You know it’s time to post an update when people following
your blog start messaging you to check if you’re still alive. I know, I’m way overdue.
On Wednesday I headed off to UCLA to start a new treatment
plan with the latest and greatest in breast cancer research. What an
amazing and incredible difference from Kaiser. In May I made the decision
to switch my insurance to a PPO. This switch meant losing my double
coverage (we have health insurance through Brandon’s work as well), but allows
me to seek medical care just about anywhere outside Kaiser. I was at a
breaking point with my doctor and my care. My questions were never really
answered, my appointments were few and far between, tests and scans were taking
weeks to book, and my doctor made me feel like I was a nuisance, like with
stage 4 cancer, I shouldn’t bother. I’m guessing a lot of doctors are
like this, very analytical, focusing on facts and statistics. But there
is a lot to be said about hope. It’s powerful.
Hope has a direct impact on how you perceive a situation and
how you chose to face the obstacles in your way. It is well documented
that outlook has a profound influence on your prognosis. Optimists do
much better than pessimists. And while I consider myself the eternal
optimist, I am human and I have my moments of doubt and depression.
Understandably so. Most people in my situation would as well.
There are times I feel panic start to rise up and threaten to engulf me
in sheer madness. Raw and undiluted. And boy, does it sneak up on
you! A fellow cancer fighter once told me, when I was first diagnosed, to
never linger or let my mind stray to the idea that my kids will grow up without
their mother. But the mind is complex and plays trick on you. It
betrays you and holds you hostage to its thoughts. It’s a terrible
feeling, worse than any physical pain I have yet to experience. But hope is
the best medicine for depression. It breathes life into you and pulls
from the panic and allows you to live. It rescues you from captivity.
When I was at Kaiser, I felt the hope slowly seep away and no matter how
hard I tried to hang on, I was losing my grip.
When my Kaiser doctor told me my cancer was terminal, it was
over phone. Yes, that’s right, over the phone! Brandon asked her
what the test results meant, could I beat this? Her response was, “No,
this is a terminal diagnosis”. Then…silence. She sat there silent
over the phone as the panic overtook me and I sobbed and Brandon sat frozen and
shocked. She was silent for quite some time. Six little words
destroyed any offer of hope. It is by far the most excruciating pain I
have ever experienced in my life. I felt trapped. I was suffocating
on her words. And in that time, she failed to console or offer any hope.
Of course, many might say it is not the responsibility of the doctor to
lift you up or give you hope, but that's like saying a teacher isn’t
responsible for giving students hope either, for making them believe they have
the power to succeed, to overcome their circumstances. And, you know,
maybe that’s true, that doctors and teachers aren't obligated to foster
hope…but those that do are often the ones that make a difference and achieve greatness. Words are powerful. Deep
down I knew I needed a new doctor, one that had the same passion for their
patients, like I have for my students. I found her at UCLA. 
Dr. Rena Callahan was prepared for our first visit in a way
that proved her expertise and compassion. The first thing she asked when
we met was to tell my story from start to finish. She asked me questions
in between and didn’t make me feel rushed. When we discussed medications
she knew what the latest studies and trials showed and had reasoning for every
decision of the treatment plan she made. She treated me like I had a life
to live and we were going to do our damn best to make certain I had the right
medications to ensure it. At the end of our appointment, she left me with
a solid plan and renewed hope. At the end of the appointment, as Dr.
Callahan left the room, Brandon, Jeanette (my die hard, crazy protective, at every appointment sister), and I each looked at each other in
disbelief. I could breathe again. On Wednesday I met with Dr.
Callahan again and a palliative care nurse. I started four new medications:
1. Ibrance
One
pill a day for 3 weeks then 1 week off
Ibrance
was just FDA approved last year and is hailed a “breakthrough” drug in the
fight against breast cancer. In studies,
it doubled the median delay in disease progression. Ibrance works by disrupting proteins in
cancer cells from signaling and therefore slowing it’s ability to grow and
divide.
2. Faslodex
2 Monthly
injections
Faslodex
works in conjunction with Ibrance. Their
a killer team…no pun intended. Faslodex
essentially blocks estrogen. It sits in
the cells and leaves no room for estrogen to take up residence and feed the
cancer. I get two
injections at a time. One in each
cheek. The medication is so thick it has
to be given slowly.
3. Denosumab
Monthly
injection
Denosumab
is a very expensive bisphosphonate that helps stop bone cells from breaking
down while strengthening bones. My last CT
scan showed no new cancer grown in my spine and showed what looked like new
bone growth. But my back is still
hurting. I am hoping this medication
will be the ticket to some much needed relief.
4. Lupron:
Monthly
injection
This
medication will shut down my ovaries and put me into menopause. My cancer is estrogen fed, so shutting down
my ovaries will help to reduce the amount of estrogen in my body.
The last thing to do is sit back and brace myself for any
side effects. The most common side
effect that I will have to keep a close eye on is a drop in my white blood
count due to the Ibrance. Dr. Callahan
said if my counts do drop, I may need to hold off Ibrance an extra week. 2 weeks off instead of one. I feel confident with my decision to continue
treatment at UCLA. The care so far has
been far superior and is worth the crazy 2+ hour commute to get there. Both visits the waiting room was empty when I
got there and empty when I left. It felt
like I was the only patient of the day.
No overbooking, no rushing, no half ass answers and care. Dr. Callahan wants to see me once a month for
my monthly dose of injections and to see how I’m tolerating my cancer cocktails.
I know the reality of my situation. My switch to UCLA isn’t going to save my
life, but I have no doubt it will extend it.
Whether by 1 week or 10 years doesn’t matter, I just know UCLA will give
me more precious time with my family. I’ll
take whatever I can get.
