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	My First Year of Living with Breast Cancer: Tips and Tales for the Newly Diagnosed Installment Two, October 2005 By Stephanie M. Day


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	Aptos, CA (between Santa Cruz and Carmel) Installment One dealt with my diagnosis of Inflammatory Breast Cancer and recommended treatment plan. This second installment describes the first three-month treatment regimen, side effects and addresses the question of what’s next if this does not work. Health History Microchip Looking Better and Better As I reported previously, Inflammatory Breast Cancer (IBC) is the most aggressive form of breast cancer. According to The Susan G. Komen Breast Cancer Foundation’s Web site, “It is called IBC because its main symptoms are swelling and redness of the breast. It often lacks a distinct lump or tumor. It grows in nests or sheets that spread through the breast. It is not usually detected by mammograms or ultrasound unless there is a defined lump. Treatment for IBC often starts with several rounds of a systemic treatment like chemotherapy, hormone therapy or both.” December 2003 was a whirlwind of activity. After my December 2 appointment with my surgeon, Dr. Mathew Hansman, and my December 3 appointment with my oncologist, Dr. Michael Alexander, my body was subjected to the following exams over the next three weeks to see if could withstand chemotherapy: EKG (measures the electrical signal of the heart to determine heart strength) Echo Cardiogram (heart ultrasound also to determine my heart’s strength) Complete blood work up X-rays CAT scan (computers and X-rays create pictures of the body’s organs) MRI (magnetic waves create clear pictures of the body) PET scan (computer pictures using sugar in the bloodstream; cancer cells use more sugar than normal cells; used to spot cancer in the body) A “baseline” physical exam of the affected breast and armpit by a radiation oncologist, Dr. Jay Meisel Dr. Alexander’s office (Drs. Poth, Alexander and Shapiro) scheduled these appointments admirably and had perfected the task to that of an art form, including having my PET scan done on Christmas Eve. As for me, I approached the whole scenario with the same ferocity I had used successfully to solve business problems. I researched ad nauseam on the Internet, read everything I could get my hands on, including Dr. Susan Love’s Breast Book, recommended by one of my nieces, Kimberly. That reference book, while informative, was a bit shy on Inflammatory Breast Cancer and what was there was downright depressing. “Even with the best treatment only 45% of women with IBC are alive and have no sign of the disease five years after their diagnosis,” according to the book. I recognized the symptoms of information overload and took a small break from reading about cancer. This is a common condition for newly diagnosed cancer patients. I also started a file on myself, complete with plastic page savers for each appointment, including phone numbers and applicable preparations for each exam, or so I thought. With that much activity going on, especially in the month of December, there were bound to be missteps. Some of the telephone numbers, which I relied on to confirm dates and times, turned out to be fax numbers, some preparations I knew nothing about, allergies (in my case iodine, which is the main element in shellfish allergy) had not been transmitted to the examining technicians, and here’s the kicker—in most cases, I needed to fill out a complete health history for each different office. Scan Like a Can! I finally figured out at the end that making a copy of my history and taking it with me to the next exam (where I still had to transcribe it onto THEIR form) would save a lot of gray matter in trying to remember which family member had suffered their demise from what disease. Of course, by then, I never needed to use it again. At that point, a huge database in the sky, accessible to all the various doctors, would have been appreciated. To be fair, some facilities are networked together so that once your information is inputted into a computer, you needn’t fill out a history form, but I found that to exist in only one of my exams. The real benefit as I saw it, to having a microchip implant (which was approved by the FDA in 2004) was that my allergy to iodine would have been duly noted by a simple scan of the rice-sized chip. “Scan like a can!” screamed the headline announcing the FDA approval. Privacy concerns aside, it seems like a good idea to me. A national health database, such as the one being championed by Veterans Affairs, also seems like a viable approach to solving the same problem. As I write this in October 2005, with the country still reeling from the tragedy wrought by hurricane Katrina, it seems as though an electronic health database could have helped thousands of folks whose paper health trails were wiped out by the storm. Iodine is used as the contrasting element in CT scans and had I not volunteered the information, I would have been injected with the stuff, a life-threatening event for me. (For my first CT scan, Dr. Alexander explained the procedure and prescribed Prednisone to be taken the day before, of and after the scan to the negate the effects of iodine.) For another scan, I had to drink a gallon or two of orange-flavored yuck as a contrasting material prior to the exam. However, I arrived for the test not knowing that I was supposed to have picked up the yuck the day before and should have downed it the morning of the exam. Rather than reschedule the test, I elected to sit right there in the waiting room and consume the awful stuff, figuring if I had any reaction to it, I’d already be at a medical facility. Tip #5: Assume information about you, such as allergies, has not traveled to your various medical offices, so make sure you tell them. Have your doctors fax prescriptions to pharmacies and orders for exams to applicable medical office, but retain originals and take them with you. Make sure you have a complete health exam prior to agreeing to undergo chemotherapy, which in itself can be life threatening. All the tests went relatively well and my first session of chemo was scheduled for December 19 (even though the PET scan was performed December 24). Two bits of information bothered me, though. Dr. Meisel, the radiology oncologist, said that he would be surprised if the lymph nodes detected by Dr. Alexander as swollen did NOT have cancer in them. And, the PET scan indicated “traces” of cancer in my spine. Uh-oh. However, I was told that those machines are so sensitive that it could be a false positive reading and that it wouldn’t change the recommended treatment, anyway. (A little bit of cancer; is that like being a little bit pregnant?) Tip #6: If you are claustrophobic or fidgety, ask if you can take something to keep you calm and still while undergoing scanning tests. It shouldn’t be a problem. I had some Valium left over from a back injury due to a car accident, and it worked like a charm. Aside from griping about all the multi-part forms I had to fill out for each medical office, no one ever asked for my type of insurance coverage prior to agreeing to treat me. How refreshing! Everyone seemed genuinely interested in me as a patient as opposed to a money machine. Fortunately, though, we have good insurance, an individual PPO, for which we pay a fortune. While I was still working, I had switched us from an HMO at the first opportunity after a run-in with a doctor who didn’t want me to have a CAT scan following my severe car accident. Even though the hospital to which I was transported insisted that initial X-rays of my neck indicated a possible fractured vertebrae! After my high-tech Silicon Valley company went belly up, we were eligible for COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act of 1985, a convoluted way of saying that you may be entitled to continue your health insurance coverage under a group plan without a physical and without fear of being denied coverage due to a preexisting condition. The cost is about the same as paying for an individual policy, but it is worth it in order to have health insurance. I tried to change our policy to reflect a higher deductible and a lower monthly premium, since we were never sick. I found out then that whatever insurance you transfer to while on COBRA is what you’re stuck with. After having been diagnosed with a very expensive disease like cancer, I am happy to pay those high premiums. Tip #7: Purchase the best insurance possible while you are healthy; it could mean the difference between financial health and bankruptcy. Losing My Hair, Preparing for Chemo Leos who have manes pride themselves on them, and I was no exception: long, dark, naturally curly hair to die for. (Years ago, one of my girlfriends jokingly asked me to leave her my hair in my will.) But my mane had to go. I knew my hair would fall out as a result of my particular chemo regimen (not all chemo drugs produce Alopecia, or hair loss) and I did not look forward to finding 18-inch strands on my bed pillow in the mornings. So, on December 9, in between all my exams, I squeezed in an appointment with my wonderfully creative hair stylist, Kelli, telling her it was time for that short, curly “do” I had been musing over for some time. She took the reason why with both shock and sadness and after sharing a few tears, we got down to business. The deed was done and I said I’d be back for a head shave in January, when my hair was due to fall out. Kelli and I discussed wigs and looked at some offered by a co-worker at her salon who worked a lot with cancer patients. Finding nothing suitable, Kelli agreed to accompany me to a boutique in Los Gatos, called The Next Step, which serves women who have experienced breast cancer. This meant a trip over the hated Highway 17 through the Santa Cruz mountains, but it was well worth it. We found the perfect wig for me, almost an exact match to my own hair. Many women choose to experiment with a new look during this phase, going the opposite direction of their natural hair, say blond and straight when they had been short and dark. Not me. I wanted to look as much like me as possible. We also found darling hats and a sleeping cap. I didn’t know then how handy that cap would be—70-80% of your body heat is retained in your head, by your hair! I would also come to appreciate one of the all-time great inventions, the dual-control electric blanket. Losing my hair was not a big concern for me; losing my life was. I had one focus and that was to live. I expressed this sentiment to Dr. Alexander in very specific terms. No matter how bad I felt during chemo, no matter what I said, as long as I was still breathing I did not want him to cut back on my dosages. I had read that sometimes patients feel so bad that they either discontinue treatment or request lower amounts, with sometimes devastating results. With an agreement hatched, we commenced chemo treatments December 19, as planned. Bad Veins and an Attitude Two problems surfaced immediately: I had bad veins and I had an attitude. The first didn’t surprise me that much because I had been poked repeatedly over the years by well-meaning but inept people relentlessly checking my blood for anemia, which I had. Years ago, there was no “three tries, you stop” rule and blood was drawn by nurses in a private doctor’s office, not by experienced folks in a lab. The result for me was that my arms sprouted a fair amount of scar tissue and sported ugly bruises. But experienced oncology nurses, Kathy, Kendra and Rene, in Dr. Alexander’s office were able to get an IV into my veins by applying lots of hot water and slapping my arms. However, ribbon-thin, rolling veins still present a problem for chemo drugs which are “pushed” from a syringe directly into the vein. Adriamycin, in particular, “can leak out of the vein and cause a very severe skin burn that could require skin grafting. For this reason, it’s generally given in a very specific way: avoiding weak veins, and running in the IV with lots of fluids, so that if it should leak out it won’t cause as much harm,” according to Dr. Susan Love’s Breast Book. Having to face this situation every Friday was very stressful for both the nurses and me. Eventually, the nurses suggested that I have a catheter port implanted if I were to require additional rounds of chemo. I didn’t understand then how sage their advice would be. The port suggestion brings me to the second problem: my attitude. I really believed that this whole cancer thing was a temporary blip on the radar screen of my life and that the tumor would shrink, disappear and that would be that. I applied the same sort of thinking that had served me so well in my career: identify a problem, confront it, solve it and move on. Dr. Alexander apparently saw my upbeat demeanor in a slightly different light. During my first three visits, where he would measure the size of the tumor and draw blood prior to having chemo administered, he would ask/state, “You do realize how serious this is, don’t you?” Well, I thought I did. I knew I had a life-threatening disease, which, if all went well, I would get through by doing everything medically possible. Death was the alternative. How much more serious could it be? So, for the beginning of our relationship I thought him a bit stern, and I believe he thought me perhaps a bit cavalier. It didn’t take long to get over that and to start getting smiles and hugs from the good doctor. When he announced that he thought the tumor was shrinking, I was so elated that had circumstances been different, I might have felt compelled to compromise the virtue of my lovable doctor. My elation, though, turned out to be short lived. Living in a Bubble Germs and consequent infections are cancer patients’ worst enemies. I was warned at the beginning of treatment that my blood counts could get dangerously low, low red count resulting in anemia and low white counts resulting in a severely compromised immune system, i.e., no ability to fight infection. Because chemo drugs kill all dividing cells and do not differentiate between good and bad cells, it is essential that a chemo patient does not get sick. Therefore, it was imperative that I not be around sick people, crowds or children, who tend to carry germs. We have no children so that part was easy for me, but I cannot fathom how difficult it must be for families of cancer patients with little ones at home. Avoiding sick people and crowds meant not attending the memorial service for a dear family friend or traveling to Cambria, CA, a beautiful artsy enclave on the coast near Hearst Castle. We had been making the three-hour road trip frequently for the past 15 years, but especially at Christmas to spend that special holiday with my father. We did not know then that Christmas 2003 with my Dad would be our last holiday with him. To avoid getting sick, we asked all visitors to our house not to come if they even had a sniffle and we stopped going to movies and restaurants. Touching anything outside of my house and shaking hands became terrifying incidences for me and I kept a bottle of hand sanitizer in my purse in case I couldn’t get to a faucet to wash my hands. (Good grief, I was turning into Howard Hughes!) I had developed the hand washing and sanitizer habit years ago because during my career in public relations I encountered many hands. As a result of my hygiene habit, I rarely contracted colds or the flu. During this winter, though, I felt particularly vulnerable. Flu shots are out of the question for me because they are cultured with raw egg, to which I am allergic. To avoid breathing other people’s germs, we even tried out our local grocer’s on-line shopping service, which worked out well. The only downside is that you need to be specific as to brand if you are an ingredient shopper, as I am. Excessive sodium causes water retention in me, which I hate. So, we decided to grocery shop during “off” hours when there would be fewer people in the store. Eventually, grocery shopping and all other errands became the responsibility of the love of my life, my husband, Gil. I had my second chemo treatment December 26, which also contributed to making a Christmas trip to Cambria infeasible. Part of my chemo regimen was oral Cytoxan, consisting of three blue pills to be taken a couple of hours apart with plenty of fluids to be consumed before 3:00 p.m. each day. By the time this round of chemo was completed in March, I hated orange juice and gagged at the sight of a blue pill. All in all, things were going well, and I couldn’t understand what the fuss was all about with regard to chemotherapy. There’s that attitude! It just hadn’t hit me yet. I kept a daily journal of what times I took my pills, what my temperature read and if I felt any side effects. (I had heard of “chemo brain” or loss of memory, and I wasn’t going to fall prey to that, no siree, not this patient.) Temperature is important, I was told, because if it exceeds 100.5 degrees, it’s time to call the doctor; an infection may be taking hold, which could be life threatening. Tip #8: Certain chemo drugs suppress your immune system; therefore, you do not want to fall ill. Avoid public places and sick people. Wash your hands often, use paper towels to dry instead of community kitchen towels and wear rubber gloves for all household chores. Chemotherapy: Not Your Movie Version Whenever I thought about chemo treatment for cancer, which wasn’t often prior to my diagnosis, I visualized baldness and vomiting. One recent movie, Pieces of April, portrayed a family’s road trip being constantly interrupted by stops to provide the cancer-stricken mother a place to vomit. Things have changed considerably in recent years. Pre-meds are administered to prevent vomiting and anti-nausea pills are prescribed in case the need arises at home. My oncology nurses described in great detail what to expect from my treatment and provided drug fact sheets which were easy to understand and very helpful. Everyone’s case is different and everyone reacts differently, but the side effects from my first three-month round of chemo, Adriamycin, 5-FU and Cytoxan, were as follows (from worst to least): § Mouth sores. These were more painful than I could have imagined. Think of the worst canker sore starting from deep inside your tongue and growing into an ulcerated white circle of pure hell. They hurt so bad that it was painful to swallow. Consequently, I lost 23 pounds. I also lost my appetite, a contributing factor. My doctors prescribed a specially formulated mouthwash called “Stanford Mouth Wash,” which helped, but eventually “Cocaine Mouth Wash” rushed to the rescue. After the sores were under control, a good friend nurse, Amanda, suggested Aloe Vera liquid, which is supposedly helpful for digestive problems, also. I couldn’t get past the taste to try out that particular application, but swishing it around my mouth did help control the sores. Apparently, your mouth contains more dividing cells than anywhere else on your body, hence the tendency to be affected by chemo in a major way. § Energy Loss. This was another biggie for me. It crept up on me slowly, but let its presence be known in a big way. My frenetic Type-A personality found itself succumbing to a fatigue I had never experienced. I had read in various cancer books that it was best not to give into fatigue, because rest was not going to help and could actually exacerbate it. For weeks I resisted, but finally found myself staying in bed longer and longer and watching more and more television (even reading was a stretch). Eventually, I was too tired to drive a car and had to give up my independence temporarily. Periods of dizziness and light-headedness were not conducive to driving. They say that a cancer patient can expect to experience fatigue for as long as treatment lasted. In other words, if treatment continued for a year, fatigue can persist for an additional year. “Cancer Fatigue” is now a recognized medical condition. § Low Blood Counts. I discussed these side effects earlier and why knowing one’s temperature and avoiding germs is particularly important when your white blood cells deplete. Low red blood cells, or anemia, were of concern in my case because I have suffered from anemia most of my life and it contributed to my fatigued condition. Anemia can reduce the clotting ability of blood, so the nurses advised me to be careful not to cut myself and not to take aspirin or any other type of painkiller that can cause stomach bleeding. § Gastrointestinal Disorder. A result of the chemo drugs, bouts of constipation intertwined with incidences of diarrhea until I got the combination and timing just right with respect to laxatives and anti-diarrheals (Imodium). I found that taking fiber pills for several days, beginning the day of treatment and not waiting for the problem to start, worked best. What I did not know, and found out when my pulse started racing at 120 beats per minute, was that excessive bowel movements in any form could result in dehydration, which messes up the electrolytes in your blood. Another great suggestion from my doctors and nurses: keep on hand a supply of Gatorade or other sports drink containing lots of Potassium and Sodium and consume like crazy should the need arise. It fixes the problem pronto. § Insomnia. You would think with my loss of energy as described above, I’d have not problem sleeping at night. Not so. In order to extend the number of days for the anti-nausea component in the pre-meds to work, sometimes a bit of steroid is added to the mix. This also provides the added benefit of having a little more energy than usual for a couple of days. But if you cannot sleep, ask for something to help you. In fact, I was advised to ask for anything that might help in any way to get through this ordeal. There is no reason to suffer in silence. You may notice that two common side effects are missing from my list: vomiting and hair loss. I experienced very little nausea and a prescription for Compazine took care of it in a matter of days, while my body acclimated to the chemo. My hair started falling out after two and a half weeks of treatment, precisely as predicted by my nurses. It was expected, so I wasn’t traumatized. What wasn’t expected was the nasty rash that appeared on my chest about this same time. Dr. Alexander sent me to a dermatologist, Dr. Magid (an addition to the team) who performed a biopsy and proclaimed the rash to be an allergenic reaction to chemo, most likely the 5-FU. Antibiotics and a skin cream cleared it up, never to appear again. Family and Friends Circle the Wagons “Damaged people are dangerous; they know they can survive.” That is my favorite line from Damage, the book, and fine movie featuring Jeremy Irons. To me, it sums up how contracting a life-threatening disease like cancer changes one’s perspective on life. We know how we feel and may be scared, but we know what we need to do to pull through. Our families and friends are scared and feel helpless. Reach out to them and let them help, or not, depending on the relationship. In January 2004, my soul sister, Chryssie, the one who practically raised me, came to California for the first of four visits within six months. Spiritually and emotionally, being with her was like an additional treatment for my situation. One morning shortly after she and my brother-in-law, Bill, arrived, she was startled to hear me laughing hysterically in my bathroom. I was gazing into the mirror at what was left of my hair and the reflection I saw reminded me of Charlie Brown from the Peanuts comic strips. The final tufts of hair were sticking straight out and I looked ridiculous. Off we went to my hairdresser to have my head shaved. We also attended at our local Katz cancer center a “Look Good, Feel Good” seminar which teaches women how to apply makeup when they have no eyebrows or eyelashes, how to tie scarves around their heads when they have no hair and other helpful beauty tips. Chryssie also accompanied me to my chemo session, which was not only comforting, but gave Gil a much-appreciated break. From the minute I was diagnosed, family and friends stepped up to the plate, offering support, both moral and physical. My wonderfully creative mother in Virginia started knitting caps (cloche, I believe they are called) out of the softest yarn, in all color combinations for all seasons. I wore these caps more than my wig because they were more comfortable. My oldest sister, Cele, with whom I was not raised, became very communicative via e-mail, offering her support, and we have become much closer as a result. My husband’s adorable 13-year old niece, Erin, asked her parents for a day off from school so she could bring me a picture she had colored of us on the beach with talking bubbles that both said, “I love you.” Erin also chose as one of her school projects to read Lance Armstrong’s cancer book and report on it to raise cancer awareness. One of my “doggie park” friends, Vivian, is a fine artist and requested that I save some of my hair for her so that she could turn it into a “hair painting,” which incorporated my hair into handmade paper. I did and her two renditions are wonderful. She also invited my husband and me to join her and other “park” friends to her house for a fabulous dinner. New friendships were forged that night. Two of my darling nieces, Kimberly and Jennifer, announced that they would be participating in the Washington, D.C. fundraiser Avon walk for breast cancer in May 2004 in my honor. I spread the word to many of my friends, who contributed mightily to their campaigns, ensuring Chryssie’s daughters’ success. One good friend and former co-worker of mine, Mike, contributed $1,000, more than half of the $1,800 to which Kim was committed. Kim and Jenny requested that I send a photo of me for their Web sites in order to promote the Avon walk. I was reluctant at first, but then decided to go totally for it and provide a photo without hair, depicting one of the true “pictures” of what cancer looks like. Here it is: My sister Chryssie claimed I had a “Nefertiti-shaped head,” which I suppose was a good thing. Other friends came forward to offer “been there, done that” advice, for which I was grateful. My good friend and business associate, William P. put me in touch with Pat, a cancer survivor and patient advocate, who sent me a detailed message with all kinds of good advice. She said, “Time to clean house and remove all stress. Anyone with an attitude goes right out the window.” Unfortunately, we had to act upon that advice with a couple of relationships that had simply turned toxic. Pat put it best, though, in one sentence, “Remember, you are living with cancer, not dying from it.” I keep that saying with me always, even though my cancer experience got progressively worse, as you will read in future installments. Tip #9: Let family and friends help you. It helps them as much or more than it does you. Give a break to your caregiver whenever you can, be they a spouse, partner, family member or friend. My husband had been at my side for four months when he received an invitation to play in a golf tournament. I asked a friend to take me to chemo so he could play. We were both thrilled to have the illusion of leading a “normal” life for a little while. My Bubble Bursts The high hopes I had earlier that my tumor would shrink to nothingness began diminishing in late January when Dr. Alexander expressed his disappointment that it wasn’t shrinking much and not quickly. By the beginning of March 2004, my elation came to a screeching halt when he announced that the tumor’s size had been reduced slightly, just enough to perform a mastectomy. At about that same time, my 84 year-old Dad called from Cambria to say he didn’t feel well. With his history of stroke, pace maker and congestive heart failure, I urged him to call 911 and get to a hospital, the closest of which was 45 miles away in San Luis Obispo. He took my advice and several days and many tests later, his doctor called me to report that my Daddy had had two heart attacks, was dying and that his heart would last about one more month. There was nothing further they could do. Daddy was fully aware of his grave situation and requested that he be allowed to die at home. His doctor said that was fine, as long as he had 24-hour in-home care and Hospice care, which meant he would not have to leave his home for medical visits and would die as he requested. Because of previous bouts with a stroke, carotid artery surgery, colon polyp removal, insertion of the pace maker and simply getting older, I had arranged for him to have partial in-home care. Now, I called everyone I had had contact with to get 24-hour care, with competent people serving in various shifts. Next, I called my sister Chryssie in Virginia and described the situation. We agreed that she and Bill should come to California and they arranged to be here when Daddy was released from the hospital in about a week, so that they could take him to his home. Gil and I would come down a couple of days later, in between my chemo treatments. I requested that Chryssie inform all my Dad’s friends, who also were my friends, that we would not be doing our customary hugs and kisses because of my suppressed immune system. (My Dad was a star in his church and town and had, literally, hundreds of friends, who were now streaming in and out of his house all day long.) My Dad had not seen me since I had been diagnosed with breast cancer four months earlier and did not know what to expect. The look of his face when I entered his house was absolute relief. Whatever he had imagined was apparently far worse than the reality. Other than losing 23 pounds (which I could afford to lose) and being bald, I looked pretty much like my old self. Everyone said my color was good; I never did have that gray pallor that many chronically ill patients get. The few days we had with each other were absolutely precious. Daddy was as articulate, funny, sweet, entertaining and brilliant as ever. His mischievous blue eyes were sparkling and clear. It was difficult to believe that he was dying. Saying goodbye to him when we had to return for my chemo treatment was the most difficult thing I’ve ever done in my life. We held each other for what felt like an eternity and wept unabashedly, knowing that we’d never see each other again. I could not fathom that I would no longer visit, confide in and share all aspects of my life with the man who had encouraged me to “be all that I could be”; who had provided guidance to my high school friends in the tumultuous 60s, when kids could not communicate with their own parents; who was sensitive, creative and outrageous all at the same time. This was the artist/writer who defended me unconditionally, bailed me out when I got into trouble, who decorated a Christmas tree against my stepmother’s religious beliefs, who gave me a dog, again against my stepmother’s wishes, and made sure I enjoyed the picture-perfect wedding I envisioned, again against the wishes of his wife. Oh sure, he could be a total jerk when he threw alcohol-induced temper tantrums during our early childhood years, but he had traded that in for rehab in 1976 and hadn’t touched a drop since. I felt honored to have known his best side. We returned to Aptos, CA, on Thursday, March 18, 2004, leaving Chryssie to finalize the details of ‘round the clock care before she had to return to Virginia. I talked to my Dad on the following Monday, March 22, and he sounded weak, but still good. On Wednesday, March 24, my Dad’s caregiver called to tell me that Daddy had died that morning at 8:30 a.m., after eating his breakfast and taking a nap, from which he simply did not wake up. It was comforting to me to know that his last days were as exactly as he wished--peaceful, at home, surrounded by friends, his classical music and a caregiver he trusted. (They shared a love of classical music, of which my Dad had hundreds, if not thousands of LPs and CDs and his caregiver, Denman, wrote children’s operas.) I was still reeling from the news of my Daddy’s death when Gil and I made our appointed round at Dr. Alexander’s office two days later, on Friday, March 26, for my chemo treatment. What he told me was stunning. “Your blood level counts are too low to give you chemo and you need to check into the hospital.” “For what and for how long?” was my response. “At least for the weekend was his answer.” I whined, why don’t you give me an oral antibiotic like Dr. Poth did last month when I had a slight temperature? Dr. Alexander’s answer shocked me. “I won’t be around this weekend and I would feel really bad if your blood went septic and you died within the next 48 hours.” My cavalier attitude retorted, “I think I would even feel worse.” Even for me, his was a convincing argument. However, I still stalled for time. “I have an appointment with Dr. Hansman, my surgeon, this afternoon at 3:00 p.m. to schedule my mastectomy, and I need to get a few things from my home. Is that O.K.?” Dr. Alexander glared at me and relented, saying, “Fine. But get your things and get to the hospital fast. I may need to transfuse you.” I checked into Dominican Hospital in Santa Cruz, CA, Friday, March 26, for what was to be a two-day stay. Next installment of my story begins with my recollection of eight days in the cancer ward. My mastectomy was scheduled for April 22, the day after my husband’s birthday. Tip #10: Life is uncertain; eat dessert first. Cancer liberates you from emotional baggage. You are freed to pick and choose what’s really important to you for whatever time you have left to live. Coming in future chapters: Mastectomy; Lose a Boob, Save My Life? Her2 Positive, Herceptin and Heart Failure Radiation Treatment Following Mastectomy Back on Chemo; a Different Regimen Out of Chemo and into Limbo It’s Back! Cancer Metastasizes in my Spine Radiation Treatment, Again Chemo, again; Still Another Regimen Tragedy Strikes My Oncologists’ Office Still Fighting, Staying Alive in 2005 © Copyright 2005 by Stephanie Day Back to Stitch in Time

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