Dad's update - April 11th 2008

Hello everyone,
Sorry I'm late on getting an update out to all of you. Rebecca had her third chemo treatment last Tuesday, and she continues to do well -- which is pretty much to say it's "status quo". They were able to get an IV started this time on the first try, which is better than the times before. Her blood chemistry (especially white blood counts) before the chemo were very good. She was able to work about a half day on Wednesday (the day after the treatment), and went back to work on Thursday pretty much full-time.
Unfortunately, chemotherapy drugs can cause mouth and esophagus ulcers, which have begun to manifest themselves in Rebecca. Her doctor has prescribed "Magic Mouthwash" that provides some relief. Other than that, there have been no dramatic changes in Rebecca's condition or side effects. Some side effects seem to have become a little more of a nuisance, but others seem to be less so.
The biggest problem right now is insomnia -- Rebecca gets very tired for the first few days after chemo, and she usually falls right to sleep at night (with the help of an anti-nausea aid called Lorazepam, and a sleeping aid called Ambien). However, she isn't able to stay asleep all night -- and often wakes up between 2:30am and 4:30am. She can't go back to sleep, so she just gets up and does "stuff". Which makes her even more tired. We're going to have the doctor suggest some alternatives that might help.
Rebecca says the nausea was a little more intense this time, but that still seems to be under control. She stays so very active -- and doesn't seem to let it slow her down any.
Obviously, she has lost all of her hair -- but she is very open and accepting about that -- and goes out of her way to make others feel comfortable with it, too. She went through a drive-thru the other day, and the attendent told her she had a really cool buzz cut. Rebecca told him, "Thank you; it's the most expensive hair cut I've ever had!" After a pause, he said, "Oh", and seemed to finally understand that her hair style wasn't voluntary. But it's so great that Rebecca is not self-conscious about it, and has such a great sense of humor. She is still 'hot' to me and acts so natural -- that this side effect simply has no impact on any of us anymore. Alyssa has also been very busy making her mom beautiful jewelry that match the scarves that Rebecca wears.
The headaches after chemo seemed to be far more manageable this time. We are anticipating that the "bone pain" from the Neulasta shot will probably hit in the next couple of days, and are a little more prepared this time with Advil and Tylenol. Last round it dropped her to her knees, lasted a couple of days, and then totally disappeared. It's a relatively short-lived side effect of the shot.
Rebecca's appetite remains good. She is eating normally, and has no problem except with hydrating. She says many things, especially water (which she normally guzzles) tastes metallic. She has been walking occasionally to get exercise, and now that the weather is starting to get better, we'll probably go on more walks outside together in the evenings.
Her next chemo round will be Tuesday, April 22nd, and it will be her last adriamyacin/cytoxin treatment ("red and clear gravy"). She will begin 4 bi-weekly treatments of taxol or taxotere 2 weeks later. We are expecting that there might be slightly different side effects with those chemicals -- but we'll cross that bridge later.
The only detectable change in the tumor so far is that is seems to be "softer" according to her oncologist. It doesn't appear to have gotten smaller yet -- but it's not any bigger either. The doctors told us we probably wouldn't see any dramatic changes until after the 3rd treatment. Perhaps that will be by the time we have the exam prior to the next chemo. The fact that the tumor is "softer" is good -- the oncologist said it is a sign that the chemo is having an impact (dissolving isn't the right word, but that's the concept).
We are also hoping to receive the results of the genetic testing from Myriad Genetics for the BRCA-1 and BRCA-2 genes. This test will determine if Rebecca has the "breast cancer and/or ovarian cancer gene" that makes carriers more susceptible to breast and ovarian cancer. The results of this test may impact the surgery we choose for Rebecca after chemo. Unfortunately, the insurance carrier denied reimbursement for this test (which is very costly), but we felt it was important enough for Rebecca's health, as well as the future health of her children and sisters that we went ahead with it anyway. Her mom was diagnosed with BC at age 50 and passed at 56 and she also lost two maternal aunts to BC.
We continue to have the love and support of so many people in our neighborhood, ward, and Rebecca's work. They bring meals every night for the first week after a round of chemo, and Rebecca's co-workers have also arranged for a maid-service to clean the house once every other week for us! This is a total luxury; one we would never have considered, but it has been such a blessing to us. Rebecca has lots of friends who inquire after her, so we are well-cared for.
Thank you again for all of your prayers, kind thoughts, and well wishes.
Love,
Mark