Kris, Dave and the Lumps: The weeks before surgery #1

I've been a bit remiss, here is me catching up:

Monday 25-Aug-2008:
Kris met with Dr. Jones who was happy to note that the wound is finally healing! We have hopes that by the time it heals... well, we'll have had the port out and a new wound to heal in its place! Everything looks good from the surgeons point of view. He mentioned that they are discussing Kris' case at the cancer board meetings with an eye towards determining if they can do radiation treatment. They are still awaiting data from Austin.

Tuesday 26-Aug-2008:
Muga scan. This is the scan that can give ideas as to how strong the heart is... specifically, they are trying to make sure that the chemotherapy did not have adverse effect on the heart which would cause a delay or change in treatment... just being cautious and gathering more data for the final determination on how we will proceed with the surgery.

Kris, Dave and the Lumps: Chemo the last!

Tuesday 19-Aug-2008
Last infusion of Taxotere and Herceptin!
Saw a colleague of Dr. Moran. Seems Dr. Morans PA was out, Dr. Moran was on hospital duty and later we found out that another of his colleagues was out sick! She was very familiar with our case through the cancer conference! We'd heard early on that our case was going to be presented at such a gathering of Oncologists. What we didn't know was that they meet like this about once a month. On the one hand it's nice to hear that so many folks are reviewing your case. On the other, I can't help but wonder why our case gets so much attention. She suggested a change in our next appointment with Dr. Moran so that he would have time to hear the review from the conference before our appointment with him. The radiologist as well as our surgeon and reconstructive surgeon (read: plastic surgeon) all sit in on that conference too, so, we'll have a review where all of our Drs. are discussing our case.

She revealed that they only had the summary of the radiation films from the Round Rock Cancer Center from Kris' first bout with breast cancer. We needed to make sure that the full charts were forwarded. We signed another release form just to make sure that would not be an obstacle to getting the reports released from the Round Rock Cancer Center.

We then went on for the infusion and everything went smoothly. While we were doing that, I wandered off and rescheduled our appointment with Dr. Moran, scheduled the appointment with Dr. Antel (the Radiologist). His assistant revealed that he may well call and cancel if he's positive that we can't do radiation due to the previous treatment.

During the infusion we met a nice man I nick named 'stanley steamer' because he was carrying an oxygen machine around with him that would 'puff' every so often. He asked me if I was cheating to beat Kris at Cribbage... I assured him that I was not, despite the fact that it is pretty much the only way to beat her at the game!

When the infusion was done, we got a cup of kisses (Hershey's) and a certificate of completion signed by the whole staff... or at least those present! It's a nice touch we also got from the Round Rock Cancer Center.

Friday 17-Aug-2008
Met with Dr. Moran to review how things are going in preparation for Tuesdays infusion. Dr. Moran wants Kris to see a Radiologist to discuss the possibility of radiation treatment after surgery. We were given to understand that she's had her lifetime limit. This request personally makes me a little anxious that he doesn't believe we'll get a cure from the treatment we are going through. Kris is upset at the prospect of having a mastectomy with no reconstructive surgery until the radiation treatments are done.

He also wants Kris to get an MRI and a pet scan and to have those results before we see the Radiologist.

We made a point of showing him Kris' nails. They are discolored for the latter half of the bed (that's the red or pink part of the nail, attached to the finger). We were thinking this is a side effect of the Xeloda, but, it's apparently a known side effect of Taxotere. As for the Xeloda, Kris' hands are still just a tidge pink and her Acid Reflux is quite bad. Based on this, he decided that we'd not to Xeloda for this round... so, we are done with Xeloda! The down side is we have tons of the stuff left over... there's a pile of money down the tubes. It's not like we can give the drugs back for a refund and while the cost isn't huge for us, it is a cost somewhere and in the end we pay for these things by increased insurance rates (or companies dropping insurance). For the Acid Reflux, Dr. Moran suggested that we include Pepcid AC along with the Nexium. We'll give that a whirl.

Finally, before leaving we made appointments for the follow-up with Dr. Moran as well as the Pet and MRI scans.

Kris, Dave and the Lumps: Chemo #5, Week #2

13-Aug-2008

No news is indeed good news. We are waiting for the next round of appointments. Meanwhile, Kris is doing ok, but, still suffering the effects of Xeloda. This is by no means as bad as when she is taking the drug. Obviously it takes this stuff quite a while to get out of the system. Right now her hands are mostly ok but her acid reflux is not very good. Almost done... one more infusion to go!

Kris, Dave and the Lumps: Chemo #5, Week #2

Monday, 4-Aug-2008:
Went to see Dr Kuisle, the plastic surgeon. Our impression from Dr Moran was that we would be able to do surgery middle or early of September. Dr Kuisle put the kabosh on that! We will be having surgery in Early October. This means that Kris will be out longer than 6 months which means she has to wade through the mountain of paper work for Long Term Disability (LTD form here on out).

Warning: anatomically correct stuff to follow, don't read this part if you are squeamish or don't want to read words that might offend the easily offended.

Dr Kuisle said that there will be an outpatient procedure first. This is to clip off some blood vessels that feed the tissue in her stomach that will be used to reconstruct her breast. Not to fear, these blood vessels are from below, there is another set from above. The set from above will be used to supply fresh blood (and remove blood which needs refreshing) from the new breast. The idea is that they want to strengthen the set from above and make sure that it's the primary source of blood for this tissue. There will also be subsequent surgeries to balance both breasts. You don't want one brand new perky breast and the other one either higher or lower so, he'll be adjusting the one to match the other... well, within the norm. Much like feet, both are almost never perfectly identical (part of what makes us unique, and special... and human).

Resume to the safe stuff:
We also saw Dr. Jones. He hemmed and hawed and basically said that things look good enough (in relation to the port wound which still hasn't closed). We told him about our visit with Dr. Kuisle and he said that he'd leave the port wound alone for Dr. Kuisle to deal with. We said that when he takes it out, Dr. Kuisle wouldn't be touching the right breast (where the port is... oops, sorry, one of those words popped in here) until it was time to match it to the reconstructed left one. This would be a while after the initial surgery. Based on that information, he said that he'd take the port out during the mastectomy and, I'm sorry I don't remember the word but basically he'd 'freshen' the wound so that it would heal normally after the surgery to remove the port.

Tuesday, 5-Aug-2008:
Ran errands today in pursuit of long term disability. What seems odd to us is that they want us to fill out LTD forms 3 months in advance to start LTD at the 6 month mark. Initially we weren't even sure the treatment would last 6 months or more so held off. Now that we are filling it out, we find out that we are required by Cigna to apply for Social Security LTD benefits... however, Social Security doesn't give benefits until a year out. Thus, Cigna is requiring that you pursue LTD 9 months before you can get it (from Social Security). Oy Vey!

Having said that, it does make some sense. Basically, to defray the cost of Long Term Disability, the insurance company requests any benefits you get from Social Security... then they just handle cutting you a check. Now, SS won't kick in until the year mark, so, the insurance agency will cover it fully until then.

Wednesday, 6-Aug-2008
Kris is fighting with the LTD paperwork. Amazing how frustrating, detailed and generaly ponderous this process is. They are asking for the names of the prescriptions she's on for her treatment, when each procedure (or at least many of her procedures) was performed. Then, 2 hours after starting the paperwork (online), the form disappeared... My take on this is that they really want to dissinsent folks from using this benefit. Did I mention that studies are investigating the relationship to stress and triple negative breast cancer (the kind Kris has). Ie: there is evidence that says stress helps the cancer to grow... seems criminal to have paperwork that is designed to be stressful for a patient of this disease, doesn't it?