November 29, 2015


I really don't have anything interesting to say about Thanksgiving. You'd think I would, but it seems maudlin to talk about why am I still alive after watching so many friends die of their cancers. So I'm turning over this post to my wonderful husband Rik, who wrote it November 22, 2015 on his Facebook page.

Why I am grateful this Thanksgiving.
Great article from the New York Times today brought it all home. Adding some personal reasons too!
Grateful for Jill being in my life for 21 plus years, and her having the best team of medical care in the world over the last 16 years to manage her Breast Cancer and mets disease, but particularly the last month as she has been hospitalized with two infections, continued chemo, almost finished radiation on four spots and successfully managed Gamma Knife to her brain.
Also grateful for the support of my community of friends, neighbors, and synagogue members who have brought us meals, rides for Jill, company, and of course my colleagues at Roosevelt High for all the support in rides, hugs, good wishes, coffee, coverage of classes for me when needed, and giving me lots of slack, and my students who always are wonderful caring human beings who get that school assignments are not the most important things in life.
See attached photos for Jill in action making the cancer go away!
Jill wears the full gamma knife gear

"What, no second breakfast?!"

And at the conclusion of radiation to four separate spots. That face mask was awful and didn't even look like her.

November 22, 2015

XRT and gamma knife

Tomorrow is the last day of this round of radiation. It will have been ten days, plus one especially for gamma knife to the brain. Of the four types of radiation treatment, I'll have had three: proton, electron and gamma knife, to five different sites (skin met on scalp, skin met on chest, lymph node on neck, lower right rib and brain).

The gamma knife lasted longer than I recall from my first experience, but of course I insisted on having conscious sedation that time, so I don't remember much. This time I accepted six mg of Ativan instead. The numbing lidocaine injections in their three inch needles (so Rik told me, I didn't see them, thankfully) hurt like the devil, but there's no way around that. At least the pain subsided quickly. I have four more tiny holes on my head, two in front and two in back. Those are covered by hair. They're all healing nicely.

Here are some awful photos. Like my snack and the bubble too? The bubble helps the nurse measure the exact shape of the head. I think the "crown" keeps my head still and must get attached to the gamma knife. They didn't show me that part.

Wearing the bubble
With the "crown" and enjoying second breakfast:
 hot mocha and a croissant 
I sent Rik home once it became clear that the procedure would take hours and he could at least be more productive at home than at the hospital. He didn't want to leave but how awful must it be to sit for so many hours with no involvement in what's going on? And at least he could be with the dogs. Or they with him. Not sure how that worked, exactly.

So, a long day. Dr V gave me a prescription of steroids, tapering slowly down from two mg four times a day over several weeks to none at all. The Decadron disturbs my sleep, but I hope a dose of Ambient will help that tonight. I seem to be fine. That first day afterwards was a bit odd. I think I made many verbal goofs but no one seemed to mind. Much. 

Tomorrow, back to my last session of XRT with the kindest, most respectful technicians since the last time. I gave them some vitamin CH as a small thanks for treating me with such delicacy and caring.

Posing with the face mask for regular radiation

November 13, 2015


Today ends the first full week of two for radiation to four spots, otherwise known as XRT (X-ray therapy). I was so fatigued earlier in the week, but I realized this morning that I had tried to squeeze in a blood draw and oncologist appointment on Tuesday and Wednesday, with radiation separated by more than an hour. No wonder I was so pooped.

Yesterday was much more pleasant. I got up early, ate and showered, crashed for a bit and went to XRT. Today the same but I haven't crashed or showered yet. Yesterday's dog walker was a wonderful young woman who instantly fell in love with the pooches, and they with her.

Our synagogue has been providing help through the Mitzvah Corps, a neighborhood group that supports families in need - whether it's a new baby, a death or illness in the family, etc. So far we've had daily dog walkers (and I know not all these people really like walking dogs, but they want to help) and delicious meals twice this week. It's been so wonderful to have this support. It helped us thirteen years ago when I broke my leg and needed assistance with everything, including getting my own lunch.  I fondly remember one friend from Radost who showed up with her mop, bucket and vacuum cleaner to clean our house! I've tried to pay it forward to other families over the years, and now the circle comes around again.

The XRT is first to the skin met on my head, which is doing really well on it, although it will leave a permanent bald spot. I'll have to have a comb over when I grow enough hair. Then to the skin met on my chest, which is bleeding freely when I remove the bandage but which I hope is also healing on this regimen. Then they zap my shoulder and neck lymph node combined. Hard to tell on how well this one is working, because it still hurts. Last is to my right lowest rib, which might have fractured when Bob the dog jumped on it (this happened once before) or is just a new bone met. At any rate, it hurt enough to warrant treatment. The radiation techs are terrific gentle men, who treat with me with dignity and delicacy, worry when I stain my shirt with blood, and actually pick me up and place me down on the gurney to put me in the proper position.

Dr Eulau the wonderful radiation oncologist has actually treated me four times over the years, from my original diagnosis, my mets diagnosis, my ulnae, and now. He is a fabulous, caring physician and I wouldn't have asked anyone else to be on my dream team.

Now it's time for a shower, clothing and more laundry. I actually feel well enough to do all this today!

November 07, 2015

Radiation etc.

It's been a whirlwind week of doctors but now I know what to expect through the next several weeks. If you remember, I told my mets many years ago that if they were quiet, they could live with me, but if they got noisy, I'd bring up the big treatments. So here we go!

1. I met with Dr Sandra Vermeulen, the gamma knife (targeted radiation) specialist, and she says she can zap my brain mets. Maybe only some of them, but some is better than none! She's going after the ones on the top of my head, where most of them live. Then she's going after the three largest in my cerebellum. We actually had a chat after our talk about where to zap, and she's not a chatty lady. Go Dr Sandra!

2. Then I saw Dr Stephen Eulau, my general radiation oncologist. He's treated me several times over the years, from the very beginning in 1999. He's an incredibly sweet, kind man, just the type of person you want on your care team. Now he will treat the two skin mets (the one on my head, the one on my chest), the enlarged lymph node on my neck, the newly diagnosed left shoulder bone met and the also newly diagnosed right lower rib bone met. I had a simulation last week and have to wear a plastic mask each time. It's got holes for my nostrils, eyes and mouth, but still it's icky. I get zapped for ten days, thirty minutes at a time. I didn't like the face mask at all, but a little Ativan helped relax me, as well as some yoga breathing and remembering to keep the top of my head touching the inside of the mask. It's pretty awful but I am tough. Tough enough to deal with a two inch round permanent hair loss. I'll just have to have a comb over like The Donald.

3. I spoke to the wonderful nurse Sally at the Cherry Hill Wound Center and she told me to stop wearing the plastic-ey Tielle bandages and switch to a gauze bandage attached to my skin with tape after I start radiation. I will be sad to lose the Tielles since they work so well and I can wear them in the shower with no extra covering, but Sally told me I can either remove the gauze bandage or cover it with Cling Wrap in the shower. Either way works fine.

4. Dr Flugstad the orthopedist was so happy to see me. It had been two years since our last visit. He's the amazing guy who fixed my left leg and kept me dancing all these years. Dr F confirmed that my left shoulder was not in immediate danger of a fracture (yay!) and that I also have some arthritis in that spot (boo). I guess not a surprise, since I have occasional off-and-on pain from arthritis in both thumbs. He also looked at the recent X-ray of my right rib and thought radiation would be fine for that spot, but noted that I have multiple bone mets in my ribs anyway. Then he watched me walk and confirmed that with the lift in my left shoe (and they were pretty amazing ankle boots) I could walk and stand without issue.

5. Then last and of course best, I saw the Amazing and Wonderful Nurse Jacque. She had to send me over to the lab for a blood draw, since I don't have a PICC line anymore. We shmoozed a little and Dr G came in for an exam.  He still wants me to see someone at SCCA for a second opinion. The only issue I have there is that they think inside the box and Dr G clearly thinks outside the box. But as he says, they know what's coming up next in the research and that can only help. So he will contact Dr Julie Gralow's scheduler. When I spoke with them she couldn't see me until January. Maybe Dr G can do more. And while I was sitting with him, he took a call from a doctor at interventional radiology about putting a "passport" in my right arm. He called me not a patient, but a close friend who is a patient of many years, gave him all the reasons I couldn't have another port-a-cath. From memory. I was so pleased to be in the room while he spoke to this doctor about me and let me overhear the details. This is why Dr G is clearly the doc for me (with apologies for the awful rhyme).

6. I also went to my weekly support group. When I gave my update -- I hadn't seen them in two weeks, since my collapse with shakes and fever while there -- four people offered to help while I was in radiation. Walk the dogs. Drive me to or from. Bring whatever I needed. It was so lovely to have friends new and old step up to help, even while they deal with metastatic cancer. Luckily when I scheduled the radiation, almost all of it will be at times when Rik can drive us both.

7. On Friday I had my latest dose of Alimta (pemetrexate), the new chemo Dr G wants me to take. I ran into a friend and we managed to get the nurses to put our chairs close together. She was alone but I had a friend and the three of us enjoyed a really good visit. This is my second dose of Alimta, and other than feeling like crap when I got home, I spent the day today lazing in bed. Dr G wants me to take Decadron on the day of chemo and for three days afterwards, but it's a very light dose for home. I hope not to have the midnight shopping mania so frequently associated with this steroid. Alimta is given once every three weeks.

That's a lot to report but it should take me through the next two weeks. I will write about how the radiation goes. Onward and upward in every direction!

November 03, 2015

On to November

Pinktober has ended and I personally am glad. Although I figured out the best way as a metster to "celebrate" it (by spending time in the hospital), I am so glad that the end of pink products and pink washing may be over. To learn more about pink washing, go to Think Before You Pink.

A friend told me on Saturday that it may take a week to recover for each day inpatient. Since I was at Swedish for six days, I am going to try to take things easy this month.

Last week I saw the brain radiation oncologist and she says she can treat my multiple brain mets with gamma knife radio surgery. She did this once before when I had only four bran mets. Now I have more than twenty but she is confident.

Today I see the radiation oncologist. Tomorrow I see the orthopedist, just in case something in my shoulder might break. I have a new met(s) there, and on my lowest right rib. I don't want to risk a fracture when I turn over while sleeping or other such event.

Today's rad onc will look at the left shoulder, right rib, enlarged lymph node on my neck and my two skin mets. I hope he can treat them all since I am so tired of complaining about the last three items for months and not really being heard.

When I have more to report I will check in. I might wait until I know about everything.

October 27, 2015

Home sweet home

Yay! Swedish sent me home again this afternoon.

Infectious Disease Dr said I have 2 bacterial infections - klebsialla (coliform, or a kind of E. coli, which everyone carries) and serratia (water based). Who knows how I got them or why. I'm getting oral antibiotic Levaquin now, once every 24 hours, for five days. Don't click on the links unless you enjoy being grossed out or like medical stuff.

My friend G told me the following: "Serratia marcescens belongs the family Enterobacteriaceae, which includes E.coli and Klebsiella pneumoniae. They are both associated with nosocomial infections (hospital acquired). Serratia in particular is associated with catheter-associated bacteremia."

So it was correct to presume that my PICC line was the cause of these infections. And I have been prone to infections for several years, since my early onset breast cancer in 1999 (I developed toxic shock syndrome in the drain placed after my lumpectomy). This shouldn't have surprised anyone. And yet it did. Even though I've been hospitalized several times over the years for infections.

But I am healthy now and ready to pick up life from where it veered last week. Thank you Swedish Medical Center's phenomenal staff!

October 26, 2015

Update Monday

I am recovering bit by bit.

The weekend was full of antibiotics and friends. Today I learned that I most likely have two different infections. One is coliform, the bacteria that can cause E. coli. You hear about kids eating hamburgers filled with fecal bacteria. But we all harbor some kind of E. coli and it takes just the right thing to trigger your own body's stuff. I think I got that right.

Dr infectious disease named the second infection in the early morning and I can't remember it now. It had something to do with water/blood bacteria.

I've had more IV antibiotics today but if Friday's and Saturday's cultures come back growing the same thing as Thursday's, I can move to an oral antibiotic and go home. So I hope to be here until tomorrow. As you know, nothing is certain when you're inpatient at the hospital.

October 24, 2015

At Swedish

I guess this is really how one "celebrates" breast cancer month: by getting admitted to the hospital.

On Thursday I developed fever and chills around 2 pm during my support group. The great social worker took me over to a nurse for my temperature (high). She called Dr G, and got me a wheelchair ride to the ER.  After a few hours, a chest X-ray, and sharing with both Dr G and the ER doc, I learned I had pneumonia. Rik's colleague gave him a ride from school and eventually we went home around 6 pm.

On Friday I awoke to a call from the ER. They think I have a blood infection, come right back. I picked up Rik from school and we arrived around 10 am. More checks, more drugs, more fever/chills. Lost my lunch several times. Dr G decided to admit me but a room wasn't ready until almost 6 pm.

Now I'm on the 12th floor with a fantastic view of downtown and the waterfront. I've had numerous antibiotics, platelets, and a blood transfusion. No one knows exactly what kind of infection I have. Most likely to be in my PICC line, which has also received its own special antibiotic.

I actually slept last night, no doubt due to fatigue, less sleep the night before and Ambien. God bless sleeping pills. I had fever /chills again  in the middle of the night but they haven't returned yet.

After my shower this afternoon I felt the best I have in days. I have energy but am stuck here on my butt until they decide whether or not to pull my PICC line. It all depends on if the infection clears up. Or as Dr G told the infectious disease doc, better to pull it than to risk her life.

So. Waiting and waiting. Bad food corrected by Rik who brought yummy lunch from Bakery Nouveau and friend C who brought dinner from Ma'ono (fried chicken). Boredom corrected by good buddy G who dropped at just the right time, five minutes after I got out of the shower. More friends coming soon. Spoke to my mom twice.

Are you getting the picture?

PS if you can, please give blood you don't have to tell me if you can or cannot. But it's a good thing to do.

October 15, 2015

Pinktober means

I have never, not even once in thirteen years, danced with "NED" in my dance with metastatic breast cancer. NED, of course, means no evidence of disease. I started off with bone mets, and once with them, as with a broken bone, there are always leftover reminders. So no, I've never danced with NED.

I've also been overwhelmed by the newest mets-sisters belief that they are dying of mets; that pink is not a cure; and that there is nowhere near enough research on mets. The second and third bits are true: pink isn't a cure and the NCI still funds too little towards any metastatic cancer.

But I have have a hard time grasping the first point. Am I dying from mets? How does that explain 13 years of living with it?

I remind myself that at the very beginning of this dance with advanced cancer I dreamed that my house was too noisy with other people I didn't know. I ran from room to room asking them to be quiet. And when I woke up, I realized that the house was my body and the people were my tumors. I gave my cancer a chance to quiet up and I would give it a home forever, because if I died, my cancer would die.

That's still true after 13 years, and I have to remind myself of it, especially now that I'm involved with younger activists who argue differently. I still want to be involved with them. They are the future of metastatic cancer.

I just am not ready to die.

Think Before You Pink.

The day we died on the Capital.

Awash in Pink.

October 13, 2015

Metastatic breast cancer awareness day

Yes, out of all of Pinktober and the entire year, they give us ONE DAY. In honor of that one day, I want to quote from my friend Mandi, author of the blog Darn Good Lemonade

About Mandi
My Diagnosis & Treatment
The List

5 Things Not to Say to Someone With Metastatic Breast Cancer
Posted By Mandi on Oct 13, 2015 | 1 Comment

In honor of metastatic breast cancer awareness day (October 13), here are 5 things not to ask someone with metastatic breast cancer:

1. When will you be done with treatment?

The answer is never. We will be in treatment until we die. Even if the magical NED (no evidence of disease) status comes. Once you have stage IV breast cancer you have circulating cancer cells in your bloodstream that have to be kept in check. The average lifespan is 3 years after metastatic diagnosis.

2. I thought breast cancer had a cure?

You will see 99% and 95% cure rate stats floating around. Those stats say that with early stage detection, 95-99% of women will leave past 5 YEARS. Not live forever. read the fine print. I hate this stat. 20% of women with stage IV live past 5 years after diagnosis of stage IV. 5 years past my stage IIB diagnosis is coming up on December 30, 2015. I am not even going to give you stats that involve brain metastasis, we are already pretty upset at my house these days without stirring that pot. Let’s just hope I make it to that 5 year mark, just need 2 more months eh?

3. But you look healthy?

When I won an award that required I be in active treatment for breast cancer, the other woman there with me happened to be early stage and acted fairly upset that I was there with all of my hair (little did she know 5 minutes after shooting the news spot I had to run and get radiation to my spine). It really upset me, I felt like she seemed to think I was faking my illness and it also concerned me that she knew nothing about metastatic breast cancer (spine radiation was one of the worst things I have ever been through by the way). Just because someone doesn’t looks sick on the outside, doesn’t mean they aren’t sick. This goes for many other diseases that are called “invisible illnesses.” I know sometimes people mean well when they point that out, but we don’t exactly want to look sick and it isn’t a gauge on how we are really feeling.

4. But you got the “good cancer?”

HA! All cancer sucks. Yes, some people live longer with some cancers. Some cancers are nearly curable. They all require crappy treatment and side effects. Let’s just cure ALL cancers and I seriously want to hear how cancer in my spine, lungs and brain is the good cancer, mmkay?

5. Men don’t have breasts, they can’t get breast cancer?

Men do get breast cancer. They actually have the inner-workings of a breast that just don’t actually become them because of hormones. That whole XY chromosome thing. I don’t need to teach you biology, but men get breast cancer and they get metastatic breast cancer. Don’t forget them.

For metastatic breast cancer awareness day, I beg you to share a story of someone you love/loved that has been impacted by stage IV breast cancer, share facts, share what it is. Share that we need metastatic breast cancer research. SHARE! <3 Also, if you have metastatic breast cancer – what did I miss? Add in the comments.

Jill's news:
I saw Dr G today and Monday's CT was "not favorable." I have new mets in my liver and lungs.The lung mets have come and gone over the years and are particularly tiny (5 mm each), so I guess I'm not going to worry about them much.

Dr G wants to increase my dose of carboplatin and add Alimta (pemetrexed). Nurse Jacque said these are given once every three weeks, with vitamin B12 for the Alimta. That shot had a very tiny needle. I'll know more once Premera has approved these chemos. Alimta crosses the blood-brain barrier and has low toxicity, so it's very appealing. We also discussed ixabepilone, cytoxan and a new therapy called abemaciclib. 

He'll get me in to see a radiation oncologist to treat my skin mets and enlarged lymph node. Dr G will also try to get me in to see Dr Julie Gralow at UW for a second opinion. She's a widely renowned oncologist who travels around the world and is most likely to know about new research. But since she travels so much, it may be a long time before I get in to see her.