Sunday, January 31, 2010

A Few more details...

In the last entry, I spoke a little about the treatments that my Dr. and I have agreed on.
However, because of my need for re-grouping and tea, I didn't have a chance to mention a few other options that we had discussed. Here goes...

For those of you who are wondering if I will be forced to undergo any more chemotherapy, I can't give you an honest answer yet. I've got my fingers firmly crossed in the hopes it doesn't come to that.
The only way that I will be undergoing more chemo, is if the oncologist find that my cancer has spread elsewhere.
Just for a little background knowledge, the most common sites of metastasis include bone, liver, lung and brain.
Chemotherapy will not help kill the cancer tumors already in my brain because it can not cross the blood brain barrier. The cells here restrict the movement of objects in and out of the brain, for our own safety. No doubt, this includes chemicals such as chemotherapy which would otherwise destroy the healthy tissue in our brains.

In London over the next two weeks, I will be undergoing a battery of testing, including two more CT scans (abdomen & chest), an MRI, and a bone scan. If it has metastasized beyond my brain, the results of these tests will help us with a specific course of action for treatment. Although it is on my mind, I'm staying positive about this thought. Nothing can be done until the results are in, and I have enough to think about as of this moment.

As far as additional treatments for the brain mets (which is far easier to type, so out of laziness, will hereby referred to as such), my radiation oncologist and I also spoke about neurosurgery and radiosurgery.
Before my visit, Dr. Read had already contacted a neurosurgeon to gather his input on how effective surgery would be at this point. His response was understandable. At this point, there is no real reason for surgery. Opening up the cranial cavity and poking and prodding around to remove things is generally a pretty scary thing to do. If any tiny thing goes wrong, I could be left off far worse than I started. I would like to keep my senses about me for as long as I personally can. He did say that if the tumors become too large, and they are severely impacting my ability to function normally, then surgery is definitely and option.
As far as radiosurgery, that is also a possible treatment option for the future. Dr. Read informed me that should this treatment not work the way that we are hoping, then she will be more than willing to refer me to one of the few centers in Canada that utilize this form of treatment.
I'm not about to bore everyone with the details, but I found the link below quite beneficial in explaining what it is all about.

The side effects from the radiation that I will be undergoing could possibly include swelling of the brain, headaches, nausea and vomiting and hair loss. I know its silly, but I am really kind of bummed about that last one. I mean, I JUST grew my hair back in. JUST. So weak.
Oh yeah, and possible memory loss... as if i don't have problems with that one anyway :)

On Friday, I was visited by my home care nurse. I am lucky enough to have the same nurse I had follow me through my treatments last time. She is absolutely wonderful.
We were able to speak at pretty great lengths about what is going on and what steps I need to be taking to keep myself on the right track. She suggested that I start meeting with a palliative care physician as soon as possible so we can help reduce any pain and discomfort that I have to increase my quality of life.
Palliative is not a word that I though I would ever have to hear, and it kind of hit my like a sack of rocks in the gut when she said it. Regardless, I believe that it is the right decision for me at this point, if even just to help me get my head around what is going on.
I've aso been referred to a social worker who spends quite a bit of time dealing with people that find themselves in situations similar to my own.
Lastly, she gave me a little piece of advice. She told me that this beast isn't going away. It lives in my home and occupies the same space that I do, but I need to focus on shoving it into the closet and getting on with my life as best as I possibly can. I need to give the the respect it deserves, which is non whatsoever. It may be here, but I'm not giving up my fight.
In accordance with this, my Dexamethasone(steroids) was served with cake this morning. It felt pretty darn good :)

Saturday, January 30, 2010

The latest news...

My whole life I've had my plans all set out. I knew that I was going to go to university. Always had a good idea where I was going to live. Where I was going to end up... that sort of thing. I knew that one day, I'd join a profession that would help me to reach out to others and make a difference. I've always been a real stickler for my plans. However, I'd like to think that I also maintain the ability to adapt to different circumstances. For example when I up and moved to Calgary... and Korea. When I was diagnosed, it kind of put a hold on all of the plans that I had in the works. I had planned to work for a few more months and travel around southeast asia with my friend Asia. Needless to say, it didn't pan out quiet as planned. I was able to work an additional week, and with the help of a few friends, buy my plane ticket back to Petrolia, Canada, where I am still residing with my parents.

Over the past year of treatments, I had time to make some more plans. I am working for the Red Cross, going to school to become a personal support worker. I am also, as I mentioned before, working part time at the Mall in Sarnia (30 mins from my house) and volunteering at the hospital in Sarnia as well. Things have been going really quite well. Up to this point I've received exceptional marks in my classes and actually feel like life was on its way to getting back to normal. I recently sent in part 1 of a two part application to the University of Toronto for Nursing school which begins in September.

This is where life threw me another curve ball. As I'm sure you read from my last post, the cancer was tougher than I gave it credit for. While I was making other plans, it snuck its way up into my brain and decided to take up residency.

On Thursday, I was able to have an emergency appointment with my radiation oncologist in London, ON. This is where I had all of my chemo and radiation after my initial diagnosis. I knew by the glum look on her face that she was not looking forward to imparting the knowledge that she was being forced to. It did still come as a bit of a surprise to me when she said " We can't cure this" and informed me that the treatment will be aimed at keeping the tumors small and retarding their (and others) growth as much as possible. In other words, they are trying to keep me alive as long as possible, with the best quality of life as possible... but It will eventually win out in the end.

Tough words to swallow. After telling me this, she did a physical exam to test for any weakness that might be starting to affect me from the tumors in the cerebellum. The good news is that she didn't detect any differences yet. I have been noticing a few slight differences, but nothing really to get too upset over.

The steroids that the Dr. put me on seem to be doing their job. I have very little pain in my head and neck anymore, which is a kind of small miracle in and of itself. They are hoping to start weening back the use of steroids when my treatments are underway. Apparently the dosage that they have me on is the strongest that one is allowed, and will start causing its own pretty significant side effects after about a month.

As far as the treatment goes, I will be undergoing 10 sessions of whole brain radiation in an attempt to shrink what is already growing. Ultimately, she would like for the two in my cerebral cortex to pretty much disappear and the two in my cerebellum to shrink right down to the point where they won't cause any impairment. I've got my fingers crossed for this outcome too. In addition to the whole brain radiation, they will be spending a little more time blasting the two larger tumors (1.7cm & 9mm) in my cerebellum with radiation. I was fitted for my face shield on Thursday (ew), so now they just need to clear the time for me on the machine. I anticipate starting late this week.

I know that there are other details that I need to add in here, but i'm kinda of worn out that the moment. Before I go, I want everyone to know that I will be completing the application to the University of Toronto. It is due on the 15th, and I do intend to be accepted. I'm not ready to die yet, I still have a lot of fight left in me, and I plan on living as full and normal of a life as I can. No one knows how long that is going to be.

I'm going to go have a hot cup of tea and try to re-group. I will post another blog in the very near future, to give out details that I may have forgotten and to tell you about the visit that I had with my home nurse and the suggestions that she had.

Thank you so much for the love and support that you al have been showing me.
You have no idea how much it has help at this very difficult time. You are all amazing.


Wednesday, January 27, 2010

Don't you give up on me...

Everything has been going really well here in my neck of the woods for the last few months. I was fortunate enough to be able to be surrounded by my family at Christmas, and then head off to California shortly after to see the sights and meet Adams extended family.
I've been attending the local college taking a PSW course to occupy my time and have been volunteering at the Hospital in Sarnia about 4 hours a week. In addition to that I managed to pick up a part time job at a local retail store, where I have been enjoying the company of some of the most amusing and hilarious staff members ever. They have been making the time pass much quicker and I know I will always have at least one really good laugh every shift.
I've make a few trip to London lately to visit my medical oncologist and radiation oncologist and they have been fairly successful, despite my complains of being unable to focus and some severe pain in my upper back.
Yesterday morning I made a trip into the ER, where luckily we were able to catch my GP to check me out. I've been dealing with some pretty severe headaches over the last 3 weeks and was kind of getting concerned as they weren't going away.
After checking me out, my GP sent me to Sarnia to have a CT scan done and then asked me to go back to his office after it was finished for the results.
"No problem" I think, a tiny bit upset because I knew that this would cause me to miss a shift at work.
After the CT, I returned to the Dr.s office in Petrolia.
Apparently, the news wasn't so good. They found several spots on the CT, and given my previous diagnoses, they concluded that my breast cancer had metastasized to my brain. I was able to get my paws on the report, and from what I was able to comprehend, the tumors are located in the cerebellum.
Clearly I should have taken the advice of my old pal Prof. Brudzynski and taken a few neuroscience credits in university. Hindsight is 20/20, eh?

For those of you with no knowledge of neuroscience (like me), I've posted the link to wikipedia :) enjoy.

For those of you who want the Coles notes version, this area is associated with motor control. It also has links to attention and language, and perhaps to emotional functions.

So... As of yesterday, I've been started on steroids to control the swelling in my brain. I will be speaking to my GP today regarding when I will be starting radiation therapy on my brain. I'm not even sure if they will be performing Whole brain radiation or radiosurgery or both.
I don't really know anything yet.

I promise to try to be better about updating you this time than I was last time.

Thanks Guys.
Love you. xoxo
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