pre-Winter Solstice Update

12/21  marks the last day of Fall and tomorrow (12/22) , the first full day of Winter: The Winter Solstice.  I'm looking forward to gaining a few more moments of daylight as the days progress.  Unfortunately, the Winter brings my least favorite weather: snow; cold; ice; and host of other meteorological 'joys' that demand immediate attention. As has been the case, time will fly by and we'll be changing the clocks ahead.  Until then: wait and see.

I had my follow-up visit with Dr. Pare for my abdominal aortic aneurysm (Triple A).  Six months ago I was given good news that my malady had no changes in size.  Unfortunately, I did not receive the same prognosis after today's ultra sound.

Dr. Pare said, "Last time your aneurysm was about 4.8 to 4.9 cm. Since then it is now measuring 5 to 5.1 cm.  I don't want to alarm you, but we are now at the point were we need more information.  I will order a CAT scan at Holy Family to have a better view.  Based on that, we can make a determination on the next step.  I believe that a relatively non-invasive stent can be placed at the site.  Let's see what the CAT scan shows. We'll make an appointment today for sometime in January."  He asked if I had heart troubles, pains, shortness of breath, to which I responded no.  I did say that there is a history of heart disease in my family. After wishing me happy holidays, I was told to button up and see his assistant on the way out.

I walked by the assistant's office when I heard my name being called. I went in and she (didn't get her name - she had an accent) told me that I would need blood work and insurance authorization before scheduling.  In addition, I would need a follow-up with Dr. Pare after the scan.  She will call me over the next few days once the insurance company gives approval.  However, she said that I could go anytime for blood work.  While I was in Methuen, I decided to head to Holy Family to get the blood done.

All of my blood work had been done at the Dana Farber Cancer Care unit, so I went there first, but I was directed to the main hospital.  Upon entering the lobby, I was greeted by a woman who looked at my work order and directed me to the lower level.  I found room G-21 and immediately recalled that I was there during the reconstruction of the Dana Farber lab.  I entered, spoke with the reception and was told to wait to be called.  They weren't busy, but I waited almost a half hour.  It was lunch time.

A woman walked by and asked if I was there for blood work. [Well dah!!!] Answering yes, she then invited me into her lair.  She went right to work and drew blood with a minimal amount of discomfort.  Merry Christmas, she said as I left.

So now it's a waiting game.  Depending on the results and prognosis following the CAT scan, if I do need a procedure, I will contact St. Elizabeth's in Brighton.  I originally went there, but was told to 'take care of the cancer first'.  I got the baseline images for the Triple A, at Dr Pare's only out of convenience.  If there was no change (as was the case up until today), I would continue to have it monitored locally.  Now let's see what the CAT scan shows.

Not the Christmas gift I was hoping for.  More to come.

Mammogram anyone?

Arrived at Holy Family's Breast Cancer Care unit for my (I guess it will be) annual mammogram.  It was quite busy in the waiting room, but I needed to complete some paperwork so the wait seemed lessened by the time it took me to complete the task.  While answering the questions or placing N/A for answers ( - When was your last period?), I sensed some hubbub about a machine and/or computers not working.  Lovely.

After almost a 45 minute wait, I was called in.  I followed the technician to an imaging room and was asked to remove my shirt(s).  After the obligatory questions to determine if I am the correct patient and that the proper procedure will be performed there was some question as to which side was going to be imaged.  I was under the impression that both sides would be done. However, the order stated that just the left breast would be done.  There seemed to be some confusion as to which left - mine or hers.

[Recollection of the Three Stooges - "Walla Walla" episode came to mind. The Stooges needed to open a wall on the left. Of course depending on how you were facing both sides could be considered the 'left'. They ended up opening both sides.]

She left the room to get clarification.  While waiting bare-chested, I began to get chilled since the AC was keeping the electronics cool.  Not too long after, she returned and said it was my left (non-cancerous) breast. It makes sense now considering the right one was removed and there was now no breast tissue that could be considered cancerous.  While waiting there chilled, she was having trouble with the machine.  Feeling sorry for me, she asked that I place my shirt over my shoulders.  After some fussing with the machine and related PC she determined that it was not operational.  I was escorted to another room and was instructed to stand in front of the imaging machine.  After some very uncomfortable squeezing and pinching, I was done.

She asked that I wait in yet another room, while the doctor/technician reviewed the images to ensure that they were 'good enough'.  Thank heavens they were.  I was given the green light to get dressed and be on my way. Glad that's done.

More to come.

[Post Script: I received a letter a few days after this mammogram indicating that no cancer was found/detected.]

Icing on the cake?

I had my 6 month follow-up with Dr. Chatson today.  All staff members had mentioned that they couldn't believe it's been that long since my last visit.

After my vitals check, Dr. Chatson's assistant, Jude was making some chit-chat as she recorded my results.  She had mentioned that Kelley, the Physician's Assistant had recently departed the practice.  A new P.A. is now on board, but I did not meet her - yet. Jude left me and indicated that Dr. Chatson would be right in.

And it was true, he came right in.  After exchanging pleasantries he asked me to remove my shirt(s). As I was disrobing, he said, "I was looking at your chart notes and we were going to see if the new nipple needed to be reduced or if any other 'sculpting' was needed." Upon seeing my bare chest he exclaimed, "This looks very good.  I'm happy with the shaping (sculpting) and the nipple had receded (somewhat).  So there's no need for a reduction."  I was happy to hear this, since I was not looking forward to any more cutting and healing. He then asked me to re-dress. While I was dressing he explained the next step - tattooing. 

He said, "Tattooing is a half hour procedure performed under local anesthetic where I will attempt to get the aureola and nipple color as close to the other."  He asked that I schedule something after January.  He wished me a Merry Christmas and a Happy New Year and said he'd see me early next year.

On my way out the receptionist was already looking for a time for my tattooing and finally settled on February 22nd. So this next step will be very cosmetic, much like icing on the cake. 

More to come.

And the beat goes on....

La dee dah dee dee; la dee dah dee dah

Had our first 'shovel-able' snow yesterday.  Was supposed to be a dusting then turn to rain.  Wrong!  How about 3+ inches of heavy wet snow?  It is what it is - or was, for that matter.

Today I had my 6 month check-up with Dr. Mehta at Dana Farber, Methuen.  After check-in and vitals check, I was greeted by a smiling Dr. Mehta.  Right away he got to business asking me how I was doing and how my side effects were progressing.

I told him that the neuropathy of my feet appeared to be getting 'worse' on my left foot. So much so that I was not walking correctly and may have injured my heel (somehow).  Since this had just happened a few days ago, I've been refraining from my daily walks.  As a result, my muscle spasms have increased.  The odd neuropathy in my finger thumb continues to exhibit a cycle on its own [that I'm trying to figure out - with no luck.]

Dr. Mehta said, "The neuropathy is a result of the chemo and not a side effect of Tamoxifen (which was not my understanding)."  He continued, "Tamoxifen does not 'go after' new cells like the chemo.  It goes after a specific type of receptor cell.  In your case, the estrogen receptor."  He asked if I had seen a neurologist.  To which I answered, no.  He then indicated that he would refer me to Dr. Ross.

Dr. Mehta asked that I remove my shirt(s) so he could examine me.  Upon completion of my partial disrobe, he said, "Wow, he did a great job on the reconstruction.  It looks completely normal."  That was nice to hear especially since I have an appointment with Dr. Chatson tomorrow morning.  I'm hoping he has the same reaction.

As Dr. Mehta was examining me and feeling for 'lumps', I had mentioned that I had seen Dr. Moore last week and requested that I have a mammogram (also scheduled for tomorrow).  I told him Dr. Moore performed a similar exam and said he found nothing unusual.  Dr. Mehta then said, "I'm going to say the same thing."  He then asked about any other side effects specifically hot flashes.  I admitted that I have had few episodes but they were few and far between.  He said that if they become too numerous, I could take ginseng. [Interesting.]

He said that he would see me in six months and he would also refer me to Dr. Ross.  I re-dressed and proceeded to check out.  While I was checking out the healthcare associate was on the phone with Dr. Ross's office registering me as a new patient.  Shortly after she asked if February 2nd was OK.  I said, yes.

So the beat goes on.   More to come.

Annual Follow-up with Dr. Moore

The end of the year seems to accelerate faster and faster.  It's hard to believe it's already been a year since I last saw Dr. Moore.

I had my annual follow-up today and was examined for anomalies in my breasts and arm pits.  Last month after having a very bad cold, my lymph glands were swollen and tender.  But thankfully (as I found from my internet research), they were 'doing their job' and draining.  I had noticed last week that I was no longer having those symptoms.  I did tell the doctor that my heightened awareness of my body's changes always makes me think that the cancer is returning.  Well he didn't find anything 'unusual'.  However, he asked when I last had a mammogram.  I believe that was when the lump was first discovered (a year ago March).

Doctor Moore requested that I have a mammogram and scheduled it for next week at the Breast Care Center of Holy Family in Methuen.  He wanted both breasts done so he can have a base line.  He also wants me to have one next year before my follow-up so he can compare the two for changes.

I had mentioned that there wasn't much 'meat' on my left (reconstructed) breast.  He said, "There's still tissue".  [I'm sure I'll have an interesting report following the mammogram.]

So next week will be busy with two doctor visits (Mehta and Chatson) and a mammogram.

More to come.

November - Check-in

Well the scary season is over (Halloween and the election).  Unlike costumes that are put away until next year, it will be extremely difficult for everyone to stow away our political costumes and come together for a common cause.  The coming days/months will demonstrate how well we will do.  Optimism persists despite the prevalent feelings we share.

The Fall foliage appears to be holding on (literally).  There are so many trees still with leaves.  There are some vibrant colors still to be seen, but the majority is on the muted spectrum of the color chart.  It's still a pleasant daily walk that I religiously take, but I am anxious to see what kind of weather New England will get this next season.  One day at a time!

On the health front I only have a few updates to share.  Mostly side effect changes, but I'm concerned with some developments.

Side Effects

• Neuropathy - I'm still trying to figure out why my finger/thumb numbness has cycles and what those triggers might be.  Although not debilitating, it still makes certain actions difficult: picking up small things; turning the page of the newspaper/magazine; buttoning those small collar buttons and a host of other 'things'.  The neuropathy in my feet appear to be getting worse.  Before it was always the balls of my feet.  Now my middle toes on my left foot are losing feeling.  I can still move my toes and it doesn't yet affect my walking but I don't like the fact that it's spreading.  
• Muscle cramps - Even though I'm getting in about 20-25 miles of walking per week, I'm still plagued with charlie horses while sleeping.  There's no rhyme or reason when they happen, but it's not fun.  Last August (while playing guitar outside in high humidity), I had terrible cramps in my forearm and heel of my right hand.  I attributed this to dehydration, but last week the same thing happened.  Unlike a charlie hose in the calf where you can stand up to relieve the 'knot', it took me some time to figure out which position was best for my arm/hand to alleviate the pain.  The longer you wait the more intense and crippling the pain becomes.  Very disturbing.
• Hot flashes - Although a listed possible side effect of Tamoxifen, I haven't had too many episodes, however over the last month I've seen an increase.  [I have a new appreciation of women going through the change now.]

New aches and pains

Having a heightened sense of my body's workings, I'm tuned in to any new aches/pains. The fall I took last August affected my right shoulder but that seems to be slowly improving.  My range of motion for normal things seems okay, but out of the ordinary movements sometime are associated with a sharp pain and/or weakness.  I'm still having difficulty sleeping on that side and I generally wake up in the night with some pain in that shoulder.  But, I turn over and fall back to sleep.  Unfortunately, I've been waking with numbness in my right hand, which goes away with some movement.  My chiropractor said that I may be pinching a nerve and he has given me some exercises to increase range of motion in my shoulder.

Not sure if my body is compensating for one pain and causing another.  In mid October, I caught a nasty head and chest cold that seemed to be lingering (coughing).  At the height of the cold, my entire body ached (like the flu), but slowly began to recover.  However, I've been having some errant pains in both arm pits.  But the odd part is that I can't pinpoint where the pain is.  Self examinations don't yield any results.  So I'm not sure if it's muscular or not.  [My biggest fear is lymph nodes.  Although I'm on Tamoxifen, there is a 7-9% change of cancer - again.] 

I have a follow-up appointment with Dr Moore in a few weeks and both doctors Mehta and Chatson early next month.  Let's hope that everything is OK.

More to come.

Mid-October shout out

It's almost peak foliage in my neck of the woods.  I absolutely love this time of year because it's generally nice weather in the day and cool temps at night which is conducive to good sleeping.  Of course this is also my favorite month because Halloween is the last act.  I've attended a few Halloween parties already, but I'm saving this year's creation for Halloween weekend.  I truly hope that the weather cooperates so my pilgrimage to Mecca (Salem) will be agreeable to my costume.  If it's too cold, then I may have to resort to a 'repeat' costume.  Fingers crossed!

The Muse continues to keep my creativity flowing.  I have so many songs in the works, I have to keep a spreadsheet to keep track of their progress.  [Not complaining].  I have noticed that I'm writing more about "us" and less about "me".  Given the wave of senseless acts violence and the craziness of social media, my message is changing in my music.  I suppose my compendium of work will show all sides to my story and message.

On the health front there is no too much to report. However, there have been some developments that I'll describe below.

Head and chest cold - I guess it's going around, but I managed to catch that nasty head and chest cold. For the most of last week, I've been filling my barrel with used tissue.  Between the constant nose running, post nasal drip and death rattle chest congestion, I've been miserable. At one point, my voice was so low (from coughing) that I decided to right a song where I would be singing in that register (Johnny Cash/Barry White reference).  Not sure how I'll hit those low notes when I'm back to normal.  We'll see.

Side Effects

• Neuropathy - I still cannot figure out the cycle of my neuropathy.  I go through spells (flare-ups) where my finger/thumb numbness is off the chart.  Then slowly it dissipates.  A real mystery.  My feet seem to be getting a little worse, but luckily not (yet) debilitation.  However, if I stand too long without moving, I do sense nerve pain.  [Just something else to monitor].
• Mussel cramps/spams - Although I continue to walk about 30-35 miles a week, I still get rudely awakened from a sound sleep with a charlie horse.  I'm still looking for home remedies and am open to suggestions.  It seems everything I've been told or have researched is not working.  In addition, I've begun developing cramps/spasms in my arms and hands.  Not sure if it's because I've had long sessions playing guitar or keyboard, but this is relatively new.  And still another thing to monitor.

Something new

In mid-August I slipped and fell (hard) on my left side.  My left knee was affected as well as my shoulder and arm.  The knee worked itself out (probably because of my walking schedule).  However, my shoulder has been extremely tight and my range of motion was (initially) very limited.  I've been doing some range of motion exercises and normal movement has returned.  But, a few weeks ago (after our first drenching rain), my lawn needed mowing.  I had all I could do to pull start the mower.  No strength and quite painful.  Following that episode I attempted to 'find' the area of pain and cannot locate any specific area.  In doing my self examination, I'm still not familiar with my 'new' upper body resulting from my reconstruction.  Fat graphs feel lumpy to me (not painful) but disconcerting since I'm not sure if they are fat lumps or the beginnings of cancer.  After all, I still have a 7-9% chance of getting breast cancer again.  So my heightened awareness of my body's aches and pains always takes me to the question: Is it back?  Welcome to the new normal!

Thanks for reading.  More to come.

Happy Halloween everyone.