TCHP

 Thank you for all the well wishes and support. We have a planned start date of Monday, January 29th for my first day of chemotherapy which will consist of four main infusions known as TCHP.

TCHP stands for:

• T – Taxotere® (Docetaxel)
• C – Carboplatin (Paraplatin®)
• H – Herceptin® (Trastuzumab)
• P – Perjeta® (Pertuzumab)

T & C are chemotherapy medications and are an antineoplastic agent and platinum chemotherapy, respectively.

H & P are targeted therapy for HER2+ cells and are monoclonal antibodies.

We decided not to biopsy my vertebra as the treatment would not change, and it is most important to get the treatment started as soon as possible. It is possible we will biopsy it at a later date, but that is still to be determined.

Many of you know how long my to do list normally is, but for now, I'm going to keep it simple:

One Day at a Time

 I came across a great post on Pinterest titled "I had Cancer & This is What I Needed". There is no "how-to" book on this and just like you, I'm:

I found her points clear and helpful as we navigate these waters together. I appreciate everyone's support and want to ensure you're as supported as I am, as this is a two-way relationship and we're all going through our side of it whether we like it or not. Here are some thoughts from a fellow 30ish year old breast cancer survivor who then found herself being the caregiver/friend not even 2 years after her recovery for her not even 30 year old friend:

1. Do not say “it’s all going to be okay.”  Unless you are a fortune teller, you don’t know this to be the truth, so stay away from it.  It’s the first thing you will think of – I thought it too, but it’s not helpful, I am sorry to say.  
2. Be yourself.  The reason you are in this person’s life is because they love you for you.  Don’t try to suddenly be the person you think they need because they are fighting cancer.  Stay true to yourself. Trust me, this makes the fight easier for them…and for you.
3. Treat them to something they love.  I am not saying go out and buy them the world, but if they like to read, get the newest bestseller, if they like chocolate, buy them a sweet treat, etc.  If they enjoy writing or journaling, buy them something beautiful to write in like the Love Heals journal. You get the idea. *** Some of my go-tos so far are my metal stone that says "One Day at a Time" sent by an amazing friend in Idaho, a soup care package from Spoonful of Comfort from my mother-in-law that filled our tummies with delicious homemade chicken and rice soup, a beautiful sage cardigan that is a hug any time I put it on from my two coworkers/friends, and my amethyst bracelet handmade by a coworker/friend's daughter who is a major hustler and sold it to me for $10 (instead of $5) because she only needed $10 to get the item in the gift shop she really wanted. Her mom was proud and embarrassed. I was just proud of the little entrepreneur and happy to pay $10 to see her smiling face achieve her financial goal! ***
4. Laugh with them.  I latched onto humor like it was a lifesaver.  I made fun of everything from my bald head, to my forgetful mind (thank you chemo.)  Follow the person’s lead here, but if they open up the door to laughter and humor, play along.  It will help them and you too.
5. Don’t run.  It seems like a safe place to just run from them because you don’t know what to say or do.  I don’t suggest this. It tells them you don’t care. Just because you don’t feel like you have the absolute perfect words to share about cancer, so what?  Be a part of their life like the friend or family member you have always been to them. Trust me, they will want things as normal as possible.
   
6. Stay away from “motivational” cancer stories and verbiage.  This is hard to explain, but as I was going through treatment, I didn’t want to hear about “new normal” and I am just going to “have to deal with the changes in my life.”  I hated all that. I hated hearing “you can’t get your old life back.” I am super well aware. However, at the time, it felt good just to get those words out. Don’t try to sugar coat the situation.
7. Let the person grieve. This ties into point 6.  Don’t be “Suzy Sunshine” every time you hear them talk about being scared, sad, fearful, etc.  Let them speak it!! They are going through potentially one of the worst moments in their life and they are scared out of their minds.  Telling them not to think the horrible thoughts that they are fearful of dying is not helpful. You may not want to hear it and they surely don’t want to say it, but it’s there and it’s in their mind.  Let them speak it.
8. Ask questions.  Feel out what the person is willing or not willing to share.  I appreciated it when people wanted to know what was happening, how I felt, how the treatment was going, etc.  I had no problem chatting about it. See where this goes. Some people will be open to share and some won’t. Both are just fine.
9. Do not share stories of unhappy endings.  I feel this is obvious, but you would be surprised.  I always got one or two of the “my friend had cancer too, but….she died.”  Not helpful. Nothing else necessary to say here.
10. Talk about the happenings in your life too.  I literally hated when people refused to tell me about their day to day lives.  They would say “oh you have so much worse things happening than hearing about how my car broke down.”  No no!! I LOVED to hear about everyone’s daily lives. It made me feel normal and sane. Trust me on this one.

One Day at a Time.

Sometimes Courage Looks Like Patience

 The words are flowing a bit less freely for this post. Findings of my PET scan received on 1/16/24 confirmed the known malignancy but also added yet another layer to the ongoing information gathering session. The Pros: No further confirmation of involved lymph nodes (but to be finally determined by biopsy during surgery). The Cons: Areas of increased uptake at T11 and L1 warranting further imaging to determine if incidental finding or potential metastases. This, my friends, is why I waited until after a thoracic and lumbar MRI with and without contrast on 1/19/24 before posting this next post. Unfortunately, the MRI wasn't as helpful as we had hoped either. It identified some incidental findings showing hemangiomas at C7, T3, T4, and T10. 

There is still an area of undetermined involvement in T11, although noted to be in a different area than what was visualized on my PET scan. It states "Potentially this could represent reactive edema from the degeneration however, metastatic disease cannot be completely excluded on this exam and attention on follow-up examination is recommended." There is also findings of a Schmorl's Node in my T11 vertebrae. Hang on tight everyone, we're now in unchartered territory together. I may as well plan to donate my body to the Mütter Museum in Philadelphia. Been there, seen that. It is worth it if you get the chance!

The long and short of it is that there is more to come after my visit to the oncologist on 1/22/24 to determine if a bone biopsy is needed or if we're good to go on starting chemo.

I had my powerport placed on 1/19/24. I'm a little sore but that is to be expected. The care I have been receiving and continue to receive at Mat-Su Regional Medical Center is exceptional.

TL;DR

This is me, being patient.

The Realist's Optimistic View of Cancer - The Beginning

 If you're reading this, you're someone who I deeply care about and am fortunate to look to for support (so thank you!). I hope this platform is helpful to gain knowledge, increase early detection via preventive health services, and provide solace for those reading this. I plan to add helpful links if you wish to go down the rabbit hole, and TL;DR (Too Long; Didn't Read) options for the quick and dirty version.

 On December 14th, at a well-woman exam, my primary care provider (PCP) who is a DNP (Doctor of Nursing Practice) found a lump she didn't like. Since I am 38 years old, I had not yet had a mammogram, and she referred me for a mammogram and ultrasound. Due to there being a concern, there was an interventional radiologist on retainer for the 2 hours which allowed my mammogram and ultrasound findings to be further investigated and ultrasound biopsy and clip (I got a heart one!) insertion done on the same day (December 26th).

 He was honest, which I appreciated, and stated while he could not diagnose cancer from a mammogram alone, he had concerns at this time through their BI-RADs category (I was a 4C at the time and have since increased to a 6 after MRI) which led to the three core needle biopsies to be taken. Preliminary pathology results were sent to my PCP on December 29th who let me know it showed Invasive Ductal Carcinoma, the most common type of breast cancer. Final pathology results were available on January 2nd which showed it was Triple Positive (Estrogen, Progesterone and Human Epidermal Growth Factor Receptor 2 aka HER2 positive) which means the little thing (currently 1.3 x 2.0 x 2.2 cm) loves everything and therefore grows really fast. HER2+ breast cancers tend to grow faster and are more likely to spread. On the flip side, it also responds better to breast cancer treatment that targets HER2 proteins, which is a positive (pun intended). 

 The next test I received was an MRI with contrast. From there, it was decided I should get a PET scan to truly know the full involvement at this time. I had the PET scan on January 12th and had to wait for the radioisotope to fly in on Alaska Airlines from Seattle, hoping it didn't fly out the door. Sorry, was that too soon?

 I also received an echocardiogram (ECHO) to get a baseline status of my heart as the suggested chemotherapy is cardiotoxic (can cause heart damage). At this time, next step is to get the PET scan results and meet with the medical oncologist on January 16th which is also the day all four of my physicians will be in the same room discussing my case.

TL;DR

Thank you again. I'll leave you with this, for now:

River Trail Yurt

We decided to explore another yurt in the Eagle River Nature Center area. It is Rapids Camp Yurt and right on Eagle River. In mid August, the trail, Albert Loop Trail, closes due to bear activity with the spawning salmon. We didn't have any bear visitors during our stay.

Bore Tide Cabin

The PTs and Air Force Pilots made a trip to Bore Tide Cabin and glamped for the weekend. Who has ever heard of paella over the camp fire!?

Yukla Yurt

Our group returned to Yukla Yurt to enjoy more winter wonderland.

Barber Cabin

Barber Cabin is located on the Kenai Peninsula and sits on the Lower Russian Lake. We hiked in with an ice auger, 6-man ice fishing tent and all our gear just to find a double avalanche not even 1 mile from the cabin. The decision was to go over the stable avalanches instead of over the lake with unknown ice levels due to a mild winter.