Friday, February 25, 2011

Day 89: Bonnie G in Mathmagic Land


Do you remember film strips in grade school?  You know, the films that the teacher actually had to thread through the reels and project on the screen above the teacher's desk?  With the grainy lines and hairs showing up on the projection from time to time?  It might be ancient history for those of you reading this blog, but it brings back fond memories for me.  The memory of a dimmed classroom filled only with the the sound of a spinning film reel makes my heart warm.

When I was in grade school, my favorite film strip was "Donald Duck in Mathmagic Land." It was full of interesting historical references and practical applications to math -- things that were actually fun to learn about like Pythagoras and his "golden rectangle" theory that was the basis for architecture and art, math's relationship to the octave scale in music, and how angles and geometry are the basis for billiards. It opened up a whole new world to me...and made math cool (as an aside, this "featurette" was nominated for an Oscar in 1959).  If you want to see the strip, you can view it here.

For the last two weeks, my head has been filled with numbers and all I can think about is Donald Duck consumed by mathematics.  So, in grand fashion, I'll break out this blog into a few parts: Fractions, Statistics, and Things Which Are Irrelevant (to this post's theme).

Three-Eighths (3/8) Does Not an Interesting Fraction Make
I completed my third round of chemo yesterday.  Three down, five to go.  In some senses, I can't wait to get to chemo each treatment, because it is one step closer to finishing chemo!  But yesterday, I was feeling sort of "blah" about the experience. After all, now all I can say is that I'm "3/8th of the way through."

3/8ths: What a lame fraction.  What has that fraction ever done for anyone?   If you were wagering with odds of 3/8, it wouldn't be a great bet, right?  It's just over 1/4, but not quite 1/2.  It's what one would call a "tweener" fraction.  Wimpy. Weak.  I want a bold fraction like 3/4.  Or better yet 4/5 -- even closer to a "whole" 1/1 = 2/2 = 3/3, ad infinitum!

But, I can look at this in a positive light, too.  I am 3/4 of the way through the first half of my chemo treatment, which is supposedly a little harsher than the second half. I am taking a different set of drugs during the first four sessions than the last four sessions (Adriamycin and Cytoxin for the first four treatments, versus Taxol for the last four sessions, for those of your cancer geeks out there).  The "A" drug is the trippiest.  Here's a pic of what it looks like.  I can't wait to have that one over with.


The next session will be something to really celebrate: half of the way through to completion.  If you make it to 13.1 miles in a marathon, you're not stopping, that's for sure.  The same goes for this treatment, too. 

So, I shouldn't complain.   While I'm allowed to comment on how weak the fraction 3/8 is, a fraction that lame doesn't even have the power to dim my positive attitude. 

What helped me through the session is that my brother joined me for my treatment yesterday and the time flew by.  For those of you who know my brother, he is pretty chatty guy.  So, he barrelled into my chemo treatment room, sat down, and immediately said, "Okay, let's talk industry gossip."

Bob and I both work in the Chicago financial community. And we both tend to know a fair amout of people, so he's always regaling me with news of "so-and-so changing jobs" or telling me about the details on the new $4 million house that so-and-so Portfolio Manager bought in Winnetka (a leading indicator for the health of that PM's firm, perhaps).
 
Here's a picture of me and Bob after my third chemo treatment.


And here's a pic of my udpated Chemo Countdown Board.  I can't wait to get to the bottom half of that thing. 


"There are Three Kinds of Lies: Lies, Damned Lies, and Statistics" - Benjamin Disraeli


So, something else I was thrown with for the last two weeks, were a lot of new statistics.    I know, I know. Statistics are booooring.  So I'll try and lay them out for you pretty quickly and easily.  Read the underlined portion for the cliffnotes on this.

1) Radiation: I met with a radiologist last week who gave me some charcoal grey statistics on the benefit from me undergoing radiation therapy following my chemotherapy.  For someone like me, with between 1 and 3 positive (cancerous) lymph nodes (in my case, I had one positive node that was removed along with 6 non cancerous nodes), the statistical benefits from radiation are mixed.  There are some adverse side effects from radiation (after all, it's radiation being targetted into your body daily for six weeks), so it's a tough decision.  I will likely proceed with it but only after I get a second opinion.  Basically, what my guy said was that there is an older study (before the improvements of chemo and surgery were made) that indicates a 10% reduction in the recurrence of the cancer in the lymphatic area.  This is completely unrelated to the information in point 2 below (different area of the body; different odds).
Statistics: 10% improvement based on old studies.  Verdict: Jury Still Out.

2) Chemotherapy: So, I finally got around to asking my oncologist about the statistical benefits of my chemotherapy.  All along, she said said that my cancer is "curable" and that I'll have a "very low" chance of the chemotherapy not eliminating all of the cancer in my body.  But there is still the risk.

Basically, here's the deal.  After my lumpectomy, without chemotherapy, I had a 30-40% chance of the cancer still being present in my bloodstream and showing up at a later date (typically between one and three years) in the form of metastasis.  There is no way that they can test for that until the metastasis happens.  Let's hope it doesn't.

After chemo, my odds of metastasis go down by 20%.  So, I still have a 10-20% chance of any cancer not being eliminated through chemotherapy and later showing up in the form of metastasis.  The most likely areas for metastasis are in the lung and liver.  I was hoping the statistic would be better than 10-20%, but my doctor said that attitude has shown to be a huge contributor to non-recurrence, and I think I have a pretty damn good attitude for someone who got cancer at 36 years old.  So, I just gotta make it to 2015, folks, and then I can hope to be in the clear.
Statistics: 10-20% chance of recurrence in the form of metastasis post-chemotherapy.  Verdict: Wish it was less, but there's nothing else I can do but have a great attitude and live my life.   

3) BDM and Oophrectomy
I spent nearly 12 hours at Northwestern yesterday. I started my chemo at 7:30am and didn't finish all my appointments until 7pm. I'm usually out of chemo by 11am and home shortly thereafter, but yesterday I decided to meet with a reconstructcive surgeon regarding my decision to go forward with a prophyactic bilateral double matectomy (BDM) and reconstruction. I also tagged along with a friend who is also BRCA positive in her meeting with an ovarian doctor regarding our collective risk of getting ovarian cancer, the deadliest cancer for women.  I was reminded of a few important statistics, that make me confident of the steps I plan to take to lower my risk.

Let me break it down:

I have a 50-80% chance of a new breast cancer developing if I don't get a BDM.  My risk drops to virtually 0% post-BDM.
Given that I am BRCA 1 mutation positive, I have a 50-80% chance of getting breast cancer again in my lifetime. Each of us has two BRCA 1 genes; one of mine is mutated, (ie, its broken).   It is likely I am at the higher end of the risk scale for a new cancer developing, because my lovely "healthy" BRCA strand has shown it has been able to break down and since the broken one can't help it recover, I got cancer.  Eventually, the "healthy" gene repairs itself, but since it broke down temporarily once, it may have a propensity to do that again, causing another cancer of the breast to form.   So, removal of all of my breast tissue is the best option for me to reduce my risk by close to 100%.  This is what Christina Applegate did two years ago.  She has been quoted as saying, "Whatever I'm gonig to die from, I know it won't be breast cancer."  That's a place I'd like to be, too.   I will likely undergo this procedure sooner than later. Likely this summer.  I am confident in this decision and appreciate all of the support from friends and family on this.  I know it's a squeemish topic, but it is so important for women to be able to discuss this openly.  We have the knowledge to get ahead of what could kill us later in life and remove it from our bodies as soon as possible that there is no reason to be shy about it.  Plus, the reconstruction doctors are all amazing.

I have a 15-40-% of developing ovarian cancer as a result of this mutation without an oophrectomy. This risk drops to ~1% following an oophrectomy
The general population has a 1.5% chance of developing ovarian cancer in their lifetime.

The issue with ovarian cancer is that it is nearly impossble to "screen" for ovarian cancer right now until it's already too late.  Ovarian cancer typically doesn't show up on ultrasound screens until has already metastasized into areas around the ovaries (bladder, pancreas, liver, etc).  An oophrectoomy is the removal of the ovaries, which prevents ovarian cancer from occurring. This is a procedure I plan to get right after Joe and I have kids in a few years.  Typically, experts recommend waiting until after children and as you hit the age of 40.   The good news is that using birth control and having at least two children reduces your overall risk for ovarian cancer.

I joined Gilda's Club last month, which was started by one of the original cast members of Saturday Night Live, Gilda Radner.  Gilda died of ovarian cancer in 1989 at the age of 42 before we had knowlege about the link between ovarian cancer and the BRCA mutation.  Her symptoms started at age 39 and she was diagnosed a year later.  She was a beautiful, hilarious, phenomeonally spirited woman, who I just wish could have benefitted from what we know now about how to prevent this cancer.  Us BRCA 1+ women today have her to thank.  We stand on her shoulders and our grateful for our own surival. Thanks, Gilda.

Gilda Radner

Onto Unrelated Topics

Joe
Joe recently quit his job as head of the Fine Art Department at LH Auctioneers and started a new position at the Haven Art Group this week, where he will be advising private clients, galleries and museums on the handling, preservation, and claim management of their art collections.  I am very excited for this new development for him.  It is busy times for us, but we are happy and doing well.

My New Hair
So, I debuted my new hair at the office two Mondays ago.  Things went fine and I'm already very used to it.  I have been taking meetings with colleagues outside of the firm and I really don't get a sense that they can tell at all.  So, that's good.   I misspoke in my prior post about my hair being from Mongolia. My hair guys corrected me last week.  My hair is actually from Siberia.  Sorry, Setseg. 

Thank you for the wonderful support
Over the last two weeks, I have received numerous gifts and words of encouragement. It is impossible to thank everyone since I know I'll be leaving a few people out, but I want to try to acknowledge you all here. If you don't see your name,  it's not intentional.  Your outreach made an impact.

Celeste and Chris: for your fun presents throughout this whole journey.
Mom, Dad, Suzy, Colleen, and Bob: Thanks for everything. Colleen, thanks especially for the soup!
Robyn & Drew: Thanks for the thoughtful package of scarves and hats.  It was a lovely gesture.
Cousin Barbara, Brooke, and Syndey: for the lovely card. I loved that the girls wrote me positive wishes!
Aunt Marcia, Rachel, Josh, and Elizabeth: Thank you for the beautfiful flowers! They are so cheerful!
Paulina, Guy, Petra, and Cameron: for the *delicious* Valentines Day cake!  We ate it all right after you left!
Terry and Amelia: for the beautiful flowers!  Thank you.
Rachel & Dave: for the fun DVDs - can't wait to watch
Jess & Fred: for the wedding care package and the bird clips. So cheerful
Ann, Josh, and Sophia; for the wonderful Godiva chocolates for our engagement!  You are ever thoughtful.
Amanda K: for positive attitudes and fun gifts in the mail & please thank your mom for her thoughtful card.
Anne and Joe: for the cheerful yellow flowers. Thank you.
Owen: for sending on some new tunes. It really made my day when I had the chance to listen to them!
Tenaya and Eric: for your weekend meal drops and fun conversations.
Nicole Simon: for your thoughtful card.
Heather (Mouse) : for the tootsie rolls. Are you sure we didn't know each other in another life?
Treasa M and Brenda L: Brenda, thanks for the package of materials  T, thanks for the beautiful earrings!

Peace and Love and Joy and Health,
Bonnie

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