herceptin

Well the Alberta government has finally seen fit to make Herceptin available to all breast cancer patients who would benefit from this drug.

For more info on Herceptin, check out this excellent article from the CBC (Canadian Broadcasting Corporation, www.cbc.ca) web site:

The promise of Herceptin
Last Updated August 30, 2006
CBC News

When the government of Alberta announced that it would begin picking up the tab for the breast cancer drug Herceptin for patients in all stages of the disease, it became the last province to do so.

Before the Aug. 28, 2006 announcement, Alberta covered the cost of the drug only for people in the advanced stages of breast cancer treatment. That's what the drug was approved for by the U.S. Food and Drug Administration in 1998. And it had proven quite effective in lengthening the lives of women in the late stages of breast cancer.

Herceptin therapy can cost $40,000 a year per patient. Alberta's health minister — Iris Evans — estimates the move will cost the province about $8 million a year.

"I'm very satisfied that the clinical trials have given strong evidence that this is an important therapy for us to use," she said.

Most provinces began paying for the drug for patients in the early stages of breast cancer a year before Alberta's move. Evans said the province wanted to wait until clinical trials were complete before making the same decision.

For advocates of the therapy, the evidence of Herceptin's effectiveness had been indisputable long before Alberta agreed to follow the lead of the other provinces.

Herceptin is an antibody that binds to a protein on human skin cells — the human epidermal growth factor receptor 2 (HER2). It is believed an excessive amount of this protein increases breast cancer growth — and increases the risk of recurrence of the disease and death.

Approximately 25 per cent of patients have this aggressive form of breast cancer.

In May 2005, three large-scale studies of the drug were abruptly halted because of overwhelmingly positive results.

The studies showed the rate of breast cancer recurrence was reduced by more than half when Herceptin was given to women undergoing chemotherapy compared to women who received traditional chemotherapy alone.

Among the findings:

* After two years, there were 261 events (such as return of the cancer, second primary cancer or death before recurrence) in the control group and 133 events in the group taking Herceptin.

* After three years, 87.1 per cent of patients taking Herceptin were alive and disease-free compared to 75.4 per cent in the group not taking Herceptin. After four years, 85.3 per cent of patients on Herceptin were still alive and well compared to 67.1 per cent for those on standard chemotherapy.

* Women taking Herceptin with a particular chemotherapy regimen had a 33 per cent reduction in risk of death.

Dr. Brian Leyland-Jones of Montreal's McGill University was the lead author on one of the studies. He called Herceptin the most important advance in breast cancer therapy in 30 years.

He noted that in traditional breast cancer therapy, one in four women will see their cancer spread sometime after undergoing surgery. In the Herceptin studies, that number dropped to one in 10.

"We're not quite sure [how Herceptin works]," Leyland-Jones said. "There are different factors that stimulate the growth of cells in your body. The targeted therapy interferes with the binding of this stimulating growth factor."

In October 2005, the New England Journal of Medicine reported on the three clinical trials. In an editorial, the Journal called the results "revolutionary."

"The results are simply stunning. With very brief followup (one to two and a half years), all three trials show highly significant reductions in the risk of recurrence of a magnitude seldom observed in oncology trials," the editorial said.

As many as 5,000 Canadian women a year stand to benefit from early use of Herceptin.

There is one significant side-effect. There is a small risk of heart damage in women undergoing Herceptin treatment. Approximately one woman in 200 could suffer heart damage.

grumpy

I am burned and tired and just plain fed up.

Only six more treatments to go.

a conversation

As I sat waiting for my family to pick me up outside the cancer centre yesterday, I was approached by an elderly woman who had been sitting on the next bench.

"You have beautiful skin," she said. I was of course thrilled at the compliment, as I have been feeling anything but beautiful lately.

She asked if I was in treatment at the centre. I said that I was.

"I have lung cancer," she said. "I never smoked but I worked in intelligence. I worked mostly with men. The rooms we met in would be blue with smoke."

"And also, the spyplanes brought in films taken overseas which I handled regularly" she continued, "They had a coating on them. My colonel says he wouldn't be surprised if that's what caused the cancer, as several others we worked with also have it."

I told her that I have breast cancer. She replied that her sister had breast cancer and is doing well but is nervous as she approaches the five-year mark.

"I have lung cancer," she repeated. "And it's not the good kind of lung cancer."

"I'm thinking of going to San Antonio, Texas. There is a doctor there...They can cure cancer now but if the drugs don't make money, then the drug companies won't sell them. And the doctors here, they won't do anything that isn't in the medical mainstream."

"I think I'll go. But I need to find out more. I shouldn't say this, but I have lots of money. Still, I want to make sure they aren't quacks. I looked the place up on the internet and it looks good. I have a brother who is a doctor in Victoria. Im going to get him to look into it but I think I'll go."

"So many people have cancer now."

She paused to look at the book in my lap, "What are you reading?" (It was The Lighthouse, by PD James). "I haven't read that one. She's not my favourite. Well, her stories are OK, but as a person...(makes a face)."

"Are you waiting for a ride?" I ask her.

(Laughs) "Yes, my daughter. She drives an old jalopy. It's a wreck. She has a million dollar house but still drives that thing. She's not a showoff, that's for sure."

"Such beautiful skin," she says again, and reaches out to stroke my face.

I go back to my book, and shortly after, her daughter pulls up in a battered blue Toyota Camry, with the windows rolled down.

She waves goodbye as she gets in the car.

I liked her.

I wonder how much of her story was true.

good to be here

I ran into a group of friends yesterday, one of whom I hadn't seen in a long time. When she said that it was nice to see me, I replied, "It's good to be here."

My friend C., who was in my shoes two years ago, said, "It means a whole lot more than it used to doesn't it?"

It does indeed.

It's good to be here.

in perspective

I was going through some papers today, looking for information on lymphedema when I found some notes summarizing the results of the tests performed on my tumours.

I've been so bogged down in the grind of treatment and its side effects that I sometimes lose perspective on why I am doing this. This was a worthwhile, if chilling, reminder to re-visit the medical big picture.

The pathologists from whom I had asked for an informal second opinion explained that I had a "high grade tumour and very agressive cancer." They also advised me that I probably had dormant cells elsewhere in my body, since my cancer cells "showed an inherent characteristic of dissemination", as was evident from the fact that I had positive lymph nodes (and, by the time of surgery, palpable tumours under my arms). Their final words of advice were, "don't hold back thinking you'll have multiple ways to come back at this. Assume this is your best shot now."

And that is why I am putting myself through all this. Agressive cancer means agressive treatment.

As my friend A. said, in a very loving message she sent me in February, "Cancer is bad but we will be badder."

And we have been.

the revolution starts now

Today's blog is brought to you by Steve Earle, from the Revolution Starts Now (2004).

I was walkin’ down the street
In the town where I was born
I was movin’ to a beat
That I’d never felt before
So I opened up my eyes
And I took a look around I saw it written ‘cross the sky
The revolution starts now
Yeah, the revolution starts now

The revolution starts now
When you rise above your fear
And tear the walls around you down
The revolution starts here
Where you work and where you play
Where you lay your money down
What you do and what you say
The revolution starts now
Yeah the revolution starts now

Yeah the revolution starts now
In your own backyard
In your own hometown
So what you doin’ standin’ around?
Just follow your heart
The revolution starts now

Last night I had a dream
That the world had turned around
And all our hopes had come to be
And the people gathered ‘round
They all brought what they could bring
And nobody went without
And I learned a song to sing
The revolution starts now

I especially love that second verse. Sometimes, during treatment, I have needed to stick my head in the sand. Sometimes, like tonight, thinking about the big picture has helped me to feel strong and optimistic and purposeful. This is such a hopeful song.

Next week end, Steve Earle is playing at the Ottawa Folk Festival and I am going to see him.

cancer and me

A few days ago, I attended a Melissa Etheridge concert. It was an amazing show. The woman is a wonderful musician and song writer who performed with great energy for more than two hours.

And she's a cancer survivor. In fact, she discovered her lump when she was last in Ottawa in 2004. Her return to this city must have felt triumphant. I have always been a fan of her music but the way she handled cancer and what she wrote about the experience have turned her into one of my heroes (and her description of chemotherapy really resonated with me. It's hard not to feel a kinship with someone whose experiences so closely reflect my own).

I have listened to her music a lot during treatment; her old songs, to which I know all the words and some new ones, recorded more recently, that can bring tears to my eyes or make the hair on the back of my neck stand up.

It was quite wonderful to see her on stage, obviously strong, fit and joyous.

There was, however, a moment during the concert that has given me much to think about. Melissa talked about the brutality of chemo and the love and support of her spouse and community that got her through. She also talked about how cancer made her re-examine her life and re-think her priorities. These things are true for me as well. Then, she summed up her experience by saying, "Cancer is a gift."

That's when she lost me.

There is no question that there are ways that having cancer has enhanced my life. I am stronger and more confident. I am also much more cognizant of what a fortunate person I am. I have benefitted greatly from the time I've had to reflect over the last few months.

But would I say that cancer is a gift? Am I glad that it happened to me?

Absolutely not.

I am still furious.

Not long after my diagnosis, I purchased a t-shirt from www.gotcancer.org that more accurately reflects my feelings. It has the letters CCKMA emblazoned on the front, with the smaller caption: "Cancer can kiss my ass."

39

Sounds like a fake age, doesn't it? But today is really, truly my 39th birthday.

Thirty-nine things I have learned this year (in no particular order):

1. Sometimes all it takes is a bit of initiative to create change in an unpleasant situation.

2. Most people will surprise you with their goodness and generosity (this is especially helpful to remember in today's disturbing global context).

3. I have a greater capacity to forgive than I thought I did.

4. It is possible to fall in love all over again.

5. Children, no matter how sensitive, are surprisingly resillient.

6. My children are lovely human beings (OK, so I knew that already but the boys have been tested this year and have impressed me in countless ways).

7. Laughter really is the best medicine.

8. I am loved (I knew that before but now I can feel it in my bones).

9. I have a nicely shaped head.

10. I really am a 'glass is half full' person.

11. I am also, as a friend said when I was first diagnosed, 'a tough customer.'

12. I should feel proud of my strength and positive outlook. They are getting me through treatment in better shape than many cancer patients.

13. I can do anything I set my mind to do.

14. I don't have to do everything, just because I can.

15. Somewhat paradoxically, admitting vulnerability makes me stronger.

16. As youth is wasted on the young, good health is wasted on the fit. I didn't know enough to appreciate good health until my health was seriously threatened.

17. Sadness and joy can be inextricably mixed.

18. Someone I love told me a few months ago that I had impossibly high expectations of those who care for me. Just because someone cannot do one thing I ask or expect does not mean they do not love me or that they are rejecting me. She was right. This was a very important lesson for me to learn.

19. Trusting is not a sign of weakness, nor is distrust a way to protect myself from getting hurt (see above).

20. It is OK to ask for help when I need it.

21. Red and blue are my two favourite colours. Passion and peace, activity and reflection. These are things I require in equal measures.

22. A pedicure is good therapy.

23. Exercise is a panacea.

24. There is no perfect way to support someone in crisis. Whatever feels right to you will probably be the right thing.

25. I am less judgemental than I used to be.

26. I will never be a religious person.

27. Very sick or severely disabled people used to scare me. They still do but I know how to get past my fears.

28. My own fears help me understand why some people are now uncomfortable being around me.

29. It is fortunate that I was in the best physical shape of my life when I was diagnosed with cancer. I was the only woman in my arm of the clinical trial who was not admitted to hospital during treatment. My doctors think this is because I was mentally tough and physically fit.

30. I love to write and I'm good at it.

31. Being patient is very hard work but worth the rewards.

32. Life is too short for pettiness.

33. Having a life-threatening illness is not a scary as I feared it would be.

34. A missed opportunity is not a disaster. Life is full of opportunity if one is open to it.

35. It is infinitely easier to be sick and middle class than sick and poor.

36. Medicare works.

37. There is a cancer club. None of us would have chosen to join but we understand each other in a way that no one else can.

38. I have a very good life.

39. I still have a great deal left to learn.

overwhelmed

Too much to think about. New experience, new information to absorb. I had been warned that the mind can go to a pretty scary place when the door closes on the radiation room and the buzzing starts.

It's too soon to feel the effects of the beam and each session only lasts for a few minutes. I find it hard, though, not to lie there and ponder what these rays could be doing to my body. And to consider my own mortality. It is after all, a bit of a mind-fuck that the treatment for cancer is in itself carcinogenic.

I'm fine, though, really. And the radiation therapists are really nice.

Twenty-three radiation sessions to go.

I think it's time to curl up with a bowl of ice cream and a good murder mystery while I listen to my dog snore on the couch beside me.

it ain't contagious

Cancer makes some people very uncomfortable.

Even some folks I know fairly well clearly find it hard to meet my eye or spend any time in my presence since I started undergoing treatment.

They should be bit more like my friend S. I had beer and nachos with him and a couple of other friends last Friday night (although we've been in regular contact, it was the first time we'd seen each other since I went on leave from work in January). At one point I commented that I was feeling pretty full and sleepy. "Don't pass out!" he admonished. "We'll take a marker and write stuff on your head!"

I really believe it's better to name the elephant at the table. And if you can make me laugh in the process, so much the better.

Tomorrow, I go under the beam. I'll write soon about what is bound to be a surreal experience. Meanwhile, check out David Hlynsky's blog (http://davidhlynskybeam.blogspot.com). It is a beautifully written account of undergoing treatment for prostate cancer. David has finished treatment and his blog is done. I miss it.

the wisdom to know the difference

I'm not much for prayer but the first few lines of the mantra for twelve steppers (http://www.aahistory.com/prayer.html) are speaking to me today. I'm working on "the serenity to accept the things I cannot change" and "the courage to change the things I can."

I've been finding it hard to give myself the space to get better. I am tired of feeling like a cancer patient and I want to feel like my old self again. I had a very important conversation with a very wise friend today about cutting myself some slack. She told me that it's not a failure on my part to admit that there are some things that I am just not ready to do. I really needed to hear that.

The pressure to have fully recovered is not coming from my spouse or my family. It's something I'm doing to myself. I am impatient and I want to put treatment behind me. I also want to remind myself and others that I am smart and competent and that there is much more to who I am than cancer.

I read an interview with an oncologist yesterday who said that, in her experience, the time it takes to recover is the same length of time from the first sign of cancer (i.e. finding the lump) to the last day of treatment (not including Tamoxifen or Herceptin). If this applies to me, and radiation ends on September 6, I should feel like myself again in May 2007.

Meanwhile, I am accepting the things I cannot change. Progress is incremental. Chemotherapy has left my muscles and ligaments stiff and sore. An old case of achilles tendinitis has flared up again so I have had to forego the running clinic. I have lymphedema (swelling in my arm, chest and back due to a build up of lymph fluid), which is exacerbated by heat, salt and repetitive motions (including knitting or spending too much time at my computer keyboard).

Every day look for the courage to change the things I can. I can't run but I can swim. Not well, or for very long, but even a few minutes of swimming or exercising in the water really help with the swelling in my arm. I had thought that swimming during radiation was a no-no but my research has indicated that it's fine to swim as long as I stay moisturized and stop if radiation burns cause the skin to break.

I was tempted to try an aquafit class at my local YMCA but put off at the idea of being bald and one-breasted in an exercise class. I enlisted my mother-in-law and went anyway. It turns out that everyone was too busy exercising to pay attention to me and I was too busy concentrating on the exercises to feel self-conscious. It was a good workout. Tonight my arms are that good kind of sore.

At the end of the class, a woman came up to me in the showers and said, "We're part of the same club." She finished treatment eleven years ago.

It turns out that someone did notice me. I'm glad.

tired

I am unbelievably tired.

Early mornings with this child...


...and late nights with this one...

...and making sure this family member is exercised...

Have left me so tired by day's end that I can barely move.

I am feeling very frustrated with my post-surgery, post-chemo body these days. My body doesn't look or feel the way it once did. Recovery is slow and there are some things that have been irrevocably changed. I have moments every day that I want to cry from frustration and my feelings of loss.

But my dependents pictured above also take me out of myself, provide love and distraction and remind me of the things I am still able to do.

They're good for me.

I just wish I weren't so damn tired.

gobsmacked

Yesterday, I had the following conversation, in a cab, on my way home from seeing my shrink.

Driver: How is life these days?

Me: Good, thanks.

Driver: Are you a married lady?

Me (Don't ask why I answer these sorts of prying questions. It must be the first born child in me, or the fact that I am stuck in this guy's cab with the doors locked): Yes.

Driver: Your kids are out on their own, then.

Me (See above): No, they're not. They're three and eight.

Driver: Oh! So it was a late marriage.

Me: Not that late.

Driver (Turning around to get a better look): You look like you have no hair.

Me (Sharply): I have cancer.

Driver (Chagrined): Oh! I'm sorry. (Pause) I shave my head most summers.

Silence

Driver: But I didn't this summer.

Me (Politely): Mmmm.

Long, awkward silence.

Driver: So are you going to be OK? What do the doctors say?

Me: I hope so.

Driver: Good, that's good.

I was enormously relieved when his cellphone rang. It was the longest cab ride of my life.

My spouse, when I told him the story: Did you turn the cab around and go right back to the shrink?

When given the choice, I prefer to laugh than cry. And a little righteous anger never hurt anyone.

a week in paradise (or what i did on my summer vacation, part 2)

I have a hazy memory of, at some point during cancer treatment, being told by a nurse to imagine myself somewhere that I feel safe and happy (to distract myself from whatever horrible thing was happening at the time). Last week, my physical self got to go where my mind has gone many times over the last several months.

My father-in-law has a cottage on the most beautiful little lake in northern Ontario. Time stands still there but the days go by quickly (I've never been able to figure out how that works). It is a place of healing (my father-in-law sought refuge there during his own cancer treatment two summers ago), relaxation and joy.

On July 13th, we toasted the fact that I wasn't in chemo (I had treatments every third Thursday) and every day I felt a little stronger. On July 16th, we drove home, feeling restored (the kids didn't even fight once during the five hour drive). My little family really needed this respite.

I did mention that we were in paradise, a place where even children behave perfectly.

what i did on my summer vacation (part 1)

I'm back.

We did manage to get away. And had a wonderful time.

On July 7th, we celebrated my mother-in-law's 65th birthday. The next day these people (her three sons, spouses and assorted children):

all piled into cars and took her on a surprise trip to Niagara Falls (this was taken in our hotel parking lot and it should be noted that D., my young son who dances naked in front of the mirror at every opportunity and loves to be photographed, refused to take part).

During our week end together, I was struck repeatedly by how much I genuinely like each of these people. What's more, their support and love during cancer treatment has made me realize to what extent they are not just my spouse's family but mine, too.

This is a gratuitous photo of my children at Centreville on the Toronto Islands. Doesn't S. look thrilled to be riding with his little brother? For some reason, this cracks me up.

In other news, I have learned that I will start radiation therapy on August 1st and finish on September 6th.

The end is in sight.

what passes for normal

This is what we did today:

In case it's not obvious, the boys are being Wolverine (as so ably played by Hugh Jackman in the Xmen movies).

We used coffee grounds to make the chest hair.

Look at this angelic child. Surely not the same one who's temper tantrums are legendary in these parts.

We had a busy Canada Day with friends and family. I was feeling relaxed and quite celebratory (my own personal no-more-chemo milestone trumping my feelings about Stephen Harper and the Tories). It slowly started to sink in on this beautiful long week end that I am not recovering in order to get ready for the next round. I am done. No. More. Chemo. I am so relieved.

We are in chaos at the moment; trying to get organized to get out of town for a couple of weeks. The house is a mess, we are still working our way through our to do list and my spouse and I have been more than a little irritable with each other. If we are all still speaking to each other, it will be good to get away. I'm going to pretend I'm not a cancer patient, just a very tired bald person.

I've had my "radiation planning session" last week (more on that in a future post) and am now in the queue for radiation. I could be waiting anywhere from two weeks to two months. I plan to use that time working at feeling healthy again. I'm going to do a running clinic for breast cancer survivors at the Running Room (www.runningroom.com) and maybe take up yoga again.

Unfortunately, I seem to have developed lymphedema in my right arm. I am trying not to feel sorry for myself but it does feel pretty unfair. You can find more info on lymphedema at www.breastcancer.org and http://www.cancersupportivecare.com/lymphedema.html.

Thanks to all those who sent messages of condolences about Emma-dog. She was a lovely beast and we miss her terribly. As someone pointed out in the comments, we have fourteen years of beautiful memories.

Emma Goldman Kingston (aka Golden Breeze Lady Emma Delight), b. July 17, 1992, d. June 29, 2006.

I am grieving an old and dear friend today.

By L. (age 38) and S. (age 8):

We miss Emma because:

1. She loved kids and always protected them, even when they didn't need protecting.

2. She was so affectionate with us.

3. She thought her name was "Beautiful Dog."

4. She enjoyed a good tummy rub.

5. She was the most stubborn dog we've ever met. From the time she was a round little puppy carrying tree branches, she did things her way.

6. She lived until she was almost fourteen and still loved us.

7. She once ate a dozen chinese buns and was so full she could barely stand up.

8. There will never be another dog to replace Emma.

mushy and queasy

It has been brought to my attention that my last couple of posts have been a bit over the top. I am completely unapologetic about this. Years ago, my spouse said to me that I always describe the people I love in terms of superlatives. Can I help it if my family and friends are all gorgeous, brilliant and wonderful people?

I just feel incredibly grateful for the all the love and support that people have shown since this cancer nightmare began. It is because of my friends and family (and some complete strangers) that I have found the strength to get through the worst of the cancer treatment.

Despite how hard many things are right now, I have moments where I can't believe how lucky am.

Last chemo completed yesterday. I feel pretty crummy today. This is the last time, though, and that does make it easier.

once more unto the breach

Tomorrow is my last chemo.

I have not written much in the last few days because I have been too busy spending time with my kids and being hedonistic in my spare time.

I have spent my time with people who fill me up - make me feel good about myself and fortunate to be in their presence.

A lovely dinner Friday night with three amazing women. I am awed that they think of me as their friend.

An extended week end with my friend L. Spending time with her is like a balm. I don't have words for how wonderful she is. We met on the first day of an impossible class in university. I walked up to her and said, "You look like someone I would be friends with." This was totally out of character for me and the best thing I ever did.

I spent most of today with my friend B. We went for lunch, engaged in a little retail therapy (cancer presents: new clothes that fit my chemo-bloated body. I feel so much better about myself) and a facial at the spa. When I told B. last January that my biopsy had confirmed that I had cancer, she said, "This is a campaign and we are going to win it." B. is a formidable woman. When she says things like this, I believe her.

On another note entirely, it turns out I am not as much of a hypochondriac as I thought I was. My oncologist took one look at me this morning and said, "Your eyes are irritated." It turns out irritated, runny eyes are a common symptom of chemo, especially near the end. I feel vindicated.

for a very good dad

Today's blog is dedicated to a wonderful father.

I love you, my dear spouse. You have exceeded my expectations of a partner, father and friend in the fifteen years we have been together but never more than in the last six months. The boys and I are very fortunate to have you in our lives.

Happy Fathers' Day!

the hardest thing i've ever done

There is a sense of pride and accomplishment that comes with knowing that I have almost completed chemotherapy. Nothing I've ever done has been as hard as this.

I am stronger than I thought I was. And tougher.

I know that I still have one more horrible chemo and the grind of radiation (not to mention Herceptin treatments every three weeks for a year) but I just realized today that the worst really is behind me.

Breast cancer has cost me a lot, physically, mentally and emotionally. I have not stopped being angry that it happened to me (and to other women, in frightening numbers). I have, however, gained a sense of my own strength and the confidence of understanding what it means to be a 'survivor.'

I know that others have always seen me as confident but I know how often I avoided challenges or situations which made me feel scared or intimidated. I think that will happen far less often in the future.

It's not that I don't expect to feel frightened or intimidated. It's that I know I can face those fears. I've written before that I did not anticipate how much of the fight against cancer is mental. I now know that I am brave enough to face a life threatening illness and strong enough to survive treatment with my optimism and sense of humour intact. There are very few challenges that now seem insurmountable.

That is the gift my cancer has given me.

portrait of the insomniac as an eight year old boy

After tossing and turning (and a few tears of frustration), S. finally falls asleep on his bedroom floor.

bald hypochondriac

I never see other bald women when I am out in public.

For the first several weeks of being bald, I kept my head covered in public all the time. Then it got hot. And I got sweaty. And the hat or scarf started to slide around on my head.

I just don't suffer in silence very well, so I've started taking off the head covering and offering up my head to the elements (or rather, to the air conditioning. I do keep my head protected from the sun).

The first time I exposed myself like this, I was out at a nice restaurant with friends. I felt naked and acutely self-conscious at first but became gradually more comfortable. My friend B. said afterwards that there was at least one woman in the restaurant that night, hot and sweating in her wig, who was wishing she had the confidence to do what I had done.

I wonder if that's true. Given the cancer stats, there should be many more bald women out there. I'm not particularly brave, nor do I enjoy drawing attention to myself. I just don't have a high tolerance for discomfort. Am I violating some taboo I didn't know about? Where are all the bald women?

On another note, the depressed immune system from chemotherapy is exacerbating my not-so-latent hypochondriac tendencies.

My spouse took my youngest son to the doctor last week with a suspected eye infection (another child had been sent home from day care with an infection earlier in the week and D.'s eyes were suspiciously puffy), which I became sure he had given to me. All morning I complained of itchy, watery eyes. I figured it was just a matter of hours until the infection would blind me completely.

I was stunned when my spouse called to say that D. did not have an eye infection. He had a mild case of tonsillitis. My eyes cleared up immediately.

At least I can't become convinced that I have tonsillitis, too. I had my tonsils out when I was eight.

going bald

On March 18 (after the first round of chemo), I shaved my head. The wisdom of others (and my own gut) told me that, even though I had very short hair, it would be infinitely easier to have it fall out in bristles than in thick clumps. I was right.

It turned into a bit of a party. Who knew so many people would want to watch me shave my head?



My friend L., who sports a tattoo under that now-conservative hair cut, did the honours. I don't think he was expecting it to be a performance but he took it all in stride. And he donated the clippers. What a guy.



No going back now...


We had a wonderful evening. And I think it made the whole going bald thing much easier for my kids, as well as for me.

random thoughts

There are trees in the cancer centre where I go to receive treatment. Real ones. They built the building around them. They're a little spindly but I love that they're there.

There is no rhyme nor reason to what I want to eat, after the first couple of days post-chemo have passed. This round it's shrimp soup, spaghetti, my spouse's super-high-fibre granola bars and soda biscuits. The first couple of rounds it was chicken soup and pita. I think about food a lot these days and the pleasure I know I will get out of it when I turn the corner. My appetite tends to come back with a vengeance about 10 days after chemo, and, every round, I have killed the time lying in bed imagining the things I am going to eat when I feel better. I also love that so many people have fed my family over the last several months. The impact of this food has been a source of sustenance that is much more than physical.

My cyclical funk has set in. Too much time to think and too little energy to do anything or concentrate for very long. The lingering effects are relatively minor (mild nausea, lightheadness, foul taste in my mouth, fatigue and the surgical aches exacerbated by sitting still) but they serve as constant reminders that I have cancer.

I did not fully expect how much of fighting this disease would be mental.

A poll of the medical staff at the cancer centre confirms that my new-grown fuzz will likely fall out again before chemo is done. It's OK. I only have one more round to go.

friends don't let friends knit stoned

So I picked up my knitting needles yesterday evening. This is always a sign to me that I am starting to climb out of the trough, but I think I may have been a little optimistic.

I am knitting a garter stitch shawl (for non-knitters this means that I knit every row, over and over, gradually increasing stitches until I have a shawl), so I figured that even though I was feeling pretty stoned from all the chemo drugs, the pattern was simple enough that I should be able to knit away without screwing anything up.

I was wrong. I will now have to spend more time fixing my mistakes than I spent making them. Sigh.

Someone step up and stop me before I do this again, OK?

p.s.: For my knitting readers (and I know you're out there), the yarn is from Fleece Artist, in Halifax (http://www.fleeceartist.com/) and I am knitting with the Goldilocks. You can see why this is going to be a huge pain to tink (knit backwards) and redo, even if it is just a couple of rows.

Toxic Nation

I'm not really up for writing much today. Instead I provide you with the following link:
http://www.environmentaldefence.ca/toxicnation/home.php.

Food for thought, no?

chemo day

The gorgeous woman pictured above is my sister. She is coming to chemo with me today. This picture was taken at my head shaving party. I didn't plan for a head shaving party, once just kind of happened and it was wonderful. More on that in a later post, but I do highly recommend to others that shaving your head makes the inevitable hair loss much, much easier to take.

I have had someone different come to each chemo appointment with me. Each session lasts more than three hours, so this companionship has been incredibly important (In fact, I would also advise cancer patients to bring someone with them to most appointments. It is common to find that any info provided is forgotten as soon as it's heard unless you have someone to take notes. Just as important is having someone to help you find where you're going and to keep you company while you wait).

Each person who has come with me has been special to me.

My spouse came to my first appointment. It was great to have his wry humour and our shared sense of the bizarre as we took in this experience for the first time.

My friend J. drove me to the second chemo. We work together and have always really liked each other but chemo gave us the time to really get to know each other. I feel like our friendship has become richer and more intimate.

D., one of my oldest friends, came to chemo number three. We both lead very busy lives and don't see each other as much as we'd like, so it was lovely to have this uninterrupted time together. D. stood in for my sister at my wedding (my sister was working Japan at the time). D. has always been very important to me. I also have to stay on her good side; she has my power-of-attorney (I call it 'power to pull the plug') should something happen to both my spouse and me.

My friend H. came to my last appointment. We had really just found each other as friends when I found the lump, yet she was one of the very first people I told. She has been one of my most important sources of support throughout this experience and continues to exceed my expectations of friendship. She has also injured herself prior to each appointment that she has attended with me. Not sure what that's about.

B. will be coming to my final round of chemo. She is a true force to be reckoned with and a wonderful friend. B. puts the same energy into coordinating a political campaign as she did into coordinating friends to come to appointments, make food for my family and provide support in so many important ways. She also really knows how to have a good time and has helped me to remember how to have fun during these last few months.

I really am a very lucky person.

fuzz, fears and fleece

My hair is growing back. The patches that were completely bald (most of my head) now have a fine covering of fuzz. This makes me feel like I can truly begin to see the light at the end of the tunnel.

I had a second meeting with my radiation oncologist yesterday. He seems nice enough, other than being a bit paternalistic (I am increasingly irritated when medical practitioners speak to me as though I am a child) and also completely flummoxed by the fact that I don't have my husband's last name ("But you are married to him? I suppose it's nothing personal.")

I'll start radiation two weeks to two months after I finish chemotherapy. Some women who undergo mastectomies are spared radiation. However, given the size and agressiveness of my tumours, the oncologist believes that radiation could further reduce my chances of recurrence by as much as ten per cent (doesn't sound like much, but every little bit helps, I guess).

Pros of radiation: Fewer side effects than chemotherapy and much shorter sessions (a half hour at most, compared to the three plus hours of chemo).

Cons of getting zapped: Sessions five days a week for five weeks, likelihood of burns at the radiated sites, fatigue, increased chance of lymphedema, no swimming (this matters only because I will likely be undergoing radiation during the hottest part of the summer), the fact that radiation itself is potentially carcinogenic (I find this more than a little scary).

As we were leaving the hospital yesterday, I said to my spouse (only half-jokingly) that I thought I might skip radiation. It just seems like a lot of bother.

Of course I'll do it, though. I need to feel like I have done everything I can to make sure the cancer never comes back.

In case anyone was wondering, my chemo present to myself this round is several knitting books. I have really been enjoying knitting, a meditative process which results in the creation of something lovely, soft and warm (at least when it works, it does). Two of the books are by Stephanie Pearl-McPhee (Yarn Harlot: the secret life of a knitter and Knitting Rules. I already owned Meditations for Women who Knit too Much). Check out her blog (which I read daily) if you like to knit or just want to laugh: www.yarnharlot.com.

better

The pity party is officially over. Life is too short to be spent wallowing and, besides, I have so much for which to be grateful (starting with Exhibits A and B, pictured above).

I went for a long walk in the sun and had the chance to have fun with each of my children today.

I am exhausted tonight but feeling much more relaxed and content.

I can get through this. In fact, I am a whole lot stronger than I thought I was before I knew I had cancer. This is something that will stay with me, I think, long after this struggle is over. What challenge could be tougher than this one?

I will get my life back. When I do, I will be ready for anything.

not fair

Today's blog has been pre-empted by a bout of self-pity. Regular programming will no doubt resume shortly.

I am feeling pretty bitter today.

I am sick of being in treatment for cancer.

It's the National Capital Race Week End and instead of running (albeit very slowly) in the half-marathon, I need to rest when I take my dog for a walk. It broke my heart to see the participants in the 10K stream down the street near my house today.

I miss my work and I am sick of feeling side-lined.

None of my clothes fit me any more.

I am fed up with being stared at, even when the glances are sympathetic but especially with those who are clearly uncomfortable with my appearance (perhaps because they don't want to believe it could happen to them).

I have lost patience with those who hurriedly change the subject when I acknowledge my cancer as though I am being indiscrete.

I hate looking and feeling like a cancer patient.

I am tired of handling other people's emotions around my breast cancer.

I hate that my family is being made to live through this.

I had a good life before my diagnosis (just six months ago) and I want it back.

in the eye of the beholder

My son D. is a supremely confident child. He goes through life secure in the knowledge that he is interesting, charming and beautiful. People respond to him in kind.

When he was a baby, I would often carry him in a back pack as I did errands. Every time, I would see even the most preoccupied strangers' faces break into smiles, reacting to my engaging child.

He is the centre of any group of children, regardless of age. Teenage friends of his caregiver's children greet us on the street and stop to shake his hand or ask for a hug. He is able to charm the dourest of adults and makes friends wherever he goes.

D. loves to play dress up, picks out his own clothes and cares whether his socks match his shirt (a concept that is foreign to his father and brother). One of his first sentences was, "I'm D. and I'm cute."

I have never, ever thought of myself as beautiful. But D. looks a lot like me. And D. knows he is beautiful. And, so, gradually, D. has taught me to see myself as beautiful, too.

Now, I am bald and bloated. Surgery and chemo have taken their toll on my body. But if I look carefully, I can still see the beauty there. I have a nicely shaped head. There is still a sparkle in my eyes and warmth in my smile. I still have my dimple and the laugh lines around my eyes.

I may never enjoy dancing naked in front of our full length mirror (one of D.'s favourite pastimes). D. has taught me, however, that I have a choice in how I see myself. I am still me. I am still beautiful.

"don't die"

We have an-almost-fourteen year old golden retriever, who is nearing the end of her life. This dog has been my friend and my companion through some very hard times (and lots of good ones) and I will be heartbroken when she dies.

So will my kids, especially S., who is very attached to the old dog and who is himself old enough to understand loss and to fear death.

S. hasn't said anything to me about Emma-dog but he talked to his grandmother about her on the week end (he wanted to know how old his Grandma was and was reassured to learn that, in dog years, she is still a spring chicken). He raised the subject again with my spouse yesterday morning ("So, is Emma in the dying phase of life?").

We have all reassured S. that Emma is not suffering and that she has had a long and wonderful life. I think it's a very good sign that S. is working this through with us, instead of keeping his questions and fears to himself.

Yesterday, before he left for school, he threw his arms around my neck and said, "Please don't die."

My mother-in-law and spouse were with me when this happened and agreed that he was just fooling around, not realizing what he was saying until it was out of his mouth. I responded by laughing and telling him that I wasn't going anywhere.

But I wish I could protect my kids from having these thoughts, protect them from loss and death and fear. I guess all parents do. Instead, the best we can do is love unconditionally, listen when we are asked to and let our kids know that it is as normal to fear and to grieve as it is to love.

Our dear old Emma may pass on soon and it will be very hard for my family.

I want my kids to understand, though, that I am doing everything I can to make sure that I am around for a very long time.

chemo brain...

...is not just in my head.

Finding the right word eludes me. Being consistently coherent is an unrealistic goal. My short term memory is more or less non-existent.

My brain has slowed right down.

I have lost about a hundred consecutive Scrabble games (I play online at www.pixiepit.co.uk/scrabble, a site worth visiting for its amusement value).

I really hope the damage isn't permanent.

worth a pound of cure

I am in a much better mood today, as my energy begins to return. It's also good to get a bit of respite from the rain; there is something very pleasant about sitting outside with the laptop, even under a cloudy sky (see what I mean about the post chemo euphoria? Sitting in my damp backyard - really need to clean up after the dogs - is the best thing I've ever done).

I have cancer prevention on the brain today. A friend sent me two very interesting links: http://www.bcam.qc.ca and www.stopcancer.org.

A couple of months ago, when the Canadian Broadcasting Corporation first aired, "Chasing the Cancer Answer" (on Marketplace: http://www.cbc.ca/consumers/market/files/health/cancer/index.html), I wasn't ready to watch. I think I am moving into a place where the questions raised by journalist and recent cancer patient Wendy Mesley are going to be ones with which I will also be grappling.

Expect to hear lots more from me about this in the coming months.

what i need

It turns out that sometimes what I need to do is exactly the opposite of what I think I need.

Today, the only thing I wanted to do (and felt I could do) was stay in bed with a pillow covering my head, such was my fatigue and the blackness of my mood. I told my spouse this morning that I was "unfit for human consumption." (I meant to say, "unfit for human company," but my brain is in a chemo induced muddle. However, the statement I did make is pretty accurate, given the toxicity of my chemotherapy regimen.)

I had definitely been fighting a losing battle with the funk I have described in previous posts. I felt so overwhelmed by anxiety and despair last night and this morning, that 'just two more to go' had been wiped out by 'I can't do two more.'

I'm not sure why these first days when I start to improve physically are so much harder than the trough of the first few days after treatment. I know that impatience to feel better has something to do with it. Also, I feel pretty stoned during much of the trough period (this is a good thing) so it is hard to muster up the energy to feel sorry for myself.

Then, when I regain a degree of physical energy, I am so happy to be out in the world that it becomes pretty easy to keep the dark thoughts at bay.

During these in between days, though, it is a struggle not to dwell on the hard parts and the scary questions. How will I get through this? What if the cancer comes back? Why me?

Busy mind. Idle body. Bad combination.

And so my instinct this morning was to go up into the attic, never to emerge. Instead, I called a friend, had a vent and a laugh at the outrageousness of the world. I feel infinitely better.

It would seem that, sometimes, I just need to get out of my own head.

On another note, the results of a study released today provide further evidence that women who over-express the protein HER2 (also called HER2/neu) benefit from more agressive drug treatments (the lovely Red Devil, described in a previous post), while (and a whole host of other factors need to be taken into consideration) women who are HER2 negative may not. As someone who is HER2 positive, I found this oddly satisfying. I think it would have pissed me off (especially today) to find out near the end of treatment that I might have done as well on an easier regimen.

You can get more info on the study at http://www.sunnybrook.ca/news .

another list

I need to make a (somewhat random) list of things I know about myself that have nothing to do with breast cancer:

1. I am the mother of the two most beautiful, sweetest, smartest boys to ever walk the face of the earth.
2. I am happily married to a real cutie (who will be both mortified and chuffed at being called a 'cutie' in public. What the heck, he's extra cute when he's embarassed). We have been together 15 years and we still make each other laugh.
3. I am crazy about dogs. I have two biggish beasties with sweet dispositions, who get me out in the world when I don't feel like going and who are the loveliest of companions.
4. I have put up for many years with a neurotic, malevolent tabby cat to whom I am unreasonably attached.
5. I knit. My knowledge and interest greatly outstrip my ability but I love it.
6. Before the cancer, I had become a runner (albeit a very slow one) and I will be one again. Like knitting, I find it meditative and good for the soul (not to mention what it does for my legs). Also like knitting, running doesn't come naturally. It tickles me that two of the things I love best to do are things which do not come easily. That was a big hurdle to overcome and I'm glad I did it.
7. The first sign that I am starting to lose control over a fast-paced life: I lose things. It usually starts with my keys.
8. I have a somewhat addictive personality. When I get into something, it can become an obsession.
9. I am not someone who should own a Blackberry (see above).
10. I love good coffee (black), good chocolate (dark) and good wine (usually red, but not always).
11. I love working in the labour movement and have a strong commitment to social justice. My spouse shares these values and I am proud to see my children absorbing them.
12. I have surrounded myself with a community of chosen family. Never have I been more grateful for this than in the last several months.

fighting the funk

Starting to resurface from the most recent round of chemo (no anti-nauseants today). Fighting the funk that seems inevitably to descend when I reach this place (basically, well enough to feel sorry for myself but not to do much else).

To address this, I think it's time to make a list of things for which I feel grateful (not the big picture stuff but why, right, now, today isn't so bad):

1. Sleep. I got much more of it this round.
2. My doctors and nurses really ask about my side effects from chemo and seem eager to find the best ways to get through this. This has helped a lot (for example, no weird twitching this time).
3. I had just enough of my friend B.'s healing soup to get through the last few days. It was the only thing I wanted to eat this round.
4. While my dear old dog has a terrible sore on her leg, I have a vet who will come to my house to take care of her.
5. My house is clean, thanks to my mother, and I will not have to spend the whole time the vet is here feeling embarassed.
6. I only have two more rounds of chemo to go.
7. I am able to blog.

As I think of others throughout the day, I will update.

I forgot to add the following anecdote to my list of "strange happenings":

During a chemo session a round or two ago, I chatted a bit with the woman whose husband was in the bed beside mine. He has lung cancer and is taking part in a clinical trial involving infusing the patient with chlorophyll. The substance in the iv bag was definitely a very bright green.

A couple of hours later, when the couple got up to leave, I noticed that the man was now green. He had not taken on a greenish tinge. He was green.

hot flashes

They start in the morning but come infrequently until the afternoon. By evening, they plague me in waves, starting up my chest, overwhelming me with heat until I am literally dripping sweat.

I almost took my clothes off at my son's birthday party two nights ago (thus ensuring years of therapy in his future).

I am experiencing what some call "faux menopause." The chemo has shut down my ovaries, my periods have stopped and I am experiencing some spectacular hot flashes.

The night of my son's birthday (when, in my defence, I was under some stress), I also became convinced that my spouse was not being adequately sympathetic, that he just didn't get it, that in fact he was not being nearly supportive enough. And I told him so. Then I remembered that there are other menopausal symptoms. My poor spouse.

I have two friends who claim that they're respective partners have offered to go out in the middle of the night, in the thick of snowstorms to replace empty menopause-related prescriptions, such is the spousal fear of menopausal mood swings. My friends are both lovely women (and two of my heroes), yet they insist that this is true. Perhaps their spouses would like to form a support group with mine.

I know this is not the worst part of chemo just insult to injury, really.

To my menopausal readers: My respect for you for being able to function in the world while you go through this has increased immeasurably. If you are feeling less than sympathetic towards me consider this: If, as my doctor suggested yesterday, my menstrual cycle is likely to resume in a year or so, I get to go through menopause twice.

my big boy

My beautiful firstborn son turned eight years old today. I can't believe it.

He cracks jokes like a teenager but sleeps with a bedful of softoys (all dogs, he is his mother's son).

He hates school yet loves to learn and remembers everything that he takes in.

He can be infuriatingly rude and then behave with heart-melting empathy (he called me from the office of his school the day after my surgery. He needed to check that the nurse was coming and that there was someone there to take care of me).

He is very sensitive but also the funniest person I know.

He has inherited the 'sleep gene' that plagues his father's family. Often awake beyond exhaustion late at night, and impossible to wake in the morning, even when we let his little brother jump on him (Santa, who must not like this child's parents very much, brought S. an alarm clock that sounds like a rooster crowing. While his parents curse, my boy sleeps soundly through the racket).

He is too smart for his own good.

We share a love of coffee shops, surfing the internet and fine bath products.

I love him very, very much and I could not be more proud of him.

i buy myself presents

It's true. Prior to each round of chemo, I have bought myself a present.

Now, I know that this is a really frivolous thing to do. I know that buying stuff won't buy me happiness. I also know that I am damn lucky to be able to afford such frivolity (thanks to public health care and a very good job with great benefits). But it really does make it easier to face the awfulness of chemo.

For the first round, I bought an ipod (this was a big ticket item but, in theory, the whole family "shares" it).

For the second round I bought a teapot. I ordered it online. As a replacement for one I had bought in London. I am pleased to say that it survived the flight over and arrived from England in one piece.

I bought two beautiful hats prior to round three, from a local craft fair. They are both fine examples of millinery. Why two? Because I couldn't decide between them (please don't judge me). When I wore the black one (with a big green and red flower) to pick up my older son, he said, "You can't even tell that you're bald."

I have chemo this Thursday. On Monday I bought the most beautiful pair of red sandals (I will try and post pictures, once I can get the technical details sorted). I had this idea in my head of a pair of very comfortable sandals for my longer walks but with a bit of an edge. I found the perfect pair at the first place I looked (at Glebe Trotters on Bank Street in Ottawa. Go see them. The guys who run the place are really nice and know their way around a shoe). They are bright red. I wore them yesterday and two people stopped me on the street to ask where I had bought them. Joy.

On another note entirely, it is now much easier to post comments on this blog. After complaining for days about the fact that would-be commenters (commentators?) were being foiled by all the hoops they had to jump through, I decided to write a note to Blogger and complain. Before doing so, I thought I should double check with the help function. Doh! (as my older son and Homer Simpson would say). I had set things up so that only registered users could comment.

I have changed my settings so that anyone who wishes to do so can now offer their two cents. Let me know if it works.

why i blog

I am not an exhibitionist. I thought twice and three times before some of my more personal posts, especially before discussing my mastectomy.

Writing for me has always been therapeutic but that doesn't explain why I chose to expose myself so publicly.

I am doing this, in part, as way to keep friends and loved ones updated, as well as to help them better understand how I'm feeling and what this experience is like.

I am doing this because some apects of cancer treatment are so bizarre that they must be shared.

I am doing this because our culture sometimes treats breast cancer like some kind of terrible secret, which in turn makes having cancer seem slightly shameful. Talking openly about my cancer makes people feel less awkward around me, which is much, much easier for me. I have always believed in acknowledging the elephant at the table and while I respect the decision of others to keep their cancer a secret, it's really not the right choice for me. I guess I was pretty much an open book anyway (to mix my metaphors liberally) and don't see why cancer should change that.

I am also writing because people like Margaret Wente (a columnist with the Globe and Mail, one of Canada's "national" newspapers) really piss me off. In a recent column Ms. Wente scoffed at the idea of a cancer epidemic, talked about the cancer bandwagon and said that, of course there is more breast cancer now because there are more older people. She also dismissed the idea of environmental factors and the need for research into prevention.

I want Ms. Wente and others to know that I'm here, 38 years old, with no breast cancer in my family and very few of the risk factors associated with the disease. I really felt that my lump and subsequent diagnosis with stage 2b breast cancer came from out of nowhere. I didn't chose to hop onto this particular bandwagon, nor did the many other women in my circle (including several diagnosed before the age of 40). I don't know if I would use the word 'epidemic' but I do know that our numbers are growing and feel very strongly that 'why' of this must be further explored.

Finally, I am writing because, after my diagnosis, I found a dearth of stories about younger women with breast cancer and I thought that if I appreciate others' stories, then someone might like to read mine.

That's why I blog.

strange happenings

I love my work and when I'm feeling well, I miss it. It's hard not too feel some sadness and anger at times that life is going on without me (which of course it must).

However, as my friend C., who has been through this, commented the other day, this is a rare time in my life to be an observer, to really notice and think about life - the positive, the difficult and the truly bizarre.

Listed below is a random list of some of the more absurd things I have observed and experienced in the last several weeks:

1. My insurance company requires a letter from my doctor, including my diagnosis before they will reimburse me for my prosthesis (the prosthethis cost $350 and Medicare pays for $180). "Why is this necessary? Who would buy a prosthetic breast just for fun?" I asked what I thought were rhetorical questions. My spouse replied that it takes all kinds and that you never know what could turn up with a Google search. I don't dare try this.
   
   
2. My anatomy was recently enhanced with a 'portacath', a disk with some tubes attached that are connected directly to a vein that goes to my heart. It was inserted beneath the skin, a couple of inches under my collar bone, on my left side. It makes chemo infinitely easier, as I can now use my arms during the hours I am receiving treatment and no longer experience the burning sensation that I did when chemo was infused into a vein in my arm. Chemo also hardens and shrinks the veins, so the portacath is saving me the trauma of being poked repeatedly as the nurses try to find a vein in my arm. My portacath is a really nifty thing but I do feel that I more closely related to the 'Borg' from Star Trek than I used to be.
   
   
3. Acupuncture is supposed to help with nausea, so I thought I would try it out. I've been seeing a doctor of traditional Chinese medicine who has considerable experience working with cancer patients. He also has a considerable number of eccentricities. For example, the first time I saw him, he greeted me warmly, then handed me a piece of paper stating that, suspecting that someone was spying on him, he'd had a private security company in and they'd found listening devices all over his clinic (I have no idea if he is delusional or if this is true). Since that day, he asks that all his patients communicate with him in writing only -even while we are being treated. When he does talk, the doctor communicates chiefly in song titles: "You are always on my mind," and "I'll be waiting for you."
   
   
4. At my last appointment, my very cool oncologist suggested that smoking dope would be the best thing to alleviate nausea and other side effects from chemo. My mother-in-law responded by couriering me a pot cookie.
   
   
5. I took part in Look Good Feel Better, a free session put on by the cosmetics industry. The idea is that women in treatment will feel better if they can be shown a few tricks to look more like themselves. And you get lots of free stuff (I love getting free stuff). I thought it would be a lift, a bit of light-hearted fun (and so what if I left wearing more makeup than I usually apply in a month). However, the 'team leader' for my session was a martinet, barking out orders like we were in boot camp ('Apply mascara now!' 'Left hand on left eye! Right hand on right eye!'). I spent the whole session frantically trying to catch up (and giggling madly). When the martinet informed us that it was time for 'a moment of silence to remember the fallen', I stopped laughing. I doubt there was a participant in that room who needed to be reminded of the 'fallen.' Or who hasn't had many moments of silence filled with the fear we might join them.

joy

I am fundamentally a 'glass is half full' sort of person.

It's not that I am always in a good mood (those closest to me would be sure to tell you otherwise). In fact, I have struggled with depression since my teens, and need to work hard at staying healthy. It's just that if there are two ways to look at a situation, I naturally gravitate to the most positive interpretation.

That's why I can say that during these months of chemotherapy, I feel well half the time.

A clear physical and emotional cycle has emerged after three rounds of chemo. The first couple of days afterwards I feel light-headed and queasy. By the week end (every chemo is on Thursday), I go into the 'trough', which lasts for several days. I feel pretty awful during this period but the symptoms are better managed than during the first round. By early the next week, I emerge from the worst but go into an emotional funk (last week I spent several days exhausted and furious at how different my life is right now from what I expected it would be).

Then I turn the corner.

I went for a walk last Saturday, bubbling over with everything that is good with the world. The sunshine. My beautiful children. My dogs. My eyebrows (thinner, but still there).

I seem to get a week and half of feeling better (the effects of chemo are cumulative, so I know that this period could get shorter, but I know it will come), during which time I am positively euphoric.

I love my family. My neighbourhood. I have the best friends in the world. I am getting the best of medical care. I am happy. The fact that I can't find anything in my cluttered mess of my house only bothers me a tiny bit.

Chemotherapy is very hard and I really, really hate it. I am however, very grateful for this opportunity to experience joy, and to be reminded that, really, I have a very good life.

boob in a box

I went to into my room to get dressed yesterday morning and found my new prosthetic breast sitting on top of its box.

My boys had been playing 'Pirate Treasure Hunt' (although I think it was really an excuse for soon-to-be-eight years old S. to look for hidden birthday presents) and I gather the box on my shelf had been too much for two curious boys to resist.

I immediately went to tell my spouse. Should I talk to S. about his find? Did I think it would be more traumatic if I talked to him or should I just let it go? My husband, who had his hands full baking a cake for my three-year-old's birthday, said in so many words that he didn't think it was a big deal and that, while I could talk to him about it, I really didn't need to worry.

So I decided to wait for the right moment. A couple of hours later, I had the following conversation with my older son:

"Did you take something of mine out of that box on my shelf this morning?"

"Yeah. It was a white, squishy thing. What was that?"

"Um. Well...You know when I had my surgery...it left me flat on one side. This is to make me look the same on both sides."

"Cool!"

Pause.

"So it makes you look normal."

"Yeah."

"Cool."

End of conversation. Kids really do take most things in stride.

My prosthethis has provided a real lift to the spirits, is comfortable to wear and makes my clothes fit better. It is really bizarre, though, thinking that I will be putting my breast away in its box every night and taking it out again every morning.

chemotherapy (part 3 - the grim aftermath)

Two down, four to go.

Feeling a little "off" after this morning's chemo but OK.

Anxious, though, because last time I was fine for the first 24 hours and then...became very sick.

I spent the week end curled up in the fetal position, in agony, unable to deal with sound, light, movement (I read an interview with Melissa Ethridge yesterday, in which she described living through the exact same experience after chemo. I'm in good company). On the Saturday afternoon, I had the home care nurse come and give me an injection of an anti-nauseant which helped me keep the oral medicine down.

As for eating, once I could keep food down, chicken soup and soda crackers were the only item on my menu. That's tonight's dinner.

Once the nausea subsided (the following Tuesday), I started to experience the bone pain associated with the injection I get to keep my blood cells up (at $3,000 dollars an injection, which I'll get each round of chemo), an unbelievable case of the jitters and restlessness (like I'd had three pots of coffee injected directly into my bloodstream) and a weird twitch in my hands (couldn't knit or type). Turns out that was a side-effect of the anti-nauseant.

We've tinkered with my drug regimen slightly this round and I'm going to acupuncture tomorrow. Hopefully that will help. This is all so surreal. I still can't quite believe I'm this person with cancer and seven different prescriptions to take at bedtime.

On the other hand, when the fog lifts and the nausea subsides I feel joyous (I have a friend who is going through this at the same time I am and she describes this feeling as euphoria). I feel so damn grateful not to be sick that everything seems wonderful. I have grabbed onto those days and carry them with me because I know they'll come again.

I've been listening to a lot of music lately. The album of choice today is Casino by Blue Rodeo, in particular the tracks "Till I am Myself Again," and "What am I Doing Here?"

Not very subtle, I know.

chemotherapy (part 2)

This is what it was like to get chemotherapy:

1. The Vampires
They're actually three attractive nurses but the women who work in pharmacology were introduced to me as the vampires, and as such I will always think of them. This is where I had blood drawn and ended up performing a duet of Patricia the Stripper (Chris DeBurgh, circa my misspent youth), to which, I was astonished to realize, I remember all the words.

2.The Chemo Room
This is a large room with a nursing station at the centre. At a guess, there are at least thirty of us receiving chemo along the room's perimeter, at any given time.

Before, we begin the infusion, an oncology nurse goes over my extremely complicated post-chemo drug regimen. I have seven different prescriptions to be taken at varying intervals over the next several days.

3.Red Devil
The first chemo drug is nicknamed this way by the oncology nurses because it's bright red, it burns, it's the one that guarantees hair loss and - you excrete bright red after it's infused. The red devil takes 15 minutes to do its work.

4.Icy Fingers
After an hour's break, during which I receive saline, it's time for the Taxotere, famous for the fact that it can make your fingernails turn black and fall out. In an attempt to prevent this, patients are encouraged to spend the hour and fifteen minutes of treatment with their gloved hands in ice (I am reminded of my college Economics prof, "A statistician is someone who has his head in the oven and his feet in a bucket of ice and says, on average, he's comfortable.")

5. The Closer
The last drug is a walk in the park, because I can move my arm, and, thus, read. It takes about half an hour and then, after my "vitals" are taken, I am free to wobble off home. All told, I have been at the hospital for nearly 6 hours.

My spouse has observed how surreal it is that an experience can be simultaneously so intense, yet so unbelievably boring. Thank god we brought music. Greg Brown, Jesse Winchester, Johnny Cash and the incredible Melissa Ethridge got me through it, along with the aforementioned very patient spouse.

chemotherapy

Today I learned that if I throw up on my clothes in the first forty-eight hours after receiving chemotherapy, I am to put them in a plastic bag and bring them to the cancer centre, where they will burn them.

I am not making that up.

Chemotherapy is very scary stuff.

On March 9 and every third Thursday thereafter, I will spend at least three hours in the chemotherapy room, being infused with a toxic cocktail. Then, after a break of a couple of weeks, I will be radiated every Monday to Friday for five weeks.

Being a cancer patient is a full-time job.

I had a fitness test done at the gym at the cancer centre yesterday (every cancer patient gets a free life-time membership). I am in excellent shape, despite my post-surgery inactivity. This made me feel very good.