Phone Call No. 13

A couple days later, the phone rings again.

“Hi Heather, this is Tara, Dr. Rugo’s nurse practitioner. I’m so glad to finally get you on the phone in person!”

We’d been playing telephone tag for the better part of a week.

“Well, we got the results back from the echocardiogram you had the day before surgery.”

Herceptin can cause temporary damage to the heart muscle, bringing down the “ejection fraction” of the left ventricle of the heart. This number measures how efficient the heart is at pushing blood out to the rest of the body. My first echo, just before chemo starts, shows an ejection fraction of 70. Toward the end of chemo, a second echo shows that ejection fraction number had dipped to 50, on the low end of normal but still a big drop.

So Tara and Dr. Rugo cancel my next Herceptin infusion until a third echocardiogram can be done. Herceptin infinitely improves the outcome of women who have Her-2 positive cancers like mine, but it’s not great to cure the cancer at the cost of causing congestive heart failure.

“So what’s the number?” I ask.

“It’s 50 again,” Tara says. “I’m thinking that you were tense in your first test and that that number was artificially high. I’m going to make an appointment for you to have another Herceptin infusion, six weeks after your last. Then we’ll do another echo. If it’s OK, then we’ll go back to the every-three-weeks schedule for Herceptin.”

“Sounds like a plan,” I say. “Tara, may I ask you a question about the pathology report from surgery?”

“Sure,” she says.

“Well, are those pre-cancer, slightly abnormal cells they found in one sample anything to worry about? Dr. Hwang says not to worry. But pre-cancer can lead to cancer, right? If you were me, that would worry you.”

“That’s what the radiation is for,” Tara says.

“Ah.” I say. “That’s why the risk of recurrence without radiation is so high, I guess.”

“Exactly.”

The radiation makes a last pass and zaps the remaining abnormal cells that cannot repair the damage the radiation causes. That takes in both cancer and pre-cancer, apparently. Why didn’t they say so in the first place?

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About leftbreast

I have had breast cancer. I was diagnosed at 47, and am now 49. I have finished "active treatment," two surgeries, chemo, radiation, monoclonal antibodies. These days, I only take a drug to suppress my uptake of estrogen, since my tumor was highly reactive to that hormone. I have been married to my husband Pete for 21 years. I have a stepdaughter, Maureen, 30, and a daughter, Erin, 10. I've been a freelance magazine journalist for 20-plus years, covering everything from Chinese foreign policy to Catholic nuns to endangered species. I have had a great life. I have lived in Asia and all over the United States. I have spent nights with tree-sitters in Oregon and with astronomers at the Mauna Kea observatory in Hawaii. I've been to a cocktail party on the poopdeck of a British destroyer docked in Shanghai. I've taken the bus to Tibet, and tramped through the cloud forests of Panama with biologists. A magazine sent me on a raft trip down the Colorado through the Grand Canyon; another sent me to cooking school for a week. I have spent time with celebrities, presidents and heroin dealers. I love my work. I have a loving, supportive family and more friends than I probably deserve. I have had the space and time to camp, ski, cycle, garden, cook and spoil my pets (an Australian shepherd, a German shepherd and a tabby cat). If it all ended tomorrow, I would have to say that it has been a really, really good ride. When I was in thick of treatment, I was simply fighting for more time. Now, I'm trying to connect the experience of cancer with the rest of my life, with the time that's been won. I hope the cancer never comes back, but if it does, I'll be ready. That's what this blog is about.
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