Is It All In My Head?

So the good news is....the muscle and joint pain I feel is not caused by my joints degenerating. I was getting quite concerned that Femara, which keeps my body from producing estrogen, was having a degenerative effect.

My ankles, knees and hips ache. This is not new. For a while now, however, I've felt that my knee joints were slipping when I am out running. Do you know the slipping feeling? You get a sharp pain below the kneecap and then the knee sort of collapses and you have to catch yourself. My mind associates lasting new abnormal aches and pains, that occur more than they used to, to the effects of Femara.

So I submitted another question to the University of Montana Drug Information Service. I wanted to know if my joint pain, stiffness and slipping weirdness was going to progressively get worse. I wanted to know if it was caused by Femara. My fear was that I wouldn't be able to run at some point. Below is their response.

Thank you for your question regarding Femara and muscle or joint deterioration.

Femara (letrozole) is an aromatase inhibitor that is used in the adjuvant treatment of breast cancer and the prevention of its recurrence. It blocks the action of the aromatase enzyme, which converts androgens to estrogens. Letrozole causes the near complete inhibition of the aromatase enzyme, which will results in a considerable depletion of estrogen levels after two to four days of therapy. This results in the starvation of estrogen-sensitive cancer cells. There have been no published reports of letrozole causing muscle or joint deterioration, but it has been reported to cause musculoskeletal pain, with a 22% incidence of arthralgia and bone pain, 18% incidence of back pain, 10% incidence of limb pain, and a 7% incidence of arthritis and myalgia. The exact cause of musculoskeletal pain is unclear, but the estrogen deprivation associated wtih aromatase inhibitor therapy may provide some explanation.

Estrogen may have an effect on how a person responds to pain. It has been shown that estrogen seems to have an anti-inflammatory effect on tissues in the body, which has been illustrated by the improvement of rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease in women who are pregnant and therefore have higher estrogen levels. Studies suggest that high levels of estrogen may help reduce pain by causing the release of endorphins and enkephalins in the receptors that reduce pain sensitivity in the body. Neurons in the brain and spinal cord that contain opioid receptors may have estrogen receptors that reduce pain sensitivity in the presence of estrogen. When estrogen levels decrease, the ability to reduce pain is diminished. Estrogen deficiency can also cause loss of bone mineral density, which may also contribute to arthralgias.


Aromatase inhibitors such as letrozole, can cause musculoskeletal pain. The exact mechanism is unknown, but there have been no published reports indicating the pain is due to joint or muscle deterioration. The current hypothesis is that the estrogen deficiency caused by aromatase inhibitors may be responsible for increasing the body's sensivity to pain.

There you have it! The pain is in my head (my brain to be exact)! I feel pain more clearly now because I don't have estrogen to block my brain from perceiving it. Thats all. This makes me feel much better about my future. I can handle the pain. Anyone who exercises knows that pain from working your body can feel good. You know you have "damaged" your muscles enough that they will rebuild stronger.

Now when I wake in the morning and hobble to the bathroom I will remember that my joints are fine. I am just feeling more than I used to.

Here's John and I out on a hike a few weeks ago. Check out my hair 3 months post chemo!

Does Femara change red wine's effect on estrogen in the body?

I posed this question to my boss, a pharmacist, and an intern, at work one day. They graciously did research for me and also contacted the University of Montana Drug Information Service.

You see, I love a glass or two of red wine before dinner but the current advice from the American Cancer Society is to avoid alcohol altogether if you want to not raise the risk of breast cancer. I have estrogen-driven cancer so they are talking to me.

Now I have posted before about a study on mice that showned that a phytochemical in red wine has an anti-cancer effect. But does that finding cross over to humans? And could Femara counteract the increase estrogen circulating in the blood stream that happens when I drink a glass of wine?

Here is the answer from the Drug Information Service:

Thank you for your question regarding Femara (letrozole) and its ability to decrease red wine's effect on estrogen in the body.

Estrogen plays a large role in the human body, especially in female patients who have experienced breast cancer or other hormone sensitive cancer. The substances in red wine believed to have possible effects on estrogen and cancer are phytochemicals. Resveratrol is the phytochemical that has been studied the most. Letrozole is an aromatase inhibitor that is used to treat breast cancer, because it inhibits conversion of androgens to estrogens. Currently there are no published reports of a food-drug interaction between Letrozole and red wine or red wine extract.

Red wine is thought to be cardioprotective. However the data on its effects on breast cancer are conflicting, with some studies showing an increased risk and others showing a decreased risk. There have been no studies conducted with both red wine and letrozole, but there have been several studies conducted with red wine extract in animals. Studies in mice with over-expression of aromatase found that red and white wine have both in vivo and in vitro aromatase inhibitor activity. The studies used samples of several types of wine, including pinot noir, merlot, zinfandel, hardonnay and carbernet. Another study found that red and white wines only have estrogenic activity in mammalian cells, since the extracts had no effect on a yeast estrogen screen assay. These studies included all active components of wine, not just resveratol. Red wine has more aromatase inhibitor activity that white wine because the grape skin, where phytochemicals are primarily found, is removed when making white wine.

There is currently a study being conducted in healthy premenopausal women examining the effect of red and white wine on estrogen and progesterone levels. The results of this study will most likely not be published until late 2008 or early 2009.

The data regarding red wine, estrogen and Letrozole is limited at this time. The studies provide insufficient data to prove red wine's effectiveness as a chemoprotective agent. It is possible that the aromatase inhibitor activity of both agents could be additive; however there are no published reports of an interaction between Letrozole and red wine.

There you have it. No conclusive answer available and no study in process that is looking at Femara's ability to counteract the rise in estrogen level caused by drinking alcohol. Maybe some day we'll have the answer. I haven't quit drinking red wine but think twice about it each time I have a sip.

First Day Of My Life

Can you let go of the stupid shit that distracts you from the important ones in your life for 3 minutes? I hope so. Put on your headphones and listen to Bright Eyes.

Level Out

Will this post resonate with you? For some it will. For some it won't. It's written in sympathy for the people in the first group.

I no longer feel as though I'm dying. I BELIEVE I am well today. I didn't convince myself. I've never been able to force myself, through sheer will, to believe something. After I was diagnosed, well meaning assurances that I would be okay only magnified my doubt about my prognosis. Those assurances, however, played an important role in my journey. They caused me to explore why someone telling me to "be positive" made me feel inadequate and weak. Hearing "you'll be fine" felt like the kiss of death. I heard these things from people who I am not very close to and they meant well.

I believe that I came to center, leveled out, by spending alot of time in mourning. Exploring what death means. Understanding how we die. Really coming to terms with the truth that our society shushes. Becoming comfortable with going to sleep forever.

For those who are suffering from cancer and debilitating fatigue, depression and fear, I hope you allow yourself to grieve your losses. Allow yourself to feel terrified. Allow yourself to mourn for you and your family. While being strong and staying positive is important because it will help those around you, its okay to go off on your own and get angry and cry until you sleep.

This song is for you.





When panic grips your body and your heart is a hummingbird
Raven thoughts blacken your mind until you're breathing in reverse
All your friends and sedatives mean well but make it worse
Every reassurance just magnifies the doubt
Better find yourself a place to level out

Got a cricket for a conscience always looks the other way
A cocaine soul starts seeming like an empty cabaret
Hey, where have all the dancers gone? Now the music doesn't play
Tried to listen to the river but you couldn't shut your mouth
Better take a little time to level out

I never thought of running
My feet just led the way

Mixed up Signals
Bullet Train
Cars are switched out in the crazy rain
I could meet you any place
If the Brakeman turns my way

All this automatic writing I have tried to understand
From a psychedelic angel who was tugging on my hand
It's an infinite coincidence but it doesn't form a plan
So I'm headed for New England or the Paris of the South
Gonna find myself somewhere to level out

Are your brothels full, Oh Babylon, with merry Middlemen?
Never peer out of their periscopes from those deep opium dens
All this death must need a counterweight always someone born again
First a mother bathes her child then the other way around
The Scales always find a way to level out

I tried to pass for nothing
But my dreams gave me away

Mixed up Signals
Bullet Train
People snuffed out in the brutal rain
I could live to any age
If the Brakeman turns my way

It is an old world it's hard to remember
Like a dime store mystery
I'm a repeat first time offender
Who has rewritten history

Mixed up tea leaves
Phantom Pain
Fuzzy logic in the crazy rain
Getting better every day
If the Brakeman turns my way
Mixed up Signals
Bullet Train
Cars are switched out in the blinding rain
He'll be smiling as he seals my fate
When the Brakeman turns my way

I Passed!

Guardian Oncology called this morning while I was at work. I'm well. I'm really better than well, I'm fantastic!

The tumor marker tests CA 27-29, CEA and CA 15-3 all came back good. The CA 27-29 number is slightly raised from 3 months ago but not a significant amount. I had a worrysome result from the CA 27-29 during chemo.

The CA 125, for ovarian cancer came back below 1. They had never seen a result this low before so they had it retested. There was no mistake. Its really that low. Its really that good.

An arthritis test also came back negative. My vitamin levels are good. Slightly anemic but not too bad.

Nothing but good news. I have no need to worry. I'm healthy as I can be. Could I be 'cured'?

3 Month Checkup

What do you do when you are nearing panic and your 3 month cancer checkup runs two and a half hours late? You go shopping thats what.

There's just nothing like shopping to refocus your thoughts. And when the mall is having clearance sales on summer stuff like swim suits, shorts, cute dresses you can make off like a bandit. Spent close to $200 shopping today and really only need to pack brand spanking new clothes for my trip to Michigan tomorrow and it was worth every cent to me.

Having my sister with me in the waiting room, torture room (where they draw the blood) and exam room was priceless.

Six vials of blood, 18 (yes, thats right eighteen xrays) and an hour with my oncologist and I missed my whole shift at Target. You know what? I don't even have my cancer marker results or 16 of 18 xrays analyzed and I feel so much better than this morning.

What I love about my oncologist, Dr. Judy Schmidt, is that she doesn't sugar-coat anything and thus I trust her 100%. I was completely open with her about my bad habit (daily wine consumption) and with my belief that my cancer will recurr. I told her the reason I am so certain is because of my high oncotype , grade and mitoses scores. She did not tell me to just relax and stop being so negative. What she told and showed me is that I will be watched very carefully over the next 4 years. Three years of seeing her every three months, then 1 year of seeing her every 4 months, followed by X years every 6 months. She also told me that the mean recurrence time for an aggressive cancer, if it were to recurr, is 30 months thus the aggressive monitoring.

My complaints were aching and stiff joints, which I've bitched about plenty on this blog. Sore ribs on the cancer side and a sore spot in my clavicle on that side. Although she spotted a torn ligament on physical exam that is undoubtedly the cause of my lower rib pain, she ordered the 16 additional xrays just to rule out cancer in that area. Those xrays combined with the results of a couple of cancer marker blood tests will determine if we look any further into the rib pain. If she doesn't like the blood test results or xrays she will order an MRI.

They are short staffed in the lab so I will likely need to wait until monday for the cancer marker results. I should have the xray results tomorrow. They'll call my cell phone. I have to tell you that phone calls from Guardian Oncology give me a few seconds of terror until I hear the results. Makes me not want to answer my cell phone for the next few days.

Dr. Schmidt also ordered ovarian cancer marker and arthritis tests. She wants to make damn sure I don't have anything bad brewing down below. She stated that I still have an elevated risk of ovarian cancer even though I have my ovaries taken out. NOW THEY TELL ME! I actually think she has her statistics wrong on me still having an elevated risk but I wasn't going to argue. What's another vial of blood right? I had a clear pap smear a couple weeks ago. So that is cool.

My white blood cell count is low which she said is likely still because of one of the chemo drugs, cytoxan. Gonna take more vitamins (folic acid, vitamin d, vitamin b-12) to try to bring it back up.

Well thats it in a nutshell. Where I was quite stressed and panicing this morning, I am feeling better tonight. Thanks to Dr. Schmidt, sister Annie and my sweeter than sweet husband John for calming me down this morning.

Gotta go pack. The laundry that needs to be folded is gonna wait. I'm off to see my Michigan homies tomorrow! Can't wait.

Solidarity

When I was recuperating in the hospital from my oophorectomy/mastectomies, John Brownell Senior, who was also in the hospital at the time, passed a message on to me that he was having his ovaries removed in solidarity with me. Now that is a sense of humor. Classic John Brownell Sr. humor. Even while struggling with his own serious health concerns he gave his gift of humor to make me feel better.

This brings a tear of joy to my eyes. There were many moments like this in the short time I knew this man. Sitting with the family on any given evening Mr. Brownell would get a wry smile on his face. Sometimes he would share the thought with us, most times not. Whether he chose to or not was not very important. I found it easy to connect with him by sharing in the entertainment of sitting back and enjoying a Brownell family discussion.

I found such inspiration in him. He taught me how to make the best of the little moments. His effect on me did not truely bloom until after I recovered from the initial shock of a cancer diagnosis. Later, during chemo, I knew that no matter how crappy I felt he was a thousand miles away doing his best to find joy in each day despite his challenges.

I feel confident that my checkup on Wednesday will generate good news.

If some day I get the news, that cancer people can't bear to hear, I will try hard to continue to find joy in the small moments and help others along. Meaningful relationships happen that way.

I Hope You Know

I hope you know how much you are missed John Sr. The void caused by your passing is felt way out here in Montana.

You live on. In your family's mannerisms, intelligence, integrity and bountiful joy for living.

For those of us fortunate enough to have known you, the 4th of July has new meaning. While the day will forever be tinged with sadness, we can gather each year to celebrate your life, tell stories and perhaps find comfort in shared grief.

You lived well, fought the good fight and took care of your family until the last moment. Rest in peace dear man.

His Extraordinary Courage

My heart is with my father-in-law tonight. He is in the hospital. The hospital is the last place he wants to be and he held off as long as he could before admitting himself late last week.

John Brownell Senior is courageously enduring until he can go home. He has persevered downturns and rebuilt strength several times since I met him a few years ago. I have not seen him complain or feel sorry for himself. In fact, even when feeling deplorable, he generously gives his gift of humor. Taking the burden of harsh sadness off of others onto his shoulders. His family needs him and he does everything in his power to be there with his wise and loving counsel and support.

I believe he can come home again.

What I Wouldn't Give

To be told that there is a cure. Like this one. Melanoma is a frightening form of cancer. Especially stage 4. Yet this man, with stage 4 cancer received this revolutionary treatment and appears to be cancer free after 2 years. Reading this article makes me feel like it could really happen for all of us. A treatment that does more than save a life. A treatment that gives another a release from the fear that a recurrence will drastically alter their life again.

Man, my 3 month checkup cannot come soon enough. I am looking now at another condition and what it might mean. The skin on my left hand side, where my breast used to be and that which swelled after surgery because of a seroma, is puckered and wrinkled and has a scaly appearance. I've always assumed that the scaliness would go away, but it hasn't. The skin is totally numb. All nerves there are dead. Well my internet wandering eyes find that skin that is puckered and scaly is a sign of advanced breast cancer. Crap. Reading that makes me nervous as hell. But, realistically its just my skin doing the best it can after surgery.

I really just need to see the doctor.

Would You Care To Share?

How has my, or another loved one's diagnosis or personal tragedy affected the way you live your life afterward?

If you don't feel comfortable posting publicly and would like to help me learn about how people react and change from another's life altering event, feel free to email me at lpacemissoula@hotmail.com.

Thank you in advance for sharing.

Subconscious Manipulation Part Deux

I made an appointment with my oncologist today for my 3 month post chemo checkup. It's set for a couple of weeks from now, July 9th, the day before I head to Michigan to visit John's parents, grandma and his sibling's families. I am so excited to go. The last time I saw any of them was a few days before my mastectomy/oophorectomy surgery last November. We'll have so much fun catching up. There will be lots of hugs, smiles, storys and some really good food and wine to share. Brownell family here we come!

I had a dream last night that is indicative of my current state of insanity. John woke me up in the middle of the night because I was shaking and moaning and was covered with goosebumps. I remember him waking me and I was able to tell him what I was dreaming about.

I was at a school with my sister Anne to learn how to be wizards. Wizards, that when fully educated and experienced, can cure cancer. The school looked in my dream like Hogwarts, Harry Potter's boarding school of wizardry. We had made it through the first year of challenging courses. We had left our families in order to attend. When John woke me up, Anne and I were flying through the air, laughing an evil laugh, chasing a poor human who was running from us on the ground. At the same time we were being chased by flying demons/ghosts. It was terrifying. Aaaaaack! It makes my chest tighten up thinking about it.

I have a fear that a pain in my left ribcage might be a cancer metastisis. I have felt it for the last 4-5 days when my bra presses against it. Or especially when I lay on that side.

Now, the chance of it being cancer are probably miniscule. The thing that is driving this fear is that the sore spot is located behind where my tumor was. I now understand why people worry incessantly about aches and pains that you would not give a second thought. Aches and pains that turn out to be nothing to worry about. Its commonly told to cancer patients to wait 2 weeks before reporting a worrysome symptom to your oncologist. It will probably go away before then.

My rib will stop hurting any day now too.

Be A Good Girl And Eat Your Mushrooms

This is very cool. White stuffing mushrooms inhibit aromatase, which is an enzyme that the body needs to produce estrogen. Researchers used laboratory and mouse studies to confirm that the anti-aromatase compounds stopped the growth of breast cancer cells. They found that mice that were fed mushroom extract had a 58 percent reduction in breast tumor growth. Read the complete article here.

This anti-cancer effect is also being studied with respect to prostate cancer.

Fun Weekend At The Lake

Had a magical weekend at the lake. Fun, easy days enjoying my family. Watching my son and nephews head straight to the dock and jump on the jet skiis for their first rides of the year. Permagrins on their faces out on the water. Lots of laughter and screams from the shock of cold water and terrifying tube rides. Pristine green foliage. The smell of pine trees. Happy faces all around. It was a beautiful sunny 85 degrees. The lake was like glass on Saturday.

Appreciating my dad. He works so hard to make the lake place heaven on earth for his family. He worked 90% of the time that he was there this weekend and that is only a fraction of the time and expense that he has so generously given this spring. Appreciating my mom and sister. We had so much fun painting and redecorating our beloved cabin.

I would post pictures but I forgot my camera in Kalispell. Will be sure to share some as soon as I can.

I am so happy and grateful for what I have.



John on the dock a couple of years ago.










Me pulling a skier a couple summers ago. Yes, I should be looking where I am going.

So Here's What I'm Thinking

I'd like to write a small book. A guide for people newly diagnosed.
Not from a medical perspective, there's plenty of those. My book will describe the emotional side of cancer. It will serve as a guide through the process of losing your sense of self. Of rebuilding.

That's what happens when you get diagnosed.

You go through profound changes in a very short amount of time.

You lose your looks. You do what you can to not draw attention to your self when you grow pale, thin, hairless and weak.

You lose your safe foundation that has been meticulously constructed. First built from your parents beliefs that are ingrained in the very fiber of your being. Then through the lessons, big and small, learned through your school and adult years. Drastically, that safe foundation is ripped out from under you and you grapple with fear issues and frightening surgery and medical treatments.

You lose the ability to function at a high level. Its embarrassing.

All of these things can lead to isolation.

Its my hope that I can explain, from the perspective of someone who's been through the ringer, how important it is to feel the grief. Collapse and surrender to the fear. Cry like you've never cried before. Acknowledge your mortality. Thrive from the lessons that physical suffering brings. Experience the overwhelming warmth that loved ones provide. Dive in deep when shared fear and realization that life is short gives you the chance to deepen relationships. And then smile, when you wake up and realize that you have several days ahead free of nausea and feeling poisoned.

Some days are a struggle. Other days are precious and you feel a level of contentment many others are unaware of.

The old Laurie would have never attempted writing a book. The cool thing about getting cancer is that its given me a what the hell attitude. What the hell.

My Body Without Estrogen

There is a downside to taking a prescription drug that keeps your body from creating estrogen. Since the cancer cells from my biopsies were tested and found to feed off estrogen, taking Femara is a no-brainer.

I've been on Femara for 8 weeks now and the side-effect of stiff and painful joints is spreading. Just this week my shoulders and elbows started aching when I sleep. I don't feel achy in those particular places during the day. My hips and ankles bother me the most during the day. Pain and stiffness in my hips, knees and ankles is most pronounced when getting out of bed.

Another interesting side effect is muscle soreness after exertion. I'm not talking about normal soreness I grew accustomed to during my 20+ years of running. Now, when I up my mileage a reasonable amount I am sore for 4 or 5 days. Prior to Femara, soreness only lasted the typical 48 hours. Scientific studies have found that estrogen plays a part in healing strained muscles.

I don't like to think about what shape my joints will be in after being on Femara for 5 years.

Breast Cancer Survivor

I don't care for being referred to as a breast cancer survivor. My image of a survivor is someone who has won a battle. Someone who can celebrate their victory and put the ordeal behind them. For me, survivor doesn't define what being stricken with breast cancer is about. To me, more appropriate labels include unlucky, casualty, prey, underdog.

When I traveled to Helena for the Komen Race For the Cure last month I was surprised how strongly I was repelled by the label of survivor being thrust upon me. I didn't want to put on the pink survivor t-shirt. I didn't want to be part of that group. I was not proud to be part of the group. I was there to run a race. I was there to run with my son, nephew and sister and enjoy being active and strong after a depressing winter of chemo treatment. I was there to visit Jody, my dear sister-in-law from my previous marriage, who has supported me with such unselfishness and kindness.

When it was time to join the other survivors on the Capitol steps I reluctantly put on my pink t-shirt and walked up with the 1 year survivors. The other groups of cancer survivors were called up according to the length of time since their diagnosis. Then it was announced that the song "We Are Family" would be played so that we could clap and sing along. After the song started I looked around at the singing and celebrating women surrounding me and I felt irritated and indignant. What were we celebrating? Being afflicted with cancer? I can't celebrate, in any way, having a harrowing, hideous and vicious disease.

We can't fight to survive cancer. Either treatment works or it doesn't. We are either lucky or we're not. Its quite simple, we take the treatment and we endure. We try to stay positive. Not because we really believe that a good attitude increases our chances of surviving, but because its easier to cope that way. And, the really great thing is that we don't know which direction we are headed.

Survivor my ass, its not that glamorous.

Featured Blogger

I was contacted by the Chief Medical Information Officer at Wellsphere.com, where they are building a network of health bloggers. They are going to put my blog stuff within a not yet live Breast Cancer community area of the site, and also within a magazine-like Wellsphere360 section. If I contribute often enough they'll feature me on the home page. I'll give you a link once my stuff is published there.

I'll Believe Anything

Last week was one of those weeks that cancer people have. Where the mind keeps nudging you to pay attention to the fear that stalks you. Maybe if you stop and focus, and just think intelligently about it you'll find the solution. You'll find some sort of proof that convinces you that you don't need to keep your thoughts in the present. Regain the courage to dream beyond 5 years. But no matter how many times you replay conversations with the oncologist in your head, or review statistics, the problem cannot be solved. Rightly, no credible doctor or researcher will give you a guarantee of a future without the return of cancer.

After several days I was just plain tired of being fearful. Being around others was difficult. I preferred to be in a dark quiet place because I didn't have much tolerance for noise. Searching online for new articles about developments in cancer research was comforting because it kept my mind occupied. When I failed to find the nebulous information I was seeking I started reading other cancer people's blogs. I came across Bert Scholl's blog and read it with interest. This reading introduced me to the Gerson Therapy. A natural, diet-based cancer therapy. Bert's blog intrigued me enough to look further into the therapy. Watching the 11 part video series on YouTube took me the good part of a Sunday. I was enthralled. The stories told started to give me hope. Hope for a future without worry and sickness. All I had to do was follow this diet/supplement/enema regime. I truely began to believe. With all my heart. I had spring in my step again and I was excited. Secretly I started thinking about a way that I could go to the Gerson clinic in Mexico to begin the therapy as a way to forestall a recurrence of breast cancer.

When John walked into the room while I was watching a Gerson video I felt defensive. I didn't want any one to burst my bubble of hope and optimism. I so badly wanted to stay optimistic about having a future without worry. But, it was at that moment that I realized that I was deluding myself. My dream of a carefree future began to unravel. When John left the room I cried.

I held on to the dream though for a few days. I don't remember exactly when I stopped. I just stopped looking for proof.

I am not ashamed to admit that I was foolish. You can snicker and laugh. It won't hurt my feelings. I won't stop myself from following another foolish dream in the future. It felt that good to be carefree for a while.

Janitors Say The Darndest Things

At Target we have a sweet, but most annoying janitor. Each morning, like clockwork, he comes to the pharmacy to have one of us come and unlock the pharmacy-only restroom so that he can clean it. I understand why, now, that management doesn't just give him a key. We would not feel comfortable using the restroom knowing that he has a key.

The pharmacist always gets very busy when the janitor asks to be let in, so its always me that goes out into the hallway behind the pharmacy to let him in. He's Italian, approximately 25 years old and speaks broken english.

He has a problem with talking too much, interrupting people's work and not getting his work done in a timely manner. You literally HAVE TO walk away while he is still talking to you. If not, you will still be there 20 minutes later looking for a way to politely end a conversation. He says things like "I wear cologne today and shave to make girls say aaaahhhhh he look good today". Also "I have sense of humor, right? You not need to be afraid of me".

A few weeks back I was letting him in the restroom. The door is really heavy so I was holding it open so that he could get his mop bucket rolled in. He turned around and said "High five"! I squeamishly put my hand up, so I didn't rudely leave him hanging, and he grabbed it and pulled me in the bathroom! I must have looked horrified because he let go and started in on another rendition of "I am funny, see? I have sense of humor". I left him in the dust and walked quickly back to the pharmacy.

So, last week I decided I'd had enough of the itchy wig and wore a baseball cap to work instead. When the Italian janitor came to the pharmacy, a new intern, who doesn't know yet how to duck when he comes around volunteered to let him in the bathroom to clean. Later, on my break I passed him in a hallway and acted like I didn't see him. He yelled after me, "Are you lady that works in Pharmacy"? I was caught, and turned halfway around. "Yes", I replied. He was puzzled and said "You not recognize me"? I grunted and tried to keep moving. Then he said "You look very different". "You shave head"? I didn't want prolong the converstation so I said yes. Then he dropped the truth bomb. "You much prettier woman before". "Before you look like woman, now you look like girl, or boy".

Ha ha! He's right, but jeez!

Here's me today, 8 weeks post chemo, with my wig and without it.

Six Months Since

Six months ago today I came home from the hospital after bi-lateral mastectomy and oophorectomy surgeries. A couple weeks later I started chemotherapy. And I was scared to death.

Today things are much different. You have probably noticed I don't write much these days. There's not much to write about other than good things! Funny thing is it doesn't occur to me to sit down at the computer to write about good news. Writing has been what I've done over the past few months when I felt overanxious.

As far as my body is concerned I have only a few complaints. Joint pain, a common Femara side effect, continues. Especially in my hips and knees. The left side of my chest, on the side, under my armpit has pulsing pain every minute or so. Sort of a burning and stinging feeling. Its not strong enough to wake me at night though. My theory is that some nerve healing is going on. I do not feel a lump there so I am not worried about it.

My hair continues to grow. This makes me happy. I would describe it as thickening fuzz now. Not quite as long as a very short crew cut. Have you seen Robin Roberts from Good Morning America recently? She's stopped wearing her wig and I think she looks great. I think that my hair will be about the length her's is now, by early August. I can see myself feeling comfortable wearing my hair that short in public.

I got hit by fatigue yesterday and took a 3 hour nap in the afternoon and then slept soundly all night. For a few days prior I noticed my legs felt increasingly tired, especially after walking up a flight of stairs. Just one week prior I was energetic and able to run 5 miles at a time without fatigue. When I feel this fatigue I also notice a strange feeling when stretching my quadriceps (kneeling down, sitting on my feet and leaning back). Instead of the feeling of stretching I feel fatigue in the muscle. I'd like to know why that is.

Work is going well now. I really look forward to going to work each day. How lucky am I?

Wear Sunscreen

I'm passing on this link to a powerful blog written by a young gal named Sarah. Read it, it will break your heart. But it just may convince you to take better care of yourself. You deserve that.

Sarah's Blog

Detached

My perspective is still skewed. My new normal I guess. Several times a day I find myself holding back from really engaging in life. It all still feels so temporary to me. As if the return to normalcy that I am experiencing now could be pulled out from under me at any moment.

I've let myself imagine, only once or twice since finishing chemo, finding evidence of disease in my body. A small lump in my chest or under my arm or in my neck. The ominous feeling of "knowing" it's bad news feels like heartburn in my chest and fear rises up from my stomach into my throat.

You see, I keep a part of me protected from this dreaded experience by not letting hope seep all the way into my heart. This protected part of me would not be shell-shocked by horrific news, if it were to occur.

To Genava

My friend is going through a very hard time. I want you to know Gen that you are a beautiful, unselfish, loyal person. I hope you realize how much you mean to me and all of the other countless people who are blessed have you in their lives. I believe that you will come out of the death you are dealing with now, stronger. Don't hesitate to call for help when you have doubt.

Love ya Gen

Do You Realize?

This song was written by the Flaming Lips for a friend who was dying of cancer. I think it applies to any sort of loss. The lyrics remind us that life is short and its hard to make the good times last. Its most important to let people you love know that they bring joy and meaning to your life. The sun doesn't really go down, its just an illusion we believe for now. Things will get better.

Counting Hairs

I've counted em. Only 3 left on the right and 5 left on the left. My eyelashes that is. WTF? This happens now? Six weeks AFTER finishing chemo? I remarked to John tonight that I look more like a chemo patient now than I did during treatment. He responded saying he didn't think so. I have color in my face now. I've also gained 4 pounds which fills out my face. I feel much better now too.

I am so much less self-conscious now of my hairless state so its a blessing that this didn't happen earlier.

I forget that I still look alot different than other people. I was in McDonalds last week having breakfast by myself. I was wearing a beanie hat, eating and reading a book called Pretty Is What Changes. Its such a good book (thank you Shar!). Halfway through my breakfast a young gal who was washing tables came up to me, said hello and asked me what I was reading. I told her the title and that it was a book about breast cancer. She responded asking "Is that what you have?". It was so sweet, the way she asked. I was taken aback by how empathetic and sincere she was. I told her yes, that I had breast cancer. She stopped her work and looked me right in the eye and said, I hope things turn out okay for you and you get well again. It felt so good to hear those kind caring words from a stranger.

I'm Ordering This T-Shirt

My Crutch

Its time I come clean. Not only have I had unwavering support from family and friends through my cancer ordeal but I have also kept a fragile emotional state in check by taking antidepressants.

I started taking them several weeks after diagnosis. I take Lexapro in the morning and Trazodone just before bed. These wonderful medications have given me a fresh new perspective each day and the ability to sleep soundly every night. I think that without Lexapro I would have fallen prey to deep depression. I needed something to help with paralyzing fear and a steady decline in my ability to cope. I did not get much sleep during the nights before starting Trazodone. Thats when my terror-filled thoughts were at their most extreme.

I think I'm ready to taper off using the medications and learn to deal with fear on my own. I'm halfing my Lexapro dose as a start. I suspect you'll be reading more posts about fear and uncertainty as I begin dealing with life without crutches.

Red Wine & Breast Cancer Recurrence

While perusing the breastcancer.org website today I found some good news. Its good news for me because I like to drink a glass or two of red wine before dinner. All I have ever hear prior to today was that red wine causes up to a 20% increase in the risk for cancer. So I have felt guilty for every glass I've raised since being diagnosed.

An interview on breastcancer.org answers questions on the subject of red wine consumption and breast cancer. There have been no studies show an increased risk of breast cancer recurrence for moderate red wine drinkers. Also on the good news front, there is scientific evidence that a phytochemical in grape skins (which is contained in red wine) inhibits aromatase, which lowers a woman's estrogen level. This is good news for estrogen-driven cancer like mine. In fact, I take a drug called Femara, to the tune of $350 dollars per month, that inhibits aromatase on a much stronger level.

Cheers! Drinking a little red wine actually starves estrogen lovin' cancer cells.

Laurie

Intriguing Article On Fasting and Chemotherapy

I really wish I had seen this article before I started chemo. I would have tried fasting prior to chemo treatments.

Excerpt from the article

Starving mice for a few days before chemotherapy treatments protected their healthy cells from damaging side effects, offering a possible way to shield cancer patients from the debilitating hair loss, nausea and anemia that now plagues the treatments, researchers reported Tuesday.

The study, published in Proceedings of the National Academy of Sciences, could also allow the use of more potent chemotherapy doses without endangering patients.


Read the entire article here
http://www.latimes.com/news/science/la-sci-starve5apr05,0,6821595.story

State Of The Body Address

Taking stock of my body this morning I must say things are looking up. My energy level, while still affected by overdoing it some days, is gradually stepping up. My nose has stopped its bleeding completely. Five months after bi-lateral mastectomy/lymph node removal surgery, nerve healing is still going on in my chest made evident by periodic sharp burning pains under the incisions. Strangley, the pains happen most often where nipples used to be. Where lymph nodes were removed under my left arm there is growing stiffness from scar tissue. When I lift my left arm into the air I see and feel a string of muscle that goes from my armpit up to my elbow. It needs to be stretched, but it hurts, so I don't stretch it like I should. My chest still feels really tight which I've noticed causes me to cave in my chest a little so that I don't feel the tightness so much. I've been trying to push my shoulders back to stretch that area.

I am feeling the side effects of Femara which is an aromatase inhibitor. Femara keeps estrogen from being produced by my body. This causes joint pain which I feel in my hips, knees and sternum. At first I thought the joint pain was from working out. But I have been lazy when it comes to exercising and the joint pain is getting more pronounced. I really notice it in the morning.

Chemo and the lack of estrogen has taken its toll on my skin. It has less elastisicity which is most apparent around my eyes. The area above my eyes has sort of a hooded look now and the skin below my eyes has more crinkles.

Four weeks out from chemo, my hair is coming in pretty well on my head. I have a bald spot on the front center crown area because of wearing a tight wig and hats. I have a rather large head so this area has constant pressure and rubbing happening there. I talked with the HR director at Target yesterday about wearing a hat to work rather than my wig. She said no problem. I just need to order a Target bullseye baseball cap. This will make me much more comfortable. I've had enough of wearing a wig.

This concludes my State of the Body Address. Good luck and God bless America.

Heh heh.