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Cancer Number Three and RA


It is almost a month since I had a robotic radical hysterectomy and it has been four days since I had my first chemo. I feel pretty good all things considered. Additionally, a minor surgical procedure placed a power injectable SMART PORT under my skin connected to a catheter that was threaded into my jugular vein and down to my superior vena cava creating fast access to my body’s circulation.  It is not as bad as it sounds. Sloan Kettering has a PDF that explains the procedure. My skin has been tender, but the lidocaine ointment works and relieves the discomfort.

My RA is complaining with all joints hurting morning and again evening time. Walking hurts my feet even though I have custom shoes and custom triple layer inserts.  I am glad I take methotrexate injections, Plaquenil and meloxicam. I take 6 mg Medrol and can boost the dose into a dose pack if needed. So far, I am holding steady.

With RA I think it is important to move. Aerobics are nice but not practical in my situation. So, my old routine of activity alternated with rest works well. I read the Washington Post over coffee and then make breakfast. Next is the activity of showering and dressing. Showering and dressing is an activity when in cancer treatment or in an active flare (some of us are in a variation of a flare all the time.) Next is a short rest period with rereading Mukherjee’s book, Gene, or writing a letter to a friend.

Next activity for me is to check the garden. Fill the feeders and the bird bath. Water the container plants. Next will be a rest period while I check email and google something I’m researching, or I just watch the local squirrel munch on the zucchini plants. He is an incorrigible, determined squirrel. It has taken me this long to realize he is the culprit eating the zucchini.

My cancer is uterine papillary serous carcinoma. It is a very aggressive subset of endometrial cancer affecting 5-10 % of those with endometrial cancer. It behaves similarly to ovarian cancer which also affects the serous cells. Tamoxifen can cause it. My immune system is compromised with RA. Close relatives who have colon cancer match genetically. My brother had colon cancer.  Serous cancer was isolated in 1982. Before then it was lumped in with endometrial cancer. It has a high death rate whereas endometrial cancer doesn’t.

Treatment is aggressive surgery, six cycles of Taxol/ Carboplatin, and brady cuff vaginal radiation. For me that should finish it off. However, you never know with this cancer.

My oncology nurse, Trisha, recommended that I premedicate with the Zofran. I have done so. Nausea is light, but I have no appetite. Protein shakes will probably be the answer.

It is almost two months since my diagnosis with this cancer, my number three. Initially, I was scared. At the time I understood that once again my world would be consumed by things cancer. It is. Tomorrow, I see my hair stylist, Audry, who has experience with cancer patients. She will chop off my hair very close to my head. Hair loss starts about ten days into this chemo. It is better to cut it than have it come out in clumps. My Cathy sent me an adorable cap of daisies on a pink background. Tomorrow I will start wearing it.

My summer and fall have been mapped out for me. I know what to expect. I know where I stand. I will be immersed in this cancer in my life. I am good. I am okay with it.

My surgery is over, and after an overnight hospital stay I am safely home. The doctor took many things out of me and she biopsied the rest. My doctor is a GYN oncologist surgeon, Sara Jordan. She is amazing and couldn’t be better. She feels that my serous uterine cancer, a rare subset of endometrial cancer and known for recurring, needs to be treated aggressively. I completed the first step, surgery.

Prepping for the surgery was a challenge. I was required to spend Mother’s Day on a clear liquid diet. Then on Monday I was reduced to NPO status even though surgery wasn’t until one pm. I was running on empty so when I approached my preop, well-padded bed, I was relieved to get in. Stripped down like a hijacked car, clothed in the traditional blue gown, IV successfully inserted, I was ready for surgery. OR nurse stopped in. Anesthesiologist checked in. Dr Jordan reviewed the surgery again and introduced me to the second surgeon. Time seemed to accelerate. It was five minutes past one when I was wheeled toward the OR for major robotic surgery.

After time in the recovery room, I was brought to a private room and to my sons. All was well. The good news was that the cancer had not spread. Caught early. Still I had to be catheterized in the middle of the night. Not much there. Bummer. The nurses kept pouring in the IV fluids. Not much in there to come out. I was dehydrated. Next day I peed on my own. It was my pass to go home. My boys took me home. Very glad to be in my own bed in my own room.

I felt crampy but otherwise I felt fine. For robotic surgery five small incisions were made across my upper abdomen. The middle incision, a little larger than the others, is where the camera was inserted. The other four incisions were entry points for the robotic arms. I had two IVs as a safety measure.

After surgery I was given IV ibuprofen. I loved the stuff. I had not heard of it. I think it is fairly new for post op patients. With my joint pain being relieved, I felt very good indeed. Mobile. I wish I had some right now.

I started thinking about the next step, chemo. It will start in a few weeks. My doc has ordered a ton of meds including Ativan and two strong medications for nausea. This suggests to me that I will not want to eat very much. The chemo is the standard for this cancer consisting of two drugs. It will be given every three weeks for six doses. That will take me up to October. My year shot again. Sometimes I feel that I have to go through an awful lot just to stay alive.

Now I was getting depressed, but I continued on to thinking about the third part of the treatment. Brady radiation. It is where a devise is placed in my vagina and then the radiology oncologist places a powerfully radioactive material into the devise. I will be left alone for about 15 minutes. Then the radioactive material and the devise will be removed. That’s about all I know about it for now. Maybe it is too much to know. Not a comfortable type of a treatment. Now it takes me into November. I am definitely spending my year as a patient. I became depressed after thinking through the timeline. Big mistake.

This thinking does not work. I need to stick with the one day at a time theory. I can handle that. Divide up my day. Make chocolate bread. Watch the squirrel and the chipmunk. The quail. Write. Knit a bit. Tomorrow will come soon enough. See. Happier already.








My RA and CA and me

If it weren’t for the third cancer hanging over my head, I would be a very happy soul. As it is I am just a happy soul. My roses are blooming. This is their big month and they are not disappointing.  Gardening and puttering through the various chores of my household reminds me of my housewife days. Good days. I aspire to the Hobbit life. Mellow and satisfying. Life in my home.

I attend warm water pool classes at the Presbyterian Healthcare facility on Eubank. It is a long drive, but the classes are worth it. A comprehensive and aerobic workout that is manageable in the pool but not on land. Yesterday, I suddenly had a severe pain in my pelvic area that ran down the inside of my leg. Something new. Scared me. I thought about getting out but decided to lower my exercise level and see if it would pass. It did. I am no stranger to pain, back pain, joint pain and now this. Johnny Cash’s Peace in the Valley is sounding better all the time. Getting out of the pool is also painful and getting dressed is not much better. By the time I get to Trader Joe’s I have worked it out somewhat. Moving can be good for some pain, but not for others. My body is clear to me about the difference. During my hip replacement ordeal, I didn’t see the inside of a Trader Joe’s for six months. I refuse to miss this opportunity.

A coping skill that I have learned to conserve energy is to have my grocery bags carried out. Staff are always willing, and I always give them a few dollars. They protest but I insist, and I feel the better for it. It doesn’t sound like much but pushing the cart out, unloading the bags and returning the cart sap needed energy. It is wise to use the opportunity of help when it is available. Tipping isn’t necessary so if your budget is tight, don’t tip. They will still smile and are happy to be helpful.

I am in an RA flare. I have learned to manage. Well, I feel it is managing. Methotrexate(MTX) is a God send for me. Once I got past the initial side effects and on to the injections, it has been a maintenance drug for me. Plaquenil complements the MTX. Tramadol and Gabapentin help. Medrol gets me through flares along with cannabis cream for my feet and hands. I always wear custom orthotic shoes. I sleep on a heated mattress pad, summer and winter. I do all that I can.

The serous uterine cancer that is presently in my body is also genetic especially if you have a close relative with colon cancer. My brother died of cancer of the appendix.  Of course, Tamoxifen is the main culprit. I always figured I would have another cancer, a new one. I had not even heard of this cancer. I believe that there is no point in worrying as the thing you are worried about is not the thing that is lurking in the bushes, a thing most dreadful and a thing waiting to attack.

My RA, my CA and I are heading back to the garden. Time to move one plant into a bigger pot and put a new plant in the old pot. Back to living in the now. A very good place to be.