Yes, a hysterectomy is in my future

The good Dr G communicated with my new GYN, Eleanor Friele, and they agree I ought to have a hysterectomy. Dr. F's office told me their surgical coordinator will contact me, hopefully by the end of the coming week. I did ask that if possible we try to schedule the procedure so that I can be mostly recovered before Rik leaves to escort that student trip to northern Ireland in February. "We'll see what we can do."

The plan is for me to have the hysterectomy, recover, and then Dr G will decide on a treatment plan: Continue with the Fareston (toremifene)? Explore estradiol? Look into another chemo? The possibilities loom large.

More grey Seattle days

I know I shouldn't complain about winter when we live in one of the most moderate climates in the nation, but these grey, wet days are making me crazy! The sun hardly seems to come up until 9 AM. The heavy rain makes it too wet to take the dogs for a big walk, so Bobka doesn't get enough exercise, then wakes up during the night. I come home from a walk and only want to curl up on the sofa, which leads to more naps than I need. (My recent bout of vertigo only aggravates this tendency.) Rik came down with a cold and I made a pot of chicken soup, but that's been the limit for my creativity.

Pumpkin is content to snooze all day and evening. He's the only one who is happy.

Vertigo

Last summer I had vertigo for about a week. I would lie down on the bed and the room would spin. Actually, just my head, but it felt like the room was spinning. It resolved naturally and hasn't troubled me again until this past weekend.

On Friday and Saturday nights I had the same feeling of the room spinning. Then nothing Sunday or Monday but on Tuesday the vertigo reappeared to a lesser degree. I mentioned it to Dr G when I saw him on Monday.

I am trying not to move my head too rapidly or look up and down or from side to side too quickly. So no more typing today!

Hopefully this will resolve soon on its own as well.

Test results

Good news -- the GYN's office called yesterday to say that my Pap smear and endometrial biopsy were both normal. But when I saw Dr. G later the same day, he told me that he thought I should consider having a hysterectomy. Evidently the vaginal bleeding was cause for concern on his part. And of course having one cancer makes you more likely to get a second cancer. We took care of the risk for ovarian cancer, which is most closely related to breast cancer, when my ovaries were removed. But uterine cancer is quite dangerous and no one wants me to be at risk for that.

Dr. G was going to talk with the GYN doc and get back to me today. I expect that they will both agree that I need the hysterectomy. At least it could be done via laparoscopy (where they enter through the belly button), and so would have a much faster recovery than the traditional entry through the lower belly. I had a similar procedure about 25 years ago and they told me to expect a six week recovery. (Of course, I led a tour to Israel in the seventh week, but still...) That was half my lifetime ago, and I don't think my bounce back from a traditional surgery would be the same now. So if a hysterectomy is in my future, I hope it will be via laparoscopy.

Comfort food

When I was a kid my favorite food after chocolate pudding was Rice-A-Roni, "the San Francisco treat!" Something about it completely appealed to my taste buds. Was it the toasted pasta? The chicken flavor? I've never been sure. Risotto comes close but can be more hassle to make.

As a kosher-keeping Jew, I can't cook Rice-A-Roni in my kitchen because it's made with non-kosher chicken flavoring. But a friend recently served me something she called "rice with stuff" which tasted just like my childhood fave. She shared the recipe with me and I am sharing my brown rice adaptation with you.

Jill's Homemade Rice-a-Roni
(serves four)

3/4 cup brown rice
1/2 cup tiny broken pieces of vermicelli (or orzo pasta)
1 small onion, chopped
2 1/4 cups chicken or vegetable broth
2 tablespoons olive oil
1 teaspoon salt (optional)

Preheat oven to 350 degrees.

In an oven- and stove-proof pot that has a lid, saute chopped onion in olive oil. Add pasta and continue to cook until it begins to brown. Add rice, pour broth over rice/pasta mixture and add salt if desired. Cover with a tight fitting lid and place in hot oven. Bake 1 hour until rice is tender and all liquid has been absorbed.

I also saute mushrooms and other vegetables with the onion to boost the flavor and add even more fiber. Last night's version included artichoke hearts in olive oil and was very tasty!

Need a nap

Bobka, the number two dog, has been getting up several times a night every night this week. He wanders around the house. Sometimes he needs to go outside and then he stands by the back door and barks. Since both dogs sleep on the bed with us you can see how this is a problem. Pumpkin, of course, sleeps through everything. I swear that dog has a cast-iron bladder, despite his advanced age.

Rik has mostly gotten up with Bobka this week. That's on top of working one night at Antioch University and waking up at 6 AM every day to teach. I offer to get up. If I am having a night sweat it's no hardship to get out of bed and cool off, but sometimes Bobka wakes me up from a sound sleep and then I can't move.

So I have been taking a morning nap every day and today I missed my yoga class. There has got to be a better way to deal with this. Dog training tips, anyone?

Managing lymphedema

My hand has continued to swell from lymphedema, a continuation of the troubles that started Labor Day weekend in September. I've been so tired of wearing my glove and having a sweaty hand all day long. Rik got sick of hearing me complain and came up with a suggestion -- why not stop wearing the sleeve and glove for a day and see what happens? At most it would be the same or a little worse. At best maybe there would be some improvement.

On Monday morning (three days ago) I did not put on the sleeve and glove. By evening my hand had actually reduced in swelling. So on Tuesday morning I took out the measuring tape and a pad of paper and noted my arm measurements in four places: hand, wrist, 12 cm up the forearm and elbow.

I have not worn the sleeve or glove all week. My measurements have been about the same: a little reduced in the hand, wrist and elbow, a little increased at the forearm. We're talking millimeters of decrease or increase, but as long as the cold weather continues, and my measurements don't change dramatically, I think I will continue the experiment.

I developed lymphedema just a month or so after my lumpectomy in 1999. I had a life-threatening infection of toxic shock syndrome from the drain left in the axilla (underarm) incision. This infection, coupled with the removal of lymph nodes at the axilla, most likely caused the lymphedema.

I haven't not worn a sleeve in almost 11 years. Let me tell you, it's downright weird to feel the fabric of my clothing against the skin of my left arm.

I don't think my lymphedema is gone forever, but this is sure a great break from wearing the compression garments and not having full use of my left hand.

Side effects and what they lead to

Last week I began to experience vaginal bleeding. It was listed as a side effect of the toremifene, so I called my oncologist, who ordered a uterine ultrasound and asked me to see a gynecologist. He also stopped the toremifene. I had only been taking it for about 2 1/2 weeks.

My primary care physician referred me to a very nice GYN with a great sense of humor. She performed an endometrial biopsy, which was just on the edge of painful even with some topical anesthetic. I expect the lab results in 7-10 days. (The results may arrive in time for my appointment with Dr. G next week.)

You may ask, why the rush to deal with this side effect? Well, vaginal bleeding is listed as a serious side effect of the toremifene. As with any cancer, the patient has a chance of developing a second cancer. In this case, they would be concerned about uterine cancer, since I no longer have any ovaries.

The GYN assured me that in most cases the result of the endometrial biopsy is benign, but because of my complicated medical history, we should wait and see. I suppose there is a chance I would need a hysterectomy, but it's too soon to speculate.

So we wait and see. Again.

Ice cream for breakfast!

Today we went to Molly Moon's Ice Cream Shop to have ice cream and oatmeal for breakfast. This festive tradition started last winter and we like to go at least once during the season. On fall and winter weekend mornings, Molly Moon's serves freshly made steel-cut oatmeal with the ice cream of your choice and toppings such as frozen berries, chopped nuts and chocolate, maple syrup, brown sugar, spices, etc. Coffee and orange juice were included.

Being kosher-keeping Jews, we didn't choose the maple bacon flavored ice cream. Instead I had salted caramel ice cream and Rik selected half maple walnut and half cardamom.

This is such a delicious way to start the day! It reminded me of International Ice Cream for Breakfast Day, which friends introduced to us last winter. Family created, the tradition is to:
1) eat ice cream
2) for breakfast
3) on the first Saturday in February.

We hope to be among the many people worldwide celebrating this tradition in 2010.

Happy new year to all

I woke up a little grouchy this morning, still a bit sore at the new port site, but thrilled to take a shower for the first time since Wednesday. After eating breakfast, I was alert enough to realize that IT'S A NEW YEAR!

I wasn't sure I would live to see 2010 after having been diagnosed with metastatic breast cancer. But I am pleased to be here to celebrate the turning of a new year and a new decade. And to remember those we love who are no longer with us. (Emily, I am thinking of you today.)