Wednesday, July 25, 2007

Getting Back to Good

Getting back to good 7/23/07-7/25/07

Now that my life has changed in so many ways I have now had the experience of actually being a patient on a neurosurgery floor in the hospital. This experience is in sharp contrast to being a worker on a neurosurgery floor. It was a very strange time but a very positive one.

First off, my kudos got out to the staff of 5 East at the Cherry Hill Campus of Swedish Hopsital. They are a wonderful group of people who treated me so well. Most of the nurses that I worked with had been working there for 20, 25, 30+ years. It was very funny because this campus, where the Swedish Neuroscience Institute is housed is actually the Old Sisters of Providence Hospital in the Central District of Seattle. Many of you know that not only did I work at this hospital for 5 years but my Dad practiced at Providence for 30 years. He was Chief of Staff at one time. I remember as a kid, going with my Dad to round on patients on holidays or other times. I have vivid memories of eating with him in the ‘doctor’s lounge’ (read cafeteria.) At one time you came into the hospital and his picture was on the wall. Lots of memories for me. It is a beautiful facility and my time spent there was really good.

I also remember working in the gift shop, working in the Family Medicine Clinic as well as Outpatient Rehabilitation. A major component of my childhood and young adult life is mixed in with Providence Hospital. Additionally, after my Dad passed away one of the services we did for him was in the Auditorium at Providence. As I look back it was this memorial service that really represented closure for me after my Dad died.

Now I was back as a patient. Room 544 East. Being an inpatient in a hospital can be really difficult (especially for the control freaks in the room……………..not that we know any of these people.) You are really stripped down to basics and you have no schedule. One basically just waits around for the next diagnostic study, or the next meal, the next medication or the next physician visit.

The reason I was being admitted was to review the state of affairs in my spine post auto accident. I am not going to go into this information at this time. Suffice to say the neurosurgeons are on board with up to date films to monitor my spine closely as I go through treatment. For now no surgery is necessary.

The other aspect of my care that was handled while I was an inpatient was my pain management program. Pain management is hugely important and relates directly to how well people do during cancer treatment. I am sure there is a study out there with a ton of empirical date but just think about it. Who is going to respond better to cancer treatment? A patient who is in agonizing pain, who can’t think straight or focus or someone that has their pain under control and can function? Obviously the latter will.

I frequently use this type of an analogy when presenting AFLAC policies to people. Who will do better during cancer treatment? The client that has just been diagnosed and is worried about losing their job, losing their house, putting food on the table, bouncing checks, not having the money to make important treatment decisions or the client that has a cancer plan? Once diagnosed the first check they see from AFLAC is for at least $5,000. The money just keeps coming to them during their treatment. It is not contingent on their ability to work or not. Very powerful stuff.

The Pain Management Team at Swedish is a group of rock stars. They went far beyond asking me questions about my cancer/bone pain. They were focused on me and my family and what my life looks like. They wanted to now about my girls and my activities and my support network. This way, in am empowered to be in charge of my pain instead of the other way around. I left with a plan and a program and many options to manage the pain I may or may not have. This was the best takeaway from the inpatient stay I could have. To know that I can be at home, with my stuff, and my bathroom, and my family instead of having to be in the hospital really did a lot for my and how I am visualizing this fight going forward.

I was really happy.

I will sign out from this dispatch knowing that my family and I are in your thoughts and prayers every day that passes. You all are part of this. You are the legions of people in our ‘Family of Choice’ that are standing with us. I feel lifted up and closer to wellness and protected because of each and everyone of you. Please do not forget, for even one moment, that we are all exactly where we should be right now and your presence in my life is so very precious to me.

Love Meesh

Saturday, July 21, 2007

And so it goes...

To this we just say “WTF?”

I hope you can all handle the swearing. For you that have been in direct proximity to my potty mouth I am that you are fine. For those of you that it offends I am trying to remain acronym friendly for the kids.

Thursday, July 19, 2007

Off we go in the Durango. Gas guzzler-yes- but the access for me is easy and the ride is deluxe. It also feels safer to be in a 6,000 pound vehicle instead of the ‘roller-skate.’ We have an appointment at Evergreen Medical Center to meet with Dr. Jennifer Shook in the Diagnostic Radiology Center. Need to get some final reads on films, check-in and the like. Our plan is to be home before 5:30 p.m.

It has been an all around great couple of days because Mila had her ‘big girl bed’ installed as well as the furniture in the family room so that people can stay over and wake up with the girls SHOULD I NEED TO BE ADMITTED IN THE NIGHT. It was really a team effort with Chrsita, Matt, Tom & Anne, My Mom, the Knoles, Costco, neighbors and everyone stepping up to make these changes at our house.

So we are off and taking an inland route through Kirkland to get to the hospital. Wouldn’t want to drive on 405?!?!?! (I am still on spine precautions BTW.) Stopped at a light and the sound you just don’t want to hear “Smack” to the back of the car and the impact. “HS! Was that us?!” to whit Matt replies “GOD DAMMIT! IT SURE WAS!” We pull off and so does she (the tailgater) and this is when I get to tell my Officer Hyra that upon impact my right upper shoulder, outer arm, down to my pinky in numb and tingling and I am now having new pain in the right side as well as the left neck up into jaw. Here is what you get when you are married to a cop. “I’m rollin’ fire!” So tough!

Yeah baby, rear-ended on the way to the hospital while being on spine precautions. Does it get any better? Probably 400 other cars in the area with targets painted on the bumper but WE WERE CHOSEN! (Last comment awash in sarcasm……..)

So let’s just chat about a couple of things in regard to a car accident when spine precautions are in place. EXTRACTION: That was a real treat. 5 guys trying to delicately move my big ass out of the front seat, while maintaining my cervical spine. Me ever the control freak promising with every breath that I will be a “good patient” if they just cease to torture me further. Every bump every crack in the sidewalk was just excruciating. EXTRACTION not for the faint of heart. Good outcome here though. The first Kirkland cop on the scene, his wife is going through the same diagnosis. I have already received an email from them. Very cool and the wife has made herself available should I want to chat or get together. She heard about us from our Firefighter friend Janelle. Number two. First medic on the scene, Chris Martin, who led up the extraction (and let me keep my sunglasses on) his wife was diagnosed with breast CA two years ago. She is doing great. These are some of the people on my path. Pretty effin’ cool! Also, another example that when I am in the picture the 6 degrees of separation in the world changes to about two. Seattle is such an overgrown village.

So I an now and strapped down to a backboard, hard neck collar in place, forehead taped down, body crisscrossed in chain link and strapping that would get a rise out of a dominatrix and on my way to my ultimate destination, the hospital. Now I am just receiving door-to-door service.

Seen in the ER, SOP, maintaining my spine. We need a CT of the neck and an MRI. I am just lying around. Matt’s playing games with my blood pressure readings and betting. I think I am down to him $1.25 because my systolic never got about 120. We are just hangin’ in Trauma 7. The staff in the ER at Evergreen is amazing and that has got to be the cleanest ER in Western Washington. Most of the people that were taking care of me had previously worked at Harborview so there were lots of stories. Thankfully, they were very generous with the IV pain meds and anti-anxiety meds. I came in at a “10” for pain and left with no pain. I had one temper tantrum after being on a back board for 5 hours. It was appropriate. I apologized later and they said “It was okay coming from you. At least you had a legitimate gripe.” In the insurance industry we say that “AP solves all problems.” In the ER, IV Ativan seems to work the same way.

Result: Getting rear-ended has caused some changes in my spine. (For my many readers who are in the medical field. Previously I had a significant amount of damage and bone destruction at C7, T7, and T10. There was no cord compression at these sites just compression fractures and we were going to monitor to make sure that if there were any neuro changes they could be accounted for. Now, post-MVA there are significant changed at C4-5, C5-6 and C6-7. The cord is compressed at C4-5 and C6-7. We are able to compare directly to the films from the beginning of the week. The numbness and tingling is resolving. Pain is more. Now I am on full spine precautions at home and I AM THE MOST COMPLIANT PATIENT EVER!!!!) I did talk them out of admitting me to Swedish over the weekend if I maintain full spine precautions at home over the weekend. I agreed. I really did not want to be admitted. Thankfully, my team of docs is wonderful and reasonable and so we will reassess on Monday. For now I get to stay home. This is much better for me and the family and my ever growing team of sherpas.

Our goal was to avoid any spinal changes until we got through this 8 weeks hormonal treatment window. The reason being 2 sided. One, we don’t want to have to make a move on treating the spine with radiation if we don’t have to. We would rather see if the hormone therapy coupled with strengthening the bone will arrest the issue. Two, if my spinal cord was compromised in some way and allowed cancer cells into the cord that would be bad.

This is where we are at. Again if these dispatches are too much for you or not working for you just don’t read. My friend Anna is going to set me up with a blog. I think this will be great. I really need all of you and to be able to communicate to you is really important to me. Also, who doesn’t secretly relish in being able to hear themselves rant?

Stay tuned. Certainly something funny, or ironic or wonderful will happen this weekend. It is only Saturday morning.

Thank you for all the emails, and cards, and flowers and your presence. There are few in the world as fortunate as I to have all of you with the depth of your spirit and the breadth of your caring. You are so awesome.

I will probably send something out in the next couple of days. Who knows maybe one of the frozen blue ice blocks that dump out of airline toilets can fall in the backyard?

Love you! Meesh

Wednesday, July 18, 2007

This is what my world looks like today...

Having never been through something like this before we have decided that we will share with all of you what we know. This info may come in fits and spurts (as I hope to stop being awake from 3 am to 5 am) but for me this is the best.

It has been made so abundantly clear to us how deeply you care, how strongly you are behind us and how important your faith perspectives are I will just make the information available to you.

Do with it what you will-as long as it is positive and serves the greater good. If this gets one woman in for her “mammo that she has been meaning to do” or one of you guys “decides to get that funny looking mole checked out” and it is nothing then we all win.

July 17, 2007

After starting out on this journey on July 9th we had finally completed all of the testing. In the end I have had a chest X-ray, a mammogram, a breast ultrasound, a MRI breast, a needle guidance biopsy, labs, an oncology consult, a MRI brain, cervical, thoracic, lumbar and sacral spine, a PET scan, a CT scan or the abdomen and thorax, a porta-cath placement and the final 3 hour oncology consult last night and WE STARTED TREATMENT!!!!!!

I have been diagnosed with invasive breast cancer with lymph node involvement and extensive metastasis to the skeleton (the mets are from the top of my femurs, through hips, pelvis, rib cage, sternum, spine, collar bones, skull, shoulders and neck. While scanning I look like a Christmas tree all lit up with radioactivity.)

The good news is that my cancer is very responsive to hormone treatment. So much so that we will start with hormone therapy first and see how I respond over an 8 weeks period of time. No chemo for now. I will be put into menopause (started last night with a big ole’ shot in the buttocks of LUPRON,) my body will cease to make estrogen. Then I will take a daily oral drug called TAMOXIFEN which will block any other estrogen that is being produced in my body. Ongoing drug therapy and I will also be given bone growth enhancers. Not like baseball players but more like the Boniva you see Sally Field pushing on TV. My drug ZOMETA is 1,000% stronger than the drugs women take for osteoporosis and I get it in an IV. This will help the bones re-grow strength so that they become impermeable to the invasion of more tumor growth.

Success of the hormone therapy is measured by how I feel, cancer cell markers in my blood and scans. Apparently, one of the best measures of how well I will do is how ‘hardcore’ the “flair” is over the next 3 to 14 days. My little cancer cells are going to be mad about be cut off at the estro-bar of Michele. They are going to let me know. Feel for Matt and accept my apologies in advance. Likely, I will be quite the unhappy, rotten feeling, witch.

Additionally, I am on strict restrictions as to the use of my spine. No bending, deep stretching, lifting, and tilting. My spine is compromised at multiple levels and an accident or a slip or a bad lift could cause grave damage to my spinal cord. YOU ALL HAVE PERMISSION TO MAKE SURE I AM 100% COMPLIANT!

I am so encouraged by my meeting with Dr. Hank Kaplan. We are lucky because we have so many options.

Eventually here is what to come:
· Removal of my ovaries (oopherectomy just think it is a cool word)
· Hysterectomy
· Bilateral mastectomy
· Radiation to the spine
· Vertebral reconstruction
· Breast rebuild

Every aspect of treatment is a contingency: If this works à then. If this responds à then.

We are ready. Your words, your support, your faith and your love with these we will beat this. I am 100% certain that we were chosen for this. Ultimately, this will be life changing for our family both large and small. I had a spiritual epiphany yesterday and I really believe that TDUB (the divine universal being) has a plan for me.

I would love to take to time to thank each an everyone of you personally but I cannot. We appreciate you so very much. All your support, and words or wisdom, your jokes, your ideas, your assistance, your prayers but mainly your presence. It is each of you that we will be relying on to carry us through.

Thanks, I go to sleep at night knowing that I am loved, that you would do anything for us and that my girls will come out of this enhanced, better people with a depth of knowledge and empathy that many wait a lifetime to get. Matt is my rock. He is the greatest man and to see him in this role is the most amazing thing I have ever imagined. I knew he was a great Dad but he is wonderful caregiver too. Simply amazing.

This is a lot of info. If this is not your thing arrange for a different method. If you don’t want to hear just delete. Some people do better with information than others do.

For know we are optimistic, we have a plan, we are moving forward. Each of you plays a role in this success.

With love,

Meesh

Saturday, July 14, 2007

Hello Friends

Friends and Family-

It is with a heavy heart that I let you all know that on Monday I was diagnosed with breast cancer. Matt & I have been spending all of our time running from here to there, having tests, meeting with physicians, doing research, calling in well-networked friends and colleagues to assist us during this time.

For background: Last year in May 2006 my Primary Care doctor found a lump in my R breast. I went in and had a mammogram as well as an Ultrasound. Then I met with a breast surgeon just to confirm that the scans were clear. They were and the L side was also scanned at this time.

Two weeks ago when doing my monthly self-exam (gal pals it is time to start doing these!!! You can sign up at www.CheckYourBoobies.org and get a monthly email reminder.) I found a lump under my L armpit. I immediately went in and saw my doctor and she identified 2 lumps in the armpit and one lump in the breast.

My mammogram/ultrasound was scheduled July 9th at 0830. After the Mammo/Ultrasound the Diagnostic Radiologist was concerned and asked that I stay for a Breast MRI. The preliminary results from the mammo-ultrasound-MRI warranted a needle biopsy that same evening. What a day!

Although we only just received the results from these tests and in the meantime I have had a MRI of the Spine and the Brain. I have been diagnosed with Infiltrating Ductal Carcinoma of the L breast. There is also a significant amount of metastatic disease that has spread to my spine and skull. I did have a chest x-ray that was clear. This is a good thing. Additionally, today or tomorrow I will have a CT scan of my abdomen, a PET scan and a Bone scan to see just how fast this has spread.

The pathology suggests that this is a hormone reception cancer, which is a good thing. The other side of the coin is that the bone destruction in my spine is so significant that we may have to start chemotherapy next week to arrest the spread in the bones. This is a very aggressive cancer which the doctors are estimating has only been growing for 7 months. In contrast we have had 72 hours to make decisions about how to proceed.

If you need more information to process this (as I did) there are 2 excellent websites (along with a whole host of other not so reputable sites) to get information.

www.cancer.org
www.breastcancer.org

We will need your help and support at this time. The SPD has been very kind and fair to Matt so that he can be with me. As most of you know, I am self-employed at AFLAC and my team is stepping up to the plate to cover me for the next 6 months or more to ensure that my book of business doesn't not close.

Please keep us in your thoughts and prayers. Don't be afraid to email or send a note. The phones are a bit busy right now.

We are not planning on telling the girls until this weekend. Please keep this in mind.

Many of you have spent the last years of your life complaining that you can't get a hold of us. Here is the 4-1-1

Matt, Michele, Anya and Mila Hyra

Mailing:
PO BOX 843
Woodinville WA 98072

Home 425-788-1027
Fax 425-844-9765
Michele 206-850-8555
Matt 206-852-7766
email: teamhyra@msn.com

Love, Michele