Team Margie, NY Office

My brother Joe is heading up operations for Team Margie New York. I can’t think of a better person to be in charge. Three years ago Joe had an accident that resulted in a number of serious injuries, including a traumatic brain injury. Joe has spent every day since fighting to regain his strength, and to build the life that he wants—always with courage, determination, and amazingly, humor. Joe is my role model on how to face a medical crisis head-on—I think of him every day as I go through my own fight with cancer.

After Joe’s accident, my parents chose to move to New York, where they could spend more time with Joe and support him however he needed. Their courage and determination matches Joe’s. I’m happy to say that they are working part-time for Team Margie now!! (Thanks Joe for sharing them!).

Some Old Friends

This weekend, when I told Alice that I had some old friends visiting, she looked concerned, and asked, “How old”?

So, Kathy is not one of my oldest friends, but she’s certainly been a friend longer than anyone. Kathy drove out from Elk Grove on Saturday, we took a hike around Bon Tempe, and we just hung out. In the 40 years we’ve known each other, we’ve been through a lot together, and after spending the day together, I felt very reassured that this breast cancer is just another blip in the road of our long friendship.

Joan and Veenu also stopped by for a visit, and as is the tradition with us, came loaded with food and some pretty good stories. It is always fun to hang with them and rehash some of our sillier memories. I love you guys!

My brother Jim ran the Hood to Coast this weekend (he’s the handsome devil on the right), which as many of you know is one of the more grueling relay races out there. That Jim chose to spend his birthday weekend running this race says a lot about who he is—he’s one strong guy. And in a moment of endorphin overload, Jim invited me to run with him next year, and I immediately accepted. I’m sure he did not check with his team first, but too late—I’m in for 2012!!

Identity Theft

Week 2 of chemo…done. Ten more chemo weeks, six more rest weeks—one of which is next week.

Because I feel so good, and you can’t tell from looking at me that I have cancer, for the most part, I feel pretty much like my normal self right now. Sure I think about having cancer a lot—but I don’t have many moments where I feel like a Cancer Patient.

On chemo days though that tends to change. The IV in my arm, the pole that goes everywhere with me—its hard to maintain a sense of normalcy during those few hours in the lounger. The moments where reality hits hardest are when I have to drag my pole with me into the bathroom, catch a glimpse of myself in the mirror and almost don’t recognize myself.

The good news though is that I’m feeling great and looking forward to 10 chemo-less days—that’s a good long stretch to feel normal. Happy weekend everyone!

(Ton of bricks/3) + Chris + Chocolate = Fine

Monday was a big chemo day, and it hit me last night. I wouldn’t say it hit me like a ton of bricks, but maybe hit me like a horse? Or a piano? In any case, the wind-down started in the afternoon and by dinnertime I was cooked. Chris sent me to bed with a book, and then took care of dishes, helped Elsa with homework, and got the girls into bed. This after shopping and cooking dinner. Best. Husband. Ever. (Thanks Susie!).

Fortunately, my friend Heidi stopped by yesterday with a well-timed gift of chocolate, from the company she works for, Chocolatl. There is plenty of conflicting information out there about the right diet to follow when you have cancer. One of the few foods people seem to agree on as beneficial is dark chocolate—and by dark, I mean really dark (65-70%), with a serious dose of cacao beans (not sugar!).

Chocolatl is an amazing company that creates amazing chocolate—you can check out their website to learn more about them, but suffice it to say, they are doing everything right, including creating a rocking piece of chocolate.

Between the good sleep I got last night, and the chocolate, I felt good enough to go the gym this morning. All is well!

A Couple of Bad Nodes

The picture above is definitely not of a couple of bad nodes. It is in fact of two very good girls on their first day of school. We are so glad school has started, and that we are back in the midst of so many wonderful Wade Thomas teachers and families. Thanks everyone for your support!

The week after my diagnosis, I had an MRI, which showed a couple of nodes that looked, in scientific terms, weird. The MRI was followed by an ultra-sound, which was followed by a PET scan last week.

PET scan results show that the cancer has spread into two nodes in the internal mammary chain. What does this mean? It means the cancer has spread beyond the tumor, and it means that I am now officially in Stage 2, not Stage 1.

In terms of what it means for treatment—from what I can tell, not a lot. It may mean the nodes are monitored throughout chemo, and biopsied or removed when I have surgery. I know that it is an additional piece of information about me for the doctors to track, and as far as I’m concerned, more information is always good.

What it means in terms of our outlook is again, not a lot. We were a little bummed out when we found the cancer was officially “Stage 2”, because it was so nice to say Stage 1. But we’ve moved on from that. We are still fighting this in the same way, with the same doctors, and the same family and friends around us.  Thanks all for staying with us through this fight.

Ride on the Hairplane

Week 1 of chemo…done.  My chemo drugs are given on Mondays, with the study drug given on Mondays and Thursdays. This means side effects are most likely going to hit within a day or two of Monday’s chemo.

This week I felt really good, except from about Wednesday morning to Thursday afternoon. It wasn’t that I was feeling sick (hooray for anti-nausea meds!), but that I felt a little fuzzy around the edges and was moving in slow motion. The nurses yesterday all said the same thing: “Chemo brain!”.  I told the girls about chemo brain and that I may have a few days after chemo where I just was moving a little slowly, and that they might need to be patient with me. Alice helpfully offered to punch me in the arm to snap me out of it if she thought I was getting too spacy.

Another side effect looming, is losing my hair. Its unclear if this is going to happen yet as these drugs do effect everyone differently, but I decided to prepare myself for the worst-case scenario. Paid a visit to JD at Hairplane this week and he worked his rock-star magic. Most of my hair was left on his salon floor, so if it does fall out, there is less of it to lose.

Camp Chemo

Monday I had my first chemo treatment. Walking down the hall towards the chemo room, I didn’t know what to expect, but as we rounded the corner, Herb, my fabulous chemo nurse turned to me and said, “Welcome to Camp Chemo”. As soon as Herb said that, I knew I was going to be OK.

Here’s what chemo is like at California Cancer Care in Greenbrae. The chemo room is an L-shaped space with a view of Mt. Tam. There are about 10 loungers set up, each with an IV pole where the bags of medicine hang. My meds were in four bags (1 anti-nausea, 2 chemo drugs and the study drug), with each drug given one at a time. So, I was in the lounger for about 3.5 hours.

I have to admit, cancer aside, it wasn’t a bad way to spend the afternoon. The nurses in the chemo room are unbelievable—they are extremely compassionate and skilled, and on top of that they bring everyone drinks, homemade banana bread (made by Herb), pillows and blankets. There is jazz playing and a view of Mt. Tam. I had my MacBook and answered emails, surfed, answered texts—really, how often do you get 3.5 hours of uninterrupted time like that?

As of Wednesday (or Day 3), I’m feeling good. I managed a visit to the gym this morning, and felt a bit nauseous during the workout. My friend Lisa Travaglini reassured me that she felt nauseous too—it wasn’t the chemo, the workout was just that hard! So far, so good!!!

When Josie Comes Home...

While a cancer diagnosis is bad news at any time, the timing of Margie's is even more jarring to us: on July 2nd, we put down our beloved eight year-old Australian shepherd, Mizque, because of cancer.

Margie and I considered Mizque our first-born, and she went everywhere with us. We got Mizque in April of 2003 from Kim Abney of Canyon Oaks Aussies, picking her up in Coalinga, Calfornia while returning from a spring break trip to Zion National Park. Because Margie was six months pregnant with Elsa and we wanted to avoid the inevitable "A puppy? Are you crazy?" comments, we told no one, and showed up to an Easter dinner at Susie and John's house with our new little dog. In the following eight years, Mizque was an important part of our life, and her cancer and early passing, followed by Margie's cancer diagnosis left us shell-shocked.

Although we had vague plans to get another dog "someday," we couldn't get over the feeling of how empty our home felt without Mizque. We live in a great neighborhood for walking, and we know many people because of being out and about with our black tri-colored Aussie. Margie works from home, and Mizque was at her feet all day long. With Mizque gone, there was a void in our home that we couldn't stop noticing.

A few weeks ago, while Margie and I were running at Bon Tempe Lake, we came across a little blue merle with her owners, and Margie lit up at the sight of her. Further along our run, we saw the dog again, zig-zagging along the trail as she herded her owner; Margie and I finished our run talking about the mighty Aussie, and what great dogs they are. We decided there could be no other breed for us, and later that night, after the girls were in bed, Margie again commented on Mizque's absence. We talked a bit more about how much we missed our dog, and how having a new pup during Margie's treatment and recovery would be good therapy for all of us. I e-mailed Kim to see if she had any litters planned, and she offered us a blue merle female she was going to keep out of a litter her dogs had produced in April. We planned to meet with Kim after our Tahoe vacation, and this four month-old girl would become part of our lives.

The wait was tough, but we made the best of it--just like the first time around, Margie and I told no one. In fact, we spread a little misinformation to our relatives: I repeatedly claimed I was tired of Aussies and I wanted a "small dog". During our stay at Tahoe, Hilary, my sister, came home from a run to tell me about a German short haired pointer she'd met out on a trail. I repeatedly told Elsa and Alice that I was thinking of getting a pug, and they'd just roll their eyes (kids know when you aren't telling the truth).

Yesterday I left our home at six a.m., drove up I-5 to meet Kim in Yreka to make the transfer, and was back home before dinner, walking up our stairs to surprise the kids with their new "sister."

In just a day, Josie has proven herself smart, fun, and loyal--in other words, totally Aussie, and just what we need right now.

Good-bye Tahoe, Hello PARP

Tomorrow we return to Marin, after spending a week and a half in Tahoe. The picture shows our spot at Bliss a few days ago, but a picture taken any other day this past week would have looked pretty much the same. There really is no place like Tahoe.

Here is some information about the type of breast cancer that I have. It is called triple-negative because my estrogen, progesterone and HER2 receptors are negative. While triple-negative is known to be an aggressive cancer, it is also very responsive to chemotherapy. The challenge for triple-negative patients is that it won’t respond to some treatments normally given to patients with positive receptors.

Until recently, all chemotherapy treatments pretty much took out everything, good cells and bad, in order to get to the cancer—one of my doctors described it as “hitting an ant with a sledgehammer”.   Now, cancer treatments are becoming much more targeted to the cancer type. Because triple-negative accounts for about 15% of breast cancer, and is known to be aggressive, new treatments are being developed that target triple-negative. I am extremely lucky in that one of these treatments is available through my oncologist. 

To receive this treatment, I am participating in a study, which has a long and complex name, but which we are calling the PARP study. The PARP study combines two powerful chemotherapy drugs (gemcitabine and carboplatin) with a PARP-inhibitor drug. A PARP enzyme repairs cancer cells and causes them to grow back after receiving chemo. A PARP-inhibitor is not a chemotherapy drug, but a drug that interferes with a cell’s ability to create the PARP enzyme.

The PARP study is going on in ten different study centers around the country. Until July, Dr. Head was sending her patients down to Stanford if they wanted to participate, but right before my diagnosis, the study opened up in Marin. I am the first patient in Marin to be able to get my chemo in Marin. All things considered, this is a real stroke of luck.

The study results so far have been very promising, and we are very excited that we are able to participate. We also know that I am being monitored extremely closely, and if it looks like I am not responding to treatment, we will be switched to another chemo regimen. Finally, from what I have learned about chemo treatment so far, there really is no slam-dunk, perfect fit, even with treatments that have been around for years. Deciding on this chemo treatment was a difficult decision for us. We made many, many phone calls, and asked our doctors lots of questions. (This is the type of situation in which it is very good to work in health care).  We feel we have made the best choice possible for me and for our family, and it sounds strange, but I am looking forward to starting treatment on Monday--I'm ready to get  this fight started.

Thanks everyone for your continued support--we appreciate all of you so much!

A Long Day in Greenbrae

Our family left for Tahoe last week, right as my many diagnostic appointments and tests were beginning. Dr. Bobbie Head, my exceptional and understanding oncologist, reorganized my testing schedule so that we could come to Tahoe—as long as Chris and I drove back to Marin for one day to do the remaining diagnostic work that needed to happen before I could start chemo. We drove down to Marin Tuesday night, with Elsa and Alice staying in Tahoe with my amazing sister-in-law, Hilary and her husband Todd.

By 4pm yesterday, we were done, and back on the road. More diagnostic stuff to happen next week, but the most important thing I learned yesterday was that I start chemo on Monday, August 15. Here’s the schedule:

6 rounds of:

Week 1 - 2 days x chemo

Week 2 -  2 days x chemo

Week 3 - Off

If all goes as planned, last day of chemo will be December 8.

Before my day of appointments I went to the gym, and you can see from the picture what was waiting for me. Toni Zepponi is responsible for organizing the Team Margie bracelets—thank you Toni, and all my TJ’s friends who are now wearing these very awesome bracelets. It means the world to have friends like you!

Here's What We Know

On July 25, 2011, I was diagnosed with triple-negative breast cancer. With no known family history, my age (46) and my healthy lifestyle, this came as an enormous shock. As Chris and I began to share this news, we were bowled over by the kindness and support of our family and friends. To help keep these amazing people updated on how we are doing, we have started this blog.

So, here’s what we know so far about the cancer:

Tumor size: 1.6 cm (by sonogram)

Clinical Stage: I

Node involvement: 0 (by sonogram)

Grade: 3

Division Rate: 2

Receptors: ER negative, Progesterone low-positive (2-5%), HER-2 negative

Here’s what else we know: we are going to beat this. I am a strong and determined person, with the most incredible family behind me, and a skilled team of medical providers on my side. Within minutes of being diagnosed, Chris and I were in complete agreement—there is no option but to stay positive, and get through this. We want you all to know that this is how we are approaching this, and we are so glad that you are behind us.