Antidepressant reduction

Did I mention that I've been tapering off my antidepressants? I've been taking Cipralex (also known as Lexapro) ever since I was diagnosed with the mets and I ended up on a fairly high dose of 30mg/day. I'd been wanting to try to decrease the dose for a few years now, mainly because I sensed that my brain was a bit fuzzy: I felt like I wasn't getting to enjoy things quite as much as I wanted to and that my thinking was duller than it used to be. I also felt like my body and brain were missing a connection and I didn't feel quite right.

However, my family doctor didn't support the idea when I first talked to him about it a couple of years ago. I could sort of see his point as at that time I was still undergoing some pretty intense therapy to deal with my childhood and my traumatic past and my new tools for dealing with life's events weren't as well-used.

However, about six months ago, after having spent two years with my psychologist, I felt ready to try to slooooowly taper off the Cirpalex. I knew I didn't want to do this too quickly because I'd heard about some unpleasant side effects (SSRI discontinuation syndrome) that could happen if the dosage was reduced too quickly. I also wanted to be sure that I really could handle life without the antidepressant (or at least this level of it) and I was confident that I could. My psychologist was also careful to make sure that I knew that it might not be possible for me to go off of the Cipralex entirely; it may be that my brain requires the chemical to function.

My psychologist helped me set up a self-monitoring plan to chart things that were early signs of worsening depression and/or poor coping skills. Each day I track the amount of sleep I get at night and from naps, how cranky I am, and how many commitments I'm dropping (the more I drop, the worse I'm doing). I also track more general signs of depression each week. She agreed to help monitor me as I do this as well, and somehow all of that convinced my doctor that I was doing this taper in a responsible way and he said I could do it.

I've been dropping 5mg/day every six or eight weeks or so and this week I just got down to 10mg/day (remember I started at 30!). The only side effect I've noticed is that I'm more tired and easily fatigued when I first drop down a level. It's as though my brain has to work a little harder when the dosage is reduced and gets tired more easily. Aside from that, I haven't noticed any other issues.

I saw my psychologist today and she agrees that I'm doing well. I'm feeling creative and my brain feels alive in a way that it didn't before. Apparently this 10mg/day is the level beyond which I might not be able to go and if that turns out to be true I'm ok with that. I'm still going to try to get down to zero and if I make it, that's great but if I don't, things are pretty good right now. Even if I do go to zero, I won't rule out taking an antidepressant (or increasing the dosage) in the future if I need it. It's a tool in my coping toolbox and it has its place. In the meantime, I'm looking forward to life without quite so many chemicals in it.

Screen Actor's Guild Awards 2014 Red Carpet

I bet you didn't think you'd get another red carpet post so soon after the last one! Well, you're in luck - it's awards season and I'm interested in what they're wearing this year. I don't think I usually look at the SAG Awards red carpet but I figured that I finished the Golden Globes post in time so why not do this one?

Enjoy the pretty (and not so pretty, and downright strange)...

One more thing

I forgot to mention one thing that came up in yesterday's appointment - I got so focused on the nurses' new best practice's that everything else left my brain.

When I got my flu shot this year, it knocked me flat for days. I couldn't figure out why but then I realized that the flu shot uses the immune system to build antibodies. The denosumab/Xgeva I've been receiving every month for a while now is a monoclonal antibody and also uses the immune system to do its job. Even though I got the flu shot halfway between my denosumab shots, my immune system still ended up overloaded and couldn't handle making antibodies for both. Hence me feeling like I was run over by a truck.

I mentioned this to my oncologist yesterday because denosumab is anew product and they're still gathering side effect information. We agreed that getting the flu shot is very important because I can't afford to get sick and that being laid up like that isnt ideal. So for next year, I'll skip a month on the denosumab and get the flu shot six weeks after the last denosumab injection. That should give my immune system plenty of time to heal up.

I know this isn't a big deal but I wanted to bring it up here for others who are on the denosumab and get flu shots.

Oncology appointment

Today was oncologist day. My tumour markers from November were at 40 (still well within my norm) and I'll get today's tumour markers when I see her again in three months. We've decided that since I'm still so stable, I'll see her every three months instead of every two. It used to be that I had the tumour marker bloodwork done two weeks before I saw my oncologist but it stopped being scheduled that way and I got tired of calling them to change it.

I think things are going to change when I get my bloodwork, though. I've been getting it done in the chemo suite because I have a port-a-cath. My veins are super-crappy from my primary cancer treatment and the less they have to be accessed, the better. I've kept the port because I figured I was going to need it for treatment - and long before now, to be honest - and because it could be used to do bloodwork at the hospital, eliminating a regular assault on my crappy veins. My port gets flushed by the home care nurses at their office in between hospital appointments.

However, at today's bloodwork appointment, I was told that their new best practices are that they don't access ports unless the person is receiving treatment that day. In other words, their best practices tell them to not access ports just for bloodwork to reduce the risk of infection. In my case, the port has to be flushed at that time anyways so it's not like it would be getting an additional access to it.

I spoke with my oncologist about this and she told me that the nurses run everything there and to push back against them. The policy doesn't make sense for me or for anyone who has bloodwork the day before they have treatment (as was happening to someone while I was there). Hopefully I'll be able to convince them to continue accessing my port instead of forcing me away.

Golden Globes 2014 red carpet

I'll bet you never thought you'd see another red carpet post from me. I've actually started a few over the last year but by the time I got to working on them it was so far past the event that it didn't seem worth posting them. This time, I really wanted to get one done. So here it is!

Most of the outfits people wore looked ok although there are always a few that are not quite right for the occasion. I'm happy to report that the strapless mermaid dress is fading from view but sad to tell you that the mullet skirt (shorter in front and longer in back) is showing up more frequently. Sparkles and embellishments are more subtle than they used to be which is a pleasant change.

Enough of me talking; go and have a look at the outfits. Enjoy!

Metalsmithing projects I have finished

One of the biggest changes for me in the last few months is that I've actually finished some metalsmithing projects. You read that right - I finished a couple of projects. I have many projects that are partly-done but very few finished objects. To prove that I finished something, I took some (rather bad) cellphone pictures.

Two sterling silver rings that I made. Each was carved out of carving wax, cast by my instructor, and then polished and finished by moi.

A side view of the rings. One of them, as you can see, has a peak all the way around while the other has just the one pointy bit.

Another view of the rings. You can see that the pointy but on the one ring is kind of a pyramid shape.

A top view of the pyramid ring so that you can see the point. You can also see the side view of the other ring.

I guess it would have been useful to include pictures of me wearing the rings, huh? Well, you'll just have to imagine them on my finger (my middle finger, as it happens). I'm quite pleased with these rings, especially considering that they're my first real attempt at carving and casting anything. They aren't perfect but I love them.

We'd learned carving before but I was having trouble carving something that looked good. I was having a hard time keeping my carvings balanced; often when I tried to file away the wax I didn't want I'd end up filing too much off of one side and my design would end up torqued. I did some research and found a fabulous, step-by-step pdf file that helped me tremendously. The best tip from that guide was scribing center and other guide lines on the wax. That tip alone helped me keep my designs from torquing.

Now that carving is easier for me, I'm finding it a very relaxing thing to do. I'd like to do a few more rings around the pyramid theme and maybe some others involving more complex carving. We'll see; I have some other projects I need to finish, too. And still others that I need to start :)

Our fluffybutt, Gozer

I'm sure you're all wondering how Gozer has been doing. She thinks she's the center of our universe so you must think so, too, right? Ok, maybe not, but since she is the center of our universe I want to talk about her.

It was a rough fall for Gozer. Just before Thanksgiving she was being treated for yet another ear infection and the vet suggested that she had food allergies. She was constantly scratching and licking and developing ear infections, all of which are signs of food allergies in dogs. She had also developed red spots on her abdomen.

We switched her over to a new veterinary food, Hill's Prescription Diet z/d Ultra which has hydrolyzed proteins and tried that for a few weeks. She stopped licking and getting ear infections but her stool was very soft. The vet kept urging us to stay on this food because it's great for dog's digestion but our dog needs to have good, solid poops and these were not them.

We switched her over to a Lamb and Potato mix and within a week she was licking like crazy so we had to take her off that right away. We moved her over to a limited ingredient Turkey and Pea protein food that she seems to be tolerating fairly well. We're giving her the treats we were first given with the Hill's diet because she likes them and tolerates them. We'd tried other treats but she seemed to still be licking more than when on these treats so that's what she gets.

After we started the turkey food, she developed red sore-looking things under her arms and the vet told us that we had to put her on antibiotics for two weeks. These antibiotics were very hard on her, giving her an upset tummy, very loose stool, and lots of lethargy. She was barely eating anything at all and so we tried giving her canned pumpkin mixed with her food to make her eat. It worked for about two days before she stopped wanting to eat again. We ended up hand-feeding her some of her food and playing with other parts (so that she could hunt for her kibble) so that she'd eat.

It's been a few weeks since she finished the antibiotics and she's now eating full meals again. We had to reduce her "full meals" to ensure that she finished them, but she is eating everything in her bowl now. She's also having regular, well-formed bowel movements. That's all good.

On the downside, she's got a yeast problem. I thought that corn-chip smell she had was just her smell but it's actually the smell of yeast. We're using one of the eardrops we'd been previously given for yeast infections which seems to be clearing that up, and we're also trying a new shampoo to try to clear the yeast off of her paw and thighs since she's still licking there occasionally. The old shampoo was good for her but it has oatmeal in it and I read somewhere that yeast like oatmeal so it isn't necessarily the best way to clean her and get rid of the yeast.

A little bit more concerning is that she's having anal gland issues. After she finished the antibiotics she was clearly having problems there because she was licking like crazy and appeared uncomfortable. The vet expressed them and said that they were almost impacted. I figured that this had happened because the antibiotics had made her stool very soft and her glands weren't emptied properly with her bowel movements.

The vet told us to have her glands expressed no more than every six weeks. Since she's being groomed every six weeks and they can express her glands then for only $15 extra (compared to a normal vet visit of $90), we're having it done then. Three weeks after her glands were expressed, she was groomed and we had her glands expressed again - we figured it wouldn't hurt and it would help us get into the habit of having it done.

It's just as well that we had her anal glands expressed because they were quite full again. I thought that this might have been because her stools weren't completely regular or well-formed at that point. However, now I'm questioning that conclusion because she's been licking her butt again and is looking uncomfortable. I think her glands are in need of expressing yet again and it's only been about three weeks since they were last done.

Our sweet little rescue doggie has turned out not to be maintenance-free. I hope that in 2014, she stays stable on her food, her yeast infections go away, and her anal glands start working properly.

Some updates

So... I guess it's been ages since I updated you about my cancer, hasn't it? That's because nothing's changed, really. I see my oncologist every two or three months, we do CT and bone scans every nine months or so, and a mammogram once per year. All of them have come up clean.

Well, that's not precisely true: in fact, my bone scans reveal that the cancer lesions are continuing to heal. This is great! It's also weird. So much of the last six years have been about me coming to terms with having cancer and having a terminal illness. But if the lesions go away then my illness really is controlled and I don't have cancer in the same immediately terminal way that I thought I had it.

When other cancers disappear like my lesions are doing, they say that the cancer goes into remission. However, it's different for breast cancer because once the cells travel outside the breast and nearby lymph nodes, they can hole up and stay dormant for ages. Therefore, we who have stage four breast cancer are said to have No Evidence of Disease (NED) when the cancer can't be detected by scans.

Most of the people I know who get a NED status are thrilled about it - and I am, too - but it still feels strange. If I'm not the person who has cancer, who am I?

I should tell you that my tumour markers have stayed stable as well. They tend to oscillate up and down fairly regularly - in fact, I made a chart of their values over the years (up until August, 2013) that shows the oscillation very clearly:

Well, hello there

It's been quite a while since I was here. Several people have asked me what I planned to do with my blog and I haven't really had an answer for them.

I started this blog as a way of keeping my family and friends informed about my cancer status and treatments and then as my cancer stayed stable it became a place to keep my family and friends in touch with my life. It also became a place for me to think through and talk about things going on in my life.

After my mom died I found myself having a hard time posting here every day, partly because I was depressed and partly because in my head much of my blog was a way for her and I to be closer. Then of course I had the breakdown and didn't know what to write, and later it was enough for me to post small updates as my Facebook status.

These days, I'm finding myself missing the ritual of writing my posts and it's no longer enough for me to put something on Facebook, so I'm thinking that I want to start posting here again. I don't know that this means that I'll post every day but I do hope to post a little more often I'd posted over the last couple of years.