Test

Painful Bump on the Head

“Ouch!”

I noticed I had a bump on the right side of my head while I was washing my hair a few days ago.  I don’t think I hit my head.  As I went to a clinic today, I informed the oncologist.  After she examined my bump, it got more tender and hurt even with a yawn.

“ Where should we start?”  Washing her hands doctor pondered for a while, and then she recommended a CT scan.

Radiation on my brain?  No!

A chest and abdominal CT scan is due now, and I don’t want to add more radiation especially on my head.

“ How about a MRI?” I asked.

She said a MRI would be  too big a deal.

“Then a PET?”

“No, PET is not good because the brain has so many activities,” she said.

Finally we decided to start with an ultrasound scan.

I didn’t think about it seriously, but talking with the doctor, I realized this could be a cancer.  One after another—concerns continue.   I just bought a ticket to go to Japan.  Can I leap over this new hurdle and enjoy the trip?  I have to pray more.

 

The Bump Is Most Likely Fluid Filled

The result of the ultrasound I took last Monday finally came back after I e-mailed my oncologist.  She said it  is most likely fluid filled.  At least it’s not malignant!

The radiologist suggested いt could be swelling, skin infection, or bruise.  Yet I don’t think I bumped my head, and the oncologist didn’t find anything suspicious on my head skin when she examined it.

It is still swelling but the pain is getting milder this week.  The oncologist said let’s monitor a little longer and if it doesn’t go away, ask a surgeon what to do.

I still don’t  know why it’s swelling, and hope it’s not a blood clot, but I am relieved and thankful for this result.  Thank you for those who prayed for me!!

 

 

Waiting, Waiting, and Waiting

It was last Monday (3/31) when I took a CT.  Though the technician told me it would take 5-7 days to get the result,  9 days after, I am still waiting for it.

Last Friday as I e-mailed my oncologist getting antsy, a nurse called me back and said, “ We haven’t received the result yet.  I will request to expedite, but usually it takes 7-10 days.”

10 days!?  I’ve never waited for so long.

For a CT scan, I have to take off all metals.  When I was asked twice if I were wearing a bra by a nurse and a technician,  I answered, “No,” with confidence.   At night, however, I was shocked and couldn’t believe that I was wearing the bra under a camisole:  I thought I took off the bra and exchanged to wear the camisole before I left home, but actually I was wearing the camisole simply on the top of the bra.

Immediately I checked the bra if there were any wires in it bending this way and that way.  The soft bra seemed like there was no wire in it, but on the back, I found three sets of metal hooks.  Shoot!

Is the reason why it takes so long to get back the result  because I was wearing the metals that messed up to read the CT?

Is it because Obama-care created many more patients and less doctors?

Or  is it because the doctor found some suspicious tumors?

I was doing well being patient and in peace until today, which is the 9th day, but now I am getting agitated.

Last Monday, there was actually a mistake and I was told I had to reschedule the CT:  The blood work I took two days prior to the CT was for  vitamin D level and not for the kidney function, which was prerequisite for a CT.

I insisted to have the CT on the same day.   If I hadn’t done the CT on Monday, the result would come back much later.   I am leaving for Japan on the 14th, and  I want to go without worrying about the result.  Sigh!  I hate waiting !

 

CT Result–Overall OK

Finally, 11 days after the CT scan,  I received the result in the regular check up with the oncologist.

” Overall it was good, but there are a few things to check on,” said the doctor.

First, two new “prominent lymph nodes” were found in the same sternum area where the metastasis happened in 2012.  Normally a node is less than 1cm.  It is  still too early to call them cancer, so we will wait for the next CT, which is scheduled for three months from now.

Second, there is a 5mm lesion in the liver, but this is also so small.  The doctor will consult the specialist.

Third, there are possible abdominal varices, clots in a vein.  Again, the doctor will consult the specialist.

I wish the results were better without any new findings.  Yet,  as there is nothing to pay urgent attention, I will focus on Japan’s trip for the next 17 days.

GOD, thank you for allowing me to go to Japan, again!

Sleepy and Hungry with UES

It was 95F outside.  Yet I was at Kaiser, where the AC was on, in the morning as well as in the afternoon.  In the morning I went for  a liver ultrasound and in the afternoon I went back for my first experience of an upper endoscopy.  Both were for the follow up of the CT I took before the Japan trip to exam if I had varices, swollen vein, around my stomach.

The varices around  a stomach is a secondary problem of  a liver disease, which blocks the blood circulation in a liver, such as cirrhosis, according to a GI doctor.  He denied the connection of the varices and cancer or side-effects of chemo.

The blood test I had prior showed an improvement of AST, an enzyme that indicates abnormality of a liver, with other results, which were all in normal range.   AST was increasing while I was on T-DM1, but now it started decreasing after I changed the regimen to Herceptin and Perjeta this February. Though the number is still a little higher than the standard, it makes me think that the reason of high AST is not a liver disease but a side effect of T-DM1.

The ultrasound took longer than usual and I wondered if there were any suspicious problems, but the endoscopy was done while I was sleeping. I think that the doctor said there were novarices and he would order  a liver biopsy, but I am not sure because I was affected by the sedative, though I remember I was craving for food:  I was fasting from the midnight until after 5 pm when the exam was done.  
I ate big packed lunch (or dinner), some donuts, and fruits, and then slept again on a couch until after 10pm.  When I woke up, George was already in bed.  
Well, I have to wait for the morning to ask him if the doctor really said to me that there were novarices and next exam would be the biopsy.  Without him, I am always short.

Cancer Progressed Again

Today was the 7th Cycle of Herceptin and Perjeta.  Sitting in a chemo chair, I asked a nurse, who was opening my medical record in a computer, if the CT result I took last week had arrived already or not.   She said, “ Yes, “ so I asked her for a copy of the result.  A nurse is not allowed to explain a result, but she can certainly make a copy.

In the three-page result, I started reading the last page where the impression was written.

  1. Stable 9mm right lower lobe nodular opacity.
  2. Scarring and volume lose at the posterior left lung apex likely represents sequela of postradiation change.
  3. Interval increase in size of aortopulmonic lymph nodes.
  4. ….
  5. ….
  6. ….

 Cancer woke up!  At least 6 lymph nodes around the lungs have been growing.

The 5mm lesion in the liver was improved and besides the same possible abdominal varices just like the last finding in March, other organs and bones showed no remarkable changes.  –Those are all relief for me.

I will see the oncologist next Wednesday and hear more about the result.  Yet I am sure that my remission is over.  For the last two years, I was hoping that I was cancer-free, but instead, cancer was just sleeping and now it’s awake and active again, I guess.

I changed to the current regimen in January 2014 due to some side-effects of T-DM1.  I knew that although Perjeta was an excellent drug, without an additional chemo drug, a combination of two antibody drugs (Herceptin and Perjeta) works less than 20%, but  I chose the regimen because I wanted to rest my body from all side effects. Now I have to change the regimen again quickly.  I feel like I had a fall and have to climb up all over again a giant steep mountain, which I thought I saw the top almost.

May the Lord lead me to the right medicines and to the miracle again!

Taxol Again, but Liver Biopsy First

The oncologist and I discussed about the new regimen and decided to add Taxol, which shrunk metastasized cancer completely two years ago, to the current regimen, Herceptin and Perjeta.

I will lose hair, which finally became long enough, again, and am concerned with the peripheral neuropathy, which has worsened since I first used Taxol.  Yet, shrinking cancer is the priority and I am betting on this drug.

Once I decided the regimen, I wish to start it ASAP.  However, instead of a chemo nurse, the diagnostic imaging center called me telling I had to take a liver biopsy first.  The last two CTs showed possible varices.  Because an EGD (Esophagus stomach camera procedure) was negative, I held off the biopsy but the GI doctor told me this is important for me. That means I have to wait for the new regimen until 6/30.  If I think that cancer has been active since March, I get upset and crazy.  Instead of watching the storm, I have to say to myself, “ Focus on Jesus.  He is in the same boat with you!”

Stressful Liver Biopsy Was Negative

The result of the liver biopsy, which I had three days ago, finally arrived and it was NEGATIVE! I am so relieved because If lit was not negative, the new chemo regimen scheduled this coming Monday would have been canceled.

It all started from the “possible varices” on a report of the CT on 3/31. As I was referred to a GI doctor, he explained to me that varies could occur when a liver had a malfunction and the blood circulation in the liver is blocked. I had a blood test, liver ultrasound, and esophagus stomach endoscopy. Everything was negative and there was no varies. Then the doctor ordered the liver biopsy.
I didn’t understand why I would need the biopsy as there were no varices found, especially after I heard the liver biopsy was a little more complicated than other biopsies. When the most recent CT was scheduled, I decided to hold off on the biopsy until I saw the result.
6/4 CT result reported the varices again as well as the recurrence of cancer. Discussing with the oncologist, I thought she said that it would be better to have the biopsy, but starting the new regimen promptly should be the priority.
While I was waiting eagerly for the phone call to know when to start the new regimen, a different phone call came and I was told that I needed to schedule for the biopsy.
A lady over the phone said this was based on the agreement with the oncologist.

Being uneasy without full comprehension, I headed for the biopsy on Tuesday. A nurse who was preparing for my procedure asked me, “Do you know what you are going to have today?”
” I know I will have a liver biopsy, but not sure of the reason. I’d like to talk with the doctor before the biopsy,” answering to the nurse, I was thinking that until I fully understand why I have to have it now, I’m not going to sign on any consent forms.

Waiting for more than three hours, finally I, on the gurney, was moved to the procedure room, where I met the doctor.
” I am going to tell you what I will do.” Standing next to the gurney, he explained about the procedure and the risks, and said, ” Do you have any questions?”

“Yes,” I continued laying on the gurney. ” I don’t understand completely why I have to do this. I am a breast cancer patient, and was told that cancer came back. I am scheduled to start a new regimen on Monday, and if this procedure affects that, I’d like to cancel it.”

Changing the face expression, he said, ” If you don’t have the biopsy, you can’t have chemo.”
Now it was my turn to be surprised.
The doctor had his assistant read the order of the biopsy.
” The patient needs the biopsy prior to have chemo….”
I had no choice and had to say yes for the biopsy.
The procedure was done while I was sleeping without any troubles.
However, I was nervous thinking if I could start the new regimen this coming Monday, and anxious, “what if the biopsy finds cirrhosis?”, until today.
Thank God! YOU ARE ALWAYS SO GOOD!

CT Tomorrow

It has been three months since cancer came back in June and now it’s time to see if the tumors are gone or not.
For the last two months, I have added Taxol, which took me into the two-year remission last time, onto the newest combo of Herceptin and Perjeta, together with vitamin D, which is also effective in breast cancer according to the recent news. If this were an Olympic event, this regimen would be a medal candidate.
My expectation is high, but because it’s so, I would be very shocked if the result is bad. I get scared if I think, “what if?”.

About a week ago I got an awesome phone call telling that a young man, who has had a very rare type of sarcoma and was told that he had only three months to live, is now recovering miraculously by the last chance medicine. He surprised his doctor, and he and his wife, who has given totally herself to take care of him, are going to Hawaii to have a wedding ceremony they haven’t had because of cancer.
God granted our prayers for him, and I believe the same faithful God is with me, also. So, what should I be afraid of? I shake off the concern and will go to have the CT!

Improvement in CT

The e-mail came from the oncologist regarding the result of the CT I took last Sunday.  It said the CT showed some improvement!  The mediastinal lymph nodes, which had increased the size, became smaller.  Taxol is working again!

I don’t know how small they became without the report, but I will hear the details on the 9th at the clinic.   I expected a good result, but opening the e-mail always makes me nervous.  Now I am encouraged and hopeful that I may be able to go back to a remission again.  Requesting the report, next I will go to a heart echo tomorrow.

THANK YOU FOR ALL WHO HAVE PRAYED FOR ME!!  GOD IS GOOD ALL THE TIME!

 

 

 

The Regimen Is Working within Expectation

The CT result showing the cancer shrinkage was certainly good news, but how much did they shrink? While it is said that the 2nd round of a medicine is not as effective as the 1st time,  how about in my case?

I visited the oncologist to discuss about the most recent CT result.

In the report, the lymph nodes became “ mildly enlarged” from “prominent”. Yet the largest lymph node shrank only 1mm
From 13mm to 12mm, and the word,” stable” used here and there bothered me. Two years ago when I was on Taxol with Herceptin and Tykerb, the shrinkage was more significant and the word “stable” was found less on the report.

The doctor said that the recent result was within her expectation and she doesn’t think it was less effective compared with two years ago.

OK. That’s encouraging. The doctor told me to continue the same regimen and take the next CT in two months.

I also told her that I resumed the herb medicine, Goshajinkigan.
“ This medicine is the only one that works for the peripheral neuropathy. Without it I cannot sleep because of all the pains and discomforts.”
Then she said, “ If the liver fails, it will be serious. I want you to know that, but I understand what you’re saying.”

She will monitor the liver enzyme levels weekly instead of every three weeks from now on.
I am relieved as now the doctor knows I am taking the herb. I hope and pray that the regimen will continually work without any problems, as well as the herb medicine.

Bloody Urine after Scan

I have taken many CT scans, but I have never had such an experience.
In the procedure of a CT, a contrast medicine is injected. I was told to drink a lot of water to flush out the medicine, and I think I drank about four battles of water.
Yet perhaps it wasn’t enough. Wednesday morning as I went to the bathroom, I felt a hot burning sensation.
As I emailed the oncologist informing about it, a phone call from the hospital came soon telling me to drink a lot of water and go to the urgent care.
I made a 6:30 pm appointment. Yet by then I felt better and also got exhausted cooking ahead for Thanksgiving. So I cancelled it, which was a big mistake.
By the morning of Thanksgiving I had all the symptoms of UTI (urinary tract infection) and I felt miserable. I went to have a urine test as the first thing in the morning.
The result came back right away showing exceeding white and red blood cells in the urine. Yet it was the holiday. I had to wait until Friday to get an antibiotic.
One of the side effects of the contrast medicine is damaging kidneys. I have had UTI many times since my diagnoses of cancer, but this one is the worst. Hopefully the antibiotic is working, and next time when I take a CT, I must really drink lots of water.

CT Result Is “Stable”

“ There are multiple lymph nodes in the mediastinum, measuring less than 9mm in short axis, not enlarged by CT criteria, and not significantly changed in size or number compared to the prior study,” said the result.

What happened to the 12mm lymph node in the previous result? If it shrank to 9mm, I am very happy.

Because I expected the word “improvement”, at first I was disappointed thinking now I can’t get back to remission any more, but in the second thought this is still good news because it could have been worse increasing in size or numbers.
The regimen is working and I have to be thankful for that.

Thank you for the prayers!

GOD IS GOOD ALL THE TIME!

From Beginning Cancer Was Metastasized

On Friday, I went to see my oncologist and changed Taxol to Xeloda.

The doctor said that the size change of 9mm to 11mm was too small to change the regimen because the criteria of the progression of disease means 50% increase of the size, but with Dr. Slamon’s recommendation, who was concerned with my progressed side effect, the peripheral neuropathy, she allowed the new regimen.

I got curious how long this enlarged nodule has been observed. So I looked back at the past CT reports and found a statement about the same nodule, which increased the size from 7 to 9mm in May 2012, when I was told that cancer spread into lymph nodes around the sternum and the lungs.
Yet, she told me that this same nodule was already found and informed on the first CT report in May 2010, even before the treatment started.

The nodule was not growing or growing so slow that it was not identified as cancer. My first diagnosis was stage ll b out of four stages, but actually cancer had already spread into the lung, stage lV, from the very beginning.

It was a kind of shocking.

The two year remission I thought cancer was gone was the period that cancer was there just in small sizes.

Normal cells repeat the cycle of cell division to death, but cancer cells never die and keep cell divisions and growing. Despite the intense five-year treatment, cancer hasn’t disappeared and grown back. I realized the stunning resilience of cancer and the extremely daunting challenge.

Brain MRI Again

I went to take a brain MRI last Friday. The headache, which stopped after a chemo infusion last week, came back this week. It’s constant.
I need to find out if the cause is the brain metastasized cancer or not.
It has been two years since the last MRI. I don’t have to worry about the radiation exposure with a MRI, but I remembered the uncomfortable intense feeling being still in the narrow “tunnel” with the loud noise for 30 minutes.

As soon as I laid down on the hard narrow exam table, which would move into the tunnel, without a pillow, I felt my head was placed lower than the sleeping position, and the mucus dripped down to the throat. I got afraid that the mucus might choke me. The neck and back hurt and I almost felt the cramps would happen. Can I be still for 30 minutes?

The young female technician was preparing the exam putting ear plugs and a helmet on me, and handed me a buzzer saying, “ if something happens, please push this buzzer.” I wondered, “With this buzzer, if I get choked or clamped, can I get out from this tunnel and stand up from the exam table right away?”

Becoming fearful, I prayed.
“Jesus, please protect me. Hold me tight so that I can be still without any trouble.”

Closing eyes though, I felt the exam table was moving into the tunnel, and even with the ear plugs, I heard the laud wild noise.

Finally the exam table I laid on moved out from the tunnel and the exam was over. “You did a good job,” said the technician with a smile, but probably she had no idea that I kept praying all the way.

It will take a week to get a result. I can’t wait, but I know that I will be very nervous as I open it.

No Mets In The Brain

Yay! The brain MRI result came back negative! I was concerned with cancer spreading into the brain because my headache became constant for the last couple weeks. On Tuesday, people in the Bible class put hands on me and prayed for me. I trusted the Lord, but it is almost too good to believe this result. This is the power of prayers and of the faithful God.

Tomorrow George and I will go to Hollywood Ball concert, which is a gift from a friend. I feel so free that I am ready to enjoy the live concert looking up at the starts and the moon God created.

I am so thankful for those, who prayed for me and God, who loves me so tenderly with Grace.

Disappointing CT Result

I received the CT result at the doctor’s office. Both mediastinum lymph nodes and couple nodules in lungs increased a few millimeters in size.

Since last year when I quit Kadcyla (T-DM1) due to side-effects and changed to Herceptin and Perjeta, cancer became active again, and though Taxol held cancer stable for 6 months, since January in this year cancer has been growing.

The blood work I took after the clinic showed sharp increases in both AST & ALT, the liver enzymes. (I am still waiting for the platelet count.) I guess my body was much more sensitive to the 2nd use of Kadcyla, but it was less effective to the cancer.

Some people who have been on Kadcyla facing the same problems of side-effects told me that they were continuing kadcyla by reducing the dose or expanding the cycle because it has been still effective. Listening to their stories, I was expecting to do the same, but it will no longer to be an option.

My oncologist seems not to know what to do with me. Then my last bet is Dr. Slamon, who invented Herceptin. The appointment with him is on 8/25. There will be still three weeks, but since there is no clear option and my body needs to recover from the side-effects, the oncologist decided to give me a break from chemo. Without it, I feel like my body is vulnerable; all the doors are open for the cancer to progress, but probably it is necessary and a good idea for whatever I will do next.

The grapefruit I regretted so much to eat, is now ok to eat again. I took out the juice, which I had frozen when the doctor had told me to avoid, from the freezer. I didn’t expect to be able to drink it so soon, but the cold sweet taste comforted my plunged heart.

Relation between Neutrophil and Lymphocyte

Passing a lab test this week, I could complete an Abraxane cycle-three weeks in a row followed by a week off-for the first time since I started this regimen from this September. Because I had canceled the infusion already twice, even after I sat in a chemo chair, I was afraid that the cancelation might happen any time until a nurse really hang the drug on the pole.

This week the lab result showed one of the white blood cell counts, Neutrophil, was slightly above the standard range, while Lymphocyte, another type of white blood cell count, was slightly below the standard range. As I told the nurse that I was concerned this could cancel the infusion, she said that Neutrophil and Lymphocyte are in a relative relation, so if one increases, the other decreases.

I had no idea of such a thing, but now it made sense. When the count of Neutrophil improved by Neutrogena, a shot, the reason why the count of Lymphocyte went down was not because I stopped a mushroom supplement AHCC but simply the Neutrophil count went up.

The nurse continued that maybe the Neutrophil count went so high because the dose of Neutrogena was too high. I asked if it’s because I was infected so Neutrophill was fighting against the agent of the infection increasing the number. This week I took a diuretic since I felt like I was passing less urine and the feet were a little swollen. The doctor ordered a urinary test, but it came back negative. Then I asked if I needed to reduce the dose of Neupogina, but the doctor said, “No,” again.

I won’t check my blood counts until the following week, but I am glad that I could learn something important again. Our body is a total mystery and festinating.

Optimistic About Scans

Welcoming my high school friends from Japan, I had a busy week, driving to Downtown LA, Hollywood, Big Bear, Queen Mary, and Reagan Museum. Though I was not sure if I could make it to spend the whole week with them, I could drive, walk, and cook without even being bothered by numbness and tingling of the feet. It was a good week!

Then after sending them off with tears at LAX, I headed to Kaiser for a bone scan, which was ordered due to a rising liver enzyme, ALP.
I expect the result coming back in a week,but since I have no pain, and perhaps I had a fun week, I am optimistic about the result.

The next day, Monday, I went to have Herceptin, which closed the 2nd full cycle of the current regimen. In four weeks, when one more cycle is done, I will have a CT scan to evaluate the regimen of Abraxan and Herceptin. For this one, also, I am optimistic right now because a cough, which I believed clonic and was due to the tumor– the oncologist thought, stopped after I increased the dose of a cough medicine from 1/3 to the full described dose, as well as a chest pain.

If so, I could have one more joyous holiday season!

Bone Scan Was Negative

The result of the bone scan I took last Sunday came back as negative. Yay!
It said that as there were some changes in the lower spine and skull, though they could be arthritis, or artifact – follow up CTs were recommended.
I will take the next chest-abdominal CT on 12/2. Though a brain CT was also ordered, I am afraid of exposing to too much radiation in a short period. As a brain MRI I took a couple months ago was negative, I am asking the oncologist if I can postpone or even cancel the brain CT.

The exams will continue. The treatment will continue. They may cause side effects or after effects, but at least I am ok now, and thankful for that.