I've been busy being OK

It's October already. It's not even the beginning of October, but the middle. It's almost Halloween. I've actually seen some Christmas lights in the neighbourhood. My summer was fantastic, after all the surgeries, I guess anything would classify as fantastic. We did lots of camping, of course, and then came September.

We all started back at school this year, me included. I always felt left out when everyone got new pencils and notebooks, so I decided to take a course. I registered for the School and Community Support Worker Program in March, and I am loving it. There's a lot of work involved - lots of reading and essays. That's why I am writing in the blog now. It's because I have three assignments due, and I love to procrastinate. The last time I was in University, I baked when I was avoiding work. Now I play the piano. I've actually become quite good!

It's a two year program, part-time, and most of the courses are in the evening. There are two practicums; one is community-based, and the other is school-based. I've signed up with a residential drug treatment facility for January, and I'm really looking forward to the experience. I am so happy to finally be doing something with my life. Of course I'm glad that I have a life to do something with. I feel well and it feels good to be on the path of normalcy.

I've still got another surgery in January to replace my tissue expander and put in a permanent implant. Apparently, it's a fairly simple procedure. After that, a nip and tuck to equalize things, and I should be ready to party. Other news to make me smile is I have had my last appointment with my cardiologist. I was seeing him for two reasons, one is that my heart function became impaired during my chemo treatment, and the other reason was for an irregular heart beat. This bigeminy (the heart alternates a regular beat with a premature beat) was discovered during my partial mastectomy, back in November 2008. It hasn't caused me any concern, and the belief was that it would be with me for the rest of my life. Not so. My function is back and my heart beats the way it should. I've got a regular ticker now. Picture me with more grey hair, 20 pounds overweight, still lopsided up top, but normal, good, in fact - great. 

It's coming up to my two-year cancerversary  (November 11), and I'm very thankful for every day I have. Our family just participated in the Run For the Cure at the beginning of October, and we shared a fabulous Thanksgiving dinner with Wanda and her family. These are beautiful days.

kerthump, kerthump

On Wednesday, I went to Victoria for my cardiologist's appointment. Joelle (my friend who moved from Nanaimo last fall - the mother of Victoria's friend, Kanika) and Claire met Wanda and I at the hospital for a quick lunch before my appointment. We waited a bit in the office before the doctor came in, but what an enjoyable wait. The receptionist is French, from France, and her English is quite limited, but boy is she ever a hoot. The waiting room was full of people, and she had us all involved in a conversation and was passing out little candies to us. Finally, the resident called me in. He looked over the result of my echocardiogram, which was done three weeks ago, and asked if I had been notified of the results yet. No, wondering "what now". However, he had good news.

Explanation of an echocardiogram:

An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart. Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart. The latest ultrasound systems now employ 3D real-time imaging.

In addition to creating two-dimensional pictures of the cardiovascular system, an echocardiogram can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave Doppler ultrasound. This allows assessment of cardiac valve areas and function, any abnormal communications between the left and right side of the heart, any leaking of blood through the valves (valvular regurgitation), and calculation of the cardiac output as well as the ejection fraction.

My results were normal! Yeah. My ejection fraction is at 60%, up from the 45% it was when they detected trouble. Now it's back up to normal.


Here's another explanation:

A normal cardiac ejection fraction is between 45 and 60 percent. Any number lower or higher needs further investigation by your medical team. If your ejection fraction is below 45 percent it is an indication that you may have significant risk of heart attack because of weakening of the heart muscle itself. If the heart is unable to pump an adequate amount of blood to the rest of your body other organs are in danger of collapse. If your ejection fraction number is over 60 percent it is an indicator of high blood pressure. Your cardiologist will be able to determine the appropriate course of treatment. Early intervention will help you avoid a possible tragedy.

So I'm tickety-boo in the heart department. I still have the extra beat, but that is being looked after with medication.

5th treatment

Tuesday, April 14

I know I should have posted this before, but life got in the way of writing. The week in question was a busy week. Rosalie had an MRI scheduled for her knee the same time I was scheduled for my blood work. Wanda, my second self,and personal escort came along to make sure Rosalie got in for her MRI on time. As soon as I was finished, I rushed up to the imaging department to fine Rosalie. Shortly after I arrived, she was called to get changed.

She was not impressed with the giant baggy pants. They are one size fits all, made to accommodate the largest man. She is 9 year old girl who is very sensitive to how her clothes fit and feel. I could sense disaster coming, but Wanda was able to cheer her up and make her feel OK. Off we toddled to the big fancy room. I thought that I had had an MRI before, so I did not explain it correctly to Rosalie.


She had to lay on the table perfectly still. Check. She could pick a radio station to listen to with big comfy headphones. Check. The machine will make a very loud banging noise. EEhh - not good. Wanda and I received ear plugs and the noise was disconcerting to me. Rosalie did all all right at the beginning of the first 5-minute session, but she was getting uncomfortable towards the end. I couldn't hear her, but she was mouthing "how much longer?". The technician came in and helped her calm down, and gave her a face cloth with which to cover her eyes. After that, she was much more calm and did manage the next two sessions fine. It helped that she was imagining the machine as a giant doughnut.

That part off the day being over with, we went downstairs for my pre-chemo appointment with Dr. Dunne. The complaints from the last session were reviewed and then we were released. When I got home, I received a call from Dr. Cameron's office (Rosalie's orthopedic surgeon) asking for her to come to his office the next day. She mentioned the word, "urgent". After some give and take with her, I was able to get an appointment at 8:30 am, right before chemo.

Wedensday, April 15

Why did she say the appointment was urgent? I have learned to hate that word. No worries, though. The doctor saw her, went over her MRI results, and everything checked out. She has a lot of fluid on the knee, a bruised bone, and torn cartilage. Since she's young, she should heal without any medical intervention. He even gave the OK for her to join the Track and Field club. What a relief that she will be fine. Thank you, God.

The next day was chemo and Evelynne joined me for this one. She and I played "Apples to Apples" with a volunteer. What a good game! We had the junior version, but there is an adult version and it meant for 4 - 10 players - perfect for our entire family and parties. We also played "Snakes and Ladders 3-D" - very fun! The volunteer really took to Evelynne and offered her every snack available. She had cheese and crackers, a Popsicle, juice, and ice cream. All in all, it was a pleasant way to spend time.

Saturday April 18

A weekend of skating, in Port Alberni this time. Lucas skated in his singles event, in a new level this time and placed second. Just he and I went for the drive, so that was nice. We stopped for a giant ice cream cone and went to the waterfront. Port Alberni is in the centre of Vancouver Island, 50 kms from the east coast and 95 kms from the west coast, but is on an ocean inlet that flows all the way to the open Pacific on the west coast. It's a beautiful spot, nestled in the mountains.

I decided to skip the cone, but Lucas enjoyed his!

My son and I

The team - Kanon and Lucas

Korin, Lucas, Yuzuki, and Kanon

"I hate getting pictures taken, Mom. Will you please hurry", although I don't think he said the "please".

Sunday April 19

The whole family drove up the next day for the 8:00 am pairs event. Lucas had to be there by 7:00 am, which meant we had to leave by 6:00 am. You can imagine what it's like getting 4 kids out of bed at 5:30, to be on the road by 6:00 am. Not easy. They snacked on the road, and we got there in plenty of time. They skated really well, and received the gold medal. I love watching them skate.

Now you will remember that I had chemo on Wednesday. Day 5 always seems to be the start of my troubles. Guess what day Sunday was? By the time the kids skated, the results were posted, had the medal presentation, I was famished and beginning to get kind of shaky. We drove off in search of food, and I felt a bit better after that, but was starting to get very tired. I slept some on the way home, ate lunch once we got home, then climbed right into bed. I thought I would have a little nap, but slept the afternoon away. I could not open my eyes, nor could I move out of bed even if I had wanted too. It wasn't a feeling of being tired, more like completely drained of every energy cell. It's a strange feeling. It lasted most of the way through Monday as well. I got out of bed to do errands with Norm, but stayed in the car most of the time. I was up and at 'em by Wednesday, and saw Dr Carr on Thursday (those details are in the previous post).

Sunday April 26

Victoria had a soccer tournament on Salt Spring Island this last weekend. Norm took her for the Saturday games, and the family plus Grandma came on Sunday. She played so well! What a tough girl. Victoria really took a beating on Saturday, doing a crash onto her shoulder and getting kicked in the shin. She can get up from a fall faster than anyone I know and is able to beat the person who caused the fall to the ball. Their team was playing up a year, so all these girls had already hit their growth spurt. Vitoria has not - she is small for 11. A lot of girls from the other team are already 13 and very big. That did not matter to my small, quick daughter. Her team played two games on Sunday morning and we were able to explore the Salt Spring fro the afternoon. Another gorgeous place, but expensive. At the farmer's market, someone was asking $18 for a loaf of lemon poppy seed bread. Crazy. It's an island populated by both hippies and the wealthy. Since we don't fall into either of those categories, we will visit again, but could never live there. 18 bucks for a loaf of bread- can you imagine the house prices? We walked along the waterfront, near Ganges, and vowed to come back with our boat to tour through the Gulf Islands. It's a beautiful area. Here's a link if you want to see what I'm talking about: http://maps.google.com/maps?t=h&hl=en&ie=UTF8&ll=48.862633,-123.49288&spn=0.039356,0.111237&z=14

And some pictures:

On the ferry, heading toward Vesuvius, Salt Spring.

Looking East from Ganges Harbour

Monday, April 27

A very nice weekend, and back to business on Monday. Victoria felt that she didn't get enough exercise over the weekend, so she and a friend, along with Norm and Rosalie, rode their bikes to school, a distance o about 7 km. They also rode back the long way, another 12 kms, then she had soccer practice that evening. By then, she was tired.

Tuesday April 28

I had my mammogram yesterday. They did both breasts, and next week, I will have an ultrasound only of my unaffected breast - the left one. I have a bad feeling about the mammogram. I peaked over to the screen and I swear I saw a lump. The images of both breast were up, so I don't know what I was looking at. The technician asked me a couple questions that made me think, uh, what's up now. Maybe it's just scar tissue, I don't know, but I'm not going to get all crazy about it yet. Dr. Carr will phone if there's anything, and so far the phone has not rung. My ultrasound is next Thursday, so all will be revealed by then. In the meantime, I am going to see the cardiologist in Victoria today for him to go over the previous tests I had on the 26th of March. I am looking forward to a nice drive with Wanda, and a visit with Joelle and Claire.

That's all for now. Cheerio.

another treatment

I went for my MUGA scan (they inject me with a radioactive isotope and see how my heart pumps the blood) yesterday and saw the doctor today. The scan did show a a significant decrease (25%) in heart function. There is hope I can recover the loss over time (I guess so - who do they think they are talking about anyway?). 

In any case, I have to switch treatments to a less toxic one. Now instead of Epirubicin, I will have Methotrexate. The other two drugs (Cyclophosphamide and Fluorocil) remain the same. 1 - 1.5% of the people on Epirubicin will experience a decrease in heart function, and I am lucky enough to fall into that category.  

There won't be much of a change - I will have my last four treatments of CMF instead of FEC, and will still finish at the beginning of May. One good thing is that Methotrexate does not cause total hair loss. 

I'm picking up Mom this afternoon and she's spending the weekend with me. She's coming with me to my treatment tomorrow along with Lucas. I see a morning of "Crazy 8 Countdown" in my very near future. 

On a side note, it snowed like crazy yesterday afternoon and evening. 43 cm (17 inches) of snow fell on us in a very short amount of time. School was cancelled - yeah. Go ahead and make fun of us, but honestly, no one can drive around here. Norm picked up Lucas from church last night and he saw a taxi making a u-turn in the middle of traffic, people backing up, and others passing on the wrong side of the road. It's chaos. Plus, it takes forever for the city to send out the snow plows. Norm had to come home from work to take me to the doctor this morning because our lane was not plowed. The snow was so deep that there's no way the van could get through. It is a joke. I thought spring was here. What is going on? It's February 26th for Pete's sake. I was getting used to the smell of hyacinth in the air. Now the poor things have been crushed under a mound of white stuff. 

Here are some pictures of what Nanaimo looked like last Wednesday, before the snow. I took these on my way home from taking Lucas to skating in the morning. The first two were taken at Departure Bay and the last two were taken at Piper's Lagoon. 

 

heart

When I was on the operating table, it was discovered that I had an irregular heartbeat. Oh, not another thing! This was not a nice way to enter the drug induced sleep of anesthesia. Right as the sleep was beginning to overtake me, I heard, "Did you know you have an irregular heartbeat?" "uh, ... no". Now what? There's no going back. I hoped I would wake up again. Of course I did, and everything is fine, so to speak. As I was in recovery, Dr. Carr and the anesthesiologist came by to see me. I was presented with a copy of my ECG from surgery. They didn't think it was anything to worry about, possibly it's a one-time deal, but you need to see a doctor about this. 

Another round of doctors began. Dr. Carr and my family doctor, Sheila Findlay, were literally tripping over each other to get me in to see an internist in a timely fashion. I ended up going to the office of Dr. Baillie on the 4th of December to pick up a Holter monitor. This little device would record my heart beats for 24 hours. The technician told me that most people had PVCs (premature ventricular contractions) and that it's probably nothing to worry about. Fine, consider me officially "not worried". The day came and went. Julie was visiting, so we passed a very pleasant day visiting and walking and enjoying the good weather. I dropped off the monitor the following morning with an appointment to see Dr. Baillie on the 10th. 

A very nice man, is Dr. Baillie. And he has a lovely Scottish accent to boot. Considering I am rereading my beloved "Outlander" books again, this is high up on my list of things that matter. He diagnosed me with having moderately severe PVCs, but still wasn't worried. He explained that ventricular premature beats are extra beats that cause an irregularity or abnormality in the usual rhythm of the heart. These extra beats are known as a premature ventricular complexes (PVCs). His main source of concern was to clear me of any underlying heart problems before I start chemotherapy. I did the stress test in his lab right then and there. No problems. As was hoped for, my heart returned to a proper rhythm with exercise. I asked if I should be exercising more in order to get my heart to do the right thing. "No", he said. "You don't have to run everywhere". OK, thanks. The next step was to go to the hospital for an echocardiogram to see if my heart is in fact healthy. Dr. Baillie called last night to say that my heart was just fine, peachy in fact. That's one of my favourite expressions! My valves and the muscle looked perfect. He's going to call me on Monday to discuss medication - beta blockers. This will regulate my electrical system, but will also lower my blood pressure. Since mine is already on the low side, I'm not sure I want this. We'll talk Monday.