Doctors and Nurses and Techs, Oh My!

This week is tune-up and preventative maintenance week.  Yesterday I had a follow-up with my surgeon and a bone density scan.  Tomorrow I have a follow-up with my oncologist, a zometa infusion and an MRI. 

I currently think of myself as a healthy person so it is kind of strange to be spending so much time at doctors offices and hospitals but it also helps me to maintain the idea that I am a healthy person.

The bone density scan is something I will have once a year (this is my second one).  Because I was forced into menopause through chemo and because I am taking Tamoxifen, there is some concern about bone loss so I will have this test each year to make sure that my bones are holding up.

I have an appointment with my oncologist every 3 months.  For the most part, these are now just appointments to make sure I'm not having any adverse side effects of the drugs, she will also do a breast exam and check my lymph nodes.  I have blood work done each time that tests various things such as my iron, my vitamin D level, my estrogen level and my tumor markers.

I will have my 3rd infusion of Zometa.  Zometa is a bisphosphonate which is essentially a bone density drug.  For me, with my diagnosis, this drug is a preventative.  Zometa has been shown to reduce the risk of a recurrence to the bones by roughly 30 percent.  I will have it every 6 months for 3 years.  It takes about 45 minutes for an infusion and so far I have had minimal side effects.  I generally have a day of feeling just a bit off, maybe a bit flu-like and tired.  It isn't debilitating though, and worth it in the end.

The MRI is just one more tool in my toolkit to look for lumps or differences in my breast tissue.  I have a mammogram every 6 months and alternate those with the MRI so I am having some type of imaging test done about every quarter.  

It is hard sometimes to force myself to spend the day at doctor's offices.  It is especially hard to have the Zometa infusion as that is in the same place that I had chemo.  It reminds me of how difficult it is.  Cancer is hard.  There is just no denying that it is a terrible, difficult disease.  However, I am grateful for good health care and thankful that so many people are on my team, helping me to make sure that I remain healthy.  So, I will go in on Friday and I will be grateful that I am going there to remain healthy and not because I am sick.

In Good Hands

Albert B. Einstein Jr



The original Einstein

Today I went in for a 3 month checkup with my oncologist. Though I have always been happy with the care that I have received at Swedish Hospital, I really did not want to be there today. I just didn't. I am enjoying being part of the land of the healthy. I didn't want to be sitting there with people who are bald and sick and waiting to go through chemo. That isn't where my head is at these days. I didn't want to have my blood drawn or get on a scale, I didn't want to be poked and prodded and I wasn't excited about having my second Zometa infusion. I wanted to be at home enjoying the warm weather.

My oncologist is not only a fabulous doctor (one of the top 3 in Seattle) she is also very similar to me. She is my age, she has two children and she is a breast cancer survivor. I was lamenting to her about not wanting to come in today. She laughed and said that she has learned to not take it personally that people really don't look forward to seeing her. She also said that in her own cancer journey, she really doesn't want to go see her oncologist either.

The appointment went well and she doesn't want to see me for another 3 months. The zometa infusion was also uneventful. I can expect to not feel well tomorrow, but I am keeping my fingers crossed that this is not the case.

I had to have my doctor sign a medical waiver for me to be able to walk in this year's 3 day walk. Per the 3 day guidelines it has to be on official letterhead. My doctor gave me her blessing to walk and wrote it out on her letterhead, which I did not look through until after my Zometa infusion. The official letterhead has a list of all of the doctors that are in the cancer institute. At the very top? Executive Director-Albert B. Einstein Jr. It made me laugh. Albert Einstein and I share a birthday so I have always had a connection to him. I guess if Albert Einstein can spend his time at Swedish Hospital, I can do it too. I am in good hands.

All Clear?

The mammogram went well yesterday and the doctor was pleased that she didn't see anything out of the ordinary. The MRI went well also, though I do not yet know the results of that. I hope to hear from my doctor today telling me that everything looks clean and clear.

The Zometa infusion was relaatively uneventful, although it was very strange being back in the infusion room. The nurses there are great and do their best to make the experience as easy and painless as possible. The explained to me that the Zometa essentially pulls calcium out of your system and then dumps it back into the bones which is why bone and joint pain can occur.

I was hoping to get away with no side effect, but unfortunately woke up this morning achy and with chills. These are expected side effects and generally only affect people after the first infusion. I am laying low today and trying to remember that this means it is working the way it is supposed to. No pain, no gain!

Preventative Maintenance

Today I have 3 appointments. The first one is my first post-surgery mammogram to establish a new baseline for future tests. The second one is an MRI for the same thing. This will be my new preventative maintenance routine. I will have a mammogram and an MRI every six months to make sure there has been no return of the cancer. Though I have no reason to expect that there is any cancer left, I am still just a little bit nervous. The last time I had a mammogram was in May and the outcome was a breast cancer diagnosis. In addition, I now have quite a bit of scar tissue from both the surgery and the radiation so it makes reading of the mammogram and the MRI just that much more difficult. The good news is that the diagnostic center that I am going to will go over the results with me at the appointment so I won't have to wait and worry about the results.

The 3rd appointment is my first infusion of Zometa. I will have these infusions twice a year for at least 3 years. This drug is currently used for osteoporosis and is also used for people diagnosed with advanced stage cancer that has metastasized to the bone. In my case, it is preventative. It is found to help reduce the risk of a spread to the bone. Though I hope to not have any side effects from this particular drug, some people do have flu like symptoms after the first infusion and sometimes bone and/or joint pain. I can't say I like the idea of going back into the infusion center where I did my chemo, but I will try to remember that I am lucky to be getting Zometa as not everyone has the opportunity. I am happy and thankful to be at the preventative maintenance stage.

Zometa

I had a follow-up appointment with my oncologist today. Among other things we talked about, I asked her about prescribing Zometa for me since I couldn't get into the clinical trial that I wanted to. This is why I love her. She immediately said yes and prescribed semi-annual infusions of Zometa. I will receive my first one on January 13th.

Zometa is a drug primarily used for osteoporosis. However, it has been found to drastically reduce the risk of recurrence to the bone in people with my exact diagnosis--diagnosed young, early stage, pre-menopausal, estrogen positive and taking Tamoxifen. There have been several large studies and it appears that adding Zometa to the Tamoxifen reduced the chances of recurrence by about 30-35 percent. It is not yet the standard of care to prescribe it, but I believe it will be eventually. I am thankful to have a doctor that is willing to work with me. She was voted one of Seattle Magazine's top 3 oncologists and this is why. She lets the patient be part of the conversation.

I'll take 35%. I'll take every 1 or 2 or 10% that I can.