St Croix River Road Ramblings

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Wednesday, August 1, 2012

Margo Buys a TV and Chair

Friends Judy and Dottie
 joined us at the Polk County Fair
Old School house.  They
got ribbons on Genealogy
projects.  Margo and I
got a dozen ribbons too!

Margo has been handling the last few weeks since she found out that she has breast cancer very well.  She had been calm, rational, and optimistic.  The many tests and visits with many doctors at Mayo Clinic in Rochester have been somewhat overwhelming, but also reassuring as we see the tremendous effort to pin down the type and extent of the cancer and plan the treatment. 

We have a home near Rochester, about 25 miles from the downtown Cancer Center at Mayo, and that and because I worked there for 25 years, means that we have done our family doctoring and specialty doctoring at the Clinic for all that time.  It is a place with people who inspire confidence.

At the fair this week, we visited with our Cushing neighbor, Joyce, who is 5 years into her own cancer battle, and doing quite well.  She said “When I go to Mayo they must have a notice on my medical records that says I am to be treated special, because they surely do treat me as if I were the most important person they have to see.”   We have felt the same way.

Margo has found that she has triple negative metastatic breast cancer at stage II-III.  There is one large tumor in her left breast, and a few smaller ones as well as at least one lymph node found with abnormal cells.  It was found with her annual mammogram although we had also thought we found a change in the breast too-a kind of long lump that was noticeably different than the rest of the breast.

Triple negative means the cancer cells do not have estrogen, progesterone nor Her2 receptors.  This determines the treatment, and can make it more difficult to treat. There are many types of triple negative, so the cancer therapy has to be varied to find the right kind of treatment that is effective with her particular cells. 

The cancer is fast growing and that is both good and bad.  It is good as the cancer cells are more easily killed than the normal ones with treatments that kill fast growing cells, and bad as it has come on rapidly and continues to grow.

As far as the testing could determine, it hasn’t spread beyond possibly one lymph node nearby.  “We can’t be absolutely sure where cancer cells have spread—maybe a few here and there, so our treatment will be to assume there might be some and treat the whole body instead of  just the breast.” 

Chemotherapy comes first to try to shrink the tumor before surgically removing it.  Margo starts chemo every Tuesday for 12 weeks beginning August 13th.  The first drug is Taxol, derived from the bark of Yew trees.  She will have 12 weeks of weekly doses, and then an evaluation before phase 2 of chemotherapy with stronger drugs.  After that an evaluation and surgically removing the breast (or lumps) and lymph nodes followed by radiation to again attack any fast growing cells.  The treatment is about a year long total.  Her prognosis now is about 85% likelihood of being alive in 5 years.  It is still unknown how well her cancer will respond to treatment, so the statistics are overall for everyone with her condition.  Being younger and otherwise healthy is certainly a plus.

The main cancer doctor Margo will be working with is Dr. Tufia Haddad. After she talked to us about Margo’s condition, I asked her if she knew an Anne Haddad, a woman I had worked with closely back in the 1980s at Mayo in digestive disease research.  “She was my Mom,” replied our new doctor.   Anne got breast cancer in at age 40 and within 6 months had died from it, leaving Tufia, then 18, determined to make a difference. She went through college, worked at Mayo in research, then to medical school and residency, then as an oncologist at the University of MN.  Recently she moved to Mayo and back to her home town of Rochester.  She enrolled Margo in a clinical trial that adds an additional promising treatment drug to the normal treatments.  

We both knew her mother quite well and it wonderful to see her daughter taking on her mother’s killer.  Dr. Haddad is about the age her mother was when cancer struck her down—a loss that was very personal to me at the time.  I was introducing computers into Mayo research, and Anne was one of those who embraced the change and made my job easier.  Tufia's mother would be very proud of her. 

Our son Scott lives with us at our home in Pine Island.  He works winters and generally takes the summers off and has been available to help.  He has been wonderful in taking on both Margo and my recent health problems, ferrying us to appointments and being supportive and taking care of our home there.  It would be quite difficult for us otherwise. 

Margo is settling in for a year of treatments.  She and Scott went “comfortable chair” shopping this week and ended up with an Amish built recliner that she liked very much that includes a motorized tilt unit that lets you move from lying back to upright with a press of a button. 

They go to Wal-Mart today to pick up the 42 inch flat screen TV we ordered online.  Our old 19 inch was fine for occasional watching, but with Margo and me both limited in physical activities, we thought that we would blow a few hundred and get one we could watch from our chairs without binoculars to read the online guide.  We have a ROKU box that gets many internet channels, online Netflix, and get many local channels from the antenna including Iowa and MN public TV stations.  We already have high speed internet and Margo and I each have our own laptop—so our entertainment center is quite well stocked for a long winter.

Margo and I were talking about health and health insurance and how that we were insulated from the costs of our care having both Medicare and a supplemental program (I continued my insurance through Mayo Clinic when I retired—high cost and high benefits—so between the two we are well covered).  I wonder what it would be like if you didn’t have either and had the same problems?  That worry would certainly make this harder.  I think that is why we are so supportive of the Obamacare initiative—knowing there are 40 million folks out there who don’t have insurance, mostly because they can’t afford it.  Those who want to get rid of it seem not to have any solution for the problem, just a get rid of it and let the poor folks go without for fear the rich might have to share a little.  

That is absolutely not acceptable in a society that is as rich as ours—which of course then moves us to the idea that the tremendously unequal distribution of earnings between the rich and the poor, those who can and can’t afford medical care, is immoral.  What I can’t understand is how many of my friends, who claim to be Christians, can accept this as the way things should be, and want to get rid of what benefits are dribbled out to poor folks now.   I think they have lost sight of what Jesus taught us.

So, with Margo beginning her year-long fight against cancer, we are hunkering down for a hard year, but optimistic things will come out good in the end.  Whatever the outcome, we plan to try to enjoy the life we have left to us. 

 I am 3 months into my own less pressing battle with myasthenia gravis.  As you may recall from previous posts, this is where your own immune system creates antibodies that get between nerve endings and muscle beginnings and block the signals to move the voluntary muscles (breathing, eating, talking, arms, legs, fingers…).  

The design of human bodies is flawed -- no one who understands how things work or don't work and screw up all the time, could possibly believe an intelligent design theory!  Much easier to accept an evolutionary trial and error process, with lots of errors along the way.  Problem is that we pass on our genes while still young and healthy, so no selection is made for longevity. Only way to solve that I can think of is having very old healthy men be fathers of children--and sadly, that rules me out. 

I am not improving nor getting worse, but coping.  I take medicine 1 to function on a daily basis and it brings me up to just able to do the things one needs to do to live, but not able to do much beyond the minimums.  I can walk, see, drive, talk, eat, type, breathe, etc.,  as long as I take this stuff.

Medicine 2, prednisone, is to shut down the immune system from making the crappy antibodies.  If that stops, then my muscles will work OK, however, of course, one doesn’t get along very well without an immune system, so the goal is to run the immune system lower and cope with some antibodies and some immune system—a balancing act that will be with me the rest of my life.  Right now my immune system is still too robust, cranking out the bad stuff, so I am continuing to increase the prednisone and watching it push me into diabetes—trying, so far successfully to limit my diet just like a diabetic including the blood sugar testing. My problems are chronic and I can cope with them, and our attention is focused on Margo’s battle for the coming months.     

Saturday our Rock Club has its big rock show at Frederic WI at the high school on hwy 35 north of town.  Margo hopes to be there as a host.  Saturday is also Doc Squirt Day in Cushing, so I need to put out a display of old pictures and books from our history society.  Maybe will see you at one or the other.  So many wonderful friends stopped by and wished us luck last weekend at the school house museum at the fairgrounds that it was like a reunion!  We plan to stay as active as possible while in our dwindling years.