Friday, August 31, 2012

Out With The Old...Or Just The Thyroid

Yesterday I went in to see my endocrine surgeon at St. Thomas in Nashville for a routine re-check of my thyroid mass. I've been having this checked for almost 3 years now and have had it biopsied twice. Both times the biopsy has come back benign which is awesome, but the darn mass keeps growing. At this point, the mass is the same size, if not a tad larger, than my actual thyroid lobe.
So, after the ultrasound was done and the doctor had time to review it, he came into the room I was in and after exchanging pleasantries, told me that he was not comfortable leaving the thyroid in any longer because of how much it has grown...especially how much it has grown in just the past 6 months. He said that even though the biopsies were benign, that the thyroid could still have cancer cells in it and that if they don't hit the exact spot when the biopsy is done, that there will be false-negatives. He said it doesn't happen often, but it could. And with mine still growing, pressing on my trachea when I sleep on my stomach or left side, and being a solid mass (not a cyst) that it just needs to come out. He also said that he would take out the entire thyroid and not just the left lobe because of two reasons. First, if the left side comes back showing cancer, they would have to go right back in 2 days later and operate again to remove the right side. Second, the right side also has a small solid mass on it. He said if we leave it there, then that mass will likely grow because it will be doing double the work and then in a few years we will be right back to where we are now.
Dr. Thomas has been an EXCELLENT doctor as far as respecting my wishes to take the "wait and see" approach and has never pressured me. He's always been willing to just let me steer the ship per say. So when he was as "highly suggestive" as he was yesterday, I just felt comfortable to move forward and get it over with. I've put off the inevitable now for a year or more knowing that eventually it would need to be removed. Also, one of the nuclear medicine scans that I had showed that there is a higher chance mine could be cancer because of the way the gland took up the radioactive substance.
So, I say "let's do this thing." I have a date already set to have the surgery, but am highly considering moving it up because of some things that Team Blevins has planned and some other things going on. I didn't want to do it too soon because I want my body to heal from the chemo I have been taking before I go under the knife, but I don't want to wait and let it interfere with my family plans either. I have a call to his nurse already put in so that I can ask her a few questions and then see if I can move the date up. I know he won't have an issue with it because it was me who wanted to wait until November to begin with. Oh, and he is also going to remove my portacath (the permanent IV in my chest for chemo) while I am on the OR table so we'll be killing two birds with one stone!
Am I scared? Nah, not really.
Am I worried it's cancer? Nope. Not at all.
Could it be a spread of breast cancer? HIGHLY unlikely. It could happen, but it would be RARE
Does it hurt? Nope. Just can't sleep how I want to because it does press of my "windpipe"  making breathing and swallowing a bit harder.
When will this happen? As of now, early November, but hoping to move it to mid October. We will see.
Am I bummed out? Yeah, a little because I thought I would be done with all health related stuff for a while come middle September. But like I said earlier, I'm really okay with this because we have taken the wait and see approach and what we have seen is just not okay anymore.
Hospital Stay? One night and if I am comfortable going home, then that will be it. If not, then I will stay another night.
Incision: about 5 inches in the neck fold so it will be barely visible. No drains or anything like that so that is a plus! And then the portacath incision will probably be the same one that they used to put in it. About 2 inches on the chest wall below the collar bone.
Recovery Time: 5 days to recover from the surgery and then 2-4 weeks to get back to normal daily activities...lifting, sudden movements, etc...

And there we have it folks. That's the rest of the story... ;)

Friday, August 24, 2012

Looking Back

So, before I blog what is really on my heart, I wanted to just say this because it is a HUGE praise! This past treatment was a really really good one. Everything went off just perfectly. Just a little bit of coughing, a little nausea, and extreme fatigue...but only for a few days. Nothing that I couldn't handle and nothing that made me want to run for the hills and never come back. Just a "normal" treatment. What a change and what a relief! JUST ONE MORE TO GO NOW!!! I know this may come across as cliche or whatever, but truly if you know me and my heart you will understand that every time I say this, I mean it: God is so faithful! I cannot believe that next month will mark the one year date of getting this horrific treatment and I really can't hardly fathom how God has provided for me and my family in the worst and best of times over the past 12 months. This time last year, I was on an all time high in my life. I had been able to put cancer and the horror of my reconstruction attempts behind me, come to terms with all of it, and really begin enjoying my life again. And then the hammer dropped and things went from really awesome to pretty much a year of off and on despair. Don't get me wrong, some amazing things have happened this year, but some pretty crappy ones have to. Such is life though, right?!? 
And now, as I sit here alone with my thoughts and just this darn keyboard, I think back to the beginning. How 3.5 years ago I was just finishing up the first bouts of IV chemo. The 16 rounds that took every cancer cell captive and killed it. And now 3.5 years later I am finishing up another 18 rounds bringing my grand total to 34 rounds of cancer killing drugs. Whew. It's a wonder I have any normal cell left in my body at all. Not to mention the 3 years of Tamoxifen I have taken and the 1 year of clinical trial chemo I took. And who could forget the daily radiation treatments that left my skin forever darkened and temporarily burned? Not I. And then there are the scars from 7 different chest surgeries and the weakness that has ensued. When I look back at all of these things, it's pretty easy to sit here and get all teary eyed and think "woe is me." But it doesn't last too least most of the time it doesn't because there is worse. You heard me; it's so true. There are worse things! PROMISE! If you don't think so, or find it hard to imagine, try this:
1. I just went to an amazing community CrossFit event where we honored the life of a 40 year old Special Forces Soldier who died from lung cancer - having never been a smoker in his life. He left behind a wife and 2 year old daughter
2. I lost my "kindred spirit" and chemo buddy to breast cancer - about 2 months after she heard the words..."no evidence of disease"
3. I have another friend who is living with breast cancer that has metastasized throughout her body and will find out in a few days if it has invaded her brain.
See, I told you there are worse things in life than your own lot...

I'm not really sure why I have had to endure such a long and drawn out treatment plan for this cancer. Normally, for stage 3A, estrogen positive, aggressive cancer the treatment totals 1 year maximum. But what I can say for sure is that I know that none of it has been in vain. That every single trip to Vanderbilt, every single drop of chemo that has entered these veins of mine, and every single pill I have had to take has all been for His great glory. And the fellow cancer "victims" that I mentioned above, their stories have all been for a greater plan and purpose too, as is yours. Even though we may never see how the story unfolds, unfold it does and it is up to us to live a life that points to Christ so that when it does unfold, others can see that NOTHING in this life is about us, but is all about the Son of God.

John 11:4 -No, this sickness will not end in death. It happened for the glory of God so that the Son of God will receive glory from this.

Wednesday, August 8, 2012

Update # 1,745,349 (or something like that)

I am writing from the comfort of my home as I sit and watch my 5 year old daughter build a tent and my almost 4 year old son play the iPad. Yep, that's right, today they are getting a free day to do pretty much nothing. And I'm giving myself that kind of day too which is why I am blogging in the middle of the day and not at 10 PM at night after everyone is in bed.

Last week marked a big hurdle for me. Treatment number 16 out of 18. The one that I was nervous to get because of the way #15 left me severely short of breath for days on end. I was fearful that it would happen again and possibly be even worse this time around. However, the morning of the treatment, I woke up feeling strangely at peace and I say "strangely" but we all know that it was GOD...nothing strange about it. Anyways, my mentor Debbie came to pick me up since David couldn't go with me and we set off to Nashville. I just need to break here and tell you all how much I simply adore Debbie. I have known her for about a year and I can tell you that she has been the voice of reason for me, the sound of laughter, and the reason for joy for me in so many ways. Every single piece of advice or encouragement she offers is grounded in Truth which is priceless in this world where so many people will just offer what you want to hear regardless of whether it is honest or true. Plus, she is just super fun to be around and a wealth of information. No really, she is and get this...she home-schooled SIX kids and knows how to do just about everything. 
OK, sorry, but I needed to tell you about Debbie. Back to subject though... when we got there and got put into my treatment room, my nurse walked in and I was so thrilled to have one of my nurses that took care of me 3 years ago too! Ms. Linda!!! I have not had her this entire year that I have been back and she was a welcome sight in my room. She loves God, is a great nurse, and loves to talk which are 3 amazing qualities in my book. I knew it was going to be a good day when she walked in and started spouting off the plan:
"OK, Ms Kelly, this is what we are going to do: I am giving you a full liter of fluids, I am going to hang a bag of Phenergan instead of pushing it in. I will then hang your Decadron, then your Emend. Then we are going to wait 30 minutes before we start the chemo and I am going to give it over 2 hours. Ok? OK." I love her confidence, her plan, and her determination. We then talked about all of the breathing problems that happened last time and she made it clear that it was quite obvious that I was having allergic reactions to the Herceptin each and every time and that is why she wanted to do things her way this time with the times and amounts etc.... She also then asked "Why is Dr. M continuing to make you take this? You cannot do this 11 more times!" I looked at her and told her that I only had 3 treatments left including that one and definitely not 11. Apparently somewhere on the orders, someone had written that I was to have 11 more treatments. Haha....NOPE!!! Not happening. We got that all straightened out and carried on. 
I pretty much slept through the whole infusion except for having to pee 18000 times, or so it seemed. All I know is that I was getting quite aggravated at having to get up and stumble to the restroom with my IV pole and fight to keep my eyes open while trying to pee just to get back to my chair, get comfy and have to go again. Poor Debbie readjusted my blankets a million times from all of my moving. And speaking of moving, the restless leg was HORRIFIC this time. My nurse gave me heating pads though and told me I could have pain meds if I wanted them but I really didn't want anymore meds in my system. Anyways, at the end of the infusion, the cough started and was hard to stop but I had brought my inhaler with me and used it like the pulmonologist told me to at the onset of the cough. It helped! I did get short of breath and remained that way all of Friday and Saturday but it was not nearly as horrific as the last time around. I was able to manage it with the inhaler and steroids at home and was really okay. I think starting the steroids the day BEFORE my treatment really made a big difference with the respiratory issues. By Sunday I was okay. Just really tired and a little short of breath but over all I felt okay. On Monday, I was up and doing my normal stuff around the house and just stopping as my body indicated.
So, that whole novel was written to just really say that this treatment went really well!!! I only have TWO more. Just 2. I really would love to skip these last two and be done, but I felt this way the last time also with wanting to skip the last two Taxols and call it a day. Something about the last ones are just so hard and I think it is because mentally you are done, and over it and physically your body is just exhausted because the meds just build up in your body with each treatment. At this point, I actually will have Herceptin hanging out in my system until January although I stop it in September. It just gets tiring and I find myself losing motivation in all aspects of my life. However, it's nice that I can remember that I felt this way before and forged on and then really did begin feeling better after it was done.
Plan from here:
August 21 - chemo, and start Tamoxifen back until August 2014
September 13 - heart scan and LAST TREATMENT!!!!!
and after that, who knows...I may just go on a vacation or two :)

Thursday, August 2, 2012

Answers...FINALLY Got Some Answers

Today was a big day for me. I met with the Pulmonology doctor at Vanderbilt. His name is Dr. Rickman and upon meeting him, I knew I was with the right doctor. One provided, once again, by God.
It all started though with his nurse, Charla. She came in first to introduce herself and get a little health history from me. She was so sweet, and funny. We could totally be friends if I lived in Nashville! We just seemed to hit it off instantly. Although at the end, I said something really "nurse-y" sounding and she asked if I was a nurse and then what kind of nursing I did. When I told her, she couldn't believe I held out on her. I really don't like telling other nurses though that I myself am a nurse because I feel like it makes them feel weird or something. I know that when I had a pediatric patient in the ICU who's parent was a nurse or doctor, I thought to myself, "great, I drew the short straw today" because they (we) watch everything like a hawk. Ha! So I never like to "out" myself because I want them to treat me and talk to me like I know nothing at all about my illness.
Anyways (that was really off topic), here is what I learned today:
1. What happened with the last treatment is NOT the start of pulmonary toxicity. If it was, there would have been fluid in the lining of my lungs or actually in my lungs on the CT scan and xrays. WHEW!!!
2. Dr. Rickman asked about the cough (because I happened to hack like crazy when I had to take deep breaths for him) and then told me that it really sounded like bronchial asthma...the upper airways I have are swelling and constricting causing me to not be able to get air through properly. He then asked if I had a history of asthma to which I replied no. He said that it is possible that I could have developed asthma from the Herceptin but that he didn't know of any real research that showed patients getting asthma as a result of getting Herceptin.
3. When he listened to my lungs with his stethoscope, he could tell I was still tight sounding and not getting air all the way out (another effect of asthma).
4. He did say that he thinks the severe symptoms of shortness of breath and wheezing, etc....that happened last time was either a flare up of asthma or an allergic reaction to the Herceptin. UGH!!!
5. He thinks it is well worth having another treatment (which is tomorrow - Friday) and seeing if it happens again. In order to prevent it from happening though he started me on another Steroid Dose Pack (I will start it the day before chemo from here on out) that I will take for 6 days. Here's to praying that it works!!!
6. He suggested staying in Nashville tomorrow in case anything happens so I would be close to Vanderbilt ER. He doesn't blame me for not wanting to go back to Gateway and was FLOORED that the hospital diagnosed me with bronchospasm and bronchitis but never gave me a breathing treatment or sent me home with a script for one.
7. He ordered some pulmonary function tests that I did right after I saw him. It was hard and left me seeing silver spots from trying to exhale so hard and for so long and left my chest tight and hurting. They gave me Albuterol before I left and within 20 minutes I felt relief. I should have results of those tests from the doctor tomorrow.
8. When I left it was Nashville's rush hour so I was sitting in traffic. I decided to google "asthma caused by Herceptin" and what came back was a study that was done that showed 1% of patients developed bronchial asthma during treatment with Herceptin and most of them developed it in the 6-12 month mark of Herceptin. Well, my horrific cough started earlier than that but has progressively worsened so I fit right in that category.
9. I should have asked him if after stopping the Herceptin next month if the asthma would clear after the medicine was totally out of my body (generally 4-6 months after treatment stops) or if it was a "forever deal." I will ask him when I hear back about my pulmonary function tests.
10. Oh, and he did say that if it does happen again tomorrow, that he will call Dr. Mayer (my oncologist) and have a discussion with her as to whether I should really take the last two treatments due to how my lungs are responding now.

So, again, God went above and beyond in providing clarity and answers through Dr. Rickman. I feel very comfortable and at peace with this plan of care and am grateful to finally know what we are dealing with. I am a little nervous about treatment tomorrow and how things will go afterwards, but I feel confident that God will continue to take care of me regardless of what happens. I doubt I will stay in Nashville tomorrow because my mentor is taking me and honestly, I always just want to get home as soon as the infusion is finished. David suggested going back to Nashville when he got home from work tomorrow and staying in a hotel, but I think we will just play it by ear. If I start to get a little wheezy and short of breath, we will pack a bag and go right away. I have a babysitter lined up on stand by if we do have to go to Nashville. Plans are in place and I feel peace.

YAY!!!!! 15 down, 3 to go!!!!! Just praying I get some sleep tonight because I am all hyped up already from the steroids. I had to take all 6 of the "day 1" pills all at the same time since it is so late in the day. EEEEEK! I may be so wired that I clean my whole house tonight while everyone else goes into dreamland. Hey, at least it will stay clean for a few hours...before they all wake up.