Thursday, November 10, 2011

C day - next Thursday

I got the phone call yesterday and my first chemo treatment is next Thursday. Woo hoo! (Although it seems kind of odd to be so excited about having toxic chemicals injected into my body.)

I asked for Monday or Friday, but because of the Remembrance Day holiday, appointments are backed up. So, my first treatment will be next Thursday, with subsequent ones on Fridays. Why the day-of-the-week request? Because I know from experience I generally feel okay for two days and then fall into a black hole for a few days, where I experience the pain, lethargy and disinterest. When taking steroids to combat nausea, "Bitchy Tina" makes an appearance on about day five post-treatment. If my chemo is on a Friday, those black days fall on weekdays, when I'm alone most of the time. I can moan as much as I want without worrying others and don't have to make an effort be civil. It takes enough energy just to deal with the side effects, let alone feel as though I have to step up and be social.

As for the chemotherapy drugs I'm going to receive, the decision is still up in the air. When I wrote my blog yesterday comparing the carboplatin/paclitaxel treatment versus the carboplatin/gemcitibine one, I noticed I was emphasizing the good things about Gemcitibine - less toxicity, less nausea = no need to take steroids, not losing my hair (yes, vain Tina is talking here) - and I wondered why I wasn't choosing that option if the effectiveness statistics tend to be about the same.

Then my sister, smartie pants that she is, asked a good question, "If I take the paclitaxel again and this is the last time it's effective, won't that exclude me from future clinical trials that involve this chemotherapy drug?" There's no guarantee it will stop being effective if I do receive it, nor is there a promise it will work this time. I was contemplating calling Dr.W yesterday afternoon when he called me. Fortuitous timing for me because getting through to the right person at the cancer centre can be a challenge. We talked through Angie's question and again contemplated the pros and cons of each drug. I'm also meeting with him this afternoon, where we'll determine which chemo I'm going to start next week.

I'm heading to the cancer clinic again today to provide some of my ascities for the Translation Ovarian Cancer Research Group to use for its research work. I'm more than happy to give them as much as the researchers want and hope using it in studies leads to interesting discoveries. What's vile to me is valuable to them. And I'll do whatever I can to facilitate research or raise awareness of this awful disease.

Speaking of awareness, the Run for Ovarian Cancer got some media coverage at the cheque presentation last week. As we work towards the $1 million goal for the 2012 run, awareness of the event and the disease is extremely important. As a survivor, I was interviewed and quoted in the article. Yup, it's part of my 15 minutes of fame. While I would have preferred to be in a situation where I'd talk about more pleasant subjects (perhaps me winning the lottery or becoming a famous author), I guess I'm destined to use these 15 minutes to talk about ovarian cancer. If it helps fund research or make more people aware of the devastating nature of this silent stalker, it's the least I can do.

Tina

Wednesday, November 9, 2011

Moving forward

We finally have a plan!

It's not exactly the course of action I was seeking because that would have involved the added kick of a clinical trial drug, but I'm happy to be moving forward. Next week I start carboplatin and paxlitaxel chemotherapy. These are the same two drugs I've taken for my past two chemotherapy treatments, and they're considered the standard for treating ovarian cancer.

We're proceeding with these two drugs because they've worked in the past to kill the cancer, and the docs in both London and Hamilton believe it has a great chance of working again, especially since I have the BRCA gene mutation. Research shows ovarian cancer in those with this gene mutation tends to respond positively to chemotherapy treatment (positively for the patient, but not for the cancer cells because they die). My London oncologist did point out this responsiveness tends to slow down at some point, but he's optimistic the chemo will work again this time.

Yesterday, I had an appointment with Dr. W, my London oncologist who also coordinates clinical trials. He patiently discussed the pros and cons of the various treatment options available to me - the ones Dr. H suggested, as well as a few more of his own. While two clinical trial drugs sound promising - the P53 inhibitor and a different PARP inhibitor - both studies are in the approval phase with no clear sense of when they're going to start. It could be a couple of weeks or a couple of months.

I'd prefer to take one of these in conjunction with my chemo, but I can't wait. I feel like I've been stagnant long enough, allowing the cancer to grow inside me. I have to start sending my stealthy ninja warriors (aka the chemo) back in to hack, slice and defeat those cancer cells. Luckily, I found out yesterday that while I have "lots of cancer" inside me, the CT scan reveals it's still on the surface of organs and hasn't penetrated any of them. So I need to get some chemo in there, shrink those tumours and distract them from trying to invade new organs.

While Dr. W and I decided to go with the carboplatin and paxlitaxel combination, I also had the option of trying a different chemotherapy option with approximately the same success rate - carboplatin and gemcitibine. Paclitaxel is a more toxic chemotherapy, producing nausea, neuropathy (tingling and loss of feeling in hands and feet), joint and muscle pain, etc. Gentle Gem, has fewer of the nasty side effects, although its more common ones are fever, joint aches and rash. Approximately five per cent of patients find the Gem's side effects intolerable.

Part of me would like to go the Gemcitibine route because of these gentler side effects and because it won't necessarily make all my hair fall out. I know, it's a stupid reason and one I didn't really use to make a decision, but it'd be a bonus.

Another plus would be the ability to skip the pre-chemo steroids to prevent nausea. Dr. W said they may not be necessary with the Gemcitibine. Given the steroids may have caused the ulcer (if that's what I had), I'm a little leery of them now. Although when I talked to the pharmacist during my stint in the hospital, he said a couple of big doses, which is what I'd take with chemo, are more easily tolerated than a small dose over a longer period of time. But they still make me nervous.

Another option Dr. W discussed was coming in for a weekly dose of Paclitaxel chemotherapy. Research shows it tends to be better tolerated and works well to combat cancer. But I'd have to be on steroids and go into the cancer centre every week with this treatment regime. I turn into Bitchy Tina on steroids, so having this unpleasant side effect weekly would be hard to tolerate. I can't stand myself when this happens and I feel extremely sorry for my family.

The weekly Paclitaxel treatments are currently being studied in conjunction with a clinical trial drug, but I don't even qualify for this study because I've had surgery within the past six months. In fact, Dr. W said I may be excluded from some future clinical trials because of my bowel perforation. It disappoints me enormously that some potentially life-saving treatments may not be available to me now.

So I considered all these options and the recommendations of Dr. W and Dr. H, to determine my plan of attack. I'm going to go with the paciltaxel and carboplatin chemotherapy. I think it's the best choice from the options available to me today, despite its potential toxicity. I've also been through the chemo combination before and know what to expect. It's not pleasant, but I know I can get through it.

Now I'll anxiously wait by the phone for the call telling me which day I'll start treatment next week. Believe me, I tried to push for an appointment in the chemo suite for this week, but hospital staff are off because of Remembrance Day on Friday, so no such luck. Perhaps that's for the best because starting next week means I should feel okay for Christmas. (Yes, I've examined the calendar in detail.)

By going with this treatment option, we'll keep the gemcitibine combination and all the other potential treatment options in our back pockets to use if this treatment doesn't prove effective this time around or in the event of reoccurence. But hopefully, when that happens, the timing will be right for me to participate in another clinical trial that may prove effective against this aggressive and deadly disease.

Tina

Tuesday, November 8, 2011

Life and death

When I read the newspaper, I always peruse the obituaries. I've been doing it for years now to see if I know anyone (or perhaps their parents). It must be my stage of life. Since my cancer diagnosis, I also look at the age of the people who died. If they're young(ish), I try to determine the cause, which is often discernable by the donation requests for a specific charity.

On the weekend, I was happy (and that's probably the wrong word) to note only one listing announced the death of a young man who died in a car accident. The rest were for individuals who died in their late 70s, 80s, 90s and beyond.

I know my perspective is tainted by cancer, but I'd be thrilled to make it to age 75 plus. That's 30 more years of living and experiencing all the world has to offer. It's watching my children grow up and perhaps witnessing the birth of some grandchildren. Retiring, senior-citizen curling, living in Port Franks, empty-nest syndrome with my honey and travel would fit nicely into those 30 years.

But this aggressively persistent cancer has me mulling over the wording for my own obituary. I've been planning to write it since my surgery and too-close-for-comfort brush with death, but I've been procrastinating. The words come to me easily, so I'm not sure why it's so difficult to open up a Word document and simply type them up. Maybe it's the concrete nature of having a formal obituary.

Ironically, I had an appointment with a friend who works at a funeral home scheduled for the day after my surgery. I'd planned to sit down, talk about funeral options, look at the caskets, talk about the services and make my final arrangements. Since I was recovering in the hospital, I obviously didn't make it. But it's one of those items, like the obituary, that's on my to-do list. My planner characteristics are coming through when I'm concerned about an event that will take place after I'm dead. In reality, I don't want to leave the responsibility to those who will be filled with grief when I die. A little silly, I know, but that's just me.

I'm not talking about this to be morbid or sad, but to let you know what fills my brain some days. I know it's weird to think about one's funeral, what it would be like and who would attend, but I think those who suffer serious health issues (or perhaps get to a certain age) entertain similar thoughts.

We're all marching towards death because it's an inevitable part of living. Just remember, this is one journey where it's not about reaching the finish line. Instead it's about the activities that fill those days, hours and minutes that make up a life. It's filling the time with wonderful people and activities, creating memories that will live long after we leave this earth.

Go out there and live!

Tina

Monday, November 7, 2011

Recovering but. . .

I'm slowly recovering from my surgery that unceremoniously took place 5-1/2 weeks ago. My incision and drainage tube sites have healed up nicely and my stamina is slowly returning. I actually have small periods of time when my stomach doesn't hurt and there are days when I don't reach for the bottle of Tylenol (I rely on a dose or two most days to take the edge off).

But I think the cancer is wreaking havoc on some of my internal systems. In fact, it may be contributing to my stomach discomfort and causing rib pain. While my capacity to eat has improved, I think the cancer is pressing on my stomach, causing pain when I eat too much. I've also started throwing up at night when I feel too full. I've vomited three times in the past four days. It's very unpleasant, but I feel so much better afterwards. While this may be an effective weight-loss method, I certainly don't want this to become a way of life for me. I'd rather be a fat foodie with no vomiting issues, thank you very much.

While I'm grumbling, I'd better throw in a few complaints about the long drainage tube and collection reservoir I drag around with me everywhere. The tubing is as tall as I am (a statueque five feet), which is impossible to hide within my clothing, so I carry around a pretty red bag with a ladybug on it to hide this medical paraphenalia. I shower, sleep, cook, shop, go to appointments and walk with the whole kit and caboodle.

It's easy to get the tubing caught, which pulls on the insertion site in my abdomen. The aggravating tube gets clogged and comes undone (last night it did that in bed, creating a soggy little mess). I worry about keeping it sterile to prevent infection. It's also pulling on my skin at the insertion site to create a bigger hole through which ascities can seep when the tube gets clogged. I'll be very happy when the treatment stops the cancer from creating ascities and I can get rid of this contraption. I'm sure it will be very freeing.

And I may as well throw in another minor little complaint while I'm whining: the area under the bandage around my PICC line gets extremely itchy - and I can't scratch it properly. Ugh!

Behind all this complaining, I'm really worried. I'm scared that even when I start chemotherapy, and the ascities dries up and cancer shrinks, my body won't go back to "normal." By that I mean being able to eat a decent meal, drink water, coffee and maybe even alcohol without discomfort, and enjoy a pain-free day. It also means not having tubes snaking from my body.

I know I'll have the chemo-related side effects and the resulting bad weeks, but I hope to also be able to once again experience the good weeks where I feel as though I'm playing hooky from work because I feel so well. I know I've said this before, but I'm really afraid this is as good as it gets from this point forward, and that makes me angry.

I'm furious this stupid disease is stealing time. It's sucking up happiness from me and my family. It's robbing me of strength and peace. Regularly, when someone mentions an event in the future, I wonder if I'll be around for it. I watch older people on the street and lament I'll probably never know what that feels like. I hear about the burdens of old age and give a sad, little cheer I won't have to worry about them.

I fret about the future of my wonderful husband and family. I want to celebrate all the milestones of my children and grow old with Michael, but statistics scream I probably won't be. I want to have hope, strength and determination, but some days (obviously) I don't. The burden of this disease is a heavy weight and sometimes it's hard to be positive and believe.

I'm sorry I'm starting this week out with a semi-depressing blog. It is a beautiful day and I'm sure my mood will improve, but this morning, I'm tired of all the crap and needed to vent a bit. Thanks for listening.

Tina

Friday, November 4, 2011

All for research

It was, literally, a big cheque and the number on it - $120,600 - was a significant amount. Thanks to the hard work of all those involved in the Run for Ovarian Cancer, that money will support ovarian cancer research in London. Woo hoo!

I attended the cheque presentation/celebratory event last night at the London Regional Cancer Centre. The event left me exhilerated, and a little exhausted. Yet I couldn't fall asleep last night because my mind kept replaying snippets of the evening.

Several run team captains and family members of women with or who succumbed to ovarian cancer attended the event, along with the hardworking members of the organizing committee, the generous sponsors, the brilliant doctors and researchers and gracious representatives from the London Health Sciences Foundation.

I gave a little speech to the group about my experience with ovarian cancer and the clinical trials with which I've been involved. I also shared my story with two reporters covering the event. Apparently, many women don't want to talk about their journey with this cancer, but I welcome any opportunity to share if it means better awareness or more research. Unlike some other cancers that have lots of publicity and a famous spokesperson, ovarian cancer remains in the shadows of the spotlight and therefore doesn't get the same degree of funding or attention. If my incessant little voice can increase the cause's awareness, I'll talk until I'm hoarse. I may not be famous - and I'm a little shy and introverted - but I'll do what I can.

Last night, the attendees had the opportunity to tour the research labs and learn about the exciting work of the scientists. Their focus is treating ovarain cancer, especially in its later stages, which is the state of the disease when many women are diagnosed. I love hearing about the avenues they're exploring and the collaboration with other cancer research. It gives me hope a better solution is around the corner. As a doctor emphasized last night, it's about giving those with ovarian cancer more time to enjoy life. That means success.

Several people told me last night they read my blog and follow my story. I was buoyed by all the support and well wishes. Many also expressed gratitude for sharing my experiences, both via my blog and my little speech.

A researcher shared he gains insight from my blog into what a patient experiences every day when dealing with ovarian cancer and the issues important to her. He gave me an example: If someone could figure out a way to stop ascities production, it would improve quality of life. My reaction was an emphatic, "Yes!" But unfortunately, he isn't aware of any research going on in that area. Yet insights like this can be extremely valuable to those working at the laboratory workbenches.

Last night's celebration made me excited about the 2012 run, it's 10th anniversary. The event's goal is to raise $160,000, to bring the overall total to $1 million for ovarian cancer research. Wow! While this fundraising target is aggressive, it's achievable with hard work and dedication; something those involved and participate in this event have in abundance. Lace up your running shoes and get fundraising early; we've got an exciting goal to reach.

Tina

Thursday, November 3, 2011

14

In some ways, it feels like only a few short years since Michael and I welcomed our adorable little son into our lives. Yet today, he turns 14 years old.

He was a cute baby, with dark hair and bright, inquisitive eyes. He was also a good baby, sitting in his car seat, watching me bake, shop or fold laundry and listening to me babble - until he'd fall asleep. While he was full of energy and needed regular stimulation, he was a good baby. He was quick with the milestones too: rolling over at 3-1/2 months, walking at eight and talking in short sentences at a year old.

Today, he's a typical teenager with his own language (powned, epic fail - what?!), a wacky sense of humour, a need for a lot of sleep and a unique, "why don't you take a shower" aroma. As with most teenagers, his priorities are different than ours (the need to keep his room neat or do chores on time) and his friends are important. He can also be thoughtful, sensitive and helpful. He's smart as a whip, quick with a pun and an awesome drummer.

In grade 9, he's discovering new talents and skills, which are expanding his horizons. I hope I have the opportunity to see what career piques his interest and which girls capture his heart. I get excited envisioning the best for my little boy (for he'll always be that), who made his appearance 14 years ago today.

Tina

P.S. I have an appointment with Dr. W on Tuesday to talk treatment. I was hoping for this week, but no such luck.

Tuesday, November 1, 2011

London Life rocks

Almost nine years ago, I started working for an amazing company, with unbelievably generous people. In early December 2002, I joined London Life's communications department on a one-year contract and I haven't looked back since.

I've always said, it's the people who make or break an organization. Well, those at London Life are the cream of the crop. I've never felt more supported or loved than by my colleagues (aka friends) at this company. When I went into the hospital a month ago, my wonderful friends started asking how they could help me and my family. I was visited by several of them while in the hopsital and food started arriving at my doorstep from the time I arrived home.

These same friends also started Team Tina to participate in the Run for Ovarian Cancer when I was diagnosed in 2009. Many of them participate and raise funds for ovarian cancer research every year, and for that I'm very thankful. This event raises money for ovarian cancer research in London; work that may lead to a discovery to help me in my fight.

London Life, the organization has also been wonderfully supportive during my journey as well. It matches the funds raised by Team Tina, up to $6,000, each year, which gives the diligent researchers even more funds to support their work. In addition, the organization supports me financially through disability benefits while I take time off to fight this stupid disease. I'm lucky to belong to the London Life family.

I went into work yesterday to clean out my cube. I won't be using it for the next six months or so, and space is in high demand. While I was there, many stopped to say hi, give me a hug, ask me if I needed help and wish me well with my treatment. I loved seeing all the friendly, supportive faces. (And apparently, I look much better than I did before I went off. Apparently, I wasn't looking so good.)

Throughout my journey with cancer, my work friends have showered me with food, gifts, love, friendship, hugs and support. At times it's overwhelming how generous people are because I know I can never say thank you enough or repay the generosity. I marvel once again at how lucky I am to have such wonderful people in my life. I'm truly blessed.

Tina