Buh-bye Dark Cloud

Annual doctor’s appointment & blood work: Normal
Annual eye exam: Normal and now eligible for LASIK
Annual retinal scan: Normal—no signs of side effects from the Tamoxifen
6-month oncology check-up: Normal
6-month dentist appointment: Normal
3-month Pap: Normal

It’s been a LONG time since I have had normal test results. I don’t know what to do with myself. I guess I’ll finish my Masters, focus on getting stronger and healthier and plan my wedding.

It is nice not having a dark cloud following me around anymore.

This time, when I went to visit my oncologist, Dr. David Heyer, I took Matt with me. It was important to me that he meets Dr. Heyer; after all he is the man who saved my life. If Matt is going to marry me, I want him to understand that this will always be my reality. We can’t ignore it, or hide from it … we need to face it head on … together.

Dr. Heyer: “If this is completely out of line, please tell me.”
me: I smiled knowing exactly where Dr. Heyer was headed.
Dr. Heyer: “Do you two intend to have children?”
me: Without hesitation I replied, “Yes.”
Dr. Heyer: “Four years ago when all of this began I never thought it would be a possibility for you to get pregnant. I was certain that with the amount of chemo we were giving you that I would push you into menopause permanently.”
me: I interrupted, “Right, but I only missed three months and started right back again consistently every 28 days.”
Dr. Heyer: “I know, and it’s pretty remarkable, even unheard of. Now, in the past people worried that when a woman got pregnant that change in hormones could cause cancer to return. I am telling you that this assumption is NOT true. Getting pregnant will not give you cancer.”
me: “OK.”
Dr. Heyer: “Also, a woman with breast cancer WITHOUT lymph node involvement runs a risk of getting cancer later in life, so there would be a long gap between the first and second diagnosis. However, a woman with breast cancer WITH lymph node involvement, like yours, runs a risk of getting cancer within the first couple of years of remission. So, once we get you past a certain point, we shouldn’t need to worry as much. But you and I have decided it’s never coming back, right? We’re done with this.”
me: “Right.”
Dr. Heyer: “Jennifer, I see absolutely no reason why you can’t get pregnant. You have surprised me and beaten the odds on everything else. However, I want you to finish the Tamoxifen … it’s essential that you have a full 5 years.”
me: “I understand. So, how soon after I’m off the Tamoxifen can I start trying?”
Dr. Heyer: “That’s not really my area of expertise, so I’d defer to your Women’s Physician, but I’d say 3 months.”

6/18/2008: PETScan Results

"There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder," I read the PETscan results aloud to my mother as we stood outside my surgeon's office embracing the gorgeous sun for a moment. We looked at each other, both scared to say aloud what we were both thinking. Dear God, had the cancer spread?

My mom suggested I go talk to my surgeon about the test results. My stomach turned, my vision became blurry, my eyes swelled and I shook. I wanted to know what those words meant, however part of me could not bear hearing more bad news. I talked to Dr. Mason's assistant and she said that I could sit in the waiting area and Dr. Mason would be with me shortly. Sitting in the waiting area my heart raced with fear and panic. Do I have to have chemotherapy again? Will I spend the rest of my life fighting cancer? Am I going to die?

Dr. Mason entered the waiting room and said, "Everything looks great!" I jumped into attack mode. "What does that last line mean? What is FDG?" Dr. Mason smiled kindly and said, "Come on back, Dear." Dr. Mason ushered me into one of the examining rooms and I asked my questions again. I know Dr. Mason could see me shaking violently and my eyes swelling with tears. He said, "Everything looks great. I cannot remember what FDG stands for, but the G is glucose, which is sugar."

(Note: FDG stands for Fluorodeoxyglucose. When you have a PETscan they take your sugar level first, and then give you an injection of glucose. Cancer cells metabolize faster than normal cells, so the imagining can tell where the cancer cells are in the body.)

I said, "Does 'physiologic accumulation' mean that the cancer has spread." I couldn't believe I was able to actually craft the words. Dr. Mason looked at me with kind eyes, "I need you to take a deep breath and try and relax." He reached out touching my armpit, "Your cancer is all right here. It hasn't spread anywhere and I assure you that we will get it all. We're going to get it all, Dear" He repeated himself again in order for his words to resonate. I felt my body grow less tense. He told me that his only concern is the two lymph nodes still left in the armpit. However, they have shrunk and will be taken out during my mastectomy. I thanked Dr. Mason for being so wonderful and told him that I would see him on July 1 for surgery. "I expect your best work on surgery day," I joked as I walked through the door.

PETscan Findings
There is an abnormal enlarged left axillary lymph node with abnormal FDG metabolism and maximum SUV of 9.9. This mass is smaller than prior study. Smaller left axillary lymph node demonstrates a maximum SUV of 1.9. Left axillary seroma is smaller. Other axillary lymph nodes do not demonstrate abnormal FDG metabolism.

Previously seen left internal mammary chain lymph node is smaller and also demonstrates no abnormal FDG metabolism.

Left anterior 6th rib also no longer demonstrates abnormal FDG metabolism.

Findings are compatible with marked response to chemotherapy.

There is physiologic accumulation of FDG in the myocardium, liver, bowel and excretion tracer in the kidneys and urinary bladder

4/6/2008: The Baby Grape

I was washing my red grapes today and the tears ran down my dry, peeling cheeks … I cannot remember ever appreciating things in my life like I do now, or being this fulfilled and happy.

I had my Herceptin treatment today that I have every Friday. Earlier this week I had some upper respiratory problems, so prior to getting treatment, my nurse Jessi had to get approval from my oncologist, Dr. Heyer, to continue the Herceptin. The nurses checked my oxygen and listened to my chest. Everything was great … even my blood work. I was told the rustling in my chest was most likely allergies and that the show could go on.

Dad and I sat during treatment and shared our favorite recipes as we watched the Cooking Network. Today was a good day and I was just beaming about the meeting I had this morning, my interview with Hannah from the Gannetteer yesterday, dinner with Dan who just returned from Egypt, time spent with Drew and the other events from the week. I know it cannot be easy for my Daddy to watch his little girl go through all this, but he still manages to give me a smile when those beautiful green eyes swell. When he gets to that point he offers me a Frappuccino or Ginger Ale that he always seems to have stashed away for my treatments. That's Daddy's cure for all ... he knows that a Frappuccino is the key to my heart.

Dr. Heyer came to visit me during my treatment, which was a pleasant surprise. He asked about the respiratory issues and how I was coping with my third round of chemotherapy. We talked and joked for awhile and Dr. Heyer asked how my incision was from where I had the hockey puck-sized lymph node removed mid-January. I told him other than some toughness along the actual incision I felt nothing unusual. He said he wanted to do an exam of the area and my breast after treatment. He said if nothing was there he didn't see a reason to do midway testing. I started pouting and he told me I could talk him into anything. He agreed to an MRI this Wednesday at noon. YAY! This will tell us how well the chemotherapy is working. Keep your fingers and toes crossed for great results.

After my treatment I went back to an examination room and undressed for my exam. Dr. Heyer came in and the first thing he asked me was "How's Dad holding up?" (Are you trying to make me cry, Heyer? Sheesh.) He said, "It must be so hard for your parents. I couldn't imagine my baby going through this. (I was choking back the tears.) Dr. Heyer felt around my incision then looked at me. He said "I don't believe this. Your lymph nodes have completely shrunk and feel normal. I really don't believe you've improved this much already." I just beamed. I could not hide my excitement. He completed the breast exam and said "I am very, VERY pleased." He said in addition to my lymph nodes shrinking, my blood work, weight, side effects … everything has been just extraordinary. Typically, they have to adjust treatment and change regimens with patients, but I have just been a stellar patient. (Again, I think Milano cookies have something to do with it.) He did his usual threatening of taking away my BlackBerry during office visits and I joked back with him to just try. He's an amazing doctor.

I left Daddy with a hug and a kiss, went to the grocery store and came home. Washing my grapes I reflected on the day and how truly blessed I am. I got to the last grape in the bag … it was the baby. I giggled a little remembering growing up when Daddy would go grocery shopping on the weekends and come home and wash the grapes like I do now. He would yell for me to come into the kitchen. He would tell me that he had found a "Jennifer-sized grape" … the baby. He always saved them for me. The tears rolled down my face holding the Jennifer-sized grape in my hand and marveling at how much I love my friends and family and how truly blessed I am. Today was such a good day.