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April 27, 2007

Busy!

I've had a pretty hectic past 3 weeks, much of it made hectic by my own choices.

So last week I was in Seattle all week. It was a trip that had been planned for about 8 or 9 months, so it's arrival was not unexpected. The trip was originally planned around a trip that Adam and I had won. Round trip airfare and hotel to Anaheim CA. Of course we figured we'd go to Disneyland the one day we were there. But the trip ended up having a dual purpose which was to try and see my mom (see the earlier post about her having just been diagnosed with breast cancer not too long ago). I wanted to go over and see her for 4 of the 7 days I was in Washington, but it ended up not happening. I had so much work to do for school last week that I just couldn't justify adding in another trip. I eventually decided not to buy the extra plane tickets becuase my mom was doing so well and I'm going to be home for a few weeks during May, so I figured I'd actually be able to see her and be able to help out with stuff, rather than be like "hi mom, excuse me while I go work on this paper on the computer" :-)

Mom started chemotherapy yesterday. So far she's feeling fine, but they told her it would take about 24 hours until the steroids they gave her wear off and then she will probably start to feel yucky. She's taking all of the anti emetic drugs, but I guess they work differently in different people, so hopefully hopefully she is one of the people who they help alot. I think the part she is most afriad of with the chemotherapy is the nausea. She'll be on 4 doses (8 weeks) of AC chemo, then 4 doses (8 weeks) of Taxol, then 6 weeks of radiation, then 5 years of tamoxifen. So she'll be done in about six months probably (end of September, beginning of October-ish). So anyway, I'm looking forward to seeing her in a few weeks.

With all of this happening, it's been pretty hard to concentrate on school. Though I think I've been doing a pretty decent job of keeping up with my school stuff during all of this. My professors have been very understanding and flexible. At this point in the semester there are just a handful of things left to do, but when you write it all down it still looks like quite a bit

School stuff
Biostats homework
Epi homework on questionnaire design
2 postings left for online ethics class
some question postings for Cancer epi
Cancer epi take home final
Epi final
Biostats final

Other stuff
Friend coming in from out of town on May 1st
Work DFA planning meeting on May 7th
Attend cancer summit on May 8th
Help out at commencement on May 14th and with all of the pre-commencement activities over the weekend.
Head home to Seattle on May 17th or 18th.

I don't really feel overwhelmed with school at all right now. I feel like everything left to do is pretty reasonable and have pretty much felt that way about most of my first year of graduate school here at the U of M

April 12, 2007

Update

My mom is doing really well. She went to her surgeon yesterday and got cleared for physical activity and prescribed some physical therapy to help her get her arms limbered up again after the surgery. They invited her to participate in a phase III clinical trial. You can read the description of the study at

http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=334899&version=healthprofessional
or

http://www.ctsu.org/ and search for breast cancer trials
The study is called...
Phase III Trial of Continuous Schedule AC + G Vs. Q 2 Week Schedule AC, Followed by Paclitaxel Given Either Every 2 Weeks or Weekly for 12 Weeks as Post-Operative Adjuvant Therapy in Node-Positive or High- Risk Node Negative Breast Cancer.

We haven't decided for sure yet if she is going to participate, but think that she probably will.

I've had a TON of class work to take care of this week and I'm hoping to be pretty much caught up with my work by tomorrow.

April 4, 2007

A Sad and Happy Story

The good news is that everything is going to be okay.

I debated and I thought for quite a while about weather or not I wanted to share this story with the general global community and have eventually decided yes…

As a public health student and professional, I realized that I have developed a “knowledge will protect me? attitude. That if I can just know enough about a topic then I will be protected from the ravages of that disease or bad health exposure.

About 5 weeks ago ago my mom went to the doctor to schedule her colonoscopy and also mention a lump that she could feel in her breast. She has had fairly regular mammograms over the last 14 years, but because of “dense? tissue in her breasts the last scan did not detect a smaller version of this lump. The mammogram revealed a mass in her right breast that was fairly large (about 3cm). The day before her biopsy she finally told me what was happening. I was heartbroken, but placed a great deal of my faith in the low chance of having a lump biopsy come back positive for cancer. The days of waiting in between the biopsy and the results were torturous and nerve wracking.

The Friday that spring break was starting I was at the airport waiting for my plane to take me home to Seattle. I called my mom to find out if she had the biopsy results yet and she sounded like she had been crying. I knew right then that the tests were not what we had hoped for. We cried alot those first few days and then got over the sadness and on to fighting the battle. Further diagnostics revealed that there were two tumors which may or may not be bridged, and still further diagnostics revealed two more tiny tumors in her right breast and a suspicious area in her left breast.

Initially the plan had been to do chemotherapy, breast conserving surgery, and then more chemo/radiation. But once they discovered that there were several tumors and that they were widely dispersed in her breast, they decided that mastectomy was the only option. My mom decided as soon as they told her she had breast cancer that if they had to remove one breast, then they were going to remove both of them. She firmly believes that breasts are for one thing, breast feeding, and they served that purpose a long time ago.

They had my mom scheduled for anesthesia on the 23rd to do her sentinel node biopsy and to install a port for chemo. Since she was already going to be knocked out, they decided to do the double mastectomy at the same time. So just two weeks after she found out she had cancer, she had a double mastectomy. Everything has just been moving so fast it's hard to keep my wits about me.

The pathology results from the surgery came back last Tuesday. We were thrilled to learn that there is no nodal involvement with her tumor which indicates there probably isn't any metastasis of the cancer! Hooray! They also learned in dissecting her breast that the two larger tumors were bridged and so her tumor will be registered in the cancer registry as an "Invasive ductal, stage 3 5cm tumor that is Estrogen/progestin receptor positive and HER2 negative."

She is going to do 4 rounds of chemotherapy and will start that in about 2 or 3 weeks depending on how fast she continues to heal from her surgery. I hope to be able to go home and visit her sometime in the next month or so.

I've been really glad that I have been able to help my mom navigate the health care system a little even though I am so far away. And I've been able to help her understand all of the research literature that's out there and interpret that they mean. She has a really great friend support network at home and my Aunt from California has been able to take time off work and helped my mom through the toughest parts of the surgery recovery.

The moral of the story is: Remember the saying of "cobblers children wear no shoes" If you are a health professional, don't forget that those near and dear to you need screening just as much as the next person. Make sure you encourage your older friends and family to stay current on their health care screenings and to see a doctor if they feel like something isn't right with their bodies.

Had my mom not gone in to see the doctor about the lump she felt, a few more months might have been the difference between no metastasis and metastasis. Luckily it looks like we managed to get hit with just a few bullets, but dodged some other larger artillery.

Since all this has happened we have also done alot of thinking about our family history of breast cancer, what was said and what wasn't said. When my grandma was 52, she felt a lump in her breast and went in for a lumpectomy. When she woke up from anesthesia she only had one breast! No one had even asked her if that was what she wanted, they just did it (thank goodness for progress in informed consent procedure). I don't think they ever told her if the mass in her breast was cancerous or not, so we can only assume that it might have been. It was never said that my great grandmother died of breast cancer, but in trying to remember some of the stories my grandma used to tell about her mother, it seems like that might have been what happened to her. I'm considering asking to be screened for the BRCA genes just to confirm my own curiousity about weather I have the gene or not. I'm already planning on heightened screening, so knowing if I have the gene would just be for curiousity's sake more than anything.

So anyway, just thought I would share my story. Maybe some of you have gone through the same sort of thing and felt the same sorts of feelings of helplessness, or maybe this can just give you something to think about as another aspect of your professional careers bumping into your personal life.