Door #2

Some of you may know this and some may not. I was up at Swedish Hospital as an inpatient from March 21 to March 26. I was admitted with pneumonia. I had been feeling yucky since March 5th. I didn't really think much of it until I took Mila in for a nasty cough and they took my temperature too. I had a fever. I called Dr. Kaplan and he said that many of his patients had this same thing. It was going around. He called in a weeks worth of oral antibiotics and an inhaler. Sadly, even after the week of abx I wasn't feeling any better, the cough was sounding more like a pack a day habit and I was sleeping all the time.

I called Dr. Kaplan back and he said either go to your PCP in Woodinville and get a Chest Xray or come in here and do the same thing. Making the choice based on traffic on 520 I picked this side of the lake.

The CXR came back with a pneumonia in the right upper lobe. Dr. Kaplan then gave me a choice. Another 10 days of oral abx or get admitted and get 2 types of IV antibiotics, 2 types of inhalers (with someone actually teaching me how to do it correctly. I had been squirting it into my throat) and IV steroids. This would be stronger and wipe this out in a few days. Discussed it with Matt and we opted for the admit.

I was in the hospital on 12SW at Swedish where the view is amazing and the staff is just fantastic. I was all ready to be discharged on Sunday, didn't happen. Monday, still no go and then the hopes were for Tuesday were dashed. On Monday I had this huge lump under my left armpit return. It was hard and palpable and felt like a golf ball. Additionally, it is the most painful thing I have felt in a long time. I have compression fractures in my spine and broken ribs and pain wise this is way worse. Dr. Kaplan ordered a CT scan because he knew "I would drive myself crazy" waiting until my PET scan on April 1st. CT scan and the contrast you drink for it is terrible. YUK!

CT scan came back and it looked to Dr. Kaplan that the lymph node in that armpit was necrotic at this point. We would wait for the PET scan to find out what was going on at a cellular level. There were two options that we discussed in the hospital. One, that the treatment was working and the lymph node was necrotic through and through and we would just manage the pain and wait for it to be reabsorbed by my body. Two, the lymph node was necrotic in the center but had Tamoxifen resistant cancer on the outside. I like to think of it like a "whopper" malted milk ball.

I was sprung from Swedish on Wednesday and was so happy to be home. Even though Matt had brought the girls up to visit every day and/or himself I was tired of being in the hospital and happy to be going home. Once back at HQ with my creature comforts and my family I just laid low. I was so surprised how much I slept. I have never been a great sleeper so I feel like I made up for the last 20 years.

Jump ahead to April Fools Day. Have PET scan which it an easy scan. The contrast is tolerable and the people at Radia are so nice. My only complaint is that my veins are shot in my arms so the IV went in my hand which is uncomfortable. No big deal!I just can't be around kids or pregnant people for 10-12 hours after the test so Matt and the girls went to a neighbors for dinner. This made it much easier on me. It is hard to be in the same space as the girls and not be able to get near them.

Thursday, April 3rd I went in for my scheduled infusion. Dr. Kaplan said the PET scan showed that the armpit was a large necrotic node but the Whopper kind with Tamoxifen resistant cancer around it. There are other nodes like this in the same area perhaps 3-5. There is also some new 'hot' nodes on the chest wall (intermammary nodes) that seem to be perking up with cancer and the breast tumors are getting larger. On the lighter side all the bone mets are stable and getting better and stronger and there are still no mets in my liver or lungs.

So here is where we are at. I have been taken off Tamoxifen (a free floating estrogen eater.) It was a good 8 month run and Tamoxifen but it does have a ton side effects that now I am free from. Now I am on Faslodex (an estrogen receptor faker-outer) and a new aromitase inhibitor called Arimidex. AI's stop estrogen production. So I guess in my world of analogy they are on strike and shutting down the production line.

There are many different AI's and the worst side effect is an arthritic like joint pain and your cholesterol can go up. Since mine is 152 I am not worried. Arimidex is a pill that I take every day so no IVs or anything like that.

Plan: Now we try the Arimidex for 4-8 weeks and see how I do. Does the golf ball under my armpit shrink? Do I feel better? What do my tumor markers do? I also have a surgical consult because if the AI's don't work we move on to discuss regular chemotherapy, radiation or surgery to resect the masses.

That is what I know and have been processing since Thursday. I know many of you have been trying to reach me but I need time a space to process information. I have always been this way.

Here is what I am holding onto. A few months ago Dr. Kaplan told me that we have about 30 doors to pick from for treatment. The image in my mind is "The Price is Right" chose from what behind door # 1, 2, or 3.

Dr. Kaplan,".....and we were are only on Door #1."

On Thursday after this new news I asked him, "What door are we on now? Like Door #22?"

Dr. Kaplan, "No, now we're on Door #2."