this time so no new news on the tumors. He said he would do one before my last round of chemo. I feel like my tumors are continuing to shrink but I guess the MRI I get after the next round will be the real judge.

This round made me so tired. I slept most of the day on Wednesday. On Thursday I worked and I definitely did not feel very well. I left at 3 and was asleep on the lazy boy by 3:30. I slept until 5 when I woke up and ate dinner. I think I was awake until 7, when I went to bed and slept until 6 am. Other than the sleeping, I'd say that I am having most of the same side effects as last round but they are a little worse. As I've been told, chemo has a cumulative effect.

The effexor has not been effective in helping with the hot flashes and night sweats. Dr. Coluzzi doubled my dose to see if that would help. I'm writing this about five days after doubling the dose and if anything, the hot flashes are worse. I'm not sure what can be done at this point. Dr. Coluzzi said I had about a 50-50 chance of ever having a period again. They'll eventually go away, right? Eventually?

I walked on Tuesday and Wednesday. I try to do two laps around the perimeter of our apartment complex (1 lap = 1 mile) and then I walk across the street to get coffee or something to eat. It's probably about three miles total. I walked a small amount on Thursday and Friday. On Saturday morning, I went to CrossFit. I kept getting light headed so I took it very easy. I would run 200 m and then I would rest a bit and then jump rope. Box step-ups, rest, push ups, rest, dumbbell clusters, rest. Goblet squats, rest. Dumbbell snatches, rest. Done. I'm hoping to be able to do a little more in the coming week but I'll listen to my body and see where I'm at. I feel much more wiped out than I have with the other rounds.

The CrossFit open is coming up. Seth is encouraging me to enter. The open is five workouts; one is done each week. It is announced on Thursday and then you have until Monday to do the workout and post a score. It is the start of the competition that you see on ESPN. Everyone starts with the open. I did it last year. The problem with this year is that the first workout is three days after my last chemo and the last workout is after I have my mastectomy. It's not a big deal if I can't do it or take a no score for a workout so I probably will register.

Insurance
Things had taken a turn for the worst regarding insurance between rounds 4 and 5 of chemo. My plea to have Dr. Z, my plastic surgeon, accepted by my insurance was denied. (My appeal was based on the high-risk nature of my surgery and the lack of a qualified professional to do it within 30 miles of my home.) Apparently they found one other doctor in Orange in a completely different hospital system who does the surgery I need. Then Aetna came back and said that Dr. Lin, my radiation oncologist, was also out of network. This was after saying that they thought he was in network and me going to an appointment with him.

I pleaded with my nurse navigator/case manager at Aetna. She said she would take it to her supervisor but I had no confidence anything would happen. So I called my benefits person at my company. I can't say what I hoped to accomplish when I called her but I was so frustrated at that point, I think I just needed to vent. WHY IS THIS SO HARD??

In law school, when they teach you how to write a brief or try a case, they insist that you come up with your "theory of the case." This is the story you tell and the theme around which you make your arguments. At some point during my call with my benefits person, I came up with my theory of the case. To successfully navigate cancer treatment, I have to have four different doctors. Aetna and my company cannot expect me to be getting the best care if they insist I use doctors who do not work in the same hospital system or have an effective way to communicate. Also, the benefits person began to see that I need to focus on fighting cancer, not fighting Aetna. She was worried that I was too stressed out. (I may have said something like, what's $5,000 when you're talking about dying?) So, the benefits person decided that she would take care of business. Within 24 hours, she had gotten Dr. Lin and Dr. Z to agree to be "in-network" through July. Seriously. Less than 24 hours later. This doesn't solve all of my problems as Dr. Z will need to do work after July but it will get me through radiation. To say that this is a relief is a very serious understatement.

Thanks again to everyone for all your love and support!