Treatment Plan and Next Steps! (Updated July 29, 2006 4:32 AM)

Now that we have a better idea what we are up against, the next step is a treatment plan.

• Thursday, July 20 - 9:30 AM - Today we meet with Dr. Barstis the Medical Oncologist who will lay out the treatment plan for Radiation and Chemotherapy (two very informative links on both kinds of treatment) today. Valerie also has another pre-op meeting with our regular physician, as she will be going under (about a one hour procedure, so the doctor says) one more time next Thursday to have an "Implanted Port" put in.
• Friday, July 21 - 10:12 PM - Well we met with Dr. Barstis and yet the final treatment plan is still not finalized (it would seem the plan changes as needed, depending on new information and patient reaction to what is being done!). They are still awaiting the results of the "FISH" test to determine what (if any) Hormone therapy can be used after the Chemotherapy. We do know that the first Chemo treatment will be on Monday, August 7, 2006. Apparently there are many new drugs that will try to eliminate the side effects (nausea, low red, white and platelet blood counts) that normally occur after a Chemo treatment. However Dr. Barstis says within 24 hours, Valerie will likely feel very weak (like how you feel on the back end of a cold, aching all over and wanting to sleep) for about 3-5 days after the treatment.
• Tuesday, July 25, 2006 - 9:00 AM - Valerie finally got her drains (two) removed at UCLA. Gross, but reality, they helped drain fluid from the surgery area and had to be emptied every 12 hours. She was also given the good news that she could finally take a shower on Wednesday! YEAH! We do love you Valerie, but love is blind not Anosmic!

  

  She also got to pick up one of her wigs today from Intimate Images....funny, I do all this polling (like I was ever planning on letting you dictate which one she could get) and then she goes out and picks her own! Oh well, she is happy with it. This one is her "just got to run to the store" wig, and she ordered her custom made one (which we have not seen yet) from Piny that is to be done next week. I am told the one from Piny is long and looks even better than her real hair! Time will tell (and so will I). We also met with Dr. Barstis today, to go over the Hormone test results. Unfortunately they do not have the FISH results yet. They tell us it should be in a couple days. This does not change when Chemo starts though. Chemo will start Monday, August 7th.

• Wednesday, July 26, 2006 - 7:23 PM - She really did take a shower! Tomorrow we head in for the Implanted Port surgery (she will be under for about one hour) and then rest in preperation for our trip next week. Yes we made the decision to go on our planned trip to Lake Mohave with our neighbors and Dion's cousin. Don't worry, if it is too hot for Valerie she already has plans to sit at a Blackjack table at our hotel while I drag the kids around the lake (something tells me 73 degrees will be too hot!).
• Thursday, July 27, 2006 - Into surgery for the Implanted Port at 9:14 AM and out at 10:57 AM (although I don't get to see her until almost 12:30 PM). Dr. Senofsky says it went great and she is fine. While it seems like a very simple procedure and small incision, an unexpected side effect is that Valerie has quite a bit of pain in her left shoulder, arm and upper chest area (where the port is). Two days later and she can still only barely lift her arm. Doctors say it is normal, but we are both a little surprised.
• Saturday, July 29, 2006 - 4:32 AM - Well we got some great news yesterday! Dr. Barstis called with the test results and her cancer cells are hormone receptive which basically means they like hormones to grow. Valerie will be able to include in her treatment, drugs that will limit or eliminate her body's production of Estrogen and Progesterone with some side effects. Another good piece of info the FISH test indicates her cancer cells are HER2 negative which means she won't have to undergo Herceptin treatment and the cells tested are less aggresive than originally thought. One advantage to living near the treatment center is that Dr. Barstis is going to be able to treat Valerie with her Chemo treatment every 2 weeks instead of 3. For women with node-positive disease, a common treatment regimen is four cycles of AC, followed by four cycles of Taxol or Taxotere. Bottom line Dr. Barstis says her prognosis is better than his initial expectations! We will be asking why AC and not TC treatment and ultimately go with what Dr. Barstis believes will beat it! Today Valerie also picks up her other wig at Piny in Beverly Hills (I hope it is longer than the other one!).
• Sunday, July 30, 2006 - 12 years ago today I told this beautiful woman who stood in front of me that I would stand by her side "in sickness and in health", I'm still here and we're still in love! We are taking a family vacation to Lake Mohave to do some boating, skiing, tubing, fishing and relaxing. Next step will be chemotherapy on Monday, August 7th, I'll update more then!

On her way to another surgery! This one for the Implanted Port. Into surgery at 9:14 AM and out at 10:57 AM. Dr. Senofsky says it went great and she is doing fine.

Breast Cancer Post-Surgery Update (last update July 17 - 5:35 PM)

• Wednesday, July 12 - 11:35 AM - Off to the OR, doctors say it should be about 4 hours.
• Wednesday, July 12 - 2:16 PM - Nurse Lori just called from the OR and so far so good. Got about 2 more hours to go.
• Wednesday, July 12 - 3:35 PM - Dr Senofsky just came out. She is still being operated on by Dr Watson and they found another tumor hiding near the one we knew about and pre-cancerous cells (D.I.C.S?) on the right nipple, which they also removed. Not sure what makes a cell pre-cancerous, versus cancerous? Really struggling with how to tell her this info, made the decision to let her recuperate these next few days and she will know on Monday when we get the pathology report from Dr. Senofsky and Dr. Watson. I can't bear to see her worry over this news until Monday, so I will keep it from her. I may regret that decision but I have her health and mental well-being as top priority right now. Hopefully Monday will bring news that all the margins are clear and they got it ALL! If not, Monday could be a very rough day.
• Wednesday, July 12 - 6:15 PM - She is out of surgery, She handled surgery very well physically but Dr. Watson says he and Dr. Senofsky were both "disappointed" by what they saw. This has got to be the most disturbing news of the night. He did end his conversation by telling us he is extremely optimistic and feels very positive that Valerie will be fine.....good words to hear, but hollow after the other statement. Dr. Watson clarified that his disappointment was in finding the second tumor and that unlike the first one (which was ductile), the second was lobular. In addition they removed approximately twenty Lymph Nodes as well as the right nipple. In putting this together (Thursday night while Valerie rests) I found the link above (ductile vs. Lobular) and must say it took a huge pressure off my mind....only time will tell what they really are, but I pray it is nothing!
• Thursday, July 13 - 2:00 AM - I snuck in past the security guard and went to Valerie's room. She is doing ok, still very tired but ok and telling me so. They let me stay for about 15 minutes, but because it was a shared room, I had to leave so I wait in the lobby and miss her!
• Thursday, July 13 - 6:35 AM - Doctors checked her, and were happy with her progress. Today is a good day to visit as they will likely discharge on Friday (at least that is what they think so far), so come on by if you want to.
• Thursday, July 13 - 2:16 PM - She stood up for the first time a minute ago, a little woozy but made it to the restroom! Too bad she'll have to get up every 5 minutes! Those that know Valerie will know why.
• Thursday, July 13 - 3:32 PM - Moved to the new room (714) and the new number is (310)267-1568. At least tonight I can stay in the room with her.....no more sneaking in! The nurses (Patrick, Mimi, Kathleen and Rosa) were very helpful in making this happen.
• Thursday, July 13 - 10:45 PM - A couple updates from Valerie's room while I watch her sleep peacefully. Dr. Watson has decided to keep Valerie until Saturday or even Sunday if she wants (helps to have the Chief of Staff as your surgeon!). Second thing is Valerie knows about everything (second tumor and the doctor's "disappointed" comment). She handled them all admirably and is eager to start the battle against this long, slow car crash called Cancer that we will both safely walk away from! Both our hearts go out to the others suffering in this hospital, many had no warning a hug, kiss, "I love you" or "see you tonight!" was the last their loved one would hear from them, so much hurt, and so much hope all in one place.

• Friday, July 14 - 3:38 PM - Our kids visit Mom in the hospital. I forgot to take a picture of our son (I am sorry bud, I was too busy giving you hugs)! Valerie also had a visit from Jackson (the hospitals pet therapy Golden Retriever), which I also forgot to take a picture of (Bad day to have dad holding the camera). We should be leaving around 10 AM on Saturday for home. Today was a good day!

• Saturday, July 15 - 12:05 PM - On our way home, yeah so it is a little blurry, I was a little excited!

• Saturday, July 15 - 12:52 PM - Me waiting for Dion to drop off prescriptions and then we will go home and wash off the stink...and yes I stink! She said it not me, so it must be ok to post this one.
• Sunday, July 16 - 8:20 PM - Well, it has been great to be home, but it has not been without its own challenges. Unfortunately we wait for the results of the pathology report to determine what kind of battle really lies ahead (even then, does anyone really know what to expect?). The results are due Monday, July 17. The challenges have been with what can only be described as "panic" or "anxiety" attacks. Valerie has a true fear of leaving her children and me behind. Not a fun thing to experience, and largely psychological with no real remedy for this particular cause of her fear. I can only hope that the pathology results on Monday will bring an end to this fear she has. I think I'm pretty good at calming people down, but am sure being tested lately! Unfortunately these attacks occur during sleep (right when she wakes up), so it does not give me a whole lot of time to "chat" her down. Many of you have had some great suggestions (go to sleep thinking of something good, know that you are safe and will wake up to a new day, know that God is caring for you, you are safe in his arms). To all of us not experiencing it, it seems easy "chill out", "calm down" or "relax", but those words don't fix the underlying issue. Hopefully tomorrow will be a beautiful day!

Today at 5:30 PM we got the pathology results......still quite a battle, but I must say A BEAUTIFUL DAY! Still not the happiest news on the planet, but you gotta take the good when you can! Clear margins are a good thing....now the fight is on!

• Left Breast - Negative for malignancy (nothing there!)
• Right Breast - Invasive Ductal Carcinoma at its closest point is 5 MM from the deep margin (doctors usually want to see 2 MM at a minimum), which means the margins are clear!
• Lymph Nodes - 21 of 22 tested positive for Metastatic Carcinoma, largest one was 2.3 CM with Extracapsular invasion present and Perinodal Lymphvascular invasion present.
• Overall described as late Stage II or early Stage IIIA.

Specifically the Histologic Grade of the two tumors are:

Tumor #1 (Infiltrating Lobular Carcinoma) Tubule Formation:3 Nuclear Pleomorphism:2 Mitotic Counts:1 Size of Lubular Carcinoma:1.3 CMHistologic Score:6 Histologic Grade:2

Tumor #2 (Infiltrating Ductal Carcinoma) Tubule Formation:3 Nuclear Pleomorphism:3 Mitotic Counts:3 Size of Lubular Carcinoma:0.9 CMHistologic Score:9 Histologic Grade:3

Wig #1 got 15.7% of the 242 votes (38)

Wig #2 got 5.0% of the 242 votes (12)

Wig #3 got 28.1% of the 242 votes (68)

Wig #4 got 33.5% of the 242 votes (81)

Wig #5 (no this was not a voting option, she overuled us all!). There was an option for "None of the above, let the Sinead O'Connor in you out! That got 17.8% of the 242 votes (43).

Feeling lots better!

Eating her first food (celery)! Not real pleased but it is food!

Big smiles! Well the lighting really sucks, but she was smiling for the first time. Even with the thermal blanket they placed on her to regulate body temperature. The white blanket is actually connected to a large blower (heater) that blew hot air (about 98 degrees) for the entire night over her entire body. This did not make Valerie happy as she described it as "being cooked" or sitting under a blow dryer for several hours (imagine the "Stay-Puft Marshmallow Man"). I'll bet she misses that thing next time we go skiing!

Surgery today, waiting in admissions!

You mean well, but better to be informed!

What a past couple days, my beautiful bride Valerie, my wife, my life long partner has a serious fight in front of her. She is going to grow old with me, she is going to help me spoil our grandchildren, we will beat this! I have faith, and I believe, but I also believe you cannot hide from the awful truths, this is not a nice disease. Three of the best doctor's in the world do not come rushing to your aid in ONE DAY if they thought "you will easily make it through this" (which is what it seems I am always telling Valerie) I am trying to be strong, I feel I have to be, but sitting here in front of an inanimate object I find it easier to share my inner fears. I do have faith we will make it through this.....it just won't be easy.
Some facts you may not know from www.youngsurvival.org:
Despite the prevailing opinion that young women don’t get breast cancer, the reality is that they can and they do. In fact, one in every 229 women between the ages of 30 and 39 will be diagnosed with breast cancer within the next 10 years. Following are some additional startling facts about breast cancer in young women:

• Breast cancer is the leading cause of cancer death in young women ages 15-54.
• More than 11,100 women under age 40 will be diagnosed with breast cancer this year, and more than 1,100 will die.
• There are more than 250,000 women in the United States age 40 and under currently living with breast cancer.
• Young women’s cancers are generally more aggressive and result in lower survival rates.
• The five-year survival rate for young women with breast cancer is 82 percent, which is lower than their post-menopausal counterparts.
• Young women with breast cancer struggle with many issues that their post-menopausal counterparts don’t face, including: the possibility of early menopause, pregnancy after diagnosis, generally more advanced cancers at diagnosis, and higher mortality rates.
• As the incidence of young women with breast cancer is much lower than in older women, young women are an underrepresented population in many research studies.