Continuing on with Herceptin

Although done with chemotherapy, I will continue on until mid-November with the Herceptin infusions. So, I've been doing more research into Herceptin or Trastuzumab. Trastuzumab (trade name Herceptin) is a monoclonal antibody that interferes with the HER2/neu receptor. The HER receptors are proteins that are embedded in the cell membrane and communicate molecular signals from outside the cell to inside the cell, and turn genes on and off. The HER proteins regulate cell growth, survival, adhesion, migration, and differentiation—functions that are amplified or weakened in cancer cells. In some cancers, notably some breast cancers, HER2 is stuck in the "on" position, and causes breast cells to reproduce uncontrollably, causing breast cancer. Trastuzumab reverses the effects of an overactive HER2 receptor.

The original studies of trastuzumab showed that it improved survival in late-stage (metastatic) breast cancer, but there is controversy over whether trastuzumab is effective in earlier stage breast cancer. Trastuzumab is also controversial because of its cost, as much as $100,000 per year [yikes!], and while certain private insurance companies in the U.S. and government health care systems in Canada, the U.K. and elsewhere have refused to pay for trastuzumab for certain patients, some companies have since accepted trastuzumab treatment as a covered preventative treatment.

Since it is possible to determine the "erbB2 status" of a tumour, that information can be used to predict efficacy of treatment with trastuzumab. If it is determined that a tumour is overexpressing the erbB2 oncogene and the patient has no significant pre-existing heart disease, then a patient is eligible for treatment with trastuzumab. It is surprising that although trastuzumab has great affinity for the receptor and the fact that such a high dose can be administered (due to its low toxicity) 70% of HER2+ patients do not respond to treatment. In fact resistance is developed rapidly by treatment, in virtually all patients [so the odds are against me?].

Some recent clinical trials have found trastuzumab reduces the risk of relapse in breast cancer patients by 50% when given in the adjuvant setting (i.e. after breast cancer surgery, before the cancer has spread any further) for one year. Even among the 20% of first-time breast cancer patients for whom trastuzumab is an appropriate treatment, the actual net benefits are not overwhelming when viewed in terms of all-cause mortality. All-cause mortality helps balance a reduced risk of death from cancer against the increased risk of death from a treatment's side effects. Repeated, large-scale studies show that it is usually necessary to treat between 25 and 100 patients to prevent a single death during the next two to four years. For each life saved, between ten and 25 patients will develop heart disease; despite effective treatments, some of these patients will die from heart disease [Great, even more good news!]

The optimal duration of adjuvant trastuzumab is currently unknown. One year of treatment is generally accepted as the ideal length of therapy based on current clinical trial evidence that demonstrated the superiority of one year treatment over none. However, a small Finnish trial also showed similar improvement with nine weeks' of treatment over no therapy. Due to the lack of direct head-to-head comparison in clinical trials, it is unknown whether a shorter duration of treatment may be just as effective (with less side effects) than the current accepted practice of treatment for one year. [I just love being a guinea pig] Debate about treatment duration has become a relevant issue for many public health policy makers due to the high financial costs involved in the administration of this treatment for one year. Don't you just love modern medicine?

Whip It vs. Reality

I'm finally feeling better and was able to go to derby practice this morning. Since I write about Roller Derby a lot you may be asking this question - How well does the movie Whip It capture the sport of modern roller derby? The answer: Pretty well! While there are a handful of Hollywoodisms -- for example, a coordinated everyone-stop-dead-and-throw-an-elbow is not a viable tactic in today's derby -- on the whole, the action is represented fairly accurately. Perhaps more importantly, the film does a pretty good job of demonstrating how meaningful the derby community can be for its members. Modern roller derby provides a unique opportunity for the thousands of people who've become involved as skaters, referees, stats, and support crew to live without labels and do something bold.

So many little details ring true: derby names, comparing giant bruises, the terror/excitement of tryouts, the newfound family of the derby team, the mild lunacy of the after party, the not-about-winning/actually-no-it's-about-winning progression, the toll derby can exact on existing friendships, the newfound confidence, Bliss's "I... am in LOVE with this" moment -- all are completely familiar to modern derby participants. If there's anything not quite on the mark about the film, it's the age of the protagonist. While the camaraderie of the derby community often spurs its members along the journey of self-discovery experienced by 17-year-old Bliss in Whip It, the real-life protagonists are most often women in their 20s, 30s, and even 40s.

One other key difference: with a handful of local exceptions, physical fights are essentially extinct in modern roller derby. Today's audiences are just too savvy to be taken in by an old-school scuffle, wherein hits to delicate areas are carefully avoided. Fake fights are obvious, but real fights are dangerous -- and don't win bouts. If you've seen a roller derby bout, or watched videos of modern roller derby online, you may have been surprised to see the sport played on a flat floor surface, rather than the traditional banked track of classic roller derby. While a handful of local leagues use banked tracks (as portrayed in the film Whip It), over 98% of the 400+ leagues playing modern roller derby around the world skate on flat surfaces.

The viability of roller derby without a banked track was discovered almost by accident, during the reinvention of the sport in Austin in 2001-2003. To raise funds and stir interest, the first skaters organized exhibition bouts in a skating rink, with an oval track taped out onto the floor. Much to everyone's surprise, they discovered that roller derby actually works just fine on a flat track. While the speeds are lower, the hard hits remain, and the lack of an outer rail means a solid hip check to the outside can send a skater sliding all the way to the edge of the audience. Not even basketball provides quite this level of audience proximity to a spectator sport. Despite the challenges, a few modern leagues have made a go of it on banked tracks, including the L.A. Derby Dolls, Red Dirt Rebellion in Oklahoma City, and the TXRD Lonestar Rollergirls in Austin.

Cancer as a change agent?

As a cancer survivor (can I say that yet?) I now think of life as B.C. and A.C. -- for, of course, before cancer and after cancer. Once you've coped with cancer, life isn't the same. Survivors will often talk about major and minor overhauls of their lives--from taking another look at their family life and other relationships to switching jobs, finding an entirely new career or pursuing new leisure activities. While I know at some level that life is finite, I had never thought about it as concretely or as frequently as after my diagnosis of breast cancer. I am acutely aware of our limited time on earth. Mortality is, quite literally, in my face. The cancer experience affects your perception of time (I always say time flies while you're having cancer). I am suddenly impatient and acutely aware of my frustration at spending time on things I have always perceived as meaningless—only now they seem more so. Whenever you have a more acute sense of time being finite, you start to think more and more about what matters to you and how you want to spend your time. Trite as it may sound, cancer truly is a life-changing event. Often, someone who has weathered a cancer diagnosis comes through treatment much stronger—and ready for change.

No one says, "I'm glad I got cancer." But it has changed the way I look at my life, the way I handle relationships, my career, everything. My reaction is considered typical. Mental health experts who work with cancer survivors say it's common for people to seek out more creative, and therefore meaningful, avenues of work or leisure. It's typical to hear an investment banker say she'd like to be a poet, but much less rare to hear a poet decide to become an investment banker. For many people trying to shift to a more meaningful job or career, money becomes secondary--despite the fact that medical bills may be overwhelming. I have a sense of "forward propulsion" that comes out of this experience, a sense that the sickness, hopefully soon to be in the past, is perhaps one of my greatest motivators. And, with some patience and planning, the end of my cancer story will be a happy one, complete with more meaningful relationships on and off the job.

Sick and tired of "feeling" like a cancer patient!

Today Hannah noticed that I lost a lot of my eyebrow hair. I then explained that I lost hair pretty much everywhere. Yes, I mean everywhere! It seems that I actually retained more on my head than anywhere else. I'm not sure exactly how that happened. Not that I'm complaining about having nice smooth legs, though. Hair loss does not occur with all chemotherapy. Whether or not your hair remains as it is, thins or falls out, depends on the drugs and dosages. I was told that my hair would fall out and most of it did, but some remained. I also discovered that my toenails are messed up! I'm experiencing what they call onycholysis, which is the separation or loosening of a fingernail or toenail from its nail bed. Most of them look like they are about to come off! All of these skin reactions are temporary and eventually resolve once the drug causing the change is stopped and the affected nails grow out (this may take weeks to months). Yikes, can you imagine no toenails for months?

I am still so tired and weak from this infection. Since I finished my chemo regimen and because my white blood cell count was high, they decided not to give me the Neupogen shots. It makes me wonder if they should have? White blood cell boosters are drug therapies that are similar to substances produced by the body. They can help your body make more of its natural white blood cells to help protect against infection. White blood cell boosters can be administered one day after chemotherapy, starting with the first cycle to help strengthen your body's natural defense system and reduce your risk of infection. Neutropenia, or low number of a certain type of white blood cells, is a common side effect of some types of chemotherapy and can disrupt your chemotherapy schedule. By receiving white blood cell booster right from the beginning of chemotherapy, white blood cell counts may return to a sufficient level faster, thereby reducing your chance of infection. So, what the hell happened here? I am so sick and tired of "feeling" like a cancer patient!!!

An ex-boyfriend, Burt Reynolds and a boatload of kids

Yet again my dreams are trying to tell me something. Maybe because I have felt so incredibly bad these past few days and for the first time during this cancer journey, I actually thought that I was dying. The good news is that the echocardiogram showed that I do, in fact, still have a beating heart, which makes me "officially" alive. Sadly, I'm not feeling up to Roller Derby practice tonight and that just SUCKS! I think they have finally infused enough toxins into me to actually kill me! Anyway, I dreamed that I was at an ex-boyfriend's house with Burt Reynolds (Geez, of all the celebrities I could dream of I choose Burt Reynolds?) and a boatload of kids. Apparently, I was in charge of all of these children (thankfully they weren't all mine!).

To see an old ex-boyfriend from childhood in your dream, refers to a freer, less encumbered relationship. The dream servers to bring you back to a time where the responsibilities of adulthood (or marriage) didn't interfere with the spontaneity of romance. You need to recapture the excitement, freedom, and vitality of youth that is lacking in your present relationship. To see an actor or actress in your dream, represents your pursuit for pleasure. Your admiration of a particular celebrity may lead to a desire to have some of their physical or personality traits (doubtful, he's an abuser). Consider also who this actor/actress is and what characteristics you associate with him or her. These may be the same characteristics that you need to acknowledge or incorporate into yourself (he is considered quite the storyteller). The dream may also be a pun on his or her name. To see children in your dream, signify an aspect of yourself and your childlike qualities. You may be retreating back to a childlike state where you are longing for the past and the chance to satisfy repressed desires and unfulfilled hopes. Perhaps there is something that you need to see grow and nurtured. Take some time off and cater to the inner child within (Roller Derby perhaps?). Alternatively, the dream may be highlighting you innocence, purity, simplicity, and carefree attitude.

In our dreams, we can go anywhere, we can be anybody, and we can do anything. When we dream, we are like passengers on a moving train, unable to control our actions and choose surroundings. We let our mind take over. Sometimes, dreams can be understood in the the context of repressed thoughts. Dreaming serves as an outlet for those thoughts and impulses we repress during the day. When we go to sleep at night and slip into our dream state, we feel liberated and behave and act in a manner that we do not allow ourselves in our waking life. Here's to sleep!

I'm here for you so don't be scared...

I'm almost upright at this point! I cannot believe how unbelievably rotten I have felt. The worst part about this bull**it cancer is what it is doing to my family and friends. I have clearly seen the fear in their faces these past few days while I have been so sick. I can try to reassure them that I will get through this and be just fine but they are only words. I think that the person diagnosed with cancer actually has an easier time than do family and friends. Having experienced that paralyzing fear after Mike's accident does give me some insight. It's the fear of being left behind and adrift. What happens to me? How do I carry on? There really is no way to take away that fear.

See, a diagnosis of cancer changes a family forever. Figuring out what's for dinner or what your plans are for the weekend are suddenly less important. Family and personal values are questioned and priorities are tested and changed. Unsettled feelings and arguments may resurface during a family's struggle with cancer. Often a family must sort out and revisit old, unresolved feelings before they can start to battle cancer together, as a family unit. Cancer can cause role changes in the family, too. The head of the household may now be more dependent on other family members. Others may need to work outside the home or work different hours. When family members take on new roles, the way they interact within the family can change. New responsibilities may overwhelm some family members.

Parents might look to their children for support. If the children are old enough, they may be asked to take on more responsibilities within the household (thankfully Hannah now has her license). These requests often come when children themselves need support. How a family handles cancer is depends a lot on how the family has dealt with problems in the past. Those who are used to communicating openly and sharing feelings are usually able to talk about how cancer is affecting them. Families who solve their problems as individuals instead of a team might have more trouble coping with cancer. Cancer treatment includes care for the patient and the family, not just the cancer. I'm still trying to find the balance of taking care of myself and taking care of them. I don't think I've been taking very good care of them lately.

Whatever happened to mind over matter?

I hate it when I am wrong. I don't mind admitting when I'm wrong, I just hate being wrong! I was so sure that I could "outsmart" chemotherapy and feel just fine by using mind over matter. Mind over matter is a phrase popularized during the 1960s and 1970s that was originally used in reference to paranormal phenomena, especially psychokinesis. However, it has also been used in reference to mind-centric spiritual and philosophic doctrines such as responsibility assumption. It is the belief that the mind is more powerful than the body. Specifically, mind over matter refers to controlling pain that you may or may not be experiencing, such as holding your hand under extremely hot water and feeling no pain. Also, "self-help" personalities such as Tony Robbins claim that, through the power of concentration and "positive thinking", people can walk on hot coals without getting burned.

I have utilized this phenomenon many times in my life. Like the time in Junior High when Randy Higbie put itching powder down my back. Now itching powder isn't really a powder, but actually looks like hundreds of tiny slivers. It will just keep itching and itching until it can be washed off. Well, that afternoon I decided that I wouldn't give him the satisfaction of scratching, so I willed myself not to scratch. He was actually quite impressed with my ability to withstand the agony. But, when I got home, I made my mom scratch my back for what seemed like hours until the itching subsided. My question is, was it worth it? I sat with that crap down my back for at least 2 hours, refusing to scratch!

So, today I went to the clinic because I felt so god-awful. I think I have only felt this bad once before and that was when I had meningitis (yes, a very scary thought). They say this could very well be the cumulative effect of chemo and to ride it out. Of course the doctor was running behind today so, as I was laying across 3 seats in the waiting room trying not to spew bodily fluids everywhere, I surrendered to the chemo. Yes, chemo wins! I will allow my body to feel the effects and let them dissipate naturally.

I caught a damn cold!

They have been telling me all along about how chemotherapy suppresses the immune system and to be careful. I made it through 5 rounds of chemo without even a sniffle but finish round 6 of chemo and wham, I caught a damn cold somewhere. During treatment for cancer, there are times when the body will not be able to protect you as well. While your immune system is recovering, you may be told to try to avoid being exposed to possible infection-causing germs. Cancer and its treatment weaken the body's immune system by affecting the blood cells that protect us against disease and germs. As a result, your body cannot fight infection, foreign substances, and disease as well as a healthy person’s body can.

The immune system comprised from immune cells, like white blood cells, antibodies and other substances that fight against microbes and thus defend us against infections. People with chronic diseases, like diabetes or cancer, or those exhausted from long lasting hard work, starvation or psychological stress may also have lowered immunity and therefore frequent infections. So, now I feel like shit because of this cold, not because of chemo!

Then, as I was messing around on the Internet, I discovered this interesting news: The common cold may do more than just bring on a nagging case of the sniffles. Researchers at Saint Louis University School of Medicine have discovered that a genetically modified version of the adenovirus, one of 200 viruses that cause colds, may work to attack and destroy cancer tumors. In lab tests, when the live virus was injected directly into a tumor, it worked to destroy cancer cells, apparently without seeming to affect healthy cells. Researchers speculate that, unlike chemotherapy and radiation, cold-virus treatment may have no significant side effects -- not even a cold. That's because the virus remains in the tumor and does not travel to the respiratory tract, says lead researcher William S.M. Wold, PhD, chairman of the department of molecular microbiology and immunology. The therapy is expected to go into clinical trials next. If it's proven safe and effective, it could become a treatment option for any type of cancerous tumor within a few years. Too bad they didn't discover this sooner!

The aliens are leaving the body!

I am happy to report that I did feel well enough to attend derby practice this morning! I woke up starving this morning which is always a good sign, so I grabbed a quick bite to eat, grabbed my skates and headed to practice. At practice, I got wiped out during a scrimmage, landing on my butt and hitting my head! I guess that's what protective gear is for! Now my right butt cheek is very swollen and bruised but you know what, I'm not very bothered by it. Yeah, it hurts but that's what you gotta expect in Roller Derby. And since Derby makes me feel "alive", it'll take a lot more than that to keep me away. After practice, I took my sore and bruised butt out to lunch with my mom, who comes down every time I have chemo, and my sister. They had come to see me at practice this morning (mostly to keep an eye on me I think!) But I enjoyed our lunch very much. After lunch I went home, took a hot shower and settled down with a good book (Randy Pausch's The Last Lecture).

Then about 3 pm, the alien baby started acting up! Again, he managed to scare the dog. Poor Harley looked startled, jumped up and ran away! He went and hid in the corner. But when the alien baby starts acting up and growling, it's a sign that I had better be close to the bathroom. And then about 6 pm, it started. The toxins started to pour out the body. Don't get me wrong, you want the toxic chemicals out of your body as quickly as possible but that's what zaps all your energy. I'm starting to feel fatigued but luckily have nothing pressing on my schedule for the next few days. I know that I can get through this last go-round with chemo as I've done it 5 times before.

Now lets just hope the side effects from Herceptin alone are not as severe. According to the Herceptin website, Herceptin is not chemotherapy. Once you finish chemotherapy and are receiving Herceptin alone, many of the chemotherapy-related side effects will likely go away or be less severe. But the most common side effects associated with Herceptin are fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain. We won't know if the effects will be less severe until after March 12, when my first dose of Herceptin only is administered. So, keep your fingers crossed!

Hanging in there

So far, so good. Other than feeling a little tired, dealing with some minor digestive issues and that horrible metallic taste, I'm feeling ok. Now I am still on steroids so that may be helping. Tomorrow should be the real test. I'm hoping to feel good enough to go to derby practice. They say that most chemotherapy side effects are temporary and disappear once your treatment is over. Each person will recover in their own time, and it may take a little while for energy levels and emotions to return to normal. But chemotherapy can cause long term changes in the body for some people. The changes may happen months or many years after the chemotherapy has finished. The most worrying long term side effect of some drugs is a risk of getting another cancer in the future. This is usually called a second cancer. For peace of mind, it is important to get this in perspective. It is a very small risk, and only occurs with some chemotherapy drugs. They also say it can take up to a year for hair to fully grow back in (lets hope not!).

I keep hearing from others how while they felt relieved that the chemotherapy had finished, they missed the close support of the clinic staff that they had during treatment. Now although I still have to continue with Herceptin infusions for the next 8 1/2 months, I can't imagine actually "missing" the clinic staff. Not that they aren't wonderful, caring folks it's just that I hate what the oncology ward stands for. Every time I would go to the lab, which is on the same floor as oncology, I would say to myself how glad I was that I didn't have to go to those offices. Then all of a sudden one day I became a cancer patient and ended up in those very offices.

You may already know that I had decided that I needed to start focusing on going forward from here on out and start caring for myself again. My self-esteem and confidence both took a beating during chemotherapy. That's where Roller Derby entered my life and gave me the motivation to move on!

Chemo is finished :-)

Today was my last chemo treatment!!! Hip, hip, hooray! They have no reason to believe that the chemo wasn't successful but will do follow up tests as appropriate. I will still receive Herceptin infusions every three weeks through November but the infusion itself will only take an hour; but add labs and seeing the doctor and the time increases by another 2 hours but it will still shorten the time I spend there. I do have an echocardiogram scheduled later this month. An echocardiogram is a test in which ultrasound is used to examine the heart. My heart has to be monitored due to possible side effects of Herceptin. Herceptin can cause heart problems including an inability to pump blood effectively, irregular heartbeats, high blood pressure, disabling heart failure, weakening of the heart muscle, and sudden loss of heart function leading to death. Herceptin may cause reduced heart function even if there are no symptoms. A study showed that only 2.9% of patients who received Herceptin with docetaxel and carboplatin (my regimen) had side effects from Herceptin, so I'm feeling pretty confident in my use of Herceptin.

I was also prescribed Tamoxifen. Tamoxifen (Nolvadex®) is a drug, taken orally as a tablet, which interferes with the activity of estrogen, a female hormone. Estrogen can promote the development of cancer in the breast. Tamoxifen helps prevent the original breast cancer from returning and also helps prevent the development of new cancers in the other breast. Studies have shown that tamoxifen is only effective in treating estrogen receptor-positive breast cancer (which I have). When taken for 5 years, tamoxifen reduces the chance of the original breast cancer coming back in the same breast or elsewhere. It also reduces the risk of developing a second primary cancer in the other breast.

Today, my friend Pat was my "chemo buddy". I guess she wasn't having enough fun in her life and thought this experience could provide it! LOL. First thing this morning she picked me up and drove me to the clinic. Actually I was very glad she came with me because today was a very full day at the chemo ward and I ended up in a small room with only 2 chairs. I'm usually in a larger room with four chairs so there are more people to converse with. So, I had Pat to talk with and she ran out to grab me some lunch also. So a big thank you to Pat for being my "chemo buddy" today. I really appreciated it.

Am I paranoid?

I think I'm becoming paranoid! Paranoia is an unfounded or exaggerated distrust of others, sometimes reaching delusional proportions. Paranoid individuals constantly suspect the motives of those around them, and believe that certain individuals, or people in general, are "out to get them." I don't know if it's caused by the chemo drugs, which mess with your brain, or the cancer itself, because it makes you feel like "less" of a person. If I'm less, then I'm not at my best. If I'm not on top of my game, you might not want me to be a part of your organization or team or what have you. The reason I say this is because there have been a few instances where the paranoia has gotten the better of me. Like when I thought my board of directors was planning to "retreat" without me. Or when I thought I missed an extra roller derby practice because I didn't know about it. Or that my support group deliberately left me out of the group picture. I must qualify this as it is just my crazy thoughts, not that I think anyone has actually done those things. That's why I like Roller Derby, it gives me a chance to prove that I can "derby" with the best of 'em! I am still a "whole" person even though I only have one boob!! I am a person with cancer, not a cancer patient!

Some days I just want to be Tami, Executive Director, Roller Derby Queen and Hannah's Mom, not Tami, breast cancer survivor. It is something I struggle with every day. Living with the paranoid demons in my head that say, "uh oh, your back hurts, must be the cancer" or uh oh, your nose is bleeding, must be the cancer". Sometimes its hard to live day-to-day once you've been diagnosed with a potentially terminal illness. But I'm learning and my priorities are shifting. I have yet to discover where this journey will take me.

Tomorrow is my last chemo! YEAH :-) Maybe once the cancer drugs get out of my system, I'll stop being so damn paranoid. Tonight was Roller Derby practice and Steroid Queen here was tearing it up in my Rocky Horror Picture Show t-shirt! So I'm gearing up for tomorrow and am actually less anxious than usual - probably because it is the last round of chemo and because of derby practice, which makes me feel "alive". Besides I am kickin' cancer's ass!

What really matters

A number of years ago, a young family was on the Oprah show—a mother, father, and two kids—and the mother was dying. She had a number of months to live and she was making videotapes of all the very mundane, ordinary things in our lives that she wanted her kids to know about after she was gone. She was doing videotapes of things like when to get your hair cut and how to steam an artichoke and how to tell when you’re in love, both big and little things. As part of this process, she and the father took these kids on incredible trips to Disneyland and beyond to try and impress on these young minds the memory of this woman who wouldn’t be with them very long. After she died, Oprah invited this family back to the show, and the kids were there and Oprah said to them—thinking they would comment on these incredible trips they had taken—‘What is one of your fondest memories of your mom?’ And the little girl said something that was so striking. What the little girl said, instead of talking about Disneyland and swimming with the dolphins, what she said was, ‘I remember one time when my mom asked me to get her a bowl of Cheerios and we ate them together.’ I am so struck by that; apparently it’s not the big things, it’s not the things we plan for months, it’s not the Broadway musical numbers we create in our lives. It’s the tiny things that have more meaning.

So, should we be looking at our lives in a different way—as if the extraordinary is the thing that is in front of us all the time and not the thing we need to seek? Just how precious is an ordinary day? What are the things of our lives—whether it’s relationships, routines that we have or the things we see around us; and if everything else fell away but what we see, would we be happy? Is it our task to say a wholly ‘yes’ to the real things in our lives? Not the big things, not the powerful things, not the neat things that have the feng shui all figured out but rather the bowl of Cheerios and the junk drawer? Can you can find meaning in anything and everything in your life? What is in front of you? Not what you hope to be in front of you or what your life plan says should be in front of you, but what is in front of you—the relationships, the people, the colors, the smells—everything you find around you all the time. Can you find meaning in what is really in front of you?

Author Alfred de Souza once said, "For a long time it had seemed to me that life was about to begin; real life. But there were always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt left to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." I think he summed up my life in that quote! But the question is, "Can I find the meaning in the obstacles?"

Embracing "Crazy"

It has been interesting to see people's reactions when I say I joined the Roller Derby league. People either think I've lost my mind or think it's cool. I have to admit that at first I was just going to see about volunteering or helping out due to being too old (46) and battling breast cancer. But I remembered how much I love roller skating and know that age is just a number. So I decided to "embrace crazy" and go for it. And I'm so glad I did because I'm lovin' it! When I say ‘crazy’, I’m talking about the good crazy, the out of the box thinking crazy. This means being bold enough to blaze your own trail, birth those ideas and create your own reality. It’s that out of the box thinking and not allowing anybody else to define what’s possible for you.

Having cancer has made me decide to live life "in the moment" with no regrets and no fears. I may bust my ass and get banged up but I'll have fun doing it. So, laugh if you must but once you see me in action, you'll understand. I said before that when I'm skating, I "forget" I have cancer. My friend Eunice says it's probably because I have to concentrate on staying upright [she really should be a comedian]. Actually, I can remain upright without too much trouble. When I'm skating, I'm living in the moment. I'm not worried about having only 1 boob or the fact that my cancer has a very good chance of recurrence. I am just enjoying myself.

I encourage everyone reading this to "embrace crazy". So, why have you not embraced your crazy idea(s)? The top 3 reasons most often cited:

1. You think you will fail;
2. You think you'll be laughed at; and
3. You think you don't know how.

Most people think they lack the resources or the knowledge to make it happen, and because of that, they never even start. Something happens when you step out with courage and take that first step, it’s like you’re unleashing something within you. The answers to the questions just start showing up. I think it starts with desire - from knowing that the dream is possible and that your "crazy" ideas are a good thing. When you embrace those ideas without judgment, the flood gates just may open, allowing you to achieve great things! Just go for it!

Rocky Horror Picture Show

On September 18, 2007, computer science professor Randy Pausch stepped in front of an audience of 400 people at Carnegie Mellon University to deliver a last lecture called “Really Achieving Your Childhood Dreams.” I was flipping through Randy's book and read something that made me think. He talked about making memories with his children before he died (from pancreatic cancer). Remembering his words, I just had to introduce Hannah to the "theatre" experience of Rocky Horror. It was something I enjoyed doing in college, as my friend & roommate Sharon, was in a troupe that performed at the midnight show. Although Hannah's seen the movie because we have the DVD, she hadn't seen it at the theatre. We went to see the Champaign Urbana Theatre Company's stage production with friends Julie, Tasha and Scotty. Then they stayed for the midnight movie. Hannah thoroughly enjoyed the experience. My ringtone for text messages is "Time Warp". I think I embarrassed Hannah when I was doing the Time Warp outside the theatre. LOL!

For those of you who are not familiar with Rocky Horror Picture Show (or RHPS for short), it is a 1975 British musical comedy film that parodies science fiction and B-movie horror films. The film is an adaptation of the British musical stage production The Rocky Horror Show. The film introduces Tim Curry and features Susan Sarandon and Barry Bostwick along with cast members from the original Kings Road production of the play first performed in the Theatre Upstairs at the Royal Court Theatre in 1973. Still in limited release 34 years after its premiere, it has the longest-running theatrical release in film history. The film is considered a cult classic. It gained notoriety as a midnight movie in 1977 when audiences began participating with the film in theaters across the United States. Rocky Horror is the first film from a major studio, such as 20th Century Fox, to be in the midnight movie market. Widely known by mainstream audiences, it has a large international following and is one of the most well known and financially successful midnight movies of all time. In 2005, the film was selected for preservation in the United States National Film Registry by the Library of Congress as being "culturally, historically, or aesthetically significant."

Everyone really should know how to do the Time Warp:

1. (It's just a) JUMP TO THE LEFT, with hands UP.

2. A STEP TO THE RIGHT (Time-Warper ANNETTE

FUNICELLO suggests a very WIDE step.)

3.* (With your hands on your HIPS) YOU BRING YOUR

KNEES IN TIGHT.

4. (Then) THE PELVIC THRUST (if repeated FIVE times,

it nearly drives you insa-a-ane).

5. HIPSWIVEL (if not driven insa-a-ane by step four).

6. LET'S DO THE TIME WARP AGAIN!

*Those with LIMITED LIMB ABILITIES may find it necessary to ALTER or

DELETE this action, but NO EXCUSES for alterations to steps four and five.

If you've never experienced Rocky Horror Picture Show, you're missing out!

Roller Derby-the awesomest sport ever!

Roller Derby is the awesomest sport ever and I get to skate with the most awesomest group of women. Our mission is to bring roller derby to the Champaign-Urbana community by fostering athleticism, empowerment and sportsmanship among women, girls and supporters, while benefiting local non-profit organizations through our charitable donations and service. Now, that's why they are so awesome! This is the equipment you must have to Roller Derby. So, how do you like them skates? Pretty snazzy, huh?

Today we had a guest coach--Annsanity #96, a blocker for the Sugar Kill Gang, from the Rocky Mountain Rollergirls of Denver, Colorado. We got to learn all about blocking. A block is any motion, engagement of an opponent, or position that attempts to impede the progress or motion of an opponent. Blocking is used to stop/slow down the opposing jammer or neutralize opposing blockers by keeping them from competing their objectives. Any form of hitting, body checking, slowing, or skating to impede may be considered a block. Common blocking technique includes knocking an opponent down or out of bounds in order to impede their progress. A J-block is a powerful hit that employs an upward trajectory of the blocker’s body. The blocker stays low, and when she’s ready to hit, swoops her body low and then upward in a J-motion, and throws her shoulder into her opponent. A hip check is a bump delivered using the hips while skating immediately next to the target. We then got to practice blocking.

So how do you hit really hard? First and foremost, you've got to get balanced, and balance comes from two things: proper skating stance and core strength. A proper skating stance is one that's low and wide. You knees should be deeply flexed, your butt should be down, not up in the air, and your torso should not be hunched over your thighs. You should always be centered in relation to your skates. The second element of balance, and the one that tends to get overlooked is core strength. What is your core? Simply put, it's the very center of your body and the power source behind any thing you do that transfers momentum. Your body core is made up of the muscles in your abs, hips, glutes and lower back. When blocking in roller derby, you don't hit someone with your shoulder, you hit them with your whole body, contracting and expanding your core like a spring to put the 'pop' in a J-block. The power to veer into a check doesn't just come from your legs, it comes from driving your hip toward your target.

So, how did I end up in the league? I love to roller skate and I am just as competitive as the next gal! After all, roller derby is a competitive, full-contact sport and the women who skate in roller derby are athletes who train very hard to compete in bouts. It's the hardest workout you'll ever love! If you haven't already done so, be sure to check out our website at www.twincityderbygirls.com!

Combating Chemo Brain

Many people going through cancer treatment notice changes in their memory and thinking abilities. "Chemo brain." It's a term that I use often. It's that... well, how to describe it to someone who hasn't had it? It's a fuzzy feeling, like trying to think through a fog. Throw in a little bit of fatigue and it doesn't leave you at your cognitive best. I don't get it all that often. But when I do, it's hard to concentrate. It's hard to focus. It's a little hard to write this blog sometimes and have it make sense. It's a little bit like the feeling you get when you've had one drink too many, and you don't want to be drunk. You try to will yourself into clarity, but it doesn't always work. Coping with symptoms of chemo brain involves finding ways to remember things better and doing activities that keep your memory sharp. Below is a list of tips for combating chemo brain:

• Make lists
• Use a portable planner or personal organizer
• Get a wall calendar
• Keep a "memory notebook"
• Leave a message on your answering machine to remind yourself of something important
• Organize your environment
• Avoid distractions
• Have conversations in quiet places
• Repeat information aloud after someone gives it to you, and write down important points
• Keep your mind active
• Proofread
• Train yourself to focus
• Exercise, eat well and get plenty of rest and sleep

Chemo brain is extremely frustrating so I spend time doing all sorts of puzzles to try to keep my mind sharp. I'm also doing yoga and skating with Roller Derby. Have I said how much I'm enjoying Roller Derby? Keeping active really does seem to help.

5 down, 1 to go!

One week from today I will wake up dreading the day, as it will be chemo day. I readily admit to wondering what would happen if I just didn't bother to show up. But next Thursday is my last chemo treatment. That calls for a party! But I will continue to have Herceptin infusions every three weeks through November. Herceptin (trastuzumab) is a monoclonal antibody. Antibodies are substances the body produces to help fight infection or other foreign particles. Monoclonal antibodies are made in the laboratory, and some are designed to attack specific cancer cells. Herceptin targets cancer cells that “overexpress,” or make too much of, a protein called HER–2 or erb B2, which is found on the surface of some cancer cells. Herceptin attaches to the HER–2 positive cancer cells and slows or stops the growth of the cells. Herceptin is used only to treat breast cancers that are HER–2 positive. HER–2 positive cancers overexpress the HER–2 protein or have amplification (too many copies) of the HER–2 gene. Approximately 20 to 30 percent of breast cancers overexpress HER–2. These tumors tend to grow faster and are generally more likely to recur (come back) than tumors that do not overproduce HER–2. My biggest fear is that the cancer will recur and chemotherapy will become my life. I would much rather sacrifice my remaining breast than to go through another chemo regimen!!!

In 2005, the results of four clinical trials showed that Herceptin is effective in the treatment of early-stage breast cancer that overexpresses HER–2. In all four studies, women who received Herceptin and chemotherapy lived longer and had significantly less chance of the breast cancer coming back than patients who received chemotherapy alone. I can only hope!

They say the most common side effects associated with Herceptin are fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain. I am hoping that once I am only receiving the Herceptin infusions, the side effects will actually lessen.

Practice

Tonight we had roller derby practice. I wore my prosthetic boob and I did notice a difference in my balance-it really helped. Most women's roller derby leagues have the same philosophy regarding new skaters -- physique is irrelevant, and it doesn't matter if someone hasn't worn skates in years. Leagues hold practice sessions to teach the rules and basic skating techniques, and no one actually competes until the team is confident that they can do so safely. Leagues also encourage players to skate whenever they can in addition to organized practices. We practice two days a week, and always begin with stretching and warm-ups to help prevent injuries. Practices focus on endurance and maneuvering. We learn to squat, how to dodge, and how to jump over stuff and over people. Endurance and skating practices use traditional roller derby drills, modified hockey drills or exercises that the coaches have developed. In addition to building endurance, these drills reinforce our abilities to:

• Start and stop
• Skate at high speeds
• Dodge obstacles
• Dodge other players
• Fall without injury

In addition, drills encourage players to stay aware of their surroundings and react to the unexpected. Tonight we worked on our stops. I've pretty much mastered the plow stop but still need to work on my T-stop. We also have to be able to complete 25 laps in 5 minutes-at this point I can do 21 in 5 minutes so I need to work on my speed. I am loving this!

Taking Control

I'm sick of feeling crappy. I’m sick of being sick. I’m also sick of writing about being sick and talking about all the stuff that goes with being sick. I read a quote from a woman who had ovarian cancer - she said, "You have to have hope. You have to take control." So that's what I have done. I decided that chemo doesn't get to make me feel bad anymore! Now I don't for one second think that I actually have control over the physical side effects of chemo but I sure feel better thinking I do! I'm tired of my life being "on hold". That's why I joined the Twin City Derby Girls. I've said before that sleeping is the one time I don't think about cancer; skating is the other. I fell in love with roller skating at age 4 and am thrilled to be at it again. When I'm out there on that rink, I am living in the moment, enjoying it to the fullest; cancer is the farthest thing from my mind. I am laser-focused on the task at hand--roller derby! When you have cancer, you feel like a victim, that you have no control of the situation and you can't stop it. But with Roller Derby, I have control of the situation.

Ten percent of your life is made up of what happens to you and the other 90% is how you react to what happens. Attitude is defined as a manner of acting, feeling or thinking that show's one's disposition, opinion and mental state. I may not be able to control the situation, but I can choose my attitude about the cancer- victim or survivor; passive or aggressive; depressed or striving toward joy and happiness; caught in the "why me's" or searching for the meaning of life. Cancer is a very powerful word. People think when they hear 'cancer' that they're going to die, and it's not necessarily true. Some people are cured of cancer, some live for many years with cancer and some sadly die. We really don't know exactly how each person will do. It is important to have hope and continue to live each day as fully and as well as we can. One thing I do know - everybody is going to die eventually. When I die, hopefully my friends and family will join together and celebrate my life. Whatever life I have, I must live it well, productively, with hope and love.

Look Ma, a New Boob!

For those of you who want to know but are afraid to ask, here is what the fake boob looks like, front & back. Actually, the insurance company refers to it as a "durable medical device", which I find hilarious. The blue case it is sitting on is its "cradle". Apparently, it is to be babied. It does take a little getting used to once you are used to not having one. A silicone breast prosthesis is weighted and simulates the natural breast. One of its advantages is that it helps your body be symmetrical again and remain in balance. When the body is out of balance following a surgery of this kind, other muscle-skeletal problems can develop. Back, neck and shoulder problems are common as well as a tendency for one shoulder to drop downward and inward while the other rises up. Women also often report that the bra rides up or moves around if there is no weighted breast form on one side of the bra. Special bras are made that have pockets to hold the prosthesis. There are many attractive bras that come in varying colors (e.g., white, ivory, black, & nude/beige) that can be fitted at the time of the prosthesis.

I have decided that I do not want to have only one breast reconstructed. If I can't have 2 new, perky boobies, then just forget it. Also, when women have only 1 breast reconstructed, they run the risk of asymmetry if they gain or lose weight in the future. Natural breast tissue will respond to the change in the subcutaneous fat layer by changing shape. The reconstructed breast has had the fat layer disturbed and will not respond in kind. Implants can migrate, causing unusual fullness in the anterior or lateral chest wall. Some women are opting to have their implants removed completely. They are sometimes left with a small tissue mound for a breast. Prostheses can be used to even out the change in appearance without requiring additional surgery.

I'm hoping to put on my new "durable medical device" (a.k.a. new boob) and go skating to see if I can tell the difference in my balance while wearing the prostheses. My plan is to go skating tomorrow night, if the weather isn't too bad. I'll keep you updated!

Yoga and the Pink Zone game

A big shout out to my friend Kim, a yoga instructor, for the yoga instruction this morning! What most people refer to as simply "yoga" is actually Hatha Yoga. Hatha Yoga is a system of yoga introduced by Yogi Swatmarama, a yogic sage in the 15th century in India. This particular system of yoga is the most popular one, and it is from which several other Styles of Yoga originated including Power Yoga, Bikram Yoga, Ashtanga Yoga, and Kundalini Yoga. The word "hatha" comes from the Sanskrit terms "ha" meaning "sun" and "tha" meaning "moon". Thus, Hatha Yoga is known as the branch of Yoga that unites pairs of opposites referring to the positive (sun) and negative (moon) currents in the system. It concentrates on the third (Asana) and fourth (Pranayama) steps in the Eight Limbs of Yoga. Hatha Yoga tries to achieve balance between body and mind, as well as attempts to free the more subtle spiritual elements of the mind through physical poses or Asanas, Breathing Techniques or Pranayama, and Meditation.

Asanas are various body positions designed to improve health and remove diseases in the physical, causal, and subtle bodies. The word "asana" is Sanskrit for "seat", which refers not only to the physical position of the body but also to the position of the body in relation to divinity. They were originally meant for Meditation, as the postures can make you feel relaxed for a long period of time. The regular practice of Asanas will grant the practitioner muscle flexibility and bone strength, as well as non-physical rewards such as the development of will power, concentration, and self-withdrawal.

Pranayama is derived from the words "prana" (life-force or energy source) and "ayama" (to control). It is the science of breath control. This is an important part of Hatha Yoga because the yogis of old times believed that the secret to controlling one's mind can be unlocked by controlling one's breath. The practice of Pranayama can also help unleash the dormant energies inside our body.

The practice of Hatha Yoga can help you recognize your hidden physical and mental potentials. Through the continued performance of Asanas, you will gain flexibility and strength, and learn to be more relaxed under otherwise stressful situations. Hatha Yoga's Relaxation Exercises will open the energy channels, which in turn allows spiritual energy to flow freely. Some Hatha yoga poses also massage and tone your internal organs, helping to prevent diseases such as diabetes, arthritis, and hypertension. They also bring balance to internal and glandular functions. Pranayama, on the other hand, can help manage asthma and bronchitis. Hatha Yoga can also help you cope with stress, relieve tension, and deal with anxiety and depression. More importantly, it will help you put your mind in a focused state to prepare for Meditation and, eventually, the search for enlightenment. While I didn't find enlightenment just yet, I did feel more relaxed.

Then, this afternoon, we attended the Illinois Women's Basketball game. It was the annual Pink Zone game. Hannah, Mike, Bert & I, along with several other breast cancer survivors and their families, formed a "Tunnel of Hope" for the players to run through on their way to the court. It was pretty cool. Unfortunately, the Illini lost to Indiana.

Roller Derby and a new boob

I have been wanting to get active again, so today I went out and joined the Twin City Derby Girls (TCDG) Roller Derby League. So what is Roller Derby you ask? In 1935, during the Great Depression, Leo Seltzer invented a spectacle called Roller Derby. Sometime in early 1935, Leo read an article in Literary Digest magazine that said ninety-three percent of Americans roller skated at one time or another during their lives. Discussing the article with some of the regulars at Ricketts, a restaurant in Chicago's Near North Side, Seltzer was challenged to come up with a sport utilizing roller skating participants.

Originally, the derby was a long distance track race. Periodically collisions and crashes occurred as skaters tried to lap those ahead of them. Seltzer realized this was the most exciting part of the event and Roller Derby became a full contact sport with elbowing, body checks and fights. The fans loved it. The sport peaked in the late forties and fifties, drawing as many as 30 - 40 thousand fans per bout. The hype continued through the sixties and seventies until the expense of travel and competition from other entertainment forms killed off the larger leagues in the late 1970's.

Since then, Roller Derby has remained largely dormant until recently. The National all-female derby revival began in 2001 in Austin, Texas and has been gathering speed ever since. The new generation of derby skaters pays homage to the theatrical tradition of the past but play by real rules with real penalties, real referees and real champions. Modern day roller derby is a fast paced, hard hitting, explosive sport that combines the spirit of Seltzer's vision with genuine athleticism.

On Saturdays they have an open skate where they run practice drills, giving you a chance to see if you like it. It was the most fun I've had in a while even though it was a workout. I didn't remember just how physical roller skating was until this morning. Hell, I even managed to work up a sweat. Not having been on skates for several years, I was a little worried about staying up on my feet, but it took me all of about 5 seconds to get into the swing of it again. I did bust my ass a few times as I was practicing jumps but I got right back up. Right after practice, I joined up. I even ordered a pair of skates before leaving the roller rink. Now I have to come up with a cool derby name. I have to decide by Wednesday, so if you have any suggestions let me know by then! Be sure to check out TCDG at www.twincityderbygirls.com!

Now, while skating, I did notice that my balance was slightly off due to having only one boob. I had not noticed a balance problem before but get up on wheels and watch out! I was wondering how to compensate for it when I realized what I had to do -- get a new boob! So, I went to Confidentially Yours and bought myself one. Actually, insurance paid for a good portion of it. I got the Amoena Natura which, according to the brochure, features a soft front drape that closely matches a natural breast shape, while the gel back flows gently over your chest wall for a close fit, moving naturally with you. I was so enamored with it that I couldn't stop touching it!

Magic mouthwash: Effective in treating chemotherapy mouth sores?

The mouth sores are at it again! I actually have a sore on the tip of my tongue as well as a few others. I'm really getting tired of them! I found this information on "Magic Mouthwash". "Magic mouthwash" is the term given to a solution prepared by pharmacists and used to treat mouth sores (oral mucositis). Oral mucositis can be extremely painful and can result in an inability to eat, speak or swallow. Magic mouthwash may be used to treat mouth sores that result from some forms of chemotherapy and radiation therapy. There are many versions of magic mouthwash. The doctor will likely write a prescription listing the ingredients and the amount of each. Magic mouthwash usually contains at least three of these basic ingredients:

1. An antibiotic to kill bacteria around the sore
2. An antihistamine or local anesthetic to reduce pain and discomfort
3. An antifungal to reduce fungal growth
4. A corticosteroid to treat inflammation
5. An antacid to enhance coating of the other ingredients inside the mouth

Most formulations of magic mouthwash are intended to be used every four to six hours, and to be held in your mouth for one to two minutes before being either spit out or swallowed. It's recommended that you don't eat or drink for 30 minutes after using magic mouthwash so that the medicine has time to produce an effect. It's unclear how effective magic mouthwash is in treating oral mucositis. That's because of the lack of standardization in the formulations of mouthwash, and poorly designed studies done to gather data. Side effects of magic mouthwash may include problems with taste, a burning or tingling sensation in the mouth, drowsiness, constipation, diarrhea, and nausea. Well, its not like I don't already experience all of those side effects anyway! I'll have to ask the doctor about this at the next (and last) chemo.

Cancer--catching a wave and having no option except to ride it!

One way I deal with cancer is to retreat to my "Happy Place" when things get rough. My "Happy Place" is Pacific Beach in San Diego. I can see it so clearly, even feeling the warmth of the sun and hearing the ocean waves. I've caught a wave and I'm trying to "ride it out", remaining atop my board. The combined energy and support of everyone helps me ride this wave I have caught. In the beginning I remember considering ways of handling my situation and deciding that I was just going to go with the flow, sort of like Pooh in Benjamin Hoff’s The Tao of Pooh. I do not look back; I do not anticipate; I try to live almost completely in the moment, because I believe that this is the only way I can deal with everything that comes my way. If I think too much about it, it becomes overwhelming and unbearable. I also knew that the only way I could handle the whole process was to let people know what was going on. Consequently, I seem to tell everyone, even complete strangers! Sometimes I just can't help myself. I'm sure it is because of the trauma of the situation. In order to heal from trauma, you have to retell the story, acknowledge the experience and integrate it into your being.

I often say "Cancer sucks" to anybody who will listen as if I have to convince them of that fact. I believe it is important to give free-rein to all of my thoughts and feelings, no matter how crazy or morbid. And it's important to say it out loud! How does cancer suck? It sucks your energy, your memory, your appetite and your ability to stay focused. It compromises your digestive and immune systems, which really sucks!

I have always believed that humor is an essential part of living; and cancer is no exception. If you have a sense of humor, you can find "The Benefits of Chemotherapy". Benefits include:

1. You don’t have to bikini wax.

2. You never have a "bad hair" day though you sometimes have a "no hair" day.

3. You have a good excuse for being a bitch.

4. You save money on hair cuts and shampoo.

I especially enjoy #3! I have always believed that humor makes life easier; and it proves to be the same with cancer. So, the way I understand it is:

If I’m alive and cancer-free in 5 years, they will declare me cured.

If I’m dead in 5 years, they will tell my family I was not cured.

Just some more of my sick humor; however in essence it is true. My odds are supposedly good; but what difference do odds make if you die. In the meantime, I consider it my obligation ride this wave by enjoying life, providing support to my family and friends as they need it, remaining open to my spiritual connection, and living in the moment as much as I can.

Exercise post chemo

Since chemotherapy will soon be over, I've been thinking a lot about exercise. While I may still feel the after-effects of the treatment, including fatigue, aches and mental fog, I have been told that I should consider engaging in moderate exercise after chemotherapy to help restore my energy, build strength and stamina, and even help prevent cancer from recurring. A recent study by Andrea Mastro, Ph.D. and a professor of microbiology and cell biology at Pennsylvania State University, found that regular exercise helped breast cancer survivors' immune function return to normal after chemotherapy. Another study by Lis Adamsen, Ph.D. at the University of Copenhagen, noted that exercise noticeably reduces fatigue. The results of these studies gives me two more reasons to lace up my running shoes.

A recent study has shown that regular exercise after chemotherapy would boost the immune function by stimulating the T-cell activity. A T cell is a type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders. Researchers have found that in about three to six months, the group who were assigned to exercise had more activated lymphocytes (a type of white blood cell) compared to the group who were in the non-exercise group. Lymphocytes that were damaged or killed by chemotherapy were more quickly replaced by new and young lymphocytes in the exercise group compared to the group who were not exercising. The exercise group also scored higher on overall quality of life, and social well being. The exercise group also experienced less fatigue compared to the group who didn't exercise.

To avoid fatigue patients are often advised to rest and limit their daily activities. These recommendations might unintentionally perpetuate fatigue. By exercising, patients are able to keep their muscles in shape, which can make everyday tasks easier. Physical activity can also produce secondary benefits such as improved states of mind and mood, increased self-confidence, decreased depression, and higher levels of physical independence. To help overcome fatigue, cancer patients should be counseled to increase their level of exercise rather than the amount of rest in the recovery phase after high-dose chemotherapy.

Chemo is HELL!

I’m almost at the home stretch and yet these chemotherapy cycles keep getting harder and harder to handle. In case you are not aware, chemotherapy infuses just enough toxins into your body so as to just about kill you. I'm amazed by the fact that they know the right combination in order to avoid killing you. The problem is, you then spend the next week after chemo wishing they would kill you because living requires too much energy. Chemo is HELL! Childbirth was a cakewalk by comparison. Singer Melissa Etheridge described it best when she said, "It's the closest to death I have ever been. The chemotherapy takes you as far down into hell as you've ever, ever been.”

Chemotherapy is equally a modern marvel of science and a special delivery straight from the fiery depths of hell. I’d love to pretend it is anything less than that, but it’s not. Every three weeks I sit in a lazy boy, stuffed with warm blankets (if needed), my laptop and a tv, receiving several hours worth of IV bags. It kills your cells, both healthy and cancerous. It takes you within an inch of your life for at least seven horrible days, and just when you start feeling better, it's time to go back for your next treatment. There’s something about lying in your bed wondering if this unfamiliar feeling of what can only be described as dying that gives a person some time to think and reorganize your priorities. It is the ultimate boot camp for survival, patience, faith, and self control. Chemo is bone pain, nausea, vomiting, fever, cold sweats, muscle cramps and spasms, losing your hair, and a constant terrible stomachache.

I've decided that I could be the military's secret weapon because I swear I am shooting fire out of my butt every time I go to the bathroom. I could end all war with the chemical warfare going on inside this body! I think that, like childbirth, if they told you what to really expect from chemo, nobody would do it. If I had only known what havoc it would wreak upon this poor body, I might have run away! It might make for a nifty party trick and it certainly gives the saying "shit-fire" a whole new meaning!

But on a lighter note, Hannah got her driver's license today! Watching her drive away this morning by herself was a little heart-wrenching. Now, don't get me wrong, this is a fabulous thing and I'm happy this day arrived. It's just that it makes you realize how fast they grow up and just how soon they will be leaving you. Time is fleeting and cancer makes me live with this realization every day.

Please make this horrible metallic taste go away!

Ugh! I can't stand this metallic taste in my mouth any longer! So, I've been searching for answers. A metallic taste, sometimes referred to as transient taste changes, often accompany cancer treatments, throwing your taste buds for a loop and making food not taste right. If your sense of taste is off you can lose your connection to food and become less interested in eating. To overcome this, Chef Rebecca Katz has developed a simple tool that's called FASS, ("Fat," "Acid," "Salt," and "Sweet"), for tricking the taste buds and making the natural flavors in any dish soar. This little trick to achieving "yum", even during cancer treatments, will allow flavors to balance out, making them suitable for whatever is happening with your taste buds.

Fat coats the tongue carrying flavors back and forth like little magic carpets. Fats also add heft to a dish and give you a more satisfied feeling. Cold-pressed extra virgin olive oil, organic butter, coconut oil or ghee (clarified butter) and cashew or almond cream work well. Adding a little extra good fat drizzled on top of your food will help erase some of that metallic taste. Fats are also good if you are experiencing mouth sores, since the fat creates a coating action that smoothes over a sore mouth.

Acid (especially citric acid) counterbalances anything in a dish that your taste buds perceive as having a too sweet or too salty taste. Lemons, limes and oranges are good choices. So, adding a spritz of lemon or lime can make even the blandest food taste better. This will also animate the other flavors in the dish, making them easier to taste and enjoy.

Salt "unlocks" the flavor in every food it comes in contact with. A pinch of salt will help if food is hard to taste or it's bland. The flavor should start to build towards the front of the mouth; you may need a couple of generous pinches to make the food come alive. Sea Salt is recommended due to its mineral content; it is also less bitter than processed salts.

Sweet-adding a sweet ingredient can cut an acidic or bitter taste in a dish. Grade B organic Maple Syrup is a favorite remedy. It has a more complex, satisfying flavor than refined sugar and very little is needed. Honey, agave nectar will also work in a pinch. A little bit of sweetness can help tame the metallic taste!

So, I've been trying these suggestions and they actually seem to be helping. Also, a big thank you to my friend Camille, for the ginger cake. It really does the trick in calming the stomach. Now, if I could just get the "Alien Baby" to calm down, I might be able to get back to work!