Day 43 (Wednesday, 23 October): My treatment plan

It's 1p and I just got home from my 10.40a appointment with my medical oncologist. She was running late because the breast cancer multi-disciplinary team meeting was a bit heated and ran late.  As I said before, I love the idea of having all those specialists (surgeons, medical oncologists, pathologists, radiation oncologists, Breastcare nurses, etc.) applying their expertise and brains to my "case" (amongst others, of course).  I did forget to ask whether it was my "case" that caused the heated discussion but I suspect that's best left unasked...

The great news is that I really gelled with Dr. Fran.  She, like Dr. Andrew, is pretty straight forward yet compassionate.  She started by asking about my journey and my family, interests, etc.  Then she queried my knowledge of chemotherapy in the big picture and asked what Dr. Andrew and I had discussed.  After getting this picture, she moved on to treatment specifics.
Again, the good news is that I expected what she had to tell me.  The top-level is that, starting on Tuesday, 26th November, I'll have 6 cycles of chemo at 3 week intervals, followed by 3 weeks of recovery, then into 5 weeks of daily radiotherapy (M-F because, as Dr. Fran said, "radiation oncologists have worked out that cancer cells don't grow on the weekends"), followed by hormone blocking drugs (Tamoxifen) for 5 years.

The specifics of my chemo are as follows:- the first 3 cycles will consist of a cocktail of Epirubicin3, cyclophosphamide and 5-fluorouracil (5FU) 
- this will be followed by 3 cycles of docetaxel (Taxotere®) alone.

The side effects can be:
- hair loss
- decreased white blood cell count (I'll need to inject Neulasta, a booster drug, the day after my treatment and be very aware if I have a fever about 38 degrees C)
- nausea (I'll be taking anti-nausea meds)
- interference with the heart muscle's strength (!)

Dr. Fran suggested that I try the "scalp-cooling" to see if I can retain some of my hair for the first few cycles and then I could start the school year next February with a new hair style.  I like her reasoning, if nothing else than for Remie's peace of mind.

And for all to whom it matters, my cancer is a Stage III (T3, N1, M0 - with the latter to be hopefully confirmed after my full body scans).

I have to get the full body scans and blood tests before I start.  Thankfully I have another 5 weeks to do so and get my strength back and prepare.  For all of you who are local, I'll be in touch soon with requests for help (apparently the week following treatment is going to be the toughest).  The plan is to expect the worst and hope for the best!

At least now I know that my days will number over 250 as of 6th May 2014 when this treatment plan will be behind me and I have to set my sights on ticking away at that.  One day at a time.

Day 42 (Tuesday 22 October): Pause

The house guests left this morning. My diary was fairly free. I used a few quiet moments after dropping off the kids to get caught up on admin. Whew. Other than that it felt like a day of calm before the storm of my oncologist appoitment tomorrow and the ensuing information to digest.

Continued thanks to all for your support. Bozo, Lis, Carol, V and Cren: thanks so much for your messages and the pearls of wisdom (and jokes) they contain. Sandra, your humour keeps me going. Sandy, you know I appreciate all you and Mig do for all of us; thanks for the chat today.  And thanks to my mother for preparing a little "care package" with all sorts of essentials to help me through treatment.

Emma, it was great to finally see you. Thanks so much for the idea of Champagne brunches"in between chemo cycles as something to look forward to (more on this later).  Kylie, thanks for your time and listening today and for finding the kids' book about breast cancer at the library; Remie loved it.  Sue, you are a legend for setting up the Meal Train. I'll post the link when I can find it so those who are keen to cook can book it in ;-). Louise, you helped infinitely in getting my head to the right place for tomorrow. And finally, my dearest Nick, I am eternally grateful for all that you do, even though I might act otherwise.

I'm optimistic that a good night's sleep will enable me to be as strong and brave as possible for this next step. One day at a time.

Day 41 (Monday 21 October): Reality

I just snapped at my father-in-law. He and my mother-in-law have been here since the day after I my surgery "holding down the fort". They have cooked and cleaned, looked after the kids and did projects around the house bin short they have been phenomenally helpful and we are lucky to have their support.

The end of dinner discussion moved to FIL's 70th next April and the possible party. I said with regret that I was likely to still be in treatment given the 6 cycles  of chemo at 3 week intervals followed by 6 weeks of daily radiotherapy, all starting roughly 4 weeks from now. He joked and told me to tell the person organising it that it would have to wait: a bit of a laugh in the normal world. I snapped, saying i didnt want to talk about it right now. He apologised Sincerely. I am sorry I reacted badly, but this is my reality.

I had lunch today with a friend I haven't seen in over a year. Our kindergarteners,were at the same pre-school and did ballet together for awhile. I learned from a mutual friend that K is on the same path I am travelling, just 2 weeks ahead of me - plus we both are seeing the same surgeon. Bizarre small world. We exchanged stories, hada laugh, talked details and pledged to try to sync our chemo schedules and stay in contact.

It was very strange to meet with someone I know who is going through this. I've considered it my cross to bear and I think I may now have an idea as to how others are taking in my news.

Day 40 (Sunday 20 October): Numbers

I can't believe it's been 40 days (nearly a month and a half!) since Dr. Karen told me I have cancer. Noah survived the flood in the same amount of time. It seems like years ago given everything that's happened. I found myself wondering what the final count will be until I get beyond "it".

I pulled together all my pathology and all my invoices earlier today. I thought I should get started creating a useable file before it got too out of hand. I was curious to learn that my total medical costs to date, before Medicare and private Heath fund payments, is just over $8,000, making it a daily average of $200. If I weren't sick before totalling that I now have real reason to be! I wonder what that daily average will be as I near the end of the journey. I best submit my claims to date soon.

Day 39 (Saturday 19 October): Preparation and celebration

As I headed out on my Saturday early morning "training with the girls" (which this week consisted of walking down to and along the beach to meet Rach and Jen for brekkie before the kids' swim club), I thought about how my training for road races, triathlons and other competitions has prepared me for this challenge. I didn't know if I could finish my first half-marathon then a full marathon then not drown in the swim leg of a tri. I was terrified when I climbed Mt. Shasta and still panic every time I do an ocean swim. But I do it. I just breathe deeply, think positively, ignore the pain to the best of my abilities and rely on my friends. I'm going to use the same strategy this time ;-)

We had a lovely evening down the street at Little Manly beach and kiosk for dinner with the families of the 3 girls with whom I train. This is a key part of our extended family in Sydney as the kids have known each other for as long as they can remember. We made it Alex's birthday celebration, so the grown ups drank too much champagne (and wine and beer) and the kids had a ball roving the beach with sparklers until dark. The cake made by our fabulous neighbours (with Lego figurine topers in fondant made by a pre-school mum) was divine. It was a great night shared with friends, which really is one of the things that makes life grand. 

Day 38:(Friday 18 October): Uplifting

I had my post-op appointment with Dr. Andrew today.  Rebecca took me in and started the discussion. As she read through my pathology and got to the actual surgery and positive read on my sentinel lymph node, she summed up our experience by saying that "I threw them curve balls at every step".  Have I not said that it is all about one's perspective?!

I essentially learned nothing much new about my treatment in terms of the practical details. I did get a bit more information on why I need chemo (lymphatic invasion, type 2 and 3 tumours, my youthful age) and radiotherapy (breast was filled with both DCIS and invasive cancer, some close to the skin, so it's a bit of insurance). I will need radio on the glands at the base of my neck, it sounds like, as it seems my breast drained that way as well. Go figure.

I asked Rebecca why they didn't given a stage rating to my cancer (generallynused for prognosis and treatment). After asking me if I really wanted one, she said they need additional tests that my medical oncologist was likely to order, so she wrote them (bone and full body). Apparently the 2 tests will take all day; I am quickly starting to understand why people have said that they are so sorry I have to go through this.

I have an appointment with Dr. Fran, my medical oncologist, next Wednesday morning, in which I suspect we'll discuss dates, frequency and cocktail for my chemo. (I'm angling for 18th Nov start to be ok for the kids' dance concerts and then for Xmas). I

I am healing well and everything looks good. The most surprising part of my appoitment was an "inflation": Dr. Andrew filled a syringe with 60ml of saline and injected it into my expander and my boob got 60ml bigger. Now the new one sits up high and is getting perky while the old one hangs low and is definitely droopy. Bizarre. 

Finally, the convertible inspection was a bit of a bust as Nick says it'll need lots of repairs so I should spend $10k more to get something more reliable and I'd rather spend that money on a holiday/girls' weekend. I'm sure this is a continuing saga...

Day 37 (Thursday 17 October): A reason to be home

Happy 9th birthday to my beautiful boy! It's funny to think that 9 years ago I thought that having a caesarean after 16 hours in labour was hard work. I swear it is all in one's perspective.

I am so pleased to have been able to be home and feeling good to celebrate Alex's birthday. It started with pressies first up then Nana's lemon cake after brekkie. A celebratory dinner out was capped with ice cream sundaes. Lots of cuddles before bed ended a great day.

I also had a fabulous visit from a lingerie and breast prosthesis woman who fitted me in my own home. She was positive and respectful and shared some wonderfully uplifting (pun intended) stories. It was a fabulous experience and I now have a fake booby that balances me out plus some bras and singlets with pockets for my insert. She also tells me i can pop my insert into my normal swimmers so  I'm loking forward to getting back to laps in 5 weeks. Perhaps.it wasn't the most glamourous of consultations but I do feel more confident about my imbalance.

In preparation for my jappointment with Dr.Andrew tomorrow, I just went through the "Understanding Your Pathology" chapter of the "Breast Cancer: Taking Control" book at the Breastcare nurse gave me.  There is a reason I'm not in medicine. I at least feel like I know what to ask but have to go to sleep now as I am exhausted yet again.