Chemo #5: Almost there

Learning from chemo #4, when the side-effects was painful and long, we tried to avert it this time by planning to go to rehydration a day after chemo #5 and continue for more as needed.

I went in for hydration on Tuesday, a day after chemo.  It helped during the first three days, alleviating the nausea and weakness but I still cannot taste food or tolerate liquids. 

On Friday, I thought I was strong enough and volunteered to drive to Seafood City in Carson, a Filipino grocery store.  As I was driving toward the 405 freeway entrance, I felt a little weak and felt I needed to go to the bathroom.  I made a U-turn and tried to go back home.  Good thing I wasn't too far away yet.  Suddenly my vision became blurred and it turned into an all-white vision.  I couldn't see anything but white cloudy shades.  I drove 5 mph to make it home and try not to get into an accident.

When I got home, I felt too weak I could barely get up.  We decided to call Jim at work to bring me to the hospital to get rehydrated again.  While waiting for Jim, my 2-year old son James, saw me crying (which I always try to hide from him as much as I can).  He came over me to hug me and in my weakness, I placed my head over his shoulder.  I didn't expect that at his age he can understand what was going on.  But he held my head over his shoulder and I could feel that he was comforting me.  It was a moment I can never forget.

Jim had to carry me to the car and get to UCLA.  As we arrived, the nurses have prepared everything needed for me and had to bring me to a room to lie down during infusion instead of the recliner we usually sit on.  I was also given Reglan thru IV. It is an antiemetic drug used 27 years ago to fight nausea and vomiting among chemotherapy patients.  My current medications ativan, zofran, compazine and sancuso patch have not been helping and have been causing severe constipation so my oncologist decided to put me on Reglan to try if it will work.

After 3 hours, I started to feel a little stronger, enough to walk back and sit on the wheelchair.

I went back for another hydration the following Monday.  This time I felt much better and started to eat and drink normally a day after.


It has been a better chemo cycle than chemo #4 from which we have learned how to forestall the side effects.  Although we still encountered a little difficulty, I was able to recover a little faster and have been able to get more food in body.  The depression still comes every now and then, which I still cannot pinpoint the cause most of the time.  I cry sometimes, feeling deep sadness without any cause.

My Med School friends from 12 years ago, Zennia, Jad, Mitch and Carol

But most of the time I felt surges of energy than ever before.  It helped that I have been getting a lot of visits from beloved friends that I forget my moments of weakness and sadness.  I ate with gusto with them like its a feast.  

College friends Irene and Iris and kids

I've set my mind that I will make something special for Jim's birthday on July 30.  Although I wasn't sure if I would have the energy, I still prepared myself by watching tens of YouTube videos on how to make a fondant birthday cake.  I have been a big fan of two of the best cake makers I know, Chris Edrei De Leon-Soriano (Cakes by Edrei) and Mayen Bioc-Orido (Way Beyond Cakes).  I know I couldn't do their works of art as well but their inspiration was enough for me to try making my first cake, for Jim.

Chocolate cake with buttercream icing and white fondant

Red velvet cake with buttercream icing and blue fondant with chocolate icing trims

I made it when Jim was at work, in between rest times, taking care of James and some household chores (which my mostly takes care of).  We also made a tray of Lumpiang Shanghai (Filipino egg rolls).  James and I surprised Jim with the cakes and Lumpia by bringing it to his work on his birthday.  Yes, he worked on his birthday.

I was happy that most of his co-workers, including Jim of course, liked the cakes and the lumpia. 

I never imagined how tiring and tedious cake-making was until I tried it myself.  All the more I admire how my friends Edrei (who is undergoing regular dialysis) and Mayen (who has a four year old and a newborn) can do this excellently.  If you visit their pages (please click the links above) you will see how great their cakes are.  I will almost think twice eating it and might just want to display it.

Aside from my friends visiting, one thing that has given me a lot of strength to fight chemo#5 is the effort and love of friends from Manila, Philippines.  A group of friends is organizing a benefit dinner on August 27 at the Orchid Gardens Suites, to help raise funds for my treatments and to help raise awareness on breast cancer among young women and men and on hereditary breast and ovarian cancer gene (BRCA gene).  They have opened the event to everyone who would like to join.  I never imagined that so many people care so much to make this event possible.  I wish I will be able to join them physically, if were not still undergoing treatment.

Next chemo, on August 8,  will be my last (hopefully!).  We will know if I need more chemotherapy or other treatments after they run PET scans, MRI, blood tests, ultrasound and full body scans the following week.  I will start radiation therapy on August 19, Monday thru Friday for 35 cycles.



I believe there's hope and an end to every challenge.  I'm almost there.  I know I will survive.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

35 and Thankful

I woke up to a great morning.  I usually check my phone emails and there they are, 250+ notifications of greetings from friends near and far. Birthday greetings flooded my facebook page and I was enveloped in happiness.  I just turned 35.

I wish I could have responded to each greeting but in my heart, I want to hug each and everyone who remembered me.

There are also a ton of things I thought I should be thankful for despite my situation.  Of course, there are moments of anxiety, frustration, pain, depression and sadness but looking back at these things I am grateful for, they make me smile.

I have learned to let go a little.  Smile more.  Appreciate more.  Love more and say it to people I love meaningfully at every chance I get.

Thankful that cancer has taught me to live life now and appreciate what lies in front of me rather than worry about what lies ahead... these make it worth every while.  

 

I have three wishes on my birthday:

- to live long to see James have children of his own

-to grow old with Jim and hold hands with him till our hairs are all grey

-to be an instrument and advocate of early detection of breast cancer among young men and women and that there be more knowledge about the BRCA genetic testing especially in the Philippines where there is none. 

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Chemo #4: I almost wanted to quit

Chemo #4 was tough. From the morning, I had to take the bus because Jim, my better half, had to take our son James to Children's Hospital. James was born with multicystic dysplastic left kidney (his left kidney is a composed of dozens of cysts looking like a kidney but it does not function), we have to take him regularly to his nephrologist and urologist at Childrens. I had to leave at 7 am to make it to my 10:00 am appointment. I was leery of taking the bus because my immune system is not as strong as it used to be and being in a enclosed public transportation, I can catch germs easily. A seemingly-homeless man was sitting next to me the whole time and even with my face mask on, I could smell something unsanitary. But I made it. I got to the hospital safe.

Usually, three to four days after Chemo, I would start to be able to taste at least strong tasting food. The first few days are really tough and I expect it. Soil-like texture of food, bitter-tasting drinks, weakness and tiredness. But this time around it was taking longer than usual.

On the sixth day, I was still weak, and cannot eat or drink anything. I called my doctor to ask if I can do anything. He told me to come in the following week (it was a saturday when I called) so they can check me out.

On the seventh day, I cannot handle the feeling of being weak anymore. I almost slept all day, I couldn't help take care of James and just couldn't walk without feeling like I will fall anytime. My hip bones down to my feet were all painful and weak. So I emailed my oncology nurse practitioner: I would like to stop at chemo #4. And I dont think I can do radiation either.

I have a scheduled initial appointment with my radiation oncologist that Thursday, July 7 and I was planning to cancel it too.

That Monday, the chemo infusion center called me early in the morning to ask if I can come in for hydration. I agreed and went to the hospital. They checked my vitals and weight and took blood tests. I lost 8 pounds in 1 week. I was also dehydrated and my heart rate was fast (135 per minute). They gave me two hours of hydration via chemo port.

After two days, I started to feel better. I started to taste the food and drinks. Although my usual drink, Gatorade, was still bitter, I found an alternative. I loved the taste of Naked Mango smoothie. It was the only drink I can tolerate for now. I even had a date night with Jim and ate a salad. Wow! I got so excited because it means this is a start of feeling better again before I go for the next infusion.

So far, this is the worst side-effects I have experienced. But even though it took longer that it used to be, I started to have hope that there will be an end to every suffering. I am so grateful for Jim and my mom. My mom took care of James the whole day while taking care of my dad too, and tried to make me eat by cooking what supposed to be really are yummy Filipino dishes. And Jim, even though he was very tired after work, he would take James out and entertain him or keep him busy to give me more time to rest.

Its amazing that a lot of people care for me so much that they go out of their way to help me recover.

Its even more amazing that there are a lot of people all over the world who care and love me. We started a fundraising to help us with the medical bills which has been summing up to $228,000 and still adding up. (chemotherapy and radiation are not yet billed). It will also be funding the possible litigation against the insurance company if we cannot resolve it by arbitration or other means.

Right now, we are awaiting for an approval or denial of my radiation treatment. We will decide what to do or where to go for my radiation treatment depending on what the insurance says.

We want to thank all of our friends and families who have helped us in the fundraising.  It was very humbling but I know all your love comes with it.  Some have donated very generously, some donated even though they dont have that much and it is a form of sacrifice, some helped by posting it in their Facebook walls, blogs and websites. Some sent a handwritten card with their donation (which I got so excited about because I seldom receive a card in the postal mail anymore). Some sent more prayers and well wishes for recovery. One friend suggested to make t-shirts which I hope will be successful. These are people whom I have known for decades, have just met these past years, and some don't even know me.

One very special friend, Mike Cortez, is publishing THREE coffee table books to raise funds. He made a preview of the book in a video below.  You can email him at senseimiyaki@gmail.com.



All these love all over the world, all the support I have been receiving made me think twice... why would I quit my treatment? No. I will finish the battle. It may be tough, but I can get through it again.

Chemo #2 and #3- Learning honesty, humility, patience and hope

Honesty, humility, patience and hope. These are some of the things I have learned in the past 6 weeks I have received two chemo treatments.

I have been waiting for the day to write a blog entry when I'm feeling more hopeful, up and energetic and can express my joys despite the current treatment I'm going through. It has taken a while.

In fact, as much as I want to deny it or conceal it from everyone, I've been depressed.  I've been reading lately how chemotherapy can bring about depression. But luckily, I am going through counseling and taking several anti-depressants.

I've been holding off writing a blog because I thought I should be this positive and strong person when I face people reading the blog.  The longer I push myself to be that person, the more I became depressed, because I feel like I'm failing people's expectations to be that strong and fighting person with cancer.

The truth is, I am having a lot to take on.  From physical pain, to anxieties of what the future holds, financial hardship from treatment costs, exhaustion from just doing normal daily activities, loneliness from not being able to socialize as before, frustration from not being able to enjoy the things I used to do and most of all, the fear of death.

Sometimes a simple question I get such as "How are you doing? Hope everything's well" is tough to face.  Should I say,  "I'm fine.  Just in a lot of pain lately and in a deep sadness which I dont know why" ?

But in counseling, my therapist told me its okay to be sad and be weak and it's okay for people to know this.  Its all part of what I am going through and will go through.  Putting on a face thats not me just puts on another burden on top of what I have.

Chemo #2 hit me hard the second day with severe nausea and fatigue. I have taken all the prescribed medicines but nothing seems to work. I felt like there's a metallic layer all over my mouth that everything I taste is like metal. I'm hungry but I cannot eat. I feel like my appetite is also decreasing. I want to get up from bed but my body refuses to. I decided that I will speak with my doctor that this is it, I will stop at chemo #2.

But I wrote about it on facebook. Everyone cheered me up. Everyone gave me hope. Everyone wanted me to fight. A stare at James playing made me want to hit myself for thinking of giving up. Jim and I  are the only people he has to take care of him. What am I thinking?

So I went on day-after-day, waiting for the side-effects to subside. The doctor finally prescribed an anti-nausea patch, Sancuso transdermal patch,  that will give me 7-days of continuous medication to relieve nausea. It gave me hope at first but when we found out that the cost is $309 per patch, that will be a total of $927 for three weeks until my next chemo. Jim just got back to work and we are a little struggling with the finances with all the expenses of my treatments.

We were able to buy one patch, and luckily, the doctor gave us a one-time discount coupon for $200 so we only had to pay $109. I cherished every day that the patch gave me the relief.

I got through three weeks from chemo #2 and was feeling great and energetic the day before chemo #3. I almost dreaded another monday of going back for another infusion.

I had chemo #3 on June 6, 2011. This time, I followed my doctor's instruction to put lidocaine numbing cream on my port and take Percocet pain medication an hour before they will stick the needles in. It worked! I didn't feel the needle at all. But this time, after the 6-hour infusion, my fatigue and stomach pain was worse than it has ever been. I don't want to get up from bed, i feel like my stomach and intestines are getting pulled out of my gut. I'm refusing to eat or drink anything (aside from 7-11's slurpee). This time, I'm decided, I don't want to go through the rest of it anymore.

And then came all the supportive messages again from friends, cheering me on. Telling me how I am inspiring them. A part of me want to tell them, "no, I'm weaker than what you think I am, I am about to quit it". But my heart just cant. How can let all these people believing in me down?

The battle in my mind of wanting to give up and staying positive makes me sometimes want to throw myself on the wall. Most of the time I feel so confused. I know its part of a cancer patient's life to be depressed and anxious and confused. This is real and I can feel it everyday. All I want is for everything to stop and go back to normal. I want my old normal life again.

All I want is:
-to taste the sour vinegar
-chew food and savor its flavor
-be able to get up and do everyday household chores
-be able to walk James to the park
-play with James at home all day if he likes to
-go out to do errands, go grocery-shopping, etc
-visit friends and spend some time just chatting over coffee
-drink and taste anything my mouth desires.
-work
-a simple trip to see the oceanside or a quiet park
-bring James to museums and parks
-wake up without feeling sick

These are the things I never appreciated before. The littlest things that seem to matter now. Humility. The simplest things matter most when you aren't given the chance to do it. I used to wish for grandier things. A house, better car, a great travel vacation, a great job, bring James to disneyland, a grand wedding, visits to the Philippines, and a whole lot of other bigger things. Now I just want to feel better today.

These two treatments have also taught me patience. No matter what my mind does, I cannot force time and space to move forward to another day with the hope that it will be better tomorrow. I have to wait. I have to go through the whole 24 hours and wait if it will feel better tomorrow. And if it doesn't, I will wait another day. This experience has made me look forward to night times, when everything is quiet and I have to go to sleep. Not feel anything and not be in pain. When my mind momentarily forgets the slow but painful effects of the treatments. Patience. I go from one day to another day. And eventually those days turn into a week and then another week. And then the whole three weeks have passed. I survived another infusion.

Hope. There is really hope in the midst of challenges. Just when I thought I will just have to endure the rest of the two weeks without the expensive patch, just because we cannot afford it for three weeks, I found a website that will help in paying for the patches if I qualified. ProstraCare, Patient Assistance Program.  I tried, applied and God is GOOD! I was approved for 4 patches a month at no cost for six months. God never ceases to let go of me. He knows when I need his help most. They just sent the first shipment and everything will be taken cared of from hereon.  The patient representative who helped me was Filipina, her name is Glory, based in Illinois and she was so sympathetic.  I felt her love and concern even just over the phone.  (I had to send her James and my picture with a thank you note for helping us through the process).

A patient's challenge doesn't end in trying to feel better everyday and getting through the rough effects of treatments.  It gets complicated by the insurance company trying to refuse to pay for the treatments from diagnosis to surgery to chemo.  The bills keep coming summing up to almost $180,000.  It is the last thing one needs at this time, to be more stressed.Studies have indicated that stress can affect tumor growth and spread, but the precise biological mechanisms underlying these effects are not well understood. Scientists have suggested that the effects of stress on the immune system may in turn affect the growth of some tumors. (Psychological Stress and Cancer)

Challenges may continue in this journey but I'll try my best to continue holding on....and continue learning.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

I Had A Dream

I had a dream last night. I was being chased by boys, some cute and some aren't! I didn't like them so what I did was take off my wig and they all went running away. But when I thought I got rid of them, there's this one guy, he was handsome and a gentleman. He didn't chase me but just approached me. But I still took off my wig (i don't know why) maybe I thought he will just go away anyway if he finds out I'm bald. But he stayed and embraced me. It was a nice dream.

When I woke up I clearly remembered my dream which is unusual because i always tend to forget my dreams. I thought about it and realized it was triggered by my conversation with Jim last night. I normally wear nothing on my head at home except when I'm too cold, I would put on my hoodie. Jim asked me if I want to shave my head already while staring at my very thin-haired head.

I said, I'm not yet sure. I don't know if I'm ready to be really totally bald. I used to say I'm going shave it off when it starts thinning out or even when it just starts to fall off. But now I'm scared to shave, i think. I asked him, "do you think i should shave it?" He paused a bit, and he said, "well....."

And then he said "I'm just thinking you might get depressed everytime you see your thinning hair". I said it's ok because I don't look at the mirror that much anymore anyway.

And then I asked him to touch my head. He hesitated a little and gave me a slight scared look. I took his hand and put it on my head. I said, "isn't it so soft?" and smiled. He said "uhmm yeah," still with the "scared and unsure" look and quickly pulled his hand away.

Maybe at the back of my mind, I took that conversation to my sleep and dreamt of something that people are afraid of my balding head. And that it makes them want to go away. And somehow someone whom i love has the same feeling. I felt a little bad about it and made me feel self-conscious and undesired.

So I shared my dream with Jim's mom in the morning. I told her the dream and the conversation I had with Jim last night. She had a different thought about it. She said maybe Jim feels bad about it for me too. Like its tough for him seeing me bald coz it makes it more real that I'm sick. Which at first, it was how i felt bad about my hair falling out, it makes it more real that I have cancer.

She also said maybe Jim feels bad about me being sick. Like the time I felt I wish I was sick instead of baby James when he was at the hospital because of his kidney condition. I always prayed that God give me any disease instead of baby James.

I felt a little better after my conversation with mother-in-law. It must be tough for Jim to see my balding head all the time and he has no choice but to see it. At least I have a choice not to see it, I just have to avoid looking at the mirror or touching my head.

It must be tough for my family. I wish I can shield them from it.

So I wrote our couple's counselor this morning. She has been helping us go through challenges that couples encounter especially during the first year of having a child. And now she still sees us through as we go through another challenging phase in our lives as a family.

I want to share what she has to say, which made me feel better and cry a little:
"Aren't dreams interesting? They definitely help you sort through and pay attention to feelings. The baldness is an adjustment for you and everyone. As you know, even someone just changing their hairstyle and color can be shocking and take awhile to get used to. I know you are in the process of making peace with your hair loss and seeing it as temporary. In my experience, people will get used to it and react off of you. I have seen people fighting cancer wear their baldness with pride and a smile, knowing it is a sign that they are doing their best to live a long life. Yes, it might scare people (including Jim) at first and be a reminder of how fragile life might be. People can be very uncomfortable talking about any kind of illness or knowing what to say- they can follow your lead when you talk openly or remain quiet, depending on how you feel. Most people know someone who has dealt with cancer and just like when you are pregnant, often feel like sharing their own stories. Of course Jim feels terrible that you are ill- he loves you and it can be a helpless feeling for a partner. In time, I think you will find that your friends and family will relax with it and focus on you and not your scalp. Honestly, you don't need to worry about shielding people from this. It is simply a reality of life. Be your beautiful, loving self Krissy and that is what will be noticed :)"

Its true, change is difficult at first. But in time, it will get easier. Its also true how most women are afraid to even change hairstyles, or even change hairstylist. Our hair may be our crowning glory but beneath and beyond it is more important.

I'm going to embrace it from now on.

________Side Note________________
Thursday was a happy day to be bald! I went to American Cancer Society's Helens Room which gave me the biggest smile that day when they asked me to come in for my wig appointment. Not only was it free, but whatever hats, caps and scarves i touched and liked, they gave it to me! More generous people should multiply on earth. They truly made me happy being bald today.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

The Day It Starts To Fall Off

It's different when everyone at the doctor's office tells you your hair will fall off eventually. I see it in the chemo room sometimes, some patients don't wear wigs and just put a cap on that you see their bare scalp. Its easier knowing it.

But when it actually happens, no matter how much I read on it, see it or hear about it, it seems tougher to muster up the feelings that comes with the reality. My hair started to fall off tonight.

It started with an itchy scalp at the back of my head. Scratched it of course and there goes a bunch of hair strands between my fingers. I did it again and it still continues.

I have to cry a bit to express the sadness of reality. Jim is tougher than me so I just leaned over to him and put his arms around me and more tears trickled down.

This is the start of it. I know they say it will grow back and I can wear a wig. For me, It's a physical manifestation of the cancer for me that I cannot deny when I look in the mirror.

Sometimes when my energy is up I tend to forget I have the big C. And go on with the day until I feel fatigued. But looking at a balding head is an instant sign that I have it.

As my friend Abi just texted me, it will grow back and it will just be part of getting the treatments to get better.

I guess so. For now, I'll be adjusting with the fact for a little while. Maybe cry for just a while... like my great friend Mike Cortez sent me in a video... " Coz deep inside this armor, the warrior is a child"

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Chemo Round 1 - Taxotere-Cytoxan + Neulasta

That week in preview:
April 23, Saturday- Surgery to harvest my remaining healthy eggs
April 25, Monday- First chemotherapy appointment
April 26, Tuesday - Surgery to implant port for chemotherapy

Its been a week since I got my first chemotherapy infusion.  At the back of my mind, maybe I didn't want to have my first chemo yet because I "thought" the appointment that Monday, April 25, was just to tour me around the infusion room, give me all the "tips" and educate me about my first chemo.  I was still sore from the ovary surgery two days before.  When I got in the UCLA central infusion center,  the nurse told me to pick my recliner and get comfortable.  I asked "Uhhmm, am I getting chemo now?"  She said, "Uhmm , yes.."

I was supposed to take two steroid pills a day before and a day after chemo.  I wasn't able to take it the day before because I "thought" it was just a sneak-peak tour.  But nurse Nancy said its ok this time, she will just give it to me intravenously and double the dosage. 

So I picked a recliner near the window and *tried* to get comfortable.  I was obviously scared because its something I've never experienced.  I watched her bring over an armful of bags of infusion intravenous bags.  She sat down next me and started chatting away what all these IV bags are for, while she tied my arm, rubbed my veins and made it as "angry" and visible as possible.  As usual, Jim was next to me showing James' cute videos from his iPhone to distract me from the needles entering my veins.

She took 4 vials of blood for testing and started then started four pre-chemo meds through my veins: Aloxi an anti-nausea; Decadrone a potent steroid for nausea and vomiting; Benadryl for any allergic reactions; Pepcid for heartburn.

While she waited an hour and a half for the pre-chemo medications to finish dripping, she explained the kind of chemotherapy I will be getting, side-effects, how to care and where the free snacks and drinks are located in the infusion room.  (the last part was all I paid attention to)

I am getting two kinds of chemotherapy drugs, Taxotere (Docetaxel) and Cytoxan (Cyclophosphamide). One infusion every three weeks and 6 cycles which approximately will last six months.  A day after each cycle (infusion), I need to come back to the hospital to get a shot of Neulasta, which will make my body produce white blood cells (WBC) to fight infection.  Chemotherapy is known to decrease your body's ability to fight infection by decreasing these WBCs. The Neulasta shot is known to cause bone pains as side effect.

Each infusion lasts 5 and a half hours. The day of first chemo, I was feeling ok.  The toughest part was when the needles taken out.

A day after, I had surgery to implant the port for chemotherapy so the nurses wouldn't have to prick my veins each time.  It was a short and outpatient surgery, but I didnt realize it will be painful after.  My chest was sore and my left side of the neck where they inserted the tube to the jugular vein was also painful when I move my head. but I just kept taking my pain medications for a week now.

Chemo side effects are experienced by more than 30% of patients with an
Onset:  for 4 to 7 days
Nadir: for 5 to 9 days (Nadir is the low point between chemo treatments when I am most susceptible to infections and lowest blood counts.)
Recovery : in 21 days (on the 22nd day, you will get the next infusion, Yay to recovery!) ;)


I did not experience a lot of the known side effects for the first two days, except I have felt the following on days 3 to 7 after Chemo and Neulasta shot:
- head sweating (I mean, extreme.  Its really dripping on my neck while my body is chilly and cold)
- Nausea
- Loss of appetite - everything tasted like medicine and tarty or bitter)
- Weakness and sudden extreme tiredness
- Constipation
-Bone pain (this one I hate most!  It feels like when you hit your shin on a corner.  My bones from head to toe feel these sudden shooting pain for days)

From days 5 to 8:
- less of the bone pain but more flu-like symptoms
- painful stomach cramps and diarrhea
-painful gums, dry tongue and mouth
- sensitive scalp
-painful fingernails
-extreme changes in body temperature
-continued fatigue and weakness
- bladder problem (uncontrollable)
-right hand tingling
-unexplained nightmares

Other side effects that they told me to watch out for in the next week or two are:
- Hair loss
- Discoloration of skin and nails or possibly loss of nails
- Loss of fertility
- Low blood counts

Fortunately, with developments in cancer management, these side-effects can be managed or at least tolerated by most patients. Some of the solutions are pills, wig, IVF treatment.  I dont know what to do yet with loss of nails. 

I'm taking about 12 pills three times a day to combat nausea, vomiting, diarrhea, constipation, allergies, swelling, depression, anxiety, pain and bone pain.  (I stare at these pills in my hand for 30 mins hoping they will taste like m&m's). When I can, I also try to walk for 5 minutes in front of our house about 4 times a day to keep my body moving and not experience severe weakness and joint stiffness.

I have a prescription for cranial prosthesis, a.k.a. Wig, which fortunately with the help of American Cancer Society and Helen's Room foundation, I can get a wig for free on May 14 when I get a fitting appointment.  The medications, co-payments, and other cancer-related expenses have been too costly for a family who only have one breadwinner and the wig may be an expense I can just forego . 

Speaking of help, the L I V E S T R O N G foundation of Lance Armstrong has been a huge help with our fertility treatment.  They shouldered almost $12,000 of the $15,000 cost to preserve my egg and fertilize it until I am done with my cancer treatment.  My fertility oncologist was able to harvest 16 eggs.  We were on pins and needles whenever we get a call update from them.  At  first, 8 eggs were matured enough to fertilize, then 6 were starting to fertilize.  On Thursday, only one was successfully fertilize but on Friday, 3 more eggs came back and successfully fertilized for freezing.  So now we have a total of possible 4 eggs fertilized for in vitro fertilization in the future.  Although I am still praying that we will be blessed with another child, I am still aware of the fact that not all IVF treatments are successful.  I am hoping and praying for a little Krissy in the future. We still need to pay the cost of freezing every year, but we will cross the bridge one year at a time.

As I was watching Regis and Kelly the other day, Eva La Rue was talking about an organization called Beckstrand Cancer Foundation which helps families that are devastated by the cost of treatments, which we are already feeling.  Because our insurance company is starting to give us a hard time with claims and paying for my treatments which are running up to almost $200,000 now, I hope I can get through them to help us in navigating through the difficult ins-and-outs of cancer treatment and insurance.  The last thing a cancer patient needs to handle is fighting the insurance to get treatments to be able to live.

I still believe no burden will be given to us if we cannot carry it.  And as I look back, when Jcube was in the hospital for treatment for his multicystic dysplastic kidney, I kept praying to God to PLEASE just GIVE ME whatever health problem there is as long as my child lives healthy from hereon.  Jcube was seen by his urologist today at Children's Hospital Los Angeles and the Doctor said his ultrasound is okay.  He is generally healthy right now and will be back for his regular kidney check up in 4 months.  I'm glad my prayers for a healthy child were answered, no matter what I am feeling physically at the moment.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Chemotherapy and IVF Treatment

I have been healing well with my surgery and Im looking forward to a few more weeks when I can do normal things again! I have started taking little morning walks without a wheelchair in the neighborhood to get some sun and to get my strength back.  I just hope my appetite will come back soon. 

CHEMOTHERAPY
We finally met with the Medical Oncologist Dr. John Glaspy on April 7, 2011.  He gave us the overview of the chemotherapy regimen I will have.  A combination of Taxotere (treatment for symptoms of locally advanced or metastatic breast cancer) and Cytoxa (which treats several types of cancer in combination with other drugs to treat breast cancer.  It will be given by infusion that will last about 4 hours through intravenous. It will be given every 3 weeks and I will be given the maximum dose of 6 cycles, which will last for six months.

To alleviate the pain of being given an intravenous line each chemotherapy session,  they will install a Port-a-Cath. It is a device that will inserted in your chest during a one hour surgery. A port is a small disc made of plastic or metal about the size of a quarter that sits just under the skin. A soft thin tube called a catheter connects the port to a large vein. Your chemotherapy medicines are given through a special needle that fits right into the port. You also can have blood drawn through the port. When all your cycles of chemotherapy are done, the port is removed during another short outpatient procedure.

Some people feel the pain when it is first installed but later on they are thankful because they do not need to get poked each time an IV line is done.  Also all the blood test will be done through the port.  They take blood test each chemotherapy session.

A day after the chemotherapy, I have to come back to the hospital to get a Neulasta injection.  It is used to reduce the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection).

Unlike many years ago, the side effects of chemotherapy is vomiting, nausea, anorexia and hair loss.  They has developed many medicines that will help with nausea and vomiting.  I will be taking -Decadron twice a day before and after chemo (which may cause restlessness and insomia) . 
-Compazine every 6-8 hours but which may sleepiness
-Ativan every 4-6 hours which may cause sleepiness
-Zofran every 12 hours for vomiting

The doctor was outright in telling me that I will lose my hair about 1-2 weeks after the first chemo.

Other side effects are constipation, diarrhea, mucositis (mouth becoming tender), Neuropathy (numbness, tingling of hands and feet), Nausea, Fatigue which increases with each chemo session, bone pain within 48 hours after infusion which can last 2-3 days, weight gain.

FERTILITY AND MENOPAUSAL ISSUES
One side effect of chemo is women can become infertile after the treament.  At the same time, pre-menoupausal women such as myself will go into early menopause.  Which is why we are in under the care of their cancer fertility clinic under the care of Dr. Mousa Shamonki for IVF or In-Vitro Fertilization.

Dr. Shamonki did an ultrasound of my ovaries and found 15 viable eggs that can be retrieved.  I haven't been ovulating since I got pregnant in June 2008 and havent mentruated since then.

They have started me on egg stimulation regimen consisting of daily injections of Menupur which is  follicle-stimulating hormone (FSH), which helps stimulate egg production; and luteinizing hormone (LH), which helps the eggs mature and release (ovulate). I also inject Gonal RFF Pen used to help ovaries make more eggs. It is used in ovulation induction.  I do this injections every night at home for 10 days.  Jim has also started taking medicines to prepare him for the sperm collection.

On the 5th day, the doctor will do an ultrasound to see the progress of the egg production.  On the 10th day or when it is determined via ultrasound that the eggs are viable for harvesting, I will undergo an IVF surgical procedure to remove the eggs from my ovaries. 

The process continues, eggs and sperms will be fertilized and become embryos, it will be frozen until the time they will be ready to be implanted in me after five years of my cancer treatment. 

I'm also under the care of a oncology gynecologist who monitors my ovaries for possible cancer every three months because I have 42% chance being BRCA 2 positive gene mutation (breast and ovarian cancer gene mutation).  After I am done with IVF, my doctor is recommending removing my ovaries to lessen the chances of ovarian cancer.  It will still be possible to get pregnant with IVF after removal because my uterus will still be normal. 

The costs of IVF treatment for cancer patients is very expensive but we were blessed to have been approved by Sharing Hope, a national organization providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.  It is because of Lance Armstrong that this organization under Livestrong was made possible. He suffered cancer himself and has vowed to help cancer patients.  They are shouldering a big part of the costs of the treatments and giving the medications for free costing about $5,000.  just he medicines itself is so expensive!

My IVF treatment will be done next week hopefully by April 21 and my chemotherapy is starting on April 25. 

After chemo, I will meet with the radiation oncologist to discuss the radiation therapy treatment.  I will be getting radiation treatment everyday for about two months.

Yesterday, my sister finally went back home to Singapore and it was one of the saddest moments of my life.  She took care of me selflessly.  She came here in a week's notice. Spent more than a thousand dollars to fly out here. Gave me showers, changed my gauze dressings, dressed me up everyday, stayed with me in the hospital, took care of James all day for a month, prepared all my meals, ran errands, slept with me, woke up in the middle of the night to give me my medicines on time, tucked me in bed because i needed special bed wedges for my wounds, most of all comforted me in the most difficult time of my life dealing with cancer.  I don't know what I could have done without her.  I wish she never left.  But I know she has a life of her own to deal with too.  I couldn't stop crying for an hour when we dropped her off at the airport. I love her to the moon and back. I just wish she was here with me forever.

I'll miss you so much, May.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

Post Surgery Updates

I'm back on the blog!  Thanks to everyone who sent their prayers and thoughts our way.  It meant a lot whenever I get to read a message from all of you.  Each one of them kept me stronger everyday.

Thanks to my better half Jim, for keeping the blog going for awhile. Despite his very busy days, he found time and stayed up till 5am to write the entries.  And still have to wake up early at 8am to attend to Jcube and me for the rest of the day.  Thanks to my sister too who's been on top of everything I need help with, from waking up to going to bed, she was like an extension of me.  Seems like she never rests.

Its been 10 days since I got out of the hospital.  Nothing is better than being home with family.  The love is overflowing and I know they are there every minute to support me. I cant thank Jim and Mhae (my sister) enough. Also baby James for the entertainment all day long. Although I have a lot of rough days physically and emotionally, they still continue to help me in every way possible. 

I can barely remember anything while I was in the hospital.  My memory seems to be from the few seconds I was in the operating table while the anesthesiologist was counting down to make me sleep then it jumped to about 5 days after the surgery.  I was told that because of the long 12 hour surgery, the anesthesia was significant and the strong pain medications given, a lot of things were blurry.  I remember though I was having rough times while I was on morphine drip.  I was having hallucinations, nightmares and chills.  My appetite was also nonexistent while I was on I.V. pain medications.  

When i got home, I had drains in my chest to get fluids out of the surgery sites, to avoid seroma.  The body tends to fill up with fluids where tissues have been removed.  I had two drains in my abdomen too but the doctors had to remove it while I was still in the hospital, way earlier than it should be, because it was pressing on nerves which were causing a lot of pain.  The fluids had to be emptied frequently and monitored in terms of volume.  The goal was to remove the drains when the output was lower than 30cc.  I had my chest drains removed on Friday, March 25, two days after I was discharged.  It was a whole lot of relief because the tubes were between the skin and chest muscles that ran across my chest to the armpit.  Everytime I moved, it gets painful.  Even turning my head became painful on the chest.  I was so afraid of getting it removed because of the thought of having tubes sliding out of my chest, awake and sitting upright without anesthesia.  But I made it!  Thanks to Jim holding my hand the whole time.

I feel lucky to have it out in 10 days after surgery because some people have it for almost a month.  The longer you have it, the more prone to infections you are, plus the irritation to the muscles is tough.

On Tuesday, March 29, I had my first follow-up visit with my breast surgeon Dr. Helena Chang and plastic surgeon Dr. Jaco Festekjian, who are both the best doctors in their fields.  They both said my wounds are so far healing good!  I was so glad to hear it.  It will take 8 weeks though before I can return to normal daily activities. 

I was also given the reports of what was done in the surgery and the surgical pathology results:

- simple mastectomy was done on the left and it was clear of cancer

- modified radical mastectomy was done on the right and two cancerous lumps were removed, one was 5cm and one was 2cm.

- 20 lymph nodes were removed from the axilla (armpit)  and 6 were cancerous with the largest cancerous deposit measuring 2.6cm.

- The cancer cells have a histologic grade of Grade 3 (out of 3)

-  The tumor biomarker Ki-67 is 50% (anything more than 20% is high)

- The hormone receptors of the cancer cells are 90% Estrogen positive, 3% progesterone positive and HER2 negative

- the margins were clear

Given all these, the cancer stage is now Stage 3  and TNM staging T2N2aMx

The five-year survival rate is 67% and the eight-year survival rate is 40%.

These results will determine the cocktail of chemotherapy drugs and radiation that I will be receiving. I will be meeting with the Oncologist - Dr. Glaspy of UCLA on April 7 to discuss these with him. 

My surgeon also ordered to get physical therapy sessions to start four weeks after surgery and lymphedema massages for the right arm. 

From now on, I will be at risk for Lymphedema of the right arm because numerous lymph nodes were removed.  The lymph nodes filter the lymph fluid, removing bacteria, viruses, cancer cells and other substances that could cause harm to the body.  Without it, fluids can start to build up in the tissues and it causes swelling, pain, numbness or infection of the arm.  There are many things I should do to avoid this such as:  not having blood drawn, IV, vaccinations, blood pressure cuffs on the right arm for the rest of my life.   I should avoid cuts, wounds, scrapes or insect bites on this arm.  No heavy or repetitive lifting on this arm.  Avoiding sunburns or burns on this arm.  Avoiding sauna or hot baths.  Wearing gloves when doing household chores like dishes, gardening etc to avoid cuts and infections.  Wearing compression sleeve and gloves in high pressure cabins or high altitude.

I just need to be aware of how to take of care of my arm from now on. It will be a bit of adjustment in my daily activities but I know its manageable. 

I am still wearing a binder on my abdomen to hold the long incision that stretches from side-to-side, where they took the fats, skin, veins and little muscle to place on my chest for the reconstruction.  I have to stand slouching to avoid stretching the sutures. 

So far, my chest is numb and it will take a while before the nerves will rebuild itself to get normal sensation.  The nerves usually grow back about 1 inch per month.  

The pain and sensation on my right armpit, shoulder and back will go back to normal in about 18 months.  

It will be quite a road to recovery but I am glad I got one step done in the list of treatments we have lined up.  I can't wait till I am up and about to hug, play rough with James and bring him to the playground again. I can't wait till I can have date nights with my honey-bunny again.

Next up..chemotherapy.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

A Welcomed Homecomin'

Jim again. Krissy has nominated me to continue her blog on her behalf. Sure, she just had major surgery, includin’ the removal of 20 lymph nodes from her right armpit, which directly inhibits her ability to type, but I suspect that she secretly enjoys havin’ her own personal scribe. Whatever. She just filed tax returns on my behalf, so I’ll call it even.

I apologize for the lack of blog updates. ‘Tween carin’ for Krissy an’ my son, James, a.k.a. J. Cube (James III), a.k.a. JP3, a.k.a. King James, etc., I have had lil’ time to eat, let alone type. (I’ve lost five pounds thus far.) My goal is to write as much as possible, but currently, there just aren’t ‘nough hours in my day.

Providin’ some much needed relief is May, Krissy’s sister, who flew in from Singapore to assist in care. She will be stayin’ with us for one month an’ she has been an enormous help. I wouldn’t have been able to tend to both Krissy an’ James’ needs without her. If anyone has a clonin’ machine, please post yo’ contact info.

Anyway, Krissy was discharged on March 23, 2011 after a six-day stay in the hospital. Our insurance company tried to throw her out on the previous day, but luckily her doctor stepped in an’ ordered more rest. Per her insurance company’s matrix, patients should be recovered ‘nough to leave within five days. (Can you quantify an exact recovery time? Apparently.)

Now that she is home, Krissy’s spirits have greatly improved. For starters, she’s much more mobile. She walks small distances, performs light-impact strengthenin' exercises an' on occasion, stands an' sits on her own. (Bear in mind, Krissy had two major surgeries at once with an estimated eight-week recovery period.)

Secondly, her comfortability with her familiar surroundings is apparent. Although the hospital staff cared for her dutifully, requestin' assistance from May an' I is more to her liken' than to ask strangers. Generally, we're more sympathetic to her pain.

Thirdly, the biggest change since bein' back home is that Krissy was able to see her son for the first time in nearly a week. (Baby James was banned from the hospital due to his parents' mysophobia an' his pension for maulin’ his loved ones, which would have adversely affected Krissy’s recovery.) Given her occupation of full-time homemaker/super mommy, Krissy’s absence from James was traumatic for her an’ she eagerly anticipated their reunion. (James tried to play it off as no big deal, but he later confided that he really missed her.) His mere presence is better than any prescribed pharmaceutical.

With chemicals dissipatin' from her bloodstream, Krissy is more lucid in thought an' enjoys readin' all of yo' well wishes. Thank you for yo' continued concern an' support.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

The (Un)Sweet Pain of Success

Word. This is Jim, Krissy lesser half, steppin' in to update her legion of fans of her current medical condition. (This might not be my last cameo, so I apologize in advance for my obnoxious writin' style, insensitive humor, bad breath, poor posture...etc.)

So, Krissy had her first surgery yesterday, March 17, 2011. She insisted to undergo the knife on St. Patty's Day 'cause she stated that she already associated pain with the taste of Irish food. (She didn't really say that.)

Our day started off at 3:30 a.m. with typical chaos. When we were in line to check-in for surgery, a fire alarm went off. I asked Krissy if she wanted to evacuate the buildin', to which she scoffed. She was motivated to remove this cancer...an' she was probably still half-asleep an' not of sound mind. After 10 minutes of sirens an' flashin' lights, the alarm was deemed false an' we were allowed to enter.

Once inside, we discovered that since a standard arm insertion might obstruct the surgeons' accessibility to her breasts, the nurse stated that he needed to place the intravenous drip (IV) into Krissy's foot. Not known for her vast pain threshold, Krissy squealed an' squirmed to such a degree that he simply gave up an' suggested knockin' her out with gas first. (He was serious.) Luckily, Krissy's plastic surgeon permitted that the IV could be placed in her left arm an' he'd work 'round it. (I liked the gas idea.)

Regardless of the initial (figurative) speed bumps, Krissy weathered the 12-hour surgery like a champ. (Admittedly, she was unconscious.) Both of her breasts were successfully removed an' her belly fat was utilized to make two new ones. As Krissy had previously blogged, when she gains future weight, her boobs will grow, so everybody wins! (Who said cancer doesn't have it's perks?)

Anyway, Krissy is now restin' uncomfortably in the hospital. She's in considerable pain, but has a morphine drip to help when things get too intense. She lies under an inflated, plastic heatin' device, used to blanket her organs an' keep 'em warm. Krissy has to blow in a tube, at least ten times per hour, to keep her airways clear an' prevent pneumonia. Her throat was roughed up from the anesthesiologist's air tube, her abdomen is very sore, she feels nauseous, has a fever an' has yet been able to eat. (We were warned that the first couple of days, post-surgery, would be rough, an' they're provin' to be just that.)

However, she is lucid, drinkin' water an' textin', facebookin' an' talkin' (albeit softly). Each day will pass an' Krissy will feel better/grow stronger. (She'll be back to performin' cartwheels in no time.)

We'd like to thank everybody for the overwhelmin' amount of love an' support that we've received durin' this time of hardship. From offers of free meals/babysittin'/transportation to countless encouragin' sentiments, all yo' sweet efforts have really made a considerable difference in Krissy's demeanor an' motivation. The feelin' of bein' "sick" can be quite isolatin', but when people reach out, it reminds Krissy of her place/value in other's lives an' helps her to keep focused on recovery. Since I need her more than anyone, I applaud you all for actively readin'/participatin' in this blog.

If you didn't keep Krissy's spirit so strong, I'd have to raise a two-year old solo, which is a fate that I wouldn't wish on my worst enemy.

(By the way, if the font size is different in spots, I have no idea as to why. E-mail blogger.com an' complain.)

If you can , please help in raising funds for Krissy's Breast Cancer treatment: