Tuesday, April 30, 2013

Enrolling

Early Monday morning the medical committee got back to the research assistant to let her know that they are also considering my 4mm of inflammation as inflammation and to move ahead with my enrollment in the vaccine study. Yay!!

Now I have read the study protocol multiple times and I am aware that they need a urine sample the day of tests. I however, was running a little late to my appointment and peed the second I got there. The research nurse provided me with a couple bottles of water as they drew more blood and we reviewed the day 1 plan. Thankfully, I have never had a shy bladder and was able to give them a sample. The urine sample has to be processed before they do anything in the study so it was very important urine. Labeled STAT with a bright yellow sticker. Seriously good thing water goes straight through me. They need to make absolutely positive that I am not pregnant as the vaccine is teratogenic.

After having another physical per the study protocol the research nurse was ready to give me the skin test. This involves two injections into my thigh. We have to wait for the research pharmacist to bring the two syringes up. One is water and the other contains the additives to the vaccine to make certain that I don't have an allergic reaction. I asked the research nurse if she knew which syringe was which. She said no even the skin test was double blinded. They are both identical in clarity and are just labeled with my name and medical record number. I am impressed with the study protocol so far. They work really hard to remove all the bias. The research nurse then does the two transdermal injections. If you have ever had a TB test its similar to when they inject the ppd, except this feels like being stung by two giant bumble bees! She finishes and my response to her was "DAMN". After maybe a minute the burning goes away. There is only slight puffiness at the injection site and no redness. I am surprised because I often have swelling with simple injections. I went back to work and today I can't even tell where I was injected. I would say I am killing the skin test.

Tomorrow is vaccine day! I will get 4 bee sting injections. I am the first person at this hospital enrolled in the study so they are all very interested to see if it hurts, etc. I will have to sit and be monitored for an hour. Then I will be sent home with a swelling tracker which is an overhead projector sheet with a bullseye on it that I have to mark my redness on for 3 days. This should be interesting.

Because the research nurse said they would feel like bee stings all I could sing while she was injecting was this (as I call it the bumble bee song):

Sunday, April 28, 2013

7 min/mile and the art of the awkward overshare

This morning I learned three things: I can still run 7 min/mile, I am still a competitive jerk and I am a master of the awkward overshare. One of my colleagues asked me back in February to sign up to run a 5k with her. I agreed and today was a perfect spring day to run. We lined up at the starting line and she told me she was going to try to keep up. The race started with a countdown (weird) and in the first 4 steps I said to her I am just going to go around some of these people. She took one look at me and told me to just go. Yup, in 4 steps I left the person who I signed up to race with because I already wanted to go faster. I have mellowed out in some ways, but I remain a seriously competitive jerk.

Halfway through the race I started thinking about how long a 5k was and how uncomfortable I was running. Then, I think the mantra of everyone who has ever had cancer tx, I thought to myself "I've had chemo, this is nothing". I finished the course in 21:47 or exactly 7 min/mile. My goal was to see if I could still break 22 minutes so I was happy. I however had a masterful awkward overshare moment upon finishing. I thanked/congratulated the woman who finished ahead of me. I stalked her the whole race, but was never able to catch her. She asked me if I was happy with my time or some other benign post race chit chat and I unloaded this beauty on her. "Yeah, I am happy with anything as I finished cancer treatment 2 months ago". Welp, had not intended to do that. She looked at me and said "Well, I'm stunned. How long was treatment?". Bless her she was really trying. "August through the end of February". Her: "Jesus. Were you able to exercise during it?" "Yup. Sometimes 3 times a week. I was really fortunate (In my head all I can think is this poor poor woman I have entrapped in the most awkward conversation, why for the love of Pete can't I stop myself and thank her for her kindness). "Well I've heard exercise can be helpful during treatment. Oh look there are the other people I was running with..." Sprints away. I apologize to you Bib#507.

Here's the thing, now that I am done with active treatment occasionally I still slip back into the all I know how to talk about is cancer mode. I do much better in long conversations, but occasionally with short interactions I am still oversharing. I'll keep working on it, but hey it's been 2 months and I know the more time I put between me and treatment I'll at least decrease the awkward overshare moments.

This song also popped into my head while running, also used in every running montage ever.

Saturday, April 27, 2013

2 months into the BCS bank

2 months into the survivorship bank. Lovin' it. Still haven't heard if the clinical trial is off, but I have my skin test appointment on Monday remains so I'll just keep going until someone says stop. My oncologist told me she was submitting the CT findings to the review board as "Right Lung Inflammation/Not cancer". She was pretty certain that it will be ok.

I didn't get to run as much as I would have liked, but lets just say the 4 mm does not effect my ability to still run 3.5 miles. What makes my run a little uncomfortable is the tweaked knee (workout in the ran last saturday, not my best plan) and the reemergence of heartburn. You see having Mochaccino  flavored barium for dinner Monday night and then Tuesday night having a Fenway frank, cracker jacks and a full strength coke may have aggravated my digestive system. Each day of not eating those things make it a lot better.

Another item that showed up on the CT scan was the post op changes from having the tumor and lymph nodes out. What it showed was a small fluid collection, which is normal but exactly why I can't have anything infused into my right arm. No lymphedema wanted here! And I keep stretching out the post op are and breaking up any scar tissue by doing things like pull ups. (Sadly, I have to do assisted pull ups, but the assist weight is getting less each week). They are not the most comfortable, but the surgeon said I didn't need to be afraid in the gym. Last week I also did something I hadn't done in about 10 months-push ups! I take great pride in the fact that I can still do 3 sets of 10 real (no knees) push ups.

A Must Read
Someone sent me the best article of what not to say to people when you find out they are ill. It has a great info-graph that has rings on it and the message is Comfort In, Dump Out. Well worth the read.  It is pretty funny how people really mean well and some of the things they say when they find out about cancer/illness.  Now that I have a full head of hair and I am wearing a pink ribbon more and more people at work have felt comfortable enough to ask me about what kind of cancer I had, how I am feeling and what my next steps are. 90% of these conversations start with "I really wanted to tell you how great your hair looks. It's really come in nice". Loving the chemo curls.


Tuesday, April 23, 2013

4 mm

4 mm. 4 mm of lung inflammation may derail my enrollment in the vaccine trial. The CT scan that I had yesterday showed some inflammation in my right lung right where I had my boost of radiation. So, your saying the invisible treatment really did do something? My oncologist came into my office this morning and told me "Don't worry, but I want to show you something". Every patient's favorite phrase. She took me into her office (which is literally around the corner from mine) and showed me my CT scan. She scrolled through the slices (views) and there was a slight little bright spot. We reviewed the radiologists report to which basically just said there was something there and we should take a look again in 4-6 weeks. My oncologist told me it was not abnormal after XRT to have some lung inflammation and usually patients wouldn't have a CT Scan this close to finishing treatment, but for enrollment in the trial it was required. She will submit the finding to the medical review board of the study and they will decide if we can proceed. She is fairly confident that it should be fine, but there is still a chance that I won't be able to move forward.

Not being able to move forward would be disappointing especially after the marathon of tests I squeezed in between work. I started my day with a bone scan. Being a runner with a history stress fractures, bone scans are old hat for me. In between seeing patients I started my day with a visit from the IV nurse. The lovely people of nuclear medicine remembered that I was a hard stick and one of the fantastic IV nurses came in and got me hooked up in a jiffy. The nutrition department works closely with many of the IV nurses and this happened to be one of my favorites. She looked at me and said "Sara, I really have to get something off my chest. I didn't realize that you had been sick. I thought you were someone who had shaved your head for kids with cancer or something. I feel awful". I told her she needn't worry about it, especially if she was going to be putting IV's in me with such ease.

After I had my IV and another dose of radioactive technetium I went back to work for 3 hours. Well, having been the bald colleague and now I'm walking around with an IV hanging out of my hand (yes hand, that's where some of my only good veins remain) garnered a lot of attention from my colleagues. One of the nursing assistants in the MICU decided that it was not ok for me to walk down with an IV hanging out all day and wrapped up my wrist and IV so it looks like I just had an ace bandage. Did I mention I love the people I work with?

3 hours later I had a bone scan. This is really simple. You nap on a metal slab for an hour as a machine silently moves up and done. It was nice and warm and quiet in the room, which was great. Bone scan looks good per the oncologist (Yay for no bone mets!).

Next up came and EKG. This is hilarious to me. It takes the nursing assistant longer to put on all the leads then to do the the EKG. It's over in a heartbeat (ok that's a bad joke).

Finally I ended my day, after squeezing in 8 hours of work, with the previously mentioned CT scan. Thankfully no more radioactive injections! I am a spider bite away from being spiderman. Unfortunately, it also meant the return of Mochachino flavored barium! After eating 2 pieces of banana bread for lunch I was hungry, but Mochachino barium was the last thing on my list. I sucked down the first 450 ml no problem, the second 450 ml proved to be a challenge. The little old lady who was my waiting room friend gave me the knowing nod as she too was working on her second barium shake. In between making noises like this:
we both finally got our shakes down. I burped it up for the remainder of the night. For my repeat CT in 4 weeks no barium!

After the hour of Mochachino barium drinking came the actual scan. Without the PET scan a CT  only lasts for 10 minutes. However, the special dye is the one that makes you feel like you pee your pants! Oh holy uncomfortable feeling. Don't move, hold your breath for 30 seconds and feel like you peed your pants. Awesome. What would have helped is if they rhythm of the machine made me think of Jimmy Fallon. So I added fighting off laughter into the CT mix.

For now, we'll just wait and see what the review board says. Finger's crossed!

Saturday, April 20, 2013

Every Heartbeat

Yesterday was a very interesting day in the Greater Boston area. Because of the lockdown/shelter in place order public transportation was not running. My mother, really who else, came and picked me up at 6:20 am to drive me to work. She knew that I had my MUGA (heart) scan and that enrolling in this trial was very important to me. Also, as she and the rest of the Commonwealth haven't been sleeping very well she was awake and ready to go. We rode to work glued to the radio listening to everything going on.

MUGA Scan
At 9 am I changed out of my work clothes and into my test uniform (Columbia Athletics T-shirt and shorts, game day ready). Because I have had my lymph nodes out in my right side any injections have to go in my left arm. Well, as all of chemotherapy went through the left arm my veins are still in pretty rough shape. The Nuclear medicine techs found that out. It took 3 attempts (each by a different person) but finally using a vein in my thumb were able to do the radioactive Technetium-99m in. The techs felt really bad and were apologizing left and right. I reassured them that a) it is fine b) 3 sticks was pretty good and that it once took 5 sticks to get the chem running c) bruising is way down there on my injury list. After sitting for 20 minutes in the waiting room under a tv with the news coverage of the active manhunt I was looking forward to the quite room of the scan. MUGA scans happen in two parts.

Part 1 involves sitting in a chair and basically hugging a large metal arm that is laid around your chest to get pictures of your heart. Given my age and general appearance the fourth nuclear medicine tech I met asked me the same question each of the previous 3 had. Do you know why your having this test? When I explain because I've had chemo and I am enrolling in a clinical trial for a breast cancer vaccine I still get a shocked look from people. This poor tech couldn't recover. She started stammering about chemo being cardiotoxic and good thing they were getting pictures and how often she see's people who have had chemo and then trailed off and just said "don't move I'm starting the scan". Part one is 4 minutes of hugging metal. I took this opportunity to sing Don Johnson. Thank you years of watching VH1's I love the 80's for introducing me to it.

Part 2 of the scan involves laying on a thin metal strip and getting velcro-d in place not to move. As the tech who was able to find my vein was the one getting me ready for the 2nd scans I took the opportunity to ask some curiosity questions about the scans. My biggest was I wanted to know if they were taking video of my heart? He explained there are mostly static photos, but some dynamic photos. He was very basically explaining what they were measuring, and I interrupted and said "Oh I know, we are checking my ejection fraction and I was wondering how they would be able to do it with out video". The tech took a deep breath, looked at me and said "Ok so don't move, we're starting the scan now". I figured that I would continue with Don Johnson, but my brain had a surprise-Amy Grant!
 

Once the hour of injections and scans were done I changed my clothes and headed back to work. They gave me a card to carry around until Monday because according to the card, although I am not a public danger I am still radioactive enough to set of geiger counters. My spidey sense is tingling.  I got an e-mail from my oncologist who let me know that all the bloodwork from Thursday was normal (yay normal labs) and that my MUGA scan looked great. Not good, GREAT.

I celebrated my healthy heart and paid tribute to all of this weeks heroes and victims by spending my morning running a track workout in the rain. I did half a ladder: 500, 400, 300, 200, 100. A good way to start a Saturday.

Thursday, April 18, 2013

Sara 45 Genes 0 and getting the clinical trial ball rolling

I got some good news earlier this week. The research study that I enrolled my blood work came back. It tested 42 separate genes for breast cancer. All came back negative. For those keeping score at home that is 45 negative genetic tests. As the genetic counselor told me on the phone, we have ruled out all the known genetic causes, but still can't say with 100% certainty that all genetic factors have been ruled out. My reaction went down like this. "Yay!....wait a minute..." which means the cause of my breast cancer is most likely environmental. Let me be clear I am very very very happy that cancer is not in my genes as this means I get to keep my boobs and decreases the risk of recurrence. Now I just have 200,000 other causes that are not as easily ruled out with tests which leads to the crazy pants investigation into chemicals as previously documented. I found myself suspiciously eyeing my couch the other night and then even shouted at it "Damn you Scotchgaurd!". Living by yourself is much more entertaining than you would think.

Breast Cancer Vaccine
Today I had my clinical trial enrollment appointment with my oncologist. At 1 pm I went back down to the hematology/oncology waiting room. I surveyed the waiting room and all the very anxious faces.  One of the fantastic volunteers picked up that one of the woman was having an especially tough time with her appointments. She was there by herself and he just sat next to her and chatted with her to help ease her anxiety. He is retired and spends most of his afternoons as a volunteer in the oncology waiting room handing out snacks and clearly making patients visits much easier.  I really felt for these people and was happy their was a volunteer their to make their day a little easier.

The research coordinator's office is directly across from mine at work so she had come over to let me know about all my appointments and reminded me that I needed to give a urine sample she said they sometimes forget. To remind myself I wrote a sticky note and left it on my desk. Here is a mock up of the sticky:
Now because I reminded myself they needed urine I was waiting to have bloodwork and give a sample and there were 5 people ahead of me. My oncologist popped her head in and decided we would do the exam and consent before the bloodwork. I made it through the physical exam and preliminary questions when she handed me the packet of information to review that further detailed the clinical trial. This was a very important document and she could see me squirming in my chair and I finally asked "Do you need a urine sample, because I really can't read this until I pee!" Yes, another very proud moment for me and my over active bladder. The oncologist was great and got my sample cup for me so I could get back to signing papers.

Here are some interesting facts about the clinical trial. Only 100 people have ever received the vaccine. The study is double blind, but everyone receives an immune booster shot. If you are placed in the treatment arm of the study you get the vaccine (a specific peptide) that is in the immune booster. Also, the vaccines are done transdermally (like a TB test) and in your thighs! Weird. There is always a risk signing up for a clinical trial as the vaccine has been tested on very few people, but someone once tried the chemotherapy or radiation treatments that I had and I am thankful that they did. Also, they presented me with a schedule for the amount of tests and scans I have to do throughout the study and lets just say they monitor you very closely.

Tomorrow I get to be radioactive again! This time for a MUGA scan. This is a test to see if I am truly a muggle. Just kidding. It's a radiological test to look at how well my heart functions and make sure I do not have heart failure and see how efficient my heart works. I'll have it done every 6 months for the next 3 years to make sure that I am healthy enough for the trial.

Next week I'll have to have an EKG, bone scan, CT scan and skin test to make sure I am not allergic to any of the vaccine components. Having tests done when you are not anxiously waiting the results is so much easier and dare I say fun to see inside myself. But that's just the engineer in me who loves to see how things work!

Tuesday, April 16, 2013

Resilience

If life over the past 8 months has taught me anything it is that human beings are resilient. If being a life long Red Sox fan has taught me anything it is that the passionate people of Boston have resilience in their DNA. I am still pissed off about the horrible acts of terrorism yesterday at the marathon. I am buoyed by the images of the first responders running toward the explosions, the amazing stories of acts of kindness/heroism, and  that all my teammates and their families were physically left unscathed. I know the 117 year old tradition of the world's greatest marathon will continue and I know that the event will continue to be the centerpiece of every New Englander's Patriots day. We are a people who love and protect our traditions. We still have Quaker Blue Laws on the book. The best way to continue to stick it to a-hole(s) who planted the bombs is to continue to live our lives and run our miles. I stand with you Boston, forever and always.


Sunday, April 14, 2013

Gonna Live My Life Everyday

To the surprise of no one I have done a lot of research since finishing treatment about how to ward of recurrence and about what environmental causes could contribute to cancer. As far as the research has come there are still many unknowns and conflicting reports. Below is a brief(ish) summary of some of the things that I am doing daily to keep myself cancer free. I believe it also demonstrates how being a cancer survivor makes it a lot easier to put on your crazy pants and go slightly overboard when reading and researching items [and talking about them].

Eating Organic on the Dirty Dozen
One of the pesticides used in conventional produce, RoundUp (glyphosate), is being studied for being an endocrine disruptor. From what I have read, it turns out that endocrine disruptors can then be stored in places such as mammary glands within the body. Seeing as I cut out a large chunk of my right mammary gland in September I would prefer not to have chemicals building up inside them. Organic produce, while using pesticides, do not use Round Up. The Dirty Dozen is the list of foods with the highest pesticide residue when tested after either being washed or peeled (how they are most commonly eaten).

The Dirty Dozen + two (here is the source)   
1. Apples (I eat an apple 5-6 x/wk)
2. Celery
3. Bell Peppers
4. Peaches
5. Strawberries
6. Necterine-Imported
7. Grapes
8. Spinach
9. Lettuce
10. Cucumbers
11. Blueberries-Domestic
12. Potatoes (I believe my love affair with potatoes are well documented on this site)
13. Green Beans
14. Kale and Collard Greens

Now, let me just say that I am cheap frugal. So this shift meant at the grocery store I needed to turn a blind eye to the prices and focus on them being the best for my health.

Avoiding Triclosan
Sometimes after I have done a lot of research on something I get to the point where I can't hold in a thought and filter it and end up going on a soap box rant. This occurred last week in the office. Many of my co-workers brush their teeth after lunch. We've had many a long discussion about what our dentists have told us about best toothpaste, etc. Based on our general dentist consensus we all use colgate. However, one of the ladies had Colgate Total. I took one look at the tube of toothpaste in her hand and out came the anti-triclosan word vomit. Triclosan is an anti-bacterial agent that is recommended to be avoided as it may help create super bacteria and is being investigated as an endocrine disruptor. After about 2 minutes of me spewing off what I read on the FDA and EPA websites everyone wrote down Triclosan to look for and avoid. Being investigated right now is enough for me to avoid and my toothpaste and soap are all triclosan free.

Cleaning Materials
Cleaning is a stress release, or at least it used to be. Cleaning off the counters, getting everything wiped down and washing the floor would always make me feel better. Then I started reading about cleaning chemicals and then I just sat and stared at my multipurpose cleaner. Staring down the bottle is a much less effective way to clean the house unless you have mastered Jedi mind tricks. I have curtailed this research for a little while as it was making me totally bananas and making me feel like I was going to need an ativan to clean the house, not the feeling I was going for. I remember when my friend beat lymphoma and she started cleaning everything with vinegar and baking soda. There are very specific reasons (such as were both a little cray cray) that her and I are friends.

Maintaining the Anti-Cancer Lifestyle
This means:
  • 5-7 fruits and vegetables per day.
    Benefit of being a dietitian. Done and Done.
  • 150 minutes of moderate exercise or 75 minutes of vigorous exercise every week.
    Running, thankfully, is considered vigorous! I do 5.5 hours of vigorous exercise a week and 1.5 hours of moderate.
  • Avoid alcoholI have always been a light drinker (1 or 2 alcoholic beverages a month at most) so cutting this out is thankfully a non-issue for me. Although the mechanism is still unclear, alcohol raises your circulating estrogen level. Tamoxifen, the drug I take every day to prevent recurrence, lowers circulating estrogen levels. I don't really want to do anything to work against all the good work I am doing.
  • The Great Soy DebateAs the majority of the research I have is nutritionally based I can overall not get a straight answer on this. It would appear that whole soy foods (edamame, tofu) may be ok in small daily amounts and that they may even have a synergistic affect with the Tamoxifen. However, soy can produce some weak estrogen like effects. Given my cancer was ER+ I have decided to stay away from soy and particularly soy protein isolate. Soy protein isolate has a higher concentration of isoflavones which have the estrogen like effects. This means no protein bars, certain cereals and commercially produced veggie burgers. In the middle of chemo my mother got a panic stricken phone call from me "Mom I just ate a veggie burger from the freezer! All the soy! Ahhhh". Yup, because you know 1 veggie burger was going to cause recurrence.
  • Filter tap water Faucet filter attached.
  • Vitamin DI was found to be vitamin D deficient in 2011. This is one of the nutrients they are looking at and questioning if deficiency is related to cancer occurrence and recurrence. I am still waiting for my bloodwork to come back to see what level of supplement 1,000 IU vs 400 IU I should take everyday on top of my 3 servings of fortified dairy. 
I can often be found riding the bus ready some research about breast cancer and usually the nutrition related concepts. Some days I find I can't get enough. Other days I just read Game of Thrones or re-read Tina Fey's Bossypants. Just living my life. Everyday.



Here is a list of some of my sources:
  • http://www.ewg.org/foodnews/summary/
  • http://www.dana-farber.org/Health-Library/Nutrition-Plan-for-Breast-Cancer.aspx
  • Rock, C., Doyle, C., Demark-Wahnefiried, W., et al (2012) Nutrition and Physical Activity Guidelines for Cancer Survivors. CA A Cancer Journal for Clinicians, 62:242-274.
  • Thomson, C. (2012). Diet and Breast Cancer: Understanding Risks and Benefits. Nutrition in Clinical Practice, 27(5): 636-650. DOI: 10.1177/0884533612454302.
  • Trukova, K., Gustuch, J., Lammersfield, C., Liepa G (2012). Prevalence of  Vitamin D Insufficiency Among Breast Cancer Survivors. Nutrition in Clinical Practice, 27(1): 122-128. DOI: 10.1177/0884533611431461
  • Hemmelgarn, M. Biotechnology and GMO: From Farm to Label. AND Public Policy Workshop. March 11, 2013. 
  • http://www.epa.gov/endo/


Wednesday, April 10, 2013

Chemo Curls!

I was told they would come and I was skeptical. Every day my hair gets curlier. It's just straight up weird. When I was little I envied my mother and brother's curly locks. I would sleep with curlers in, braids in and even got a perm (twice!), but my previous hair lacked any form of texture. It refused to hold any curl, bobby pins, hair elastics, clips, volume,  anything that was shellacked in with 12 coats of hairspray . It really should have been washed twice a day because it was so fine that it showed every hint of dirt.

Now that I have a full head of hair I have full thick hair! The curls started on the back of my head. No matter how much I brush them out or try to straighten my hair while it's wet they curl. Now that the hair on the side of my head has gotten longer it too has started to turn. When my hair is wet I can actually get it to curl and stand out in every direction. Yesterday it was a little humid and I had two giant swirls on top of my head. I am so excited to have hair and I am frankly a little overwhelmed with what to do with curls. I know that part of me wants my straight hair back as I have had a couple of dreams the past month of putting my hair up in ponytails. One morning after I woke up I spiked my hair into a fauxhawk and guess what it stayed in place for hours! That would never have happened with my straight hair. This is going to be fun.

Here is what it looks like:
Well in fairness, my brother's hair is a little longer in this picture and lighter in color. Otherwise I am pretty sure we could pass for twins.

Sunday, April 7, 2013

3 Thumbs Up

As part of my follow up in post cancer treatment I had my yearly physical with my PCP, 1 month follow up with the radiation oncologist and my 6 month follow up with my surgeon. All with glowing reports.

My PCP called me the day after I was diagnosed to check to see if I needed anything. She's pretty great. She told me that she is not often surprised, but was shocked when they sent her my cancer findings especially because when I had seen her in March 2012 there was no lump. We reviewed last years physical and the great (negative) results of my mammogram. She mailed me the actual mammogram report. I am hanging it on the wall next to my radiation completion certificate. She and I agreed to check a couple of vitamin levels (B12 an D) to make sure that chemo didn't wipe out those stores as well. One physical exam done, with good results. The blood work is still pending, however was an experience to have done. The tests have to be done fasting which means I hadn't eaten anything since 5:30 pm the night before and then went and did a track workout. Needless to say I was ready to eat the lab tech when she couldn't find a vein. My left arm is still mad about having chemo infusions and all the veins ran away. The first vein my right arm said no after the needle went in. The 2nd vein in my hand filled 3 out of the 4 tubes. 35 minutes for blood work with a grumbly stomach did not make me the most patient patient.

My radiation oncologist was pleased to see that I have zero skin affects left. She did the second thorough physical exam of the week. Her main concern was that I had a vacation scheduled. I love it! (For the record, yes I do have a vacation scheduled). Her nurse and I discussed running shoes. 2 out 2 excellent follow ups.

My surgeon was happy with the mammogram and happy to see I have hair now. I asked him about the transient pain I have while doing dips/bench press. He said that it me breaking up scar tissue and "not to be afraid" in the gym. He also did a thorough physical exam and we were 3 for 3. I also was happy to double check that I have no restrictions in the gym. I did dips (and I think all the scar tissue from the lymph nodes has been broken up) and finally did bench press with the bar! Getting back to normal one exercise at a time.

While at the gym my favorite Kelly Clarkson song came on and it is one I have listened too a lot since August. If I am in your car and it comes on the radio I apologize, but I will crank it and fist pump it out. This is my favorite video for it by the Seattle Children's Hospital Heme-Onc floor.

Wednesday, April 3, 2013

Can I walk home barefoot?

This in-between spring and winter weather is killing me. 31 in the morning means hats, scarves and heavy coats. It also means I pick a sweater that was only 3/4 sleeve, but that would turn to be 3/4 way to many. After lunch I was on one of my floors that I cover and had just gone in to see a patient. I was sitting in a computer area writing my note when I could feel my cheeks turning red. I asked the case manager and the nurses sitting near by if it was hot on the floor. They told me it was not. I fanned myself with my consult while I hurriedly wrote my note and ran down to my office to remove my lab coat and drink some ice cold water. The removal of the polyester lab coat helped quell the fire for a little while. I wrapped up my work for the day and then put my coat, scarf (oooh big mistake) and hat and got on the bus ride home.

The bus ride home started benignly. I was reading my Kindle Fire and the woman sitting across from me opened a window saying it was too hot in the bus. It seemed fine to me, but in about 3 minutes I would want to hug this woman (this woman then proceeded to yell at the young girl who shut it "I'm really hot! You cannot shut the window". There were 30 people on this bus). As the bus turned the corner for Arlington, meaning 2/3 of the way through the trip, I had a full on hot flash. From my head to the bottom of my feet. Holy crap my feet! I was so hot I thought I was going to throw up on the man sitting next to me. I also was pretty sure that the scarf wrapped around my neck must have turned to ash. When I made it off the bus and off the subway what I really wanted to do was walk home without my shoes and socks on.

I immediately called the one woman who we used to torture because she kept our house at 58 degrees, my mother. When she picked up the phone I started singing this:

I walked home with coat half off and scarf and hat in hand. Once I cooled off I became friggity freezing. Now I can't get warm. Fleece pajamas, warm blanket, fleece socks. I even broke down and turned the heat back on.

Fun times with endocrine system!

I should have known this was on the way. Tuesday I had my yearly physical and while chatting with the physician and wearing a johnnie I got really hot and sweaty why telling her that I really hadn't had any side effects from the tamoxifen. I hadn't noticed that I was fanning myself with a copy of my current medications when she looked at me and said "Are you sure you have had none?". Well maybe I am running a little warm these days.