Monday, March 19, 2012

The new haircut

Sarah's new "do"!
5 weeks of taxol finished, so Sarah's nearly halfway done with the first half of her chemotherapy.  She's doing much better than we had expected.  She's a bit more tired than usual, and she's losing her hair (hence the haircut), but otherwise we can't complain all that much.

We did visit her medical oncologist the day of Taxol #4, and she said that Sarah's doing great, and that she should just keep on keeping on....

Meanwhile, in the brief spare time that Sarah has when she's not working, visiting doctors, receiving chemotherapy, and recovering from chemotherapy, she's finally able to ride again (and Ronan has been awesome!), although we've also had heavy rain that's keeping Sarah out of the saddle more than she'd like.

Wednesday, February 22, 2012

The way to finished is through begun

This last week Sarah had her power port central venous catheter implanted, her first taxol treatment, and continued looking at wigs.

The catheter surgery is not trivial, but it went well. The port is implanted under the skin on Sarah's chest just under her collarbone, and the catheter runs through her jugular vein into her heart. Sarah was sedated for the surgery, but did not need a general anesthetic, and the surgeon sang standards while performing the surgery. The surgery site is still a bit sore, and having the port under her skin makes her feel like a Borg-in-training, but otherwise she's doing well.

Sarah then had her first chemotherapy infusion the same day, using her brand new port. She was told by the chemo nurse that if she felt any different at all when the infusion started, she needed to let them know. Aside from the taxol itself, the solvent used apparently causes some people to have an allergic reaction. Fortunately, Sarah had no problems, and was able to sleep through the treatment.

Sarah spent the following day resting, and also shopping for wigs with her mother. She already has a nice collection of awesome inexpensive wigs, and she's found some nicer ones for special occasions.

Sarah was off work on Saturday, so she got to spend the day scrapbooking with her friends. She had an awesome day, and she received quite the basket of goodies from her friends who wanted to show their support.

So, right now, Sarah is doing well. Sarah's a bit more tired than usual, and it's all still rather scary, but she's moving forward. 11 more weeks of taxol to go, then 4 cycles of FAC, then surgery.

Some not so good news

Here's the news

Sarah has breast cancer. The cancer is in her left breast. It's aggressive (grade 3) and invasive (stage II), but it has not spread, as far as anybody can tell. After a lot of chemotherapy, a mastectomy (or two), and hormone therapy, there's a very good chance that Sarah will be completely clear of breast cancer.


And the details

At the end of 2011, Sarah found a lump in her left breast. She'd had a lump four years ago which turned out to be fibrocystic (benign), and the doctor had mentioned at the time that such lumps would likely come and go, so she wasn't terribly surprised. She had an OB-GYN appointment already scheduled for January of this year, and at that appointment she mentioned that another lump had arisen, and he sent her across the street (to the Baylor clinic, which is staffed by doctors on the faculty of the Baylor College of Medicine) for a mammogram, ultrasound, and biopsy.

The Baylor clinic's breast center is awesome. Sarah had the mammogram, then an ultrasound, and then the head radiologist came out to repeat the ultrasound. At that point she told Sarah that she thought the lump was pretty bad--likely cancer. Essentially she gave Sarah the same speech, in pretty much the same way, that Sarah so often has to give to her clients. They then went ahead and performed two sets of biopsies. One set that was ultrasound-guided, and another set that was x-ray guided (stereotactic). The results of the biopsies were that she has a 3.5 cm mass of both ductile carcinoma in situ and invasive breast cancer. Pathology determined that the cancer is Stage II (invasive) and Grade 3 (aggressive), and that it is strongly estrogen responsive and mildly progesterone responsive.

Next, Sarah met with an oncologist at Baylor, had an MRI done of both breasts, had a BRCA1 and BRCA2 genetic test performed, and had a fine needle aspirate done of one of her lymph nodes. The oncologist at Baylor recommended three months of chemotherapy (4 3-week cycles of AC), followed by a mastectomy, followed by another three months of chemotherapy (4 3-week cycles of taxotere), followed by five years of tamoxifen. The MRI found no cancer in the other breast, and no enlargement of the lymph nodes. The genetic mutation test was negative, as was the fine needle aspirate. As far as anybody can tell, the cancer has not spread to the lymph nodes or the other breast, and hopefully no where else as well.

Sarah then went to MD Anderson for a second opinion, since MD Anderson is one of the best cancer hospitals in the country. The oncologist at MD Anderson had Sarah repeat the mammogram and ultrasound done by Baylor, and also had the pathology re-read, in every case coming to the same conclusions about the cancer as Baylor. The MD Anderson oncologist then recommended a very similar treatment: chemotherapy consisting of 12 weeks of weekly taxol infusions (taxol and taxotere are both taxanes), followed by 4 3-week cycles of FAC (adding another drug to the AC cocktail), followed by surgery, and then 5 years of tamoxifen. The reason to have the chemo done before the surgery is that is then possible to use the tumor's response to monitor the effectiveness of the chemotherapy.

MD Anderson is a pretty big machine, but the people there have been really nice, and in many cases these are the best people in their fields. Sarah is therefore going to have her treatments done at MD Anderson.


More details

It's hard to wrap one's head around having cancer at age 37. Sarah's coming to terms with it all, but it's really hard.

Sarah's health insurance is quite good. It's a PPO with co-payments for physician visits, an 80/20 plan for surgeries, MRIs, and other big-ticket items, and a $3000 out-of-pocket maximum. That means we can budget for the medical expenses.

The major financial impact of Sarah's cancer will be the fact that if she can't work, then she doesn't get paid. Her practice has promised her that she'll keep her job and her benefits, though, which is really good news. She's also going to try to work as much as she's able. During the taxol phase of her treatment she's planning to take a day off for the infusion, and the following day off to rest, and then she's hoping to work a fairly regular schedule. The FAC cycles will certainly take more out of her, so she's probably going to have to take the first week off, and then work the next two weeks during that phase. Then she'll have to take time off after surgery to recover.

While this is all going on Sarah will be able to ride, until her surgery, as long as she feels up to it, but she won't be able to train or compete. That's a real shame because Ronan has been getting much braver this winter, and Brook has been just awesome.

Meanwhile, Sarah is riding until she has to stop, and she's started looking at wigs. (Yes, she will lose her hair, although it will grow back once she's done with chemo.) Her boss says Sarah has cancer, so she can wear whatever color hair she wants!

Monday, February 13, 2012

Testing rst2blogger

Here's a simple post to test out rst2blogger to generate blog entries in blogger using restructured text.
Along the way I had to deal with some upstream weirdness in the python gdata bindings. The first is that the usual https_proxy="" format doesn't work. Instead separate proxy_username and proxy_password variables are needed. There is a bug report for this one that says it's been fixed (, but it's not working for me. The second is that the BLOG_ID2_PATTERN regex that is used to find the blog ID needs to be updated if your blog ID looks like user-g\d+ instead of user-\d+ ( Oops.

Wednesday, January 18, 2012

Charging a kindle from Fedora

When a kindle is plugged into a USB port it acts as a flash drive by default.  The device itself is nice enough to tell you that you need to eject it if you want to either use it or charge it via the USB cable.  Unfortunately, in linux one needs to use "eject"; simply unmounting via nautilus does not suffice.  (I've no idea why.  What does "eject" do that "unmount" doesn't?)

So, a really stupid "kindle_charge" script:

#! /bin/bash
beesu eject /dev/disk/by-label/Kindle


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