Tuesday, March 29, 2011

Running for your life

The realization that treatment may result in irreversible harm is a fact of life for cancer patients receiving chemotherapy. Many of the chemotherapy drugs, because of their cell-killing qualities, result in side effects that do not disappear when the drug is no longer administered.

The chemo regime I'm on involves four doses of Epirubicen, part of a class of drugs called anthracyclines. The anthracyclines are very effective against breast cancer, but are known to be "cardiotoxic." What that means is that a percentage of people treated with these drugs die of congestive heart failure. Some studies show that almost half of the patients exposed to anthracyclines show cardiac abnormalities 10 to 20 years after the original infusion, including approximately 5% who develop congestive heart failure because of dysfunction of the left ventricle.

The most vulnerable to suffer from heart failure are the elderly, diabetic, and those with pre-existing heart problems. Though I do not fit into those categories, the high percentage of patients who suffer from anthracycline damage is a cause for concern.

Still, the use of anthracyclines, I am told, will reduce my risk of recurrence of the breast cancer from 35% to 20%. Additional therapy from 5-years administration of a pill called an "aromatase inhibitor" which inhibits the production of estrogen will further reduce the percentage to 10%.

Clearly there is a compelling need to go through chemotherapy. Though I can't help but think that if the cancer won't kill you, it is ironic that the treatment will.

It is one of the choices that I, as a cancer patient, need to make. And I have very little control over the dosage given to me of a certain drug, or the drugs that are offered. Either I consent to the recommended treatment or not. Weighing the risks, it is clear that future heart problems may not be as much of a concern to a healthy person like myself than the risk of having this breast cancer return. After a bilateral mastectomy, if it returns, it will show up somewhere else in the body, such as the bones, liver or lungs. That is not a possibility I want to risk. Going through this as a Stage II once is bad enough. Going through this a second time as a Stage III or IV would be devastating.

So I move forward with my anthracycline therapy, the third one to be administered tomorrow, March 31.

Fortunately I have come across one identifiable step I can take to protect my heart. Running. Endurance exercise. An oncologist I spoke to, told me that the Rocky Mountain Cancer Rehabilitation Institute in Colorado had overseen some studies on rats concerning the impact of exercise on anthracycline therapy.

I got on the internet and searched for those studies and was able find detailed abstracts. The studies show that the rats who exercised during chemotherapy had, in the short run at least, healthier hearts. In one study, the rats were forced to run on a treadmill for ten weeks before chemotherapy. Their heart function was tested four weeks after chemotherapy. The result: the rate of heart malfunction was higher in the control group made up of rats who were sedentary couch potatoes. The runners were healthier.

At least half a dozen studies were done. Some with five weeks exercise, some with five days exercise, some with a single burst of exercise before chemotherapy. The result of every study shows that the hearts of running rats showed less damage than the sedentary rats

So, finally, there is something to this process I can control. I am a runner, I can run. Pushing myself aerobically during chemotherapy is at least one way I can protect myself from damage caused by the treatment that is supposed to help me.

Tuesday, March 22, 2011

The Skullcap to Beat all Skullcaps

As I rapidly lose my hair, the realization that a good head covering will be needed, and immediately, clouds my mind. It interferes with my better judgment. I panic. When your hair is falling out in 50-strand clumps, you need to act fast. There's no time for dilly-dallying. Either you are going to enter the world ready to handle the chill of the day as a bald woman in style, or you are going to be stuck in a cheap synthetic wig until you do.

There is no dearth of options. And the challenge is finding something that fits into an office environment, that you can wear with a suit and not look like a biker chick. Or a boy.

First thought, especially to the naive, is to buy a scarf. Wouldn't that be the easy choice? A simple large square scarf that folded up into an African turban. So I ran down to the local head shop in New Paltz and bought myself a few bandannas to try out. Large enough for a head, or so it seemed. But folding those things to fit on the head was near impossible without sewing it into my scalp. I tried folding into a triangle, then tying over the head, being careful to tuck the triangle into the knots. Perfect from the front. Turning around, checking the back, and there, in all its glory, was a 3-inch sneak peek of my bald, white naked scalp. Oh no! This would not do.

The next scarf I purchased was large, beautiful, silky. Perfect to hide my naked scalp in a cool soft mound of silkiness. The problem here: it's a fine line between looking fashionable, and Amish. A very fine line indeed. Not that there's anything wrong with it. If you're Amish, which I am not. I like to let it all hang out, not in. Hiding in a large head scarf would make me stand out more, like a lady in a red dress at a funeral.

So I weighed my options without completely giving up on scarves. I am not that creative with scarves, and can't just drape it over my head casually and hit the town without fear of it unraveling at my feet at the most inoportune moment.

The thought of having a hat hit me. Not a regular hat, but a do-rag. Or a skullcap or beanie, whatever you want to call it. Heck, maybe a yarmulke will do. Anything that does not need advanced sailing skills to get the perfect knot. I need something low maintenance and colorful. I scoured the web. Ordered a few different ones from different websites. Finally found the selection to beat all sections at www.sparklingearth.com with all sorts of fabrics and colors.

A few days later, I saw that padded envelope package in my mailbox. With anxious anticipation, I ripped it open at the mailbox. My four new do-rags tumbled onto the driveway. Red with flowers, turquoise and black bandanna fabric with rhinestones, brownish with dots, southwestern fabric. I picked up the rhinestoned fabric, opened it up, ran into the house and took off my baseball cap, placing my doo-rag on my very round fuzzy head, tying the ties in the back. There was nothing to adjust, it fit just perfectly perched on top. Shook the head back and forth, up and down, and the hat stayed in its place.

Finally, simple problem resolved.

Sunday, March 20, 2011

6 year old cutie pie

Watching my little girl Sami reading adventures of Frog and Toad to me. She is so beautiful, happy, funny, active, caring, social, energetic, creative, original. Amazing to think that she shares my genes and my husband's genes. We are so lucky to raise such an adorably wonderful little girl.
I love the other one to death too, just that she's not here today.

Saturday, March 19, 2011


The hard thing about normal daily life during chemotherapy is that your white blood cell count goes down. And when those white blood cells disappear, you can't fight easy infections and they get worse and worse.

Case in point: during my first chemo cycle, I developed a little sore throat on my third day post chemo. Honey, tea, gargling with salt water, nothing worked. It got so bad that I couldn't swallow water without serious pain. After 3 sleepless nights and fever that wouldn't let up, I broke down and called the oncologist, who directed me to the hospital for intravenous antibiotics and blood count tests. Then 10 days of oral clindamycin, and a one week delay of my chemo cycle was the consequence.
No I do not want to relive that horrible experience. The sore throat caused more distress than the cancer, to be honest.

So Sami (my 6 year old) and I are banished while my hubby and other daughter battle out another bad head cold. A day in NYC watching a Martha Graham dance troupe performance was hardly painful. And two days of rest and relaxation at dad's home in Connecticut is very peaceful. But it would be nice to be back home, I can't lie.

Tuesday, March 15, 2011

The Buzz Cut

Tuesday March 15, 2011

Who knew that losing hair can be so messy? After approximately ten days to two weeks of receiving certain chemotherapies, you start to lose your hair. Once it falls out, it falls out rapidly. Not in clumps, but in large amounts of strands that shed on pillows during sleep. It covers your body during showers. Rubbing your palm against the head will inevitably result in a fistfull of hair strands.

At some point you need to do something about it. Losing your hair is just plain messy. And the scalp hurts. It's as if the hair follicles have had enough and they just want to push the hair out. Your head feels sensitive, and short hair starts to stand up straight before falling out.

My decision at this point but to take some action and just get rid of the problem. So after days and nights of thinking of the inevitable, I decided that shaving is the answer. And I couldn't do it myself. There was too much hair left, and the thought of nicking my head with a razor and having to deal with blood as well as baldness would be too much to handle.

So, on on the spur of the moment while driving back to work after I meeting, I ran into Ann's Hair Salon and Manicure in Goshen New York. I had never been in this old-fashioned salon in a little building shared with a plumbing contractor. It was tucked away on a one-way street, and the sign outside said in fading light blue letters, in cursive, "Ann's Hair Salon." The fact that none of my colleagues or friends would likely be walking in, was a big factor in my selection of this hair salon.

I saw a woman with greyish-blue hair under one of those large hairdryers from the 1960's that covers your whole head. A woman in her late 60's, apparently the owner, was cutting the few strands of hair left over on the scalp of a man who was virtually bald. That seemed to be very similar to the haircut I sought. When I told Ann my predicament, she agreed to stay overtime for me since the shop closed in five minutes.

While waiting, I browsed her bulletin board. In addition to photos of lots of little children, surely her grandchildren, there was a 1996 certificate from American Cancer Society thanking the store for its donations. On the bookshelves, among the trashy romance novels, there were brochures displayed for a breast cancer walk, and an American Cancer Society wig catalog. A coincidence that this was the storeowner’s chosen cause, or fate?

She took me in a chair, and gave me a brochure from TLC, the American Cancer Society’s brochure with cheap wigs and head coverings for sale, and gave me a business card from the organization that teaches cancer patients how to look good and feel better during treatment. Actually, it really is called “Look Good Feel Better.”

She offered to bring me in the back room. I looked around and saw the only other customer was the elderly woman with greyish blue hair at that point. She eyed me curiously, while I eyed her back. Here is fine, I said. Low odds that a colleague would come bounding in this little old lady salon at 4pm on a Tuesday.

She then took my glasses off and started shaving my round itchy head. I couldn’t look. Thank goodness I can’t see a thing without my glasses, and she turned the chair so I was not facing the mirror.

Up to now, I felt at peace with the idea of losing my hair, and actually had looked forward to wearing my scarves and getting it over with. But once the buzzer started doing its job, I was overcome with emotion - well almost. Last thing I wanted to do was cry in the barber chair. So I held my ground.

When she was done, I got my wallet. She waved her hand at my wallet and said “this one’s on me.” I gave her a big hug and left. . She made a potentially traumatic experience very painless.

So now I have a Sinead O’Connor hairdo. Looking in the mirror, you can suddenly see features, such as cheekbones and ears and nose. Eyebrows. Glasses. I don’t look half bad. Then again I don’t look half good. But I can live with it. Just hope that people around me don’t start thinking I’m sick. Because I’m not.