2.25.2013

My Lung Garden

For the last 3 months I've been walking around knowing that I might have cancer still growing in my body after all.

For the last 2 weeks I've been living in a state of what I would call "near emotional devastation" at the thought of having metastatic cancer and all the implications it brings with it.

So without further ado, the results are in and the post-Oscar award goes to...


There.

I'll give you a second to sigh with disbelief.

Metastatic cancer.

Adenocarcinoma is the exact type of cancer I had in my colon, so it confirms that those little cancer cells took a road trip on the lymphatic highway and found a new place to bed down for the night. For reasons we'll probably never know, this little flower was present at my very first CT scan, but showed no signs of growing until last November.

Let me illustrate it for you: I have a lung garden full of seeds. As with any garden, many seeds are duds and never grow. In my garden, one of them has and blossomed into a cancerous flower.

Though the party has now moved to my lung, I technically still have colon cancer. I know it's not in my colon, but it originated in my colon and so the colon gets all the credit for this one. And because I know you're wondering, my colon is doing amazingly well. Extremely well. Youthfully well. Well enough that some people in this house are a little jealous.

What I have can technically be called Stage IV Colon Cancer or Metastatic Colon Cancer.

We meet with my oncologist on Friday, were it will actually be nice to know the bad news before sitting down in his office. As discussed in our last appointment, we know that the plan involves more treatment; a chemotherapy regime called FOLFURI (verses my last treatment called FOLFOX).

At this point, given the tininess of my nodule cancerous flower, the pulmonologist did not feel that surgery was an option. There is the potential that any of the other even tinier nodules might turn out to be cancerous, so surgically removing my cancerous flower now might be futile should these other seeds start to grow.

Yes, it's devastating. The thought of going through treatment again is nauseating. The pending disruption to my kid's lives is upsetting. But it is what it is and I am grateful that we have known about this naughty little nodule cancerous flower from its very beginning. It has been watched, measured, scanned and cultivated under the watchful eye of my oncologist.

But life goes on, and the rest of the week will consist of swim lessons, the gym, preschool, Spin class, normalcy, cancer and being awesome. Just because we know doesn't change a thing right now. I still feel great, my lungs are functioning at 100% (confirmed again today with a "walking" test) and I will once again seize every day because I CAN.









2.20.2013

No PETs Allowed

Since I am an expert at explaining things on a preschool level to a preschooler, I will give you the basic idea of a PET scan and its usefulness with cancer detection. If you still have all your baby teeth and believe Santa is real, than this is on your level. If you can't add without a calculator or spell without spell check, than you are on my level.

I love sugar, and go to the gym to burn off the calories.

Kids love sugar, and run around in circles to burn off the energy.

Cancer LOVES sugar, but can't do anything about it so it holds on to it like my backside holds on to french fries.

I know all the medical professionals of the world are rolling their eyes at my inaccurate description, but I'm breaking it down for the average people, so cut me some slack.

You get injected with fancy modified sugar (glucose). It's a bit more radioactively complicated than that, but we're in preschool here, so we're calling it sugar.

The PET scan detects anything in your body that goes to the sugar party and doesn't know when it's time to shut the party down. While all the other guest go home, cancer just wants to stay and keep dancing on top of the pool table to George Michael. Your whole body will get excited, but quickly process and purge the sugar. Cancer gets excited, but doesn't purge it. And for this reason, anything retaining the sugar will show up on the PET scan.

Cancer sort of gives the PET scan that crazed look a 5 year old gets in his eyes after eating cotton candy.

Or that look I get when someone hands me an entire plate of Rice Krispie Treats and says they are all for me. While most people can eat one and walk away, I hold on to the Rice Krispie Treats like a hoarder.

Like me, cancer just can't let go of the Rice Krispie Treats and so the PET scan catches it in the act of eating the entire plate in one siting. Not that I've ever done that. Ever. Maybe.

Unfortunately, the PET scan can only technically detect the crazy cancer party if it's 1cm in size or larger. Some would argue that it could be as small as 7mm. But my insurance carrier will argue that it needs to be at least 8mm. Since the little garden I'm growing in my lung has nothing larger than 7mm, I have officially been rejected for a PET scan by they who pay the bill.

So the next step will be to wait and wait and wait some more because I LOVE to wait when it comes to cancer. My pathology results from Monday will probably be available today or tomorrow. But in Cancerland, I still have to wait for my appointment next Friday to find out the results. I can only hope that there are results and we don't continue to live in the land of ambiguity or more invasive procedures.

2.19.2013

Put that Camera Down

My photo album entitled "What I Look Like on the Inside" continues to grow. I must say that going in to have a camera stuck down your throat requires much less preparation than having it stuck in other holes. The only down side is having a sore throat, whereas in the other case, you don't have a sore anything if you use those flushable wipes properly.

Inside my wind bags. So nice and perfectly healthy I say with a snicker.
My bronchoscopy when well, the pulmonologist said he took plenty of good samples and I finally got to see my infamous nodule. When I first looked at my CT scan, I was a little overwhelm. I would have asked a million questions about the million little white dots that appeared, but I had a nebulizer in my mouth to numb my throat and I could feel some drugs starting to take me to a better place. And when those drugs kick in, it's best not to open your mouth or you might start singing songs from church summer camp circa 1985.

If you doubt this, Kyle has a video he'd like to show you from the recovery room of my last colonoscopy.

I was able to snap a few picture of the scan after the procedure and all I can do is stare at it with a huge pit in my stomach. Of course I don't understand it, but even from my little perch, it doesn't look pretty.


My eyes bugged out of my head when I saw all these giant white dots, but my pulmonologist didn't even mention them when he was pointing out the nodules he was going after. I was too loopy to even ask what they were, so maybe his lack of interest meant they weren't anything exciting. Either way, it looks SCARY.
The biopsy results should be available in a few days, but in Cancerville, I still have to wait another week and then some. Because that's what cancer is really all about: waiting. Lots and lots of waiting.

I'm currently up in the air for tomorrow's PET scan. I've been told not to cancel the appointment yet, but my insurance carrier has sent me a nice letter saying they will not cover it. In their eyes, it's currently being considered an "elective" procedure. I'm not sure if that's because my oncologist did not send them enough documentation, or they think that my 7mm nodule is too small to justify it. Apparently insurance companies make a stink about the money they'll spend on a PET scan to detect cancer, but don't put up a fight when a hospital charges $400 for an Advil.

Not sure what body parts are there on the right, but this was the view from my bed during the bronchoscopy.

2.13.2013

Carlos the Pulmonologist

Willy Wonka and Scarface worthy.
I've spent the last 6 months working out 5+ days a week. And all for the cardiovascular glory of sitting in a little glass box and breathing on demand today. Not really, but it's always nice to get affirmation beyond my endurance on the treadmill or sweat in a Spin class to know that what I'm doing is worth it for my health.

I sort of snicker saying that. Am I doing anything for my health right now considering that it may not matter what I do at this point to be healthy? In the end, cancer trumps all!

For some naive reason I was expecting to have my lung biopsy today, and fasted accordingly. That means I not only had to wake up to an alarm that didn't come in the form of shouts from a crib, but that I had to skip the coffee that would help facilitate waking up before the sun. It was all in vain, as today just turned out to be a preliminary appointment with the pulmonologist.

On Monday, I'll go in for the outpatient procedure; a bronchoscopy. He'll stick a camera down my nose and try his best to find the nodules and biopsy them. I say do his best, because they really are very small. Small enough that even the largest one (at 7.1mm) won't show up on the x-ray he'll use as guidance. Instead, he'll use last week's CT scan as his map and head to the areas of greatest density. And I can assure that greatest density is probably not the greatest phrase to hear in my case.

"Areas of greatest density" shouldn't be hard, since apparently I have so many new little nodules that the radiologist reading my CT scan gave up and just described them as "too numerous to count." I never thought to ask how many on Friday when we were told of the new guys. I just assumed it was a few new ones, but that went out the window faster than some of the exhales I did for the respiratory therapist this morning. 

"Too numerous to count." That phrase will suck the air out of the ol' wind bags in a hurry.

The best possible outcome is that he's able to find numerous nodule sites and take a plethora of biopsies. The more samples he takes, the better the chances of them finding out if these are boring nodules or not. 

Should he not be successful, the next line of defense would be a needle biopsy while I was actively being CT scanned. Yeah for even more radiation! Another option is something call VATS (video-assisted thoracic surgery). With that procedure, they make a small incision in the lung and remove a nice little chunk of lung tissue about half the size of your thumb. This would require surgery and lung perforation and a few days vacationing in the hospital. So in the end, we can all hope this first attempt works, because we all know how much I hate to be left alone in a hospital room with the TV to myself, heavy narcotics and people bringing me everything I need.

I'm going to freely admit that I've spent every day since Friday in a bit of a daze. I walk around thinking about cancer. I can't sleep without dreaming about cancer. I can't look at my kids without thinking of the possibility of cancer.

Several times a night I wake up and for 5 fleeting seconds I think, "Oh, what a relief! It was just a dream." Then I remember that it's not, and I toss and turn while trying to drift off to other thoughts. It rarely works.

Even if this turns out to be nothing, I have realized that I became instantly complacent over the whole experience. I think I felt like I had a leg up on the disease because I had it all removed from my body. I had operable cancer. But I've had my reality check. I know I was as close to have metastatic cancer as you can get 15 months ago. Should I really be shocked if it shows up again? Or in this case, was there all along and playing coy.

That's why I prepare for the worst before I even know what's there. It's human nature and it's brutal, but it's what we do for our own emotional survival.
Lungs: Not intended as toys for children under the age of 18.
"Look mom, bronchi!!!"





2.08.2013

Finally that Friday

This video has been circulating the popular social hangouts of the internet and I thought it appropriate for my day today. If you haven't seen it, watch it. If you have seen it, watch it again. In fact, watch it every single morning for the rest of your life.



I knew regardless of the outcome of my CT scan, I was going to be awesome.

I was going to be AWESOME, after I finished having a complete meltdown.

I was going to be awesome because I was going to take my life, regardless, and make the most of the situation. There is nothing I can do to change it, so I have no excuse.

And in my case, that situation is rather ambiguous. We didn't get the best of news today, but we also didn't get the worst news. Yet.

Today, no one told me I had cancer. So that's good, right? Except that no one told me I didn't have cancer.

The nodule of interest has indeed grown. He was originally 1.6mm at my very first scan back in the day. In November, he was 4.7mm. And today, he comes in at a whopping 7.0mm. Still very tiny, but trying his best to grow.

He also invited some new little friends to the party, but they could just be the result of me hacking my lungs to pieces for 2 weeks over Christmas. They could also be like those kids from the wrong side of the tracks that show up at your preppy party to spoil the fun, like Danny and the T-Birds. Only time will tell.

We won't know official answers for another 3 week, when we meet with my oncologist again. Until then, I have fun things to look forward to like a PET scan and some quality time with a pulmonologist, who will stick a camera down my throat and try to biopsy what's in my lung.

Worst case scenario? I get to go through treatment again. Different treatment, similar side effects. So nausea and vomiting will replace working out and watching Netflix as my top two hobbies.

In the mean time, life will go on as normally as it can and I'll bury any thoughts I have of a sequel to last year. That's already a challenge with the calendar quickly filling up with appointments and shuffling the kids all over town to be looked after.






2.07.2013

Cancer Purgagory

It's that time of year when I pay my dermotologist an annual visit so she can look at me and say nice things like: "Well, you've just already got A LOT of sun damage on your face." Thanks for the affirmation, but I already say the exact same thing to myself every single morning when I look in the mirror. So I beat you to it, lady. Now leave so I can put my clothes back on.


It's also that time of year when I get to leave Cancer Purgatory. It's that place I have been so humbly living for the last three months, knowing that I may or may not be cultivating a little cancer garden in my right lung. That naughty little nodule had its come-to-Jesus moment last night when it was frozen in time by my latest CT scan. 

Tomorrow morning we'll meet with my oncologist and find out which map I'll need for the next road trip in my life. 

I've had three long months to process and plan out both possible outcomes. I can't say I've come to terms with the idea of going through treatment again, but given that I won't have a choice, I'm as ready for it as I'll ever be. I also can't say I won't be devastated, but at least it will be far less shocking news the second time around. Ain't that the truth!


I remind myself daily that my bad news isn't the worst news. And in terms of cancer, I do have the upper hand. What is in my lung has been there from the very first CT scan, so it's not new. It's also very, very small. And if it is indeed cancer, it is very, very slow growing.

So Friday morning, I will dress in my Spin clothes as I do every week, in hopes that I can joyfully make it to class after my appointment.  I will prepare for the worst, while hoping for the best.

Nothing will really change except having the knowledge of what's inside me. I am no weaker. I am no less. I am just a girl who once had cancer. And on Friday morning, I'll know if I should change that to the present tense.