Ch. 17 - My White Blood Cell Count Drops
Lab Work Day: December 13, 2007
My last round of chemotherapy went fairly well, BUT, when I had my blood work done, I had a critical WBC value, a LOW 2.5. I was at work when the doctor called me and was immediately told by my supervisor not to treat any more patients due to my high risk of infection rate due to the lack of immunity. This part was not a problem, I actually felt okay, but what about my blood counts?!? Dr. Zhang's office called me and told me that I needed to start taking a Neupogen injection for 3 days to help boost my immune system in preparation for my next chemotherapy on Tuesday, December 18th. It was crazy how the injections affected my body. It made my joints and muscles ache like I had the flu. BUT, come Monday morning, I went to the lab and got my results a couple of hours later..... my WBC was now extremely high, at 70!!! The medication really worked and now I am ready for my third round of chemotherapy in the morning at 9:30 am.
Today: December 22, 2007
So far, this round of chemo has been the usual, nothing out of the ordinary. Due to my WBC dropping so low last time, the doctor does have me taking Neupogen injections every morning for 3 days after chemotherapy. I do not know what my lab values are right now, but they should be doing okay. I know that my body feels sluggish and achy, so I assume everything is going as planned. One fact that I have left out of my blog recently is in relation to my periods. So far, I have maintained my menstrual cycle. So... out of a 50:50 chance of infertility, I may actually be on the good half of the 50 this time. That makes our odds of having a baby after all of this excellent!! With the 8 frozen embryos at HRC, and my continuing cycles, the clouds above our house do have silver linings. We will keep our fingers crossed in regards to this with only 1 round of chemo remaining. It will be on January 8, 2007.
Thank you all again for all of your support. We wish you a very Merry Christmas and Happy New Year!!!
Saturday, December 22, 2007
Thursday, November 29, 2007
Ch. 16. - The Parties Begin
Ch. 16 - The Parties Begin
November 29, 2007
A lot has happened since my last entry. As far as chemotherapy and its side effects, they got worse before they got better. By the time Friday rolled around, the diarrhea worsened as well as the nausea. That afternoon while I was at work, I just could not do it anymore and left 2 hours early just to go home and crash!! That evening was rough, I could not even tell you how many times I visited the bathroom that night!! By the morning, I could not believe that there was anything left in my body to come out, but somehow, my body found a way. At about 9:00 am Saturday morning, I found a new problem!!! I think it is a hemorrhoid!! I have never had one before, but I know that something is there, that I am not able to sit on my behind, and wiping after using the bathroom has brought me to tears. So.... my husband went to CVS and bought Preparation H, baby wipes, tucks pads, Imodium AD, and miscellaneous other items, anything to make his wife more comfortable. It was a miserable experience. After suffering for the whole day and diarrhea continuing, I finally called a nurse friend of mine to ask her what she recommended me to do. She said that I needed to go to the ER. She said that I might be getting dehydrated and that I needed someone to look at the problem area for pain management issues. So off we go, to the ER for rectal pain. By this time, it was about 8:30 pm on Saturday night. They finally called me back after only about 30 minutes of waiting. They drew blood and started me on IV fluids. When the doctor came in, he took a look at the problem and stated that I had a thrombosed hemorrhoid!! A WHAT!!! He also stated that it would require surgery... SURGERY!!! I had read about this on the Internet over the course of the day, but had no idea that at this time during feeling so bad that I would have to have something else done to me!! He stated that he could do it in the ER, but that it would be very uncomfortable and painful so he recommended for me to follow up with my surgeon the next week. I knew that I could not wait that long and asked him is he would just do ahead and take care of it. He really did not want to, I mean who would, but he finally agreed. So here we go... first a painful shot to numb me, then another painful slice of the scalpel, another shot to help finish the numbing, and the rest was just a feeling of pressure. Throughout the whole procedure, I was white knuckled, clinching my husband's hands. And finally, the torture was over. Immediate relief was felt. Although bleeding and burning remained even after I got home, I was just so excited to be able to sit up!!! The next day, Sunday, I slept the entire day. I think the trauma and all of the morphine followed by hydrocodone finally caught up with me, as well as the side effects of chemotherapy. Come Monday, I made it to work though with tucks pads in my purse and neosporin in hand. It was an interesting day, but by this time, the side effects of the chemotherapy were beginning to wear off and I was beginning to feel like Jennifer again!!! For dinner on Monday I actually ate my first meal, a bean and cheese burrito from Taco Bell. The spicy food really helps get rid of the metal taste in my mouth, at least temporarily!!!
On Monday, November 12, I took my last dose of Letrozole. My estrogen levels had finally dropped back down to normal. This meant no more visits to Dr. Michelle Evans, at least until we get to thaw out our frozen embryos and try to have a baby, but this will be several years down the road. That call is completely up to my oncologist. So we will see.
This Monday was for some reason very stressful to me. I think the trauma of the weekend really caught up with me emotionally. And when you show up for work, no one knows what you have been through. It was very weird because you expect an easy day, but your work day is normal, and even worse because it is a Monday, left over items from the weekend. I broke down and made an appointment with EAP. I spoke to Frank Mazzola for about an hour and he helped me put this in perspective and also reminded me to take it easy on myself. He encouraged me to join a support group as well and taking it easy and doing enjoyable activities when I feel up to it. He stated that this would help avoid depression. I also went to my OBGYN later today and had a follow-up pap smear and a post-op check from my emergency room experience. He said that everything was healing and looked clean. This helped me feel a little more at ease as well, because the last thing that I wanted at this point was an infection. Having an infection during this time is actually pretty easy since my immune system is compromised, but he told me that at this point I did not need antibiotics, it should heal fine on its own.
On Thursday, November 15, 2007, I enjoyed a Thanksgiving dinner with my coworkers at While Memorial Medical Center. It was a nice time to relax and enjoy each other's company. Also, my friend, Barbara had gone into Labor earlier today and had been admitted to Labor & Delivery. I made this announcement at the dinner and everyone was very happy. At about 6:30 pm she called me and asked me it I wanted to see the birth!?! I told her I would love to. She said that I had about 20 minutes to get up to her room. Luckily I was still at work and finished up in a hurry and went straight to her room. The baby was born at 7:08 pm. What a beautiful experience. I made me very thankful for life and reminded me what is important, friends, health, life and love!!!
On Friday, November 16 2007, we celebrated Pink Day at the ADHC, my other place of employment. It is an Alzheimer's Facility with about 40 participants per day. They are all very precious!! On this day, they made pink ribbon pins out of pink felt paper and when I arrived at work, they had already finished them and everyone was wearing them. All of my coworkers were dressed in pink and they had raised $5.00 each for the Susan Koman Foundation. It was such a touching experience. We also topped off the event with a pizza party. We had a good time.
The next day, Saturday the 18th, my same co-workers from the ADHC center, threw a party for me, a hair cutting party. They had put so much work into this event. The main goal of the party was to have my hair cut really short because it had started to thin and I did not want to watch it fall out every day. Another goal was to encourage people with long hair to donate their hair to charity. For Locks of Love, you have to have 8 inches of non-dyed hair and for Wigs for Kids, you can donate dyed hair, but you have to donate 10 inches. Out of 20 people, we had 4 people donate their hair. This was such a beautiful experience. I was the one that got to cut off the ponytails for the donation and then the hair stylist gave this a nice style. BUT for the return favor, everyone at the party got to have a chance at using the buzz cutter to shave off my hair. I chose a No. 3 for a nice crew cut. It was a very fun time, and I actually liked the outcome of my hair cut. My head is nice and round and but cut does not look bad at all, I even had some people say that is was sexy, AND Clayton like it too!! So the event was a win-win for everyone!!!
The next week I started to feel more like myself. My hair was continuing to fall out slowly, but the side effects of the chemotherapy were wearing off. No more nausea, GI upset, just the metal taste in my mouth. I began to regain my strength and did not fatigue as easily, but bedtime was definitely by 9:30 pm every night. On Thursday, Thanksgiving, Clayton and I flew home to Georgia to be with family and also for my "Celebration of Life" party planned for the 24th. When we arrived, we were greeted by my parents. It was so great to see them. This was the first time I had seen them since I had been sick!!! The last time they had seen me was in March when we all took a trip together. I think my Mom gave me 3 big hugs as soon as she saw me. It was great to feel her arms around me. After the airport, we celebrated Thanksgiving at the Cracker Barrel. The food was great. And we also shopped for hats in their gift shop. I wound up the 2 new hats to cover my head, the weather in Georgia is cold!!! Later that evening we celebrated Thanksgiving with my sister-in-law and her family. It was great to see them as well.
When I woke up on Friday morning and took my shower, my hair was falling out like crazy!! It was all over my hands, the towel, the shower, and my body. I could not get rid of all of it even to get dressed!!! I told my husband and he gave me a closer buzz cut, a No. 1. We hoped that this would help, the hair would be even shorted and less noticeable than at a No. 3. It also helped make the bald spots not as noticeable as well. But from this time on, I will definitely always have on a hat or scarf, my hair is really short, and my almost bald head stays really cold!! After my hair cut, we went over to my grandmother's house for Thanksgiving dinner with my family including my aunt, grandparents, cousins all on my mother's side, as well as my sister and her family. This was a very joyous time. Her daughter is now 6 years old, smart and beautiful. Her son is 16 months old and starting to crawl and even pull up on the sofa. It was precious getting to spend this day with them.
The next morning, my head was very sensitive to wearing caps. The stubble left from the No. 1 was not very comfortable when it would be stuck on the threads of the caps, scarves, and boggins. So... once again, I am getting another hair cut. This time with a straight razor. Clayton did this one for me as well. I was really crazy becoming bald, but when he got finished, my head felt so much better, NO MORE STUBBLE!!! Now I am ready to conquer the day.
It is now, Saturday, November 25th rolled around, the day of the party. 
We had invited so many friends and family to my best friends house, Katy Norman for this event. We though this would be a great time for everyone to get together, give my inspiration, and enjoy each other's company. It would be a good time to revisit the things that are important in life. At the party there was information provided regarding breast cancer, and well as breast cancer support pins and bracelets. By the time the party was over, the head count had reached 82 people!!! It was 
unbelievable. People including my mom's friends from work, friends of mine from the church where I grew up, other friends from differing periods in my life including grade school, high school, and college. Also included were my husband's family including his mom, sister's family, and his aunt, as well as friends of his from grade school. It was a blessed event, one that I will never forget.
The rest of the weekend was spend visiting friends and family. We flew back to Los Angeles, CA on Tuesday, November 27, 2007. The flight went well and now we are home sweet home.
Yesterday, Wednesday, November 28, 2007, I has my second chemotherapy treatment. So far I only have a little nausea and diarrhea. My face and chest are a little red, but otherwise unremarkable. We will see how the rest of the week and weekend go. My main goal is to stay out of the ER!!!
Thanks again for sharing my life with me through my blog. The support that you give me is incredible and a real life line. I continue to love you all!!!
November 29, 2007
A lot has happened since my last entry. As far as chemotherapy and its side effects, they got worse before they got better. By the time Friday rolled around, the diarrhea worsened as well as the nausea. That afternoon while I was at work, I just could not do it anymore and left 2 hours early just to go home and crash!! That evening was rough, I could not even tell you how many times I visited the bathroom that night!! By the morning, I could not believe that there was anything left in my body to come out, but somehow, my body found a way. At about 9:00 am Saturday morning, I found a new problem!!! I think it is a hemorrhoid!! I have never had one before, but I know that something is there, that I am not able to sit on my behind, and wiping after using the bathroom has brought me to tears. So.... my husband went to CVS and bought Preparation H, baby wipes, tucks pads, Imodium AD, and miscellaneous other items, anything to make his wife more comfortable. It was a miserable experience. After suffering for the whole day and diarrhea continuing, I finally called a nurse friend of mine to ask her what she recommended me to do. She said that I needed to go to the ER. She said that I might be getting dehydrated and that I needed someone to look at the problem area for pain management issues. So off we go, to the ER for rectal pain. By this time, it was about 8:30 pm on Saturday night. They finally called me back after only about 30 minutes of waiting. They drew blood and started me on IV fluids. When the doctor came in, he took a look at the problem and stated that I had a thrombosed hemorrhoid!! A WHAT!!! He also stated that it would require surgery... SURGERY!!! I had read about this on the Internet over the course of the day, but had no idea that at this time during feeling so bad that I would have to have something else done to me!! He stated that he could do it in the ER, but that it would be very uncomfortable and painful so he recommended for me to follow up with my surgeon the next week. I knew that I could not wait that long and asked him is he would just do ahead and take care of it. He really did not want to, I mean who would, but he finally agreed. So here we go... first a painful shot to numb me, then another painful slice of the scalpel, another shot to help finish the numbing, and the rest was just a feeling of pressure. Throughout the whole procedure, I was white knuckled, clinching my husband's hands. And finally, the torture was over. Immediate relief was felt. Although bleeding and burning remained even after I got home, I was just so excited to be able to sit up!!! The next day, Sunday, I slept the entire day. I think the trauma and all of the morphine followed by hydrocodone finally caught up with me, as well as the side effects of chemotherapy. Come Monday, I made it to work though with tucks pads in my purse and neosporin in hand. It was an interesting day, but by this time, the side effects of the chemotherapy were beginning to wear off and I was beginning to feel like Jennifer again!!! For dinner on Monday I actually ate my first meal, a bean and cheese burrito from Taco Bell. The spicy food really helps get rid of the metal taste in my mouth, at least temporarily!!!
On Monday, November 12, I took my last dose of Letrozole. My estrogen levels had finally dropped back down to normal. This meant no more visits to Dr. Michelle Evans, at least until we get to thaw out our frozen embryos and try to have a baby, but this will be several years down the road. That call is completely up to my oncologist. So we will see.
This Monday was for some reason very stressful to me. I think the trauma of the weekend really caught up with me emotionally. And when you show up for work, no one knows what you have been through. It was very weird because you expect an easy day, but your work day is normal, and even worse because it is a Monday, left over items from the weekend. I broke down and made an appointment with EAP. I spoke to Frank Mazzola for about an hour and he helped me put this in perspective and also reminded me to take it easy on myself. He encouraged me to join a support group as well and taking it easy and doing enjoyable activities when I feel up to it. He stated that this would help avoid depression. I also went to my OBGYN later today and had a follow-up pap smear and a post-op check from my emergency room experience. He said that everything was healing and looked clean. This helped me feel a little more at ease as well, because the last thing that I wanted at this point was an infection. Having an infection during this time is actually pretty easy since my immune system is compromised, but he told me that at this point I did not need antibiotics, it should heal fine on its own.
On Thursday, November 15, 2007, I enjoyed a Thanksgiving dinner with my coworkers at While Memorial Medical Center. It was a nice time to relax and enjoy each other's company. Also, my friend, Barbara had gone into Labor earlier today and had been admitted to Labor & Delivery. I made this announcement at the dinner and everyone was very happy. At about 6:30 pm she called me and asked me it I wanted to see the birth!?! I told her I would love to. She said that I had about 20 minutes to get up to her room. Luckily I was still at work and finished up in a hurry and went straight to her room. The baby was born at 7:08 pm. What a beautiful experience. I made me very thankful for life and reminded me what is important, friends, health, life and love!!!
On Friday, November 16 2007, we celebrated Pink Day at the ADHC, my other place of employment. It is an Alzheimer's Facility with about 40 participants per day. They are all very precious!! On this day, they made pink ribbon pins out of pink felt paper and when I arrived at work, they had already finished them and everyone was wearing them. All of my coworkers were dressed in pink and they had raised $5.00 each for the Susan Koman Foundation. It was such a touching experience. We also topped off the event with a pizza party. We had a good time.
The next day, Saturday the 18th, my same co-workers from the ADHC center, threw a party for me, a hair cutting party. They had put so much work into this event. The main goal of the party was to have my hair cut really short because it had started to thin and I did not want to watch it fall out every day. Another goal was to encourage people with long hair to donate their hair to charity. For Locks of Love, you have to have 8 inches of non-dyed hair and for Wigs for Kids, you can donate dyed hair, but you have to donate 10 inches. Out of 20 people, we had 4 people donate their hair. This was such a beautiful experience. I was the one that got to cut off the ponytails for the donation and then the hair stylist gave this a nice style. BUT for the return favor, everyone at the party got to have a chance at using the buzz cutter to shave off my hair. I chose a No. 3 for a nice crew cut. It was a very fun time, and I actually liked the outcome of my hair cut. My head is nice and round and but cut does not look bad at all, I even had some people say that is was sexy, AND Clayton like it too!! So the event was a win-win for everyone!!!
The next week I started to feel more like myself. My hair was continuing to fall out slowly, but the side effects of the chemotherapy were wearing off. No more nausea, GI upset, just the metal taste in my mouth. I began to regain my strength and did not fatigue as easily, but bedtime was definitely by 9:30 pm every night. On Thursday, Thanksgiving, Clayton and I flew home to Georgia to be with family and also for my "Celebration of Life" party planned for the 24th. When we arrived, we were greeted by my parents. It was so great to see them. This was the first time I had seen them since I had been sick!!! The last time they had seen me was in March when we all took a trip together. I think my Mom gave me 3 big hugs as soon as she saw me. It was great to feel her arms around me. After the airport, we celebrated Thanksgiving at the Cracker Barrel. The food was great. And we also shopped for hats in their gift shop. I wound up the 2 new hats to cover my head, the weather in Georgia is cold!!! Later that evening we celebrated Thanksgiving with my sister-in-law and her family. It was great to see them as well.
When I woke up on Friday morning and took my shower, my hair was falling out like crazy!! It was all over my hands, the towel, the shower, and my body. I could not get rid of all of it even to get dressed!!! I told my husband and he gave me a closer buzz cut, a No. 1. We hoped that this would help, the hair would be even shorted and less noticeable than at a No. 3. It also helped make the bald spots not as noticeable as well. But from this time on, I will definitely always have on a hat or scarf, my hair is really short, and my almost bald head stays really cold!! After my hair cut, we went over to my grandmother's house for Thanksgiving dinner with my family including my aunt, grandparents, cousins all on my mother's side, as well as my sister and her family. This was a very joyous time. Her daughter is now 6 years old, smart and beautiful. Her son is 16 months old and starting to crawl and even pull up on the sofa. It was precious getting to spend this day with them.
The next morning, my head was very sensitive to wearing caps. The stubble left from the No. 1 was not very comfortable when it would be stuck on the threads of the caps, scarves, and boggins. So... once again, I am getting another hair cut. This time with a straight razor. Clayton did this one for me as well. I was really crazy becoming bald, but when he got finished, my head felt so much better, NO MORE STUBBLE!!! Now I am ready to conquer the day.
It is now, Saturday, November 25th rolled around, the day of the party. 
We had invited so many friends and family to my best friends house, Katy Norman for this event. We though this would be a great time for everyone to get together, give my inspiration, and enjoy each other's company. It would be a good time to revisit the things that are important in life. At the party there was information provided regarding breast cancer, and well as breast cancer support pins and bracelets. By the time the party was over, the head count had reached 82 people!!! It was 
unbelievable. People including my mom's friends from work, friends of mine from the church where I grew up, other friends from differing periods in my life including grade school, high school, and college. Also included were my husband's family including his mom, sister's family, and his aunt, as well as friends of his from grade school. It was a blessed event, one that I will never forget.The rest of the weekend was spend visiting friends and family. We flew back to Los Angeles, CA on Tuesday, November 27, 2007. The flight went well and now we are home sweet home.
Yesterday, Wednesday, November 28, 2007, I has my second chemotherapy treatment. So far I only have a little nausea and diarrhea. My face and chest are a little red, but otherwise unremarkable. We will see how the rest of the week and weekend go. My main goal is to stay out of the ER!!!
Thanks again for sharing my life with me through my blog. The support that you give me is incredible and a real life line. I continue to love you all!!!
Thursday, November 8, 2007
Ch. 15 - Chemotherapy Begins
Ch. 15 - Chemotherapy Begins
The day finally arrived, Tuesday, November 6, 2007. I was so nervous. I took the day off from work and had to arrive at the infusion center at 9:30 am. The 2 drugs of choice by my oncologist are and will continue to be, Cytoxan and Taxotere. Although I view them as poison because they have the potential to make me very sick, but I also see them as my friends to help with my continue recovery against breast cancer. Although I was nervous, I was also excited in a way to have someone finally use my port-a-cath. It has felt like I had this big thing inserted in my chest and no one was using it. I had so many blood draws for the egg retrieval, none of which were taken from the port, and I was put under anesthesia for the actual retrieval procedure, but the anesthesiologist chose to run a IV line in my left thumb. So I is nice the the device to finally be used. When she first ran the line, I could not believe how big the needle looked that went into my port, but all I felt was the initial needle stick followed by a lot of pressure, but NO BURNING!!! I really liked that part!!!
My first dosing consisted of IV fluids, an antibiotic, and Benadryl. This concoction made me have to go the urinate, it seemed like every 15 minutes and the Benadryl made me very sleepy, but I was too nervous to sleep. I did paperwork for work, balance my checkbook, talked to Clayton and even tried to start reading a book, but the drugs finally won, and I took a nap. The infusion nurse, Josephine, told me when the chemotherapy drugs were starting, but I did not feel anything different, just continued to have to go to the bathroom due the all the fluids. I had on my regular clothes, but had to push the IV pole every time I had to go down the hall to potty. Clayton helped me each time since I was a little light-headed and sleepy, but NO FALLS, thank goodness.
The entire process took about 3.5 hours. During chemo they fed me a small lunch and made sure that I was feeling okay. Josephine told me that I may become nauseated, but to remember to take the medication that was prescribed for this and hopefully I would be fine, but if not, to give her a call. She did tell me that in about 2 weeks I would probably start to see my hair falling out or thinning, but this is a normal side effect.
After leaving the infusion center, I actually caught the last 30 minutes of a meeting at work. I was recently nominated to represent the rehabilitation department for the cancer panel at the hospital where I work. This was my first meeting and I at least wanted to make an appearance and general introduction. When I walked in, they could not believe I was there. Part of the counsel consists of my oncology team who new that I had chemo that same morning. Clayton waited for me and then I shared with him my excitement of being part of the panel. We will be meeting quarterly and I think it will be a good experience.
After the meeting, we went to the grocery store, and then home. I crashed on the sofa and the rest was history. I began to feel nauseated, but no vomiting or diarrhea. I feel very lucky and can't wait to go to sleep, having survived my first chemo!!!
Thursday, November 8, 2007
Well, the past 2 days have not been a lot of fun including indigestion and nausea with the onset of fatigue, diarrhea, and impaired concentration. My skin color is actually a little red in my face and my chest, so I will have the nurse check it out later. Most of my nursing friends tell me that I should start to feel better around next Wednesday, but for right now, that just seems way too far away, but all-in-all, I am still blessed to not have the severe side effects so far. I will keep you posted!!
Thank you for all of your thoughts, comments, and prayers!!! Clayton and I love you all!!
The day finally arrived, Tuesday, November 6, 2007. I was so nervous. I took the day off from work and had to arrive at the infusion center at 9:30 am. The 2 drugs of choice by my oncologist are and will continue to be, Cytoxan and Taxotere. Although I view them as poison because they have the potential to make me very sick, but I also see them as my friends to help with my continue recovery against breast cancer. Although I was nervous, I was also excited in a way to have someone finally use my port-a-cath. It has felt like I had this big thing inserted in my chest and no one was using it. I had so many blood draws for the egg retrieval, none of which were taken from the port, and I was put under anesthesia for the actual retrieval procedure, but the anesthesiologist chose to run a IV line in my left thumb. So I is nice the the device to finally be used. When she first ran the line, I could not believe how big the needle looked that went into my port, but all I felt was the initial needle stick followed by a lot of pressure, but NO BURNING!!! I really liked that part!!!
My first dosing consisted of IV fluids, an antibiotic, and Benadryl. This concoction made me have to go the urinate, it seemed like every 15 minutes and the Benadryl made me very sleepy, but I was too nervous to sleep. I did paperwork for work, balance my checkbook, talked to Clayton and even tried to start reading a book, but the drugs finally won, and I took a nap. The infusion nurse, Josephine, told me when the chemotherapy drugs were starting, but I did not feel anything different, just continued to have to go to the bathroom due the all the fluids. I had on my regular clothes, but had to push the IV pole every time I had to go down the hall to potty. Clayton helped me each time since I was a little light-headed and sleepy, but NO FALLS, thank goodness.
The entire process took about 3.5 hours. During chemo they fed me a small lunch and made sure that I was feeling okay. Josephine told me that I may become nauseated, but to remember to take the medication that was prescribed for this and hopefully I would be fine, but if not, to give her a call. She did tell me that in about 2 weeks I would probably start to see my hair falling out or thinning, but this is a normal side effect.
After leaving the infusion center, I actually caught the last 30 minutes of a meeting at work. I was recently nominated to represent the rehabilitation department for the cancer panel at the hospital where I work. This was my first meeting and I at least wanted to make an appearance and general introduction. When I walked in, they could not believe I was there. Part of the counsel consists of my oncology team who new that I had chemo that same morning. Clayton waited for me and then I shared with him my excitement of being part of the panel. We will be meeting quarterly and I think it will be a good experience.
After the meeting, we went to the grocery store, and then home. I crashed on the sofa and the rest was history. I began to feel nauseated, but no vomiting or diarrhea. I feel very lucky and can't wait to go to sleep, having survived my first chemo!!!
Thursday, November 8, 2007
Well, the past 2 days have not been a lot of fun including indigestion and nausea with the onset of fatigue, diarrhea, and impaired concentration. My skin color is actually a little red in my face and my chest, so I will have the nurse check it out later. Most of my nursing friends tell me that I should start to feel better around next Wednesday, but for right now, that just seems way too far away, but all-in-all, I am still blessed to not have the severe side effects so far. I will keep you posted!!
Thank you for all of your thoughts, comments, and prayers!!! Clayton and I love you all!!
Saturday, November 3, 2007
Ch. 14 - The Egg Retrieval
Ch. 14 - The Egg Retrieval
On November 1, 2007, I began taking the antibiotics that my doctor prescribed in preparation for the procedure. I have to take the medication twice daily, Doxycycline 100 mg. This was a good exchange, 2 pills in the place of 3 injections and 1 pill. NO MORE SHOTS!!!
I worked all day at my job on Thursday, the day before the retrieval. During the course of the day, everyone told me "good luck" and gave me all the best wishes along with hugs all day long. I have such supportive people in my life!! I also received a phone call back from my oncologist, Dr. Zhang today and gave me my first chemotherapy date, Tuesday, November 6, 2007. I am nervous, but also ready to get things started so that I can hopedully close this chapter in my life. Another important thing that happened today is that we finally figured out how the egg retrieval work, simply because Clayton has been working at the American Film Market who does not allow time off, so it has been challenging to figure out how to get sperm from him while he is at work?!?! But today, it all came together. Since my procedure is so early in the morning, he will take me, give his donation, and then leave me with Dr. Evans for the procedure. He will go to work and my friend Barbara will arrive at 7:00 am to take me home. She will also stay with me until I am feeling like I can be left alone.
So... this is it, as the say at the circus, "the moment we have all been waiting for". Friday, November 2, 2007, had arrived. We woke up early, I dressed for surgery (comfy clothes) and Clayton dressed for work. We arrived at the office at 5:00 am. By 5:30 am, I was on the operating table, and Clayton was giving his sample. The anesthesiologist, Dr. Smith (my maiden name), put me to sleep, and Dr. Evans performed her magic. We I woke up, she told be that she was able to retrieve 11 EGGS!!! I was so excited. I called Clayton as soon as I could focus enough to dial his number to let him know that I was okay and to tell him the good news, it had worked, and... we have the potential for 11 embryos!!! He was excited and glad to hear that everything had gone so well. He said it had been hard leaving me there in the office. This was the first time he would not be with me during a procedure. But, we made it. Barbara arrived and took me home. Dr. Evans told me that she would call me on Saturday to let me know how many embryos we were able to get, this would be the number that would be frozen on Monday, they allow 72 hours of growth time before freezing, if I understood her correctly.
Once I got home, I felt great... until the pain medication wore off that was given to me along with the anesthesia. By this time, Barbara had gone home to her family, and I was by myself. The cramps were terrible. I used a heating pad, deep breathing, hot water, relaxation, anything I could think of to help the cramps go away!! I finally had to call the office and they called me in some pain meds to the local pharmacy, Fairoaks Pharmacy, in Pasadena. After several hours passed, the cramps eased up enough to allow me to drive and pick up the pain medicine. I was supposed to take the medication with food, put I bought an orange juice on my way out and popped a pill with it. In about 45 minutes, the cramps were a little better. Thank goodness for good medicine when you need it. Clayton later arrived home from work, AFM, and we ate dinner together. He then helped me get ready for bed and off to sleep we went.
Well, I guess you call it sleep. I tossed and turned all night long. I think I saw every hour go by on the clock. It was so hard to get comfortable due to the cramps. But I made it. When Clayton got up for work the next morning, I got up to take another pain pill. The pill helped the cramping once again. Later this morning, November 3, 2007, Cynthia from HRC called me to tell me that out of the 11 eggs, they were able to prepare 8 embryos for freezing. WHAT GOOD NEWS!!! She told me that if I needed anything else from them, just to give them a call. She wished me the best of luck during my treatment and said that they would take good care of "our babies". This is very exciting and releiving!! I cannot wait to tell Clayton. So, now I am just taking it easy, taking to you guys and waiting for Clayton to come home. I don't know what we have planned, but it probably includes just taking it easy!!!
On Monday, I went to my follow-up visit with Dr. Evans for blood work and an ultrasound. I was very uncomfortable and having pain in my lower abdomen. On ultrasound, she showed me how big my follicles were which is the reason I am uncomfortable. She told me that after the retrieval, the follicle collapses, but then refills with blood. This blood can take 1-2 months to be fully reabsorbed by the body, GREAT!! And, she measured my follicle sizes, and they averaged 26 mm, much larger than they were upon retrieval!!! But, at least I now know why I am still so uncomfortable. At this visit, she also told me the final results of my embryo freezing, we have 8 in all. Four of them are 8 cell (the best), 2 of them are 5 cell, and 2 of them are 4 cell. It is very exciting to have this part of the process behind us.
She did later call me and tell me that my estrogen level remains high, at 631, so I am to resume the Letrozole and return to her office on Friday, November 9, 2007 at 7:30 am. I will keep you posted!!
On November 1, 2007, I began taking the antibiotics that my doctor prescribed in preparation for the procedure. I have to take the medication twice daily, Doxycycline 100 mg. This was a good exchange, 2 pills in the place of 3 injections and 1 pill. NO MORE SHOTS!!!
I worked all day at my job on Thursday, the day before the retrieval. During the course of the day, everyone told me "good luck" and gave me all the best wishes along with hugs all day long. I have such supportive people in my life!! I also received a phone call back from my oncologist, Dr. Zhang today and gave me my first chemotherapy date, Tuesday, November 6, 2007. I am nervous, but also ready to get things started so that I can hopedully close this chapter in my life. Another important thing that happened today is that we finally figured out how the egg retrieval work, simply because Clayton has been working at the American Film Market who does not allow time off, so it has been challenging to figure out how to get sperm from him while he is at work?!?! But today, it all came together. Since my procedure is so early in the morning, he will take me, give his donation, and then leave me with Dr. Evans for the procedure. He will go to work and my friend Barbara will arrive at 7:00 am to take me home. She will also stay with me until I am feeling like I can be left alone.
So... this is it, as the say at the circus, "the moment we have all been waiting for". Friday, November 2, 2007, had arrived. We woke up early, I dressed for surgery (comfy clothes) and Clayton dressed for work. We arrived at the office at 5:00 am. By 5:30 am, I was on the operating table, and Clayton was giving his sample. The anesthesiologist, Dr. Smith (my maiden name), put me to sleep, and Dr. Evans performed her magic. We I woke up, she told be that she was able to retrieve 11 EGGS!!! I was so excited. I called Clayton as soon as I could focus enough to dial his number to let him know that I was okay and to tell him the good news, it had worked, and... we have the potential for 11 embryos!!! He was excited and glad to hear that everything had gone so well. He said it had been hard leaving me there in the office. This was the first time he would not be with me during a procedure. But, we made it. Barbara arrived and took me home. Dr. Evans told me that she would call me on Saturday to let me know how many embryos we were able to get, this would be the number that would be frozen on Monday, they allow 72 hours of growth time before freezing, if I understood her correctly.
Once I got home, I felt great... until the pain medication wore off that was given to me along with the anesthesia. By this time, Barbara had gone home to her family, and I was by myself. The cramps were terrible. I used a heating pad, deep breathing, hot water, relaxation, anything I could think of to help the cramps go away!! I finally had to call the office and they called me in some pain meds to the local pharmacy, Fairoaks Pharmacy, in Pasadena. After several hours passed, the cramps eased up enough to allow me to drive and pick up the pain medicine. I was supposed to take the medication with food, put I bought an orange juice on my way out and popped a pill with it. In about 45 minutes, the cramps were a little better. Thank goodness for good medicine when you need it. Clayton later arrived home from work, AFM, and we ate dinner together. He then helped me get ready for bed and off to sleep we went.
Well, I guess you call it sleep. I tossed and turned all night long. I think I saw every hour go by on the clock. It was so hard to get comfortable due to the cramps. But I made it. When Clayton got up for work the next morning, I got up to take another pain pill. The pill helped the cramping once again. Later this morning, November 3, 2007, Cynthia from HRC called me to tell me that out of the 11 eggs, they were able to prepare 8 embryos for freezing. WHAT GOOD NEWS!!! She told me that if I needed anything else from them, just to give them a call. She wished me the best of luck during my treatment and said that they would take good care of "our babies". This is very exciting and releiving!! I cannot wait to tell Clayton. So, now I am just taking it easy, taking to you guys and waiting for Clayton to come home. I don't know what we have planned, but it probably includes just taking it easy!!!
On Monday, I went to my follow-up visit with Dr. Evans for blood work and an ultrasound. I was very uncomfortable and having pain in my lower abdomen. On ultrasound, she showed me how big my follicles were which is the reason I am uncomfortable. She told me that after the retrieval, the follicle collapses, but then refills with blood. This blood can take 1-2 months to be fully reabsorbed by the body, GREAT!! And, she measured my follicle sizes, and they averaged 26 mm, much larger than they were upon retrieval!!! But, at least I now know why I am still so uncomfortable. At this visit, she also told me the final results of my embryo freezing, we have 8 in all. Four of them are 8 cell (the best), 2 of them are 5 cell, and 2 of them are 4 cell. It is very exciting to have this part of the process behind us.
She did later call me and tell me that my estrogen level remains high, at 631, so I am to resume the Letrozole and return to her office on Friday, November 9, 2007 at 7:30 am. I will keep you posted!!
Sunday, October 21, 2007
Ch. 13 - The Medication Worked
Ch. 13 - The Medication Worked
Entry Date: October 21, 2007
I really enjoyed my day off on Thursday, not off from work, but off from doctor's visits. On Friday, I had to go to the lab early in the morning after taking my last (3 of 3) cycle suppression injections. We arrived at Huntington Reproductive Center (HRC) around 7:30 am. They took my blood, and that was that. I was told they would call me later to let me know what the next step. Later in the day the office called and told me that the medication had WORKED!!! My estrogen level was at 20 instead of 120 or higher. The doctor and I were relieved. That meant that I could now, start the follicle stimulating medications. So, Saturday would be my first day of 2 injections. The first is a medication Gonal-F 225 mg and the other is Menopur 1 cc. I also have a take a pill Letrozole 5 mg. This will start the stimulation part of the process. Dr. Evans told me that I would not have to come to the visit scheduled for Saturday, but instead, I would be called on Monday to schedule an ultrasound for Tuesday or Wednesday. I really hope it continues to work. If my body cooperates, I my have my egg retrieval on October 31, 2007, a Halloween conception. I will keep you posted.
And, don't forget about Moe's procedure on Monday. I have to be at the dermatologist's office at 3:00 pm for the procedure. He said that it would take about 2-3 hours in total. Wish me luck once again!!
Monday, October 22, 2007
Today I had my appointment at Dr. Martin Kay's office for Mohs Procedure on my face. The procedure took 2 hours in total due to him taking frozen sections and looking at them in the lab to determine if he had clean margins. He had to do this cycle 2 times before my margins were clear. He then stitched me up with about 5 stitches and I have to return to him in 1 week for removal of the stitches. I am so glad that procedure is over. The incision looks nice too. It is in the crease between my mouth, nose,and cheek. I would take a photo, but would rather you guys have better visual memories of me that with the big gauze on my face!?! Maybe next week I will do a photo shoot to show off my new scars, I now have 3 in only 2 months.
I am continuing my follicle stimulating medication, two shots every morning and two pills. I did not hear from Dr. Evans office today, I am sure she will call me tomorrow to let me know when to come in for the next ultrasound. I will let you guys know as soon and I do. Take care and thank you for sharing in my life through my blog.
Saturday, November 2, 2007
I can't believe it has been so long since I did a blog entry, but life has been really busy!!! On Wednesday, October 24, 2007 I returned to Dr. Evans for blood work and an ultrasound. She said that my folllicles were beginning to grow, but they had a lot more growing to do. For now, I am just to continue the daily injections of Gonal-F and Menopur as well as the Letrozole. The Letrozole is taken in order to keep my estrogen levels low since I am a breast cancer patient and my type of cancer is estrogen receptor positive, meaning that if any cancer remains in my body, stimulating my follicles would in turn increase my estrogen levels which would stimulate cancer growth. I am so thankful to be in the good hands of Dr. Evans, she keeps a close eye on me. It is such a funny struggle every morning to make myself self-inject. My belly is so sore. I really feel sorry for diabetic patients and other patients who have to take injections everyday. It is not fun at all.
On Friday, October 26, 2007, I returned to Dr. Evans at 9:00 am for another ultrasound and blood work. My estrogen level was good, only at 200, but my follicles still need to grow more. The goal is to have the follicle size average at 20 mm. I cannot remember my follicle sizes at the visit, but unfortunately, they have to grow more. It is really a weird sensation. You feel bloated like you do when it is a few days before your period, but you do not have any of the other symptoms such as sore breasts, oily face, etc. Oh well, just another learning experience at add to the collection. At the visit, I was to continue my Gonal-F and Menopur as well as the Letrozole. She told me also to increase my injection dose from I Menopur to 2. So I had to go home from this visit and take an additional dose of Menopur. Another injection, but whose keeping track.
Well Saturday rolls around and I do my normal medication regimen. I think it took my 30 minutes to do it today. For some reason, I just could not force myself to make my self hurt. I delayed as much as possible each time today, but finally got through them all. I then got ready and met up with a friend of mine, Barbara, and her daughter, Addison. We are going to the L.A. Zoo today for their Halloween weekend. We had so much fun, but I was so tired when we finally got home. I was also stressed out too!!! Why you ask?!? Well when they increased my Menopur dose on Friday, I did not notice that I did not have enough of the medication to last me through Sunday when I would see the doctor again. This is major considering you have to take the medication at the same time everyday, my time is 6:00-6:15 am. So I needed more DRUGS!!! I called HRC at 7:00 am so that I could take care of this early before going to the zoo just in case I had to go to who knows were to pick up some medication. Most pharmacies do not carry infertility drugs and I received my drug package through the mail last time. The offfice finally calls me back and tells me that I can pick up 3 vials of the Menopur at Fairoaks Pharmacy in Pasadena later on Saturday. They will have it waiting on me and they stay open until 8:00 pm. I was relieved. I was so nervous because this is like my one and only chance to do this egg preservation procedure, and maybe my only chance ever of having children if the chemotherapy kills my ovaries, so I did want to miss a dose, or take a dose late. So finally, I could breathe. As I said, we went to the zoo and had a great time and left in plenty enough time to get to the pharmacy before they closed. We arrived at the pharmacy at 5:15 pm. It was closed. WHAT?!?! CLOSED!!! The gift shop stayed open until 9:00 pm, but the pharmacy closed at 5:00 pm. I broke down. I told the poor girl at the cashier's desk my whole story, that I was a cancer patient going through egg preservation before chemotherapy and that I needed my medication to that I would be able to have some embryos frozen. She said that the owner of the store is the pharmacist and that she said she would be back in 2 hours to check on the store, but did not know if she would open the pharmacy to give me my medication. Clayton was at work or he could of helped calm me down. He was actually on a shoot in Lagoona Beach, 1 1/2 hours away. My friend Barbara was in the car waiting on me, starving, with a 2 year old crashed in her car seat. And by the way, Barbara is also 9 months pregnant. The last thing I wanted to do was to stress her out. She was nice enough to come and pick me up so that both of us did not have to drive, how could I ask her to wait 2 hours at the pharmacy. AND, her 2 year old is almost potty trained, right before she fell asleep, Addison said that she needed to poo-poo. We told her to hold it just a minute while I went to get my medicine and then she could go to the bathroom at my house, about 10 minutes away. WHAT DRAMA!! I walked out of the pharmacy crying, crying, crying. Not to mention being so stressed out about the medicine, but with my hormones being so whacked out I could not stop crying. I went up to window of my friend's car and told her the story and said that I would wait at the pharmacy for the 2 hours so that I would not miss the pharmacist, and I would take a cab home. I felt that this was too important to take a chance. Barbara demanded that I sit in her car for a minute to get myself together and she would be right back. She marched (waddled) into the pharmacy and came back a few minutes later. She said that the pharmacist was going to come back to the pharmacy in about 5 minutes for me and that we were invited to come into the store to enjoy some ice cream while we waited. WHAT AN ANGEL!!! So we did just that, and I received my medication. We also laughed about the situation all the way home. The power of hormones is amazing (and scary)!!
On Sunday, October 28, 2007, I returned to Dr. Evans office again at 8:45 am. Can you believe that they are open 7 days a week, and their office is always busy. I think that I am their only cancer patient at this time, but the office is always filled with women, men, and couples, all with fertility problems. I cannot believe that each women that is having IVF performed has to go through all of these stimulating medication treatments. It makes you so tired, your bellly becomes sore, and you just get tired of being a patient!!! At the visit today, she does another ultrasound and blood work. Today a wrote done my follicle size numbers and they were 16, 15, 13, 9, 8, 15, 15, 16, 15, 12, and 11 mm. Ahhhh!!! They seems so far away from 20mm. But Dr. Evans did give me encouragement, she said that the follicles typically grow about 2 mm per day. However, mine were growing a little slower because I have to keep my estrogen levels down. She does want me to continue my Gonal-F, Ganirelix, and Menopurs as well as the Letrozole at this point with the addition of one more injection, Ganirelix. I should of asked what this was for, but I did't, oh well!!! She said that we would might be able to trigger ovulation soon, maybe by the middle or end of the week.
On Monday I continued the medication regimen and returned to her office on Tuesday, October 30, 2007 for an ultrasound and blood work. Before going to this appointment, I also went to see another doctor, Dr. Kay Martin for the removal of my stitches. I had actually already removed them, they were getting on my nerves, but I needed him to check the incision to make sure everything was okay. He told me to return to his office in 3 months for a total body skin check. He thinks that more than likely I have a few more areas, but he does not want to put too much on my plate at this point in my life, and I agreed!! After the appointment with Dr. Evans, she said that my follicles need to grow 2 more mm and that she would call me later for my estrogen level result. She did call after 4:00 pm and my estrogen level is less than 1,000 which is good and she was pleased. She also scheduled me to come into her office the next morning at 6:00 am for another ultrasound and blood work. After the ultrasound, she spoke the most beautiful words, "You are ready". What a relief!! I did however, have to go home for one last Ganirelix injection because she said I could not go greater that 24 hours before giving myself the trigger injection without a Ganirelix. I was later scheduled for my egg retrieval on Friday, November 2, 2007 at 5:30 am. I was told that the trigger injection of HCG had to be given exactly 35 hours prior to the retrieval which would be at 6:30 pm on October 31, 2007. We missed the Halloween conception, but at this point who cares!!! I am happy to be "READY". So after work on Halloween, I hurried home to be sure taht I gave the injection on time. I was so nervous that I would forget or somehow mess up. This point in time just seemed to carry so much significance!!! But, guess what... I DID IT.
Entry Date: October 21, 2007
I really enjoyed my day off on Thursday, not off from work, but off from doctor's visits. On Friday, I had to go to the lab early in the morning after taking my last (3 of 3) cycle suppression injections. We arrived at Huntington Reproductive Center (HRC) around 7:30 am. They took my blood, and that was that. I was told they would call me later to let me know what the next step. Later in the day the office called and told me that the medication had WORKED!!! My estrogen level was at 20 instead of 120 or higher. The doctor and I were relieved. That meant that I could now, start the follicle stimulating medications. So, Saturday would be my first day of 2 injections. The first is a medication Gonal-F 225 mg and the other is Menopur 1 cc. I also have a take a pill Letrozole 5 mg. This will start the stimulation part of the process. Dr. Evans told me that I would not have to come to the visit scheduled for Saturday, but instead, I would be called on Monday to schedule an ultrasound for Tuesday or Wednesday. I really hope it continues to work. If my body cooperates, I my have my egg retrieval on October 31, 2007, a Halloween conception. I will keep you posted.
And, don't forget about Moe's procedure on Monday. I have to be at the dermatologist's office at 3:00 pm for the procedure. He said that it would take about 2-3 hours in total. Wish me luck once again!!
Monday, October 22, 2007
Today I had my appointment at Dr. Martin Kay's office for Mohs Procedure on my face. The procedure took 2 hours in total due to him taking frozen sections and looking at them in the lab to determine if he had clean margins. He had to do this cycle 2 times before my margins were clear. He then stitched me up with about 5 stitches and I have to return to him in 1 week for removal of the stitches. I am so glad that procedure is over. The incision looks nice too. It is in the crease between my mouth, nose,and cheek. I would take a photo, but would rather you guys have better visual memories of me that with the big gauze on my face!?! Maybe next week I will do a photo shoot to show off my new scars, I now have 3 in only 2 months.
I am continuing my follicle stimulating medication, two shots every morning and two pills. I did not hear from Dr. Evans office today, I am sure she will call me tomorrow to let me know when to come in for the next ultrasound. I will let you guys know as soon and I do. Take care and thank you for sharing in my life through my blog.
Saturday, November 2, 2007
I can't believe it has been so long since I did a blog entry, but life has been really busy!!! On Wednesday, October 24, 2007 I returned to Dr. Evans for blood work and an ultrasound. She said that my folllicles were beginning to grow, but they had a lot more growing to do. For now, I am just to continue the daily injections of Gonal-F and Menopur as well as the Letrozole. The Letrozole is taken in order to keep my estrogen levels low since I am a breast cancer patient and my type of cancer is estrogen receptor positive, meaning that if any cancer remains in my body, stimulating my follicles would in turn increase my estrogen levels which would stimulate cancer growth. I am so thankful to be in the good hands of Dr. Evans, she keeps a close eye on me. It is such a funny struggle every morning to make myself self-inject. My belly is so sore. I really feel sorry for diabetic patients and other patients who have to take injections everyday. It is not fun at all.
On Friday, October 26, 2007, I returned to Dr. Evans at 9:00 am for another ultrasound and blood work. My estrogen level was good, only at 200, but my follicles still need to grow more. The goal is to have the follicle size average at 20 mm. I cannot remember my follicle sizes at the visit, but unfortunately, they have to grow more. It is really a weird sensation. You feel bloated like you do when it is a few days before your period, but you do not have any of the other symptoms such as sore breasts, oily face, etc. Oh well, just another learning experience at add to the collection. At the visit, I was to continue my Gonal-F and Menopur as well as the Letrozole. She told me also to increase my injection dose from I Menopur to 2. So I had to go home from this visit and take an additional dose of Menopur. Another injection, but whose keeping track.
Well Saturday rolls around and I do my normal medication regimen. I think it took my 30 minutes to do it today. For some reason, I just could not force myself to make my self hurt. I delayed as much as possible each time today, but finally got through them all. I then got ready and met up with a friend of mine, Barbara, and her daughter, Addison. We are going to the L.A. Zoo today for their Halloween weekend. We had so much fun, but I was so tired when we finally got home. I was also stressed out too!!! Why you ask?!? Well when they increased my Menopur dose on Friday, I did not notice that I did not have enough of the medication to last me through Sunday when I would see the doctor again. This is major considering you have to take the medication at the same time everyday, my time is 6:00-6:15 am. So I needed more DRUGS!!! I called HRC at 7:00 am so that I could take care of this early before going to the zoo just in case I had to go to who knows were to pick up some medication. Most pharmacies do not carry infertility drugs and I received my drug package through the mail last time. The offfice finally calls me back and tells me that I can pick up 3 vials of the Menopur at Fairoaks Pharmacy in Pasadena later on Saturday. They will have it waiting on me and they stay open until 8:00 pm. I was relieved. I was so nervous because this is like my one and only chance to do this egg preservation procedure, and maybe my only chance ever of having children if the chemotherapy kills my ovaries, so I did want to miss a dose, or take a dose late. So finally, I could breathe. As I said, we went to the zoo and had a great time and left in plenty enough time to get to the pharmacy before they closed. We arrived at the pharmacy at 5:15 pm. It was closed. WHAT?!?! CLOSED!!! The gift shop stayed open until 9:00 pm, but the pharmacy closed at 5:00 pm. I broke down. I told the poor girl at the cashier's desk my whole story, that I was a cancer patient going through egg preservation before chemotherapy and that I needed my medication to that I would be able to have some embryos frozen. She said that the owner of the store is the pharmacist and that she said she would be back in 2 hours to check on the store, but did not know if she would open the pharmacy to give me my medication. Clayton was at work or he could of helped calm me down. He was actually on a shoot in Lagoona Beach, 1 1/2 hours away. My friend Barbara was in the car waiting on me, starving, with a 2 year old crashed in her car seat. And by the way, Barbara is also 9 months pregnant. The last thing I wanted to do was to stress her out. She was nice enough to come and pick me up so that both of us did not have to drive, how could I ask her to wait 2 hours at the pharmacy. AND, her 2 year old is almost potty trained, right before she fell asleep, Addison said that she needed to poo-poo. We told her to hold it just a minute while I went to get my medicine and then she could go to the bathroom at my house, about 10 minutes away. WHAT DRAMA!! I walked out of the pharmacy crying, crying, crying. Not to mention being so stressed out about the medicine, but with my hormones being so whacked out I could not stop crying. I went up to window of my friend's car and told her the story and said that I would wait at the pharmacy for the 2 hours so that I would not miss the pharmacist, and I would take a cab home. I felt that this was too important to take a chance. Barbara demanded that I sit in her car for a minute to get myself together and she would be right back. She marched (waddled) into the pharmacy and came back a few minutes later. She said that the pharmacist was going to come back to the pharmacy in about 5 minutes for me and that we were invited to come into the store to enjoy some ice cream while we waited. WHAT AN ANGEL!!! So we did just that, and I received my medication. We also laughed about the situation all the way home. The power of hormones is amazing (and scary)!!
On Sunday, October 28, 2007, I returned to Dr. Evans office again at 8:45 am. Can you believe that they are open 7 days a week, and their office is always busy. I think that I am their only cancer patient at this time, but the office is always filled with women, men, and couples, all with fertility problems. I cannot believe that each women that is having IVF performed has to go through all of these stimulating medication treatments. It makes you so tired, your bellly becomes sore, and you just get tired of being a patient!!! At the visit today, she does another ultrasound and blood work. Today a wrote done my follicle size numbers and they were 16, 15, 13, 9, 8, 15, 15, 16, 15, 12, and 11 mm. Ahhhh!!! They seems so far away from 20mm. But Dr. Evans did give me encouragement, she said that the follicles typically grow about 2 mm per day. However, mine were growing a little slower because I have to keep my estrogen levels down. She does want me to continue my Gonal-F, Ganirelix, and Menopurs as well as the Letrozole at this point with the addition of one more injection, Ganirelix. I should of asked what this was for, but I did't, oh well!!! She said that we would might be able to trigger ovulation soon, maybe by the middle or end of the week.
On Monday I continued the medication regimen and returned to her office on Tuesday, October 30, 2007 for an ultrasound and blood work. Before going to this appointment, I also went to see another doctor, Dr. Kay Martin for the removal of my stitches. I had actually already removed them, they were getting on my nerves, but I needed him to check the incision to make sure everything was okay. He told me to return to his office in 3 months for a total body skin check. He thinks that more than likely I have a few more areas, but he does not want to put too much on my plate at this point in my life, and I agreed!! After the appointment with Dr. Evans, she said that my follicles need to grow 2 more mm and that she would call me later for my estrogen level result. She did call after 4:00 pm and my estrogen level is less than 1,000 which is good and she was pleased. She also scheduled me to come into her office the next morning at 6:00 am for another ultrasound and blood work. After the ultrasound, she spoke the most beautiful words, "You are ready". What a relief!! I did however, have to go home for one last Ganirelix injection because she said I could not go greater that 24 hours before giving myself the trigger injection without a Ganirelix. I was later scheduled for my egg retrieval on Friday, November 2, 2007 at 5:30 am. I was told that the trigger injection of HCG had to be given exactly 35 hours prior to the retrieval which would be at 6:30 pm on October 31, 2007. We missed the Halloween conception, but at this point who cares!!! I am happy to be "READY". So after work on Halloween, I hurried home to be sure taht I gave the injection on time. I was so nervous that I would forget or somehow mess up. This point in time just seemed to carry so much significance!!! But, guess what... I DID IT.
Thursday, October 18, 2007
Ch. 12 - Beginning the Egg Preservation Cycle
Ch. 12 - Beginning the Egg Preservation Cycle
Well, since getting my period, life has been a little crazy. First thing Monday morning I was in contact with Cynthia at Dr. Evans office. She was very helpful with all of my questions and sent me an email regarding my cycle schedule. The daily schedule is a little overwhelming, but I plan to take things day by day.
Tuesday arrived and Clayton and I went to my appointment with Dr. Evans at 9:45 am. At the visit, she performed a vaginal ultrasound to see the state of the follicles and everything else. During this exam, she noticed a cyst on my left ovary measuring 2.11 cm. She stated that the cyst was growing due to the increase in estrogen in my body (if I understood her correctly). Anyway, at this point, she stated that it was important for her to know the location and size of the cyst so that when it came time to retrieve the eggs, she would not mistake the cyst for a follicle since they look the same on ultrasound. She said that normally we (being the patient and the doctor) would wait to continue with the cycle until after the cyst went away on its own or until it could be removed, but we do not have the luxury of time at this point because of my need to start chemotherapy. I trust the doctor and her recommendations, so I guess at this point the cyst size and location was noted, and the show must go on. After the ultrasound, I had blood drawn for analysis and I was also instructed in how to inject myself with the medication and how to properly prepare the medication before injection. The needle that I will use is the same as a diabetic needle which is small, so everything should go okay. They instructed me to begin this medication today. The only thing I had to do was to make sure that I took the medication at the same time everyday, so I decided that I would take it at night so that I would not be rushed in the mornings.
At about 5:30 pm this same day, I received a call from my physician. She stated that the blood work showed that my estrogen levels were higher than she had expected for this point in my cycle. My estrogen level was around 120 and she had anticipated the level to be at around 60. She told me at this point to hold off on taking the medications for now and wait for her to call me back. She said that she is determining what to do because the levels are elevated because of the growing cyst and also due to the fact that my cancer is ER+ and I have not yet started my chemotherapy regimen that would kill off any remaining cancer cells. So for now, the waiting game has returned. She said that she wanted to confer with a couple more of her colleagues regarding what to do at this point and she would be in touch with me later in the day, just DO NOT start the medication.
Dr. Evans called again at 6:30 pm. She said that she had decided that the cyst needed to be aspirated in order to get rid of the cyst and its associated cells. She said by doing this, and starting a different medication, my estrogen levels should drop and we would be able to start from scratch, the cycle all over again in about 3 days. So... she scheduled me for the aspiration procedure for 6:15 am in her office. She stated that this would be done with local anesthesia and would take about 30 minutes with an additional 45 minutes recovery time. By now, it just feels like, here we go again. Just tell me where to be and at what time, I will be there and do as I am told, but with questions asked, of course.
Well, as scheduled, we were at her office at 6:15 am. Clayton and I were both so tired, but the doctor had to be tired as well. She is such a busy lady. She took me back without Clayton and performed the procedure. I could see the cyst on the ultrasound screen before it was aspirated, then after the procedure, it was gone, just that simple. The only discomfort was when she numbed the area before the aspiration, but otherwise, definitely no complaints. I was then given a new medication to take that would "kill" my cycle, Cetrotide 0.25 mg (cetrorelix acetate for injection). I am to start today by giving myself injections, one a day for three days straight. We then have to return to her office on Friday, October 20th for blood work and then again on Saturday for another ultrasound and additional blood work. So, this has been added to the ever-changing calender.
And, if you remember, this is also the day that I get the biopsy results on the "cyst" removed from my face. Clayton and I went to see Dr. Martin Kay this same morning at 11:15 am. He explained to me that my biopsy results came back positive for basal cell carcinoma. He stated that if you had to have skin cancer, this was the best to have. It does not metastasize and is easily managed. He stated that he recommends a procedure called Mohs procedure. During this procedure, the area is excised in small portions and each sections is looked at by pathology, frozen section biopsy, once the area has clean margins, the area is stitched and the procedure is over. He said that it should take 2-3 hours. I explained to him my current battle with breast cancer, egg retrieval, and awaiting chemotherapy in order to explain my urgency is getting this taken care of on my face before my life gets even more complicated. He agreed, placed URGENT on the authorization request for the insurance company, and scheduled the procedure for Monday, October 22, 2007 at 3:00 pm. The way I see it now, just one more thing, and one step closer to being back on my feet again!!!
Today is Thursday, and I honestly do not have any doctor's appointments. YEAH!!! I get to be normal for a day. The things we take for granted. But for now, I am just enjoying my day off.
Well, since getting my period, life has been a little crazy. First thing Monday morning I was in contact with Cynthia at Dr. Evans office. She was very helpful with all of my questions and sent me an email regarding my cycle schedule. The daily schedule is a little overwhelming, but I plan to take things day by day.
She also scheduled for me to come into the office for the initial "cycle" visit on Tuesday, October 16th at 9:45 am. She also instructed me that Freedom Pharmacy would be calling me soon regarding the medication order that was not included in the Fertile Hope grant. Later in the day, Freedom Pharmacy called and payment for the medications and delivery was taken of. The medications were $635.00 in total. My insurance company decided that they would pay for one of the medications, and guess which one, the one that was only around $6.00 per pill and only 6 pills were ordered, let me see, $36.00 of the original. I wonder if I should send them a "thank you for your generosity" card?!? Anyway, they are sending the medications over-night via Fed-Ex since I was scheduled to start my medication cycle the next day, Tuesday.
Tuesday arrived and Clayton and I went to my appointment with Dr. Evans at 9:45 am. At the visit, she performed a vaginal ultrasound to see the state of the follicles and everything else. During this exam, she noticed a cyst on my left ovary measuring 2.11 cm. She stated that the cyst was growing due to the increase in estrogen in my body (if I understood her correctly). Anyway, at this point, she stated that it was important for her to know the location and size of the cyst so that when it came time to retrieve the eggs, she would not mistake the cyst for a follicle since they look the same on ultrasound. She said that normally we (being the patient and the doctor) would wait to continue with the cycle until after the cyst went away on its own or until it could be removed, but we do not have the luxury of time at this point because of my need to start chemotherapy. I trust the doctor and her recommendations, so I guess at this point the cyst size and location was noted, and the show must go on. After the ultrasound, I had blood drawn for analysis and I was also instructed in how to inject myself with the medication and how to properly prepare the medication before injection. The needle that I will use is the same as a diabetic needle which is small, so everything should go okay. They instructed me to begin this medication today. The only thing I had to do was to make sure that I took the medication at the same time everyday, so I decided that I would take it at night so that I would not be rushed in the mornings.
At about 5:30 pm this same day, I received a call from my physician. She stated that the blood work showed that my estrogen levels were higher than she had expected for this point in my cycle. My estrogen level was around 120 and she had anticipated the level to be at around 60. She told me at this point to hold off on taking the medications for now and wait for her to call me back. She said that she is determining what to do because the levels are elevated because of the growing cyst and also due to the fact that my cancer is ER+ and I have not yet started my chemotherapy regimen that would kill off any remaining cancer cells. So for now, the waiting game has returned. She said that she wanted to confer with a couple more of her colleagues regarding what to do at this point and she would be in touch with me later in the day, just DO NOT start the medication.
Dr. Evans called again at 6:30 pm. She said that she had decided that the cyst needed to be aspirated in order to get rid of the cyst and its associated cells. She said by doing this, and starting a different medication, my estrogen levels should drop and we would be able to start from scratch, the cycle all over again in about 3 days. So... she scheduled me for the aspiration procedure for 6:15 am in her office. She stated that this would be done with local anesthesia and would take about 30 minutes with an additional 45 minutes recovery time. By now, it just feels like, here we go again. Just tell me where to be and at what time, I will be there and do as I am told, but with questions asked, of course.
Well, as scheduled, we were at her office at 6:15 am. Clayton and I were both so tired, but the doctor had to be tired as well. She is such a busy lady. She took me back without Clayton and performed the procedure. I could see the cyst on the ultrasound screen before it was aspirated, then after the procedure, it was gone, just that simple. The only discomfort was when she numbed the area before the aspiration, but otherwise, definitely no complaints. I was then given a new medication to take that would "kill" my cycle, Cetrotide 0.25 mg (cetrorelix acetate for injection). I am to start today by giving myself injections, one a day for three days straight. We then have to return to her office on Friday, October 20th for blood work and then again on Saturday for another ultrasound and additional blood work. So, this has been added to the ever-changing calender.
And, if you remember, this is also the day that I get the biopsy results on the "cyst" removed from my face. Clayton and I went to see Dr. Martin Kay this same morning at 11:15 am. He explained to me that my biopsy results came back positive for basal cell carcinoma. He stated that if you had to have skin cancer, this was the best to have. It does not metastasize and is easily managed. He stated that he recommends a procedure called Mohs procedure. During this procedure, the area is excised in small portions and each sections is looked at by pathology, frozen section biopsy, once the area has clean margins, the area is stitched and the procedure is over. He said that it should take 2-3 hours. I explained to him my current battle with breast cancer, egg retrieval, and awaiting chemotherapy in order to explain my urgency is getting this taken care of on my face before my life gets even more complicated. He agreed, placed URGENT on the authorization request for the insurance company, and scheduled the procedure for Monday, October 22, 2007 at 3:00 pm. The way I see it now, just one more thing, and one step closer to being back on my feet again!!!
Today is Thursday, and I honestly do not have any doctor's appointments. YEAH!!! I get to be normal for a day. The things we take for granted. But for now, I am just enjoying my day off.
Sunday, October 14, 2007
Ch. 11 - My Breast Cancer Registry
Ch. 11 - My Breast Cancer Registry
First of all, I would like to thank everyone for their love and support. I have recevied so many cards, flowers, gifts, emails, and telephone calls from friends and family which have all meant the world to me. Some friends have brought by food and desserts to help during the recovery process which has also been greatly appreciated. I also have had many people ask me what I need or, I guess, things that I would want during this time to make life a little easier and maybe just to put a smile on my face or to feel extra special for a day. Now that I have had more time to think and process the directions of my life for now, I have found some things that I could include on my Breast Cancer "Registry". My mom actually recommended the idea because she wants to do something for me, something special; and, I also thought this was a great idea.
1. Purchased by Katy Goolsby - Thank you!!!
2. The following item can be found at www.tlcdirect.org.
Item #7784 - Colors Wine & Pink with size - average
3. The following item can be found at www.tlcdirect.org.
Item #7933 in Chocolate
4. The following item can be found at www.tlcdirect.org.
Item #7622 - Size average
5. The following item can be found at www.tlcdirect.org.
Item #7706 - Color: Ivory Size: Average
6. The following item can be found at www.tlcdirect.org.
Item #7747
7. The following item can be found at www.tlcdirect.org.
Item #7764
8. The following item can be found at www.tlcdirect.org.
Item #7987 & 7655 respectively
9. The following item can be found at www.tafford.com
Item #NMX605-PR
10. The following item can be found at www.tafford.com
Item #NAW360
Size: Small
Color: White
Embroidery: NLOGO130 (Breast Cancer Ribbon)on Right Chest
11. The following item can be found at www.landsend.com
Item #25791-222X
12. The followng item(s) can be found at www.landsend.com
Item #17218-5228
Size: Medium
Colors: Ice Pink, Pewter Heather, Aspen Green
13. The following item(s) can be found at www.landsend.com
Item #18477-2226
Colors: Ice Pink, Pewter Heather, Aspen Green
14. The following item can be found at www.landsend.com
Item #24904-4225
Size: Petite medium Pants, Medium Top
Color: Red/White Stripe
15. The following item can be found at http://www.landsend.com/
Item #: 23488-323X
Size: Medium
16. The following item(s) can be found at http://www.fordcares.com/
First of all, I would like to thank everyone for their love and support. I have recevied so many cards, flowers, gifts, emails, and telephone calls from friends and family which have all meant the world to me. Some friends have brought by food and desserts to help during the recovery process which has also been greatly appreciated. I also have had many people ask me what I need or, I guess, things that I would want during this time to make life a little easier and maybe just to put a smile on my face or to feel extra special for a day. Now that I have had more time to think and process the directions of my life for now, I have found some things that I could include on my Breast Cancer "Registry". My mom actually recommended the idea because she wants to do something for me, something special; and, I also thought this was a great idea.
My Breast Cancer Registry
1. Purchased by Katy Goolsby - Thank you!!!
2. The following item can be found at www.tlcdirect.org.
Item #7784 - Colors Wine & Pink with size - average
3. The following item can be found at www.tlcdirect.org.
Item #7933 in Chocolate
4. The following item can be found at www.tlcdirect.org.
Item #7622 - Size average
5. The following item can be found at www.tlcdirect.org.
Item #7706 - Color: Ivory Size: Average
6. The following item can be found at www.tlcdirect.org.
Item #7747
7. The following item can be found at www.tlcdirect.org.
Item #7764
8. The following item can be found at www.tlcdirect.org.
Item #7987 & 7655 respectively
9. The following item can be found at www.tafford.com
Item #NMX605-PR
10. The following item can be found at www.tafford.com
Item #NAW360
Size: Small
Color: White
Embroidery: NLOGO130 (Breast Cancer Ribbon)on Right Chest
11. The following item can be found at www.landsend.com
Item #25791-222X
12. The followng item(s) can be found at www.landsend.com
Item #17218-5228
Size: Medium
Colors: Ice Pink, Pewter Heather, Aspen Green
13. The following item(s) can be found at www.landsend.com
Item #18477-2226
Colors: Ice Pink, Pewter Heather, Aspen Green
14. The following item can be found at www.landsend.com
Item #24904-4225
Size: Petite medium Pants, Medium Top
Color: Red/White Stripe
15. The following item can be found at http://www.landsend.com/
Item #: 23488-323XSize: Medium
16. The following item(s) can be found at http://www.fordcares.com/
Sweatshirt size: Medium
T-shirt Size: Large
Ch. 10 - Getting my Port-a-Cath & My Period
Ch. 10 - Getting my Port-a-Cath & My Period
Surgery on Friday, October 12, 2007, went well. The port-a-cath procedure took about 1 hour followed by 2 hours in recovery. I have a dressing over the surgical site. Dr. Sherin Shirazi performed the procedure. She said that I did not need to follow-up with her, just to follow-up with my oncologist, Dr. Zhang next week and he would remove the dressing. She did use sutures to close the incision but stated that these would dissolve and not have to be removed. I felt great after surgery. They gave me apple juice and jello and then sent us home. On the way home, I became a little nauseated and as soon as I got home, the vomiting began, but without much in your stomach, not much can come out. The nausea and vomiting only last about 1 hour and then I was able to eat some toast and go to bed.
Today is Sunday and I have been sore after the surgery and have been taking Hydrocodone for pain as needed. I only take about2 tablets during the course of the day, but it sure does help. We went out to run some errands yesterday and I was so nervous. I did not want anyone to bump into my left shoulder (the side of the procedure). I felt and still feel very vulnerable. It seems very scary to have something that someone could bump into that is connected directly to your artery and is located right above your lung, near your first rib and clavicle, and... on the same side of your heart. I know that it is safe, but it is an uncomfortable thought. However, I am very happy and pleased with the procedure; it is behind me and it will make chemotherapy and all the blood draws much easier!!
And, the long await is over, I got my period today!!!!! It seems so strange to be so happy about this, but my period is the key to the beginning of the egg preservation procedure and eventually starting chemotherapy. I have already called the office of Dr. Michelle Evans and left a message that I got my period. I feel like a teenager. I have had my period so many times, over a 20 year period, would be about 240 times, but today was different. I was like is this it? Is this really my period, or some how just a false alarm. I guess it just seemed like it could not be true. So much rides on this moment. I can't wait to share the rest of my story, but for now, we all have to wait and see what excitement with morning brings. I will keep you posted.
Surgery on Friday, October 12, 2007, went well. The port-a-cath procedure took about 1 hour followed by 2 hours in recovery. I have a dressing over the surgical site. Dr. Sherin Shirazi performed the procedure. She said that I did not need to follow-up with her, just to follow-up with my oncologist, Dr. Zhang next week and he would remove the dressing. She did use sutures to close the incision but stated that these would dissolve and not have to be removed. I felt great after surgery. They gave me apple juice and jello and then sent us home. On the way home, I became a little nauseated and as soon as I got home, the vomiting began, but without much in your stomach, not much can come out. The nausea and vomiting only last about 1 hour and then I was able to eat some toast and go to bed.
Today is Sunday and I have been sore after the surgery and have been taking Hydrocodone for pain as needed. I only take about2 tablets during the course of the day, but it sure does help. We went out to run some errands yesterday and I was so nervous. I did not want anyone to bump into my left shoulder (the side of the procedure). I felt and still feel very vulnerable. It seems very scary to have something that someone could bump into that is connected directly to your artery and is located right above your lung, near your first rib and clavicle, and... on the same side of your heart. I know that it is safe, but it is an uncomfortable thought. However, I am very happy and pleased with the procedure; it is behind me and it will make chemotherapy and all the blood draws much easier!!
And, the long await is over, I got my period today!!!!! It seems so strange to be so happy about this, but my period is the key to the beginning of the egg preservation procedure and eventually starting chemotherapy. I have already called the office of Dr. Michelle Evans and left a message that I got my period. I feel like a teenager. I have had my period so many times, over a 20 year period, would be about 240 times, but today was different. I was like is this it? Is this really my period, or some how just a false alarm. I guess it just seemed like it could not be true. So much rides on this moment. I can't wait to share the rest of my story, but for now, we all have to wait and see what excitement with morning brings. I will keep you posted.
Thursday, October 11, 2007
Ch. 9 - The Waiting Game
Ch. 9 - The Waiting Game
October 11, 2007
All I can say is that the past week has been a little crazy, why? Well, I guess it is a little more accurate to say that it was full of ups and downs. As far as the insurance coverage, I think it will come through, but since time is of the essence, it is very stressful because we all know that speaking to an actual person rather than leaving a message on voice mail can be very difficult. I did speak with the claims manager finally and she told me what she needed from the doctor in order to present it to the Claims Review Committee to see what they will or won't pay for. I left a message with Dr. Evans office regarding my needs. I also spoke to Nancy in her office who told me not to worry, she would talk to Dr. Evans and then get back with me. This was Monday. On Tuesday, we had not heard anything, but we also had an appointment at the office for Clayton to give them the sperm sample. Let me tell you, that was an unique experience for us. Entering a small room in a doctor's office with a chair for the donor and a television in front of him with a fairly wide selection of porn to choose from to help with the procedure. IN A DOCTOR'S OFFICE!! We were new to this and found it hard to take it seriously at first, but the laughter was what we both needed as well. As we were leaving, we stopped by the finance department and spoke with Nancy personally. She stated that she would call me first thing in the morning with the answer regarding how the procedure would be billed and paid. After we got in the car and drove off, Clayton asked me what we were up against in terms of financial obligation. I told him that nobody had given me a total, he said "$5,000, $50,000, what do you think?" I told him that I was sure it was expensive, but I did not have any idea. Well, we could not take the suspense, so we called the office back and asked more specific questions to Nancy. She told us that normally the procedure is $7,000, anesthesia is $400.00, cryopreservation is $700.00 and the medication are between $3,000 and $5,000. She said that in special cases like mine, they do make price adjustments. She encouraged us to wait until we heard from her, after she had talked to Dr. Evans. We were thankful to finally have numbers given to us, but where do we get the money to cover the procedure? This was the pressing question in the event that my insurance does not cover the cost. Yikes! Overall, Monday was a pretty good day overall.
Tuesday, October 9, 2007 started out positive. I received a personal call from Dr. Evans. She stated that she had received the message I left for her in regards to the information the insurance company was requesting, basically a letter of medical necessity with cost estimates to be provided. She said that she would do this, but rather than to postpone my procedure while we wait on insurance to decide what they were going to do, she thought she had a better plan. She told me that the office supported her decision and that she will perform the procedure for free, but that I would have to cover the anesthesia and the cryopreservation costs. I cried. What an angel. I felt that I could finally breathe. The stress surrounding this procedure was overwhelming. Mostly because of so many unknown financial factors and just the scheduling of everything on top of delaying the start of my chemotherapy to preserve my eggs. But with all these special and wonderful people, I am able to see the light at the end of the tunnel. Dr. Evans is a wonderful person.
On Wednesday, I received a call from Fertile Hope (www.fertilehope.org). They were completing my application for financial help with the drugs needed for the egg preservation procedure and realized that my application was incomplete. They needed tax forms from last year, the 1040 form. I did not know they needed this, so initially it panic I went into a stated of panic. There was financial criteria that needed to be met in order to be eligible. Would we be eligible? I don't know?!? Secondly, we have been keeping all of our things in our basement (paper and such) while we remodel the fixer-upper in January. Would I be able to locate them in time to meet the deadline for submission and then would we qualify AND then would we be able to accomplish all of this before I get my menstrual cycle in 7-8 days. After breaking down and crying, a lot, just from the overall all stress I think, I pulled myself together. I was able to later locate the tax information, fax it to Fertile Hope, and later receive a phone call from the organization that we were approved!!!!! What a relief. It makes me happy to have financial help, but it makes me prouder to be able to empower myself to face an anxieties and continue to fight for the things that I am entitled to as a cancer patient, at my age, not having any children, etc, etc. Everything was then in order for my retrieval procedure, now we all are just waiting for the first day of my menstrual cycle. I feel like a teenager again. I have not worried so much about staring my period in a long time. For so many years, it was just a natural course that comes each month and goes away just the same, but right now it has achieved a level of utmost significance.
Later, this same day while I was still at work, I received a phone call from the dermatologist's office who removed that "cyst" from my face. It was the nurse who told me that they had received the results and that the doctor, Dr. Kay Martin, wanted to see me in his office to discuss the results. I did not ask many questions because I know that the nurse is not able to give results, and also if it is bad news, this is typically not done over the phone. I was then transferred to the receptionist was gave me an appointment for October 17, 2007. It looks like another period of waiting is in store for me and my husband.
So for now, I have my port-a-cath placement surgery Friday @ 3:30 pm. I will be be put under anesthesia for the procedure and have to arrive at the hospital 2 hours prior. I plan to have a good dinner tonight since I will not be able to eat anything after midnight until I wake up from my surgery. Wish me luck!!
October 11, 2007
All I can say is that the past week has been a little crazy, why? Well, I guess it is a little more accurate to say that it was full of ups and downs. As far as the insurance coverage, I think it will come through, but since time is of the essence, it is very stressful because we all know that speaking to an actual person rather than leaving a message on voice mail can be very difficult. I did speak with the claims manager finally and she told me what she needed from the doctor in order to present it to the Claims Review Committee to see what they will or won't pay for. I left a message with Dr. Evans office regarding my needs. I also spoke to Nancy in her office who told me not to worry, she would talk to Dr. Evans and then get back with me. This was Monday. On Tuesday, we had not heard anything, but we also had an appointment at the office for Clayton to give them the sperm sample. Let me tell you, that was an unique experience for us. Entering a small room in a doctor's office with a chair for the donor and a television in front of him with a fairly wide selection of porn to choose from to help with the procedure. IN A DOCTOR'S OFFICE!! We were new to this and found it hard to take it seriously at first, but the laughter was what we both needed as well. As we were leaving, we stopped by the finance department and spoke with Nancy personally. She stated that she would call me first thing in the morning with the answer regarding how the procedure would be billed and paid. After we got in the car and drove off, Clayton asked me what we were up against in terms of financial obligation. I told him that nobody had given me a total, he said "$5,000, $50,000, what do you think?" I told him that I was sure it was expensive, but I did not have any idea. Well, we could not take the suspense, so we called the office back and asked more specific questions to Nancy. She told us that normally the procedure is $7,000, anesthesia is $400.00, cryopreservation is $700.00 and the medication are between $3,000 and $5,000. She said that in special cases like mine, they do make price adjustments. She encouraged us to wait until we heard from her, after she had talked to Dr. Evans. We were thankful to finally have numbers given to us, but where do we get the money to cover the procedure? This was the pressing question in the event that my insurance does not cover the cost. Yikes! Overall, Monday was a pretty good day overall.
Tuesday, October 9, 2007 started out positive. I received a personal call from Dr. Evans. She stated that she had received the message I left for her in regards to the information the insurance company was requesting, basically a letter of medical necessity with cost estimates to be provided. She said that she would do this, but rather than to postpone my procedure while we wait on insurance to decide what they were going to do, she thought she had a better plan. She told me that the office supported her decision and that she will perform the procedure for free, but that I would have to cover the anesthesia and the cryopreservation costs. I cried. What an angel. I felt that I could finally breathe. The stress surrounding this procedure was overwhelming. Mostly because of so many unknown financial factors and just the scheduling of everything on top of delaying the start of my chemotherapy to preserve my eggs. But with all these special and wonderful people, I am able to see the light at the end of the tunnel. Dr. Evans is a wonderful person.
On Wednesday, I received a call from Fertile Hope (www.fertilehope.org). They were completing my application for financial help with the drugs needed for the egg preservation procedure and realized that my application was incomplete. They needed tax forms from last year, the 1040 form. I did not know they needed this, so initially it panic I went into a stated of panic. There was financial criteria that needed to be met in order to be eligible. Would we be eligible? I don't know?!? Secondly, we have been keeping all of our things in our basement (paper and such) while we remodel the fixer-upper in January. Would I be able to locate them in time to meet the deadline for submission and then would we qualify AND then would we be able to accomplish all of this before I get my menstrual cycle in 7-8 days. After breaking down and crying, a lot, just from the overall all stress I think, I pulled myself together. I was able to later locate the tax information, fax it to Fertile Hope, and later receive a phone call from the organization that we were approved!!!!! What a relief. It makes me happy to have financial help, but it makes me prouder to be able to empower myself to face an anxieties and continue to fight for the things that I am entitled to as a cancer patient, at my age, not having any children, etc, etc. Everything was then in order for my retrieval procedure, now we all are just waiting for the first day of my menstrual cycle. I feel like a teenager again. I have not worried so much about staring my period in a long time. For so many years, it was just a natural course that comes each month and goes away just the same, but right now it has achieved a level of utmost significance.
Later, this same day while I was still at work, I received a phone call from the dermatologist's office who removed that "cyst" from my face. It was the nurse who told me that they had received the results and that the doctor, Dr. Kay Martin, wanted to see me in his office to discuss the results. I did not ask many questions because I know that the nurse is not able to give results, and also if it is bad news, this is typically not done over the phone. I was then transferred to the receptionist was gave me an appointment for October 17, 2007. It looks like another period of waiting is in store for me and my husband.
So for now, I have my port-a-cath placement surgery Friday @ 3:30 pm. I will be be put under anesthesia for the procedure and have to arrive at the hospital 2 hours prior. I plan to have a good dinner tonight since I will not be able to eat anything after midnight until I wake up from my surgery. Wish me luck!!
Tuesday, October 2, 2007
Ch. 8 - Egg Preservation
Ch. 8 - Egg Preservation
Last week on Thurday I went to see Josephine in the infusion clinic. She took a look at my veins and stated that she recommended for me to have a port-a-cath. She stated that the chemotherapy medications are strong and can be uncomfortable going in. She told me to check with Dr. Zhang to set up a time to have this performed. I went by the office and the nurse told me she would refer me back to Dr. Shirazi, my surgeon, for the port-a-cath placement. When I called her office, Roberta told me to let her know what date I would be starting chemo and she would arrange for placement of the cath about 1 week before. Yeah!! I will not have to be stuck each time they need blood from me or when I need to receive my chemotherapy. This was good news.
On the same day, September 27, 2007, I also went to see my OBGYN. This office visit was to check on the status of my IUD, to make sure everything was going okay with me, and to discuss fertility issues. My IUD was fine with no follow-up needed until my yearly exam in March. As far as the fertility issues, he referred me to Dr. Michelle Evans, a fertility specialist at Huntington Reporductive Center in Pasadena. I did attempt to ask him general questions regarding my possiblities, but he deferred answering and reassured me that Dr. Evans would answer all of my questions. He had already spoke to Dr. Evans regarding my case and she was awaiting my call. I did however ask him if the egg preservation or other options would be covered by my insurance, he stated he did not know, but that I should contact the Human Resources Department at the hospital where I work and ask the benefits specialist. I was please with my visit with Dr. Spencer-Smith and scheduled my follow-up with him for March of 2008.
After leaving his office I immediately began researching my financial options. I made several calls to my insurance company and left messages as well as calling the benefits specialist, Marci. She told me that anything concerning my treatment associated with breast cancer should be covered. She helped my anxiety, but I really wanted to hear the same information from my insurance company since they are the ones that pay the bills. Between myself and Dr. Spences-Smith's office, we FINALLY got the insurance approval for me to see Dr. Evans. It sounds easy, but involved many tears and multiple phone calls, but the perseverance paid off.
Dr. Evans is a wonderful person. I went to see her on Friday, September 28, 2007. She took me into her office and went over my current and past medical history including my husband's medical history. She described my options but highly recommended one over the others (taking Lupron, egg freezing, and a couple bad ideas). Her recommendation was Cryopreservation (embryo freezing). The outcomes from this method are the best and the freezing procedure has stood the test of time. She had one patient who delivered healthy baby with an embryo that had been frozen for 17 years!!! The procedure will be customized since we have limited time for harvesting so that I can start my chemotherapy in the recommended window determined by my oncologist. She paged my oncologist, Dr. Zhang, and he immediately called her back and gave her the green light; but, I have to start chemotherapy immediately after the harvesting procedure. This was such a relief!! It finally felt like I had an all inclusive plan covering all aspects of my treatment process. As far as the procedure, on the day of my period, I am to call her office, on day 3 they start me on a drug to do something (I think to overstimulate my follicles) and then I think 12 days later, I will go into her office, receive sedation, and she will extract as many eggs from me that she can using a needle. She hopes to be able to extract around 10-11 eggs. These will then be combined with Clayton's sperm by using one of two methods, but I do not remember all the details honestly. These embryos will then be frozen, just waiting for the time the doctors give us the okay to have a baby in the future. We did choose to register the embryos with the FDA for implantation back into myself or into a surrogate. At least that way their usage cannot be restricted in the future. Dr. Evans states that if you only register for the embryos to be implanted into yourself and something happens and the doctors do not want you(me) to be pregnant, you would NOT be able to this point to implant them into a surrogate. Sounds crazy, but rules are rules. So we chose both options.
So hopefully in about 2 1/2 weeks from now, we will have frozen embryos on the shelf and I will be starting chemotherapy soon. The only thing in between is getting blood work done (Clayton & I) for the preservation procedure, getting my flu shot before chemo starts, having the port-a-cath inserted into my chest, have the BRCA test done, and buy that deoderant. The BRCA, breast cancer gene test, is a blood test to check for specific changes (mutations) in genes that will help control normal cell growth. For a person with breast cancer, like myself, results from a BRCA gene test can help other family members know their chances of breast cancer. Oh yeah, I am also having a cyst-type something removed from by face tomorrow by a dermatologist Dr. Kay. He will remove and biopsy it in his office and sent it out for a pathology report. The suspect is skin cancer, but hopefully not. I am tired of that word, but I also want to be healthy and live a long time, so it is okay. And, I am establishing myself with a new primary care physician, Dr. Susie Lau. My previous PCP physician was not an internal medicine doctore which is what I need now. This appointment is Thursday, October 4, 2007, the day after the facial skin biopsy. Wish me luck!!
Thursday, Ocotber 4, 2007
I had the biopsy performed yesterday and it was easy. They shaved off the area and are sending it to the lab for examination. I have to wait 2 weeks for the pathology report. But, today, I am a little stressed. I have done a lot of leg-work on getting as much as I can covered by my insurance company. I thought that things were going well with the egg preservation procedure when I spoke with my human resources representative and with my insurance company last week. The visit with the fertility specialist was covered and she reassured me that everything would be okay and not to worry about the financial aspects. She told her office would do everything they could do get the medications for me for free. I had already spoke with HR who stated that everything related to my breast cancer diagnosis would be covered by insurance. However, I recevied an email from Dr. Evans today which sent me into a state of panic because she stated she needed a copy of my insurance card emailed to her because she did not see any information regarding insurance in my account. It had almost been a week since my visit, and nothing has been done regarding pre-certification for my procedure, this made me nervous. First because chemotherapy is on hold while we complete this process and second because I had already submitted this information to them and it had not been noticed until a week later that it was not there. Yikes!! Also, in the email she stated that she would call my insurance company to see what is covered in regards to infertility. I AM NOT INFERTILE, I HAVE BREAST CANCER! I called the billing office at Dr. Evans office and explained all of this toJacki. She did somehow then be able to find my insurance information in my record from when I gave it to them. She then explained that she would call my insurance company to get my overall coverage for out-patient surgeries and infertility coverage. It still does not seem that she understands that I am not infertile, but what can I do, it seems like just wait it out. What!?! I am Jennifer Bailey. I have a really hard time waiting it out, so, I have put a call into Claims Central of my insurance company in order to find out personally what exactly my coverage is and have it given to me rather than a third party. I am now waiting on their return phone call.
Also today I went to establish myself with a new PCP, Dr. Susie Lau. The visit went great and I felt very confident in regards with her ability to appropriately manage my case. She is very compassionate and respectful. She did state that after chemo radiation, I should have a bone scan before starting the hormone therapy. I made a note of this in my calender. Also, today Clayton and I got all of our blood work done for the egg preservation procedure that was ordered by Dr. Evans. Yeah! One less thing to think about. The only thing that Clayton has left to do is to give a sperm sample next week in Dr. Evans office in Pasadena.
Friday, October 5, 2997
Today I received a call from Dr. Evans office and spoke with Nancy, the financial counselor for my case. She stated that she would place another call to the insurance company today to see what all of my benefits are since the first call inquired about my fertility benefits, which as I said before, I am not INFERTILE. She put my anxiety to rest. She stated that she would call me back Monday or Tuesday. So now I can relax and enjoy my weekend. I think the only thing I have scheduled for next week so far is my port-a-cath insertion surgery scheduled for Friday, October 12, 2007.
Last week on Thurday I went to see Josephine in the infusion clinic. She took a look at my veins and stated that she recommended for me to have a port-a-cath. She stated that the chemotherapy medications are strong and can be uncomfortable going in. She told me to check with Dr. Zhang to set up a time to have this performed. I went by the office and the nurse told me she would refer me back to Dr. Shirazi, my surgeon, for the port-a-cath placement. When I called her office, Roberta told me to let her know what date I would be starting chemo and she would arrange for placement of the cath about 1 week before. Yeah!! I will not have to be stuck each time they need blood from me or when I need to receive my chemotherapy. This was good news.
On the same day, September 27, 2007, I also went to see my OBGYN. This office visit was to check on the status of my IUD, to make sure everything was going okay with me, and to discuss fertility issues. My IUD was fine with no follow-up needed until my yearly exam in March. As far as the fertility issues, he referred me to Dr. Michelle Evans, a fertility specialist at Huntington Reporductive Center in Pasadena. I did attempt to ask him general questions regarding my possiblities, but he deferred answering and reassured me that Dr. Evans would answer all of my questions. He had already spoke to Dr. Evans regarding my case and she was awaiting my call. I did however ask him if the egg preservation or other options would be covered by my insurance, he stated he did not know, but that I should contact the Human Resources Department at the hospital where I work and ask the benefits specialist. I was please with my visit with Dr. Spencer-Smith and scheduled my follow-up with him for March of 2008.
After leaving his office I immediately began researching my financial options. I made several calls to my insurance company and left messages as well as calling the benefits specialist, Marci. She told me that anything concerning my treatment associated with breast cancer should be covered. She helped my anxiety, but I really wanted to hear the same information from my insurance company since they are the ones that pay the bills. Between myself and Dr. Spences-Smith's office, we FINALLY got the insurance approval for me to see Dr. Evans. It sounds easy, but involved many tears and multiple phone calls, but the perseverance paid off.
Dr. Evans is a wonderful person. I went to see her on Friday, September 28, 2007. She took me into her office and went over my current and past medical history including my husband's medical history. She described my options but highly recommended one over the others (taking Lupron, egg freezing, and a couple bad ideas). Her recommendation was Cryopreservation (embryo freezing). The outcomes from this method are the best and the freezing procedure has stood the test of time. She had one patient who delivered healthy baby with an embryo that had been frozen for 17 years!!! The procedure will be customized since we have limited time for harvesting so that I can start my chemotherapy in the recommended window determined by my oncologist. She paged my oncologist, Dr. Zhang, and he immediately called her back and gave her the green light; but, I have to start chemotherapy immediately after the harvesting procedure. This was such a relief!! It finally felt like I had an all inclusive plan covering all aspects of my treatment process. As far as the procedure, on the day of my period, I am to call her office, on day 3 they start me on a drug to do something (I think to overstimulate my follicles) and then I think 12 days later, I will go into her office, receive sedation, and she will extract as many eggs from me that she can using a needle. She hopes to be able to extract around 10-11 eggs. These will then be combined with Clayton's sperm by using one of two methods, but I do not remember all the details honestly. These embryos will then be frozen, just waiting for the time the doctors give us the okay to have a baby in the future. We did choose to register the embryos with the FDA for implantation back into myself or into a surrogate. At least that way their usage cannot be restricted in the future. Dr. Evans states that if you only register for the embryos to be implanted into yourself and something happens and the doctors do not want you(me) to be pregnant, you would NOT be able to this point to implant them into a surrogate. Sounds crazy, but rules are rules. So we chose both options.
So hopefully in about 2 1/2 weeks from now, we will have frozen embryos on the shelf and I will be starting chemotherapy soon. The only thing in between is getting blood work done (Clayton & I) for the preservation procedure, getting my flu shot before chemo starts, having the port-a-cath inserted into my chest, have the BRCA test done, and buy that deoderant. The BRCA, breast cancer gene test, is a blood test to check for specific changes (mutations) in genes that will help control normal cell growth. For a person with breast cancer, like myself, results from a BRCA gene test can help other family members know their chances of breast cancer. Oh yeah, I am also having a cyst-type something removed from by face tomorrow by a dermatologist Dr. Kay. He will remove and biopsy it in his office and sent it out for a pathology report. The suspect is skin cancer, but hopefully not. I am tired of that word, but I also want to be healthy and live a long time, so it is okay. And, I am establishing myself with a new primary care physician, Dr. Susie Lau. My previous PCP physician was not an internal medicine doctore which is what I need now. This appointment is Thursday, October 4, 2007, the day after the facial skin biopsy. Wish me luck!!Thursday, Ocotber 4, 2007
I had the biopsy performed yesterday and it was easy. They shaved off the area and are sending it to the lab for examination. I have to wait 2 weeks for the pathology report. But, today, I am a little stressed. I have done a lot of leg-work on getting as much as I can covered by my insurance company. I thought that things were going well with the egg preservation procedure when I spoke with my human resources representative and with my insurance company last week. The visit with the fertility specialist was covered and she reassured me that everything would be okay and not to worry about the financial aspects. She told her office would do everything they could do get the medications for me for free. I had already spoke with HR who stated that everything related to my breast cancer diagnosis would be covered by insurance. However, I recevied an email from Dr. Evans today which sent me into a state of panic because she stated she needed a copy of my insurance card emailed to her because she did not see any information regarding insurance in my account. It had almost been a week since my visit, and nothing has been done regarding pre-certification for my procedure, this made me nervous. First because chemotherapy is on hold while we complete this process and second because I had already submitted this information to them and it had not been noticed until a week later that it was not there. Yikes!! Also, in the email she stated that she would call my insurance company to see what is covered in regards to infertility. I AM NOT INFERTILE, I HAVE BREAST CANCER! I called the billing office at Dr. Evans office and explained all of this toJacki. She did somehow then be able to find my insurance information in my record from when I gave it to them. She then explained that she would call my insurance company to get my overall coverage for out-patient surgeries and infertility coverage. It still does not seem that she understands that I am not infertile, but what can I do, it seems like just wait it out. What!?! I am Jennifer Bailey. I have a really hard time waiting it out, so, I have put a call into Claims Central of my insurance company in order to find out personally what exactly my coverage is and have it given to me rather than a third party. I am now waiting on their return phone call.
Also today I went to establish myself with a new PCP, Dr. Susie Lau. The visit went great and I felt very confident in regards with her ability to appropriately manage my case. She is very compassionate and respectful. She did state that after chemo radiation, I should have a bone scan before starting the hormone therapy. I made a note of this in my calender. Also, today Clayton and I got all of our blood work done for the egg preservation procedure that was ordered by Dr. Evans. Yeah! One less thing to think about. The only thing that Clayton has left to do is to give a sperm sample next week in Dr. Evans office in Pasadena.
Friday, October 5, 2997
Today I received a call from Dr. Evans office and spoke with Nancy, the financial counselor for my case. She stated that she would place another call to the insurance company today to see what all of my benefits are since the first call inquired about my fertility benefits, which as I said before, I am not INFERTILE. She put my anxiety to rest. She stated that she would call me back Monday or Tuesday. So now I can relax and enjoy my weekend. I think the only thing I have scheduled for next week so far is my port-a-cath insertion surgery scheduled for Friday, October 12, 2007.
Tuesday, September 25, 2007
Ch. 7 - Preparing for Treatment
Ch. 7 - Preparing for Treatment
Date of entry: Tuesday, September 25, 2007
Recovery continues to go well. Thank you to you all for all of your continued support. I appreciate everything and will continue to need your thoughts and prayers. The past few weeks have gone really well. I returned to work on September 18, 2007. It felt good to be back at work, but a little weird too. It was like I had been gone forever. On the second day I returned, the Rehabilitation Department gave me a surprise breakfast. It was so nice to have all of my immediate co-workers around me and giving me such good food and warm wishes. I also had some patients that were still in the hospital from before my surgery. They were also glad to have me back as well. It was strange receiving encouragement and support from the very people that are normally on the receiving end. Although strange, it made me feel very special. It reminded me to always go above and beyond to make people feel special each and every day. We never know what burdens someone may be carrying around.
At this point it would seem that returning to work would be one of my biggest challenges, but it has been really easy. I have occasional discomfort in my right axilla, but it does not bother me all the time. My strength is good, but I do tire a little more easily than I am accustomed. The tough part has been keeping up with work on top of my busy physician schedule and cancer related activities. I returned to work on a Tuesday. Every day that went by I reminded my husband, Clayton, of my upcoming appointments. Friday was a big day for me. I had my first appointment scheduled with the radiation oncologist, Dr. Ana Grace. When Friday finally arrived, Clayton and I had it all worked out, i.e. when and where to meet to walk into the physician's office together (her office is located at the hospital that I work). Clayton was on his way and I decided to go ahead to her office in order to meet him there. Upon arriving, I did notice that the office was a little quiet, but there were two ladies sitting in the office. I asked them for the sign in sheet. In return they asked me if I had an appointment, etc..... Long story short, I had written the appointment date down on the wrong day in my day planner. My appointment was yesterday, and I had MISSED IT! I was in shock. Inside I am thinking, how could I have done this to myself!?! I was so very disappointed. Without even thinking, tears started to roll down my face. I was speechless. I explained to them how important this visit was to me. Of course they tried to get me to relax and realize that it was not the end of the world, but for some reason, it sure felt like it!! After continuing to have tears roll, they gave me a new appointment for Monday. I would see her at 11:00 am. I attempted to compose myself and told them thank you. I then proceeded to call Clayton on his cell phone to let him know not to walk into the office. When he did not answer and I got his voice message, I really began to cry. I told him in the message what had happened and that I did not know why I was so upset, but I was really upset. I hung up, and he called me right back, he was in front of the hospital. I did not even talk to him through the phone because he was close now and I just hung up and sobbed in his arms. He calmed me down after a little while, and now... I can laugh about it. Thank goodness!!! It is really crazy how much my emotions have been all over the place at times during this challenge with cancer.
On Monday, September 24, 2007, I had two doctor appointments. At 9:00 am I saw Dr. Zhang, the oncologist who will be determining my chemotherapy course. He gave us good news. I will only have to have chemotherapy for 3 months instead of the anticipated 6 months. I will have four cycles, one treatment every 3 weeks. The drug combination he will use is Taxotere & Cytoxan. All the normal chemo drug side effects apply, but he reminded me that everyone reacts differently. With Taxotere the common side effects include neutropenia, leudopenia, anemia, hair loss, fluid retention, mouth sores, weakness, and nerve pain or unusual burning or tingling sensations. Other common side effects of taxotere include low platelets in the blood, diarrhea, nail changes, muscle pain, vomiting, and joint pain. The common side effects associated with Cytoxan include hair loss, vomiting, diarrhea, mouth sores, sterility, and jaundice. For the nausea he provided me with 2 prescriptions for anti-nausea medicine including Decadron & Zofran. Both of which I have already had filled. He stated that chemo could start at any time, just to let him know when I am ready. The only reason for the delay is that I have an appointment with my OBGYN regarding harvesting of my eggs and other fertility issues on Thursday, September 27, 2007. Dr. Zhang also mentioned that I may need a port-a-cath so that I do have not to be poked so many times during the chemo process. This sounds good to me. I just have to follow-up with the infusion nurse sometime later in the week. Also during this visit, he explained that after the 3 months of chemo, I would follow with 6 weeks of radiation, and THEN 5 years of hormonal therapy. The hormonal therapy will be in pill form and the name of the drug is Tamozifen. This was the first I had heard of this being in my treatment course, but whatever it takes is fine with me.
After leaving Dr. Zhang's office, Clayton and I headed to see Dr. Ana Grace for the radiation visit. She explained radiation in general and stated that my radiation would be for 6 weeks to the right breast only. She will be treating the entire breast with the radiation. The treatment will be daily (Monday - Friday) for 33 visits, totaling 6 weeks. When I arrive for my first visit and they do the alignment for the radiation machine, they will tattoo me to ensure proper alignment each and every time. The tattoos will be 3 small (freckle sized) blue dots. I though this would be kind of cute, like a conversation piece later in life, although only Clayton will be seeing them, it put a smile on my face. I had no idea that radiation oncologist were also tattoo artist.!?! She stated that after about 3 weeks, my skin would begin to appear like a sunburn. When this happens, she has a cream that she prescribes to aid in healing and reducing discomfort. She also stated that during radiation I cannot wear deodorant under the right arm. And overall during this time she recommended for me to purchase a metal-free deodorant from Trader Joe's (I have not purchased this yet). Each treatment should only take about 20 minutes. She gave me a booklet covering all the aspects of radiation in general and encouraged me to read in before radiation begins. She gave me an appointment for December and stated that the radiation should begin sometime at the first of the year, after completion of the chemotherapy.
All in all, I think that is everything that I know up until this point. I have two more appointments ahead of me this week, one with my OBGYN regarding fertility issues and the other is with Josephine to set up the date to have the port-a-cath inserted, if she feels this is necessary (I hope I get to have one, it should make life much easier during chemo).
Date of entry: Wednesday, September 26, 2007
This morning I went to see Josephine in the infusion center to check my veins. She said that my veins are small and would recommend a port-a-cath to be inserted. With that information, I went to Dr. Zhang's office to let him know what she said. He will therefore order for the port-a-cath insertion. This will be done by Dr. Shirazi, my surgeon. Her office will call me to set up an appointment to see her in her office and then she will schedule the out-patient surgical procedure after the visit, upon insurance verification and approval. I also did some research regarding fertility issues and feel more prepared for my visit with Dr. Spencer-Smith tomorrow.
Wednesday, September 19, 2007
Ch. 6 - The Pathology Report
WHITE MEMORIAL MEDICAL CENTER
DEPARTMENT OF PATHOLOGY Location: 4511
1720 Cesar E. Chavez Avenue Patient Name: BAILEY, JENNIFER
Los Angeles, CA 90033 Date of Birth:
Telephone: (323) 268-5000 Sex: F
Attending Phys: Shirazi, Sherin K MD
Attending Phys: Shirazi, Sherin K MD
PATHOLOGISTS/DIRECTORS Collection Date: 24AUG07
M. Cosgrove, MD K.U. LEe, MD Received Date: 27AUG07
G.E. Dalgleish, MD D. Sahmedini, MD
G.E. Dalgleish, MD D. Sahmedini, MD
J.B. Harris, MD C. Seneviratne, MD
D.V. Kon, MD
SURGICAL PATHOLOGY FINAL
SOURCE OF TISSUE:
1. RIGHT BREAST SENTINEL NODE
2. RIGHT SENTINEL NODE
3. RIGHT BREAST MASS
4. RIGHT BREAST ADDITIONAL TISSUE
CLINICAL INFORMATION:
Rt. breast mass
INTRAOPERATIVE CONSULTATION:
1RFS: NEGATIVE FOR METASTASIS.
2RFS: NEGATIVE FOR METASTASIS
3RFS: INFLTRATING CARCINOMA
4RFS: NEGATIVE FOR METASTASIS
GROSS EXAMINATION:
1. The specimen is received fresh for frozen section labeled "rt. breast sentinel node" and consists of a 2 x 1.5 cm. portion of fibroadipose tissue containing a single node. A representative section of this node is submitted in 1RFS; the rest of the node is sectioned and submitted entirely in 1A and 1B.
2. The specimen is received frest for frozed section labeled "rt. breast sentinel node" and consists of a 1 x 0.6 x 0.4 cm. tan/yellow node. Submitted entirely in 2RFS for frozen section.
3. The speciment is received fresh labeled "rt. breast mass" and consists of a 5.5 x 4 x 3 cm. portion of fibroadipose tissue with dense stroma. A short suture is tied to the "superior" margin, and double long suture is seen at the "lateral" margin. Dense white stroma extends to all of the margins. A distinct mass is not grossly identified; however, indistinct induration involving an approximate 0.8 cm. area is seen approximately 1 cm. from the deep margin and 0.8 cm from the inferior margin. This area of induration is 1.5 cm from the cuperior and lateral margins and 1 cm from the medial margin. Representative sections of the frozen sepcimen are labeled 3RFSA and 3RFSB; additional representative sections submitted in 3A-3H.
CASSETTE SUMMARY
3A, 3B - inferior margin
3C - area of induration, deep and inferior margin
3D - deep margin
3D - superior margin
GROSS EXAMINATION:
3F - superficial margin
3G - medial margin
3H - lateral margin
4. The specimen is received frest for frozen section labeled "rt. breast mass" and consists of a 3.8 x 1.5 x 1 cm. portion of fibroadipose tissue with a suture attached. The area of this suture is dyed black. The rest of the specimen is not linked. A representative section is in cassette 4FS for frozen section. Dense white stroma is seen through approximately half of the specimen. Representative sections are submitted in cassettes 4RFSA-4RFSC.
MICROSCOPIC DESCRIPTION:
1. Multiple sections show a benign lymph node with focal sinus histiocytosis and focal fatty infiltration. No evidence of malignancy is seen.
2. Multiple sections of the entire specimen show fibroadipose tissue with no evidence of lymph node.
3. The frozen section shows a somewhat ill-defined infiltrating malignant neoplasm measuring 0.9 x 0.6 cm. This area is infiltrated by small and partially spindling malignant neoplastic cells in the dense fibrous tissue. At the peripheral portion of the invasive duct carcinoma are multiple dilated ducts showing intraductal carcinoma, small cell type, with occasional centrol necrosis. Tumor cells are basically small in size with occasional focal areas of spindling transformation. No evidence of tubule formation is seen. Tumor cells show very few mitotic activities. Multiple sections from different areas of the specimen show no evidence of residual infiltrating duct carcinoma. All the sections show fibrocystic changes with occasional sclerosing adenosis.
4. Multiple representative sections and frozen section show benign breast tissue with focal areas of old hemorrhage, fibrosis and lymphocytic infiltrates. No evidence of malignancy is seen.
DIAGNOSIS:
1. BENIGN LYMPH NODE (1) - RIGHT BREAST SENTINEL NODE
2. FIBROADIPOSE TISSUE WITH NO EVIDENCE OF LYMPH NODE - SPECIMEN LABELED AS "RIGHT SENTINEL NODE".
3. INFILTRATIN DUCT CARCINOMA, MODERATELY DIFFERENTIATED;
NOTTINGHAM HISTOLOGIC SCORE (6) WITH TUBULE FORMATION (3), NUCLEAR
PLEOMORPHISM (2) AND MITOTIC COUNT (1).
SIZE: 0.9 X 0.6 CM.
FREE RESECTIONS MARGINS.
ABSENT VENOUS/LYMPHATIC INVASION.
MICROCALCIFICATIONS NOT IDENTIFIED.
DUCT CARCINOMA IN-SITU, INTERMEDIATE NUCLEAR GRADE (NG2)
4. BENIGN BREAST TISSUE - RT BREAST ADDITIONAL TISSUE
Cancer Shecklist Summary: Breast
SPECIMEN TYPE:
_x__ Excision
___ Mastectomy
___ Other (specify): _____
___ Not specified
LYMPH NODE SAMPLING:
___ No lymph node sampling
_x_ Sentinel lymph node(s) only
___ Sentinel lymph node with auxillary dissection
___ Axillary dissection
SPECIMEN SIZE (for excisions less than total mastectomy)
Greast dimension: 5.5 cm
*Additional dimensions: 4.0 x 3.0 cm
___ Cannot be determined (see comment)
LATERALITY
_x__ Right
___ Left
___ Not specified
TUMOR SITE (check all that apply)
___ upper outer quadrant
___ lower outer quadrant
___ upper inner quadrant
___ lower inner quadrant
DIAGNOSIS:
___ Central
_x_ Not specified
MICROSCOPIC
SIZE OF INVASIVE COMPONENT
Greatest dimension: 0.9 cm
*Additional dimensions: 0.6 x __ cm
___ Cannot be determined (see comment)
HISTOLOGIC TYPE(S) (check all that apply)
___ Noninvasive carcinoma (NOS)
_x_ Ductal carcinoma in situ
___ Loular carcinoma in situ
___ Paget disease without invasive carcinoma
___ Invasive carcinoma (NOS)
_x_ Invasive ductal carcinoma
___ Invasive ductal carcinoma with an extensive intraductal component
___ Invasive ductal carcinoma with Paget disease
___ Invasive lobular
___ Nucinous
___ Meduliary
___ Other (s) (specify): __
___ Carcinoma, type cannot be determined
HISTOLOGIC GRADE (One grading system required)
Nottingham Histologic Score
* Tubule formation:
* ___ Majority of tumor greater than 75% (score = 1)
* ___ Moderate 10% to 75% (score = 2)
* _x_ Minimal less than 10% (score = 3)
* Nuclear pleomorphism:
* ___ Small regular nuclei (score = 1)
* _x_ Moderate increase in size, etc (score = 2)
* ___ Marked variation in size, nucleoli, chromatin clumping, etc (score = 3)
Mitotic count:
For a 25X objective with a field area of 0.264 mm 2
___ Less than 10 mitoses per 10 HPF (score = 1)
___ 10 to 20 mitoses per 10 HPF (score = 2)
___ Greater than 20 mitoses per HPF (score = 3)
or
For a 40x objective with a field area of 0.152 mm 2
_x_ 0 to 5 mitoses per 10 HPF (score = 1)
___ 6 to 10 mitoses per 10 HPF (score = 2)
___ Greater than 10 mitoses per 10 HPF (score = 3)
Total Nottingham Score:
___Grade I: 3-5 points
_x_ Grade II: 6-7 points
___ Grade III: 8-9 points
___ Score cannot be determined
EXTENT OF INVASION
PRIMARY TUMOR (pT)
___ pTX: Cannot be assessed
___ pTO: No evidence of primary tumor
___ pTis: Ductal carcinoma in situ
___ pTis: Lobular carcinoma in situ
___ pTis: Paget disease without invasive carcinoma
_x_ pT1: Tumor 2.0 cm or less in greast dimension
___ pT1mic: Microinvasion 0.1 cm or less in greastest dimension
___ pT1a: Tumor more than 0.1 cm but not more than 0.5 cm in greatest dimension
___ pT1b: Tumor more than 0.5 cm but not more than 1.0 cm in greatest dimension
___ pT1c: Tumor more than 1.0 cm but not more than 2.0 cm in greatest dimension
___ pT2: Tumor more than 2.0 cm but not more than 5.0 cm in greatest dimension
___ pT3: Tumor more than 5.0 cm in greatest dimension
___ pT4: Tumor of any size with direct extension to chest wall or skin, but only as described below #.
___ pT4a: Extension to chest wall, not including pectoralis muscle
___ pT4b: Edema (including peau d'orange) or ulceration of the skin of the breast or satellite skin nodules confined to the same breast
___ pT4c: Both T4a and T4b
___ pT4d: Inflammatory carcinoma
# Clinical information may be required to designate a tumor as pT4. Dermal invasion alone (without ulceration, satellie nodules, or inflammatory breast cancer) does not alter T category. Such cases are classified as T1, T2, or T3, depending on tumor size.
DIAGNOSIS:
REGIONAL LYMPH NODES (pN)
(Choose a category based on data supplied with specimen. Immunocytochemistry and molecular studies are not required.)
___ pNX: Cannot be assessed (previously removed or not removed for pathologic study)
___ X pNO(i-): No regional lymph node metastasis histolotically (ie, none greater than 0.2 mm), no additional examination for isolated tumor cells
___ pNO(i+): No regional lymph node metastasis histologically, positive IHC, no IHC cluster greater than 0.2 mm
___ pNO(mol-): No lymph node metastasis histologically, negative moelcular findings
___ pN1mi: Micrometastasis (greater than 0.2 mm, none greater than 0.2 mm)
___ pN1mi(+): Micrometastasis detected only by IHC
___ pN1a: Metastasis in 1 to 3 axillary lymph nodes (at least 1 tumor deposit greater than 2.;0 mm)
___ pN1b: Metastasis in internal mammary lymph nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent
___ pN1c: Metastasis in 1 to 3 axillary lymph nodes and in internal mammary nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent
___ pN2a: Metastasis in 4 to 9 axillary lymph nodes (at least 1 tumor deposit greater than 2.0 mm)
___ pN2b: Metastasis in clinically apparent internal mammary lymph nodes in the absence of axillary lymph node metastases
___ pN3a: Metastasis in 10 or more axillary lymph nodes (atleast 1 tumor deposit greater than 2.0 mm), or metastasis to the infraclavicluar lymph nodes
___ pN3b: Metastasis in clinically apparent ipsilateral internal mammary lymph nodes in the presence of 1 or more positive axillary lymph nodes; or in more than 3 axillary lymphs and in internal mammary lymph nodes with microscopic disease detected by sentinel lymph node dissection but not clinically apparent
___ pN3c: Metastasis in ipsilateral supraclavicular lymph nodes
Specify: Number examined: __
Number involved: __
DISTANT METASTASIS (M)
___ pMX: Cannot be assessed
___ pM1: Distant metastasis
* Specify site(s), if known: __
MARGINS (check all that apply)
___ Margins cannot be assessed
_x_ Margins uninvolved by invasive carcinoma
Distance from closest margin: 10 mm
* Specity which margin: posterior
_x_ Margins uninvolved by DCIS (if present)
Distance from closest margin: 10 mm
* Specify which margin: posterior
___ Margin(s) involved by invasive carcinoma
Specify which margin: __
___ Margin(s) involved by DCIS
Specify which margin: __
* Extent of margin involvement for DCIS
* ___ Cannot be assessed
* ___ Uniforcal
* ___ Multifocal
* ___ Extensive
* ___ Other (specify): __
* VENOUS/LYMPHATIC (LARGE/SMALL VESSEL) INVASION (V/L)
* _x_ Absent
* ___ Present
* ___ Indeterminate
* MICROCALCIFICATIONS (check all that apply)
* _x__ Not identifiey
* ___ Present in DCIS
* ___ Present in invasive carcinoma
* ___ Present in nonneoplastic tissue
* ___ Present in both tumor and nonneoplastic tissue
* COMMENT(S)
FIXATION: 10% neutral buffered formalin X
Other (specify)__
DIAGOSIS:
Fixation time: 6-48 hours X other (specify)
___ unknown __
Breast Prognostic Panel:
ER/PR Ordered Yes _ No _
Complete panel ordered (ER,PR, Her2) Yes x No _
In not ordered, state reason: __
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