YO Adrienne! First Day of Chemo -- Five More to Go

YO ADRIENNE!

A river runs through me tonight, and it’s not just red and white blood cells.

Thursday, I spent the entire day (7 hours) having my first chemotherapy and Herceptin treatment. I prepared myself by having a great massage and energy work by Natalie K on Wednesday, and then started the morning of chemo at the gym working out some of my anxiety – thank you to my dear friend and personal trainer Hilda for understanding and being there for me.

Then, my neighbor, Julie, drove me to chemo, brightening my day with the gift of a lovely Brighton Breast Cancer bracelet. I am one of the luckiest people to have such great neighbors for fourteen years – they are such wonderful friends, including their dog Maggie, who has helped fill the huge gap in my life that Benj left last August.

I joined 4 other chemo patients in the infusion center at the oncologists office, and waited for my turn – the oncology nurse, Sylvia, was the best – patient, explaining every step, showing a much-needed sense of humor, and easing what was obviously one very anxious “me”. It’s amazing to me how cancer patients quietly band together – several of the people in that room saw my tremendous anxiety and shared comforting words with me that helped me make each step a little easier. My friend and fellow “A” Angel H. and friend Nadya V have been a great support in that respect, as well.

Being a dental hygienist does not equal being at ease with needles! Insertion of the IV was probably the most traumatic part for me – I’ve been poked, stabbed and injected so many times in the last 2 months that the idea of having an IV every week for the next six months, and then every three weeks after that (not to mention the two upcoming surgeries) is almost more than I can bear. My veins are not the greatest, and I expected “trouble” - - unnecessarily. Not sure that I won’t still need a “chest port” (ANOTHER surgery) in a few weeks, but I’m going to at least try to avoid that if I can.

One does not just get one big blast of chemo at one time. One first gets blood drawn, vitals taken, etc. etc.. Then all the pre-chemo chemicals – steroids (which leave you completely unable to sleep at night!!) and antihistamines for anti-allergy to chemo, anti-nausea drugs, saline, who knows what else for about 1 hour. Then, one by one, each chemical of the “cocktail” is infused – Herceptin 1 1/2 hours, Taxotere 2 hours (I reacted negatively to that drug so we had to slow down the drip to drop by drop – grrr!!), Carboplatin 1 hour, saline flushes from time to time.

Thankfully, my trusty I-pod and the anti-histamine knocked me out – I couldn’t believe that I slept for nearly 1 1/2 hours! I woke up around 1:45 to a much welcomed Starbuck’s iced decaf latte from my mom, who came to keep me company and take me home (HOURS later!). And Mom very thoughtfully brought me ONE PIECE of See’s Candy for a treat after I got home.

Drip, drip, drip – by the 5^th hour, everyone else had pretty much finished their chemo, and I was the only one left in the infusion room. By 5:30, the drips were finally DONE, and I was free to go home. Mom and I stopped to visit cousin Dr. Roger, whose office is in the same building one floor down.

The anxiety over the treatment process was gone (and hopefully the blood pressure will come down), and I felt pretty darn good. I know that this is just the start of this phase – it is the weirdest feeling to have all of this poison running through my veins – and, the next challenge is the side-effects – steroid puffiness, low white blood count and eventually Neulasta (not fun), susceptibility to infection, hair and possibly nail loss, weight gain (NO!!), tingling fingers and toes, fatigue, on and on. But, particularly after talking to my fellow chemo patients today, I realized that I have to focus not on what might face me, but on what is – when the side-effect comes along, I’ll just deal with it.

So, tomorrow it’s stay home and rest – after a bout with my reclining bike, stomach work on the ball, and stretches. And drinking that water that I just CANNOT STAND – ugh --- I have to drink 8-10 cups, at least, a day!!

Then, Saturday, I plan to work out at the gym, ride that bike, and get acupuncture from my friend Lauren – the latter is probably one of the smartest things (next to massage and energy work from Natalie and Debbie) that I have done for myself. No more terrible sciatica and back pain – and, the acupuncture (with oncologist’s blessings) will help me get through side effects.

Sunday, Nazaretian/Hairabedian’s Meals on Wheels will visit with a care package after the Trex Picnic at the Ararat Home. Yummy Armenian Food! Monday, I report to work at 8:30! Wow!!

And, next Friday, my “former” co-workers at Jackson DeMarco in Westlake Village are having a lunch for me to celebrate my appointment to the ALJ position. I’m so grateful and honored to have had the chance to work with my wonderful colleagues in Westlake Village!

This treatment regime will go on until early January, and then I continue the Herceptin until this time next year. In February (moved up from fall) I will have a double mastectomy and the first part of reconstruction – probably facing four weeks off work. Then, in May, part 2 of the reconstruction, with possibly one more minor surgery following.

I’ve been told to avoid crowds while having chemo, and to try to keep my exposure to people limited to avoid infection – of course, try doing that will be challenging when I will be traveling around presiding at hearings and mediations with parents, school district and board of education reps – “You sit at the other end of the table” will probably be my subtle motto. I look forward to visiting with my friends and family in small groups at a time.

Thought for the day: In October, 2006, I had the pleasure of attending the Armenian Bar Association mid-year conference in Philly, and spent several days with my friends Garo, Tanya, and Shake. Garo drove me around Philly, stopping the Philadelphia Art Museum and the famous “Rocky Balboa” stairs – where the statue of Rocky Balboa (aka Sylvester S) lives. I think the picture at the beginning of this post says it all (don’t ask what’s in that bottle – it wasn’t Gatorade!). “Yo Adrienne” never had so much significance! And, notice the hair ... it will return.

Friends Garo and Shake

The Doc and the Judge!

A New Life's Journey

Shortly after returning from our historic visit to Western Armenia, I learned that I had breast cancer. From early July until mid-September, I have been poked, prodded, cut, radiated, examined and injected more times than I can remember. And, that is just the beginning. So, why write about it?

I have learned a lot over the past two months, and have realized that anyone who doesn't have the energy to pursue the red tape can really be faced with insurmountable medical challenges. So, this is for those who may not be so fortunate to be the pest that I can be!

We take for granted that when a claim is submitted to our insurance carrier, all will be well. NOT! I have been through the gamut of "this is not covered" (wrong), "you haven't met your limits) (wrong), "we can't do anything to help you" (wrong), etc. etc.

First, READ YOUR CERTIFICATE OF COVERAGE. This is often mailed to you when you first enroll, and it can often be obtained from the insurer's website.

Know what is covered, what your limits are (deductible, out of pocket limits, maximum amount of benefits paid, co-pays, etc.). Make sure your policy covers the procedure you are planning to have BEFORE you schedule it. If your policy requires pre-certification (ex. MRI), DON'T rely on your doctor's office to get the pre-certification. Yes, they will make the initial inquiry. But, YOU have to be sure it gets done. Call the insurance company's customer service department and ask whether it is covered, or whether you have any pre-certification conditions that must be met before certification is offered. Remember -- pre-certification only means the procedure is medically necessary. It does not guarantee that the claim will be paid, or how much.

Second, REVIEW YOUR CLAIMS ONLINE, BOTH PENDING AND COMPLETED.

If your health insurance has a web portal for you to review your medical claims, sign up and check it regularly. Why? Because a claim will show up there, before you receive your Explanation of Benefits (EOB) and often times you can make the necessary phone calls to correct mistakes before the check is cut (or not), and before you receive your EOB. You can also call your provider's billing service for assistance. I have found that most billing services are very helpful -- much more so than the insurance companies.

Third, ASK QUESTIONS! Be aggressive -- knowing beforehand is a double edge sword - - in some ways having too much knowledge can add to your stress. But, I have found that arming yourself with as much information as possible is a blessing -- each little fact helps you face your challenge with a sense of peace.

Fourth, USE THE WEB!! I have learned that Google and other search engines are blessings. If you have a question, an answer is on the Web -- and, even more valuable, regardless of what your challenge is, support groups and companies who offer support, are also out there. I found sites that support breast cancer that 1) send chemo patients beautiful pre-tied scarves at no charge (www.franceluxe.com), 2) have discussion groups for chemo patients (ex. www.breastcancer.org), 3) offer opportunities for volunteering (ex. http://www.knots-of-love.org for crocheted and knitted chemo caps), 4) offer sponsorship opportunities and information, such as Avon, Revlon and Susan B. Koman, 5) offer support for people who are uninsured for the treatments they need, and more!

Finally, DON'T GIVE UP! Help comes to those who help themselves. Yes, we do feel like victims from time to time, and I firmly believe we are entitled to do so. We ask "why me" -- a friend who had been through cancer treatment before I started all of this said to me "Don't ask 'why me' - ask 'why not me'?"

During my first chemotherapy treatment, a young man was in the infusion center with me -- he was probably in his mid-thirties, and was having his last of bi-weekly chemo (over six months) for lymphoma. He told me that he had kept his cancer a secret from his mother and sisters because he knew that they were not emotionally prepared to handle this crisis in his life. He relied, instead, on friends.

He offered me a piece of advice I found so valuable: Once you go through a challenge like cancer and its treatment, you look at life differently. You cherish every day as a gift. You cherish each friend and family member and live for each day -- life has a different focus and you gain an entirely new perspective on what and whom is important. Don't be afraid of that -- embrace it.

Good advice, whether you have cancer, financial challenges in your life, or someone whom you care for is facing similar challenges.