Yesterday was a chemo day, so I don't have much in the way of original thought to offer up to you.

It was more stressful and a longer day than most but made infinitely easier by the presence of my friend T. We had lots to talk about and she ably distracted me when I felt the stress levels rising (the guy beside me was, for much of the time, having a shouted conversation with the man across the "pod."). She even tucked me in very sweetly as I settled in for my post Demerol nap.

Between bloodwork and chemo, T. and I went out to lunch at The Green Door. Over our veggies, we got to talking about food. I've been seeing a nutritionist, who has made some initial adjustments to my diet (minimal sugar, no dairy, more raw food, a high quality protein with every meal or snack). Since I told the nutrionist that I drank no more than five drinks a week, I've also been trying to stick to that. What I need to figure out is what exactly constitutes a drink. Is a pint of beer one drink? Two? One and a half?

T. told me that her doctor has been telling all his patients to stick to the following formula: 0-2-9-14

0 - at least one night every week you have no booze at all.

2- no more than 2 drinks at any given time.

9- women should have no more than 9 drinks per week.

14 - the maximum for men.

That makes sense to me and doesn't seem too onerous. Of course, if one is hoping to lose weight, drinking less (or not at all!) makes sense. Empty calories, decreased willpower, increased appetite...there really are lots of sensible reasons to forego the booze. I do enjoy beer and wine, though and don't do well when I try to cut anything I like out completely.

What do you think?

No nausea.

No bad taste in my mouth.

No rage or sadness.

No aches and pains.

I'm just very, very tired.

I'm not complaining.

"gleeBE the Musical is the story of a group of talented, ambitious young people vying to get into the fictitious Arts Sanctuary school in the Glebe. GNAG’s spring theatre production, tells the story of their quest for this all-too-often elusive goal."

(Note: The Glebe is a neighbourhood in Ottawa, Ontario).

Smart, funny, creative, talented Sara has passed away.

I only knew her as an online presence (although we did once spend more than an hour on the phone together) but I am grieving tonight and for all the people that love her.

I am told that Sara loved red wine and good tequila so if you partake of either of these tonight (and even if you don't) please raise a glass in her honour.

I am going to put on the lava earrings I bought from her (they are my favourites).

Damn. Cancer really sucks.

Today is a treatment day.

For the first time ever, I will have Herceptin on its own (if you don't count the Demerol and Gravol I get to keep the shakes and fevers at bay).

Some people have almost no side effects with Herceptin. Some feel like they have the flu.

Will the fact that my body has such a strong response to Herceptin mean that I feel more of its side effects?

The break from chemotherapy is meant to help me heal and rebuild - physically and emotionally.

The break from chemo is also a risk.

Here's hoping it all works out for the best.

It's high time I reported in on my plan to make small and lasting health-related changes in my life this year. 

It turns out that a small change every week is too much to expect, so I'm going to stop numbering them that way. It makes me feel like less of a slacker.

First change: Weigh in and record my weight every Monday.

My scale is broken and I have yet to have it fixed or replaced.

Second change: Do strength training exercises developed for cancer survivors. Work up to about thirty minutes, three times a week.

I've done these exactly six times in the six weeks since I last updated. It's too easy to talk myself out of doing the exercises. On run days, I tell myself that I'm too tired or don't have time and on non-run days I either don't think about it or don't want to do the exercises in my street clothes. I'm lacking both structure and discipline.

I've been pondering going swimming. I also did something last week that I may live to regret. I bought a twenty class fitness pass from a local gym. It only cost twenty dollars, and I have two years from the first class to use up the pass. It's pretty low risk but I'm worried I'm going to hate it.

At least it addresses the structure question.

Third change: Drink no more than five alcoholic drinks per week.

I seem to be better at breaking old habits than starting new ones. I've had no problem with this goal.

Fourth change: Drink more water.

My original goal was to drink around ninety ounces a day. That was unrealistic and made me feel hungry,jittery and even a little nauseated. Also, I was constantly running to the bathroom. Instead, I am now aiming for the more realistic eight glasses a day. This is no problem for me.

Fifth change: Meditate every day. Start at five minutes and work my way up to twenty.  

I suck at meditating. I just can't seem to still my brain, even if only for a few minutes. I find myself making lists, wondering what to do next, even mentally writing blog posts about how hard it is to meditate.

I suppose I should keep trying, as lots of folks I respect tell me how much they gain from their daily practice. It's a struggle though. I'm comfortable with silence. I don't tend to listen to my ipod when I go for walks or running but I do find sitting still and silencing my thoughts to be hard, hard, hard.

And see above re "structure" or lack thereof.

Sixth change: Always sit down to eat.

It's a very interesting experience to notice how often I pop food into my mouth while standing up. Sometimes, I only think about my plan to change after I'm done. But it's a good habit to break and I'm glad I'm doing it.

And announcing...

Eighth change: Take all my vitamins and supplements.

A while ago, I became so overwhelmed with the amount of vitamins and supplements that had been recommended for me that I just stopped taking any of them. The bottles were taking up way too much room in my kitchen cupboard and I couldn't find a vitamin box big enough to accommodate them all. I everything up in a box and put it in the bathroom in my basement.

Last Thursday, I found a giant pill box and spent half an hour on the week end getting organized. Yesterday, I took most of the vitamins (at different times throughout the day) and had raging heartburn by early afternoon. 

Today, I have yet to take any. 

I have recently re-connected with my nutritionist and we're going to review the supplements I'm taking, at an appointment two weeks from now. I'm also confused about interactions. Some vitamins should be taken with others and some shouldn't. Some taken with food and some not. Is it any wonder I put them all in a box in the basement?

Perhaps I should be setting priorities. What should those be? Calcium? Vitamin D? Fish oil? 

Anyone else out there have the problem of getting heartburn when you take vitamins?

As always, I welcome your thoughts and feedback. What changes have you made for your health in the last while? How's it working out?

My younger son was a diagnosed with a bunch of food allergies when he was very young. He's outgrown some of these (eggs, milk) and some seem to be around for the long haul (peanuts and tree nuts). 

Among the most insidious of these is sesame. It was the first allergy we suspected and has always been the one we find the most frustrating. It's in everything - try reading labels on bread products for a few days and you'll see what I mean.

Last year, we were offered the opportunity to do a blood test that can determine the degree of reaction to some common allergens. Out of a possible 100, Daniel's response to peanuts was as high as could be measured (this allergy is not going anywhere any time soon). His sesame reaction was 0.84. That's barely a reaction at all. When Daniel had no reaction to this year's sesame skin test, the doctor suggested a sesame challenge.

This, as I remember it, was our experience:

Sunday:

2:00pm: Tim goes out to buy Sesame Snaps.

3:00pm: Tim tracks down Sesame Snaps, discovers that they "may contain peanuts."

4:00pm Tim makes own version of snaps, with sesame seeds, sugar, ginger and lemon.

10:00pm-2:00am I have insomnia, partly due to sesame challenge. This may also be due the fact that I discover my free games of Chuzzle were re-newed when we reformatted my computer.

Monday:

9:00am: Daniel and I arrive at the allergists office.

9:10am: The doctor explains to us how the day is going to unfold.

9:12am: The nurse is blown away by our home made sesame snaps. Apparently most folks just bring in seeds.

9:20am: Daniel's arm is scratched with a bit of sesame. There's a bit of redness (which might be from being scratched but nothing more). Daniel says that it's itchy but remarks that "it might be psychosomatic."

9:25am: The doctor gives us the go ahead to continue.

9:45am: Daniel eats a bit of sesame snap.

9:50am He insists that his lips and tongue are itchy and swollen. I suspect anxiety (we have never been helicopter parents but I can only imagine how he must feel after practically a life-time of hearing the message - from many directions - that a food allergy can KILL you). The nurse sees no evidence of a reaction.

9:51-9:59: I attempt to distract Daniel with hang-man, offer him lunch out and cupcakes as a reward if he sticks it out.

10:00am: The doctor examines Daniel and sees no evidence of a reaction. Daniel is still anxious. The doc holds up a mirror so Daniel can tell that he looks fine. He soberly informs my eight year old that he can walk away now "but you will have to continue to abstain from eating sesame."

10:05am: I tell Daniel that he can have the whole day off from school.

10:06am: Tim drops off Daniel's DS.

10:10am-12:00pm: Testing resumes. Ever larger amounts of sesame are consumed without hesitation or reaction.The last couple of times, Daniel barely looks up from his Pokemon game.

12:00pm: We are dismissed, with one fewer food allergy on Daniel's list. The doctor (who remarks that Daniel is "a different kid" now that the test is over) instructs Daniel to eat lots of sesame in the next little while.

12:30pm: We celebrate!

Anyone know a good falafel recipe?

saying "no" to:

beating myself up

people who make me feel bad about myself

feeling ashamed

hiding from people who love me

giving into my fears

jealousy

Saying "yes" to:

spending time with the people who fill me up

reading for pleasure

tapping my own creative resources

trying new things

fun

talking to my Mom more often

giddy about:

all the great books that are available to read

the way my kids and spouse make me laugh until I cry

dog bellies and snouts

the potential of things I could knit

the thought that I am a Writer

scared of:

dying

not being able to read, or write, walk my dogs or play with my kids

writing fiction and discovering that I don't have the talent for it

anything bad happening to someone I love

deeply inspired by: 

beautiful prose

my sister

my friends

my kids

Lene

being in love

obsessed with:

the clutter in my house (not that I do anything about it)

wondering where the day goes

finding peanut and nut alternatives

thinking about things I could knit (as opposed to actual knitting)

tracking what books i read and planning what books i'm going to read next

Scrabble

in love with:

Tim

my boys

the dogs

feeling the sun on my face on a warm spring day

saved by:

blogging and my journal

world class health care

Tim

the people who love me

good chocolate

finding a reason every day to be happy.

and you?

Thanks to Mocha Momma and Dancing Mermaid for inspiring me to do this.

Some time between when we pointed the car towards Florida and made our way back (we had a glorious time, by the way. Few photos this year but it's still this beautiful in Siesta Key), my book was published.

The dogs were less than impressed but the human members of my family are all very proud and I am so pleased to actually have a copy to hold in my hands. You can get yours from Women's Press or wait for details of the launches we are planning in Ottawa and Toronto.




And last night, S. won an Honourable Mention in the short story category (for 9-11 year olds) in the Awesome Authors contest, run by the Ottawa Public Library. His story, "The Man in the Photographs" was about how he never wants to seem as uncool as his father. "Pure fiction," he said at the awards ceremony.

Herceptin

I think I'm happy with the outcome of the brouhaha over Herceptin in Ontario. For those of you outside the province or outside the loop. Jill Anzarut, a 35 year old woman undergoing treatment for breast cancer made the news last week when she announced that the province had to pay for Herceptin because her Her2+ tumour was less than one centimetre (that's about 1/4 inch) in diameter.

The province initially refused to budge but eventually caved after a massive campaign played out in the social and traditional media. Access to Herceptin will now much more room for discretion when it comes to providing access to the drug.

I feel good about this. It's not that I think that every drug should be funded for every person. Her2+ cancers are very aggressive and, as best put by Stephen Chia, chair of the British Columbia breast-tumour group, “In HER-2 positive cancers, it’s not the size that drives it; it’s the HER-2 gene that drives it.” 

Election

Canadians are once again going to the polls. I am not happy about this. 

I'm sad that the long overdue Bill C-389 protecting the rights of transgendered people will die before it gets the chance to be thrown out by the Senate.

I'm worried that we will end up with a Conservative majority.

I have election fatigue. There was a time in my life when an election would make me feel excited and hopeful. Now I just think, "Ugh."

Presents in the mail

Did you see my scrabble pendant in yesterday's post? My friend Leslie sent it to me after I told her I'd like to have on with my initial on it. It made me very happy to open the envelope that held my surprise.

The bad with the good

Last week, I received my author's copy of the current issue of Canadian Woman Studies. The theme this quarter is Women and Cancer and I have a poem that is part of a piece called "Seven Reflections on Breast Cancer by Seven Women Who Worked Together." I'm happy about that.

I'm far less happy about another piece I stumbled on when I was leafing through the issue. It's called "The Private/Public Split in Breast Cancer Memoirs." It was written by a woman who came to my book launch in Toronto and asked for permission to speak in order to seek contributions - something to which I readily agreed. She also asked me to contribute to the issue, which prompted me to reach out to my writing group.

I had no idea that she planned to write a scathing deconstruction of my book - but that's what she did. I know that all writers get bad reviews but I found her comments to be very critical of me as a person (I guess you can't seperate the analysis of a memoir from its author) and quite unfair. 

I'm sure how to respond or react, or whether I should do so at all. I've actually been unable to finish reading the article. With a distinct lack of maturity, I threw the journal onto the living room floor and it stayed there for several days. I only just picked it up, in order to write this post.

I'll let you know what I decide to do. Meanwhile, I'm pasting my very own contribution below. It's a very small part of a greater whole (and not the strongest piece by the seven of us by any stretch) but it's mine and, like all my writing, expresses a little bit of what has been in my heart.

Snap shots

December 2^nd, 2005.

When I close my eyes, I see myself as I was then.

Short dark hair and boots with heels.

Irritable and excited in equal measure.

I knew big change was coming. And it did. But it was not what I expected.

I was getting undressed when I found the lump.

July 1^st, 2006

I close my eyes and see myself as I was then.

Round, bald and bloated. But happy.

Chemo is behind me. Or so I expect.

I am self-conscious but also hungry.

I eat two burgers at the barbecue.

December 24^th, 2006

I close my eyes and see myself as I was.

I rallied for Christmas Eve but in the end the pain got the best of me.

My liver was riddled with tumours. And I had waited too long for the morphine.

My mother had to put me to bed. That comforted me.

And so did the drugs.

June 25^th, 2007

I close my eyes and I can taste

The strawberries on my tongue

The sensual pleasure of the whipped cream

And the Niagara ice wine as it slid down my throat.

I knew I would soon have something to celebrate.

December 16^th, 2009

I close my eyes so I can think.

I have now been in remission for 30 months.

And I will be in treatment for the rest of my life.

Some days I wake up celebrating.

Some days I grieve for what I have lost.

Today is a sad day.

Tomorrow will be better. Or maybe the day after that.

Last night I dreamed that I had a lump in the lymph nodes above my collar bone.

I woke up terrified.

The comments on my last post were among the most thoughtful, moving and provocative that I've ever read. I have much to think about. Go read the stories that and responses that women shared with me. I feel grateful to each one of them.

Today, I am going to take the dogs for a walk and then ride my bike (unless I decide it's too cold) to Sassymonkey's house, where we will eat, drink, knit, watch a movie that has nothing at all to do with cancer.

Update: I've decided that my habit of using initials instead of names makes some sentences confusing and nearly unreadable. Henceforth, I will use my discretion - and mostly use names.

Hey there.

March has been a busy month for our little household. And last week was March Break. We all drove to Toronto and then our oldest, Sacha, went to visit two of his parental grandparents in Florida. It was his first flight (other than a short hop between Toronto and Ottawa) on his own (and he's now too old to be an "unaccompanied minor"). 

But I'm getting ahead of myself.

It seems that I'm not so great at multi-tasking these days. I have lots of blog posts in my head but before I write them, I thought I'd catch you up on what we've been up to since my last post.

On Saturday, March 12, I ran a bunch of errands and packed for our week away. We also went shopping for new clothes that my 7 year old could wear for a theatre date with his Grandma in Toronto.

He was very pleased with this outfit. The photo doesn't do him justice.

On Sunday, March 13, we drove to Toronto. That evening, Tim and I went out for a delicious Indian meal to celebrate our 20th anniversary (we celebrate the anniversary of our first date because our wedding anniversary is September 7. At that time of year, our lives are so busy. Besides, March needs a reason to celebrate). It's hard to believe it's been that long - and we still like each other.

I started my day on Monday, March 14 by lining up outside the Toronto office of Passport Canada, since we had realized the previous Friday (at 4:30) that our son's passport had expired (I can now safely confess this, as he has been and returned to Florida and you all can know that our parental ineptitude didn't lead to tragedy). I was second in line (well before dawn) behind a woman and her two young children from Northern Ontario who had been turned away from their flight to South Carolina the previous day (the woman's MP had assured her that her son could travel to the US on an expired passport. He could not). Her name was also Laurie and her boys were also five years apart. We bonded, as we stood on the pavement outside the passport building for 90 minutes.

Once the new passport was sorted, Tim and I took our youngest to the zoo (Sacha opted to go check out the  TIFF building with his Grandma). I didn't take any pictures but we had a great time. It's a sprawling place with animals that appear to be reasonably content. At least I hope so. Daniel was ecstatic. His favourite animals were the gorillas and the bats (no photos. I was too distracted and perhaps still groggy).

On Tuesday, March 15th, Tim drove Sacha to the airport in Toronto (I was happy not to go, since I was beside myself with anxiety) and then headed back to Ottawa to work (he was extremely patient with me as I texted him every forty-five minutes for updates).

I was happily distracted by the wonderful company of my friend Andrea We went out for brunch and then spent a few hours at the Purple Purl, one of my favourite places in the world. Andrea's spouse Patchen joined us for dinner and we three had a lovely meal. I was back at my Mom-in-Law's place before my seven year old who had spent the day with Grandma and gone to both a Second City kids' show and Billy Elliott.

On Wednesday, March 16, Daniel and I took the train to Guelph, where we hooked up with some cousins and went to the Butterfly Conservatory. Despite the heat in the building (I looked with envy at the folks who'd worn shorts), we had a great time. Besides the amazing butterflies (a gorgeous blue one landed on Daniel, to his great delight) there were many kinds of birds, fish and turtles.

Daniel and his young cousin Y. had some strong mutual admiration going on.

On Thursday, March 17, was primo cousin hanging out time. Daniel loved being the oldest cousin. Five year old N. (whose two older sisters were in Florida with Sacha) seemed equally pleased to have some boy time. 

I took the boys to see Mars Needs Moms in 3D (great animation, problematic movie) and then we went to a really great park. That evening, the boys entertained each other happily over dinner out (at Swiss Chalet - the pubs were packed with partiers dressed in green) and my brother-in-law and I had the chance to converse in complete sentences (my poor sister-in-law was at home recovering from a very bad case of food poisoning. She was more of a trooper that day than I would have been in her shoes).

On Friday, March 18, we returned to Toronto and I got to spend the afternoon and evening with my dear friend Leslie. We had lunch, browsed the Distillery District, went for a big walk along the Boardwalk and then had dinner at our favourite pub over pints. Meanwhile, Grandma took Daniel up the CN Tower and for a swim at the Y.

We took the train home on Saturday, March 19. We watched far too many episodes of The Magic School Bus  but not once did Daniel say, "How much longer?" or "Are we there yet?"

It was a very good week.

The last couple of days have been focused on re-entry - catching up with friends, going to appointments and making endless lists of things to do. As of this evening, Sacha is safely home. Tomorrow we can return to routine (bring on the fights about homework and cleaning up bedrooms). Whatever form it takes, a break from routine can be a very good thing.

On June 30th it will be three years since my first clean scan, after the cancer had spread to my liver.

For almost three years, I have had no evidence of disease (been NED, in cancer lingo).

And yet I remain in treatment.

I am asked frequently why I continue to receive chemotherapy and Herceptin, if there is no sign of cancer in my body. And the truth is that I often ask myself the same question. Certainly, I don't feel like I have cancer. And I do feel that the cumulative effects - both physical and emotional of ongoing treatment are wearing me down.

I am stuck in cancer's grey area.

My oncologist said to me last summer, "For all we know, you could be cured."

We just don't know enough.

Another oncologist I spoke to, hinted that some would take me out of treatment at this point. A third suggested that some doctors might take me off the chemotherapy and leave me on the Herceptin.

But they all agree that we just don't know enough to make any decision based on certainty. There are just too few women in my situation, younger women who have been diagnosed with metastatic breast and responded so well to treatment, to know what to do with us in the long term.

There are more of us every year, though.

In ten years' time, there will almost certainly be more answers.

And when I get too frustrated, I remind myself that if I had been diagnosed ten years earlier, I would almost certainly be dead.

So, for now, I'll take the grey.

I don't know whether it's the unseasonably warm and sunny weather (It's about time I noticed that I get depressed every winter and recover every spring), a recent change of scenery or just the passage of time but I feel myself re-engaging with the world.

Shortly after writing my last post, I decided to "give up" on forcing myself to write. I was spending tons of time staring at the blank screen or coming up with creative ways to avoid writing - and feeling pretty miserable about it. What I was doing wasn't working and I had to make a change. So I decided to walk away.

But lately my heart beats a little faster when I think about putting pen to paper and fingers to keyboard. The creative synapses are buzzing and I have lots of ideas for new projects and a whole new approach to how I go about doing them.

It feels good.

On the Saturday evening of the 10th Annual Conference For Young Women Affected By Breast Cancer, a group of participants went out for dinner.

Many of us had not met before that evening. We came from Texas, California, Massachussetts and Georgia. I was the lone Canadian. It was a truly lovely evening. The food was great and the conversation flowed - from the trivial to subjects of greater import, from the general to the intensely personal.

About half-way through dinner, the subject of health care reform was raised. I said that, as a Canadian, I couldn't understand why anyone would oppose universal health care, especially anyone who has had a life-threatening illness.

Most around the table agreed with me, while one woman stated that she was resistant to any more government interference in people's lives. I soon found myself addressing the pervading myths about our health care system and was asked whether it was true that Canadians were cut off from health care when we turn 75.

I said, "No, that's not true and we don't have death panels, either."

The conversation was very respectful and never tense (unlike many, many other debates on this issue) and soon we moved on to other subjects.

And today, I want to congratulate my American friends for ignoring the fear-mongering and taking a significant step towards greater access to health care.

I'm in Toronto for March Break and having a lovely time and have been online only intermittently. Yesterday afternoon, though, I got some surprising news that I wanted to share.

I found out yesterday that Not Done Yet is a finalist in the ForeWord Reviews 2009 Book of the Year Awards in the "autobiography/memoir" category.

"The finalists, representing 360 publishers, were selected from 1,400 entries in 60 categories. These books are examples of independent publishing at its best...

...ForeWord's Book of the Year Awards program was designed to discover distinctive books from independent publishers across a number of genres."

I feel very, very proud.

Ottawa, Ontario. March 12th. 10:30 am.


Scranton, PA. March 12, 4:15pm. S. is a huge fan of The Office. We made a detour for this photo.


Harrisburg, PA. March 12th, 6:30pm. T. checks GPS while the boys ham it up.


Port Wentworth, Georgia. March 13th, 10:45pm. He feel asleep with his arm around my neck.

When I left off yesterday, I was stranded at the Detroit airport, standing in a line-up for three hours waiting to re-book my flight to Atlanta. 

A very drunk young guy in front of me spent the whole time hitting on all the younger women in line (I was only brought into the conversation for affirmation, "Isn't she pretty?"). He also showed us the the alligator Crocs he'd bought for his young nephew (whom he called while standing in line. Not sure where his nephew lives but it was well after 10:00pm in Detroit) and asked if the shirt and tie he'd bought matched each other. Under different circumstances, he might have been endearing but I was well and truly done with him by the time we reached the front of the line.

At the 2.5 hour point, the woman behind me in line, who had been reading the Book of Ruth and worrying relentlessly about what would happen next, stepped out of the line and went directly to an agent - who served her and sent her on her way. There were some very disgruntled rumblings about this but I'm surprised to say that no one had a meltdown, or even complained to the staff. I was very impressive by the behaviour of the crowd throughout our frustrating wait.

And there were some folks around to give us perspective, chief among them the 6 year old boy who I did not hear complain even once. There was also a big guy who was sharing some beef jerky with his neighbours. I heard him say. "This is a pain in the ass but it's better than being in Iraq." Seriously. He went on to explain that he'd recently returned from a tour of duty.

It was around this time that I overheard an agent telling folks who had succesfully re-booked that they would be given a voucher for a hotel room, if their layover was due to mechanical failure but not if it was due to weather. When she then asked folks one by one which was the reason they'd missed their flight, I did my best to send them telepathic messages, "Say 'mechanical failure'!" - because, really, if no one is checking, why would you say anything else?

I knew that my own case was ambiguous, since my original delay had been due to weather but languishing on the tarmac in Detroit had sealed my fate - and in Detroit the skies were clear and there was no snow on the ground. I was fully prepared to argue my case when it was my turn to do so, to raise my voice, to threaten a blog post and even to play the cancer card. Basically, I was ready to stoop really low to ensure that my head would rest on a pillow that night.

It was after 11:00 by the time it was my turn.

I approached one of the two agents on duty. He asked me how I was. I took one look at his face and said, "I'm just fine. How are you?"

He replied that he was OK, just frustrated because the computers were now working really slowly, to which I said, "That's OK. I've been really patient until now, I can be patient for a few more minutes."

I thought at that point that the guy was going to burst into tears. He said, "You've been really..." then interrupted himself and concentrated on getting me out of town the next day. It took a while but when I left him I had a ticket on a 7:15 flight to Nashville the next morning, a connection to Atlanta, vouchers for a hotel room (no questions asked) and for breakfast the next morning and the reassurance that my suitcase would meet me in Atlanta the next day.

After getting lost trying to find my way to the hotel shuttles, I called the hotel listed on my voucher to find out how to get there. The voice on the other end of the phone told me they were full and I should go to the Quality Inn. I called the Quality and was told how to find their shuttle.

As I left the airport, I spotted the drunk guy from the airport. He was holding the free phone to hotels looking confused. I silently wished him well but was too tired to stop and see if he needed help.

I boarded the hotel shuttle as instructed, along with a lot of other punchy, exhausted travellers (we were sitting in a circle and someone started singing, "Kumbaya!"). Our first stop was a little Days Inn. I got off to confirm with the driver that he would be stopping at the Quality Inn. 

"You have to go here, Ma'am. The Quality Inn is full and all passengers are being re-routed here."

"But I just spoke to someone at the Quality Inn and she said to come on over." I'm sure I sounded petulant.

"I've been told to take everyone here, Ma'am but I'll call for you." He placed the call while I stood there and I listened as a hysterical voice on the other end of the phone shrieked at him that they were completely full, as she had already told him.

I apologized, thanked the guy profusely and got into yet another lineup in the lobby at the Days Inn. There was one person at the front desk and she was really flustered. She loudly announced that she was not at all sure she was going to be able to acccomodate all of us. As I stood at the back of the line, I felt tears pricking my eyes.

In the end, she did have a bed for me, in a smoking room (incidentally, this is the only time in my life that I have checked into a hotel room without being asked for any form of id or a credit card). I was hungry but also nauseated, so I skipped the restaurant which was filled with smoke (it  had also been a really long time since I'd been in a public place where smoking is permitted). I went up to my room, flopped down on the bed and turned on the TV just in time to watch Joannie Rochette accept her bronze medal.

The alarm went off 4 hours after I'd closed my eyes. I showered, dressed (from now on, I'm carrying clean underwear in my carry-on) and headed down to join a throng of bleary-eyed travellers in the lobby (my "free breakfast" turned out to be a tray of wizened, sugary pastries with a large sign overhead saying "Please do not smoke during breakfast." I was tempted to take a photo but didn't want to linger, out of fear of missing my shuttle).

The hotel clerk, a young man, was on the phone as I checked out, trying frantically to find another hotel shuttle. I gather that there were twice as many people in the lobby as had signed up for the airport shuttle the day before. After a couple of minutes, a shuttle was succesfully located - another instance of someone, who is no doubt paid minimum wage to do a difficult job, pulling out all the stops. I was impressed (and I emailed hotel management to tell them so).

The rest of my trip was uneventful. I sailed through security. Bought a latte and a new paperback book and read my way through my next two flights. I arrived at the hotel in Atlanta 90 minutes before the start of my conference.

I was very happy to be there. And way too relieved to complain when I discovered that my "city view" room looked out on a giant car park.

I've written before about the one major limitation of Herceptin - that it doesn't cross the brain-blood barrier. A couple of years ago (after meeting several young women with metastasis that had spread to the brain), I underwent a brain MRI. To my very great relief, there was no evidence of trouble but I think I'll will be requesting another before too long.

A few days ago, my friend Deanna posted a link to Breast Cancer? But Doctor...I Hate Pink and to Ann's take on the news that Viagra may help Herceptin to (ahem) penetrate the blood-brain barrier and thus help reduce the size of brain tumours.

 As Anne tells it:

"Herceptin, the wonder drug, has a flaw: it does not cross the blood-brain barrier. The blood-brain barrier was erected designed by nature to protect our brains from dangerous substances, such as bad viagra jokes, but what it means for cancer patients is that certain drugs can't get through to kill swollen bad cells. Herceptin cannot treat HER2+ breast cancer that has engorged spread invaded the brain. Apparently, if you add a big large generous dose of Viagra to Herceptin, it adds enough thrust power to break through that blood-brain barrier and bathe the brain in its heaving healing properties."

It's seriously interesting news but go read Ann's full post. It will make you laugh.
 
Cross-posted to Mothers With Cancer.

"We have all the tools to eliminate mortality from Her2 positive breast cancers in the next 10 years."

-Dr. Eric Winer, Director, Breast Oncology Centre, Dana-Farber Cancer Institute (February 28, 2009, 9th Annual Conference For Young Women Affected By Breast Cancer).

Her2 is a protein. And it fuels cancer cells. Her2+ breast cancers are always very aggressive and, had I been diagnosed before Herceptin was widely available, I am sure that I would not be alive today. Now, a whole host of new drugs are being developed to attack this breast cancer that affects primarily younger women.

Dr. Winer's words are among the most hopeful that I have heard in a long time.

And then today, I heard a story on the CBC about a man who is being forced to choose between taking an oral chemotherapy drug for his brain cancer or feeding his kids. It's heart-breaking.

And, I can't help but wonder, what if, when the Herceptin stops working, neither my government or my insurance company will pay for the next course of treatment? What happens then?

Dr. Winer also noted that 30-40% of all women with breast cancer metastases will eventually have the cancer spread to the brain. He told us that Herceptin doesn't pass through the brain and suggested that all women with metastatic her2 positive breast cancers have brain scans done every 6 to 12 months. Guess what I am going to be talking to my oncologist about during my next appointment? (Although, vinorelbine, the chemo drug I'm taking is sometimes used to treat brain mets. That's reassuring).

I hope this is making at least a little bit of sense. I have a raging head cold and am feeling pretty muddled. My spouse was laughing at me this evening, reminding me that I am always very stoic about the big things (like, say, having a liver the size of a watermelon) but a garden variety head cold turns me into a whimpering puddle of goo.

I guess I am reminded that, generally speaking, I am very healthy these days. And that, in itself, is very hopeful.

This brings me to my second favourite quote from the conference:

"The best predictor of doing well is doing well."

-Dr. Winer.

Cross-posted to Mothers With Cancer.