Adult with Breast Cancer Risk Behavior Survey

I am very sad that drinking alcohol causes cancer. I really like drinking alcohol. Even when I hate the taste, I always love the warm feeling of comfort and well being that it brings. The latest study shows that even as few as four drink a week may increase your risk of getting breast cancer. And I'm not talking vodka martinis, my friends. I'm talking vodka martinis AND that wimpy glass of chardonnay that we middle-aged suburban ladies are so fond of, AND everything in between.

I do not believe that I am alcoholic for a number of reasons:

• I never have a drink before 5:00 PM...yea, yea, yea, I've heard the joke...east coast time 
• I never drink alone
• I mostly confine my drinking to Friday and Saturday nights with a group of friends
• I usually do not drink more that 2 or 3 glasses of wine in an evening
• I do not see my aggressive efforts to get that group of friends together religiously every freakin' Friday and Saturday nights as cause for concern

So I spend a lot of time considering the impact of this bad news on my risk of recurrence, or more candidly, on my risk of dying within the next couple of years. I think that I have been aware of studies that indicated that there is an association between breast cancer and alcohol consumption for at least the last ten years. I never did much in response to this knowledge except feel guilty every time I had a drink. In fact, it was my guilt about drinking over the holidays that inspired me to do a punishing breast self exam on January 2, 2011 that got this blog started. 

So it's no surprise that I am certain I got breast cancer from alcohol consumption. You would think that this theory would put the kibosh on drinking, and through chemotherapy it did, mostly because I couldn't stand the taste of it then. Sadly, once I finished chemotherapy, my taste for alcohol returned. 

So I thought it might help to analyze here, in this public place, my risk of recurrence in connection with my alcohol consumption. A fairly pessimistic estimate, I think, of my risk of recurrence is about 20%  (my doctor tells me it is more like 8%, but I think he's just trying to cheer me up.) According to the latest study, drinking an average of 10.0 to 19.9 g of alcohol per day (6 to 12 drinks a week) results in a 22% increased risk of developing breast cancer. Although my average consumption is lower than that, I will continue with the worst case scenario approach. So adding the additional risk of .044 brings my personal risk of recurrence up to about 24%. So what do you think? Check out the new poll on the right. A couple of additional considerations to keep in mind as you place your votes:

• there is no evidence yet that discontinuing alcohol consumption lowers risk
• if I can't drink, life isn't worth living
• the anxiety that I feel with each drink might increase my risk of recurrence
• I am NOT an alcoholic 

Autumn Yoga

Happy Autumn, my friends. I've already written about changing seasons and their nostalgic associations so I won't do that again, but wanted to point out that I've selected a new background for the blog to celebrate the season. Too clever, I know.

So I thought I would give you a sense of what a yoga class with cancer patients is like. I used to like doing "hot yoga" which is basically fast yoga in a room heated to about 98 degrees. I was the least skilled at it, but it was so efficient. I got the benefit of yogic breathing and stretching in addition to the "cardio" that came from trying to keep up with the pace, and mimicking positions that hurt like hell and couldn't possibly have been good for me. But when I was in "downward dog", the resting position, I could see the sweat drip on the mat from body parts that I never knew could excrete sweat. Gross but gratifying.

Yoga with cancer patients is a different experience. I arrive at class five minutes late. No problem. The ladies (it is all ladies - with breast cancer) are still signing in, pulling out mats, strolling back and forth to the bathroom, the water fountain. Fifteen minutes after the class was scheduled to start the group is lined up, standing on their mats facing the instructor. The instructor talks for 10 minutes about the importance of breathing. The instructor tells us to swing our arms around our bodies to enjoy the "stretch" that comes with the slightest twist of the torso. Someone farts. We are instructed to pull up a chair, have a seat, breeaaaatttthhhhh. Stand up, grip the back of the chair, make sure we are well balanced, then (this is the climax of the class)  lean over to "stretch" our hamstrings. Someone farts.

Someone asks, "can you write down these steps so that I can do them at home?" Someone else says, "what a good idea! I only do this "exercise" in class. I should really try to do it more often." Someone farts.

Then the following conversation takes place:

"My daughter-in-law has been doing yoga for years, and she looks fabulous."
"Oh, is that the daughter with the twins?"
"Yes. I spent the afternoon with them yesterday. They are too funny."
"Did I tell you? My son's wife is due in December!"
"You must be so excited."
"Oh, I am. I hope I live long enough to meet the baby."

To those of us still bent over our chairs, the instructor says, "stand up straight and swing the arms to release the muscles, and breeaaaath." "Now it is time to lie down on our mats. Raise the knees and breeeeaaaaath." Relax your toes, relax your ankles (huh?), relax your knees, relax your buttocks, relax your pelvis (once again, huh?), relax your lower back, your stomach, your shoulders, your neck (you'll note one body part we needn't bother relaxing, since for most of us that body part is in a landfill somewhere).

Loud snoring is heard from the back of the room. Someone farts.

Farming Update

Dear Blogees,

BIG NEWS ON THE FARM!

Yes my friends, the hens have blessed us with...an egg. Just look at that thing! Is that beautiful or what! And for a first try it ain't too shabby. The picture below gives you some perspective:

Our is the little one on the end. Stop laughing! Those other, stinky, commercial ones, (though organic, free range, grain fed and whatever) are Extra Large. I would say that our egg would weigh in as Regular? Medium? Who knows. But that is one nice egg, you've got to admit. Check out the artful little speckles on one end.

There's just one problem. What should we do with it? I've got zero interest in eating that thing. I know where it came from and it's not a pretty place.

The husband has a web cam in the coop and he knew that the girls were getting close. So we both spent more time than we should have today checking out the goings on in the coop from our desks. I swear, we saw that girl sitting in her little box (lower left), prepare her little nest, and squat that thing out.

We are very proud egg guardians. I am especially proud of the husband who put in an inordinate amount of labor, love, and money to deliver that egg. When you think about it, that is one precious egg. (I'll have to google cryonics for chicken eggs...) Those birds better get busy if they want to even begin paying us back.

On another matter. I apologize for my last post. I "published" it by accident, unfinished, unedited, un-illustrated. But I guess it doesn't matter among friends.

Be well.
Love, Amy

Still Here

Yes, my friends. I ain't dead yet. I realize it's only been a week or so since my last post, but don't forget that in addition to cancer, there are buses that could run me over, criminals who might slit my throat, snakes that if they came too close could give me a heart attack, and all kinds of other dangers out there that could knock me off, or you off, for that matter.

Don't mean to bring you down. I am feeling rather cheerful this morning, really. The annual physical went okay yesterday, although the suggestions for additional medical consultations could pretty much fill all my time:  dermatologist, bone density, genetic testing, questions for radiologist, questions for oncologist, future appointments with her. Add to that all of the consultations that will be required for exploring and possibly implementing breast reconstruction...you begin to wonder about quality of life after cancer diagnosis. Maybe I should take a walk across the Mass Pike.

Still sounding a bit negative, am I? Okay. This time I will really try. I am looking forward to the day. It is Saturday. The dogs let me sleep in until 7:30. I don't have to see any medical professionals today. The sun is shining. I am looking forward to a fun evening out with the husband. Maybe there's an egg in the chicken coop. My plan for the day is to rip out all of the withering vegetable plants from the garden which will make it look tidy and fertile. (Sometimes I prefer a garden that has nothing in it, to one that is filled with messy, dirty plants.) Tomorrow, good friends are coming to visit.

Phase IV - Life

Dear Friends,

Last Friday was my last day of radiation. Another milestone passed. This week I have no doctors' appointments. I can't say that my feeling is one of pure joy since there is plenty to worry about if I wanted to. For the most part I have been successful in not focusing on the uncertainty and the 10% chance that there are still some devil cells hiding out, regrouping and steeling themselves for the slaughter. But now that I am not receiving very frequent treatment it may be harder to push those thoughts away. On the other hand, every three weeks for the next seven or eight months I will receive a mini infusion of chemotherapy, and every day for the next five years I will take an oral form of chemotherapy. I will also see my oncologist every six weeks. So my treatment isn't exactly over, which is some comfort.

The one thing that doesn't happen with this cancer is regular CAT scans - at least at this stage. This is a relief. I guess they figure that no good will come from discovering renegade tumors after all this treatment. If those nasty, little cells were able to survive eight months of chemo blasting, we might as well give up since no amount of early detection will save me.

I have my annual physical next week. Remember the jealous internist who was sad about missing all the cancer drama? Well she's making me come in the first week of October. I know it is silly, but I am terrified of that appointment. I am sure she will find a new cancer threat to worry about. Cancer, cancer, cancer. Every health professional on the planet is so eager to find cancer: the internist looks for lumps and tests your blood hoping to find whacked out readings that might suggest there are tumors in your kidneys, your liver, your intestines or your blood. The gynecologist also enjoys finding internal malformations and taking cells out of your personals to look for cancer. The dermatologist looks for god-only-knows what since every blemish on the body looks like cancer to me. Even the dentist likes to do a kind of mammogram of your head to look for tumors in the jaw or some crazy place. There is no limit to the creativity of cancer to find new body parts to chew up. You got to admire it, really. Cancer has every characteristic that my father used to try to grind into me: determination, tenacity, guts, imagination...no wonder it is so successful.

So the question is what to do with this blog. The original idea was to keep you all posted on my progress. Now that the treatment is pretty much done and there is nothing to do but wait to see how long I live, there won't be much to report until something terrible happens, in which case I may not feel like writing about it here. On the other hand, if I don't write this blog you might think I'm dead. You could just assume I am alive until the husband posts an epilogue on the blog. Another option is for me to write occasional, boring updates on my gloriously, humdrum existence. Lets go with the last option...for now.

Thank you all for supporting me through this ordeal. Your help with meals, gifts, companionship and kind words made me feel more lucky than unlucky. Thank you also for reading and commenting on these posts and for letting me know that now and then they made you laugh.

Until the next time I have something to say...

xoxoxox

The End of a Season

I read a poem every morning, thanks to The Writers Almanac sponsored by American Public Media. Today it was Robert Frost and it caught the mood of what I wanted to write about in this post.

Reluctance

by Robert Frost

Out through the fields and the woods
And over the walls I have wended;
I have climbed the hills of view
And looked at the world and descended;
I have come by the highway home,
And lo, it is ended.

The leaves are all dead on the ground,
Save those that the oak is keeping
To ravel them one by one
And let them go scraping and creeping
Out over the crusted snow,
When others are sleeping.

And the dead leaves lie huddled and still,
No longer blown hither and thither;
The last lone aster is gone;
The flowers of the witch-hazel wither;
The heart is still aching to seek,
But the feet question 'Whither?'

Ah, when to the heart of man
Was it ever less than a treason
To go with the drift of things,
To yield with a grace to reason,

And bow and accept the end
Of a love or a season?

"Reluctance" by Robert Frost, from A Boy's Will and North of Boston. © Penguin, 2001. Reprinted with permission. (buy now) 

September. The sad music of the nighttime crickets brings back years of memories of lying in my childhood bed the night before the start of a new school year. I felt so sad about the end of summer in those days. I thought of summer as a time when I didn't have to worry about homework and could play with friends any day of the week. It wasn't that I disliked school so much, but that last night before the new school year began I imagined I would feel homesick that next day, that I would miss my mom and swimming and playing "My Side of the Mountain" in the woods. This is a feeling that is ingrained in me. Every September I am haunted by a back-to-school anxiety and "reluctance" even during those few years of my life when the crickets heralded no change to my routine.

So why does the end of summer make me feel so blue? Might it be the loss of long and lazy summer days? That is NOT it. The pace of my summer day is closer to that of a labor camp than that of a day at the beach. Hours spent pulling at the billions of stinkin' weeds which threaten to strangle all living creatures on my property, or dragging two miles of hose around the yard with arms connected to a recently mutilated torso, are enough for me to long for snow-bound, winter days trapped in my office.

Is it the loss of having my darling children near me all day long? Those sweet little voices chiming pleasantly throughout the house atop of summer breezes floating through the window screens? I don't think so. Take for example the greetings I am likely to receive after the daily trip to the grocery store that is required when my voracious offspring are in residence. "Mommy! You forgot to buy that critically important, incredibly exotic, habanero, tequila spiked, roasted chipolte hot sauce I need. I've asked you to buy that five times already!" Or, "Don't tell me you forgot to go that store that is about 20 miles out of your way to buy that bottle of probiotic organisms that costs about $90.00 but that is absolutely critical to maintaining the natural balance of my intestinal microflora?"  No, I don't think it is the cheerful family banter that I miss so much.

Perhaps it is the shared pastimes of summer that I miss. Such as when my darlings "share" with me their gigantic towers of laundry that they have been saving up until they have worn their last pair of 13-year old underwear twice. Probably not. I feel like passing out when I see their sheets. My daughter's look like several people were slaughtered with a dull knife in her bed. And my son's look (and smell) like they had been used to clean out the chicken coop.

Could it be the colorful clutter that charmingly adorns their bedrooms and that makes me shudder with repulsion every time I accidentally allow my eyes to shift in their direction when I walk by? Not likely. It took me weeks to remove from their rooms the empty seltzer cans, dirty coffee mugs, shreds of tampon and razor packaging, crumpled sheets of notes on topics like "Dance and Society: 1960 - present" (Jesus, what are we paying for!?) or "World Politics" (huh?), and most horrifying of all, a large, albeit unopened, box of condoms.

So I am reminded of another "poem" of sorts - one perhaps that my daughter might have "danced" to last semester....

One less bell to answer
One less egg to fry
One less man to pick up after
I should be happy
But all I do is cry...
Songwriters: Hal David;Burt Bacharach

Phase III - Radiation

So I haven't told you about radiation. I don't like it. Before I started phase III of this adventure, I had the impression that radiation was a piece of cake by comparison to surgery and chemo because it didn't hurt, it didn't make you nauseous, it didn't make you bald, and it didn't mess up the nerves in your hands and feet. But, as it turns out, it's not that much fun.

My chemo experience includes sitting in a chair that looks like something you might test drive at a Brookstone store in the mall, complete with massage functions and heat. The minute I sit down, the staff gently covers me with a heated blanket. Volunteers come round to offer reading materials, snacks and drinks. While I sit enjoying the heated massage, I read an absorbing novel, like Ann Patchett's State of Wonder, for example, which takes me far away to a land without cancer, needles, chemicals, death (well, perhaps I could have picked a better example than a book about human subjects experimentation, but you get the point...).  From an upper floor of the hospital I have a million dollar view of the Boston skyline through clear, enormous windows. Now and then someone comes by to check on me, or to switch the bags of medicine (I no longer think of it as poison - how can I?) It's a little like flying first class. You don't really want to be spending all this time cooped up in an airplane, but if you have to do it, it's nice be treated like a VIP.

By contrast, my radiation appointments are in the basement of the hospital, which has me thinking that the stuff they do in that department is so dangerous they need to keep it underground.  The procedure requires that I strip down to my waist and put on one of those detestable hospital johnnies. I then sit in a waiting room, along with other ladies wearing ugly johnnies. This part of the ordeal brings back terrifying memories of mammograms. When my name is called, I walk into a dark room with a giant, spooky machine that looks like some kind of prehistoric monster. I lie down on a hard table that has a funny bump in it that my butt is supposed to rest against, but always seems to hit in just the wrong place. There are at least four technicians scurrying around the room officiously. One of them removes the johnny from the part of the body that is going to be radiated. They call out numbers to each other, they jerk my body around to line it up properly. They draw little blue marks all over my skin. They talk and move as if they are conducting a complex military maneuver. Then they all scatter from the room, leaving me to take the "heat" alone.

After the technicians are safe and sound in another room, I hear strange noises that alternate between those associated with the moving machine and those of the radiation beams shooting out, I guess. I'm too freaked out to watch what is going on. I lie there with my eyes closed knowing that parts of me are in the line of fire. I worry that the movement of my chest as I breath will result in collateral damage. I try not to breath. I am so oxygen deprived I feel the need to take a really deep breath but don't. I feel like passing out. And then it is over.

If I were to look on the bright side, however, I appreciate that the treatment itself takes only about 15 to 20 minutes most days. And, so far, I have no side effects, although I am told to expect burnt skin and fatigue.

Yesterday, my treatment was cancelled. The radiation machine was broken. Apparently getting your radiation machine fixed is about as easy as getting your refrigerator fixed. All day long the radiation technicians were calling me giving me updates on the repairs, the likelihood of getting replacement parts, the vagaries of the radiation machine repair people's schedule... In the end, they cancelled my appointment for that day.

The machine was still not fixed this morning. The radiation staff seemed stressed.  At 7:00 AM, I got a call from one of the technicians telling me that the machine was still not fixed. I got the impression that it would be super dangerous if I were to miss another day. I started to panic and began thinking that I should look around for another radiation machine that worked. Before I got too far with that strategy, I got a call that the machine was operational, and I should come in.  I sped into town, practically starved for my next dose of radiation. Shoot me up, monster machine.