Silver Lining Booby Report

F-Bomb.

One of the many challenges of navigating the healthcare world is that there are a trillion, no, make that a gazillion of decisions to make, informed by millions of people with trillions of opinions. So much, coming from so many directions is really, really tough to manage, both mentally and emotionally.

Medicine often equal parts science AND art, which makes it an incredibly challenging universe to navigate. DUH.

While there are certain specific algorithmic treatment modalities for certain types of cancers and other diseases, many considerations go into coming up with an individual treatment plan. The majority of the considerations come from the pathophysiology of the disease.  Pathology reports are done both a the time of the original biopsy and (hopefully!) at the time of surgery (to ensure a corroborative diagnosis).

So, in preparing for our meetings with Oncologists, we  came up with a list of questions prior to our discussion.  Notice I said “we”…as a reminder it is always best to go to an appointment as important as this with someone.  Clearly I learned my lesson the first time!

Another piece of unsolicited advice: it is always a good idea to have a list of questions when meeting with your physician or any healthcare provider.  Why?  Well, because it’s so easy to forget what you what to discuss when you are in the actual meeting.

Now where was I?  Oh, yeah, our list of questions:

1. What type of chemotherapy?
2. How many drugs?
3. How many cycles?
4. What is the timing for medication delivery? Every week?  Every two weeks?  Every three weeks?
5. Will I get Radiation?
6. How can I incorporate integrative (i.e., alternative) medicine (very important to me!)?
7. Will I get a port-a-cath? A port-a-cath is a small medical appliance that is installed beneath the skin (usually in the chest, sometimes in the arm). A catheter is a tube  inserted into a vessel to allow the administration drugs, among other uses. A port-a-cath is designed to permit repeated access to the venous system for the delivery of medications and for the sampling of  blood. Port-a-cath’s are GREAT for a number of reasons:

• Chemotherapy is toxic, and can damage skin and muscle tissue;  therefore it is best to not be delivered directly through veins (though some Oncologists disagree). Port-a-caths provide a great solution by delivering drugs quickly and efficiently while preserving skin and muscle tissue.
• Good aesthetics and intact body image.  Vanity is clearly NOT an issue for me at this point; however, if I could avoid looking like poor Penny at  Sunnyside Day Care in Toy Story 3, then I’m all for it.

• 

• Patients can resume regular activities, including swimming, exercise and sports (contact sports, however, should be avoided).  Too bad that I’ll have to miss out on the annual Brookside Full Contact croquet.
• Prior to every chemotherapy dose, blood is drawn to ensure that your body is up to the chemo challenge du jour.  Blood can be drawn through the port-a-cath, which is soooooo much better than drawing blood directly from already weak veins.
• Below is a sample of what a port-a-cath looks like:

So, this week The Husband and I hit the open road of Oncology meetings.

The first Oncologist  with whom we met had the following sign above his desk. What a SL way to start the process.

I appreciate and adore this phrase because it talks about EVERY JOURNEY.  Every single journey.  Whether going to the Farmer’s Market or FBC.  Now, I recognize that these  two experiences are at, well, F-bomb opposite ends of the spectrum; however, let me repeat:  EVERY JOURNEY BRINGS BLESSINGS (and Silver Linings I might add!).

So, suffice it to say, after several intelligent, kind, sensitive, patient, and personal dialogues with Oncologists, we have come up with a pretty solid plan.  I will now answer the questions posed above:

What type of chemotherapy?

• TAC, which encompasses: Docetaxel, which is commonly known as Taxotere® + Doxorubicin, which was originally called Adriamycin® + Cyclophosphamide
• This is the narley, balding, hardcore chemo.  I have to take this because FBC was found in one of my lymph nodes.

How many drugs? Three (as described above)

How many cycles? Six cycles

What is the timing for medication delivery? Every three weeks

Will I get Radiation? There is a very, very strong likelihood that I will NOT have to have radiation.  Yipppppeeeeee-dooo!  F-Bomb SL!!!!

How can I incorporate integrative medicine? Every possible way I can, including:

• Acupuncture
• Chinese herbs
• Reflexology
• Moxibustion
• Diet
• Supplements
• Yoga (OK, OK…I’ll try it.  In the past, I have never been able to do it because I would always thing of 8 million other things I’d rather be doing other than being stuck on that mat in contortionist positions to which my body rebelled; HOWEVER, since I’m in a different place in my life, I’m completely willing to commit to try it!)
• Meditation (zen-ly refer to above on the same yoga mentality…)
• Music Therapy
• Reiki
• Aromatherapy
• Physical Therapy
• Hypnosis

Will I get a port-a-cath? A resounding F-Bomb YES!

The very best part of the week, the most grand and exciting SILVER LINING (SL) is that I don’t have to start Chemotherapy until AFTER CHRISTMAS!

One Oncologist told us that we need to approach this as a long-term project.  It is much better to wait long enough to start chemotherapy so that when I do start it, I’ll be well enough to continue.  Staying on schedule is more important than starting earlier. Because I’ve had so many pain complications after my surgery,waiting until my mind and body are strong enough for round two of the FBC extermination can, joyfully, wait until after Christmas.  See, there was a SL to all of this F-bomb pain after all.  I will have a strong, healthy, and fully present Christmas with my family and friends and THEN begin Chemo.

Wishing you all a SL-filled day!