Heading into the tube...

The Oncotype DX results still aren't back.  Apparently, for genomic testing 🧬 the insurance company requires a "treatment plan" despite the fact that this test will be the only way that the doctors CAN determine a treatment plan.  Around and around in circles we go... Hopefully the situation will be resolved and we will have results within the next week.

MEANWHILE...my radiologist decided to go ahead with the preparations for Radiation Therapy on the assumption that I won't need chemo. (From his mouth to God's ears!)  So today we headed out to MMC Radiation Therapy for a "Simulation" where I was scanned and outfitted with three tattoos (three little dots...not the lightning bolts ⚡️⚡️I was hoping for 😜) to align me correctly for each of the 16 treatments I will undergo. Dr. Bristol and his three wonderful assistants positioned me in the "tube", a super high tech machine that will deliver the doses of radiation to the exact areas where the breast cancer occurred.  They had me practice holding my breath to inflate my lungs and distance the radiation as far as possible from my heart to avoid any possibility of damage.  Other than the fact that the room was freezing, it was an easy and comfortable  process. 

My first treatment is scheduled for next Wednesday, March 4 at 3:30. I will also get the full schedule of treatments. If, by some chance, the test results arrive before then and indicate the need for chemo, the radiation process will be put on hold until that is completed.  I will be meeting with Dr. Inhorn, my oncologist the day before to [hopefully] get my magic number which [🤞] signals no chemo and to discuss post-radiation hormone suppressants. 

If all goes as planned, I will finish Radiation on March 25 and life should become relatively normal thereafter.  I'll have some possible side effects to contend with such as fatigue and "sunburning" of the radiation site.  Given my tendency to burn easily [thank you Irish complexion!] I will have to be pretty aggressive with the treatment cream they will provide. I may also have to forego my bra to minimize irritation and wear soft, loose-fitting tops...a throwback to my hippie days!!✌🏻Maybe I can dig out some old tie-dyes ☮️.  How GROOVY would that be?  Ok, maybe not...

But things are moving along.  The surgery site has healed well, I continue to feel good and am still very optimistic that this adventure into the world of tests and tumors will be ending shortly, leaving me none the worse for wear.

I couldn't have endured the past four months without all of the amazing support that poured into my life.  Brendan deserves a medal for being my rock and staying by my side for every minute of this roller coaster ride.  Each step was a little easier thanks to family and friends and their "You've Got This" messages.  A special thanks to my many Alpha Sigma sorority sisters who have proved that 50 years is but a blink of an eye when "Friends, Friends, Friends we will always be"!  Each facebook message, get well card, lovely [or quirky] gift, email encouragement, phone call, visit or in person conversation kept me going and convinced me that this will soon be an episode for my lifetime rearview mirror. I love you all and can never adequately thank you for the difference you have made.

Keep those good thoughts coming...and don't forget to get those Mammograms, ladies!!  Early detection saves lives!!!  

  

The Healing Power of Horses

I have a happy place, a refuge from the distractions of a world that, these days, seems bent on making life complicated, challenging and maddenly negative.  When I arrive there all of that disappears. A cheerful staff greets me and, most beautifully, dozens of horses welcome me with whinnies, demands for nose kisses and unconditional acceptance. My happy place is a horse shelter, the Maine State Society for the Protectional of Animals.  

The name is a bit cumbersome and belies the fact that it is a stand-alone organization, unaffiliated with the state (and thus receiving no state funds) and that it is strictly an equine shelter, housing horses and an occasional donkey or mule.  But its mission is clear: provide refuge, rehabilitation, and placement of seized equines, support the placement of surrenders, and educate the public. The vision is the elimination of equine abuse and neglect. And it relies solely on donations to accomplish a huge job.

Many of my equine friends have been dealt a bad hand early in life.  Abuse, neglect, poor medical health and other factors beyond their control have compromised their potential and left them vulnerable.  In many cases MSSPA is their last hope.  They arrive with fragile bodies and broken spirits, undernourished, riddled with parasites, dealing with cracked or overgrown hooves, damaged legs and backs, sporting coats, manes and tails that badly need attention.  Their heads are lowered with a look of hopelessness and despair in their eyes.  We are heartbroken for them and angry at the circumstances that bring them to us. Some of them are beyond the point of return to the beauty and pride which should be their birthright and the staff sadly have to consign them to their fate, but not before putting up a valiant fight.

A team of farm staff along with vets and farriers begins the long process of bringing each horse back to the best of their ability.  The transformation can be miraculous in some cases; in others the goal is to provide palliative care to ease the pain of a chronic leg or back injury which will never heal but will allow the horse to live comfortably for whatever time remains.  Some horses will recover to the point where they can be provided training to be adopted into a loving home and even become wonderful saddle horses.  Others will stay with us, enjoying a spacious stall, nutritious meals, expert medical care, the company of other horses and long days in grassy paddocks basking in the sun.

My jobs there as a volunteer are varied.  I clean stalls and provide comfortable bedding, fresh hay and water.  I also help in the office, generating descriptive stall cards for each new horse and inputting data into the volunteer data base. By far my favorite duty is conducting tours of the farm for the many visitors on Saturday afternoons and during school vacations.  It is especially gratifying to introduce people, many of whom have never been near a horse, to sweet Diana, the 17 hand Belgian, quirky Apollo who was an orphan foal and is just learning appropriate social skills, complacent Tonka who has earned the nickname Uncle Tonka for his gentle nature and willingness to step in as a surrogate parent, and Windy River, the one year old foal who was born on the farm to Daphne, a feral mare rescued shortly after she became pregnant.  Each of the 35+ horses has a distinct personality but all seem to enjoy the attention of visitors, volunteers and staff.  And we, in turn, have a special place in our hearts for each of them.  Yes, I have my favorites.  How can I not love Windy River who has always known love and care and responds like an overgrown puppy?  Beautiful Ebony, a petite mare radiates sweetness and headstrong Jafaar, the Arabian teenager craves attention and will literally rattle his stall door if he feels overlooked.  Gentle giant Bodie is often paired with the youngsters in hopes that his gentlemanly manners will serve as models (so far THAT has not worked for Apollo and Jafaar, the chief targets!).  And then there is Belle, the other Belgian who insists on staying outdoors year round (with a run-in shelter) and loves sunbathing in her roadside paddock, laying out prone and often prompting passing drivers to pull in to inform us that we have a dead horse in the field...until we call her with apple in hand and she miraculously comes to life and gallops over to demonstrate her "resurrection".  Valiant and sweet Dexter came to the farm with grossly overgrown hooves that his owner clumsily trimmed with a hacksaw, rendering him virtually unable to walk and prone to a long sequence of abscesses which nearly cost him his life.  With persistent attention from a farrier over many months his hooves are now perfect and healthy.  During that entire process, despite being in excruciating pain, he never abandoned his sweet nature and was always available to visitors for a neck scratch and a nose kiss.  We recently acquired two mini-horses, Treasure and Sage whose issue was not malnutrition, but rather a little TOO much nutrition.  Both of them "rolled" into the farm like the little teapot "short and stout" and are now on strict diets, much to their displeasure.  Little do they realize that we are giving them a better chance at a longer, happier life.  

Those are just a few of the reasons I look forward to my hours  at the farm.  Whatever else is going on in my life, I know my spirits will be lifted when I walk into the barn and hear the nickering, neighing, whinnying and other greetings from my four legged friends.  They seem glad to see me and I am ALWAYS so glad to see them.  It truly IS my happy place.

Romeo and Marley, two former residents who were personal favorites and have since been adopted to loving homes.

A happy Romeo out in the paddock.

Now THAT'S a nose!

A Clean barn is a happy barn

Bell in "sunbathing" mode

Horses on the Hill

Heading out to the paddock                   

 Jafaar is definitely up to something!

Windy River at one month old.  He will celebrate his first birthday on March 1st with a full-out birthday party at the farm.  All are invited to come join the celebration!

For more information, check out the website at www.msspa.org

Taking the bumps with the lumps...

So, foolish me for assuming that this process would go totally smoothly.  Tomorrow I was scheduled to meet with Dr. Inhorn, my oncologist, to learn the results of the genomic testing on the breast tumor. Those results will determine whether my next step is chemotherapy or radiation.  OF COURSE, the lab doesn't have my results ready so the appointment will have to be postponed until the first week of March when Dr. Inhorn is back from his hospital rotation. Dr. Bristol, the Oncology Radiologist was supposed to meet with me on Wednesday to do a preliminary catscan and tattoo the spots  for the radiation but he has to wait until this "next step" decision is made so that appointment will have to be postponed.  To say I am disappointed would be a mild understatement.  But, as the quote above advises, I am desperately trying to learn to dance in this storm. 

I have managed to stay out of the dark places in my head so far, mostly because the prognosis is so positive and I have the benefit of such an incredible support network to keep me going.  But every once in a while a few shadows creep in and the stress of the past four months begins to eat away at my optimism.  I know everything will be fine in the end...I just want the damn end to get here!  And delays like this just add fuel to the fires of my frustration. I guess that makes me human.  I think it would be impossible for anyone to sustain a "roses and sunshine" attitude throughout this  entire ordeal (unless she was a relentless Pollyanna...and nobody really likes those, admit it!)  

I have not lost sight of the fact that I am incredibly blessed to have the people in my life, especially Brendan, my patient life partner, who has his own anxiety about all of this and deserves an Oscar for his efforts to maintain the "jelly side up" approach to it all for my benefit. The support of my family and friends has been huge and I love you all for being there for me more than you can EVER know! And I know I have placed my life in the hands of the best medical team available, bar none.  I feel more than a little embarrassed by my anger and disappointment at this latest [temporary] delay but also feel the need to let off a little steam from the pressure of the overall situation which has dragged on for so long. Plus I promised so many of you the number news tomorrow 😁.  And, truly, that's all this is, a bit of frustration  caused by some frazzled nerves.  I am fine and will be back on the Smiling Cancer Warrior chariot very soon...probably by the time you are reading this. So no measures are required on your part...I know your love and support are out there because I truly can feel them. Just indulge me this one little petulant post and it will be out of my system, I promise!

And here is a representation of my attempt to dance in the rain:

 

Unstoppable

Today was followup day after my lumpectomy sixteen days ago.  I awoke with the song "Unstoppable" from the Broadway show Tootsie in my head and it has been doing a constant loop all day, something I take to be a good sign, despite feeling a little under the weather.  And speaking of weather, another stellar Maine February day greeted us: constant snow and below freezing temps...Yay [sarcasm alert].  Being a sturdy upstate New York girl by origin, I don't mind driving in winter weather but poor Mr. B absolutely hates it.  Nonetheless he did the snowblower thing and took a deep breath before we left for our full afternoon of appointments.  It wasn't quite the white-knuckle ride we had the day of my biopsy in December but I could sense he was well out of his comfort zone. He was a trooper though and never complained.❤️

First meeting was with my surgeon, Dr. Teller.  She checked me over and declared me well on the road to recovery.  The two incisions are healing nicely and the swelling has reduced significantly.  She then went over the pathology report and translated the medical jargon for us. The smaller tumor was a 1 cm invasive lobular tumor,  estrogen and progesterone receptive and with cells that "had behaved themselves", classifying it as a grade 1 (the best case).  Margins were clean so she had removed it in entirety.

The larger tumor was more of a bad boy.  It was a 2cm invasive ductal, also estrogen and progesterone receptive but with cells which had "acted up" a bit, classifying it as a grade 2, like a bunch of neighborhood kids let loose with cans of shaving cream. [Grade 3 cells are the true nasties, running amok with the cell architecture and disrupting their neighbors like a continuous wild frat party].  Dr. Teller got clean margins on that troublemaker so it is totally gonzo!

She also took three sentinel lymph nodes using the radioactive seeds to track them.  They all tested completely negative indicating that the "party" had been contained.  All great news to be sure!

The next meeting was with the Oncologist, Dr. Inhorn.  He and Ashley, his Nurse Practicioner spent a good deal of time with us, outlining some next steps in great detail.  He was a bit surprised that I had both a ductal and a lobular tumor since typically women usually have one or the other.  But, as he indicated, "cancer" and "typical" don't really belong in the same sentence. He talked to us about a relatively new test called OncotypeDX.  Chemotherapy wasn't originally a part of my treatment plan but this test, studied and written up in the New England Journal of Medicine in 2018 provides a more definitive predictor of chemo's effectiveness in preventing future recurrences of tumors like mine.  My larger tumor will be genetically analyzed and assigned a number based on its genetic makeup ("markers").  A number lower than 26 would mean I skip chemo and go right to radiation.  A higher number means chemo would likely snuff the crap out of any residual cancer and send it packing.  B and I both agreed that it was a test worth taking.  Results will take two weeks, arriving right before I am scheduled to begin Radiation.  Over 26 and I "drink the kool-aid" first for three months; under 26 and I go right to radiation.  I've never found myself hoping for a low score on a test in my life but you can bet your butt I'm looking for one now!  The magic reveal date will be February 21st.  Cross your fingers, gang...and say a few prayers if so inclined.  I will still need to take Estrogen Suppressant medication by pill for five years after the radiation, likely an aromatase inhibitor such as anastrozole.

Our final meeting was with Dr. Bristol, the radiologist. In contrast to Dr. Inhorn's mild and conservative manner, very paternal, scientific and cerebral, Dr. Bristol breezed in wearing a sports warm-up suit and athletic shoes...very hip.  He spoke about ten times faster than either Dr. Teller or Dr. Inhorn, going over the facts of my case completely in about 90 seconds.  He had met with both previous doctors so knew exactly what was going on and radiated (sorry!) complete assurance. He outlined the Radiation process which will be the same whether it begins in two weeks or after three months of chemo: sixteen sessions over a three week period with some very mild side effects.

All three doctors, while totally different in demeanor, left us a complete sense of confidence that we were in the right place.  They are the perfect team, in our opinion, each with a special expertise and total respect for the other members' skills and judgement.  Together they are truly Unstoppable!!!  I am totally convinced that I am most definitely on my way to a complete cure. And this wild ride will all have been worth every moment!