Radiation To Include My Arm

Dr. Sherman is going to speak with Dr. Carmello about including my arm in the radiation therapy. I guess that means that the area to be radiated will be enlarged to include my humerus....the part that had the cancer in it. I think this means that I will need to spend more time getting "mapped" out for the CT Scan at the radiation place. I wonder if that means I will need another appointment?

Aredia

Dr. Sherman is going to start me on Aredia on Friday morning. Aredia is a drug I will be getting through an IV to help strengthen my bones. It will take three hours to administer.

Aredia - Use and Side Effects Information

	What is the medication Aredia used for? What are Aredia' side effects? What happens with some types of cancer is that cells break away from the original tumor, travel through the bloodstream, and begin to grow somewhere else in the body. This process is called metastasis. In certain cancers such as breast, multiple myeloma, kidney or prostate cancers the bone is a common site for metastasis. The bone metastases secrete substances that can cause cells called osteoclasts to dissolve or "eat away" a portion of the bone. These lesions weaken the bone and can lead to complications. Some of the complications are bone pain, fractures, and less commonly, calcium levels in the blood can become dangerously high as a result of the bone breakdown. Aredia is one medication that fits into the class of medications called biphosphonates. Biphosphonate medications are used to slow down the osteoclast's effects on the bone. In doing this it can be useful in slowing down or preventing the complications (bone pain, fractures, or high calcium levels) of the bone breakdown. Biphosphonates may be given while a person is receiving other chemotherapy to treat cancer, or it may be given alone to treat high calcium levels, or bone pain. Aredia side effects: Some of the more common side effects that have been reported in studies of patients taking Aredia were; fatigue, fever, nausea, vomiting, anemia and skeletal pain. However it is thought that some of these reported side effects of Aredia may be due to other treatments patients were on or the cancer itself. Sometimes patients reported muscle and joint pains within 1 to 3 days after the second or third treatment of Aredia. The doctor may recommend a mild pain reliever that may help prevent or relieve these symptoms. Aredia is cleared from the body through the kidneys. Even if a person's kidneys are not working properly, studies show that changes in the dosage of Aredia should not be necessary. However, Aredia has not been studied in many patients with severe kidney problems.

BBQ

My birthday is coming up on Thursday so Mark and I are going to have a BBQ at my house on Sunday evening.

1. To celebrate the end of chemotherapy
2. To celebrate the beginning of the last phase of my treatment (radiation)
3. To celebrate that I am turning 40

Come on by!

Bad Day Yesterday

I had a bad day yesterday. I feel like they've all been headed in that direction. I feel so useless. I have a difficult time walking. I waited all day for Mark to come home yesterday. What a way to spend the day. It must be so hard for Mark. I don't want it to be too hard for Mark. I made a confession when he got home: I told him about the secret between me and God. I told him I had been asking God to let me die, so that life would be better for Mark. Awful. I feel like I am going insane.

I am better today. I don't feel like that anymore. Mark had a good long talk with me. So did my cousin Yolanda and my sister Arlene, and my Auntie Josie. I think I know how Mark feels, but I don't. He loves me more than I thought. Now when I think about it, if I died, it would make it easy for ME, and nobody else. I have to live...for Mark.

When we give each other a hug and I feel Mark's chest against mine it is like...heaven. It is like home to me. It is the highlight of my day...my life.

I just have to be patient with myself. Everyone gets sick. You don't just give up when you are at your worst. You can't reach rock bottom and then just keep digging, Mark says. The digging I've been doing is thinking that I am worthless and useless. That is bad self-talk. If I am in a hole I have got to keep my eyes on the sun. I didn't choose this hole, but, by God, I am in it. I intend to get out of it.

It's not so easy. I have never been this immobile. It is hard to imagine getting better. But I want to be stronger...I want to be strong like I used to be. Mark says that is the key. Keep wanting it. But give myself time to get it back. It wasn't overnight that I got this way.

Good News and Bad News

The good news:

According to the PET/CT:

"No current PET-CT evidence of metastatic disease"

(I am cancer-free!)

The bad news:

According to the PET/CT:

"SKELETON: Currently, there is a diffuse marrow simulation pattern without focal abnormality in the skeleton and consistent with chemotherapy. With regard to the previous lesion at the left humeral shaft, I reviewed the previous exam and that lesion was 14-14.5 cm distal to the humeral head surface, precisely at the level that the MRI was positive and most likely the focus was a metastatic humeral shaft deposit but misregistered due to arm motion between CT and PET acquisitions on the previous exam. "

(This information means that my cancer is stage IV)

Three Tattoos

I met my new Radiation Oncologist this afternoon. He is Dr. Carmello. The receptionist there in Radiation Oncology told Mark & me (when we first got there) that we had missed our 2:00pm appt today. All we knew about was our 3:45 pm appointment. WTF? SO, I guess that was when we were supposed to meet Dr. Carmello. Oh well. Rescheduled for Aug 3rd!

I will start radiation therapy no sooner than Aug 4th. Can you believe that? That is so far away! Another two weeks, right? Geez!

Anyway, today's appointment was basically for marking up the area that will get the radiation...my left breast and some lymph nodes on the left side too. The lymph nodes are in my neck, so that'll be weird. The doctor kinda went nuts with the felt-tip marking pen. He drew outlines of the entire breast, then they took a CT scan of the area after taping wires on the lines he drew so that they would show up on the CT scan.

Then, I got my three tattoos. The tattoos help the techs when I get the radiation...it helps them aim the laser I think.

It was a fun appointment.

Radiation Oncology - Gail

Today I met Gail in Radiation Oncology. She had all the answers to all of the questions I have been wondering about for the last several weeks!

Quest Diagnostics - Maria

Maria! Maria is also quite good at making me bleed. She is fairly new at Quest I think. Everyone at Quest always makes me feel good while they are punching holes in my body for blood. Hahahaha...

Quest Diagnostics - Marevil

Isn't she cute? I love Marevil. She is so good at poking my veins. I mean, she really knows how to make me bleed!!

Quest Diagnostics - Alice

This is Alice. Alice works the front desk at Quest Diagnostics in Walnut Creek on La Casa Via. She is always warm and welcoming. She makes me feel like I am a special patient. She makes all patients feel that way.

Dr. David - the chiropractor

David Basco, D.C.

Bay Area Injury Center

2133 MacArthur Blvd.

Oakland, CA

510-482-3883

Radiation

If anyone knows what I should expect during radiation therapy, please let me know...I am curious to find out.

Monday & Tuesday

I picked up my MRIs and brought them to Dr. David Basco in Oakland. Basically, this leg problem I am having (numbness) is the same problem that I saw him for two years ago in September 2003. I had a bulging disk at that time and apparently I have more than one bulging disk now, and also arthritis now, too, in my back. Great. So the problem is exacerbated. No cancer in my back though!

So my leg is still numb, I can't sit for really any length of time that exceeds more than five or ten minutes or so, I can't walk up and down stairs without pain....ARGH. AND, there is no quick fix on the horizon.

My primary care provider, Dr. Sreenivasan wants to wait on sending me to physical therapy until after I am done with radiation thereapy, but I can't wait that long- I have to get back to work soon! So, I am going to see Dr. David the chiropractor three times per week starting yesterday. Actually, my leg seems a little better already.

As for the cancer, I am feeling ok. Swimming yesterday was difficult. Hard to catch my breath. I will see Dr. Sherman on Thursday with my Large Blood Count results in hand. I will also get another red blood cell booster shot. If this means (which I think it does) that my red blood cells are low, it would explain the shortness of breath when swimming, now wouldn't it? Dr. Sherman is going to talk to Mark & me about the future (follow-up testing for cancer, etc.) and he should also be giving us the results of the PET scan from last week. I am anxious to hear about those test results.

Computer Problems

I had a little bit of trouble getting onto the internet for the past couple of days so I couldn't post.

MRI Results and Jimmy

Dr. Sreenivasan called me on Saturday to tell me the numbness in my leg is not cancer related. Well I knew that. I think she said that the numbness is due to a nerve being pushed on by a bone. She also mentioned herniated disk problems...so she wasn't very specific about anything except that it wasn't cancer related. Yeah. I knew that. Ok. Thanks.

I think I will go pick up the images and the radiologists' report to Dr. David Basco to see what he thinks about them. And maybe get a little chiropractic care, too!

My leg is still numb, but I am getting better at walking on it. I am feeling less scared about walking on it. SO I will go see Dr. David tomorrow for sure.

Here is a great website that shows the anatomy of back pain.

I made a birthday cake for my co-worker Jimmy today. Mark and I just got back from dropping it off at the office at his desk. Hopefully it will be there in the morning and so will he. I taped a birthday card and a knife on the top of the tin foil covering the cake. I was thinking about taking a piece of cake for myself...since I wouldn't be there in the morning to sing HAPPY BIRTHDAY and all. Heeheehee! ;-) Happy Birthday Jimmy!

As far as the cancer goes, I feel fine. Still a little nauseous from time to time, but ok, I guess. I am still tired but I feel myself getting stronger. :D I have a couple of appointments this week - one with Dr. Sherman, and another with Dr. Massulo (first appointment with my new radiology oncologist). Have a great week!

Leg Still Asleep

Spent most of the day in bed. My leg is still asleep. I got a call from David Basco, D.C. - he wanted me to come out to his office in Oakland, but I didn't have a ride.

Can you believe the A's had perfect games broken up in the eighth inning two nights in a row? Unbelieveable! Rock on Harden & Zito!

My Leg

Last night I was so uncomfortable. It was difficult for me to sit in any position. The pain is in my lower back on my left side. So, normally I go back to the bedroom and lie down on my bed and let the NORCO take over. I usually get to napping and will wake up just fine - any discomfort is relieved. However, this was not to be the case last night. Last night, I dozed off and woke up without my foot. Actually, without my leg! You know how it feels when you fall asleep on your arm, you wake up but your arm is still sleeping(?) You shake your arm, the ants come and a couple of minutes later - your arm is back. But I shake my leg, I get no ants and today, I still have no ants!

Ok, so I had to go to get my PET scan this morning on crutches. This is just a follow-up PET scan for the abnormality found in my arm late March. We will have the results of that in a few days. Those of you who know what my first scan was like, this one went much better than that. ThankYouVeryMuch!

So after coming home from the PET scan, we called Dr. Sreenivasan's office - no answer. No answering machine. I thought she was out of business. I also called Kathleen Fitterer (NP)and left a message and then I took another nap. Thankfully, my little sister Erin, was here to watch over me while Mark went to attend to business things. We decided after watching Anchorman on HBO (with Ron Burgundy), to call Dr. Sreenivasan again. Dr. Sree told us to come right down to pickup an order for a thoracic MRI and a lumbar sacro MRI. Busy day to say the least. Because, we wasted a trip to Pacific Imaging in Walnut Creek, where we were referred for these MRI's. They said that they were too busy and that the soonest they could do the tests would be Monday. H-e-l-l-o? Can't feel my leg! The order from Dr. Sree had "STAT" written across it. Thanks! FOR NOTHING! They only re-directed to their Concord facility. Well, Concord was great. In fact, the moment we entered - they asked, "Deirdre Cronan?...we've been waiting for you". Gigi was my MRI technician, who set me up with classical music to listen to through headphones during the hour and a half procedure. Erin waited just outside the room and heard the music loud and clear.

Rash

Sometime over the weekend I have developed a rash on my right arm (inside of my elbow) and also the left side of my neck. The one on my neck looks like a couple of dark purple hickies. Vedry strange. I don't know what to think about them.

Tomorrow I will go in for another PET scan, so I think I should go to Quest today to get blood drawn for my CBC, since tomorrow's blood will be radioactive.

I am so tired.

Lunchtime

Here is Arlene at lunchtime.

Arlene & Me

Here we are at the opening ceremony - about 6:30 am in Golden Gate Park