Bottoming Out

While we had hoped that things were getting better on the day of Marce's haircut (Wednesday), things took a turn for the worse on Thursday with heavy aching, headaches, and fatigue. On Friday we met with Dr. Kaplan for her 10 day checkup from her first infusion. It turns out that day 10 is when blood levels tend to "bottom out". They primarily look for 3 things - red blood count, platelets, and white blood count. She was good in the first two areas, but her white blood count had dropped to 1.1 from 3.4, which is below average and a bit of a concern. Unfortunately white blood count has nothing to do with her aches, fatigue, etc., rather with her immune system's ability to fight off infection. Hence, Dr Kaplan has recommended she avoid going out in public for the next 4 days to avoid exposure. So we are all taking vitamins and washing our hands like crazy to prevent Marce from getting sick. As of today (Saturday) she is feeling slightly better, but still basically bedridden. Dr. Kaplan says she is unfortunately reacting harder to her chemo than the "average" person, but thinks she should improve this coming week.

Today is also Marce's birthday. We had a gluten-free cake that Michelle baked and watched the movie "Enchanted" while Marce popped Advil for her pain. While not her best birthday ever, we hope that her suffering will provide her with decades more birthdays to celebrate with family and friends.

On a different note, Michelle is taking driving classes from Swerve, a local driving school. She meets twice weekly for "ground school", then takes flight one to two days per week in cute, boxy Scions. While Michelle cringes at the Scions, we think they're great. Here's a few pictures of Michelle getting ready for flight #2 with her flight instructor. Go Michelle!

Marc

Michelle prepares for "takeoff" with her instructor!

Michelle in the "cockpit" of her cute driving car!

The New Doo

Today, Marce turned the corner and "crawled out from under the rock she's been living under" --at least that's how she's felt lately! We're all so happy to have her back in action. It was an extra-special day with Barbara, my mom, swinging by to pick her up and whisk her off to trendy Belletown, in downtown Seattle, to treat Marce to a haircut. Sinclair, the swank owner of "Halo", has been cutting Mom's hair for 27 years. After watching him in action and seeing the results, Marce now knows why she's stayed with him for so long. Marce commented after the haircut that she hasn't had her hair this short since she swam competitively because people thought she looked like a boy. Well, you can probably guess what she heard upon arriving back home. Yep...Marina immediately blurted out, "Mommy, you look like a boy!", which gave her a big laugh. Marce responded, "Sweetie, you ain't seen nothing yet!" It will be interesting to see how she reacts to Marce losing her hair in another couple weeks. While we are sending Marina back for remedial sensitivity training, it didn't matter to Marce because she loves her new style. And the rest of us think she looks beautiful! Marce also had a nice talk with her mother tonight, who encouraged her to keep up with the chemo plan. So, with a bit of a spring in her step, Marce is now gearing up for round two in a couple of weeks.

Marc

Side Effects

I am posting this Tuesday morning since some of you might be wondering how Marce is doing with her treatment. Things are not going as well as we had hoped, but we hope they will improve since most people have side-effects with this chemo on days 3-5, which would have been Friday- Sunday. On Thursday evening Marce started feeling significant side-effects from the chemo, which was pretty much per the "schedule". It started with an aching in her scalp, then moved to give her symptoms which would resemble a bad chemo "flu". Aches, pains, and a headache were the center of her side-effects. She has also developed neuropathy in her body, which usually manifests itself in tingling of the fingers. Instead she has what I call "voodoo doll" pains, where she feels like sharp knives are jabbing her all of a sudden. The episodes tend to come in clusters, and the sensations happen all over her body in an unpredictable fashion. She had had little improvement in the side-effects as of now.

We appreciate your thoughts and prayers that her side-effects will diminish quickly.

Thank You!
Marc

Successful First Chemotherapy

Marce successfully completed her first regime of chemotherapy. Following a blood test to establish her baseline, we first met with Dr. Kaplan who went over the specifics of treatment. Prior to receiving chemo, she received three pre-treatments to help minimize the side-effects. One of them, for example, was an anti-nausea medication. She then took her two chemotherapy drugs in succession rather than at the same time. The first one was Taxotere, which is a synthetic form of Taxol, which comes from the Yew tree. They administered all drugs via IV, starting out slowly to make sure there weren't any negative reactions. The second chemo drug was Cytoxan, which was administered at a faster rate. Marce had a few minor reactions but nothing major. A bit of a minor headache and blurry vision were the most significant effects. So what ended up being a 7 hour experience today should become a 2-3 hour experience the next time she comes in.

If she follows the typical course, she should feel fine tomorrow (Thursday) and then tired on Friday and Saturday, recovering Sunday. But every one is different and there are possibilities for more significant and severe reactions. We appreciate your thoughts and prayers that her side effects would be minimal.

Marc

Hunt for the Perfect Wig

Now that Mom has decided to move forward with chemo, we can’t have her going around bald for three months. So we set out on a couple of wig expeditions the last few days. With so many cute wig styles to choose from, I don't see why we all don't go bald and have perfect hair-dos in just seconds! Wouldn't that make life so much easier? The first hair salon we hit had a nice selection of wigs filling the wall. What do you think of these wigs?

Picture A)

First wig! But not the right color

Picture B)

Wow, Mommy in blond! Wouldn’t she get some funny stares if she walks into church with this one?!

I wonder if Madeline was having more fun than Mommy

The second shop we visited contained around 2,000 hair wigs! Imagine the excitement of five girls walking into a galaxy of perfection. We definitely liked this shop’s selection the best. Hmm, where should we start?

Picture C)

This one looks similar to Mommy’s hair cut

Picture D)

I have never seen Mommy’s hair so short before, but it won’t be the last. We all were a little surprised when she popped the wig on. Sorry, about Marina in the back. It’s one of her interesting poses!

Picture E)

Oh, definitely a possibility!

Picture F)

Picture G)

I think you will all agree with me that this is the perfect wig for Mommy!!! Won’t it bring out her sparkling blue eyes?? :-) Besides, she has always wanted curly hair and you can’t get curlier than this.

Michelle picks out Mommy’s new eyelashes. I wonder how they stay on. Yikes, they are WAY too long!

Picture H)

This is definitely my favorite!

Please vote for your favorite hair wig by using the letter above each picture and writing it in the comments. We would greatly appreciate your in-put!

Only one more day to go...

~Meagan

Chemo countdown

Well, after a week of countless prayers and petitions to God, researching into the "wee hours of the night", and many conversations with doctors, friends and family, the decision has finally been made. Marce starts chemotherapy treatments on Wednesday, March 26th and, if everything goes as planned, should finish up on Wednesday, May 28th.

As a reminder, the chemotherapy's purpose is to destroy any rogue microscopic breast cancer cells which may have spread someplace in Marce's body prior to her mastectomy. One of the things we have learned is the smaller the total number of cancer cells, the better chance the chemotherapy has of killing all of them. This is true because single cells have plenty of nutrients and oxygen, and divide more rapidly than larger cancerous masses, which have fewer resources to draw from. And it is during the process of cell division that the chemotherapy can destroy the cancer cells. But should Marce decide to wait and see if the cancer returns, it would likely be 1-5 years later until it could be detected. At that time any tumor would be much larger and therefore more difficult to obliterate with any treatment. Hence, now is the most effective time to take chemo. It is somewhat paradoxical that she is taking chemo for a cancer that might not be a threat because it it too small. But, given her relatively young age, we have decided to hope for the best but prepare for the worst. The worst is that there are indeed undetected cancer cells in her body.

A friend of ours from Australia had breast cancer almost two years ago, and undertook the exact same chemo treatment which Marce will take. It is called TC, which is short for 2 poisons (I mean drugs) called Taxotere and Cytoxan. She will take four intravenous treatments every three weeks, the first of which will take four hours to administer. Although TC is one of the less-aggressive types, our Australian friend has given us her blow-by-blow account of what to expect. It will not be pleasant, and will probably knock Marce out of commission for five days following the administration. She will lose her hair between weeks 2 and 3, be tired, and experience digestion problems. She may experience a metallic taste, darkening of the nail beds, numbness and tingling of hands and feet, muscle and joint aches, etc.--not a cakewalk!! In between treatments she should feel better, but it will likely be 3 months of living under a dark cloud. It is our hope that all of this will enable Marce to be around for decades to come.

This has been an unusually tough decision for Marce, as she rarely will take even over-the-counter medicines because of their potential long-term side effects. If an aspirin is like a bullet, she is about to voluntarily submit to a nuclear explosion. We have both wrestled hard with the modern medical treatments versus alternative treatments. While we think alternative treatments have much to offer, they do not have the statistics to back up their effectiveness. We are using our brains to decide on the facts and our hearts to trust God Who is our ultimate Physician and Healer.

We are thankful for your prayers and support!

5 days and counting...

Marc

Onco DX Test Results

Yesterday (Friday) we met with Dr. Kaplan who gave us the results of Marce's Oncotype dx testing. This test provides us with the likelihood that her cancer will reappear with and without hormonal and/or chemotherapy. This website gives a good overview of the test.

http://www.genomichealth.com/oncotype/about/what.aspx

While the test scores were not bad, they weren't as good as we and Dr. Kaplan had hoped. Prior to yesterday's test results, Marce's "recurrence risk" was estimated to be:

Do Nothing 15% chance of cancer returning in her life
Hormonal Blocking Therapy (i.e. Tamoxifen) 8%
Hormonal + Chemotherapy 5-7%

Based on that, Marce was mentally gearing up to take Tamoxifen, but not thinking chemotherapy since it would only provide an insignificant benefit of 1-2%. The new numbers from the Onco DX testing are:

Do Nothing 30% chance of cancer returning in her life
Hormonal Blocking Therapy (i.e. Tamoxifen) 13%
Hormonal + Chemotherapy 8-10%

Dr. Kaplan said we are in the 'grey zone' in his thinking about whether to do chemo or not. He definitely recommends Tamoxifen, but the chemo decision is a personal risk decision about the small but significant improvement provided by chemo. Its the old trade study of short term pain vs. long term benefit. This has significantly changed things to the point where Marce is now strongly considering chemotherapy. If she does elect chemo, the good news is that the specific therapies Dr. Kaplan would recommend are the most mild forms of chemo. There are two choices she has, which are:

Opton 1 - CMF http://www.chemotherapy-info.com/cmf.htm
Pros
- The least side effects, with tiredness lasting about 1 week per month for 6 months
- Only 30% chance of losing her hair
Cons
- 6 month treatment

Option 2 - TC http://www.breastcancer.org/treatment/chemotherapy/new_research/20060217.jsp
Pros
- Tiredness is typically shorter, around 3 days, rather than 7
- Half the treatment duration as CMF
- Similar benefits to CMF
Cons
- High probability of hair loss
- Side effects can be tougher than CMF, although still mild for any chemo

The other thing Dr. Kaplan said is that if the cancer does come back, regardless of whether she does chemo now or not, then it will be very difficult to beat. If she is ever to do chemo, now is the most effective time. Given that she is relatively young, we want to maximize her longevity. Plus it will be easier for her to recover from chemo now than, say in 10 or 20 years if it were to reappear. So, with all of that, we are both currently thinking that the small but significant 3-5% improvement in survivability is worth 3 months of the relatively mild inconvenience of chemo side-effects. Additionally, we have found a great naturopathic doctor who specializes in cancer oncology, and he has given us some good information and supplements which will further help Marce's survival.

So, where we find ourselves today is that Marce will definitely do the Tamoxifen, which is 5 years following chemo. While still uncertain about the chemo, we are leaning that direction based on the above information. We would appreciate your prayers that God would give us wisdom and peace about whatever Marce finally decides.

Marc