Kristy Merrill

Long Overdue

2009-02-27T10:48:00.004-07:00

I have a few friends who have traveled this Big C road. And I checked their blogs every day. I counted on their updates and was so glad they kept me in the loop with them. So please accept my apologies for being so slow around here. Especially since it's really all good news these days. For a change.

First bit of good news, which I realize is old news to many of you.

Remember this machine?

It is the PET/CT scan machine, and by far, the easiest of all tests. Here is a link to a more complete description of what it does: PET scan. Essentially, though, after they take some of my blood, they mix it with radioactive isotopes, re-inject it, and then scan my whole body to see if they find any cancer baddies anywhere. I had this test done right before we went to Disneyland.

On the day of the test, I re-discovered my old friend Anxiety. And his best friend Panic. The scan is easy; the waiting is hard. I convinced myself that the cancer had spread and grown, and I was overcome with distress all afternoon. I called my doctor at least four times, begging for the results, "even if it's very bad news."

When she finally called at 5:30, I burst into tears when she told me that they couldn't see any cancer baddies anywhere ... not in my breast, lymph nodes, or anywhere else.

See? I have bad days. People often wonder at my positivity and optimism, and about 90 percent of the time, it's that good for me. I feel great. But that day was a bad day. I didn't even want to write about it for a while because it brought back those yucky feelings.

Next up: surgery. I probably mentioned that my doctor recommended a mastectomy of my left breast because there were two tumors there, plus the cancer had spread to my lymph nodes. However, I opted to remove that one, plus the girl on the right, so that I wouldn't need to have constant tests, worry, and frequent visits to Huntsman. Having a bilateral mastectomy would reduce my chances of a breast cancer recurrence by 90%. So I went for it. Part of the reason for that decision was that my grandmother had breast cancer, too, in one breast (which she had removed), and two years later, it showed up in her other breast (forgive me if I've mentioned that before). I am not particularly interested in going through this again if I can help it.

Now, for more talk of breasts and their size and so forth. At the time of my mastectomy (two and a half weeks ago now), they placed "expanders." Those are sort of like empty implants, which they filled with a little saline at the time of surgery. Then, every few weeks, they'll add a little more saline, until they're all filled up to the size I like. That's when I'll have my final surgery, when they'll replace those babies with real implants.

Right now, I have what I call "Frankenboobs." It feels like I had a funky breast reduction. They don't look terrific. But soon, my doctor assures me, I will have "Barbieboobs." These are perky and nipple-free, just like Barbie's. They can tattoo on a nipple if I'd like. But really -- who needs 'em?

And now, because you have endured all this talk of surgery, nipples, and breasts, I will share the best news of all.

After surgery, the pathology department conducts a complete analysis of all the breast tissue and lymph nodes that were removed during surgery. And guess what, people? There was no cancer anywhere. This is huge. You would think we weren't completely surprised because of the PET scan, but really, you never know for sure until the pathology report comes back. I'd like to say this: I am officially cancer-free. They told me that only about 10 percent of people have such a complete response to chemotherapy, so I feel extremely blessed and grateful.

Thank you for your prayers, thoughts, positive energy sent my way, brownies, cards, e-mails, cookies, and other outpourings of support. I strongly believe that you helped my treatment to be so successful.

Now, I will continue to heal from surgery, and I'll start radiation in March. I'll also continue to have Herceptin every three weeks for a year.

I promise I'll try to post more often now, and soon, I'll even post a picture of me and my crew cut. It's not that cute. But at least it's hair.

Reduce Your Cancer Risk

2009-02-07T14:02:00.000-07:00

Cancer seems to come at us from every direction. Plastic bottles, cell phones, food. But it’s possible to cut your risk, says Dr. David Servan-Schreiber in his book. Here’s his 4-step approach to fighting the Big C, just in time for National Cancer Prevention Month.

Our bodies continuously make defective cells, our genes can undermine us and our environment assaults us. And while they're well-equipped to detect and eliminate damaged genetic material, sometimes the broken DNA leads to cancers that our bodies can’t repair without help from drugs and other treatments.

That’s where David Servan-Schreiber, M.D., comes in.

As a cancer survivor himself, Servan-Schreiber has firsthand knowledge of the challenges in treating the disease. And as a researcher, he has logged long hours studying the brain’s processes.

Ironically, his own research led to his diagnosis. He was mapping brain activity on people who performed mental tasks while undergoing MRIs. When one volunteer didn’t show, the doctor took his place, and a walnut-sized tumor in his own brain was detected.

Servan-Schreiber’s book, Anticancer – A New Way of Life (Viking Adult, 2008), details his journey through cancer and discovery of the role of alternative and complementary medicine in treating illness. Although he acknowledges the importance of modern medical science, Servan-Schreiber is convinced that the healing process involves more.

So he looked at environmental factors. If our bodies can fight the development of tumors naturally, he asked, how can we assist it?

The cancer researcher describes four new approaches to boost the chances of preventing and defeating cancer. First, he focuses on environmental factors that he feels promote the onset of the disease.

Cancer used to be a disease of old people,” he says. “Now it is common to know a younger person with cancer.”

Second, our diets should include vegetable-derived compounds known to fight tumors, he says. Some of the easiest steps are adding certain spices and foods. “Consider adding green tea, turmeric or garlic to your diet,” he says.

For 25 foods that fight disease, click here.

Servan-Schreiber’s third focus is psychology. “There has been no link established between stress and the development of cancer,” he says. But in animal studies, “Reaction to stress can speed up or even slow down cancer growth,” he says.

And fourth, Servan-Schreiber wants us to create “a relationship with our bodies that stimulates the immune system and reduces inflammation that makes tumors grow.”

Focusing on yourself as a living, breathing human and “loving yourself” for as little as 15 minutes per day can have positive health benefits, he says. Too many self-help efforts start with a negative.

Add “some new spices to the diet, walk each day for 10 to 15 minutes and work up to more, or join a group with common interests,” he says. Once you build confidence in your ability to adapt new behaviors, “then you are better able to let go of old habits,” he says.

Here are some of his suggestions for an anti-cancer way of life:

Approach #1: Detox Your Environment
Environmental toxins have mushroomed since the 1940s, according to Servan-Schreiber. Some strategies to protect yourself include:

Air out dry-cleaned clothing.

Avoid pesticides and insecticides.

Avoid parabens and phthalates in cosmetics.

Avoid chemical cleaning products.

Avoid cigarette smoke and other atmospheric pollutants.

Filter your tap water.

Here are his suggestions to minimize cell-phone electromagnetic radiation exposure:

Don’t allow children under 12 years old to use cell phones, except for emergencies.

Avoid carrying a cell phone with you constantly.

Don’t use the phone when the signal is weak because it will maximize power to find a source.

Approach #2: Change Your Diet
So what changes does Servan-Schreiber suggest for our diets?

About 56% of our calories are from three sources that were nonexistent when humans were emerging, he says. These include refined sugars, such as cane and beet sugar, and corn syrup; bleached flour; and vegetable oils, including hydrogenated or partially hydrogenated trans fats. Servan-Schreiber recommends minimizing these.

He also urges using low-glycemic foods (which don’t cause a blood sugar spike) in place of sweeteners and other starches. Agave nectar and stevia are two plant-derived sweeteners with a low glycemic index. Instead of bleached flours, he recommends mixed, whole-grain cereals, multigrain bread and whole grain rice, such as basmati or Thai.

Swap in lentils, peas, beans, sweet potatoes and yams for the higher glycemic starches found in potatoes. Avoid jams, jellies and fruit cooked in sugar, or fruit in syrup. Fruit in its natural state is preferred and can be sweetened with agave nectar.

Finally, he recommends a glass of red wine a day with a meal.

The anti-cancer diet also includes:

Animal proteins (optional, if you’re a vegetarian) derived from fish, organic meat, omega-3 eggs and organic dairy products

Whole grains

Fats and oils, such as olive, canola or flaxseed oil

Herbs and spices, such as turmeric, mint, thyme, rosemary and garlic

Vegetables and fruits and vegetable proteins, such as lentils, peas, beans and tofu

Approach #3: Address Your Emotions
Persistent anger or despair, social isolation, denial of true identity and a sedentary lifestyle all can inhibit immune cell production and aggravate inflammatory responses, Servan-Schreiber says. He recommends:

Resolving past traumas

Facing one’s difficulties

Obtaining support from family and friends

Finding someone with whom you can share your emotions

Engaging in regular physical activity

Approach #4: Get In Touch
Several studies have shown that touch and massage reduce stress hormones and increase protective cells in women with breast cancer. If you have the disease, Servan-Schreiber advises:

Trying easy activities that stimulate the body gently

Joining a group

Having fun

Figuring out the appropriate activity level for your cancer

Want more? Get your own copy of Anticancer - A New Way of Life.

MRI'm So Happy!

2009-01-24T19:44:00.004-07:00

I am a fan of clinical trials. In fact, I would (and have) sign up for every one I could, as long as my doctor approves. I'm in two right now, but will let you in on the next one as soon as that starts ... after surgery. Until then, I have Really Good News.

Perhaps I've mentioned this trial in previous posts: it's the MRI trial. With a very long and complicated name that I can't recall. Essentially, though, the purpose of the trial is to complete several MRIs through the course of treatment to see if, ultimately, women going through breast cancer treatment receive better information, response, and if the data gained from the frequent MRIs ultimately affect their results.

People often ask me why I didn't have my surgery first, and there are two answers. First, I was originally considering a lumpectomy, as opposed to a mastectomy. The surgeon strongly recommended chemotherapy before surgery to shrink the tumor first. So I started chemo. Then, they found a second very small tumor in the same breast when they did my MRI. Thus ended my hopes for a lumpectomy. However, I probably still would have done chemo first so I could be a part of this study. My long discussions with my doctor assured me that the survival rates for neo-adjuvant and adjuvant therapy (surgery first or chemo first) are exactly the same).

And now, for the Really Good News. My latest MRI, which was actually in November (I know. I'm very slow.) revealed that the cancer is gone. People, the radiologist couldn't even find either tumor, even though he could still see the little metal markers that were placed in the tumor at the beginning of all this.

Naturally, this is a huge relief to me and, I think, a giant advantage to doing chemo first. I know the chemo is working. I hope that if I am unfortunate enough to have little cancer cells anywhere else in my body that are too small to see, that the chemo is working on those, too. It has made me hate chemo less to know that it is wiping out the wicked bad dudes even as it has been killing my own healthy cells.

On this journey, any good news is welcome, and this news made me exceptionally happy!

What Do You Know?

2008-12-19T18:52:00.002-07:00

How much do you know about cancer prevention? I got 100% on this awareness quiz. Tells you what I've been reading about lately, doesn't it?

Click here to check your knowledge:

Nutrition, Physical Activity and Cancer Quiz...Test Your Knowledge

Cookies for the Cure

2008-12-09T20:39:00.002-07:00

You may be in the mood for a Milano (or, my favorite, a Mint Milano) after playing this game:

Circles of Inspiration (I just call it the Cookie Game)

Your Mother Was Right

2008-12-03T21:50:00.003-07:00

Broccoli Compound Fights Cancer Growth

(Dec. 3) - The mystery of how a compound in broccoli and cabbage fights cancer has been solved, scientists announced Tuesday. And the discovery may lead to the development of anti-cancer drugs with fewer side effects.

The compound, indole-3-carbinol (I3C), diminishes the activity of an enzyme in rapidly advancing breast cancer, University of California, Berkeley, researchers said. The compound is already undergoing clinical trials in humans after it was found to stop the growth of breast and prostate cancer cells in mice.

A compound in cabbage and broccoli called indole-3-carbinol lowers activity in an enzyme associated with late-stage breast cancer, University of California, Berkeley, scientists announced Dec. 2. The discovery could lead to anti-cancer drugs with fewer side effects, researchers said. Click through for other studies on disease-fighting food and food compounds.

Though I3C has been known to fight cancer since the 1970s, the new findings are the first to explain how the compound stops cell growth. Scientists are hopeful that the discovery will help make drugs that are more naturally effective in fighting a range of breast cancers and prostate tumors.

"Humans have co-evolved with cruciferous vegetables like broccoli and Brussels sprouts, so this natural source has a lot fewer side effects," said study coauthor Gary Firestone.

I3C, one of many plant-derived chemicals called phytochemicals, inhibits the enzyme elastase. Breast cancer patients with high levels of elastase respond less effectively to chemotherapy and endocrine treatments, and they have lower survival rates.

I3C, which is available as a supplement, is a preventative treatment for recurrent respiratory papillomatosis, a condition involving non-malignant tumors of the larynx. Scientists said this shows that the chemical may also help treat cancers other than those of the breast and prostate.

Field Trip

2008-11-26T11:07:00.006-07:00

Since a day of chemotherapy is so much fun, I thought you might like to join me on a field trip.

Ready?

It's not a bad drive to Huntsman. I just head up Foothill, past the University, then a little further east to the hospital. Would you believe they have valet parking? With no tipping allowed? It's very convenient.

I stopped in the middle of the road to take this picture, so please take a moment to appreciate it. It was quite crooked until I used the "straighten" tool in Picasa. Have you tried it? I love it.

This really is a gorgeous facility and doesn't "feel" like a hospital, which is so very nice. It is light, clean, and modern, but doesn't even smell like a hospital. Actually, it feels more like a hotel, but I haven't had the pleasure of a sleepover ... yet. There are two good restaurants on the top floor. I'll tell you more about those shortly.

Every few weeks, I see my doctor first. She checks me out and answers all my questions and always has a big hug for me. I love her. Have I told you that? Dr. Saundra Buys, in case you should find yourself in need of an amazing breast cancer doctor. My friend Courtney echoed my sentiments exactly about these doctor visits: it feels like Mardi Gras because everyone always wants me to lift up my shirt and show them my girls!

Next stop: the IV and labs. They draw my blood every time I have chemo (which is every Friday, by the way) to check my kidney and liver function, my white and red blood cell count, and a whole bunch of other stuff. Assuming everything is working okay, I get the gift of toxicity. So far, they haven't turned me away yet, which means that my body is handling the chemo just fine. Sometimes, a nurse will strongly encourage me to get a port, which is a thing about the size of a quarter that would go just under my collarbone and stay there until I'm done with chemo. I don't want one, though, and since I don't have to have one, I choose a different vein each time for my IV. If I were scared of needles or if I had already had surgery, I would need one, but for now, I just tell them where to stick it.

While I wait for my labs to come back and my chemo to be prepared, I usually have time for lunch. There are two really good restaurants on the top floor, and if I have time, I nearly always get the blackened salmon, steamed vegetables, and green tea. Antioxidants, anyone?

This is the long, long hallway that goes to the infusion room, which is the place where everyone gets their chemotherapy and any other injectable, like blood, I guess, when you have to get hooked up to an IV to get it then sit and wait a while. They plunk me in a recliner that has a TV, offer warm blankets and pillows, and connect me to the toxins.

See?

It usually takes me about three hours or so to finish up, so I always take my laptop. Sometimes, the beeping and cancer talk all around me start to make me a little nuts, so I've found it's really helpful to take my big old Bose headphones and a movie. I like to chat with the other patients, too, and have some good friends there since we see each other all the time, but not everyone is chatty. Some people will have chemo for the rest of their lives, while others like me will finish up and move on, and the nurses sing, ""Happy end of chemo to you ... your therapy is through!"

This is the infusion room nurses' station. They are all extremely nice and helpful, like everyone I've met at Huntsman, and one of them is assigned to me the whole time. When I'm done and the alarm beeps, they free me from the IV, which always makes me happy. They nearly always have a big basket of chocolate (smart ladies) and there are always free hats that nice people knit or sew and donate to us baldies. Our heads get cold in the winter.

It helps to have cute socks, because I like to kick back in the recliner and I wouldn't want to have ugly feet. Thank you, Brent, for the cute socks.

Was that fun, or what? I'm glad you joined me on the field trip via blogland, because a real day of infusion therapy is really quite boring.

FAQ

2008-11-06T21:31:00.004-07:00

Bad blogger.

Bad returner of phone calls.

Bad e-mailer.

Please don't think I am ignoring you. Really! I love you and your calls and cards and e-mails. I even love blogging.

But sometimes, I get tired of talking about cancer, chemo, breasts, and tests. When we're talking on the phone and I change the subject to talk about your PMS, your kids' messes, your new living room furniture or latest great (or terrible) recipe, you might think, "Oh, the poor thing. She is really uncomfortable talking about her breast cancer."

In actuality, I just find it really ... boring.

I have discovered that being diagnosed with cancer seems to also mean being defined as having cancer. I know this and am not in denial. However, I am still a mom, friend, photographer, procrastinator, reader, animal lover, cake stand collector, and iTunes addict. Those things (and yours) are much more fun to talk about, especially if I'm returning phone calls and have already answered all the questions you ask me that day several times over.

Please don't feel bad for asking, though. Just understand if I change the subject, and here: let me answer a few of the questions I've been asked a lot recently, in case I haven't returned your phone call or e-mail or doorbell ring or letter. I was probably asleep, if you want to know the truth, and just too darn pooped to get up and answer the door, and I probably had the phone turned off, and I might not even have checked my e-mail all day.

1) Are you done with chemo?
Not yet. I finished four rounds of Adriamycin/Cytoxan (also known as "AC" or "red Kool-Aid," because the Adriamycin is wicked red and so is your pee afterwards). I have had one visit with my new combination: Taxol/Herceptin. I go every week for 12 weeks for this combination. It makes me very tired and achy.

2) How are you feeling?
Pretty good, actually. As I said, I get very, very tired a couple of days after chemo and it lasts for a couple of days, and I feel extremely fortunate to be able to sleep pretty much anytime I want to during that time. This is thanks to Saint Anthony, my family, and my ward, who watch my kids and bring us food.

3) What is your prognosis?
This is my least favorite question, but it seems to come up a lot. To me, it is a question that is really asking, "Are you going to live or die?" I know that's probably not what the questioner truly has in mind, but still. I plan to live and my doctor says I should live a very long life. We discovered this early enough that I can beat it, but it will take a while to get there.

4) What's next?
After I finish my chemo, I will have surgery. This means a mastectomy, and my hope is to have a bilateral mastectomy. Good-bye, both boobs. Hello, reconstructed Frankenstein-ish boobs. You see, my maternal grandmother, aunt, and many cousins had breast cancer, and in my grandmother's case, hers started in one breast and came back in the other two years later. I am really not interested in having breast cancer twice, so I would rather just have the surgeon take them both and build me a fresh set. Surgery should happen in February. After that, I have radiation. I'm not sure how long that will last.

Grandpa and Grandma Tibbitts

5) Have you considered vitamins/grapeseed oil/holly injections/etc. instead of chemo?
No. Thank you. I have a rather aggresive form of breast cancer and, as you may guess, I am not interested in it hanging around. My belief is that this traditional method of treatment is the best option for beating this cancer. That being said, I certainly offer up my respect for each individual's right to treat their own cancer how they want. I am pursuing some complementary treatments, including yoga and acupuncture, but that is in addition to the chemo/surgery/radiation.

P.S. Please don't tell me that chemo will probably kill me if the cancer doesn't. It won't.

6) Do you wear a wig?
Not yet. I have one, but haven't had George steam, cut, and style it yet. I like my baseball caps, knit caps, scarves, and other stylish head coverings (thank you, Heidi, Kathleen, and my mom's nice co-worker) better so far. I'm getting tired of the same look, though, so that may change in the future. It helps that A. is always telling me I'm beautiful (when he's not calling me "baldy," that is).

7) Are you bald? Totally?
Yes. I have a little bit of stubble left, but not much. No, I don't have to shave my armpits or legs anymore. I haven't lost my eyebrows and eyelashes yet, but they tell me the Taxol may do that later.

That's all I can think of for tonight. I have chemo tomorrow, which means I will sleep for several days, and probably won't be blogging much in that time period. But don't think I've forgotten you, blog readers and friends of mine. I love you and appreciate your prayers and kind words, food, cards, and so much more. You help me more than you know.

Please send more questions so I can write FAQ volume 2 soon.

Find a Cure

2008-10-31T15:06:00.000-06:00

Thanks, Julie C. :-)

Breakthrough

2008-10-24T12:48:00.006-06:00

Did you know it's Breast Cancer Awareness Month? Surely you haven't missed all the pink ribbons, pink Tic-Tacs and M&Ms, pink t-shirts, cool on-demand breast cancer educational programs, and oh, so much more?

Did you know I used to avoid buying pink things during October? Because I was superstitious and scared? I thought then that I was just a hypochondriac, but now I think I was psychic.

Did you know that breast cancer is the most-researched and best funded of all the cancers? Your purchases of Yoplait (with the pink tops) and awareness mints (with the pink ribbon on the tin) and maybe even your pink Kitchen Aid mixer are helping women like me.

The latest discovery is extremely exciting, and my doctor is communicating with The Powers That Be in San Antonio to get me on board with their clinical trial next year: a breast cancer vaccine.

Even though I already have breast cancer, this vaccine will hopefully be able to prevent a recurrence, especially for women like me who are HER-2 positive. So please, when you have a chance to buy those products that help fund breast cancer research, go for the pink!

NeuVax™ (E75)

NeuVax is a peptide-based immunotherapy that recruits the immune system to fight cancer and activates "Killer T-cells" to target tumors. NeuVax specifically targets cancer while leaving normal, healthy tissues unharmed. The key to NeuVax is a small peptide called E75 that is derived from HER2/neu, a protein expressed by tumors.

T-cells from NeuVax-treated patient attacking cancer.

Unlike existing monoclonal antibody therapy which requires frequent, ongoing, intravenous (I.V.) infusion, NeuVax can produce continuing activation of the immune system and therapeutic levels of Killer T-cells with a once monthly intradermal (under the skin) dosing schedule that is less expensive and more convenient for both the patient and physician.

NeuVax is currently undergoing clinical testing for the adjuvant (after-surgery) treatment of early-stage HER2/neu-expressing breast and prostate cancer. NeuVax may also be developed to treat other types of solid tumors.

Pity Party

2008-10-22T17:05:00.003-06:00

In case you haven't talked to me, you may not know that I was not excited about losing my hair. I knew it was coming, as the nurses called Adriamycin the "automatic hair removal system," but still, I didn't realize how unhappy it would make me.

And this made me feel guilty, because I thought, of all the worries I have, why should I be worried about my hair? After all, it will grow back, right? But still, it was tough to see it go.

When it started coming out in chunks and handfuls and covered my brush, I couldn't take it anymore. I called George, who agreed to get rid of it all for me. When I first got there, he saw that I did still have plenty of hair (or so it seemed) and asked if maybe I wasn't jumping the gun a little bit? So I just ran my fingers through my hair and, when George saw the handful that came out, he said, "Okay, girl. Sit down."

And then I was horrified. I couldn't look at myself in the mirror for many days. Anthony said I didn't need to hold my hands on my head when I talked to him, but I couldn't help it. I tried to picture Natalie Portman and Demi Moore, but it just didn't match up with seeing myself all bald.

Gradually, though, I've gotten used to it. I usually wear a baseball cap, which is what I feel most comfortable wearing, or a scarf, which looks a little dressier, and I've started wearing these comfy Adidas ski caps that I really like, too.

And once ... just once! I even went bald. Tyler and I went to yoga class and he encouraged me to go all melon-headed to class, and I did. And I don't think anybody really cared. But I felt ultra proud of myself.

I do have some really cute hats (thanks, Heidi and Kathleen!) that I haven't taken pictures of yet, but I will soon. And despite my sadness over the (temporary!) loss of my hair, I have to admit these things: 1) It is much cheaper to be bald (sorry, George); and 2) I can get ready really, really fast.

Messages

2008-09-29T10:28:00.003-06:00

I am posting this post as a means of procrastinating the baldness post.

Got it? Okay.

I have received so many kind and encouraging e-mails, phone calls, visits, cards, and so forth. You know what? Those messages really do help. I feel stronger and loved. I am so touched to know that people are thinking about my family and I really believe that all our combined positive energy and prayers make a difference in my healing.

Most of the messages are just too personal to share, but I am going to share this one, from a very old friend, Alan. I hope he doesn't mind. I didn't ask permission. Sometimes I get a bit weary of all the sadness-scary-cancer stuff and appreciate a little humor. So here you go:

Since I have no idea what it's like to be chemo'd and don't have a good opinion on if I'd take it or leave it, I will hope and wish you the intestinal fortitude to persevere. I know it's bad (and bad ass) medicine. Can you at least get some Marinol or some of that Government Grown to alleviate some nausea, loss of appetite or melancholy attitude that goes along with being voluntarily poisoned? Now baldness, that I can relate to, having been that way several times. Have you had any surgery? Maybe you can get a new rack that will be perfect? Keep your chin up and think positive.

Two Down, Two to Go

2008-09-24T09:27:00.003-06:00

Oh, my friends. I am happy to report that I have completed two of the four rounds of the AC chemotherapy. I am extra happy to report that round two was much better than round one, and while I am not certain that the next two times will go as well, I am very hopeful.

On chemo day last time, my ickiness hit me about seven at night and lasted several days. Don't get me wrong here -- it could have been much worse -- and I really felt like the anti-nausea drugs did their job well. Still, though, I was sick. But this time, I really didn´t have any tummy trouble. And my chemo headache went away after the first day. And my chemo brain was not so befuddled this time. The only thing that was the same is that I was tired. Way tired. Like sleep anywhere, anytime tired. And do you know how lucky I am? I was able to sleep and sleep and sleep some more.

Anthony took the boys to Boondocks after school on Friday to drive go-carts, and Mom took Christopher to Provo. Anthony entertained Nate until James & Mard took him to a 3-D moon movie and Chuck E. Cheese. Friends and neighbors and family brought food, so when I was awake, I was able to eat really good food before I went back to sleep. Oh, and when I got tired of sleeping, Anthony took me on a long drive to see the fall leaves. Not a terrible weekend.

After two more rounds of this AC, I switch to Taxol, and I will receive that chemo every week for 12 weeks. They say it's not as bad, but that I might have tingly fingers and toes. We'll see!

Oh, yes. My hair is gone. More on that event later. I'm not quite ready to talk about it yet.

Hair Today ... Gone Tomorrow

2008-09-18T15:12:00.003-06:00

My doctor and nurses have assured me that my hair is going to fall out. Slowly at first, they say, then in handfuls and brushfuls and chunks. Sounds nice, doesn't it? In fact, my infusion nurse calls Adriamycin the "automatic hair removal system." They said it starts about two weeks after your first treatment, so tomorrow could be the beginning, and if not tomorrow, surely it will be shortly thereafter.

So the last time I had George do my hair, I had him put in extra-long extensions so I could really live it up, Marcia Brady style, for my last few weeks with locks. Some people have suggested I cut it short now so I can get used to it, but I like my long hair, and I'm going to enjoy it as long as I can.

George took me wig shopping. It was depressing. But I bought a wig anyway and also a really cool sort of wig that will attach inside a hat. I also ordered some scarves and, frankly, I think they're much better looking than a wig.

I've been pretty concerned about the stigma of having cancer, and I haven't been sure I wanted people looking at me and thinking, "Cancer patient!" or "Chemo girl!" Truly, though, I'm not sure I care. I know cancer scares people, but it's what I've got, and I have to put up with it for a while, too. Surely, I shouldn't have to wear a hot, ugly wig, too, should I? If I don't want to?

But we'll see. Will I be brave enough to post a bald picture? Well, now, I just don't know about that. Courtney did, but she is gorgeous. I'm afraid I'll look like Gollum.

As If!

2008-09-16T20:55:00.002-06:00

I just received this letter from Huntsman Cancer Institute:

Dear Kristy Merrill,

Thank you for obtaining your breast imaging at the University of Utah. We are pleased to inform you that the exam done on August 26, 2008 was normal.

Your breast images and report will be kept on file here as part of your permanent medical record and are available for your continuing care. Please be sure to inform any new physician or new mammography center of your medical record with us.

Remember that a negative mammogram does not exclude the possibility of breast disease. If you ever have a breast lump or anything else of concern to you during your self exam, you should not ignore it, regardless of the results of your mammogram. If you find a lump or other change, talk to your health care provider about it as soon as possible. Please keep in mind that good breast care involves a combination of three important steps: monthly breast self examination, an annual examination by a health care professional, and periodic mammograms.

The most recent mammography guidelines recommend yearly mammography beginning at age 40.

Thank you for allowing the University of Utah to help you in meeting your healthcare needs. We look forward to seeing you on your return visit.

Sincerely,

The Comprehensive Breast Care Center

Hmm. I guess they didn't get the message that Kristy Merrill has breast cancer. Oops!

My doctor recommended that my sister, Nancy, just skip the mammogram and go straight to the MRI, since she is high risk. I was also considered high risk because of my family history, but my breasts are also "dense," they tell me, and my mammograms all looked perfect.

Still, it's nice to hear that one test was okay, even if it was just wrong!

Mail Call

2008-09-14T12:55:00.004-06:00

This is what my mail looks like these days:

I got all of these medical bills in one day last week, and I received several more each day after. I am very, very fortunate to have good medical insurance the covers the majority of my costs, but even so, it's not cheap to have cancer.

But I don't seem to feel overwhelmed by keeping track of the bills; rather, each time I open them and pay them or follow up with the insurance company or the finance guy at Huntsman, I am brought back to the same thought: what do people do who cannot afford medical insurance? Do they simply go into debt? Do they delay or ignore treatment? Are they denied treatment? Do they have to go to an inferior treatment facility?

The other group that keeps coming to mind is the elderly. It is so difficult to deal with the physical and emotional toll of cancer, so how do weakened, older people navigate a pile of bills like this? How do they find the strength to call and fight with Medicare or the hospital? And remember to eat right and take their medication on schedule?

Do you have answers for me?

Round One

2008-09-12T10:35:00.002-06:00

People, I finished my first round of chemotherapy! Last Friday, I started a regimen of Adriamycin and Cytoxan, plus a kabillion or so anti-nausea drugs to go along with the chemo.

Symptoms and side effects, it seems, vary widely from one person to another, even when those people are on the same drugs and dosage levels. Here's what I had: a painful tummy (that's still there), a headache (mostly gone now), a strong need to sleep at all times, feeling like I had the flu, complete with aches and pains, and "chemo brain."

I have heard the term "chemo brain," but not from the doctors or nurses who educated me All About Chemotherapy. My brain seriously felt as though it was functioning at about 40% of its usual capacity, and it continued to climb upward from chemo day until I finally feel almost back to normal today -- maybe 90%? Or maybe I just like that "chemo brain" as an excuse for my typical forgetfulness?

The day after chemo, I visited the hospital again for a shot of Neulasta, which is another one of the many miracle drugs I am lucky enough to receive. Neulasta helps my body create more white blood cells so that I'm not quite so vulnerable to infection. It makes my bones ache, but no worse than a regular trip to the gym, really. Still, I enjoy Lysol and hand sanitizer very much these days, and I think my boys are tired of me telling them to wash their hands.

My hair is still attached to my head, but the nurses refer to the Adriamycin as the "automatic hair removal system," so I expect to start losing it next week, and George has promised to shave it when it's all falling out. Even though Courtney looked great with no hair, I am not so optimistic for myself and am not looking forward to that day!

I feel well enough now that we can celebrate Ro's birthday this weekend, and I hope to get caught up on life again next week before round two: on September 19.

Home Away From Home

2008-09-07T23:09:00.002-06:00

I have been spending a whole bunch of time at the Huntsman Cancer Institute lately. It is a truly remarkable place and I feel so very fortunate to have such terrific health care resources available to me just 20 minutes away from my home. There are many patients who travel much farther than I to receive treatment here, including some from Alaska!

In addition to having the finest resources around to treat cancer, the Huntsman Institute is also a beautiful building. I always feel comfortable and well-cared for there, and I really love the fact that it doesn't feel like a hospital at all. Well, the infusion room kind of does, but not so much. I'll take pictures there next time. The photo above is of the ceiling, and the photo below is the view of the Salt Lake Valley.

And this photo is the PET scan machine. It is my favorite scan to get (I had three MRI's last week. Hate 'em.), because it is quiet and quick. It is also sort of a scary one, because it can find cancer anywhere in your body. It is not very fun to wait for the results. Happily, I only have cancer in one small part of my body, so the PET scan is still my friend!

I often get bored while wandering around between appointments, so prepare yourself for more photos from Huntsman.

Smooth

2008-09-05T12:17:00.006-06:00

There was a time in my life (think mid '80s) when I thought it was cool to have unshaven legs. I was dating a guy who saw a crunchy biker girl and he made an offhand comment that it was great that she didn't shave her legs. So I tossed my razors and for a few years there, I was furry-legged.

But even then, I didn't consider for a single moment not shaving my armpits. I mean, really. Who wants fuzzy pits? Not I. And I never understand why those women on Survivor don't at least go in for a waxing before filming starts.

So please don't think I'm compulsive or anything, but I pretty much shave my armpits every day in the shower. Maybe in the winter I skip a day or two, but with the warm summer weather and t-shirts and swimsuits and all, it's just better not to be fuzzy. Consequently, I'm pretty familiar with the geography of my armpits, as I always feel for stubble before completing my shower.

That marble rolling around under the skin of my left arm really surprised me. "Huh!" I thought. "Feels like a lymph node." Well, I did have a sinus infection. Maybe that was it. I'm sure nothing is wrong. I did have a fluttery panicky feeling for a minute, but it passed quickly, 'cause I'm generally an over-worrier. But I did remember from all those magazine articles I've read over the years that a lump in your armpit could also be breast cancer, so I headed to my gynecologist the next day for an exam.

"Probably hormonal," she said, "But if it's there in two weeks, let's get you in for a mammogram. Oh -- and I'm sure you felt this lump, too, in your left breast?" Uh, no. Hadn't noticed that. Felt like the rest of my breasts to me. "Probably just fibrous tissue." Wait and see. But only for two weeks.

Every day, pretty much all day, for the next two weeks, I felt that lymph node to see if it had changed. I tried not to. I tried to ignore it, but it was like a little magnet. One night, I made the mistake of googling "lymphoma" on the Internet. Lump in armpit? That's me! It was the first of many panicky moments induced by an Internet search.

But two weeks later, both the marble and the lump were still there. Unchanged. I headed to Huntsman Cancer Institute for my mammogram. The technician said it went great and I was a terrific patient and my mammogram looked perfect. "But they're going to want to do an ultrasound on that little bump in your armpit. It's probably just a cyst."

By the way, I do enjoy that reassuring kind of talk. I like honesty and directness, too, but in carefully measured doses. I already knew that bad stuff that it might be, so I was glad for all the sweetness and kindness.

The first doctor who looked at my ultrasound tried to be sweet and kind and reassuring, and almost sent me home, but at the last minute, decided it "might be a good idea" to have someone else look at the lump in my armpit. And that doctor's reassurance was like this: "Don't freak out until it's time to freak out." And she scheduled a biopsy.

Two days after that, when the phone rang and it was Huntsman, I breathed a huge sigh of relief. Finally, I thought. I can quit worrying and get on with my life! Unfortunately, the doctor said, she had bad news: I had metastatic adeno carcinoma. That meant that my lymph node had cancer cells in it and it was fighting cancer somewhere in my body, but they didn't know where: could be breast, lung, pancreas, colon, kidney, liver ... who knew? What a sinking feeling I had that day. Never had I thought, I hope it's breast cancer ... but it seemed the easiest of the lot, and thankfully, that's what it turned out to be.

On with the fight now.