Sunday, March 5, 2023

December 7th to March 5th 2023 - New Year, New Challenges


At this stage of my life, I am excited about every extra six months I get. My oncologist, who is reluctant to offer a prognosis, is willing to say when she is confident I'll be around another six months. Such was the prognosis in December. I happily said that gives me a new year, an additional birthday and even a third anniversary of my cancer journey.

We immediately started making plans to visit my sister in Mt. Dora, FL in mid-February. We love visiting Karen because, in addition to her kids' company, we can leisurely decide what to do when. Even our dog, Adie, loves staying with her.

This year we decided to take the canal boat tour in Lake Dora. I can't recommend this enough. The flora and fauna were amazing. We were joined by cousins Barb and Jim Pharo, pictured below. We rode our bikes on the Wilderness Nature Trail where we encountered numerous bird species and alligators. We traveled to Clearwater to visit Julie and had a great lunch at an oceanside restaurant followed by a visit to a local state park. The weather was great for the 10 days we were there.

The Health Update

My most recent CT scan still described my cancer as "stable." The drug regimen I am on is working for now. The same CT scan, however, identified that my previously identified "moderate aortic stenosis" had progressed to "serious." I visited my onco-cardiologist who scheduled me for an echocardiogram so he could compare results to last year's echo. Not only did it also identify "serious" aortic stenosis, but I experienced atrial fibrillation (AFib) throughout the procedure.

If you are unaware, aortic stenosis, I've included an image and a link to an explanation:

What is aortic stenosis?

Atrial fibrillation is an irregular and at times very rapid rhythm (arrhythmia) that can lead to blood clots in the heart. This increases the risk of stroke, heart failure and other heart-related complications.

Next Steps

My doctor is referring me to a stuctural heart valve clinic and an Afib clinic. Their job will be to determine whether or not valve replacement is the best choice for me. There are many options to be considered.

So spring is in the air, I'm feeling pretty good and I plan to carry on -- at least in six-month increments. I hope this finds you well.


Tuesday, December 6, 2022

September 2nd to December 6th - Answers, Answers and More Answers


It's been more than two months since I updated this blog. I felt like I had nothing to say. I've been feeling pretty good. Yet I was feeling "unsettled." When you have "comorbities" it's difficult to sort out what symptoms come from which health concern. Not only do I have cancer, but I have issues with my heart. These include afib, and significant calcifications in my aortic valve and root.

I'm now on my 5th round of Ibrance and tolerating it surprisingly well. This drug is designed to slow the progression of my type of cancer. It must be working. I want to thank those who convinced me to give this drug a shot. (You know who you are).

Since September I've had a mammogram, targeted ultrasound, total body bone scan and a CT scan. I had a clear mammogram and the findings for both the bone scan and and CT described my cancer as "stable.".

I met with my cardiologist last week and he scheduled me for an Echo in February so we can measure any changes in calcification in my aortic valve. I may eventually be a candidate for a valve replacement. But how does this square with Stage 4 cancer?

Today I met with my radiologist and got nothing but good news. Despite having radiation fibrosis, it, too, was described as "stable." She reviewed CT scan images with me and answered all of my questions. She said that my Stage 4 cancer is different from other Stage 4 cancers. The involvement of my sternum is indicative of a small progression from my chest wall. Typically, cancer spreads through blood vessels or lypmph nodes, which she said is not what has happened in my case. She claims I could live for years if my medications are able to keep my cancer "stable." I never knew what a wonderful word "stable" could be.

So I'm going to shift my focus to Christmas and other end-of-the-year celebrations instead of "waiting for the other shoe to drop." I realize how blessed I am to have such a wonderful team of doctors who treat me as an individual and not just my disease.

Decorating is hard for me, but I at least managed to get something together. Here is the outside of our house. Now all I need is a fire in the fireplace and the company of my husband and our dog.

I wish all of you who have shared this journey with me the best the holidays have to offer. Blessings to you, your families and all who are struggling with their own health battles. Love you.


Thursday, September 1, 2022

August 7th to September 1st - I Am So Happy!


I always look forward to September 1st. As a long-time teacher, September has always represented the excitement of a new school year. The days get a little cooler. My idea of "perfect" weather is one where you don't need air conditioning or heat. 

I'm also happy because I am now on my second round of treatment with Ibrance. This drug is designed to slow down cell growth. It impacts cell division in both healthy and cancerous cells. It does have known side effects, but I seem to be tolerating them fairly well (as opposed to my experience on Verzenio).

It costs a lot of money to keep me going. The list price for 21 Ibrance pills is $13,000 plus. Add to that the cost of my monthly injection of fulvestrant ($740). This does not include the cost of bi-weekly doctor visits and blood draws. Luckily for me, I "only" have to pay $297 a month for Ibrance and a $25 deductible for the fulvestrant. I really don't know how people with fewer resources do it.

I'm just grateful for these additional days with good quality of life. So celebrate with me. There are many beautiful fall days ahead.


Sunday, August 7, 2022

August 7th - A Time of Transition- Part II


The Tipping Point - Health Update

Last September, I had a discussion with one of my surgeons who had just done a surgical biopsy on my breast. Although all of my doctors agreed that I had cancer in my chest wall, the pathology report did not confirm that. (An additional biopsy at Ohio State did confirm "mucin" in one of their samples, but individual cells could not be stained). 

I asked my surgeon what I could expect. I had to laugh when he said "pain", because I had honestly kept the thought of pain off of my radar. So I write this post almost as a "marker" in my cancer journey. 

I started taking Ibrance a week ago Friday after much reluctance. Luckily, I haven't seemed to experience any of the negative side effects I did on Verzenio. Ibrance belongs to a class of drugs designed to inhibit cancer cell reproduction. 

I realized this morning that most of the pain I am currently experiencing is within my breasts/chest wall and not from the bruises from my recent bike fall. This is new and I don't know if the medication is playing any role at all. We'll just have to wait and see.

So this post is short and sweet. 


July 17th to August 7th - A Time of Transition - Part I


The Tipping Point

I am approaching the two-year anniversary of my major chest reconstruction (August 19th). I have been truly blessed during the past two years. I've been able to travel (Utah and the Canadian Rockies), take a few bike trips (West Virginia, Virginia, and the GAP Trail in Pennsylvania), and have wonderful life experiences with my family and friends. All of this has happened with no pain, despite my acknowledgement that I do in fact have breast cancer that has also invaded my chest wall.

In an earlier post, I acknowledged that my oncologist advised me not to ride my bike any more. I was devastated as this is my "happy place." After I got over the shock, I spent a couple of weeks trying to find a bike that would enable me to ride more safely with fewer balance challenges. I considered a trike, but was surprised to read how often people tip those when riding around a corner at too great a speed. I settled on a Rad Enhance5 that has a lower center of gravity and fat tires -- the combination upping the chances that I would not fall. Here is a picture:

Bill and I put it together, taking care that the handlebars and seat height were comfortable for me. For two days, I rode it to the bakery with no problem. On the third day, I decided to ride it to my oncology appointment, a trip of 15 miles when combined with a bakery stop. Things were great -- I even told my doctor of my new purchase. BUT my luck was about to run out.

Shortly after leaving the doctor's office (luckily riding on a bike path vs the road), the handlebars slipped. Bill and I had forgotten to tighten down the handlebars once we agreed on positioning. They slipped forward, and when I tried to correct it, the handlebars actually rotated 180 degrees, making it impossible for me to grab the brakes. Down I went, and this fall was hard.

Two wonderful women stopped to try to help, as did a man with a pickup truck. They picked me up and the man put my bike in the back of his truck and drove me across the street to a picnic shelter so I wouldn't have to wait for my husband in the sun. Bill arrived and was more than a little irritated with me as he thought I was riding to the Christ Outpatient facility in Montgomery (four miles) and not all the way to Mason (15 miles on the road). I was bruised and the pain was pretty significant, but that is to be expected.

Unfortunately (or fortunately) I had to tell my lovely daughter, Liz, about the fall because we had tentatively planned to go to Columbus on Sunday. She called my oncologist's office to tell them of my fall. The next thing you know, I get a call advising me to go to an Urgent Care because I take blood thinners. The doctor at the Urgent Care wanted me to go to the ER because he felt a CT scan of my brain was in order. Otherwise, I could have an undetected brain bleed. (I was wearing a helmet). All tests came back negative. It was just going to take time for me to heal, and boy has this past week been a week of pain and healing.

Once again, I was advised NOT to ride my bike. So the question is, am I stubborn or stupid?

But wait -- there's more. Read Part II for an update on my cancer journey.

Note: I've mentioned before that writing this blog is therapeutic for me. I really appreciate all of you who are on this journey with me. Thank you. It means a lot to me.


Sunday, July 17, 2022

July 17th - The 100th Anniversary of My Mom's Birth


It's been a tough day!

I'll be honest. I've been on the verge of tears all day. It's my Mom's birthday anniversary. She would have been 100 years old. We were really close my whole life, and today I miss her. I wish I had been able to talk to her more about her cancer experience. She always seemed to take it in stride. 

In about September or October of the year before she died, my mother knew that her breast cancer had returned. She lost about 35 pounds in two months. Sixteen years before, her doctors had predicted that she had about nine months. Sixteen years and two husbands later (my Dad died at the young age of 57 of cancer), my mother was sure she was having a recurrence. Multiple scans and tests could not confirm it. Fun Fact: It takes about one billion cancer cells to form a 1 cm lump that can be detected by most of our technology. See paragraph 7. When she was finally diagnosed, it was in her brain, stomach and bones. One of my surgeons explained to me that I, too, could have cancer throughout my body that is not yet detectable. Who knew?

By December, there was no longer any doubt. My mother asked me to come to her house and help her label some of her things for distribution among my siblings following her death. I have five brothers, so you can imagine there weren't going to be a lot of things they would want. For instance, I doubted they wanted one of her many dolls. While we were working, I expressed my feeling that her husband would be reluctant to do "what she wanted" because he would want to her to hang in there and I knew she valued quality of life. She said he would respect her wishes. I won't go in to detail, but suffice it to say, that I think she was "tortured" her last few weeks of life.  As things progressed, she said she didn't want a feeding tube, but he overame her reluctance. (It is because of my first-hand observation of her quality of life post-feeding tube, that I've had it put in my medical record that I do not want one).

I remember one of the last real conversations we had. I was scheduled to go to Wyoming for a two-week science course in July and was debating whether or not I should withdraw. She asked me when it was. When I gave her the dates, she said there would be no problem "as it all will be over by then." She died on June 28th.

My stepfather tried to limit our visits. I think it was because we had accepted her eventual death and wanted it to be as comfortable as possible. He had lost his first wife to cancer and felt that perhaps he had not done everything possible to save her. He wasn't making that mistake again. If I'm honest, part of me was grateful because I really didn't want to be too involved in the every day dying process. But now I wish we could have a conversation. How did she maintain her overall positive attitude up to the end? How could she think of others needs (like my desire to take a course) when she KNEW she would die soon? 

Sometimes, it is the happy thoughts that bring tears to my eyes. About 8 months ago, my cousin Jim Ryan and his wife Karen, digitzed their old family movies. They shared one with me from 1948. It had been filmed by Mom's brother, Jim, who is featured at the end of the clip. My Mom and Dad were newlyweds. As I was born in April 1949 and the movie was shot in August, I was probably conceived that month. Here is a link to a one-minute movie of my Mom in front of their apartment, At that time, life was very exciting, with all of the possibilities of their lives before them. 

Click on this link for video:

Mom, thinking of you today. Hope you are thinking of me. I need some advice.


Monday, July 11, 2022

July 11th - The Dreaded Health Update



In June I was scheduled for both a bone scan and a CT scan to assess if my treatment plan needed to be adjusted.

The bone scan did not appear to have significant changes. The major difference is that previous reports did not mention "faint uptake in the medial left clavicle."

Next up was the CT scan. This wasn't quite as optimistic.

In previous studies, the radiologists have mentioned how difficult it can be to measure the "soft tissue mass." However, the radiologist noted that the mass had increased in measurement by 3 mm. Of more concern to me was the second sentence which noted that the mass "appears to extend through the chest wall and into the pleural space and is suggestive of invasive neoplastic process." He also noted that there was "worsening of the underlying pleural" and "extensive intrathoracic involvement." Here is a comparison of the March and June images:

My daughter, Liz, accompanied me to the followup appointment. The weekend before, I had my 70-pound bike fall on me as I tried to dismount. I tried to break the fall with my arm and had experienced a fair amount of pain over the following couple of days. This, in combination with the falls I had on our bike trip led my doctor to suggest that I no longer ride. I felt like crying.

She also ordered up an immediate brain MRI to see if the cancer had metastasized to my brain. Thankfully, it had not. However, the report did note "moderate chronic small vessel ischemic white matter disease." My limited reasearch indicated that this can contribute to balance issues in older adults." If I'm honest with myself, I know my balance is not quite what it used to be.

After reviewing these results, my doctor suggested that I consider taking Ibrance at a lower dose. She had a nurse educator call me. Among the side effects she mentioned were impacts on white blood, hemoglobin and platelet counts. You are more susceptible to infection and I'm to call if my temperature exceeds 104. It can lead to increased fatigue and poorer liver function which they will monitor carefully. In rare cases, the medication can lead to interstitial lung disease.

I had previously refused this medication because it is similar to Verzenio which I stopped due to side effects. I am stressed about what to do, although I said I would "try" it and see. Now I'm second-guessing this.

So there you have it. I think I'll let my mind travel back to Canada. Here is one of my favorite pictures from that trip.

Peace to all who are sharing in my journey. I appreciate you.


June 3rd to July 10th - Vacation in Seattle and the Canadian Rockies


We decided to take one final "big" trip. It was difficult to plan because we had a lot of criteria:

  • We wanted to limit the amount of walking we had to do.
  • It had to be largely planned by someone other than us.
  • We wanted to limit our Covid exposure as much as possible.   
We decided to travel to Seattle for a couple of days and then travel to Vancouver, British Columbia to take the Rocky Mountaineer train. For those who are unaware, the Rocky Mountaineer is a daytime only train with a choice of four routes. Nights are spent in hotels arranged by the tour operators. Luggage is transported to each hotel and is in your room when you arrive. 

We wanted to go to Seattle to visit the Rad Showroom, the maker of our ebikes. Luckily for me, there were no new models that I lusted after. I came away quite satisfied with the bike I have. We took the ferry over to Bainbridge on a beautiful day and were able to get beautiful shots of Mt. Ranier. On previous trips, we faced rain and fog which made pictures of Mt. Ranier impossible.

After a short visit in Vancouver, we took a taxi to the Rocky Mountaineer train station and prepared for our adventure.

I can't recommend this trip highly enough. I have more than 300 pictures. Hopefully, these will give you a feel for the experience. 

The area just outside Vancouver was very green. Referred to as the Frasier River Basin, snow melt from the mountains formed very fast currents in the valley. The area has experienced warmer than usual temperatures.

The next ecosystem was a dry desert area. The temperature got up to 101 degrees at one point. They advised us not to go outside to take pictures as the air conditioning could not keep up with the door being repeatedly opened.


For two days, we traveled the Canadian countryside in absolute comfort. The drink cart came down the aisle starting at 10:30 am -- and the "drinks" included every kind of non-alcoholic and alcoholic drink you can imagine. This was followed by the snack cart. A couple hours later, gourmet lunches were delivered to your seat based on your order earlier in the day. Of course, this required the "drink" cart to come by. The drink cart made its way down the aisle five times a day along with the snack cart (twice a day) and the dinner cart. They also included a dessert. We were treated very well.

As the elevation increased, so did the beauty of the surroundings. I'd need to post another 100 pictures to do it justice. 

At the end of Day 2 on the train, we ended our adventure at Lake Louise. Buses took us to our hotels. You can't imagine the amount of organization, as this train consisted of 23 cars and 700 passengers.

The next morning, Bill and I got up and took a bus up to Lake Louise. The lake lived up to its hype.

The next morning, we went by bus to the town of Banff in the province of Alberta, Canada. This was clearly the highlight of our trip. We stayed in the most incredible hotel (Rimrock) for two nights. 

In Banff, a full-day tour was scheduled.The highlights included a ride on a gondola to the top of Sulphur Mountain. There were several scheduled stops in the area, including lunch in a great local restaurant.

We took a one-hour boat ride on Lake Minnewanka.

On our final day in Canada, we were bussed to Calgary for our flight home. We enjoyed a great dinner out and rested up for our return trip. We were proud that, once again, we were able to rise to the challenge, and make it home with nothing but good memories. 

In the next post, I will provide a short health update. So click on Part II if you are interested in the nitty-gritty.


Thursday, June 2, 2022

April 12th to June 2nd - Catching Up


          "Do what you can with what you have where you are."                                                                  Theodore Roosevelt

I've written this post in my mind at least three times. I considered writing a tribute to my husband, who has so lovingly and patiently helped me deal with my ups and downs. I thought I might discuss my health, but there really isn't much to say. I'm scheduled for a bone scan and a CT scan in the next two weeks and may have something to add then. In keeping with my theme of "dying or going on vacation", I could discuss our accomplishments and future plans. I think I'll go with option #3.

At my April oncology appointment, I asked my doctor how long she thought I could safely plan a trip -- in other words, feeling well enough to do the basics. I was surprised at her answer. She said if I didn't hold her to it, she thought I'd have six months. She then added the caveat that one of the variables is "what I'm willing to do do treat it." She knows that I've repeatedly emphasized that I value quality of life over quantity of life. As good as I've felt, however, I expected her to think I could safely plan a trip in the next year. 

I'm at the stage where you have to schedule everything around doctor appointments and tests. We already knew we were going to take a bike trip on May 19th to ride about 70 miles of the Great Allegheny Passage (GAP Trail) from Ohiopyle, PA to Cumberland, MD. 


We drove to Ohiopyle, PA which has a great state park famous for white water rafting in the rapids of the Youghiogheny (Yug) River. The GAP Trail is 124 miles from Pittsburgh to Cumberland, MD. Here the path connects to the C&O Canal Trail enabling the ambitious rider to ride from Pittsburgh to Washington, D.C. Bill and I both find it difficult to walk any distance, but we didn't anticipate some of these difficulties:

  • At our first BnB, we were required to climb a rock stairway of about 20 steps with a rise of about 10 inches for each step -- almost impossible for us.
  • The second night, we stayed on the second floor of a BnB with a very low toilet and no grab bars. I struggled to get off the toilet.
  • On our first day out, we rode 33 miles with over two hours in a severe thunderstorm. This made the path muddy and more difficult to navigate. The entire path had a small uphill grade of 1% to 2% as we were traveling up to the Eastern Continental Divide. On any other day, I think I could have done it, but we were both so exhausted that we didn't have the strength to go to dinner. We settled for instant oatmeal cereal at the BnB.
  • I was aware of the "cancer" in my chest and had pain in my underarm where the lymph nodes had been removed.
  • All of the above made me aware that my future could include physical challenges I am not yet ready to accept.  

 So How Was the Trip?

I knew once we'd been home for a week, all of the memories would be good. On the first day, we rode through a major thunderstorm. My phone signalled a tornado watch, but when we arrived in the next town, the sirens were a call to the volunteer fire department to clear downed trees and power lines. It was not fun. However, we met several cyclists at a local lunch stop. Two were riding from D.C. to the state of Oregon. I was impressed.

Day 2 was beautiful. We traveled up to the Eastern Continental Divide. From there we had a beautiful view. However, as soon as we went through the tunnel, I came in too "hot" and managed to fall. I insisted that Bill take a picture of me looking like a beached whale. From this point on, the trail gradually descended. We stopped in a town called Frostburg for the night.

I managed to short out my bike battery by touching the key to the "wrong side." This forced us to shuttle the last 16 miles to Cumberland, MD where we played tourist and rode a diesel train through the exact section we would have ridden on our bikes. It was very relaxing.

We stayed at the Fairfield Inn in Cumberland which is on the bike trail and caters to bikers. It was wonderful. It was so unusual to have breakfast with an ever-changing cast of bikers with their bikes. Most were picking up the trail and riding on to D.C. We caught a shutte with our bikes back to Ohiopyle, picked up our car and decided to head home a day early. Rain was forecast for the rest of the day.

Bottom Line

The trip was a success. We "upped our game" by taking all of our clothing, etc. on our bike and traveling straight through. I think my days of traveling 33 miles in one day are over, but 15 miles would be very doable. Every time I mention problems we may encounter to my husband, his standard answer is "we'll figure it out." And "figure it out" we did. So what's next?

We listened to my oncologist's advice and planned a trip we thought we could handle. On June 23rd, we are flying to Seattle for a couple of days, then traveling to Vancouver, CA and taking a trip on the "Rocky Mountaineer." This train only travels during daylight to Kamloops, Lake Louise and Banff. From there we will be bussed to Calgary. We will fly home from there via Toronto. It's all planned with comfy hotels and luxury train travel. We can't wait. We got our second COVID booster in hopes that COVID won't prevent us from going.

I'll let you know how the scans go. Meanwhile, we're going to do "what we can with what we have." Blessings to all reading this.


Monday, April 11, 2022

February 21st to April 11th - What's Next?

 What's Next?

This seems to be the question I ask myself every day -- several times a day. Should I plan a trip? What will I be able to do? When will this cancer begin to take its toll? Why do I keep putting on weight? Will these Cincinnati gray and rainy days ever end?

My Health Update -- or at least as I understand it.

In late February, I had CT scans of my chest, abdomen and pelvis. This was followed up by a whole body bone scan in mid-March. A visit to my oncologist was pretty encouraging. The CT scan was "stable." When the area of concern in the bone scan was compared to the same area on the CT, my oncolgist said that she "would not specifically call this progression." I've included a picture of the bone scan.

The part in the red box seems to show cancer in the area of my collar bone (clavicle) and sternum, the same area where I had surgery August 19th, 2020. My oncologist did not suggest that I change anything in my treatment plan, which includes a monthly injection of fulvestrant to control estrogen production in my body. My tumor, like Mom's, is ER+ or "feeds" on estrogen.

I continue to feel great. I told her I like to "pretend" that I don't have cancer. She told me, that in her professional opinion, I do. This is what she put in my notes:

The last couple of days, I feel like there has been a "lot" of activity in my chest. I have no idea if this is indicative of anything, but I won't have long to wait. My next appointment is in 11 days. Apparently, I'll have scans every three months. 

My mood always improves as the weather warms up and there is more sun in the sky. I also celebrated my 73rd birthday on April Fool's Day, a date I wasn't sure I'd make a year ago. So I guess all I have to do is see "what's next." Thanks for reading along with me.