The lessons, oh, the lessons...

I am now three quarters of the way through the chemo! Woo-hoo! The second treatment with Taxol went very well and my blood counts were high enough that Dr. P said I wouldn't need the shot of Neulasta, the shot given twenty-four hours after the chemo that boosts the white blood cell count, so we got to go home that same day.

The Neulasta is a very, very, very expensive though quite-useful-when-you-need-it shot. It's about three times the cost of the chemo itself clocking in on the itemized statements from the Mayo at $3, 990.00 per shot. All I can say is buy stock, people!

Kyle was able to join us for the festivities this session. It was lovely to have my whole family there. I did have to explain to him that only I would get the wrist band and be able to ride all the rides at the Chemo Park. Each time I check in at the desk I always clarify that the wrist band is for all the rides and the water park- if you don't ask sometimes they forget to include that and it's such a bummer when you've brought your water wings.

We were fortunate enough to get a private room again for the lengthier chemo. I prefer this because then we won't disturb the other patients, who may be wanting quiet time, with our laughter as we continued to watch the hilarious Canadian comedy that Janis gave to me for my birthday, "Slings and Arrows". It's a series about a Shakespearean acting troupe that's falling apart at the seams and with lines like "The lighting designer has been working very hard these last three days and assures me that there will not be another fire" you can see why we're in stitches! Thank you to my dear friends Maria and Howard for the loan of their snazzy new portable DVD player which makes all that laughter possible.

While passing on the Neulasta shot seemed a positive thing at the time, this week has been a challenging one with fatigue. I haven't felt this kind of fatigue in weeks and I must say it is humbling: the tank is empty and there are no reserves. No kidding. Now, I'm not certain that the fatigue is from not having the shot or if it's just the cumulative effect of the chemos but in combination with the neuropathy (numbness in the fingers and toes) it has made for wobbly, weak legs and a lot- and I do mean a lot- of sitting down.

When the fatigue set in on Tuesday I thought 'Oh, this is just the day after a treatment and it will pass'. When it was there on Wednesday in force my brain said 'No worries- just push through' even when my body was saying 'Let's have a seat' and 'How about a rest?'. By Thursday I was sure sorry I hadn't sat down and taken more time to rest because I was wiped out and that has continued through the weekend.

The lesson for me here is to listen to my body. Even a week ago I had more stamina and could do things like stand for extended periods of time but that was last week and things have changed. Getting my head to accept that is the challenge. It's the driver and knows where it wants to go but the body is the vehicle and without proper maintenance and attention to things- like the gas gauge- it won't be able to carry the head anywhere.

Boy, are there a lot of lessons in this darn cancer. Not to worry, I'll catch on ...

In our meeting with Dr. P last week I said there's no more cancer for those hungry piranhas to eat because now they're nipping at my toes and fingers! I told her I was having some tingling in my finger tips and toes as well as occasionally my lips. She thought the lip tingling was unusual but a possible side-effect from the platinum (and that's really all I ever want to know about what is in the drip bag!). Platinum, my goodness! They could certainly cut down on the cost by keeping that platinum out!

The tingling and numbness I'm feeling is the nerve endings being effected by the chemo which for me will be reversed once the treatments are completed. To aid in this repair I have now added another mighty creature to the animal arsenal: the starfish. Alright, maybe not mighty but certainly hearty! I picked starfish because they can grow back their extremities if one is eaten off by a predator or lost in a tragic escalator accident (they're not as fast on land as they are in the sea). So each time I become aware of the numbness or tingling I think 'Grow on, little starfish, grow on!'

It's hard to be certain of your steps when you can't really feel the front third of your feet, so, in light of that, I made a difficult call to Janis yesterday and asked... for help (Oh curses! Has it come to that?!)... with my laundry. It's not easy to ask for help when you're used to being self-sufficient and needing help with something as mundane as carrying laundry down stairs seems ridiculous. But it isn't when you've only got a limited amount of energy, wobbly legs and a lot of laundry. So a hearty thank you to Jan for her assistance with the three loads of whites, darks and towels.

Through this experience of asking for help (not an easy task for stalwart Germans) I have come to understand more clearly why older people continue to do things themselves that they really should have help with: they were just doing the laundry/driving/cleaning the gutters on their own last week/month/year, for goodness sake, why shouldn't they be able to do it now? You think you can do it on your own- you used to be able to do it on your own- and it's hard to acknowledge that things have changed. But they have for me and I need to accept the changes, tough as that may be.

Thank you to all of you who continue to send cards and letters letting me know what's going on in your neck of the woods. It's so meaningful to know you're keeping me in your thoughts and prayers especially on days when the fatigue is so present and being positive is a challenge. On those days especially your gifts are a welcomed repose! Thank you!

A Guest Post by Margaret and John (a.k.a. Mom and Dad)

It has been a "joy" to observe Karen as this very positive, young woman who sincerely meets life head on! She has kept her marvelous sense of humor and encourages those around her to see "The Comedy Hour" moments in so many scenes of this cancer story.

We have watched her reach out with encouragement to people who are
dealing with their chemo; we have listened, while driving to
Rochester, as she continues to do her job in handling pricing,
deadlines and concerned clients all with a positive upbeat attitude;
and we have observed her with friends and family as she focuses on
their health, their day, their problems.

Our daughter hasn't changed because of being thrust into the spotlight
of cancer, but rather has continued to live her life to the fullest.
For example, at her second chemo treatment Karen made the statement to
the nurse who was preparing her for the chemo injection, "I am keeping
positive thoughts that I'll be able to keep my hair". And the nurse
said, "Karen, the side effects of each of the two chemo drugs is hair
loss." Karen then said, "I guess we will be looking at wigs this
afternoon".

That, in a nutshell, is what we have come to admire about this
daughter of ours! She is keeping positive about each step of this
cancer treatment, but she is also being practical and proactive to the
many side issues of cancer.

We thought our role would be to hold her, comfort her, encourage her
but she has been the one to help us to be able to accept the journey
she is traveling through. We are proud to be able to stand with her.

We also want to thank Janis for her role in being researcher,
note taker, blogmaker and the best sister support that Karen could have
and to thank Kyle for all his concern, calls, and now being in
Minneapolis to be there for her too.

You three make us feel very proud.

The Love and Support "Posse",
Mom and Dad

Fatigue: it's not just for camoflage anymore

Here I am on the upswing of the time between treatments and I'm feeling great. It's been a challenging week this last week in that the fatigue has taken me to the mat a couple times (Pin! Ooh, that was a sneaky move!) but I am rested and ready for the next session of chemo with a new drug, Taxol.

I had the best laugh at myself on Thursday. I had my blinker on to move into the right lane when out of nowhere a black car with tinted windows breezes past on my right. I said out loud to the mystery driver in such a hurry- and I'd like to say that I don't usually talk to myself out loud- "Where do you think you're going?" and then with a tone of self-satisfaction just seconds later when I see him get boxed in up ahead "Well, I guess nowhere fast!".

Then I realized that I'd turned into a crabby person whose Driving School was holding open enrollment and laughed and laughed to the point of tears at what the lack of sleep will do to a person. Naps, with all their virtues, which I have extolled herein, are really like snacks: tasty as they are you can't make a meal out of them. Thankfully these last few nights have been good, solid sleep nights and I'm feeling myself again.

One of the things I've come to clearly understand through this unexpected journey is that sleep is critically important to my state of mind. I am myself when I've had enough sleep; without it I'm not my best me.

This week, with the cumulative lack of sleep and fatigue which set in, it was a challenge to remain positive. My positive self said 'We're going to be positive if it's the last thing we do!' and the tired self said with a grin 'Well, it'll be the last thing you do.'. When I'm tired and find the doubt and fear starting to worm their way into my thoughts I remind myself that that is the tired talking and not the real me.

A big thank you to my Aunt Verlinda and Uncle Rich for sending such a beautiful and perfectly-timed card. There have been so many lovely cards from so many people! This arrived mid-week when I was feeling unsure of myself for the coming Monday treatment which, because of the change in drugs, had brought up some fear and trepidation in me. The card stated simply: "You can do it. You have everything you need right inside of you." And how true that is! I can do it. And I will do it. I have - as we all do - everything I need right inside of me. What a powerful thought to know that is true.

This sort of synchronicity has been happening quite a bit this week. I had been thinking a lot about the story of the Little Engine that Could and its simple message of how what you believe is what you will do. It's something I believe to be true: where the mind goes the body will follow.

I ran out to do an errand one evening this week and just as I got into the car the radio program on MPR was talking about trains of some sort. They ended the segment by playing this song- and I swear it was sung by Berle Ives- from "The Little Engine that Could". It goes something like "I think I can, I think I can... da da da dat da da... if you put your mind to it you'll be doing it before long..." and then ends with "I knew I could! I knew I could!". It was such amazing timing to hear that song when it was something I'd been tumbling around in my head.

Thanks to my friends Nicole, Galen and family for the beautiful piranha finger puppet with its sharp teeth and voracious appetite who will accompany me on the journey to the Mayo this Monday. The Amazonian piranhas, imported for the first half of the sessions, have done such outstanding work and I thank them from the bottom of my heart for their tenacity and bite. Now the new piranhas which have been flown in fresh from Paraguay (boy, are they sure hungry from their travels!) will come in and do their good work. It's going to be terrific!

Thank you to all of you for all your good thoughts and prayers as I begin the last four sessions of chemo on Monday!

Appreciation and gratitude

The halfway point for the chemotherapy has been reached! Session four of the eight went very well on Monday. I am ever so grateful and appreciative that the good drugs Adriamycin and Cytoxol have done such good and thorough work shrinking the tumor so quickly for me. This session was the last time I will have these drugs in my lifetime. Next session will begin a four course treatment with our new ally, Taxol. It is the combination of these three drug treatments (thanks to all those researchers working hard in their labs!) that has the best proven outcome.

This week I have come to have a better understanding of two year olds as my energy reserves aren't what they have been. I go from fifty to zero in no time. This has given me a new insight and understanding as to how toddlers go from being friendly, fine and fun to tired, touchy and irritable at the drop of a hat. It's really been surprising how quickly the energy goes when it does.

So, in light of this halfway point change, I have started to bundle everything into little packets: little bits of food, of sleep, of exercise, of play and of work. This way I can still enjoy the things I like to do and need to do while keeping well rested and strong.

With the shortage of a full night's sleep caused by the frequent bathroom visits from the steroids I've incorporated nap time into my days. Now this is the sensible way to live, I say! Toddlers have it going on. As you can guess 'Naps for Everyone Everywhere' would be be my platform should I ever run for Miss America. Life is always a little more manageable after a good nap... nap on, Good People, nap on!

Thanks to all of you for your continued good thoughts and your support. It has been one of the most touching things about this unexpected journey: to know you are carrying me in your hearts and minds. What a powerful gift it is! As I move into the next four chemo sessions over the coming eight weeks and prepare for surgery in early November your continued thoughts and prayers for strength and peace are most appreciated.