Wednesday, July 16, 2008

Medically Speaking...

Howdy Folks,

Time for a little medical update.
I had my weekly visit to the oncologist yesterday.
You all will be happy to know that my weight has continued to stay consistent. I fluctuate by 2 pounds weekly -- This has my doctor very pleased since he wants me to maintain my current weight. My counts were very good. White Blood Cells at 10K so the Neulasta injection the day after Chemo really did its job and the bone pain was not as intense this go around. I did still feel the little teeny tiny bones in my ears but only for a short time.

I took several questions to this appointment and received some answers that I want to share with you all.

1) Hysterectomy vs. Ovary & Tube Removal
I am leaning towards having all of my remaining lady bits removed for a myriad of reasons. My ONC is not in disagreement. A few things need to be discussed before a final decision can be reached. There are the results of one more genetic test (CHEK2) that are pending. The idea of what poses less toxicity to my system and a conversation with my OBGYN. Next week I will meet with my OBGYN to discuss toxicity and a few other things. My blood is currently being tested for the CHEK2 gene (results take close to 6 weeks.) Since my cancer is hormone receptor positive I really have to do something to curb the normal hormone producing process in my body and the idea that once off Chemo (which has thrown me into menopause) to only go through menopause again at the "normal" time seems like a twisted joke. But I will patiently await more information.

2) How long after Chemo before starting on Tamoxifen or Aromatase Inhibitor with/without Zometa
My ONC was one of the authors on the recent big study on Zometa and feels it may not be the best option for me. A Bone Density study will be needed before any decisions are made along with the final decision on question 1. If my ovaries remain inside of me (for whatever reason) then I would be on Tamoxifen for the next 5 years (taken like a vitamin) but if I am without them then I would be on an Aromatase Inhibitor.

3) Radiation
I DO NOT need radiation -- Yeah!
4) Tumor Markers
These will be monitored regularly after my last Chemo forever and ever.
The current post Chemo plan of attack is to begin the healing and recovery process for my mind, my body and my spirit and will include:
Port-A-Cath removal -- done in hospital but out patient procedure. I will need DDAVP prior (this is the clotting factor my body does not produce enough of [see earlier post on Von Willebrand's]). This may be done with the following or on its own. Since my body heals a bit slowly from surgery due to the VW my ONC wants to keep things as simple as possible since the end results will be the same.

Lady Bit removal surgery -- pending answers to questions above. I foresee earliest I would be able to do this is in early September.

Reconstruction surgery -- if all goes well I can proceed with this surgery 3 to 6 months following my last Chemo (so I am thinking somewhere between 10/29/08 & 1/29/09) -- If you know someone who had reconstruction surgery and they were happy with their surgeon please let me know.
And now for my Chemo Side Effects update. I am continuing to feel good and am grateful for the good days and the ability to go out and about and do things. I am listening to my bodies cues and trying to not overdo it. If I need to rest I rest. The last couple of days I have been experiencing an odd feeling in my lower legs (knees down to feet) -- kind of a heavy feeling as if I am wearing lead ankle weights. No need to worry -- I am checking in with my ONC daily. My ankles are not swollen and I am elevating my legs even as I type this. I will keep you in the loop. I am (with my ONC's blessing) continuing to exercise lightly during this as well.

The buzz cut continues to make me happy.

The hot flashes continue to make me hot and I seem to be waking between 4A and 5:30A daily... only to go back to sleep until the alarm sounds.

That's my medical news thanks for reading.

Ancora Imparo


Juls said...

Okay, you don't have to answer my email. INCREDIBLE news that you don't have to do radiation! Woo-Hoo!!!! As for the lady parts, sounds like there are a few things up in the air to know exactly which is best. But in either scenario (whole or partial), there's a game plan for drugs accordingly. YAY. See, it's all falling into place.

When do you get the Porta-Cath removed? How long after chemo is finished? Or when the female bits are decided, would it all happen at the same time?

I'll ask my friend who's sister just has reconstruction if she was happy and pass along accordingly.

This was a great blog post. I'm so excited and happy that it's almost over and that it's all pretty much on the upswing.

We love you, you know that!!

Aaron said...

Howdy Marla!

No radiation is fantastic news!!! While this whole process is rather like a mine field, its great to know that there's at least a nice little part of it you can walk without any surprises. The management of side effects, stable weight, good white counts - its all extremely encouraging news! As for the 4AM daily awakenings...glad to know I'm not the only one who does that! :)

I'm also glad to see that you are continuing to do your homework and are now getting to focus on longer term goals. Its an awful lot to take in, but to the extent that you are at least able to look ahead to the reconstructive surgery in a reasonable timeline, its a nice reminder that your treatment is well along the way.

Thanks, as always, for keep us posted. Have a GREAT rest of the week!


Anonymous said...

Great news, all the way around...and the fact that you had these questions at this point is a sure indicator that your chemo rounds are almost done...Onward and upward...looking toward the light.

Always, Marilyn, Fred and Betty

Anonymous said...

Marla, it was so good to read your update and see what's going on right now. I'm so happy that you have such pardon-the-put "cutting edge" medical specialists. And I'm so impressed and inspired by your whole thoughtful approach, the questions you have, the analysis you do, all of that.

Just know that we're in your corner out here, and keeping you, Mike and Sully in our thoughts continually.

So happy to see bright lights ahead at the end of the proverbial tunnel.

Susan, Larry and Matthew

joyce said...

So glad we talked on the phone today and made the connection with Mark. I am completely confident that you will be in the best of hand and I look forward to seeing those "Angelina's"!!
I love you,