27

is my latest AFP (tumor marker) count, which is down from 301 last time (3 weeks ago), 1700 before I started chemo, and 6000 before surgery. Goal: 6 or under. Grazelda is getting gone. Huzzah!

Bonus Super Feel-Good Week

I went in for Therapy 3.1 today, the first day of my 3rd cycle, the first day of the icky 5-day week. And they couldn't get a good IV in my right arm (my left arm, with its thrombophlebitis and general clotted-ness, is verboten). One of them got started, and got in enough benedryl to give me a nice mid-morning snooze, but that one blew, too, before I finished my pre-meds. There are all kinds of reasons - I have small veins that have gone through a lot the past few months, some of the good spots are scarring from the harsh drugs, other spots are bruising, and they're just frail. After 4 pokes, my nurse calls the doctor and they recommend installing a port, which is a little plastic thing that is surgically implanted beneath my skin, below my collar bone with a line going almost all the way to my heart. There aren't too many options, I need to be able to have a reliable IV, and with my "hypercoagulative tendencies" (I clot easily), they don't want to try another PICC line.

A Portacath: The first ever picture on this blog that is not of me!
(But don't worry, I'll probably make you look at a picture of it protruding from my chest on Saturday)

I didn't get any chemo today, and I won't get any chemo all week, not even on Wednesday - so this is like Bonus Super Feel-Good Week, like Intermission exactly halfway through my 12 weeks. I'll probably do more Feel-Good things like go into work, maybe more hiking, and ckraphts! And then I have outpatient surgery on Friday to insert the port (performed by my favorite surgeon, Dr. Hank Hallum himself). Well, it's outpatient unless my lung accidentally gets punctured, which is a minuscule possibility, but I mention it because I've been beating the odds in so many ways lately. Fortunately that depends on my surgeon, whom I trust, rather than my body, which has been doing some unfortunate things.

Oh yeah, and I'm off my Coumadin and back onto self-injecting heparin-based blood thinners so that my blood can be the proper thickness (PTINR=1.0) when I get cut open. So then a week from today I start my 3rd cycle. This pushes everything back a week and means I won't be done by Halloween. It also means that, since I won't have an IV in my arm during chemo, I may be able to knit while the poison drips in. How could they forget to list this as a Port Access Advantage in the brochure??

Well, friends, there you have it: yet another plot twist in Margaret's Medical Drama. Not a huge one, and you must admit there was ample foreshadowing in the past 6 weeks, but I'm still astounded that this very straightforward chemo plan has experienced complication after complication after complication. Frankly, I figured my bad luck should have just about run out by now!

Looking ahead: there has been some Ckraphting going on in Margaret's Casita and I can promise pictures of a new headscarf, fresh from being pressed.

The Perils of Feeling Good

The Event in the past few days was a lovely overnight at a friend's cabin in the mountains. For those of you not in Tucson, the Mountains are extremely important during summer (which lasts from March to November), in order to escape not only the concrete city bustle, but also the brutal heat. I spent the first 4 hours in the mountains napping in a hammock. That's right: four glorious hours of sleep in the afternoon, followed by a full ten-hour night. I guess I'd been falling behind on my rest, but in any case it felt amazing, and gave me lots of energy for taking walks in the pine trees by the streams.

Yesterday, it happened. I wouldn't say I forgot that I have cancer, nor that I have to go in for the dreaded 5-day chemo week next week. But between the refreshment of being up in the mountains, the excitement of having a friend in town, and the general busy-ness of the day spent feeling great, I did forget that I was supposed to go into the lab for a blood draw. I realized this at 5:15, 45 minutes after the lab closed on Friday afternoon. And this isn't just the blood draw to make sure my blood thinner levels are good, this is also the 3-vial draw to check my blood cell counts and my kidney functions that they need to ensure I'm healthy enough to be kicked in the bum again with the chemo.
So I worried about it a little bit, eventually found that I could go in on Saturday (today), and convinced myself that it would be okay. I felt guilty enough, but I went in this morning and got my blood drawn unceremoniously.

My sister comes in today, hopefully to take the edge off next week's treatment, or at least bring me 7Up when I need it and make sure I get to my blood draws in time.

Happy Thursday

This week my friend and old college roommate Meghan is here. I am so pleased to see her, and even more pleased to feel good enough to do things, even after a Bonus Bleomycin Wednesday, which took 2 pokes and less than 2 hours. All my side effects have cleared up for now - even my BMs have been proper without pharmaceutical encouragement! - except my superficial thrombophlebitis (the little blood clot in my forearm), but even that is less swollen and tender than it was 3 days ago. Oh yeah, and I guess I'm still bald, but who cares?! So last night I went swimming for the first time since Grazelda took up residence, and today we're going up to the mountains for a little gentle hiking and a little just being in the cooler weather in the pine trees.

Here's what I can tell you: it feels really good to feel good.

September is Ovarian Cancer Awareness Month

I was wondering what I could do on my blog to observe this (besides shouting,

"HEY! I HAVE OVARIAN CANCER!!!"

in really large, bold, teal italics, of course). I hope that this blog is doing something to increase awareness, but I realize that I haven't provided a whole lot of general information about ovarian cancer in these tomes. It's a little bit complicated by the fact "my" type of ovarian cancer (malignant endodermal sinus tumor, which is a kind of germ cell tumor) is not very common amongst ovarian cancers, so the information I have given has been somewhat Grazelda-Specific.

Ultimately, this is what I would like every woman to know:
The 4 Primary Symptoms of Ovarian Cancer:

• Bloating (gaining girth without gaining weight elsewhere)
  
• Pelvic or Abdominal pain
• Difficulty eating or feeling full quickly
• Urinary urgency or frequency

I had all of the above (plus fever, cough, diarrhea. Yeah, it was miserable). If you have any of these for more than 2 weeks, don't freak out - it could be something else - but do talk to your doctor. Ovarian cancer is typically hard to diagnose because the symptoms are often so subtle and can also be indicative of other conditions such as irritable bowel syndrome (and pregnancy - you have no idea how many doctors thought I was pregnant!!), so knowing the symptoms and seeking help immediately is that much more important.

The Other Thing I Have To Say, Which Also Applies To Men
(not that the men should ignore the previous, since each of you cares for many women)
Two months ago to the day (unless you're on the west coast and so totally addicted to my blog that you're reading this mere minutes after I post, bless you) I woke up with severe abdominal pain. Before that, not only did I feel amazingly healthy, I was leading an unquestionably healthy lifestyle: I ate the right stuff, I got my exercise, I've never smoked, I drink alcohol in moderation, I even gave up coffee after one bad caffeine trip last year. There is not a lot of cancer in my family. I was 24 years old. And then, bam, I got cancer. That is to say, you could get cancer. Just for a minute, let go of the list of lifestyle choices you've been making to minimize your risk factors (because I did all that and more), and let that thought sink in. There's your existential pondering for the day.

Now, make sure you have health insurance, and keep doing what you can to prevent it!

If you want more information, www.ovariancancerawareness.org is very accessible and well-organized, while www.ovarian.org goes a little more in depth.

P.S. Said simply, I feel great today.

My Big Bad Bald Self

Today in the shower, maybe even while I was washing my scalp (ironically with Wonder Waves shampoo), I had the following thought:
"How am I going to do my hair today?"
And then I remembered that right now, that is not a concern of mine. So I threw on my rainbow-tie-dyed-with-sparkles scarf and went out.

No, I haven't gone out in public without a headcovering yet, but why would I when I have so many great scarf options?! However, it is becoming more and more probable that I really may forget one day, and I don't think it would be so bad. I have been increasingly happy and comfortable as a mostly-bald woman. I happen to think I have a nice-looking head. Which is fortunate, as I suffer from an inability to not look at myself in the mirror (narcissism exposed!).

I haven't lost my eyebrows or eyelashes, and I still have a little bit of hair by my sideburns, which is what makes a woman look really bald, even with a hat on. In fact, they sell little self-adhesive sideburns for wearing under hats or scarves.

Anyways, here I am:


And just for comparison . . .

(This picture is really for my Dad's brothers, proving my status as Baldest Member of the Penner Family)

Superficial Thrombophlebitis

. . . looks like this:


That thing that is circled in blue ink pen on my forearm is a blood clot (thrombosis) that either migrated or grew backwards from my PICC line clot. When you have a blood clot, it just sits there in your veins (that's the -phleb- part). Blocking blood flow can cause pain and swelling, and it can even get inflamed (-itis).

For the past few weeks I've had this spot on my arm where I can feel a very well-defined vein. My doctor said that it was a blood clot and nothing to worry about. I'm already on drugs to take take care of my Hypercoagulating tendencies, and my arm is a great (=relatively safe) place for a clot to hang out. But yesterday I woke up and it was worse. It hurt (a little) to straighten my arm. It was (a little) redder, and (a little) visibly swollen. So after some re-arranging of schedules to get my Dad to the airport and me to the doctor's simultaneously (Thank you Scott and Jeanne!!) I had the quickest doctor visit yet: He drew the dotted line around it and told me to call if it got a lot bigger or redder or more swollen, and I'd go on antibiotics just to make sure it doesn't get infected.

In the middle of his explanation, to make sure I was following him, Dr. Hallum asked me to recall why I was prone to blood clots, "Because I have cancer!" was my prompt, and correct, answer. It felt a little bit like I was in Sunday School or children's story, where "Jesus!" is always the right answer, or at least is never wrong: All these random side effects and symptoms are because of cancer or chemo (which is because of cancer). Otherwise, underneath all of that, I'm healthy!

And probably going contra dancing tonight!