Thursday, October 30, 2008

a quicker update...

we got a call from dr. jeffery's office yesterday...

trish's surgery has been bumped from november 11th, to november 4th.

to go from having 10 days to mentally and physically prepare, to a few... its kinda crazy, but we have been waiting for this day all along.

trish is doing great physically.

emotionally she knows this is all part of the plan of living a low maintenance life, but it doesn't mean she has to like it...

the silver lining:
november 11th is a scheduled herceptin day. if she had surgery on that day, herceptin would have been postponed...
she will now be able to stay on her schedule to worryfreetown, usa.

Tuesday, October 28, 2008

a quick and overdue update...

hi all..

its been a little over a week since i last updated everyone.

since we got the good news last, last monday, we have been busy meeting with the docs to arrange the next couple months. so this is basically the run down from the last week..

monday 10/20:
got the great news

tuesday 10/21:
met with doc carlson, and he reinforced how well trish has done... he agreed with the tests, and No Evidence of Disease, and said trish could not be doing any better. he gave trish her orders for herceptin, and headed upstairs for the 1.5 hour infusion (3x the amount now that trish gets it every 3 weeks). we will meet with dr. carlson again in 6 weeks (after surgery), then we will be on a 9 week schedule of seeing him.

wednesday 10/22:
in the morning, we headed back to the cancer center for a flu shot that they forgot to give trish on tuesday. feeling great, trish and ria brought caden and lucas to the woodside library for story time a little later.

thursday 10/23:
trish, jane and i heading back to the stanford cancer center for a cancer fair / survivor celebration.. got some good information on some up coming clinical trials, post surgery bras and saw chemo buddy christine.

in the evening, trish headed to healing touch.

friday 10/24:
trish, ria and i heading back to stanford for our first meeting with the plastic surgeon, dr. gordon lee (scroll to the bottom for his bio). we both liked dr. lee, and we talked for a while about the choices that need to be made going forward. dr. lee has a 1 hour long video of a presentation he gave on the topic of breast reconstruction, and talks in detail of all the options available today. if you are interested, here is the link to it:

What's New in Breast Reconstruction? on

basically the choices are:

mastectomy: single or double

tissue expanders: same day as mastectomy, or after radiation (both have pros/cons physically and mentally) tissue expanders make it more difficult to deliver radiation, but there isn't any definitive study saying if radiation is less effective with expanders in the way, but it is harder getting a good angle to deliver it.

tissue expanders are basically implants that get filled with saline every week to help expand the tissue to the size of implants you will have in the future...
they also help emotionally knowing that "something" is there immediately after surgery.

DIEP-Flap (tummy tuck, and implants using your own tissue) or artifical implants (saline or silicon)... the silicon of today is much different than the silicon implants the FDA banned in 1992. they were reintroduced by the FDA 2 years ago, and 16 years of research has made a difference in their safety, and currently 95% of dr. lee's patients opt for silicon as it feels more natural and comfortable, especially when laying down on your stomach. this is a decision that we will make later down the road, not now.

timing: if trish decides on a double mastectomy, she can choose to remove both at the same time, or just remove the "cancer" side now, and wait to remove the second later

so its kinda information overload. there is no perfect solution, no simple solution.

scenario 1:
remove both and have tissue expanders put in during that surgery, have radiation for 5 weeks, then put in the implants in a second surgery months later.
pros: least amount of surgeries, wake up after surgery with "something" there
cons: radiation effectiveness MIGHT be compromised with the expanders in place. the skin may be affected by radiation, and wont be repairable.

scenario 2: remove one, and do not have tissue expanders put in. have radiation for 5 weeks, have a second surgery to remove the second breast and put expanders in both sides at that time, followed by third surgery for implants several months down the line
pros:best way to deliver radiation, still have 1 breast for the time being.
cons:wake up with "nothing" on the bad side. is having 1 breast really better than having none, or is that worse? most # of surgeries.
symmetry may suffer as mastectomies happen during different surgeries.

scenario 3: remove both, no expanders. have radiation. have a second surgery to put in expanders... have a third surgery months down the road to put in final implants.
pros: radiation can be delivered easier, symmetry will be the same on the left and right.
cons: most # of surgeries, wake up with nothing on both sides.

i think we know what decisions will be made, but its really a lot to absorb, and make a good educated decision on whats best for trish. you can't just take into account the short term, or the long term... you need to take each into consideration.

there are physical and emotional extremes with all of the choices, but we need to weigh both and determine what is the best route to take for trish. although the short term is easiest to think about right now, we need to think about a year, 5, 10, 20 down the road, and the choices we make now, will affect the results later.

this will all be a distant memory in time, and although some choices may to tough to endure for the short term, trish is mentally and physically tough, and it wont be any worse than anything she has faced in the past six months.

needless to say, its a real personal decision.... and a difficult one.

saturday 10/25:
trish and steve took the boys to the redwood parents nursery school for a halloween fun day

sunday 10/26:
trish and cerena took the boys up to burlingame to get their hair cut

i finally got the bathroom countertop complete.. ive wanted to build a concrete countertop for 6 years, and i finally had an opportunity. took a few weeks, but its done. we had the terlet, then the tub and then the shower... its nice to finally have a working sink to go with it all... the bathroom is 98% complete now.

monday 10/27:
trish did some grocery shopping and did some baking for monday's play date.

tuesday 10/28: today... tuesday... and the first time in a long time we didn't have a chemo or herceptin appointment.. it was kinda nice. trish hosted a play date this afternoon with the story time moms and their kids. it was great having a bunch of kids play around in the backyard and decorate pumpkins.. i think everyone had a fun time.

we got a call from dr. jeffrey's office this morning, and trish's surgery is currently scheduled for tuesday, november 11th. we know this needs to be done, and surgery has always been "in the next month or so..." but now we know the day, and it makes it tougher, it makes it real, knowing that the date is closing in. nonetheless, the whole point of this is to get trish 100% healthy so we can get on with a worry-less, low maintenance life..

so over the past week, trish has been feeling absolutely great.
no signs of any sickness, fever, nausea, etc...
she is normal, and her hair is starting to come back, and she is really excited for that.

trish has been getting out of the house everyday, walking, driving and shopping.. just trying to lead a normal life. she pushes herself a little bit more each day, but makes sure she isn't overdoing it. her strength is on its way back and she seems to be smiling a little more these days.

sorry for not updating anything lately, but its been a great week and we just kinda savored it...

it hasn't been like this in a while.

thanks for checking in...

Hay, its today's play date


the missing link, the bathroom sink

Monday, October 20, 2008

the test results are back...

this morning, dr. jeffrey's office called with the results of trish's MRI, PET-scan, mammogram and ultrasound she had over the past coupla weeks.

there are no signs of cancer in trish's body.

yes, i typed that correctly.

mri: found nothing of concern
pet-scan: showed her lymph nodes have shrunk, and they are of no concern
mammogram & ultrasound: could not detect the cancer in trish's right breast, and did not show any signs of cancer in a new lump discovered in trish's left breast two weeks ago.

its been a very emotional day, a good day... a great day. this does not change surgery, radiation, etc, but trish has responded tremendously to the chemotherapy and herceptin. we still have plenty of questions for dr. jeffrey and dr. carlson, as we received the news from dr. jeffrey's nurse over the phone. but for today, we can relax a little.

we have an appointment with dr. carlson tomorrow morning and afterward trish will begin her 12 month regimen of herceptin.

i literally just finished watching 'Living Proof' a few minutes ago. it debuted on Lifetime this past saturday night, and we tivo'ed it. there will be an encore presentation tonight (monday) at 8pm on Lifetime, and i encourage everyone to watch it. even though trish was not part of the clinical trials a decade ago, it was like i was watching my life on tv. many women have benefited from the work of dr. slamon & genentech since herceptin's approval by the FDA on September 25th, 1998.

'Living Proof' is the true story of oncologist and researcher Dr. Dennis Slamon, the UCLA doctor who helped develop the breast cancer drug Herceptin, and his effort to keep the drug trials afloat. His inspiring journey shows the sacrifices he makes in his personal life and the obstacles that he faces to get the drug approved. Thousands of lives have been saved because of his dedication. (Based on Robert Bazell’s book “Her-2.”) Renée Zellweger, Neil Meron and Craig Zadan, and screenwriter Vivienne Radkoff are the executive producers

trish is living proof.

Tuesday, October 14, 2008

now that we have the weekend behind us...

its tuesday morning, how bout a big bowl of herceptin and a side of benadryl.

trish, myself and our special VIP guest star, ginger, headed to the cancer center this morning to get the last treatment of round 3.

its been a long handful of days leading up to today, but trish is doing really well. no signs of any fever. trish was really happy to get home and spend some time in her own bed with caden.

nurse denise tapped trish's port around 8:50am and starting the premeds.
denise also gave us the results of trish's ANC count from yesterday (we left the hospital before we knew the actual number...)

trish has gone way up :)

Absolute neutrophil count (ANC):
friday (trip to the ER): 0.25
saturday: 0.3
sunday: 0.9

the drum roll please...

monday's test results that we received today: 5.2

this is the highest they have been since trish began the FEC rounds of chemo on august 19th. the neupogen is doing its job, and trish's body is recovering nicely. her platelet count is at an all time low, even lower than friday nights trip to the ER, but they will come back up on their own, and it isn't a concern right now.

so.. the deacadron and benadryl and dripping right now, and the 30 minutes of herceptin should begin in the next half hour or so...

later this afternoon trish will have her mammogram and ultrasound.

after today's treatment, i believe she is switching her herceptin schedule from once a week, to once every three weeks. we will meet with dr. carlson next tuesday, but im not sure if trish will begin her new herceptin schedule next tuesday, or three tuesdays from now.

thanks for checking in...

10:30am update
the herceptin is just about done... just a quick heparin flush of the port, and we are out of here... early lunch today, we just cant decide where..

trish & ginger
(taking different kinds of shots)

Monday, October 13, 2008

the weekend update... addendum


guess i put the cart before the blog... or the blog before the horse, or put a blog in my mouth or a foot in my blog.... i dunno what the hell happened...

after we finished the pet-scan on friday ~ 5pm-ish, we headed to draegers to get trish some food, since she hadn't eaten for almost 24 hours.

about an hour after we got home, trish started running a fever up to 101.4ish

we called the emergency "on-call"ogist... and she said....

"bring her into the ER"

and i was thinking

"WTF, SOB, MF, $#!&"

so we headed over to the stanford ER friday evening around 7pm..
again, if it was business hours, we woulda went over to doc carlson, but nahh... couldn't have that kinda luck...
at the ER, they triaged trish in the waiting room and her fever was 99.7.

the benefits of being a cancer chick with a fever is that are pretty quick to get you into a private room, so again, we were put into a pediatric private ER room, and got the same great nurse, monika, we had last trip to the ER.

i kept taking trish's temp every 45 minutes or so, and we saw it go down pretty quick to a normal 98.6 ish an hour or two later..
no drugs, no iv's, no nothing.. hell, we hadn't even seen a real doctor at that point.

dr. oak says it was all part of the long day of no food, some radioactive dye getting pushed into her and her body being a little grumpy at her.

my money was on us coming home that night, perhaps even with a prescription for an antibiotic...

well.. dr. oak was wrong... and glad i didn't wager the 'under' on time spent at the hosptial this weekend.

the real doc came in around 11:30pm (4+ hours later) to let us know that trish's blood counts were really low..

ANC: .25

so... this meant they were gonna admit her to the hospital until her counts went up, and make sure the fever didn't return.

we (well, actually I) weren't too thrilled, but its all to get her better... we are thinking long term here, and if it means a short stay at the hosptial, sobeit..

i left the ER saturday morning around 1:30am, and trish was moved to her private hospital room at 2:30am.

on saturday, her counts had gone up a little..

ANC: .6 (the chemo cutoff is 1.5)

all this time, trish was feeling really good.. absolutely no sign of fever, they put her on some antibiotics to make sure they killed anything that may have been growing in her.

on friday night in the ER, they did a chest xray, and on saturday they told us the results...
the docs maybe saw some stuff that lead them to maybe believe that trish maybe had some maybe little perhaps onset of some maybe pneumonia... i call bullshit, but i aint the doc, and we gotta keep her safe..

so they gave her more antibiotics for the pseudo-pneumonia that may or may not mighta have been there

this meant there was no way they were gonna release her on saturday... ahh another night at stanford penitentiary, oh joy.

its like a little weekend getaway with a craftmatic adjustable bed.

so sunday... no fever, blood counts still creeping up, still on the antibiotics, eating good, looking good, feeling good, walking good...

ANC: .9 (still low, but going in the right direction.. frame of reference, she was .36 and at home, the day before my sisters wedding that she didn't go to..)

we took a walk around the hospital, and again... she was feeling really good, laughing and in good spirits.. just disappointed that she was still stuck in this fine facility...

part of her was comfortable with the fact that she was in the right place if her health decided to go south, but man... a 2 hour long fever that went away by itself 2 days ago.. dr. oak remained skeptical and was lobbying for the doctors to vote her off the island... but i kinda think trish was getting too attached to the awesome nurses she had... julia & patty

the real docs came in on sunday morning and basically said "you should be home by tuesday"... WTF, tuesday? whats wrong with monday... doc oak was wrong again.

anyhow... better being safe than sorry... trish's health is the priority and i guess we gotta make sure her 2 hour fever from friday doesn't come back sunday night or even monday.
so another night at the st. regis stanford, another night of anitbiotics, another night of hospital food.

so now as i pull my foot out of my blog, its monday morning, and the docs just came in... her monday blood test results are still pending, but her white blood counts (different than absolute neutrophil count) are back, and they are way up, so they are assuming the ANC will be within normal range..

the docs and nurse said trish should be paroled out of here by 11:30am... doc oak is happy.

literally 5 minutes before the parole board walked in to release trish, trish rubbed her nose cause it felt dry, and it sprung a leak. nose bleeds haven't been common for trish, but neither has 4 days of conditioned, dry, hospital air... i thought for sure the docs were gonna put her in solitary confiment for another week, but the docs didn't feel it was caused by anything but her nose being dry..

so thats that.. she, i , everyone is looking forward to getting her home.. she misses caden, and caden misses his mamma... she isn't sick, so lets get her the hell out of here..

i thought the friday night, saturday night, sunday night stay was a little overkill, but thats what i get for getting my doctorate from the local junior college...

ya can never be to careful with our favorite little cancer girl...

anyhow... trish's friend ginger flies in tonight from LAX, assuming the airport hasn't burned down by then...
we have herceptin, mammogram and ultrasound tommorrow...

just another (normal) hectic week...

trish & the nosebleed kit

i believe the C stands for Cell, as in jail...

Friday, October 10, 2008

the weekend update...

a quick update

we met with dr. jeffrey, the surgical oncologist. she ordered a few tests/scans for trish before we decide how to proceed with surgery.

trish had her herceptin as scheduled.. we didn't realize it until we got into bed that night, but it was trish's 6 month anniversary of her diagnosis...

trish, ria and I went back to stanford for an MRI...
scheduled at 8pm, it finally started around 9pm, and we left around 10pm... long night, but we did swing by town & country to check out the pink lights (but i forgot my camera)

trish picked up her new (to us) car... a little soccer mom volvo suv rig..
her current car goes bye bye on monday, so we needed to get her something to drive as i dont trust her riding a bike with my son.

back at stanford right now for her PET (positron emission tomography) scan...
they are gonna pump her with a radioactive chemical and it will be absorbed by any cancerous cells.. she will then go into a scan, and the resulting image will show the extent and location of any cancer.. she went in about 2:30pm, and they said it would take 2 hours... so another waiting game for ria and i.

trish is doing good today, just a little grumpy and tired.
she hasn't been able to eat anything before the scan today.. it woulda been nice to have it scheduled in the morning, rather than mid afternoon... but she is looking forward to a deli sandwich and a caesar salad when this is done.

tomorrow is kinda of weird day for trish.
she is basically getting fired from work. her 6 month short term disability is up, and she will now go onto long term disability, but her employer, GlaxoSmithKline, will terminate her employment tomorrow.

so no more company car, laptop, etc...
but more importantly, trish is disappointed that she is losing her job. she has spent 7 years with GSK as a pharmaceutical sales rep in several different specialty areas, and has enjoyed the interactions and friendships she has made with co-workers, doctors and staff over the years. although she hasn't been able to work in the past six months, she will miss her job and being part of the GSK team.

maybe she can start pushing Herceptin, a Genentech product, once we get all this stuff behind us. :)

speaking of herceptin and genentech..

trish has been asked by genentech to give a presentation about the benefits herceptin has on her type of cancer, Her-2/neu Positve. the audience will be 100 or so genentech employees and trish will be introduced by the senior vice president of bio-oncology.
trish has been planning her presentation for a couple weeks, and looks forwards to share her story with the fine folks of genentech.

unfortunately, this is NOT a public event, so you wont see me out front scalping tickets for triple face value.
whats on tap...

trish will get her scheduled herceptin, as well as a mammogram and ultrasound of her boobies.. trish's college roommate, ginger, is flying up from LA to visit for the day, so she is really excited to see ginger, but having a machine smash her boobies... not so much.

the herceptin talk with genetech

next, next monday
the plan right now is to meet back with dr. jeffrey on monday, october 20th, to go over the results of the mri, pet scan, mammogram and ultrasound..

anyhow, trish is still feeling really good.. by far the best couple of weeks in a while. the biggest issue she is having these days is the heartburn... and if thats the biggest issue, we will take it..

she has been doing a fair amount of walking this past week, and its helped her emotionally and physically. she has also been able to hang out with some girlfriends, outside of the house, this week and she really enjoyed the time doing that.

thanks for checking in, enjoy the weekend...

Tuesday, October 7, 2008

H-Town, USA

herceptintown, antibodyville, 94305, ITA...
whatever ya want to call it, we are back..

today should be a relatively quick day... 30 minutes of herceptin, and we should get home before caden goes down for his nap...

its 9:30am and nurse shelby is gonna tap trish's port, and get some premeds going in..
herceptin will probably/hopefully start in about an hour or so..

trish, jane, cerena and i made a trip to the cancer center yesterday to have our first meeting with trish's surgical oncologist, Dr. Stefanie Jeffrey.

we went over a rough time line of when surgery will be... 4-6 weeks away, as we already knew. as for the exact surgical strategy, dr. jeffrey wants to make that decision after an updated round of scans are performed. she wants to see how trish's body has reacted to the chemo, but after a physical exam of her boobie and lymphnodes, dr. jeffrey was really happy with how trish's body has responded to the chemo, saying things such as 'great' and 'this is awesome'.

the doc ordered several scans that trish will have in the coming week or so. starting off with an MRI on wednesday night, and a PET-CT friday afternoon. next week there will be a mammogram and an ultrasound.

the results of the scans will will give a better insight on exactly how we should proceed with the mastectomy and determine the extent of the lymph node removal.

this was the first time any of us have met dr. jeffrey, and we were really happy with her. she obviously knows her trade, but it was really easy to talk with her about different options/methods/philosophies, etc..
all four of us left with a good feeling, knowing that trish would be in great hands, and i think having a female surgeon will help ease trish's anxiety a bit.

the highlight of the day for trish was when we were on our way to meet dr. jeffrey, we saw another chemo buddy, cindi, in the waiting room for her doctor.
trish and cindi have only met once, while getting chemo months back, but they have exchanged many emails since then. both the the girls are looking and feeling good.. its really nice to see others around ya getting better as well.

after we left the cancer center, we headed over to town & country village in palo alto for a little lunch at Douce France, a french cafe and pastry shop.

october is breast cancer awareness month, and town & country village is hosting a fundraiser called "Town & Country Goes Pink", and all proceeds go to a local organization called Breast Cancer Connections.

During the month of October, Town & Country Village in Palo Alto will be draped in 5,600 pink lights in support of National Breast Cancer Awareness month. It's the first year Town & Country management and the shopping center's 20 tenants have partnered with the Palo Alto-based nonprofit Breast Cancer Connections to "shine a light" on the disease and broadcast the availability of helpful services.

The shopping center presented a kickoff reception for "Town & Country Goes Pink" on Wednesday night, and general manager Joan Fantazia invited the community to purchase a light for $10 to honor a friend or loved one who has experienced breast cancer. One hundred percent of the funds raised by the lights will go to the free support services provided by Breast Cancer Connections.

Douce France's owner, victor, and trish's coworker rochelle, purchased a pink light in honor of trish... since it was lunch time, we didn't get to see the lights turned on, but we plan on taking a look tomorrow night after we finish up the MRI.

the last few days have continued to be good to trish...
she is eating well, and is just battling a little bit of nausea..
nothing too extreme, nothing unexpected.
she is getting sore from the neupogen shots (this is a good thing, unfortunately)

so, considering by this time, last round, we were sitting in the emergency room...
trish is doing much better in her 3rd round (insert cliché here).

thanks for checking in...

a quick update...

11:15am: herceptin is done... just waiting on a quick flush and we are outta here..

Friday, October 3, 2008

last call for chemo...


its friday, and we arrived back at chemoville around 9:45am for trish's second (AND LAST) dose of 5-FU this week.

im not gonna be able to call this place chemoville anymore, as TODAY IS THE LAST OF THE CHEMO... i guess ill have to call the place "monoclonal-antibodyville"

we are in suite B2 today with nurse margaret.
trish is currently taking a little nap while she gets her hydration IV. i dont think she needs the hydration, but might as well be safer than sorrier, as we are here anyhow for HER LAST DOSE OF CHEMO (in case i hadn't mentioned that)

we still need to come back to the cancer center to hang out with our favorite nurses, and to get trish's IV's of herceptin (an antibody, not chemo), over the next two tuesdays, and then continuing every 3 weeks for the next year...

but as for any and all of the actual "chemotherapy" drugs she has received in the last 164 days (since april 22, 2008)

- the adriamycin
- the cytoxan
- the 5-FU
- the taxol
- the epirubicin

she will be done with all of it in a couple hours :)

trish has felt really good this week... much better than round uno y dos..
we are hoping this continues, but we know it takes 7-10 days for the tuesday's "big dose" of chemo to really start kicking her ass..

on wednseday trish put up all the halloween decorations in the morning, and monica's mom, melissa, stopped by to visit deliver a beautiful blanket made by one of her coworkers.

yesterday, she went shopping at whole foods with her dad in the morning, and to healing touch with her mom in the evening. her stamina has been pretty decent, nausea has been under control (she took the last of the 3 emend pills). she has had a good appetite and continues to be relatively regular..
so far, so good..

so today:

at 10:20am, the hydration IV began

at 11:50am, nurse margaret began the manual push of the 5-FU

five minutes later, on October 3, 2008 at 11:55am, trish completed her chemotherapy.

so how bout a big FU to the 5-FU and its friends

today is a big day, a huge milestone... today is a milkshake day...

still plenty ahead of us, but its really nice to utter the words


trish getting her final push of 5-FU, while cuddled up with her new prayer blanket handmade by Pam of the Valley Church of Cupertino