Tuesday, March 30, 2010

Celebrations!

Put the big girl pants away for now; they aren't needed this week. Instead, everyone raise a glass and toast my good health! Yesterday I saw my doctor and she told me that my scan results came back. There is no evidence of any new cancer. I have been given a clean bill of health!

I will be getting my next set of scans three months from now, sometime in July, which means I get to party it up and have a fabulous spring and early summer.

I'll talk more in future postings about how I have learned to live a full life in three month increments in between scans, but today is all about celebrating.

I have truly been given a new lease on life! Life is good today.


Tonight I am taking off my big girl pants and putting on my party pants. Momma, the Big Man and I are going out for a celebratory dinner. I invite all of you to join us in celebration. Thank you for your prayers! They worked!

Saturday, March 27, 2010

Inspiration

Ok Everyone,

As if scan time wasn't inspiration enough for me, I just received word of a 28 year old beautiful young spirit who was diagnosed with Stage 4 breast cancer. Allison is getting married on May 8th.

What is going on with this world????

I know my scans will be good. Let's send all the good vibes we have gotten from dancing and loving life Allison's way. http://www.facebook.com/group.php?gid=401096972787&ref=nf

Also, if you have not yet gotten involved in the fight against breast cancer, either with a Susan G. Komen Race for the Cure, a 3-Day for the Cure,  or as my younger cousin at Dennison University did a "Bench Press for the Cure", get involved now. To do so, visit www.Komen.org. It can be as big or as little as you would like but this is an issue that affects us all. We all have mothers. We all have grandmothers. We all have aunts. We all have sisters. We all have daughters. Enough is enough now.

Friday, March 26, 2010

Rainy Friday

This weekend is shaping up to be a Big Girl Pants kind of weekend, and this weekend is one of the reasons I started this blog. Today I will be heading in for my first set of scans since October. Scans are at the heart of the metastatic breast cancer journey. The fact that I need scans every three months is what it means to not have a cure. My doctors do the best that they can. My doctors are the best in this field. As one of my favorites put it, "we carpet bombed you" with chemo. We do the most aggressive surgery. We consider all options. And then, we wait and we watch.

The hardest part of scans is not having my morning coffee. As soon as I get out of that tunnel I make a beeline for Starbucks! I have to starve myself for 4 hours before the scan. The other annoying part is the sheer time I must devote. I have to arrive 90 minutes before my actual appointment time. I've never understood why they don't just schedule the scan for the hour when I have to arrive, but I'm not in health care. There must be some bureaucratic explanation.

When I arrive 90 minutes early, I am given a lovely little cocktail of Crystal Light and Barium. They are so nice as to ask my preference- Iced Tea or Fruit Punch. I've tried Barium with any number of things and unless its a stiff alcoholic drink strong enough to overpower the metallic taste of the medicine, it is no difference. I sit there for 90 minutes and drink three whole bottles of this stuff intended to coat my insides with "contrast". The Barium tastes like a mixture of metal and dirty feet. It's not so offensive as to make you get sick, but there is a gag reflex.

Now you may recall, I was diagnosed as a senior in college. While some may think that is incredibly unfair, I actually see that timing as a gift from God. Why you may ask? Well...I bring my college drinking skills to the table at scan time!

While all the other old ladies are sipping their contrast with straws, I take a deep breath and throw that baby back. The nurses tell me my nauseousness after the scan is over would be better if I sipped, but I'm young enough to still have my eyes on the prize. I'm 26, I'm allowed to throw caution to the wind when it comes to thinking about the end results of my actions. And so I chug. I want to go to Party City one day and find a pink beer bong and bring it with me to my next appointment. I can picture it now, I am going to be going down on one knee in my gorgeous hospital robe holding the beer bong up high and downing that Crystal Light in two seconds. Then I'll teach the rest of the waiting room!

After 90 minutes of waiting, you would expect the actual scan to be a big deal, but it is actually like that roller coaster ride at the amusement park. You wait hours in line and then the experience is way underwhelming and only lasts for .3 seconds. I have timed the CT scan, and it is never more than 10 minutes long.

But then the real waiting begins.

At the beginning of my cancer journey, when I first moved to Boston in 2006 and began going to Dana Farber, I would spend a whole day at the hospital. I had my scan in the morning, break for lunch and then go see the doctor for results in the afternoon. But then one time, the results came back bad. I had probably only been in Boston for 3 months. My hair was just sprouting. I was joyfully cavalier that I had beaten it. This cancer thing was just one year of my life. Just one horrible year. And then, the scans. I came to the results appointment alone. That was the last time I ever spent scan-time alone.

Since my journey has been so unpredictable and outside of the usual realm of cancer patients, my doctors tend to get creative with my treatment plan. Many doctors weigh in on statistics and treatment options and then my doctor and I get together and usually end up with a plan that is some where in the middle of the whole spectrum. I really enjoy being a partner in my care and knowing all of the options and all of the pros and cons. Well that first recurrence back in 2006, they saw the tumor in my liver grow. My doctor had just gotten the results minutes before my appointment and she came in unsure of how we would proceed. She had not had ample time to think about a game plan. It was an all around unpleasant experience because the news was bad enough but leaving without a game plan is enough to send me over a steep cliff. I must always have a game plan. Knowing that I have options keeps me sane.

So now, I get the scans on Friday and get the results on Monday. It makes for a difficult weekend, but my mom flies up to play with me and we fill our time with all sorts of fun things. This weekend, mom is teaching me to garden. We are also going to get the usual mani-pedi action. We have a list of shopping we need to get into on Newbury Street. The Big Man and I will take Mamma to our favorite restaurants. The days with mom fly by and I find that I forget about the impending appointment that could potentially take this beautiful life and throw it all to pieces again.

I don't remember until I'm sitting in the waiting room.

So everyone, enjoy this weekend for me. Get out there and take a brisk walk. Go to a party. Go to a hip restaurant. Dance. Have an amazing weekend. Love Life. Because on Monday, my life could change. I will of course update everyone as soon as I know anything.

Saturday, March 13, 2010

The Ol' Ticker

It's time for an update everyone! Do you have on your big girl pants?

So the most recent drama in Bridget-world revolved around my heart. My beautiful, loving, humongous heart. My heart is probably the organ I love the most because it conspired with me to make the best-wedding-ever a reality and it brought The Big Man, as he shall be known on this blog, into my life.  That's The Big Man and me in Rockport, MA. See....isn't he friggin' tall?? Totally deserving of The Big Man title.

So, The Big Man and I both really like my heart. I think on a day to day basis I work out the ol' ticker pretty regularly with all the love that I send everyone's way. But, unfortunately, the chemo is not kind to my heart.

Five years of chemotherapy can take a serious toll on one's body. That is one of the many downsides of having metastatic breast cancer which makes it so difficult to treat and to beat. I will never forget the moment in 2005 when my mom, dad and I went to visit my mother's long time thoracic surgeon. This was shortly after the devastating cancer diagnosis and we were having a pow wow to decide the plan of action. Understandably, my clan was in full on fighter mode.

After making us wait for more than an hour, we were the only patients left in the waiting room. Here's a life lesson for all of you, if the doctor wants to make sure the office is cleared before seeing you, it's going to be a long and difficult evening. After a cursory exam he brought us into his office. He seemed flustered, also not a good sign. He sat down behind his desk. His office was the typical dark mahogany with framed diplomas everywhere, except there were stacks of patient records on every clear surface available. It must have been a defense mechanism that, after we left, all I could talk about was how I wanted to get in there and clear up his clutter; but I digress.

So he sat us down and launched into a long winded monologue. I don't remember much about the monologue except two phrases. The first, "This cancer is incurable." The second, "I want to be wrong, but I would be surprised if you lived to see 30.  Yes, I could give you some drugs that will bide you some time, but I want to you to know that each drug might give you only an extra year or two."

The world started spinning. The only thing I knew to do was cast a side glance at my father. I will never forget the pain on his face.

I took a deep breath and started asking questions about clinical trials, surgeries, different hospitals with specialists. I pride myself on staying informed and educated. After my diagnosis I did the only thing I knew to do, I started reading books and medical journals. I wanted to stun this doctor with my knowledge. I wanted to challenge his hypothesis so that we could come up with a plan. But every possible solution or comeback I had, the doctor seemed to have an answer for it already. 20 minutes into this horrible conversation, Dad spoke for the first time.

"Hold on a second here. What do you mean, Incurable?"

I will never forget how his voice cracked and how he reached for my hand, but the distance between our two mahongany chairs was simply too great to grab hold.

In the past five years, I have learned so much.

Here's what "incurable" means. Once breast cancer is metastatic, it has spread to the bones, lungs, liver or brain, and no treatment or combination of treatments will be able to completely eradicate the disease. Although it may respond well to a given treatment, metastatic cancer will, in almost every case, develop resistance to that treatment and eventually grow back and spread. That is why a cure has been so elusive. Cancer is friggin' smart and over time on a certain drug, the cancer cells remaining in the body will figure out how that drug is working and find a work around. It's like encountering a traffic jam. The cancer gets stuck for a bit, but then the little wench reprograms it's GPS and goes a different route. There are so many millions of cancer cells in my body, eventually one of those teeny tiny little suckers is going to grow. When you catch cancer earlier, there are fewer cells to kill, so you have a higher survival rate. In the case of breast cancer, early breast cancer has more than a 95% five year survival rate. For metastatic breast cancer, the five year survival rate is less than 20%.

So, when the cancer progresses, another treatment is tried, and then when that treatment fails, another is tried and so on.  This is referred to as "lines" of treatment. The metastases themselves and the different lines of treatment all cause side effects. I've been through several "lines of treatment", but I know there will be more lines to come. I plan on living a long life, but it's going to be a tough one.

It's been long enough that now, not only do I have to deal with the treatment and the cancer, but I also am starting to deal with the side effects of years of treatment.

In January, I found out my heart was failing. Good heart function is considered about "60% EF" or higher, whatever that means. The drug I am on, Herceptin, is known to cause Congestive Heart Failure, so they scan me regularly for trouble. For years my "EF" was around 60%. Then, in January, they scanned my heart and saw my heart function drop. My doctor called at 6pm on a Friday, never a good sign, and immediately ordered I stop my drug regimen. We wanted to see if my heart function would bounce back after a break. I got another scan of my heart earlier this month and my heart did not get better.

Which brings us to this blog post. This week I went for an echocardiogram and had a meeting with my new Onco-Cardiologist.

What is an Onco-Cardiologist you say? Well, Brigham and Women's Hospital and Dana Farber Cancer Insitute have teamed up to start a cutting edge department in their cardiology division, aka the division that treats hearts. This new program is looking at the toxicity of chemotherapy and studying how to prevent toxicity in the first place, how to detect it earlier, and how to treat it once the heart is affected by treatment. Exciting stuff!


The Echocardiogram

An Echocardiogram is really a fancy pants name for an ultrasound of my heart. Most women get ultrasounds when they are pregnant. It's fun and exciting and you get a print out of the baby for your fridge. I have never had one of those ultrasounds (I can practically hear The Big Man breathing a sigh of relief!) but I have had many ultrasounds of my boobies and my lymphnodes.

As of this week I was an Echocardiogram virgin. Now that I have had my first, I would say the Echocardiogram is the most like the pregnant ultrasound, which made me sad. They turn on the machine's sound so you can hear your heart swish swishing. I wish the swish swishing I heard this week was a little baby's, but alas that is not to be at the moment. Instead the goal is to keep me alive long enough to have little babies and hear their hearts on this ultrasound machine!


The Echo lasted about an hour and they pressed this wand all over my chest. I just had a mastectomy about 3 1/2 months ago so The Girls are quite tender, and by quite I mean really, really insanely tender, so the Echo was really not fun.

I then met with my new Onco-Cardiologist whom I love a) because he's easy on the eyes and b) because he's young and clearly brilliant.  I am a huge fan of young doctors. When you are surrounded by elderly patients, it is refreshing to converse with someone in your same generation. I also find that younger doctors tend to treat me more like a peer than a patient.

My Heart Doc says that my heart isn't amazing, but it is functioning at an acceptable level.

Everyone, on the count of three, take a deep breath and then let it out with a smile!

I don't need any heart drugs quite yet, but my new heart doc does want to see me every three months and I have to go for an echo every three months too. I'm not too thrilled because the echo hurt, and it sounds like Heart Doc thinks my heart function might eventually get to the point where I need Heart Drugs. So I plan on exercising like woah to try to delay that moment.

Maybe one day my heart function will return to normal. Maybe it will be like a Lance Armstrong-style heart beat. When that day comes, I plan on getting a print out from my ultrasound and pasting it to my fridge.


**disclaimer, the echo pic above is not actually my echo. It's courtesy of Google Images. I'm saving my heart pic for the day when my heart gets better!

Wednesday, March 3, 2010

How Are You Doing?

Think about the phrase "How are you doing?" Everyday, in every city across the globe, hundreds of people are asking that very question. Mothers ask sons over phone calls, girlfriends ask over a glass of wine, long lost friends connect over coffee, doctors ask patients as they give a pat down.

Sometimes, like during high school reunions, people don't really care about the answer. Instead of listening to the answer, the questioner simply prepares for when the same question comes back her way. But every once in a while this simple question is posed in such a way that makes the heart sing.

I notice a lot when people ask me how I am "doing" because I never quite know how to respond. When I answer the, "How are you doing" with the expected, "Fine, thank you and how are you?" I am almost always lying.

Five years ago, on June 3, 2005, I was diagnosed with Stage IV breast cancer.  I was 21 years old. It was two weeks after my college graduation. I had no family history of the disease.

Five years ago, some people started to dread asking me 'the question'. Five years ago, some people I have never met and may never meet started asking how I was doing. And five years ago, for the first time ever, I noticed how wonderful and liberating it can be when someone asks, "how are you doing?" and really, truly wants to know.

As my new blog title implies, life with Stage IV breast cancer requires a pair of Big Girl Pants. If you're going to enter my world, you better put on a pair of your prettiest party pants and buckle them up tight, because my answer to "How are you doing?" is always long winded!

My long winded answers are what prompted this blog. For years, I've been filling people in on my latest adventures in cancer over coffee or dinner, at cocktail parties or in mass emails. I bring people up to speed in 500 words or less. Over five years struggling with recurrences, I am slowly realizing that my life will never be normal enough to sum up over dinner. Instead, life with Stage IV cancer means that every day major news is happening. Every month a new hurdle pops up. Every week a new drug is tried. Every evening we pray.

Sharing my story over dinner, over coffee, at weddings, is unfair for my friends and family and it is a disservice to the huge hurdles that I overcome every single day. I plan to use this blog to share those day to day struggles.

I plan to update this blog everyday, or at least once a week, with reflections on where I've been, updates on where I'm headed, and general thoughts about life and about facing down death.

In an ideal world, people will actually read this and share it as well. I am also giving birth to this blog because I want to raise awareness about living life with breast cancer. Not beating it, not surviving it, not closing that door, but truly, happily, sadly, thoroughly and completely living with it.

I joke sometimes about being scary. I really am not joking.

My story scares people, especially fellow cancer patients. I am the worst case scenario.

I was diagnosed way late. By the time someone sent me for a mammogram five years ago, the cancer had traveled from my breast to my liver. One doctor gave me a 16% chance of celebrating my 30th birthday. Over the past five years, I have had three recurrences and 5 surgeries. I have been on nine different types of drugs. My cancer just won't quit. The doctors can sometimes be quite grim about my "prognosis"

But I am living well. I am living fully. I am happy. I am one of the happiest people I know. I just got married in August (best wedding ever!!) and some days I call my husband in the middle of the day to just thank him for the amazing life that we have made together. I created a song that I sing (way off tune!) while cooking dinner about how much I love my little life. I think these facts can help people, even though my situation might scare you.

It is this happiness that keeps me motivated when life isn't very happy. This day to day happiness makes me a fighter.

So let's kick off this journey by sharing one of my most favorite-est pictures ever. This is me with Stage IV cancer.


Do I look sick to you?

Does it look like I might feel sorry for myself?

Now I'm off to a doctor's appointment and will update everyone shortly! I hope there will be someone reading.