I trust everyone had a safe and restful Labor Day.
I find it hard to fathom that the summer is (technically) over. With focus on my health challenges since the end of April, one half of the year has slipped by. These months of coping and recovering have certainly broken my regular cycle of doing things. Previously, I had my daily and weekend routine down pat. I'd get up for work, have coffee, do my exercises, iron, shave and shower and head to the highway. Now my being retired, I have yet to establish a new routine - although I've been trying.
Now that the chemo is (thankfully) done, I've been trying to get back into the swing of things. The most difficult part has been regaining energy and maintaining my stamina. Although the spirit is more than willing the flesh is still weak. Some of the simplest tasks like doing laundry, grocery shopping and the mundane (but necessary) household chores (can) wipe me out. When I have a 'good day', I earnestly try to re-start my life. I've had some productive exercise sessions, but the ensuing dizziness and overall weakness is frustrating. My biggest scare happened last week when I was rearranging some furniture on my three season porch to ready it for my least favorite season. I was taking my time, but at one point (after standing up quickly), I almost passed out. Not wanting to fall, I gracefully sat on the floor and eventually lay flat while it 'passed'. After what seemed like too long, I was able to slowly get up and sit. I sat for nearly an hour until my breathing settled. Clearly I did (and tried to do) too much. That episode wiped me out for a day. Very frustrating.
I'm aware that I haven't 'exerted' myself physically for nearly six months so it will take time to get back. But what I haven't anticipated was my having to take things even slower. Whatever I decide to accomplish, I need to build in extra time and ensure that the task is 'manageable'. It's disconcerting to 'want to' do something (taking steps forward), but having to retreat by taking a step back to recover. In addition, I'm cognizant that my body has been through hell and it needs time to get back on track, but only having energy to play the guitar (standing) for a half hour, or trying to vocalize for just fifteen minutes is disheartening. I do have to remind myself that it's only been a week from a theoretical chemo treatment and things take time. But, I'm so far from being able to load my gear into the car and set up for a gig and put in six to eight hours. This scares me. Especially after having that episode on my sun porch. I hate to entertain the thought that I may not be at that point to handle that for another year.
So the lesson learned is - you can push yourself but be prepared for push back. I'm still learning my limits and try to push on those when I can. When 'inside' you fell you can do what you used to, I'm rudely reminded that I'm not ready yet. Frustrating yes. But this is the new reality.
Thanks for reading. More to come.
Wednesday, September 9, 2015
Tuesday, September 1, 2015
If it isn't one thing, it's three
I had my eye doctor appointment today. After getting away without glasses for 62 years, I'm now strongly encouraged to join the corrective lenses club. Yup - glasses.
The good news is I don't have glaucoma, my 'eye structures' are healthy and I don't have macular degeneration. Although, being an older light skinned male, I'm susceptible to it.
Age-related macular degeneration, often called AMD or ARMD, is the leading cause of vision loss and blindness among Americans who are age 65 and older. Because people in this group are an increasingly larger percentage of the general population, vision loss from macular degeneration is a growing problem.
The eye doctor said tht this is something that is monitored and prevention is eating leafy green vegetables (like spinach - which I love).
Now the bad news. I have cataracts.
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
A cataract can occur in either or both eyes. It cannot spread from one eye to the other.
I have cataracts in both eyes, but my right eye has the clouding in my line of vision. The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.
A cataract needs to be removed only when vision loss interferes with everyday activities, such as driving, reading, or watching TV. In most cases, delaying cataract surgery will not cause long-term damage to my eye or make the surgery more difficult. I do not have to rush into surgery.
I've been given a prescription for distance. My near vision is pretty good (20/30), but my distance is 20/40. Glasses will help bring that to 20/30.
The doctor said she doesn't know how long I've had these, but surmises that I've had them for about a year, but she has no other data on me for comparison. Some of her patients experience little to no change over time, while others show a greater progression. This is something to monitor, she said.
I asked what causes these other than age, she said that there are many variables (one being stress). [Gee I haven't had any reason for that.]. But added that my taking Tamoxifen for just over the last week had no affect. In addition, if there was any long term affect, it would not be cataracts.
She said it possible that I've had this problem (in my right eye), but didn't notice until I was asked to be cognizant of vision changes (as a result of Tamoxifen). The body does compensate, in this case by relying on the better eye. I may have been unaware of my impaired vision in my right eye.
Things could always be worse. So I'll get eye glasses for distance (driving mostly) and monitor my vision in between becoming an "I eats my spinach", Popeye.
More to come.
The good news is I don't have glaucoma, my 'eye structures' are healthy and I don't have macular degeneration. Although, being an older light skinned male, I'm susceptible to it.
Age-related macular degeneration, often called AMD or ARMD, is the leading cause of vision loss and blindness among Americans who are age 65 and older. Because people in this group are an increasingly larger percentage of the general population, vision loss from macular degeneration is a growing problem.
The eye doctor said tht this is something that is monitored and prevention is eating leafy green vegetables (like spinach - which I love).
Now the bad news. I have cataracts.
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
A cataract can occur in either or both eyes. It cannot spread from one eye to the other.
I have cataracts in both eyes, but my right eye has the clouding in my line of vision. The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.
A cataract needs to be removed only when vision loss interferes with everyday activities, such as driving, reading, or watching TV. In most cases, delaying cataract surgery will not cause long-term damage to my eye or make the surgery more difficult. I do not have to rush into surgery.
I've been given a prescription for distance. My near vision is pretty good (20/30), but my distance is 20/40. Glasses will help bring that to 20/30.
The doctor said she doesn't know how long I've had these, but surmises that I've had them for about a year, but she has no other data on me for comparison. Some of her patients experience little to no change over time, while others show a greater progression. This is something to monitor, she said.
I asked what causes these other than age, she said that there are many variables (one being stress). [Gee I haven't had any reason for that.]. But added that my taking Tamoxifen for just over the last week had no affect. In addition, if there was any long term affect, it would not be cataracts.
She said it possible that I've had this problem (in my right eye), but didn't notice until I was asked to be cognizant of vision changes (as a result of Tamoxifen). The body does compensate, in this case by relying on the better eye. I may have been unaware of my impaired vision in my right eye.
Things could always be worse. So I'll get eye glasses for distance (driving mostly) and monitor my vision in between becoming an "I eats my spinach", Popeye.
More to come.
Friday, August 28, 2015
'Them Summer days. Those Summer Days.....' - Sly Stone
When the weather is fine and it also happens to be summer, I can hear Sly and the Family Stone playing "Hot Fun in the Summertime" in my head. Like comfort food it's comfort music and it harkens back to an earlier time when worries where few and summer seemed to last forever.
I've noticed remarkable improvement in my general health and well being over the course of this week. My sense of taste has returned; the numbness in my finger and thumb is rapidly dissipating; I've been playing the guitar and returned to singing; I have energy; I've returned to doing my daily exercises; I'm watching less TV and I'm doing mini-projects around the house. In addition, the weather makes it much easier to do things.
I'm still bothered by various aches, pains and the lingering side effects of the chemo. [Chemo brain is real]. I'm optimistic that these too will begin to dissipate. I also have a heightened sense of awareness to any new side effects that Tamoxifen MAY bring. Some of the early side effects have either calmed down or I'm getting used to them. It's still early as Tamoxifen will also be cumulative like the chemo (unfortunately). I've never heard back from the doctor's office about my vision changes, but I'm satisfied that the eye doctor will have first dibs in determining if it's an age thing or something else.
I did get news for my reconstructive surgery. Pending insurance approval (and hopefully not a problem), I'm scheduled for my pre-op mid October and my first of two surgeries mid November. My immediate concern is the impending season of white stuff and my abilities to deal with it given stitches and recovery. Both the Farmer's Almanac and the Old Farmer's Almanac have told New Englanders to 'give up and die'. But it is what it is. However, I may just break down and buy a snowblower this year to ensure that we have no white stuff. Now I'll have to consider how I'll tackle keeping the roof free of the eight foot iceberg (like last year).
I hope everyone enjoys the last vestiges of "Them Summer Days"!
More to come. Thanks for reading.
I've noticed remarkable improvement in my general health and well being over the course of this week. My sense of taste has returned; the numbness in my finger and thumb is rapidly dissipating; I've been playing the guitar and returned to singing; I have energy; I've returned to doing my daily exercises; I'm watching less TV and I'm doing mini-projects around the house. In addition, the weather makes it much easier to do things.
I'm still bothered by various aches, pains and the lingering side effects of the chemo. [Chemo brain is real]. I'm optimistic that these too will begin to dissipate. I also have a heightened sense of awareness to any new side effects that Tamoxifen MAY bring. Some of the early side effects have either calmed down or I'm getting used to them. It's still early as Tamoxifen will also be cumulative like the chemo (unfortunately). I've never heard back from the doctor's office about my vision changes, but I'm satisfied that the eye doctor will have first dibs in determining if it's an age thing or something else.
I did get news for my reconstructive surgery. Pending insurance approval (and hopefully not a problem), I'm scheduled for my pre-op mid October and my first of two surgeries mid November. My immediate concern is the impending season of white stuff and my abilities to deal with it given stitches and recovery. Both the Farmer's Almanac and the Old Farmer's Almanac have told New Englanders to 'give up and die'. But it is what it is. However, I may just break down and buy a snowblower this year to ensure that we have no white stuff. Now I'll have to consider how I'll tackle keeping the roof free of the eight foot iceberg (like last year).
I hope everyone enjoys the last vestiges of "Them Summer Days"!
More to come. Thanks for reading.
Wednesday, August 26, 2015
Follow-up with Dr. Chatson and Tamoxifen update
Visited with Dr. Chatson today to discuss the next steps for my reconstructive/reduction surgeries.
The waiting room was pretty full and as a result, I had to wait a half hour before getting to see Dr. Chatson. Finally being called, I had two two professionals working in tandem, to take my vitals. Then I waited for the doctor to join me.
Dr Chatson came in and wasted no time. Asking me to remove my shirt he closely inspected the surgical area and related scars. He asked me to step in front of the mirror so he could discuss his thoughts/findings as he directed my attention to the corresponding parts of my body.
He said that the scar was still very tight. It had relaxed somewhat since our last visit, so he thought that over time it would continue to relax. Dr. Chatson did say that due to my current state (of body healing), he would have to rethink his approach. Apparently because the surgical area was 'opened' two times, there is considerable scarring tissue that is tight and causing a concavity. He thought that a fat graft/liposuction approach first discussed may not work this time. Because of the tight scarring, the end result of that approach would still have a considerable degree of concavity.
He paused and said, "I may have a better approach." He asked me to wait while he left the room. Upon his return he had his book of before and after pictures of other (anonymous - no face) patients. He turned to the back and said,"Here's someone with a similar situation".
So the tentative plan now is to wait a few months (some time in November) and approach this in two phases.
At the highest level:
Phase 1 - reduction and liposuction of my left (good) breast and initial liposuction of certain areas of the surgical area. Some of my own fat (near my waistline) will be taken to replace and remold. He will need to reopen the surgical site to remove some scarring and insert some (he called hard fat) to relieve the concavity.
Phase 2 - after recovery and healing, he will take a skin graft from the other side of my abdomen to create a new nipple.
He cautioned me that when all was said and done I may still have some concavity, but it's too soon to tell. [It can't be worse that now.]
Because this is a change to the approach, he needed to write up a new case for the insurance company. He didn't believe there would be a problem, but thought that the November time frame was realistic. He said he would notify me when the surgery is scheduled and when I would need to arrive for pre-op.
Sounds like a plan. So now I wait.
Tamoxifen update
I'm on my third day of Tamoxifen. With the host of possible side effects this medication MAY cause, Dr. Mehta told me to notify him immediately for a certain few. One being change in vision.
Change in vision is very broad, so one might be willing to accept little things that may have happened in the past as being 'normal'. For instance, if some dust gets in your eye and you instinctively rub it, your eye may tear a bit. This could be a 'change in vision' but one would argue it was caused by my rubbing and not the affect of Tamoxifen.
To keep cool and comfy, I have been sitting in front of a fan. I know that from time to time one eye may get too much of a breeze and I feel like 'dry eye'. I thought little of that in the past, but my heightened sense of change now triggers an alarm. I had noticed yesterday that the vision in my right eye seemed 'not as clear'. With both eyes, I had no problem seeing or reading, but I did have the sensation of having my 'lens' smudged. Last evening while watching TV, I closed my left eye and my right eye was significantly blurry. Hmmm Hoping a night's sleep would take care of things, I waited until today.
I'm having the same symptoms today. I did make an appointment with the eye doctor. It's possible that after 62 years I need glasses. But panic set in and I was looking up possible causes - cataract? To be safe and the coincidence of this onset with my beginning to take Tamoxifen, I did call Dr. Mehta's office and reported this.
As this writing I've not heard back from either the eye doctor or my oncologist.
Yes, it truly is - 'always something'. More to come.
[Post Script: Eye doctor's office called me back for an appointment for early next week.]
The waiting room was pretty full and as a result, I had to wait a half hour before getting to see Dr. Chatson. Finally being called, I had two two professionals working in tandem, to take my vitals. Then I waited for the doctor to join me.
Dr Chatson came in and wasted no time. Asking me to remove my shirt he closely inspected the surgical area and related scars. He asked me to step in front of the mirror so he could discuss his thoughts/findings as he directed my attention to the corresponding parts of my body.
He said that the scar was still very tight. It had relaxed somewhat since our last visit, so he thought that over time it would continue to relax. Dr. Chatson did say that due to my current state (of body healing), he would have to rethink his approach. Apparently because the surgical area was 'opened' two times, there is considerable scarring tissue that is tight and causing a concavity. He thought that a fat graft/liposuction approach first discussed may not work this time. Because of the tight scarring, the end result of that approach would still have a considerable degree of concavity.
He paused and said, "I may have a better approach." He asked me to wait while he left the room. Upon his return he had his book of before and after pictures of other (anonymous - no face) patients. He turned to the back and said,"Here's someone with a similar situation".
So the tentative plan now is to wait a few months (some time in November) and approach this in two phases.
At the highest level:
Phase 1 - reduction and liposuction of my left (good) breast and initial liposuction of certain areas of the surgical area. Some of my own fat (near my waistline) will be taken to replace and remold. He will need to reopen the surgical site to remove some scarring and insert some (he called hard fat) to relieve the concavity.
Phase 2 - after recovery and healing, he will take a skin graft from the other side of my abdomen to create a new nipple.
He cautioned me that when all was said and done I may still have some concavity, but it's too soon to tell. [It can't be worse that now.]
Because this is a change to the approach, he needed to write up a new case for the insurance company. He didn't believe there would be a problem, but thought that the November time frame was realistic. He said he would notify me when the surgery is scheduled and when I would need to arrive for pre-op.
Sounds like a plan. So now I wait.
Tamoxifen update
I'm on my third day of Tamoxifen. With the host of possible side effects this medication MAY cause, Dr. Mehta told me to notify him immediately for a certain few. One being change in vision.
Change in vision is very broad, so one might be willing to accept little things that may have happened in the past as being 'normal'. For instance, if some dust gets in your eye and you instinctively rub it, your eye may tear a bit. This could be a 'change in vision' but one would argue it was caused by my rubbing and not the affect of Tamoxifen.
To keep cool and comfy, I have been sitting in front of a fan. I know that from time to time one eye may get too much of a breeze and I feel like 'dry eye'. I thought little of that in the past, but my heightened sense of change now triggers an alarm. I had noticed yesterday that the vision in my right eye seemed 'not as clear'. With both eyes, I had no problem seeing or reading, but I did have the sensation of having my 'lens' smudged. Last evening while watching TV, I closed my left eye and my right eye was significantly blurry. Hmmm Hoping a night's sleep would take care of things, I waited until today.
I'm having the same symptoms today. I did make an appointment with the eye doctor. It's possible that after 62 years I need glasses. But panic set in and I was looking up possible causes - cataract? To be safe and the coincidence of this onset with my beginning to take Tamoxifen, I did call Dr. Mehta's office and reported this.
As this writing I've not heard back from either the eye doctor or my oncologist.
Yes, it truly is - 'always something'. More to come.
[Post Script: Eye doctor's office called me back for an appointment for early next week.]
Monday, August 24, 2015
Chemo # 4 - Follow-up with Dr. Mehta
Are people that bad of a driver or are they exercising 'uber car protection' by purposely taking up two parking spots?
Looking for a space to park today at Holy Family - Dana Farber was quite difficult. I don't recall it being so busy there. I guess my prior appointments have been on less busy days. There must have been room for for an additional dozen cars but selfish people were parked outside the lines making the adjacent space un-park-able. I ended up finding a spot the furthest distance away from the Cancer Care Unit. Not that I minded walking, but trawling for a spot took more time than I anticipated and I was now running late. Turns out it didn't matter.
The waiting area was packed. While checking in I was scoping out a seat - any seat. Luckily someone was called in as I was about to sit. Most waiting were having their blood taken and vitals checked, so as one would leave, one would return causing a musical chairs effect. I waited a good half hour before being called for by blood draw.
There was a small line for blood with only one phlebotomist who was been harangued by a medical professional (a doctor possibly) because the lab worker wasn't working as fast as she wished. Quite stressful atmosphere and not conducive to the likelihood of a near pain-free venipuncture. Which turned out to be the case. At least it was quick once it was my turn. So quick that small talk was kept at a minimum and I nearly got much of a response to how busy it was. [I guess it was an understatement so she may have felt it more rhetorical than an opportunity to explain why.] I was dismissed to the waiting room (purgatory) and yet another chair.
Not to be judgmental, but most of the crowd in purgatory where older than myself, so there was no one missing work (I surmised), but the lady next to me kept asking for the time and was huffing because her doctor was now 15 minutes late. I wanted to add that I had now been waiting an hour, but passed at being the 'one-up guy'. I had pulled my cap over my eyes hoping she would think I was asleep and stop asking the time. It worked, but she was asking others around me. I was gladdened to hear my name being called for the vital check.
Once again there was a line, but everyone knew the drill and things moved pretty well. Apparently there was a trend for high blood pressure readings, mine included. I wonder why?
I was released to spend more time in purgatory. But finding yet another chair to sit and reflect on past grievances, I had noticed that Lady Time was gone. Of course every void gets filled and this time it was someone who insisted on having a loud cell phone conversation. The things that people say in public places when they believe their cell conversation is private. So many rolled eyes. Entertaining if nothing else. An angel opened the pearly gates and called my name. Yes!
I was guided to a familiar examination room and was told that Dr. Mehta would be right with me. Compared to my other waits, he did show up quickly. He looked refreshed after having some time off. I almost asked if he enjoyed his vacation, but dispensed with the small talk and got right into my reflections on chemo # 4. Clearly this has been the most challenging. He agreed that the cumulative effect would result in this being the toughest. We spoke of some of the persistent side effects, notably the neuropathy but spent more time talking about my loss of appetite and the changes to my sense of taste.
Dr. Mehta said, "These are all classic symptoms and compared to others, you did very well." He indicated that my counts were lower compared to my other readings, but not low enough where I would need a booster. He anticipated the levels would be near normal over the next few days. This definitely mirrored how I was feeling, since yesterday was my first 'good day', but my having interrupted sleep patterns last night, today wasn't 'as good'. He said, "You are free from breast cancer.' (Really free - what could have survived that 12 week ordeal?) So, I asked, "What's next? Another CAT scan or other tests?"
Dr Mehta said, "In women a mammogram and ultra sound would be next, but since you have no breast tissue I'm just monitored every three months." He said that he was going to start me on Tamoxifen today. I asked if it was for 5 or 10 years? Dr Mehta indicated that Tamoxifen will 'kill' any new breast cancer cells by blocking the estrogen (my cancer is estrogen receptor positive). However, there isn't enough data on men other than the comparative data of the Oncotype DX. He said in five years there may be more data. He'll be seeing me at intervals of every six months eventually.
We discussed the Tamoxifen and possible side effects. He said that he wasn't worried, but regular blood tests and my knowing my body - and reporting these symptoms if they occur, the risk of 'bad side effects' is low. He shook my hand, congratulated me and said he would see me in November. "Go on and live your life", he said.
By the time I reached check out, the waiting room was almost empty. How is that? I had been there three hours - wow. I got my paperwork for my next blood test (day before my birthday) and appointment just prior to Thanksgiving. That's full circle since that's when I discovered the lump while shoveling snow last Thanksgiving.
I called home to check voice messages and Walgreens had left a message that my prescription was ready to be picked up. I headed there.
The doctor told me he was going to give me a prescription for 90 pills with four refills to cover a year, but when I picked it up there were only 30 pills. When I told the pharmacy assistant what I was expecting he said the insurance wouldn't cover 90, so they split it up. Knowing you can't fight the insurance company I said how much. He said nothing. Very odd. I don't ever recall getting any pills for free. But I'm not complaining. Sure I'll gladly come back each month for my next free 30 pills. [I'm still suspicious though.]
Getting home, I read the insert and was shaken by all the possible side effects. I guess the most dominant ones are hot flashes, head aches that dissipate over time and possible weight loss or gain (flip a coin). There were some specific to the female gender that don't apply to me unless I sprout a vagina. Just one more self examination I have to be mindful of. One caution was that shouldn't operate a motor vehicle or heavy equipment until I know how this Tamoxifen will react with me. So I decided to stay in and do some grocery shopping tomorrow.
It will be difficult over the coming days to determine if I'm recovering from chemo slower or having some effects of the Tamoxifen. I have experienced a dull headache, but that could be from caffeine withdrawal. (I did have one mug today. Maybe tomorrow I'll try more.)
So the chemo chapters are just about to close, but the challenge continues with reconstructive surgery and tending to my Triple A.
Much more to come.
Thanks to all my readers for your support as well as my family, friends, musicians and former work colleagues.
Looking for a space to park today at Holy Family - Dana Farber was quite difficult. I don't recall it being so busy there. I guess my prior appointments have been on less busy days. There must have been room for for an additional dozen cars but selfish people were parked outside the lines making the adjacent space un-park-able. I ended up finding a spot the furthest distance away from the Cancer Care Unit. Not that I minded walking, but trawling for a spot took more time than I anticipated and I was now running late. Turns out it didn't matter.
The waiting area was packed. While checking in I was scoping out a seat - any seat. Luckily someone was called in as I was about to sit. Most waiting were having their blood taken and vitals checked, so as one would leave, one would return causing a musical chairs effect. I waited a good half hour before being called for by blood draw.
There was a small line for blood with only one phlebotomist who was been harangued by a medical professional (a doctor possibly) because the lab worker wasn't working as fast as she wished. Quite stressful atmosphere and not conducive to the likelihood of a near pain-free venipuncture. Which turned out to be the case. At least it was quick once it was my turn. So quick that small talk was kept at a minimum and I nearly got much of a response to how busy it was. [I guess it was an understatement so she may have felt it more rhetorical than an opportunity to explain why.] I was dismissed to the waiting room (purgatory) and yet another chair.
Not to be judgmental, but most of the crowd in purgatory where older than myself, so there was no one missing work (I surmised), but the lady next to me kept asking for the time and was huffing because her doctor was now 15 minutes late. I wanted to add that I had now been waiting an hour, but passed at being the 'one-up guy'. I had pulled my cap over my eyes hoping she would think I was asleep and stop asking the time. It worked, but she was asking others around me. I was gladdened to hear my name being called for the vital check.
Once again there was a line, but everyone knew the drill and things moved pretty well. Apparently there was a trend for high blood pressure readings, mine included. I wonder why?
I was released to spend more time in purgatory. But finding yet another chair to sit and reflect on past grievances, I had noticed that Lady Time was gone. Of course every void gets filled and this time it was someone who insisted on having a loud cell phone conversation. The things that people say in public places when they believe their cell conversation is private. So many rolled eyes. Entertaining if nothing else. An angel opened the pearly gates and called my name. Yes!
I was guided to a familiar examination room and was told that Dr. Mehta would be right with me. Compared to my other waits, he did show up quickly. He looked refreshed after having some time off. I almost asked if he enjoyed his vacation, but dispensed with the small talk and got right into my reflections on chemo # 4. Clearly this has been the most challenging. He agreed that the cumulative effect would result in this being the toughest. We spoke of some of the persistent side effects, notably the neuropathy but spent more time talking about my loss of appetite and the changes to my sense of taste.
Dr. Mehta said, "These are all classic symptoms and compared to others, you did very well." He indicated that my counts were lower compared to my other readings, but not low enough where I would need a booster. He anticipated the levels would be near normal over the next few days. This definitely mirrored how I was feeling, since yesterday was my first 'good day', but my having interrupted sleep patterns last night, today wasn't 'as good'. He said, "You are free from breast cancer.' (Really free - what could have survived that 12 week ordeal?) So, I asked, "What's next? Another CAT scan or other tests?"
Dr Mehta said, "In women a mammogram and ultra sound would be next, but since you have no breast tissue I'm just monitored every three months." He said that he was going to start me on Tamoxifen today. I asked if it was for 5 or 10 years? Dr Mehta indicated that Tamoxifen will 'kill' any new breast cancer cells by blocking the estrogen (my cancer is estrogen receptor positive). However, there isn't enough data on men other than the comparative data of the Oncotype DX. He said in five years there may be more data. He'll be seeing me at intervals of every six months eventually.
We discussed the Tamoxifen and possible side effects. He said that he wasn't worried, but regular blood tests and my knowing my body - and reporting these symptoms if they occur, the risk of 'bad side effects' is low. He shook my hand, congratulated me and said he would see me in November. "Go on and live your life", he said.
By the time I reached check out, the waiting room was almost empty. How is that? I had been there three hours - wow. I got my paperwork for my next blood test (day before my birthday) and appointment just prior to Thanksgiving. That's full circle since that's when I discovered the lump while shoveling snow last Thanksgiving.
I called home to check voice messages and Walgreens had left a message that my prescription was ready to be picked up. I headed there.
The doctor told me he was going to give me a prescription for 90 pills with four refills to cover a year, but when I picked it up there were only 30 pills. When I told the pharmacy assistant what I was expecting he said the insurance wouldn't cover 90, so they split it up. Knowing you can't fight the insurance company I said how much. He said nothing. Very odd. I don't ever recall getting any pills for free. But I'm not complaining. Sure I'll gladly come back each month for my next free 30 pills. [I'm still suspicious though.]
Getting home, I read the insert and was shaken by all the possible side effects. I guess the most dominant ones are hot flashes, head aches that dissipate over time and possible weight loss or gain (flip a coin). There were some specific to the female gender that don't apply to me unless I sprout a vagina. Just one more self examination I have to be mindful of. One caution was that shouldn't operate a motor vehicle or heavy equipment until I know how this Tamoxifen will react with me. So I decided to stay in and do some grocery shopping tomorrow.
It will be difficult over the coming days to determine if I'm recovering from chemo slower or having some effects of the Tamoxifen. I have experienced a dull headache, but that could be from caffeine withdrawal. (I did have one mug today. Maybe tomorrow I'll try more.)
So the chemo chapters are just about to close, but the challenge continues with reconstructive surgery and tending to my Triple A.
Much more to come.
Thanks to all my readers for your support as well as my family, friends, musicians and former work colleagues.
Sunday, August 23, 2015
Chemo # 4 - day 10 check-in
Certainly this round of chemo has been the toughest yet. Other than the my consistent side-effects: fatigue; low energy; lack of appetite; disrupted sleep patterns; persistent numbness in my thumb and forefinger (and to a lesser degree - my feet and toes) and general achiness, the cumulative affects of these poisons have amplified some of these side effects and manifested into 'new' ones.
Fatigue
This has been a constant, but this round (so far) it hasn't let up. During 1-3, by day 10 if not sooner, I 'felt' an improvement. There could be many factors why this is not the case right now. The atmosphere (weather) has been very 'heavy'. Between the humidity and the rain storms, the air is super saturated and not conducive to one feeling energized. Allegedly, Wednesday will be the break in the current weather pattern. [Hurricane Danny may change that.] Although it's been humid, sitting in front of a fan seemed to work and I have not turned on the air conditioner. [My electric bill should reflect this.]
Low energy
I'm sure this is directly related to the fatigue and my lack of appetite. In addition, my standing causes dizziness to the point of a near black-out to various degrees with no particular pattern. This makes me immediately stand and wait (making sure I'm near a chair or something to hold on to). Once my 'blindness' passes, I able to move cautiously. Once up, I'm OK unless I forget and bend over to pick up a dropped spoon or whatever (not feeling things picked up with my left hand causes many small things to drop). Once erect, the dizziness returns. [It should be noted that dizziness is a side effect of the blood pressure medicine I'm taking, so this is not foreign to me. However, the degree of dizziness has been much greater while undergoing chemotherapy.]
Lack of appetite
Throughout this ordeal, I have been fortunate not to have nausea. However, there have been many foods that I used to eat daily (salads, oranges, fresh fruits, coffee) that I have little tolerance for. Certain vegetables when cooked are 'passable', but others and some fruits, I can't eat. Not that they make me nauseous, but I get 'the burps' and lately, spells of hiccups and gas pains. My online research has made me understand that the chemo does affect the entire digestive track and many of these foods are too much at this time (hopefully). Prior rounds, I relied on my cravings, but this round even my cravings can cause problems.
Taste changes
Most likely related to my lack of appetite and the effects of chemo on my digestive tract, I've been most affected by taste changes for round 4. During previous rounds, I had cravings for foods not as healthy for me, like steak and cheese subs, pizza, burgers and fries. But I was able to tolerate these and did get some nutrition. However, this week all of my cravings have seemed flat tasting and basically tasteless. Even fish (salmon, haddock, scallops) has not been satisfying. My old stand-by of bland foods: cottage cheese; yogurt; cheese; oatmeal and crackers are soon becoming a turn off. I'm now resorting to soup, nuts and chocolate. Possibly for their salt content. But even salt taste is diminished. I am forcing my self to eat something, but choices are getting smaller. I've lost almost 10 pounds since my last weigh-in. [I'm usually bloated from all the fluids, so the last weigh-in indicated a higher weight than normal. In reality I'm probably 5 pounds from my 'normal' weight.]
Having been a coffee drinker for 30 years, giving up coffee seemed to make my brain foggier than 'normal'. Today, I broke down and had a cup of instant (Starbucks). So far so good.
Disrupted sleep patterns
In previous rounds, the first few days/nights I experienced intermittent sleep. Generally waking up every hour or two and during one round not being able to fall back asleep for hours [Law and Order marathon reference here]. Round 4 had similar patterns, but most recently, I've been waking up with back pains, leg and arm pains. There could be various reasons why this is more prevalent now since I haven't had the energy to take walks, thus causing muscles to atrophy and be painful. It's a two sided sword, but I'll try to 'ease' into a regimen of light exercise and walking as soon as this round 'breaks'.
Neuropathy
Listed as possible side effect of Adriamycin, I have had 'slight' numbness to my feet and a few toes. Nothing debilitation, but noticeable when standing in one spot for too long (4-5 minutes). The most aggravating neuropathy has been to my left thumb and forefinger. Dr. Mehta had mentioned that neuropathy is generally symmetric and since I haven't experienced this on my right hand, it's probably not chemo related. I don't want to be charged with practicing medicine without a license, but I do believe this is related. As the rounds of chemotherapy wind down, the numbness begins to dissipate. It's at this time that I'm able to play the guitar again. While this numbness is heightened (first two weeks of a chemo), the 'fine' sense of touch is gone. In addition, pressing my finger against the string actually hurts. Other normal functions, like picking up a small object, turning a newspaper page, opening an envelop, or separating paper are quite difficult. I can still button and unbutton clothing (which would be impossible if this was Charcot Marie Tooth (CMT) which runs in my family). I'm hopeful that by next week, I'll begin (again) to get my guitar chops up.
General achiness
Much like a neglected house, my body is in need of repairs. Most of these should be done by the body's recuperative powers which will need my attention in ensuring that I have the right sustenance and exercise regimen in place. Until this happens, I'm really feeling old. Chemo has done a number on me. My veins ache, my mouth seems on the verge of being sore, my muscles need basic toning, my stamina needs rebuilding, and I have many other aches and pains.
Some things will bounce back, while others will take some time. I'm fearful of the things that will never return or the 'things' I will need to live with the rest of my life. But I'll face those when they are identified. Until then, I have more to go with chemo # 4.
On Monday, I have a follow-up with Dr. Mehta. In the words of Roseanne Roseannadanna, "It's always something."
More to come.
Fatigue
This has been a constant, but this round (so far) it hasn't let up. During 1-3, by day 10 if not sooner, I 'felt' an improvement. There could be many factors why this is not the case right now. The atmosphere (weather) has been very 'heavy'. Between the humidity and the rain storms, the air is super saturated and not conducive to one feeling energized. Allegedly, Wednesday will be the break in the current weather pattern. [Hurricane Danny may change that.] Although it's been humid, sitting in front of a fan seemed to work and I have not turned on the air conditioner. [My electric bill should reflect this.]
Low energy
I'm sure this is directly related to the fatigue and my lack of appetite. In addition, my standing causes dizziness to the point of a near black-out to various degrees with no particular pattern. This makes me immediately stand and wait (making sure I'm near a chair or something to hold on to). Once my 'blindness' passes, I able to move cautiously. Once up, I'm OK unless I forget and bend over to pick up a dropped spoon or whatever (not feeling things picked up with my left hand causes many small things to drop). Once erect, the dizziness returns. [It should be noted that dizziness is a side effect of the blood pressure medicine I'm taking, so this is not foreign to me. However, the degree of dizziness has been much greater while undergoing chemotherapy.]
Lack of appetite
Throughout this ordeal, I have been fortunate not to have nausea. However, there have been many foods that I used to eat daily (salads, oranges, fresh fruits, coffee) that I have little tolerance for. Certain vegetables when cooked are 'passable', but others and some fruits, I can't eat. Not that they make me nauseous, but I get 'the burps' and lately, spells of hiccups and gas pains. My online research has made me understand that the chemo does affect the entire digestive track and many of these foods are too much at this time (hopefully). Prior rounds, I relied on my cravings, but this round even my cravings can cause problems.
Taste changes
Most likely related to my lack of appetite and the effects of chemo on my digestive tract, I've been most affected by taste changes for round 4. During previous rounds, I had cravings for foods not as healthy for me, like steak and cheese subs, pizza, burgers and fries. But I was able to tolerate these and did get some nutrition. However, this week all of my cravings have seemed flat tasting and basically tasteless. Even fish (salmon, haddock, scallops) has not been satisfying. My old stand-by of bland foods: cottage cheese; yogurt; cheese; oatmeal and crackers are soon becoming a turn off. I'm now resorting to soup, nuts and chocolate. Possibly for their salt content. But even salt taste is diminished. I am forcing my self to eat something, but choices are getting smaller. I've lost almost 10 pounds since my last weigh-in. [I'm usually bloated from all the fluids, so the last weigh-in indicated a higher weight than normal. In reality I'm probably 5 pounds from my 'normal' weight.]
Having been a coffee drinker for 30 years, giving up coffee seemed to make my brain foggier than 'normal'. Today, I broke down and had a cup of instant (Starbucks). So far so good.
Disrupted sleep patterns
In previous rounds, the first few days/nights I experienced intermittent sleep. Generally waking up every hour or two and during one round not being able to fall back asleep for hours [Law and Order marathon reference here]. Round 4 had similar patterns, but most recently, I've been waking up with back pains, leg and arm pains. There could be various reasons why this is more prevalent now since I haven't had the energy to take walks, thus causing muscles to atrophy and be painful. It's a two sided sword, but I'll try to 'ease' into a regimen of light exercise and walking as soon as this round 'breaks'.
Neuropathy
Listed as possible side effect of Adriamycin, I have had 'slight' numbness to my feet and a few toes. Nothing debilitation, but noticeable when standing in one spot for too long (4-5 minutes). The most aggravating neuropathy has been to my left thumb and forefinger. Dr. Mehta had mentioned that neuropathy is generally symmetric and since I haven't experienced this on my right hand, it's probably not chemo related. I don't want to be charged with practicing medicine without a license, but I do believe this is related. As the rounds of chemotherapy wind down, the numbness begins to dissipate. It's at this time that I'm able to play the guitar again. While this numbness is heightened (first two weeks of a chemo), the 'fine' sense of touch is gone. In addition, pressing my finger against the string actually hurts. Other normal functions, like picking up a small object, turning a newspaper page, opening an envelop, or separating paper are quite difficult. I can still button and unbutton clothing (which would be impossible if this was Charcot Marie Tooth (CMT) which runs in my family). I'm hopeful that by next week, I'll begin (again) to get my guitar chops up.
General achiness
Much like a neglected house, my body is in need of repairs. Most of these should be done by the body's recuperative powers which will need my attention in ensuring that I have the right sustenance and exercise regimen in place. Until this happens, I'm really feeling old. Chemo has done a number on me. My veins ache, my mouth seems on the verge of being sore, my muscles need basic toning, my stamina needs rebuilding, and I have many other aches and pains.
Some things will bounce back, while others will take some time. I'm fearful of the things that will never return or the 'things' I will need to live with the rest of my life. But I'll face those when they are identified. Until then, I have more to go with chemo # 4.
On Monday, I have a follow-up with Dr. Mehta. In the words of Roseanne Roseannadanna, "It's always something."
More to come.
Wednesday, August 19, 2015
Almost a week into Chemo # 4
As expected, I've been feeling progressively worse since my last entry. I've had days of waking up every hour or two; little to zero energy; hardly any appetite barring the occasional craving; sporadic episodes of hiccups; a change in the way food tastes (or doesn't taste); a near black-out each time I stand; and my 'strange' neuropathy to my thumb and forefinger has manifested itself to a greater degree. I'm once again hopeful that this will dissipate over time (as it appeared to do in my third week).
I've been more than content to watch TV. I've switched to musical and historic offerings. On the premium music channels, i.e., Palladia, I've watched entire concerts of McCartney and Wings over America (filmed in 1976), the Who (Quadraphenia) and others. I found that Mysteries at the Museum was available from Netflix (sans commercial interruption), so I started from the beginning and watched in the breeze of a window fan. Although we've been having a heat wave, it hasn't bothered me. Sitting still and doing virtually nothing doesn't generate much heat, so the fan suffices. I have noticed that the house temperature has been 84 degrees, but I've been OK without turning on the air conditioner. It's cooled down at night so I sleep with blankets on. I'm now to the point where I sleep uninterrupted for longer periods of time. However, I've been having very strange dreams.
Last evening one of my temperature readings was 99.2 degrees. In the past, this pattern has shown that I've reached Nadir and soon after I begin to feel better. If so, this has come a few days earlier than the other treatments. So I'll be monitoring this to see if it's not just a fluke. I have noticed that I'm less dizzy when standing and I even had energy to do a load of laundry. I'm hopeful that the days will begin to get better.
More to come.
I've been more than content to watch TV. I've switched to musical and historic offerings. On the premium music channels, i.e., Palladia, I've watched entire concerts of McCartney and Wings over America (filmed in 1976), the Who (Quadraphenia) and others. I found that Mysteries at the Museum was available from Netflix (sans commercial interruption), so I started from the beginning and watched in the breeze of a window fan. Although we've been having a heat wave, it hasn't bothered me. Sitting still and doing virtually nothing doesn't generate much heat, so the fan suffices. I have noticed that the house temperature has been 84 degrees, but I've been OK without turning on the air conditioner. It's cooled down at night so I sleep with blankets on. I'm now to the point where I sleep uninterrupted for longer periods of time. However, I've been having very strange dreams.
Last evening one of my temperature readings was 99.2 degrees. In the past, this pattern has shown that I've reached Nadir and soon after I begin to feel better. If so, this has come a few days earlier than the other treatments. So I'll be monitoring this to see if it's not just a fluke. I have noticed that I'm less dizzy when standing and I even had energy to do a load of laundry. I'm hopeful that the days will begin to get better.
More to come.
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