Update for Monday, November 20

It was so great to see everyone at church on Saturday night and there were so many people that I didn't get to hug. I hope to do that next week. I'll try to go to Sunday video cafe service as well next week. I wasn't up to it yesterday and I really wanted to do my own bible reading at home and do my exercise regimen. I took it really easy yesterday and I'm glad. It's so funny to me becuase I have my best energy in the morning pretty much so I find that I'll make a list of a whole bunch of things that I'll want to do and by the afternoon, they just don't happen because I run out of steam. However, on the flip side I am getting better at listening to my body and if it needs a nap, it gets one, even if it's just to lay down for 20 minutes and not even sleep, but rest.
I did manage to make dinner for myself last night so that was good and now I have some chicken left overs for the next few days.
Regarding radiation, I forgot that I had bookmarked a study online that was actually a meta-analysis (basically a synthesis and critique of other studies) on post-mastectomy radiation. It does appear that it is helpful and reduces the risk of local recurrence(meaning in the chest wall, scar or in the nodes nearby) and it seems that the absolute benefit is anywhere from 8-20% reduction in that risk depending upon which group of data you look at. There are also some statistical risk factors that they outline according to how many positive nodes you had, what size the tumor was, whether or not it was estrogen sensitive, etc, and the data does take into account a person that has had chemotherapy and it just examines the benefit of doing radiation in addition to the chemo and the surgery. It also shows that there is a benefit to doing the radiation even if you are node-negative (that is no positive lymph nodes). Apparently from what I read, the greatest risk of recurrence is in the chest wall (If it does reoccur,70% of the reoccurrences happen here) follwed by the scar area, and then the supraclavial/infraclavicular nodes (10-20%) and then lowest in the lymph nodes (5-10%). I think reading this study shed some light on the radiation question, though this review of studies was published in 1998 so the data is older and the radation techniques were different (I'm going to make the assumption that they've improved). I'm interested to discuss the data with the radation oncologist at USC tomorrow (Dr. Streeter) and see what he says and pick up some more literature on it. It's kind of funny because in my undergrad major I had to do meta-analyses of other studies several times, so it was kind of fun to read all of the literature and make sense of it. I really do enjoy that kind of thing, and be able to understand what it means when they say p<.005 versus p<.001 becuase it indicates the strenth of the statistics that they cite. Anyway, it was helpful to read it and have some numbers to think about....However, I am asking Jesus to show me His wisdom and what path He has for me. I pray that Jesus would show me which way to go so that I can walk in it.

Tomorrow I go to LA to see Dr. Sherman again at 11am for another fill up and then right after that I'll go to see Dr. Streeter (radiation oncologist at USC mentioned above) for a consultation at 1:30 and then after that I'll go to see my physical therapist Jennifer at 4pm in Pasadena. After that I'm sure Ill be wiped so I'll go to the Remy's and stay with them that evening. My brother will be in town for the whole week so I might see him Tuesday night, but he will also come out later in the week to the desert. Wednesday I have an appointment with Dr. Khanna here at Curci Cancer center at 11am for a follow-up consult with her.

Thanksgiving is going to be different this year for our family. Normally it is our big holiday as a family but my grandmother is ill and in the hospital as well as my cousin's daughter is getting her tonsils out the day before Thanksgiving so, instead of going up tot he mendocino coast as we have done in the past to gather together, we are splitting up. However, one cool thing is that my dad and his wife Ellie are going to get away from SF for a few days down here from Friday to next Monday so I'll be able to see them a bit while they're here, which is nice. So my brother will likely stay here with me next weekend a night or two so that we can spend time with Dad and Ellie together.

Anyway, it's time for me to work on my arm exercises again...
Please pray for wisdom so that I would make the right decision regarding radiation.

My next post will likely be on Wednesday so I can bring you all up to date on the doctor visits.
Thank you!
Julie
p.s. Thanks to Linda Matsko for helping me load my keyboard in and out of my car at home and to Chris Jacobsson for the livestrong t-shirt! I'm going to wear it to the gym this morning :-)